The Effects of Human Bone Marrow-Derived Mesenchymal Stem Cell Conditioned Media Produced with Fetal Bovine Serum or Human Platelet Lysate on Skin Rejuvenation Characteristics

Background and Objectives@#Human mesenchymal stem cell-conditioned medium (MSC-CM) is produced using mesenchymal stem cell culture technology and has various benefits for the skin, including wrinkle removal, skin regeneration, and increased antioxidant activity. Its popularity is thus increasing in the field of functional cosmetics. @*Methods@#and Results: In this study, we analyzed the effects of fetal bovine serum-supplemented MSC-CM (FBSMSC-CM) and human platelet lysate-supplemented MSC-CM (hPL-MSC-CM) on skin rejuvenation characteristics.We found that the concentrations of important growth factors (VEGF, TGF-β1, and HGF) and secretory proteins for skin regeneration were significantly higher in hPL-MSC-CM than in FBS-MSC-CM. Furthermore, the capacity for inducing proliferation of human dermal fibroblast (HDF) and keratinocytes, the migration ability of HDF, extracellular matrix (ECM) production such as collagen and elastin was higher in hPL-MSC-CM than that in FBSMSC-CM. @*Conclusions@#These results support the usefulness and high economic value of hPL-MSC-CM as an alternative source of FBS-MSC-CM in the cosmetic industry for skin rejuvenation.

Culturing at Low Cell Density Delays Cellular Senescence of Human Bone Marrow-Derived Mesenchymal Stem Cells in Long-Term Cultures

Background and Objectives@#Mesenchymal stem cells (MSCs) have immense therapeutic potential for treating intractable and immune diseases. They also have applications in regenerative medicine in which distinct treatments do not exist. Thus, MSCs are gaining attention as important raw materials in the field of cell therapy. Importantly, the number of MSCs in the bone marrow is limited and they are present only in small quantities. Therefore, mass production of MSCs through long-term culture is necessary to use them in cell therapy. However, MSCs undergo cellular senescence through repeated passages during mass production. In this study, we explored methods to prolong the limited lifetime of MSCs by culturing them with different seeding densities. @*Methods@#and Results: We observed that in long-term cultures, low-density (LD, 50 cells/cm2) MSCs showed higher population doubling level, leading to greater fold increase, than high-density (HD, 4,000 cells/cm2) MSCs. LD-MSCs suppressed the expression of aging-related genes. We also showed that reactive oxygen species (ROS) were decreased in LD-MSCs compared to that in HD-MSCs. Further, proliferation potential increased when ROS were inhibited in HD-MSCs. @*Conclusions@#The results in this study suggest that MSC senescence can be delayed and that life span can be extended by controlling cell density in vitro. These results can be used as important data for the mass production of stem cell therapeutic products.

Surgical Results of Topography Supported Customized Corneal Ablation

PURPOSE: To investigate the clinical outcome based on topographic supported customized corneal ablation (TOSCA). METHODS: The 20 patients (20eyes), who had already undertaken excimer laser surgery at least 6 months ago, resulting in decrease of best-corrected visual acuity, were included. Topography-guided corneal ablation was performed to correct de-centered ablation or irregular astigmatism using with the Mel-70-scan (ascleapion Meditec Inc. Germany) equipped with a Gaussian spot beam. RESULTS: The average uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) in Log MAR scale was 0.52 +/- 0.35 and 0.33 +/- 0.14, preoperatively. The average of UCVA and BCVA was improved to 0.29 +/- 0.29 and 0.11 +/- 0.14, respectively after TOSCA was done. It was statistically significant difference (p<0.05). CONCLUSIONS: TOSCA may be considered as effective method to improve BCVA in patients who suffer from decrease of BCVA in duced by decentered ablation.

A Prospective Multicenter Study of Community-acquired Pneumonia in Adults with Emphasis on Bacterial Etiology / 감염

BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading causes of mortality and morbidity. Despite progress in diagnostic techniques and treatments, management of pneumonia remains challenging, because the precise etiology remains uncertain in as many as 49 % of cases. The limitaions of identifying etiologic agents make it necessary to use empiric antibiotics in almost all patients, and furthermore emergence of antibiotic-resistant organisms pose difficulties to the selection of an empiric antibiotic regimen. For the optimal choice of empirical antibiotics, we should know the frequency of etiologic agents and antimicrobial resistance rates in the community. METHODS: A prospective multicenter study of community-acquired pneumonia in Korea was carried out between May 1997 and April 2000. The microbiologic diagnosis was based on the results of sputum culture, blood culture and pleural culture. RESULTS: Five hundred eighty eight cases of community-acquired pneumonia in 562 patients admitted to the hospitals. The mean age was 59.9 with male predominance (58.3%), and 370 (63%) had underlyin gillness. The etiologic agents were identified in 38.3%, and the list of individual agents, in decreasing order, was Streptococcus pneumoniae (21.7%), Klebsiella pneumoniae (14.8%) Pseudomonas aeruginosa (9.8%), Staphylococcus aureus (9.5%), viridans group streptococci (5.7%), Enterobacter cloacae (4.2%), Hemophillus Influenza (3.8%). The rates of admission to the intensive care unit was 10.4%. The motality was 7.1%. Susceptible rates of S. pneumoniae to penicillin was 36.6% and showed multidrug resistant. Forty percents of S. aureus were methicillin-resistant S. aureus. K. penumoniae were susceptible to cephalosporin and quinolone. CONCLUSION: In Korea, S. pneumoniae is the most important agent causing community-acquired pneumonia. Susceptible rates of S. pneumoniae to penicillin was 36.6 % and showed multidrug resistant. Gram negative bacteria such as K. pneumoniae, P. aeruginosa showed high incidence when compared with that of other countries. Most of them had underlying diseases including bronchiectasis and chronic obstructive pulmonary diseases.

Usefulness of Circumsporozoite Protein Genotype-Specific PCR (Polymerase Chain Reaction)-Hybridization Assay for Diagnosis of Vivax Malaria / 감염

BACKGROUND: Molecularornucleicacid-based method has been developed for diagnosis as well as epidemiological studies of malaria infection recent years. We developed and evaluated a polymerase chain reaction (PCR)-hybridization assay for its usefulness in diagnosis and genotyping of vivax malaria resurged in South Korea. METHODS: Blood samples were collected from 30 patients diagnosed as vivax malaria and 48 patients with other diseases. The circumsporozoite protein (CSP) gene fragment of Plasmodium vivax was amplified by PCR and hybridized with genotype (VK210 or VK247)-specific oligonucleotide probes. The performance of the assay was evaluated and compared with that by a commercially available immunochromatographic test (ICT; AMRAD, Australia). RESULTS: Twenty-five out of thirty P. vivax-positive blood samples were positive for the PCR-hybridization assay. All products amplified were hybridized only with the VK210-specific probe and showed size polymorphism with approximately 900~ and 865 bp, suggesting of genetic variations of CSP gene. Based on the results of Giemsa-stained blood smear, comparative analysis of test performance demonstrated that sensitivities of the PCR-hybridization assay and ICT were 83.3% and 73.3%, respectively and no false positive results were found. The ktest ratio of two tests yielded results of 0.91 with excellent correlation. CONCLUSOIN: The study suggested that vivax malaria resurged in South Korea has the VK210 genotype of CSP with presence of genetic variants, and that the PCR-hybridization assay is useful for diagnosis as well as genotyping of vivax malaria.

Optimal time to localize bleeding focus and the usefulness of flexible bronchoscopy in hemoptysis / 결핵

No abstract available.

Correlation of Tracheal Cross-sectional Area with Parameters of Pulmonary Function Test in COPD / 결핵

BACKGROUND: Maximal expiratory flow rate is determined by the size of airway, the elastic recoil pressure and the collapsibility of airway in the lung, and one of major functional impairments of emphysema, which represents COPD, is the obstruction of expiratory flow. Neverthless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. METHOD: We collected 20 patients with emphysema (which was diagnosed by radiologic and physio logic criteria) from January to August in 1997 at Seoul Municipal Boramae Hospital, and chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were done from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this calibrated area with such parameters of pulmonary function tests as PaCO2, PaO2, airway resistance, lung compliance and so on. RESULTS: Expiratory cross-sectional area of trachea has significant correlation with PaCO2 (r=-0.61, p0.05 with PaCO2, r=0.26, p>0.05 with PaO2, and r=0.44, p>0.05 with minute ventilation). Minute ventilation has significant correlation with tidal volume (r=0.45, p0.05). Cross-sectional area of trachea doesn't have any significant correlation with other parameters of pulmonary function such as FEV1, FVC, FEV1/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area is expiratory or inspiratory. CONCLUSION: Cross-sectional area of trachea narrowed during expiration in emphysema and its expiratory area has significant correlation with PaCO2, PaO2, and minute ventilation.

The Tissue Changes of Filtering Site Following Glaucoma Filtration Surgery with Various Mitomycin C Concentrations

The most common cause of the postoperative failure of glaucoma filtration surgery(GFS) is scarring secondary to fibroblast proliferation and fibrosis at the interface of the episclera and conjunctive. To inhibit this process, mitomycin C(MMC) has been studied experimentally, both in vivo and in vitro. In evaluating the toxicity of MMC, we observed the inhibition of fibroblast proliferation and of fibrosis by light microscope, and the ultrastructual changes of the sclera by transmission electron microscope following the soaking of MMC during GFS in rabbit eyes. The sixty rabbits which comprised this study were divided into four groups; the first control group(I) was soaked with the BSS during GFS, the second(II), the third(III), and the fourth(IV) group were soaked with the 0.2 mg/ml, 0.5 mg/ml, and 0.5 mg/ml MMC soaked groups, respectively, during GFS as experimental groups. On histologic examination, the degree of proliferation of fibroblasts with fibrosis and infiltration of lymphocytes in MMC soaked groups was less than those of BSS soaked group at 2 weeks and 2 months after GFS. At six months after GFS, there was ultrastructural evidence of degenerative changes of scleral fibroblasts such as clumping of nuclear chromatin, wrinkling of nuclear membrane, and cystic dilatation of rough endoplasmic reticulum in MMC soaked groups. Higher concentration of MMC caused more degenerative changes in cellular structures. These results surggested that the scar formation after GFS could be significantly suppressed by a single application of MMC during surgery, and MMC could be0 used effectively in cases of poor prognosis of GFS. Further experiments need to be conducted to determine the optimal concentration, exposure time, and application method of MMC.

A Case of Endoscopically Diagnosed Gastric Cancer with Metastasis to Thyroid and Breast / 대한소화기내시경학회지

Metastatic malignant tumors involving the thyroid gland are not as unusual as was once believed. They may in fact be more common than primary cancer of the thyroid, especially if careful screening is performed at autopsy. The origins of primary neoplasms that metasta size to the thyoid are myriad, but reports obviously indicate predminantly cancers of the kidney, breast, and lung and malignant melanoma. Occasienally, metastatic lesions from several gastrointestinal neoplasms such as colo-retal and esophageal carcinoma are seen, but metastasis from gastric cancer is very rare. We have seen one case of thyroid cancer metastasized from the stomach cancer. It simultaneously spread to the breast also and confirmed with gastrofiberscopic biopsy, fine needle aspiration cytology of the thyroid and excisonal biopsy of the breast. We report this case with reriew of literature.

Intraocular Pressure After Cataract Extraction in Silicone tube Implanted Glaucomatous eye

The functioning filtering bleb constructed after trabeculectomy in glaucomatous patient might be fail after cataract operation probably due to transient collapse during cataract extraction and inflammatiry reaction of the filtering bleb which result in unsuccessful intraocular pressure control. To compare if the results were identical in cases with the use of encircling band to enlarge the aqueous absorbing scar tissue to trabeculectomy, intraocular pressure was followed for more than 6 months after cataract extraction and posterior chamber lens implantation in 7 eyes that previously underwent silicone tube insertion with the use of encircling band. There were no cases with increased intraocular pressure needed to control postoperatively. Therefore it could be possible to concluded that inflammatory reaction of the filtering bleb or transient collapse during cataract extraction has no negative influences on intraocular pressure in silicone tube implanted eye using encircling band.

Clinical Evaluation of New Handheld Air Impulse Tonometer

To evaluate the clinical usefulness of new handheld air impulse tonometer(Pulsair, Keeler), the intraocular pressures of 147 eyes of 80 men and women at the age range of 9 to 82 year without corneal opacity or corneal edema were measured with the Goldmann applanation tonometer as well as noncontact air impulse tonometer. The IOPs measured with both tonometer were compared to evaluate the correlation coefficiency. The correlation coefficiency between two instruments is 0.89. Therefore, the new type of noncontact tonometer could be useful for clinical applications due to its accuracy, simplicity, painlessness, portability, and repeatability-especially at glaucoma screening programs.

Clinical Evaluation of Posterior Chamber Intraocular lens Implantation in thee Eye Without Poosterior Capsular Support

The use of a secondary intraocular lens is the best method for the management of spectacle-and contact lenses-intolerant aphakic eye. Because of the high incidence and the great variety of complications associated with anterior chamber lenses, a sulcus-fixed posterior chamber lens is more desirable than an anterior chamber lens. Therefore we have performed newly developed surgical techniques using 25-gauge needle for implanting a posterior chamber lens in the eye without posterior capsular support by securing haptic of the posterior chamber lens to the sclera at the ciliary sulcus with 9~0 prolene suture. These techniques have been sucessfully performed and have produced considerable visual improvement in thirteen aphakic eyes, two patients who had dislocated lens, and two pseudophakic patients who had sun-set syndrome. Eighty-eight percent of the 17 eyes had a postoperative visual acuity of 20/30 or better. The complications in three eyes were transient hyphema, transient vitreitis and exudate in lens surface, and pupillary capture. We have not yet experienced in our series any serious complication, such as lens dislocation, cystoid macular edema, retinal detachment, 2ndary glaucoma, endophthalmitis, and corneal decompensation, but long term follow up and more experience are necessary to establish the safety.

Modified Silicone Tube Implant in Refractory Glaucoma Using Encircling Band

The long term results in 22 eyes of 21 patients of intractable glaucoma who are managed by silicone tube shunt to encircling band in a modified method by author are presented. Ten eyes had neovascular glaucoma and twelve eye had refractory nonneovasular glaucoma in whom previous several surgery was unsuccessful. All cases have been followed up for at least six months. Using the author's criteria, the success rate was 86%. Visual acuity was maintained or improved in 82%. The author's personal method of making a pressure valve like slit incision for prevention of postoperative shallow anterior chamber is described.

Early Postoperative Visual Acuity and Visual Field Change Following Filtration Surgery in Advanced Glaucomatous Damaged Eyes

There has been many ophthalmologists warning sudden loss of central vision and small residual visual fields in far advanced glaucomatous damaged eyes after filtration surgery. Although this warning against glaucoma surgery in patients with limited visual fields has been a concern for over a century, little data exist to convincingly support this belief. The purpose of this paper is to share our experience in facing this dilemma. Authors performed filtration surgery on 31 eyes with advanced glaucomatous field defects and evaluated postoperative visual field and visual acuity at 8 weeks postoperatively in order to ensure if there was any change. The eyes were classified into three categories according to the severity of the visual field loss evaluated with Humphrey computerized visual field analyser. No patients suffered a sudden loss of central visual acuity or a rapidly progressive loss of small residual visual fields after filtration surgery during 8 weeks follow-up period. In the light of our clinical experiences, authers concluded that there was nothing to worry about in performing filtration surgery on far advanced glaucomatous damaged eyes just only because they have small residual visual fields.

Argon Laser and Nd-YAG Laser Combined Iridotomy

Argon laser iridotomy is at present the procedure of choice in Korea for the treatment of pupillarx block and angle closure glaucoma. However, despite modified argon laser techniques, difficulties in penetration of irides and closure of hole have been widely reported. Recently reported Q-switched Nd-YAG laser iridotomy have a many complications such as bleeding, lenticular opacity and small hole. And so argon laser and Nd-YAG laser combined iridotomy was performed on 80 eyes, 57 patients with angle closure glaucoma. The follow up period ranged from 1 to 14 months. 71(88.7%) of 80 eyes treated required a single lasing session for patency, and six eyes required two sessions and three eyes required three sessions. Closure of the iridotomy site occurred in 6.2% of eyes, an incidence remarkably lower than that of argon laser iridotomy alone. Localized lenticular opacity and bleeding were not observed, but immediate postoperative iritis and elevation of intraocular pressure were observed.

Argon Laser and Nd-YAG Laser Combined Iridotomy

Argon laser iridotomy is at present the procedure of choice in Korea for the treatment of pupillarx block and angle closure glaucoma. However, despite modified argon laser techniques, difficulties in penetration of irides and closure of hole have been widely reported. Recently reported Q-switched Nd-YAG laser iridotomy have a many complications such as bleeding, lenticular opacity and small hole. And so argon laser and Nd-YAG laser combined iridotomy was performed on 80 eyes, 57 patients with angle closure glaucoma. The follow up period ranged from 1 to 14 months. 71(88.7%) of 80 eyes treated required a single lasing session for patency, and six eyes required two sessions and three eyes required three sessions. Closure of the iridotomy site occurred in 6.2% of eyes, an incidence remarkably lower than that of argon laser iridotomy alone. Localized lenticular opacity and bleeding were not observed, but immediate postoperative iritis and elevation of intraocular pressure were observed.

Effects of Beta-blocking Agent Carteolol on Healthy Volunteers and Glaucoma Patients

The effects of topically applied cartoelol, a beta-adrenergic blocking drug, on intraocular pressure, pupil diameter, pulse rate, and blood pressure and adverse effects were studied in fifteen healthy volunteers and six ocular hypertension, and fifteen chronic open angle glaucoma patients. In control study, the fifteen healthy volunteers were enrolled. Carteolol hydrochloride ophthalmic solution in concentrations of 1%, 2% was instilled, and the IOP, pulse rate, blood pressure, and pupillary diameter were measured before and after 1, 2, 4, 6, 8, and 12 hours. The same method was repeated to evaluate the early effects at six ocular hypertensions and fifteen chronic open angle glaucoma patients. And to evaluate the long term effects, carteolol(one or two percent) was instilled twice daily and IOP, pulse rate, blood pressure, and pupillary diameter were checked before and 1, 2, 4, and 8 weeks after the instillation in ocular hypertension and chronic open angle glaucoma patients. Two concentrations of carteolol were used; 1%, 2%, if their first intraocular pressure were measured above 25 mmHg, the 2% carteolol was used, and if their pressure were measured below 25mmHg, 1% carteolol was used. The results were as follows: 1. The early intraocular pressure reduction effect in healthy volunteers was significant statistically except at 12 hours, and the maximum intraocular reduction was noted at 4 hours (23.3% and 24.3%) respectively. 2. The early intraocular pressure reduction effect in ocular hypertension and POAG-patients was significant statistically except at 1 hour and the maximum intraocular reduction was noted at 4 hours (30.8% and 33.8%), respectively. 3. The long term intraocular pressure reduction effect was significant statistically and the maximum IOP reduction was noted at 2 weeks (29.2% and 31.8%) respectively and 3 patients received the additional therapy. 4. The systemic blood pressure and pulse rate were slightly decreased but not significant statistically and no ocular change was demonstrated by routine ophthalmie examinations following the administration of carteolol solution. On the basis of the results both 1% and 2% carteolol are considered to be optimal to be clinically used in patients with glaucoma.