Prognosis of Full-Thickness Skin Defects in Premature Infants

BACKGROUND: In the extremities of premature infants, the skin and subcutaneous tissue are very pliable due to immaturity and have a greater degree of skin laxity and mobility. Thus, we can expect wounds to heal rapidly by wound contraction. This study investigates wound healing of full-thickness defects in premature infant extremities. METHODS: The study consisted of 13 premature infants who had a total of 14 cases of full-thickness skin defects of the extremities due to extravasation after total parenteral nutrition. The wound was managed with intensive moist dressings with antibiotic and anti-inflammatory agents. After wound closure, moisturization and mild compression were performed. RESULTS: Most of the full-thickness defects in the premature infants were closed by wound contraction without granulation tissue formation on the wound bed. The defects resulted in 3 pinpoint scars, 9 linear scars, and 2 round hypertrophic scars. The wounds with less granulation tissue were healed by contraction and resulted in linear scars parallel to the relaxed skin tension line. The wounds with more granulation tissue resulted in round scars. There was mild contracture without functional abnormality in 3 cases with a defect over two thirds of the longitudinal length of the dorsum of the hand or foot. The patients' parents were satisfied with the outcomes in 12 of 14 cases. CONCLUSIONS: Full-thickness skin defects in premature infants typically heal by wound contraction with minimal granulation tissue and scar formation probably due to excellent skin mobility.

Induction of Heme Oxygenase-1 by Traditional Herb Mix Extract Improves MKN-74 Cell Survival and Reduces Stomach Bleeding in Rats by Ethanol and Aspirin in vivo

Chinese herb medicines have traditionally been used to treat or alleviate the symptom of various diseases. The rationale for use of certain herbs to certain disorder is now getting unveiled by modern technology. In the present study, we investigated whether herb mix extract (HMX), which is alleged to be useful for gastric ulcer, protects stomach from oxidative stress. Rats were allowed to normal diet with and without HMX (1, 5, 10 mg/kg) for 30 days. To induce gastric ulcer, ethanol (75%, 1.5 ml) or acidified aspirin (100 mg/kg in 0.2 N HCl) was administered by oral route in 24 h-fasted rats and examined the gastric ulceration (bleeding) by measuring the size 1 h after the treatment. Results indicated the area of gastric bleeding was significantly less in HMX fed rats than in normal diet fed ones, and it was dependent on the duration and amount of HMX. To investigate the underlying mechanism by which HMX protects stomach from oxidative stress, expression of enzymes like heme oxygenase (HO), cyclooxygenase (COX), and inducible nitric oxide (iNOS) were investigated in MKN-74 cells, where aspirin or H. pylori was introduced. The results were compared with RAW 264.7 cells to check if there's cell specificities exist. The expression of HO-1 but not COX-2, iNOS was significantly increased by HMX. Furthermore, HO-1 inhibitor, SnPP IX reduced the HO-1 activity and reversed the survival rate in HMX-treated MKN-74 cells. There's no difference between RAW 264.7 cells and MKN-74 cells. We, thus, concluded that HMX is beneficial for protection from oxidative injury, and induction of HO-1 by HMX in gastric cells is, at least, responsible for protection from oxidative stress such as ethanol, aspirin and possibly H. pylori infection.

A Case of Rhino-orbital Mucormycosis, Treated with Intraconal Amphotericin B Irriation and Abscess Drainage

Mucormycosis is a relatively uncommon opportunistic fungal infection that occurs more commonly in patients with immunosuppression and diabets mellitus, particularly those with ketoacidosis. Successful therapy for rhinoorbital mucormycosis requires early diagnosis, correction of predisposing conditions, prompt use of amphotericin B, and aggressive surgical debridement. We experienced a 56-years-old poorly controlled diabetic woman with rhinoorbital mucormycosis that was successfully treated with intraconal amphotericin B irrigation and packing without exenteration.

Effect of Superior Oblique Tuck Surgery in the Patients with Unilateral Superior Oblique Palsy

This study was conducted to assess the amount of superior oblique tuck surgery and the corrected amount of vertical strabismus and head tilt after superior oblique tuck surgery in patients with unilateral superior oblique palsy.Superior oblique tuck surgery was performed on 13 patients with unilateral superior oblique palsy, which corresponded to the second or the third type with hypertropia of 25 PD (prism diopters)or less of Knapp classification. The mean preoperative vertical deviation was 17.8 PD and the mean postoperative vertical deviation was 8.8 PD:the mean corrected amount of vertical deviation was 9.0 PD.Head tilt, which had been observed in 10 (77%)patients preoperatively, improved by over 5 degrees, head tilt in 5 (50%)of them postoperatively.The results suggest that superior oblique tuck surgery may as well be combined with ipsilat eral inferior oblique weakening or with ipsilateral or contralateral vertical rectus muscle surgery in unilateral superior oblique palsy patients with the amount of vertical deviation of 15 PD or more.