Effects of Xanthium stramarium and Psoralea corylifolia Extracts Combined with UVA1 Irradiation on the Cell Proliferation and TGF-beta1 Expression of Keloid Fibroblasts

BACKGROUND: Xanthium stramarium (XAS) and Psoralea corylifolia (PSC), phototoxic oriental medicinal plants, has been used in traditional medicines in Asian countries. OBJECTIVE: The effects of highly purified XAS or PSC extract combined with ultraviolet A1 (UVA1) irradiation on cell proliferation and transforming growth factor-beta1 (TGF-beta1) expression of the keloid fibroblast were being investigated to define potential therapeutic uses for keloid treatments. METHODS: The keloid fibroblasts were treated with XAS or PSC alone or in the combination with UVA1 irradiation. The cell viability, apoptosis, and expression of TGF-beta1 and collagen I were investigated. RESULTS: XAS and PSC in combination with UVA1 irradiation suppressed cell proliferation and induced apoptosis of keloid fibroblasts. Furthermore, the XAS and PSC in combination with UVA1 irradiation inhibited TGF-beta1 expression and collagen synthesis in keloid fibroblasts. CONCLUSION: These findings may open up the possibility of clinically used XAS or PSC in combination with UVA1 irradiation for keloid treatments.

Effects of Xanthium stramarium and Psoralea corylifolia Extracts Combined with UVA1 Irradiation on the Cell Proliferation and TGF-beta1 Expression of Keloid Fibroblasts

BACKGROUND: Xanthium stramarium (XAS) and Psoralea corylifolia (PSC), phototoxic oriental medicinal plants, has been used in traditional medicines in Asian countries. OBJECTIVE: The effects of highly purified XAS or PSC extract combined with ultraviolet A1 (UVA1) irradiation on cell proliferation and transforming growth factor-beta1 (TGF-beta1) expression of the keloid fibroblast were being investigated to define potential therapeutic uses for keloid treatments. METHODS: The keloid fibroblasts were treated with XAS or PSC alone or in the combination with UVA1 irradiation. The cell viability, apoptosis, and expression of TGF-beta1 and collagen I were investigated. RESULTS: XAS and PSC in combination with UVA1 irradiation suppressed cell proliferation and induced apoptosis of keloid fibroblasts. Furthermore, the XAS and PSC in combination with UVA1 irradiation inhibited TGF-beta1 expression and collagen synthesis in keloid fibroblasts. CONCLUSION: These findings may open up the possibility of clinically used XAS or PSC in combination with UVA1 irradiation for keloid treatments.

Determination of Diastolic Dysfunction Cut-Off Value by Tissue Doppler Imaging in Adults 70 Years of Age or Older: A Comparative Analysis of Pulsed-Wave and Color-Coded Tissue Doppler Imaging

BACKGROUND AND OBJECTIVES: The cut-off value of diastolic dysfunction by tissue Doppler imaging (TDI) is affected by aging and modalities used (pulsed-wave vs. color-coded). The purpose of this study was to investigate the diastolic function of healthy elderly people and to determine the appropriate cut-off value of diastolic dysfunction in elderly individuals. SUBJECTS AND METHODS: Healthy volunteers (n=76) and patients with hypertension (n=51) aged > or =70 years underwent 2-dimensional and Doppler echocardiography. Mitral annulus velocities of TDI were measured at septal and lateral sites using the pulsed-wave and color-coded modalities. The appropriate cut-off value of diastolic dysfunction for healthy elderly individuals was defined as the lower limit of the 95% confidence interval for early diastolic mitral annulus velocity (Ea). RESULTS: The mean septal and lateral Ea were 6.5+/-1.5 and 8.3+/-1.7 cm/s, respectively, by pulsed-wave TDI, and 6.1+/-1.4 and 7.9+/-1.7 cm/s, respectively, by color-coded TDI. The cut-off values for diastolic dysfunction were as follows: septal and lateral Ea were 6.1 and 7.9 cm/s by pulsed-wave TDI, and 5.7 and 7.5 cm/s by color-coded TDI, respectively. When the group was stratified by gender, Ea was significantly lower in women than men. CONCLUSION: When interpreting diastolic function as measured by TDI in elderly subjects, different cut-off values should be considered based on the TDI modality, annulus site, and gender.

Segmental Tissue Doppler Image-Derived Tei Index in Patients With Regional Wall Motion Abnormalities

BACKGROUND AND OBJECTIVES: Although the Tei index is a useful predictor of global ventricular function, it has not been investigated at the level of regional myocardial function. We therefore investigated the segmental tissue Doppler image derived-Tei index (TDI-Tei index) in patients with regional wall motion abnormalities. SUBJECTS AND METHODS: We prospectively studied 17 patients (mean age 62+/-9 years, 5 women) with left ventricular (LV) regional wall motion abnormalities. The Tei index, defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET), was measured in the basal and mid segments of the LV walls from standard apical views (4-, 2-, and 5-chamber views). We also obtained TDI velocity data in each segment. LV wall motion was classified as normal, hypokinetic, or akinetic, based on visual analysis. The TDI-Tei index, peak systolic myocardial velocity (Sm), early diastolic myocardial velocity (Em), and late diastolic myocardial velocity (Am) were analyzed in a total of 203 segments. RESULTS: Mean LV ejection fraction was 41.8+/-8.5%. TDI-Tei indices of dysfunctional segments (akinesis or hypokinesis, n=63) were significantly higher than those of normal segments (n=140) (0.714+/-0.169 vs. 0.669+/-0.135, p=0.041, respectively). Average values of TDI-Tei index, Sm, Em, and Am were 0.742+/-0.201, 4.206+/-1.336, 5.258+/-1.867, and 5.578+/-2.354 in akinetic segments; 0.677+/-0.101, 4.908+/-1.615, 5.369+/-2.121, and 5.542+/-2.492 in hypokinetic segments; and 0.669+/-0.135, 5.409+/-1.519, 6.108+/-2.356, and 6.719+/-2.466 in normal segments, respectively. A significant negative correlation was apparent between the TDI-Tei index and Sm (r=-0.302, p<0.001). CONCLUSION: These data suggest that the value of the segmental TDI-Tei index differs significantly according to regional function grade.

A Case of Cardiac Amyloidosis With Diuretic-Refractory Pleural Effusions Treated With Bevacizumab

Cardiac amyloidosis describes a clinical disorder caused by infiltration of abnormal insoluble fibrils in the heart, characterized by progressive heart failure and a grave prognosis. Pleural effusion in cardiac amyloidosis may represent a sign of heart failure, but it can also result from pleural infiltration of amyloid, manifested by recurrent large fluid accumulations. Recently, the role of vascular endothelial growth factor (VEGF) has been implicated in the pathogenesis of refractory pleural effusion. We report a case of a 53 year-old female patient with cardiac amyloidosis who presented with recurrent accumulation of large pleural effusions. She was initially treated with high dose loop diuretics, but the pleural effusion persisted, with the daily amount of drainage averaging 1 L/day. Accumulation of pleural fluid did not subside after 3 cycles of melphalan/prednisolone therapy. After the introduction of bevacizumab, an anti-VEGF antibody, the amount of pleural effusion decreased significantly. Efficacy of anti-VEGF therapy for refractory pleural effusions needs to be defined through further studies.

A Case of Right Ventricular Dysfunction Caused by Pectus Excavatum

Pectus excavatum compresses the underlying right side of the heart, which might lead to right ventricular dysfunction as illustrated in this case report.

Abciximab (ReoPro)-Induced Thrombocytopenia Diagnosed Through Measurement of Heparin-Dependent Antibody

Abciximab (ReoPro) is an extremely potent inhibitor of the glycoprotein IIb/IIIa receptor. Its main application is in the maintenance of coronary flow after suboptimal coronary intervention. Complications associated with this drug include bleeding and severe thrombocytopenia. We report a case of severe thrombocytopenia secondary to abciximab therapy for percutaneous coronary intervention in a 65-year-old woman suffering from an acute myocardial infarction. Her platelet count dropped to 1,000/mm3 7 hours after abciximab administration and improved with transfusion of 12 units of platelet concentrate the following day. The patient was diagnosed through measurement of heparin-dependent antibodies and readministration of heparin.

Prevalence and predictors of tortuous radial artery in patients undergoing transradialcoronary angiography / 대한내과학회지

BACKGROUND: It is well known that the presence of a tortuous radial artery, in patients undergoing transradial coronary angiography (CAG), may cause undesirable results such as access failure and arterial dissection. Thus, our aim was to investigate the prevalence and predictors of the presence of a tortuous radial artery in patients undergoing transradial CAG. METHODS: We prospectively investigated the tortuosity of the radial artery in 158 consecutive patients. The tortuosity of the radial artery was determined by radial angiography. A tortuous radial artery was defined as one with a maximal angulation of more than 45 degrees. To determine the predictors of a tortuous artery, we examined clinical and intra-procedural characteristics. RESULTS: A right radial angiography was easily performed in 154 patients (97.5%) without any complications. A tortuous radial artery was identified in 34 patients (22%). On the univariate analysis, advanced age, female gender, short stature, underweight, hypertension, and absence of progression of the mini-guide wire were significantly associated with the presence of a tortuous radial artery. Significant independent predictors of a tortuous radial artery by multivariate analysis were: advanced age, absence of progression of the mini-guide wire and hypertension. CONCLUSIONS: These data showed that the presence of a tortuous radial artery could be predicted by advanced age, absence of progression of the mini-guide wire and a history of hypertension. Thus, identification of a tortuous radial artery prior to coronary angiography may be helpful for a safe transradial CAG in patients at high risk for a tortuous radial artery.

Large Pleural Effusion Causing Right Atrial Collapse and Tachycardia

We observed one patient with large pleural effusion causing severe dyspnea, tachycardia, and severe right atrial collapse, which findings were completely resolved after thoracentesis. Our report shows that massive pleural effusion also can make severe right atrial collapse and symptom like cardiac tamponade, and thoracentesis can improve this condition.