RESUMO
BACKGROUND: Periostin is a novel matricellular protein expressed in many tissues, including bone, periodontal ligament, and skin. Although its expression is prominent in various fibrotic conditions, studies of periostin in localized scleroderma are rare. OBJECTIVE: To investigate the expression of periostin and other molecules in localized scleroderma. METHODS: A retrospective study of 14 patients with confirmed mature stage localized scleroderma was undertaken. Fourteen age-matched and biopsy site-matched subjects with normal skin were included as controls. Collagen fiber deposition, periostin, procollagen, transforming growth factor-β, and matrix metalloproteinase (MMP)-1 expression were assessed and compared between the two groups. Co-localization of α-smooth muscle actin and periostin was evaluated using confocal microscopy. RESULTS: Periostin was predominantly expressed along the dermo-epidermal junction in the controls. Conversely, patients with localized scleroderma demonstrated increased collagen fiber deposition and periostin expression that was more widely distributed along the entire dermis. MMP-1 staining showed increased expression in the epidermis and dermis of patients compared to scanty expression in the controls. A semi-quantitative evaluation showed a higher proportion of excessive collagen bundle deposition (57.1% vs. 7.1%, p=0.013), diffuse periostin positivity (42.9% vs. 0%, p=0.016), and moderate MMP-1 positivity (71.4% vs. 7.1%, p=0.001) in patients than in the controls. CONCLUSION: Compared to the controls, patients with localized scleroderma had enhanced periostin expression corresponding to increased collagen fiber deposition and unexpected overexpression of MMP-1. The results of this human in vivo study may implicate the pathogenesis of localized scleroderma.
Assuntos
Humanos , Actinas , Biópsia , Colágeno , Derme , Epiderme , Microscopia Confocal , Ligamento Periodontal , Pró-Colágeno , Estudos Retrospectivos , Esclerodermia Localizada , Esclerose , PeleRESUMO
Carbon dioxide (CO2) laser is one of the most widely used lasers in dermatology. CO2 laser can precisely ablate the skin with good hemostasis, which makes it an ideal surgical laser. With the development of pulsed CO2 laser, which enabled cleaner ablation with less residual thermal damage, CO2 laser resurfacing became the gold standard for skin rejuvenation. The rejuvenation effect of full-face CO2 laser resurfacing is unparalleled to other methods; however, it is associated with a relative high incidence of side effects and prolonged downtime. Fractional CO2 laser was developed to overcome this problem. With a new technology of fractionating the laser beam into hundreds of microbeams, fractional CO2 laser resurfacing can improve various skin conditions including skin laxity, photodamage, and acne scars with short downtime and significantly lesser side effects. For optimal treatment results, clinicians have to decide the treatment depth and density based on proper understanding of the laser tissue interaction and underlying skin conditions.
Assuntos
Acne Vulgar , Dióxido de Carbono , Carbono , Cicatriz , Dermatologia , Hemostasia , Incidência , Lasers de Gás , Rejuvenescimento , PeleRESUMO
Since the first successful replantation of incompletely amputated digit was performed by Kleinert in 1962, Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. Nowadays, further improvements in instrumentation and surgical skill are accomplished and replantation of digit has been popularized widely. But sometimes the functional results of replanted digits are not excellent expected and there is a place for discussing gain between the result and efforts to replantation. We have been analyzed 28 cases of finger replantation in 17 patients from June, 1982 through June, 1984 at the Department of Orthopedic Surgery, Kyungpook National University Hospital. The results were as follows: 1, Male were 12 and female were 5, and average age was 20.5 years old. 2. The most common injury was done by cutting machine. 3. The number of amputated fingers were as follows: thumb, 6 cases; index finger, 11 cases; middle finger 7 cases; ring finger, 3 cases; The level of amputation was as follows: Zone II, 6 cases; Zone III, 15 cases; Zone IV, 7 cases; 4. The maximum ischemic times for successful results of finger replantation were 19 hours. 5. The total ratio of successful replantation of digits in our cases was 82.1%. 6. The functional results of replantation including joint motion, sensory recovery, two point discrimination, pinch power, sweating were relatively satisfactory. (Normal 8, Fair 11, Poor 3, Protective 1 case) 7. The main cause of replantation failure was thrombosis of the vein.