ABSTRACT
BACKGROUND: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. METHODS: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. RESULTS: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). CONCLUSIONS: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.
Subject(s)
Humans , Constriction, Pathologic , Fluoroscopy , Intervertebral Disc , Magnetic Resonance Imaging , Medical Records , Neck Pain , Neck , Retrospective Studies , Spinal Stenosis , Visual Analog ScaleABSTRACT
PURPOSE: Compound tissue defects remain a challenge to reconstructive surgeons. The objective of this study was to introduce examples of successful reconstruction of compound defects of the head and neck and upper and lower limbs, using chimeric flaps based on the subscapular vascular system. METHODS: We report 19 reconstruction cases using chimeric flaps based on the subscapular vascular system. The scapular flap, scapular fascia, scapular bone, parascapular flap, latissimus dorsi, latissimus dorsi perforator flap, latissimus dorsi myocutaneous perforator flap, serratus anterior, serratus anterior fascia, and rib bone were used as components for chimeric flaps. 12 cases had defects of the upper limb, three in the lower limb, three in the head and neck area, and one case had a defect of the thoracoabdominal wall. RESULTS: Defect sizes ranged from 6x8cm to 20x22 cm. The component used most often for skin coverage was the latissimus dorsi perforator flap; for soft tissue bulk, the latissimus dorsi; for fascia coverage, the serratus anterior fascia flap; and for bone reconstruction, the scapular bone flap respectively. In all cases reconstruction was done successfully without additional operative procedures or flap necrosis. CONCLUSION: Because it is fairly easy to employ vascular pedicles of sufficient length and diameter, enabling the use of diverse types of tissue with various shapes and sizes, the use of chimeric flaps based on the subscapular vascular system allows one-stage reconstruction tailored to the characteristics of the defect area.
Subject(s)
Fascia , Head , Lower Extremity , Neck , Perforator Flap , Ribs , Skin , Surgical Procedures, Operative , Upper ExtremityABSTRACT
PURPOSE: Oncostatin M(OSM) has been known as a role in fibrosis and anti-inflammatory effects of various organs and tissues. Although there have been a number of studies which are focused on the roles and mechanisms of OSM, there are few reports on its effects in chronic wound healing. The purpose of this study is to evaluate the effects of OSM in wound healing activities of dermal fibroblasts of chronic wound in vitro. In particular, this study is focused on cell proliferation and synthesis of collagen and glycosaminoglycan(GAG), which are the major components of the extracellular matrices, of diabetic fibroblasts. METHODS: Fibroblasts were isolated from excess skin that was obtained from diabetic foot ulcer patients who underwent debridement. The isolated fibroblasts were cultivated in presence of OSM(100ng/mL). Cell proliferation, collagen synthesis and GAG levels were compared. RESULTS: All the components tested in this study increased in OSM treatment group. In particular, collagen and GAG synthesis demonstrated statistically significant increases(p<0.05 in the Mann-Whitney U- test). CONCLUSION: These results indicate that OSM increases wound healing activities of dermal fibroblasts of chronic wound in vitro.
Subject(s)
Humans , Cell Proliferation , Collagen , Debridement , Diabetic Foot , Extracellular Matrix , Fibroblasts , Fibrosis , Oncostatin M , Skin , Ulcer , Wound HealingABSTRACT
PURPOSE: Oncostatin M(OSM) is a multifunctional cytokine that belongs to the interleukin(IL)-6 family. Although there have been a number of studies that focused on the role and mechanism of OSM in various organs and tissues, there are few reports on its effect on wound healing. The final purpose of this project is to evaluate the effect of OSM on wound healing. This pilot study was designed to investigate the effect of OSM on proliferation and matrix synthesis of human dermal fibroblasts, which are the major components of the wound healing. METHODS: Excess skin that was obtained from patients who underwent skin grafts, was used for this study. From this material, fibroblasts were isolated and cultured. The cultured fibroblasts were treated with one of four concentrations of OSM. The OSM concentrations used were 0, 50, 100, and 200ng/ml, respectively. After the OSM treatment, cell proliferation was determined by the MTT assay, collagen synthesis by the C1CP method, GAG levels by the Blyscan Dye method. The parameter levels of each group were compared. RESULTS: OSM treatment increased all the components tested in the study. In particular, cell proliferation, GAG synthesis demonstrated statistically significant increases(p<0.05 in the Mann-Whitney U-test). The highest increase in all the components was obtained at a 100ng/ml concentration of OSM. CONCLUSION: The results of the present study indicate that OSM stimulates proliferation and matrix synthesis of human dermal fibroblast and the optimal concentration for wound healing is 100ng/mL.
Subject(s)
Humans , Cell Proliferation , Collagen , Fibroblasts , Oncostatin M , Pilot Projects , Skin , Transplants , Wound HealingABSTRACT
Several suspension biomaterials are available for soft tissue augmentation. Although these gel type implants have been shown to be relatively safe and convenient, their varying degrees of resorption require repeated percutaneous injections. Previous in vivo and in vitro studies have shown that the injection of cultured human adipocytes can produce a sufficient volume effect with extended in vivo stability. This pilot study was undertaken to evaluate the clinical efficacy of this method. Between November 2007 and January 2008, 5 patients were treated with implants of autologous differentiated adipocytes for wrinkle correction and forehead augmentation. The contour changes of the treatment sites were investigated in accordance with the passage of time, as was the occurrence of complications. The degree of patient satisfaction was also evaluated. The injected bioimplants remained in situ. Two weeks after injection, they began to show evidence of a soft tissue augmentation effect. All patients were satisfied with the overall results of this method, and no complications occurred during the follow-up period. The results obtained indicate that differentiated human adipocytes may be successfully injected as living grafts for long-term implants, and that this method is a well tolerated, effective way of performing soft tissue augmentation.
Subject(s)
Humans , Adipocytes , Biocompatible Materials , Follow-Up Studies , Forehead , Patient Satisfaction , Pilot Projects , Skin Aging , TransplantsABSTRACT
Overlap syndrome is a combination of major features of more than one rheumatic disease present in the same patient such as rheumatoid arthritis (RA), systemic lupus erythematosus, systemic sclerosis, and polymyositis. Polymyositis and RA are independent rheumatic diseases that may have a variety of overlapping clinical, radiological, and pathological manifestations according to different accepted criteria. Overlap syndrome with RA and polymyositis is rarely reported worldwide. We reported a rare case of overlap syndrome RA and polymyositis with relevant literatures.
