Effect of Recombinant Human Epidermal Growth Factor Impregnated Chitosan Film on Hemostasis and Healing of Blood Vessels

BACKGROUND: Bleeding can be a problem in wound debridement. In search for an effective hemostatic agent, we experimented with a chitosan film combined with the recombinant human epidermal growth factor (rh-EGF), hypothesizing that it would achieve effective hemostasis and simultaneously enhance arterial healing. METHODS: Forty-eight Sprague-Dawley rats were used, and 96 puncture wounds were made. The wounds were divided into the following four groups: treated with sterile gauze, treated with gelatin sponge, treated with chitosan, and treated with chitosan combined with rh-EGF. Immediate hemostasis was evaluated, and arterial healing was observed histologically. RESULTS: Groups B, C, and D showed a significant rate of immediate hemostasis as compared to group A (P<0.05), but there were no significant differences among groups B, C, and D. Histologically, only group D showed good continuity of the vessel wall after 1 week. It was the only group to show smooth muscle cell nuclei of the vessel wall. CONCLUSIONS: We observed that chitosan has an effective hemostatic potential and the mix of rh-EGF and chitosan does not interfere with chitosan's hemostatic capabilities. We also identified enhanced healing of vessel walls when rh-EGF was added to chitosan. Further research based on these positive findings is needed to evaluate the potential use of this combination on difficult wounds like chronic diabetic ulcerations.

Primary Cutaneous Infection with Scedosporium apiospermum Successfully Treated with Intravenouse Itraconazole / 대한의진균학회지

Scedosporium apiospermum is a rising opportunistic fungus that may infect immunocompetent individuals and may cause often fatal disease among the increasing immunosuppressed patient population. This pathogen is typically difficult to treat because of its particular resistance to commonly used antimycotic drugs. We describe an 83-year-old male patient with a history of long-term corticosteroid treatment for chronic prurigo simplex, who developed multiple suppurative nodules on a erythematous plaque at the right forearm. Histological examinations revealed granulomatous infiltration with hyphae and spores in dermis and fungal cultured isolation for definitive diagnosis showed S. apiospermum. Treatment was started with oral fluconazole, but skin lesions were getting worse. Then patient was treated with 200 mg of intravenouse itraconazole daily. Skin lesions showed a marked improvement after 1 week, and completely healing after 3 weeks.