Efficacy and safety of non-invasive body tightening with high-intensity focused ultrasound (HIFU).

BACKGROUND: Noninvasive skin-tightening devices have become increasingly popular in response to increasing demand for improvements in skin laxity and tightening with minimal risk and recovery time. OBJECTIVE: We evaluated the efficacy and safety of HIFU for skin tightening in the face and body. METHODS: A total of 32 Korean subjects enrolled in this prospective clinical trial. The subjects were treated with HIFU to both cheeks, lower abdomen, and thigh. Skin elasticity was measured before and after treatment using a Cutometer (CT575, Courage and Khazaka® , Cologne, Germany). Three blinded, experienced dermatologists evaluated paired pre- and post-treatment (week 4 and 12) photographs according to the Global Aesthetic Improvement Scale (GAIS). Participants also completed self-assessments using GAIS. Subjects rated their pain on a numeric rating scale (NRS) immediately, 7 days, 4 weeks, and 12 weeks after treatment. RESULTS: Skin elasticity measured via a Cutometer was significantly improved 12 weeks after treatment at all treated sites (P<.05). Both IGAIS and SGAIS showed significant improvements 12 weeks after treatment. Immediately after treatment the mean NRS score was 3.00±1.586, but no pain was reported at 4 and 12 weeks post-treatment. No serious adverse effects were observed during the follow-up period. CONCLUSION: HIFU safely and effectively improves skin elasticity and clinical contouring of the face and body.

Referred symptom from myofascial pain syndrome: One of the most important causes of sensory disturbance in breast cancer patients using taxanes.

The aim of this retrospective study was to evaluate common causes of upper extremity sensory disturbance in breast cancer patients. Breast cancer patients who received surgery and taxane chemotherapy (CTx) with upper extremity sensory disturbance that began after CTx were included. With comprehensive clinical history, physical examination and electrodiagnostic results, diagnosis for each patient was made. Fifty-two patients were included: 23 (44.2%) were diagnosed with chemotherapy-induced peripheral neuropathy (CIPN), 7 (13.5%) with myofascial pain syndrome (MPS), six (11.5%) with carpal tunnel syndrome (CTS), four (7.7%) with CIPN and MPS, and three (5.8%) with CIPN and CTS. CIPN was more correlated with sensory symptoms at upper and lower extremities, a shorter time from CTx start, and adriamycin and cytoxan (AC) plus paclitaxel, than with AC plus docetaxel and fluorouracil, epirubicin and cyclophosphamide plus taxanes. MPS was correlated with longer duration of CTx and use of hormone therapy. CTS was correlated with wrist trauma history. Patients with CIPN showed similar degrees of pain even after 3 months of treatment, in comparison to the patients with MPS and CTS. When breast cancer patients complain of upper extremity sensory disturbance, various causes, especially referred symptom from MPS, should be considered for effective treatment.

The clinical significance of infrared thermography for the prediction of postherpetic neuralgia in acute herpes zoster patients.

BACKGROUND: Infrared thermography is a non-invasive diagnostic tool that provides information for damage to the nerve, there was some reports that thermal asymmetry of acute Herpes zoster (HZ) patients was significantly related to development of PHN. OBJECTIVE: To identify whether infrared thermography is useful as a predictor for the development of postherpetic neuralgia (PHN) and as an objective assessment tool of subjective pain in acute HZ patients. METHODS: Infrared thermography was performed on the affected body regions of 112 patients who had been diagnosed with an acute stage of HZ. Demographic and clinical data were recorded. Differences >0.5°C for the mean temperature across the face and trunk were considered abnormal. According to whether PHN developed or not, we analyzed the correlation of risk factors. RESULTS: The study consisted of a total of 112 subjects (46 males and 66 females) with an age range of 9-93 years. The following summarizes the analysis results. (1) As pain severity increased, the occurrence of PHN increased significantly. (2) In older patients, the occurrence of PHN was significantly higher. (3) As the temperature difference between the affected and contralateral dermatome (ΔT) increased, the occurrence of PHN increased significantly. (4) There is a statically significant association between diabetes mellitus and the occurrence of PHN. (5) There is no correlation between pain intensity and ΔT. CONCLUSION: In this study, we showed that infrared thermography is useful as a predictor of PHN development in acute HZ patients but is not useful as an objective assessment tool for indicating subjective pain.

Effect of high advanced-collagen tripeptide on wound healing and skin recovery after fractional photothermolysis treatment.

BACKGROUND: Collagens have long been used in pharmaceuticals and food supplements for the improvement of skin. AIM: We evaluated the efficacy of high advanced-collagen tripeptide (HACP) on wound healing and skin recovery. METHODS: Using an in vitro model, we performed HaCaT cell migration assays and collagen gel contraction assays using HACP concentrations of 1, 10 and 100 µg/mL. In this pilot study, eight healthy volunteers were randomly divided into two groups. Both the control and experimental groups received fractional photothermolysis treatment, but in the experimental group, four subjects received 3 g/day of oral collagen peptide (CP) for 4 weeks. To assess transepidermal water loss in each patient before and after the treatment, we used a Corneometer and a Cutometer, and we also assessed the patient's Erythema Index. RESULTS: The cell migration assay showed that HACP enhanced wound closure, but not in a dose-dependent manner. The collagen gel contraction assay showed increased contractility when patients were treated with 100 µg/mL HACP, but the results were not significantly different from those of controls. We found that post-laser erythema resolved faster in the experimental group than in the control group (P < 0.05). In addition, the recovery of skin hydration after fractional laser treatment was greater in the experimental group than in the control group by day 3 (P < 0.05), and the experimental group showed significantly improved post-treatment skin elasticity compared with the controls by day 14 (P < 0.05). CONCLUSIONS: Collagen tripeptide treatment appears to be an effective and conservative therapy for cutaneous wound healing and skin recovery after fractional photothermolysis treatment.

Impairment of the proximal to distal tonic gradient in the human diabetic stomach.

BACKGROUND: Little has been known about the contractile characteristics of diabetic stomach. We investigated spontaneous contractions and responses to acetylcholine in the gastric muscle in diabetic patients and non-diabetic control subjects according to the region of stomach. METHODS: Gastric specimens were obtained from 26 diabetics and 55 controls who underwent gastrectomy at Samsung Medical Center between February 2008 and November 2011. Isometric force measurements were performed using circular muscle strips from the different regions of stomach under basal condition and in response to acetylcholine. KEY RESULTS: Basal tone of control was higher in the proximal stomach than in the distal (0.63 g vs 0.46 g, p = 0.027). However, in diabetics, basal tone was not significantly different between the proximal and distal stomach (0.75 g vs 0.62 g, p = 0.32). The distal stomach of diabetics had higher basal tone and lower frequency than that of control (0.62 g vs 0.46 g, p = 0.049 and 4.0/min vs 4.9/min, p = 0.049, respectively). After exposure to acetylcholine, dose-dependent increases of basal tone, peak, and area under the curve (AUC) were noticed in both proximal and distal stomach of the two groups. In the proximal stomach, however, the dose-dependent increase of basal tone and AUC was less prominent in diabetics than in control. CONCLUSIONS & INFERENCES: On the contrary to control, the proximal to distal tonic gradient was not observed in diabetic stomach. Diabetic stomach also had lower frequency of spontaneous contraction in the distal stomach and less acetylcholine-induced positive inotropic effect in the proximal stomach than control.

Monitoring PAH-contaminated soil using laser-induced fluorescence (LIF).

The heterogeneity and opacity of soil matrices pose considerable challenges for the quantification of soil contaminants. In order to investigate the feasibility of applying the Laser-Induced Fluorescence technique to measure contamination levels of soils, statistical analyses of contaminant levels and intensity of fluorescence were investigated in relation to soil properties. A significant correlation (R2 > 0.97) between contaminant levels and intensity of fluorescence was shown under different matrix conditions, such as moisture content and particle size distribution. Higher fluorescence intensities were obtained from soils with higher sand and moisture content. The statistical results in relation to the interaction between fluorescence intensity and matrix properties rejected the hypothesis that all properties of the matrices and contaminants had an equal influence on fluorescence. This implied that the concentrations of contaminants had the greatest contribution to the fluorescence intensity, but other variables also showed a considerable influence.

Bifidobacterium bifidum exhibits a lipopolysaccharide-like mitogenic activity for murine B lymphocytes.

To determine the role of bifidobacteria in the systemic and mucosal antibody response, we examined the direct modulatory effect of bifidobacteria on the synthesis of antibodies by murine spleen B cells. Whole spleen B cells were cultured with Bifidobacterium bifidum or Clostridium perfringens (Welch's bacilli, negative control), and antibody synthesis was measured by ELISA and enzyme-linked immunospot assay. The B. bifidum, but not C. perfringens, substantially increased total secretion of major immunoglobulin (Ig) isotypes and the number of IgA-secreting cells. In addition, B. bifidum increased proliferation of spleen cells by threefold, and C. perfringens had little to diminishing effect on the cells. These results indicate that B. bifidum increased Ig synthesis through its mitogenic influence on B cells. Further, B. bifidum induced spleen B cells to be reactive to transforming growth factor-beta 1 and interleukin-5 and resulted in increased surface IgA expression (approximately threefold) and total IgA production (> 20-fold) but not increased production of IgM and IgG2a isotypes. Together, these studies indicate that B. bifidum can act as a lipopolysaccharide-like polyclonal activator for B cells. Furthermore, that bifidobacteria enable B cells to respond to transforming growth factor-beta 1 and interleukin-5 for the IgA production has important implications for the primary defense against pathogens in the gastrointestinal tract.

Peroral immunization of microencapsulated human VP8 in combination with cholera toxin induces intestinal antibody responses.

To develop an orally delivered subunit vaccine for rotavirus infection, a trypsin cleavage product of VP4, recombinant VP8*, was expressed in Escherichia coli. The recombinant VP8* (rVP8*), purified by affinity chromatography, was reactive against human rotavirus positive serum in Western-blot analysis. To further evaluate the immunogenicity of the oral-delivered rVP8*, it was encapsulated with alginate-microsphere and administered in combination with cholera toxin (CT) as a mucosal adjuvant perorally into mice. The ELISPOT assay showed that the number of rVP8*-specific IgG1 antibody secreting cells increased about 3-fold and about 2-fold in spleen and Peyer's patch, respectively as compared to non-immune mice. In addition, the number of rVP8*-specific IgA antibody secreting cells increased about 2-fold in Peyer's patch. Finally, rVP8*-specific IgA antibody response was significantly enhanced in the intestinal fluids from the mice immunized perorally with encapsulated rVP8* and CT. Taken together, these results indicate that rVP8* possessed proper immunogenicity and it would be potentially useful as a subunit vaccine against rotavirus-associated disease through peroral immunization.

Giant-cell interstitial pneumonia in a gas station worker.

Giant-cell interstitial Pneumonia (GIP) is a very uncommon respiratory disease. The majority of cases of GIP are caused by exposure to cobalt, tungsten and other hard metals. In this report, we describe GIP in a patient who worked in gas station and dealt in propane gas vessels. He presented with clinical features of chronic interstitial lung disease and underwent an open lung biopsy that showed DIP-like reaction with large numbers of intra-alveolar macrophages and numerous large, multinucleated histiocytes which were admixed with the macrophages. Analysis of lung tissue for hard metals was done. Cobalt was the main component of detected hard metals. Corticosteroid therapy was started and he recovered fully.

Bronchioloalveolar carcinoma: clinical, histopathologic, and radiologic findings.

Bronchioloalveolar carcinoma is characterized pathologically by a pulmonary neoplasm showing lepidic growth. More than half of all patients with bronchioloalveolar carcinoma are asymptomatic. The most frequent symptoms and signs are cough, sputum, shortness of breath, weight loss, hemoptysis, and fever. Bronchorrhea is unusual and a late manifestation. Nonmucinous bronchioloalveolar carcinoma tends to be more localized and has a lower frequency of bronchogenic spread than mucinous bronchioloalveolar carcinoma. Bronchioloalveolar carcinoma appears radiographically as a single nodule, segmental or lobar consolidation, or diffuse nodules. At computed tomography (CT), the single nodular form appears as a peripheral nodule or localized ground-glass attenuation with or without consolidation, frequently associated with bubblelike areas of low attenuation and open bronchus signs. The lobar consolidative form may demonstrate the CT angiogram and open bronchus signs. The diffuse nodular form appears as multiple nodules or areas of ground-glass attenuation or consolidation. The single nodular form has a better prognosis than the others but may show false-negative results for malignancy at 2-(fluorine-18) fluoro-2-deoxy-D-glucose positron emission tomography.