To investigate the effects of topically applied 17β-estradiol on the expression of extracellular matrix proteins in aged human skin, 17β-estradiol (0.01%) and its vehicle (70%propylene glycol, 30%ethanol) were appli...To investigate the effects of topically applied 17β-estradiol on the expression of extracellular matrix proteins in aged human skin, 17β-estradiol (0.01%) and its vehicle (70%propylene glycol, 30%ethanol) were applied to aged (68-82 y, eight females and five males) human buttock skin under occlusion for 2 wk (three times per week). Topical 17β-estradiol was found to increase the expression of type 1 procollagen mRNA and protein significantly in human aged skin in vivo. In addition, MMP-1 protein levels were reduced by topical 17β-estradiol. The expressions of TGF-β1,TGF-βtype II receptor, and Sma and Mad related (Smad)3 were increased by topical 17β-estradiol in aged human skin, and TGF-β1 neutralizing antibody inhibited 17β-estradiol-induced procollagen synthesis in cultured fibroblasts. We also found that the expressions of tropoelastin and fibrillin-1 mRNA and protein, and elastic fibers in aged skin were also increased by topical 17β-estradiol. Topical 17β-estradiol also increased keratinocyte proliferation and the epidermal thickness in aged human skin. We also observed the same effects of topical 17β-estradiol in young skin. In conclusion, our results suggest that topical 17β-estradiol treatment may improve the cutaneous function of aged human skin by improving the connective tissue and increasing epidermal thickness.展开更多
Objective. There is increasing interest in ultrasound-diagnosed non-alcoholic fatty liver disease (NAFLD) in the ambulatory care setting. The aim of this study was to determine the clinical and metabolic features of u...Objective. There is increasing interest in ultrasound-diagnosed non-alcoholic fatty liver disease (NAFLD) in the ambulatory care setting. The aim of this study was to determine the clinical and metabolic features of ultrasound-diagnosed NAFLD. Material and methods. Fifty ultrasound-diagnosed NAFLD patients who had not consumed alcohol for at least the previous 3 months were matched with 100 controls by age and gender distribution. Clinical, biochemical, and nutritional variables were compared between the ultrasound-diagnosed NAFLD patients and the controls. Conditional logistic regression analyses were used to identify independent factors associated with ultrasound-diagnosed NAFLD. Results. The ultrasound-diagnosed NAFLD patients had higher values on the anthropometric measurements than those of the controls. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), uric acid, and γ-glutamyl transpeptidase levels were higher in the ultrasound-diagnosed NAFLD patients than those in the controls (p < 0.001). The ASAT/ALAT ratio of the ultrasound-diagnosed NAFLD patients was lower than that of the controls (p < 0.001). Total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, non-HDL-cholesterol, atherogenic index, fasting glucose, systolic blood pressure (BP), diastolic BP, and pulse pressure were higher in the ultrasound-diagnosed NAFLD patients than in the control subjects, while lipoprotein(a) was lower. There were no significant differences in low-density lipoprotein (LDL) cholesterol levels or nutritional intake between patients and controls. Abnormal ASAT or ALAT, hypertriglyceridemia, lower HDL-cholesterol levels, silent myocardial ischemic pattern on electrocardiogram (ECG), impaired fasting glucose, and obesity were common among the ultrasound-diagnosed NAFLD patients. The only independent factor associated with ultrasound-diagnosed NAFLD was obesity (p < 0.001). Conclusions. Our data suggest that NAFLD diagnosed by ultrasound is associated with hypertriglyceridemia, impaired fasting glucose, silent myocardial ischemic pattern of ECG, obesity, and abnormal liver tests in adults. Among these factors, obesity was the only independent factor associated with ultrasound-diagnosed NAFLD.展开更多
Background: Most of the eye drops currently used replace only the aqueous phase of the tear film. But, due to the fact that, with approximately 80% of the patients with a dry eye, a disturbance of the lipid phase is p...Background: Most of the eye drops currently used replace only the aqueous phase of the tear film. But, due to the fact that, with approximately 80% of the patients with a dry eye, a disturbance of the lipid phase is present, an approach for new treatment methods needed to be found. We examined a new therapy concept with an eye spray containing liposomes for the therapy of the “ dry eye” in a long- term study. Goal: An examination of the effectiveness of a liposome eye spray (TEARS AGAIN., Optima Pharmaceutical GmbH, Germany) in patients with “ dry eye” compared with a spray containing a balanced salt solution was carried out. Methods: Between August 2003 and May 2004 a double- blind study with 382 patients was accomplished. The treatment group (V; n=191) was compared with the control group (K; n=191) for a period of 6 months regarding the following examination criteria: eyelid edge parallel conjunctival folds (LIPCOF), BREAK UP time (BUT), Schirmer I test, best corrected visual acuity, as well as slit lamp findings of the cornea and conjunctiva. Follow- up was after 4 weeks and 6 months. The statistical analysis was performed with the statistical program SPSS v.11.5. Results: The examined parameters such as LIPCOF, BUT and Schirmer were significantly better in the treatment group than in the control group. We found likewise significant improvements of the inflammations of the edge of eyelid with a remarkable decrease of around 89.5% . Questioning of the patients resulted in, among other things, the belief that the liposome eye spray led altogether to a clear subjective improvement of the symptoms in 72% of the cases, although an initial burning sensation was mentioned after the application. All patients were of the opinion that application with a spray is more favourably and more pleasant than teardrops. Conclusion: The liposome tear substitute shows statistically significant advantages against a balanced salt solution. This new liposome eye spray represents a new, revolutionary and effective procedure in the therapy of the “ dry eye” . Considering the disturbance of the lipid phase in 80% of the patients, TEARS AGAIN. ought to be a first choice treatment.展开更多
Background: Acute pulmonary thromboembolism(APTE) remains an important cause of morbidity and mortality in Western countries.In Korea, both the incidence and the mortality rate of APTE were thought to be low compared ...Background: Acute pulmonary thromboembolism(APTE) remains an important cause of morbidity and mortality in Western countries.In Korea, both the incidence and the mortality rate of APTE were thought to be low compared to Western countries. We performed the present study to investigate the current status of APTE in Korea. Methods: Eight hundred and eight registry patients with APTE were analyzed with respect to clinical symptoms and signs, the presence of underlying diseases or predisposing factors, diagnostic methods, treatment and clinical course. Results: The most common risk factors were prolonged immobilization(22.9% ), deep venous thrombosis(22.0% ), a recent operation(19.2% ), and cancer(15.8% ). The most common symptoms were dyspnea(78.6% ), and chest pain(26.9% ). The most common abnormality on chest radiography was effusion. The overall mortality rate at 3 months was 11.0% . Multivariate logistic regression analysis demonstrated that increased mortality risk was independently associated with the following baseline factors: onset in hospital(OR 1.88; 95% CI 1.03-3.42; p=0.03), lung cancer(OR 9.20; 95% CI 1.96-43.27; p=0.005), tachycardia(OR 3.50; 95% CI 1.86-6.60; p=0.0001), cardiogenic shock(OR 6.74; 95% CI 2.73-16.64; p=0.0001), and cyanosis(OR 3.45; 95% CI 1.27-9.44; p=0.01). Conclusions: Some differences did exist for the risk factors, symptoms, chest X-ray findings, mortality rate and prognostic factors as compared with those for Western patients. These results can prove especially helpful in the diagnosis as well as for the treatment of patients with APTE.展开更多
Background. We report a case of adenocarcinoma arising in a vaginal müllerian cyst. Although the most common pathological type of vaginal cysts is müllerian cyst, malignant change of a müllerian cyst ha...Background. We report a case of adenocarcinoma arising in a vaginal müllerian cyst. Although the most common pathological type of vaginal cysts is müllerian cyst, malignant change of a müllerian cyst has not been reported before. Case. A 48-year-old woman presented with a 3 cm-sized ruptured vaginal cyst. The cyst had been asymptomatic for 20 years, but ruptured 2 months before her visit. After the diagnosis of atypical glands was made on punch biopsy of cyst wall, she underwent an operative excision and the final histopathologic examination revealed an adenocarcinoma arising in the müllerian cyst. After the surgery, she received a course of external radiation therapy followed by brachytherapy. At 6 months following treatment, the patient remained without evidence of disease. Conclusion. To our knowledge, this is the first case report of an adenocarcinoma arising from a müllerian cyst. The possibility of malignant transformation should be considered and careful follow-up is warranted even in cases of asymptomatic vaginal cysts.展开更多
文摘To investigate the effects of topically applied 17β-estradiol on the expression of extracellular matrix proteins in aged human skin, 17β-estradiol (0.01%) and its vehicle (70%propylene glycol, 30%ethanol) were applied to aged (68-82 y, eight females and five males) human buttock skin under occlusion for 2 wk (three times per week). Topical 17β-estradiol was found to increase the expression of type 1 procollagen mRNA and protein significantly in human aged skin in vivo. In addition, MMP-1 protein levels were reduced by topical 17β-estradiol. The expressions of TGF-β1,TGF-βtype II receptor, and Sma and Mad related (Smad)3 were increased by topical 17β-estradiol in aged human skin, and TGF-β1 neutralizing antibody inhibited 17β-estradiol-induced procollagen synthesis in cultured fibroblasts. We also found that the expressions of tropoelastin and fibrillin-1 mRNA and protein, and elastic fibers in aged skin were also increased by topical 17β-estradiol. Topical 17β-estradiol also increased keratinocyte proliferation and the epidermal thickness in aged human skin. We also observed the same effects of topical 17β-estradiol in young skin. In conclusion, our results suggest that topical 17β-estradiol treatment may improve the cutaneous function of aged human skin by improving the connective tissue and increasing epidermal thickness.
文摘Objective. There is increasing interest in ultrasound-diagnosed non-alcoholic fatty liver disease (NAFLD) in the ambulatory care setting. The aim of this study was to determine the clinical and metabolic features of ultrasound-diagnosed NAFLD. Material and methods. Fifty ultrasound-diagnosed NAFLD patients who had not consumed alcohol for at least the previous 3 months were matched with 100 controls by age and gender distribution. Clinical, biochemical, and nutritional variables were compared between the ultrasound-diagnosed NAFLD patients and the controls. Conditional logistic regression analyses were used to identify independent factors associated with ultrasound-diagnosed NAFLD. Results. The ultrasound-diagnosed NAFLD patients had higher values on the anthropometric measurements than those of the controls. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), uric acid, and γ-glutamyl transpeptidase levels were higher in the ultrasound-diagnosed NAFLD patients than those in the controls (p < 0.001). The ASAT/ALAT ratio of the ultrasound-diagnosed NAFLD patients was lower than that of the controls (p < 0.001). Total cholesterol, triglycerides, high-density lipoprotein (HDL)-cholesterol, non-HDL-cholesterol, atherogenic index, fasting glucose, systolic blood pressure (BP), diastolic BP, and pulse pressure were higher in the ultrasound-diagnosed NAFLD patients than in the control subjects, while lipoprotein(a) was lower. There were no significant differences in low-density lipoprotein (LDL) cholesterol levels or nutritional intake between patients and controls. Abnormal ASAT or ALAT, hypertriglyceridemia, lower HDL-cholesterol levels, silent myocardial ischemic pattern on electrocardiogram (ECG), impaired fasting glucose, and obesity were common among the ultrasound-diagnosed NAFLD patients. The only independent factor associated with ultrasound-diagnosed NAFLD was obesity (p < 0.001). Conclusions. Our data suggest that NAFLD diagnosed by ultrasound is associated with hypertriglyceridemia, impaired fasting glucose, silent myocardial ischemic pattern of ECG, obesity, and abnormal liver tests in adults. Among these factors, obesity was the only independent factor associated with ultrasound-diagnosed NAFLD.
文摘Background: Most of the eye drops currently used replace only the aqueous phase of the tear film. But, due to the fact that, with approximately 80% of the patients with a dry eye, a disturbance of the lipid phase is present, an approach for new treatment methods needed to be found. We examined a new therapy concept with an eye spray containing liposomes for the therapy of the “ dry eye” in a long- term study. Goal: An examination of the effectiveness of a liposome eye spray (TEARS AGAIN., Optima Pharmaceutical GmbH, Germany) in patients with “ dry eye” compared with a spray containing a balanced salt solution was carried out. Methods: Between August 2003 and May 2004 a double- blind study with 382 patients was accomplished. The treatment group (V; n=191) was compared with the control group (K; n=191) for a period of 6 months regarding the following examination criteria: eyelid edge parallel conjunctival folds (LIPCOF), BREAK UP time (BUT), Schirmer I test, best corrected visual acuity, as well as slit lamp findings of the cornea and conjunctiva. Follow- up was after 4 weeks and 6 months. The statistical analysis was performed with the statistical program SPSS v.11.5. Results: The examined parameters such as LIPCOF, BUT and Schirmer were significantly better in the treatment group than in the control group. We found likewise significant improvements of the inflammations of the edge of eyelid with a remarkable decrease of around 89.5% . Questioning of the patients resulted in, among other things, the belief that the liposome eye spray led altogether to a clear subjective improvement of the symptoms in 72% of the cases, although an initial burning sensation was mentioned after the application. All patients were of the opinion that application with a spray is more favourably and more pleasant than teardrops. Conclusion: The liposome tear substitute shows statistically significant advantages against a balanced salt solution. This new liposome eye spray represents a new, revolutionary and effective procedure in the therapy of the “ dry eye” . Considering the disturbance of the lipid phase in 80% of the patients, TEARS AGAIN. ought to be a first choice treatment.
文摘Background: Acute pulmonary thromboembolism(APTE) remains an important cause of morbidity and mortality in Western countries.In Korea, both the incidence and the mortality rate of APTE were thought to be low compared to Western countries. We performed the present study to investigate the current status of APTE in Korea. Methods: Eight hundred and eight registry patients with APTE were analyzed with respect to clinical symptoms and signs, the presence of underlying diseases or predisposing factors, diagnostic methods, treatment and clinical course. Results: The most common risk factors were prolonged immobilization(22.9% ), deep venous thrombosis(22.0% ), a recent operation(19.2% ), and cancer(15.8% ). The most common symptoms were dyspnea(78.6% ), and chest pain(26.9% ). The most common abnormality on chest radiography was effusion. The overall mortality rate at 3 months was 11.0% . Multivariate logistic regression analysis demonstrated that increased mortality risk was independently associated with the following baseline factors: onset in hospital(OR 1.88; 95% CI 1.03-3.42; p=0.03), lung cancer(OR 9.20; 95% CI 1.96-43.27; p=0.005), tachycardia(OR 3.50; 95% CI 1.86-6.60; p=0.0001), cardiogenic shock(OR 6.74; 95% CI 2.73-16.64; p=0.0001), and cyanosis(OR 3.45; 95% CI 1.27-9.44; p=0.01). Conclusions: Some differences did exist for the risk factors, symptoms, chest X-ray findings, mortality rate and prognostic factors as compared with those for Western patients. These results can prove especially helpful in the diagnosis as well as for the treatment of patients with APTE.
文摘Background. We report a case of adenocarcinoma arising in a vaginal müllerian cyst. Although the most common pathological type of vaginal cysts is müllerian cyst, malignant change of a müllerian cyst has not been reported before. Case. A 48-year-old woman presented with a 3 cm-sized ruptured vaginal cyst. The cyst had been asymptomatic for 20 years, but ruptured 2 months before her visit. After the diagnosis of atypical glands was made on punch biopsy of cyst wall, she underwent an operative excision and the final histopathologic examination revealed an adenocarcinoma arising in the müllerian cyst. After the surgery, she received a course of external radiation therapy followed by brachytherapy. At 6 months following treatment, the patient remained without evidence of disease. Conclusion. To our knowledge, this is the first case report of an adenocarcinoma arising from a müllerian cyst. The possibility of malignant transformation should be considered and careful follow-up is warranted even in cases of asymptomatic vaginal cysts.