A Comprehensive Review of the Acne Grading Scale in 2023

Acne is a common skin inflammatory condition that can significantly affect the patient's quality of life. Therefore, accurate assessment scales are very important for treatment and management of acne vulgaris. This review article issues a comprehensive review of various acne severity assessment scales. In this text, the authors review the acne grading scales, such as the Pillsbury scale, Cook's acne grading scale, Leeds acne grading system, Global Acne Grading System, and investigator's global assessment, etc. And we delve into the characteristics, advantages, limitations, and applicability of these scales. The acne grading scale to be developed in the future should be objective, accurate, comprehensive, easy to use, and applicable in a variety of clinics and research settings. Current technologies, such as artificial intelligence, could potentially contribute to the development of ideal acne grading scales that meet unmet needs.

Resonance Characteristics in Epiglottic Cyst: Formant Frequency, Vowel Space Area, Vowel Articulatory Index, and Formant Centralization Ratio

OBJECTIVES

Resonance characteristics can change due to alterations in the shape of the vocal tract in patients with epiglottic cysts. This study aimed to analyze the resonance characteristics before and after the surgical excision of epiglottic cysts.

METHODS

Twelve male patients with epiglottic cysts were enrolled in this study. We analyzed the first and second formants (F1 and F2) in vowels /a/, /e/, /i/, /o/, and /u/, vowel space area (VSA), vowel articulatory index (VAI), and formant centralization ratio (FCR). We measured these parameters before and after the surgical excision of epiglottic cysts.

RESULTS

There was a significant increase in the F1 values of /a/, VSA, and VAI, and a significant decrease in the value of FCR after the surgery.

CONCLUSION

We confirmed the change in the resonance characteristics in patients with epiglottic cysts. It is considered that further studies on epiglottic cysts and resonance changes are needed in the future.

The Usefulness of Multi Voice Evaluation for Measuring Voice Recovery After Endolaryngeal Phonomicrosurgery in Patients with Vocal Fold Polyps

OBJECTIVES

The purpose of this study was to the usefulness of a five-variable model predicting perceived voice severity and incorporating acoustic analysis based on cepstral analysis and self-reported questionnaires, for measuring voice recovery after endolaryngeal phonomicrosurgery in patients with vocal fold polyps.

METHODS

In this study, 72 patients with vocal fold polyps were included. Two voice evaluations, including acoustic analysis, self-reported questionnaires, and auditory perceptual assessments for each patient, were implemented before and after endolaryngeal phonomicrosurgery. Using these evaluations, we compared the mean values of the perceptual evaluation of voice, acoustic analysis parameters, self-reported questionnaires, and the five-variable model estimated severity pre- and post-endolaryngeal phonomicrosurgery.

RESULTS

Various parameters related to acoustic analysis, self-reported questionnaires, and auditory perceptual assessments were useful for measuring voice recovery after endolaryngeal phonomicrosurgery. In particular, a five-variable model incorporating spectral/cepstral analyses and self-reported questionnaires was able to effectively track voice changes after endolaryngeal phonomicrosurgery.

CONCLUSION

We verified that most of the variables and the five-variable model were useful for measuring voice recovery in patients with vocal polyps after endolaryngeal phonomicrosurgery.

Effect of Novel Polymer-Free Nitrogen-Doped Titanium Dioxide Film-Coated Coronary Stent Loaded With Mycophenolic Acid

Background: Titanium is commonly used in blood-exposed medical devices because it has superior blood compatibility. Mycophenolic acid inhibits the proliferation of vascular smooth muscle cells. This study examined the effect of a non-polymer TiO₂ thin film–coated stent with mycophenolic acid in a porcine coronary overstretch restenosis model.

Methods: Thirty coronary arteries in 15 pigs were randomized into three groups in which the coronary arteries were treated with a TiO₂ film–coated stent with mycophenolic acid (NTM, n = 10), everolimus-eluting stent with biodegradable polymer (EES, n = 10), or TiO₂ film–coated stent (NT, n = 10). A histopathologic analysis was performed 28 days after the stenting.

Results: There were no significant intergroup differences in injury score, internal elastic lamina area, or inflammation score. Percent area stenosis was significantly smaller in the NTM and EES groups than in the NT group (36.1 ± 13.63% vs. 31.6 ± 7.74% vs. 45.5 ± 18.96%, respectively, p = 0.0003). Fibrin score was greater in the EES group than in the NTM and NT groups [2.0 (range, 2.0–2.0) vs. 1.0 (range, 1.0–1.75) vs. 1.0 (range, 1.0–1.0), respectively, p < 0.0001]. The in-stent occlusion rate measured by micro-computed tomography demonstrated similar percent area stenosis rates on histology analysis (36.1 ± 15.10% in NTM vs. 31.6 ± 8.89% in EES vs. 45.5 ± 17.26% in NT, p < 0.05).

Conclusion: The NTM more effectively reduced neointima proliferation than the NT. Moreover, the inhibitory effect of NTM on smooth muscle cell proliferation was not inferior to that of the polymer-based EES with lower fibrin deposition in this porcine coronary restenosis model.

Influence of Local Myocardial Infarction on Endothelial Function, Neointimal Progression, and Inflammation in Target and Non-Target Vascular Territories in a Porcine Model of Acute Myocardial Infarction

BACKGROUND

Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels.

METHODS

In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting.

RESULTS

A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group.

CONCLUSION

In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.

A Study of Skin Disease of the External Ear in Older Adults According to Anatomical Location

Background

Due to its anatomical location, the external ear is easily exposed and damaged due to trauma, weathering, and inflammation. Therefore, depending on the patient’s age, different cutaneous diseases can occur. In addition, because of its small percentage of the overall body area, patients and doctors may miss observing dermatologic diseases of the ear. The purpose of this study was to provide information on the most common dermatologic diseases according to the location on the external ear.

Methods

This retrospective study was conducted on patients who visited the Department of Dermatology of Chosun University Hospital in the past 7 years.

Results

We included 269 patients and categorized their ear lesions according to 8 anatomical locations and 5 types of dermatologic diseases. In older patients over 60 years of age, the most common site of dermatologic disease was the postauricular region (33.9%), followed by the antihelix (19.4%), and earlobe (12.9%). The most common dermatologic disease was benign tumor (53.2%), followed by malignant and premalignant tumors (32.3% and 9.7%, respectively).

Conclusion

The proportion of older adults with premalignant and malignant diseases was relatively high and these were most commonly observed in the antihelix and postauricular area. Therefore, it is important to aware the need for the examination, diagnosis, and treatment of disease in the antihelix and postauricular area.

The cut-off analysis using visual analogue scale and cepstral assessments on severity of voice disorder

Purpose: The aims of this study were to: (1) determine the visual analogue scale (VAS) and cepstrum peak prominence (CPP) cut-off points on the ratings of numerical scale (NS) related to the severity of voice disorder ratings and (2) verify the discriminative power of these cut-off points for distinguishing between different severities of voice disorder. Methods: Auditory-perceptual severity assessments (VAS and four-point NS) of 214 voice samples were performed by three speech-language pathologists and CPP parameters were used for the acoustic analysis. Both VAS and CPP cut-off points were obtained using receiver operating characteristic (ROC) curve analyses, based on their correspondence with NS ratings. Results: A high level of inter- and intra-rater reliability was found for the auditory-perceptual assessments of both VAS and NS. The VAS cut-off points for overall severity (OS), between normal variation and mild/moderate severity, mild/moderate and moderate severity, and moderate and severe severity were 32.7, 51.7, and 71.7 points, respectively, and CPP cut-off points were 7.050, 4.651, and 2.989 points, respectively. Areas under the ROC curves demonstrated excellent specificity and sensitivity of all cut-off points. Conclusions: The VAS and CPP cut-off points of OS of voice disorder demonstrated a high power to discriminate between different severities of voice disorder. The results of this study suggested cut-off points for clinical use.

Ischemic oculomotor nerve palsy due to hyaluronic acid filler injection

Hyaluronic acid (HA) is the most popular agent today for intradermal injections to improve wrinkles and other cosmetic defects. Ischemic necrosis due to injection of HA is one of the serious complications. Because there are many vascular branches around the nose, caution and care should be given during facial filler injection. Although the incidence is rare, blindness and permanent visual loss may occur. We describe a 29-year-old woman presented with painful erythematous swelling with violaceous patch on right periocular area and glabella after HA filler injection. After injecting the filler, she felt pain and dizziness, and her vision became blurred. She immediately received hyaluronidase around the HA filler inject area and during hospitalized for 10 days, she was successfully treated with systemic steroid, vasodilator, prophylactic antibiotics, and LLLT (low-level laser therapy) without any defects.

Cases of acute mercury poisoning by mercury vapor exposure during the demolition of a fluorescent lamp factory

Background

In 2015, workers dismantling a fluorescent lamp factory in Korea were affected by mercury poisoning from exposure to mercury vapor.

Case presentation

Eighteen out of the 21 workers who participated in the demolition project presented with symptoms of poisoning and, of these, 10 had persistent symptoms even at 18 months after the initial exposure to mercury vapor. Early symptoms of 18 workers included a general skin rash, pruritus, myalgia, sleep disturbance, and cough and sputum production. Following alleviation of these initial symptoms, late symptoms, such as easy fatigue, insomnia, bad dreams, and anxiety disorder, began to manifest in 10 out of 18 patients. Seven workers underwent psychiatric care owing to sleep disturbance, anxiety disorder, and depression, and three workers underwent dermatologic treatment for hyperpigmentation, erythematous skin eruption, and chloracne-like skin lesions. Furthermore, three workers developed a coarse jerky movement, two had swan neck deformity of the fingers, and two received care at an anesthesiology clinic for paresthesia, such as burning sensation, cold sensation, and pain. Two workers underwent urologic treatment for dysfunction of the urologic system and impotence. However, symptomatic treatment did not result in satisfactory relief of these symptoms.

Conclusion

Awareness of the perils of mercury and prevention of mercury exposure are critical for preventing health hazards caused by mercury vapor. Chelation therapy should be performed promptly following mercury poisoning to minimize damage.

Effect of Stents Coated with Artemisinin or Dihydroartemisinin in a Porcine Coronary Restenosis Model

Background and Objectives

Artemisinin and dihydroartemisinin are drugs used to treat malaria. These drugs suppress inflammatory reactions. The aim of this study was to examine the anti-intima hyperplasia effect of a novel drug-eluting stent with artemisinin or dihydroartemisinin in a porcine coronary restenosis model.

Materials and Methods

Pigs were randomized into four groups; in the first, the coronary arteries (20 pigs, a total of 40 coronary arteries, with 10 coronary arteries in each group) was implanted with bare metal stents (BMS, n=10); the second group was given polymer-coated stents (PCS, n=10); the third group was treated with artemisinin-eluting stents (AES, n=10); and the fourth group was given dihydroartemisinin-eluting stents (DAES, n=10). Histopathologic analysis was performed 28 days after stenting.

Results

The injury and fibrin scores among the four groups were not significantly different. However, the internal elastic lamina, lumen area, and neointima area were significantly different. Moreover, the percent area of stenosis (46.2±18.66% in BMS vs. 89.4±10.92% in PCS vs. 83.3±17.07% in AES vs. 36.7±11.20% in DAES, p<0.0001) and inflammation score (1.0 [range: 1.0-1.0] vs. 3.0 [range: 2.25-3.0] vs. 3.0 [range: 1.0-3.0] vs. 2.0 [range: 1.75-3.0] in BMS, PCS, AES, and DAES, respectively; p<0.001) were markedly decreased in the DAES group compared to the PCS group.

Conclusion

DES, which uses a natural substance, dihydroartemisinin, showed a neointima and inflammatory suppressive effect in a porcine coronary restenosis model.

Reliable femoral chronic total occlusion model using a thin biodegradable polymer coated copper stent in a porcine model

Chronic total occlusions (CTOs) are common in patients with peripheral arterial disease (PAD). This study aimed to examine the feasibility and reliability of a CTO induced by a thin biodegradable polymer (polyglycolic acid) coated copper stent in a porcine femoral artery. Novel thin biodegradable polymer coated copper stents (9 mm long) were crimped on an angioplasty balloon (4.5 mm diameter × 12 mm length) and inserted into the femoral artery. Histopathologic analysis was performed 35 days after stenting. In five of six stented femoral arteries, severe in-stent restenosis and total occlusion with collateral circulation were observed without adverse effects such as acute stent thrombosis, leg necrosis, or death at 5 weeks. Fibrous tissue deposition, small vascular channels, calcification, and inflammatory cells were observed in hematoxylin-eosin, Carstair's, and von Kossa tissue stains; these characteristics were similar to pathological findings associated with CTOs in humans. The neointima volume measured by micro-computed tomography was 93.9 ± 4.04 % in the stented femoral arteries. CTOs were reliably induced by novel thin biodegradable polymer coated copper stents in porcine femoral arteries. Successful induction of CTOs may provide a practical understanding of their formation and application of an interventional device for CTO treatment.

A novel antagonist to the inhibitors of apoptosis (IAPs) potentiates cell death in EGFR-overexpressing non-small-cell lung cancer cells

In the effort to develop an efficient chemotherapy drug for the treatment of non-small-cell lung cancer (NSCLC), we analyzed the anti-tumorigenic effects of a novel small molecule targeting the inhibitor of apoptosis (IAPs), HM90822B, on NSCLC cells. HM90822B efficiently decreased IAP expression, especially that of XIAP and survivin, in several NSCLC cells. Interestingly, cells overexpressing epidermal growth factor receptor (EGFR) due to the mutations were more sensitive to HM90822B, undergoing cell cycle arrest and apoptosis when treated. In xenograft experiments, inoculated EGFR-overexpressing NSCLC cells showed tumor regression when treated with the inhibitor, demonstrating the chemotherapeutic potential of this agent. Mechanistically, decreased levels of EGFR, Akt and phospho-MAPKs were observed in inhibitor-treated PC-9 cells on phosphorylation array and western blotting analysis, indicating that the reagent inhibited cell growth by preventing critical cell survival signaling pathways. In addition, gene-specific knockdown studies against XIAP and/or EGFR further uncovered the involvement of Akt and MAPK pathways in HM90822B-mediated downregulation of NSCLC cell growth. Together, these results support that HM90822B is a promising candidate to be developed as lung tumor chemotherapeutics by targeting oncogenic activities of IAP together with inhibiting cell survival signaling pathways.

Effect of atorvastatin-eluting stents in a rabbit iliac artery restenosis model

Statins have pleiotropic effects, which include the inhibition of neointima hyperplasia, the inhibition of vascular inflammation, and platelet inhibition. The aim of this study was to examine the effect of an atorvastatin-eluting stent (AES) in a rabbit iliac artery overstretch restenosis model. Ten rabbits were used in this study (10 rabbits, 10 iliac arteries for each stent). An AES and paclitaxel-eluting stent (PES) were implanted in the left and right iliac arteries in a rabbit (2 stents in each rabbit). The stents were deployed with oversizing (stent/artery ratio 1.3:1), and histopathologic analysis was assessed at 28 days after stenting. There were no significant differences in the injury score, lumen area, or inflammation score. There were significant differences in the neointimal area (0.7±0.18 mm² in the AES group vs. 0.4±0.25 mm² in the PES group, p<0.01), in the percentage stenosis area (14.8±5.06% in the AES group vs. 10.5±6.80% in the PES group, p<0.05), and in the fibrin score (0.4±0.51 in the AES group vs. 2.7±0.48 in the PES group, p<0.001). Although the AES did not suppress neointimal hyperplasia compared with the PES, it showed a superior arterial healing effect in a rabbit iliac artery overstretch restenosis model.

Histopathological Comparison among Biolimus, Zotarolimus and Everolimus-Eluting Stents in Porcine Coronary Restenosis Model

Background and Objectives

The aim of this study was to examine the histolopathogical effects among the biolimus, zotarolimus, and everolimus eluting stent (EES) in the porcine coronary restenosis model.

Subjects and Methods

Pigs were randomized into three groups in which the coronary arteries (15 pigs, 10 coronaries in each group) had either a biolimus A9 eluting stent (BES, n=10), zotarolimus eluting stent (ZES, n=10) or an EES (n=10). Histopathologic analysis was performed at 28 days after stenting.

Results

There were no significant differences in the injury score among the three groups. There was a significant difference in the internal elastic lamina, lumen area, neointima area, percent area stenosis, and the fibrin and inflammation score among the three groups (4.3±0.53 mm², 2.5±0.93 mm², 1.8±1.03 mm², 40.7±20.80%, 1.7±0.41, 1.4±0.72 in the BES group vs. 5.1±0.55 mm², 2.3±1.14 mm², 2.8±1.00 mm², 55.4±21.23%, 2.0±0.39, 1.6±0.76 in the ZES group vs. 4.4±0.53 mm², 1.7±1.22 mm², 2.8±1.23 mm², 64.0±26.00%, 1.8±0.76, 2.1±0.90 in the EES group, respectively). BES is more effective in inhibiting neointimal hyperplasia compared to ZES and EES (p<0.0001). According to the fibrin and inflammation score, BES and EES are more effective in decreasing the fibrin deposition compared to ZES (p<0.001). Moreover, BES and ZES are more effective in reducing the inflammatory reaction compared to EES (p<0.001).

Conclusion

The result demonstrates that BES shows better histopathological characteristics than ZES and EES at one month after stenting in the porcine coronary restenosis model.

Mechanical and Histopathological Comparison between Commercialized and Newly Designed Coronary Bare Metal Stents in a Porcine Coronary Restenosis Model

The aim of this study was to compare the stent designed by Chonnam National University Hospital (designated as CNUH) with commercial cobalt-chromium coronary stent in a porcine coronary overstretch restenosis model. CNUH stent was subjected to mechanical performance tests. Pigs were randomized into two groups in which the coronary arteries (10 pigs, 10 coronaries in each group) had either CNUH stent or control commercial bare metal stent. Histopathologic analysis was assessed at 28 days after stenting. In mechanical performance tests, CNUH stent showed 2.65N, 35.1N, 0.52N, 1.94%, 4.29% in the flat plate radial compression, radial force, 3 point bending, Foreshortening and recoil test, respectively. There was no significant difference in the injury score, internal elastic lamina (IEL), lumen area, neointima area, percent area stenosis, inflammation score and fibrin score between the two groups (1.2±0.35, 4.1±0.41 mm², 2.7±0.56 mm², 1.6±0.47 mm², 36.7±11.2%, 1.2±0.62, 0.2±0.34 in CNUH stent group vs. 1.2±0.38, 3.7±0.64 mm², 2.5±0.49 mm², 1.5±0.61 mm², 36.3±12.17%, 1.1±0.12, 0.4±0.46 in commercial stent group, respectively). In the mechanical performance test, CNUH stent showed the moderated performance under the guideline of FDA. CNUH stent demonstrated similar histological reactions compared with commercial cobalt-chromium stent in a porcine coronary overstretch restenosis model.

Germinal vesicle chromatin configuration and meiotic competence is related to the oocyte source in canine

This study investigated the effect of deriving oocytes from different stages of the estrous cycle on oocyte diameter, germinal vesicle (GV) chromatin configuration, and in vitro meiotic competence in canine oocytes. Cumulus oocyte complexes (COCs) were recovered from both ovaries during anestrous, follicular, and luteal phases and in vivo ovulated oocytes. The diameter of canine oocyte was compared with or without the zona pellucida (ZP) before in vitro maturation (IVM). Also, GV chromatin configuration was evaluated before (0 h) or 72 h after IVM by fixation with 3.7% formaldehyde supplemented with 10 microg/ml Hoechst 33342 for 30 min. COCs were matured in TCM199 supplemented with 10% fetal bovine serum (FBS), 0.6 mM cysteine, 0.2 mM pyruvic acid, 50 microg/ml gentamycin sulfate, and 20 microg/ml 17beta-estradiol (E(2)) at 39 degrees C and 5% CO(2) in air for 72 h. The diameter of in vivo ovulated oocytes with the ZP (167.5+/-12.7 microm) or without ZP (133.9+/-5.3 microm) was significantly greater (p<0.05) than those of anestrous, follicular, and luteal oocytes (with ZP, 151.2+/-7.4, 153.1+/-8.8 and 152.8+/-5.4 microm, respectively; without ZP, 115.3+/-7.6, 122.1+/-4.9 and 114.3+/-6.6 microm, respectively). At 0 h, the GV-II configuration was more prevalent in oocytes from anestrual ovaries than from follicular or luteal ovaries or in vivo ovulated oocytes (63.6% versus 14.8%, 33.0%, and 0.0%; p<0.05), whereas the proportion of oocytes with the GV-V configuration was higher in follicular phase and ovulated oocytes than in oocytes from anestrus and luteal phase (57.4% and 100% versus 2.0% and 22.7%; p<0.05). However, oocytes in luteal phase exhibited diverse GV configurations (10.3%, 33.0%, 16.5%, 13.4%, and 22.7% in GV-I, GV-II, GV-III, GV-IV, and GV-V, respectively). After 72 h post-IVM, a greater percentage of in vivo ovulated oocytes progressed to MII than those oocytes collected during anestrous, follicular, and luteal phases (50.0% versus 5.5%, 11.5%, and 9.1%; p<0.05). In conclusion, the oocyte diameter, GV chromatin configuration, and meiotic maturation of canine COCs are related to the oocyte source. These results indicated that the oocyte source could be critical to nuclear progression to MII stage in canines.

The study on photoreflectance characteristic of semi-insulating GaAs surface region by its exposure to 6 MeV electron beam

Photoreflectance measurements were performed to investigate the optical properties in the electron beam irradiation semi-insulating GaAs(e-beam irradiation GaAs) and semi-insulating GaAs(SI-GaAs). A considerable increase of the PR amplitudes has been registered after the e-beam irradiation in comparison with the GaAs. It is that result of a higher electron scattering on the lattice defects created by the e-beam.

Subcellular redistribution of protein kinase C isozymes is associated with rat liver cirrhotic changes induced by carbon tetrachloride or thioacetamide

BACKGROUND AND AIMS

Protein kinase C (PKC) plays a key role in the alteration of signal transduction in the liver, which may contribute to the development of liver cirrhosis. The aim of the present study was to examine the subcellular redistribution of PKC isozymes in rat liver cirrhosis, which is induced by two different cirrhotic chemical agents, carbon tetrachloride (CCl4) and thioacetamide (TAA).

METHODS AND RESULTS

Thioacetamide and CCl4 were administered to rats for 8 and 30 weeks, respectively before rats were killed and autopsies performed at 9, 20 and 30 weeks later. The TAA induced a fibrotic pattern in the liver that differed from that produced by CCl4, notably in the formation of fibrous connective tissue and the proliferation of bile ductule cells. Cholangiofibrosis and clear-cell foci were also observed in TAA-treated rats at 30 weeks. Histological examination revealed that severe cirrhotic changes were present 9 weeks after the commencement of CCl4 treatment and 30 weeks after TAA treatment.

DISCUSSION

When the subcellular redistribution of PKC isozymes (PKCalpha, -beta1, -delta, and -epsilon) was examined, all the PKC isozymes in CCl4-treated rats were found to be translocated to the membrane fraction, which may mean PKC activation, and then downregulated by proteolytic degradation after 9 weeks of treatment, which coincided with peak cirrhotic changes. All rats treated with CCl4 recovered to the control level after 20 weeks of treatment. In the case of TAA-treated rats, PKC isozymes were translocated to the particulate fraction of the liver after 9 weeks of treatment and this persisted in most of the rats for the duration of the experiment.

CONCLUSIONS

From these results, it would appear that PKC translocation preceded morphologic changes, and that an altered subcellular distribution of the PKC isozyme may be associated with the response to liver damage and carcinogenesis.

Radiation augments a sequential program of differentiation in PKC inhibitor- pretreated mouse epidermal cells

The aim of this study was to determine whether gamma-rays affect differentiation in mouse epidermal cells. After a pre-treatment with the PKC inhibitor staurosporin (STS) or 1-(5-isoquinolinesulfomyl)-2-methylpiperazine (H7), gamma-rays were irradiated with or without an elevation of 0.12 mM Ca2+ and expressions of differentiation markers and each PKC isozyme were examined in normal primary and v-rasHa transformed mouse keratinocytes. Gamma-rays induced the expressions of differentiation markers of keratin 1 and 10 (K1 and 10), filaggrin, loricrin and SPR-1 in normal keratinocytes when the Ca2+ concentration was increased, and these phenomena were augmented in H7 pretreated cells. Similar results were obtained in STS pretreated cells; in this case, gamma-rays enhanced the expressions of the differentiation markers even without an elevated Ca2+ concentration. In v-rasHa transformed cells, gamma-rays induced the expression of differentiation markers not only at 0.05 mM Ca2+, but in 0.12 mM Ca(2+)-shifted cells, and in H7 pretreated cells, these phenomena were augmented. The translocation of PKC alpha to the particulate fraction was seen in H7 pretreated normal keratinocytes. Radiation also induced PKC alpha expression in STS pretreated cells, independent of Ca(2+)-shift, as well as altered expressions of PKC delta and -eta, while expressions of PKC alpha, -delta, -epsilon, and -eta were enhanced in v-rasHa transformed cells. In conclusion, gamma-rays augmented the expressions of both spinous and granular differentiation markers in normal and v-rasHa transformed keratinocytes and this effect was augmented when PKC inhibitors were used, which may be mediated by the cellular redistribution of PKC isozymes.

Retrospective analysis of 305 consecutive cases of endometrial ablation and partial endomyometrial resection

STUDY OBJECTIVE

To assess the efficacy and safety of operative resectoscopy, partial endomyometrial resection, and endometrial ablation in the evaluation and treatment of abnormal uterine bleeding.

DESIGN

Retrospective analysis of 305 consecutive cases of endometrial ablation and partial endomyometrial resection.

SETTING

Midwestern urban obstetric and gynecology group practice and teaching hospitals.

PATIENTS

Three hundred five women (age 30-72 yrs) with abnormal uterine bleeding. Interventions. Partial endomyometrial resection and endometrial ablation.

MEASUREMENTS AND MAIN RESULTS

Of the 301 patients who completed surgery and follow-up, 283 (97%) reported improvements in amenorrhea (55%), hypomenorrhea (41%), and eumenorrhea (1%). Ten (3%) failed to report improvement. In 24 (7.9%) women, hysterectomy was performed for various reasons after endometrial ablation, including recurrent bleeding in 4. Four uterine perforations occurred, infection was suspected in one patient, and loss of Laminaria occurred in another; all patients, however, were observed appropriately and discharged the same day of surgery.

CONCLUSIONS

Partial endomyometrial resection and endometrial ablation is a safe and effective treatment of abnormal uterine bleeding, and may be an alternative to hysterectomy in selected patients.

Postablation-tubal sterilization syndrome

Operative resectoscopy and endometrial ablation are often performed to treat abnormal uterine bleeding, but little is known about the potential late complications of these procedures. We reviewed the records of 305 women who underwent endometrial ablation at a midwestern obstetrics and gynecology group practice and teaching hospital between July 1990 and October 1995. For 71 women, tubal ligation, salpingectomy, or tubal sterilization was performed at the time of ablation. Of these, six (8.4%) developed intense cyclic pain 5 to 40 months after surgery. Four subsequently underwent exploratory laparotomy and hysterectomy, and two others underwent laparoscopic tubal resection and destruction. Gross pathologic findings revealed hematosalpinx, and microscopic examination showed endometriosis, acute and chronic inflammation of the fallopian tubes, and acute and chronic myometritis. We believe these characteristic clinical and pathologic findings are consistent with postablation-tubal sterilization syndrome, a distinct clinical entity arising as a late complication of endometrial ablation in patients with a history of tubal ligations and/or obstruction.

Current concepts of cell-cycle regulation and its relationship to oocyte maturation, fertilization and embryo development

Genetic and biochemical approaches have contributed to an explosion of literature on cell-cycle control. Regulation of the cell-cycle is controlled by a series of kinases and phosphatases. Key control points are during the G(1)-S and G(2)-M transitions. During both transitions, cyclins interact with a specific kinase to allow a cell to pass through that phase. The meiotic maturation of oocytes, fertilization and embryo development are all events influenced by cell-cycle regulation. Understanding cell-cycle control should provide new ways for gamete and embryo biologists to approach culture and development problems.

Effect of calcium ion on the maturation of cumulus-enclosed pig follicular oocytes isolated from medium-sized graafian follicles

Porcine follicular oocytes from medium-sized follicles (3-5 mm in diameter) were cultured in modified Hank's balanced salts solution (MHBS) to which pyruvate, lactate, and glucose were added as an energy source. Bovine serum albumin (0.4%) was added as a protein source and the oocytes were cultured for 42 h at 37 degrees C in 5% CO2 in air. In this medium porcine oocytes underwent 80-90% nuclear maturation after 42 h. Oocytes were cultured in MHBS with various amounts of CaCl2 as well as in the presence of verapamil, a Ca2+ channel blocker, and the divalent cationophore A23187. It was found that the lowest concentration of Ca2+ required for oocyte maturation was around 0.0265-0.053 mM. Such a requirement for Ca2+ in the culture medium extended through metaphase II. If Ca2+ was omitted during the final 4 h of culture, the metaphase II chromosomes appeared extremely condensed or degenerated. Verapamil at a level of 0.2 mM inhibited germinal vesicle breakdown or resulted in degeneration, whereas lower concentrations did not affect oocyte maturation. In the presence of 0.02 mM verapamil, the maturation of cumulus-enclosed oocytes was not affected, whereas at the same dose of verapamil the maturation of denuded oocytes was inhibited. Less than 3.8 X 10(-7) M divalent cationophore did not inhibit oocyte maturation. Maturation was inhibited by 3.8 X 10(-7) and 3.8 X 10(-6) M divalent cationophore. In conclusion, maintenance of oocytes in a nondegenerated state also requires the constant presence of Ca2+ in the culture medium.

Actions of hormones and other factors upon oocyte maturation

Oocyte maturation is controlled by a combination of hormonal and local follicular factors. Osmolarity, pH, and perhaps Ca2+ concentration of the surrounding medium are also important. Follicular fluid contains a low molecular weight OMI which acts to keep the oocyte from maturing. Luteinizing hormone added to cultured cumulus enclosed porcine oocytes can reverse the inhibitory action of OMI. The level of OMI in the follicular fluid appears to decrease as the follicle matures. Addition of FSH and prolactin to cultured granulosa cells stimulates OMI secretin whereas addition of testosterone or dihydrotesterone brings about a decrease in OMI secretion. Elevated LH in vivo may bring about oocyte maturation before ovulation by (a) an antagonist action on OMI; (b) stimulating the synthesis of testosterone by theca cells and thus inhibiting the synthesis of OMI by granulosa cells; and (c) action on the granulosa cells to promote luteinization which may also cause a decrease in OMI synthesis. The hastened oocyte maturation associated with follicular atresia could be due to a decline in OMI due to granulosa cell death and/or elevated follicular androgens.

Porcine granulosa and cumulus cell properties. LH/hCG receptors, ability to secrete progesterone and ability to respond to LH

In order to compare the properties of isolated cumulus and granulosa cells, granulosa cells and cumulus cells surrounding oocytes were harvested from small (1-2 mm), medium (3-5 mm) and large (6-12 mm) porcine antral follicles and the number of LH/hCG receptors was measured by the binding of [125I]hCG. The ability of the cells to secrete progesterone in culture was examined in the presence and absence of hCG and LH. In 3 separate experiments of 1-h incubations at 37 degrees C using cells harvested from medium-sized follicles, granulosa cells bound 10--15-fold more iodinated hCG than an equivalent number of cumulus cells. During a 2-day culture period, cumulus cells secreted less progesterone than granulosa cells from medium- and large-sized antral follicles (p less than 0.01). The potential of both cumulus and granulosa cells to secrete progesterone in culture increased as the follicle progressed from small to large size. Also, the ability of the oocyte to mature in culture increased with antral follicle size. Concurrently the ability of cumulus-oocyte complexes to form monolayers in culture decreased as the follicle matured. Cumulus and granulosa cells harvested from small- and medium-sized follicles responded similarly to LH and hCG with a stimulation in progesterone secretion after 2-6 days in culture.

Maturation of rabbit follicular oocytes in a defined medium of varied osmolality

Rabbit oocytes from follicles greater than or equal to 1 mm in diameter were cultured for 18 h in a defined medium with osmolality adjusted in 20 mosmol increments from 230 to 350 mosmol by altering only the NaCl concentration. Adjustment, based upon determination of the osmolality of the medium, was necessary because a difference existed between calculated and achieved osmolality in this complex solution. The proportions of oocytes which matured to meiosis II with polar body formation were 64, 68, 64 and 65% in media of 250, 270, 290 and 310 mosmol, respectively.

Effects of hormones on the maturation of rabbit oocytes recovered from follicles of various sizes

Progesterone stimulated oocytes to develop more rapidly in culture. The time-dependent effect was more pronounced on large preovulatory Graafian follicles than on small- and medium-sized follicles. Treatment with LH had no effect.