Type 1 diabetes mellitus (T1DM) is a pathological condition associated with osteopenia. $WNT/{\beta}$-catenin signaling is implicated in this process. Trabecular and cortical bone respond differently to $WNT/{\beta}$-catenin signaling in healthy mice. We investigated whether this signaling has different effects on trabecular and cortical bone in T1DM. We first established a streptozotocin-induced T1DM mouse model and then constitutively activated ${\beta}$-catenin in osteoblasts in the setting of T1DM (T1-CA). The extent of bone loss was greater in trabecular bone than that in cortical bone in T1DM mice, and this difference was consistent with the reduction in the expression of ${\beta}$-catenin signaling in the two bone compartments. Further experiments demonstrated that in T1DM mice, trabecular bone showed lower levels of insulin-like growth factor-1 receptor (IGF-1R) than the levels in cortical bone, leading to lower $WNT/{\beta}$-catenin signaling activity through the inhibition of the IGF-1R/Akt/glycogen synthase kinase $3{\beta}$ ($GSK3{\beta}$) pathway. After ${\beta}$-catenin was activated in T1-CA mice, the bone mass and bone strength increased to substantially greater extents in trabecular bone than those in cortical bone. In addition, the cortical bone of the T1-CA mice displayed an unexpected increase in bone porosity, with increased bone resorption. The downregulated expression of WNT16 might be responsible for these cortical bone changes. In conclusion, we found that although the activation of $WNT/{\beta}$-catenin signaling increased the trabecular bone mass and bone strength in T1DM mice, it also increased the cortical bone porosity, impairing the bone strength. These findings should be considered in the future treatment of T1DM-related osteopenia.
In the present study, the therapeutic potential of purified and well-characterized bacteriophages was evaluated in thermally injured mice infected with Klebsiella pneumoniae B5055. The efficacy of five Klebsiella phages (Kpn5, Kpn12, Kpn13, Kpn17, and Kpn22) was evaluated on the basis of survival rate, decrease in bacterial counts in different organs of phage-treated animals, and regeneration of skin cells as observed by histopathological examination of phage-treated skin. Toxicity studies performed with all the phages showed them to be non-toxic, as no signs of morbidity and mortality were observed in phage-treated mice. The results of the study indicate that a single dose of phages, intraperitoneally (i.p.) at an MOI of 1.0, resulted in significant decrease in mortality, and this dose was found to be sufficient to completely cure K. pneumoniae infection in the burn wound model. Maximum decrease in bacterial counts in different organs was observed at 72 h post infection. Histopathological examination of skin of phage-treated mice showed complete recovery of burn infection. Kpn5 phage was found to be highly effective among all the phages and equally effective when compared with a cocktail of all the phages. From these results, it can be concluded that phage therapy may have the potential to be used as stand-alone therapy for K. pneumoniae induced burn wound infection, especially in situations where multiple antibiotic-resistant organisms are encountered.
Lee, Jun-Ho;Choi, Bong Gyu;Lee, Jin Ho;Kim, Jae Won
Journal of the Korean Burn Society
/
v.22
no.1
/
pp.15-19
/
2019
Purpose: Pain management in burn treatment is important in improving wound healing and quality of life. Ibuprofen is a proven pain relieving agent in patients with partial thickness burn by intraveous injection. The purpose of this study is to evaluate the efficacy of Biatain Ibu® (polyurethane foam containing ibuprofen) in pain control for outpatients with partial thickness burns. Methods: A prospective randomized clinical trial was performed in outpatients with partial thickness burn from August 1, 2017 to July 31, 2018. Acute pain, chronic pain, complications, days for re-epithelialization and patient's satisfaction were compared between Biatain Ibu® and Biatain® groups. Results: A total of 20 patients (Biatain Ibu®, n=10; Biatain®, n=10) were assessed in the trial. On Burn days 3, 5, 7, 11, 13, and 15, the acute pain levels were significantly lower in the Biatain Ibu® group than in the Biatain® group. Complications, chronic pain levels and days for re-epithelialization were not significantly different between the two groups. Patient's satisfaction was not statistically significant but was higher in the Biatain Ibu® group. Conclusion: Biatain Ibu® is effective in relieving pain in outpatients with partial thickness burn without decreasing patient satisfaction, wound healing ability or developing any complications.
Kim, Min-Keun;Yoo, Ki-Yeon;Kwon, Kwang-Jun;Kim, Seong-Gon;Park, Young-Wook;Lee, Kwang-Gill;Jo, You-Young;Kweon, Hae-Yong
Maxillofacial Plastic and Reconstructive Surgery
/
v.36
no.3
/
pp.111-115
/
2014
Purpose: This study evaluated powdered burn wound dressing materials from wild silkworm fibroin in an animal model. Methods: Fifteen rats were used in this experiment. Full-thickness $2{\times}2cm$ burn wounds were created on the back of rats under anesthesia. In the two experimental groups, the wounds were treated with two different dressing materials made from silkworm fibroin. In the Control Group, natural healing without any dressing material was set as control. The wound surface area was measured at five days, seven days and 14 days. Wound healing was evaluated by histologic analysis. Results: By gross observation, there were no infections or severe inflammations through 14 days post-injury. The differences among groups were statistically significant at seven days and 14 days, postoperatively (P<0.037 and 0.001, respectively). By post hoc test, the defect size was significantly smaller in experimental Group 1 compared with the Control Group and experimental Group 2 at seven days postoperatively (P=0.022 and 0.029, respectively). The difference between Group 1 and Group 2 was statistically significant at 14 days postoperatively (P<0.001). Group 1 and control also differed significantly (P=0.002). Group 1 showed a smaller residual scar than the Control Group and Group 2 at 14 days post-injury. Histologic analysis showed more re-epithelization in Groups 1 and 2 than in the Control Groups. Conclusion: Burn wound healing was accelerated with silk fibroin spun by wild silkworm Antheraea pernyi. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials can be used for treatment of burn wound.
Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, $Acticoat^{(R)}$ is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of $Acticoat^{(R)}$, silver-containing dressing on the treatment for HF injury wound. Methods: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. $Acticoat^{(R)}$ dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with $Acticoat^{(R)}$ and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. Results: We therefore reviewed 10 cases of HF-induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, $Acticoat^{(R)}$ dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.
Burns are one of the most devastating forms of trauma and wound healing is a complex and multicellular process, which is executed and regulated by signaling networks involving numerous growth factors, cytokines, and chemokines. Recombinant human granulocyte macrophage colony-stimulating factor (rhGM-CSF) was specifically produced from rice cell culture through use of a recombinant technique in our laboratory. The effect of rhGM-CSF on promotion of deep second-degree burn wound healing on the back skin of a hamster model was evaluated through a randomized and double-blind trial. As macroscopic results, hamster skins of the experimental groups showed earlier recovery by new epidermis than the control groups. Immunohistochemical reactions of proliferating cell nuclear antigen and transforming growth factor-b1, which are indicators of cell proliferation, were more active in the experimental group, compared with the control group. On electron microscopy, basal cells in the epidermis of the experimental group showed oval nuclei, prominent nucleoli, numerous mitochondria and abundant free ribosomes. In addition, fibroblasts contained well-developed rough endoplasmic reticulum with dilated cisternae. Bundles of collagen fibrils filled the extracellular spaces. Particularly, ultrastructural features indicating active metabolism for regeneration of injured skin at 15 days after burn injury, including abundant euchromatin, plentiful free ribosomes, and numerous mitochondria, were observed. These findings suggest that use of rhGM-CSF could result in accelerated deep second-degree burn wound healing in animal models.
Purpose: Electrical burn of scalp is uncommon. Much more, chronically exposed dura in unstable burn scar is quite exceptional. Hence, we report a case of chronically exposed dura following electrical burn. Methods: A 63-year-old man presented with an about 40 years history of an ulcerative lesion arising from electrical burn scar with 'squeeze like sensation' around wound. Wound was about $6{\times}8$ cm. Area in the center was $3{\times}3$ cm nonviable dura without sequestrum. Tangential excision with an intraoperative neurosurgical consultation and transposition flap under general anesthesia was done. Intraoperative biopsy was done. The wound was diagnosed as chronic osteomyelitis, not Marjolin ulcer. Flap was taken successfully. But after 5 days, infectious discharge had been appeared during 2 weeks, despite irrigation and drainage. As flap was re-evaluated, we could see remnant necrotic dura. After that, latissimus dorsi muscle free flap with meshed split thickness skin graft was transferred without excision of necrotic dura. Results: Flap was taken successfully. Follow-up at 10 weeks has been uneventful, with good and stable coverage of the wound. Conclusion: It is true that complete excision of devitalized tissue with sagittal sinus obliteration is prerequisite to flap taken. But necrotic dura was tangentially excised instead of total dura excision, because, posterior two-thirds of the sagittal sinus was involved underneath. Muscle is rich in blood vessels and decrease the recipient-site bacterial count effectively. In this case, muscle flap with skin graft without total dura excision is an alternative treatment.
The effect of silver sulfadiazine (SSD) on the proliferation of human dermal fibroblast (HDF) was studied to determine the impact of the drug on the wound healing process and dermal mechanical strength. Human dermal fibroblasts were cultured to 80% confluency using DMEM with 10% FBS and viability of the cell was estimated using neutral red assay. In addition, the $2^{nd}$ degree burn wound was prepared on the anterior part of rabbit ear skin and dressings containing SSD were applied for 96 h. Presence of inflammatory cells and degree of re-epithelialization were investigated in the wound. After 15 day of the induction of burn wounds, the treated area was excised and dermal mechanical strength was quantitatively measured with a constant speed tensiometer. SSD was found to be highly cyto-toxic in cultured HDF cells. The topical application of SSD (2%) could control the infection as evidenced by the lack of accumulation of inflammatory cells in histological evaluation. Therefore, these observations suggested that the impairment of dermal regeneration and decreased mechanical strength of dermal tissue was resulted from the cyto-toxic effect of SSD on dermal cells. Since the decreased mechanical strength may lead to reduction in resilience, toughness and maximum extension of the tissue, the identification of optimum dose for SSD that limits infection while minimizes the cyto-toxic effect may be clinically relevant.
Kim, Hoon;Kim, Hong-Bee;Seo, Jae-Hwi;Lee, Dong Cho;Cho, Kyong Jin
Medical Lasers
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v.10
no.1
/
pp.22-30
/
2021
Background and Objectives Ocular alkali burns cause severe damage to the ocular tissues and vision loss. Solcoseryl is a standardized calf blood extract that normalizes the metabolic disturbance and aids in maintaining the chemical and hormonal balance and has been used to treat burns in various tissues. This study examined the effects of Solcoseryl on a rat corneal alkali burn model. Materials and Methods Twenty rats were assigned randomly to four equal groups, including alkali burn, hyaluronic acid, Solcoseryl eyedrop, and Solcoseryl gel. A corneal alkali burn was induced by a NaOH-soaked paper disc. The treatments were given twice a day, every day. The wound area was measured after 24 and 48 hours, and the degree of neovascularization and corneal opacity were scored every week. The rats were sacrificed after three weeks for immunohistochemistry (IHC) to compare the level of inflammatory cytokines, IL-1β, IL-6, and TNF-α. The thickness of the retinal layers was compared to observe any changes in the retina. Results The use of Solcoseryl on corneal alkali burn accelerated wound healing with less neovascularization, greater opacity, and less cataract. IHC showed that the inflammation of the cornea was controlled by both the hyaluronic acid and Solcoseryl treatments. On the other hand, the inflammation had spread to the retina. When the dosage forms were compared, eyedrops were more effective on corneal inflammation, while the gel-type had a greater effect on retinal inflammation. Conclusion Solcoseryl was effective in accelerating the wound healing rate on a corneal alkali burn but could not prevent the spread of inflammation from the cornea to the retina. Eyedrops were more effective on inflammation in the cornea, and the gel was more effective in the retina.
Hong, Seok Won;Choi, Hwan Jun;Kim, Jun Hyuk;Lee, Da Woon
Journal of the Korean Burn Society
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v.22
no.2
/
pp.21-24
/
2019
Incidence of low-temperature contact burn by use of an electric pad is increased recently, especially in depressed sensory. Acquired immune deficiency syndrome patient using antiretroviral agent suffered with sensory depression as side effect. There are many limitations in wounds treatment of these patients. These patients are vulnerable to infection due to their weak immunity, so it is necessary to keep them in a state of isolation when a wound occurs. We report a case of a third degree burn by electric pad with a surface area of approximately 5% of the body surface of a patient who underwent a sensory depression, which is a side effect of antiretroviral drugs used for treatment in patients with AIDS. In this regard, we report the case with literature review, which is safely recovered using negative-pressure wound therapy and split-thickness skin graft.
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