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Conditioned media from various sources comprise numerous growth factors and cytokines and are known to promote the regeneration of damaged tissues. Among these, natural killer cell conditioned medium (NK‑CdM) has been shown to stimulate collagen synthesis and the migration of fibroblasts during the wound healing process. With a long‑term aim of developing a treatment for skin photoaging, the ability of NK‑CdM to prevent ultraviolet‑B (UV‑B) damage was assessed in neonatal human dermal fibroblasts (NHDFs) and an in vitro reconstructed skin model. The factors present in NK‑CdM were profiled using an antibody array analysis. Protein and mRNA levels in UV‑B exposed NHDFs treated with NK‑CdM were measured by western blotting and quantitative reverse transcription‑PCR, respectively. The total antioxidant capacity of NK‑CdM was determined to assess its ability to suppress reactive oxygen species. The anti‑photoaging effect of NK‑CdM was also assessed in a 3D reconstituted human full skin model. NK‑CdM induced proliferation of UV‑B‑treated NHDFs, increased procollagen expression, and decreased matrix metalloproteinase (MMP)‑1 expression. NK‑CdM also exhibited a potent antioxidant activity as measured by the total antioxidant capacity. NK‑CdM inhibited UV‑B‑induced collagen degradation by inactivating MAPK signaling. NK‑CdM also elicited potential anti‑wrinkle effects by inhibiting the UV‑B‑induced increase in MMP‑1 expression levels in a 3D reconstituted human full skin model. Taken together, the suppression of both UV‑B‑induced MMP‑1 expression and JNK activation by NK‑CdM suggests NK‑CdM as a possible candidate anti‑skin aging agent.

Background context Laminoplasty aims to decompress the spinal cord and stabilize the cervical spine in patients with multilevel cervical lesions. Not every patient with cervical compressive myelopathy is a good candidate for laminoplasty. Most studies recommend that neutral or kyphotic alignments are contraindications for laminoplasty. However, cervical sagittal alignment does not have a strong and consistent effect on the clinical outcomes of laminoplasty. Moreover, many reports on the effect of cervical sagittal alignment did not designate the ideal definition of alignment and used different definitions of lordosis. Purpose To identify the effect of preoperative cervical alignment according to two different definitions after midline splitting double-door laminoplasty. Study design Retrospective cohort study. Patient sample From August 2008 to September 2010, 58 patients were diagnosed with cervical myelopathy and treated with midline splitting double-door laminoplasty. Outcome measures The clinical results were assessed with the modified Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and visual analog scale (VAS) and were compared to analyze the rate of change between preoperative and postoperative values. Postoperative radiological results at the final follow-up examinations were compared between groups to obtain the change in range of motion and sagittal alignment. Method The effect of cervical alignment on JOA, NDI, and VAS scales and also on change of alignment and change of range of motion (ROM) at the final follow-up examinations was analyzed statistically between two groups according to two different definitions such as Toyama classification and Cobb angle. Results No difference was found between the two groups according to Toyama classification in terms of the postoperative improvement rate of the modified JOA score (p=.086), decreasing rate of the VAS (p=.940) or NDI (p=.211), postoperatively. Additionally, no difference was found for the decreasing rate of ROM (p=.427) or sagittal alignment (p=.864) based on the radiological evaluation results. Also, there was no difference between two groups according to Cobb angle in terms of the modified JOA score (p=.743), VAS (p=.548), or NDI (p=.32), postoperatively. Additionally, no difference was found for the ROM (p=1.000) or sagittal alignment (p=.440) based on the radiological evaluation results. Conclusions Despite nonlordosis cervical sagittal alignment, double-door laminoplasty would be effective for patients with cervical myelopathy because of cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament. Furthermore, sagittal alignment is not the absolute and sole factor that surgeons should consider when determining the optimal treatment strategy.

Background: The natural course of sarcoidosis is variable, but no single parameter has been generally accepted as a good marker for disease activity. Adhesion molecules are required for the migration of inflammatory cells; thus, they may be markers of activity in sarcoidosis. Methods: In 16 patients with active sarcoidosis and 11 with inactive disease (10 were male, 17 were female; mean age [6 SD], 39.6 6 11.0 years; mean follow-up, 21 6 16 months), the expression of adhesion molecules on cells obtained with BAL (measured by flow cytometry) and the level of soluble intercellular adhesion molecule 1 (sICAM-1) in the serum and BAL fluid (BALF) were measured at the time of diagnosis and during the follow-up. The changes in serum sICAM-1 level and ICAM-1 expression on cells obtained with BAL were compared with the clinical course of the disease. Results: In patients with active disease, the ICAM-1 on alveolar macrophage (AM) (relative linear median fluorescence intensity [RMFI], 3.21 6 1.55) and sICAM-1 levels in serum (575 6 221 ng/mL) and BALF (47.3 6 19.3 ng/mL) were higher than those for patients with inactive disease (RMFI, 1.67 6 0.66; p 5 0.0034; serum, 263 6 98.5 ng/mL; p 5 0.0001; BALF, 27.5 6 19.0 ng/mL; p 5 0.0209). In the patients with active disease, ICAM-1 on AM and serum sICAM-1 decreased (RMFI, 1.51 6 0.84; 284 6 118 ng/mL, respectively) after steroid therapy, but no significant change was noted in patients with inactive disease. We also found that the initial ICAM-1 on AM and serum sICAM-1 had a significant correlation with the degree of improvement in pulmonary function tests after the therapy. The disease relapsed in four patients after the discontinuation of steroids, and the serum sICAM-1 level was elevated again at the time of relapse. Conclusion: Our data suggest that the serum sICAM-1 level and the ICAM-1 expression on AM may be good markers of disease activity and also a predictor of outcome in sarcoidosis. (CHEST 1999; 115:1059 ‐1065)

Cervical artificial disc replacement is increasingly becoming popular among spine surgeons. Cervical disc arthroplasty aims to afford spinal stability and then balance this with flexibility. One of the fundamental benefits from performing cervical arthroplasty instead of fusion is preservation of motion in both the functional spinal unit (FSU) and the overall cervical spine. Eventually, preservation of segmental motion is believed to prevent the development of adjacent segment degeneration. But to justify its use, disc replacement prosthesis must demonstrate actual motion in vivo and preserve range of motion (ROM) after surgery as long as it allows. Without preservation of motion, disc prosthesis becomes just a functional arthrodesis equivalent.The purpose of this study was to analyze the possible factors affecting cervical spine ROM after single-level cervical disc arthroplasty.This is a retrospective radiological study of patients with symptomatic single-level cervical disc disorder who received the cervical disc prosthesis (Bryan Cervical Disc Prosthesis; Medtronic Sofamor Danek, Memphis, TN, USA).Procedure was performed in 39 patients.The outcome measures were statistical correlation of possible factors and ROM.We investigated possible factors that could affect cervical ROM after surgical intervention using cervical disc replacement. For this, we focused on two main components, namely, patient factors and technical factors. First, we examined patient factors, such as age, sex, preoperative FSU ROM, and preoperative overall cervical spine (whole cervical spine) ROM. Second, we then investigated technical factors, such as the amount of bone resection, disc insertion angle, and disc insertion depth. Then, our study searched if there was any statistical correlation between these factors and the postoperative cervical ROM.Significant correlation was found between the postoperative overall cervical spine ROM and preoperative overall cervical spine ROM (p.0001, R(2)=0.9062). Postoperative FSU ROM is closely correlated to both the preoperative FSU ROM (p.0001) and the disc insertion angle (p=.0097). However, no significant correlation was noted between age, sex, disc insertion angle, and disc insertion depth.Significant correlation was found between the postoperative overall cervical spine ROM and preoperative overall cervical spine ROM. Postoperative FSU ROM is closely correlated to both the preoperative FSU ROM and the disc insertion angle. Careful preoperative evaluation of the patient's radiographs and meticulous surgical technique during the surgical procedure could aid in achieving the goals and benefits of cervical disc arthroplasty.

The virus neutralizing efficacy of HB-C7A, a human monoclonal antibody raised against the surface antigen of hepatitis B virus (HBsAg), was proved using hepatitis B virus (HBV)-naive chimpanzees. One control chimpanzee which received 100CID(50) of HBV, subtype adw, without HB-C7A antibody became infected by HBV as evidenced by the appearance of HBV DNA on week 10 and subsequent appearance of HBsAg, anti-HBc and anti-HBs in the serum. Two experimental chimpanzees were inoculated intravenously with same dose of HBV as the control chimpanzee, which was previously incubated with 0.1mg and 10mg of HB-C7A antibody prior to inoculation. HBV infection was not observed in the antibody-treated chimpanzees during 12 months of follow-up, exhibiting neither detectable HBsAg nor anti-HBc antibody. This work demonstrates the neutralization of HBV by HB-C7A monoclonal antibody and shows the possibility of prevention of HBV infection using this antibody in liver transplantation and exposure to HBV.

Purpose: Beroctocog alfa is a second generation recombinant factor VIII manufactured by removing the B-domain from factor VIII. This prospective clinical trial was conducted to evaluate the efficacy, safety, and pharmacokinetics of beroctocog alfa in patients of ages ≥12 years previously treated for severe hemophilia A. Materials and Methods: Seventy subjects received beroctocog alfa as an on-demand treatment for acute hemorrhage. Results: The final hemostatic effect was excellent in 35 subjects (50%) and good in 26 subjects (37.1%). The drug showed an overall efficacy rate of 87.1%. The majority of acute hemorrhages was treated by administer ing the study drug once (86.2%) or twice (10.0%), and the mean dose administered per single infusion was 28.55±6.53 IU/kg. Ten subjects underwent 12 surgical procedures, and hemostatic efficacy was excellent in seven cases (58.3%) and good in five cases (41.7%), showing a 100% efficacy rate. A total of 52 of 88 subjects (59.0%) experienced 168 adverse events. There were 18 serious adverse events (10.7%) in 11 subjects, and two (mild dyspnea and facial edema) in one subject were related to the study drug. Only one subject formed a de novo factor VIII inhibitor, for an occurrence rate of 1.4% (one-sided 95% upper confidence limit: 3.85%). The final elimi nation half-life was 13.3 h and 12.6 h at baseline and 6 months after administration, respectively. Conclusion: Our results suggest that beroctocog alfa is safe and effi cacious as either an on-demand treatment for acute hemorrhage or a surgical prophylaxis in patients with hemophilia A.

We describe a case of 43-year-old man who had a pseudoaneurysm of the medial superior genicular artery after arthroscopic partial meniscectomy with standard anterolateral and anteromedial portals. Pseudoaneurysm of the medial superior genicular artery has been reported at the previous superomedial portal site after arthroscopy. Described herein is a unique case that involved the medial superior genicular artery at the previous anteromedial portal site after arthroscopy. The pseudoaneurysm was successfully treated with transcatheter embolization.