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Background@#Semi-rigid neck collars to protect the cervical spine can limit the extent of neck movement and mouth opening; this may further complicate orotracheal intubation. We aimed to compare intubation environments obtained with videolaryngoscopy using the technique of gliding a blade under the epiglottis and that obtained using the conventional Macintosh blade technique of blade tip placement on the vallecula. @*Methods@#This prospective randomized study included patients aged ≥ 20 years with American Society of Anesthesiologists physical status I–III scheduled for cervical spine surgery between October 2020 and August 2021. Patients were divided into two groups according to the placement of the blade of the McGrathTM videolaryngoscope: the gliding and conventional groups. The percentage of glottic opening (POGO) score was the primary endpoint. We also recorded the time to obtain the optimal laryngoscopic view, intubation duration, and ease and satisfaction of the researcher performing intubation. @*Results@#Among 176 patients, the POGO scores were significantly higher in the gliding group than in the conventional group (88.9 ± 14.7 vs. 63.8 ± 27.4, P < 0.001). The time to achieve the optimal glottic view for intubation and duration of intubation were also shorter, and ease and satisfaction in performing intubation were better in the gliding group than in the conventional group. @*Conclusion@#Our findings demonstrated a superior glottic view and more favorable intubation environments when the blade tip was placed under the epiglottis than using the conventional Macintosh technique in patients with immobilized cervical spine.
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As a result of comparing the phenolic components of cinnamon medicines, the total phenolic component content of Cinnamomi Cortex in China was about 2.65 times higher than that of Cinnamomi Cortex in Vietnam. In addition, the total phenolic component content of Vietnamese Cinnamomi Cortex Spissus was about 1.80 times higher than that of Chinese Cinnamomi Cortex Spissus. Meanwhile, Vietnamese Cinnamomi Ramulus showed a content about 3.29 times higher than that of Chinese Cinnamomi Ramulus. Cinnamaldehyde, the main component of cinnamon medicines, showed the same tendency as the total phenolic component content. In terms of the average content of the total phenolic components, Cinnamomi Cortex showed the highest content at 23964 μg/g, followed by Cinnamomi Cortex Spissus at 17489 μg/g and Cinnamomi Ramulus at 5435.8 μg/g. These results showed that Cinnamomi Cortex and Cinnamomi Cortex Spissus with stem bark as usage sites had about 3.22 to 4.41 times higher content of phenolic components than Cinnamomi Ramulus with young branches as usage sites.
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The purpose of this study is to develop a new method of producing tienchi seng (notoginseng, Panax notoginseng) extracts featuring high concentrations of the ginsenoside Rg3, Rg5, and Rg6, special components of Korean red ginseng. The chemical transformation from ginseng saponin glycosides to prosapogenin was analyzed by HPLC. Tienchi seng was heat-processed at 100 o C and the optimum conditions were identified. The highest concentrations of total saponin (29.723%) and the ginsenoside Rg3 (1.769%), Rg5 (5.979%), and Rg6 (13.473%) were produced at 48 hours. Also, when tienchi seng was subjected to the ultrasonic thermal fusion (100 o C) process, the concentrations of total saponin (30.578%), ginsenoside Rg3 (2.392%), Rg5 (6.614%), and Rg6 (13.017%) were highest at 36 hours. On the other hand, the 2-hour heat-processed extract and 2-hour ultrasonic thermal fusion-processed extract did not contain ginsenoside Rg3, Rg5, and Rg6. The ultrasonic thermal fusion process had an extraction yield that was approximately 1.26 times greater than that of the heat process. These results indicate that the highly functional tienchi seng extracts created through the ultrasonic thermal fusion process are more industrially useful than those produced using the heat process.
ABSTRACT
The purpose of this study is to develop a new method of producing tienchi seng (notoginseng, Panax notoginseng) extracts featuring high concentrations of the ginsenoside Rg3, Rg5, and Rg6, special components of Korean red ginseng. The chemical transformation from ginseng saponin glycosides to prosapogenin was analyzed by HPLC. Tienchi seng was heat-processed at 100 o C and the optimum conditions were identified. The highest concentrations of total saponin (29.723%) and the ginsenoside Rg3 (1.769%), Rg5 (5.979%), and Rg6 (13.473%) were produced at 48 hours. Also, when tienchi seng was subjected to the ultrasonic thermal fusion (100 o C) process, the concentrations of total saponin (30.578%), ginsenoside Rg3 (2.392%), Rg5 (6.614%), and Rg6 (13.017%) were highest at 36 hours. On the other hand, the 2-hour heat-processed extract and 2-hour ultrasonic thermal fusion-processed extract did not contain ginsenoside Rg3, Rg5, and Rg6. The ultrasonic thermal fusion process had an extraction yield that was approximately 1.26 times greater than that of the heat process. These results indicate that the highly functional tienchi seng extracts created through the ultrasonic thermal fusion process are more industrially useful than those produced using the heat process.
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BACKGROUND: Telogen effluvium (TE) is characterized by massive hair shedding and results from an abrupt conversion of anagen to telogen. Differentiation of TE with other hair disorders showing massive hair shedding is difficult.OBJECTIVE: To evaluate the morphologic characteristics of pulled out hair of TE.METHODS: We analyzed microscopic examination of pulled out hairs by hair pull test in TE patients, and compared these hairs with pulled out hairs in diffuse alopecia areata (AA) patients and healthy volunteers.RESULTS: Hair microscopic examination in 44 TE patients (370 hairs) and 30 healthy volunteers (295 hairs) were as follows: typical club hair, 32.7%, 62.7%; club hair with tail, 23.5%, 23.7%; club hair with remnant sheath, 23.0%, 6.8%; club hair with both tail and remnant sheath, 18.9%, 5.4%; and unclassified hair, 1.9%, 1.4%. The examination in 7 diffuse AA patients (63 hairs) was as follows: typical club hair, 23.9%; atypical club hair, 47.7%; and distinctive AA hair, 28.4%. There was statistical difference between TE patients and healthy volunteers group (p=0.000).CONCLUSION: Increased atypical club hair in microscopic hair examination might be characteristics of TE.
Subject(s)
Humans , Alopecia , Alopecia Areata , Hair , Healthy Volunteers , TailABSTRACT
Erlotinib inhibits the epidermal growth factor receptor and is used in patients with various cancers. However, it can affect the epidermis and hair because the receptor is expressed in normal skin cells. A 54-year-old woman with metastatic non-small-cell lung cancer presented with erythematous patches over her entire body and severe hair shedding 2 weeks after starting erlotinib. Histopathological examinations showed lymphocytic exocytosis; perivascular infiltration of lymphohistiocytes and eosinophils in the right arm; and marked infiltration of eosinophils, neutrophils, and lymphohistiocytes in the scalp. Erlotinib discontinuation improved hair loss and skin lesions. Hair loss has been reported in 5% of patients taking erlotinib. Our case was unusual in that there was complete baldness, and to our knowledge, no report of complete hair loss and exanthematous drug eruption after erlotinib treatment has been previously reported. Here, we report a case of severe hair loss with concurrent exanthematous drug eruption that may have been linked to erlotinib hypersensitivity.
Subject(s)
Female , Humans , Middle Aged , Alopecia , Arm , Drug Eruptions , Eosinophils , Epidermis , Erlotinib Hydrochloride , Exocytosis , Hair , Hypersensitivity , Lung Neoplasms , Neutrophils , ErbB Receptors , Scalp , SkinABSTRACT
A 72-year-old woman presented with recurrent painful erythematous nodules and ulcers on both legs. Latent tuberculosis was proven by a positive interferon-gamma release assay, and a histopathology examination revealed septolobular panniculitis with vasculitis. The initial diagnosis was erythema induratum associated with tuberculosis, but the leg ulcers became worse despite anti-tuberculosis medication and wound dressing. Computed tomography angiography showed occlusion of the superficial femoral and popliteal arteries bilaterally, supporting that the vascular event contributes to the ulcers according to the vascular territories. Under the diagnosis of peripheral arterial occlusive disease, she was treated with percutaneous transluminal angioplasty and antiplatelet medication. The skin ulcers were resolved. Elderly patients with erythema induratum have a risk of coincidental peripheral arterial occlusive disease, therefore dermatologists should be aware of the possibility of underlying vascular disease, so even minor trauma like skin biopsy can evoke serious condition shown in this patient. Here, we report a case of drastically aggravated erythema induratum due to co-existing peripheral arterial occlusive disease, which resolved with vascular intervention after not responding to antituberculosis medication.
Subject(s)
Aged , Female , Humans , Angiography , Angioplasty , Arterial Occlusive Diseases , Bandages , Biopsy , Diagnosis , Erythema Induratum , Erythema , Interferon-gamma Release Tests , Latent Tuberculosis , Leg , Leg Ulcer , Panniculitis , Popliteal Artery , Skin , Skin Ulcer , Tuberculosis , Ulcer , Vascular Diseases , Vasculitis , Wounds and InjuriesABSTRACT
BACKGROUND: There is growing interest in alopecia among the general population. Many people obtain information from easily accessible media rather than from doctors; thus, the media can play an important role in shaping public opinion. OBJECTIVE: The goal of this study was to evaluate the content and reliability of newspaper articles on alopecia. METHODS: Newspapers were categorized into three groups: one group of print newspapers and two groups of online newspapers. Online newspapers were further divided into two groups according to type of publishing company; one publishes both print and online newspapers and the other publishes online newspapers only. The most frequently subscribed or circulated newspaper in each group was selected. Articles containing information on alopecia were selected from 3 years of each newspaper and evaluated for reliability. RESULTS: Most articles in each group used the general term “alopecia” instead of naming a specific hair loss disease. The majority of articles were based on consultation with experts. Assessment of the accuracy of articles with three grade scales showed that the percentage with high accuracy was 38.9%, 47.2%, and 23.3%. Assessment of reliability scores for five selected articles in each group showed that there were statistically significant differences between common readers and dermatologists (p < 0.05). CONCLUSION: The results of this study suggest that closer monitoring of the media is required to supply easily accessible, balanced, and trustworthy information regarding alopecia.
Subject(s)
Alopecia , Hair , Periodical , Public Opinion , Weights and MeasuresABSTRACT
An 18-year-old male visited our department complaining of recurrent episodes of an itchy rash after hand washing, showering/bathing, drinking water, and getting rain-soaked. He was diagnosed with aquagenic urticaria after a water provocation test and histopathologic examination. Five months of antihistamine treatment successfully prevented further wheal formation. Aquagenic urticaria is a very unusual form of physical urticaria caused by contact with water. It manifests as pruritic small wheals surrounded by erythema within 30 minutes of exposure. The condition can be diagnosed by a water provocation test. Systemic antihistamines are the first-line treatment, with anticholinergics, phototherapy, or barrier cream used alternatively or additionally. Four cases of aquagenic urticaria have been reported in Korea, but no histopathologic evaluation was reported in the English or Korean literature. Herein, we provide both a case report of aquagenic urticaria diagnosed by the water provocation test and histopathologic examination results for this patient.
Subject(s)
Adolescent , Humans , Male , Cholinergic Antagonists , Drinking Water , Erythema , Exanthema , Hand Disinfection , Histamine Antagonists , Korea , Phototherapy , Urticaria , WaterABSTRACT
BACKGROUND: A number of anticancer agents are known to induce many adverse reactions in the skin. Related cutaneous adverse drug reactions influence the morbidity, mortality, and anti-cancer regimen of the patients. A multidisciplinary approach to cancer management has been emphasized. OBJECTIVE: To identify the causative anticancer agents and frequency of adverse reactions in the skin. METHODS: We retrospectively reviewed the medical records of patients who consulted at the Dermatology Department of Busan Paik Hospital and Haeundae Paik Hospital from January 2013 to February 2015. RESULTS: A total of 140 patients were enrolled. Among the 45 patients treated with antimetabolite analogs (30 cytarabine, 7 gemcitabine, 3 methotrexate, 2 fludarabine, 2 doxifluridine, and 1 decitabine), exanthematous drug eruption (49.1%) was the most common reaction, followed by hand-foot syndrome (28.3%). Among the 35 patients treated with fluorouracil (22 5-fluorouracil and 13 capecitabine), hand-foot syndrome (47.2%) was the most common, followed by acneiform eruption (25.0%). Among the 24 patients treated with epidermal grow factor receptor inhibitors (10 erlotinib, 10 cetuximab, and 4 gefitinib), acneiform eruption (54.8%) was the most common, followed by xerosis (19.4%). Among the 11 patients treated with anthracyclines (9 doxorubicin, 1 daunorubicin, and 1 idarubicin), acneiform eruption (45.5%) was the most common, followed by hand-foot syndrome (36.4%). Among the 7 patients treated with taxanes (4 docetaxel and 3 paclitaxel), hand-foot syndrome (42.8%) was the most common. Among the 6 patients treated with angiogenesis-inducing inhibitors (3 sorafenib, 2 pazopanib, and 1 sunitinib), hand-foot skin reaction (66.7%) was the most common. Only 2 patients (1.4%) changed treatments due to intolerable skin reactions. CONCLUSION: Clinicians should be aware of the various skin reactions of anticancer agents and predict their clinical course effectively.
Subject(s)
Humans , Acneiform Eruptions , Anthracyclines , Antineoplastic Agents , Cetuximab , Cytarabine , Daunorubicin , Dermatology , Doxorubicin , Drug Eruptions , Drug-Related Side Effects and Adverse Reactions , Erlotinib Hydrochloride , Fluorouracil , Hand-Foot Syndrome , Medical Records , Methotrexate , Mortality , Retrospective Studies , Skin , TaxoidsABSTRACT
BACKGROUND: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. METHODS: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: ‘Complete’, when twitching was observed at all needles; ‘Partial’, when twitching was present at 1 or 2 needles; and ‘None’, when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. RESULTS: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). CONCLUSIONS: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.
Subject(s)
Humans , Ablation Techniques , Catheter Ablation , Fasciculation , Low Back Pain , Needles , Prognosis , Zygapophyseal JointABSTRACT
A 71-year-old female presented with erythematous ulcerative patches on her right cheek, chest and right upper arm. She admitted to neurosurgery intensive care unit (NSICU) with mental change related to intracerebral hemorrhage. She had no underlying disease. Histopathologic examination of her right upper arm showed multiple non-septated broad hyphae with right-angled branching in dermis. She was diagnosed as primary cutaneous mucormycosis. The fungal culture demonstrated Cunninghamella species. We postulated that mucormycosis occurred after inoculation of fungi following fall down trauma. Mucormycosis, which commonly affects immunocompromised patient, is a rare fungal infection caused by the order Mucorales. Cutaneous mucormycosis is caused either by direct inoculation of fungal spores or by hematologic spread from another primary source. Clinical manifestations are various from indolent ulceration to rapidly progressive necrosis. Mucormycosis can be diagnosed based on the histologic findings and the fungal culture. Mucormycosis by Cunninghamella species have been increasingly reported, but most of them are pulmonary mucormycosis in immunocompromised patients. Herein, we report a rare case of multiple primary cutaneous mucormycosis caused by Cunninghamella species in a patient without underlying disease.