Effect of Prefrontal Repetitive Transcranial Magnetic Stimulationon the Enhancement of Working Memory

OBJECTIVE: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) applied over the left prefrontal cortex on the enhancement of verbal working memory in healthy persons. METHOD: High frequency (10 Hz) rTMS was applied over the left prefrontal cortex with the intensity of 100% resting motor threshold (RMT). A 3-back verbal working memory task was administered before, during (after applying 500 and 1,000 pulses, respectively), and 30 minutes after real or sham rTMS. RESULTS: Real rTMS, compared with sham stimulation, significantly improved working memory performance. Accuracy of response increased significantly after applying 1,000 pulses of real rTMS (p<0.05). This effect maintained for 30 minutes after completion of stimulation (p<0.05). The error rate and reaction time did not change with rTMS. There was no noticeable side effect during or after rTMS. CONCLUSION: 1,000 pulses of 10 Hz rTMS administered to the left prefrontal cortex with the intensity of 100% RMT have positive impact on verbal working memory in healthy persons. Further study is necessary to address this effect of rTMS in patients with cognitive dysfunction.

The Skin Irritations of Corrosive and Non-corrosive Irritants in Patients with Sensitive Skin / 대한피부과학회지

BACKGROUND: Sensitive skin is largely agreed to be a lay term used by individuals who have reduced tolerance to frequent or prolonged use of cosmetics and toiletries, with symptoms ranging from subjective neurosensory forms of discomfort such as stinging, burning, itching, tightness and smarting sensations to visible signs of irritation such as erythema and scaling. Although the concept of sensitive skin is intriguing to many dermatologists, the diagnosis is dependant on self-perceived symptoms. Models to define sensitive skin are not standardized, and the term sensitive skin can be misleading. OBJECTIVE: The purpose of this study was to evaluate difference of influence to skin barrier function between corrosive and non-corrosive agents in sensitive skin. METHODS: 0.1%, 0.25%, 0.5%, 2% solution of sodium lauryl sulfate (SLS) and 1%, 2.5%, 5%, 20% solution of nonanoic acid (NAA) were applied on volar forearm skin for 24 hours in healthy controls and self-perceived sensitive skin subjects without underlying problems. Clinical score, transepidermal water loss (TEWL), and erythema-index (E-index) were compared between healthy controls and the sensitive skin group. RESULTS: Clinical scores, TEWL values and E-indices showed a rising curve concentration for each irritant in a similar pattern. There were no significant differences in clinical score and TEWL value between non-sensitive and sensitive skin. In contrast, E-indices evaluated from sensitive skin subjects were much higher than those in a healthy controls. CONCLUSION: An elevated TEWL value indicates barrier impairment. An increase in the erythema parameter shows that cutaneous vascular reactions have an unspecifically exaggerated reaction to various irritants and this induces multifarious inflammatory reactions and vasodilation. Therefore, the results of this study suggest that sensitive skin without underlying disease is derived from cutaneous vascular hyperreactivity and various inflammatory reactions, rather than barrier impairment.

A Case of Oral Allergy Syndrome to Perilla Seeds / 대한피부과학회지

Oral allergy syndrome (OAS), an immediate swelling and itching sensation of the mouth and throat after ingestion of a food allergen, is the most common food allergy-related manifestation. It can be present either in isolation or in association to systemic symptoms, and may even result in anaphylaxis. We report a case of a 5-year-old child who suffered from an oral allergy syndrome after eating perilla seeds. We obtained a positive open oral challenge with crude perilla seeds.

Squamous Cell Carcinoma in situ on the Penis Successfully Treated with 5% Imiquimod Cream / 대한피부과학회지

Squamous cell carcinoma in situ on the penis has been reported to have variable success and morbidity. A 71-year-old male patient with the condition was successfully treated with a topical application of 5% imiquimod cream, three times a week for 4 weeks. A biopsy specimen was obtained to confirm tumor clearance. There was no clinical evidence of any residual tumor 3 months after the therapy was completed. There was also no evidence of scarring, deformity or systemic side effects.

A Case of Chronic Eczema Improved by a Nickel Restricted Diet in a Nickel Sensitive Patient / 대한피부과학회지

Most nickel-sensitive patients often experience aggravation of skin lesions after direct contact with nickel which is released from a variable of objects. In some patients, it is difficult to ascertain the source of exposure and alleviate symptoms, even though they avoid contact with nickel-containing objects. This suggests the possibility of an endogenous cause of nickel-induced dermatitis. Here in, we report the successful therapeutic use of a nickel-restricted diet for a nickel-sensitive patient with chronic eczema. A 39-year-old female patient was diagnosed as having endogenous nickel-induced dermatitis on the basis of personal history, physical examination and a nickel oral challenge test. Her skin lesions cleared up after follwing a nickel-restricted diet for 8 weeks.

A Case of Perforating Lichen Nitidus / 대한피부과학회지

Lichen nitidus is an uncommon, asymptomatic cutaneous eruption. There are many reports of variable subtype of lichen nitidus including of spinous, follicular, vesicular, hemorrhagic, actinic, purpuric, and perforating lichen nitidus. We report a 7-year-old boy who presented with multiple generalized papular eruption that was composed of discrete, flesh colored, 1-2mm sized, glistening, and round shaped papules. The histopathology of the biopsied specimen showed a well-circumscribed dermal infiltrate mainly composed of histiocytes. The overlying epidermis showed atrophy, thinning of granular layer and liquifaction degeneration of basal layer. Transepidermal perforation was observed and eosinophilic amorphous debris was in the channel of the perforation.

A Case of Recalcitrant Atopic Dermatitis Treated with Dapsone / 대한피부과학회지

No abstract available.

Ventilation Impairment During Anesthesia in Patients with Anterior Mediastinal Mass / 영남의대학술지

Because of location, a mediastinal mass may cause complications such as a major airway obstruction, a superior vena caval obstruction, and cardiac compression during general anesthesia. The patient's condition need to be assessed by several methods to predict the risks associated with general anesthesia. The authors took computed tomographs for a preoperative evaluation of two patients with an anterior mediastinal mass, and the risk of perioperative complications was predicted by measuring the tracheal area. The patients were managed according to the preoperative evaluation but severe ventilation impairments were encountered during anesthesia. In one patient, stable ventilation could not be maintained until spontaneous breathing appeared. The operation was cancelled and the patient was brought into the ICU. In the other patient, a tracheal tube was inserted deeper in an attempt to pass the narrowed tracheal portion due to mediastinal tumor compression resulting in improved ventilation

A Case of Kaposi's Sarcoma Treated with Paclitaxel / 대한피부과학회지

Kaposi's sarcoma (KS) is an angioproliferative disease of the skin and viscera, with the multifactorial origin arising in different clinic-epidemiologic forms. We report a case of a patient with generalized cutaneous and visceral KS, which was successfully treated with paclitaxel. A 78-year-old woman presented with a 2-month history of multiple purpuric nodules and plaques of Kaposi's sarcoma on the face, trunk, and lower extremities. She had not acquired an immunodeficiency syndrome or undergone organ transplantation, but had suffered with osteoarthritis and had taken unknown medication the year prior to presentation. Oral analgesics had also been used as required. Biopsies of both skin and stomach mucosal lesion confirmed KS. The patient was treated with bi-weekly doses of paclitaxel for 5 months. 6 months after the treatment course, histopathological findings on the resolving lesion showed no evidence of Kaposi's sarcoma.

A Study of Nickel Content in Korean Foods / 대한피부과학회지

BACKGROUND: Nickel-sensitive patients may suffer from persistent dermatitis even if they avoid cutaneous contact with nickel-plated items. Therefore, an endogenous cause of nickel-induced dermatitis has been suggested. In Western countries, many studies suggested that reduction of dietary intake of nickel might benefit nickel-sensitive patients. OBJECT: We measured the nickel content of Korean foods, since a nickel-restricted diet is essential for nickel-sensitive patients. METHOD: We ground the food, then nitric acid, sulphuric acid, and fluoric acid were added to the ground foods to dissolve organic matter. We then measured nickel content in these samples using Inductive Coupled Plasma-Mass Spectrometry. RESULTS: A green tea bag contained 235.57mg Ni/kg, a black tea bag 62.79mg Ni/kg, chocolate 27.87mg Ni/kg, crisps 12.70mg Ni/kg, wheat flour 12.15mg Ni/kg, Welsh onion 0.026mg Ni/kg, garlic 0.016mg Ni/kg, milk 0.004 mg Ni/kg, egg 0.002mg Ni/kg, and salt 0.0mg Ni/kg. CONCLUSION: High nickel concentrations were found in green tea bag, chocolate, crisps, wheat flour, coffee bean, peanuts, and kimchi etc. On the other hand, rice, barley and spice had low content of nickel. Formulation of nickel-restricted diet using these results is expected to be helpful in the treatment of nickel-sensitive patients.

Anesthetic Management of a Patient with Lowe Syndrome: A case report / 대한마취과학회지

Lowe syndrome is a rare X-linked recessive multisystem disorder affecting the eyes, central nervous system, and kidney. The clinical features include congenital cataract, growth and mental retardation, areflexia, hypotonia, and renal tubular dysfunction (Fanconi's syndrome). The chronic metabolic acidosis may be the most important component affecting anesthetic management. Also, problems such as electrolyte imbalance, hypotonia, seizure, and increase of intraocular pressure should be considered during the perioperative period. We report the experience of anesthetic management for removal of corneal keloid in a patient with Lowe syndrome.

Anesthetic Management of a Patient with Lowe Syndrome: A case report / 대한마취과학회지

Lowe syndrome is a rare X-linked recessive multisystem disorder affecting the eyes, central nervous system, and kidney. The clinical features include congenital cataract, growth and mental retardation, areflexia, hypotonia, and renal tubular dysfunction (Fanconi's syndrome). The chronic metabolic acidosis may be the most important component affecting anesthetic management. Also, problems such as electrolyte imbalance, hypotonia, seizure, and increase of intraocular pressure should be considered during the perioperative period. We report the experience of anesthetic management for removal of corneal keloid in a patient with Lowe syndrome.

A Case of Cutaneous Infection with Mycobacterium Chelonae / 대한피부과학회지

Mycobacterium chelonae is a rapidly growing atypical mycobacteria that can cause both systemic and cutaneous infections as a human pathogen. This saprophyte is ubiquitous in the environment and has been found in water, soil, and dust particles. Clarithromycin is a highly specific drug against M. chelonae. A 53-year-old man had a nodule on the dorsum of his right hand that had developed in 3~4 months. The lesion was a slightly tender 2.0x1.5cm erythematous nodule and had an overlying ruptured pustule. Culture demonstrated atypical mycobacterim, with a polymerase chain reaction (PCR) which confirmed M. chelonae.

A Study of the Effect of Tacrolimus Ointment on the Staphylococcal Colonization in Atopic Dermatitis Patients / 대한피부과학회지

BACKGROUND: It is well known that topical tacrolimus is safe and effective on the treatment of atopic dermatitis (AD) patients. Tacrolimus is a primarily immunosuppressive agent without antistaphylococcal effect. Thus the colonization of staphylococcus aureus (S. aureus), on the skin of patients treated with this agent, might be increased. OBJECT: The purpose of this study is to know the effect of tacrolimus on S. aureus colonization of patients with AD and to compare the result with clinical severity and skin barrier function. METHOD: We enrolled 65 patients with moderate to severe AD. They were treated with 0.03% tacrolimus ointment twice daily for 4 weeks. Clinical severity was assessed by the eczema area and severity index (EASI). S. aureus colonization was measured by tape method. Skin barrier function was checked by measuring the transepidermal water loss (TEWL). Evaluations were performed at week 0 (baseline), 1st, 2nd and 4th. The results were compared and the statistical analysis was performed. RESULTS: S. aureus colonization was significantly decreased with tacrolimus treatment at week 1st as compared with baseline. But there were no differences among week 1st, 2nd and 4th. EASI and TEWL showed a decreasing tendency in a time dependent fashion. The correlations between each data were variable. CONCLUSION: Topical application of tacrolimus ointment reduce the colonization of S. aureus on the skin of patients with AD. Moreover, the severity of AD and skin barrier function were improved with treatment. However it is not sure the effect of tacrolimus as a long-term maintenance therapy based on this data, because this is a short term study. In future assessment of topical agents and S. aureus colonization, it will be important to make a study by the comparative method and for a long term period.

Heparin Anticoagulation and Natural Reversal in a Patient with Anaphylactoid Shock to Protamine: A case report / 대한마취과학회지

Protamine is the only agent approved to reverse heparin induced anticoagulation after cardiopulmonary bypass, although it may cause systemic hypotension, anaphylaxis or an anaphylactoid reaction, or pulmonary hypertension. However, there are no clinically available alternatives to protamine to neutralize systemic heparin in patients who are known to be allergic to protamine. We anesthetized a patient for mitral valve replacement who had previously an anaphylactoid shock to protamine. Because of the risk of an anaphylactoid shock, we allowed spontaneous reversal of heparin anticoagulation without the use of protamine after cardiopulmonary bypass and achieved a successful result. If a severe adverse reaction to protamine is suspected, it might be appropriate to allow the spontaneous reversal of heparin despite a greater risk of bleeding.

Phototherapy of Acne Vulgaris with Low Level Narrow Band Red Light (680 nm) / 대한피부과학회지

BACKGROUND: It has been reported that the phototherapy with blue light (415 nm) or a mixed blue and red light (415 nm and 660 nm) is effective in the treatment of acne vulgaris. however, the effects of red light on acne vulgaris have not been investigated. OBJECT: To examine the effects of red light (680 nm) on patients with moderate acne vulgaris. METHODS: Patients treated their skin by themselves, using portable light source (680 nm), and irradiation was performed for 7 minute twice daily. Each patient was evaluated every 2 weeks with Burton scale and the numbers of papules and pustules. After 6 weeks, the degrees of satisfaction of patients and physicians were assessed. RESULT: Therapy with red light significantly decreased the numbers of papules and pustules (p<0.01). The numbers of satisfied patients and physicians at the end of treatment were 59 (83.1%) and 56 (78.9%) respectively. Side effect was not reported, except only one patient complained of headache. CONCLUSION: Phototherapy with red light (680 nm) was effective and safe treatment for patients with acne vulgaris.

A Case of Allergic Contact Dermatitis Due to Topical Minoxidil / 대한피부과학회지

Minoxidil (2, 6-diamino-4-piperidinopyrimidine 1-oxide) is a systemic antihypertensive agent, the topical application of which has been shown to produce hair growth. Topical minoxidil solution (5% minoxidil, propylene glycol, alcohol, water) has generally been well-tolerated, but allergic contact dermatitis has been reported. When allergic contact dermatitis to minoxidil solution is suspected, evaluation of ingredients of minoxidil solution should be performed because allergic contact dermatitis due to propylene glycol in minoxidil solution has been frequently reported. A 34-year-old male presents with a diffuse erythematous patch on the scalp. He has applied minoxidil solution for 7 days due to androgenic alopecia. A Patch test with Korean standard series and the ingredients of used topical agents showed positive reactions to 1%, 2% and 5% minoxidil solution.