ABSTRACT
BACKGROUND: Rosacea is a chronic inflammatory disease characterized by centrofacial erythema. Excess cathelicidin is suggested to be important to the pathophysiology of the disease. Recently, presence of a vitamin D response element was revealed in the cathelicidin gene promoter. OBJECTIVE: The aim of this study was to determine whether vitamin D and cathelicidin are associated with rosacea, both serologically and histopathologically. METHODS: Subjects with rosacea and without chronic skin disorders were enrolled in the patient and control groups, respectively. Serum 25-hydroxy-vitamin D and cathelicidin levels were measured. Tissue expression of cathelicidin and vitamin D receptor were measured with immunostaining-intensity-distribution index. RESULTS: The mean serum 25-hydroxyvitamin D level of patients with rosacea was 12.18±5.65 ng/ml, which is lower than that of the controls (17.41±6.75 ng/ml). Mean serum cathelicidin levels in patients with rosacea and the controls were 85.0±26.1 ng/ml and 55.0±23.3 ng/ml, respectively. Cathelicidin expression in rosacea tissue was significantly higher than that in control tissue (5.21 vs. 4.03). No significant difference was observed in vitamin D receptor expression. CONCLUSION: Higher cathelicidin expression in rosacea supports the hypothesis that an abnormal inflammatory response of the innate immune system is important in pathogenesis of rosacea, but the role of high cathelicidin serum levels is complicated. Serum vitamin D was lower in patients with rosacea, although serum cathelicidin was higher than that of the controls. This suggests that the role of vitamin D level in the pathogenesis of rosacea merits further investigation.
Subject(s)
Humans , Erythema , Immune System , Receptors, Calcitriol , Rosacea , Skin , Vitamin D Response Element , Vitamin D , VitaminsABSTRACT
BACKGROUND: Liposuction and laser ablation for treatment of osmidrosis are leading treatment methods for osmidrosis and have less complication compare to conventional surgical method. We treated patients with the two methods simultaneously to maximize the efficiency for less complication. METHODS: Eighteen patients with axillary osmidrosis (total 36 axillae) were included in this study. They had been treated by liposuction with diode laser ablation from December 2011 to August 2012. The results of operation was assessed by questionnaire subjectively and microscopic study objectively. RESULTS: Eighteen patients were followed over 10 months postoperatively (range, 10 to 18 months; mean, 13.8 months). The patients were satisfied with their results in terms of reduced foul odor except one patient. No hematoma, infections, skin necrosis, hair loss or hypertrophic scar occurred. And there was quantitative reduction of apocrine glands in microscopic study. CONCLUSIONS: We suggest that simultaneous apply of liposuction with laser ablation which is clinically and histologically proven method for treatment of axillary osmidrosis could be more effective method than treatment with each method alone, and has same morbidity allowing the patients early exercise.
Subject(s)
Humans , Apocrine Glands , Cicatrix, Hypertrophic , Hair , Hematoma , Hyperhidrosis , Laser Therapy , Lasers, Semiconductor , Lipectomy , Methods , Necrosis , Odorants , Skin , Surveys and QuestionnairesABSTRACT
Abdominoplasty may be applied to achieve aesthetic outcome and it also can be combined with other surgeries. In addition, liposuction has been offered to patients to improve contour. Liposuction combined with abdominoplasty gives us the advantage of higher patient satisfaction, better aesthetic outcome, and one-staged surgery. The authors performed a retrospective study to evaluate the outcomes. A total of 6 patients who underwent lipoabdominoplasty were included. The patients were all female and the mean age of the patients was 50.5 years old(age range, 32 to 58 years). This study surveyed lipoabdominoplasty based on the purpose of operation, type of suture, and application of quilting suture. Complication rates, patient satisfaction, and postoperative contour of the abdomen were questioned. A mild abdominal complication occurred in one patient, flap bullae, but this was healed within a week and overall flap survival was excellent with good satisfactory outcome. It appears that complication rates of simple lipoabdominoplasty group is low(1/6), and only minor complication occurs. Preservation of perforators during liposuction accounts for improved flap survival. In addition, abdominoplasty may be combined with other abdominal surgeries since other abdominal surgeries usually involve the lower abdomen, which will eventually be cut away curing the abdominoplasty stage.
Subject(s)
Female , Humans , Abdomen , Abdominal Wall , Abdominoplasty , Adipose Tissue , Blister , Imidazoles , Lipectomy , Nitro Compounds , Patient Satisfaction , Retrospective Studies , Surgery, Plastic , SuturesABSTRACT
PURPOSE: Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and improving tight adhesion between the graft and the recipient bed. To reduce post burn scar contracture and improve aesthetical result, many types of dermal substitutes have been invented and used widely. The goal of this study is to evaluate usefulness of the VAC(Kinetic concepts Inc., San Antonio, TX) in improving the take rate and time to incorporation of Integra(R) in reconstruction of burn scar contracture. METHODS: A retrospective study was performed from October, 2006 to December, 2008. The VAC was utilized for 11 patients. The patient's ages ranged from 5 to 27 with an average of 19.7 years. The surface area ranged from 24 to 1,600cm2 with an average of 785cm2. The burn scars were excised deep into normal subcutaneous tissue to achieve complete release of the scar, Integra(R) was sutured in place with skin staple and Steri-strip(R). Then slit incisions were made on silicone sheet only with No.11 blade for effective drainage. The VAC was used as a bolster dressing over Integra(R). Negative-Pressure ranging from 100 to 125mm Hg was applied to black polyurethane foam sponge trimmed to the appropriate wound size. An occlusive seal over the black polyurethane foam sponge was maintained by a combination of the occlusive dressing, OP-site(R). The VAC dressing changes were performed every 3 or 4 days until adequate incorporation was obtained. The neodermis appeared slightly yellow to orange color. When the Integra(R) deemed clinically incorporated, The VAC was removed and take was estimated with visual inspection. Very thin STSG(0.006-0.008 inches) was performed after silicone sheet removal. RESULT: The mean time for clinically assessed incorporation of Integra(R) was 10.00 days(range 9-12). The mean dressing change was 3.5 times until take was obtained. In All patients, Integra(R) had successful incorporation in tissue without serious complications. CONCLUSION: Integra(R) in combination with Vacuum- Assisted Closure(VAC) may be incorporated earlier than conventional dressing method.
Subject(s)
Humans , Acceleration , Bandages , Burns , Cicatrix , Citrus sinensis , Contracture , Drainage , Hypogonadism , Microcirculation , Mitochondrial Diseases , Occlusive Dressings , Ophthalmoplegia , Polyurethanes , Porifera , Retrospective Studies , Silicones , Skin , Subcutaneous Tissue , Transplants , Wound HealingABSTRACT
PURPOSE: Pachydermoperiostosis is a rare hereditary disease characterized by finger clubbing, periosteal reaction, and pachydermia. The underlying pathogenic mechanism of this disease remains unclear. This disease is known to be associated with a variety of diseases such as cranial suture defect, bone marrow failure, hypertrophic gastropathy, Crohn's disease, and female escuchen. METHODS: A 50-year-old male had digital clubbing of both hands, coarse hypertrophic skin changes of face, progressive thickening and furrowing on the scalp(cutis verticis gyrata), persistent pain in the limbs and joints. Other cutaneous features include moderate blepharoptosis, pole-like lower legs and feet. RESULTS: We performed surgical excision for hypertrophic skin change of scalp because of frequent eczematous skin change, severe itching sensation and cosmetic problem. Diagnosis is confirmed by bony proliferative periosteal reaction, pathologic findings, and characteristic clinical findings. CONCLUSION: Pachydermoperiostosis is manifested by finger clubbing, and hypertrophic skin changes causing coarse facial features with thickening and periosteal bone formation. We experienced a case of pachydermoperiostosis. Brief review of related literature is given.
Subject(s)
Female , Humans , Male , Middle Aged , Blepharoptosis , Bone Marrow , Cosmetics , Cranial Sutures , Crohn Disease , Extremities , Fingers , Genetic Diseases, Inborn , Hand , Joints , Leg , Osteoarthropathy, Primary Hypertrophic , Osteogenesis , Pruritus , Scalp , Sensation , SkinABSTRACT
BACKGROUND: As the menstruation has been thought to be associated with abnormal hemostasis and increased fibrinolytic activities, some surgeons and even anesthesiologists tend to postpone elective surgery. Many investigators have studied individual coagulation profiles and fibrinolytic activity during the menstruation, but conventional coagulation screens are frequently inadequate for the purpose of monitoring coagulation dynamically. This study was designed to evaluate the whole dynamic hemostatic process globally during the normal menstrual cycle by the thromboelastography (TEG). METHODS: Thirty six-healthy, normally menstruating female volunteers wrote a menstruation diary about their menstruation cycle. Blood samples were obtained for TEG analysis 3 days before menstruation, the 1st day of menstruation, the 2nd day of menstruation, the last day of menstruation and 5 days after menstruation. TEG coagulation indices (R value, K value, alpha angle, MA value and WBCLI60) were measured and statistically analysed with repeat-measured one way ANOVA. RESULTS: There were no significant difference in R value, K value, alpha angle, WBCLI60 during menstruation compared with pre- or post-menstruation period, but there was a significant decrease in the MA value on the 1st day of the menstruation. CONCLUSIONS: The result of our study showed the possibility of abnormal hemostatic function on the 1st day of menstruation. However, the more study is needed to confirm the possibility of bleeding tendency during surgery on the 1st day of menstruation.