Medical adhesive related skin injury after dental surgery

An 87-year-old woman was referred for the extraction of residual teeth and removal of tori prior to prosthetic treatment. After surgery under general anesthesia, the surgical tape was removed to detach the bispectral index sensor and the hair cover. After the surgical tape was removed, skin injury occurred on the left side of her face. After epidermis repositioning and ointment application, a dressing was placed over the injury. Her wound was found to have healed completely on follow-up examination. Medical adhesive related skin injury (MARSI) is a complication that can occur after surgery and subjects at the extremes of age with fragile skin are at a higher risk for such injuries. Careful assessment of the risk factors associated with MARSI is an absolute necessity.

Awake intubation in a patient with huge orocutaneous fistula: a case report

Mask ventilation, the first step in airway management, is a rescue technique when endotracheal intubation fails. Therefore, ordinary airway management for the induction of general anesthesia cannot be conducted in the situation of difficult mask ventilation (DMV). Here, we report a case of awake intubation in a patient with a huge orocutaneous fistula. A 58-year-old woman was scheduled to undergo a wide excision, reconstruction with a reconstruction plate, and supraomohyoid neck dissection on the left side and an anterolateral thigh flap due to a huge orocutaneous fistula that occurred after a previous mandibulectomy and flap surgery. During induction, DMV was predicted, and we planned an awake intubation. The patient was sedated with dexmedetomidine and remifentanil. She was intubated with a nasotracheal tube using a video laryngoscope, and spontaneous ventilation was maintained. This case demonstrates that awake intubation using a video laryngoscope can be as good as a fiberoptic scope.

Tick Bite by Male Amblyomma testudinarium in a Korean Woman / 대한피부과학회지

A 53-year-old woman presented with asymptomatic pedunculated mass on her buttock. She was attacked by the tick while climbing the Jungbyung mountain located in Changwon City, the southern coastal area of the Korean Peninsula. It was identified as male Amblyomma testudinarium according to its morphological characteristics. Histological examination showed dense inflammatory infiltration of neutrophils and eosinophils, and dilated vessels on the dermis beneath the biting site of the tick. There have been only few reports of the tick bite by A. testudinarium in the Korean literature. To the best of our knowledge, our patient is the second case of tick bite from this species and the first tick bite from the male tick recorded in Korea. Here, we report a case of tick bite by male A. testudinarium in a woman, including a review of relevant literature.

Prevalence of Vitiligo and Associated Comorbidities in Korea

PURPOSE: Vitiligo prevalence and its associated comorbidities rate have been reported variably among different populations. We aimed to determine the prevalence of vitiligo in Korea along with the baseline rate of comorbidities and compared the risks to the general population using hospital visit information of the total population in Korea. MATERIALS AND METHODS: We assessed demographic characteristics of vitiligo patients in Korean population from 2009 to 2011 in a nationwide data from Health Insurance Review Assessment Service. Patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with International Classification of Diseases, 10th Revision, Clinical Modification diagnosis code for vitiligo were identified. As a supplementary study, comorbidities associated with vitiligo were selected for further review to calculate relative risks compared to the general population. RESULTS: The annual prevalence of vitiligo determined by hospital-visiting rate in Korea was 0.12% to 0.13% over a three year period. In sync with other previous epidemiological studies, there was bimodal distribution among the age groups and no difference between genders. Also, vitiligo in Korean population was associated with various autoimmune/non-autoimmune diseases such as thyroiditis, atopic dermatitis, and psoriasis. CONCLUSION: This study was by far the most comprehensive review on prevalence of vitiligo using a data of total population in Korea. The prevalence is within a range of those reported in previous literatures, and increased risk of comorbidities such as thyroid diseases and psoriasis in vitiligo might aid clinicians in the initial work up of vitiligo patients and concurrent follow ups.

A Multicenter Collaborative Study by the Korean Society of Vitiligo about Patients' Occupations and the Provoking Factors of Vitiligo

BACKGROUND: It was previously thought that persons with genetic predispositions to vitiligo develop the condition after exposure to various precipitating environmental factors. However, in many cases, the aggravating factors of vitiligo have not been clearly identified. OBJECTIVE: To identify the aggravating factors of vitiligo in the working environment and daily life. METHODS: A total of 489 vitiligo patients were recruited from 10 institutions in South Korea; patients were provided with a questionnaire about environmental factors and behavior patterns in the workplace and in daily life, and their association with vitiligo. RESULTS: Ninety-five of the 470 enrolled patients (20.2%) answered that environmental risk factors in daily life and in the workplace affected the development of vitiligo. The most frequently attributed causes were trauma and burn (13.6%), followed by sunlight (12.8%), stress (12.8%), cleaning products/disinfectant/chemicals (4.9%), and hair dye (2.1%). CONCLUSION: Vitiligo of the hand and foot was associated with frequent exposure to aggravating materials and overexposure to sunlight, along with frequent trauma of these areas, all of which could be considered important risk factors of vitiligo. The development of vitiligo could potentially be controlled through the early detection of aggravating factors.

Effects of Xanthium stramarium and Psoralea corylifolia Extracts Combined with UVA1 Irradiation on the Cell Proliferation and TGF-beta1 Expression of Keloid Fibroblasts

BACKGROUND: Xanthium stramarium (XAS) and Psoralea corylifolia (PSC), phototoxic oriental medicinal plants, has been used in traditional medicines in Asian countries. OBJECTIVE: The effects of highly purified XAS or PSC extract combined with ultraviolet A1 (UVA1) irradiation on cell proliferation and transforming growth factor-beta1 (TGF-beta1) expression of the keloid fibroblast were being investigated to define potential therapeutic uses for keloid treatments. METHODS: The keloid fibroblasts were treated with XAS or PSC alone or in the combination with UVA1 irradiation. The cell viability, apoptosis, and expression of TGF-beta1 and collagen I were investigated. RESULTS: XAS and PSC in combination with UVA1 irradiation suppressed cell proliferation and induced apoptosis of keloid fibroblasts. Furthermore, the XAS and PSC in combination with UVA1 irradiation inhibited TGF-beta1 expression and collagen synthesis in keloid fibroblasts. CONCLUSION: These findings may open up the possibility of clinically used XAS or PSC in combination with UVA1 irradiation for keloid treatments.

Effects of Xanthium stramarium and Psoralea corylifolia Extracts Combined with UVA1 Irradiation on the Cell Proliferation and TGF-beta1 Expression of Keloid Fibroblasts

BACKGROUND: Xanthium stramarium (XAS) and Psoralea corylifolia (PSC), phototoxic oriental medicinal plants, has been used in traditional medicines in Asian countries. OBJECTIVE: The effects of highly purified XAS or PSC extract combined with ultraviolet A1 (UVA1) irradiation on cell proliferation and transforming growth factor-beta1 (TGF-beta1) expression of the keloid fibroblast were being investigated to define potential therapeutic uses for keloid treatments. METHODS: The keloid fibroblasts were treated with XAS or PSC alone or in the combination with UVA1 irradiation. The cell viability, apoptosis, and expression of TGF-beta1 and collagen I were investigated. RESULTS: XAS and PSC in combination with UVA1 irradiation suppressed cell proliferation and induced apoptosis of keloid fibroblasts. Furthermore, the XAS and PSC in combination with UVA1 irradiation inhibited TGF-beta1 expression and collagen synthesis in keloid fibroblasts. CONCLUSION: These findings may open up the possibility of clinically used XAS or PSC in combination with UVA1 irradiation for keloid treatments.

The Principles of Intense Pulsed Light and Its Clinical Application / 대한피부과학회지

Intense pulsed light (IPL) is a high-intensity pulsed light source emitting polychromatic, non-coherent, and defocused light with a broad wavelength spectrum. However, IPL can similarly work as a conventional laser with the help of variable cut-off filters. It enables selective destruction of target chromophores based upon the theory of selective photothermolysis. Clinicians can combine variable factors including wavelengths, pulse durations, and fluences in IPL systems, which allow great versatility in treating wide ranges of dermatologic diseases and flexibility in optimizing individual treatment parameters according to different skin types or indications. These properties are of great advantage for skilled and experienced clinicians but can be a source of unwanted serious adverse effects for untrained ones at the same time. Therefore, we summarized the basic principles and clinical application of IPL devices to provide the practical guidance. In addition, critical diagnostics, a great deal of experience, and a thorough knowledge of skin pathology and physiology are required for an effective and safe IPL treatment.

Pyoderma Gangranosum of the Penis

We report a patient who developed pyoderma gangrenosum in the penis with invasion of the distal urethra. The patient was treated with prednisolone and thalidomide, followed by a reconstructive surgical repair using a scrotal island flap. We report this case with a brief review of the literature.

Comparison of the Short Term Results of Monarc and TVT-O Transobturator-tape Procedures for the Treatment of Stress Urinary Incontinence

PUROPOSE: Transobturator sling is a new minimally invasive treatment for female stress urinary incontinence. We compared the efficacy and safety of the two procedures, Monarc and TVT-O. MATERIAL AND METHODS: We included 110 patients with stress urinary incontinence who underwent the Monarc (n=52) or TVT-O (n=58) procedure and followed up at least for 1 year. Preoperative evaluations, the indices of voiding and postoperative complication were investigated. They were analyzed by Student's t-test, Paired t-test and chi-square test. RESULTS: There were no significant difference in the preoperative patients' characteristics, postoperative complication and success rate between the two groups. The preoperative and postoperative storage symptoms between two groups had no significant difference but the patients of both groups had significant improvement in storage symptoms such as frequency and urgency after surgery. CONCLUSIONS: The Monarc and TVT-O is equally effective and safe procedures as a treatment method of female stress urinary incontinence.

The Effect of Tamsulosin on Expulsion of Ureteral Stones after Extracorporeal Shock Wave Lithotripsy / 대한비뇨기과학회지

PURPOSE: The aim of this study was to evaluate the effect of tamsulosin on expulsion of ureteral stones after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: Seventy-six patients(39 with upper ureteral stones and 37 with lower ureteral stones) treated with ESWL for stones <10mm were randomly divided into two groups. Tamsulosin(0.2mg orally once daily) was administered to group 1; group 2 received no medications. All patients were evaluated with respect to the number of episodes of ureteral colic, the expulsion rates of stones after ESWL, and the mean number of sessions of ESWL until complete expulsion of stones. RESULTS: The complete expulsion rates of upper and lower ureteral stones did not differ significantly between groups 1 and 2 during each session of ESWL; however, the mean session of ESWL was lower in group 1 than in group 2. For upper ureteral stones, 1.8 sessions were necessary per patient in group 1, while 2.3 sessions were required for the patients in group 2(p=0.039). For lower ureteral stones, 2.0 sessions were necessary per patient in group 1, while 2.9 sessions were required for the patients in group 2(p=0.032). There were significant decreases in the number of episodes of pain in group 1 with lower ureteral stones(p=0.014). There were no side effects associated with tamsulosin. CONCLUSIONS: The use of tamsulosin in the treatment of upper and lower ureteral stones after ESWL can decrease the mean number of sessions of ESWL and the number of episodes of pain, but cannot improve the expulsion rate. Further research regarding the cost-effectiveness of tamsulosin after ESWL is needed.

Clinical Significance of the Expression of Tubulin alpha and betaII in Prostate Cancer / 대한비뇨기과학회지

PURPOSE: This study examined the significance of tubulin alpha and beta II expression in benign prostatic hyperplasia(BPH) and prostate cancer. MATERIALS AND METHDOS: A total 103 cases diagnosed with either BPH or prostate cancer were divided into 4 groups: BPH(n=25), localized prostate cancer(n=41), locally advanced prostate cancer(n=18), metastatic prostate cancer(n=18). The tissues were taken through a transurethral resection of the prostate, suprapubic prostatectomy, prostatic needle biopsy or radical retropubic prostatectomy. The expression was measured by immunohistochemical staining. The degree of expression was graded on a 4-point scale. The data was compared in terms of stage, the serum prostatic specific antigen(PSA) level and Gleason score. The statistical comparisons were made using one-way ANOVA test and a Fisher's exact test. RESULTS: The levels of tubulin alpha and betaII expression were stronger in the patients with prostate cancer than those with BPH(p0.05). The level of tubulin alpha expression was stronger in the patients with a Gleason score > or =8 than in those of Gleason score or =4ng/ml than in those with the serum PSA level <4ng/ml(p<0.001). CONCLUSIONS: The expression of tubulin alpha and betaII may be associated with the development of prostate cancer. These might be used as useful markers for the diagnosis, prognosis and treatment response.

The Comparision of the Short Term Result of Transobturator and Retropubic Mid Urethral Slings in the Female Stress Urinary Incontinence

PURPOSE: Transobturator slings have become an alternative to retropubic slings for the surgical treatment of stress urinary incontinence (SUI). We aimed to compare the efficacy and outcome between transobturator and retropubic mid-urethral sling procedures. MATERIALS AND METHODS: We reviewed the chart of 186 consecutive women who had sling procedures with a follow-up of at least 1 year from 2001 to 2006. The retropubic sling procedure was perfomed on 76 women assigned to retropubic group. A total 110 women received transobturator slings assingned to transobturator group. The preoperative evaluations, the indices of voiding, and postoperative complications were analysed by Student's t-test and chi-square. RESULTS: Two groups were similar in their preoperative characteristics and the perioperative parameters except the period of hospitalization and operative time. There were significant difference between the 2 groups in terms of the postoperative obstructive and iatrogenic complications. Transobturator group had shorter hospitalization and operative time and lower complications than retropubic group. CONCLUSIONS: Because transobturator sling procedures showed better results and less complications than retropubic slings, it is a safe and efficient surgical treatment for female SUI.

Detection of Cryptic Microorganisms in Patients with Chronic Prostatitis by Multiplex Polymerase Chain Reaction / 대한비뇨기과학회지

PURPOSE: Chronic prostatitis frequently occurs in men of all ages. Recent studies suggest that fastidious microorganisms may play a role in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The aim of this study was to evaluate the usefulness and significance of multiplex polymerase chain reaction (PCR) in the diagnosis of CP/CPPS. MATERIALS AND METHODS: First voided urine (FVU) and/or expressed prostatic secretions (EPS) were collected from 92 patients. Multiplex PCR, using Dual Specificity Oligo (DSO(TM)) primers, was used to test for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Ureaplasma urealyticum (UU). RESULTS: Multiplex PCR can be easily analyzed via visual comparison. Nine (39.1%) of the 23 CP/CPPS IIIa and 12 (17.4%) of the 69 IIIb patients had positive multiplex PCR, with a total of 27 microorganisms isolated, including CT, MH, MG, UU, TV and NG in 9, 7, 4, 4, 2 and 1 case, respectively. Co-infections with 2 or 3 organisms occurred in 5 cases. For the samples collected from 32 patients for both FVU and EPS, 68.7% gave the same results. CONCLUSIONS: Multiplex PCR, using DSO(TM) primers, can be useful for the simple detection of fastidious microorganisms in CP/CPPS. To achieve reliable results with multiplex PCR, feasible guidelines and standardization are of major importance. Further studies will be required to define the usefulness of molecular tests for CP/CPPS in clinical practice.

Three clinical cases of cutaneous larva migrans

Three cases of cutaneous larva migrans (CLM) were diagnosed in a returnee from a trip to Thailand and in 2 domestic farmers during July and September, 2003. The linear and serpiginous skin lesions on the lower extremities were presented in all 3 cases. Routine laboratory findings were normal. In the imported case, a 650 x 30 micrometer sized filariform nematode larva, presumably a species of hookworm, was detected in the lesion. All cases were treated with 400 mg albendazole once daily for 3-5 days, and their skin lesions gradually improved. In the present study, a causative agent of CLM was isolated for the first time in the Republic of Korea. Moreover, we speculate that CLM is prevalent in farmers who are in frequent contact with soil in the Republic of Korea.

Evaluation of Sun-cap Protection from Ultraviolet Radiation / 대한피부과학회지

BACKGROUND: Although sun-caps are widely used to shun hazardous solar ultraviolet (UV) radiation in Korea, little is known about their protective efficacy. OBJECTIVE: We tried to measure and compare sun-cap protection from UV radiation. METHODS: Seventeen commercially available sun-caps (products 1~17) were evaluated against UV-protection by spectrophotometerically measuring absorption and transmission spectra, percent protection of solar UVB and UVA photometerically, and solar UV-spectra spectroradiometerically. RESULTS: The absorption and transmission spectra of 17 different sun-caps were different, and they were not related to either price or their stated UV-guarantee. Percent protection showed some correlation, particularly with that of UVB. Protection against solar UV-spectra was similar to that of the absorption ond transmission spectra. CONCLUSION: Protection of sun-caps were highly varied, and this was not related to their price or stated UV- guarantee. Among three evaluation methods, absorption and transmission spectra seemed to be more objective. Further studies would be necessary to provide proper information and guidelines to dermatologists and consumers on the UV- protection of sun-caps.

A Case of Subcutaneous Phaeohyphomycosis Caused by Exophiala jeanselmei / 대한피부과학회지

We report a case of subcutaneous phaeohyphomycosis caused by Exophiala (E.) jeanselmei in a 75-year-old female, who showed subcutaneous abscesses on the both forearms for 8 months. Histopathologically, suppurative granulomatous inflammation and short hyphae & spores were observed. Fungal culture grew out the typical black-gray velvety colonies of E. jeanselmei after 3 weeks. The isolate grew well at 25degrees C, but very poorly at 37degrees C. No growth could be observed at 40degrees C. We confirmed E. jeanselmei by colony & microscopic morphology and temperature tolerance test. The patient had been treated with fluconazole for 3 months.

Flat Foot Survey in 8 Year Old Primary School Children / 대한족부족관절학회지

PURPOSE: To estimate the prevalence of flat foot in the 1st grade primary school children in the Kang-Dong Gu, Seoul, Korea. MATERIALS AND METHODS: We examined 1336 8 year old the first grade children (2672 feet) in primary school at 5 primary school for prevalence of flat foot and the associating factors in Kang-Dong Gu in April 2003. The group was examined with 2 mm-pannel in physical examination at erect position to put diagnosis of flat foot which showed no plantar arch. The height, weight, foot length and foot width were estimated in all children. We used obesity grading system of Korean Pediatric Association for overweight evaluation. RESULTS: We enrolled 728 boys and 608 girls, and prevalences of each gender were 20.8% and 14.9%. The children who had flat foot were 243 and the prevalence of flat foot was 18.2%. The foot length ranges between 152 mm and 300 mm (mean value 183.6 mm, SD 10.6), and the foot width were between 50 mm and 107 mm (mean value 2.16 mm, SD 4.8). Of the 1336 children group, 1215 children (90.0%) were in range of normal weight, 72 children (5.4%) were in grade-1 overweight, 38 (2.8%) were in grade-2 overweigh and, 11 (0.8%) were in grade-3 overweight. The prevalence of flat foot of each overweight group were 16.3%, 34.7%, 39.5% and 45.5%. Overweight in children effected increased prevalence of flat foot. But there were no significant relationship with flat foot in other factors. CONCLUSION: Over all prevalence of flat foot of 8 year old children was 18.2% and most of patients were flexible flat foot. The prevalence of flat foot was influenced by overweight remarkably.

A Case of Pyogenic Granuloma on the Fissured Tongue / 대한피부과학회지

Pyogenic granuloma is a benign vascular tumor related to trauma, infection, or hormonal changes. When it affects the oral cavity, the most frequent site is the gingiva and involvement of the tongue is very rare. Occurrence of pyogenic granuloma on the fissured tongue has not been reported yet. We present a rare case of pyogenic granuloma on the tongue in a 64 year old female patient in which the fissured tongue seemed to play important roles in the pathogenesis of occurrence of the pyogenic granuloma.

Comparative Study on Function and Stability of Sunscreening Products / 대한피부과학회지

BACKGROUND: A lot of protective tools such as sunshades (sun-cap), sun-shielding tints and various sunscreens are widely used to protect solar ultraviolet (UV) radiation. Although dermatologists are aware of these products, they do not know the exact protective efficacy or their stability after strong UV irradiation. OBJECTIVE: We tried to measure the spectal absorbance and transmittance of various sunscreening products. In addition, we measured change of sunscreens's absorbance or transmittance after strong UV irradiation for 30, 60 and 90 minutes. METHODS: We purchased five commercially available sunshades (product A-E), five sun-tinting films (product A-E), and eight sunsceens (product A-H) with similar sun-protection factor (SPF) around 30, and measured spectral absorbance and transmittance of those agents. For the sunscreens, they were irradiated with 250 watt Xenon-Arc lamp and change of spectral responses were evaluated. RESULTS: In absorption and transmission spectra of five different sun-caps, sun-cap C showed very good protection in entire UV range whereas all others protected UV only partially. Absorption and transmission spectra of six different sun-shielding tints showed all of them protected UV fairly well and tint C showed the best protection. Eight different sunscreens showed profound differences in spectal absorbances or transmittances. Sunscreen-A showed the best protection and there was no relationship between price and spectral-protection of sunscreens. In the photo-stability of eight sunscreens after UV-irradiation, there were big differences. Only sunscreen-A showed the least change after UV irradiation, and all other sunscreens showed a change of specta by increased UV-irradiation time. CONCLUSION: Protection efficacies of sunscreening products were variable, and most sunscreens were unstable to strong UV irradiation. Further studies would be necessary to give proper information for protecting UV effectively to dermatologists and consumers.