• Title/Summary/Keyword: Plastic Surgery

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Protective Effects of EGCG on UVB-Induced Damage in Living Skin Equivalents

  • Kim, So-Young;Kim, Dong-Seok;Kwon, Sun-Bang;Park, Eun-Sang;Huh, Chang-Hun;Youn, Sang-Woong;Kim, Suk-Wha;Park, Kyoung-Chan
    • Archives of Pharmacal Research
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    • v.28 no.7
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    • pp.784-790
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    • 2005
  • In this study, we evaluate the effects of (-)-epigallocatechin-3-gallate (EGCG) on ultraviolet B(UVB)-irradiated living skin equivalents (LSEs). Histologically, UVB irradiation induced thinning of the LSE epidermis, whereas EGCG treatment led to thickening of the epidermis. Moreover, EGCG treatment protected LSEs against damage and breakdown caused by UVB exposure. Immunohistochemically, UVB-exposed LSEs expressed p53, Fas, and 8-hydroxy-deoxyguanosine (8-OHdG), all of which are associated with apoptosis. However, EGCG treatment reduced the levels of UVB-induced apoptotic markers in the LSEs. In order to determine the signaling pathways induced by UVB, Western blot analysis was performed for both c-Jun $NH_2$-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MAPK), which are associated with UVB-induced oxidative stress. UVB activated JNK in the epidermis and dermis of the LSEs, and EGCG treatment reduced the UVB-induced phosphorylation of JNK. In addition, p38 MAPK was also found to have increased in the UVB-exposed LSEs. Also, EGCG reduced levels of the phosphorylation of UVB-induced p38 MAPK. In conclusion, pretreatment with EGCG protects against UVB irradiation via the suppression of JNK and p38 MAPK activation. Our results suggest that EGCG may be useful in the prevention of UVB-induced human skin damage, and LSEs may constitute a potential substitute for animal and human studies.

Levofloxacin and Torsades de Pointes (Levofloxacin과 Torsades de Pointes)

  • Kwon, Se-Ah;Kim, Cheol-Hong;Song, Won-Jun;Koo, Ja-Kyung;Lee, Soon-Jae;Park, Ji-Young;Hyun, In-Gyu;Ko, Jang-Hyu;Kim, Hyun-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.6
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    • pp.474-479
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    • 2010
  • Torsades de pointes associated with a prolonged QT interval is a life-threatening arrhythmia, which may be induced by any of the following: drugs, electrolyte imbalances, severe bradycardia and intracranial hemorrhage. Torsades de pointes is characterized by beat-to-beat variations in the QRS complexes in any ECG leads with rates of 200~250 per minute. Fluoroquinolones are widely used and well tolerated antibacterial agents. However, prolongation of the QT interval leads rarely to Torsades de pointes as a significant adverse effect. So, it should be used with caution in high-risk patients for developing Torsades de pointes. We report one case of 67-year old man with contact burns who experienced Torsades de pointes, which probably resulted from the use of levofloxacin, and no further episode occurred after its withdrawal.

Inhibitory Effect of Deer Antler on Osteoclastic Bone Resorption (파골세포의 골 흡수에 미치는 녹용의 억제효과)

  • Kim, Yun-Kyung;Choi, Yun-Hong;Song, Jeong-Hoon;Jang, Sung-Jo;Kim, Hyun-Jung;Lee, Chang-Hoon;Ahn, Ho-Seon;Lee, Ji-Eun;Kim, Jeong-Joong;Choi, Min-Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1299-1304
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    • 2009
  • We have previously shown that water extract of deer antler (WEDA) inhibited RANKL-mediated osteoclast differentiation from bone marrow macrophages by suppressing c-Fos and NFATc1 expression. Thus, we examined the effect of WEDA in inflammation-induced bone loss in vivo. Here we found that WEDA inhibited osteoblast-supported osteoclast differentiation induced by lipopolysaccharide (LPS). However, WEDA did not suppress the expression of receptor activator of NF-${\kappa}B$ ligand (RANKL) in response to LPS in osteoblasts. WEDA also inhibited the bone resorptive activity of mature osteoclasts. To examine the effect of WEDA on bone loss, when LPS injected subcutaneously in mice, bone loss was greatly increased, but WEDA treatment inhibited LPS-mediated bone loss. Taken together, we conclude that WEDA inhibited osteoclast differentiation and bone resorption in vitro and in vivo. Thus WEDA may be useful in the treatment of bone-related disorders.

Reconstruction of basement membrane in the artificial skin (인공피부 제조시 기저막 재건의 효과)

  • Yi, J.Y.;Park, K.C.;Kim, S.H.;Suh, H.;Son, Y.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.335-338
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    • 1996
  • We attempted to reconstruct basement membrane (BM) in between the epidermal compartment and dermal compartment in the artificial skin preparation and examine its effect on the skin architecture as well as on the epidermal differentiation. Laminin, one of the component of BM, stimulate the migration of the basal cells but type IV collagen which is a major component of the mechanical network of BM did not stimulate epidermal migration. However laminin in the presence of type IV collagen at a 1:1 molar ratio did not stimulate epidermal migration but provide nice demarcation between epidermis and dermis. This mixture of laminin and type IV collagen enhanced epidermal differentiation in the artificial skin based on the morphological observation as well as biochemical criteria. The epidermal acquirement of migratory ability on the laminin-rich substrate suggest that this type of unbalance in the expression of the components of BM may prevail in the area of healing tissue and the invasive transition of the tumor. The result in this study provide the technical improvement in the artificial skin preparation and further application of this technique for the reconstruction of other bio-artificial organ.

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Korean Medicine Treatment for Pressure Injury in Terminal Stage Cancer Patients with Debridement and Local Flap: A Case Report (변연절제 및 국소 피판술을 시행한 말기 암환자의 욕창에 대한 한의학적 치료 1례)

  • Song, Juyeon;Moon, Jiseong;Min, Seonwoo;Kim, Hakkyeom;Kim, Youngji;Ahn, Lib
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.478-486
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    • 2020
  • Objectives: Pressure injury is a common symptom of end-stage cancer, which impact quality of life. This case study reports on use of traditional Korean medicine in an end-stage cancer patient with pressure injury after debridement and local flap. Methods: A pressure injury with debridement and a local flap was treated using herbal medicine, a carbon arc, acupuncture, dressing, and cooperation in plastic surgery. Pressure injury was followed up with photographs. Results: On the 22nd day of treatment (26 days after the debridement and local flap), redness, swelling, and the condition of pressure injury were all improved. Moreover, the condition of the pressure injury was good without dressing. Conclusions: These results show that traditional Korean medicine may have a positive effect on a pressure injury and improve the quality of life of cancer patients. However, further study is needed to confirm these findings.

Evaluation of the Effects of Feedback and Remediation after Formative Assessment in the Introduction to Clinical Medicine (임상실습 입문교육에서 형성평가 후 되먹임 및 재시험의 효과)

  • Lee, Yong Jig;Choi, Son Hwan
    • Korean Medical Education Review
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    • v.18 no.1
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    • pp.38-43
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    • 2016
  • The authors investigated the effect of feedback and remediation after formative assessment (FRFA) by comparing the FRFA score and that of summative assessment (SA) in a course on clinical skills. In March 2015, 33 subjects underwent evaluation of their ability to perform a complex clinical skill using a real-time ready-made mobile assessment form tool, and through e-mail they were supplied with their feedback and final score (the pass group earned 2 points; the intermediate group earned 1 point; the nonpass group earned 0 points) followed by their self-reflection. The nonpass group underwent a re-test and e-mail feedback again until they passed the test, given the ease of performance. In December 2015, the 33 subjects took a 10-item SA, and one of the 10 items addressed a similar clinical skill. The difference between the first score on the FRFA and the score on the SA was evaluated statistically (p=0.05) through data analysis, variance distribution, correlation analysis, and linear regression analysis using SPSS software ver. 16. The increase from the score on the SA to that on the FRFA was statistically significant ($4.5{\pm}9.29$) in the pass group and the intermediate group, and was $29.7{\pm}11.49$ in the nonpass group of the formative evaluation (p<0.001). Using an FRFA could decrease the range in the standard deviation of the score and increase the minimum score among the subjects.

Visualization of Epidermis and Dermal Cells in ex vivo Human Skin Using the Confocal and Two-photon Microscopy

  • Choi, Sang-Hoon;Kim, Wi-Han;Lee, Yong-Joong;Lee, Ho;Lee, Weon-Ju;Yang, Jung-Dug;Shim, Jong-Won;Kim, Jin-Woong
    • Journal of the Optical Society of Korea
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    • v.15 no.1
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    • pp.61-67
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    • 2011
  • The confocal laser scanning microscopy and two-photon microscopy was implemented based on a single laser source and an objective lens. We imaged and compared the morphology of identical sites of ex vivo human skin using both microscopes. The back-scattering emission from the sample provided the contrast for the confocal microscopy. The intrinsic autofluorescence and the second harmonic generation were used as the luminescence source for the two-photon microscopy. The wavelength of the Ti:Sapphire laser was tuned at 710 nm, which corresponds to the excitation peak of NADH and FAD in skin tissue. The various cell layers in the epidermis and the papillary dermis were clearly distinguished by both imaging modalities. The two-photon microscopy more clearly visualized the intercellular region and the nucleus of the cell compared to the confocal microscopy. The fibrous structures in the dermis were more clearly resolved by the confocal microscopy. Numerous cells in papillary dermal layer, as deep as $100\;{\mu}m$, were observed in both CLSM and two-photon microscopy. While most previous studies focused on fibrous structure imaging (collagen and elastin fiber) in the dermis, we demonstrated that the combined imaging with the CLSM and two-photon microscopy can be applied for the non-invasive study of the population, distribution and metabolism of papillary dermal cells in skin.

Update on infantile hemangioma

  • Jung, Hye Lim
    • Clinical and Experimental Pediatrics
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    • v.64 no.11
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    • pp.559-572
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    • 2021
  • The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

Quality Improvement Priorities for Cosmetic Medical Service Using Kano Model and Potential Customer Satisfaction Improvement Index (Kano 모델 및 잠재적 고객만족 개선 지수를 이용한 미용성형의료서비스 품질 개선 우선순위)

  • Park, Youyoung;Jung, Hunsik
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.42 no.3
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    • pp.176-183
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    • 2019
  • The environmental changes in the Korean cosmetic medical service industry in the $21^{st}$ century are forming intense competition among medical institutions due to the quantitative expansion of its market. For stable growth of the cosmetic medical service industry, continuous quality improvement is necessary based on empirical research on the quality of cosmetic medical services rather than external expansion. The purpose of this study is to classify the quality attributes of cosmetic medical service using Kano model and to derive the degree of satisfaction and dissatisfaction of each quality attributes through Customer Satisfaction Coefficient (CSC). Through this, the study identified strategic priorities and suggested specific step-by-step approaches and quality improvement priorities that can increase customer satisfaction using the Potential Customer Satisfaction Improvement Index (PCSI Index). Based on SERVPERF, this study used measurement tools consisting of five dimensions : tangibles, reliability, responsiveness, assurance, and empathy. In addition, it was used of measurement items reconstructed into positive, negative, and satisfaction questions for Kano model analysis, CSC analysis, and PCSI Index analysis. A total of 300 medical consumers who experienced cosmetic medical services for the past one year in medical institutions such as plastic surgery and dermatology were collected with convenient sampling. As a result, urgent items for improving the quality of service using the PCSI Index, 'Consideration for customer benefits' in empathy category was followed by 'Immediate help' and 'Sincere response' in responsiveness category, and 'Understanding customer needs' in empathy category, respectively. That is, it is required to improve human service quality attributes such as empathy and responsiveness rather than physical service quality attributes. This study contributes practically in that it provides specific and discriminatory approaches to improve customer satisfaction on cosmetic medical service quality and suggests improvement priorities.

Scientific review of the aesthetic uses of botulinum toxin type A

  • Park, Mee Young;Ahn, Ki Young
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.1-10
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    • 2021
  • Botulinum toxin type A (BoNT-A), onabotulinumtoxinA (Botox) was approved by the United States Food and Drug Administration for temporary improvement of glabellar lines in patients 65 years and younger in 2002, and has also been used widely for aesthetic purposes such as hyperhidrosis, body shape contouring, and other noninvasive facial procedures. BoNT-A inhibits presynaptic exocytosis of acetylcholine (ACh)-containing vesicles into the neuromuscular junction at cholinergic nerve endings of the peripheral nervous system, thereby paralyzing skeletal muscles. ACh is the most broadly used neurotransmitter in the somatic nervous system, preganglionic and postganglionic fibers of parasympathetic nerves, and preganglionic fibers or postganglionic sudomotor nerves of sympathetic nerves. The scientific basis for using BoNT-A in various cosmetic procedures is that its function goes beyond the dual role of muscle paralysis and neuromodulation by inhibiting the secretion of ACh. Although the major target organs for aesthetic procedures are facial expression muscles, skeletal body muscles, salivary glands, and sweat glands, which are innervated by the somatic or autonomic nerves of the peripheral cholinergic nerve system, few studies have attempted to directly explain the anatomy of the areas targeted for injection by addressing the neural physiology and rationale for specific aesthetic applications of BoNT-A therapy. In this article, we classify the various cosmetic uses of BoNT-A according to the relevant component of the peripheral nervous system, and describe scientific theories regarding the anatomy and physiology of the cholinergic nervous system. We also review critical physiological factors and conditions influencing the efficacy of BoNT-A for the rational aesthetic use of BoNT-A. We hope that this comprehensive review helps promote management policies to support long-term, safe, successful practice. Furthermore, based on this, we look forward to developing and expanding new advanced indications for the aesthetic use of BoNT-A in the future.