Hwa Jung Ryu

Iatrogenic Mycobacterium abscessus infection associated with acupuncture: clinical manifestations and its treatment

Background  Mycobacterial infections transmitted by acupuncture are an emerging problem. There have been two reports of mycobacterial infections complicating acupuncture in the English literature.

Outcomes of polydioxanone knotless thread lifting for facial rejuvenation.

BACKGROUND Thread lifting is a minimally invasive technique for facial rejuvenation. Various devices for thread lifting using polydioxanone (PDO) are popular in aesthetic clinics in Korea, but there have been a few studies regarding its use. OBJECTIVE To describe PDO thread and techniques adopted to counteract the descent and laxity of the face. METHODS A retrospective chart review was conducted over a 24-month period. A total of 31 thread lifting procedures were performed. On each side, 5 bidirectional cog threads were used in the procedure for the flabby skin of the nasolabial folds. And, the procedure was performed on the marionette line using 2 twin threads. RESULTS In most patients (87%), the results obtained were considered satisfactory. Consensus ratings by 2 physicians found that objective outcomes were divided among “excellent,” “good,” “fair,” and “poor.” Texture wise, the outcome ratings were 13 as excellent and 9 as good. Lifting wise, ratings were 11 as excellent and 6 as good. The incidence of complications was low and not serious. CONCLUSION Facial rejuvenation using PDO thread is a safe and effective procedure associated with only minor complications when performed on patients with modest face sagging, fine wrinkles, and marked facial pores.

A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars.

BACKGROUND The use of ablative lasers based on the fractional approach is a novel strategy for the treatment of postoperative and acne scars in addition to wrinkles. OBJECTIVE To evaluate and compare the efficacy of carbon dioxide ablative fractional laser (AFL) and the pulsed dye laser (PDL) for the improvement of surgical scars. MATERIALS AND METHODS Fourteen Korean patients with surgical scars were enrolled for this study. Half of each scar was treated with a 10,600-nm AFL and the contralateral half with the 595-nm PDL. For early intervention of the postoperative scar, the laser treatments were begun after 2 weeks from the Mohs micrographic surgery. RESULTS Both PDL and AFL produced statistically significant improvements. However, comparatively, there was no statistical difference between them. In each variable, AFL was more effective than PDL in the improvement of pliability and thickness. In contrast, PDL was superior to AFL in the improvement of vascularity and pigmentation. CONCLUSION Pulsed dye laser and AFL treatments for surgical scar provide significant improvement. Pulsed dye laser was more effective in color of scar compared with AFL, which showed marked improvement in the contour of scar. Overall improvement was not statistically different in the Vancouver Scar Scale.

The efficacy of a microwave device for treating axillary hyperhidrosis and osmidrosis in Asians: a preliminary study

Abstract A microwave-based device has been developed to treat axillary hyperhidrosis by selectively heating the interface between the skin and underlying fat in the axilla. This study was conducted to evaluate the efficacy and safety of microwave-based devices for axillary hyperhidrosis and osmidrosis in Asians. Eleven patients (8 females and 3 males, age range 20–52 years, mean age 37.6 years) with axillary hyperhidrosis or osmidrosis were enrolled, treated with the microwave-based device, and followed up for 7 months. Procedure efficacy, patient satisfaction, and treatment safety were assessed. The clinical records were reviewed and the patients were interviewed individually at follow-up visits or via telephone. Evaluation of sweating showed at least a 2-point drop or greater in hyperhidrosis disease severity scale (HDSS) in 83.3% subjects (10/12 axillae) as measured at the 7-month follow-up. Of 16 axillae with osmidrosis, 93.8% (15/16 axillae) showed good to excellent results. Histologic findings also showed destruction of eccrine and apocrine glands that were replaced with fibrosis. Regarding safety, altered sensation of arms developed in one case that resolved after 3 months. This novel microwave-based treatment appears to be effective and well tolerated for the treatment of axillary hyperhidrosis and osmidrosis in Asians.

Evaluation of silica nanoparticle toxicity after topical exposure for 90 days

Silica is a very common material that can be found in both crystalline and amorphous forms. Well-known toxicities of the lung can occur after exposure to the crystalline form of silica. However, the toxicities of the amorphous form of silica have not been thoroughly studied. The majority of in vivo studies of amorphous silica nanoparticles (NPs) were performed using an inhalation exposure method. Since silica NPs can be commonly administered through the skin, a study of dermal silica toxicity was necessary to determine any harmful effects from dermal exposures. The present study focused on the results of systemic toxicity after applying 20 nm colloidal silica NPs on rat skin for 90 days, in accordance with the Organization for Economic Cooperation and Development test guideline 411 with a good laboratory practice system. Unlike the inhalation route or gastrointestinal route, the contact of silica NPs through skin did not result in any toxicity or any change in internal organs up to a dose of 2,000 mg/kg in rats.

Multiple Arterial Embolism After Illicit Intranasal Injection of Collagenous Material

Local injections of various materials to the face have become increasingly popular for cosmetic purposes. These procedures can cause serious adverse effects if they are not done properly or if they are performed with improper materials. Embolic arterial occlusion is rare but can be a devastating complication after injection in the facial area. Here we report multiple embolic occlusions involving branches of the internal carotid artery (ICA) and the external carotid artery (ECA) with anatomical considerations. In this case, a reticular pattern of skin necrosis, retinal branch artery occlusion (RAO), acute cerebral infarction, and secondary subarachnoid hemorrhage (SAH) occurred immediately after illegal intranasal injection of a collagenous substance. This is the most extensive and devastating case of embolic complications involving branches of the ICA and ECA after illicit facial injection for cosmetic purposes ever reported.

Clinical effectiveness of non-invasive selective cryolipolysis

Abstract Background: Excess subcutaneous fat causes not only cosmetic issues, but also substantial systemic health problems. Cryolipolysis has been reported to provide non-invasive fat reduction that significantly reduces subcutaneous fat cells with controlled, localized cooling. Objective: This study is intended to determine whether a cryolipolysis device can effectively reduce subcutaneous fat without damaging the overlying skin or causing significant side effects and ultimately produce improved cosmetic results. Materials and methods: A total of 15 patients participated in this study and they were treated unilaterally in a split-body trial manner with a non-invasive cryolipolysis device (Micool™, Hironic Co., Seongnam, Korea). The degree of improvement was assessed by both objective and subjective assessments. Complications and side effects were recorded at every visit. Results: The results of both objective and subjective assessments showed significant improvements in subcutaneous fat reduction without any meaningful complications. Conclusion: Non-invasive selective cryolipolysis has been reported to be a safe and effective treatment modality for the reduction of excess adipose tissue. Therefore, cryolipolysis is a promising technology that could be an appropriate and safe therapeutic option for subcutaneous fat reduction.

Transient median and ulnar neuropathy associated with a microwave device for treating axillary hyperhidrosis.

An antineoplastic agent derived from Streptomyces, mitomycin C inhibits DNA synthesis by cross-linking strands of the DNA double-helix, preventing tissue proliferation. Historically, mitomycin C has proven successful in the fields of ophthalmology and tracheal surgery. Early case reports in the use of resection and adjuvant mitomycin C to treat keloids were equivocal, although the concentration of mitomycin C used in these early case reports was low (0.4 mg/mL). Gupta and Narang, in a 2010 review, successfully treated 26 pinna keloids by applying a higher concentration of mitomycin C (1 mg/mL) immediately postoperatively and 3 weeks after surgery. We have also found success with a higher concentration and staggered application of mitomycin C.

Non-invasive cryolipolysis to reduce subcutaneous fat in the arms.

Background: Cryolipolysis received U.S. Food and Drug Administration clearance for reducing fat from the flanks, abdomen, and thighs. The upper arms are an off-label indication for cryolipolysis, and outcome data on reducing fat from the arms using a cryolipolytic device has rarely been published. Objective: This pilot study evaluated cryolipolysis to reduce upper arm fat. Materials and methods: A flat vacuum applicator was used to treat seven subjects in a single-side study. The patients underwent one cycle of upper-arm cryolipolysis treatment, and the contralateral arm served as a control. Follow-up was conducted at 8 weeks. Equalization treatments were delivered subsequently to the opposite arm. Efficacy was evaluated by ultrasound imaging, physicians assessment, and patient satisfaction. Side effects and adverse events were monitored. Results: Ultrasound measurements showed a decrease in the fat layer at 83.3% of the 12 measured sites. The mean reduction in fat layer thickness was 15.3%, corresponding to 2.03 mm. A significant difference was detected between baseline and 8-week assessments (p = 0.001). Conclusion: One treatment using a flat vacuum cryolipolysis applicator was safe and effective to reduce arm fat.

The efficacy of 3% minoxidil vs. combined 3% minoxidil and Korean red ginseng in treating female pattern alopecia.

the incidence of metastasis to the vulva might be similar to that to the scrotum. Indeed, vulvar metastases from visceral malignancies are rare; however, their incidence seems to be higher than that of scrotal metastases. Lerner et al. estimate that vulvar metastasis accounts for 5–8% of all vulvar malignancies. In 2003, Neto et al. reported 66 women treated at a single institution (the MD Anderson Cancer Center, Houston, TX, USA) over a period of 57 years who developed vulvar metastasis. Nearly half of the patients (46.9%) had a primary gynecologic tumor representative of cervical (22.7%), ovarian (12.1%), endometrial (9.1%), or vaginal (3.0%) cancer. The most common extragenital tumor site was the gastrointestinal tract (18.2%). In our review of cutaneous scrotal metastasis, we performed an extensive search of the literature available on PubMed and were able to identify only 29 men in whom recurrent visceral malignancy manifested with metastases to the scrotum. The most common sites of primary tumor were the prostate (27.6%) and gastrointestinal tract (27.6%), followed by the lung (13.8%). When gender-specific organs are excluded, gastrointestinal tumors are the most likely cancers to develop scrotal or vulvar metastases. The prognosis for patients who develop scrotal or vulvar metastases is poor. Neto et al. reported a median survival of just 7.5 months after the appearance of vulvar metastasis. Similarly, we found median survival to be only two months in men who developed scrotal metastases. In conclusion, the appearance of a new skin lesion on either the scrotum or the vulva in a patient with a prior or current history of visceral malignancy should prompt the clinician to consider the possibility of cutaneous metastasis.