Sun-Eun Choi

Phenolic compounds from the root of Phragmites communis

Phragmitis Rhizoma (Phragmitis communis), rhizome of reed, has been used as an oriental traditional medicine for esophageal cancer, vomiting, lung abscess, fever, dysurea, and tetrodotoxin detoxication [1]. Previously, β-sitosterol, vanillic acid, ferulic acid, p-hydroxybenzaldehyde, and p-cinnamic acid were isolated from Phragmitis Rhizoma and their antihyperlipidemic effect reported [2]. Serotonin, tryptophan, and tryptamine were identified by co-chromatography with the respective authentic compounds from Phragmitis Rhizoma [3]. In the present study, a known phenolic acid and two lignans were isolated from Phragmitis Rhizoma for the first time. The fresh root of P. communis was extracted with aqueous acetone, and the extract was subjected to a combination of Sephadex LH-20, MCI gel, and YMC-ODS column chromatography to afford methyl gallate (1), (+)-lyoniresinol (2), and (+)-lyoniresinol-3α-O-β-D-glucopyranoside (3). Compound 1 gave a brown coloration when sprayed with alcoholic ferric chloride on TLC. Negative LC MS spectrum of 1 showed a molecular ion peak at m/z 182.8 [M–H]–, and the 1H NMR spectrum of 1 showed two singlet at δ 7.05 (2H, H-2,6) and δ 3.81 (OCH3) attributable to a galloyl and a methoxyl proton, respectively. The 13C NMR spectrum of 1 also showed a galloyl group at δ 110.1 (C-2 and 6), 139.9 (C-4), 146.7 (C-3 and 5), and 169.3 (COO) and a methoxyl group at δ 52.3. These results suggested that 1 is methyl gallate, which was confirmed by comparisons with the spectral data in the literature [4]. Compounds 2 and 3 gave a green coloration when heated after spraying with 10% H2SO4 and showed a dark brown coloration when sprayed with alcoholic ferric chloride on TLC. The negative LC MS spectrum of 2 and 3 showed a molecular ion peak at m/z 417.6 [M–H]– and 581.4 [M–H]–. The 1H NMR spectrum of 2 showed three singlet signals at δ 3.69, 3.33, and 3.80 corresponding to the signals from four methoxyl groups. The 1H NMR spectrum of 2 also showed two singlet signals attributable to a galloyl and an aromatic methine proton at δ 6.40 (H-2′, 6′) and 6.55 (H-6), two alcoholic methylene signals at δ 3.49 (H-9′), 3.52 (H-9a), and 3.59 (H-9b), three methine signals at δ 4.26 (H-7′), 1.95 (H-8′) and 1.59 (H-8), and another methylene signal at 2.65 (H-7eq) and 2.55 (H-7ax). The 13C NMR spectrum of 2 showed four methoxyl groups at δ 55.5, 55.9 (2C), and 58.8, a methylene and two alcoholic methylenes at δ 32.8, 65.5, and 62.8, and three methines at δ 41.5, 38.8, and 48.2 which indicated an estimated two sinapyl alcohols of the cyclolignan type (Table 1). Each proton and carbon assignment could be completed by 1H–1H COSY, HSQC, and HMBC in the form of two cyclolignan sinapyl alcohol as 4,4′,9,9′tetrahydroxy-3,3′,5,5′-tetramethoxy-2,7′-cyclolignan[(+)-lyoniresinol] [5].

Efficacy and safety of non-invasive body tightening with high-intensity focused ultrasound (HIFU)

Noninvasive skin‐tightening devices have become increasingly popular in response to increasing demand for improvements in skin laxity and tightening with minimal risk and recovery time.

Hyaluronic acid injection via a pneumatic microjet device to improve forehead wrinkles.

arranged in a dense matted mass involving mainly the centred scalp area (Fig. 1). The hair mass was clean, and odour-free. No other associated lesions except for a mild seborrhoeic dermatitis could be noted on her scalp. Trichoscopic analysis of the compact mass showed 180° twisted hairs, bended and fractured hair shafts, retained telogen hairs and trichorrhexis nodosa (Fig. 2a and b). The treatment suggested was the hair cut. The exact ethiopathogenesis of AHM is still poorly understood, and multifactorial causes have been accepted. Excessive friction and compression in a liquid medium are believed to cause the conglomeration of contiguous hair fibres. However, some reports after regular use of harsh shampoos and following irritant contact dermatitis of the scalp have been described so far. The main differential diagnosis is neglected hair care, which may be associated with scalp inflammation and hair infestations. Specific hair practices, such as applying sticky materials over the hair or using dreadlocks, entangled masses of matted ropes of long hair, may also be misdiagnosed as AHM, although these are chronic processes usually with dirty and malodorous hairs. Trichoscopy is a non-invasive and practical diagnostic tool that can help to better assess hair and scalp conditions and to identify specific features in the hair shafts. Treatment of AHM involves cutting the matted hair, and manual separation using organic solvent can be tried in early cases. Prevention of AHM includes regular use of soft hair cleansers and deep hair conditioners, and gentle combing to avoid entangling of hair fibres.

High intensity focused ultrasound as a potential new modality for the treatment of pigmentary skin disorder

The clinical skin tightening benefits of high intensity focused ultrasound (HIFU) have been established, but its mechanism of action in pigmented skin disorders remains unknown. We macroscopically and histopathologically investigated dermatological changes after HIFU at different exposure doses in a UVB‐induced guinea pig model of hyperpigmentation.

Improved methods for evaluating pre-clinical and histological effects of subcutaneous fat reduction using high-intensity focused ultrasound in a porcine model

Non‐invasive body sculpting procedures are becoming increasingly popular. High‐intensity focused ultrasound (HIFU) treatment is a non‐surgical fat reduction procedure that permanently destroys unwanted abdominal fat. Despite its increasing popularity, evaluation methods for the procedure have not yet been fully developed.

Tightening effects of high-intensity focused ultrasound on body skin and subdermal tissue: a pilot study

High‐intensity focused ultrasound (HIFU) has been introduced as a new treatment modality for skin tightening through application mainly to the face and neck.

Lump on the lower eyelid due to hyaluronic acid filler

A 29-year-old East Asian woman presented to our plastic and reconstructive surgery clinic with asymptomatic, well-defined, yellowish round nodules on her left lower eyelid. Four years previously, she had received an injection of hyaluronic acid (HA) filler (Restylane ; Q-Medical, Uppsala, Sweden) into both lower eyelids for lower pretarsal augmentation at a local clinic. Approximately 5 months after the injection, a firm, lumpy area developed on the left lower eyelid, at the injection site. Physical examination revealed firm, yellow lumps on the patient’s left lower eyelid (Fig. 1a). There were no inflammatory signs or symptoms at the site of injection. The patient underwent surgical excision of the nodules under local anaesthesia. The excised specimen was 3 9 3 mm in size, and was a well-demarcated, firm, yellowish, round nodule (Fig. 1b). To determine whether the lump consisted of HA, we stained the excised specimen with Alcian blue pH 2.5. The excised lump stained positively (Fig. 2a), and after processing with hyaluronidase, it stained negatively (Fig. 2b), thereby confirming that the lump was noninflammatory and composed purely of HA filler. In general, inflammatory nodules and granuloma formation are considered late adverse events of fillers, occurring 8–12 days after injection. These nodules may subsequently enlarge over 6 months at all injected sites. Many theories exist as to the aetiology of foreign-body reaction to HA filler injections. A hypersensitivity reaction to a tiny amount of protein contaminants within the filler or bacterial contamination at the time of filler injection have been suggested as potential aetiologies for the granulomatous response. However, the nodule in this case represents a very rare local complication of HA filler injection. Furthermore, the mechanism by which a noninflammatory lump from HA filler injection develops is not clear. We suggest several hypotheses to explain this mechanism. First, there is a possibility that the depth of filler injection was inadequate. It is better to inject into the mid to deep dermis or beneath the dermosubcutaneous junction or submuscular level than into the superficial dermis in order to avoid nodule formation. Second, the amount or activity of hyaluronidase might differ according to the depth of the skin tissue. In addition, there may also be differences in individual hyaluronidases. Third, there are active facial muscle movements around the perioral area; hyperfunctional movement of the orbicularis oculi muscle might push the injected HA filler materials superficially, at which point the injected HA materials might not be able to disperse into surrounding tissue and therefore will clump in the dermis. Fourth, a foreign-body reaction, such as granulomatous or inflammatory responses, might not have developed because of the fibrous capsule formed earlier. Quite recently, the first case of a late-onset, noninflammatory, encapsulated reaction to HA filler injection was reported. Although a delayed noninflammatory nodule is a very infrequent complication of HA filler injection, physicians need to be alert to the possibility of the development of a pure HA nodule. (a)