Dermatite fotoalérgica ao pigmento azul de tatuagens: relato de um caso e breve revisão da literatura / Photoallergic dermatitis due to the blue pigment in tattoos: a case report and brief literature review

A prática de tatuagens é muito antiga e atualmente tornou-se extremamente popular, porém traz consigo riscos que não podem ser ignorados. As tintas utilizadas nas tatuagens são um fator importante para o aparecimento de reações adversas. A reação de hipersensibilidade aos pigmentos das tintas é uma das mais comuns. Entre elas, encontram-se reações alérgicas tipo dermatites de contato ou reações de fotossensibilidade, sendo esta última o motivo deste relato. O tratamento indicado é o uso de corticoides e a fotoproteção. Neste artigo, discorreremos especificamente sobre a reação de fotossensibilidade ao pigmento azul, com o relato de um caso e breve revisão da literatura.

Tattooing is a very old practice that has become extremely popular in recent years; however, it carries risks that cannot be ignored. The inks used in tattoos are an important factor for the appearance of adverse reactions. Hypersensitivity reactions to the pigments in the inks are some of the most common. These include allergic reactions such as contact dermatitis or photosensitivity reactions, the latter being the reason for this report. The recommended treatment is the use of corticosteroids and photoprotection. In this article, we will specifically discuss the photosensitivity reaction to the blue pigment with a case report and a brief literature review.

La iniciativa paperless, innovación al servicio de la conservación del medio ambiente / The paperless initiative, innovation at the service of environmental conservation

La presente investigación tuvo por objetivo establecer las relaciones de la innovación en las tecnologías de la comunicación e información así como la evolución de los formatos móviles con la creación de propuestas que se presenten como alternativas ecológicas al uso del papel, a través de la revisión bibliográfica y de experiencias alrededor del mundo que logran sustentar la iniciativa paperless como una alternativa para el desarrollo sostenible y el equilibrio ambiental gracias a la reducción del consumo de papel a través de la migración al uso de archivos digitales en oficinas y sitios de trabajo con gran volumen de consumo de papel, casos como el de Axtel en México y las propuestas del MIT con la creación de tintas digitales, fungen como sustento de las innovaciones en función del medio ambiente. Entre los resultados encontrados se presenta la necesidad de ir más allá de los esfuerzos que se han iniciado en América Latina para crear una cultura del reciclaje e incentivar a la población a utilizar las tecnologías desarrolladas para la sustitución del papel como método de reducción de la explotación ambiental.

The objective of this research was to establish the relationships of innovation in communications and information technologies as well as the evolution of mobile formats with the creation of proposals that are presented as ecological alternatives to the use of paper, through the literature review and experiences around the world that support the paperless initiative as an alternative to sustainable development and environmental balance by reducing paper consumption through migration to the use of digital files in offices and workplaces with large volume of paper consumption. Cases such as Axtel in Mexico and the proposals at MIT with the creation of digital inks, serve as support of innovations according to the environment. The need to go beyond the efforts that have been initiated in Latin America to create a culture of recycling and encourage people to use the technologies developed for the replacement of paper as a method of reducing environmental exploitation are important findings of this research.

Comparison of the diagnostic yield of various systematic randomized prostate biopsy protocols using prostate phantoms made of devil's tongue jelly

PURPOSE: The purpose of this study was to compare the diagnostic yield of five systematic randomized protocols using 12–20 biopsy cores with variably-sized phantoms. METHODS: A total of 100 prostate phantom models were produced by casting liquid devil's tongue jelly using silicone molds. Sets of 20 phantoms were created with the following volumes: 20 mL, 40 mL, 60 mL, 80 mL, and 100 mL. Three focal lesions were created by injecting 0.5 mL of warm agar solution stained with red, blue, and green ink into each phantom model. The focal lesions were verified by ultrasonography. The systematic randomized biopsy protocols consisted of 12, 14, 16, 18, and 20 biopsy cores. The diagnostic yield of the multiple systematic biopsy protocols was compared. RESULTS: The overall detection rates of each model set were 93.3% for 20 mL, 88.3% for 40 mL, 71.7% for 60 mL, 43.3% for 80 mL, and 30.0% for 100 mL. Statistically significant differences in the detection rate were found between 40 mL and 60 mL and between 60 mL and 80 mL. No statistically significant increase in the detection rate was observed within a given volume set even when the number of core biopsies increased from 12 to 20. CONCLUSION: The diagnostic yield of systematic randomized biopsies is inversely proportional to the phantom volume.

Parameters Affecting India Ink Artifacts on Opposed-Phase MR Images

PURPOSE: To determine the MR parameters affecting India ink artifacts on opposed-phase chemical shift magnetic resonance (MR) imaging.MATERIALS AND METHODS: The use of a female Sprague-Dawley rat was approved by our Institutional Animal Care and Use Committee. Using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images, which is a modified Dixon method, axial opposed-phase images of the abdominal cavity were obtained with different MR parameters: series 1, different repetition times (TRs; 400, 2000, and 4000 ms); series 2, different echo times (TEs; 10, 50, and 100 ms); series 3, different field of views (FOVs; 6, 8, 16, and 24 cm); series 4, different echo train lengths (ETLs; 2, 4, and 8); series 5, different bandwidths (25, 50, and 85); and series 6, different slice thicknesses (1, 2, 4, 8, and 16 mm). Artifacts on opposed images obtained with different parameters were compared subjectively by two radiologists. For objective analysis, the thickness of the artifact was measured. Spearman's correlation between altered MR parameters and thicknesses of India ink artifact was obtained via objective analysis.RESULTS: India ink artifact was increasingly apparent using shorter TE, larger FOV and ETL, and thicker slices upon subjective analysis. The objective analysis revealed a strong negative correlation between the thickness of the artifact and TE (r = -0.870, P < 0.01); however, strong positive correlations were found between FOV (r = 0.854, P < 0.01) and slice thickness (r = 0.971, P < 0.01).CONCLUSION: India ink artifact was thicker with shorter TE, larger FOV, and larger slice thickness.

Characteristics of Smell Identification Test in Patients With Parkinson Disease

OBJECTIVES: Parkinson disease (PD) is frequently associated with olfactory disorder at early stage, which is caused by deposition of Lewy bodies emerging from the olfactory bulb to higher olfactory centers. Early detection of olfactory disorder in the patients with PD may lead to the early diagnosis and treatment for this refractory disease. METHODS: Visual analog scale (VAS), Jet Stream Olfactometry, and Japanese smell identification test, Open Essence (OE), were carried out on 39 patients with PD. Thirty-one patients with postviral olfactory disorder (PVOD), which was caused by the olfactory mucosal dysfunction, were also enrolled in this study as control. RESULTS: There were no significant differences in detection thresholds (2.2 vs. 1.4, P=0.13), recognition thresholds (3.9 vs. 3.5, P=0.39) and OE (4.8 vs. 4.2, P=0.47) between PVOD and PD, while VAS scores of PVOD and PD were significantly different (2.0 and 6.2, P<0.01). In OE, significant differences were observed in the accuracy rates of menthol (68% vs. 44%, P=0.04) and Indian ink (42% vs. 15%, P=0.01) between PVOD and PD. Of particular interest, patients with PVOD tended to select “no detectable,” while patients with PD tended to select wrong alternative other than “no smell detected.” CONCLUSION: Discrepancy between VAS and OE, and high selected rates of wrong alternative other than “undetectable” in OE might be significant signs of olfactory dysfunction associated with PD.

Click Chemistry-Based Injectable Hydrogels and Bioprinting Inks for Tissue Engineering Applications

BACKGROUND: The tissue engineering and regenerative medicine approach require biomaterials which are biocompatible, easily reproducible in less time, biodegradable and should be able to generate complex three-dimensional (3D) structures to mimic the native tissue structures. Click chemistry offers the much-needed multifunctional hydrogel materials which are interesting biomaterials for the tissue engineering and bioprinting inks applications owing to their excellent ability to form hydrogels with printability instantly and to retain the live cells in their 3D network without losing the mechanical integrity even under swollen state. METHODS: In this review, we present the recent developments of in situ hydrogel in the field of click chemistry reported for the tissue engineering and 3D bioinks applications, by mainly covering the diverse types of click chemistry methods such as Diels–Alder reaction, strain-promoted azide-alkyne cycloaddition reactions, thiol-ene reactions, oxime reactions and other interrelated reactions, excluding enzyme-based reactions. RESULTS: The click chemistry-based hydrogels are formed spontaneously on mixing of reactive compounds and can encapsulate live cells with high viability for a long time. The recent works reported by combining the advantages of click chemistry and 3D bioprinting technology have shown to produce 3D tissue constructs with high resolution using biocompatible hydrogels as bioinks and in situ injectable forms. CONCLUSION: Interestingly, the emergence of click chemistry reactions in bioink synthesis for 3D bioprinting have shown the massive potential of these reaction methods in creating 3D tissue constructs. However, the limitations and challenges involved in the click chemistry reactions should be analyzed and bettered to be applied to tissue engineering and 3D bioinks. The future scope of these materials is promising, including their applications in in situ 3D bioprinting for tissue or organ regeneration.

Tatuagens: de temporárias a permanentes / Tattoos: from temporary to permanent

A realização de tatuagens temporárias é frequente, sendo percebida como inofensiva. A tinta usada deriva da henna, pigmento castanho-avermelhado obtido de uma planta. No entanto, para obter "henna negra" e facilitar a realização da tatuagem, são adicionados outros compostos, mais frequentemente a parafenilenodiamina. Esta está associada a reações alérgicas, por vezes graves e com sequelas. Os autores apresentam um caso de uma criança de 10 anos com uma reação alérgica exuberante com provável sobreinfecção bacteriana em local de tatuagem temporária. Havia história de sensibilização prévia, pelo que a reação foi precoce e mais agressiva. Os sinais inflamatórios francos motivaram o internamento sob corticoterapia sistêmica e antibioticoterapia endovenosa. Apesar da boa evolução clínica, permaneceu uma lesão hipopigmentada sequelar. Pretende-se alertar para os perigos desta realidade e também para a falta de legislação existente.

Temporary tattoos are quite popular, and they are perceived as harmless. The ink used in temporary tattoos is made from henna, a reddish-brown coloring pigment obtained from a shrub. However, in order to obtain "black henna" and facilitate the tattooing process, other compounds are added to the mixture, especially p-phenylenediamine. This compound is associated with allergic reactions that are sometimes severe and may leave sequelae. The authors describe a case of a 10-year old child presenting with allergic reaction and probable bacterial superinfection in a temporary tattoo area. The patient had a history of prior skin sensitization, and therefore the reaction was early and more aggressive. The severity of the inflammatory signs motivated hospital admission for systemic corticosteroid therapy and intravenous antibiotic therapy. Despite the good clinical evolution, a hypopigmented lesion persisted. Our goal is to raise awareness on the dangers of this practice and to highlight the lack of legislation in the area.

The Usefulness of Intraoperative Circumferential Frozen-Section Analysis of Lumpectomy Margins in Breast-Conserving Surgery / 한국유방암학회지

PURPOSE: Intraoperative frozen-section analysis of the lumpect-omy margin during breast-conserving surgery (BCS) is an excellent method in obtaining a clear resection margin. This study aimed to investigate the usefulness of intraoperative circumferential frozen-section analysis (IOCFS) of lumpectomy margin during BCS for breast cancer, and to find factors that increase the conversion into mastectomy. METHODS: From 2007 to 2011, 509 patients with breast cancer underwent IOCFS during BCS. The outer surfaces of the shaved lumpectomy margins were evaluated. A negative margin was defined as no ink on the tumor. All margins were evaluated using the permanent section analysis. RESULTS: Among the 509 patients, 437 (85.9%) underwent BCS and 72 (14.1%) finally underwent mastectomy. Of the 483 pathologically confirmed patients, 338 (70.0%) were true-negative, 24 (5.0%) false-negative, 120 (24.8%) true-positive, and 1 (0.2%) false-positive. Twenty-four patients (4.7%) among total 509 patients had undetermined margins as either atypical ductal hyperplasia or ductal carcinoma in situ in the first IOCFS. The IOCFS has an accuracy of 94.8% with 83% sensitivity, 99.7% specificity, 93.4% negative predictive value, and 99.2% positive predictive value. Sixty-three cases (12.4%) were converted to mastectomy, the first intraoperatively. Of the 446 (87.6%) patients who successfully underwent BCS, 64 patients received additional excisions and 32 were reoperated to achieve clear margin (reoperation rate, 6.3%). Twenty-three of the reoperated patients underwent re-excisions using the second intraoperative frozen section analysis, and achieved BCS. Nine cases were additionally converted to mastectomy. No significant differences in age, stage, and biological factors were found between the BCS and mastectomy cases. Factors such as invasive lobular carcinoma, multiple tumors, large tumor, and multiple excisions increased the conversion to mastectomy. CONCLUSION: The IOCFS analysis during BCS is useful in evaluating lumpectomy margins and preventing reoperation.

3D-Printed Nose-to-Larynx Airway Model, Preliminary Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Flexible fiberscopy is essential in the examination of the nose to larynx airway. However, the instrument is sensitive to manipulation and can sometimes be damaged when excessive external force is applied. In addition, patients can be injured during fiberscopic examination. In this regard, a airway model mimicking the human airway passage was developed for the education of fiberscopy to minimize the danger to both patient and fiberscope. MATERIALS AND METHOD: Neck CT data was used to 3D-print the airway model. Using the 3D doctor software, the outlines of the air-filled cavities were extracted. The outline data was modified to make the inside of the outline empty and the outside filled with 3D ink resin. The airway data was used to 3D-print the replica in three pieces, which were then assembled into one. Flexible laryngoscopic examination of nose to larynx was performed using the nose-to-larynx airway model, and for a male patient enrolled in the study. Virtual endoscopy was performed using the same CT data. The examination data were then compared frame by frame with regards to the shapes and positions of nasal inlet, inferior turbinate, torus tubarius, hypopharynx, epiglottis and vocal cord. RESULTS: The airway model was very similar in shape and position of the anatomic landmarks compared with real human airway examined by the fiberscope. CONCLUSION: The results of 3D-printed airway model showed similar shapes as the real human airway, and real time endoscopy could be done using the model. This technique can be extended to make models of tubed organs such as the intestine or the bronchial tree.

The Practice Patterns and Perceptions of Korean Surgeons Regarding Margin Status after Breast-Conserving Surgery / 한국유방암학회지

Two consecutive surveys for breast surgeons in Korea were conducted to comprehend the practice patterns and perceptions on margin status after breast-conserving surgery. The surveys were conducted online in 2014 (initial) and 2016 (follow-up). A total of 126 and 88 responses were obtained in the initial and follow-up survey, respectively. More than 80% of the respondents replied to routinely apply frozen section biopsy for intraoperative margin assessment in both surveys. Re-excision recommendations of the margin for invasive cancer significantly changed from a close margin to a positive margin over time (p=0.033). Most of the respondents (73.8%) defined a negative margin as “no ink on tumor” in invasive cancer, whereas more diverse responses were observed in ductal carcinoma in situ cases. The influence of guideline establishment for negative margins has been identified. A high uptake rate of intraoperative frozen section biopsy was noted and routine use needs reconsideration.

Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study

BACKGROUND/AIMS: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC. METHODS: Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip. RESULTS: All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding. CONCLUSIONS: In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.

Permanent Makeup Removal from Murine Skin Using 1,064-nm Q-switched Nd:YAG Laser and 694-nm Q-switched Ruby Laser: Comparing the Degree of Removal Following Irradiation at Different Time Points after Application / 대한피부과학회지

BACKGROUND: Q-switched lasers have made it possible to remove tattoos without leaving unsightly scars. OBJECTIVE: Tobdetermine the optimal time for permanent makeup removal using Q-switched Nd:YAG and ruby lasers, we compared the degree of removal and associated histological changes following irradiation at different time points. METHODS: Using black ink and a permanent makeup machine, we performed 108 separate permanent makeup applications on rat skin. The 1,064-nm Q-switched Nd:YAG laser (QSNDL) and 694-nm Q-switched ruby laser (QSRL) were used to irradiate the permanent makeup on the day of its application and also 3, 5, 7, 14, and 21 days later. We assessed changes in pigmentation over time at each irradiated site using Mexameter® measurements and skin biopsies. RESULTS: The Mexameter® analysis demonstrated no significant differences in pigment removal among irradiations with QSNDL or QSRL on the day of permanent makeup application or at 3, 5, 7, 14, and 21 days later. Histological analysis demonstrated that permanent makeup pigment migrated from the epidermis to the superficial and mid dermis over time. QSNDL more effectively removed pigment throughout the epidermis and dermis compared to QSRL. CONCLUSION: For maximum pigment removal efficacy, the melanin index results suggest that laser treatment should be performed on the day permanent makeup is applied. However, from the histological perspective, permanent makeup should be removed approximately 1 week later, at which point the crusts have peeled off and the wound repair process is almost complete. In this study, histological analysis suggested the superiority of treatment with QSNDL to that with QSRL.

Therapeutic effect of low molecular weight chitosan containing sepia ink on ethanol-induced gastric ulcer in rats

ABSTRACT PURPOSE: To evaluate the role of low molecular chitosan containing sepia ink (LMCS) in ethanol-induced (5 ml/kg) gastric ulcer in rats. METHODS: Animals were divided into four groups (n = 12): normal group (Normal), negative control group (Con), experiment group (LMCS) and positive control Omeprazole group (OMZ). Gastric empty rate was detected in the first 7 days. Rats were sacrificed at 7, 14 and 21 day for histology and ELISA detections. RESULTS: Gastric empty was no significant differences among the groups (P > 0.05). Histological observation showed gastric mucosal LMCS treated had better healing effect. Hydroxyproline (Hyp) was significantly increased from 7 day (P < 0.05). LMCS significantly inhibited malondialdehyde (MDA) generation for lipid peroxidation from 7 day (P < 0.05). LMCS significantly promoted the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) at the earlier stage (P < 0.05). OMZ had the similar effects above. As for myeloperoxidase (MPO), LMCS significantly decreased and restored it to normal levels from 7 day (P < 0.05), it is earlier than OMZ which is from 14 day. CONCLUSION: LMCS can improve gastric mucosa tissue repair, exert significant influences on oxidative and antioxidant enzyme activities and neutrophil infiltration.

Effects of chitin and sepia ink hybrid sponge on the healing of burning wound rats and its impact on macrophages in vitro

PURPOSE: To detect whether chitin and sepia ink sponge (CS) can promote wound healing and elevate impact of CS on phagocytosis ability of macrophages. METHODS: Forty-eight rats were assigned to four groups: Normal group (Normal), negative control group (Con), chitin and sepia ink sponge group (CS) and positive control Surgicel Gauze(r) group (SG). Deep second-degree burn model was created in rats. Wound area was recorded by digital imaging and determined using Image J software. Samples were collected and kept at -80oC on 3d, 7d, 14d and 21d for cytokines detecting. Transforming growth factor (TGF)-β1, interleukin (IL)-6, matrix metalloproteinase (MMP)-1, hydroxyproline (Hyp) and macrophage activity reflected by tumor necrosis factor (TNF)-α were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: Comparing to Con and SG, scabs in CS group fell off and basically healed on 21 day. TGF-β1, IL-6, MMP-1 and Hyp were significantly increased by CS and SG comparing to Con (p < 0.05), CS had more apparently adjustment on TGF-β1 and MMP-1 compared to SG; results in vitro indicated CS significantly promoted phagocytosis ability of macrophages reflected in TNF-α (p < 0.05). CONCLUSION: CS improved wound healing through exerting significant influences on secretion of kinds of cytokines and activating macrophages.

Current Status of Three-Dimensional Printing Inks for Soft Tissue Regeneration

Recently, three-dimensional (3D) printing technologies have become an attractive manufacturing process, which is called additive manufacturing or rapid prototyping. A 3D printing system can design and fabricate 3D shapes and geometries resulting in custom 3D scaffolds in tissue engineering. In tissue regeneration and replacement, 3D printing systems have been frequently used with various biomaterials such as natural and synthetic polymers. In tissue engineering, soft tissue regeneration is very difficult because soft tissue has the properties of high elasticity, flexibility and viscosity which act as an obstacle when creating a 3D structure by stacking layer after layer of biomaterials compared to hard tissue regeneration. To overcome these limitations, many studies are trying to fabricate constructs with a very similar native micro-environmental property for a complex biofunctional scaffold with suitable biological and mechanical parameters by optimizing the biomaterials, for example, control the concentration and diversification of materials. In this review, we describe the characteristics of printing biomaterials such as hydrogel, synthetic polymer and composite type as well as recent advances in soft tissue regeneration. It is expected that 3D printed constructs will be able to replace as well as regenerate defective tissues or injured functional tissues and organs.

Risk assessment of di(2-ethylhexyl) phthalate in the workplace

OBJECTIVES: A hazard assessment of di(2-ethylhexyl) phthalate (DEHP), a commonly used workplace chemical, was conducted in order to protect the occupational health of workers. A literature review, consisting of both domestic and international references, examined the chemical management system, working environment, level of exposure, and possible associated risks. This information may be utilized in the future to determine appropriate exposure levels in working environments. METHODS: Hazard assessment was performed using chemical hazard information obtained from international agencies, such as Organization for Economic Cooperation and Development-generated Screening Information Data Set and International Program on Chemical Safety. Information was obtained from surveys conducted by the Minister of Employment and Labor (“Survey on the work environment”) and by the Ministry of Environment (“Survey on the circulation amount of chemicals”). Risk was determined according to exposure in workplaces and chemical hazard. RESULTS: In 229 workplaces over the country, 831 tons of DEHP have been used as plasticizers, insecticides, and ink solvent. Calculated 50% lethal dose values ranged from 14.2 to 50 g/kg, as determined via acute toxicity testing in rodents. Chronic carcinogenicity tests revealed cases of lung and liver degeneration, shrinkage of the testes, and liver cancer. The no-observed-adverse-effect level and the lowest-observed-adverse-effect level were determined to be 28.9 g/kg and 146.6 g/kg, respectively. The working environment assessment revealed the maximum exposure level to be 0.990 mg/m³, as compared to the threshold exposure level of 5 mg/m³. The relative risk of chronic toxicity and reproductive toxicity were 0.264 and 0.330, respectively, while the risk of carcinogenicity was 1.3, which is higher than the accepted safety value of one. CONCLUSIONS: DEHP was identified as a carcinogen, and may be dangerous even at concentrations lower than the occupational exposure limit. Therefore, we suggest management of working environments, with exposure levels below 5 mg/m³ and all workers utilizing local exhaust ventilation and respiratory protection when handling DEHP.

Antioxidant Effect of Sepia Ink Extract on Extrahepatic Cholestasis Induced by Bile Duct Ligation in Rats / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of our study was to assess the complications of hepatic fibrosis associated with bile duct ligation and the potential curative role of sepia ink extract in hepatic damage induced by bile duct ligation.</p><p><b>METHODS</b>Rattus norvegicus rats were divided into 3 groups: Sham-operated group, model rats that underwent common bile duct ligation (BDL), and BDL rats treated orally with sepia ink extract (200 mg/kg body weight) for 7, 14, and 28 d after BDL.</p><p><b>RESULTS</b>There was a significant reduction in hepatic enzymes, ALP, GGT, bilirubin levels, and oxidative stress in the BDL group after treatment with sepia ink extract. Collagen deposition reduced after sepia ink extract treatment as compared to BDL groups, suggesting that the liver was repaired. Histopathological examination of liver treated with sepia ink extract showed moderate degeneration in the hepatic architecture and mild degeneration in hepatocytes as compared to BDL groups.</p><p><b>CONCLUSION</b>Sepia ink extract provides a curative effect and an antioxidant capacity on BDL rats and could ameliorate the complications of liver cholestasis.</p>

The Comparison of Ultrasound Guided Cricothyroid Membrane Identification Method and Anatomical Landmark Palpation Cricothyroid Membrane Identification Method in Intubated Patients

PURPOSE: Cricothyroidotomy had a high failure rate. Ultrasound-guided cricothyroid membrane (CTM) identification may be more accurate and easier than anatomical landmark palpation. The purpose of this study was to compare the accuracy of ultrasound-guided CTM identification method (ultrasound method) and anatomical landmark palpation CTM identification method (palpation method) in patients who were intubated in an emergency medical center. METHODS: Using fluorescent invisible ink, the emergency physician was asked to mark the center of the CTM with the patient by palpation method. After 5 minutes, the participant found the CTM using the ultrasound method and drew a cross with a blue pen. An emergency medicine specialist or senior resident identified the actual center of the CTM with ultrasound and drew a cross with a black pen. The distance between the actual and estimated center of the CTM was measured. Participants measured the ease of use of each method using a 0~10 visual analog scale (VAS). RESULTS: Nineteen patients were enrolled and 38 tests were performed. Both first and second year emergency medicine residents showed that identifying the CTM was more difficult in cases of using the palpation method compared with the ultrasound method. VAS score was 3.0 (1.0-5.0) and 4.0 (2.0-8.0), respectively (p=0.006). Using the ultrasound method and another method, the horizontal length differences were 1.0 mm (IQR 0-2.0) vs. 2 mm (IQR 1.0-3.0) (p<0.001) and the vertical length differences were 1.5 mm (IQR 0-2.0) vs. 3.0 mm (IQR 1.0-9.3), respectively (p<0.001). CONCLUSION: Using the ultrasound method is an easier and more accurate way to find the center of the CTM compared with the palpation method in patients who were intubated in an emergency medical center.

Permanent Makeup Removal from Murine Skin Using a 1064 nm Q-switched Nd:YAG Laser: Comparison of the Degree of Removal When Irradiated at Various Time Points after Application / 대한피부과학회지

BACKGROUND: Various Q-switched (QS) lasers, such as ruby, alexandrite or neodymium:YAG (Nd:YAG) lasers, are used to remove tattoos and permanent makeup. To our knowledge, there has been no indication or guideline published for the optimal time for laser-mediated tattoo removal. OBJECTIVE: To set a guideline for the optimal irradiation time for tattoo and permanent makeup removal via 1064 nm QS Nd:YAG (QSND) laser, we compared the degree of tattoo removal and skin histologic changes when the irradiation was employed at different time points. METHODS: Rat skin was marked with 54 artificial permanent makeup marks with black ink using a permanent makeup machine. The marks were irradiated with a 1064 nm QSND laser on the application day, and 3 days, 5 days, 1 week, 2 weeks, and 3 weeks after application. Pigmentation changes were checked over time using a Mexameter(R) and skin biopsy. RESULTS: There was no significant difference in the degree of pigment removal as examined by Mexameter(R) on the day of makeup application compared to 3 days, 5 days, 1 week, 2 weeks, and 3 weeks after application. Histopathologically, the permanent makeup pigments seemed to move from epidermis to superficial and mid dermis with time. The pigments were relatively well removed throughout the epidermis and dermis when the laser was employed 7 days after tattoo application, compared to laser irradiation on the day of application, as viewed histologically. CONCLUSION: Laser removal of permanent makeup is effective on the day of application, as determined by testing pigment levels. However, based on histopathology, it is recommended to use lasers to remove permanent makeup about a week after application, since the wound repair process is almost complete at that time.