Biodiesel production and exploring properties of Datura stramonium L. oil with its optimization using combined approaches-Taguchi, grey relational analysis, and response surface methodology

Biodiesel production through the synthesis of Datura stramonium L. oil is studied to explore the most efficient approaches to suggest an alternate feedstock for biodiesel production. The main objective of this work is to optimize the process variables of biodiesel synthesis by using some statistical approach (Taguchi method, grey relational analysis (GRA), and response surface methodology (RSM) analyzing three parameters, i.e., alcohol-to-oil molar ratio, catalyst (NaOH) concentration, and process temperature for achieving maximum biodiesel derived from Datura stramonium L. oil. The transesterification process is applied by using an ultrasonic-assisted technique. Grey relational analysis (GRA) was successfully applied with the Taguchi method resulting in the optimum combination of A2B1C1. Based on the findings, the best operating conditions for transesterifying are attained with the RSM approach consisting of a 5.697:1 molar ratio (level 2), 0.3 (wt.%) NaOH concentration (level 1), and 70 °C process temperature (level 1). With a value of 87.02%, these ideal operating conditions produce the maximum yield as compared to grey relational analysis (GRA) yields 83.99%. The obtained results have been verified through the characterization of oil and biodiesel as well. Also, the fuel qualities of DSL biodiesel were identified and assessed. DSL oil was found 137.6 degrees of unsaturation during fatty acid profile analysis. DSL biodiesel was found the best kinematic viscosity (4.2 mm2/s) and acid value (0.49) when compared to Karanja and palm biodiesel. D. stramonium L. was recognized as a suitable species for biodiesel feedstock according to the findings.

Parent perspective of an intensive splinting intervention following palmar burn injury in young children

BACKGROUND

Parents may experience challenges implementing their child's therapeutic treatment following burn.

METHODS

A mixed methods study was conducted to explore the parent experience of intensive splinting following palmar burns in young children (median age 16 months [IQR 14]). Thirteen parents were interviewed after cessation of their child's splinting (mean 12 months [SD 2] following burn). Parent interviews were semi-structured with open-ended questions and conducted one-to-one. Inductive thematic analysis was completed by two researchers with consensus achieved through discussion and agreement from third researcher. Themes were triangulated with quantitative data, including range of motion (ROM), scar, developmental and quality of life outcomes.

RESULTS

Children used the splint intensively (>12-24 h/day) for median 179 days (IQR 74) with all splinting ceased by median 275 days (IQR 105). All children had full ROM at scar maturation. Thematic analysis revealed two main themes: parents perceive the impact of splinting to be greater on them than their child and parents perceive outcomes to be more important than burden. Parents described the importance of routine and therapeutic relationships in ongoing engagement with intervention.

CONCLUSION

Parents consider intensive splinting to impact them more than their child with burden of care manageable considering overall outcomes.

Hidroadenocarcinoma Mimicking Epidermal Inclusion Cyst of the Palm

Hidradenocarcinoma is a rare malignant tumor of sweat glands of the skin that has been reported several times in the hand. We report a case of hidradenocarcinoma of the palm in a 55-year-old woman that presented as a painless volar hand mass. A staged rotational forearm flap was used after resection.

Pool Toes: A Case Report

Pool toes, a sport-related dermatosis, are caused by mechanical friction and water exposure, resulting in a special variant of irritant contact dermatitis. It is common in children, often misdiagnosed, and rarely reported. Here we report a case of a 7-year-old girl who developed this unusual type of frictional dermatitis; a pool toes diagnosis has been made. With topical corticosteroids, favorable results have been achieved. The recovery and healing process will be facilitated if one is aware of the underlying causes of such dermatitis and ceases the triggering factors.

Blends of palm kernel oil, soybean oil and palm stearin as an alternative to milk fat for frozen dessert application

In this study, the ternary blends of palm kernel oil (PKO), soybean oil (SBO) and two types of palm stearin (PS) (PS33 and PS38) were systematically prepared and evaluated for their application as an alternative to milk fat in frozen dessert. The physicochemical characteristics namely fatty acids constituent, triacylglycerols (TAGs) composition, melting behavior, solid fat content (SFC) and microstructure were studied. All ternary blends of PKO/SBO/PS33 and PKO/SBO/PS38 had comparable microstructure to that of milk fat. However, 80/15/5 (PKO/SBO/PS33) and 80/15/5 to 80/5/15 (PKO/SBO/PS38) mixtures were found to have similar SFC as milk fat at temperature above 20 °C, allowing these ternary blends to be completely melted at body temperature. With this, 80/15/5 (PKO/SBO/PS33) and 80/15/5 to 80/5/15 (PKO/SBO/PS38) mixtures were able to provide similar meltdown and mouth feel as milk fat at room temperature. Nonetheless, fatty acids constituent, TAGs composition and melting behavior of the blends were different from milk fat. This study showed that ternary blends of PKO, SBO and PS at ratios 80/15/5 (PKO/SBO/PS33) and 80/15/5 to 80/5/15 (PKO/SBO/PS38) can be potentially used as a milk fat alternative for frozen dessert application based on its similar microstructure and SFC profile as the milk fat.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s13197-022-05507-z.

Leaf fossils of Sabalites (Arecaceae) from the Oligocene of northern Vietnam and their paleoclimatic implications

Recent paleobotanical investigations in Vietnam provide a good opportunity to improve our understanding of the biodiversity and paleoclimatic conditions in the geological past of Southeast Asia. Palms (Arecaceae) are a diverse family of typical thermophilous plants with a relatively low tolerance for freezing. In this study, we describe well-preserved fossil palm leaves from the Oligocene Dong Ho Formation of Hoanh Bo Basin, northern Vietnam. Characters of the fossil leaves, such as a fan-shaped costapalmate lamina, an unarmed petiole, a costa slightly enlarged at the base that then tapers distally into the blade, and well-preserved amphistomatic leaves with cuticles, suggest that they represent a new fossil species, which we herein designate Sabalites colaniae A. Song, T. Su, T. V. Do et Z.K. Zhou sp. nov. Together with other paleontological and palaeoclimatic evidence, we conclude that a warm climate prevailed in northern Vietnam and nearby areas during the Oligocene.

Reliability of a novel technique to assess palmar contracture in young children with unilateral hand injuries

BACKGROUND

Palmar contracture in young children can have significant developmental consequences. Despite this, objective techniques to measure palmar range of movement and quantify contracture in young children are limited.

PURPOSE

The purpose of this study was to determine the reliability of hand span and hand length measures in young children and to establish whether there is any association with age, sex and presence of a palmar burn injury in the reliability of these measures. The study also sought to determine the normative difference and establish a cut off value for the between-hand difference to identify loss of movement in 1 hand.

STUDY DESIGN

Cross sectional METHODS: Forty-four children aged 0 to <5 years were recruited. Twenty-two children had a unilateral palmar burn injury and 22 did not have a palmar burn injury. Each child's hand span and hand length were measured 3 times. This was performed twice by the first assessor and once by the second assessor. Intraclass correlation coefficients were calculated to determine the intra-rater and inter-rater reliability. The largest of the 3 values for both hand span and hand length from the first assessor's first assessment were used to determine the normative between-hand difference. Outliers were removed prior to determining the normative difference. Children were considered outliers if their between-hand difference in hand span and/or hand length was in the top 5% of values.

RESULTS

Excellent reliability was established for hand span and hand length measures for the whole group (intra-rater ICC_2,1 ≥0.95, inter-rater ICC_2,1 ≥0.94). The mean normative between-hand difference for both measures was 2 mm. The cut-off for the normative difference in hand span was <9 mm and hand length was <6 mm.

CONCLUSION

This measurement technique has excellent reliability and could be a useful method to quantify palmar range of movement and identify contracture in young children with unilateral hand injuries.

Kopyor versus macapuno coconuts: are these two edible mutants of Southeast Asia the same?

Kopyor and macapuno are two coconut mutants from Southeast Asia that are often described erroneously or interchangeably mismatched due to a lack of research, so future studies are encouraged. Coconut (Cocos nucifera L.; Arecaceae), a widely distributed plant with popular culinary applications, especially of the endosperm, has several nutritional and medicinal benefits. Two coconut mutants are widely recognized in Southeast Asia, namely kopyor and macapuno, specifically in Indonesia and Philippines, respectively. Kopyor coconut is known for its brittle solid endosperm while macapuno coconut is known for its gelatinous solid endosperm. Both mutant types have many other synonyms in other countries. Over many decades, the biology of macapuno coconut, including endosperm anatomy, histology, cytology, physiology, and genetics have been described, while kopyor coconut is still understudied. However, some literature and websites erroneously describe kopyor as macapuno coconut, or consider them interchangeably, which is an unintentional consequence of insufficient scientific research on these coconut mutants. Additionally, in Indonesia, there is another local mutant in Banten called wax coconut ("kelapa lilin") that some researchers claim as the actual Indonesian macapuno coconut due to its strong resemblance to kopyor coconut. Unfortunately, wax coconut is not only understudied, it is rarely documented. Additional evidence of their differences, in terms of morphological, biochemical and genetic characteristics, is needed. Moreover, clear documentation will also be needed for a better comparison. Understanding the differences between kopyor and macapuno coconuts will not only help to further clarify their scientific description in the literature, but will also guide locals, researchers, and industries to characterize similar mutants, if found in specific regions, for future study and bioprospecting.

Development model for palm processing industries with emphasis on total innovation management (TIM) in Kerman province

Conversion and complementary industries are one of the best ways to develop agricultural waste prevention. One of the problems facing the date-making and finishing industries is the problem. Lack of attention to the innovation of these industries and consequently lack of sufficient share in domestic markets and lack of access to global markets. This study examines the total innovation management in the fields of branding, packaging and pricing, customer orientation, and date and time-consuming advertising. Method: According to the goals and assumptions, descriptive-analytical research and its survey method is a survey. According to the Cochran formula, 155 people are involved in marketing, packaging and processing of dates in Kerman province. To answer the research question, a questionnaire was designed as the main research tool. SPSS software and AMOS software were used to analyze the results. Findings "Extensive Database of Resources", "New Technology", "Risk-taking Power", "How to Manage Workshops" are Top Priorities in Comprehensive Innovation Management in Convertible and Supplementary Industries and "Customer Oriented" Component Marketing And in the packaging of the component "smart packaging to maintain product quality" and in the processing of products "investment in the disinfection and grading sector" are the most important elements in the development of conversion and complementary industries.

Molecular approaches for improving oil palm for oil

The oil palm, originating from Africa, is the most productive oil crop species. Palm oil is an important source of edible oil. Its current global plantation area is over 23 million ha. The theoretical oil yield potential of the oil palm is 18.2 tons/ha/year. However, current average oil yield is only 3.8 tons/ha/year. In the past 100 years, conventional breeding and improvement of field management played important roles in increasing oil yield. However, conventional breeding for trait improvement was limited by its very long (10-20 years) phenotypic selection cycle, although it improved oil yield by ~10-20% per generation. Molecular breeding using novel molecular technologies will accelerate genetic improvement and may reduce the need to deforest and to use arable land for expanding oil palm plantations, which in turn makes palm oil more sustainable. Here, we comprehensively synthesize information from relevant literature of the technologies, achievements, and challenges of molecular approaches, including tissue culture, haploid breeding, mutation breeding, marker-assisted selection (MAS), genomic selection (GS), and genome editing (GE). We propose the characteristics of ideal palms and suggest a road map to breed ideal palms for sustainable palm oil.

Location of the Cut Flexor Tendons in the Palm Using Surface Anatomy: A Simple Guide for Minimal Incision Surgery

BACKGROUND

Hand Zone 2 flexor injuries are among the most important tendon lesions and its prognosis is poorer than the other hand zones. Limited incisions prevent multiple skin flaps. The present study aimed to determine the location of palmar flexor tendons using surface anatomical markers to provide a simple and easy guide for hand surgeons assisting them in minimal incisions.

METHODS

Patients with hand injuries in Zone 2 were taken to the operating room for surgery. The skin and subcutaneous tissue over the flexor tendons sheath were incised. After finding the flexor tendons in the palm, their exact position was located with a blue needle (23G) over the palm crease and marked relative to the finger borders.

RESULTS

Thirty-eight patients with the mean age of 27±3.6 years were operated. Totally, 57 fingers and 38 palms were dissected. The flexor tendons were located under the proximal and distal palm creases between two parallel lines extended from finger borders and mid-axial axis of the fingers. The average distance from finger print to distal palmar crease was 25, 32 and 24 mm for little, ring and long finger, respectively and 32 mm from index finger print to mid palmar crease.

CONCLUSION

The precise position of flexor tendons can be easily determined in the palm according to surface anatomical markers and plan for limited incisions.

[Effect of free medial plantar perforator flap in repairing deep burn wound on palm with the assistance of three dimensional computed tomography angiography]

Objective: To explore the effect of free medial plantar perforator flap in repairing deep burn wound on palm with assistance of three dimensional computed tomography angiography (CTA). Methods: From March 2015 to January 2018, 11 patients with deep burn wounds of palm were admitted to the Department of Burns and Plastic Surgery of Yidu Central Hospital of Weifang City, including 6 males and 5 females, aged 19-53 years. The wound area after debridement was 3.0 cm×2.5 cm-8.0 cm×6.0 cm. Before the operation, CTA of the foot was performed, and the three dimensional digital model was reconstructed by computer software to observe the initial position, course, and distribution of the arteries and veins in the donor site. The medial plantar perforator flap was designed according to the area and shape of the wound, with area of 3.5 cm×3.0 cm-8.5 cm×6.5 cm. After the wound was covered by the flap, the perforating branch of the medial plantar artery was anastomosed end to end with the carpal epithelial branch of the ulnar artery, the accompanying vein or the branch of the great saphenous vein was anastomosed end to end with the accompanying vein of the carpal epithelial branch of the ulnar artery, and the terminal branch of the saphenous nerve or the medial dorsal cutaneous nerve was anastomosed end to end with the superficial palmar branch of the ulnar nerve. The wound of donor site was covered with full-thickness skin graft from the outer thigh of the same side. The perforators of the medial plantar artery observed during the operation were compared with the reconstructed three dimensional CTA images. The survival of flap was observed, and the appearance and function of the flap were followed up and evaluated with trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association. Results: The initial position, course, and distribution of the perforator of the medial plantar artery during the operation were basically the same as those of the reconstructed three dimensional CTA images before the operation. All the flaps of patients survived after the operation. During the 6 months to 1 year follow-up, the appearance of flap was good, with no obvious swelling or pigmentation, but with good elasticity. The discrimination distance between the two points was 5.0-8.0 mm, and the flaps were evaluated as excellent in 4 cases, good in 6 cases, and fair in 1 case. Conclusions: The free medial plantar perforator flap is an ideal choice for repair of the deep burn wound on palm. Three dimensional CTA before the operation can detect condition of vascular variation, with high accuracy of vascular anastomosis during operation.

Microwave steam activation, an innovative pyrolysis approach to convert waste palm shell into highly microporous activated carbon

Microwave-steam activation (MSA), an innovative pyrolysis approach combining the use of microwave heating and steam activation, was investigated for its potential production of high grade activated carbon (AC) from waste palm shell (WPS) for methylene blue removal. MSA was performed via pyrolytic carbonization of WPS to produce biochar as the first step followed by steam activation of the biochar using microwave heating to form AC. Optimum yield and adsorption efficiency of methylene blue were obtained using response surface methodology involving several key process parameters. The resulting AC was characterized for its porous characteristics, surface morphology, proximate analysis and elemental compositions. MSA provided a high activation temperature above 500 °C with short process time of 15 min and rapid heating rate (≤150 °C/min). The results from optimization showed that one gram of AC produced from steam activation under 10 min of microwave heating at 550 °C can remove up to 38.5 mg of methylene blue. The AC showed a high and uniform surface porosity consisting high fixed carbon (73 wt%), micropore and BET surface area of 763.1 and 570.8 m²/g respectively, hence suggesting the great potential of MSA as a promising approach to produce high grade adsorbent for dye removal.

Empirical investigation of locally made biodiesel on the automobile properties of diesel engine

Research have been able to resolve the challenges of biodiesel production from whatever source. The ultimate use of locally made biodiesel for domestic automobile engine is the focus of the study. Biodiesel from palm biomass was made using proven laboratory techniques. The derived biodiesel was mixed with petro-diesel in the proportion of B10 and B20. The TD 200 diesel engine was used to estimate automotive outcomes such as torque, rotational speed, differential pressure, operational temperature, power generated, sound of engine, power generated by engine in horse power, thermal efficiency, normal engine efficiency and brake mean effect pressure. The advantage of the experimental method is to:

•

Provide a simple and efficient way of analyzing locally made biodiesel.

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Parametrically investigate the pros and cons of biodiesel product.

•

Fully understand the impact of biodiesel on the well-being of diesel engines.

•

Chat a new course for biodiesel engine design for maximum utilization.

High-Resolution Ultrasound Visualization of Pacinian Corpuscles

The aim of this study was to evaluate the possibility of visualizing Pacinian corpuscles in the palm of the hand with high-resolution ultrasound (HRUS). In this prospective study, HRUS with a high-frequency probe (22 MHz) was used. The palms of two fresh cadaveric hands were screened for potential Pacinian corpuscles. Still ultrasound images and dynamic video sequences were obtained. In five regions with large amounts of suspected Pacinian corpuscles, tissue blocks were excised and histologically processed, and corresponding slices were compared with ultrasound images. Further, the transverse diameters of five Pacinian corpuscles, at the level of the metacarpal heads in the palm, were assessed on both sides (in total 100) in healthy volunteers. On ultrasound, Pacinian corpuscles presented as echolucent dots in the subcutis, adjacent to digital nerves and vessels and located 2-3 mm beneath the surface. On histologic sections, these echolucent dots corresponded to Pacinian corpuscles with respect to their position and topographic relationships. The mean transverse diameter for all volunteers was 1.40 ± 0.23 mm (range: 0.8-2.2 mm). This study confirms the ability to reliably visualize Pacinian corpuscles with HRUS, which contributes to our basic understanding of ultrasonographically visible subcutaneous structures and may enhance the diagnosis of pathologies related to Pacinian corpuscles.

Topical Selenium Sulfide for the Treatment of Hyperkeratosis

Hyperkeratosis presents as thickened skin. It can be congenital or acquired. Typically, it affects the palms and soles; the distribution of epidermal involvement is either diffuse, focal, or punctate. Microscopically, the pathologic signature of hyperkeratosis is marked orthokeratosis of the stratum corneum. Topical treatments provide the mainstay of therapy for hyperkeratosis. These include keratolytics (such as urea, salicylic acid, and lactic acid) and retinoids; physical debridement, topical corticosteroids, and phototherapy (using topical psoralen and ultraviolet A phototherapy) are other local therapeutic modalities. Selenium is a non-metallic essential element; its water-insoluble salt, selenium sulfide, is an active ingredient that is used (in either a foam, lotion, or shampoo) to treat not only seborrheic dermatitis but also tinea versicolor. Three individuals with hyperkeratosis involving their palms and/or soles are described; the hyperkeratosis was successful treated with topical selenium sulfide in either a 2.5% lotion/shampoo or a 2.75% foam. The response to topical selenium sulfide was not only rapid but also complete and sustained; none of the patients experienced any adverse events secondary to the therapy. In conclusion, we recommend that topical selenium sulfide be added to the therapeutic armamentarium for congenital or acquired hyperkeratosis—particularly for those patients with involvement of their palms and soles.

Pyrolysis production of fruit peel biochar for potential use in treatment of palm oil mill effluent

Fruit peel, an abundant waste, represents a potential bio-resource to be converted into useful materials instead of being dumped in landfill sites. Palm oil mill effluent (POME) is a harmful waste that should also be treated before it can safely be released to the environment. In this study, pyrolysis of banana and orange peels was performed under different temperatures to produce biochar that was then examined as adsorbent in POME treatment. The pyrolysis generated 30.7-47.7 wt% yield of a dark biochar over a temperature ranging between 400 and 500 °C. The biochar contained no sulphur and possessed a hard texture, low volatile content (≤34 wt%), and high amounts of fixed carbon (≥72 wt%), showing durability in terms of high resistance to chemical reactions such as oxidation. The biochar showed a surface area of 105 m²/g and a porous structure containing mesopores, indicating its potential to provide many adsorption sites for use as an adsorbent. The use of the biochar as adsorbent to treat the POME showed a removal efficiency of up to 57% in reducing the concentration of biochemical oxygen demand (BOD), chemical oxygen demand COD, total suspended solid (TSS) and oil and grease (O&G) of POME to an acceptable level below the discharge standard. Our results indicate that pyrolysis shows promise as a technique to transform banana and orange peel into value-added biochar for use as adsorbent to treat POME. The recovery of biochar from fruit waste also shows advantage over traditional landfill approaches in disposing this waste.

Nodular fasciitis involving the palm

Nodular fasciitis (NF) is a self-limiting fibrous neoplasm that can be mistaken for a soft tissue sarcoma. It is characterised by rapid growth, slight pain and local tenderness. Although it is frequently found in the forearm, a lesion distal to the wrist is quite rare. We present two unusual cases of NF involving the palm, supported by detecting ubiquitin specific protease 6 gene rearrangement. The first patient had non-intraneural NF presenting as peripheral neuropathy affecting the digital nerve while the second patient suffered from painless, non-tender NF in the palm, which had not regressed spontaneously during the five months prior to surgery.

Expanding our understanding of leaf functional syndromes in savanna systems: the role of plant growth form

The assessment of leaf strategies has been a common theme in ecology, especially where multiple sources of environmental constraints (fire, seasonal drought, nutrient-poor soils) impose a strong selection pressure towards leaf functional diversity, leading to inevitable tradeoffs among leaf traits, and ultimately to niche segregation among coexisting species. As diversification on leaf functional strategies is dependent on integration at whole plant level, we hypothesized that regardless of phylogenetic relatedness, leaf trait functional syndromes in a multivariate space would be associated with the type of growth form. We measured traits related to leaf gas exchange, structure and nutrient status in 57 coexisting species encompassing all Angiosperms major clades, in a wide array of plant morphologies (trees, shrubs, sub-shrubs, herbs, grasses and palms) in a savanna of Central Brazil. Growth forms differed in mean values for the studied functional leaf traits. We extracted 4 groups of functional typologies: grasses (elevated leaf dark respiration, light-saturated photosynthesis on a leaf mass and area basis, lower values of leaf Ca and Mg), herbs (high values of SLA, leaf N and leaf Fe), palms (high values of stomatal conductance, leaf transpiration and leaf K) and woody eudicots (sub-shrubs, shrubs and trees; low SLA and high leaf Ca and Mg). Despite the large range of variation among species for each individual trait and the independent evolutionary trajectory of individual species, growth forms were strongly associated with particular leaf trait combinations, suggesting clear evolutionary constraints on leaf function for morphologically similar species in savanna ecosystems.

Preparation and Optimization OF Palm-Based Lipid Nanoparticles Loaded with Griseofulvin

Palm-based lipid nanoparticle formulation loaded with griseofulvin was prepared by solvent-free hot homogenization method. The griseofulvin loaded lipid nanoparticles were prepared via stages of optimisation, by altering the high pressure homogenisation (HPH) parameters, screening on palm-based lipids and Tween series surfactants and selection of lipid to surfactant ratios. A HPLC method has been validated for the drug loading capacity study. The optimum HPH parameter was determined to be 1500 bar with 5 cycles and among the palm-based lipid materials; Lipid C (triglycerides) was selected for the preparation of lipid nanoparticles. Tween 80 was chosen from the Tween series surfactants for its highest saturated solubility of griseofulvin at 53.1 ± 2.16 µg/mL. The optimum formulation of the griseofulvin loaded lipid nanoparticles demonstrated nano-range of particle size (179.8 nm) with intermediate distribution index (PDI) of 0.306, zeta potential of -27.9 mV and drug loading of 0.77%. The formulation was stable upon storage for 1 month at room temperature (25 ^°C) and 45 ^°C with consistent drug loading capacity.

Hand coverage by alcohol-based handrub varies: Volume and hand size matter

Visitors of an infection prevention and control conference performed hand hygiene with 1, 2, or 3 mL ultraviolet light-traced alcohol-based handrub. Coverage of palms, dorsums, and fingertips were measured by digital images. Palms of all hand sizes were sufficiently covered when 2 mL was applied, dorsums of medium and large hands were never sufficiently covered. Palmar fingertips were sufficiently covered when 2  or 3 mL was applied, and dorsal fingertips were never sufficiently covered.

[REPAIR OF PALM SOFT TISSUE DEFECT WITH MEDIAL TARSAL COMBINED WITH MEDIAL PLANTAR FLAP PEDICLED WITH FREE DORSALIS PEDIS ARTERY]

OBJECTIVE

To investigate the effectiveness of medial tarsal combined with medial plantar flap pedicled with free dorsalis pedis artery in the repair of palm soft tissue defect.

METHODS

Between September 2013 and December 2015, 9 cases of palm soft tissue defects were repaired with medial tarsal combined with medial plantar flap pedicled with free dorsalis pedis artery. There were 7 males and 2 females with a mean age of 33 years (range, 21-52 years). The causes included traffic accident injury in 4 cases, crushing injury by heavy object in 3 cases, and electrical injury in 2 cases. The time between injury and admission was 3 hours to 2 days (mean, 9 hours). Five cases had pure soft tissue; combined injuries included tendon exposure in 2 cases, median nerve defect in 1 case, and exposure of tendon and nerve in 1 case. After debridement, the soft tissue defect area ranged from 6 cm×4 cm to 11 cm×6 cm. The flap size ranged from 7.0 cm×4.5 cm to 13.0 cm×7.0 cm. The vascular pedicle length was from 6 to 10 cm (mean, 7.5 cm). The donor sites were covered with ilioinguinal full thickness skin graft.

RESULTS

Nine flaps survived, primary healing of wound was obtained. Partial necrosis occurred at the donor site in 1 case, and the other skin graft successfully survived. All patients were followed up 6-20 months (mean, 10 months). All flaps had soft texture and satisfactory appearance; the cutaneous sensory recovery time was 4-7 months after operation (mean, 5 months). At last follow-up, sensation recovered to grade S4 in 4 cases, to grade S_3⁺ in 3 cases, and to grade S3 in 2 cases; two-point discrimination was 7-10 mm (mean, 8.5 mm). According to Society of Hand Surgery standard for the evaluation of upper part of the function, the hand function was excellent in 5 cases, good in 3 cases, and fair in 1 case. The donor foot had normal function.

CONCLUSIONS

The medial tarsal combined with medial plantar flap pedicled with free dorsalis pedis artery can repair soft tissue defect of the palm, and it has many advantages of soft texture, satisfactory function, and small injury at donor site.

Palmoplantar Dermatoses- A Clinical Study of 300 Cases

INTRODUCTION

Dermatoses affecting palms and soles are among the most difficult of all dermatological therapeutic problems. Many previous studies have focused on the specific diseases of palmoplantar dermatoses. However, none of them have included a comprehensive study of palmoplantar dermatoses.

AIMS

To study the epidemiological aspects like age distribution, sex distribution, the dermatoses affecting the palms & soles and the frequency of involvement of palms, soles or both palms & soles, in patient with palmoplantar dermatoses.

MATERIALS AND METHODS

This cross sectional study was conducted in the Department of Dermatology between October 2011 to September 2013. First 300 cases attending the department of dermatology primarily with complaints pertaining to palms and soles were enrolled in the study. After taking consent a detailed history and clinical examination pertaining to the aim of the study was recorded and analysed, which included inspection of morphology and distribution of lesions and palpation of any swelling. Direct microscopic examination of scrapings, wet mounted with 10% potassium hydroxide was done for cases with scaly lesions. Those who had a pustule, gram staining was done. Patch testing using Indian Standard Battery Series was done for those cases of eczema. A sample for biopsy was taken when diagnosis could not be arrived clinically, and subjected to histopathological examination.

RESULTS

In our study of 300 patients with palmoplantar dermatoses, 164 were females and 136 were males, the ratio observed being 1.2:1. The peak incidence was found in the age group 21-30 years, with 41 females (25%) and 35 males (25.7%). Most frequently affected individuals in this study were housewives (30%). The most common five diseases of palmoplantar dermatoses were palmoplantar psoriasis (20.7%), moniliasis (19%), palmoplantar hyperhidrosis (7%), keratolysis exfoliativa (6%) and pitted keratolysis (6%). Majority of patients had involvement of both palms and soles (44.3%) as compared to patients with involvement of only palm (28%) and only sole (27.3%). The commonest palmoplantar dermatoses with only palm involvement was keratolysis exfoliativa (16.7%), with only sole involvement was moniliasis (41%) and with both palms and soles involvement was palmoplantar psoriasis (41.4%). Associated nail changes were seen in 80 cases (26.6%), with maximum incidence in palmoplantar psoriasis (62.5%). Associated dermatological conditions were observed in 43 patients (14.3%).

CONCLUSION

Palmoplantar dermatoses are frequently encount-ered in the dermatologic field. Further investigation with a wider and larger population is necessary to understand the epidemiology, based on which accurate diagnosis and proper treatment could be achieved.

Zigzag bipedicle flaps for closure of full-thickness longitudinal palmar defects

This paper reports a new technique of closure of longitudinal full-thickness palmar defects with bipedicle flaps, used in six patients.

Curculio Curculis lupus: biology, behavior and morphology of immatures of the cannibal weevil Anchylorhynchus eriospathae G. G. Bondar, 1943

Weevils are one of the largest groups of living organisms, with more than 60,000 species feeding mostly on plants. With only one exception, their described larvae are typical plant-feeders, with mouthparts adapted to chewing plant material. Here we describe the second case of a weevil with early-instar larvae adapted to killing conspecifics. We have studied the life history of Anchylorhynchus eriospathae G. G. Bondar, 1943 (Curculioninae: Derelomini sensuCaldara, Franz & Oberprieler (2014)), a species whose immatures feed internally on palm flowers and fruits. We provide detailed descriptions of all immature stages, including the extremely modified first-instar larva. Unlike other weevils and later instars, this stage exhibits a flat body with very long ventropedal lobe setae, a large and prognathous head with a gula, and falciform mandibles, each with a serrate retinaculum, that are used to fight with and eventually kill other first-instar larvae. We also provide biological notes on all stages and the results of behavioral tests that showed that larval aggression occurs only among early life stages. Finally we show that adult size is highly dependent on timing of oviposition. This specialized killer first instar probably evolved independently from the one other case known in weevils, in Revena rubiginosa (Conoderinae: Bariditae sensuPrena, Colonnelli & Hespenheide (2014)). Interestingly, both lineages inhabit the same hosts, raising the possibility that both intra- and inter-specific competition shaped those phenotypes. Given the scarcity of knowledge on early larval stages of concealed insect herbivores, it is possible that our findings represent an instance of a much broader phenomenon. Our observations also allowed us to conclude that Anchylorhynchus eriospathae and A. hatschbachi G. G. Bondar, 1943 are actually the same species, which we synonymize here by considering the latter as a junior synonym (new synonymy).

Antioxidant activities of annatto and palm tocotrienol-rich fractions in fish oil and structured lipid-based infant formula emulsion

The abilities of annatto and palm tocotrienol-rich fractions (TRFs), as natural antioxidants, to inhibit lipid oxidation in menhaden fish oil and structured lipid-based infant formula emulsion, were evaluated and compared. The peroxide and anisidine values of the bulk oil and oil-in-water emulsion samples stored at 37°C were measured over a 28-day period. The results showed that annatto TRF was a more effective antioxidant than palm TRF and α-tocopherol in both food systems at 0.02% and 0.05%. Factors, including structural differences in chromanol head and isoprenoid tail, polarity, concentration, oxidation time, and the method used to monitor lipid oxidation, were responsible for the different behaviours of tocopherols and tocotrienols. In contrast to the reported findings in vivo, addition of α-tocopherol (0-75%) did not interfere with the antioxidant activity of tocopherol-free annatto TRF in foods. Our findings may lead to the development of new natural antioxidant products for food applications.

[Thorn synovitis: Report of 2 cases]

INTRODUCTION

Thorn synovitis is related to plant or animal thorn punctures. We report two cases of thorn synovitis.

CASE REPORTS

The first patient was a 41-year-old-woman who presented with recurrent arthritis of the right knee after needle fish injury. The immunological tests and cultures were negative. X-rays and MRI showed the foreign bodies in the soft parts on the outer side of the knee. An arthroscopy was performed and the thorn removed. Clinical outcome was favourable with complete symptoms resolution. The second patient was a 58-year-old-man, with a family history of spondylarthritis, who was admitted with a monoarthritis of the left wrist that occurred 10 weeks after palm tree thorn injury. Patient received unsuccessfully antibiotics and anti-inflammatory drugs. Immunological tests and cultures were negative. Wrist ultrasound showed erosive synovitis. Intra-articular lesion removal by arthroscopy allowed favourable outcome.

CONCLUSION

Thorn synovitis diagnosis is based on the discovery of a foreign body. Treatment is based on their removal. Suspicion of infection with deficient pathogen, especially Pantoea agglomerans, remains difficult for the practitioner.

Special locations dermoscopy: facial, acral, and nail

Although dermoscopy reflects the anatomy, skin anatomy is different on facial and acral skin as well as in the nail unit. Malignant patterns on acral sites include the parallel ridge pattern and irregular diffuse pigmentation, whose presence should lead to a biopsy. Malignant patterns on the face include features of follicular invasion (signet-ring images, annular granular images, and rhomboidal structures) and atypical vessels. Malignant patterns on the nail unit include the micro-Hutchinson sign and irregular longitudinal lines.

A large epidermoid cyst developing in the palm: A case report

INTRODUCTION

Epidermoid cysts, also called atheromas, are frequently observed. These cysts originate mostly in the pilosebaceous apparatus but rarely in areas without hair, such as the palm and sole. The mechanism of their development has been reported to be epidermal inclusion secondary to trauma or human papillomavirus (HPV)-60 infection. We report the patient who developed an epidermoid cyst in the palm without any known cause.

PRESENTATION OF CASE

A 93-year-old male noticed a mass in the left palm 3 years earlier, was diagnosed with an epidermoid cyst based on incisional biopsy, and underwent incision drainage several times during the 3-year period. However, since the cyst spontaneously ruptured and was infected, debridement and resection of the cyst were performed. The postoperative course was favorable, without signs of infection. The pathological diagnosis of the resected specimen was an epidermoid cyst.

DISCUSSION

This case was a rare epidermoid cyst originating in an area without hair, and there was neither a clear history of injury nor findings strongly suggesting HPV-60 infection. Causes other than repeated loading on the palm could not be considered for epidermal inclusion. To our knowledge, this case is the largest reported epidermoid cyst.

CONCLUSION

Epidermoid cysts are frequently observed, but their development in areas without hair is rare, and its mechanism has not been clarified. The association between this cyst and trauma or HPV is clear. However, repeated loading on areas such as the palm that tend to undergo chronic loading can also be a cause, as in this patient.

Palm-based diacylglycerol fat dry fractionation: effect of crystallisation temperature, cooling rate and agitation speed on physical and chemical properties of fractions

Fractionation which separates the olein (liquid) and stearin (solid) fractions of oil is used to modify the physicochemical properties of fats in order to extend its applications. Studies showed that the properties of fractionated end products can be affected by fractionation processing conditions. In the present study, dry fractionation of palm-based diacylglycerol (PDAG) was performed at different: cooling rates (0.05, 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0°C/min), end-crystallisation temperatures (30, 35, 40, 45 and 50°C) and agitation speeds (30, 50, 70, 90 and 110 rpm) to determine the effect of these parameters on the properties and yield of the solid and liquid portions. To determine the physicochemical properties of olein and stearin fraction: Iodine value (IV), fatty acid composition (FAC), acylglycerol composition, slip melting point (SMP), solid fat content (SFC), thermal behaviour tests were carried out. Fractionation of PDAG fat changes the chemical composition of liquid and solid fractions. In terms of FAC, the major fatty acid in olein and stearin fractions were oleic (C18:1) and palmitic (C16:0) respectively. Acylglycerol composition showed that olein and stearin fractions is concentrated with TAG and DAG respectively. Crystallization temperature, cooling rate and agitation speed does not affect the IV, SFC, melting and cooling properties of the stearin fraction. The stearin fraction was only affected by cooling rate which changes its SMP. On the other hand, olein fraction was affected by crystallization temperature and cooling rate but not agitation speed which caused changes in IV, SMP, SFC, melting and crystallization behavior. Increase in both the crystallization temperature and cooling rate caused a reduction of IV, increment of the SFC, SMP, melting and crystallization behaviour of olein fraction and vice versa. The fractionated stearin part melted above 65°C while the olein melted at 40°C. SMP in olein fraction also reduced to a range of 26 to 44°C while SMP of stearin fractions increased to (60–62°C) compared to PDAG.

Metastatic gastric adenocarcinoma presenting as a solitary plaque on the palm

Cutaneous metastases from gastric adenocarcinoma are extremely rare. When present, metastasis typically signifies disseminated disease with a poor prognosis. We report a case of an 80-year-old male with gastric cancer who presented with a single, erythematous plaque on the left palm, a very rare site for skin metastasis. Results of a skin biopsy demonstrated that the cutaneous metastasis originated from the stomach. This report emphasized the need for appropriate investigation into newly appearing, unusual, or persistent skin lesions.

Anomalous flexor digitorum superficialis muscle belly presenting as a mass within the palm

Anomalies of the flexor digitorum superficialis muscle are extremely uncommon and usually present as a painful mass or pseudotumour within the palm. Diagnosis may be difficult because many other soft tissue tumours (lipomas, ganglions, giant cell tumours and hamartomas) may present similarly. Magnetic resonance imaging helps to define the extent and characteristics of this anomalous muscle belly and to distinguish it from a soft tissue sarcoma, whereas plain radiographs are of little value. Three types of flexor digitorum superficialis muscle anomalies have been described, and treatment consists of subtotal or total surgical debulking of the mass if symptoms persist or if the diagnosis is in question. Most patients have complete resolution and full recovery. To date, 20 cases have been reported in the literature, usually involving the right small finger. In the present paper, the case of an anomalous flexor digitorum superficialis muscle in a 17-year-old male patient's left index finger is reported. Symptoms were relieved following surgical debulking and hand-based occupational therapy.

Angiolymphoid hyperplasia with eosinophilia on the palm

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon dermal angioproliferating tumor, characterized by red to brown papules or nodules on the head and neck, though also occurring in the mouth, trunk, extremities and inguinal area. The palm is a very unusual site for ALHE, and there have been very few cases reported globally thus far. ALHE can be pruritic and painful and histopathologic findings show vascular proliferation with infiltration of eosinophils and lymphocytes in the dermis. Plump endothelial cells protrude into the lumen. We report a case of ALHE occurring at an unusual site, the right palm, in a 62-year-old man, who had suffered from a solitary pinkish-colored, central depressed round hyperkeratotic plaque on his palm for 4 years. On the basis of clinical and histopathologic data, a diagnosis of ALHE was made. To our knowledge, this is the first report of ALHE on the palm in Korean dermatologic literature.

A case of palmar lichen nitidus presenting as a clinical feature of pompholyx

Lichen nitidus (LN) is an uncommon chronic eruption of an unknown cause, and it is characterized by tiny, discrete, flesh-colored papules. The sites of predilection are the genitalia, trunk and extremities. Unilateral palmar involvement with pruritus is infrequent. We report here on a case of LN confined to the right palm, and the patient presented with multiple, pruritic, erythematous to flesh-colored, tiny papules and vesicles that mimicked pompholyx. The histopathological examination of a skin biopsy specimen showed the typical findings of LN.