Anatomical and Ultrasonographic Analyses of the Levator Labii Superioris Alaeque Nasi Muscle at the Level of the Nasal Ala / Análisis Anatómico y Ecográfico del Músculo Elevador Nasolabial a Nivel del Ala Nasal

SUMMARY: We aimed to determine the width of the levator labii superioris alaeque nasi muscle (LLSAN) at the level of the nasal ala through cadaveric dissections and ultrasonography (US), to provide essential anatomical information for use during both invasive and noninvasive procedures in the nasal ala region. The LLSAN was investigated in the 40 hemifaces of 20 Korean cadavers, comprising 10 males and 10 females with a mean age of 73.6 years. The LLSAN width of the 40 specimens at the level of the midpoint of the nasal ala was 5.02±2.35 mm (mean±standard deviation), and ranged from 1.45 mm to 10.11 mm. The LLSAN widths were 5.96±2.36 mm and 3.93±1.89 mm in males and females, respectively, with ranges of 2.40-10.11 mm and 1.45-6.96 mm, respectively. The LLSAN widths on the left and right sides were 4.77±2.72 mm and 5.26±1.99 mm, respectively. The proportions of the LLSAN fibers inserting into the nasal ala and upper lip were similar in 13 specimens (32.5 %), while more fibers inserted into the nasal ala in 11 specimens (27.5 %) and more fibers inserted fibers of the LLSAN into the upper lip in 16 specimens (40 %). When clinicians need to target or avoid the LLSAN, the present width and range data can be helpful for ensuring the efficacy and safely of both invasive and noninvasive procedures. In addition, the possibility of asymmetry in the width of the LLSAN in the nasal ala region should be confirmed by US before performing such procedures.

Nuestro objetivo fue determinar el ancho del músculo elevador nasolabial (MENL) a nivel del ala nasal mediante disecciones cadavéricas y ecografía, para proporcionar información anatómica esencial, para su uso durante procedimientos invasivos y no invasivos, en la región del ala nasal. El MENL se estudió en 40 hemicaras de 20 cadáveres coreanos (10 hombres y 10 mujeres) con una edad media de 73,6 años. El ancho de MENL de las 40 muestras a nivel del punto medio del ala nasal fue de 5,02 ± 2,35 mm (media ± desviación estándar) y osciló entre 1,45 mm y 10,11 mm. Los anchos de MENL fueron 5,96 ± 2,36 mm y 3,93 ± 1,89 mm en hombres y mujeres, respectivamente, con rangos de 2,40 a 10,11 mm y 1,45 a 6,96 mm, respec- tivamente. Los anchos de MENL en los lados izquierdo y derecho fueron 4,77 ± 2,72 mm y 5,26 ± 1,99 mm, respectivamente. Las proporciones de fibras de MENL que se insertaban en el ala nasal y en el labio superior fueron similares en 13 muestras (32,5 %), mientras que se insertaron más fibras en el ala nasal en 11 muestras (27,5 %) y además, se insertaron fibras de MENL en el labio superior en 16 ejemplares (40 %). Cuando los médicos necesitan apuntar o evitar el MENL, los datos actuales de ancho y rango pueden ser útiles para garantizar la eficacia y seguridad de los procedimientos, tanto invasivos como no invasivos. Además, la ecografía puede ser utilizada para confirmar una posible asimetría en el ancho del MENL en la región del ala nasal antes de realizar los procedimientos.

Separated muscle belly of the flexor digitorum brevis for the fifth toe: a case report / 대한해부학회지

This case report describes a variation of the flexor digitorum brevis (FDB) with a separated muscle belly and tendon at the fifth toe. The narrow tendon and muscle belly for the fifth toe arose from the intermuscular septum between the FDB and abductor digiti minimi adjacent to the arising fibers of the FDB, separating from its other fibers. The tendon and muscle belly for the fifth toe became wider at the base of the metatarsal bones and narrower as it coursed toward the toes in a fusiform shape. The tendon and muscle belly for the fifth toe became thin at the midfoot and coursed just beneath the flexor digitorum longus tendon and entered the digital tendinous sheath. FDB variations including that described herein should be considered when performing various surgical procedures and evaluating the biomechanics of the foot.

Short-term Efficacy and Safety of XEN Stent Implantation with or without a Conjunctival Incision

Purpose@#Comparison of the 6-month outcomes of ab externo XEN 45 gel stent implantation with conjunctival resection in Korean glaucoma patients. @*Methods@#From January to May 2021, 43 open-angle glaucoma patients who underwent ab externo XEN stent insertion alone and were followed for more than 6 months were classified into incision (n = 23) and non-incision (n = 20) groups according to the presence or absence of a conjunctival incision and analyzed retrospectively. Qualified or complete success was defined as achieving the personal target intraocular pressure (IOP) with or without medication, respectively. @*Results@#The IOP measured 6 months after surgery decreased significantly in both groups. The number of IOP-lowering drugs required was also reduced. The decrease in IOP after surgery was greater in the non-incision group. Six months after surgery, the qualified success rate was 55% in the non-incision group and 52.2% in the incision group, while the complete success rate was 40% and 8.7%, respectively. During follow-up, 58.1% of the patients underwent bleb needling more than once, and 20.9% underwent additional IOP-lowering surgery, but there was no difference between the two groups. @*Conclusions@#XEN stent insertion helped to reduce IOP and the number of IOP-lowering agents after 6 months regardless of a conjunctival incision. However, to maintain the target IOP, bleb manipulation was required in many cases.

Effects of Vascular Endothelial Growth Factor on YAP/TAZ Signaling in Trabecular Meshwork Cells

Purpose@#To investigate the effects of vascular endothelial growth factor (VEGF) on yes-associated protein (YAP)/transcriptional coactivator with a PDZ-binding motif (TAZ), a Hippo pathway-related transcription factor, and the role of YAP/TAZ induced by trabecular meshwork stimulation. @*Methods@#Human trabecular meshwork cells were cultured and treated with various VEGF concentrations to verify cell cytotoxicity using the CCK-8 solution. Transforming growth factor β-2 (TGFβ2; 5 ng/mL) and VEGF (30 ng/mL) were applied and YAP/TAZ expression was assessed by western blotting, reverse transcription quantitative polymerase chain reaction and immunocytochemistry. Fibronectin, collagen 1, and myocilin expression were also assessed by western blotting. The cells were stained using Alexa Fluor 488-phalloidin to observe F-actin changes. @*Results@#YAP and TAZ expression increased following TGFβ2 and VEGF treatment for 24 hours. Fibronectin and collagen 1 increased significantly in all three treatment groups, while myocilin increased in the TGFβ2 and TGFβ2+VEGF groups. The F-actin staining showed increased cross-linking in the trabecular meshwork cells. @*Conclusions@#VEGF induced YAP/TAZ signaling and increased trabecular meshwork cell fibrosis. Based on the functional changes caused by VEGF, it is suggested that VEGF and YAP/TAZ may increase aqueous humor outflow resistance in trabecular meshwork cells.

Dentists’ Recognition of Child Abuse and Neglect and Mandatory Attitude to Report / 대한소아치과학회지

In this study, the recognition of child abuse and neglect (CAN) and reporting attitudes of general dentists and pediatric dentists in Korea were estimated. A survey was conducted among dentists working at clinics or university hospitals, including interns and residents at dental hospital training institutions. The questionnaire, consisting of 32 questions and detailed questions, subdivided into ‘general characteristics of respondents’, ‘CAN’, ‘CAN report’, ‘laws to CAN’, ‘countermeasures against CAN’. The survey was conducted using a messenger, and 176 respondents’ answers were analyzed. The recognition of CAN showed high scores in the order of physical abuse, neglect, and emotional abuse. The positive attitude toward reporting CAN had a higher score than the negative attitude. Of the total respondents, 19 said they reported child abuse, and 18 said they were suspected of child abuse but hesitated to report it. Among the laws related to CAN, the protection measures for CAN reporters and the protocol for CAN showed low awareness. Since then, they have wanted to know how to find abused children and how to deal with them in education. This study is expected to be used as data to improve dentists’ awareness and consciousness of CAN in the future.

Pilot Study About the Effects of the Soma Experiencing Motion (Soma e-Motion) Program on Interoceptive Awareness and Self-Compassion

Objective@#The purpose of this study was to examine the effects of the Soma experiencing motion (Soma e-motion) program on interoceptive awareness and self-compassion among novices. @*Methods@#A total of 19 adults (clinical group=9, non-clinical group=10) participated in the intervention. Psychological and physical changes after program were qualitatively analyzed using in-depth interviews. The Korean Multidimensional Assessment of Interoceptive Awareness (K-MAIA) and the Korean version of the Self-Compassion Scale (K-SCS) were used as quantitative measures. @*Results@#The non-clinical group showed statistically significant differences in the K-MAIA scores (z=-2.805, p0.05; K-SCS: z=-0.178, p>0.05). According to the in-depth interviews, the results of the qualitative analysis were categorized into five dimensions (psychological and emotional, physical, cognitive, behavioral, and aspects participants found challenging and needs improvement). @*Conclusion@#The Soma e-motion program was feasible for improving interoceptive awareness and self-compassion in the non-clinical group. However, further research is needed to investigate the clinical efficacy of the Soma e-motion program for clinical group.

Feasibility of artificial intelligence-driven interfractional monitoring of organ changes by mega-voltage computed tomography in intensity-modulated radiotherapy of prostate cancer

Purpose@#High-dose radiotherapy (RT) for localized prostate cancer requires careful consideration of target position changes and adjacent organs-at-risk (OARs), such as the rectum and bladder. Therefore, daily monitoring of target position and OAR changes is crucial in minimizing interfractional dosimetric uncertainties. For efficient monitoring of the internal condition of patients, we assessed the feasibility of an auto-segmentation of OARs on the daily acquired images, such as megavoltage computed tomography (MVCT), via a commercial artificial intelligence (AI)-based solution in this study. @*Materials and Methods@#We collected MVCT images weekly during the entire course of RT for 100 prostate cancer patients treated with the helical TomoTherapy system. Based on the manually contoured body outline, the bladder including prostate area, and rectal balloon regions for the 100 MVCT images, we trained the commercially available fully convolutional (FC)-DenseNet model and tested its auto-contouring performance. @*Results@#Based on the optimally determined hyperparameters, the FC-DenseNet model successfully auto-contoured all regions of interest showing high dice similarity coefficient (DSC) over 0.8 and a small mean surface distance (MSD) within 1.43 mm in reference to the manually contoured data. With this well-trained AI model, we have efficiently monitored the patient's internal condition through six MVCT scans, analyzing DSC, MSD, centroid, and volume differences. @*Conclusion@#We have verified the feasibility of utilizing a commercial AI-based model for auto-segmentation with low-quality daily MVCT images. In the future, we will establish a fast and accurate auto-segmentation and internal organ monitoring system for efficiently determining the time for adaptive replanning.

Problematic Smartphone Use and Its Relationship With Anxiety and Suicidal Ideation Among South Korean Adolescents

Objective@#This study aimed to investigate the prevalence of problematic smartphone use (PSU) among adolescents and its association with anxiety and suicidal ideation. @*Methods@#The 16th cross-sectional, population-based Korea Youth Risk Behavior Web-Based Survey was administered in 2020 and included 54,948 adolescents. We used the Korean version of the smartphone overdependence scale and the 7-item Generalized Anxiety Disorder scale to assess PSU and anxiety. Suicidal ideation was assessed through responses to the self-report question. Multiple logistic regression analyses with complex sampling were conducted to identify the association of PSU with anxiety and suicidal ideation. @*Results@#In total, 25.1% of the adolescents reported PSU, 33.2% had anxiety symptoms, and 10.9% had seriously considered suicide during the past 12 months. Girls with PSU had a higher risk of anxiety (adjusted odds ratio [aOR], 2.81; 95% confidence interval [CI], 2.65 to 2.97) and suicidal ideation (aOR, 1.77; 95% CI, 1.64 to 1.91) than non-PSU girls. Boys with PSU reported more anxiety (aOR, 2.89; 95% CI, 2.72 to 3.07) and suicidal ideation (aOR, 1.82; 95% CI, 1.66 to 1.99) than the non-PSU group. In addition, girls with the lowest household income reported more suicidal ideation than girls with the highest household income (aOR, 3.40; 95% CI, 2.69 to 4.28). @*Conclusion@#This study demonstrated the prevalence of PSU among South Korean adolescents in 2020. The prioritization of the detection of PSU and the identification of psychological factors may help improve the diagnosis and management of mental health problems and potentially yield significant psychosocial benefits.

A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study

Objective@#The health behavior and mental health problems of adolescents have shown a variety of changes due to the coronavirus disease-2019 (COVID-19) pandemic. This study compared health behavior, obesity, and mental health among Korean adolescents before and during the early COVID-19 pandemic. @*Methods@#Population-based and cross-sectional data from the 2019 and 2020 Korea Youth Risk Behavior Web-Based Surveys were used. Data of 57,048 and 54,948 adolescents from the 2019 and 2020 surveys, respectively, were compared. Multiple logistic regression analysis was conducted to compare health behavior, obesity, and mental health before and during the COVID-19 pandemic. @*Results@#The adjusted odds ratio (aOR) of overweight, obesity, and body image perceived subjectively as fat, were higher in the 2020 sample compared to the 2019 sample. The aOR of the frequency (more than 3 times a week) of fast-food consumption was higher in 2020 than in 2019. However, the aOR of physical activity, alcohol use, and smoking experience were lower in 2020 than in 2019. In addition, during COVID-19, adolescents were less likely to have perceived severe stress, depressive moods, and suicidal ideation. @*Conclusion@#Current evidence suggests the co-occurrence of positive and negative changes in health behavior, obesity, and mental health among Korean adolescents during the early COVID-19 pandemic. The results contribute insights for monitoring adolescents’ health behavior and promoting their mental health during school shutdowns.

Association of Social Support and Postpartum Depression According to the Time After Childbirth in South Korea

Objective@#This study examined the association between social support and postpartum depression (PPD) according to the time after childbirth within 12 months in South Korea. @*Methods@#Data were collected from 1,481 women in Chungnam Province, South Korea from September 21 to 30, 2022. Multivariate logistic regression models were used to examine the association between social support and PPD. Subgroup analysis of the associations of support from family, friends, and significant others with PPD according to the time after childbirth was undertaken using crude and adjusted models. @*Results@#Of the participants, 39.91% had PPD. The prevalence of PPD was 36.05% at <3 months, 37.50% at 3≤ to <6 months, and 44.41% at 6≤ to <12 months. A 1-point increase in the social support score was associated with an increase in the adjusted odds ratio of PPD of 0.91 (95% confidence interval=0.90–0.93). Social support from family was significantly associated with PPD regardless of the time after childbirth. Support from significant others was significantly associated with PPD after 6≤ to <12 months. @*Conclusion@#Family support should be provided consistently to women after birth; social connections with significant others can prevent PPD.

Coronavirus disease 2019-associated acute necrotizing encephalopathy in a 9-year-old boy

Coronavirus disease 2019 (COVID-19) is associated with a variety of neurologic manifestations. Acute necrotizing encephalopathy (ANE) is a rare, life-threatening complication characterized by rapid deterioration of neurologic status following viral infection, such as influenza or human herpesvirus 6. Since the COVID-19 pandemic, a rise in ANE cases associated with the infectious disease has been reported in adult patients. We present a case of COVID-19-associated ANE in a 9-year-old boy. The patient experienced 3 days of fever and mild respiratory symptoms, followed by lethargy. Magnetic resonance imaging on day 4 showed hyperintensity in the bilateral thalami, midbrain, pons, hypothalamus, and cerebellum, along with some areas of hemorrhage. From the imaging findings, ANE was strongly suspected, leading to the initiation treatment involving a 5-day course of remdesivir and multiple immunomodulator therapies, including high-dose corticosteroids, intravenous immunoglobulin, tocilizumab, and 10 cycles of therapeutic plasma exchange. Subsequently, the patient gradually improved, experiencing only minor neurological sequelae and showing favorable radiologic improvement. In COVID-19-infected patients presenting neurologic symptoms, it is crucial to promptly suspect and investigate unexplained encephalopathy using neuroimaging. Early administration of immunomodulator therapy is vital for the diagnosis and optimizing clinical outcomes.

A Case of Orbital Infarction Syndrome in a Patient with Hemophagocytic Lymphohistiocytosis

Purpose@#To report a case of orbital infarction syndrome in a patient with hemophagocytic lymphohistiocytosis (HLH).Case summary: A 70-year-old woman with diabetes mellitus and hypertension was referred to the Department of Ophthalmology for sudden-onset left upper eyelid ptosis after being diagnosed with HLH. After 3 days, the best corrected visual acuity in the right eye was 0.8, while there was no light perception in the left eye. In the left eye, the ocular motility examination showed limitations in all fields of gaze. On fundus examination, optic disc pallor, retinal hemorrhage, and narrowed retinal arteries were observed in the left eye. Fluorescein angiography showed no blood flow in the retinal arteries and veins in the left eye. On neck computed tomography angiography, the left distal internal carotid artery was narrowed. Orbit computed tomography showed exophthalmos and extraocular muscle hypertrophy in the left eye. Orbit magnetic resonance imaging confirmed optic nerve edema, enhancement of the optic nerve sheath, and high signal intensity of the intraocular fat in the left eye. Slit-lamp examination revealed ischemia of the anterior segment and ischemic necrosis of the eyelid in the left eye. The patient was diagnosed with orbital infarction syndrome. @*Conclusions@#Several factors may lead to ischemia of the orbital tissues in patients with HLH, including coagulopathy, an increased incidence of blood clots, and inflammation in the orbit. It is necessary to consider the possibility of orbital infarction syndrome when HLH patients present with visual loss, ocular movement limitations, and anterior segment ischemia.

Palinacousis after Cerebral Venous Thrombosis in the Temporoparietal Lobe

Palinacousis is a rare auditory phenomenon characterized by the persistence of sounds beyond their actual duration. It has been associated with various brain conditions such as stroke, tumor, and seizure in the temporoparietal lobe. We present a case report of a 43-yearold man who developed palinacousis following cerebral venous thrombosis and seizure with lesions including the left auditory cortex. This case highlights the intriguing relationship between cerebral venous infarction, seizure, and the development of palinacousis in specific brain regions.

Multiple Antiplatelet Therapy in Ischemic Stroke Already on Antiplatelet Agents Based on the Linked Big Data for Stroke

Background@#Optimal antiplatelet strategy for patients with ischemic stroke who were already on single antiplatelet therapy (SAPT) remains to be elucidated. This study aimed to evaluate the effect of different antiplatelet regimens on vascular and safety outcomes at 1 year after non-cardioembolic stroke in patients previously on SAPT. @*Methods@#We identified 9,284 patients with acute non-cardioembolic ischemic stroke that occurred on SAPT using linked data. Patients were categorized into three groups according to antiplatelet strategy at discharge: 1) SAPT; 2) dual antiplatelet therapy (DAPT); and 3) triple antiplatelet therapy (TAPT). One-year outcomes included recurrent ischemic stroke, composite outcomes (recurrent ischemic stroke, myocardial infarction, intracerebral hemorrhage, and death), and major bleeding. @*Results@#Of 9,284 patients, 5,565 (59.9%) maintained SAPT, 3,638 (39.2%) were treated with DAPT, and 81 (0.9%) were treated with TAPT. Multiple antiplatelet therapy did not reduce the risks of 1-year recurrent stroke (DAPT, hazard ratio [HR], 1.08, 95% confidence interval [CI], 0.92–1.27, P = 0.339; TAPT, HR, 0.71, 95% CI, 0.27–1.91, P = 0.500) and 1-year composite outcome (DAPT, HR, 1.09, 95% CI, 0.68–1.97, P = 0.592; TAPT, HR, 1.46, 95% CI, 0.68–1.97, P = 0.592). However, the TAPT groups showed an increased risk of major bleeding complications (DAPT, HR, 1.23, 95% CI, 0.89–1.71, P = 0.208; TAPT, HR, 4.65, 95% CI, 2.01–10.74, P < 0.001). @*Conclusion@#Additional use of antiplatelet agents in patients with non-cardioembolic ischemic stroke who were already on SAPT did not reduce the 1-year incidence of vascular outcomes, although it increased the risk of bleeding complications.

Can We Notice the Suicidal Warning Signs of Adolescents With Different Psychometric Profiles Before Their Death?: Analysis of Teachers’ Reports

Background@#This study aimed to analyze the suicidal warning signs of Korean students with different psychometric profiles based on teacher reports. @*Methods@#This was a retrospective cohort study based on Korean school teachers’ responses to the Student Suicide Report Form. In total, 546 consecutive cases of student suicide were reported from 2017 to 2020. After missing data were excluded, 528 cases were included. The report consisted of demographic factors, the Korean version of the Strengths and Difficulties Questionnaire (SDQ) for teacher reporting, and warning signs of suicide. Frequency analysis, multiple response analysis, the χ2 test, and Latent Class Analysis (LCA) were performed. @*Results@#Based on the scores of the Korean version of the teacher-reported SDQ, the group was divided into nonsymptomatic (n = 411) and symptomatic (n = 117) groups. Based on the LCA results, four latent hierarchical models were selected. The four classes of deceased students showed significant differences in school type (χ2 = 20.410, P < 0.01), physical illness (χ2 = 7.928, P < 0.05), mental illness (χ2 = 94.332, P < 0.001), trigger events (χ2 = 14.817, P < 0.01), self-harm experience (χ2 = 30.618, P < 0.001), suicide attempts (χ2 = 24.072, P < 0.001), depressive symptoms (χ2 = 59.561, P < 0.001), anxiety (χ2 = 58.165, P < 0.001), impulsivity (χ2 = 62.241, P < 0.001), and social problems (χ2 = 64.952, P < 0.001). @*Conclusion@#Notably, many students who committed suicide did not have any psychiatric pathology. The proportion of the group with a prosocial appearance was also high. Therefore, the actual suicide warning signals were similar regardless of students’ difficulties and prosocial behaviors, so it is necessary to include this information in gatekeeper education.

Attention, Externalizing and Internalizing Problems Mediated Differently on Internet Gaming Disorder Among Children and Adolescents With a Family History of Addiction as an Adverse Childhood Experience

Background@#This study aimed to examine the factors associated with internet gaming disorder (IGD) and the mediating role of pediatric symptoms (attention, externalizing problems and internalizing problems) in children and adolescents with a family history of addiction as an adverse childhood experience (ACE). @*Methods@#A total of 2,586 children and adolescents (mean age = 14.04 ± 2.34; age range = 11–19 years; 50.5% boys) completed the Internet Game Use-Elicited Symptom Screen and the Pediatric Symptom Checklist-17. IBM SPSS Statistics 21 was used to calculate descriptive statistics and Pearson correlation coefficients and to conduct multiple regression analyses.Mediation analysis was performed using the Sobel test and the SPSS PROCESS macro. Serial multiple mediation analysis was performed using bootstrapping with 5,000 replications. @*Results@#The higher levels of Attention problems (β = −0.228, P < 0.001) and externalizing problems (β = −0.213, P < 0.001) were associated with IGD. Furthermore, the indirect effect of the independent variable on the dependent variable through the mediators was significant (Sobel’s T: Z = −5.006, P < 0.001). These findings suggest that attention and externalizing problems mediate the effect of family history of addiction on IGD. @*Conclusion@#This study demonstrated the associations among the family history of addiction, IGD, and pediatric symptoms (attention, externalizing problems, and internalizing problems) among Korean children and adolescents. Therefore, we need to pay attention to pediatric symptoms and develop systematic alternatives to improve mental health among Korean children and adolescents with a family history of addiction as ACEs.

Anatomical connections between the inferior fibers of the musculus orbicularis oculi and musculus levator labii superioris alaeque nasi / Conexiones anatómicas entre las fibras inferiores del músculo orbicular del ojo y levantador nasolabial

SUMMARY: This study aimed to determine the anatomical connections between the inferior fibers of M. orbicularis oculi (OOc inf.) and the M. levator labii superioris alaeque nasi (LLSAN), providing anatomical variations of the connecting fibers. This study examined the OOc and LLSAN of 44 specimens from 22 embalmed adult Korean cadavers. Connecting fibers between the OOc inf. and LLSAN were observed in 29.5 % of the specimens. Connecting patterns of the OOc inf. to the LLSAN were classified into three categories according to the directions of the connecting fibers; Type I (13.6 %), in which some of the OOc inf. coursed medially to blend with the lateral originating fibers of the LLSAN. Type II (11.4 %), in which some of the OOc inf. descended vertically to blend with the LLSAN. Type III (4.5 %), in which both types I and II were found simultaneously. Some of the OOc inf. coursed medially to blend with the lateral originating fibers of the LLSAN, and some of the OOc inf. descended vertically to blend with the LLSAN. These findings provide greater knowledge of the connecting fibers between the OOc inf. and LLSAN, thereby helping us understand complicated expressions, inject BoNT-A into related wrinkles, and analyze EMG activities.

RESUMEN: Este estudio tuvo como objetivo determinar las conexiones anatómicas entre las fibras inferiores del músculo orbicular del ojo (MOO inf.) y el levantador nasolabial (Musculus levator nasiolabialis; M. levator labii superioris alaeque nasi) (LNL), proporcionando variaciones anatómicas de las fibras conectoras. Se examinó el orbicularis oculi (MOO) y LNL de 44 especímenes de 22 cadáveres coreanos adultos embalsamados. Se observaron fibras conectoras entre los MOO inf. y LNL en el 29,5 % de los especímenes. Patrones de conexión del OOc inf. a LNL se clasificaron en tres categorías según las direcciones de las fibras conectoras; Tipo I (13,6 %), en el que algunos de los MOO inf. cursaban medialmente para mezclarse con las fibras de origen lateral del LNL. Tipo II (11,4 %), en el que algunos de los MOO inf. descendían verticalmente para mezclarse con el LNL. Tipo III (4,5 %), en el que se encontraron simultáneamente los tipos I y II. Algunos de los MOO inf. cursaron medialmente para mezclarse con las fibras de origen lateral de la LNL y algunas de las MOO inf. descendían verticalmente para mezclarse con el LNL. Estos hallazgos aportan un mayor conocimiento de las fibras conectoras entre los MOO inf. y LNL, lo que nos ayuda a comprender expresiones complicadas, inyectar BoNT-A en las arrugas relacionadas y analizar las actividades de EMG.

Influence of COVID-19-related Nursing Experience on Job Stress of Nurses / 한국직업건강간호학회지

Purpose@#This study aimed to compare and analyze the job stress of nurses with and without in COVID-19-related work. @*Methods@#A structured self-reported questionnaire survey was conducted to assess job stress. The extent of job stress was compared between nurses with COVID-19 (COVID-19 group) and those without such experience (non-COVID-19 group). Multiple regression analysis was performed to identify the factors influencing job stress. @*Results@#Job stress was higher in the COVID-19 group compared to the non-COVID-19 group (t=2.54, p=.12). In sub-categorical comparison, stress driven by a taxing work environment, relationship conflict, and work schedule was higher in the COVID-19 group than the non-COVID-19 group. Multiple regression analysis revealed the job stress was higher among nurses with COVID-19-related work experience than that of non-experienced nurses. The factors affecting job stress of nurses with COVID-19-related work experience included emergency room work, providing nursing assistant for COVID-patients, and caring for these patients. @*Conclusion@#Since COVID-19-related work experience is a major factor that affects nurses' job stress, it is imperative to provide various support measures for nursing assistants such as providing a break from working in an environment with high risk of infection, adjusting work schedules, resolving conflicts between personnel, and securing support.

Variant muscle fibers connecting the orbicularis oculi to the orbicularis oris: case report / 대한해부학회지

The orbicularis oculi (OOc) is a sphincteric muscle of the eyelids, whereas contraction of the orbicularis oris (OOr), another sphincteric muscle, causes narrowing of the lips. Facial muscle fibers normally blend with adjacent muscles. However, muscle fibers connecting the various facial muscles that have different actions and that are located at distant sites, such as the OOc and the OOr have been rarely reported. Herein, we report a rare case of connecting fibers between the inferior margin of the OOc and the OOr. These connecting fibers were blended with the OOr between the inserting fibers of the levator labii superioris and levator anguli oris. Contraction of such variant muscles might affect typical facial expressions.

Missing medial tarsal artery replaced by the anterior medial malleolar artery / 대한해부학회지

The present case report describes an unusual variant of a missing medial tarsal artery (MTA) being replaced by the anterior medial malleolar artery (AMMA). The dorsalis pedis artery (DPA) did not give off any branches to the medial foot. The DPA coursed downward in the foot along with the superficial fibular nerve on the foot dorsum at the lateral side of the first metatarsal bone before entering the sole. In the medial malleolus, the AMMA arose from the anterior tibial artery and then ramified several branches, one of which descended to the medial talus. Thus, the possibility of a missing MTA being replaced by the AMMA should be considered by surgeons and radiologists when various surgeries are performed in the medial tarsal area.