Clinical application of cryolipolysis in Asian patients for subcutaneous fat reduction and body contouring

Background@#Cryolipolysis, a preferred method for minimally invasive body contouring, involves the noninvasive cooling of adipocytes to induce lipolysis without damaging other tissues. This study aimed to evaluate the safety and efficacy of cryolipolysis for the treatment of excessive fat tissue. @*Methods@#Between May 2014 and December 2017, 231 patients with 448 areas of interest were enrolled and their records were retrospectively reviewed. We used five different vacuum applicators, and the best-fitting applicator was used for each area. One cycle of cryolipolysis was applied at a cooling intensity factor of 41.6. The efficacy was evaluated 12 weeks after treatment via review of clinical photographs, the pinch test, and ultrasonographic measurements of fat thickness. The occurrence of any complications was also assessed. @*Results@#The volume was reduced in all of the areas to which cryolipolysis was applied. The rate of reduction of the fat layer as measured via the pinch test was 19.2%, and the rate of the decrease in fat layer thickness as measured via ultrasonography was 22.8%. Fat reduction of the upper arm differed significantly from that of the abdomen and flank, but no significant difference was found between sexes. The side effects were limited to erythema, edema, bruising, and numbness at the treatment site and resolved without treatment. @*Conclusions@#Cryolipolysis, with new and better-fitting applicators, is safe, fast, and effective for the reduction of excessive fat tissue on the abdomen, back, flank, and extremities. It is a good option for treating excess adipose tissue in Asian patients.

Uterine Leiomyoma Is Associated with Female Sexual Dysfunction in Postmenopausal Women

PURPOSE: To determine the relationship between uterine leiomyoma and female sexual dysfunction (FSD) among premenopausal and postmenopausal women. MATERIALS AND METHODS: The study population consisted of consecutive women who underwent gynecologic screening tests, including transvaginal ultrasound, and completed the questionnaires on FSD. A total of 841 women were included from January 2010 to December 2011. FSD was defined as Female Sexual Function Index (FSFI) ≤26.55. The relationship between uterine leiomyoma and FSD were compared according to menopausal status. RESULTS: In premenopausal group (n=564), there were no differences in the frequency of FSD (55.0% vs. 58.8%, p=0.387) and total FSFI score. However, in postmenopausal group (n=277), women with uterine leiomyoma had a lower frequency of FSD than those without uterine leiomyoma (71.3% vs. 86.4%, p=0.003). This relationship between uterine leiomyoma and lower frequency of FSD in postmenopausal women remained significant after adjusting for confounding variables. CONCLUSION: The relationship between uterine leiomyoma and FSD is different depending on the menopausal status.

Relationship between phospholipase C zeta immunoreactivity and DNA fragmentation and oxidation in human sperm

OBJECTIVE: The study aimed to evaluate the feasibility and reproducibility of measuring phospholipase C zeta (PLCzeta) using immunostaining in human sperm and to investigate the relationship between PLCzeta immunoreactivity and DNA fragmentation and oxidation in human sperm. METHODS: Semen samples were obtained from participants (n=44) and processed by the conventional swim-up method. Sperm concentration, motility, normal form by strict morphology, DNA fragmentation index assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling method and immunofluorescent expression for 8-hydroxy-2'-deoxyguanosine (8-OHdG) and PLCzeta were assessed. RESULTS: When duplicate PLCzeta tests were performed on two sperm samples from each of the 44 participants, similar results were obtained (74.1+/-9.4% vs. 75.4+/-9.7%). Two measurements of PLCzeta were found to be highly correlated with each other (r=0.759, P<0.001). Immunoreactivity of PLCzeta was not associated with donor's age, sperm concentration, motility, and the percentage of normal form as well as DNA fragmentation index. However, immunoreactivity of PLCzeta showed a significant negative relationship with 8-OHdG immunoreactivity (r=-0.404, P=0.009). CONCLUSION: Measurement of PLCzeta by immunostaining is feasible and reproducible. Lower expression of PLCzeta in human sperm may be associated with higher sperm DNA oxidation status.

Regulatory T Cells in B Cell Follicles

Understanding germinal center reactions is crucial not only for the design of effective vaccines against infectious agents and malignant cells but also for the development of therapeutic intervention for the treatment of antibody-mediated immune disorders. Recent advances in this field have revealed specialized subsets of T cells necessary for the control of B cell responses in the follicle. These cells include follicular regulatory T cells and Qa-1-restricted cluster of differentiation (CD)8+ regulatory T cells. In this review, we discuss the current knowledge related to the role of regulatory T cells in the B cell follicle.

Very Late Stent Thrombosis in Coronary Bare-Metal Stent Implantation: A Case Report

Stent thrombosis is generally a fatal complication after percutaneous coronary intervention. Despite the incidence of stent thrombosis has reduced with improved techniques and drugs, stent thrombosis persists at a rate of 0.5-2% in elective cases, and up to 6% in patients with acute coronary syndromes. It almost always causes acute myocardial infarction or sudden cardiac death. While very late stent thrombosis, occurring beyond 1 year, is not uncommon with the use of drug-eluting stents, it is distinctly unusual with the use of bare-metal stents. We report a case of very late thrombosis of a bare-metal stent occurring 880 days after coronary stent implantation.

Manifestations Like Multiple Sclerosis in a Paitent with Rheumatoid Arthritis and Sjogren's Syndrome / 대한류마티스학회지

Demyelinating syndrome can rarely occur in Sjogren's syndrome or rheumatoid arthritis. We describe a patient of Sjogren's syndrome with multiple sclerosis-like features whose rheumatoid arthritis has been managed for 3 years. The patient presented paraparesis and urinary retention, and improved with high-dose corticosteroid therapy.

The Wound Healing Effects of Alginate-crosslinked Collagen Dermal Substitute of Artificial Skin

Alginate, which is isolated from brown seaweed, is a bioabsorbable long chain polysaccharides, beta-D-mannuronic acid and alpha-L-guluronic acid. The authors produced alginates and alginate-colllagen as a disc form. Then, to evaluate the efficacy of alginate and alginate-collagen complex as a wound healing material, three full-thickness skin defects of 2 cm in diameter were made at the back of the New Zealand white rabbits. Three groups of dressing materials-alginate, alginate-collagen complex and vaseline gauze as control group - were applied on the wound and the results were evaluated grossly and histopathologically. The authors compared gross findings of sizes of healed wound, wound epithelization and wound contraction by tracing the remaining wound area at 5th, 10th, 15th, 20th, 25th day after wound introduction, and wound biopsy was performed at 3rd, 7th, 14th, 21st day, respectively. Alginate and alginate-collagen complex showed statistically higher percentage of wound contraction and wound healing compared to control group(p<0.05). Alginate-collagen complex showed statistically higher percentage of wound contraction, epithelization and wound healing compared to alginate alone. In conclusion, the result suggests that alginate has a good effect of wound healing and that alginate-collagen complex is more effective in wound healing than alginate alone.

The Histological Change of Orbicularis Oculi Muscle according to the Age

This study is to investigate the patients who had blepharoplasty for cosmetic purposes or facial nerve disorders. 21 patients were examined with an age from 17 to 63 years. Sixteen cases were classified as a normal group for investigation of the histopathologic change according to the age. The rest were patients of Bell's palsy(2), Botox(R) injection(2) and blepharospasm (1). We measured a mean diameter of myofiber and dimension's proportion of muscluar tissue per regular visual field. First, we measured a statistical significance according to the age in normal cases by grouping them into younger than 30-year-old, 30's, 40's, 50's and 60's. Second, we divided normal cases(16) into Group A and B by two bases for statistical analysis. In conclusion, although there were several differences as vacuolation, internalization of sarcolemnic nuclei between 35-year-old and 62-year-old patients in simple comparison, there was no uniform decrease according to the age. There were also no significant statistical changes in the value of a diameter of myofibers and dimension's proportion of muscular tissue according to the age in any of the two normal groups. But in Botox(R) injection and Bell's palsy, blepharospasm patients, two values showed remarkable difference compared to the normal group of same age.

Comparison of Early and Six Month Outcomes of Direct Stenting vs. Conventional Stenting in Patients with Angina Pectoris

BACKGROUND AND OBJECTIVES: Direct stenting (DS) has been shown to be safe and feasible, with demonstrable reductions in cost, procedural time and radiation exposure, and may also result in less vessel injury. The aim of this study was to compare the immediate and six month clinical and angiographic outcomes of direct stent (DS) with stent implantation implantation following balloon predilatation (conventional stenting, CS). SUBJECTS AND METHODS: Between July 2001 and June 2004, 266 patients (293 lesions) with angina pectoris were included in this study. Patients having lesion characteristics with excessive calcification, left main lesion, chronic total occlusion, severe proximal tortuosity and a bifurcated lesion were excluded. Follow up angiography was performed about six months after the initial procedure. RESULTS: Direct (73 lesions) and conventional stenting (220 lesions) were performed respectively. In the DS group, the minimal luminal diameter was larger (0.36+/-0.18 vs. 0.31+/-0.19 mm, p=0.036) and diameter stenosis lower than in the CS group (89.1+/-5.1 vs. 90.6+/-3.9%, p=0.026). However, no difference was found in the reference vessel diameter between the two groups. From the immediate angiographic results, the CS group showed a longer stent length than the DS group (18.84+/-5.61 vs. 16.16+/-3.67 mm, p=0.000), but the DS group had a higher balloon inflation pressure than the CS group (12.25+/-1.71 vs. 11.35+/-1.72 atm, p=0.000). However, no difference was found in the post-stent minimal luminal diameter, acute gain and angiographic success rates. Follow up angiography was performed in 68.6% (201/293) of lesions. The angiographic restenosis rate was similar between the two groups (DS, 19.6 vs. CS, 19.3%, p=0.966), as were the other angiographic findings. The rates of in-hospital and 6 month follow up major adverse cardiovascular events (MACE) were similar between the two groups. CONCLUSION: Direct stenting showed similar rates of angiographic restenosis as well as inhospital and 6 months MACE (death, myocardial infarction, target lesion revascularization, cerebrovascular accident) compared with conventional stenting.

The Cognition Study of the Freshman in College About Aesthetic Plastic Surgery

Recently, as standard of living has been improving and awareness of well-being has been generalized, people's desire pursuing beauty has been spreading across the world. We made a survey with 184 graduating high school girls in December 2003. According to the survey. 57.6% of them knew about plastic surgery, 41.8% of them knew well about whole field of plastic surgery, and 60.3% of them wanted to have an aesthetic surgery. 44.6% got an information about an aesthetic surgery from general public and 27.6% from TV, respectively. Regarding the use of aesthetic surgery, 59.8% answered that it makes them more confident about themselves rather than just to be beautiful. 78.8% of them have complaints about how they look. Finally, as the personal desire to make themselves look beautiful to others increases, so does the interest in aesthetic plastic surgery. In conclusion, as the society of plastic and reconstructive surgeons, we still need more effort for the correct cognition and awareness of plastic surgery among general public.

Distributional changes of the serotonergic neurons according to the hibernating cycle in the brain stem of the Korean horse-shoe bat / 대한해부학회지

No abstract available.

Treatment of Pontine Hemorrhage

Most of untreated pontine hematoma are known to be fatal. Even though the patient may survive, the sequelae of pontine hematoma is serious. Fourteen cases of pontine hematoma who were treated either surgically or conservatively were analysed. Among nine cases treated surgically, three showed good recovery, three died postoperatively, and moderate to severe disability remained in three cases. On the other hand, conservative treatment resulted in one good recovery, one moderate disability, and four deaths. We hope to emphasize the efficacy of surgical treatment on pontine hematoma.

Early Prognostic Evaluation with C-T Scan in Cerebral Contusion

The cerebral contusion(necrotic brain tissue infiltrated with blood) is common post-traumatic lesion, In 851 consecutive C-T scan performed by 48 hours from injury, the contusion were present in 193(22.%) of the case. Comparing the midline shift, area, number, size of the lesions and their etiopathogenesis with the clinical course(assessed by Glasgow coma scale), it is possible to evaluate the early prognosis. The patient who showed 1) midline shift over 15mm, 2) the contusional lesion in basal ganglia, brain stem or corpus callosum, 3) multiple or large sized lesion took poor prognosis. Cortical contusion especially in the frontal region had relatively good prognosis. The pathogenetic mechanisms(angular acceleration of the brain) is the same in basal ganglia, brain stem and corpus callosum, but a direct impact of the In conclusion, the etiopathogenetic mechanism and consequent site of the cerebral contusion are the most important factors on the evaluation of the severity of the brain damage and their prognosis.

The Early Diagnosis and Treatment in Cerebellar Infarction

Cerebellar infarction may be rapidly fatal when the patient is not diagnosed and treated promptly. Since 1980, we have encountered five patients of cerebellar infarction and here we analysed the cases and reviewed the literature. All patients were treated by means of the posterior fossa decompression with mortality rate of 20%. By the mode of onset and progression of symptoms and signs, the patient of cerebellar infarction could be divided into two groups;The patients who took the benign course showed the initial symptoms of headache, nausea, vomiting, dizziness and lack of balance, and were usually recovered spontaneously with the conservative treatment. On the contrary, the patients who took the progressive course showed rapidly progressive deterioration of the initial symptoms and signs and mental state. They could be recovered by the early posterior fossa decompression. The emphasis should be given to the early diagnosis and treatment for the purpose of recover in the patient of cerebellar infarction.

Clinical Observation of Medulloblastoma

The authors represented a clinical analysis on 31 patients with medulloblatoma who had been treated surgically at the Department of Neurosurgery, Yonsei Medical Center and Wonju Christian Hospital from Sept. 1967 to Aug. 1981. The results were summarized as follows ; 1) Among 31 patients, 19 were male and 12 were female. About 73% of cases were found under the age of 16 and male was predominant in this age group. 2) The most common clinical symptom was that of increased intracranial pressure(84%). Gait disturbance, generalized seizure and mental change were also found and duration of symptom of symptom was average 2.2 month. Neurological signs showed papilledema, cerebellar signs and lower cranial palsies. 3) Plain skull X-rays, carotid and vertebral angiography and conray ventriculography were useful diagnostic methods but brain CT scan was thought to be the most accurate, noninvasive and helpful method which showed size and location of tumor and relationship with surrounding structures. In brain CT scan hydrocephalus and compression 4th ventricle were found in 94%, and 88% revealed contrast enhancement. 4) Considering 1 year survival rate which was possible follow up in this study, microsugical total excision of tumor followed by radiation therapy disclosed the best result for reducing recurrence and seeding of tumor among the current therapeutic methods.

A Case of Multiple Huge Brain Abscesses Caused by Paragonimiasis

Cerebral paragonimiasis, occurring as an extrapulmonary infestation, is one of the important intracranial lesions in Korea. We have experienced a case of multiple huge brain abscesses caused by cerebral paragonimiasis. The patient, 17 year old boy, had chief complaints of headache and vomiting followed by mental deterioration. Neurologically, the patient presented mental change, papilledema, left abducense palsy and right hemiparesis. The treatment included the closed drainage followed by total removal of abscess capsules which was confirmed histopathologically. This paper is concerned with the description of the clinical features of cerebral paragonimiasis and review of literatures.

Clinical Analysis of Surgical Treatment of Postmeningitic Hydrocephalus

To evaluate the surgical results, the author made a clinical analysis on 70 patients of postmeningitic hydrocephalus who had been treated surgically. And the results were summarized as follows. 1) The tuberculous meningitis was the most common type causing the postmeningitic hydrocephalus(72.9%). 2) Among 70 patients, 51 were male and 19 were female. About 40% of cases were under 5 years old. 3) The most common clinical symptom was vomiting(67%). Headache, fever and generalized seizure were symptoms in order of frequency. Neurological sings represented neck stiffness, cranial nerve palsy and motor weakness. 4) The most common clinical condition on admission was stage 3 (advanced cases with unconciousness and severe neurological deficits). 5) The spinal fluid analysis showed more abnormal findings comparing to the ventricular fluid. But ventricular pressure was higher than spinal fluid pressure. 6) Plain skull x-rays, carotid angiograms were useful diagnostic methods but CT brain scan was though to be the most accurate, noninvasive method which showed size of ventricle and effectiveness of shunting procedures with Evans'ratio. In enhanced CT brain scans, the basal cistern enhancement was the most common finding beside ventricular enlargement (64.1%). 7) Ventriculoperitoneal shunting was the most common procedure in this series. 8) The initial revision rate was 12/70(19%) and the most of the revision was performed within 6 months after the initial shunting. 9) The revision rate in relation to shunting system and cerebrospinal fluid finding was not statistically significant. 10) The most common cause of the shunt malfuntion was obstruction of the ventricular catheter. 11) Forty one patients(58.6%) showed favorable outcome. The motality rate was 14/70(20%) and they were all belong to the stage 3. About half of the patients in stage 2 and stage 3 showed dramatic improvement after early shunting procedures. So the timing of operation was the most important factor influencing their outcome.

Surgical Treatment of Pontine Hematoma

Three cases of pontine hematoma accompanied by serious neurological symptoms with coma were treated surgically. All patients underwent suboccipital craniectomy with removal of hematoma and subsequently ventriculoperitoneal shunts were needed in all cases. Postoperatively all cases showed improvement with some neurological sequelae remained. Most of untreated pontine hematoma may be fatal, whereas surgical evacuation of the hematoma is safe and promising. We emphasize surgical treatment of pontine hematoma should be considered in any cases though they show serious neurological deficits.

Clinical Observation of Intracranial Abscesses

Sixty five intracranial abscesses were experienced from December , 1970 to August, 1981, of which fifty seven cases were operated. The clinical analysis and surgical experiences were summarized as follows. 1) The patients consisted of 45 male and 12 female and 31 patients(54.4%) were under 20 years of age. 2) Of the 57 patients, 45 patients(79%) had a demonstrable infectious source leading to the intracranial infection. There were 15 patients with ear infection and 13 patients with trauma. 3) Staphylococcus and streptococcus were the most common pathogens in this study. 4) Common symptoms of the patients were headache and fever, which were followed by mental disturbance and focal neurologic disturbance. 5) Brain CT scan offered accurate, non-invasive, rapid and easily repeatable means of diagnosis and following of lesions. After contrast infusion, ring enhancement had mostly thin and regular wall(88%). 6) The best operative methods of the brain abscess were aspiration and resection, or drainage and resection. The deep seated brain abscess, subdural abscess and epidural abscess could be treated using only drainage method with good results.

Subphrenic Pseudocyst as a Complication of Ventriculoperitoneal Shunt: Case Report

Abdominal pseudocysts have been recorded infrequently as a complication of intraperitoneal shunting. Authors have experienced two cases of subphrenic pseudocyst as a complication of ventriculoperitoneal shunt, which were treated with revision of shunt. First patient had medulloblastoma with hydrocephalus. The other one was a patient who had subarachnoid hemorrhage and hydrocephalus from Struge Weber syndrome. It's diagnosis and treatment were discussed with review of literatures.