ABSTRACT
It is unclear whether forearm and crural muscle fibers extend distally across the wrist and ankle joints, respectively.We hypothesized, in late-term fetuses, an over-production of muscle bellies extending over the joint. Muscle fibers in histological sections from unilateral wrists and ankles of 16 late-term fetuses (30–40 weeks) were examined and compared with 15 adult cadavers. Muscle fibers of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) in fetuses, especially muscle bellies to the third and fourth fingers, were found to extend far distally beyond the radiocarpal joint.The extensor digitorum and extensor pollicis longus on the extensor side of the wrist were found to carry distally-extending muscle fibers, but these fibers did not extend beyond the distal end of the radius. In the ankle, most muscle bundles in the flexor hallucis longus (FHL), fibularis brevis (FB) and extensor digitorum longus extended distally beyond the talocrural joint, with most FB muscle fibers reaching the level of the talocalcaneal joint. In adult cadavers, muscle fibers of the FDP and FHL did not reach the levels of the radiocarpal and talocrural joints, respectively, whereas the FB muscle belly always reached the talocalcaneal joint. Similarly, some of the FDS reached the level of the radiocarpal joint. Generally, infants’ movements at the wrist and ankle could result in friction injury to over-extended muscle. However, the calcaneal and FDP tendons might protect the FB and FDS tendons, respectively, from friction stress.
ABSTRACT
In complete denture fabrication, accurate preliminary impressions are crucial for obtaining an accurate final impression. However, it can be challenging in cases of atypical arch shapes. This case report compares diagnostic casts made with a stock tray and an intraoral scanner (IOS) in a patient with an atypical arch shape.A 58-year-old edentulous male patient with long, narrow, atypical arches was referred to the Oral and Maxillofacial Surgery department for complete denture fabrication. Compared to the diagnostic cast obtained using IOS with adequately captured anatomical parameters, the primary model obtained using a stock tray showed prominent overextended flanges on the labial and buccal sides of the maxillary arch and less prominent overextended flanges in the mandibular arch with pressure spots in the posterior palatal seal area. The custom tray fabricated from such a model required additional adjustment resulting in increased chair time during the final impression procedure.
ABSTRACT
Lithium disilicate gradation block that have been recently introduced and used in dental clinics have superior light transmittance compared to zirconia-based restorations, so that when applied to anterior restorations, better esthetic results are expected. In addition, it has the advantage that the flexural strength is sufficient and chemical bonding with resin cement is possible. However, high transparency could be a disadvantage in the restoration of abutment teeth with severe discoloration, and various methods have been tried to compensate for this. In this study, in the restoration of central incisors with severe discoloration of the abutment, the inner surface of the crown made of lithium disilicate-based polychromatic blocks was treated with a liner to block the discoloration, and thus aesthetically satisfactory results were obtained.
ABSTRACT
Improvements in the mechanical and optical properties of ceramic materials and the development of dentin adhesives have resulted in more successful results in anterior teeth restorations. Among them, porcelain laminate veneer (PLV) can achieve aesthetic improvement in a conservative way while minimizing tooth reduction. A female patient in her 20s visited for aesthetic improvement of the maxillary anterior teeth. The patient's chief complaint was aesthetic improvement of tooth discoloration after trauma and endodontic treatment, and a PLV restoration was decided to reflect the patient’s demand for minimal tooth reduction. IPS e.max Press, a lithium disilicate-based ceramic with high light transmittance and high strength, was chosen for porcelain laminate veneer. Inner surface of the veneer was treated with liner in order to block discoloration of the abutment teeth while maintaining translucency in the incisal edge. The patient was satisfied with the aesthetic result.
ABSTRACT
Colorectal cancer is a common malignancy and a major health concern in Korea. The increased use of screening colonoscopies has led to improved survival of patients with colorectal cancer despite its high prevalence; this highlights the importance of early detection and removal of neoplastic polyps such as adenoma and sessile serrated lesions. Therefore, optical diagnosis of colorectal polyps is crucial in deciding whether the lesion requires removal and if endoscopic procedures can be used for its removal.Current Concepts: Several image-enhanced endoscopy (IEE) techniques and classifications can be used to improve the optical diagnosis of different polyps that match the histopathologic findings. Kudo’s pit pattern classification is based on features of pit patterns observed from different types of polyps via chromoendoscopy. The Narrow-Band Imaging (NBI) International Colorectal Endoscopic (NICE) classification is an international classification based on patterns observed from NBI findings. The Japan NBI Expert Team (JNET) classification identifies different patterns observed from magnified images with NBI. The Workgroup serrAted polypS and Polyposis (WASP) classification helps to differentiate hyperplastic polyps from sessile serrated lesions. Endoscopy manufacturers have also developed IEE techniques such as I-scan, flexible spectral imaging color enhancement, and blue laser imaging/linked color imaging to highlight, delineate, and differentiate various polyps.Discussion and Conclusion: Optical diagnosis of colorectal polyps using IEE such as NBI with different classifications such as NICE, JNET, and WASP is important for differentiating neoplastic polyps and removing them with an appropriate method.
ABSTRACT
Sugammadex has shown faster reversal of steroidal neuromuscular blockade (NMB) than neostigmine, a traditional reversal agent for NMB, even in the intense block phase. This efficiency is possible because of the unique mechanism of action by encapsulating the NMB molecules. Therefore, with the use of sugammadex, we can also expect to avoid direct interactions with the cholinergic system and its subsequent side effects, which are disadvantages of traditional drugs. However, despite these benefits and US Food and Drug Administration (FDA) approval in 2015, rare adverse events associated with sugammadex have been reported. Herein, we report a case of bronchospasm that developed immediately after sugammadex administration.
ABSTRACT
Neural processing of tactile information in the brain has been relatively less unveiled compared to other senses, such as visual and auditory information. This is partly due to difficulties in creating tactile stimuli, a wide distribution of tactile receptors over the whole body, the lack of rich understanding of tactile perception, and tight coupling of tactile sensation with action. Nonetheless, it is important to understand how the central nervous system processes tactile information in order to develop clinical solutions for impairment of somatosensory systems, create artificial tactile systems for robots, and advance the assistive technology based on perception-action coupling for the elderly. In this review, we revisit recent investigations of neural processing of tactile information in the human brain using neuroimaging. In particular, this review focuses on cutaneous innocuous tactile information.
ABSTRACT
Background/Aims@#This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract. @*Methods@#The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016. @*Results@#UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs. @*Conclusions@#The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.
ABSTRACT
The Committee of Central Precocious Puberty of Korean Pediatrics and Adolescents of the Korean Society of Pediatric Endocrinology has newly developed evidence-based 2022 clinical practice guidelines for central precocious puberty in Korean children and adolescents. These guidelines provide the grade of recommendations, which includes both the strength of recommendations and the level of evidence. In the absence of sufficient evidence, recommendations are based on expert opinion. These guidelines have been revised and supplement the previous guidelines "Clinical Guidelines for Precocious Puberty 2011," and are drawn from a comprehensive review of the latest domestic and international research and the grade of recommendation appropriate to the domestic situation. This review summarizes the newly revised guidelines into 8 key questions and 27 recommendations and consists of 4 sections: screening, diagnosis, treatment, and long-term outcome of central precocious puberty.
ABSTRACT
The human fetal sacroiliac joint (SIJ) is characterized by unequal development of the paired bones and delayed cavitation. Thus, during the long in utero period, the bony ilium becomes adjacent to the cartilaginous sacrum. This mor phology may be analogous to that of the temporomandibular joint (TMJ). We examined horizontal histological sections of 24 fetuses at 10–30 weeks and compared the timing and sequences of joint cartilage development, cavitation, and ossification of the ilium. We also examined histological sections of the TMJ and humeroradial joint, because these also contain a disk or disk-like structure. In the ilium, endochondral ossification started in the anterior side of the SIJ, extended posteriorly and reached the joint at 12 weeks GA, and then extended over the joint at 15 weeks GA. Likewise, the joint cartilage appeared at the anterior end of the future SIJ at 12 weeks GA, and extended along the bony ilium posteriorly to cover the entire SIJ at 26 weeks GA. The cavitation started at 15 weeks GA. Therefore, joint cartilage development seemed to follow the ossification of the ilium by extending along the SIJ, and cavitation then occurred. This sequence “ossification, followed by joint cartilage formation, and then cavitation” did not occur in the TMJ or humeroradial joint. The TMJ had a periosteum-like membrane that covered the joint surface, but the humeroradial joint did not. After muscle contraction starts, it is likely that the mechanical stress from the bony ilium induces development of joint cartilage.
ABSTRACT
Objective@#Acute renal infarction is a rare and easily misdiagnosed disease. Scarce research has been conducted on the predictive factors and prognosis of acute renal infarction due to its rarity. In this study, we analyzed the clinical and laboratory findings of a patient diagnosed with renal infarction to predict clinical outcomes. @*Methods@#In this retrospective clinical study, we collected and analyzed the medical records data of 61 acute renal infarction patients diagnosed in the emergency department (ED) of Konkuk University Hospital, Seoul, South Korea from January 2007 to December 2020. @*Results@#Lactate dehydrogenase (LDH; 93.3%, 28 of 30 patients) and D-dimer (77.8%, 28 of 36 patients) levels of the acute renal infarction patients were higher than the normal. Proteinuria was found in 26 of 47 patients. The only significant prognostic factor for the occurrence of acute kidney injury (AKI) in acute renal infarction is the ratio of the infarction volume to the total renal volume. Age, occurrence of AKI, and proteinuria were correlated with the progression of chronic kidney disease (CKD). @*Conclusion@#The ratio of the infarction volume to the total renal correlated with occurance of AKI. Age, AKI, and proteinuria were correlated with the progression of CKD.
ABSTRACT
BACKGROUND/OBJECTIVES@#Aster yomena (Kitam.) Honda (AY) has remarkable bioactivities, such as antioxidant, anti-inflammation, and anti-cancer activities. On the other hand, the effects of AY against obesity-induced insulin resistance have not been reported. Therefore, this study examined the potential of AY against obesity-associated insulin resistance in highfat diet (HFD)-fed mice.MATERIALS/METHODS: An obesity model was established by feeding C57BL/6J mice a 60% HFD for 16 weeks. The C57BL6/When ethyl acetate fraction from AY (EFAY) at doses of 100 and 200 mg/kg/day was administered orally to mice fed a HFD for the last 4 weeks. Normal and control groups were administered water orally. The body weight and fasting blood glucose were measured every week. Dietary intake was measured every other day. After dissection, blood and tissues were collected from the mice. @*RESULTS@#The administration of EFAY reduced body and organ weights significantly compared to HFD-fed control mice. The EFAY-administered groups also improved the serum lipid profile by decreasing the triglyceride, total cholesterol, and low-density lipoprotein compared to the control group. In addition, EFAY ameliorated the insulin resistance-related metabolic dysfunctions, including the fasting blood glucose and serum insulin level, compared to the HFD-fed control mice. The EFAY inhibited lipid synthesis and insulin resistance by down-regulation of hepatic fatty acid synthase and up-regulation of the AMPactivated protein kinase pathway. EFAY also reduced lipid peroxidation in the liver, indicating that EFAY protected hepatic injury induced by obesity. @*CONCLUSIONS@#These results suggest that EFAY improved obesity-associated insulin resistance by regulating the lipid and glucose metabolism, suggesting that AY could be used as a functional food to prevent obesity and insulin resistance.
ABSTRACT
Background@#Benign esophageal strictures are treated endoscopically, often with balloon dilatation (BD) or bougie dilators. However, recurrent esophageal strictures have been reported after BD, and severe complications sometimes occur. The aim of this study was to compare the efficacy and complications of endoscopic incisional therapy (EIT) and BD for benign esophageal strictures. @*Methods@#We retrospectively reviewed patients who underwent BD or EIT as primary treatment for benign esophageal strictures between July 2014 and June 2021. Technical success was defined as restoration of the lumen diameter with <30% residual stenosis. Clinical success was defined as no recurrence of dysphagia within 1 month after BD or EIT and an increase of 1 grade or more on the Functional Oral Intake Scale. @*Results@#Thirty patients with benign esophageal stricture were enrolled. There were 16 patients in the BD group and 14 patients in the EIT group. No significant differences in technical and clinical success rates were found between the two groups. Furthermore, no significant differences in the re-stricture rate were observed between the groups. There was one complication in the EIT group and three complications in the BD group. Three patients who underwent BD had re-stricture and underwent EIT thereafter, and we regrouped patients who underwent EIT at least once. The clinical success rate was significantly higher in patients regrouped to the EIT group than in patients who underwent BD only. @*Conclusions@#EIT is not inferior to BD as the primary treatment for benign esophageal strictures, especially for recurrent cases.
ABSTRACT
Objective@#To investigate the health-related quality of life (HRQOL) related to hyperthermic intraperitoneal chemotherapy (HIPEC) following primary or interval cytoreductive surgery for primary ovarian cancer. @*Methods@#Between 2010 and 2016, a total of 184 patients were randomly assigned to receive cytoreductive surgery with HIPEC (n=92) or without HIPEC (n=92). Quality of life (QOL) assessment was evaluated at baseline (before surgery); on postoperative day 7; after the 3rd and 6th cycle of adjuvant chemotherapy; and at 3, 6, 9, and 12 months after randomization. Patient-reported QOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC-QLQ-C30), ovarian cancer questionnaire modules (QLQ-OV28), and the MD Anderson Symptoms Inventory (MDASI). @*Results@#Of the 184 patients enrolled, 165 (83/92 in the HIPEC group and 82/92 in the control group) participated in the baseline QOL assessment. There were no statistically significant differences in functional scales and symptom scales in QLQ-C30; symptom scales, including gastrointestinal symptoms QLQ-OV28; and severity and impact score in MDASI between the 2 treatment groups until 12 months after randomization. @*Conclusion@#HIPEC with cytoreductive surgery showed no statistically significant difference in HRQOL outcomes. Thus, implementation of HIPEC during either primary or interval cytoreductive surgery does not impair HRQOL.
ABSTRACT
Purpose@#Metabolic syndrome (MetS) is a state of chronic inflammation, and high-sensitivity C-reactive protein (hsCRP) indicates inflammation. This paper evaluates the associations between hsCRP and MetS and its components in Korean children and adolescents. @*Methods@#We analyzed the data of 1,247 subjects (633 males, 14.2±2.7 years) from the Korea National Health and Nutrition Examination Survey 2016–2017. This study defined MetS and its components using the modified National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. @*Results@#The mean hsCRP level was 0.86±1.57 mg/dL (median and interquartile range: 0.37 and 0.43 mg/dL). Subjects with MetS had higher hsCRP level than subjects without MetS (geometric mean: 1.08 mg/dL vs. 0.46 mg/dL, p<0.001). With a higher quartile value of hsCRP, the prevalence of MetS increased. Compared to the lowest quartile, the odds ratio (OR) for MetS in the highest quartile was 7.34 (3.07–17.55) after adjusting for age and sex. In the top quartile of hsCRP, the risk of abdominal obesity and low HDL was high after adjusting for age, sex, and other components of MetS. Additionally, the OR for prediabetes (HbA1c ≥5.7%) in the highest quartile was 2.70. @*Conclusion@#Serum hsCRP level was positively associated with MetS and prediabetes using NCEP-ATP III criteria. Among the MetS components, abdominal obesity and low HDL were highly correlated with hsCRP in Korean children and adolescents.
ABSTRACT
At birth, the umbilical cord contains various types of thin vessels that are near and outside the umbilicus and separate from the umbilical arteries and vein. These vessels are regarded as the remnant “vitelline vessels” and are often called “umbilical vessels”, although this terminology could lead to confusion with the true umbilical arteries and vein. No study has yet comprehensively examined these vessels using histological sections. Our examination of these vessels in 25 midterm fetuses (gestational age: 10–16 weeks) led to five major findings: (i) all specimens had umbilical branches of the inferior epigastric artery; (ii) 5 specimens had vitelline vein remnants; (iii) 4 specimens had a thin artery originating from the left hepatic artery that ran along the umbilical vein; (iv) 2 specimens had a so-called “para-umbilical vein” that was along the umbilical vein and reached the umbilicus; and (v) all specimens had lymphatic vessels originating from the umbilicus that ran caudally along the umbilical artery. The pelvic vein tributaries were well developed along the intra-abdominal umbilical artery, but did not reach the umbilicus. The lymphatic vessel was distinguished from the veins by an intraluminar cluster of lymphocytes attaching to the endothelium. The arterial branch in the umbilical cord did not accompany veins and lymphatic vessels, in contrast to the mother artery in the rectus abdominis. All these thin vessels seemed to be obliterated when the fibrous umbilical ring grew during late-term. The para-umbilical collateral vein in adults might develop outside the fibrous umbilical ring after birth.
ABSTRACT
Solitary distal vaginal atresia is generally caused by a transverse septum or an imperforate hymen. We found a novel type of distal vaginal atresia in a late-term fetus (gestational age approximately 28 weeks) in our histology collection. This fetus had a vaginal vestibule that was closed and covered by a thick subcutaneous tissue beneath the perineal skin in the immediately inferior or superficial side of the imperforate hymen. The uterus, uterine tube, anus, and anal canal had normal development. The urethral rhabdosphincters were well-developed and had a normal topographical relationship with the vagina, but the urethrovaginal sphincter was absent. Thus, vaginal descent seemed to occur normally and form the vestibule. However, the external orifice of the urethra consisted of a highly folded duct with hypertrophied squamous epithelium. Notably, the corpus cavernosum and crus of the clitoris had poor development and were embedded in the subcutaneous tissue, distant from the vestibule. Normally, the cloacal membrane shifts from the bottom of the urogenital sinus to the inferior aspect of the thick and elongated genital tubercle after establishment of the urorectal septum. Therefore, we speculate there was a failure in the transposition of the cloacal membrane caused by decreased elongation of the genital tubercle. The histology of this anomaly strongly suggested that the hymen does not represent a part of the cloacal membrane, but is instead a product that appears during the late recanalization of the distal vagina after vaginal descent. The transverse septum was also likely to form during this recanalization.
ABSTRACT
Therapeutic dentin regeneration remains difficult to achieve, and a majority of the attention has been given to anabolic strategies to promote dentinogenesis directly, whereas, the available literature is insufficient to understand the role of inflammation and inflammatory complement system on dentinogenesis. The aim of this study is to determine the role of complement C5a receptor (C5aR) in regulating dental pulp stem cells (DPSCs) differentiation and in vivo dentin regeneration. Human DPSCs were subjected to odontogenic differentiation in osteogenic media treated with the C5aR agonist and C5aR antagonist. In vivo dentin formation was evaluated using the dentin injury/pulp-capping model of the C5a-deficient and wild-type mice. In vitro results demonstrate that C5aR inhibition caused a substantial reduction in odontogenic DPSCs differentiation markers such as DMP-1 and DSPP, while the C5aR activation increased these key odontogenic genes compared to control. A reparative dentin formation using the C5a-deficient mice shows that dentin regeneration is significantly reduced in the C5a-deficient mice. These data suggest a positive role of C5aR in the odontogenic DPSCs differentiation and tertiary/reparative dentin formation. This study addresses a novel regulatory pathway and a therapeutic approach for improving the efficiency of dentin regeneration in affected teeth.
Subject(s)
Animals , Mice , Cell Differentiation/physiology , Cells, Cultured , Complement C5a/metabolism , Dental Pulp/physiology , Dentin , Receptor, Anaphylatoxin C5a , Stem CellsABSTRACT
Purpose@#This study was conducted to explore the experiences of adult cancer patients living with Chemotherapy-Related Cognitive Impairment (CRCI). @*Methods@#Data were collected by using in-depth and audio-recorded interviews with seven patients of colorectal, stomach, and breast cancer. The participants were asked to describe their CRCI experience. The data were analyzed according to Colaizzi’s method for phenomenological analysis. @*Results@#Three-theme clusters and six themes emerged: (1) Foggy daily life: brain health impairment; “I feel different from my usual self: cognitive impairment,” “Lost daily activities: work-related tasks affected,” (2) Struggle to retain memories; “Tried using all strategies I could to recall my memories,” “Need for concern and therapeutic communication,” (3) Expectation of a whole body: hope to live; “Expectations for cognitive rehabilitation,” “Reorganizing daily life.” @*Conclusion@#These results showed that patients did not consider CRCI important until symptoms affected daily activities and workrelated tasks and tried to use self-management strategies to manage CRCI. A two-way exchange of information between patients and health professionals can help patients understand and prepare for CRCI in dealing with symptoms.
ABSTRACT
Purpose@#The purpose of this study was to describe the career choice experiences of nursing students. @*Methods@#A phenomenological approach was used for the study. Data were collected from September 1 to October 1, 2021, using open-ended questions in-depth interviews. Ten nursing students who had decided to find a job or complete an application to an employment institution participated in this study. @*Results@#The four categories obtained as results were “Preparing myself,” “Chosen after conflict,” “Going through a tough tunnel and settling down,” and “Waiting with anticipation and worry.” @*Conclusion@#This study explored the meaning and essence of the career choice experiences of nursing students. These results will provide basic data that can help nursing students make career choices.