The significance of split-face studies and electromyography in forehead rejuvenation

Background@#Botulinum toxin is a neurotoxic substance with a wide range of uses, from the treatment of musculoskeletal spasms to antiaging regimens by improving wrinkles. Split-face studies in which drugs are injected in the right and left sides of the faces have been actively conducted in botulinum toxin studies. In this study, we aimed to investigate the reliability of a split-face study for determining the effectiveness of botulinum toxin based on eyebrow height and movement, and electromyography results. @*Methods@#Thirty-one women aged 35 to 55 years were included in the study. Eyebrow height was measured as the distance from the eyebrows to the upper eyelid margin on the primary gaze, and eyebrow movement was measured as the distance when the forehead was wrinkled for 5 seconds. A noninvasive method was used for electromyography of the frontalis muscles. @*Results@#No statistically significant differences in right and left eyebrow heights and movements, and electromyography findings (p= 0.256, p= 1.000, and p= 0.978, respectively) were found. Pearson correlation analysis showed that electromyography muscle activity is positively associated with eyebrow movement, respectively (p< 0.001). @*Conclusion@#We advocate the reliability of split-face study and the usefulness of electromyography of frontalis muscle in forehead rejuvenation research.

Effects of a Multifaceted Pediatric Delirium Education Program for Pediatric Intensive Care Unit Nurses on their Delirium Knowledge, Self-confidence in Delirium Nursing, and Delirium Assessment Accuracy: A One Group Pretest-Posttest Design / 중환자간호학회지

Purpose@#: This study aimed to identify the effects of a multifaceted pediatric delirium education program for pediatric intensive care unit (PICU) nurses on their delirium knowledge, confidence in delirium nursing, and delirium evaluation accuracy. @*Methods@#: This study used a one-group pretest-posttest design. The participants were 50 nurses in two units of the PICU at S General Hospital in Seoul. All participants took a 1-hour lecture with case-based practice for the first two weeks, and received feedback as they applied the program to clinical practice over the next two weeks. Test measures were completed before and after the four week intervention period for all participants. The delirium evaluation accuracy was measured using the Korean version of the Cornell Assessment of Pediatric Delirium. Data were analyzed using the chi-square and paired t-tests. @*Results@#: After the Pediatric Delirium Education Program, nurses’ delirium knowledge (x2 =11.65, p =.001), confidence in delirium nursing (t=9.71, p＜.001), and delirium evaluation accuracy (t=6.07, p＜.001) improved significantly. @*Conclusions@#: Pediatric delirium education programs for PICU nurses were effective. For active application of the program in clinical practice in the future, various cases of childhood delirium and specific strategies for each subject must be developed. To achieve this, long-term intervention and research for multiple organizations are required.

Incidentally Diagnosed Duodenal Web in Infancy

A duodenal web is an incomplete diaphragm of the duodenal lumen that causes a partial or (intermittent) complete obstruction. The size of a duodenal web’s aperture determines the degree of obstruction, age at presentation, and radiologic findings. We report a case of duodenal web incidentally diagnosed in a 14-month-old boy who presented to the hospital after ingesting a foreign body. We provide a comprehensive report of multiple studies through abdominal radiograph, upper gastrointestinal study, endoscopy, and surgical findings. We emphasize that the duodenum should be considered as the location of the obstruction when infants exhibit delayed discharge or dynamic positioning of a foreign body in a radiologic examination.

The Relationships of End-of-life Care Stress with Compassionate Competence and Attitudes toward End-of-life Care among Pediatric Nurses / 한국호스피스완화의료학회지

Purpose@#This study aimed to provide basic data for developing interventions to relieve the end-of-life care stress experienced by pediatric nurses by examining the relationships of end-of-life care stress with compassionate competence and attitudes toward end-of-life care. @*Methods@#Data were collected via a survey that was conducted from September 10to September 30, 2018 and administered to 113 nurses who had worked for more than 6months in a pediatric unit at a tertiary hospital in Seoul, South Korea. The data were analyzed for frequency, percentage, mean, and standard deviation, and the independent t-test, one-way analysis of variance, and Pearson correlation analysis were conducted using SPSS version 25.0. @*Results@#End-of-life care stress among pediatric nurses had a weak positive correlation (r=0.216, P＜0.05) with compassionate competence and had no significant cor-relation with attitudes toward end-of-life care. Among the sub-factors of end-of-life care stress, psychological difficulties had a weak positive correlation with sensitivity (r=0.309, P ＜0.01) and communication (r=0.230, P＜0.05), which are aspects of compassionate com-petence. Lack of knowledge about end-of-life care had a weak positive correlation withcommunication (r=0.209, P＜0.05) as an aspect of compassionate competence. @*Conclusion@#To improve the quality of end–of–life care provided by pediatric nurses, it is necessary to improve their compassionate competence and reduce their end-of-life care stress by developing education and support programs tailored to the characteristics of children and specific communication methods.

The Reliability and Validity of the Korean Version of the Cornell Assessment of Pediatric Delirium / 임상간호연구

Purpose@#This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). @*Methods@#For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's ⍺) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. @*Results@#Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's ⍺ was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist’s diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. @*Conclusion@#The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.

Metformin, an Activator of AMPK, Promotes the Growth of Hair Follicles via the AMPK/β-catenin Signaling Pathway / 대한피부과학회지

BACKGROUND: AMP-activated protein kinase (AMPK) is a serine/threonine protein kinase that plays a pivotal role in the balance of cellular energy metabolism. Recent studies have reported that AMPK has numerous roles in physiological conditions, and dysregulation of AMPK induces pathological processes and diseases. However, the role of AMPK and its activators have not yet been studied in the context of hair growth regulation. OBJECTIVE: To investigate the effects of metformin on dermal papilla (DP) and outer root sheath (ORS) cells, as well as the role of the AMPK pathway in hair growth. METHODS: We evaluated whether metformin, a well-known AMPK activator, had any beneficial effects on hair growth. In addition, to evaluate the molecular and cellular mechanisms that were involved, protein levels of AMPK and β-catenin were analyzed. RESULTS: Metformin increased the cellular proliferation of human DP and ORS cells. Ki-67 expression was also significantly increased after metformin treatment in the ex vivo hair follicle organ culture. Furthermore, DP and ORS cells treated with metformin had a significant increase in AMPK phosphorylation, which in turn suppressed β-catenin degradation and enhanced its nuclear accumulation. CONCLUSION: We demonstrated that metformin promoted hair growth via the AMPK/β-catenin signaling pathway in vitro with DP and ORS cells. The hair-promoting effects of AMPK activators may potentially be used for the treatment of alopecia, and further investigation will be needed in the future.

Arthroscopic Management of Intraarticular Screw Perforation after Surgical Treatment of an Acetabular Posterior Wall Fracture: A Case Report / 대한고관절학회지

Although surgical techniques for treating acetabular fracture are evolving, the use of periacetabular screws is common, and their placement in acetabular surgery is still technically demanding. For instance, intraarticular screw perforation is a serious complication that may occur during surgical treatment of an acetabular fracture. Here, we describe the case of a 50-year-old female who experienced an intraarticular screw perforation after surgical treatment of a posterior acetabular wall fracture. Removal of the perforated screw was performed arthroscopically based on its ability to offer minimally invasive access to the hip joint. One year after removal of the screw, no radiological signs of osteoarthritic changes were observed. The patient regained normal ambulation without limitations to range of motion or hip pain. To our knowledge, this is the first report on the use of arthroscopy to treat intraarticular screw perforation after surgical treatment of an acetabular fracture.

Preoperative Enoxaparin versus Postoperative Enoxaparin Thromboprophylaxis in Hip Fracture Surgery: Is Preoperative Enoxaparin Safe to Use? / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of pre- and postoperative initiation of enoxaparin in treatment of hip fracture. MATERIALS AND METHODS: In this study, we enrolled 629 consecutive patients with hip fracture who Pusan National University Hospital between March 2009 and March 2014. Of these patients, 414 patients (65.8%) met the final inclusion criteria. Enoxaparin was administered subcutaneously at 40 mg once daily starting 48 hours after surgery in 156 patients (group A), and immediately after admission in 258 patients (group B). The incidence of symptomatic venous thromboembolism (VTE) and risk of bleeding during hospitalization period were compared between groups. RESULTS: The incidence of symptomatic VTE during the hospitalization period was 7.1% (11 patients) in group A and 5.4% (14 patients) in group B. No significant difference in the rate of symptomatic VTE was found between the groups (unadjusted odds ratio [OR], 0.756; 95% confidence interval [CI], 0.334–1.710; adjusted OR, 0.554; 95% CI, 0.212–1.449). The incidence of symptomatic deep-vein thrombosis and pulmonary embolism (including fatal and non-fatal) did not significantly differ between groups. However, fatal pulmonary thromboembolism developed in two cases in group A and one patient expired postoperatively due to pulmonary hemorrhage in group B. Major bleeding and all-cause death did not differ between groups. CONCLUSION: Preoperative starting chemical thromboprophylaxis may be considered in the elderly patients with hip fracture who have risk factors for venous thromboembolism.

Insufficiency Fracture of the Femoral Neck after Intramedullary Nailing for the Treatment of Atypical Femoral Fracture - A Case Report -

Although several publications have reported delayed or non-union, there is a consensus that the standard treatment for atypical femoral fracture (AFF) is an intramedullary nailing. However, no case of tensile insufficiency fracture of femoral neck associated with intramedullary nailing in patients with AFF have been reported. Here, we report an 82-year-old woman with tensile type of insufficiency fracture of the femoral neck after intramedullary nailing for the treatment of AFF.

Cholelithiasis with Mucosal Dysplasia of the Gallbladder in a 2-year-old Child

Traditionally, it has been emphasized that hemolytic disease was the primary cause of gallstones (cholelithiasis) in most young patients. In recent years, gallstones and common bile duct calculi have been increasingly diagnosed in infants and children, unrelated to hemolytic diseases. On the matter, the World Health Organization (WHO) classified intraepithelial neoplasia (dysplasia) of gall bladder as one of the precursor lesions of invasive cancer. The following article describes the case of a 2-year-old girl who had a laparoscopic cholecystectomy due to cholelithiasis and the pathologic diagnosis was chronic cholecystitis with diffuse, mild mucosal dysplasia.

Clinical study of gingival recession and dentine hypersensitivity / 대한치주과학회지

Gingival recession is clinically manifested by an apical displacement of the gingival tissue and dentin hypersensitivity is often used to describe a painful condition in which exposed dentin is unduly sensitive to intraoral stimuli. The objects of this study were primarily to investigate the prevalence and distribution of gingival recession and hypersensitivity and secondarily to determine whether a relationship exists between gingival recession and hypersensitivity. The study population was 195 patients (102 males, 93 females) who were attended the department of periodontology, Pusan National University Hospital. 189 patients exhibited gingival recession at least more than 1 tooth, the prevalence was 96.9%. The maxillary and mandibular first premolar and mandibular incisors had the highest prevalence. The majority of patients (139 patients, 71.3%) were diagnosed as having dentin hypersensitivity. Dentin hypersensitivity was determined to 3 seconds application of cold air to the exposed root surface after isolating the test tooth and was commonest in maxillary and mandibular first premolars and mandibular incisors. Relationship between recession and hypersensitivity was analyzed using chi-square test (p=0.05), significant relation (p=0.000) was existed. Gingival recession was more severe, the prevalence of hypersensitivity was higher.

A Case of Hashimotos Thyroiditis with Anti-Triiodothyronine Autoantibody / 대한내분비학회지

Autoantibodies against thyroid hormones can be detected in the sera of patients with both thyroidal and non-thyroidal disorders. These antibodies interfere with the radioimmunoassay of serum total and free thyroid hormone concentrations, resulting in a discrepancy between the measured hormone levels and clinical features. This can in turn lead to an erroneous diagnosis and patients may receive unnecessary treatment from physicians who are unaware of the presence of the autoantibodies. We experienced a woman having Hashimotos' thyroiditis with a spurious elevation of total T3 and free T3 values according to one-step analog-tracer radioimmunoassay who was had been treated as Graves' disease in past. Through the use of a polyethylene glycol precipitation method, she was subsequently revealed to have anti-triiodothyronine autoantibodies. We report this case with a review of related literature.

Use of Natural and Synthetic Odorants in Odor Identification Test / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The odor identification tests use natural and synthetic odorants as stimuli. Synthetic odorants span a smaller qualitative range than natural ones, however, they eliminate the need for preparation, preservation and have improved familiarity owing to the improved development techniques. The aim of this study is whether we can use synthetic odorants in odor identification tests by comparing the results of tests using natural odorants and synthetic ones. MATERIALS AND METHODS: Forty-two natural and 21 synthetic odorants familiar to Koreans were applied to 40 normals and 20 patients with decreased sense of smell without sinonasal diseases. Percent-correctness shown by the controls and patients smelling natural and synthetic odorants were compared with those patients showing over 95% identifiability and in 11 corresponding natural and synthetic odorants. RESULTS: Percent-correctness of odor identification test using synthetic odorants was highly correlated with that using natural ones and there was no problem in discriminating patients from the control. CONCLUSION: Synthetic odorants can be used in odor identification tests for Koreans in a clinical context.

Petrous Apex Pneumatization on Computed Tomography / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The mastoid air cell system has been recognized as an important contributor to the function of middle ear ventilation. And, mastoid pneumatization is thought to be correlated with the petrous apex pneumatization. We attempted a comparative analysis of petrous apex pneumatization and the mastoid portion by using target imaging CT. MATERIALS AND MEDTHOD: Pneumatization of the petrous apex v as investigated in 100 subjects without middle ear disease by computer-assisted digital processing of CT images of' the hone. RESULTS: The rate of pneumatization of the petrous apex in all subjects was 22% (44/200 ears), and there was no difference in the degree of pneumatization between the left and the right ears or between sexes. In 44 ears that showed pneumatization of the petrous apex, a higher degree of pneumatization was found in larger mastoid cavities, suggesting a correlation between pneumatization of the petrous apex and the pneumatized air cells in other parts of the temporal bone. Pneumatization in all parts of the petrous apex was found in about 5% (2/44 ears), and pneumatization in some parts of the petrous apex eas about 95% (42/44 ears). In the latter cases, there was no difference in the degree of pneumatization between the lower portions of the CT slices and the higher ones. SUMMARY: These results indicate that the effects of pneumatization of the petrous apex must be taken into consideration in studies measuring the gas composition and volume of the middle ear, and in temporal bone peumatization which acts as a pressure buffer in middle ear diseases.

The effect of NO donor on contraction, cytosolic Ca2+ level and ionic currents in guinea-pig ileal smooth muscle

This study was designed to clarify the mechanism of the inhibitory action of a nitric oxide (NO) donor, 3-morpholino-sydnonimine (SIN-1), on contraction, cytosolic Ca2+ level ((Ca2+)i), and ionic currents in guinea-pig ileum. SIN-1 (0.01~100 micrometer) inhibited 25 mM KCl- or histamine (10 micrometer)-induced contraction in a concentration-dependent manner. SIN-1 reduced both the 25 mM KCl- and the histamine-stimulated increases in muscle tension in parallel with decreased (Ca2+)i. Using the patch clamp technique with a holding potential of -60 mV, SIN-1 (10 micrometer) decreased peak Ba currents (IBa) by 30.9+/-5.4% (n=6) when voltage was stepped from -60 mV to +10 mV and this effect was blocked by ODQ (1 micrometer), a soluble guanylyl cyclase inhibitor. Cu/Zn SOD (100 U/ml), the free radical scavenger, had little effect on basal IBa, and SIN-1 (10 micrometer) inhibited peak IBa by 32.4+/-5.8% (n=5) in the presence of Cu/Zn SOD. In a cell clamped at a holding-potential of -40 mV, application of 10 micrometer histamine induced an inward current. The histamine-induced inward current was markedly and reversibly inhibited by 10 micrometer SIN-1, and this effect was abolished by ODQ (1 micrometer). In addition, SIN-1 markedly increased the depolarization-activated outward K+ currents in the all potential ranges. We concluded that SIN-1 inhibits smooth muscle contraction mainly by decreasing (Ca2+)i resulted from the inhibition of L-type Ca2+ channels and the inhibition of nonselective cation currents and/or by the activation of K+ currents via a cGMP-dependent pathway.

Correlation between Magnetic Resonance Image Signal Changes and Electromyographic Findings after Sciatic Nerve Transection in the Rat

No abstract available.

The effects of vertical incision on fascia in repeated cesarean section delivery / 대한산부인과학회잡지

No abstract available.

A Clinical Study of Head and Neck Tumors Involving the Superior Mediastinum / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Traditionally, approaches to the superior mediastinum for head and neck surgeons are mainly limited to stomal recurrence. Recently, the need to approach to the superior mediastinum is increasing due to increasing thyroid surgery by head and neck surgeon. This study was designed to evaluate the approaches to mediastinum in head and neck tumors involving the superior mediastinum and to analyse the outcome of surgery in terms of morbidity and mortality. MATERIALS AND METHODS: At the department of otolaryngology-head and neck surgery of Hallym university, 15 patients who had been diagnosed as head and neck tumors involving the superior mediastinum from May 1990 to August 1998 were evaluated retrospectively. RESULTS: Of the 15 patients, the tumors involving the superior mediastinum were thyroid cancer (5 cases), hypopharyngeal cancer (4 cases), cervical esophageal cancer (2 cases), laryngeal cancer (1 case), and substernal goiter (3 cases). The surgical techniques used for approach to the superior mediastinum were suprasternal approach, clavicle resection, median sternotomy, and sternal manubrium resection. Eight patients are alive without recurrence, one patient is alive with disease, and six patients died, among them, four patients died of postoperative complication and two died of recurrent cancer. CONCLUSION: The mediastinal approach in itself is not complex and dangerous, however, in the treatment of head and neck cancers involving mediastinum, the surgeon should be careful in choosing the surgical method and approach. The surgeion should also take into consideration morbidity and mortality of the surgery, degree of tumor invasion and others, such as age of the patient.

Clinical Significance of Human Sodium Iodide Symporter mRNA Expressions in Primary and Metastatic Papillary Thyroid Carcinoma / 대한내분비학회지

BACKGROUND: The iodide transport into thyroid cells is an essential step in the biosynthesis of thyroid hormones. The sodium iodide symporter (NIS) which is responsible for iodide transport was cloned recently and identified as a plasma membrane glycoprotein. Recent report suggested the absence of human NIS (hNIS) mRNA expression of papillary carcinoma in thyroid indicates absence of response on radioiodine therapy for distant metastasis. To understand the change of hNIS expression at the stage of metastasis in papillary thyroid carcinomas, we evaluated the expression levels of hNIS mRNA in primary and lymph node metastatic papillary carcinoma tissues. METHODS: Seven pairs of primary and lymph node metastatic tissues were included in this study. The level of hNIS mRNA in lymph node metastatic tissues and primary tissues were evaluated by reverse transcriptase-polymerase chain reaction (RT-PCR). The level of GAPDH mRNA was used as internal control. RESULTS: Two among 6 lymph node metastatic tissues did not show hNIS mRNA even with significant hNIS expressions in papillary carcinoma tissues in thyroid. The levels of hNIS expression of remaining 4 lymph node metastatic tissues were lower than those of corresponding primary tissues. Interestingly, one case showed no hNIS expression in primary tissue, but significant hNIS expression in lymph node metastatic tissue. There was no correlation in hNIS mRNA expression between primary and lymph node metastatic tissues. CONCLUSION: No correlation was found in hNIS mRNA expression between primary and lymph node metastatic tissues, suggesting the measurements of hNIS mRNA level in primary tissues may not predict therapeutic response to radioactive iodine.

Prevalence of gastroesophageal reflux in infants with recurrent wheezing / 천식및알레르기

Background : Recurrent wheezing in infants is manifested in a number of disease spectrums and gastroesophageal reflux ( GER ) has been known to be associated with apnea, recurrent pneumonia, asthma, chronic cough, and wheezing. The prevalence of GER in infants with recurrent wheezing and the relationship between atopy and GER in infantile asthmatics have not yet been established, but it was hypothesized that microaspiration of food allergen could induce food-induced wheezing. Objective : To evaluate the prevalence of GER in infants with recurrent wheezing episodes, and to determine whether the presence of atopy affects the prevalence of GER in infantile asthmatics. Method : Seventy infants with recurrent wheezing episodes were evaluated for GER using 24 hour continuous esophageal pH monitoring. Patients were classified into five groups, : 12 atopic asthmatics : 20 nonatopic asthmatics : 15 infants with recurrent bronchiolitis : 8 infants with recurrent pneumonia : and 15 infants with chronic lung disease ( CLD ) of prematurity. GER was considered to be prevalent when reflux index was higher than 95 percentile of normal values by Vandenplas, 1991. Result : The prevalence of GER in infants with recurrent wheezing was 21.4%. The prevalence of GER in each group was 25% in atopic asthmatics, 20% in nonatopic asthmatics, 6.7% in infants with recurrent bronchiolitis, 12.5% in infants with recurrent pneumonia, and 40% in infants with CLD of prematurity. There were no significant differences in prevalence of GER between atopic asthmatics and nonatopic asthmatics, between asthmatics with atopic dermatitis and those without, and between asthmatics with family history of allergy and those without. CONCLUSION: The prevalence of GER in infants with recurrent wheezing was high, especially in infantile asthmatics and infants with chronic lung disease of prematurity. The presence of atopy may not affect the prevalence of GER in infantile asthmatics.