The purpose of this study was to develop prototype of virtual reality(VR) simulation with malocclusion models and evaluate its applicability. Task abilities, task completion time, and a satisfaction survey were compared between dentist trainees and dental students.
Participants were instructed to observe virtual malocclusion models and then performed three tasks to diagnose the type of malocclusion, determine clinical findings and develop treatment plans. Their satisfaction with the simulation experience were evaluated using a questionnaire containing five questions.
Task abilities of trainees related to clinical features and treatment plans were significantly higher than that of students(p < 0.01). In both groups, the task completion time for the second case was significantly reduced compared to that for the first case(p < 0.01). The satisfaction survey showed high scores and positive responses for this simulation in both groups. If the prototype of VR simulation is continuously advanced, it will be applicable for orthodontic education in pediatric dentistry.

OBJECTIVE: The aim of this study was to examine the change in the hippocampal volume and shape in early-onset mild cognitive impairment (EO-MCI) associated with the APOE ε4 carrier state. METHODS: This study had 50 subjects aged 55–63 years, all of whom were diagnosed with MCI at baseline via the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet. The EO-MCI patients were divided into the MCI continued (MCIcont) and Alzheimer's disease (AD) converted (ADconv) groups 2 years later. The hippocampal volume and shape were measured for all the subjects. The local shape analysis (LSA) was used to conduct based on the 2-year-interval magnetic resonance imaging scans. RESULTS: There was a significant correlation between APOE ε4 allele and hippocampal volume atrophy. Over two years, the volume reduction in the left hippocampus was found to be faster than that in the right hippocampus, especially in the APOE ε4 carriers. LSA showed that the 2 subfields were significantly affected in the left hippocampus. CONCLUSION: These results suggest that the possession of APOE ε4 allele may lead to greater predilection for left hippocampal atrophy in EO-MCI, and some specific subfields of the hippocampus may be more prominently involved.
Alleles ; Alzheimer Disease ; Apolipoproteins E ; Atrophy ; Carrier State ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment*

BACKGROUND: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. METHODS: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. RESULTS: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. CONCLUSION: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.
Anti-Bacterial Agents* ; Ciprofloxacin ; Disease Management ; Humans ; Insurance, Health ; Korea* ; Length of Stay ; Levofloxacin ; National Health Programs ; Outpatients ; Pelvic Pain ; Prescriptions ; Prostate ; Prostatitis*

BACKGROUND AND OBJECTIVES: Botulinum toxin type A (BTX-A) injection is well known for its effectiveness in the treatment of "Spasmodic dysphonia". However, studies on the efficacy of BTX-A injection have not been attempted in Korea. Therefore, this study was carried out to investigate the effects of BTX-A. SUBJECTS AND METHOD: The study examined 12 female patients with 'adductor spasmodic dysphonia'. Objective assesments included aerodynamic analysis and electoroglottography (EGG) of each patient before and after BTX-A. Subjective assessments included using the Korean-version of Voice Handicap Index-30 (KVHI-30) and a patient self-rating scale. RESULTS: Aerodynamic analysis revealed that only maximum phonation time (MPT) was significantly shortened after the injection of BTX-A (p<0.05). In the EGG, the mean frequency distribution was significantly increased, while the mean amplitude and the mean closed quotient distribution were significantly decreased (p<0.05). The KVHI-30 and patient self-rating scale scores were significantly decreased (p<0.01) as well, demonstrating the effects of BTX-A on the quality of life. CONCLUSION: Our results show the effects of BTX-A objectively by comparing voice characteristics, which were measured through EGG before and after BTX-A injection, as well as by determining aerodynamic characteristics. The subjective self-assessment on the quality of life is significant as it may serve as a clinically relevant measure. This study may be helpful in elucidating treatment efficacy of BTX-A in many ways.
Botulinum Toxins ; Botulinum Toxins, Type A ; Dysphonia ; Equidae ; Female ; Humans ; Korea ; Ovum ; Phonation ; Quality of Life ; Self-Assessment ; Treatment Outcome ; Voice

Background: Korean standard series (KSS) have not changed for 20 years. Moreover, the Korea Food and Drug Administration has suspended import licensing of Cosmetic series (ChemotechniqueⓇ). Objective: To analyze trends in the positive rates of allergens in patch test using KSS and present a literature review on the comparison of the results those of European baseline series (EBS) and North American Contact Dermatitis Group (NACDG) screening series. Methods: Epidemiologic findings and the positive rate of KSS allergens were analyzed from patients who visited the Department of Dermatology in Ewha Womans University Mokdong Hospital between 1998 and 2018. Literature reviews were conducted on the comparison of the results with those of the 2015∼2016 NACDG, 2013∼2014 ESSCA, and standard antigens in K-camp. Results: The positive rates of KSS allergens from 126 patients in 2018 were compared with those from 184 patients during 1998 to 2007. The top 3 allergens in the two study periods were common; nickel sulfate, cobalt chloride, and potassium dichromate. Remarkably, the positive rates for balsam of Peru and paraben mix increased from 7.1% to 17.5% and from 2.7% to 7.9%, respectively. As compared with the results of NACDG standard series and EBS, KSS lacked fragrance and cosmetic series of allergens, especially fragrance mix II, methyldibromoglutaronitrile, and methylisothiazolinone, and epoxy series of allergens. Conclusion Our results, especially the increasing trends of balsam of Peru and paraben mix, would be further confirmed in a multicenter study. Additionally, in view of the increase in fragrance and preservative allergens, KSS would need the addition of related allergens.

OBJECTIVE: To investigate differences in plantar pressure distribution between a normal gait and unpredictable slip events to predict the initiation of the slipping process. METHODS: Eleven male participants were enrolled. Subjects walked onto a wooden tile, and two layers of oily vinyl sheet were placed on the expected spot of the 4th step to induce a slip. An insole pressure-measuring system was used to monitor plantar pressure distribution. This system measured plantar pressure in four regions (the toes, metatarsal head, arch, and heel) for three events: the step during normal gait; the recovered step, when the subject recovered from a slip; and the uncorrected, harmful slipped step. Four variables were analyzed: peak pressure (PP), contact time (CT), the pressure-time integral (PTI), and the instant of peak pressure (IPP). RESULTS: The plantar pressure pattern in the heel was unique, as compared with other parts of the sole. In the heel, PP, CT, and PTI values were high in slipped and recovered steps compared with normal steps. The IPP differed markedly among the three steps. The IPPs in the heel for the three events were, in descending order (from latest to earliest), slipped, recovered, and normal steps, whereas in the other regions the order was normal, recovered, and slipped steps. Finally, the metatarsal head-to-heel IPP ratios for the normal, recovered, and slipped steps were 6.1+/-2.9, 3.1+/-3.0, and 2.2+/-2.5, respectively. CONCLUSION: A distinctive plantar pressure pattern in the heel might be useful for early detection of a slip event to prevent slip-related injuries.
Accident Prevention ; Accidental Falls ; Foot ; Gait ; Head ; Heel ; Humans ; Male ; Metatarsal Bones ; Toes

BACKGROUND: KRAS is one of commonly mutated genetic "drivers" in non-small cell lung cancers (NSCLCs). Recent studies indicate that patients with KRAS-mutated tumors do not benefit from adjuvant chemotherapy, so there is now a focus on targeting KRAS-mutated NSCLCs. A feasible mutation detection method is required in order to accurately test for KRAS status. METHODS: We compared direct Sanger sequencing and the peptide nucleic acid (PNA)-mediated polymerase chain reaction (PCR) clamping method in 134 NSCLCs and explored associations with clinicopathological factors. Next-generation sequencing (NGS) was used to validate the results of discordant cases. To increase the resolution of low-level somatic mutant molecules, PNA-mediated PCR clamping was used for mutant enrichment prior to NGS. RESULTS: Twenty-one (15.7%) cases were found to have the KRAS mutations using direct sequencing, with two additional cases by the PNA-mediated PCR clamping method. The frequencies of KRAS mutant alleles were 2% and 4%, respectively, using conventional NGS, increasing up to 90% and 89%, using mutant-enriched NGS. The KRAS mutation occurs more frequently in the tumors of smokers (p=.012) and in stage IV tumors (p=.032). CONCLUSIONS: Direct sequencing can accurately detect mutations, but, it is not always possible to obtain a tumor sample with sufficient volume. The PNA-mediated PCR clamping can rapidly provide results with sufficient sensitivity.
Alleles ; Carcinoma, Non-Small-Cell Lung* ; Chemotherapy, Adjuvant ; Constriction* ; Humans ; Lung Neoplasms ; Peptide Nucleic Acids ; Polymerase Chain Reaction*

No abstract available.
Adenoma* ; Aged* ; Cartilage* ; Female ; Humans ; Islands*

BACKGROUND: Although epidermal growth factor receptor (EGFR), v-Ki-ras2 Kirsten rat sarcoma viral oncogene (KRAS), and anaplastic lymphoma kinase (ALK) mutations in non-small cell lung cancer (NSCLC) were thought to be mutually exclusive, some tumors harbor concomitant mutations. Discovering a driver mutation on the basis of morphologic features and therapeutic responses with mutation analysis can be used to understand pathogenesis and predict resistance in targeted therapy. METHODS: In 6,637 patients with NSCLC, 12 patients who had concomitant mutations were selected and clinicopathologic features were reviewed. Clinical characteristics included sex, age, smoking history, previous treatment, and targeted therapy with response and disease-free survival. Histologic features included dominant patterns, nuclear and cytoplasmic features. RESULTS: All patients were diagnosed with adenocarcinoma and had an EGFR mutation. Six patients had concomitant KRAS mutations and the other six had KRAS mutations. Five of six EGFR-KRAS mutation patients showed papillary and acinar histologic patterns with hobnail cells. Three of six received EGFR tyrosine kinase inhibitor (TKI) and showed partial response for 7-29 months. All six EGFR-ALK mutation patients showed solid or cribriform patterns and three had signet ring cells. Five of six EGFR-ALK mutation patients received EGFR TKI and/or ALK inhibitor and four showed partial response or stable disease, except for one patient who had acquired an EGFR mutation. CONCLUSIONS: EGFR and ALK mutations play an important role as driver mutations in double mutated NSCLC, and morphologic analysis can be used to predict treatment response.
Adenocarcinoma ; Animals ; Carcinoma, Non-Small-Cell Lung* ; Cytoplasm ; Disease-Free Survival ; Humans ; Lymphoma ; Oncogenes ; Phosphotransferases ; Protein-Tyrosine Kinases ; Rats ; Receptor, Epidermal Growth Factor ; Sarcoma ; Smoke ; Smoking