C-arm fluoroscopy is useful equipment in interventional pain management because it helps to guide correct needle targeting for the accurate injection and drug delivery. However, due to increased use of C-arm fluoroscopy in various pain procedures, the risk of radiation exposure is a significant concern for pain physicians. The harmful biological effects of ionizing radiation on the human body are well known. It is therefore necessary to strive to reduce radiation exposure. Lead aprons with thyroid shields are the most fundamental radiation protective devices for interventional procedures, and are very effective. However, the operator's radiation safety cannot be guaranteed because pain physicians seem to lack sufficient interest, knowledge, and awareness about radiation safety. Also, inappropriate care and use of radiation protective devices may result in a higher risk of radiation exposure. The purpose of this article was to review the literature on radiation safety with a focus on lead aprons and thyroid shields and present recommendations related to those devices during C-arm fluoroscopic-guided interventions by pain physicians.
Fluoroscopy ; Human Body ; Needles ; Pain Management ; Protective Devices ; Radiation Exposure ; Radiation Protection ; Radiation, Ionizing ; Thyroid Gland

Intense pulsed light (IPL) Quantum SR(TM) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad wavelength spectrum of 560-1200 nm. IPL Quantum SR(TM) has been effective for the treatment of photoaging skin as a nonablative method. Three patients with photoaged skin were treated with fifth full-face treatments at 3-4 week intervals using IPL Quantum SR(TM). The cut-off filters of 560 nm and integrated contact cooling system were utilized for treatments. After the last treatments, the patients showed the overall improvement in clinical appearance, reduction in pigmentation and telangiectasia and fine wrinkle with smoothening of skin textures. Histological evaluations showed new collagen production after treatment. Full-face photorejuvenation using IPL Quantum SR(TM) can be an effective treatment modality for photoaged skin. We report herein IPL photorejuvenation is safe and effective in skin rejuvenation.
Collagen ; Humans ; Pigmentation ; Rejuvenation ; Skin ; Telangiectasis

Striae Distensae is a very common cosmetic problem. The effectiveness of various lasers, such as the 585-nm pulsed dye laser on the treatment of striae distensae has recently been reported. However, the potential pigmentary alteration of dark skin by pulsed dye laser is known. Thermage is a radiofrequency capable of delivering higher energy fluences to a greater volume of tissue than nonablative lasers, with no epidermal injury. We report three patients who had striae distensae. They were treated with Thermage and 585-nm pulsed dye laser. The treatment was effective and safe for dark skin.
Humans ; Lasers, Dye ; Skin ; Striae Distensae*

PURPOSE: To report a case of refractive change with intraocular pressure change following trauma. METHODS: Changes in intraocular pressure, refractive power, lens thickness, depth of anterior chamber, and axial length of an 8-year-old girl were measured. RESULTS: During the early period after trauma, the patient showed low intraocular pressure and shallow anterior chamber depth. The refractive power changed to transient high myopia. With temporary high intraocular pressure, the refractive power changed to hyperopia and the refractive power recovered toward emmetropia as the intraocular pressure fell to the normal level. Refractive alteration is a result of changes in intraocular pressure and depth of the anterior chamber by cyclodialysis cleft and its adhesion is induced by trauma to the eye. Herein, the authors show evidence for a relationship between refractive change and posttraumatic ocular change.
Anterior Chamber ; Child ; Emmetropia ; Female ; Humans ; Hyperopia ; Intraocular Pressure* ; Myopia

Trichoderma spp. cause large crop losses of the cultivated shiitake mushroom, Lentinula edodes. We bred several shiitake strains that are resistant to Trichoderma spp. using di-mon mating to establish a useful method for controlling the greenmold disease. We examined the competitive ability of L. edodes against Trichoderma spp. using a dual culture system to select resistant strains. By screening Trichoderma-resistant strains, we found that among 11 parental strains, 4 strains, including KFRI 36, were confirmed resistant strains. They showed especially strong resistance to T. harzianum, which formed deadlock after mycelial contact and then invaded into the territory of T. harzianum. KFRI 171 also showed resistance to T. atroviride strains. Among 13 strains, which were made by hybridization of shiitake strains, 5 were confirmed to be resistant to Trichoderma, including KFRI 58-1. Their resistance was not correlated to the resistant activity of their parents' strains. Two strains lose resistance and two strains acquire resistance compared to their parents' strains. In SEM observation, the mycelium of L. edodes at the interaction zone of Lentinula-Trichoderma was rugged and swollen by T. harzianum.
Breeding ; Chimera ; Humans ; Lentinula ; Mass Screening ; Mycelium ; Parents ; Shiitake Mushrooms ; Trichoderma

Background: Botulinum toxin type A (BTX-A) injection is being widely used off-label for muscular hypertrophy, including deltoid muscle hypertrophy. However, very few studies have evaluated the optimal dosage and its clinical response. Objective: This study aimed to assess the efficacy and safety of different doses of Prabotulinum toxin A (PBoNT) for treating deltoid muscle hypertrophy. Methods: Twelve particiapants with bilateral deltoid muscle hypertrophy were enrolled and randomly received either 16 U or 32 U of PBoNT. In each participant, the same dose was administered to both deltoid muscles. Both participants and evaluators were blinded. Deltoid muscle thickness and upper arm circumference were measured on day 0, and weeks 2, 4, and 12 after the PBoNT injection. Results: Upper arm circumference significantly decreased in both groups; however, deltoid muscle thickness was reduced in the 16 U group only. No major complications were reported in both groups. However, a few minor complications were reported in the 16 U injection group. Conclusion Both 16 U and 32 U of PBoNT intramuscular injections are safe and effective in treating deltoid hypertrophy.

Hemorrhagic cystitis is defined by lower urinary tract symptoms that include dysuria, hematuria, and hemorrhage and is caused by viral or bacterial infection or chemotherapeutic agents. Reports of hemorrhagic cystitis caused by non-typhoidal salmonella (NTS) are extremely rare. We report a case of a 41-year-old man with hemorrhagic cystitis from NTS that caused massive bleeding and shock. The patient was hospitalized for uncontrolled diabetes and obstructive uropathy related to severe cystitis. A urine culture was positive for group D NTS. This case demonstrated that hemorrhagic cystitis in a patient with a risk factor such as diabetes can be a manifestation of local extraintestinal NTS infection.
Adult ; Bacterial Infections ; Cystitis ; Dysuria ; Hematuria ; Hemorrhage ; Humans ; Lower Urinary Tract Symptoms ; Risk Factors ; Salmonella ; Salmonella Infections ; Shock

PURPOSE: We aimed to examine the effectiveness of the head-up tilt test (HUT) for the diagnosis of syncope or presyncope in children and adolescents. METHODS: HUT results and clinical features of 160 children and adolescents with syncope or presyncope were studied from May 2003 through March 2008 at the Chonbuk National University Hospital. The children and adolescents were subjected to 70degrees HUT for 45 minutes. The testees were divided into 2 groups: group I (children) comprising 39 children in the age range 7-12 years (mean, 10.59+/-1.60 years) and group II (adolescents) comprising 121 adolescents in the age range 13-20 years (mean, 15.93+/-2.28 years). Positive result rates of the HUT and types of hemodynamic response to the test in the 2 groups were compared. RESULTS: Of the 160 testees, 92 (57.5%) showed positive HUT results; they showed 3 patterns of response to tilting. Twelve patients showed a predominantly vasodepressor response; 10 patients showed a cardioinhibitory response; and 70 patients showed a mixed response. The positive result rates were 43.6% (17/39) and 62.0% (75/121) in groups I and II, respectively. Mixed response was the predominant positive hemodynamic response in both the groups. CONCLUSION: The HUT is a useful diagnostic tool for evaluating the condition of pediatric patients, including adolescents, with syncope. Further, it may be considered as the first step for evaluating the condition of such patients.
Adolescent ; Child ; Hemodynamics ; Humans ; Resin Cements ; Syncope

The vitamin D receptor (VDR) is a member of the nuclear receptor (NR) superfamily. The VDR binds to active vitamin D3 metabolites, which stimulates downstream transduction signaling involved in various physiological activities such as calcium homeostasis, bone mineralization, and cell differentiation. Quercetin is a widely distributed flavonoid in nature that is known to enhance transactivation of VDR target genes. However, the detailed molecular mechanism underlying VDR activation by quercetin is not well understood. We first demonstrated the interaction between quercetin and the VDR at the molecular level by using fluorescence quenching and saturation transfer difference (STD) NMR experiments. The dissociation constant (K(d)) of quercetin and the VDR was 21.15 ± 4.31 µM, and the mapping of quercetin subsites for VDR binding was performed using STD-NMR. The binding mode of quercetin was investigated by a docking study combined with molecular dynamics (MD) simulation. Quercetin might serve as a scaffold for the development of VDR modulators with selective biological activities.
Calcification, Physiologic ; Calcium ; Cell Differentiation ; Cholecalciferol ; Fluorescence ; Homeostasis ; Molecular Dynamics Simulation ; Quercetin* ; Receptors, Calcitriol* ; Transcriptional Activation ; Vitamin D* ; Vitamins*

PURPOSE: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no 'gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. METHODS: Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within 24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion for malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid- arm muscle circumference, serum albumin and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statdtatistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic (ROC) curve was drawn to choose a cutoff value that maximizes sensitivity and specificity. RESULTS: The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified 7 patients (13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. CONCLUSION: The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.
Arm ; Body Mass Index ; Body Weight ; Eating ; Humans ; Internal Medicine ; Length of Stay ; Lymphocyte Count ; Malnutrition ; Mass Screening* ; Mortality ; Nutrition Assessment ; Nutritional Support ; Reference Values ; ROC Curve ; Sensitivity and Specificity ; Serum Albumin ; Skinfold Thickness ; Weight Loss