This article reviewed the literatures which demonstrated correlations between therapeutic relationship variables and treatment outcomes in children and adolescents, and also examined factors which affect a positive therapeutic relationship. Results from this review revealed that a positive therapeutic relationship is essential for cognitive-behavioral treatment (CBT) with children and adolescents, and also indicated that the therapeutic effect is the most powerful when a therapist maintains a collaborative relationship. Finally, basic strategies for maintaining a collaborative relationship have been suggested. These include strategies such as ; 1) setting a goal for therapy focusing on enhanced motivation for therapy ; 2) facilitating the engagement of parents in the treatment process ; 3) creating a collaborative atmosphere ; 4) educating the client about therapy ; 5) liciting feedback ; 6) making creative and innovate modifications of traditional CBT methods ; and, 7) providing choices for the client.
Adolescent ; Atmosphere ; Child ; Humans ; Motivation ; Parents

No abstract available.
Muir-Torre Syndrome*

No abstract available.
Muscle, Skeletal*

Since nonsurgical treatment of vitiligo is not always successful, surgical interventions are viable options for patients with refractory vitiligo. Surgical treatment is a method in which melanocytes of normal skin are transplanted into vitiligo lesions and provided as a repigmentation source. Such treatments are primarily divided into tissue grafting and cellular grafting, depending on the nature of the graft. Tissue grafting includes split-thickness skin grafting, suction blister grafting, punch grafting, hair follicle transplantation, and smashed-skin grafting. Cellular grafting includes non-cultured epidermal cell suspension transplantation, non-cultured follicular cell suspension transplantation, and cultured epidermal cell suspension transplantation. Among these, suction blister grafting and micro-punch grafting have been widely performed for localized refractory vitiligo, and non-cultured epidermal cell suspension transplantation is adopted as the standard treatment for extensive vitiligo. Research on cultured cellular grafting to treat larger vitiligo areas is also ongoing. Selecting patients with stable vitiligo that has not spread for over 12 months is the most critical factor in the surgical outcome. It is also important to choose an appropriate surgical modality for each patient, and a combination of various procedures often improves the overall outcome. In conclusion, surgical intervention can be an effective and safe option for patients with vitiligo refractory to conventional treatments. Non-cultured epidermal cell suspension transplantation, which was denied by New Health Technology Assessment in Korea, should be approved to benefit patients with refractory vitiligo.

Since nonsurgical treatment of vitiligo is not always successful, surgical interventions are viable options for patients with refractory vitiligo. Surgical treatment is a method in which melanocytes of normal skin are transplanted into vitiligo lesions and provided as a repigmentation source. Such treatments are primarily divided into tissue grafting and cellular grafting, depending on the nature of the graft. Tissue grafting includes split-thickness skin grafting, suction blister grafting, punch grafting, hair follicle transplantation, and smashed-skin grafting. Cellular grafting includes non-cultured epidermal cell suspension transplantation, non-cultured follicular cell suspension transplantation, and cultured epidermal cell suspension transplantation. Among these, suction blister grafting and micro-punch grafting have been widely performed for localized refractory vitiligo, and non-cultured epidermal cell suspension transplantation is adopted as the standard treatment for extensive vitiligo. Research on cultured cellular grafting to treat larger vitiligo areas is also ongoing. Selecting patients with stable vitiligo that has not spread for over 12 months is the most critical factor in the surgical outcome. It is also important to choose an appropriate surgical modality for each patient, and a combination of various procedures often improves the overall outcome. In conclusion, surgical intervention can be an effective and safe option for patients with vitiligo refractory to conventional treatments. Non-cultured epidermal cell suspension transplantation, which was denied by New Health Technology Assessment in Korea, should be approved to benefit patients with refractory vitiligo.

Adipose tissue (AT) inflammation is strongly associated with obesity-induced insulin resistance. When subjected to metabolic stress, adipocytes become inflamed and secrete a plethora of cytokines and chemokines, which recruit circulating immune cells to AT. Although sirtuin 6 (Sirt6) is known to control genomic stabilization, aging, and cellular metabolism, it is now understood to also play a pivotal role in the regulation of AT inflammation. Sirt6 protein levels are reduced in the AT of obese humans and animals and increased by weight loss. In this review, we summarize the potential mechanism of AT inflammation caused by impaired action of Sirt6 from the immune cells’ point of view. We first describe the properties and functions of immune cells in obese AT, with an emphasis on discrete macrophage subpopulations which are central to AT inflammation. We then highlight data that links Sirt6 to functional phenotypes of AT inflammation. Importantly, we discuss in detail the effects of Sirt6 deficiency in adipocytes, macrophages, and eosinophils on insulin resistance or AT browning. In our closing perspectives, we discuss emerging issues in this field that require further investigation.

The Editorial Office of Obstet Gynecol Sci would like to correct the author's name. The Editorial Office apologizes for any inconvenience that it may have caused.

Aquaporins (AQPs) are expressed in myocardium and the implication of AQPs in myocardial water balance has been suggested. We investigated the expression patterns of AQP subtypes in normal myocardium and their changes in the process of edema formation and cardiac dysfunction following myocardial infarction (MI). Immunostaining demonstrated abundant expression of AQP1, AQP4, and AQP6 in normal mouse heart; AQP1 in blood vessels and cardiac myocytes, AQP4 exclusively on the intercalated discs between cardiac myocytes and AQP6 inside the myocytes. However, neither AQP7 nor AQP9 proteins were expressed in CD1 mouse myocardium. Echocardiography revealed that cardiac function was reduced at 1 week and recovered at 4 weeks after MI, whereas myocardial water content determined by wet-to-dry weight ratio increased at 1 week and rather reduced below the normal at 4 weeks. The expression of cardiac AQPs was up-regulated in MI-induced groups compared with sham-operated control group, but their time-dependent patterns were different. The time course of AQP4 expression coincided with that of myocardial edema and cardiac dysfunction following MI. However, expression of both AQP1 and AQP6 increased persistently up to 4 weeks. Our findings suggest a different role for cardiac AQPs in the formation and reabsorption of myocardial edema after MI.
Animals ; Aquaporin 1/metabolism ; Aquaporin 4/metabolism ; Aquaporin 6/metabolism ; Aquaporins/*metabolism ; Edema/pathology ; Immunohistochemistry ; Mice ; Muscle Cells/metabolism ; Myocardial Infarction/*metabolism/pathology/ultrasonography ; Myocardium/metabolism/pathology ; Time Factors

PURPOSE: To confirm the utility of cuff palpation for the verification of the correct endotracheal tube position. METHODS: One hundred and one intubated patients were selected randomly every three days among the 344 intubated patients in the emergency room of a tertiary care hospital between July 2006 and March 2007. After endotracheal intubation was confirmed, we recorded the probability of successful cuff palpation. We also measured the patient's weight, height and neck length; the distance from ETT tip to the incisors, and distance from ETT tip to the carina of the patients. Sedatives or muscle relaxants that used were used were noted as well. RESULTS: In the cuff palpated group (n=61), 40 patients' had the ETT tip at 3~5cm from the carina while in the nonpalpated group (n=40), 35 patients had the ETT tip placed at less than 3 cm or more than 5 cm from the carina (p value <0.001). The cuffs of the ETTs inserted in patients whose neck lengths were below 10 cm were less palpable than in patients whose neck lengths were more than 10 cm.(p=0.004) There was no relation between cuff palpability and height, BMI and use of muscle relaxant or sedatives. In addition, 9 of 10 cases whose cuffs were non-palpable, which were randomly chosen among the non-palpated group (n=40) with incorrectly positioned cuff became palpable after the repositioning of the ETT. CONCLUSION: We concluded that cuff palpation is a simple and reproducible way to verify the correct depth of endotracheal tubes.
Emergencies ; Humans ; Hypnotics and Sedatives ; Incisor ; Intubation, Intratracheal ; Muscles ; Neck ; Palpation ; Tertiary Healthcare

PURPOSE: To report the first domestic case of choroidal neovascularization in a choroideremia patient treated with intravitreal bevacizumab injection. CASE SUMMARY: A 29-year-old male presented with a sudden decline in vision in the left eye. Fundus examination revealed areas of choriocapillaries and retinal pigment epithelium atrophy with macular hemorrhage. Fluorescein angiogram revealed vascular hyperfluorescence in the juxtafoveal area. Neurosensory detachment around the macula and increased central macular thickness was also observed using optical coherence tomography. Upon the diagnosis of choroideremia with choroidal neovascularization, the patient was treated with 1.25 mg intravitreal bevacizumab. Visual acuity improved after four injections of intravitreal Bevacizumab with improvement in both detachment and fluorescein leakage. CONCLUSIONS: In patients with choroideremia presenting sudden decline in vision, ophthalmologists should detect for possible choroidal neovascularization. The results from the present study show that judicious use of intravitreal Bevacizumab may be effective in such cases. Further studies with a large sample size and sufficiently long follow-up periods are required.
Adult ; Antibodies, Monoclonal, Humanized ; Atrophy ; Choroid ; Choroidal Neovascularization ; Choroideremia ; Eye ; Fluorescein ; Follow-Up Studies ; Hemorrhage ; Humans ; Male ; Retinal Pigment Epithelium ; Sample Size ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Bevacizumab