Tretinoin(all-trans retinoic acid) is a metabolite of vitamin A and it is useful in the treatment of photoaging skin. Photoaging skin is characterized by wrinkles, mottled pigmentation, dry and rough skin, and loss of skin tone. Current use of topical tretinoin mainly acts on the epidermis, requires a long period to obtain the desired results and may cause skin hyperpigmentation. A combination of topical and injectable tretinoin has been used to reduce the treatment period as a result of its potentialized effect on the dermis when compared to graditional topical cream use. in this study, we observed histologic alterations in 5 white rabbits after using 0.05% topical tretinoin cream and 0.1% injectable tretinoin. Tretinoin was treated on the rabbits ears-group 1 and 2 on the right ear for study 1, and group A and B on the left ear for study 2. Study 1 was done to differentiate whether the dermal thickening is due to the simple physical stretching of dermis by intradermal injection, or whether it is duer to the histologic change by tretinoin. In group 1, saline was injected intradermally and in group 2, tretinoin was injected intradermally. Study 2 was done to compare the dermal thickening between the topical tretinoin cream treatment group (group A) and the combined topical and injectable tretinoin group (group B). Injection was done once a week immediately followed by 340nm blue light skin exposure. These treatment were done for 12 weeks. We harvested skin stripe from all group, group 1 and 2, and group A and B respectively, after 2, 6, and 12 weeks after treatment. Histologic differences were observed and measured. Dermal thickening was observed in group 2 and in group B(p<0.05). The results showed that intradermal injection of tretinoin mainly acts on the dermis and potentialtes the effect on photo-aging skin and fine wrinkles.
Dermis ; Ear ; Epidermis ; Hyperpigmentation ; Injections, Intradermal* ; Pigmentation ; Rabbits ; Skin ; Tretinoin* ; Vitamin A

The role of neoadjuvant chemoradiation therapy in locally advanced pancreatic cancer (LAPC) is still controversial. The aim of this study was to evaluate surgical downstaging after concurrent chemoradiation therapy (CCRT) for LAPC by measuring the objective changes after treatment. From January 2003 through July 2011, 54 patients with LAPC underwent neoadjuvant CCRT. Computed tomography findings of the tumor size, including major vessel invasion, were analyzed before and after CCRT. Among the total recruited patients, 14 had borderline resectable malignancy and another 40 were unresectable before CCRT. After CCRT, a partial response was achieved in four patients. Stable disease and further disease progression were achieved in 36 and 14 patients, respectively. Tumor size showed no significant difference before and after CCRT (3.6 +/- 1.1 vs. 3.6 +/- 1.0 cm, P = 0.61). Vessel invasion showed improvement in two patients, while 13 other patients showed further tumor progression. Thirty-nine patients with unresectable malignancy and 11 patients with borderline resectable malignancy at time of initial diagnosis remained unchanged after CCRT. Four patients with borderline pancreatic malignancy progressed to an unresectable stage, whereas one unresectable pancreatic malignancy improved to a borderline resectable stage. Only one patient with borderline resectable disease underwent operation after CCRT; however, curative resection failed due to celiac artery invasion and peritoneal seeding. The adverse events associated with CCRT were tolerable. In conclusion, preoperative CCRT in LAPC rarely leads to surgical downstaging, and it could lower resectability rates.
Adenocarcinoma/radiography/therapy ; Adult ; Aged ; Aged, 80 and over ; Antimetabolites, Antineoplastic/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Capecitabine/therapeutic use ; Carcinoma, Pancreatic Ductal/*radiography/*therapy ; Chemoradiotherapy/adverse effects/*methods ; Combined Modality Therapy ; Deoxycytidine/analogs & derivatives/therapeutic use ; Disease Progression ; Female ; Fluorouracil/therapeutic use ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Pancreas/blood supply/pathology ; Pancreatic Neoplasms/*radiography/*therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: The Mini-Cog, a composite of three word recall and clock drawing, was developed by Soo Borson as a brief test for discriminating demented from non-demented persons in a community sample. This study was conducted to prove the diagnostic validity of the Korean version of Mini-cog. METHODS: All 41 who met the criteria for probable dementia based on informant interviews and 88 with no history of cognitive decline were included. Sensitivity and, specificity of the Mini-Cog were compared with those of the Mini-Mental State Examination in the Korean version of the CERAD assessment packet (MMSE-KC), clock drawing test (CDT) and three word recall. RESULTS: The Mini-Cog had the higher sensitivity (86.11%) than MMSE-KC and fair specificity (72.09%). Cut off points of Mini-Cog was 2/3. AUC of Mini-Cog was 0.819 (p<0.001). The Mini-Cog required minimal training to administer and no test forms of scoring modifications. CONCLUSION: It suggests that the Mini-Cog might be readily incorporated into general practice and senior care setting as a routine cognitive measure.
Area Under Curve ; Dementia ; General Practice ; Humans ; Mass Screening ; Sensitivity and Specificity

No abstract available.
Humans* ; Lymphocytes* ; Mycobacterium tuberculosis* ; Mycobacterium*

PURPOSE: Although the treatment of choice for bullous keratopathy is typically penetrating keratoplasty (PKP), not all patients are suited for this treatment. Thus, we evaluated the clinical effects of phototherapeutic keratectomy (PTK) on pain relief and on the improvement of photophobia and visual acuity in patients suffering from bullous keratopathy. METHODS: Twenty-three patients with bullous keratopathy who were awaiting PKP and suffering from ocular pain, photophobia, and cosmetic problems, were assessed. Twelve eyes were treated with PTK using the excimer laser (VISX STAR S3, Irvine, CA, U.S.A). Another 11 eyes were treated with eye drops or other conservative modalities. Statistically significant differences in pain relief, photophobia improvement, and cosmetic improvement between two groups were assessed by Fisher's exact test. RESULTS: Twelve eyes with bullous keratopathy underwent PTK. At post-operative 1 month, 83% of patients showed relief of pain, 75% of patients showed improvements in photophobia, and 58% of patients had increased visual acuity of one or more line. The overall satisfaction rate of PTK was 91%, but 67% of patients showed recurrence of corneal opacity and bullae formation at 6 months after the procedure. CONCLUSIONS: Phototherapeutic keratectomy (PTK) reduced pain and improved visual acuity slightly in patients with bullous keratopathy. This procedure could be considered a valuable alternative treatment modality while awaitng PKP.
Corneal Opacity ; Corneal Transplantation ; Humans ; Keratoplasty, Penetrating ; Lasers, Excimer ; Ophthalmic Solutions ; Photophobia ; Recurrence ; Visual Acuity

Background: Although competency-based education (CBE) is becoming a popular form of medical education, it has not been used to train residents. Recently, the Korean Society of Anesthesiologists completed a pilot implementation and evaluation of a CBE program.This study aims to outline the experience. Methods: The chief training faculty from each hospital took a one-hour online course about CBE. Emails on the seven core competencies and their evaluation were sent ahead of a pilot core competency evaluation (CCE) to residents and faculty. The pilot CCE took place in late 2021, followed by a survey. Results: A total of 68 out of 84 hospitals participated in the pilot CCE. The survey response rate was 55.9% (38/68) for chief training faculty, 10.2% (91/888) for training faculty, and 30.2% (206/683) for residents. More than half of the training faculty thought that CCE was necessary for the education of residents. Residents’ and training faculty’s responses about CCE were generally positive, although their understanding of CCE criteria was low. More than 80% of the hospitals had a defibrillator and cardiopulmonary resuscitation manikin while the rarest piece of equipment was an ultrasound vessel model. Only defibrillators were used in more than half of the hospitals. Thoughts about CCE were related to various factors, such as length of employment, location of hospitals, and the number of residents per grade. Conclusions This study’s results may be helpful in improving resident education quality to meet the expectations of both teaching faculty and residents while establishing CBE.

Intracytoplasmic sperm injection (ICSI) recently has been utilized widely as the most successful technique to overcome the unfertilization problem in cases of severe male infertility in couples who could not be treated by conventional IVF. Recently, indications of ICSI have been extended further and more fertilized oocytes become available. Thus, it is necessary to examine the efficiency of freezing the surplus embryos obtained from ICSI. We compared the survival rate and the future outcome of cryopreserved embryos obtained either after conventional IVF or ICSI during the same period. After ICSI or IVF, five best-quality embryos from each patient were transferred in the stimulation cycle and the surplus pronuclear (PN) stage oocytes or multicellular embryos were cryopreserved by slow freezing protocol with 1,2-propanediol (PROH) as a cryoprotectant.4 total of 792 embryos from ICSI trial were thawed and 65.2% (516/792) survived. The survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 63.5%, 68.2%, 64.0%, respectively. After 111 transfers, 34 pregnancies were achieved, corresponding to a clinical pregnancy rate of 30.6% per transfers. We thawed 1033 embryos from IVF trials and 57.5% (594/1033) survived. In IVF cycle, the survival rates of PN stage oocyte, multicellular embryo and PN + multicellular embryo were 58.2%, 65.2%, 40.2%, respectively. Thirty eight clinical pregnancies were established after 134 transfers, corresponding to a pregnancy rate of 28.4% per transfer The cleavage rate of thawed PN stage oocytes from ICSI trial (61.3%) was significantly higher than those from conventional IVF (53.4%). The developmental rates of good embryo (> or = grade II) in thawed PN stage oocytes obtained from conventional IVF and ICSI were 63% and 65%, respectively. We concluded that PN stage oocytes, multicellular embryos resulting from ICSI procedure can be successfully frozen/thawed with reasonable clinical pregnancy rates comparable to those of IVF.
Embryonic Structures* ; Family Characteristics ; Fertilization in Vitro* ; Freezing ; Humans ; Infertility, Male ; Male ; Oocytes ; Pregnancy ; Pregnancy Rate ; Propylene Glycol ; Sperm Injections, Intracytoplasmic* ; Survival Rate