The aim of this paper was to propose a new method of bimaxillary orthognathic surgery planning and model surgery based on the concept of 6 degrees of freedom (DOF). A 22-year-old man with Class III malocclusion was referred to our clinic with complaints of facial deformity and chewing difficulty. To correct a prognathic mandible, facial asymmetry, flat occlusal plane angle, labioversion of the maxillary central incisors, and concavity of the facial profile, bimaxillary orthognathic surgery was planned. After preoperative orthodontic treatment, surgical planning based on the concept of 6 DOF was performed on a surgical treatment objective drawing, and a Jeon's model surgery chart (JMSC) was prepared. Model surgery was performed with Jeon's orthognathic surgery simulator (JOSS) using the JMSC, and an interim wafer was fabricated. Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, and malar augmentation were performed. The patient received lateral cephalometric and posteroanterior cephalometric analysis in postretention for 1 year. The follow-up results were determined to be satisfactory, and skeletal relapse did not occur after 1.5 years of surgery. When maxillary and mandibular models are considered as rigid bodies, and their state of motion is described in a quantitative manner based on 6 DOF, sharing of exact information on locational movement in 3-dimensional space is possible. The use of JMSC and JOSS will actualize accurate communication and performance of model surgery among clinicians based on objective measurements.
Congenital Abnormalities ; Dental Occlusion ; Facial Asymmetry ; Follow-Up Studies ; Freedom ; Humans ; Incisor ; Malocclusion ; Mandible ; Mastication ; Orthognathic Surgery ; Osteotomy ; Osteotomy, Sagittal Split Ramus ; Recurrence

BACKGROUND/AIMS: New definitions of acute kidney injury (AKI) have recently emerged. Some studies have suggested that duration of AKI is an additional predictive parameter for mortality. Here, we evaluated whether AKI duration was predictive of long-term mortality in patients with hospital-acquired acute kidney injury (HAAKI). METHODS: We prospectively enrolled patients who developed HAAKI at an urban university hospital, from September 2007 to August 2008 and followed them until December 2011. Patients were divided into two groups by duration of the AKI (1 to 5 days vs. > or = 6 days), and long-term mortality was compared. RESULTS: HAAKI developed in 1.2% of patients during the enrollment period. The median follow-up period was 240 days (interquartile range, 53 to 1,428). In 42.3% of patients (n = 52), the AKI lasted 1 to 5 days, while it lasted > or = 6 days in 57.7% (n = 71). Survival analysis showed that a longer duration of AKI increased the risk of death. Long-term survival was significantly different in the two groups. CONCLUSIONS: The duration of AKI influenced mortality rates in hospitalized patients. Thus, AKI duration is a parameter affecting mortality in HAAKI.
Acute Kidney Injury/diagnosis/etiology/*mortality/therapy ; Aged ; Female ; *Hospitalization ; Hospitals, University ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Republic of Korea ; Risk Factors ; Time Factors

BACKGROUND: Immunomodulators enhancing MHC-restricted antigen presentation would affect many cellular immune reactions mediated by T cells or T cell products. However, modulation of MHC-restricted antigen presentation has received little attention as a target for therapeutic immunoregulation. Here, we report that lectins isolated from mushroom Fomitella fraxinea enhance MHC-restricted exogenous antigen presentation in professional antigen presenting cells (APCs). METHODS: Lectins, termed FFrL, were isolated from the carpophores of Fomitella fraxinea, and its effects on the class I and class II MHC-restricted presentation of exogenous ovalbumin (OVA) were examined in mouse dendritic cells (DCs) and mouse peritoneal macrophages. The effects of FFrL on the expression of total MHC molecules and the phagocytic activity were also examined in mouse DCs. RESULTS: DCs cultured in the presence of FFrL overnight exhibited enhanced capacity in presenting exogenous OVA in association with class I and class II MHC molecules. FFrL increased slightly the total expression levels of both class I (H-2K(b)) and class II (I-A(b)) MHC molecules and the phagocytic activity of DCs. Antigen presentation-enhancing activity of FFrL was also observed in macrophages isolated from mouse peritoneum. CONCLUSION: Lectins isolated from the carpophores of Fomitella fraxinea increase MHC-restricted exogenous antigen presentation by enhancing intracellular processing events of phagocytosed antigens.
Agaricales* ; Animals ; Antigen Presentation* ; Antigen-Presenting Cells ; Dendritic Cells ; Immunologic Factors ; Lectins* ; Macrophages ; Macrophages, Peritoneal ; Mice ; Ovalbumin ; Ovum ; Peritoneum ; T-Lymphocytes

OBJECTIVE: Motor function critically influences daily activities and academic performance. We compared motor function in school-aged children with Attention-Deficit/Hyperactivity Disorder (ADHD) to that of normal children. METHODS: Participants were 58 children with ADHD [51 males, 7 females; mean age 9 years 6 months+/-2 years 0 months (SD)] and 70 normal controls [56 males, 14 females; mean age 9 years 2 months+/-1 years 7 months (SD)]. We assessed motor function with the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. RESULTS: The ADHD group had a significantly lower total motor composite score (t=-9.32, p<0.001) than that of the control group. Standard scores of four motor-area composites such as fine manual control (t=-3.76, p<0.001), manual coordination (t=-6.87, p<0.001), body coordination (t=-7.14, p<0.001), and strength and agility (t=-8.54, p<0.1) were significantly lower in the ADHD group than those in the control group. Among the subtests, scores on fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, and strength were significantly lower in the ADHD group than those in the controls, whereas upper-limb coordination was not significantly different between the groups. CONCLUSION: School-aged children with ADHD in Korea had significantly lower motor function compared to that of controls. Thus, it is suggested that appropriate target intervention for motor function is important in children with motor impairment in addition to pharmacotherapy or psychosocial therapy for improving the core symptoms.
Child* ; Drug Therapy ; Female ; Humans ; Korea ; Male ; Running

OBJECTIVE: Motor function critically influences daily activities and academic performance. We compared motor function in school-aged children with Attention-Deficit/Hyperactivity Disorder (ADHD) to that of normal children. METHODS: Participants were 58 children with ADHD [51 males, 7 females; mean age 9 years 6 months+/-2 years 0 months (SD)] and 70 normal controls [56 males, 14 females; mean age 9 years 2 months+/-1 years 7 months (SD)]. We assessed motor function with the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. RESULTS: The ADHD group had a significantly lower total motor composite score (t=-9.32, p<0.001) than that of the control group. Standard scores of four motor-area composites such as fine manual control (t=-3.76, p<0.001), manual coordination (t=-6.87, p<0.001), body coordination (t=-7.14, p<0.001), and strength and agility (t=-8.54, p<0.1) were significantly lower in the ADHD group than those in the control group. Among the subtests, scores on fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, and strength were significantly lower in the ADHD group than those in the controls, whereas upper-limb coordination was not significantly different between the groups. CONCLUSION: School-aged children with ADHD in Korea had significantly lower motor function compared to that of controls. Thus, it is suggested that appropriate target intervention for motor function is important in children with motor impairment in addition to pharmacotherapy or psychosocial therapy for improving the core symptoms.
Child* ; Drug Therapy ; Female ; Humans ; Korea ; Male ; Running

Background: Mobile applications (apps) on dietary supplements can increase consumers’ access to information. However, it can lead to indiscriminate use of dietary supplements. This study aims to systematically review dietary supplement apps released in English and Korean and evaluate the quality of those apps. Methods: Through the app stores, apps on dietary supplements were systemically searched and examined. Two independent evaluators evaluated the apps and presented a mean score using the Mobile App Rating Scale (MARS). The correlation between MARS scores, user and evaluator ratings, and the number of secondary features of the apps were analyzed. Results: Of the 2,772 dietary supplement apps identified, 17 apps were included according to the selection criteria. The mean MARS score was 3.28 (standard deviation: 0.29) out of 5. Apps had higher scores in aesthetics and functionality dimensions, while engagement and information dimensions had lower scores. There was a positive correlation between the number of app downloads and information among MARS dimensions. The subjective evaluation also correlated with the information dimension. There was a positive correlation between the secondary features of the apps and MARS total score as well as the engagement dimension. Conclusion The dietary supplement apps need to be managed at a higher level of quality to provide safe and reliable information to consumers. Especially, quality on information and engagement dimensions can be improved. Involvement of healthcare professionals in the app development, management with adequate referencing of information, and use of secondary features for enhanced user engagement can be helpful.

Atopic dermatitis (AD) results from gene and environment interactions that lead to a range of immunological abnormalities and breakdown of the skin barrier. Protease-activated receptor 2 (PAR2) belongs to a family of G-protein coupled receptors and is expressed in suprabasal layers of the epidermis. PAR2 is activated by both trypsin and a specific agonist peptide, SLIGKV-NH₂ and is involved in both epidermal permeability barrier homeostasis and epithelial inflammation. In this study, we investigated the effect of lobaric acid on inflammation, keratinocyte differentiation, and recovery of the skin barrier in hairless mice. Lobaric acid blocked trypsin-induced and SLIGKV-NH₂-induced PAR2 activation resulting in decreased mobilization of intracellular Ca²⁺ in HaCaT keratinocytes. Lobaric acid reduced expression of interleukin-8 induced by SLIGKV-NH₂ and thymus and activation regulated chemokine (TARC) induced by tumor necrosis factor-a (TNF-α) and IFN-γ in HaCaT keratinocytes. Lobaric acid also blocked SLIGKV-NH₂-induced activation of ERK, which is a downstream signal of PAR2 in normal human keratinocytes (NHEKs). Treatment with SLIGKV-NH₂ downregulated expression of involucrin, a differentiation marker protein in HaCaT keratinocytes, and upregulated expression of involucrin, transglutamase1 and filaggrin in NHEKs. However, lobaric acid antagonized the effect of SLIGKV-NH₂ in HaCaT keratinocytes and NHEKs. Topical application of lobaric acid accelerated barrier recovery kinetics in a SKH-1 hairless mouse model. These results suggested that lobaric acid is a PAR2 antagonist and could be a possible therapeutic agent for atopic dermatitis.
Animals ; Chemokine CCL17 ; Dermatitis, Atopic ; Epidermis ; GTP-Binding Proteins ; Homeostasis ; Humans ; Inflammation ; Interleukin-8 ; Keratinocytes ; Kinetics ; Mice ; Mice, Hairless ; Necrosis ; Permeability ; Receptor, PAR-2 ; Skin* ; Trypsin

A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit for 5 days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the intensive care unit. Conventional hemodialysis was reinitiated, and nafamostat mesilate was used again because of a small amount of continued bleeding. Ten minutes after hemodialysis, the patient complained of anaphylactic signs and symptoms such as dyspnea, hypotension, and facial swelling. Epinephrine, dexamethasone, and pheniramin were injected under the suspicion of anaphylactic shock, and the patient recovered. Total immunoglobulin E titer was high, and skin prick test revealed weak positivity for nafamostat mesilate. We first report a case of anaphylactic shock caused by nafamostat mesilate in Korea.
Abscess ; Aged ; Anaphylaxis ; Buttocks ; Death, Sudden, Cardiac ; Dexamethasone ; Dialysis ; Drainage ; Dyspnea ; Epinephrine ; Heart Arrest* ; Hemodiafiltration ; Hemorrhage ; Humans ; Hypotension ; Immunoglobulin E ; Immunoglobulins ; Intensive Care Units ; Korea ; Mesylates* ; Nephrology ; Renal Dialysis ; Skin