OBJECTIVES: Schizophrenia manifests a variety of interindividual differences in therapeutic response to antipsychotics. This might be attributable to dopamine and serotonin receptors that a important target for various antipsychotics, and the D3 receptor(DRD3) alleles they carry. The purpose of our study was to investigate whether the plasma levels of homovanillic acid(HVA) and 5-hydroxyindoleacetic acid(HIAA), and the polymorphism of DRD3 can be held as a predictor of treatment response ni chronic schizophrenic patients. METHODS: Therapeutic response for 16 korean schizophrenia patient treated during 48 weeks were assessed by PANSS used as the clinical symptom rating scales. The levels of concentration of HVA and 5-HIAA were examined by HPLC at baseline and at 48 weeks. We classified the polymorphism of DRD3 receptor using amplifying by polymerase chain reaction(PCR). RESULTS: Neither concentrations of HVA and 5-HIAA nor genotype of dopamine 3 receptor were not significantly associated with the therapeutic response. But, the patients who has A1 alleles of DRD3 gene showed poor therapeutic responses. CONCLUSION: A1 allele of DRD3 gene is associated with poor prognosis of chronic schizophrenia.
Alleles ; Antipsychotic Agents ; Chromatography, High Pressure Liquid ; Dopamine* ; Genotype ; Homovanillic Acid ; Humans ; Hydroxyindoleacetic Acid ; Plasma* ; Prognosis ; Receptors, Dopamine D3* ; Receptors, Serotonin ; Schizophrenia ; Weights and Measures

The field of artificial intelligence (AI) is rapidly advancing, and AI models are increasingly applied in the medical field, especially in medical imaging, pathology, natural language processing, and biosignal analysis. On the basis of these advances, telemedicine, which allows people to receive medical services outside of hospitals or clinics, is also developing in many countries. The mechanisms of deep learning used in medical AI include convolutional neural networks, residual neural networks, and generative adversarial networks. Herein, we investigate the possibility of using these AI methods in the field of craniofacial surgery, with potential applications including craniofacial trauma, congenital anomalies, and cosmetic surgery.

OBJECTIVE: To investigate the effect of extracorporeal shock wave therapy (ESWT) on pressure ulcers which is a major, functionally-limiting medical problem impairing quality of life for many people each year. METHOD: Seven patients who had stage 3 pressure ulcers were enrolled for the study. Each patient was treated with 6 sessions of low-energy (0.10~0.15 mJ/mm2, 1,000 impulses) ESWT. The length, width, depth and soft tissue biopsy of pressure ulcers were evaluated every 2 weeks for 6 weeks. RESULTS: The length, width and depth decreased significantly after 2 weeks of ESWT application. Healthy granulation tissue was formed. Soft tissue biopsy revealed increased the number and size of capillaries and decreased inflammatory cells in treated case. CONCLUSION: ESWT promoted wound healing and revealed favorable histological changes in pressure ulcers. We suggest that ESWT can be used for the safety and effective management of pressure ulcer.
Biopsy ; Capillaries ; Granulation Tissue ; Humans ; Pressure Ulcer ; Quality of Life ; Shock ; Wound Healing

BACKGROUND: Gross anatomy and sectional anatomy of a monkey should be known by students and researchers of veterinary medicine and medical research. However, materials to learn the anatomy of a monkey are scarce. Thus, the objective of this study was to produce a Visible Monkey data set containing cross sectional images, computed tomographs (CTs), and magnetic resonance images (MRIs) of a monkey whole body. METHODS: Before and after sacrifice, a female rhesus monkey was used for 3 Tesla MRI and CT scanning. The monkey was frozen and sectioned at 0.05 mm intervals for the head region and at 0.5 mm intervals for the rest of the body using a cryomacrotome. Each sectioned surface was photographed using a digital camera to obtain horizontal sectioned images. Segmentation of sectioned images was performed to elaborate three-dimensional (3D) models of the skin and brain. RESULTS: A total of 1,612 horizontal sectioned images of the head and 1,355 images of the remaining region were obtained. The small pixel size (0.024 mm × 0.024 mm) and real color (48 bits color) of these images enabled observations of minute structures. CONCLUSION: Due to small intervals of these images, continuous structures could be traced completely. Moreover, 3D models of the skin and brain could be used for virtual dissections. Sectioned images of this study will enhance the understanding of monkey anatomy and foster further studies. These images will be provided to any requesting researcher free of charge.
Anatomy, Cross-Sectional ; Brain ; Dataset ; Female ; Haplorhini ; Head ; Humans ; Macaca mulatta ; Magnetic Resonance Imaging ; Primates ; Skin ; Tomography, X-Ray Computed ; Veterinary Medicine

BACKGROUND: Nipple reconstruction following breast mound reconstruction is the final step in breast reconstruction. Although nipple reconstruction is a simple surgery, the psychological aspects of nipple reconstruction are thought to be important. Nipple projection is a key factor in determining patient satisfaction with the surgery. In the present study, the Hammond flap technique was introduced for nipple reconstruction. METHODS: Twenty-six patients who had undergone breast reconstruction from February 2008 to March 2012 were enrolled in this prospective study. All patients were evaluated based on preoperative photos, and their nipple diameters and heights were measured. Postoperative evaluation was conducted 3, 6, 9, and 12 months following nipple reconstruction. A questionnaire on patient satisfaction with the nipple reconstruction was administered 12 months after nipple reconstruction. Moreover, the same plastic surgeon scored nipple projection and overall cosmetic result of the new nipple. RESULTS: The mean projection was 4.4 mm (range, 3-6 mm), and it well matched the contralateral nipple. Twelve months following nipple reconstruction, the mean reduction rate in the nipple projection was 43.6%. Patients were satisfied or very satisfied with the nipple projection and the overall cosmetic result in 80.7% cases. CONCLUSIONS: In the present study, compared with other techniques, the use of the Hammond flap technique in nipple reconstruction showed competitive results with regard to nipple projection and patient satisfaction.
Breast ; Female ; Humans ; Mammaplasty ; Nipples* ; Patient Satisfaction ; Prospective Studies ; Surveys and Questionnaires

PURPOSE: To report a case of Pseudomonas fluorescens infection following endoscopic dacryocystorhinostomy and silicone tube intubation in a healthy patient who was using steroid nasal spray. In addition, a literature review is conducted. CASE SUMMARY: A 72-year-old female patient came to our clinic with tearing and hyperemia in the right eye. Ten months prior, she had undergone endoscopic dacryocystorhinostomy and silicone tube intubation due to nasolacrimal duct obstruction in the right eye. Six months after the first operation, dacryocystorhinostomy revision with silicone tube exchange was performed due to obstruction of the nasal bony orifice. In addition, the patient was using a steroid nasal spray. On slit lamp examination, conjunctival injection, marked inflammation and punctal edema around the tube were observed. The silicone tube was removed and the tube cultured. Pseudomonas fluorescens was isolated from the tube contents. The patients was treated with topical 0.3% gatifloxacin 4 times a day, methylol cephalexin lysinate 1000 mg 3 times a day and the nasal spray was discontinued. Two weeks later, all symptoms were resolved after treatment with antibiotic treatment. CONCLUSIONS: A case of Pseudomonas fluorescens canaliculitis which occurred in healthy patient who was using steroid nasal spray is presented with a literature review. Pseudomonas fluorescens canaliculitis can be treated by using proper antibiotics.
Anti-Bacterial Agents ; Cephalexin ; Corneal Ulcer ; Dacryocystitis ; Dacryocystorhinostomy ; Edema ; Eye ; Female ; Fluoroquinolones ; Humans ; Hyperemia ; Inflammation ; Intubation ; Nasolacrimal Duct ; Porphyrins ; Pseudomonas ; Pseudomonas fluorescens ; Silicones ; Canaliculitis

BACKGROUND: To examine the changes of peritoneal aquaporin-1 (AQP-1) expression and peritoneal transport in rats in response to continuous exposure of same osmotic stimuli which was induced by either mannitol or glucose in dialysis solution or glucocorticoids co-reatment. METHODS: Twenty-eight male Sprague-awley rats were divided into three groups:group I (n=10) rats were dialyzed with 5% mannitol solution (0.27 M); group II (n=9) rats were dialyzed with 5% glucose solution (0.28 M): and group III (n=9) rats were dialyzed with 5% glucose solution (0.28 M) accompanied by daily injection of dexamethasone (2 mg/kg, im) for the last 7 days of the 1 month dialysis period. Dialysis exchanges were performed 2 times a day for 1 month with 25 mL per exchange. Immunohistochemistry was performed using a polyclonal anti AQP-1 antibody. The peritoneal membrane (PM) function was assessed by one-hour PET for comparing transport characteristics. PM transport rates were assessed by D/P of urea nitrogen and D/Do of glucose. Water transport of peritoneal membrane was assessed by D/P of sodium at 1 month. RESULTS: The immunolabeling intensity of peritoneal AQP-1 was markedly increased and the most prominent in rats dialyzed with 5% glucose solution accompanied by injection of dexamethasone (group III). Consistent with this, D/P of sodium in rats of group III was significantly decreased (p<0.05), indicating an increased water permeability and ultrafiltration. In contrast, peritoneal AQP-1 labeling intensity was weaker in PD groups dialyzed with mannitol (group I) and glucose (group II) solution having an identical osmolality and was not different between the groups. Rats in group I exhibited significantly lower D/Do of glucose and increased D/P of urea nitrogen, suggesting high PM transport. CONCLUSION: These results indicate that the change of peritoneal AQP-1 expression is not specific to the glucose itself, but rather it could be altered in response to the changes of osmolality per se in PD solution. Moreover, corticosteroid up-egulates peritoneal AQP-expression, which is paralleled by an increased water permeability.
Animals ; Dexamethasone ; Dialysis ; Glucocorticoids ; Glucose ; Humans ; Immunohistochemistry ; Male ; Mannitol ; Membranes ; Nitrogen ; Osmolar Concentration ; Peritoneal Dialysis ; Permeability ; Rats ; Sodium ; Ultrafiltration ; Urea ; Water

PURPOSE: The aim of this study was to evaluate the safety and feasibility of D2 lymphadenectomy in elderly patients with gastric cancerby comparing the surgical outcomes and postoperative courses between an elderly group and a control group undergoing the same procedure. MATERIALS AND METHODS: Clinical information was reviewed for 1251 patients with gastric cancer who underwent gastrectomy between May 2004 and May 2007. Patients were classified into the following two groups: an elderly group (older than the average life span in Korea) and a control group (younger than the elderly group). Clinicopathologic features and postoperative courses after D2 lymphadenectomy were reviewed and compared between the two groups. RESULTS: There were a total of 120 (9%) elderly group patients among all those reviewed, and 86 (72.2%) of them underwent D2 lymphadenectomy. There was 27.5% postoperative morbidity in the elderly group, which was significantly different from thecontrol group (12.8%, p=0.003). However, on multivariate analysis, ASA score and combined resection were independent predictive factors of postoperative complications, while age was not predictive. CONCLUSION: Older age is not a predictive factor of postoperative complications in itself, and D2 lymphadenectomy can be safely performed in elderly patients with gastric cancer, provided they have good ASA scores and do not undergo accompanying combined resection.
Aged ; Gastrectomy ; Humans ; Lymph Node Excision ; Multivariate Analysis ; Postoperative Complications ; Stomach Neoplasms

BACKGOUND: The purpose of the study was to evaluate the effect of aminonguanidine on the inhibition of advanced glycosylation end product (AGE) formation and the expression of peritoneal vascular endothelial growth factor (VEGF). Then we analyzed the functional and morphological alterations of peritoneal membrane during long-term PD in rats. METHODS: Male Sprague-Dawley rats were randomly divided into 3 groups:group I (n=6), control rats with PD catheter but not dialyzed; group II (n=9), rats dialyzed with 4.25% glucose solution for all exchanges; group III (n=9), rats dialyzed with 4.25% glucose solution containing aminoguanidine (25 mg/kg) for all changes. Dialysis changes were performed 3 times a day with 25 mL/each exchange for 12 weeks. Immunostaining was performed using a monoclonal anti-AGE antibody and a polyclonal anti-VEGF antibody. One-hour peritoneal equilibration test were performed at every 4-week for the comparison of peritoneal transport characteristics. RESULTS: Expressions of peritoneal AGE and VEGF in dialyzed groups (group IIand III) were higher compared to control group. The level of AGE immunostaining in group III was significantly lower than in the group II. But peritoneal VEGF expression did not differ between the dialyzed groups. In dialyzed groups, D/DO glucose was significantly lower whereas D/P urea was significantly higher than in the control group. On linear regression analysis, peritoneal AGE and VEGF accumulation were directly correlated with D/DO glucose and D/P urea nitrogen. But there was no statistical significance in D/DO glucose and D/P urea nitrogen between the dialyzed groups. CONCLUSION: Peritoneal accumulation of AGE and VEGF increased with time on CAPD in dialyzed groups. Intraperitoneal aminoguanidine was greatly suppressed peritoneal AGE accumulation but no attenuated long-term dialysis related peritoneal hyperpermeability. The VEGF formation may be one of the several mediators resulting the functional deterioration of the peritoneal membrane in long-term peritoneal dialysis.
Animals ; Catheters ; Dialysis ; Glucose ; Glycosylation* ; Humans ; Linear Models ; Male ; Membranes ; Nitrogen ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Rats ; Rats, Sprague-Dawley ; Urea ; Vascular Endothelial Growth Factor A

BACKGROUND: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. MATERIAL AND METHOD: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. RESULT: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. CONCLUSION: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.
Back Pain ; Body Mass Index ; Chest Pain ; Electromagnetic Phenomena ; Electromyography ; Female ; Humans ; Hypesthesia ; Incidence ; Intercostal Nerves ; Male ; Muscles ; Muscular Atrophy ; Needles ; Neuralgia ; Paresthesia ; Rib Fractures ; Ribs