Purpose: We evaluated changes in the tear film parameters of the corneal surface, and their correlations with Munk scores,based on corneal topographic scans of patients with nasolacrimal duct obstructions who underwent dacryocystorhinostomy(DCR). We explored whether tear parameters can serve as useful indicators of functional surgical success. Methods: We assessed 72 eyes of 45 patients diagnosed with nasolacrimal duct obstruction who underwent DCR. Tear film parameterswere measured via corneal topography (Keratograph® 5M) once before, and three times after surgery, and includedtear meniscus height (TMH), and the initial and average keratographic tear break-up time (NIKBUT-first and NIKBUT-average,respectively; measured noninvasively). Results: The three postoperative TMH values were 0.31 ± 0.20, 0.30 ± 0.22, and 0.29 ± 0.15 mm, all of which were significantlylower than the preoperative value of 0.48 ± 0.29 mm (all, p < 0.001). Three months after surgery, the NIKBUT-first (6.90 ± 3.39seconds) was significantly shorter than the preoperative value (8.39 ± 5.34 seconds; p = 0.030). The preoperative NIKBUT-averagedid not differ significantly from the values at the three postoperative timepoints (p = 0.756, p = 0.753, and p > 0.999).Changes in the Munk score after surgery correlated significantly with changes in the TMH (r = 0.46, p < 0.001). When functionalsuccess was defined as a Munk score ≤ 1, the area under the curve (AUC) value corresponding to the ability of TMH to definefunctional success of 0.995, was statistically significant (cut-off of 0.31 mm; p < 0.001). Conclusions The TMH DCR correlated significantly with the Munk score, which is a quantitative measure of clinical symptomseverity. The ability of TMH to define functional surgical success was excellent.

The neuroendocrine responses to surgical stress in man include release of ACTH, GH and prolactin in the serum(Cooper and NElson, 1962: Ney et al., 1963: Ross et al., 1966: Schlach, 1967: Gordon et al., 1972: Jeffrey et al., 1977). Data on serum LH and FSH during operation under general anesthesia have been conflictiong. Evidence has also been accumulated that serum LH levels are increased significantly in male patients during operation under general anesthesia in comparison of serum LH in males might be different from that in postmenopausal females with a very high basal level of LH and from menstrating females. Effects of surgical stress under general anesthesia with halothane-N2O on serum LH and FSH levels were studied in 12 menstruating female patients, 8 postmenopausal female patients, and in 8 male patients with no endocrine disorders, liver or kidney function impairment as judged by routine tests. Control serum samples were taken immediately before anesthesia and subsequent samples were obtained from the patients 30 minutes, 1hour and 5~6hours after the onset of anesthesia and on the second and seventh postoperative day. The concentrations of serum LH and FSH were measured by a specific and sensitive radioimmunoassay method. The results are as follows; 1) Preanesthetic levels of serum LH and FSH served as controls and were within range of normal values for male and female subjects in our laboratory. 2) In male patients, serum LH levels 1 hour after onset of anesthesia increased significantly over those of preanesthesia, while no significant intraoperative increase in LH levels was found in female patinets. 3) No significant change in serum LH levels was demonstrated on the second and seventh postoperative day except female patients, who showed significant decrease in the serum LH level on the second postoperative day. 4) No significant intracperative and postoperative changes in serum FSH levels were observed in male or female patients. From the above results, it may be concluded that significant intraopertive increase in serum LH levels occurs in male patients but not in female patients.
Adrenocorticotropic Hormone ; Anesthesia ; Anesthesia, General* ; Female* ; Gonadotropins* ; Humans ; Kidney ; Liver ; Male* ; Prolactin ; Radioimmunoassay ; Reference Values

BACKGROUND/AIMS: We measured the brachial artery pulse wave velocity (BaPWV) and intima-media thickness (IMT) of the common carotid artery to evaluate atherosclerosis in young women with systemic lupus erythematosus (SLE) and healthy controls. METHODS: Twenty-one premenopausal female patients with SLE and 21 healthy controls were enrolled. The groups were matched for age, sex, ethnicity, and atherosclerosis risk factors. Smokers and those with the atherosclerosis risk factors hypertension and diabetes were excluded from this study. IMT was measured with high-resolution ultrasonography. BaPWV was measured with volume plethysmography. RESULTS: The mean age was 34.20 years in the SLE group and 36.87 years in the healthy controls. The IMT of the right and left common carotid arteries in the SLE group did not differ significantly from that in the healthy controls. The BaPWV was significantly higher in the right (1.40+/-0.26 vs. 1.17+/-0.09 cm/sec, mean+/-SD; p=0.003) and left (1.41+/-0.26 vs. 1.19+/-0.08 cm/sec, p=0.013) arms in the SLE group than in the healthy controls. There were no significant differences in the ankle-brachial pressure index (ABI), body mass index (BMI), C-reactive protein (CRP), total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, lipoprotein a, and homocysteine between the two groups. CONCLUSIONS: The IMT in premenopausal women with SLE was not significantly different from that in healthy controls, while the BaPWV, which reflects arterial stiffness, was significantly higher than in the healthy controls.
Arm ; Atherosclerosis ; Body Mass Index ; Brachial Artery ; C-Reactive Protein ; Carotid Artery, Common ; Cholesterol ; Female ; Homocysteine ; Humans ; Hypertension ; Lipoprotein(a) ; Lipoproteins ; Lupus Erythematosus, Systemic ; Pulse Wave Analysis ; Risk Factors ; Vascular Stiffness

Metastatic calcification is rare; it is found during autopsy in patients who underwent hemodialysis. Diffuse calcium precipitation of small and medium-sized cutaneous vessels, known as calciphylaxis, can result in progressive tissue necrosis secondary to vascular calcification. This condition most commonly involves the skin; however, a rare occurrence of visceral calciphylaxis has been reported. Here we report on an autopsy case. Despite a thorough evaluation, and even performing an autopsy, the underlying cause of acute-onset hypercalcemia, resulting in the production of pulmonary calciphylaxis and metastatic renal calcification associated with acute respiratory and renal failure, could not be determined. Metastatic calcification often lacks specific symptoms, and the degree of calcification is a marker of the severity and chronicity of the disease. This unusual autopsy case emphasizes the importance of rapidly progressing visceral calciphylaxis, as well as its early detection.
Autopsy ; Calciphylaxis ; Calcium ; Humans ; Hypercalcemia ; Necrosis ; Renal Dialysis ; Renal Insufficiency ; Vascular Calcification

Deep brain stimulation (DBS) in internal globus pallidus is considered to be a good option for controlling generalized dystonia in patients with this condition. In this relation, it is known that DBS has already been shown to have significant effects on primary dystonia, but is seen as controversial in secondary dystonia including cerebral palsy (CP). On the other hand, intrathecal baclofen (ITB) has been known to reduce spasticity and dystonia in patients who did not respond to oral medications or botulinum toxin treatment. Here, we report a patient with dystonic CP, who received the ITB pump implantation long after the DBS and who noted remarkable improvement in the 36-Item Short Form Health Survey, Dystonia Rating Scale, Modified Barthel Index, and visual analog scale scores for pain after an ITB pump implantation was used as compared with DBS. To our knowledge, the present case report is the first to demonstrate the effects of an ITB pump on reducing pain and dystonia and improving quality of life and satisfaction, compared with DBS in a patient with CP.
Baclofen ; Botulinum Toxins ; Cerebral Palsy ; Deep Brain Stimulation ; Dystonia ; Dystonic Disorders ; Globus Pallidus ; Hand ; Health Surveys ; Humans ; Muscle Spasticity ; Quality of Life ; Visual Analog Scale

Deep learning (DL) is a kind of machine learning technique that uses artificial intelligence to identify the characteristics of given data and efficiently analyze large amounts of information to perform tasks such as classification and prediction. In the field of neuroimaging of neurodevelopmental disorders, various biomarkers for diagnosis, classification, prognosis prediction, and treatment response prediction have been examined; however, they have not been efficiently combined to produce meaningful results. DL can be applied to overcome these limitations and produce clinically helpful results. Here, we review studies that combine neurodevelopmental disorder neuroimaging and DL techniques to explore the strengths, limitations, and future directions of this research area.

Objective: Most affective neuroscience studies use pictures from the International Affective Picture System or standard facial expressions to elicit emotional experiences. The attention system, including the prefrontal cortex, can mediate emotional regulation in response to stimulation with emotional faces. We hypothesized that emotional experience is associated with brain activity within the neocortex. In addition, modification within the neocortex may be associated with brain activity within the attention system. Methods: Thirty-one healthy adult participants were recruited to be assessed for emotional expression using clinical scales of happiness, sadness, anxiety, and anger as and for emotional experience using brain activity in response to pictures of facial emotional expressions. The attention system was assessed using brain activity in response to the go-no-go task. Results: We found that emotional experience was associated with brain activity within the frontotemporal cortices, while emotional expression was associated with brain activity within the temporal and insular cortices. In addition, the association of brain activity between emotional experiences and expressions of sadness and anxiety was affected by brain activity within the anterior cingulate gyrus in response to the go-no-go task. Conclusion Emotional expression may be associated with brain activity within the temporal cortex, whereas emotional experience may be associated with brain activity within the frontotemporal cortices. In addition, the attention system may interfere with the connection between emotional expression and experience.

Artemisia argyi is used as a health supplement, tea, and food source in Korea. This study aimed to evaluate the effect of Artemisia argyi (AA) and its active compound, dehydromatricarin A (DA), on the attenuation of airway inflammation in a murine model of lipopolysaccharide (LPS)-induced acute lung injury (ALI). The C57BL/6 mice were administered AA (50 mg/kg or 100 mg/kg) and DA (10 mg/kg or 20 mg/kg) by oral gavage from day 0 to 7 days and LPS treated by intranasal instillation 48 hours before the sacrifice. The treatment of AA and DA markedly decreased inflammatory cells in the bronchoalveolar lavage fluid (BALF) compared with that in ALI-induced mice, which was accompanied by a significant reduction in the levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in BALF. Furthermore, the administration of AA and DA clearly decreased inducible nitric oxide synthase (iNOS) expression and nuclear factor kappa B (NF-κB) phosphorylation in comparison with that in the ALI-induced mice. The histological examination of the lung tissue revealed that the administration of AA and DA suppressed the inflammatory cell infiltration into the peribronchial and alveolar lesions induced by LPS instillation. Collectively, our results indicated that AA and DA effectively decreased the airway inflammatory response induced by LPS instillation. Therefore, AA and DA may offer a potential therapy for airway inflammatory disease.
Acute Lung Injury* ; Animals ; Artemisia* ; Bronchoalveolar Lavage Fluid ; Inflammation* ; Interleukins ; Korea ; Lung ; Mice ; NF-kappa B ; Nitric Oxide Synthase Type II ; Phosphorylation ; Tea ; Tumor Necrosis Factor-alpha

BACKGROUND: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site. Especially, this technique does not require microvascular training; as such, the surgery time can be shortened. This advantage allows older patients to undergo the reconstructive surgery. CASE PRESENTATION: Reported in this article are two cases of mandibular reconstruction using the ready-made type and custom-made type T-mesh, respectively, after mandibular resection. We had operated double blind peer-review process. A 79-year-old female patient visited the authors’ clinic with gingival swelling and pain on the left mandibular region. After wide excision and segmental mandibulectomy, a pectoralis major myocutaneous flap was used to cover the intraoral defect. Fourteen months postoperatively, reconstruction using a ready-made type T-mesh (Striker-Leibinger, Freibrug, Germany) and iliac PCBM was done to repair the mandible left body defect. Another 62-year-old female patient visited the authors’ clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular squamous cell carcinoma (SCC), reconstruction was done with a reconstruction plate and a right fibula free flap. Sixteen months postoperatively, reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair the mandibular defect after the failure of the fibula free flap. The CAD-CAM T-mesh was made prior to the operation. CONCLUSIONS: In both cases, sufficient new-bone formation was observed in terms of volume and strength. In the CAD-CAM custom-made type T-mesh case, especially, it was much easier to fix screws onto the adjacent mandible, and after the removal of the mesh, the appearance of both patients improved, and the neo-mandibular body showed adequate bony volume for implant or prosthetic restoration.
Aged ; Autografts ; Bone Marrow ; Carcinoma, Squamous Cell ; Chin ; Computer-Aided Design ; Female ; Fibula ; Free Tissue Flaps ; Humans ; Mandible ; Mandibular Osteotomy ; Mandibular Reconstruction ; Middle Aged ; Mouth Neoplasms ; Myocutaneous Flap ; Titanium ; Transplants

Benign prostate hyperplasia (BPH) is a male reproductive disease that has gained increasing importance in recent years. The present study investigated whether Pycnogenol® (PYC), a standardized French maritime pine bark extract, could prevent BPH induced by testosterone propionate (TP) in rats. Male Sprague-Dawley rats were randomly divided into five groups of six rats. One group was used as a normal control rats and the other groups received subcutaneous injections of TP for 4 weeks to induce BPH. In the two treatment groups, PYC (20 or 40 mg/kg) was administered daily for 4 weeks by oral gavage concurrently with the induction of TP. All rats were sacrificed at the scheduled termination time, the prostates were weighed, and histopathologic examinations were conducted. Dihydrotestosterone (DHT) levels in serum and the prostate were measured, and the expression of proliferating cell nuclear antigen (PCNA) and Ki-67 proteins was investigated. BPH-treated animals showed increases in the relative weight of the prostate, higher concentrations of DHT in serum and the prostate, and higher expression of PCNA and Ki-67 in the prostate; in contrast, PYC-treated animals had significant reductions in these factors compared with the BPH animals. These findings indicated that PYC inhibited the development of BPH and that this was closely associated with a reduction in DHT concentration.
Animals ; Dihydrotestosterone ; Humans ; Hyperplasia ; Injections, Subcutaneous ; Male ; Models, Animal* ; Proliferating Cell Nuclear Antigen ; Prostate ; Prostatic Hyperplasia* ; Rats* ; Rats, Sprague-Dawley ; Testosterone Propionate ; Testosterone*