This study was designed to assess profile preferences among Korean youths in the year 1992. Facial esthetics was evaluated by means of silhouette profiles, eliminating the influence of a number of aspects that may affect judgment when normal lateral photographs are used. The main points of preference to be clarified here are as follows: First, on facial convexity, Second, on nasion depth, Third, on mentolabial sulcus depth, Fourth, on the position of upper and lower lips, Fifth, on facial type according to Angle's classification of malocclusion, Sixth, on Song's tangents. The 54 subjects printed in questionnaire as black and white silhouettes were selected from 300 tracings from cephalometric radiographs of people whose age ranging from 11 to 20 years. Photographs of six female subjects were retouched by computer graphic software and printed in color and black/white photographs which were used for adaptation of eyes of participants in selecting profiles in silhouette. They constitute 2 questions. The 54 subjects were grouped as 22 questions, each of them composed of 6 subjects, according to the aspects to be clarified. Twenty four questions in total were asked to assess profile preferences. For the assessment, the profile line, the facial esthetic triangle, Song's tangents, and Angle's classification of malocclusion were introduced. The profile line is composed of 11 component points which are Trichion, Glabella, Nasion, Pronasale, Subnasale, Labrale superius, Stomion, Labrale inferius, Supramentale, Pogonion, and Gnathion. The facial esthetic triangle is composed of 3 tangents: A-tangent which is the tangent of dorsum of nose, B-tangent which is the line passing through Sn and Ls, and C-tangent which is drawn on the turning point of the curve which lies between mentolabial sulcus (Sm) and pogonion (Pg). Angle's classification has 3 types of malocclusion which are Class I, Class II, and Class III. Class II malocclusion is subdivided into Division 1 and Division 2. The participants of the survey were composed of 861 college students (448 male students, 413 female students) whose majors grouped as Fine Arts Liberal Arts, and Natural Sciences, and whose mean age 21.8 years. The statistics program SPSS/PC + of SPSS Inc. was used to analyze answers of participants. Crosstabulation, Chi-square test, and Kendall test were done. The conclusions are as follows: First, Korean youths have a tendency to prefer the slightly convex face to the flat or concave face. Second, they prefer a moderately deep nasion. Third, they prefer a moderately deep mentolabial sulcus. Fourth, they prefer the position of lips which are near to Ricketts' E-line. The position of the upper lip which is slightly posterior to E-line is preferred. The upper lip which lies too far anterior or posterior to the lower lip is not perferred. Fifth, they prefer most, according to Angle's Classification of Malocclusion, Class I facial profile which has a slight inclination to Class II division 2. The order of preference is Class I, Class II division 2, Class III, and Class II division 1. Sixth, they prefer the type 2 and 3 of Song's tangents. The facial profile within which A-and B-tangent meet is preferred. The facial profile which has C-tangent that meets with A-tangent slightly posterior to the crossing point of A-and B-tangent or that parallels with B-tangent is preferred.
Adolescent* ; Computer Graphics ; Esthetics ; Female ; Humans ; Judgment ; Lip ; Male ; Malocclusion ; Natural Science Disciplines ; Nose ; Surveys and Questionnaires

OBJECTIVE: We investigated the association of platelet distribution width (PDW) and mean platelet volume (MPV) with disease activity indices of ankylosing spondylitis (AS) in patients whose laboratory results or medical conditions would not affect PDW and MPV levels. METHODS: We analysed demographic and laboratory data of 88 patients with AS. On the same day as the laboratory tests were done, we assessed AS disease activity using the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Patients Global Score and Ankylosing Spondylitis Disease Activity Score (ASDAS), including erythrocyte sedimentation rate (ESR) (ASDAS-ESR) and C-reactive protein (CRP) (ASDAS-CRP). The association was analyzed by linear regression. RESULTS: The median age of 88 patients was 38.0 years and the median length of observation was 5.5 years. The median platelet count was 266,500.0/µL, the median PDW was 10.7 fL and the median MPV 9.6 fL. The median ESR was 19.0 mm/hr and CRP was 2.5 mg/L. Among acute reactants, only CRP was negatively correlated with MPV, but not PDW (r=−0.218, p<0.041). However, both PDW and MPV were not significantly correlated with any disease activity index of AS. On multivariate linear regression analysis, only the length of observation was significantly correlated with MPV (β=0.224, p<0.044). CONCLUSION: PDW and MPV were not potent surrogate markers to reflect AS activity, with potential confounding strictly controlled, to affect MPV and PDW levels.
Baths ; Biomarkers ; Blood Platelets* ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Linear Models ; Mean Platelet Volume* ; Platelet Count ; Spondylitis, Ankylosing*

Oral dantrolene causes a dose-dependent depression of skeletal muscle contractility. A 52-year-old man treated with oral dantrolene for spasticity after spinal cord injury was scheduled to undergo irrigation and drainage of a thigh abscess under general anesthesia. He had taken 50 mg oral dantrolene per day for 3 years. Under standard neuromuscular monitoring, anesthesia was performed with propofol, rocuronium, and sevoflurane. A bolus dose of ED95 (0.3 mg/kg) of rocuronium could not depress T1 up to 95%. An additional dose of rocuronium depressed T1 completely and decreased the train-of-four (TOF) count to zero. There was no apparent prolongation of the neuromuscular blocking action of rocuronium. The TOF ratio was recovered to more than 0.9 within 40 minutes after the last dose of rocuronium. A small dose of oral dantrolene does not prolong the duration of action and recovery of rocuronium.
Abscess ; Anesthesia ; Anesthesia, General ; Dantrolene* ; Depression ; Drainage ; Humans ; Middle Aged ; Muscle Spasticity ; Muscle, Skeletal ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Propofol ; Spinal Cord Injuries ; Thigh

No abstract available.
Eclampsia* ; Female ; Humans ; Magnesium* ; Neuromuscular Blockade* ; Pregnancy

OBJECTIVE: This study examined whether glycated hemoglobin (HbA1c) and glycated albumin (GA) are well correlated with the Ankylosing Spondylitis Disease Activity Score (ASDAS)-erythrocyte sedimentation rate (ESR), and ASDAS-C-reactive protein (CRP) in AS patients without medical conditions affecting the glycated protein levels. METHODS: The data of 76 patients with AS were analyzed. Univariate and multivariate analyses of the variables associated with ASDAS-ESR and ASDAS-CRP were performed using a linear regression test. The patients were divided into active and inactive AS groups based on an ASDAS-CRP of 2.1, and the variables between the two groups were compared. RESULTS: ASDAS-ESR did not correlated with either HbA1c or GA. ASDAS-CRP was positively correlated with HbA1c (r=0.315, p=0.006) and the white blood cell (r=0.288, p=0.012), and inversely correlated with hemoglobin (r=−0.241, p=0.036) and serum albumin (r=−0.262, p=0.022), but not GA. Multivariate analysis revealed HbA1c and white blood cell to be significantly correlated with ASDAS-CRP (β=0.234, p=0.033 and β=0.265, p=0.017). The mean HbA1c, not GA, of the active group was significantly higher than that of the inactive group (p=0.020). In addition, the optimal cut-off value of HbA1c was set to 5.6, and the patients with HbA1c ≥5.6 were found to have a 3.3 times higher risk of active AS than those without. CONCLUSION: HbA1c was significantly correlated with ASDAS-CRP, and could be a useful marker to reflect ASDAS-CRP in AS patients without medical conditions affecting the glycated protein levels.
Hemoglobin A, Glycosylated ; Humans ; Leukocytes ; Linear Models ; Multivariate Analysis ; Serum Albumin ; Spondylitis, Ankylosing*

Cesarean Section ; Cohort Studies ; Female ; Gestational Age ; Humans ; Mass Screening ; Parity ; Pregnancy ; Premature Birth ; Retrospective Studies ; Risk Factors ; Seoul ; Vacuum

Postherpetic neuralgia (PHN) is a challenging condition for pain management specialists. The prevention of herpes zoster (HZ) and subsequent PHN in individuals aged 50 years and older, via the development of new vaccines, is an ongoing research project. The live zoster vaccine (LZV, Zostavax®) was the first proof of concept that vaccination could prevent HZ, but LZV cannot be used in various immunecompromised patients. This led to the development of a new non-live recombinant zoster vaccine (RZV, Shingrix®). This RZV has shown promising results in many clinical trials, with high reactogenicity and similar systemic adverse effects compared to those of LZV. The National Advisory Committee on Immunization has recommended LZV as a standard vaccine for HZ prevention in adults ≥ 50 years of age, but no studies directly comparing the safety and efficacy of RZV and LZV vaccines have been conducted. This article reviews the brief history, efficacy, and safety of the two vaccines and discusses the advantage of RZV over LZV based on the available literature.

Purpose: Intracorporeal esophagojejunostomy during reduced-port gastrectomy for proximal gastric cancer is a technically challenging technique. No study has yet reported a robotic technique for anastomosis. Therefore, to address this gap, we describe our reduced-port technique and the short-term outcomes of intracorporeal esophagojejunostomy. Materials and Methods: We conducted a retrospective review of patients who underwent a totally robotic reduced-port total or proximal gastrectomy between August 2016 and March 2020. We used an infra-umbilical Single-Site® port with two additional ports on both sides of the abdomen. To transect the esophagus, a 45-mm endolinear stapler was inserted via the right abdominal port. The common channel of the esophagojejunostomy was created between the apertures in the esophagus and proximal jejunum using a 45-mm linear stapler. The entry hole was closed with a 45-mm linear stapler or robot-sewn continuous suture. All anastomoses were performed without the aid of an assistant or placement of stay sutures. Results: Among the 40 patients, there were no conversions to open, laparoscopic, or conventional 5-port robotic surgery. The median operation time and blood loss were 254 min and 50 mL, respectively. The median number of retrieved lymph nodes was 40.5. The median time to first flatus, soft diet intake, and length of hospital stay were 3, 5, and 7 days, respectively. Three (7.5%) major complications, including two anastomosis-related complications and a case of small bowel obstruction, were treated with an endoscopic procedure and re-operation, respectively. No mortality occurred during the study period. Conclusions Intracorporeal esophagojejunostomy during reduced-port gastrectomy can be safely performed and is feasible with acceptable surgical outcomes.

Purpose: No consensus exists on whether to preserve or ligate an aberrant left hepatic artery (ALHA), which is the most commonly encountered hepatic arterial variation during gastric surgery. Therefore, we aimed to evaluate the clinical effects of ALHA ligation by analyzing the perioperative outcomes. Materials and Methods: We retrospectively reviewed the data of 5,310 patients who underwent subtotal/total gastrectomy for gastric cancer. Patients in whom the ALHA was ligated (n=486) were categorized into 2 groups according to peak aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels: moderate-to-severe (MS) elevation (≥5 times the upper limit of normal [ULN]; MS group, n=42) and no-to-mild (NM) elevation (<5 times the ULN; NM group, n=444). The groups were matched 1:3 using propensity score-matching analysis to minimize confounding factors that can affect the perioperative outcomes. Results: The mean operation time (P=0.646) and blood loss amount (P=0.937) were similar between the 2 groups. The length of hospital stay was longer in the MS group (13.0 vs.7.8 days, P=0.022). No postoperative mortality occurred. The incidence of grade ≥ IIIa postoperative complications (19.0% vs. 5.1%, P=0.001), especially pulmonary complications (11.9% vs. 2.5%, P=0.003), was significantly higher in the MS group. This group also showed a higher Comprehensive Complication Index (29.0 vs. 13.9, P<0.001). Conclusions Among patients with a ligated ALHA, those with peak AST/ALT ≥5 times the ULN showed worse perioperative outcomes in terms of hospital stay and severity of complications. More precise perioperative decision-making tools are needed to better determine whether to preserve or ligate an ALHA.

Background: Several parameters are useful for assessing disease severity in idiopathic pulmonary fibrosis (IPF); however, the role of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) is not well-defined. We aimed to evaluate the value of 18 F-FDG PET/CT for assessing disease severity and prognosis in IPF patients. Methods: Clinical data of 89 IPF patients (mean age: 68.1 years, male: 94%) who underwent18 F-FDG PET/CT for evaluation of lung nodules or cancer staging were retrospectively reviewed. Mean and maximal standardized uptake values (SUV mean , SUV max , respectively) were measured in the fibrotic area. Adjusted SUV, including SUV ratio (SUVR, defined as SUV max -to-liver SUV mean ratio), tissue fraction-corrected SUV mean (SUV meanTF ), and SUVR (SUVRTF ), and tissue-to-blood ratio (SUV max /SUV mean venous; TBR blood ) were obtained. Death was defined as the primary outcome, and associations between other clinical parameters (lung function, exercise capacity, C-reactive protein [CRP] level) were also investigated. Results: All SUV parameters were inversely correlated with the forced vital capacity, diffusing capacity for carbon monoxide, and positively correlated with CRP level and the gender-agephysiology index. The SUV mean , SUV max , and SUV meanTF were associated with changes in lung function at six months. The SUVR (hazard ratio [HR], 1.738; 95% confidence interval [CI], 1.011–2.991), SUVR TF (HR, 1.441; 95% CI, 1.000–2.098), and TBR blood (HR, 1.377; 95% CI, 1.038–1.827) were significant predictors for mortality in patients with IPF in the univariate analysis, but not in the multivariate analysis. Conclusion 18 F-FDG PET/CT may provide additional information on the disease severity and prognosis in IPF patients, and the SUVR may be superior to other SUV parameters.