BACKGROUND: Little is known concerning hair diameter variation within the safe donor area for hair transplantation surgery. Thicker or thinner hair may be needed, depending on the recipient area, hairline design, and the purpose of surgery. METHODS: Twenty-seven patients (7 men and 20 women; mean age, 28 years; range, 20–47 years) were included in this study. The midoccipital point was used as the reference point on the horizontal plane at the upper border of the helical rim. The target area width was 15 cm (7.5 cm to the right and left of the reference point) and the height was 8 cm (2 cm above and 6 cm below the reference point). The study area was divided horizontally into 3 5-cm sections (A, B, C) and vertically into 4 2-cm sections (1–4), creating a total of 12 zones. Ten anagen hairs were randomly obtained from each zone and their diameters were measured. RESULTS: Hair diameter in the 4 vertical sections varied significantly, gradually decreasing from sections 1 (superior) to 4 (inferior) in all 3 horizontal sections (A, B, and C). CONCLUSIONS: Our results suggest that sections 1 and 2 of the occipital safe donor area would be useful for obtaining thicker hair, such as in procedures to treat male- and female-pattern hair loss, whereas hair from zones 3 and 4 could be useful for transplantation surgery requiring thinner hair, such as eyebrows, eyelashes, and female hairline correction. Our results may be clinically valuable for planning hair transplant surgery and choosing the optimal donor region.
Eyebrows ; Eyelashes ; Female ; Hair Follicle ; Hair* ; Humans ; Male ; Tissue Donors* ; Transplant Donor Site ; Transplantation

It has been suggested that cortisol deficiency may be responsible for the cholestasis. Although congenital hypopituitarism was reported as a possible cause of neonatal cholestasis, congenital adrenal hyperplasia with neonatal cholestasis is a very rare report in the literature. We experienced a case presenting with neonatal cholestasis associated with congenital adrenal hyperplasia. This case provides a clinical evidence supporting the notion that cortisol has an important physiological role in bile acid synthesis and transport.
Adrenal Hyperplasia, Congenital* ; Bile ; Cholestasis* ; Hydrocortisone ; Hypopituitarism

A yeast strain, designated as JAF-11 T , was isolated from flower ofPrunus mume Sieb. et Zucc. in Gwangyang, Republic of Korea. Phylogenetic analysis showed that strain JAF-11 T was closely related to Neodothiora populina CPC 39399 T with 2.07 % sequence divergence (12 nucleotide substitutions and three gaps in 581 nucleotides) in the D1/D2 domain of the large subunit (LSU) rRNA gene, and Rhizosphaera macrospora CBS 208.79 T with 4.66 % sequence divergence (25 nucleotide substitutions and five gaps in 535 nucleotides) in the internal transcribed spacer (ITS) region. Further analysis based on the concatenated sequen ces of the D1/D2 domain of the LSU rRNA gene and the ITS region confirmed that strain JAF-11 T was well-separated from Neodothiora populina CPC 39399 T . In addition to the phylo genetic differences, strain JAF-11 T was distinguished from its closest species, Neodothiora populina CPC 39399 T and Rhizosphaera macrospora CBS 208.79 T belonging to the family Dothioraceae by its phenotypic characteristics, such as assimilation of carbon sources. Hence, the name Neodothiora pruni sp. nov. is proposed with type strain JAF-11 T (KACC 48808 T ; MB 850034).

In order to increase inhaled corticosteroid (ICS) use and to reduce hospitalization, emergency department visits and ultimately the economic burden of asthma, "Korean Asthma Management Guideline for Adults 2007" was developed. To assess the guideline effects on physician's ICS prescription for asthma, we conducted segmented regression and multilevel logistic regression using National Health Insurance claims database of outpatient visits from 2003 to 2010. We set each quarter of a year as a time unit and compared ICS prescription between before and after guideline dissemination. A total of 624,309 quarterly visits for asthma was observed. The ICS prescription rate before and after guideline dissemination was 13.3% and 16.4% respectively (P < 0.001). In the segmented regression, there was no significant guideline effect on overall ICS prescription rate. In multilevel logistic regression analyses, the effect of guideline on overall ICS prescription was not significant (odds ratio, 1.03; 95% CI, 1.00-1.06). In subgroup analysis, ICS prescription increased in secondary care hospitals (odds ratio, 1.15; 95% CI, 1.02-1.30) and in general hospitals (odds ratio, 1.10; 95% CI, 1.04-1.16). However, in primary clinics, which covered 81.7% of asthma cases, there was no significant change (odds ratio, 0.98; 95% CI, 0.94-1.02). From the in-depth interview, we could identify that the reimbursement criteria of the Health Insurance Review and Assessment Service and patient's preference for oral drug were barriers for the ICS prescription. The domestic asthma clinical guideline have no significant effect on ICS prescription, especially in primary clinics.
Administration, Inhalation ; Adrenal Cortex Hormones/*administration & dosage ; Allergy and Immunology/standards ; Anti-Inflammatory Agents/administration & dosage ; Asthma/*drug therapy/*epidemiology ; Drug Prescriptions/*statistics & numerical data ; Guideline Adherence/*utilization ; Humans ; *Practice Guidelines as Topic ; Prevalence ; Pulmonary Medicine/standards ; Republic of Korea/epidemiology ; Treatment Outcome

BACKGROUND: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. MATERIAL AND METHOD: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male : female=18 : 7, mean age 43.2+/-18.6 years) and 23 patients with isolated mitral endocarditis (Group II, male : female=10 : 13, mean age 43.2+/-17.1 years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patientsdeveloped mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II. The preoperative left ventricular ejection fraction for each group was 60.8+/-8.7% and 62.1+/-8.1% (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was 37.2+/-23.5 (range 9~123) months. RESULT: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and 100%, 84.9%, and 84.9% for Group II patients, respectively. CONCLUSION: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.
Aortic Valve ; Aortic Valve Insufficiency ; Atrial Fibrillation ; Bicuspid ; Cardiac Output, Low ; Echocardiography ; Endocarditis* ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Hemorrhage ; Humans ; Male ; Microwaves ; Mitral Valve Insufficiency ; Mortality ; Postoperative Complications ; Stroke Volume ; Survival Rate

PURPOSE: High resolution ultrasonography has made it possible to detect many non-palpable small nodules in thyroid gland. We investigated the prevalence and clinical features of non-palpable thyroid nodule and carcinoma discovered incidentally at screening ultrasonography in healthy women. METHODS: A retrospective review was undertaken on the previous healthy asymptomatic 1, 714 women where selected to undergo screening ultrasonography for the detection of the presence of non-palpable thyroid nodules from January 2004 to December 2004. The aims of study were to define the prevalence of thyroid nodule and carcinoma in healthy asymptomatic women and to access the extent of disease in patients with malignant nodule by surgery. RESULTS: Of the 1, 714 subject, thyroid nodule were detected in 822 (48.0%) women with their prevalence increasing with the increasing age of patients. The malignant detection rate based on the USG-guided fine-needle aspiration (USGFNA) results, including both suspicious and malignant groups, was 2.8% (48/1, 714) of all subjects. 38 of 50 patients with malignant, suspicious or indeterminate cytology underwent surgery and all of them were confirmed to have papillary carcinoma on histological results. In 38 patients with papillary thyroid carcinoma, the average size of tumors was 0.87+/-0.33 cm, a range of 0.3 to 1.5 cm, multifocal tumors were found in 50% (19/38), bilaterality was found in 44.7% (17/38), extrathyroidal extension was observed in 50.0% (19/38), and regional lymph node metastasis was found in 29.4% (5/17). CONCLUSION: High resolution ultrasonography detected a high percentage (48%) of nonpalpable thyroid nodules. Characteristics of thyroid nodules on ultrasonography can be used to decision of optimal management strategies. Total thyroidectomy with lymph node dissection may be suitable in patients with non-palpable papillary thyroid carcinoma due to its high incidence of extrathyroidal extension, bilaterality and regional lymph node metastasis.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mass Screening* ; Neoplasm Metastasis ; Prevalence* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography*

OBJECTIVE: This study aimed to identify factors that affect in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR). METHODS: We reviewed 99 IVF cycles in 52 women with DOR between September 2010 and January 2015. DOR was defined as serum anti-Müllerian hormone level of <1.1 ng/dL or serum follicle-stimulating hormone level of ≥20 mIU/mL. Total 96 cycles in 50 patients were evaluated after excluding fertility preservation cases. RESULTS: The clinical pregnancy rate was 11.5% per cycle, and the total cancellation rate was 34.4%. Clinical pregnancy rate was significantly associated with the antral follicle count and the cause of the DOR. Age, serum anti-Müllerian hormone and follicle-stimulating hormone levels, antral follicle count, peak estradiol level, and the cause of DOR were significantly associated with cycle cancellation. However, history of previous ovarian surgery remained as a significant factor of clinical pregnancy (model 1: odds ratio [OR] 10.17, 95% confidence interval [CI] 1.46 to 70.84, P=0.019; model 2: OR 10.85, 95% CI 1.05 to 111.71, P=0.045). In cancellation models, idiopathic or previous chemotherapy group showed borderline significance (model 1: OR 3.76, 95% CI 0.83 to 17.04, P=0.086; model 2: OR 3.15, 95% CI 0.84 to 11.84, P=0.09). CONCLUSION: DOR caused by previous ovarian surgery may show better pregnancy outcome, whereas that caused by chemotherapy could significantly increase the cycle cancellation rate. Furthermore, patients with DOR who previously received gonadotoxic agents may show reduced efficacy and increased risk of IVF cycle cancellation.
Drug Therapy ; Estradiol ; Female ; Fertility Preservation ; Fertilization in Vitro* ; Follicle Stimulating Hormone ; Humans ; In Vitro Techniques* ; Odds Ratio ; Ovarian Reserve* ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate

STUDY DESIGN: A retrospective analysis of five cases of late spinal infection after spinal instrumentation and fusion. OBJECTIVES: These cases are reviewed to verify risk factors for late spinal infection after elective instrumentation and to manifest the treatment of this complication. SUMMARY OF LITERATURE REVIEW: Late spinal infection after elective spinal instrumentation and fusion are uncommon. The diagnosis is usually hard and requires much clinical suspicion. MATERIALS AND METHODS: 5 cases were in total 374 patients of the author's cases. These cases are reviewed retrospectively. RESULTS: All patients reported aggravated back pain. 4 patients had elevated erythrocyte sedimentation rates, averaging 44.8 mm/hour and elevated C-reactive protein, averaging 26.2mg/L. No distance foci of infection was identified. All patients got the radiolucent zone around screw fixation site, averaging 4.6mmwidth. The organisms were S. epidermidis in 1 case and coagulase(-) staphylococcus in 1 case. All cases were treated by operative method with debridement, instrument removal with or without revision and postoperative intravenous antibiotics. The average follow-up period was 18.2 months, one patient recurred back pain at 7 months after operation. CONCLUSION: The diagnosis of late infection after elective spinal instrumentation and fusion requires high suspicion of clinical symptoms and signs. All except one were successfully treated by operative treatment.
Anti-Bacterial Agents ; Back Pain ; Blood Sedimentation ; C-Reactive Protein ; Debridement ; Diagnosis ; Follow-Up Studies ; Humans ; Retrospective Studies ; Risk Factors ; Spine ; Staphylococcus

Ischemic colitis is generally considered a disease of the elderly. The causes of ischemic colitis include low-flow states due to cardiac dysfunction or hypovolemia and certain medications including estrogen. Here we report a case of ischemic colitis in a 26-year-old woman. She had no specific medical history except taking oral-contraceptives for a long time. The mechanism of estrogen-induced ischemic colitis is not clearly understood. But we recommend that oral-contraceptives should be considered as a cause of ischemic colitis in young women.
Adult ; Aged ; Colitis, Ischemic ; Contraceptives, Oral ; Estrogens ; Female ; Humans ; Hypovolemia

OBJECTIVE: To investigate the effect of regular exercise program on cognitive function in chronic cerebral hypoperfused rat. METHOD: Forty-eight male Sprague-Dawley rats were used. Chronic cerebral hypoperfusion was induced by bilateral common carotid arteries occlusion (BCCAO). All rats were randomly divided into 4 groups: normal rats (group A); normal rats with regular exercise program (group B); BCCAO rats (group C); BCCAO rats with regular exercise program (group D). Regular exercise program was composed of daily 30-minute treadmill exercise for 4 weeks. Cognitive function was evaluated by Morris water maze (MWM) test. The activities of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) were checked. The neurons were microscopically analyzed on Hematoxylin-Eosin and Cresyl violet stains. RESULTS: After regular exercise program, there was significant difference in the escape latency among 4 groups in hidden platform trial of MWM test (p<0.05). There was significant difference in the number of crossings among 4 groups in probe trial of MWM test (p<0.05). The activities of SOD of group A and group D were significantly higher than those of group C, respectively (p<0.05). Histopathological study displayed the formation of apoptotic cell bodies and pyknotic cells in group C and group D. There were more normal neurons in group D than group C. CONCLUSION: Regular treadmill exercise was helpful in improving cognitive function in chronic cerebral hypoperfused rat. Therefore, regular exercise program would be one of the useful strategies for treating chronic neurodegenerative diseases.
Animals ; Benzoxazines ; Carotid Artery, Common ; Cognition ; Dementia ; Humans ; Male ; Malondialdehyde ; Maze Learning ; Neurodegenerative Diseases ; Neurons ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; United Nations ; Viola