BACKGROUND: Silicone implants are frequently used in augmentation rhinoplasty in Asians. A common complication of silicone augmentation rhinoplasty is capsular contracture. This is similar to the capsular contracture after augmentation mammoplasty, but a classification for secondary contracture after augmentation rhinoplasty with silicone implants has not yet been established, and treatment algorithms by grade or severity have yet to be developed. METHODS: Photographs of 695 patients who underwent augmentation rhinoplasty with a silicone implant from May 2001 to May 2015 were analyzed. The mean observation period was 11.4 months. Of the patients, 81 were male and 614 were female, with a mean age of 35.9 years. Grades were assigned according to postoperative appearance. Grade I was a natural appearance, as if an implant had not been inserted. Grade II was an unnatural lateral margin of the implant. Clearly identifiable implant deviation was classified as grade III, and short nose deformation was grade IV. RESULTS: Grade I outcomes were found in 498 patients (71.7%), grade II outcomes in 101 (14.5%), grade III outcomes in 75 (10.8%), and grade IV outcomes in 21 patients (3.0%). Revision surgery was indicated for the 13.8% of all patients who had grade III or IV outcomes. CONCLUSIONS: It is important to clinically classify the deformations due to secondary contracture after surgery and to establish treatment algorithms to improve scientific communication among rhinoplasty surgeons. In this study, we suggest guidelines for the clinical classification of secondary capsular contracture after augmentation rhinoplasty, and also propose a treatment algorithm.
Asian Continental Ancestry Group ; Classification* ; Contracture ; Female ; Humans ; Implant Capsular Contracture ; Male ; Mammaplasty ; Nose* ; Prostheses and Implants ; Rhinoplasty ; Silicon* ; Silicones* ; Surgeons

One author's name is misspelled. Correct Seungho Rhu into Seungho Ryu.

The basolateral amygdala (BLA) receives dense projections from cholinergic neurons of the basal forebrain. Acetylcholine can contributes to amygdala-dependent behaviors: formation and extinction of fear memory and appetitive instrumental learning. However, the cholinergic mechanism at the circuit level has not been defined yet. We demonstrated that cholinergic-induced di-synaptic inhibition of BLA pyramidal neurons exhibits a retrograde form of short-term synaptic inhibition, depolarization-induced suppression of inhibition (DSI). Activation of nicotinic receptors was sufficient to evoke action potentials in cholecystokinin (CCK)-positive inhibitory neurons, which strongly inhibit pyramidal neurons through their perisomatic synapses. Our cell type-specific monosynaptic retrograde tracing also revealed that CCK neurons are innervated by basal forebrain cholinergic neurons. Therefore, our data indicated that CCK inhibitory neurons mediate the cholinergic-induced di-synaptic inhibition of BLA pyramidal neurons.
Acetylcholine ; Action Potentials ; Basal Forebrain ; Basolateral Nuclear Complex ; Cholecystokinin ; Cholinergic Neurons ; Conditioning, Operant ; Iontophoresis ; Memory ; Neurons ; Pyramidal Cells ; Receptors, Nicotinic ; Synapses

Objective: We aimed to analyze the differences in epidemiological aspects and clinical courses of acute poisonings in each region of the Gyeonggi-do province in Korea. Methods: This retrospective study analyzed data from the National Emergency Department Information System of Korea. We retrospectively reviewed cases of acute poisonings between April 2006 and March 2015 recorded at 13 emergency departments in eight different cities of Gyeonggi-do province in Korea. The differences in the incidence, age distribution, causative agent, and clinical course of poisonings among regions were the main outcomes measured. Results: The proportion of poisonings in the ≤9 age group was high in Yongin (17.44%) and that in ≥65 age group was high in Gwangmyeong (21.76%). The proportion of cases involving carbon monoxide was high in Ansan (8.82%) in patients hospitalized and the proportion of cases involving pesticides was high in Pyeongtaek (52.78%) in patients admitted to the intensive care unit. The admission rate of poisoned patients was high in Osan (36.02%). Conclusion In this study, differences in the characteristics of poisoned patients between 8 cities were noted. Therefore, hospitals need to arrange treatment resources for poisoned patients according to the characteristics of the specific region. The results of this study may serve as evidence for new strategies to prepare for the acute poisonings in hospitals.

Objectives: Maltreatment experiences can alter brain function related to emotion regulation, such as cognitive reappraisal. While dysregulation of emotion is an important risk factor to mental health problems in maltreated people, studies reported alterations in brain networks related to cognitive reappraisal are still lacking. Methods: Twenty-seven healthy subjects were recruited in this study. The maltreatment experiences and positive reappraisal abilities were measured using the Childhood Trauma Questionnaire-Short Form and the Cognitive Emotion Regulation Questionnaire, respectively. Twelve subjects reported one or more moderate maltreatment experiences. Subjects were re-exposed to pictures after the cognitive reappraisal task using the International Affective Picture System during fMRI scan. Results: The maltreatment group reported more negative feelings on negative pictures which tried cognitive reappraisal than the no-maltreatment group (p < 0.05). Activities in the right superior marginal gyrus and right middle temporal gyrus were higher in the maltreatment group (uncorrected p < 0.001, cluster size > 20). Conclusions We found that paradoxical activities in semantic networks were shown in the victims of maltreatment. Further study might be needed to clarify these aberrant functions in semantic networks related to maltreatment experiences.

PURPOSE: The tumor microenvironment is known to be associated with the metabolic activity of cancer cells and local immune reactions. We hypothesized that glucose metabolism measured by 2-deoxy-2-(¹⁸F)fluoro-D-glucose (¹⁸F-FDG) positron emission tomography (PET)-computed tomography (CT) (¹⁸F-FDG PET-CT) would be associated with local immune responses evaluated according to the presence of tumor infiltrating lymphocytes (TILs). MATERIALS AND METHODS: We retrospectively reviewed 56 patients who underwent ¹⁸F-FDG PET-CT prior to gastrectomy. In resected tumor specimens, TIL subsets, including cluster of differentiation (CD) 3, CD4, CD8, Forkhead box P3 (Foxp3), and granzyme B, were subjected to immunohistochemical analysis. The prognostic nutritional index (PNI) was calculated as: (10×serum albumin value)+(0.005×peripheral lymphocyte counts). Additionally, the maximum standard uptake value (SUVmax) was calculated to evaluate the metabolic activity of cancer cells. RESULTS: The SUVmax was positively correlated with larger tumor size (R=0.293; P=0.029) and negatively correlated with PNI (R=−0.407; P=0.002). A higher SUVmax showed a marginal association with higher CD3 (+) T lymphocyte counts (R=0.227; P=0.092) and a significant association with higher Foxp3 (+) T lymphocyte counts (R=0.431; P=0.009). No other clinicopathological characteristics were associated with SUVmax or TILs. Survival analysis, however, indicated that neither SUVmax nor Foxp3 held prognostic significance. CONCLUSIONS: FDG uptake on PET-CT could be associated with TILs, especially regulatory T cells, in gastric cancer. This finding may suggest that PET-CT could be of use as a non-invasive tool for monitoring the tumor microenvironment in patients with gastric cancer.
Fluorodeoxyglucose F18 ; Gastrectomy ; Glucose ; Granzymes ; Humans ; Lymphocyte Count ; Lymphocytes ; Lymphocytes, Tumor-Infiltrating ; Metabolism ; Nutrition Assessment ; Positron-Emission Tomography ; Retrospective Studies ; Stomach Neoplasms ; T-Lymphocytes, Regulatory ; Tumor Microenvironment

Objective: Although cognitive models of obsessive-compulsive disorder (OCD) fall into two categories: cognitive deficit models and dysfunctional belief models, these approaches have their own ways and have hardly been reconciled. Therefore, this study aimed to investigate the potential relationships between cognitive deficit (using the Wisconsin Card Sorting Task, WCST) and dysfunctional belief (measured by scales of dysfunctional beliefs) mediated by neural activity in OCD patients. Methods: Thirty OCD patients and 30 healthy participants performed the WCST condition and a baseline MATCH condition during the 3T-functional magnetic resonance imaging (fMRI) acquisition. Results: Engagement of additional frontoparietal networks with poorer performance of WCST was found during the fMRI scan in OCD patients. Selected regions of interest from activated regions have positive relationships with dysfunctional beliefs and with the unacceptable thoughts symptom dimension in the OCD group. Conclusion Findings suggest that alteration in frontoparietal networks related to cognitive deficits can be associated with dysfunctional beliefs while performing conventional neurocognitive tasks and this association with dysfunctional beliefs may be pronounced in the unacceptable thoughts domain-dominant OCD patients.

Objective: Although cognitive models of obsessive-compulsive disorder (OCD) fall into two categories: cognitive deficit models and dysfunctional belief models, these approaches have their own ways and have hardly been reconciled. Therefore, this study aimed to investigate the potential relationships between cognitive deficit (using the Wisconsin Card Sorting Task, WCST) and dysfunctional belief (measured by scales of dysfunctional beliefs) mediated by neural activity in OCD patients. Methods: Thirty OCD patients and 30 healthy participants performed the WCST condition and a baseline MATCH condition during the 3T-functional magnetic resonance imaging (fMRI) acquisition. Results: Engagement of additional frontoparietal networks with poorer performance of WCST was found during the fMRI scan in OCD patients. Selected regions of interest from activated regions have positive relationships with dysfunctional beliefs and with the unacceptable thoughts symptom dimension in the OCD group. Conclusion Findings suggest that alteration in frontoparietal networks related to cognitive deficits can be associated with dysfunctional beliefs while performing conventional neurocognitive tasks and this association with dysfunctional beliefs may be pronounced in the unacceptable thoughts domain-dominant OCD patients.

Background: This study evaluated the use of brainstem score (BSS) on pre-procedural diffusion-weighted imaging (DWI) to predict outcomes after mechanical thrombectomy (MT) in acute basilar artery occlusion (ABAO) patients and compared its predictive effectiveness to the critical area perfusion score (CAPS) on perfusion magnetic resonance imaging (MRI) using RAPID. Methods: This study focused on ABAO patients who underwent MT after MRI at Dong-A University Hospital from 2013 to 2023. Ischemic lesion volume and DWI BSS were measured for all. For the group that underwent perfusion MRI using RAPID, CAPS were measured. The primary end point was a poor outcome at 90 days (modified Rankin scale [mRS], >2). Results: 71 patients had ABAO and underwent MT after MRI. The poor outcome group (66.2%) had significantly larger ischemic lesion volume and higher DWI BSS compared with the good outcome group. In the multiple logistic regression analysis, DWI BSS (odds ratio, 8.27; 95% confidence interval, 1.93-35.50; p<0.01) was an independent predictor of poor outcomes. In 26 patients, CAPS was measured on perfusion MRI. In this subgroup, poor outcome group (50.0%) had higher DWI BSS and CAPS than the good outcome group. In the multiple logistic regression analysis, DWI BSS remained a valid independent predictor for predicting outcomes, but CAPS did not function as an independent predictor. Conclusion In this study, the DWI BSS before MT in ABAO patients emerged as a useful imaging marker for predicting post-procedural outcomes. Its predictive ability is not only comparable to but even superior to CAPS on perfusion MRI.

Background: This study evaluated the use of brainstem score (BSS) on pre-procedural diffusion-weighted imaging (DWI) to predict outcomes after mechanical thrombectomy (MT) in acute basilar artery occlusion (ABAO) patients and compared its predictive effectiveness to the critical area perfusion score (CAPS) on perfusion magnetic resonance imaging (MRI) using RAPID. Methods: This study focused on ABAO patients who underwent MT after MRI at Dong-A University Hospital from 2013 to 2023. Ischemic lesion volume and DWI BSS were measured for all. For the group that underwent perfusion MRI using RAPID, CAPS were measured. The primary end point was a poor outcome at 90 days (modified Rankin scale [mRS], >2). Results: 71 patients had ABAO and underwent MT after MRI. The poor outcome group (66.2%) had significantly larger ischemic lesion volume and higher DWI BSS compared with the good outcome group. In the multiple logistic regression analysis, DWI BSS (odds ratio, 8.27; 95% confidence interval, 1.93-35.50; p<0.01) was an independent predictor of poor outcomes. In 26 patients, CAPS was measured on perfusion MRI. In this subgroup, poor outcome group (50.0%) had higher DWI BSS and CAPS than the good outcome group. In the multiple logistic regression analysis, DWI BSS remained a valid independent predictor for predicting outcomes, but CAPS did not function as an independent predictor. Conclusion In this study, the DWI BSS before MT in ABAO patients emerged as a useful imaging marker for predicting post-procedural outcomes. Its predictive ability is not only comparable to but even superior to CAPS on perfusion MRI.