Beau's line is a grooved transverse line on the fingernail or toenail, and is considered as a kind of nail disorder, It is known to occur with temporary arrest of nail matrix proliferation. The causes of Beau's line comprise severe systemic illness as well as drug ingestion. A 51-year-old male patient had developed Beau's line on all his fingers after about three months of oxcarbazepine administration. These nail changes disappeared spontaneously with nail growth two months later. The authors report a case of oxcarbazepine induced Beau's line.
Carbamazepine ; Eating ; Fingers ; Humans ; Male ; Middle Aged ; Nails

A 7-year-old boy, diagnosed with an arachnoid cyst and subdural effusion on initial MRI, was admitted with left limb weakness and no history of head trauma. A subsequent follow-up MRI showed different stages of hematoma within multilayered enhancing membranes and in the arachnoid cyst, which was separated by the cerebrospinal fluid cleft. Craniotomy and fenestration of the cyst wall and hematoma removal were performed. The patient was diagnosed as a having a hemorrhagic rupture of an arachnoid cyst into the intradural space, probably via some one-way valve-like defect, based on the MRI and surgical findings. The MRI features and possible mechanism of this rare disease are discussed within the literature review.
Arachnoid* ; Cerebrospinal Fluid ; Child ; Craniocerebral Trauma ; Craniotomy ; Dura Mater ; Extremities ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Lymphangioma, Cystic ; Magnetic Resonance Imaging ; Male ; Membranes ; Rare Diseases ; Rupture* ; Subdural Effusion

OBJECTIVES: To summarize the evidence regarding the association of parity and breast feeding duration with the risk of osteoporosis in postmenopausal Korean women. This was because studies have been inconsistent regarding the effect of parity and breast feeding duration on the risk of osteoporosis. METHODS: A systematic literature search of relevant studies published by December 26, 2018 was conducted in PubMed, EMBASE, the Cochrane Library, CINAHL, RISS, KISS, KMbase, and KoreaMed. Outcome estimates of odds ratio (OR) or standardized mean difference were pooled with fixed or random-effect model. In case of heterogeneity, subgroup analysis was conducted. RESULTS: Seven cross-sectional studies (with 3,813 subjects) were included in the analysis. OR for osteoporosis was 1.43 (95% confidence interval [CI] = 1.09–1.88, P = 0.010) in postmenopausal women with higher parity compared to those with less parity. Moreover, OR for osteoporosis was 1.93 (95% CI = 1.28–2.93, P = 0.002) in postmenopausal women with longer durations of breast feeding than in those with shorter durations of breast feeding. CONCLUSIONS: This study revealed that duration of breast feeding increased the risk of osteoporosis in postmenopausal Korean women. More cohort studies with high quality research designs are needed to confirm our results.
Bone Density ; Breast Feeding ; Breast ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Odds Ratio ; Osteoporosis ; Parity ; Population Characteristics ; Postmenopause ; Research Design

The purpose of this study was to examine the validity of the content of an educational curriculum by understanding the opinions of experts in the development of weekly educational content for dental communication or communication-related subjects. It was composed of educational content on how to communicate with patients by cultivating a professional attitude through basic contents and a self-understanding of communication. Three experts were asked to evaluate the feasibility of educational contents and their appropriateness in order to evaluate the criteria for certification as a dental hygienist. The validity of the weekly educational contents and the period of education were awarded 4 points out of a maximum of 5 points; overall, the curriculum was evaluated to be valid and to be acceptable for use as criteria for certification evaluation. On the other hand, it was confirmed that not only should the contents be made appropriate for the grade level, but it should be complemented so that theoretical and practical learning can be achieved in a gradual and interrelated manner rather than as a one-time curriculum. Therefore, the result of this study can be considered for use as background data for curriculum development, and for standardization of the communication course in the dental hygiene department.
Awards and Prizes ; Certification ; Complement System Proteins ; Curriculum* ; Dental Hygienists ; Education ; Hand ; Humans ; Learning ; Oral Hygiene*

PURPOSE: To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. MATERIALS AND METHODS: For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependent NMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assisted by manual thrust plus MI-E. The cough augmentation techniques were provided in random order. PCF was measured using a new device, the Cough Aid. RESULTS: All 40 enrolled participants (37 males, three females; average age, 20.9±7.2 years) completed the study. The mean (standard deviation) PCFs in the unassisted, manually assisted following an MIC maneuver, MI-E-assisted, and manual thrust plus MI-E-assisted conditions were 95.7 (40.5), 155.9 (53.1), 177.2 (33.9), and 202.4 (46.6) L/min, respectively. All three interventions significantly improved PCF. However, manual assistance following an MIC maneuver was significantly less effective than MI-E alone. Manual thrust plus MI-E was significantly more effective than both of these interventions. CONCLUSION: In patients with NMD and respiratory muscle dysfunction, MI-E alone was more effective than manual assistance following an MIC maneuver. However, MI-E used in conjunction with manual thrust improved PCF even further.
Cough* ; Female ; Humans ; Insufflation ; Male ; Neuromuscular Diseases ; Respiratory Muscles*

PURPOSE: To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. MATERIALS AND METHODS: For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependent NMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assisted by manual thrust plus MI-E. The cough augmentation techniques were provided in random order. PCF was measured using a new device, the Cough Aid. RESULTS: All 40 enrolled participants (37 males, three females; average age, 20.9±7.2 years) completed the study. The mean (standard deviation) PCFs in the unassisted, manually assisted following an MIC maneuver, MI-E-assisted, and manual thrust plus MI-E-assisted conditions were 95.7 (40.5), 155.9 (53.1), 177.2 (33.9), and 202.4 (46.6) L/min, respectively. All three interventions significantly improved PCF. However, manual assistance following an MIC maneuver was significantly less effective than MI-E alone. Manual thrust plus MI-E was significantly more effective than both of these interventions. CONCLUSION: In patients with NMD and respiratory muscle dysfunction, MI-E alone was more effective than manual assistance following an MIC maneuver. However, MI-E used in conjunction with manual thrust improved PCF even further.
Cough* ; Female ; Humans ; Insufflation ; Male ; Neuromuscular Diseases ; Respiratory Muscles*

Tuberculous uveitis is a rare manifestation of tuberculosis infection. Although early diagnosis is important to saving the sight of patients, it is difficult. In dialysis patient, the diagnosis of tuberculosis is often delayed because of non-specific symptoms and extrapulmonary involvements. We report a case involving a 37-year-old man receiving hemodialysis who was presented with persistent fever and left- sided blurred vision. At ophthalmic examination, active papillitis, vitritis, and peripapillary retinal detachment were observed. Neck computed tomography showed multiple necrotic lymphadenopathies (LAPs) in right lateral neck, which was proven as tuberculous lymphadenitis on histological examination. After anti-tuberculosis therapy, fever was subsided and LAPs were improved. Visual acuity was also improved.
Adult ; Dialysis ; Early Diagnosis ; Fever ; Humans ; Hyperthermia, Induced ; Neck ; Papilledema ; Renal Dialysis ; Retinal Detachment ; Tuberculosis ; Tuberculosis, Lymph Node ; Uveitis ; Vision, Ocular ; Visual Acuity

OBJECTIVE: To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation. METHODS: Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO₂ (ETCO₂) and pulse oxyhemoglobin saturation (SpO₂) monitoring were performed. Extubation success was defined as a state not requiring invasive mechanical ventilation via endotracheal tube or tracheotomy during a period of at least 5 days. RESULTS: A total of 18 patients with ventilatory failure who initially experienced extubation failure were finally placed under part-time NIV after extubation. No patient had any serious or long-term adverse effect from NIV, and all patients left the hospital alive. CONCLUSION: NIV may promote successful weaning in neuromuscular patients with experience of reintubation.
Humans ; Neuromuscular Diseases* ; Noninvasive Ventilation* ; Oxyhemoglobins ; Rehabilitation ; Respiration, Artificial ; Retrospective Studies ; Tracheotomy ; Weaning*

BACKGROUND: Hyperhomocysteinemia increase the risk of vascular disease, dementia and cognitive impairment. The effect of homocysteine on cognitive function may be as a consequence of direct neurotoxicity or indirectly through cerebrovascular disease. Thus we examined the association between homocysteine levels and cognitive function, and assess whether this may be mediated by cerebral white matter lesions. METHODS: Non-dementic participants were recruited from March to December 2005, and underwent brain MRI. White matter hyperintensities(WMH) were rated visually by 4-class WMH grades. Informations of age, gender, education and vascular risk factor were obtained from interview. Cognitive function were assessed by using K-MMSE and HDS-R. The cross-sectional relationship between homocysteine level and cognitive test score was assessed by multiple regression analysis. RESULTS: Severe WMH groups more exposed to vascular risk factor such as age, hypertension and higher levels of homocyteine. More severe WMH grades also had lower K-MMSE and HDS-R score. Higher group of homocysteine concentration were significantly related to poorer performances on K-MMSE and HDS-R tests. In multiple linear regression analyses for the relationship between homocysteine and cognitive performances, higher homocysteine level was also related to lower cognitive performances. Adding cerebral WMH changes to the level of homocysteine did not significantly change the effect of homocysteine on cognitive ability, and cerebral WMH had a separate and additive effect with homocysteine. CONCLUSIONS: Elevated homocysteine level is associated decreased cognitive score and cerebral white matter lesion on MRI is independent association to the cognitive abilities.
Brain ; Dementia ; Education ; Homocysteine* ; Hyperhomocysteinemia ; Hypertension ; Linear Models ; Magnetic Resonance Imaging ; Risk Factors ; Vascular Diseases

Computational virtual screening has become an essential platform of drug discovery for the efficient identification of active candidates. Moleculardocking, a key technology of receptor-centric virtual screening, is commonly used to predict the binding affinities of chemical compounds on target receptors. Despite the advancement and extensive application of these methods, substantial improvement is still required to increase their accuracy and time-efficiency. Here, we evaluate several advanced structure-based virtual screening approaches for elucidating the rank-order activity of chemical libraries, and the quantitative structureactivity relationship (QSAR). Our results show that the ensemble-average free energy estimation, including implicit solvation energy terms, significantly improves the hit enrichment of the virtual screening. We also demonstrate that the assignment of quantum mechanical-polarized (QM-polarized) partial charges to docked ligands contributes to the reproduction of the crystal pose of ligands in the docking and scoring procedure.
Drug Discovery* ; Ligands ; Mass Screening* ; Quantitative Structure-Activity Relationship ; Reproduction ; Small Molecule Libraries