Purpose: The purpose of this study was to predict measuring site suited for abdominal skin fold thickness (ASFT) by measuring the distribution of abdominal subcutaneous fat thickness (AScFT) and ascertain the correlations among obesity indicators. Methods: The size of analysis materials was 124 secondary data measured by ultrasonic device, bioelectrical impedance analyzer and caliper. Data were analyzed using t-test, and Pearson’s correlation. Results: The average of AScFT was 10.63± 6.79mm with its range 1.39-36.16 mm, and AScFT of female and of central parts were thicker than those of male and outer parts in the abdomen. The average of ASFT was 29.26± 12.59 mm. Site 5 on Figure 1 was most similar to the average of AScFT in both sexes. Body mass index (BMI) and waist hip ratio (WHR) were 23.65± 3.98 and 0.88± 0.05 respectively. The body weight, BMI, WHR, visceral fat, ASFT vs AScFT revealed in significant correlation (r= .29, r= .55, r= .39, r= .33. r= .29). Conclusion BMI and WHR seem more useful than other obesity indicators, when obesity control is necessary for Type 2 diabetes patients. Site 5 on Figure 1 is most suitable site to measure ASFT.

Purpose: This study aimed to explore the difficulties and coping that advanced practice nurses (APNs) experience in home health nursing field. Methods: The participants were 12 APNs who had experience in home health nursing for over 5 years. Data were collected through two focus group interviews between August and September, 2017. The results were analyzed using a qualitative content analysis. Results: Out of 10 sub-categories and 29 codes, 4 categories emerged: “crushed by the responsibilities as the only healthcare professional”, “worn out by family who interfere with work”, “anxiety about my safety being threatened” and “using self-learned know-hows”. Conclusion APNs face difficulties due to the environmental characteristics of the homes, the characteristics of chronically critically ill (CCI) patients and their families, and legal or systematical limitations when dealing with problems based on their personal competence. In order to ensure that professional nursing care is more readily provided to CCI patients through home health nursing services in local communities, it is imperative that support systems at the organizational and institutional levels be established in a systematic way to resolve the issues faced by APNs.

Varying degrees of complications can occur after hyaluronic acid filler injections. Tissue necrosis due to interruption of the vascular supply is an early complication that can be severe. If the site of tissue necrosis due to the filler injection is the forehead, successfully reconstructing the region without distorting the key landmarks is challenging. We describe the case of a 50-year-old man who experienced widespread forehead skin necrosis after hyaluronic acid filler injection in the glabellar area. We successfully covered the forehead area with a 3×4-cm² midline necrotic tissue using the modified double-opposing rotation-advancement flap method. Although modified double-opposing rotation-advancement flap closure has the disadvantage of leaving a longer scar compared to conventional double-opposing rotation-advancement flap closure, the additional incision line made along the superior border of the eyebrow aids in camouflaging the scar and decreases eyebrow distortion. Therefore, it is believed that the modified double-opposing rotation-advancement flap technique is an excellent tool for providing adequate soft tissue coverage and minimal free margin distortion when reconstructing widespread skin necrosis in the central mid-lower forehead that can occur after filler injection in the glabellar area.
Cicatrix ; Dermal Fillers ; Eyebrows ; Forehead* ; Humans ; Hyaluronic Acid ; Methods ; Middle Aged ; Necrosis* ; Skin* ; Surgical Flaps

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.
Anesthesia, General ; Biopsy ; Carcinoma, Merkel Cell ; Cheek ; Female ; Head ; Humans ; Mechanoreceptors ; Merkel Cells ; Middle Aged ; Neck ; Neural Plate ; Pruritus ; Sensation ; Sentinel Lymph Node Biopsy ; Surgical Flaps

BACKGROUND: The conventional surgical method for reconstructing orbital floor fractures involves restoration of orbital continuity by covering an onlay with a thin material under the periorbital region. However, in large orbital floor fractures, the implant after inserting is often dislocated, leading to malposition. This study aimed to propose a novel implanting method and compare it with existing methods. METHODS: Among patients who underwent surgery for large orbital floor fractures, 24 who underwent the conventional onlay implanting method were compared with 21 who underwent the novel γ implanting method that two implant sheets were stacked and bent to resemble the shape of the Greek alphabet γ. When inserting a γ-shaped implant, the posterior ledge of the orbital floor was placed between the two sheets and the bottom sheet was impacted onto the posterior wall of the maxilla to play a fixative role while the top sheet was placed above the residual orbital floor to support orbital contents. Wilcoxon signed-rank test and Mann-Whitney U test were used for data analyses. RESULTS: Compared to the conventional onlay method, the gamma method resulted in better restoration of orbital contents, better improvement of enophthalmos, and fewer revision surgeries. CONCLUSION: Achieving good surgical outcomes for extended orbital floor fractures is known to be difficult. However, better surgical outcomes could be obtained by using the novel implantation method of impacting a γ-shaped porous polyethylene posteriorly.
Enophthalmos ; Humans ; Inlays ; Maxilla ; Methods ; Orbit ; Orbital Fractures ; Orbital Implants ; Polyethylene ; Statistics as Topic

OBJECTIVES: This study was for analyzing the research about international marriage immigrant women and a trial to find the right direction for future research. METHODS: Sixty articles published from June, 2004 to June, 2009 were reviewed and analyzed according to the general characteristics, major of author, and theme of health domains. RESULTS: Most of them were master's thesis(71.7%) and journals(21.7%) and doctoral dissertation(6.7%) have been published mostly after thesis. Among 83.3% for quantitative research, descriptive(33.3%) and descriptive correlation(41.7%) methods were the most used and there were some qualitative researches(16.7%). The most frequently used data gathering method was questionnaire(81.7%) and the next was interview(16.7%). The major rates of the author were 61.7% for social welfare and 2.1% for nursing. The investigated variables in social health domain were adaptation(28.3%), and communication(1.7%). In psychological health domain, marriage satisfaction(16.7%), life satisfaction(11.7%), and depression(10.0%) were most researched. Utilization of medical center(5.0%) and health promotion behavior(1.7%) were investigated in physical health domain. CONCLUSIONS: Above this, most articles were researched about the adaptation of international marriage immigrant women. But the life in foreign countries can cause physical and psychosocial unhealthy conditions, so many-sided health related researches are supposed to be conducted for adaptation and prevention health problems of international marriage immigrant women.
Emigrants and Immigrants ; Female ; Health Promotion ; Humans ; Marriage ; Social Welfare

Fat-mass and obesity-associated protein (Fto) is highly expressed in the brain including, the hippocampus, and its expression is significantly decreased in the brain of Alzheimer’s disease patients. In the present study, we measured Fto immunoreactivity and protein levels in the hippocampus of obese and aged mice, which were induced by high-fat diet for 12 weeks and D-galactose treatment for 10 weeks, respectively. The obesity and aging phenotypes were assessed by physiological parameters and Morris water maze test, respectively. High fat diet fed mice showed significant increases in body weight and blood glucose levels compared to that in the control or D-galactose-induced aged mice. In addition, treatment with D-galactose significantly decreased the spatial memory. Fto immunoreactivity in the control group was mainly detected in the pyramidal cells of the CA1 and CA3 regions and in the granule cells of the dentate gyrus. In the hippocampus of high-fat diet-fed mice, Fto immunoreactive structures were similarly found in the hippocampus compared to that in the control group, but Fto immunoreactivity in high-fat diet-fed mice was also found in the stratum oriens and radiatum of the CA1 and CA3 regions and the polymorphic layer of the dentate gyrus. In the hippocampus of D-galactose-induced aged mice, fewer Fto immunoreactive structures were detected in the granule cell layer of the dentate gyrus compared to the control group. Fto mRNA and protein levels based on quantitative real-time polymerase chain reaction and western blot assays were slightly increased in the hippocampus of high-fat diet-fed mice compared to that in control mice. In addition, Fto mRNA and protein levels were significantly decreased in the aged hippocampus compared to that in the control group. Fto protein levels are susceptible to the aging process, but not in the hippocampus of high-fat diet-induced obesity. The reduction of Fto in aged mice may be associated with reduced memory impairment in mice.

Human immunodeficiency virus (HIV), when infected causes various systemic changes and is the cause of the fatal disease called acquired immune deficiency syndrome (AIDS). With the sharp increase of infection in women, pregnancy can be complicated by HIV infection. Although there have been astonishing developments in therapy there are still many risks in the pregnant HIV patients. The anesthetic management will depend on the patients clinical status, current treatment as well as the well-being of the fetus. We report a case of spinal anesthesia in a 36-year-old pregnant HIV patient undergoing cesarean section.
Acquired Immunodeficiency Syndrome ; Adult ; Anesthesia, Spinal ; Cesarean Section* ; Female ; Fetus ; HIV Infections ; HIV* ; Humans ; Pregnancy

Aluminum (Al) accumulation increases with aging, and long-term exposure to Al is regarded as a risk factor for Alzheimer's disease. In this study, we investigated the effects of Al and/or D-galactose on neural stem cells, proliferating cells, differentiating neuroblasts, and mature neurons in the hippocampal dentate gyrus. AlCl3 (40 mg/kg/day) was intraperitoneally administered to C57BL/6J mice for 4 weeks. In addition, vehicle (physiological saline) or D-galactose (100 mg/kg) was subcutaneously injected to these mice immediately after AlCl3 treatment. Neural stem cells, proliferating cells, differentiating neuroblasts, and mature neurons were detected using the relevant marker for each cell type, including nestin, Ki67, doublecortin, and NeuN, respectively, via immunohistochemistry. Subchronic (4 weeks) exposure to Al in mice reduced neural stem cells, proliferating cells, and differentiating neuroblasts without causing any changes to mature neurons. This Al-induced reduction effect was exacerbated in D-galactose-treated mice compared to vehicle-treated adult mice. Moreover, exposure to Al enhanced lipid peroxidation in the hippocampus and expression of antioxidants such as Cu, Zn- and Mn-superoxide dismutase in D-galactose-treated mice. These results suggest that Al accelerates the reduction of neural stem cells, proliferating cells, and differentiating neuroblasts in D-galactose-treated mice via oxidative stress, without inducing loss in mature neurons.
Adult ; Aging ; Aluminum* ; Alzheimer Disease ; Animals ; Antioxidants ; Dentate Gyrus* ; Galactose ; Hippocampus ; Humans ; Immunohistochemistry ; Lipid Peroxidation ; Mice* ; Nestin ; Neural Stem Cells* ; Neurons ; Oxidative Stress* ; Risk Factors ; Superoxide Dismutase

PURPOSE: The TWIK-related spinal cord K+ channel (TRESK) has recently been discovered and plays an important role in nociceptor excitability in the pain pathway. Because there have been no reports on the TRESK expression or its function in the dorsal horn of the spinal cord in neuropathic pain, we analyzed TRESK expression in the spinal dorsal horn in a spinal nerve ligation (SNL) model. MATERIALS AND METHODS: We established a SNL mouse model by using the L5-6 spinal nerves ligation. We used real-time polymerase chain reaction and immunohistochemistry to investigate TRESK expression in the dorsal horn and L5 dorsal rot ganglion (DRG). RESULTS: The SNL group showed significantly higher expression of TRESK in the ipsilateral dorsal horn under pain, but low expression in L5 DRG. Double immunofluorescence staining revealed that immunoreactivity of TRESK was mostly restricted in neuronal cells, and that synapse markers GAD67 and VGlut2 appeared to be associated with TRESK expression. We were unable to find a significant association between TRESK and calcineurin by double immunofluorescence. CONCLUSION: TRESK in spinal cord neurons may contribute to the development of neuropathic pain following injury.
Animals ; Disease Models, Animal ; Hyperalgesia ; Ligation ; Male ; Neuralgia/*metabolism/physiopathology ; Neurons/metabolism ; Nociceptors ; Pain/metabolism/*physiopathology ; Potassium Channels/*metabolism ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Spinal Cord Dorsal Horn/*metabolism ; Spinal Nerves/*injuries