After the augmentation rhinoplasty, the unnatural nasal contour is commonly happened in the patient who had premaxillary and perialar depression. In this study, the authors would like to introduce an interesting outcome that the unnatural nasal contour such as alar drooping and a spindle-shaped nostril was significantly improved by hyaluronic acid filler injection into the perialar and nasolabial fold regions in the case of perialar depression with premaxillary protrusion. The hyaluronic acid filler was injected into the perialar region first and then injected into nasolabial folds region using a 22-gauged blunt cannula through the entry site located at the central perialar region. Approximately 70% of the total filler volume (about 9.5 ml) was placed on the nasal process of the maxillary bone(attached) or in the deep fat layer (injected), while 20%–30% of the filler volume was injected into the superficial fat layer. No fatplaced under the dermal layer at the perialar region, and 10% volume was injected under the dermis at the central crease of the folds.The patient’s satisfaction was a great. The improved droopy alar, and the change of the nostril from the spindle shaped to the triangular shaped were observed. The morphological changes were corresponded to the change of measurements as follow that the angle of nostril axis and the columellar height were decreased, on the other hand, interaxial angle and the alar base width were increased. From the above result, the filler injection can be used as a reliable and non-invasive technique for the correction of alar drooping with a spindle-shaped nostril by augmentation of the perialar depression.

OBJECTIVE: The present study investigated the clinical characteristics of Alzheimer's disease (AD) dementia with low brain amyloid-beta (Aβ-AD) burden comparing with AD dementia with high amyloid-beta burden (Aβ+AD). We also developed a prediction model for the amyloid positivity on ¹¹C-labelled Pittsburgh Compound B (PiB) positron emission tomography (PET) with distinct clinical variables in AD dementia patients. METHODS: Fifty-nine clinically defined AD dementia individuals, who participated in the Korean Brain Aging Study for Early diagnosis and prediction of AD (KBASE) study, were included. All the subjects received comprehensive clinical evaluations and PiB-PET. Based on cerebral PiB retention, all subjects were divided into Aβ+AD (n=47) and Aβ-AD (n=12) subgroups. To develop a prediction model for amyloid positivity, stepwise multiple logistic regression analysis was conducted. RESULTS: When compared to Aβ+AD, Aβ-AD showed older age, later age-at-onset, and lower education. In regard of risk factors for dementia, Aβ-AD had higher frequency of hypertension and diabetes mellitus as well as lower frequency of apolipoprotein E (APOE) ε4 allele. Although there was no between group difference in Clinical Dementia Rating (CDR) or CDR sum-of-boxes scores, mini-mental state examination and constructional recall scores were higher for Aβ-AD than Aβ+AD. The final amyloid positivity prediction model included APOE4 genotype, hypertension, and diabetes mellitus. CONCLUSION: The findings from this study indicated that clinically diagnosed AD dementia may have high possibility of not being pathological AD if they have older age and higher vascular risks, and did not have APOE4 genotype.
Age of Onset ; Aging ; Alleles ; Alzheimer Disease* ; Amyloid* ; Apolipoprotein E4 ; Apolipoproteins ; Brain ; Dementia* ; Diabetes Mellitus ; Early Diagnosis ; Education ; Genotype ; Humans ; Hypertension ; Logistic Models ; Positron-Emission Tomography ; Risk Factors