OBJECTIVES: The concept of natural head position (NHP) was first introduced by Broca in 1862, and was described as a person's stable physiologic position “when a man is standing and his visual axis is horizontal.” NHP has been used routinely for clinical examination; however, a patient's head position is random during cone-beam computed tomography (CBCT) acquisition. To solve this problem, we developed an accelerometer to record patients' NHP and reproduce them for CBCT images. In this study, we also tested the accuracy and reproducibility of our accelerometer. MATERIALS AND METHODS: A total of 15 subjects participated in this study. We invented an accelerometer that measured acceleration on three axes and that could record roll and pitch calculations. Recorded roll and pitch data for each NHP were applied to a reoriented virtual image using three-dimensional (3D) imaging software. The data between the 3D models and the clinical photos were statistically analyzed side by side. Paired t-tests were used to statistically analyze the measurements. RESULTS: The average difference in the angles between the clinical photograph and the 3D model was 0.04° for roll and 0.29° for pitch. The paired ttests for the roll data (P=0.781) and the pitch data (P=0.169) showed no significant difference between the clinical photographs and the 3D model (P>0.05). CONCLUSION: By overcoming the limitations of previous NHP-recording techniques, our new method can accurately record patient NHP in a time-efficient manner. Our method can also accurately transfer the NHP to a 3D virtual model.
Acceleration ; Cone-Beam Computed Tomography ; Diagnostic Techniques, Surgical ; Head* ; Humans ; Imaging, Three-Dimensional ; Methods

BACKGROUND/AIMS: Despite improvements in surgical techniques and postoperative patient care, bile leakage can occur after hepatobiliary surgery and may lead to serious complications. The aim of this retrospective study was to evaluate the efficacy of endoscopic treatment of bile leakage after hepatobiliary surgery. METHODS: The medical records of 20 patients who underwent endoscopic retrograde cholangiopancreatography because of bile leakage after hepatobiliary surgery from August 2009 to September 2014 were reviewed retrospectively. Endoscopic treatment included insertion of an endoscopic retrograde biliary drainage stent after endoscopic sphincterotomy. RESULTS: Most cases of bile leakage presented as percutaneous bile drainage through a Jackson-Pratt bag (75%), followed by abdominal pain (20%). The sites of bile leaks were the cystic duct stump in 10 patients, intrahepatic ducts in five, liver beds in three, common hepatic duct in one, and common bile duct in one. Of the three cases of bile leakage combined with bile duct stricture, one patient had severe bile duct obstruction, and the others had mild strictures. Five cases of bile leakage also exhibited common bile duct stones. Concerning endoscopic modalities, endoscopic therapy for bile leakage was successful in 19 patients (95%). One patient experienced endoscopic failure because of an operation-induced bile duct deformity. One patient developed guidewire-induced microperforation during cannulation, which recovered with conservative treatment. One patient developed recurrent bile leakage, which required additional biliary stenting with sphincterotomy. CONCLUSIONS: The endoscopic approach should be considered a first-line modality for the diagnosis and treatment of bile leakage after hepatobiliary surgery.
Abdominal Pain ; Bile Ducts ; Bile* ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis ; Common Bile Duct ; Congenital Abnormalities ; Constriction, Pathologic ; Cystic Duct ; Diagnosis ; Drainage ; Hepatic Duct, Common ; Humans ; Liver ; Medical Records ; Patient Care ; Retrospective Studies ; Sphincterotomy, Endoscopic ; Stents

The rupture of an internal mammary artery (IMA) aneurysm in a patient with type 1 neurofibromatosis (NF-1) is a rare but life-threatening complication requiring emergency management. A 50-year-old man with NF-1 was transferred to the emergency department of Kyungpook National University Hospital, where an IMA aneurysmal rupture and hemothorax were diagnosed and drained. The IMA aneurysmal rupture and hemothorax were successfully repaired by staged management combining endovascular treatment and subsequent video-assisted thoracoscopic surgery (VATS). The patient required cardiopulmonary cerebral resuscitation, the staged management of coil embolization, and a subsequent VATS procedure. This staged approach may be an effective therapeutic strategy in cases of IMA aneurysmal rupture.
Aneurysm* ; Embolization, Therapeutic ; Emergencies ; Emergency Service, Hospital ; Endovascular Procedures ; Gyeongsangbuk-do ; Hemothorax ; Humans ; Mammary Arteries* ; Middle Aged ; Neurofibromatosis 1 ; Resuscitation ; Rupture ; Thoracic Surgery, Video-Assisted

Although cardiac myxoma is the most commonly encountered benign cardiac tumor in cardiac surgery practice, recurrent cardiac myxoma is very rare, is most commonly related to the Carney complex, and usually requires multiple cardiac operations with specific requirements in terms of perioperative management. In this report, we describe a patient who experienced the fourth recurrence of cardiac myxoma and review the diagnostic criteria of the Carney complex. This is the first report of such a case in Korea.
Carney Complex* ; Heart Neoplasms ; Humans ; Korea ; Myxoma* ; Recurrence* ; Thoracic Surgery

Seborrheic dermatitis is a chronic recurrent inflammatory disorder presumed to be caused by increased sebaceous gland secretion, metabolic changes in the cutaneous microflora, and changes in the host immune function. Stellate ganglion block (SGB) is known to increase the blood flow rate without altering the blood pressure, heart rate, or cardiac output, to stabilize hypertonic conditions of the sympathetic nerves, and to affect the endocrine and immune systems. It is used in the differential diagnosis and treatment of autonomic nervous system disorders of the head, neck, and upper limbs. The authors report the first case of successful treatment of a patient with seborrheic dermatitis through repeated SGB trials.
Autonomic Nervous System Diseases ; Blood Pressure ; Cardiac Output ; Dermatitis, Seborrheic* ; Diagnosis, Differential ; Head ; Heart Rate ; Humans ; Immune System ; Neck ; Nerve Block ; Sebaceous Glands ; Stellate Ganglion* ; Upper Extremity

p21-activated kinases (PAKs) are key regulators of actin dynamics, cell proliferation and cell survival. Deregulation of PAK activity contributes to the pathogenesis of various human diseases, including cancer and neurological disorders. Using an ELISA-based screening protocol, we identified naphtho(hydro)quinone-based small molecules that allosterically inhibit PAK activity. These molecules interfere with the interactions between the p21-binding domain (PBD) of PAK1 and Rho GTPases by binding to the PBD. Importantly, they inhibit the activity of full-length PAKs and are selective for PAK1 and PAK3 in vitro and in living cells. These compounds may potentially be useful for determining the details of the PAK signaling pathway and may also be used as lead molecules in the development of more selective and potent PAK inhibitors.
Actins ; Cell Proliferation ; Cell Survival ; Humans ; In Vitro Techniques ; Mass Screening ; Nervous System Diseases ; p21-Activated Kinases ; Phosphotransferases* ; rho GTP-Binding Proteins

p21-activated kinases (PAKs) are key regulators of actin dynamics, cell proliferation and cell survival. Deregulation of PAK activity contributes to the pathogenesis of various human diseases, including cancer and neurological disorders. Using an ELISA-based screening protocol, we identified naphtho(hydro)quinone-based small molecules that allosterically inhibit PAK activity. These molecules interfere with the interactions between the p21-binding domain (PBD) of PAK1 and Rho GTPases by binding to the PBD. Importantly, they inhibit the activity of full-length PAKs and are selective for PAK1 and PAK3 in vitro and in living cells. These compounds may potentially be useful for determining the details of the PAK signaling pathway and may also be used as lead molecules in the development of more selective and potent PAK inhibitors.
Actins ; Cell Proliferation ; Cell Survival ; Humans ; In Vitro Techniques ; Mass Screening ; Nervous System Diseases ; p21-Activated Kinases ; Phosphotransferases* ; rho GTP-Binding Proteins

Pachydermoperiostosis (PDP) is a primary hypertrophic osteoarthropathy characterized by digital clubbing, pachydermia, and periostosis, which is inherited as an autosomal dominant or recessive trait. We report on a patient suffering from bilateral knee arthritis for 6 years who was newly diagnosed as PDP. PDP was confirmed by bilateral digital clubbing, hyperhidrosis, and cutis verticis gyrata, findings of pachydermatosis on the forehead and scalp, X-ray findings of proliferative periostitis. This case indicates that PDP is one of several possible rare diseases that should be considered in patients with undifferentiated arthritis.
Arthritis* ; Forehead ; Humans ; Hyperhidrosis ; Knee ; Osteoarthropathy, Primary Hypertrophic* ; Periostitis ; Rare Diseases ; Scalp

BACKGROUND/OBJECTIVES: This study analyzed factors affecting consumption frequencies of vegetables and fruits in Korean adolescents. SUBJECTS/METHODS: Consumption frequencies of vegetables and fruits, general characteristics, meal, health, and other variables were analyzed for a total of 147,047 adolescents who participated in the KYRBWS (Korea Youth Risk Behavior Web-based Survey) conducted in 2006 and 2011 by the Korea Centers for Disease Control and Prevention. RESULTS: Consumption frequencies of vegetables and fruits more than once a day significantly decreased in 2011 compared to 2006 based on Chi-square test conducted for every factor employed in the study. Analysis of factors showed that consumption frequencies of vegetables and fruits were reduced in both study years as subjective income decreased, whereas intake frequencies increased with mother's education level and reduction of adolescent stress level. CONCLUSIONS: In general, consumption frequencies of vegetables and fruits decreased in 2011 compared to those in 2006. Thus, future research needs to improve dietary guidelines for nutrition education in order for students to recognize the importance of food consumption and necessity of increasing daily serving sizes of vegetables and fruits for their balanced consumption.
Adolescent* ; Centers for Disease Control and Prevention (U.S.) ; Chi-Square Distribution ; Education ; Fruit* ; Humans ; Korea ; Meals ; Nutrition Policy ; Risk-Taking* ; Serving Size ; Vegetables*

Gastrodia elata (GE) is traditionally used for treatment of various disorders including neurodegenerative diseases such as Alzheimer's disease. To investigate the neuroprotective effect of GE, amyloid-beta peptide (Abeta)-treated PC12 cells were cultured with GE aqueous extract. In vitro assay demonstrated that 50 microM of pre-aggregated Abeta was lethal to about a half portion of PC12 cells and that Abeta aggregate-induced cell death was significantly decreased with GE treatment at < or =10 mg/mL in a dose-dependent manner. To further examine in vivo cognitive-improving effects, an artificial amnesic animal model, scopolamine-injected Sprague-Dawley rats, were orally administered the extract for 6 weeks followed by behavioral tests (the passive avoidance test and Morris water maze test). The results showed that an acute treatment with scopolamine (1 mg/kg of body weight) effectively induced memory impairment in normal rats and that the learning and memory capability of scopolamine-treated rats improved after prolonged administration of GE extract (50, 250 and 500 mg/kg of body weight for 6 weeks). These findings suggest that a GE regimen may potentially ameliorate learning and memory deficits and/or cognitive impairments caused by neuronal cell death.
Administration, Oral* ; Alzheimer Disease ; Animals ; Body Weight ; Cell Death ; Gastrodia* ; Learning* ; Memory Disorders ; Memory* ; Models, Animal ; Neurodegenerative Diseases ; Neurons ; Neuroprotective Agents ; PC12 Cells ; Rats* ; Rats, Sprague-Dawley ; Scopolamine Hydrobromide