OBJECTIVES: Parkinson disease (PD) is frequently associated with olfactory disorder at early stage, which is caused by deposition of Lewy bodies emerging from the olfactory bulb to higher olfactory centers. Early detection of olfactory disorder in the patients with PD may lead to the early diagnosis and treatment for this refractory disease. METHODS: Visual analog scale (VAS), Jet Stream Olfactometry, and Japanese smell identification test, Open Essence (OE), were carried out on 39 patients with PD. Thirty-one patients with postviral olfactory disorder (PVOD), which was caused by the olfactory mucosal dysfunction, were also enrolled in this study as control. RESULTS: There were no significant differences in detection thresholds (2.2 vs. 1.4, P=0.13), recognition thresholds (3.9 vs. 3.5, P=0.39) and OE (4.8 vs. 4.2, P=0.47) between PVOD and PD, while VAS scores of PVOD and PD were significantly different (2.0 and 6.2, P<0.01). In OE, significant differences were observed in the accuracy rates of menthol (68% vs. 44%, P=0.04) and Indian ink (42% vs. 15%, P=0.01) between PVOD and PD. Of particular interest, patients with PVOD tended to select “no detectable,” while patients with PD tended to select wrong alternative other than “no smell detected.” CONCLUSION: Discrepancy between VAS and OE, and high selected rates of wrong alternative other than “undetectable” in OE might be significant signs of olfactory dysfunction associated with PD.
Asian Continental Ancestry Group ; Early Diagnosis ; Humans ; Ink ; Lewy Bodies ; Menthol ; Olfactometry ; Olfactory Bulb ; Parkinson Disease ; Rivers ; Smell ; Visual Analog Scale

PURPOSE: The purpose of this study was to compare the diagnostic yield of five systematic randomized protocols using 12–20 biopsy cores with variably-sized phantoms. METHODS: A total of 100 prostate phantom models were produced by casting liquid devil's tongue jelly using silicone molds. Sets of 20 phantoms were created with the following volumes: 20 mL, 40 mL, 60 mL, 80 mL, and 100 mL. Three focal lesions were created by injecting 0.5 mL of warm agar solution stained with red, blue, and green ink into each phantom model. The focal lesions were verified by ultrasonography. The systematic randomized biopsy protocols consisted of 12, 14, 16, 18, and 20 biopsy cores. The diagnostic yield of the multiple systematic biopsy protocols was compared. RESULTS: The overall detection rates of each model set were 93.3% for 20 mL, 88.3% for 40 mL, 71.7% for 60 mL, 43.3% for 80 mL, and 30.0% for 100 mL. Statistically significant differences in the detection rate were found between 40 mL and 60 mL and between 60 mL and 80 mL. No statistically significant increase in the detection rate was observed within a given volume set even when the number of core biopsies increased from 12 to 20. CONCLUSION: The diagnostic yield of systematic randomized biopsies is inversely proportional to the phantom volume.
Agar ; Amorphophallus ; Biopsy* ; Fungi ; Ink ; Prostate* ; Silicon ; Silicones ; Tongue* ; Ultrasonography

PURPOSE: To determine the MR parameters affecting India ink artifacts on opposed-phase chemical shift magnetic resonance (MR) imaging.MATERIALS AND METHODS: The use of a female Sprague-Dawley rat was approved by our Institutional Animal Care and Use Committee. Using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images, which is a modified Dixon method, axial opposed-phase images of the abdominal cavity were obtained with different MR parameters: series 1, different repetition times (TRs; 400, 2000, and 4000 ms); series 2, different echo times (TEs; 10, 50, and 100 ms); series 3, different field of views (FOVs; 6, 8, 16, and 24 cm); series 4, different echo train lengths (ETLs; 2, 4, and 8); series 5, different bandwidths (25, 50, and 85); and series 6, different slice thicknesses (1, 2, 4, 8, and 16 mm). Artifacts on opposed images obtained with different parameters were compared subjectively by two radiologists. For objective analysis, the thickness of the artifact was measured. Spearman's correlation between altered MR parameters and thicknesses of India ink artifact was obtained via objective analysis.RESULTS: India ink artifact was increasingly apparent using shorter TE, larger FOV and ETL, and thicker slices upon subjective analysis. The objective analysis revealed a strong negative correlation between the thickness of the artifact and TE (r = -0.870, P < 0.01); however, strong positive correlations were found between FOV (r = 0.854, P < 0.01) and slice thickness (r = 0.971, P < 0.01).CONCLUSION: India ink artifact was thicker with shorter TE, larger FOV, and larger slice thickness.
Abdominal Cavity ; Animals ; Artifacts ; Female ; Humans ; India ; Ink ; Methods ; Rats ; Rats, Sprague-Dawley ; Water

p-Nitrophenylphosphate (PNPP) is usually employed as the substrate for enzyme-linked immunosorbent assays. p-Nitrophenol (PNP), the product of PNPP, with the catalyst alkaline phosphatase (ALP), will passivate an electrode, which limits applications in electrochemical analysis. A novel anti-passivation ink used in the preparation of a graphene/ionic liquid/chitosan composited (rGO/IL/Chi) electrode is proposed to solve the problem. The anti-passivation electrode was fabricated by directly writing the graphene-ionic liquid-chitosan composite on a single-side conductive gold strip. A glassy carbon electrode, a screen-printed electrode, and a graphene-chitosan composite-modified screen-printed electrode were investigated for comparison. Scanning electron microscopy was used to characterize the surface structure of the four different electrodes and cyclic voltammetry was carried out to compare their performance. The results showed that the rGO/IL/Chi electrode had the best performance according to its low peak potential and large peak current. Amperometric responses of the different electrodes to PNP proved that only the rGO/IL/Chi electrode was capable of anti-passivation. The detection of cardiac troponin I was used as a test example for electrochemical immunoassay. Differential pulse voltammetry was performed to detect cardiac troponin I and obtain a calibration curve. The limit of detection was 0.05 ng/ml.
Electrochemical Techniques/methods* ; Electrodes ; Graphite ; Immunoassay/methods* ; Ink ; Microscopy, Electron, Scanning ; Troponin I/blood*

BACKGROUND: The tissue engineering and regenerative medicine approach require biomaterials which are biocompatible, easily reproducible in less time, biodegradable and should be able to generate complex three-dimensional (3D) structures to mimic the native tissue structures. Click chemistry offers the much-needed multifunctional hydrogel materials which are interesting biomaterials for the tissue engineering and bioprinting inks applications owing to their excellent ability to form hydrogels with printability instantly and to retain the live cells in their 3D network without losing the mechanical integrity even under swollen state. METHODS: In this review, we present the recent developments of in situ hydrogel in the field of click chemistry reported for the tissue engineering and 3D bioinks applications, by mainly covering the diverse types of click chemistry methods such as Diels–Alder reaction, strain-promoted azide-alkyne cycloaddition reactions, thiol-ene reactions, oxime reactions and other interrelated reactions, excluding enzyme-based reactions. RESULTS: The click chemistry-based hydrogels are formed spontaneously on mixing of reactive compounds and can encapsulate live cells with high viability for a long time. The recent works reported by combining the advantages of click chemistry and 3D bioprinting technology have shown to produce 3D tissue constructs with high resolution using biocompatible hydrogels as bioinks and in situ injectable forms. CONCLUSION: Interestingly, the emergence of click chemistry reactions in bioink synthesis for 3D bioprinting have shown the massive potential of these reaction methods in creating 3D tissue constructs. However, the limitations and challenges involved in the click chemistry reactions should be analyzed and bettered to be applied to tissue engineering and 3D bioinks. The future scope of these materials is promising, including their applications in in situ 3D bioprinting for tissue or organ regeneration.
Biocompatible Materials ; Bioprinting* ; Click Chemistry ; Cycloaddition Reaction ; Hydrogel* ; Hydrogels* ; Ink* ; Regeneration ; Regenerative Medicine ; Tissue Engineering*

PURPOSE: Intraoperative frozen-section analysis of the lumpect-omy margin during breast-conserving surgery (BCS) is an excellent method in obtaining a clear resection margin. This study aimed to investigate the usefulness of intraoperative circumferential frozen-section analysis (IOCFS) of lumpectomy margin during BCS for breast cancer, and to find factors that increase the conversion into mastectomy. METHODS: From 2007 to 2011, 509 patients with breast cancer underwent IOCFS during BCS. The outer surfaces of the shaved lumpectomy margins were evaluated. A negative margin was defined as no ink on the tumor. All margins were evaluated using the permanent section analysis. RESULTS: Among the 509 patients, 437 (85.9%) underwent BCS and 72 (14.1%) finally underwent mastectomy. Of the 483 pathologically confirmed patients, 338 (70.0%) were true-negative, 24 (5.0%) false-negative, 120 (24.8%) true-positive, and 1 (0.2%) false-positive. Twenty-four patients (4.7%) among total 509 patients had undetermined margins as either atypical ductal hyperplasia or ductal carcinoma in situ in the first IOCFS. The IOCFS has an accuracy of 94.8% with 83% sensitivity, 99.7% specificity, 93.4% negative predictive value, and 99.2% positive predictive value. Sixty-three cases (12.4%) were converted to mastectomy, the first intraoperatively. Of the 446 (87.6%) patients who successfully underwent BCS, 64 patients received additional excisions and 32 were reoperated to achieve clear margin (reoperation rate, 6.3%). Twenty-three of the reoperated patients underwent re-excisions using the second intraoperative frozen section analysis, and achieved BCS. Nine cases were additionally converted to mastectomy. No significant differences in age, stage, and biological factors were found between the BCS and mastectomy cases. Factors such as invasive lobular carcinoma, multiple tumors, large tumor, and multiple excisions increased the conversion to mastectomy. CONCLUSION: The IOCFS analysis during BCS is useful in evaluating lumpectomy margins and preventing reoperation.
Biological Factors ; Breast Neoplasms ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Frozen Sections ; Humans ; Hyperplasia ; Ink ; Mastectomy ; Mastectomy, Segmental* ; Methods ; Reoperation ; Sensitivity and Specificity

BACKGROUND/AIMS: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC. METHODS: Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip. RESULTS: All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding. CONCLUSIONS: In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.
Colon ; Fistula ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Humans ; India ; Ink ; Prospective Studies* ; Tattooing ; Treatment Outcome

BACKGROUND: Q-switched lasers have made it possible to remove tattoos without leaving unsightly scars. OBJECTIVE: Tobdetermine the optimal time for permanent makeup removal using Q-switched Nd:YAG and ruby lasers, we compared the degree of removal and associated histological changes following irradiation at different time points. METHODS: Using black ink and a permanent makeup machine, we performed 108 separate permanent makeup applications on rat skin. The 1,064-nm Q-switched Nd:YAG laser (QSNDL) and 694-nm Q-switched ruby laser (QSRL) were used to irradiate the permanent makeup on the day of its application and also 3, 5, 7, 14, and 21 days later. We assessed changes in pigmentation over time at each irradiated site using Mexameter® measurements and skin biopsies. RESULTS: The Mexameter® analysis demonstrated no significant differences in pigment removal among irradiations with QSNDL or QSRL on the day of permanent makeup application or at 3, 5, 7, 14, and 21 days later. Histological analysis demonstrated that permanent makeup pigment migrated from the epidermis to the superficial and mid dermis over time. QSNDL more effectively removed pigment throughout the epidermis and dermis compared to QSRL. CONCLUSION: For maximum pigment removal efficacy, the melanin index results suggest that laser treatment should be performed on the day permanent makeup is applied. However, from the histological perspective, permanent makeup should be removed approximately 1 week later, at which point the crusts have peeled off and the wound repair process is almost complete. In this study, histological analysis suggested the superiority of treatment with QSNDL to that with QSRL.
Animals ; Biopsy ; Cicatrix ; Dermis ; Epidermis ; Ink ; Lasers, Solid-State* ; Melanins ; Pigmentation ; Rats ; Skin* ; Wounds and Injuries

Two consecutive surveys for breast surgeons in Korea were conducted to comprehend the practice patterns and perceptions on margin status after breast-conserving surgery. The surveys were conducted online in 2014 (initial) and 2016 (follow-up). A total of 126 and 88 responses were obtained in the initial and follow-up survey, respectively. More than 80% of the respondents replied to routinely apply frozen section biopsy for intraoperative margin assessment in both surveys. Re-excision recommendations of the margin for invasive cancer significantly changed from a close margin to a positive margin over time (p=0.033). Most of the respondents (73.8%) defined a negative margin as “no ink on tumor” in invasive cancer, whereas more diverse responses were observed in ductal carcinoma in situ cases. The influence of guideline establishment for negative margins has been identified. A high uptake rate of intraoperative frozen section biopsy was noted and routine use needs reconsideration.
Biopsy ; Breast ; Carcinoma, Intraductal, Noninfiltrating ; Follow-Up Studies ; Frozen Sections ; Ink ; Korea ; Mastectomy, Segmental* ; Surgeons* ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: Flexible fiberscopy is essential in the examination of the nose to larynx airway. However, the instrument is sensitive to manipulation and can sometimes be damaged when excessive external force is applied. In addition, patients can be injured during fiberscopic examination. In this regard, a airway model mimicking the human airway passage was developed for the education of fiberscopy to minimize the danger to both patient and fiberscope. MATERIALS AND METHOD: Neck CT data was used to 3D-print the airway model. Using the 3D doctor software, the outlines of the air-filled cavities were extracted. The outline data was modified to make the inside of the outline empty and the outside filled with 3D ink resin. The airway data was used to 3D-print the replica in three pieces, which were then assembled into one. Flexible laryngoscopic examination of nose to larynx was performed using the nose-to-larynx airway model, and for a male patient enrolled in the study. Virtual endoscopy was performed using the same CT data. The examination data were then compared frame by frame with regards to the shapes and positions of nasal inlet, inferior turbinate, torus tubarius, hypopharynx, epiglottis and vocal cord. RESULTS: The airway model was very similar in shape and position of the anatomic landmarks compared with real human airway examined by the fiberscope. CONCLUSION: The results of 3D-printed airway model showed similar shapes as the real human airway, and real time endoscopy could be done using the model. This technique can be extended to make models of tubed organs such as the intestine or the bronchial tree.
Anatomic Landmarks ; Bays ; Education ; Endoscopy ; Epiglottis ; Humans ; Hypopharynx ; Ink ; Intestines ; Larynx ; Male ; Methods ; Neck ; Nose ; Printing, Three-Dimensional ; Trees ; Turbinates ; Vocal Cords