Background: Recently developed imaging techniques, such as cone beam computed tomography (CBCT) and CAD/CAM technology, have facilitated reliable implant planning and implant surgical guide production by 3D printing. This study compared the accuracy of implant-guided surgery using the R2GATE® program with CBCT before and after surgery. Patients and methods: The study included patients who visited the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital from September 2021 to March 2022. Twenty-four implants were placed in eleven patients. Using R2GATE® Windows (Megagen implant, Daegu, Korea) software, implant placement was planned. The difference was measured by the CBCT before and after surgery. The cervical and apical distance and angular deviation of the implants were measured. Statistical analysis was performed using an independent t-test, Pearson correlation, and multiple regression analyses. Results: The three-dimensional linear distance difference between the planned implant and the placed implant was 0.97 ± 0.37 mm at the cervical and 1.13 ± 0.36 mm at the apical. The difference in angle deviation between the planned implant and the placed implant was 3.42 ± 2.12°. Among the variables affecting the accuracy of implant placement, a statistically significant difference was found when using a tissue-supported implant guide, implant diameter and implant length. Conclusion Based on these results, using the R2GATE® program is useful to use an implant digital surgical guide, and it will be used in various clinic.

Background: Hand eczema refers to eczema located on the hands, regardless of its etiology or morphology. Despite its high prevalence and significant impact on patients’ quality of life, treatment is frequently challenging because of its heterogeneity, chronic and recurrent course, and lack of well-organized randomized controlled trials of the various treatment options. Objective: These consensus guidelines aim to provide evidence-based recommendations on the diagnosis and management of hand eczema to improve patient care by helping physicians make more efficient and transparent decisions. Methods: A modified Delphi method, comprising two rounds of email questionnaires with face-to-face meetings in between, was adopted for the consensus process that took place between February and September 2020. Forty experts in the field of skin allergy and contact dermatitis were invited to participate in the expert panel. Results: Consensus was reached for the domains of classification, diagnostic evaluation, and treatment; and a therapeutic ladder to manage chronic hand eczema was developed. Conclusion These are the first consensus guidelines for chronic hand eczema in the Asian population, which will help standardize care and assist clinical decision-making in the diagnosis and treatment of chronic hand eczema.

Objectives: . Facial nerve monitoring (FNM) can be used to identify the facial nerve, to obtain information regarding its course, and to evaluate its status during parotidectomy. However, there has been disagreement regarding the efficacy of FNM in reducing the incidence of facial nerve palsy during parotid surgery. Therefore, instead of using electromyography (EMG) to identify the location and state of the facial nerve, we applied an intraoperative neuromonitoring (IONM) system using a surface pressure sensor to detect facial muscle twitching. The objective of this study was to investigate the feasibility of using the IONM system with a surface pressure sensor to detect facial muscle twitching during parotidectomy. Methods: . We evaluated the stimulus thresholds for the detection of muscle twitching in the orbicularis oris and orbicularis oculi, as well as the amplitude and latency of EMG and the surface pressure sensor in 13 facial nerves of seven rabbits, using the same stimulus intensity. Results: . The surface pressure sensor detected muscle twitching in the orbicularis oris and orbicularis oculi in response to a stimulation of 0.1 mA in all 13 facial nerves. The stimulus threshold did not differ between the surface pressure sensor and EMG. Conclusion . The application of IONM using a surface pressure sensor during parotidectomy is noninvasive, reliable, and feasible. Therefore, the IONM system with a surface pressure sensor to measure facial muscle twitching may be an alternative to EMG for verifying the status of the facial nerve.

Background: The purpose of this study was to review the nationwide emergency care-related health policies during the coronavirus disease 2019 (COVID-19) pandemic disaster in Korea and to analyze the effects of the policies on the safety of patients who visit emergency departments (EDs) during this period. Methods: This study is a quasi-experiment study. The study population was patients who visited all 402 EDs in Korea between December 31, 2019 and May 13, 2020, using the National Emergency Department Information System (NEDIS) database. The study period was classified into 5 phases according to the level of national crisis warning of infectious disease and the implementation of emergency care-related health policies, and all study phases were 27 days. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay (LOS) in the ED during the COVID-19 outbreak. Results: The number of ED visits during the study period was 2,636,341, and the in-hospital mortality rate was 1.4%. The number of ED visits decreased from 803,160 in phase 1 to 496,619 in phase 5 during the study period. For in-hospital mortality, the adjusted odds ratio (OR) (95% confidence interval) was 0.77 (0.74–0.79) in phase 5 compared to phase 3. Additionally, by subgroup, the ORs were 0.69 (0.57–0.83) for the patients with acute myocardial infarction and 0.76 (0.67–0.87) for severe trauma in phase 5 compared to phase 3. The ED LOS increased while the number of ED visits decreased as the COVID-19 pandemic progressed, and the ED LOS declined after policy implementation (beta coefficient: −5.3 [−6.5 to −4.2] minutes in phase 5 compared to phase 3). Conclusion Implementing appropriate emergency care policies in the COVID-19 pandemic would have contributed to improving the safety of all emergency patients and reducing inhospital mortality by preventing excessive deaths.

Background: Osteomyelitis resulting from bacterial strains, such as methicillin-resistant Staphylococcus aureus (MRSA) that are resistant to multiple drugs, brings further clinical challenges. There is currently no model of osteomyelitis induced by MRSA using rats with calvaria defects. So, We induced osteomyelitis in rat models with the calvaria bone defect. Methods: The rats were randomly divided into six groups according to inoculation dose levels, which ranged from 6 × 100 to 6 × 105 CFU/5 µl. Bone tissues were retrieved from all rats used in the study and assessed using histology, microbiology, and radiobiology 4 weeks after surgery to evaluate the relationship between inoculation dose and infectivity. Results: In Histological results, high levels of inflammatory responses, bone necrosis, and bacteria were observed in treatment groups G3 to G5. In IHC staining, high levels of cox-2 expression were observed in treatment groups G3. Microbiological observations also indicated that significantly higher numbers of CFUs were found in G3 to G5. In radiography results, the bone mineral density in G3 to G5 was significantly higher than in the control group, G1, and G2. Our results indicate that an inoculating dose of 6 × 103 CFU/5 μl is sufficient to induce the development of osteomyelitis in rat models. Conclusion This study suggests that the minimum dose (6 × 103CFU/5 µl) can induce osteomyelitis in calvaria rat model. This can offer information and ability of more accurately modeling osteomyelitis and simulating the challenge of osteomyelitis treat.

Background: Hand eczema refers to eczema located on the hands, regardless of its etiology or morphology. Despite its high prevalence and significant impact on patients’ quality of life, treatment is frequently challenging because of its heterogeneity, chronic and recurrent course, and lack of well-organized randomized controlled trials of the various treatment options. Objective: These consensus guidelines aim to provide evidence-based recommendations on the diagnosis and management of hand eczema to improve patient care by helping physicians make more efficient and transparent decisions. Methods: A modified Delphi method, comprising two rounds of email questionnaires with face-to-face meetings in between, was adopted for the consensus process that took place between February and September 2020. Forty experts in the field of skin allergy and contact dermatitis were invited to participate in the expert panel. Results: Consensus was reached for the domains of classification, diagnostic evaluation, and treatment; and a therapeutic ladder to manage chronic hand eczema was developed. Conclusion These are the first consensus guidelines for chronic hand eczema in the Asian population, which will help standardize care and assist clinical decision-making in the diagnosis and treatment of chronic hand eczema.

Background: Osteomyelitis resulting from bacterial strains, such as methicillin-resistant Staphylococcus aureus (MRSA) that are resistant to multiple drugs, brings further clinical challenges. There is currently no model of osteomyelitis induced by MRSA using rats with calvaria defects. So, We induced osteomyelitis in rat models with the calvaria bone defect. Methods: The rats were randomly divided into six groups according to inoculation dose levels, which ranged from 6 × 100 to 6 × 105 CFU/5 µl. Bone tissues were retrieved from all rats used in the study and assessed using histology, microbiology, and radiobiology 4 weeks after surgery to evaluate the relationship between inoculation dose and infectivity. Results: In Histological results, high levels of inflammatory responses, bone necrosis, and bacteria were observed in treatment groups G3 to G5. In IHC staining, high levels of cox-2 expression were observed in treatment groups G3. Microbiological observations also indicated that significantly higher numbers of CFUs were found in G3 to G5. In radiography results, the bone mineral density in G3 to G5 was significantly higher than in the control group, G1, and G2. Our results indicate that an inoculating dose of 6 × 103 CFU/5 μl is sufficient to induce the development of osteomyelitis in rat models. Conclusion This study suggests that the minimum dose (6 × 103CFU/5 µl) can induce osteomyelitis in calvaria rat model. This can offer information and ability of more accurately modeling osteomyelitis and simulating the challenge of osteomyelitis treat.

Background: The purpose of this study was to review the nationwide emergency care-related health policies during the coronavirus disease 2019 (COVID-19) pandemic disaster in Korea and to analyze the effects of the policies on the safety of patients who visit emergency departments (EDs) during this period. Methods: This study is a quasi-experiment study. The study population was patients who visited all 402 EDs in Korea between December 31, 2019 and May 13, 2020, using the National Emergency Department Information System (NEDIS) database. The study period was classified into 5 phases according to the level of national crisis warning of infectious disease and the implementation of emergency care-related health policies, and all study phases were 27 days. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay (LOS) in the ED during the COVID-19 outbreak. Results: The number of ED visits during the study period was 2,636,341, and the in-hospital mortality rate was 1.4%. The number of ED visits decreased from 803,160 in phase 1 to 496,619 in phase 5 during the study period. For in-hospital mortality, the adjusted odds ratio (OR) (95% confidence interval) was 0.77 (0.74–0.79) in phase 5 compared to phase 3. Additionally, by subgroup, the ORs were 0.69 (0.57–0.83) for the patients with acute myocardial infarction and 0.76 (0.67–0.87) for severe trauma in phase 5 compared to phase 3. The ED LOS increased while the number of ED visits decreased as the COVID-19 pandemic progressed, and the ED LOS declined after policy implementation (beta coefficient: −5.3 [−6.5 to −4.2] minutes in phase 5 compared to phase 3). Conclusion Implementing appropriate emergency care policies in the COVID-19 pandemic would have contributed to improving the safety of all emergency patients and reducing inhospital mortality by preventing excessive deaths.

BACKGROUND/OBJECTIVES: Inflammatory Bowel Disease (IBD) has rapidly escalated in Asia (including Korea) due to increasing westernized diet patterns subsequent to industrialization. Factors associated with endoplasmic reticulum (ER) stress are demonstrated to be one of the major causes of IBD. This study was conducted to investigate the effect of Lycium barbarum (L. barbarum) on ER stress. MATERIALS/METHODS: Mouse embryonic fibroblast (MEF) cell line and polarized Caco-2 human intestinal epithelial cells were treated with crude extract of the L. chinense fruit (LF). Paracellular permeability was measured to examine the effect of tight junction (TJ) integrity. The regulatory pathways of ER stress were evaluated in MEF knockout (KO) cell lines by qPCR for interleukin (IL) 6, IL8 and XBP1 spliced form (XBP1s). Immunoglobulin binding protein (BiP), XBP1s and CCAAT/enhancer-binding homologous protein (CHOP) expressions were measured by RT-PCR. Scanning Ion Conductance Microscopy (SICM) at high resolution was applied to observe morphological changes after treatments. RESULTS: Exposure to LF extract strengthened the TJ, both in the presence and absence of inflammation. In polarized Caco-2 pretreated with LF, induction in the expression of proinflammatory marker IL8 was not significant, whereas ER stress marker XBP1s expression was significantly increased. In wild type (wt) MEF cells, IL6, CHOP and XBP1 spliced form were dose-dependently induced when exposed to 12.5–50 µg/mL extract. However, absence of XBP1 or IRE1α in MEF cells abolished this effect. CONCLUSION: Results of this study show that LF treatment enhances the barrier function and reduces inflammation and ER stress in an IRE1α-XBP1-dependent manner. These results suggest the preventive effect of LF on healthy intestine, and the possibility of reducing the degree of inflammatory symptoms in IBD patients.
Animals ; Asia ; Carrier Proteins ; Cell Line ; Diet ; Endoplasmic Reticulum ; Epithelial Cells ; Fibroblasts ; Fruit ; Humans ; Immunoglobulins ; Inflammation ; Inflammatory Bowel Diseases ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Intestines ; Lycium ; Mice ; Microscopy ; Permeability ; Tight Junctions

BACKGROUND: Vitamin is a well-known co-factor for many metabolic processes and its roles in fertility and follicular growth have been studied. Vitamin supplementation is frequently achieved by daily ingestion in the form of a complex capsule. However, the role of single and complex vitamins in in vitro maturation of murine follicles is not fully elucidated. METHODS: In this study, we evaluated the effects of two forms of vitamins. Pure L-ascorbic acid, and multi-vitamin (vitamin C+vitamin B complex) was treated at two different concentrations (50 and 100 µg/ml), to pre-puberty murine follicles during in vitro maturation. To determine the specific stage of growth that is affected by treatment with vitamins, the vitamins were treated from day 0, 4, 9, and 13. Growth of each follicle was assessed by measuring diameters of whole expanded area and of the granulosa cells. Expression of follicular and oocyte growth-related genes and the effect of vitamin on the viability of follicles was assessed using senescence associated β-galactosidase staining. RESULTS: Treatment with vitamins promoted the in vitro growth of murine follicles and the upregulated the expression of granulosa cell- and oocyte-specific genes such as BMP15, Fsh receptor, and GDF9. The proliferation of the granulosa cells was enhanced by the treatment of vitamin. Fifty µg/ml concentration vitamin showed greater effects compared to higher concentration. The viability of in vitro grown follicles was also significantly improved in vitamin-treated follicles. The effects of single L-ascorbic acid and complex vitamin were not significantly different to those of day 4 and day 9 follicles. Vitamins promoted murine follicle development in vitro with different effects on specific growth stage. CONCLUSION: Supplementation of vitamins during in vitro maturation of murine follicles is an efficient strategy for in vitro expansion of follicular cells. These results could be customized to the sophisticated culture of follicles retrieved from aged or cancer-survived female that contain smaller number of follicles with reduced potential to develop into mature follicles.
Aging ; Ascorbic Acid ; Eating ; Female ; Fertility ; Granulosa Cells ; Humans ; In Vitro Techniques ; Metabolism ; Oocytes ; Ovarian Follicle ; Receptors, FSH ; Vitamins