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Volumetric change of the latissimus dorsi muscle after postoperative chemotherapy and radiotherapy in immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap: final results from serial studies

  • Song, Kyeong Ho;Oh, Won Seok;Lee, Jae Woo;Kim, Min Wook;Jeong, Dae Kyun;Bae, Seong Hwan;Kim, Hyun Yul;Jung, Youn Joo;Choo, Ki Seok;Nam, Kyung Jin;Joo, Ji Hyeon;Yun, Mi Sook;Nam, Su Bong
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.607-613
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    • 2021
  • Background Breast reconstruction using an extended latissimus dorsi (eLD) flap can supplement more volume than reconstruction using various local flaps after partial mastectomy, and it is a valuable surgical method since the reconstruction area is not limited. However, when performing reconstruction, the surgeon should consider latissimus dorsi (LD) volume reduction due to postoperative chemotherapy (POCTx) and postoperative radiotherapy (PORTx). To evaluate the effect of POCTx and PORTx on LD volume reduction, the effects of each therapy-both separately and jointly-need to be demonstrated. The present study quantified LD volume reduction in patients who underwent POCTx and PORTx after receiving breast-conserving surgery (BCS) with an eLD flap. Methods This study included 48 patients who received immediate breast reconstruction using an eLD flap from January 2013 to March 2017, had chest computed tomography (CT) 7-10 days after surgery and 10-14 months after radiotherapy completion, and were observed for more than 3 years postoperatively. One surgeon performed the breast reconstruction procedures, and measurements of breast volume were obtained from axial CT views, using a picture archiving and communication system. A P-value <0.05 was the threshold for statistical significance. Results The average volume reduction of LD at 10-14 months after completing POCTx and PORTx was 64.5% (range, 42.8%-81.4%) in comparison to the volume measured 7-10 days after surgery. This change was statistically significant (P<0.05). Conclusions Based on the findings of this study, when harvesting an eLD flap, surgeons should anticipate an average LD volume reduction of 64.5% if chemotherapy and radiotherapy are scheduled after BCS with an eLD flap.

Analysis of dental hygiene assessment data of recall patients (mainly 20s age)

  • Choi, Hye-Jung;Woo, Hee-Sun
    • Journal of the Korea Society of Computer and Information
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    • v.27 no.6
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    • pp.131-137
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    • 2022
  • As the age increases, the oral cavity, that is, the teeth and periodontium, also begin to age, and accordingly, a preparation process is required. The preparation process is an important period for oral health management to start continuously with oral health education consisting of knowledge, attitude, and behavior from the 20s. Therefore, to design a clinical dental hygiene course for patients who visited a dental clinic in Gyeonggi-do and received continuous care in an oral health care room after treatment, we tried to analyze the data of the dental hygiene assessment. As a dental hygiene assessment tool, based on personal information and general medical history, dental visit experience, bleeding on probing(BOP), bad breath measurement, phase contrast microscopy, and O'Leary index were performed. The number of subjects who had dental visits was 75.4% and those without experience were 24.6%, and as a result of the periodontal examination, generally bleeding was found in 76.3%. In preventive oral care, the stage of dental hygiene assessment in the 20s is an important first step. From this point on, it is an important time to be systematically habituated so that you can take responsibility for your own oral condition. Therefore, in this study, the results of dental hygiene assessment through oral examinations of subjects in their 20s are derived and presented as basic data for the development of dental hygiene performance competency of dental hygienists during the clinical dental hygiene process in oral health education and oral health management.

A Systematic Review of the Effects of Visual Perception Interventions for Children With Cerebral Palsy (뇌성마비 아동에게 시지각 중재가 미치는 효과에 대한 체계적 고찰)

  • Ha, Yae-Na;Chae, Song-Eun;Jeong, Mi-Yeon;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.12 no.2
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    • pp.55-68
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    • 2023
  • Objective : This study aims to analyze the effects of visual perception intervention by systematically reviewing the studies that applied visual perception intervention to children with cerebral palsy. Methods : The databases used were PubMed, EMbase, Science Direct, ProQuest, Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), and the National Assembly Library. The keywords used were cerebral palsy, CP, and visual perception. According to the PRISMA flowchart, 10 studies were selected from among studies published from January 1, 2012 to March 30, 2022. The quality level of the selected studies, the demographic characteristics of study participants, the effectiveness of interventions, area and strategies of intervention, assessment tools to measure the effectiveness of interventions, and risk of bias were analyzed. Results : All selected studies confirmed that visual perception intervention was effective in improving visual perception function. In addition, positive results were shown in upper extremity function, activities of daily living, posture control, goal achievement, and psychosocial areas as well as visual perception function. The eye-hand coordination area was intervened in all studies. Conclusion : In visual perception intervention, It is necessary to evaluate the visual perception function by area, and apply systematically graded customized interventions for each individual.

Antiviral and Therapeutic Effects of Extracts (PB-81) of Daphne Genkwa (Siebold & Zucc.) on Bovine Rotavirus (원화추출물(PB-81)의 소 로타바이러스 설사병에 대한 항바이러스 및 치료효과)

  • Mi Young Lee;Yeon Seong Kim;Jae Myung Park;Jae Chan Song
    • Journal of Life Science
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    • v.34 no.6
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    • pp.408-417
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    • 2024
  • It was confirmed whether PB-81, a 50% ethanol extract of Daphne genkwa (Siebold & Zucc), had an inhibitory effect on virus proliferation in bovine rotavirus and a therapeutic effect on bovine diarrhea disease. The results showed that PB-81 induced the interferon beta in A549 cells, an epithelial cell line and interferon gamma in NK92 cells, a blood cell line. Furthermore, to confirm the viral proliferation inhibitory effect of PB-81, PB-81 was administered to MBDK cell line before, during, and after infection. Result shows that the virus was suppressed in all cases where PB-81 was administered, and the best virus suppression effect was achieved when PB-81 was administered before virus infection. In the toxicity test in mice, no side effects due to toxicity were observed, even at a maximum dose of 20 mg/mL. To verify the therapeutic effect on 16 cattle with bovine rotavirus diarrhea and 4 cattle in the control group, PB-81 was administered at a dose of 20 mg/5 mL, and No fatality was observed during the treatment. The average recovery duration from the initial administration of PB-81 was 2.25 days in the PB-81 administration group and 6.5 days in the control group without PB-81 administration. No side effects were observed from the tested cattle with rotavirus diarrhea.

A Study on Skin - From the Perspective of Analytical Psychology - (피부 - 분석심리학적 조명 -)

  • Young Sun Pahk
    • Sim-seong Yeon-gu
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    • v.29 no.2
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    • pp.127-156
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    • 2014
  • This thesis is an psychological study investigating the meanings of skin from the perspective of analytical psychology. Skin, as the outermost layer of our body, protects the body and carries out essential physiologic functions. It is an organ of the body and also psychological contents can be expressed on it in various forms. We can find sociocultural connotations of skin, some of which are demonstrated in our language. Skin may become a carrier of persona which defines a person's role in the society. And it can be a place where ego is expressed. Eros is the principle of relationship by Jung's definition and skin is the space where eros is realized intensely. Skin may carry meanings as a symbol of transformation. Skin disease can be interpreted as a message from Self in certain cases. The theme of casting off skin in myths and dreams can be an analogy of an individual's sacrifice for individuation, and putting on a skin may imply taking special properties in psychological level.

Antibody response to COVID-19 vaccination in patients on chronic hemodialysis

  • Heejung Choi;Sungdam Han;Ji Su Kim;Bumhee Park;Min-Jeong Lee;Gyu-Tae Shin;Heungsoo Kim;Kyongmin Kim;A-Young Park;Ho-Joon Shin;Inwhee Park
    • Clinical and Experimental Vaccine Research
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    • v.12 no.3
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    • pp.249-259
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    • 2023
  • Purpose: Since patients on hemodialysis (HD) are known to be vulnerable to coronavirus disease 2019 (COVID-19), many studies were conducted regarding the effectiveness of the COVID-19 vaccine in HD patients in Western countries. Here, we assessed antibody response of HD patients for 6 months post-vaccination to identify the duration and effectiveness of the COVID-19 vaccine in the Asian population. Materials and Methods: We compared antibody response of the COVID-19 vaccine in HD patients with healthy volunteers. Patient and control groups had two doses of ChAdOx1 nCoV-19 and mRNA-1273, respectively. Immunoglobulin G (IgG) was measured before vaccination, 2 weeks after the first dose, 2 and 4 weeks, 3 and 6 months after the second dose. Neutralizing antibody was measured before vaccination and at 2 weeks, 3 and 6 months after second dose. Since the third dose was started in the middle of the study, we analyzed the effect of the third dose as well. Results: Although antibody production was weaker than the control group (n=22), the patient group (n=39) showed an increase in IgG and neutralizing antibody after two doses. And, 21/39 patients and 14/22 participants had a third dose (BNT162b2 or mRNA-1273 in the patient group, mRNA-1273 in the control group), and it did not affect antibody response in both group. Trend analysis showed IgG and neutralizing antibody did not decrease over time. Age, sex, and HD vintage did not affect antibody production in HD patients. Patients with higher body mass index displayed better seroresponse, while those on immunosuppressants showed poor seroresponse. Conclusion: Two doses of vaccination led to significant antibody response in HD patients, and the antibody did not wane until 6 months.

Association between hearing loss and high-sensitivity C-reactive protein: the Kangbuk Samsung Cohort Study

  • Jihoon Kim;Yesung Lee;Eunhye Seo;Daehoon Kim;Jaehong Lee;Youshik Jeong;Seonghyun Kwon;Jinsook Jeong;Woncheol Lee
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.38.1-38.10
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    • 2023
  • Background: Hearing loss (HL) is linked to an elevated risk of cardiovascular diseases (CVDs). The pathogeneses of HL and CVD commonly involve inflammatory responses. Previous studies investigated elevated levels of inflammatory biomarkers in subjects with HL, however, their findings did not demonstrate statistical significance. In our cross-sectional and longitudinal study, we investigated the correlation between HL and increased high-sensitivity C-reactive protein (hsCRP) levels to determine how HL is associated with CVDs. Methods: We conducted a cross-sectional study with workers aged over 18 years who underwent health check-ups at our institution between 2012 and 2018 (n = 566,507), followed by conducting a longitudinal study of workers aged > 18 who underwent health checkups at least twice at our institution between 2012 and 2018 (n = 173,794). The definition of HL was as an average threshold of ≥ 20 dB in pure-tone air conduction at 0.5, 1.0, and 2.0 kHz in both ears. The incidence of increased hsCRP levels throughout the follow-up period was defined as a level exceeding 3 mg/L. Logistic regression and generalized estimating equations were performed to estimate the risk of increased hsCRP levels according to the occurrence of HL in groups stratified by age. Results: In the cross-sectional study, the multivariate-adjusted odds ratio (OR) was 1.17 (95% confidence interval [CI]: 1.02-1.34); the OR was 0.99 (95% CI: 0.80-1.22) in those under 40 and 1.28 (1.08-1.53) in those over 40. In the longitudinal study, the multivariable-adjusted OR was 1.05 (95% CI: 0.92-1.19); the OR was 1.10 (95% CI: 0.90-1.35) in those under 40 and 1.20 (1.01-1.43) in those over 40. Conclusions: This cross-sectional and longitudinal study identified an association between HL and increased hsCRP levels in workers aged over 40 years.

Association between shift work and the risk of hypothyroidism in adult male workers in Korea: a cohort study

  • Seonghyeon Kwon;Yesung Lee;Eunhye Seo;Daehoon Kim;Jaehong Lee;Youshik Jeong;Jihoon Kim;Jinsook Jeong;Woncheol Lee
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.41.1-41.11
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    • 2023
  • Background: Shift work has been reported to have several harmful effects on the human body. However, a small number of studies have evaluated the association between shift work and adverse effects on the thyroid. In our longitudinal study, we examined the causal association between shift work and the risk of hypothyroidism. Methods: A Kangbuk Samsung Cohort Study was conducted on 112,648 men without thyroid disease at baseline who were followed up at least once between 2012 and 2019. Shift work status and shift schedule types were categorized using standardized questionnaires. Hypothyroidism was defined using the reference ranges of serum thyroid-stimulating hormones and free thyroxine levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypothyroidism were estimated using Cox proportional hazards regression analyses with the daytime work group as the reference. Results: During the 501,237 person-years of follow-up, there were 6,306 incident cases of hypothyroidism (incidence density, 1.26 per 100 person-years). The multivariable-adjusted HR of incident hypothyroidism for the shift work total group that included all shifts compared with the daytime work group was 1.27 (95% CI: 1.15-1.40). For the fixed evening, fixed night, rotating shift, and other shift workers, the multivariable-adjusted HRs (95% CI) were 1.11 (0.76-1.61), 2.18 (1.20-3.93), 1.39 (1.23-1.56), and 1.00 (0.82-1.22), respectively. In subgroup analyses by age, the association between shift work and hypothyroidism was more pronounced in younger participants (< 40 years; HR: 1.31; 95% CI: 1.16-1.47). Conclusions: Our large-scale cohort study showed an association between shift work and the incidence of hypothyroidism, especially in younger workers with night shifts.

Cardiac Phenotyping of SARS-CoV-2 in British Columbia: A Prospective Echo Study With Strain Imaging

  • Jeffrey Yim;Michael Y.C. Tsang;Anand Venkataraman;Shane Balthazaar;Ken Gin;John Jue;Parvathy Nair;Christina Luong;Darwin F. Yeung;Robb Moss;Sean A Virani;Jane McKay;Margot Williams;Eric C. Sayre;Purang Abolmaesumi;Teresa S.M. Tsang
    • Journal of Cardiovascular Imaging
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    • v.31 no.3
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    • pp.125-132
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    • 2023
  • BACKGROUND: There is limited data on the residual echocardiographic findings including strain analysis among post-coronavirus disease (COVID) patients. The aim of our study is to prospectively phenotype post-COVID patients. METHODS: All patients discharged following acute COVID infection were systematically followed in the post-COVID-19 Recovery Clinic at Vancouver General Hospital and St. Paul's Hospital. At 4-18 weeks post diagnosis, patients underwent comprehensive echocardiographic assessment. Left ventricular ejection fraction (LVEF) was assessed by 3D, 2D Biplane Simpson's, or visual estimate. LV global longitudinal strain (GLS) was measured using a vendor-independent 2D speckle-tracking software (TomTec). RESULTS: A total of 127 patients (53% female, mean age 58 years) were included in our analyses. At baseline, cardiac conditions were present in 58% of the patients (15% coronary artery disease, 4% heart failure, 44% hypertension, 10% atrial fibrillation) while the remainder were free of cardiac conditions. COVID-19 serious complications were present in 79% of the patients (76% pneumonia, 37% intensive care unit admission, 21% intubation, 1% myocarditis). Normal LVEF was seen in 96% of the cohort and 97% had normal right ventricular systolic function. A high proportion (53%) had abnormal LV GLS defined as < 18%. Average LV GLS of septal and inferior segments were lower compared to that of other segments. Among patients without pre-existing cardiac conditions, LVEF was abnormal in only 1.9%, but LV GLS was abnormal in 46% of the patients. CONCLUSIONS: Most post-COVID patients had normal LVEF at 4-18 weeks post diagnosis, but over half had abnormal LV GLS.

Relationship Between Amyloid Positivity and Sleep Characteristics in the Elderly With Subjective Cognitive Decline

  • Kyung Joon Jo;SeongHee Ho;Yun Jeong Hong;Jee Hyang Jeong;SangYun Kim;Min Jeong Wang;Seong Hye Choi;SeungHyun Han;Dong Won Yang;Kee Hyung Park
    • Dementia and Neurocognitive Disorders
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    • v.23 no.1
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    • pp.22-29
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    • 2024
  • Background and Purpose: Alzheimer's disease (AD) is a neurodegenerative disease characterized by a progressive decline in cognition and performance of daily activities. Recent studies have attempted to establish the relationship between AD and sleep. It is believed that patients with AD pathology show altered sleep characteristics years before clinical symptoms appear. This study evaluated the differences in sleep characteristics between cognitively asymptomatic patients with and without some amyloid burden. Methods: Sleep characteristics of 76 subjects aged 60 years or older who were diagnosed with subjective cognitive decline (SCD) but not mild cognitive impairment (MCI) or AD were measured using Fitbit® Alta HR, a wristwatch-shaped wearable device. Amyloid deposition was evaluated using brain amyloid plaque load (BAPL) and global standardized uptake value ratio (SUVR) from fluorine-18 florbetaben positron emission tomography. Each component of measured sleep characteristics was analyzed for statistically significant differences between the amyloid-positive group and the amyloid-negative group. Results: Of the 76 subjects included in this study, 49 (64.5%) were female. The average age of the subjects was 70.72±6.09 years when the study started. 15 subjects were classified as amyloid-positive based on BAPL. The average global SUVR was 1.598±0.263 in the amyloid-positive group and 1.187±0.100 in the amyloid-negative group. Time spent in slow-wave sleep (SWS) was significantly lower in the amyloid-positive group (39.4±13.1 minutes) than in the amyloid-negative group (49.5±13.1 minutes) (p=0.009). Conclusions: This study showed that SWS is different between the elderly SCD population with and without amyloid positivity. How SWS affects AD pathology requires further research.