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Background: Although experimental results showed that epicutaneous exposure of urban ambient air pollution induces skin inflammation, its clinical relevance in the real-world setting has not been thoroughly examined yet. Objectives: This study investigated the short-term effect of ambient air pollution on the risk of hospital outpatient visits for eczematous skin disorders in seven metropolitan cities of South Korea. Methods: We conducted a time-stratified case-crossover study. Hourly mean concentrations of air pollutants(PM10, PM2.5, SO2, NO2) and meteorological data were obtained from the Ministry of Environment. The percent increase in the risk of outpatient visits associated with an interquartile range increase in particulate matters was determined by conditional logistic regression analysis after adjusting for national holidays and meteorological factors. Results: Among the types of air pollutants, both PM10 and SO2 were most significantly associated with an increased risk of outpatient visits for eczematous dermatitis. The effect of air pollutants on the outpatient visits was largely confined between lag 0 to 4. Cumulative lag analysis showed a gradual increase in outpatient visits by PM10 and SO2. Sensitivity analysis demonstrated significantly increased cumulative risks for atopic dermatitis, allergic contact dermatitis, and irritant dermatitis during lag 0-4. Conclusion: Our results suggest that ambient air pollution increases the risk of outpatient visits for eczematous skin diseases

During August 2020, we carried out a serological survey among students and employees at the Okinawa Institute of Science and Technology Graduate University (OIST), Japan, testing for the presence of antibodies against SARS-CoV-2, the causative agent of COVID-19. We used a FDA-authorized 2-step ELISA protocol (1, 2) in combination with at-home self-collection of blood samples using a custom low-cost finger prick-based capillary blood collection kit. Although our survey did not find any COVID-19 seropositive individuals among the OIST cohort, it reliably detected all positive control samples obtained from a local hospital and excluded all negatives controls. We found that high serum antibody titers can persist for at least up to 6.5 months post infection. Among our controls, we found strong cross-reactivity of antibodies in samples from a serum pool from two MERS patients in the anti-SARS-CoV-2-S ELISA. Here we show that a centralized ELISA in combination with patient-based capillary blood collection using as little as one drop of blood can reliably assess the seroprevalence among communities. Anonymous sample tracking and an integrated website created a stream-lined procedure. Major parts of the workflow were automated on a liquid handler, demonstrating scalability. We anticipate this concept to serve as a prototype for reliable serological testing among larger populations.

We used axial loading computed tomography (AL CT) to evaluate preoperative and postoperative talocrural joints of patients who underwent supramalleolar osteotomy (SMO) to treat varus ankle osteoarthritis.We performed retrospective analyses of 16 patients (18 feet) who underwent SMO including fibular osteotomy. Radiographic assessment was performed with weightbearing radiographs and AL CT. Clinical outcomes were assessed based on American Orthopedic FootAnkle Society (AOFAS) scale, visual analog scale (VAS) for pain, and Foot and Ankle Ability Measure (FAAM).The mean 2-year follow-up tibial-ankle surface angle, talar tilt angle, Takakura stage, and tibial-lateral surface angle were all significantly different relative to preoperative parameters (P.05). The mean 6-month follow-up talus rotation ratio was significantly corrected compared to the preoperative value (P=.001). The mean 2-year follow-up AOFAS, VAS at gait, and FAAM scores were all significantly improved relative to preoperative measurements (P=.001).Abnormal internal rotation of the talus in mild to moderate varus ankle osteoarthritis found on AL CT was significantly corrected after SMO.Therapeutic Level IV.

Backgroud Although the scallop sign is considered the most important risk factor for extensor tendon ruptures (ETRs) in patients with osteoarthritis of the distal radioulnar joint (DRUJ), previous reports provide a limited understanding of the changes at DRUJ, as risk factors were examined in plain radiographs of the wrist. The aim of this study was to assess the changes of DRUJ using axial images of computed tomography (CT) in patients with DRUJ osteoarthritis and associated ETRs and to evaluate the relationship between the changes of DRUJ and ETRs. Methods Twelve patients with ETRs due to osteoarthritis of the DRUJ were enrolled. The changes of DRUJ were examined on axial images of CT and the following 8 parameters were measured: width of radius, anteroposterior (AP) length of radius, width of sigmoid notch (SN), AP length of SN, AP length of ulnar head, subluxation length of ulnar head, dorsal inclination of SN, and distance from Lister's tubercle to SN. Radiological parameters of the DRUJ were measured in 60 control wrists without trauma or osteoarthritis, and the patient and control groups were statistically compared. Results Statistically significant differences were observed between the patient and control groups in all the radiological parameters except for the AP length of SN and AP length of ulnar head. The width of radius, AP length of radius, width of SN, subluxation length of ulnar head, and dorsal inclination of SN were greater and the distance from Lister's tubercle to SN was smaller in the patient group than in the control group. The width of SN, dorsal inclination of SN, and distance from Lister's tubercle to SN were statistically significant risk factors among the 8 parameters. Conclusions ETRs due to osteoarthritis of the DRUJ was related to the changes of DRUJ, especially the changes around SN of the distal radius. In addition to the existing risk factors, a decreased distance from Lister's tubercle to SN and increased dorsal inclination of SN were identified as new risk factors. Axial images of CT were effective to evaluate degenerative changes at the DRUJ.

1. Mineral excretion is an issue in the poultry industry. The use of micro minerals in nano form can increase bioavailability and decrease excretion rate. However, information concerning the bioavailability of nano manganese (Mn) in broiler chicks is limited.2. This experiment studied the influences of hot-melt extrusion (HME)-processed manganese sulphate on body weight gain, Mn bioavailability, nutrient digestibility and meat quality in broiler chicks fed a corn-soybean meal-based diet as a starter and grower phase. A total of 700 birds (Ross 308, 1-day-old) were randomly placed in 35 cages (20 birds per cage). The broiler chicks were fed one of seven experimental diets, which consisted of a control (without supplemental Mn), different levels of MnSO4 (IN-Mn60; 60, 120, and 200 mg/kg), or HME MnSO4 (HME-Mn; 60, 120, and 200 mg/kg).3. There was an increased serum Mn content in broilers fed diet supplemented with HME-Mn. In the grower phase, increased dietary Mn levels elevated the concentrations in the serum, liver, and tibia. There were increases in the excreta Mn content of broilers fed increasing levels. The supplementation of HME-Mn showed a lower percentage of abdominal fat compared with the IN-Mn treatment diets. Supplementation with HME-Mn decreased intramuscular fat compared with the diets supplemented with IN-Mn. The supplementation of HME-Mn decreased the thiobarbituric acid reactive substances (TBARS) at d 6 of age. The HME-Mn source showed a greater decrease in TBARS compared with the IN-Mn treatment.4. In conclusion, HME processing increased bioavailability and could be used as an environmentally friendly method to facilitate lower levels of Mn in the diet of broiler chickens.

Cellular senescence and aging result in a reduced ability to manage persistent types of inflammation. Thus, the chronic low-level inflammation associated with aging phenotype is called “inflammaging”. Inflammaging is not only related with age-associated chronic systemic diseases such as cardiovascular disease and diabetes, but also skin aging. As the largest organ of the body, skin is continuously exposed to external stressors such as UV radiation, air particulate matter, and human microbiome. In this review article, we present mechanisms for accumulation of senescence cells in different compartments of the skin based on cell types, and their association with skin resident immune cells to describe changes in cutaneous immunity during the aging process.

The 52-week results from the CLEAR (NCT02074982) study showed high and superior efficacy of secukinumab versus ustekinumab in clearing skin and improving patient-reported outcomes, with comparable safety profile in subjects with moderate to severe psoriasis. Here, we analyzed the efficacy and safety of secukinumab in Asian subjects from the CLEAR study. In this double-blind, phase IIIb study, eligible subjects with moderate to severe plaque psoriasis were randomized (1:1) to receive s.c. injection of secukinumab 300 mg or ustekinumab as per label. Of 62 subjects included in Asian subanalyses, 23 were randomized to secukinumab and 39 to ustekinumab. A significantly higher proportion of subjects achieved 90% or more improvement in Psoriasis Area and Severity Index (PASI 90) with secukinumab versus ustekinumab at week 16 (78.3% vs 35.9%, P = 0.0010) and at week 52 (60.9% vs 33.3%, P = 0.0196). Similarly, a higher proportion of subjects achieved PASI 100 with secukinumab versus ustekinumab at week 16 (43.5% vs 10.3%, P = 0.0029) and at week 52 (30.4% vs 12.8%, P = 0.0704). The median time to achieve 50% improvement in baseline PASI was 2.8 weeks in the secukinumab group versus 6.3 weeks in the ustekinumab group. The safety profile of secukinumab was in line with the known profile and no deaths occurred. Overall, 95.7% and 84.6% of subjects remained on secukinumab and ustekinumab, respectively. Similar to the core study, secukinumab showed sustained and superior efficacy with faster response versus ustekinumab, and no new or unexpected safety concerns were identified, in Asian subjects with moderate to severe plaque psoriasis.

Background and purpose Neurological involvement in Behcet's disease [neuro-Behcet's disease (NBD)] is uncommon, but it is worth investigating since it can cause substantial disability. However, difficulties exist in understanding the clinical features of NBD due to regional variations and the lack of studies utilizing well-established diagnostic criteria. We therefore analyzed the clinical features of patients with NBD based on the recent international consensus recommendation. Methods We retrospectively searched electronic databases for patients with Behcet's disease (BD) between 2000 and 2017, and reviewed their medical records. Based on the recent international consensus recommendation, patients with definite or probable NBD were included. Results Of 9,817 patients with the diagnosis code for BD, 1,682 (17.1%) visited the neurology clinic and 110 (1.1%) were classified as NBD. Ninety-eight patients exhibited parenchymal NBD and 12 exhibited nonparenchymal NBD. Their age at the onset of NBD was 37.6±10.6 years and the male-to-female ratio was 1.24:1. Brainstem syndrome (43.9%) was the most common condition in the 98 patients with parenchymal NBD, followed by multifocal (32.7%) and spinal cord (12.2%) syndromes. 72.4% exhibited acute NBD and 27.6% exhibited a progressive disease course. Frequent manifestations included pyramidal signs (52.0%), headache (45.9%), dysarthria (42.9%), and fever (31.6%). A frequent pattern in brain MRI was an upper brainstem lesion extending to the thalamus and basal ganglia. Conclusions Approximately 1% of the patients with suspected BD exhibited NBD. Neurologists must understand the clinical characteristics of NBD in order to perform the differential diagnosis and management of these patients.

Atopic dermatitis (AD) is a complex skin disease characterized by chronic recurrent eczematous skin lesions frequently associated with systemic allergic sensitization. For the pathogenesis of AD, there are innate immune cells such as eosinophils and mast cells infiltrated in combination with the acquired immune cells like dendritic cells and T cells, many researches are being actively conducted on those various and new innate immune cells. T cell immune response has been recognized as a principal immunological component since the use of T cell-inhibiting agents leads to clinical improvement of AD. Immune responses found in acute AD are predominated by Th2-type immune signature including IL-4 and IL-13 cytokines. However, in chronic AD an additional Th1-type IFN-ɣ signature is also involved in the immune responses and recent studies have found an import role of IL-22-producing T cells in AD pathogenesis. Among the AD-associated cytokines, the clinical impact of the key Th2 cytokines IL-4 and IL-13 on atopic dermatitis has recently been shown in clinical studies with dupilumab, a monoclonal antibody which blocks the IL-4/IL-13 receptor and JAK inhibitors, which block intracellular signaling of IL-4/IL-13. Those T cell immune responses in AD seem to be mediated by specific populations of skin dendritic cells which prime naive T cells to become Th2 subset. In addition, B cells are involved in AD pathogenesis by producing allergen-specific IgE and IgE-mediated allergic responses. Thus, understanding underlying mechanisms for adaptive immunity in AD will shed light on the development of novel therapeutic strategies in AD in the future.

The association between psoriasis and risk of psychiatric diseases has not been thoroughly evaluated in a large longitudinal cohort of the Asian population. We conducted a nationwide cohort study encompassing more than 1.6 million Koreans with a 12-year follow-up period. Patients were considered to be in the psoriasis cohort if they had an incident diagnostic code for psoriasis and included patients were followed up until they developed any psychiatric disease. In adjusted models, psoriasis patients (n = 10 868) were at an 18% increased risk for depression (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.09-1.26), 16% for anxiety disorders (HR, 1.16; 95% CI, 1.08-1.26), and 21% for somatoform disorders (HR, 1.21; 95% CI, 1.08-1.34) compared with the referent cohort (n = 1 620 055). Patients with moderate-to-severe psoriasis had a higher risk of developing depression and somatoform disorders than patient with mild disease (depression, HR, 1.28; 95% CI, 1.07-1.54 vs HR, 1.17; 95% CI, 1.07-1.27; somatoform disorders, HR, 1.60; 95% CI, 1.26-2.03 vs HR, 1.13; 95% CI, 1.00-1.28). Our results highlight the burden of psychiatric diseases in patients with psoriasis in Korea and suggest that appropriate medical support for possible mental illness is warranted in Asian psoriatic patients.

Extensor tendon rupture of the finger is a very rare complication of Kienböck’s disease. However, advanced Kienböck’s disease can cause an attritional rupture of extensor tendons due to displaced lunate fragment. An extensor tendon of the thumb is frequently damaged in the distal radial fracture, and an extensor tendon of the fifth finger is mainly ruptured in arthritis of distal radio-ulnar joint. On the other hand, the extensor tendons of the 2nd, 3rd and 4th fingers are usually ruptured in advanced Kienböck’s disease. We report two elderly patients diagnosed with advanced Kienböck’s disease after non-traumatic rupture of extensor tendon of the fingers. Since the extensor tendon rupture in Kienböck’s disease present as a loss of active extension of metacarpophalangeal joint in the central fingers, these patients should undergo imaging of the wrist joints to ascertain concomitant Kienböck’s disease.

There has been increased demand for the development of a system that provides easily accessible open-type housing market information and utilizes that system using large data; the objectives are to increase the positive effects of housing policy and improve understanding of the policy among the people. Since there is the increased necessity of developing a decision support system for housing policy to create reasonable and scientific housing policy, a research on “Development of Housing Market Analysis and Forecasting Model Using Large Data” was started. In this paper, This papers describes the design of the technology equipped with an open platform architecture for internal and external users.

Yonsei Dermatology celebrated its centennial in 2017, marking 100 years since Kung Sun Oh established the first Department of Dermatology and Urology in Korea in 1917. Following the footsteps of Kung Sun Oh, a pioneer of Korean dermatology, its members united and worked to provide the best medical service and achieve academic milestones in dermatology. Over the past hundred years, Yonsei Dermatology has played a pivotal role in the advancement of medical science and academia in Korea. The main activities of the department include medical care, education, and dermatologic research. Its research activities have encompassed a wide spectrum of dermatologic manifestations from skin immunology and pathology to introduction of newly developed treatment technologies. As Kung Sun Oh was the first Korean professor of dermatology at Severance Medical School and a passionate educator, we continue to serve his will by nurturing medical students and dermatology specialists to serve as global medical leaders. The Kung Sun Oh Memorial Lecture, first hosted in 1977, was the beginning of mutual international academic exchange in the field of dermatology in Korea. The memorial lecture has played a major role in advancing the academic status of Korean dermatological science by inviting distinguished dermatologists from around the world as guest lecturers. Yonsei Dermatology has played a key role in the history of modern medicine and dermatology in Korea over the last 100 years and continues to make an impact.

Background Langerhans cells (LCs) are dendritic cells that reside in the epidermis and local inflammation results in an increased differentiation of monocyte-derived LCs. Only few studies have investigated on the role of LCs in psoriasis-like dermatitis model, but the results are variable and the exact role of LCs in psoriasis model remains to be elucidated. Objective To explore the functional role of resident (rLCs) and monocyte-derived LCs (mLCs) in imiquimod (IMQ)-induced psoriasis-like inflammation using human Langerin-diphtheria toxin subunit A (huLang-DTA) mice. Methods 5% IMQ cream was topically applied on the skins. Clinical and histopathological features were evaluated. Psoriasis-related gene expression was analyzed by quantitative polymerase chain reaction. The production of psoriasis-related cytokines including IL-17A and IL-22 by T cells were assessed by flow cytometry from the lesional skins. Results huLang-DTA mice showed a common depletion of both rLCs and mLCs in the IMQ-treated skins. huLang-DTA mice had a reduced IMQ-induced psoriasis-like inflammation featuring erythema, scale, and thickness compared with wild-type mice. Psoriatic lesions from huLang-DTA mice had a decreased level of Il23a and accordingly demonstrated an attenuated cytokine production of IL-17A and IL-22 from γδlow T cells. mLCs revealed a significantly greater level of IL-23 expression compared to rLCs in response to topical IMQ treatment. Conclusion Although both rLCs and mLCs are involved in the development of IMQ-induced psoriasis-like dermatitis, inflammation-induced mLCs present a superior capacity for producing IL-23 in this murine experimental model of psoriasis.

Category: Ankle, Orthosis, rehabilitation Introduction/Purpose: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. Recently, knee walker was introduced, which minimized these weaknesses and yielded favorable results in some clinics. To the best of our knowledge, there have been no previous original article comparing the clinical results of the knee walker and axillary crutch in foot and ankle patients who require nonweightbearing. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. Methods: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. Jin Bae He Wheel Chair X 01 (JBH Medical Apparatus, Nanjing, China) was used for the knee walker and standard axillary crutch was used. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0˜100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. Results: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (pConclusion: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.

Hand, foot and mouth disease (HFMD) is a highly contagious viral infection affecting young children during the spring to fall seasons. Recently, serious outbreaks of HFMD were reported frequently in the Asia-Pacific region, including China and Korea. The symptoms of HFMD are usually mild, comprising fever, loss of appetite, and a rash with blisters, which do not need specific treatment. However, there are uncommon neurological or cardiac complications such as meningitis and acute flaccid paralysis that can be fatal. HFMD is most commonly caused by infection with coxsackievirus A16, and secondly by enterovirus 71 (EV71). Many other strains of coxsackievirus and enterovirus can also cause HFMD. Importantly, HFMD caused by EV71 tends to be associated with fatal complications. Therefore, there is an urgent need to protect against EV71 infection. Development of vaccines against EV71 would be the most effective approach to prevent EV71 outbreaks. Here, we summarize EV71 infection and development of vaccines, focusing on current scientific and clinical progress.

The association between psoriasis and risk of atherosclerotic cardiovascular disease has not been thoroughly evaluated in a large longitudinal cohort of an Asian population. We conducted a nationwide population-based retrospective cohort study encompassing more than 1.7 million Koreans with a 15-year follow-up period. The period prevalence of psoriasis was 0.33% among the baseline participants (1997-2000). In Cox proportional hazard analyses, the individuals with psoriasis had a higher adjusted hazard ratio (HR) for incidence of overall atherosclerotic cardiovascular disease (HR, 1.18; 95% confidence interval [CI], 1.09-1.27) compared with controls. Subgroup analyses revealed that the risk for myocardial infarction was commonly increased in both sexes with moderate to severe psoriasis (male: HR, 2.09; 95% CI, 1.35-3.24; female: HR, 3.23; 95% CI, 1.34-7.76), whereas the risk for ischemic stroke was specifically increased in female individuals with moderate to severe psoriasis (HR, 2.02; 95% CI, 1.24-3.30). Our data suggest that appropriate medical screening for possible cardiovascular comorbidities is warranted in Asian psoriatic patients according to disease severity and sex.

Background The association between psoriasis and risk of malignancy has not been thoroughly evaluated in a large longitudinal cohort of Asian population. Objective To determine the long-term risk of malignancy in Korean adult patients with psoriasis. Methods We conducted a nationwide population-based prospective cohort study with a 15-year observational period. During the baseline period (1997-2000), total 1 773 786 Korean subjects who received health insurance from the National Health Insurance System were enrolled and 5788 subjects were defined as a psoriasis group. The number of new-onset malignancy was collected during the observational period (2001-2015). Results Patients with psoriasis had a higher adjusted hazard ratio (aHR) for development of overall malignancy [aHR 1.08, 95% confidence interval (CI) 1.00-1.18] and gastric cancer (aHR 1.31, 95% CI 1.08-1.58) compared to controls. The risks of non-Hodgkin lymphoma and non-melanoma skin cancer were significantly increased only in patients with psoriasis who received systemic treatments (aHR 2.86, 95% CI 1.07-7.61 and aHR 3.93, 95% CI 1.47-10.47, respectively). Conclusion Psoriasis is associated with long-term risk for overall malignancy in Koreans, which was primarily driven by the increased risk of gastric cancer.

Background: The purpose of this study was to assess the functional outcomes of simultaneous distal radius fractures (DRFs) and ipsilateral elbow injuries (IEI) and to evaluate whether the DRFs and IEI affect each other’s outcomes.Methods: From February 2008 to March 2015, 29 of 846 patients treated for DRFs were found to be associated with IEI and 26 patients with follow-up over 12 months were enrolled. There were 12 men and 14 women with a mean age of 55 years (range, 17–86 years). Associated IEI was divided into fracture group (10 patients) and dislocation group (16 patients). Clinical outcomes of DRFs and IEI were evaluated using the Gartland and Werley score and Mayo Elbow Performance Score, respectively. A correlation between the wrist scoring and the elbow scoring was analyzed. In addition, the wrist scoring between fracture group and dislocation group of the elbow was compared.Results: The DRFs was rated as excellent in 14 patients, good in seven patients, and fair in five patients. The IEI was rated as excellent in 12 patients, good in 11 patients, fair in two patients, and poor in one patient. Acceptable outcome rate of both DRFs and concomitant IEI was 73%, although that of DRFs and IEI was 81% and 88%, respectively. A correlation between the wrist outcome and the elbow outcome showed a negative linear relationship (Spearman rho = −0.435, p = 0.026). In addition, there was no difference in the outcome of DRFs between ipsilateral elbow fractures group and dislocation group.Conclusions: As a correlation of DRFs and ipsilateral IEI have a linear relationship, the functional outcomes of both injuries are related to each other. Therefore, we recommend that combined injuries should be managed appropriately at the same time for contended recovery of the wrist and elbow.

Background Buttock pain is common, and there are no fixed guidelines for its diagnosis and treatment. This study compared a selective nerve root block and a facet joint block for patients with degenerative spinal disease and buttock pain. Methods Patients with degenerative spinal disease who presented with buttock pain, received a selective nerve root block (group A) or a facet joint block (group B) from June 2017 to September 2017, and were able to be followed up for more than 3 months were prospectively enrolled. Clinical results were assessed using a visual analog scale for comparative analysis. Results One day after the procedure, an excellent response was found in 7% and 6% of groups A and B, respectively; a good response was found in 41% and 13% of groups A and B, respectively. Two weeks later, an excellent response was found in 11% and 4% of groups A and B, respectively; a good response was found in 41% and 20% of groups A and B, respectively. Six weeks later, an excellent response was found in 11% and 7% of groups A and B, respectively, and a good response was found in 41% and 20% of groups A and B, respectively. At the final follow-up, more than 47% and 46% of patients showed a good response in groups A and B, respectively. In group A, the visual analog scale score improved compared to the pre-procedure value of 5.01 to 2.74 on day 1, 2.51 at week 2, 2.38 at week 6, and 2.39 at week 12. In group B, the visual analog scale score improved compared to the preprocedure value of 5.24 to 3.94 on day 1, 3.99 at week 2, 3.24 at week 6, and 2.59 at week 12. On day 1 and at weeks 2 and 6, group A showed a significantly better outcome than group B (p < 0.05). Conclusions The selective nerve root block showed superior results up to 6 weeks post-procedure. Considering that the selective nerve root block is effective for treating radiculopathy, the primary cause of buttock pain can be thought to be radiculopathy rather than degenerative changes of the facet joint.

Background: As intramedullary (IM) fixation is one of the fixation methods used in neck fractures of the fifth metacarpal, an early motion of injured finger can be allowed. The purpose of this study is to evaluate whether immediate active motion affects the stability of antegrade IM fixation in surgical treatment of neck fractures of the fifth metacarpal bone and to assess related factors. Methods: Thirty one patients treated by closed reduction and antegrade IM fixation were consecutively enrolled. All patients started active motion of the little finger since 7 postoperative days and only daily activities including writing, typing or washing were allowed until the union of fracture. All fractures were healed within four to eight weeks. The changes of angulation, fifth metacarpal length and tip to head distance of K-wire were compared between immediate postoperative radiographs and radiographs at eight weeks. In addition, the effects by age, gender, initial angulation and comminution of the metacarpal neck were assessed. Results: The average change of angulation was 0.12°, 5th metacarpal length was 1.49mm and tip to head distance of K-wire was 1.31mm. There was no significant difference in the change of angulation (p = 0.137). But, there were significant differences in the change of 5th metacarpal length and tip to head distance of K-wire ([Formula: see text]). The change of angulation was related to a comminution of the metacarpal neck and that of 5th metacarpal length was related to age and sex. Conclusions: The change of 5th metacarpal length and tip to head distance of K-wire can occur by an early mobilization in the antegrade IM fixation for neck fractures of the fifth metacarpal. However, we thought that an early active motion after surgery is important to increase the patients' satisfaction, even though careful selection of candidates is necessary.

Dendritic cells (DCs) are heterogeneous groups of innate immune cells, which orchestrate immune responses by presenting antigens to cognate T cells and stimulating other types of immune cells. Although the term ‘DCs’ generally represent highly mixed subsets with functional heterogeneity, the classical definition of DCs usually denotes conventional DCs (cDCs). Skin contains a unique DC network mainly composed of embryo precursor-derived epidermal Langerhans cells (LCs) and bone marrow-derived dermal cDCs, which can be further classified into type 1 (cDC1) and type 2 (cDC2) subsets. Psoriasis is a chronic inflammatory skin disease, which is principally mediated by IL-23/IL-17 cytokine axis. In the psoriatic skins, DCs are prominent cellular sources for TNF-α and IL-23, and the use of blocking antibodies against TNF-α and IL-23 leads to a significant clinical improvement in psoriatic patients. Recent elegant human and mouse studies have shown that inflammation-induced inflammatory DCs, LCs, dermal cDC2, and monocyte-derived DCs are pivotal DC subsets in psoriatic inflammation. Thus, targeting specific pathogenic DC subsets would be a potential strategy for alleviating and preventing DC-derived IL-23-dependent psoriatic inflammation and other inflammatory dermatoses in the future.

Psoriasis is largely mediated by interleukin (IL)-23/T helper (Th) 17 axis, and IL-21 is a pleiotropic cytokine expressed by Th17 cells. Despite previously reported possible pathogenic roles of IL-21 in human psoriasis, we found that IL-21 receptor (IL-21R) signalling was not crucial for imiquimod-induced psoriatic inflammation, using IL-21R−/− mice. The severity of imiquimod-induced psoriatic manifestation and pro-inflammatory Th17 cytokine levels, IL-17A-producing γδ T cells and CD4+ T cells, and in vitro IL-17A production by γδ T cells after IL-23 stimulation was comparable between wild-type and IL-21R−/− mice. Collectively, IL-21R signalling was not critically involved in IMQ-induced psoriatic inflammation despite an increased IL-21 expression in the IMQ-treated mouse skin. Our data may represent the significant differences between human psoriasis and murine psoriasis model, and further studies using other models will be required to elucidate the role of IL-21 in psoriasis pathogenesis.

Load shedding is a last measure to avoid nationwide cascading collapses of power system by removing the pre-determined amount of loads from the main grid. In Korea, SPS(Special Protection System) is prepared to keep the power system stability from the extreme contingency of the critical transmission line losses. Among them, we need to pay attention to 765kV T/L’s because they have great influence on the total system stability. According to the present SPS operating guide, the total loads of 1,500MW should be removed through 2 step under-voltage load shedding(UVLS) scheme in case of 765kV T/L’s contingencies. However, it is not clear to defined how to determine the typical load reduction amounts for each case. This paper proposes a method to estimate appropriate amounts of load shed for 765kV T/L’s contingencies by analyzing the relevant national and international standards.

Circulating inflammatory cytokines and markers are increased in patients with psoriasis. Recent studies have shown that a higher red blood cell distribution width (RDW) is associated with disease activity in various disorders. Our objective was to investigate whether RDW is increased in psoriasis patients, and to evaluate its possible association with disease severity. We conducted a retrospective study of psoriasis patients seen in a university hospital in South Korea. Information about demographics, hematological parameters and disease severity were collected. Statistical analysis was performed using Student's t-test, multivariable logistic regression, Fisher's exact test and Spearman's rank correlation coefficient analysis as appropriate. A total of 261 psoriasis patients and 102 healthy controls were included in our study. The mean RDW value was significantly increased in psoriasis patients compared with healthy control (P = 0.037). Compared with mild psoriasis patients (Psoriasis Area and Severity Index [PASI],7), moderate to severe patients (PASI, ≥7) showed significantly higher RDW values (P = 0.044). However, RDW did not show significant correlation with PASI (P = 0.358). When patients were divided into two groups according to their RDW value (14.6% and ≥14.6%), the mean value of PASI was not significantly different (P = 0.219). Patients with psoriasis showed increased RDW values compared with healthy controls. It was also higher in the moderate and severe disease group than the mild group. Though this is only a pilot study, it is possible that RDW value can reflect the inflammatory status of psoriasis patients.

Osteoporotic fractures in subjects with diabetes mellitus (DM) carry higher mortality and morbidity. Because bone strength and minor trauma, such as a falls, are considered to be significant factors contributing to osteoporotic fractures, it is important to elucidate the associated factors with these.This study was performed to investigate the factors associated with bone mineral density (BMD) and falls in noninstitutionalized subjects with DM aged 50 years or older.We used the database from the 2010 Fifth Korea National Health and Nutrition Examination Survey. Subjects with DM aged 50 years or older were selected and included in the data analyses. Associated factors with BMD of the femoral neck and lumbar spine and those with falls were analyzed using multiple linear regression and binary logistic regression analyses, respectively.Three hundred sixty-two subjects [209 males; 153 females; average age, 66.0 y (SD 8.2 y)] were included. Among the male subjects, the total body muscle mass (P.001), daily calcium intake (P = .001), ALP levels (P = .007), and body mass index (P = .027) were significantly associated with femoral neck BMD, whereas body mass index (P = .001) and ALP levels (P = .040) were associated with lumbar spine BMD. Among the female subjects, age (P.001), daily calcium intake (P = .011) and total body muscle mass (P = .023) were found to be significantly associated factors with femoral neck BMD, whereas age (P.001) and body mass index (P = .012) and daily calcium intake (P = .040) were those with lumbar spine BMD. Osteoarthritis (P = .024) and total body muscle mass (P = .028) were found to be significantly associated with the risk of falls.Total body muscle mass was the most prominent factor predicting femoral neck BMD and risk of falls in community-dwelling elderly subjects with DM. Further investigation is required to determine their role in preventing osteoporotic fractures in diabetic subjects.

Cutaneous vasculitis can be limited to skin or a manifestation of primary systemic vasculitis. However, there are no definite markers to predict systemic involvements. Recent studies have shown that a higher red blood cell distribution width (RDW) is associated with disease activity in various disorders. We evaluated whether RDW can be used as an indicator for predicting systemic disease in patients with initial cutaneous involvements. We reviewed clinical and laboratory information of 143 patients with cutaneous vasculitis and 15 pigmented purpuric dermatosis patients seen at single academic hospital in Korea. Various parameters, including RDW, were evaluated in patients with primary cutaneous vasculitis and primary systemic vasculitis with initial cutaneous manifestations. The RDW value between cutaneous and systemic vasculitis patients was compared and RDW level was also investigated whether it can indicate systemic vasculitis in patients with cutaneous involvements. The mean age was 32.0 years, and 102 (64.6 %) patients were female. A total of 132 patients were patients with primary cutaneous vasculitis, and 11 were primary systemic vasculitis. Higher ratio of patients with high RDW was detected in systemic vasculitis group compared with cutaneous vasculitis group (36.4 vs. 7.6 %, P < 0.05). The mean RDW was significantly higher in systemic vasculitis patients (P < 0.05). RDW had the strongest association with systemic vasculitis (P < 0.05, OR 1.834). In conclusion, elevated level of RDW was significantly associated with systemic vasculitis. RDW can be used as one of the marker to predict systemic disease in patients with cutaneous vasculitis.

This paper verifies the performance of Extended Kalman Filter(EKF) and MCL(Monte Carlo Localization) approach to localization of an underwater vehicle through experiments. Especially, the experiments use acoustic range sensor whose measurement accuracy and uncertainty is not yet proved. Along with localization, the experiment also discloses the uncertainty features of the range measurement such as bias and variance. The proposed localization method rejects outlier range data and the experiment shows that outlier rejection improves localization performance. It is as expected that the proposed method doesn`t yield as precise location as those methods which use high priced DVL(Doppler Velocity Log), IMU(Inertial Measurement Unit), and high accuracy range sensors. However, it is noticeable that the proposed method can achieve the accuracy which is affordable for correction of accumulated dead reckoning error, even though it uses only range data of low reliability and accuracy.

Adipokines modulate immune responses and lipid metabolism in allergic disease; however, little is known about their role in the skin barrier and atopic dermatitis (AD). We identified ZAG, an adipokine that regulates lipid mobilization, as a biomarker for AD. ZAG levels were consistently decreased in sera, T cells, and skin in human AD patients compared with healthy controls. ZAG was primarily detected in the stratum corneum along with FLG and LOR. Knockdown of ZAG with short hairpin RNA resulted in decreased FLG and increased TSLP. Topical ZAG treatment in AD mice recovered ZAG expression in the skin and improved AD-like symptoms, transepidermal water loss, and ceramide levels. Furthermore, topical ZAG treatment induced immunoregulatory effects, including reduction of IL-4, IL-17, and IFN-γ and increased Foxp3 in the skin and lymphoid organs. Interestingly, ZAG treatment also recovered decreased levels of ADAM17, an important player in skin barrier function and immune response in AD. Thus, ZAG deficiency is closely related to skin barrier function and the immune abnormalities of AD, and we suggest that restoration of ZAG may be a promising therapeutic option for the treatment of AD.

The purpose of this study is to develop a traffic assignment model where the variable of signal intersection delay is taken into account in assigning traffic in large-scale network settings. Indeed, despite the fact that the majority of the increase in travel time or cost involving congested urban network or interrupted flow are accounted for by stop delays or congested delays at signal intersections, the existing traffic assignment models did not reflect this. The traffic assignment model considering intersection delays presented in this study was built based on the existing traffic assignment models, which were added to by the analysis technique for the computation of intersection delay provided in Korea Highway Capacity Manual. We can conclude that a multiple variety of simulation tests prove that this model can be applied to real network settings. Accordingly, this model shows the possibility of utilizing a model considering intersection delay for traffic policy decisions through analysis of effects of changes in traffic facilities on large urban areas. 본 연구는 대규모 교통망에서 통행배정시 신호교차로에 의한 지체를 반영한 통행배정을 수행하여 보다 현실 모사가 가능한 통행배정기법을 개발 하는 것이다 . 실제로 도시부나 단속류에서 발생하는 통행시간 및 비용의 증가 원인은 많은 부분이 교차로 지체에 의한 정지 혹은 혼잡에 의해 발생함에도 불구하고 기존의 통행배정 모형은 이를 반영하지 못하고 있었다. 본 연구에서 개발한 신호교차로 지체 반영 통행배정 모형은 기존의 통행배정모형과 한국도로용량편람의 신호교차로 지체 산정 방법을 결합하여 구축하였다 . 다양한 모의실험을 통해 이 모형이 실제 가로망에 적용이 가능한 모형임을 보였다 . 따라서 본 모형은 대규모 지역에서의 교통정책 및 교통시설의 변화 등에 교차로 지체를 적용하여 분석할 수 있을 것으로 판단된다 .

We evaluated the short-term clinical outcomes and compared the component's sizes of reverse total shoulder arthroplasty (RTSA) in Korean Population.We performed an RTSA on 42 patients between December 2007 to February 2010. The mean age at surgery was 72.5 ± 5.6 (10 men, 32 women) and average follow-up period was 24 months. Twenty-two cuff tears arthropathy, 15 irreparable massive rotator cuff tears with pseudoparalysis, 5 proximal humeral fractures, and 2 infection cases were included. We evaluated clinical outcomes and also the intra- and postoperative complications to determine if any of the complications were unique to the use of a RTSA in a Korean population. In the anatomic study, 92 uninjured shoulders of 92 patients were used for measuring the inferior glenoid size, and we compared the component's sizes of RTSA with those of the normal population.The ASES (American Shoulder and Elbow), UCLA, and KS (Knee Society) scores significantly improved from preoperative 35 (0-63), 12 (5-27), and 39 (3-81) to postoperative 68 (37-95), 24 (16-35), and 68 (34-88), respectively (P .05). Postoperative complications were seen in 20% and scapular notching 35%. Three patients required further surgery for shoulder dislocation, periprosthetic fracture, and stem loosening. In the anatomic study, mean radius of the inferior glenoid was 17.1 ± 2.1 mm in male and 15.4 ± 1.6 mm in female.The short-term clinical results of an RTSA in Korean population are excellent despite high complication rate. However, the size of the glenoid is sometimes smaller than the baseplate (29 mm diameter) in female patients. More adequate size of the glenoid component should be considered.

PURPOSES: By conducting the landscape survey that considered landscape factors of the Guide Coating in the Median Barrier that applied of the various level by simulating of the Guide Coating in the Median Barrier on the expressway, they showed the quantitative standard of landscape preference factors that the Guide Coating gives. METHODS: The shape of the Structural Equation Modeling used AMOS program and made a shape that is made of landscape preference for the Guide Coating in the Median Barrier on the expressway a dependent variable. RESULTS: Result in this, they showed that functionality and emotionalism are the factors that affect the landscape preference. CONCLUSIONS: In the main study, not only showing the Guide Coating in the Median Barrier on the expressway landscape valuation but also embodying the Structural Equation Modeling(SEM) of each group, knowing the Guide Coating and unknowing the Guide Coating. By embodying this, they could study that the drivers` quantitative standard is different when the Guide Coating become first applied and being changed after.

The objective of this study is to compare a candidate β-tricalcium phosphate (β-TCP) carrier technology with the absorbable collagen sponge (ACS) benchmark to support recombinant human growth/differentiation factor-5 (rhGDF-5)-stimulated periodontal wound healing/regeneration.Routine, bilateral, critical-size (5-mm), 1-wall, intrabony periodontal defects were surgically created in the mandibular premolar region in 10 beagle dogs. Five animals received rhGDF-5/β-TCP and five animals received rhGDF-5/ACS, with a total of 20 μg rhGDF-5 per defect. The animals were euthanized for histologic and histometric analyses at 8 weeks postsurgery.Both rhGDF-5/ACS and rhGDF-5/β-TCP stimulated the formation of functionally oriented periodontal ligament, cellular mixed fiber cementum, and woven/lamellar bone. Bone regeneration (height and area) was significantly greater for the rhGDF-5/β-TCP construct than for the rhGDF-5/ACS (3.26 ± 0.30 mm versus 2.22 ± 0.82 mm, P0.01; and 10.45 ± 2.26 mm(2) versus 5.62 ± 2.39 mm(2), P0.01, respectively). Cementum formation ranged from 3.83 ± 0.73 mm to 3.03 ± 1.18 mm without significant differences between groups. Root resorption/ankylosis was not observed.The β-TCP carrier technology significantly enhanced rhGDF-5-stimulated bone formation compared with the ACS benchmark in this discriminating periodontal defect model. The structural integrity of the β-TCP carrier, preventing compression while providing a framework for bone ingrowth, may account for the observed results.

Recently, researches related to precast modular construction have been actively conducted for nuclear power plant, LNG gas tank, and small-medium PCCV as well as bridges and buildings. In this study, the precast panel cast with steel mesh reinforced mortar (SRM) which is similar reinforced ferrocement was developed for efficient precast construction, construction time reduction, and easy transportation. Mortar mixture with high strength and flowability was obtained from various case studies using silica fume and GGBS. Also, SRM and reinforced concrete (RC) panels were manufactured with reinforcing ratio of 2% and 4%. To verify structural performance of the SRM specimen, the basic material tests, free shrinkage test, and 3-point flexural test with a line loading were carried out. From the test results, it was determined that SRM specimens showed outstanding flexural capacity and ductility. However, the 4% reinforced SRM specimens must consider shear reinforcing to be used as a precast modular member.

In recent years, it was recognized that aurban policy paradigm of sustainable urban growth management and transportation policies have been shifted : from the era of automobile-oriented policy to the era of public transport policy. Against this backdrop, the introduction of the multi-modal transfer center is very consequential. Therefore, it is necessary for the introduction of wide-area and local-centric transfer facilities, as well as the center of the country-led national backbone transfer center. This study was applicable at the multi-modal transfer center plans to introduce guidelines to provide transit facilities, considering the regional and functional characteristics to classify the types of multi-modal transfer center. The final types of multi-modal transfer center were classified into six, and by considering the combination of the criteria to be classified. The multi-modal transfer center type classification based on the case analysis of the types of facilities at domestic and abroad. If the data of multi-modal transfer are accumulated continuously, can expect a more reliable type classification.

Atypical fractures have been reported as a complication of long-standing bisphosphonate therapy and occur commonly in the subtrochanteric region or shaft of the femur showing typical radiographic features. We encountered a case of atypical fracture of the proximal one-third of the shaft of the ulna. Radiographic findings of this case differed from previously reported cases of ulnar fracture in terms of showing a transverse fracture line with cortical thickening and an oblique fracture line with anterior cortical spike. On the other hand, these findings were similar to radiographic features of atypical femoral fractures. The present case was managed surgically and union of fracture was achieved after 6 months. As there are possibilities of occurrence of atypical fractures in sites other than the femur, the physicians should cautiously examine the patients' history and radiographic findings.

Although infrastructure cost comprises the great proportion of residential development cost, all of it tends to be borne by land developers which develop large area. This brings about free-riding by adjacent small development or built-up area, followed by the equity problem in terms of infrastructure development cost sharing and the privatization of development gain. This study aims to establish the method to analyze free-riding on the transportation infrastructure(roads) and investigate empirically how much the free-riding occurs. It sets several development scenarios to calculate the part generated by Bucheon Sangdong district, the case area of this study, of all the traffic flow on the roads. The Network analysis is used to estimate the proportion, by development scenarios, of traffic flow, travel time, and travel cost. As a result, the developer of Bucheon Sangdong district is responsible for 83% of the construction cost of selected roads. The methodology and empirical result of this study would contribute to determine who are liable for the infrastructure facilitation and to estimate how much of the cost the obligators have to share.