Search

Patients with Crouzon syndrome have increased risks of cerebrospinal fluid rhinorrhea and meningoencephalocele after LeFort III osteotomy. We report a rare case of meningoencephalocele following LeFort III midface advancement in a patient with Crouzon syndrome. Over 10 years since it was incidentally found during transnasal endoscopic orbital decompression, the untreated meningoencephalocele eventually led to intermittent clear nasal discharge, frontal headache, and seizure. Computed tomography and magnetic resonance imaging demonstrated meningoencephalocele in the left frontal-ethmoid-maxillary sinus through a focal defect of the anterior cranial base. Through bifrontal craniotomy, the meningoencephalocele was removed and the anterior cranial base was reconstructed with a pericranial flap and split calvarial bone graft. Secondary frontal advancement was concurrently performed to relieve suspicious increased intracranial pressure, limit visual deterioration, and improve the forehead shape. Surgeons should be aware that patients with Crouzon syndrome have the potential for an unrecognized dural injury during LeFort III osteotomy due to anatomical differences such as inferior displacement and thinning of the anterior cranial base.

Supplemental materials and methods, supplemental figure legends

Tumor-suppressor genes (TSG) are often deleted or transcriptionally suppressed in cancer. PGR codes for progesterone receptor (PR), a transcription factor whose function depends on its ligand. Although PR expression is often undetectable in cervical cancer, its relevance to the endocrine-related etiology of this prevalent gynecological disease remains unclear. In this study, we show that the deletion of one Pgr allele in cervical epithelium promoted spontaneous cervical cancer in human papilloma viral oncogene-expressing transgenic mice as efficiently as the ablation of both Pgr alleles. We also show that tumors arising in the transgenic mice with one or both Pgr alleles did not express PR or expressed at the reduced levels compared with the normal epithelium. PR status correlated with estrogen receptor α (ERα) status in the mouse model and the Cancer Genome Atlas (TCGA) dataset. TCGA data analyses revealed that PGR expression significantly decreased in cervical cancer and that the biallelic deletion of PGR was rare. Furthermore, low PGR expression was associated with poor prognosis in young patients with cervical cancer. These discoveries point to PGR as a haploinsufficient TSG in the uterine cervix. They also raise the possibility that the restoration of PGR expression may improve the survival rate.Implications:The decreased expression of PR may increase the risk of cervical cancer in human papillomavirus–infected women.Visual Overview:http://mcr.aacrjournals.org/content/molcanres/19/1/42/F1.large.jpg.

PDF file - 108K, HPV16-E6 enhances canonical Wnt/�-catenin signaling pathway in primary human keratinocytes. Wnt/�-catenin pathway activation was assessed using the TOPFLASH construct. Human foreskin keratinocytes were co-transfected with, E6, HPV16-E6�141-151 (E6�PDZ), Dvl2 and B-cat expression vectors. Both, E6 and the mutated form lacking the PDZ-binding domain (E6�PDZ), minimally activated the canonical Wnt pathway. However, both of the constructs induced very significant enhancement when they were co-transfected with Dvl2 or �-catenin (B-cat), which suggests that this effect was independent of the PDZ-binding domain.

PDF file - 103K, The E6 oncoprotein interacts with Dvl2 but not with Dvl1 or Dvl3. COS7 cells were transiently transfected with HPV-E6 and one of the Dvl cDNAs. HPV-E6 was tagged with AU1, and the Dvl genes included Flag tags. Cell lysates were prepared 48 h after transfection, and immunoprecipitation was performed with either an anti-flag antibody or anti-AU1 antibody. The immunoprecipitates were separated on a 10% acrylamide gel and transferred to membranes, and western blots were performed using anti-Flag and anti-AU1 antibodies. The Dvl proteins are indicated by arrows and the E6 proteins are indicated by the arrowheads. All three of the Dvl proteins (upper left panel) and HPV-E6 (lower right panel) were expressed at the expected size. The upper-right and lower-left panels show that Dvl2 and E6 may exist in the same protein complex. The first lane on each panel represents the resulting transfection with the empty vector as the negative control.

IHC results for p16 and Mcm7.

IHC conditions and information for antibodies and chemicals.

PDF file - 109K, HPV16-E6 but not HPV16-E7 oncoprotein enhances canonical Wnt/�-catenin pathway in cultured cells. (A) COS7 cells were transiently transfected with the TCF/B-catenin dependent luciferase reporter construct (TOPFLASH) and Renilla together with one or two of the following expression vectors encoding the following: HPV16-E6 (E6), HPV16-E7 (E7), Dvl2 or �-catenin (B-cat). Luciferase activity from culture cells was analyzed 48 h after transfection and is shown as normalized to total protein. HPV16-E6 but not E7 significantly induced TOPFLASH activity with or without B-cat cotransfection (A) or Dvl2 cotransfection (B) co-transfection, which suggests that E6 may positively modulate canonical Wnt signaling. The Renilla signal and empty vector were used to normalize luciferase activity.

Background: Despite the importance of and social concern regarding prevention of diabetes at younger ages, limited data are available. This study sought to analyze changes in the prevalence of type 2 diabetes mellitus (T2DM) in Koreans younger than 30 years according to sex, age, and level of income.Methods: The dataset analyzed in this study was derived from health insurance claims recorded in the National Health Insurance Service (NHIS) database. Participants’ level of income was categorized as low (quintile 1

High-speed metropolitan railway services have been introduced in several mega cities to solve traffic problems stemming from urban sprawl. The success of such huge public transportation projects depends on how to design them more attractively based on profound insight into people’s preferences in the context of travel mode choice. Although many previous studies have investigated factors affecting the preferences for high-speed metropolitan railway services in general, possible heterogeneity in the preferences by different travel contexts tends to be largely ignored. In addition, the effects of personal latent attitudes toward travel mode choice have not been investigated thoroughly in the context of using high-speed metropolitan railway services. Incorporating such latent attitudes in mode choice analysis is helpful for better understanding the motivation of choosing a travel mode. The present study investigates people’s preferences for high-speed metropolitan railway service and their heterogeneity by different travel contexts using stated choice data. In addition, the hybrid choice modeling approach is employed to identify simultaneously the relevant latent attitudes and their effects on the preference for high-speed metropolitan railway service. The data collection was conducted in 2021, with respect to the great train express (GTX) project of the Seoul metropolitan area. The estimation results suggest that the latent attitudes about risk-minimizing and comfort-seeking have different effects on people’s intention to use GTX according to travel contexts. Moreover, the difference in sensitivity to the attributes of GTX exists depending on the travel contexts.

To investigate the effectiveness of hydraulic pressure-assisted sinus augmentation (SA) in a rabbit sinus model in terms of radiographical and histological healing.Bilateral SA was performed in 12 rabbits. Each sinus was randomly assigned to either a hydraulic pressure-assisted SA (test) or a conventional SA (control) group. Healing periods of 2 and 4 weeks were applied (n = 6 for each week). Healing pattern including newly formed bone (NB) and residual bone substitute material (RM) was analyzed with microcomputed tomographically, histologically, and histomorphometrically.No sinus membrane perforation was detected in either group. In the microcomputed tomographic analysis, the test group exhibited higher apico-coronal spread of RM compared to the control group (p 0.05). Particularly, the test group exhibited several masses of NB out of the cluster of RM. Histologically, the test group showed an elongated shape of the augmented space, whereas the control group generally presented a dome shape. Histomorphometrically, the total augmented area and the area of NB (1.32 ± 0.56 vs. 0.84 ± 0.40 mmHydraulic pressure-assisted SA led to new bone formation in the distant areas from the bony access hole, but similar histological healing pattern to conventional SA.Hydraulic pressure-assisted SA is a promising option for treating pneumatized posterior maxilla.

The impacts of intangible assets on economic performance have increased at various levels, and the positive impacts have been well documented. However, not all firms invest in intangible assets des...

Background Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes local bone erosion and systemic osteoporosis. Harpagoside (HAR), an iridoid glycoside, has various pharmacological effects on pain, arthritis, and inflammation. Our previous study suggests that HAR is more deeply involved in the mechanism of bone loss caused by inflammatory stimuli than hormonal changes. Here, we identified the local and systemic bone loss inhibitory effects of HAR on RA and its intracellular mechanisms using a type 2 collagen-induced arthritis (CIA) mouse model. Methods The anti-osteoporosis and anti-arthritic effects of HAR were evaluated on bone marrow macrophage in vitro and CIA in mice in vivo by obtaining clinical scores, measuring hind paw thickness and inflammatory cytokine levels, micro-CT and histopathological assessments, and cell-based assay. Results HAR markedly reduced the clinical score and incidence rate of CIA in both the prevention and therapy groups. Histological analysis demonstrated that HAR locally ameliorated the destruction of bone and cartilage and the formation of pannus. In this process, HAR decreased the expression of inflammatory cytokines, such as tumor necrosis factor-α, interleukin (IL)-6, and IL-1β in the serum of CIA mice. Additionally, HAR downregulated the expression of receptor activator of nuclear factor-κB ligand and upregulated that of osteoprotegerin. HAR suppressed systemic bone loss by inhibiting osteoclast differentiation and osteoclast marker gene expression in a CIA mouse model. Conclusions Taken together, these findings show the beneficial effect of HAR on local symptoms and systemic bone erosion triggered by inflammatory arthritis.

Purpose The aims of the present study were 1) to quantitatively evaluate the extent of sinus pneumatization and 2) to determine the factors affecting sinus pneumatization. Methods Based on implant treatment records, a list of patients who underwent implant placement on the posterior maxilla was obtained. Among them, patients with pre-extraction and post-extraction (before implant placement) panoramic radiographs were selected. After excluding radiographs with low resolution and image distortion, the radiographs before and after extraction were superimposed using computer software. Subsequently, the extent of sinus pneumatization (the vertical change of the sinus floor) was measured. Simple and multiple mixed models were used to determine the factors affecting sinus pneumatization. Results A total of 145 patients were eligible for the present investigation. The average extent of sinus pneumatization was 1.56±3.93 mm at 176 tooth sites. Male sex, single tooth extraction, extraction of an endodontically compromised tooth, a class I root-sinus relationship, and sinus membrane thickening >10 mm favored pneumatization, but without statistical significance. The maxillary second molar presented the greatest pneumatization (2.25±4.39 mm) compared with other tooth types. This finding was confirmed in the multiple mixed model, which demonstrated a statistically significant impact of the extraction of a second molar compared with the extraction of a first premolar. Conclusions Maxillary sinus pneumatization was 1.56±3.93 mm on average. The extraction of a second molar led to the greatest extent of pneumatization, which should be considered in the treatment plan for this tooth site., Graphical Abstract

Objective. Fibromyalgia (FM) is a disorder characterized by chronic diffuse pain and enhanced pain response to stimuli and is caused by central sensitization. Tinnitus also is related to central sensitization. So we investigated the impact of tinnitus on FM. Methods. We included 22 FM patients with tinnitus and 25 FM patients without tinnitus. We assessed a range of symptoms using the Widespread Pain Index; Symptom Severity Score scale; Visual Analogue Scale of pain; and the Korean versions of the Fibromyalgia Impact Questionnaire (FIQ), the Insomnia Severity Index, and the Short-form Health Survey (SF-36). Information about the severity of tinnitus in FM patients was evaluated using the Korean version of the Tinnitus Handicap Questionnaire (THQ-K). Results. There were significant differences between the group that had mild tinnitus (THQ＜38) and the group that had moderate-to-severe tinnitus (THQ≥38) for FIQ score (p=0.025) and for the physical functioning (p=0.003), social functioning (p=0.035), and mental health (p=0.017) components of the SF-36. Also, after dividing patients into 2 groups according to insomnia severity, significant differences were observed in FIQ score (p=0.002) and in body pain (p=0.001), general health (p=0.008), vitality (p=0.003), social functioning (p=0.003), role limitation due to emotional condition (p=0.001), and mental health (p＜0.001) components of the SF-36. Conclusion. The FM patients with severe tinnitus had more functional impairments and lower quality of life than those with mild tinnitus. Severe insomnia also was accompanied by worse health status and lower quality of life. (J Rheum Dis 2021;28:31-37)

This study examines firms’ propensity for innovative investment, such as intangible investment and R&D expenditures, by using rich panel data of Korean firms from the Survey of Business Activities. This topic has not been documented as much as the contribution of innovative investment to economic performance. The dynamic random effects probit estimations show not only that firms’ propensity for intangible investment is persistent and dependent on firms’ characteristics, but also that the dependence on firms’ factors varies across sectors. On the one hand, estimations show that the propensity for intangible investment is complementary with internal R&D expenditures, except among ICT manufacturing firms. Among intellectual property rights, patents (trademarks) are positively associated with intangible investment in the non-ICT manufacturing (service) sector. In general, firms’ affiliation with a parent company, or their status as listing companies, affects firms’ propensity for intangible investment positively. On the other hand, firms’ propensity for R&D expenditures exhibits stronger persistence than that for intangible investment. Non-ICT manufacturing firms exhibit the strongest persistence of R&D expenditures. While intangible investment is associated positively with propensity for R&D, patent rights are the only intellectual property rights showing positive connection to R&D expenditures. This effect is clearest among ICT manufacturing firms. In conclusion, this study contributes toward a better understanding of Korean firms’ innovative investment by highlighting the role of firm-level characteristics, but also by demonstrating the heterogeneity of factors across sectors.

Dark current in optical sensors has been one of their issues. The performance of these sensors can be improved by reducing their dark current. In this study, we investigated UV sensors based on ZnO nanorods (ZNRs), in particular, their current–voltage characteristics, response and recovery times, on–off current ratio, and responsivity as a function of the device process conditions. The number of seed layer coatings was changed and an oxygen (O2) plasma treatment was applied to ZNRs. A microwave-assisted growth (MAG) method was used to grow ZNRs. The MAG method is one way to shorten device manufacturing time. The small number of seed layer coating processes played a role in reducing the dark current of the sensor. The O2 plasma treatment further reduced the dark current. The crystal quality of ZNRs was affected by changes in the sensor fabrication process. Although the O2 plasma treated device had an increased on–off current ratio, the response time was increased.

Because humans are social beings, people are members of social networks and interact with other members. As a result of social interaction, people can be influenced by the behavior of others. The present study addresses conformity behavior in activity-travel decisions, implying that in making such decisions people mimic the behavior of other members of their social networks. The presence of conformity behavior in social networks implies that sustainable behavior can be dispersed through networks. Therefore, knowing which people in a network are influential can help make a sustainable transportation policy more effective. In particular, information about the topology of social networks and geographical distribution can help maximize the policy’s spill-over effects in social and geographic spaces. This study suggests a framework to locate influential agents in relation to activity-travel decisions using three procedures: (1) estimating social distance associated with similarity in activity-travel decisions, (2) identifying influential agents by measuring centralities, and (3) exploring the spatial and activity-travel characteristics of the influential agents. The suggested framework is applied using the travel mode choices of people who had recently taken trips by road beside/alongside the Han River in Seoul, South Korea.

Behçet’s disease (BD) is a rare, chronic, auto-inflammatory disorder of unknown origin. Mucocutaneous lesions and pan-uveitis constitute the hallmark of BD. Additionally, vessels of all sizes and types are affected. In this article, we report a 53-year-old female patient diagnosed with neurovascular BD with diplopia, ipsilateral headache and ophthalmoplegia associated with cavernous sinus thrombosis, leading to Tolosa-Hunt-like syndrome. To our knowledge, this is the first report of a patient with complicated cavernous sinus thrombosis in BD.

Background Coronavirus disease 2019 (COVID-19) is generally asymptomatic or mild in otherwise healthy children, however, severe cases may occur. In this study, we report the clinical characteristics of children classified as critical COVID-19 in Korea to provide further insights into risk factors and management in children. Methods This study was a retrospective case series of children < 18 years of age classified as critical COVID-19. Cases were identified by the Korea Disease Control and Prevention Agency surveillance system and medical records were reviewed. Critical COVID-19 was defined as cases with severe illness requiring noninvasive (high flow nasal cannula, continuous positive airway pressure, or bilevel positive airway pressure) or invasive mechanical ventilation, extracorporeal membrane oxygenation (ECMO) or continuous renal replacement therapy (CRRT), between January 20, 2020 and October 7, 2021. Results Among 39,146 cases diagnosed with COVID-19 in subjects < 18 years of age, eight cases (0.02%) were identified as critical COVID-19. The median age was 13 years (range 10 month–17 years) and male-to-female ratio was 1:1. Three children had underlying diseases; one child has asthma and major depressive disorder, one child had Lennox-Gastaut syndrome and one child had mental retardation and was newly diagnosed with type 2 diabetes mellitus with the diagnosis of COVID-19. Among the eight children, seven were obese (body mass index range [BMI] median 29.3, range 25.9–38.2, weight-for-length > 97% for infant) and one was overweight (BMI 21.3). All patients had fever, six patients had dyspnea or cough and other accompanied symptoms included sore throat, headache, lethargy and myalgia. Radiologic findings showed pneumonia within 1–8 days after symptom onset. Pneumonia progressed in these children for 2–6 days and was improved within 5–32 days after diagnosis. Among the eight critical cases, remdesivir was administered in six cases. Steroids were provided for all cases. Inotropics were administered in one case. Six cases were treated with noninvasive mechanical ventilator and three required mechanical ventilator. One case required ECMO due to acute respiratory distress syndrome. All cases were admitted to the intensive care unit and admission period ranged from 9–39 days. Among all critical COVID-19 cases < 18 years of age, there were no fatal cases. Conclusion To develop appropriate policies for children in the COVID-19 pandemic, it is important to monitor and assess the clinical burden in this population., Graphical Abstract

Objectives There is no consensus on the management plan for incidental prostate cancer (IPCa) after holmium laser enucleation of the prostate (HoLEP). This study aims to investigate the natural course of this disease and suggest appropriate treatment in real clinical practice. Methods The medical records of a prospective cohort of patients with LUTS/BPH who underwent HoLEP between July 2008 and December 2020 at Seoul National University Hospital were retrospectively reviewed. Patients who underwent HoLEP for palliative purpose of prostate cancer control were excluded. The natural history of IPCa was assessed by the clinician in a descriptive manner for each treatment option. Results Among 2630 patients, 141 (5.4%) were diagnosed with IPCa after HoLEP. Pathologic T stage and magnetic resonance imaging results were highly associated with the physician’s primary treatment decision-making for IPCa. Active surveillance (AS) was performed in 80% of patients, of whom 90% underwent follow-up without intervention, while the remaining 10% underwent deferred active treatment with a median follow-up of 46.3 months due to International Society of Urological Pathology grade group upgrading or increasing core involvement percentage. Meanwhile, 20% of patients underwent immediate active treatment. With a median follow-up period of 88.3 months after treatment, only one of 25 patients had biochemical recurrence. Conclusions The incidence of IPCa after HoLEP was 5.4%, and among these, approximately 20% proceeded with immediate definitive therapy and an additional 6% ultimately received definitive therapy within a median of 4 years of AS but showed excellent oncological outcomes.

The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases.Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD.There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP.Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.