Publications by authors named "Ji-Hyun Lee"

1,405 Publications

  • Page 1 of 1

Onepot-Seq: capturing single-cell transcriptomes simultaneously in a continuous medium via transient localization of mRNA.

Nucleic Acids Res 2022 Aug 12. Epub 2022 Aug 12.

Department of Chemistry, Yonsei University, Seoul, Korea.

The development of single-cell RNA-seq has broadened the spectrum for biological research by providing a high-resolution analysis of cellular heterogeneity. However, the requirement for sophisticated devices for the compartmentalization of cells has limited its widespread applicability. Here, we develop Onepot-Seq, a device-free method, that harnesses the transient localization of mRNA after lysis to capture single-cell transcriptomes simultaneously in a continuous fluid medium. In mixed-species experiments, we obtained high-quality single-cell profiles. Further, cell type-specific poly(A)-conjugated antibodies allow Onepot-Seq to effectively capture target cells in complex populations. Chemical perturbations to cells can be profiled by Onepot-Seq at single-cell resolution. Onepot-Seq should allow routine transcriptional profiling at single-cell resolution, accelerating clinical and scientific discoveries in many fields of science.
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http://dx.doi.org/10.1093/nar/gkac665DOI Listing
August 2022

Artificial Intelligence-based biopsy site recommendation solution for melanoma: A pilot study.

J Eur Acad Dermatol Venereol 2022 Aug 11. Epub 2022 Aug 11.

Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

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http://dx.doi.org/10.1111/jdv.18506DOI Listing
August 2022

Real-world treatment patterns for atopic dermatitis in South Korea.

Sci Rep 2022 Aug 10;12(1):13626. Epub 2022 Aug 10.

Department of Dermatology, Korea University College of Medicine, 46 Gaeunsa 2-gil, Seongbuk-gu, Seoul, 02842, South Korea.

The phenotypes of atopic dermatitis (AD) are diverse, and ethnic differences have been suggested. To date, few studies have explored large-scale national data on the treatment patterns of AD in Asians. Therefore, we aimed to examine real-world treatment patterns for AD, including the probability of discontinuation of AD treatment and restart after discontinuation. A retrospective observational study was conducted using the nationwide healthcare database in South Korea between January 1, 2016 to July 31, 2020. We identified 944,559 pediatric patients and 1,066,453 adults with AD. Topical corticosteroids and antihistamines were the most commonly prescribed medications in all age groups. The frequency of topical corticosteroid prescription decreased as the age increased. Although immunosuppressive drugs were not widely used in both children and adults, cyclosporine was the most frequently prescribed immunosuppressant, particularly among those aged 12 years or more (1-2%). Pediatric patients were more likely to discontinue treatment than adult patients. Treatment restart for moderate-to-severe AD was earlier than that for overall AD. In conclusion, significant differences were observed in the treatment patterns of AD between pediatric and adult patients. These findings will improve our understanding of the latest treatment patterns for AD, which may contribute to decision-making in clinical practice.
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http://dx.doi.org/10.1038/s41598-022-17222-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365828PMC
August 2022

Differential RNA expression of immune-related genes and tumor cell proximity from intratumoral M1 macrophages in acral lentiginous melanomas treated with PD-1 blockade.

Biochim Biophys Acta Mol Basis Dis 2022 Aug 5:166516. Epub 2022 Aug 5.

Division of Medical Hemato-Oncology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea. Electronic address:

Immune checkpoint inhibitors (ICIs) offer improved survival for patients with advanced malignant melanomas. However, only a subset of these patients exhibit an objective response rate of 10-40 % with ICIs. We aimed to ascertain the effects of RNA signatures and the spatial distribution of immune cells on the treatment outcomes of patients with malignant melanomas undergoing ICI therapy. Clinical data were retrospectively collected from ICI-treated patients with malignant melanoma; RNA expression profiles were examined via next-generation sequencing, whereas the composition, density, and spatial distribution of immune cells were determined via multiplex immunohistochemistry. Patients with poor and good responses to ICIs showed significant differences in mRNA expression profiles. Different spatial distributions of T-cells, macrophages, and NK cells as well as RNA signatures of immune-related genes were found to be closely related to therapeutic outcomes in ICI-treated patients with malignant melanomas. The spatial distributions of PD-1+ T-cells and activated M1 macrophages showed a significant correlation with favorable responses to ICIs. Our findings highlight the clinical relevance of the spatial proximity of immune cell subsets in the treatment outcomes of metastatic malignant melanoma.
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http://dx.doi.org/10.1016/j.bbadis.2022.166516DOI Listing
August 2022

Risk factors of dermatophytosis among Korean adults.

Sci Rep 2022 Aug 4;12(1):13444. Epub 2022 Aug 4.

Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.

Dermatophytosis includes all fungal infections caused by dermatophytes in humans. Some risk factors for the development of subtypes of dermatophytosis have been studied; however, large-scale epidemiologic studies on risk factors for total dermatophytosis are scarce. We investigated the risk factors of dermatophytosis using a nationwide study. Total 4,532,655 subjects with dermatophytosis aged between 20 and 40 years were examined using data from the Korean National Health Insurance Service from 2009 to 2018. Women showed a lower risk of development of dermatophytosis compared to men [hazard ratio (HR) 0.848; 95% confidence interval (CI) 0.843-0.853]. Subjects with elevated waist circumference (HR 1.057; 95% CI 1.048-1.065), heavy drinking (HR 1.053; 95% CI 1044-1.061), engaging in mild-to-heavy exercise (HR 1.071; 95% CI 1.064-1.077) had a higher risk of dermatophytosis. In addition, subjects with body mass index (BMI) of more than 30 kg/m exhibited a higher risk of dermatophytosis (HR 1.36; 95% CI 1.342-1.378) compared to those with BMIs in the range of 18.5-23 kg/m. In this study, the risk of developing dermatophytosis significantly increased in individuals with elevated waist circumference or high BMI. Lifestyle modifications, including weight management, are suggested to be important in preventing dermatophytosis.
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http://dx.doi.org/10.1038/s41598-022-17744-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9352717PMC
August 2022

Usefulness of bispectral index and patient state index during sevoflurane anesthesia in children: A prospective observational study.

Medicine (Baltimore) 2022 Jul 29;101(30):e29925. Epub 2022 Jul 29.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Cortical electroencephalography-based devices are used to monitor the depth of anesthesia. In this study, we evaluated the values of bispectral index (BIS) and patient state index (PSI) during sevoflurane anesthesia in children. The ability/accuracy of BIS and PSI to predict the maintenance and recovery state of anesthesia was evaluated based on prediction probability (Pk) values and the secondary outcomes were agreement and correlation of 2 monitors. Fifty children (3-12 years old) were enrolled and the patients received sevoflurane anesthesia with remifentanil followed by propofol administration. Before the induction of anesthesia, BIS and PSI sensors were simultaneously placed on the forehead, and data were collected until the end of anesthesia. Maintenance state was defined as the period following intubation until the cessation of sevoflurane, while recovery state was defined as the period following the cessation of sevoflurane until awake. Pk, agreement or correlation of BIS and PSI in different anesthesia state were calculated. Anesthesia reduced mean BIS and PSI values. Pk of BIS (95% confidential interval [CI]: 0.78-0.91) and PSI (95% CI: 0.82-0.91) for anesthesia were 0.85 and 0.87, respectively. Agreement was 0.79 for recovery state and 0.73 for maintenance state. Pk values were comparable for BIS and PSI. Agreement between BIS and PSI measurements in the same state was relatively good. Therefore, these monitors are appropriate for monitoring for different state of anesthesia in pediatric population.
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http://dx.doi.org/10.1097/MD.0000000000029925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9333493PMC
July 2022

Comprehensive Comparison of Chemical Composition and Antioxidant Activity of Sprouts by Different Cultivation Systems in a Plant Factory.

Plants (Basel) 2022 Jul 10;11(14). Epub 2022 Jul 10.

Department of GreenBio Science, Agri-Food Bio Convergence Institute, Gyeongsang National University, Jinju-si 52725, Korea.

In this study, the primary (such as amino acids, fatty acids, and minerals) and secondary (including ginsenosides, phenolic acids, and flavonols) metabolites and antioxidant effects of Panax ginseng sprouts (PGSs) by different cultivation systems, such as soil-substrate cultivation (SSC) and deep-water cultivation (DWC), in a plant factory has been observed. There was no significant difference in the total fatty acid (FA) contents. Particularly, the major FAs of PGSs were palmitic acid (207.4 mg/100 g) of saturated FAs and linoleic acid (397.6 mg/100 g) and α-linolenic acid (222.6 mg/100 g) of unsaturated FAs in the SSC system. The values of total amino acids were all higher in SSC than in DWC. In the case of ginsenosides, the total protopanaxtriol product was 30.88 mg/g in SSC, while the total protopanaxdiol product was 34.83 mg/g in DWC. In particular, the values of total phenolic acids and total flavonols were 133.36 and 388.19 ug/g, respectively, and SSC had a higher content than DWC. In conclusion, the SSC system was shown to be higher in nutritional constituents and antioxidant activities in soil cultivation, suggesting that PGS with SSC has a positive effect on the quality of PGS in a plant factory.
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http://dx.doi.org/10.3390/plants11141818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323035PMC
July 2022

Treatment of Actinic Keratosis: The Best Choice through an Observational Study.

J Clin Med 2022 Jul 7;11(14). Epub 2022 Jul 7.

Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

Actinic keratosis (AK) is a precancerous lesion that can progress to invasive squamous cell carcinoma if untreated. However, no gold standard treatment has been established. We aimed to investigate the management of AK by comparing the effectiveness and treatment duration of treatment modalities, including cryotherapy, imiquimod (IMQ), and photodynamic therapy (PDT). We reviewed the medical records of 316 patients diagnosed with AK at Seoul St. Mary's Hospital from February 2015 to May 2020, and a total of 195 patients were included. The clearance rate was the highest in PDT, followed by cryotherapy and IMQ (82.4%, 71.2%, and 68.0%, respectively). The recurrence rate was the lowest in cryotherapy, followed by PDT and IMQ (3.5%, 6.7%, and 10.5%, respectively, < 0.05). The average treatment duration was shortest with PDT, followed by IMQ and cryotherapy (5.5 weeks, 6.8 weeks, and 9.1 weeks, respectively, < 0.05). The number of hospital visits was lowest for PDT, followed by cryotherapy and IMQ (1.8, 2.8, and 3.6, respectively, < 0.05). PDT showed the highest clearance rate, a moderate recurrence rate, the shortest treatment duration, and the least number of visits, suggesting that PDT could be the first choice for treatment of AK. Considering the advantages as a topical agent, IMQ could also be a treatment option.
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http://dx.doi.org/10.3390/jcm11143953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9316230PMC
July 2022

Changes of Immune Cell Fractions in Patients Treated with Immune Checkpoint Inhibitors.

Cancers (Basel) 2022 Jul 15;14(14). Epub 2022 Jul 15.

Department of Internal Medicine, Dong-A University College of Medicine, Busan 49201, Korea.

Background: With the development of immunology, immune checkpoint inhibitors (ICIs) have been widely used in various cancer treatments. Although some patients can benefit from ICIs, other patients have no response to ICIs or suffer from hyperprogression. There has been no biomarker for predicting the efficacy of ICIs. Thus, the objective of this study was to find biomarkers for predicting the efficacy of ICIs using peripheral blood.

Methods: Adults patients planned to be treated with ICIs were enrolled in this study. Blood sampling was carried out before and after administration of ICIs. Changes of immune cell fraction were analyzed for each patient.

Results: Among 182 patients enrolled, immune cell analysis was performed for 90 patients. The objective response rate was 14.4% ( = 13/90). The median progression-free survival (PFS) was 6.0 months (95% CI: 3.1-8.9 months), and the median overall survival (OS) was 13.9 months (95% CI: 5.6-22.2 months). Significant benefits in ORR and OS were shown for patients with increased NKp46-/CD56+ NK cells ( = 0.033 and = 0.013, respectively). The PFS tended to be longer in these patients, although the difference was not statistically significant ( = 0.050).

Conclusion: Changes of immune cell fraction before and after administration of ICIs could be a novel biomarker for predicting the efficacy of immunotherapy.
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http://dx.doi.org/10.3390/cancers14143440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315861PMC
July 2022

Risk for Behçet's disease gauged via high-density lipoprotein cholesterol: a nationwide population-based study in Korea.

Sci Rep 2022 Jul 26;12(1):12735. Epub 2022 Jul 26.

Department of Dermatology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.

Behçet's disease (BD) is a chronic inflammatory disease. Low levels of plasma high-density lipoprotein cholesterol (HDL-C) are associated with Crohn's disease, another chronic inflammatory disease. However, the effects of low HDL-C levels on BD are unclear. We investigated the effects of HDL-C levels, and variability therein, on the risk for BD. We used the Korean National Health Insurance System database to identify 5,587,754 adults without a history of BD who underwent ≥ 3 medical examinations between 2010 and 2013. Mean HDL-C levels at each visit were used to calculate variability independent of the mean (VIM) and the coefficient of variation (CV). There were 676 new cases of BD (0.012%). The risk for BD was increased in participants with highly variable and low mean HDL-C levels. In a multivariate-adjusted model, the hazard ratios (95% confidence intervals) for BD incidence were 1.335 (1.058-1.684) in a high mean/high VIM group, 1.527 (1.211-1.925) in a low mean/low VIM group, and 2.096 (1.67-2.63) in a low mean/high VIM group compared to a high mean/low VIM group. Low mean HDL-C levels, and high variability therein, are independent risk factors for BD.
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http://dx.doi.org/10.1038/s41598-022-17096-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325767PMC
July 2022

Novel Anatomical Proposal for Botulinum Neurotoxin Injection Targeting Lateral Canthal Rhytids.

Toxins (Basel) 2022 Jul 6;14(7). Epub 2022 Jul 6.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seoul 03722, Korea.

Botulinum neurotoxin injections near the lateral canthal rhytids are commonly used in cosmetic settings; however, there is a lack of thorough anatomical knowledge, and an effective way to treat them with accumulating knowledge is needed. The anatomical characteristics concerning the injection of botulinum neurotoxin into the orbicularis oculi muscle were evaluated in this review. Current knowledge on the identification of botulinum neurotoxin injection points from recent anatomical research was assessed. The lateral canthal lines are involved with the orbicularis oculi muscle and nearby anatomical structures, and the injection points can be more precisely defined. The best possible injection sites were provided, and the injection procedure was described. This review proposes evidence for injection sites associated with the surface anatomy of the orbicularis oculi muscles to enhance the effectiveness of easing lateral canthal rhytids.
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http://dx.doi.org/10.3390/toxins14070462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9316553PMC
July 2022

Hyperprogressive disease during PD-1 blockade in patients with advanced gastric cancer.

Eur J Cancer 2022 Sep 12;172:387-399. Epub 2022 Jul 12.

Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Investigations for programmed cell death-1 (PD-1) blockade-induced hyperprogressive disease (HPD) have not been stringently conducted in patients with advanced gastric cancer (AGC). We explored the occurrence of HPD and its clinical implications in patients with AGC and treated with PD-1 inhibitors.

Methods: We enrolled 169 patients with AGC and treated with either the PD-1 blockade (nivolumab or pembrolizumab; N = 112) or irinotecan monotherapy (N = 57) as a single agent. Tumour growth dynamics based on tumour growth kinetics and tumour growth rate (TGR) and time to treatment failure were analysed to define HPD. The incidence, clinical consequences and predictive markers of HPD were investigated.

Results: The optimal criteria for HPD were 4-fold increases in both tumour growth kinetics and TGR ratios and a 40% increase in TGR based on the analysis for patients treated with irinotecan. In total, 10.7% (12/112) of patients experienced HPD after PD-1 inhibitor treatment. Patients with HPD had both shorter progression-free survival (hazard ratio: 2.318; 95% confidence interval: 1.205-4.460) and overall survival (hazard ratio: 2.542; 95% confidence interval: 1.314-4.918) than patients with progressive disease without HPD, losing opportunities for subsequent systemic treatments. Although other variables including PD-L1 expression were not associated with the occurrence of HPD, hypoalbuminemia (<3.25 mg/dL) at baseline was significantly associated with the occurrence of HPD (P < 0.001) and inferior survival outcomes.

Conclusions: HPD occurs in a proportion of patients with AGC and treated with PD-1 inhibitors. PD-1 inhibitor-induced HPD is associated with worse outcome, loss of eligibility for subsequent treatment and hypoalbuminemia, warranting further investigation.
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http://dx.doi.org/10.1016/j.ejca.2022.05.042DOI Listing
September 2022

Intercomparison study of fragmentation pathways and fragment ion structures for screening of illegal drugs and their novel analogues used to adulterate dietary supplements using liquid chromatography/quadrupole time-of-flight mass spectrometry.

Rapid Commun Mass Spectrom 2022 Sep;36(18):e9353

Ministry of Food and Drug Safety, Osong Health Technology Administration Complex, Center for Advanced Analysis, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Chungcheongbuk-do, Republic of Korea.

Rationale: As public interest in health and immunity has increased in recent years, so has the demand for dietary supplements. However, supplements adulterated with illegal drugs and their novel analogues are being sold even as the pharmacological efficacies of these drugs are being advertised. Since the use of these illegal compounds can have serious side effects, they pose a risk to public health. Hence, in this study, we propose a strategy for proactively testing drugs and novel analogues that may be added to dietary supplements illegally.

Methods: The optimal conditions for liquid chromatography/quadrupole time-of-flight mass spectrometry were explored to determine the fragmentation patterns for 60 compounds. The optimal conditions were established by comparing the areas and heights of the precursor ion peaks at a fragmentor voltage of 125 or 175 V. Furthermore, the optimized spectra were acquired using collision energies of 1 to 50 eV. The energy value was selected based on the condition that the mass error of the precursor ions is 10 ppm or lower.

Results: The fragmentation pathway of each product ion and its chemical structure were predicted and determined. In addition, the obtained structural information was used to screen 18 seized samples. Based on the precursor ions and the corresponding fragmentation patterns, the unknown compounds present in the samples were identified as desulfonylchlorosildenafil and propoxyphenylthiohydroxy homosildenafil.

Conclusions: We obtained mass spectrometry-based information for various compounds by predicting the fragmentation pathways and chemical structures of their fragment ions. Subsequently, based on the obtained structural information, we tested several seized samples and were able to detect two novel analogues in four of the samples. Therefore, the proposed approach is suitable for quickly and accurately identifying the unknown compounds detected in real-world samples.
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http://dx.doi.org/10.1002/rcm.9353DOI Listing
September 2022

A Fully-Human Antibody Specifically Targeting a Membrane-Bound Fragment of CADM1 Potentiates the T Cell-Mediated Death of Human Small-Cell Lung Cancer Cells.

Int J Mol Sci 2022 Jun 21;23(13). Epub 2022 Jun 21.

Department of Biopharmaceutical Chemistry, Kookmin University, Seoul 02707, Korea.

Small-cell lung cancer (SCLC) is the most aggressive form of lung cancer and the leading cause of global cancer-related mortality. Despite the earlier identification of membrane-proximal cleavage of cell adhesion molecule 1 (CADM1) in cancers, the role of the membrane-bound fragment of CAMD1 (MF-CADM1) is yet to be clearly identified. In this study, we first isolated MF-CADM1-specific fully human single-chain variable fragments (scFvs) from the human synthetic scFv antibody library using the phage display technology. Following the selected scFv conversion to human immunoglobulin G1 (IgG1) scFv-Fc antibodies (K103.1-4), multiple characterization studies, including antibody cross-species reactivity, purity, production yield, and binding affinity, were verified. Finally, via intensive in vitro efficacy and toxicity evaluation studies, we identified K103.3 as a lead antibody that potently promotes the death of human SCLC cell lines, including NCI-H69, NCI-H146, and NCI-H187, by activated Jurkat T cells without severe endothelial toxicity. Taken together, these findings suggest that antibody-based targeting of MF-CADM1 may be an effective strategy to potentiate T cell-mediated SCLC death, and MF-CADM1 may be a novel potential therapeutic target in SCLC for antibody therapy.
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http://dx.doi.org/10.3390/ijms23136895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9266846PMC
June 2022

Use of high-flow nasal oxygen in spontaneously breathing pediatric patients undergoing tubeless airway surgery: A prospective observational study.

Medicine (Baltimore) 2022 Jul 8;101(27):e29520. Epub 2022 Jul 8.

Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

The use of high-flow nasal oxygen is gaining popularity in apneic and spontaneously breathing adult patients during anesthesia. This prospective observational study evaluated the effect of high-flow nasal oxygen in maintaining adequate oxygenation and ventilation in spontaneously breathing pediatric patients with dynamic airway obstruction, undergoing tubeless airway surgery. Oxygenation was provided via an age-appropriate, high-flow nasal cannula at a flow rate of 2 L kg-1 min-1. Propofol and remifentanil were used to maintain anesthesia while preserving spontaneous respiration. We sought to determine the incidence and risk factors of rescue ventilation. Rescue ventilation with a face mask was performed when the pulse oximetry oxygen saturation was <90% or transcutaneous carbon dioxide was >80 mm Hg. In total, 27 patients were included in the final analysis. Median (interquartile range) of pulse oximetry and transcutaneous carbon dioxide were 100% (99%-100%) and 58.4 mm Hg (51.4-70.3 mm Hg), respectively. Altogether, 9 (33.3%) patients needed rescue ventilation during anesthesia. Of these, 7 patients (25.9%) developed oxygen desaturation (<90%) and 2 patients (7.4%) developed hypercarbia. Patients who required rescue ventilation were significantly younger (8.2 vs 28.8 months, P = .02) and required a longer anesthesia time (55.7 vs 41.0 minutes, P = .04) than those who did not. In conclusion, High-flow nasal oxygen is an alternative technique to maintain oxygenation in children undergoing airway surgeries. However, younger age and longer anesthesia time are significant risk factors leading to the requirement of rescue ventilation in these patients. Further studies with large sample size are required for clinical application of these techniques.
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http://dx.doi.org/10.1097/MD.0000000000029520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259177PMC
July 2022

Straight-tip guidewire versus J-tip guidewire for central venous catheterisation in neonates and small infants: A randomised controlled trial.

Eur J Anaesthesiol 2022 08 7;39(8):656-661. Epub 2022 Jul 7.

From the Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea (E-H K, PK, ISS, S-HJ, Y-EJ, J-HL, H-SK, J-TK) and Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea (H-SK, J-TK).

Background: Central venous catheterisation in neonates and infants is challenging because of the small size of the vessels. The curve of the J-tip guidewire causes difficulty when inserting because of the larger radius and the tilted angle of the J-tip.

Objective: We hypothesised that a straight-tip guidewire can facilitate guidewire insertion and improve the first-attempt success rate of central venous catheterisation.

Design: A randomised controlled study.

Setting: This study was performed between September 2018 and July 2021 in tertiary care children's hospital.

Patients: We enrolled infants weighing less than 5 kg undergoing general anaesthesia.

Interventions: Patients were randomly allocated to the straight-tip or J-tip groups. Ultrasonography-guided catheterisation was performed using the assigned guidewire.

Main Outcome Measures: The primary outcome was the first-attempt success rate of central venous catheterisation. The secondary outcomes included the number of guidewire insertion attempts, the time required for successful guidewire insertion, and total time for central venous catheter placement.

Results: Eighty-eight patients were studied. The straight-tip group showed a higher first attempt success rate than the J-tip group (86.3 vs. 61.3%, P  = 0.007, odds ratio 4.0, 95% confidence interval (CI), 1.4 to 11.4]. Guidewire insertion attempts were higher in the J-tip group than in the straight group ( P  = 0.002, odds ratio 9.6, 95% CI, 7.9 to 92.9). Although the guidewire insertion time was longer in the J-tip group ( P  = 0.003, median difference 23.0 s, 95% CI, 7.0 to 48.0), the total catheterisation time was similar owing to the additional guidewire change process in the straight-tip group ( P  = 0.676).

Conclusion: In neonates or infants weighing less than 5 kg, central venous catheterisation using a flexible straight-tip guidewire can improve the first-attempt success rate compared with a J-tip guidewire.

Trial Registration: ClinicalTrials.gov, identifier: NCT03530618.
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http://dx.doi.org/10.1097/EJA.0000000000001695DOI Listing
August 2022

Ensemble deep learning model for predicting anterior cruciate ligament tear from lateral knee radiograph.

Skeletal Radiol 2022 Jun 9. Epub 2022 Jun 9.

Armed Forces Yangju Hospital, Yangju, Republic of Korea.

Objective: To develop an ensemble deep learning model (DLM) predicting anterior cruciate ligament (ACL) tears from lateral knee radiographs and to evaluate its diagnostic performance.

Materials And Methods: In this study, 1433 lateral knee radiographs (661 with ACL tear confirmed on MRI, 772 normal) from two medical centers were split into training (n = 1146) and test sets (n = 287). Three single DLMs respectively classifying radiographs with ACL tears, abnormal lateral femoral notches, and joint effusion were developed. An ensemble DLM predicting ACL tears was developed by combining the three DLMs via stacking method. The sensitivities, specificities, and area under the receiver operating characteristic curves (AUCs) of the DLMs and three radiologists were compared using McNemar test and Delong test. Subgroup analysis was performed to identify the radiologic features associated with the sensitivity.

Results: The sensitivity, specificity, and AUC of the ensemble DLM were 86.8% (95% confidence interval [CI], 79.9-92.0%), 89.4% (95% CI, 83.4-93.8%), and 0.927 (95% CI, 0.891-0.954), achieving diagnostic performance comparable with that of a musculoskeletal radiologist (P = 0.193, McNemar test; P = 0.131, Delong test). The AUC of the ensemble DLM was significantly higher than those of non-musculoskeletal radiologists (P = 0.043, P < 0.001). The sensitivity of the DLM was higher than that of the radiologists in the absence of an abnormal lateral femoral notch or joint effusion.

Conclusion: The diagnostic performance of the ensemble DLM in predicting lateral knee radiographs with ACL tears was comparable to that of a musculoskeletal radiologist.
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http://dx.doi.org/10.1007/s00256-022-04081-xDOI Listing
June 2022

Analysis of clinical phenotypes of neuropathic symptoms in patients with type 2 diabetes: A multicenter study.

J Diabetes Investig 2022 Jul 2. Epub 2022 Jul 2.

Department of Internal Medicine, Research Institute of Clinical Medicine, Jeonbuk National University Medical School-Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, South Korea.

Aims/introduction: We investigated the classification of diabetic peripheral neuropathy (DPN) patients by subjective symptoms, and identification of the relationship between the patterns and intensities of symptoms and the clustered groups of DPN patients.

Materials And Methods: This multicenter study analyzed epidemiological data and sensory symptoms of 649 patients with DPN. Cluster analysis was carried out to identify subgroups of patients with characteristic symptom profiles. Factor analysis was carried out to investigate the symptom patterns of the clustered groups of DPN patients.

Results: Three clusters of patients with DPN were identified: severe symptoms with decreased quality of life (cluster 1, n = 119, 18.3%), predominantly insensate symptoms with relatively good quality of life (cluster 2, n = 318, 49.0%), and moderate pain intensity and decreased quality of life (cluster 3, n = 204, 31.4%). The frequency of symptoms on each item of the Michigan Neuropathy Screening Instrument questionnaire showed a similar distribution according to pain intensities along with the three clusters.

Conclusions: Our study supports the hypothesis that diversity in sensory symptoms exists in patients with DPN. Heterogeneity in DPN patients should be taken into account for a more stratified or individualized treatment approach. Based on a multicenter study, we identified three clusters of patients with DPN. Our research supports the hypothesis that diversity in sensory symptoms exists in patients with DPN. Heterogeneity in DPN patients should be taken into account for a more stratified or individualized treatment approach.
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http://dx.doi.org/10.1111/jdi.13880DOI Listing
July 2022

Evaluation of Atopic Dermatitis and Cutaneous Infectious Disorders Using Sequential Pattern Mining: A Nationwide Population-Based Cohort Study.

J Clin Med 2022 Jun 14;11(12). Epub 2022 Jun 14.

Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

According to previous studies, the increased risk of cutaneous infectious disorders in patients with atopic dermatitis (AD) is related to impaired epidermal function, abnormal systemic immune function, and lower antimicrobial peptides. In this study, we analyzed the association between AD and cutaneous infectious disorders in the real world using sequential pattern mining (SPM). We analyzed National Health Insurance data from 2010-2013 using SPM to identify comorbid cutaneous infectious diseases and the onset durations of comorbidities. Patients with AD were at greater risk for molluscum contagiosum (adjusted odds ratio (aOR), 5.273), impetigo (aOR, 2.852), chickenpox (aOR, 2.251), otitis media (aOR, 1.748), eczema herpeticum (aOR, 1.292), and viral warts (aOR, 1.105). In SPM analysis, comorbidity of 1.06% shown in molluscum contagiosum was the highest value, and the duration of 77.42 days documented for molluscum contagiosum was the shortest onset duration among all the association rules. This study suggests that AD is associated with an increased risk of cutaneous infectious disorders. In particular, care should be taken regarding its high relevance with impetigo, molluscum contagiosum, and otitis media, which may help in preventing AD from worsening through appropriately preventing and managing the condition.
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http://dx.doi.org/10.3390/jcm11123422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225084PMC
June 2022

Ultrasonographic analyses of Crow's feet and novel guideline for botulinum toxin injection.

J Cosmet Dermatol 2022 Jun 18. Epub 2022 Jun 18.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea.

Background: Crow's feet are bilateral orbital wrinkles formed by the orbital portion of the orbicularis oculi muscle, which is the target muscle for botulinum neurotoxin (BoNT) injection.

Objectives: This study's aim was to demonstrate a novel BoNT injection guideline by assessing muscle width, thickness, and dynamic features using ultrasonography.

Methods: Twenty healthy Korean volunteers (10 men, 10 women; mean age, 25.6) participated. The width, thickness, and dynamic movement of the orbicularis oculi muscle were measured using ultrasonography. Two volunteers were selected to receive BoNT injections. Injections were administered using a novel method with two curved reference lines passing a point 15 mm lateral to the lateral canthus (conventional injection) and a point 5 mm lateral to the lateral margin of the frontal process of zygomatic bone (additional injection).

Result: At the lateral canthus level, the distance between the lateral margin of the frontal process and the most lateral margin of the orbicularis oculi muscle was 12.5 ± 1.3 mm. The thickness of the orbicularis oculi muscle at the midpoint of the frontal process, the lateral marginal of the frontal process, and 5 mm lateral to the lateral marginal of the frontal process was 0.7 ± 0.3 mm, 1.1 ± 0.3 mm, and 1.2 ± 0.3 mm, respectively. The crow's feet of the two volunteers began to disappear from day 3 and completely disappeared on day 7 after the injection.

Conclusion: The novel injection technique based on the ultrasonographic anatomy resulted in improvements in the appearance of crow's feet.
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http://dx.doi.org/10.1111/jocd.15167DOI Listing
June 2022

Application of LC-MS/MS and UHPLC-Q-Orbitrap methods for determining 54 steroids in illegal dietary supplements and other sample types.

Rapid Commun Mass Spectrom 2022 Aug;36(16):e9334

National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Center for Advanced Analysis, Cheongju, Republic of Korea.

Rationale: With the development of the Internet and social network services, the public access to or use of illegal products has been increased via on/offline black markets. Steroids refer to the compounds yielding strong treatment effects on some diseases or muscle building, and are classified as the pharmaceutical compounds that are prohibited for personal use without a prescription. The prohibition is made for their potential risk to cause serious adverse effects along with their efficacies.

Methods: To monitor the distribution of illicit products containing steroids, a simple and reliable analytical method was established and validated, allowing rapid and simultaneous determination of 54 steroids in them. During the screening, LC-Q-Orbitrap/MS was performed first followed by quantitative analysis using LC-MS/MS. For the accurate and reliable analysis, the samples were extracted using QuEChERS to reduce the matrix effect.

Results: After the screening of 617 illegal samples advertised as being effective in alleviating various diseases or improving athletic performance with the established LC-Q-Orbitrap/MS method, the validated LC-MS/MS method was used to perform the quantitative analysis of the detected steroids. Of these, 142 samples were adulterated with steroids, and several samples with two or more steroids were detected. Due to the lack of previous studies on the toxicity of these illicit products, the side effects of consuming them are unpredictable and could be harmful.

Conclusions: The development of LC-Q-Orbitrap/MS method accompanied by LC-MS/MS could be successfully applied to the inspection of illegal steroid products for public health, enabling the rapid and accurate detection of analytes and incorporation of non-analyte components.
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http://dx.doi.org/10.1002/rcm.9334DOI Listing
August 2022

Tropomyosin-Related Kinase Fusions in Gastrointestinal Stromal Tumors.

Cancers (Basel) 2022 May 27;14(11). Epub 2022 May 27.

Yonsei Cancer Center, Department of Internal Medicine, Division of Medical Oncology, Yonsei University College of Medicine, Seoul 03722, Korea.

The canonical mutations in gastrointestinal stromal tumors (GISTs) are typically activating mutations in and platelet-derived growth factor receptor alpha (PDGFRA). GISTs with non-canonical mutations are a heterogeneous group. Here, we examined tropomyosin-related kinase (TRK) fusion in GIST cases without mutations ( wild-type (WT) GISTs). We retrospectively analyzed patients who were diagnosed with GISTs at the Yonsei Cancer Center, Severance Hospital, between January 1998 and December 2016. Thirty-one patients with WT GISTs were included in the analysis. TRK expression in tumor samples was assessed by pan-TRK immunohistochemistry (IHC), and the neurotrophic tyrosine receptor kinase (: the gene encoding TRK) rearrangement was analyzed by fluorescence in situ hybridization (FISH). IHC analyses revealed that five cases in this cohort exhibited a weak to moderate TRK expression. fusions were detected in three tumor samples, and two samples harbored fusions. The remaining 26 samples did not harbor fusions. Two types of fusions were detected, and the overall fusion frequency in WT GIST cases was 16% (5/31). Our data provide insights into the molecular alterations underpinning WT GISTs. More effort should be devoted to improve methods to identify this distinct disease subtype within the WT GIST group.
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http://dx.doi.org/10.3390/cancers14112659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9179593PMC
May 2022

The Superficial Temporal Artery and Zygomatico-Orbital Artery: Superficial Arterial Distribution of the Anterior Temple Area.

Biomed Res Int 2022 26;2022:3790546. Epub 2022 May 26.

Department of Anatomy, Yonsei University Medical College, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.

A hollow temple may give rise to a false impression of early facial aging. This is corrected with dermal fillers that are injected into the hollow temple area to produce a smoother facial contour. However, various complications of this procedure have been reported, with the most common being the inadvertent injection of the filler material into the superficial temporal artery (STA). The aim of this study was to investigate the topographic anatomy of the STA and zygomatico-orbital artery (ZOA) to provide essential anatomical information to aid in various clinical procedures involving the temporal region. The superficial arterial distribution of the temple area was studied in 43 hemisectioned Korean cadavers. The courses of the STA and ZOA were identified and classified based on the line connecting the tragus and the superciliary arch (TR-SA line). The ZOA was present in 85.2% of cases and bifurcated from the frontal branch of the STA, after which it ran along the TR-SA line. In this study, the STA pattern was classified into a typical pattern where the ZOA coexists with the STA and a lower pattern where the ZOA was absent. The current findings suggested that the ZOA ran close to the TR-SA line. Therefore, to minimize vascular complications during invasive procedures, injection into this area should be avoided. In addition, clinicians should verify the existence of ZOA and the course of STA before performing various clinical procedures.
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http://dx.doi.org/10.1155/2022/3790546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9162877PMC
June 2022

Guidance to trigger point injection for treating myofascial pain syndrome: Intramuscular neural distribution of the quadratus lumborum.

Clin Anat 2022 Jun 2. Epub 2022 Jun 2.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea.

Postural habits and repetitive motion contribute toward the progress of myofascial pain by affecting overload on specific muscles, the quadratus lumborum (QL) muscle being the most frequently involved. The therapy of myofascial pain syndrome includes the release of myofascial pain syndrome using injective agents such as botulinum neurotoxin, lidocaine, steroids, and normal saline. However, an optimal injection point has not been established for the QL muscle. This study aimed to propose an optimal injection point for this muscle by studying its intramuscular neural distribution using the whole mount staining method. A modified Sihler's procedure was completed on 15 QL muscles to visualize the intramuscular arborization areas in terms of the inferior border of the 12th rib, the transverse processes of L1-L4, and the iliac crest. The intramuscular neural distribution of the QL had the densely arborized areas in the three lateral portions of L3-L4 and L4-L5 and the medial portion between L4 and L5.
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http://dx.doi.org/10.1002/ca.23918DOI Listing
June 2022

Evaluating intramuscular neural distribution in the cricopharyngeus muscle for injecting botulinum toxin.

Auris Nasus Larynx 2022 May 29. Epub 2022 May 29.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, College of Dentistry, Yonsei University, Seoul, South Korea. Electronic address:

Objectives: The objective of this study was to determine the area in the cricopharyngeus muscle (CPM) where botulinum neurotoxin (BoNT) can be injected safely and effectively by evaluating neural distribution in the CPM.

Methods: Eleven specimens of the CPM were gathered from human cadavers. The anatomical relationship between the posterior cricoarytenoid muscle (PCAM) and the CPM was evaluated. Myelinated nerve fibers in the CPM were stained using modified Sihler's method. The CPM was classified into five zones according to the area accessible within the CPM via transcutaneous and transluminal approaches for BoNT injection as follows: i) lateral area including upper area (zone 1) and lower area (zone 2); ii) posterolateral area including upper area (zone 3) and lower area (zone 4); and iii) posterior area (zone 5). Neural distribution originating from the pharyngeal plexus and the extralaryngeal branches of recurrent laryngeal nerve (EBRLN) within each classified zone in stained specimens was determined.

Results: Six specimens (12 lateral areas, 12 posterolateral areas, and 6 posterior areas) were suitable for evaluating neural distribution within the CPM. Zone 1 was adjacent to the PCAM the most in all specimens. Nerve endings originating from the EBRLN were observed on four sides of zone 2 (33.3%, 4/12 sides) in three specimens (3/6, 50%). Neural distribution originating from the pharyngeal plexus was found on ten sides (83.3%, 10/12 sides) of zone 3 in five specimens (83.3%, 5/6 specimens) and on nine sides (75.0%, 9/12 sides) of zone 4 in five specimens (83.3%, 5/6 specimens).

Conclusion: The posterolateral area (zone 3 and zone 4) is thought to be the most suitable area for alleviating the spasticity of CPM with a minimum dose of BoNT.
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http://dx.doi.org/10.1016/j.anl.2022.05.004DOI Listing
May 2022

Comparison of Six Serological Immunoassays for the Detection of SARS-CoV-2 Neutralizing Antibody Levels in the Vaccinated Population.

Viruses 2022 04 30;14(5). Epub 2022 Apr 30.

Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

Neutralizing antibody (NAb) detection is critical for evaluating herd immunity and monitoring the efficacy of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, quantitative SARS-CoV-2 antibody levels after vaccination were measured by chemiluminescent immunoassays, enzyme immunoassays, and surrogate virus neutralization tests (sVNTs), as well as plaque reduction neutralization tests (PRNT). Sequential blood samples were collected before and 1 and 3 months after vaccination in 30 healthy participants (two doses of Oxford-AstraZeneca [AZ] or Pfizer-BioNTech [BNT]). After vaccination, all sera tested positive for PRNT, with NAb titers ranging from 1:10 to 1:723. Median NAb titers were higher in the BNT vaccine group than in the AZ vaccine group at both one and three months post-vaccination. Excellent overall concordance rates were observed between serological assays and PRNT. In a quantitative correlation analysis, the results of sVNTs showed a strong correlation with those of PRNT. Results of the four binding antibody assays showed a significant correlation with those of PRNT. The serologic assays evaluated in this study could be used as sVNTs to evaluate the efficacy of SARS-CoV-2 vaccines.
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http://dx.doi.org/10.3390/v14050946DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147836PMC
April 2022

Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen's Disease: An Observational Study.

J Clin Med 2022 May 12;11(10). Epub 2022 May 12.

Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

Treatment options for Bowen's disease (BD) include surgical excision, cryotherapy, curettage with cautery, topical 5-fluorouracil or imiquimod, and photodynamic therapy. However, it is not clear which treatment is the most effective due to lack of studies. We reviewed the electronic medical records of 158 patients who were diagnosed with BD and treated at Seoul St. Mary's Hospital from January 2011 to December 2020. Treatment modalities were surgical excision, cryotherapy, photodynamic therapy, and imiquimod. A total of 121 patients was enrolled in this study. The average treatment period was longest for cryotherapy, followed by imiquimod, PDT, and excision (119.53, 87.75, 68.50, and 1 day, respectively). The therapeutic efficacy was highest in the surgical excision group (100%) and lowest in the PDT group (62.5%). The recurrence rate was highest in the imiquimod group (33.33%). Surprisingly, only in patients treated with cryotherapy, satellite lesions developed in 9.09% of them during follow-up. Surgical excision exhibited the highest clearance rate and the lowest recurrence rate, and its treatment period was the shortest, confirming that it remains the gold standard. In contrast, since cryotherapy demonstrated a relatively high recurrence rate including development of satellite lesions, careful monitoring is required when performing cryotherapy for treatment of BD.
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http://dx.doi.org/10.3390/jcm11102741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9146918PMC
May 2022

Application of Dual Metabarcoding Platforms for the Meso- and Macrozooplankton Taxa in the Ross Sea.

Genes (Basel) 2022 05 21;13(5). Epub 2022 May 21.

Department of Marine Biology, Pukyong National University, Busan 48513, Korea.

Meso- and macrozooplankton play crucial roles in the trophic web and the biological carbon pump in the ocean by transferring energy from lower to higher trophic levels and vertically exporting carbon from the surface to the deep ocean and seabed. In this study, zooplankton community structures in the Ross Sea, Antarctica, were analyzed using metabarcoding methods. Both regular barcode (RB) (using a PacBio Sequel system) and mini barcode (MB) (using the Illumina MiSeq platform) methods were utilized. As the result of a combination of the two bioinformatic pipelines used in the RB, 55 reliable haplotypes were obtained from the pooled zooplankton net samples, whereas 183 amplicon sequence variants (ASVs) were isolated from the MB metabarcoding analyses of 14 individual stations. Among these, 39 (70.9%) and 125 (90.6%) showed higher than 99% sequence identity to the database, indicating that there were sufficient reference sequences to employ metabarcoding analysis-except for several taxa, including small-sized copepods, cnidarians, and pneumodermatids. A high degree of shared taxa showed that both metabarcoding analyses were feasible for use in the analysis of zooplankton assemblages in the Ross Sea. However, RB would be more useful for the construction of a reference database due to its relatively high cost, whereas MB would be more economic for ecological surveys due to its relatively low cost (albeit, only if reference sequences were well documented using RB). Zooplankton assemblages were highly diverse in each sample site, presumably due to the narrow covered volumes of the vertical net-towed samples from polynyas in the Ross Sea. As metabarcoding data accumulate, we will gain better insights into zooplankton communities and their ecological implications in the Ross Sea.
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http://dx.doi.org/10.3390/genes13050922DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9140529PMC
May 2022

Novel Anatomical Guidelines on Botulinum Neurotoxin Injection for Wrinkles in the Nose Region.

Toxins (Basel) 2022 05 15;14(5). Epub 2022 May 15.

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seoul 03722, Korea.

Botulinum neurotoxin injection surrounding the nose area is frequently used in aesthetic settings. However, there is a shortage of thorough anatomical understanding that makes it difficult to treat wrinkles in the nose area. In this study, the anatomical aspects concerning the injection of botulinum neurotoxin into the nasalis, procerus, and levator labii superioris alaeque muscles are assessed. In addition, the present knowledge on localizing the botulinum neurotoxin injection point from a newer anatomy study is assessed. It was observed that, for the line-associated muscles in the nose region, the injection point may be more precisely defined. The optimal injection sites are the nasalis, procerus, and levator labii superioris alaeque muscles, and the injection technique is advised. We advise the best possible injection sites in association with anatomical standards for commonly injected muscles to increase efficiency in the nose region by removing the wrinkles. Similarly, these suggestions support a more precise procedure.
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http://dx.doi.org/10.3390/toxins14050342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144745PMC
May 2022

Intramuscular Innervation of the Supraspinatus Muscle Assessed Using Sihler's Staining: Potential Application in Myofascial Pain Syndrome.

Toxins (Basel) 2022 04 28;14(5). Epub 2022 Apr 28.

BK21 FOUR Project, Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul 03722, Korea.

Despite the positive effects of botulinum neurotoxin (BoNT) injection into the neural arborized area, there is no anatomical evidence in the literature regarding the neural arborization of the supraspinatus muscle. The present study aimed to define the intramuscular neural arborized pattern of the supraspinatus muscle using the modified Sihler's staining method to facilitate the establishment of safe and effective injection sites in patients with myofascial pain in the supraspinatus muscle. Seventeen supraspinatus muscles from 15 embalmed cadavers were dissected. Precise suprascapular nerve entry locations were also observed. Intramuscular neural arborization was visualized by Sihler's staining. The supraspinatus muscle was divided into four portions named A, B, C, and D. The nerve entry points were observed in 88.2% (15 of 17 cases) of section B and 76.5% (13 of 17 cases) of section C of the supraspinatus muscle, respectively. The concentration of intramuscular neural arborization was highest in section B of the supraspinatus muscle, which was the center of the supraspinatus muscle. When the clinician performs a trigger point and a BoNT injection into the supraspinatus muscle, injection within the medial 25-75% of the supraspinatus muscle will lead to optimal results when using small amounts of BoNT and prevent undesirable paralysis.
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http://dx.doi.org/10.3390/toxins14050310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143847PMC
April 2022
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