Publications by authors named "So Young Ji"

28 Publications

  • Page 1 of 1

The novel prognostic value of postoperative follow-up lateral spread response after microvascular decompression for hemifacial spasm.

J Neurosurg 2021 Sep 3:1-5. Epub 2021 Sep 3.

Departments of1Neurosurgery.

Objective: The lateral spread response (LSR) is an aberrant electrophysiological response in which a stimulus on one branch of the facial nerve spills over to other branches of the nerve, which can be captured by electrodes near each branch. The authors performed this study to evaluate the prognostic value of the follow-up LSR with a sufficient time interval from intraoperative LSR (IO-LSR) after microvascular decompression (MVD) for hemifacial spasm (HFS), excluding the interference of various intraoperative situations.

Methods: A total of 247 patients treated with MVD for HFS between June 2011 and March 2019 were enrolled in this study. The IO-LSR was routinely evaluated in all patients. The LSR was checked again on postoperative day (POD) 2 after surgery (POD2-LSR). A total of 228 patients (92.3%) were considered cured at the last clinical follow-up.

Results: The IO-LSR disappeared in 189 patients (76.5%), and among them, 181 patients (95.8%) were cured 1 year after surgery. The POD2-LSR disappeared in 193 patients (78.1%), and 185 patients (95.9%) among them were cured. Among the 189 patients in which the IO-LSR disappeared, the POD2-LSR reappeared in 26 patients (13.8%). In contrast, the POD2-LSR disappeared in 30 (51.7%) of 58 patients for whom the IO-LSR continued at the end of surgery. When classified into groups according to the status of the IO-LSR and POD2-LSR, in the group of patients in whom both LSRs disappeared, the cure rate was 98.2%, which was significantly higher than that of the other 3 groups (p < 0.05, Cochran-Armitage trend test). The use of both LSRs was found to be significantly associated with better predictability (p < 0.05, McNemar's test).

Conclusions: Postoperative follow-up LSR examination may be beneficial in predicting clinical outcomes after MVD for HFS, especially when considered together with IO-LSR.
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http://dx.doi.org/10.3171/2021.3.JNS21137DOI Listing
September 2021

Radiological assessment schedule for 1p/19q-codeleted gliomas during the surveillance period using parametric modeling.

Neurooncol Adv 2021 Jan-Dec;3(1):vdab069. Epub 2021 May 20.

Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Background: There have been no evidence-based guidelines on the optimal schedule for the radiological assessment of 1p/19q-codeleted glioma. This study aimed to recommend an appropriate radiological evaluation schedule for 1p/19q-codeleted glioma during the surveillance period through parametric modeling of the progression-free survival (PFS) curve.

Methods: A total of 234 patients with 1p/19q-codeleted glioma (137 grade II and 97 grade III) who completed regular treatment were retrospectively reviewed. The patients were stratified into each layered progression risk group by recursive partitioning analysis. A piecewise exponential model was used to standardize the PFS curves. The cutoff value of the progression rate among the remaining progression-free patients was set to 10% at each scan.

Results: Progression risk stratification resulted in 3 groups. The optimal magnetic resonance imaging (MRI) interval for patients without a residual tumor was every 91.2 weeks until 720 weeks after the end of regular treatment following the latent period for 15 weeks. For patients with a residual tumor after the completion of adjuvant radiotherapy followed by chemotherapy, the optimal MRI interval was every 37.5 weeks until week 90 and every 132.8 weeks until week 361, while it was every 33.6 weeks until week 210 and every 14.4 weeks until week 495 for patients with a residual tumor after surgery only or surgery followed by radiotherapy only.

Conclusions: The optimal radiological follow-up schedule for each progression risk stratification of 1p/19q-codeleted glioma can be established from the parametric modeling of PFS.
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http://dx.doi.org/10.1093/noajnl/vdab069DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284622PMC
May 2021

The Combination PARP Inhibitor Olaparib With Temozolomide in an Experimental Glioblastoma Model.

In Vivo 2021 Jul-Aug;35(4):2015-2023

Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea;

Background/aim: Poly (ADP-ribose) polymerase (PARP) inhibition could enhance the efficacy of temozolomide and prolong survival in patients with glioblastoma. The aim of this study was to evaluate the combination of the PARP inhibitor olaparib with temozolomide in the treatment of glioblastoma.

Materials And Methods: The in vitro and in vivo antitumor effects of the PARP inhibitor olaparib together with temozolomide were evaluated. The in vitro experimental glioblastoma model involved O-methylguanine methyltransferase (MGMT) promoter-methylated (U87MG, U251MG) and MGMT promoter-unmethylated (T98G) glioblastoma cell lines using In this model cell viability and apoptosis were assessed. For the in vivo studies, nude mice bearing orthotopically xenografted glioblastoma cell lines (U87MG) were randomized to four experimental groups: i) the untreated, ii) temozolomide alone, iii) olaparib alone and iv) olaparib and temozolomide combination groups. Mice were treated daily for 4 weeks and monitored for tumor growth and survival.

Results: In vitro we found that the combination of olaparib with temozolomide enhanced temozolomide-induced cytotoxicity in all glioblastoma cell lines regardless of the status of MGMT promoter methylation. In vivo, mice treated with temozolomide alone or in combination with olaparib showed greater survival than those untreated or with the olaparib monotherapy, as well as significantly decreased tumor volume. There was no significant difference in survival and tumor volume between temozolomide alone and the combination treatment.

Conclusion: The combination of the PARP inhibitor olaparib with temozolomide could be promising candidates for combination therapy of glioblastoma regardless of the MGMT promoter methylation status.
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http://dx.doi.org/10.21873/invivo.12470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8286506PMC
June 2021

Clinical application of patient-specific 3D printing brain tumor model production system for neurosurgery.

Sci Rep 2021 03 26;11(1):7005. Epub 2021 Mar 26.

Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea.

The usefulness of 3-dimensional (3D)-printed disease models has been recognized in various medical fields. This study aims to introduce a production platform for patient-specific 3D-printed brain tumor model in clinical practice and evaluate its effectiveness. A full-cycle platform was created for the clinical application of a 3D-printed brain tumor model (3D-printed model) production system. Essential elements included automated segmentation software, cloud-based interactive communication tools, customized brain models with exquisite expression of brain anatomy in transparent material, adjunctive devices for surgical simulation, and swift process cycles to meet practical needs. A simulated clinical usefulness validation was conducted in which neurosurgeons assessed the usefulness of the 3D-printed models in 10 cases. We successfully produced clinically applicable patient-specific models within 4 days using the established platform. The simulated clinical usefulness validation results revealed the significant superiority of the 3D-printed models in surgical planning regarding surgical posture (p = 0.0147) and craniotomy design (p = 0.0072) compared to conventional magnetic resonance images. The benefit was more noticeable for neurosurgeons with less experience. We established a 3D-printed brain tumor model production system that is ready to use in daily clinical practice for neurosurgery.
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http://dx.doi.org/10.1038/s41598-021-86546-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998007PMC
March 2021

Radiological assessment schedule for high-grade glioma patients during the surveillance period using parametric modeling.

Neuro Oncol 2021 05;23(5):837-847

Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine.

Background: An optimal radiological surveillance plan is crucial for high-grade glioma (HGG) patients, which is determined arbitrarily in daily clinical practice. We propose the radiological assessment schedule using a parametric model of standardized progression-free survival (PFS) curves.

Methods: A total of 277 HGG patients (178 glioblastoma [GBM] and 99 anaplastic astrocytoma [AA]) from a single institute who completed the standard treatment protocol were enrolled in this cohort study and retrospectively analyzed. The patients were stratified into each layered risk group by genetic signatures and residual mass or through recursive partitioning analysis. PFS curves were estimated using the piecewise exponential survival model. The criterion of a 10% progression rate among the remaining patients at each observation period was used to determine the optimal radiological assessment time point.

Results: The optimal follow-up intervals for MRI evaluations of isocitrate dehydrogenase (IDH) wild-type GBM was every 7.4 weeks until 120 weeks after the end of standard treatment, followed by a 22-week inflection period and every 27.6 weeks thereafter. For the IDH mutated GBM, scans every 13.2 weeks until 151 weeks are recommended. The optimal follow-up intervals were every 22.8 weeks for IDH wild-type AA, and 41.2 weeks for IDH mutated AA until 241 weeks. Tailored radiological assessment schedules were suggested for each layered risk group of the GBM and the AA patients.

Conclusions: The optimal schedule of radiological assessments for each layered risk group of patients with HGG could be determined from the parametric model of PFS.
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http://dx.doi.org/10.1093/neuonc/noaa250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099465PMC
May 2021

Intracranial Metaplastic Meningioma : Clinical and Radiological Characteristics of 11 Cases.

J Korean Neurosurg Soc 2020 Sep 1;63(5):657-663. Epub 2020 Sep 1.

Department of Pathology, Seoul National University Hospital, Seoul, Korea.

Objective: Metaplastic meningioma is an extremely rare subtype of World Health Organization (WHO) grade I meningioma. It has distinctive histological subtypes according to its own mesenchymal components. Owing to its scarcity, clinical or radiological features of a metaplastic meningioma are poorly described.

Methods: Between 2004 and 2018, we analyzed total 1814 cases surgically proven meningioma for 15 years. Among them, metaplastic meningioma was diagnosed in 11 cases. Magnetic resonance images were taken for all patients, and computed tomography scan was taken for 10 patients.

Results: WHO grade I meningiomas were 1376 cases (75.9%), 354 cases (19.5%) in WHO grade II, and 84 cases (4.6%) in WHO grade III meningiomas. Metaplastic meningioma was 11 cases as 0.8% of WHO grade I meningioma and 0.6% of entire meningiomas for 15 years. Among the entire 11 metaplastic meningiomas, five tumors (45%) were diagnosed as a lipomatous subtype with rich fat components, four (36%) as an osseous subtype with extensive bone formation and two (18%) as a xanthomatous subtype. There was no cartilaginous subtype metaplastic meningioma in our study. Lipomatous and osseous metaplastic meningioma have peculiar radiological characteristics according to mesenchymal components.

Conclusion: We investigated a rare metaplastic meningioma subtype based on our 15-year surgical experience with meningiomas. Further investigation will be necessary for the clear clarification of tumor nature of this rare tumor.
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http://dx.doi.org/10.3340/jkns.2020.0151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7477148PMC
September 2020

A glioneuronal tumor with fusion.

NPJ Genom Med 2020 3;5:24. Epub 2020 Jun 3.

Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, 03080 Korea.

We report a case of glioneuronal tumor (GNT) with a discovery of novel gene fusion of resulting from aberrant chromosome 7 abnormalities. We executed an elaborate genomic study on this case including whole-exome sequencing and RNA sequencing. Genomic analysis of the tumor revealed aberrations in chromosomes 1 and 7 and a fusion. Further analysis of the upregulated genes revealed substantial connections with MAPK pathway activation. We concluded that the chromosome 7 abnormalities prompted gene fusion which successively leads to MAPK pathway activation. We deliberated that MAPK pathway activation is one of the driver pathways responsible for the oncogenesis of GNT.
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http://dx.doi.org/10.1038/s41525-020-0131-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270112PMC
June 2020

Experience Profiling of Fluorescence-Guided Surgery II: Non-Glioma Pathologies.

Brain Tumor Res Treat 2019 Oct;7(2):105-111

Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.

Background: Only sporadic reports of fluorescence-guided surgery (FGS) have been published for non-glioma conditions. In this study, we focus on epidemiological data of fluorescence patterns and report the diverse experiences of FGS in non-gliomas.

Methods: During 8.5 years between July 2010 and January 2019, 900 FGS for brain tumor performed in Seoul National University Hospital. Among them, a total of 73 histologically proven non-glioma patients were analyzed. Indications for FGS have been the possibility of anaplastic tumor in intra-axial tumors in preoperative MRI and an attempt to reproduce known anecdotal experiences of 5-Aminolevulinic Acid (5-ALA) fluorescence.

Results: In cases of brain tumors except for gliomas, the most frequent cases were brain metastasis (23 cases) followed by lymphomas (9 cases) and meningeal tumors (8 cases). And there were embryonal tumors (6 cases), hemangioblastomas (4 cases), and solitary fibrous tumor/hemangiopericytomas (3 cases). Most brain metastases, meningiomas, primary central nervous system lymphomas, and treatment effect cases showed positive fluorescence. Moreover, some non-tumorous conditions also showed positive fluorescence. However, hemangioblastoma and germ cell tumor did not observe any fluorescence at all.

Conclusion: 5-ALA induced fluorescence is not limited to glioma but is also evident in non-glioma and non-neoplastic conditions. This 5-ALA-induced fluorescence may be used as an intraoperative tool for various brain conditions.
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http://dx.doi.org/10.14791/btrt.2019.7.e39DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829089PMC
October 2019

Experience Profiling of Fluorescence-Guided Surgery I: Gliomas.

Brain Tumor Res Treat 2019 Oct;7(2):98-104

Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.

Background: Numerous studies reported a usefulness of 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) in high grade gliomas. However, fluorescence patterns and intensities are variable among gliomas. In this study, we report our extensive experience with FGS in various gliomas, focusing on epidemiological data of fluorescence patterns.

Methods: A total of 827 histologically proven glioma patients out of 900 brain tumor patients who had undergone FGS using 5-ALA during the period of 8.5 years between July 2010 and January 2019 were analyzed. Indications of FGS in glioma surgery are evidence for possible high-grade foci in putative gliomas in preoperative MRI.

Results: Among the 827 gliomas, the number of cases corresponding to 2016 World Health Organization (WHO) grade IV, III, II, and I are 528 (58.7%), 193 (21.4%), 87 (9.7%) and 19 (2.1%), respectively. In terms of fluorescence rate, grade IV gliomas showed positive fluorescence in 95.4% of cases including strong intensity in 85.6%. Grade III gliomas showed fluorescence in about half of cases (55.0%), but 45.0% of the cases showed no fluorescence at all. Anaplastic oligodendroglioma had a higher positive rate (63.9%) than anaplastic astrocytoma (46.2%). Both grade II and I gliomas still showed positive fluorescence in about one-fourth of cases (24.1% and 26.3% respectively). Among them ependymoma and pilocytic astrocytoma were fluorescence-prone tumors.

Conclusion: This epidemiological data of 5-ALA fluorescence in various grades of glioma provides a basic reference to the clinical application of FGS with 5-ALA in glioma surgery.
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http://dx.doi.org/10.14791/btrt.2019.7.e38DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829086PMC
October 2019

Introduction of pulsed radiofrequency cautery in infraorbital nerve block method for postoperative pain management of trauma-induced zygomaticomaxillary complex fracture reduction.

J Pain Res 2019 11;12:1871-1876. Epub 2019 Jun 11.

Department of Chemical and Biomolecular Engineering, Hong Kong University of Science and Technology, Hong Kong, Hong Kong.

Although various cases of neuralgia and its treatments have been reported, not enough evidence is present to recommend a single type of treatment as the most effective. The patient we have dealt with experienced significant interferences in his daily life due to chronic allodynia, but the symptom could not be resolved via previously reported treatments. We report a case of which a patient who presented infraorbital neuralgia after trauma was successfully treated by a novel treatment strategy. The patient was treated by applying infraorbital nerve block and pulsed radiofrequency cautery side by side. Through this report, we evaluate proper prevention and treatment strategies for patients who develop infraorbital neuralgia through similar etiologies.
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http://dx.doi.org/10.2147/JPR.S197139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6576132PMC
June 2019

Treatment of primary cutaneous anaplastic large cell lymphoma.

Arch Craniofac Surg 2019 Jun 20;20(3):207-211. Epub 2019 Jun 20.

Department of Pathology, Dong-Kang General Hospital, Ulsan, Korea.

Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a rare subtype of primary cutaneous lymphoma with a favorable prognosis. Primary cutaneous CD30+ lymphoproliferative disorders, which include C-ALCL and lymphomatoid papulosis, are the second most common group of cutaneous T-cell lymphomas. C-ALCL is comprised of large cells with anaplastic, pleomorphic, or immunoblastic cytomorphology, and indeed, more than 75% of the tumor cells express the CD30 antigen. C-ALCL clinically presents with solitary or localized reddish-brown nodules or tumors, and sometimes indurated papules, and they may be with ulceration covering with dark eschar. Multifocal lesions are seen in 20% of the patients. Extracutaneous dissemination, which mainly involves the regional lymph nodes, occurs in 10% of patients. A 69-year-old man noticed a mild elevated cutaneous lesion containing central ulceration covering with brownish black necrotic tissue on the right lower lip, and the lesion was surgically removed. After the first operation, another skin lesion was developed and the histological examination confirmed the diagnosis, C-ALCL. Eight specimens were excised during the 7-month follow-up period. The patient started the treatment with low-dose oral methotrexate (15 mg/wk) and there was no recurrence for 11 months.
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http://dx.doi.org/10.7181/acfs.2018.02201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615420PMC
June 2019

Treatment of the wide open wound in the Ehlers-Danlos syndrome.

Arch Craniofac Surg 2019 Apr 20;20(2):130-133. Epub 2019 Apr 20.

Department of Plastic and Reconstructive Surgery, Dong-Kang General Hospital, Ulsan, Korea.

Ehlers-Danlos syndrome (EDS) is an inherited disorder of collagen biosynthesis and structure, characterized by skin hyperextensibility, joint hypermobility, aberrant scars, and tissue friability. Besides the skin, skeleton (joint) and vessels, other organs such as the eyes and the intestine can be affected in this syndrome. Accordingly, interdisciplinary cooperation is necessary for a successful treatment. Three basic surgical problems are arising due to an EDS: decreased the strength of the tissue causes making the wound dehiscence, increased bleeding tendency due to the blood vessel fragility, and delayed wound healing period. Surgery patients with an EDS require an experienced surgeon in treating EDS patients; the treatment process requires careful tissue handling and a long postoperative care. A surgeon should also recognize whether the patient shows a resistance to local anesthetics and a high risk of hematoma formation. This report describes a patient with a wide open wound on the foot dorsum and delayed wound healing after the primary approximation of the wound margins.
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http://dx.doi.org/10.7181/acfs.2018.02334DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505428PMC
April 2019

The treatment of post-traumatic facial skin defect with artificial dermis.

Arch Craniofac Surg 2018 Mar 20;19(1):35-40. Epub 2018 Mar 20.

Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.

Background: When a skin defect occurs, clinicians must work to restore the original skin quality as soon as possible. Accordingly, an artificial dermis can be used to supplement the wound and prevent severe scar contracture formation. The Terudermis is an artificial dermis that is simple and easy to use. We investigated the effectiveness of the Terudermis in the treatment of facial skin defects by analyzing previous relevant cases treated in our institution.

Methods: We retrospectively examined 143 patients who were treated with the Terudermis graft in facial skin defect at Dong Kang General Hospital in 2015 and 2016. The patients' age, sex and location, wound size, complications were analyzed. In addition, the patients were asked to complete a self-satisfaction questionnaire after 18 months from the completion of treatment. The results were compared with that of autologous full-thickness skin graft (FTSG) and split-thickness skin graft (STSG) patients in same period.

Results: The mean self-satisfaction scores evaluated by patients were 4.1±1.0, 4.0±1.3 and 3.5±1.8 for the Terudermis graft, FTSG and STSG patients, respectively. With respect to complications, there were fewer incidences of hematoma, partial skin loss and complete skin loss in the Terudermis graft patients.

Conclusion: In the present study, the Terudermis, when used to treat post-traumatic facial skin defects, is a good alternative option to obtain satisfactory aesthetic outcomes. Also, the Terudermis grafting is a simple and easy treatment method to perform.
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http://dx.doi.org/10.7181/acfs.2018.19.1.35DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894543PMC
March 2018

Surgical Methods of Zygomaticomaxillary Complex Fracture.

Arch Craniofac Surg 2016 Dec 23;17(4):206-210. Epub 2016 Dec 23.

Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.

Background: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods.

Methods: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded.

Results: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%).

Conclusion: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.
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http://dx.doi.org/10.7181/acfs.2016.17.4.206DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556838PMC
December 2016

Comparison Study of the Use of Absorbable Materials as Internal Splints with Airway Silicone Splint and Absorbable Materials as Internal Splints Alone.

Arch Craniofac Surg 2016 Dec 23;17(4):202-205. Epub 2016 Dec 23.

Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.

Background: Packing after closed reduction of nasal fracture causes uncomfortable nasal obstruction in patients. We packed the superior meatus with synthetic polyurethane foam (SPF) to support the nasal bone, and packed the middle nasal meatus with a nasal airway splint (NAS) and SPF. The aim of this article is prospectively to compare the subjective patient discomfort of SPF (Nasopore Forte plus) packing alone and SPF with NAS.

Methods: We compared the prospectively subjective patient discomfort of SPF packing alone (group A) and SPF with NAS (group B) via visual analog scale (VAS; 0, no symptom; 100, most severe symptom).

Results: At first postoperative day group B showed significant lower scores in dry mouth, sleep disturbance, conversation difficulty. However at third postoperative day, VAS scores of each group had no statistically significant differences. Moreover at fifth postoperative day group A had statistically significant lower scores for nasal pain, dry mouth than the group B.

Conclusion: Combination method of using NAS and SPF have some advantage on the patient comfort from first postoperative day to third postoperative day.
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http://dx.doi.org/10.7181/acfs.2016.17.4.202DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556837PMC
December 2016

Sepsis Leading to Mortality after Augmentation Rhinoplasty with a Septal Extension Graft and Fat Grafting.

Arch Plast Surg 2016 May 18;43(3):295-6. Epub 2016 May 18.

Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.

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http://dx.doi.org/10.5999/aps.2016.43.3.295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876164PMC
May 2016

Further Evidence of Increasing Diversity of Plasmodium vivax in the Republic of Korea in Recent Years.

PLoS One 2016 18;11(3):e0151514. Epub 2016 Mar 18.

Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, NT 0810, Australia.

Background: Vivax malaria was successfully eliminated from the Republic of Korea (ROK) in the late 1970s but re-emerged in 1993. Two decades later as the ROK enters the final stages of malaria elimination, dedicated surveillance of the local P. vivax population is critical. We apply a population genetic approach to gauge P. vivax transmission dynamics in the ROK between 2010 and 2012.

Methodology/principal Findings: P. vivax positive blood samples from 98 autochthonous cases were collected from patients attending health centers in the ROK in 2010 (n = 27), 2011 (n = 48) and 2012 (n = 23). Parasite genotyping was undertaken at 9 tandem repeat markers. Although not reaching significance, a trend of increasing population diversity was observed from 2010 (HE = 0.50 ± 0.11) to 2011 (HE = 0.56 ± 0.08) and 2012 (HE = 0.60 ± 0.06). Conversely, linkage disequilibrium declined during the same period: IAS = 0.15 in 2010 (P = 0.010), 0.09 in 2011 (P = 0.010) and 0.05 in 2012 (P = 0.010). In combination with data from other ROK studies undertaken between 1994 and 2007, our results are consistent with increasing parasite divergence since re-emergence. Polyclonal infections were rare (3% infections) suggesting that local out-crossing alone was unlikely to explain the increased divergence. Cases introduced from an external reservoir may therefore have contributed to the increased diversity. Aside from one isolate, all infections carried a short MS20 allele (142 or 149 bp), not observed in other studies in tropical endemic countries despite high diversity, inferring that these regions are unlikely reservoirs.

Conclusions: Whilst a number of factors may explain the observed population genetic trends, the available evidence suggests that an external geographic reservoir with moderate diversity sustains the majority of P. vivax infection in the ROK, with important implications for malaria elimination.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151514PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4798397PMC
August 2016

The unique distribution of the Plasmodium vivax merozoite surface protein 1 in parasite isolates with short and long latent periods from the Republic of Korea.

Malar J 2015 Aug 5;14:299. Epub 2015 Aug 5.

Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.

Background: Vivax malaria occurring in the Republic of Korea is occasionally characterized by a long latent infection induced by hypnozoites in the liver. So far, the mechanisms responsible for short and long latent infections of vivax malaria are not known. Therefore, the present study classified the parasite isolates according to the long and short latent periods and then analysed the genetic diversity of the Plasmodium vivax merozoite surface protein 1 (PvMSP-1).

Methods: Blood samples containing P. vivax isolates were collected from 465 patients from 2011 to 2013 at health centers in the Republic of Korea. PvMSP-1 gene sequences were analysed in groups classified by the collection year, and short or long latent periods. The samples in short and long latent periods were selected by the timing of vivax malaria occurrence, July-August and January-May, respectively.

Results: Three PvMSP-1 types (Sal-1, Belem, and recombinant) were observed in P. vivax isolates collected from 2011 to 2013. Interestingly, the recombinant and Sal-1 types were dominant in vivax malaria of the long and short latent periods, respectively. In addition, the S-b like subtype of the PvMSP-1 Sal-1 type was first identified in 2013.

Conclusion: This study revealed that the genetic type of PvMSP-1 is likely related to the duration of its latent period. Moreover, trends of the genetic types of PvMSP-1 seem to be stable in recent years compared with those of previous years in which various new types were observed.
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http://dx.doi.org/10.1186/s12936-015-0803-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524012PMC
August 2015

Three cases of acquired simulated brown syndrome after blowout fracture operations.

Arch Plast Surg 2015 May 14;42(3):346-50. Epub 2015 May 14.

Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital, Ulsan, Korea.

Brown syndrome is known as limited elevation of the affected eye during adduction. It is caused by a disorder of the superior oblique tendon, which makes it difficult for the eyeball to look upward, especially during adduction. It is classified into congenital true sheath Brown syndrome and acquired simulated Brown syndrome. Acquired simulated Brown syndrome can be caused by trauma, infection, or inflammatory conditions. The surgical restoration of blowout fractures can also lead to limitations of ocular motility, including Brown syndrome. We report on three patients with acquired simulated Brown syndrome, who complained of diplopia and limitation of ocular motility after operations to treat blowout fractures.
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http://dx.doi.org/10.5999/aps.2015.42.3.346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439596PMC
May 2015

Development and efficacy of real-time PCR in the diagnosis of vivax malaria using field samples in the Republic of Korea.

PLoS One 2014 22;9(8):e105871. Epub 2014 Aug 22.

Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea.

The development of sensitive, rapid, and accurate diagnostic methods for vivax malaria is essential for the effective control of malaria in the Republic of Korea, where vivax malaria patients usually show low parasitemia. In this study, a TaqMan-based real-time polymerase chain reaction (PCR) method was established and compared with other PCR-based assays, including nested PCR, loop-mediated isothermal amplification, and multiplex PCR, using samples from febrile patients with suspected vivax malaria. The established real-time PCR had a high sensitivity (99.6%) and specificity (100%). Therefore, this sensitive, specific, rapid, and quantitative real-time PCR method could be used for the routine diagnosis of vivax malaria in the laboratory of the Korea National Institute of Health.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0105871PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141806PMC
March 2016

First evaluation of glucose-6-phosphate dehydrogenase (G6PD) deficiency in vivax malaria endemic regions in the Republic of Korea.

PLoS One 2014 22;9(5):e97390. Epub 2014 May 22.

Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration, Osong, Republic of Korea.

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect and affects more than 400 million people worldwide. This deficiency is believed to protect against malaria because its global distribution is similar. However, this genetic disorder may be associated with potential hemolytic anemia after treatment with anti-malarials, primaquine or other 8-aminoquinolines. Although primaquine is used for malaria prevention, no study has previously investigated the prevalence of G6PD variants and G6PD deficiency in the Republic of Korea (ROK).

Methods: Two commercialized test kits (Trinity G-6-PDH and CareStart G6PD test) were used for G6PD deficiency screening. The seven common G6PD variants were investigated by DiaPlexC kit in blood samples obtained living in vivax malaria endemic regions in the ROK.

Results: Of 1,044 blood samples tested using the CareStart G6PD test, none were positive for G6PD deficiency. However, a slightly elevated level of G6PD activity was observed in 14 of 1,031 samples tested with the Trinity G-6-PDH test. Forty-nine of the 298 samples with non-specific amplification by DiaPlexC kit were confirmed by sequencing to be negative for the G6PD variants.

Conclusions: No G6PD deficiency was observed using phenotypic- or genetic-based tests in individuals residing in vivax malaria endemic regions in the ROK. Because massive chemoprophylaxis using primaquine has been performed in the ROK military to kill hypnozoites responsible for relapse and latent stage vivax malaria, further regular monitoring is essential for the safe administration of primaquine.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0097390PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031118PMC
June 2015

Adjunctive techniques to traditional advancement procedures for treating severe blepharoptosis.

Plast Reconstr Surg 2014 Apr;133(4):887-896

Ulsan, South Korea; and Los Angeles, Calif. From the Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital; Dream Medical Group; and the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of California, Los Angeles.

Background: To create a more physiologic eyelid opening in patients with severe blepharoptosis, the authors used lamina propria mucosa of conjunctiva, which continues to the check ligament of the superior fornix, in addition to levator aponeurosis and Müller's muscle as a composite flap. In patients with epicanthal folds with associated telecanthus, the authors also performed epicanthoplasty with medial canthal tendon shortening.

Methods: Fifty blepharoptosis patients (85 eyelids) with a degree of ptosis of greater than 4 mm underwent the advancement technique using the levator aponeurosis-Müller's muscle-lamina propria mucosa of conjunctiva as a composite flap. Twenty-one (42 percent) of those patients also underwent split V-W epicanthoplasty and plication of the medial canthal tendon for epicanthal folds with associated telecanthus. Degree of ptosis and levator function were measured preoperatively and postoperatively.

Results: Complete or near-complete correction of ptosis (degree of ptosis, <1 mm) was achieved in 54 eyelids (63.5 percent) and mild residual ptosis (degree of ptosis, 1 to 2 mm) was observed in 22 eyelids (25.9 percent) in postoperative follow-up after 6 months. The most common complication was reoperation, which was done in 15 eyelids (17.6 percent) because of incomplete correction.

Conclusions: The advancement technique using the levator aponeurosis- Müller's muscle-lamina propria mucosa of conjunctiva composite was effective in the treatment of severe blepharoptosis with levator function of 2 to 7 mm. The technique produced elevating motion of the physiologic eyelid in a superior-posterior direction. There were no serious complications, such as long-term lagophthalmos or lid lag.

Clinical Question/level Of Evidence: Therapeutic, IV.
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http://dx.doi.org/10.1097/PRS.0000000000000011DOI Listing
April 2014

First characterization of Plasmodium vivax liver stage antigen (PvLSA) using synthetic peptides.

Parasit Vectors 2014 Feb 12;7:64. Epub 2014 Feb 12.

Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong Saeng-myeong 2 ro, Osong Health Technology Administration Complex 187, Osong, Republic of Korea.

Background: Plasmodium vivax is the most widespread human malaria in tropical and subtropical countries, including the Republic of Korea. Vivax malaria is characterized by hypnozoite relapse and long latency infection by the retained liver stage of P. vivax, and somewhat surprisingly, little is known of the liver stage antigens of this parasite. Here, we report for the first time the characterization of a liver stage antigen of P. vivax (PvLSA).

Methods: Five peptides located inside PvLSA were synthesized, and specific anti-sera to the respective peptides were used to localize PvLSA on P. vivax parasites in human liver cells by immunofluorescence. Western blotting and enzyme-linked immunosorbent assay were performed using the five peptides and sera collected from vivax malaria patients and from normal healthy controls.

Results: PvLSA was localized on P. vivax parasites in human liver cells. Vivax malaria-infected patients were detected using the five peptides by western blotting. Furthermore, the peptides reacted with the sera of vivax malaria patients.

Conclusions: These results suggest that PvLSA may function during the liver stage of P. vivax.
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http://dx.doi.org/10.1186/1756-3305-7-64DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925417PMC
February 2014

Combined epicanthoplasty and blepharoptosis correction in Asian patients.

Plast Reconstr Surg 2013 Oct;132(4):510e-519e

Daegu and Ulsan, Republic of Korea From the Department of Plastic and Reconstructive Surgery, College of Medicine, Catholic University of Daegu; and the Department of Plastic and Reconstructive Surgery, Dong Kang General Hospital.

Background: In ptosis surgery, not addressing the epicanthal fold leaves a persistent rounded nasal scleral triangle, which blunts the effect of ptosis repair and leads to patient dissatisfaction. To achieve satisfactory results, epicanthoplasty is usually performed with ptosis correction. Furthermore, surgeons usually choose epicanthoplasty methods based on personal preference, and no guideline exists for selecting optimal methods. The aim of this study was to demonstrate the usefulness of a concomitant procedure (ptosis correction and epicanthoplasty) and to provide recommendations for the selection of epicanthoplasty.

Methods: The medical records of 99 patients that underwent simultaneous ptosis correction and epicanthoplasty from September of 2003 to January of 2011 were reviewed. Differences between preoperative and postoperative interepicanthal distances were analyzed by using patient photographs, and interepicanthal distance changes were evaluated for each epicanthoplasty.

Results: Epicanthoplasty was performed in the 99 patients using elliptical excision epicanthoplasty in 24 cases, periciliary epicanthoplasty in 12 cases, half-Z epicanthoplasty in eight cases, and V-W epicanthoplasty in 55 cases. Some changes in interepicanthal distances were observed after epicanthoplasty. Interepicanthal distance changes depended on the method used (elliptical excision epicanthoplasty, 3.1 mm; half-Z epicanthoplasty, 4 mm; periciliary epicanthoplasty, 5.3 mm; and V-W epicanthoplasty, 5.4 mm). The greatest differences between preoperative and postoperative interepicanthal distance values were found for periciliary and V-W epicanthoplasty, and these differences were statistically significant. No revision operations were conducted, and most patients were satisfied with results.

Conclusions: In general, concurrent ptosis and epicanthus should be corrected to provide optimal cosmetic benefit. Periciliary or V-W epicanthoplasty is indicated when epicanthal folds are severe.

Clinical Question/level Of Evidence: Therapeutic, IV.
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http://dx.doi.org/10.1097/PRS.0b013e3182a013d2DOI Listing
October 2013

Comparison of rapid diagnostic tests for the detection of Plasmodium vivax malaria in South Korea.

PLoS One 2013 7;8(5):e64353. Epub 2013 May 7.

Division of Malaria and Parasitic Diseases, National Institute of Health, Korea CDC, Osong, Republic of Korea.

South Korea is one of many countries with endemic Plasmodium vivax malaria. Here we report the evaluation of four rapid diagnostic tests (RDTs) for diagnosis of this disease. A total of 253 subjects were enrolled in the study. The sensitivities, specificities and agreement frequencies were estimated by comparing the four RDTs against the standard of nested-PCR and microscopic examination. The CareStart(TM) and SD Bioline had higher test sensitivities (99.4 and 98.8%, respectively) compared with the NanoSign and Asan Easy tests (93.0 and 94.7%, respectively). The CareStart(TM) and SD Bioline tests could detect P. vivax in samples with parasite densities <150/μl, which was a slightly better performance than the other two RDTs. The quantitative accuracy of the four RDTs was also estimated by comparing results with P. vivax counts from blood samples. Lower test price would result in increased use of these RDTs in the field. The results of this study contribute valuable information that will aid in the selection of a diagnostic method for the detection of malaria.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0064353PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646812PMC
December 2013

Rhamnetin-induced suppression of clonal expansion during early stage of adipogenesis.

Arch Pharm Res 2012 Jun 30;35(6):1083-9. Epub 2012 Jun 30.

College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju 361-763, Korea.

Adipocyte differentiation plays a pivotal role in the progression of obesity which is a major risk factor for several diseases such as diabetes, hypertension and coronary heart disease. In this study, the inhibitory effect of rhamnetin, a flavonoid compound, on adipogenesis in 3T3-L1 cells was investigated. Rhamnetin decreased the accumulation of lipid droplets, and inhibited the elevation of triglyceride content in the adipocytes (IC(50) = 17.3 μM). The expressions of PPARγ, C/EBPα, and perilipin, adipocyte differentiation markers, were significantly reduced by rhamnetin. Triglyceride biosynthesis and clonal expansion of adipocytes were completely inhibited during the early stage by rhamnetin. Additionally, rhamnetin significantly decreased the expression of C/EBPβ, an early stage marker. Our results indicate that suppression of clonal expansion during the early stage of adipogenesis by rhamnetin may be associated with inhibition of the C/EBPβ, C/EBPα, and PPARγ pathways.
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http://dx.doi.org/10.1007/s12272-012-0616-7DOI Listing
June 2012

Inverse relationship between adipocyte differentiation and ceramide level in 3T3-L1 cells.

Biol Pharm Bull 2011 ;34(6):912-6

College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju, Korea.

Adipocyte differentiation has been a target in anti-obesity strategies and is known to be closely related to lipid metabolism. Ceramide, a major sphingolipid metabolite, has been implicated in differentiation. In this study, we investigated whether ceramide biosynthesis is related to adipogenesis in 3T3-L1 cells. Preadipocytes can be differentiated synchronously by a mixture of adipogenic inducers including 3-isobutyl-1-methylxanthine, dexamethasone and insulin. The number of lipid droplets and the triglyceride content, which are differentiation biomarkers, gradually increased during adipogenesis. Interestingly, ceramide and sphingosine contents in the differentiated cells were decreased compared to those in preadipocytes. When the preadipocytes were treated with an 3-isobutyl-1-methylxanthine- or dexamethasone- or insulin-deficient mixture of inducers, the cellular ceramide levels were significantly increased compared with those in cells treated with the complete set of inducers. When preadipocytes were treated with 0, 0.1 or 1 µg/ml insulin along with 3-isobutyl-1-methylxanthine and dexamethasone, the ceramide levels were decreased and the triglyceride content was increased in a concentration-dependent manner. When the cells were treated with epigallocatechin gallate, an adipocyte differentiation inhibitor, during adipogenesis, the ceramide levels of adipocytes were increased and the fat content was decreased. In conclusion, our findings demonstrate that cellular ceramide levels are inversely correlated with adipocyte differentiation.
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http://dx.doi.org/10.1248/bpb.34.912DOI Listing
October 2011

Simultaneous HPLC analysis of ceramide and dihydroceramide in human hairs.

Arch Pharm Res 2009 Dec 17;32(12):1795-801. Epub 2010 Feb 17.

College of Pharmacy and CBITRC, Chungbuk National University, Cheongju, 361-763, Korea.

Ceramide, a major class of hair lipid, can help determine the physicochemical properties of human hairs such as the chemical diffusion barrier and water retention. In this study, we developed a quantitation method for ceramide and dihydroceramide, a saturated form of ceramide, in human hairs. Lipids were extracted with ethanol from human hairs spiked with N-oleoyl-D-erythro-C(17) sphingosine, an internal standard. Ceramide and dihydroceramide were resolved by TLC and deacylated by sphingolipid-ceramide deacylase to release sphingosine and dihydrosphingosine, respectively. The hair content of ceramide was measured by HPLC following derivatization with o-phthalaldehyde. The limits of detection and quantification for ceramide extracted from hair fibers were 0.1 and 1 pmol, respectively. The linear range of hair weight for determining ceramide and dihydroceramide contents was 1 to 50 mg, with R(2) values of 0.9695 and 0.9898, respectively. The recoveries of ceramide and dihydroceramide from intra-day and interday assays were 99.55% to 98.53%, respectively. Concentrations of dihydroceramide from the hair roots to distal tip ends ranged from 10.42 +/- 2.19 to 1.20 +/- 0.11 nmol/g hair, while those of ceramide ranged from 2.27 +/- 0.22 to 1.47 +/- 0.15 nmol/g hair. The present analytical method provides a simultaneous and reproducible quantification of ceramide and dihydroceramide, and may be used as a potential biomarker for lipid abnormality-related diseases.
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http://dx.doi.org/10.1007/s12272-009-2219-5DOI Listing
December 2009
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