Clinical characteristics and treatment modalities of vulvovaginal atrophy in genitourinary syndrome of menopause

Background: Genitourinary syndrome of menopause (GSM) causes symptoms such as vaginal dryness, dysuria, repetitive urinary tract infection and urinary urgency may affect daily activities, sexual relationships, and overall quality of life. The aim of the study was to provide the clinical characteristics of VVA patients in South Korea and the effectiveness as well as complications of the currently used low dose estrogen vaginal suppository.Methods: 52 women who has visited the outpatient gynecology clinic of the National Health Insurance Service Ilsan Hospital from January 2018 to December 2019 were recruited as study subjects. For the analysis of the clinical characteristics, subjective symptoms described by the patient’s own words such as vaginal dryness, pain, dysuria, dyspareunia, or no symptoms at all were included. Objective signs such as thinning of vaginal rugae, mucosal dryness, and mucosal fragility and the presence of petechiae were recorded.Results: Vaginal dryness was the most common complaint (92.3%). Thinning of the vaginal rugae was the most commonly noted objective sign (73.1%). Of the 52 subjects, 31 (59.6%) refrained from using the low dose estrogen vaginal suppository. The most common reason for not being able to use the suppository was the inability to insert the suppository (32.3%).Conclusions: Although patient-reported symptoms and clinical objectivity through physical examination are two components in diagnosing VVA, further study is warranted for a more objective and discriminatory diagnosis criteria for VVA. As the only available treatment modality was low dose vaginal estrogen suppository, comparison with other treatment modalities were not available

Automatic mandibular canal detection using a deep convolutional neural network

The practicability of deep learning techniques has been demonstrated by their successful implementation in varied fields, including diagnostic imaging for clinicians. In accordance with the increasing demands in the healthcare industry, techniques for automatic prediction and detection are being widely researched. Particularly in dentistry, for various reasons, automated mandibular canal detection has become highly desirable. The positioning of the inferior alveolar nerve (IAN), which is one of the major structures in the mandible, is crucial to prevent nerve injury during surgical procedures. However, automatic segmentation using Cone beam computed tomography (CBCT) poses certain difficulties, such as the complex appearance of the human skull, limited number of datasets, unclear edges, and noisy images. Using work-in-progress automation software, experiments were conducted with models based on 2D SegNet, 2D and 3D U-Nets as preliminary research for a dental segmentation automation tool. The 2D U-Net with adjacent images demonstrates higher global accuracy of 0.82 than naïve U-Net variants. The 2D SegNet showed the second highest global accuracy of 0.96, and the 3D U-Net showed the best global accuracy of 0.99. The automated canal detection system through deep learning will contribute significantly to efficient treatment planning and to reducing patients’ discomfort by a dentist. This study will be a preliminary report and an opportunity to explore the application of deep learning to other dental fields.Peer reviewe

FK506-binding protein-like and FK506-binding protein 8 regulate dual leucine zipper kinase degradation and neuronal responses to axon injury

The dual leucine zipper kinase (DLK) is a key regulator of axon regeneration and degeneration in response to neuronal injury; however, regulatory mechanisms of the DLK function via its interacting proteins are largely unknown. To better understand the molecular mechanism of DLK function, we performed yeast two-hybrid screening analysis and identified FK506-binding protein-like (FKBPL, also known as WAF-1/CIP1 stabilizing protein 39) as a DLK-binding protein. FKBPL binds to the kinase domain of DLK and inhibits its kinase activity. In addition, FKBPL induces DLK protein degradation through ubiquitin-dependent pathways. We further assessed other members in the FKBP protein family and found that FK506-binding protein 8 (FKBP8) also induced DLK degradation. We identified the lysine 271 residue in the kinase domain as a major site of DLK ubiquitination and SUMO3 conjugation and was thus responsible for regulating FKBP8-mediated proteasomal degradation that was inhibited by the substitution of the lysine 271 to arginine. FKBP8-mediated degradation of DLK is mediated by autophagy pathway because knockdown of Atg5 inhibited DLK destabilization. We show that in vivo overexpression of FKBP8 delayed the progression of axon degeneration and suppressed neuronal death after axotomy in sciatic and optic nerves. Taken together, this study identified FKBPL and FKBP8 as novel DLK-interacting proteins that regulate DLK stability via the ubiquitin-proteasome and lysosomal protein degradation pathways

Venous Hemangioma of Parapharyngeal Space with Calcification

A hemangioma of the parapharyngeal space (PPS) is an extremely rare tumor and is responsible for 0.5-1% of all tumors occurring in the PPS. We report a case of PPS venous hemangioma in a 49-year-old woman presenting with diffuse swelling in the submandibular region. A preoperative computed tomography (CT) scan showed a cystic mass with multiple calcifications in the PPS. The calcific nodules were round and about 2 mm in diameter. The hemangioma was completely resected via a transcervical approach. During surgery, we found several calcific nodules, which represented phleoboliths or areas of thrombosis with dystrophic calcification. Despite its rarity, a venous hemangioma of the PPS should be considered in a differential diagnosis when a cystic mass with calcification is found by CT scan. To our knowledge, this is the first reported case of a PPS venous hemangioma; we describe its pathognomonic findings on imaging

A case of idiopathic isolated hypoglossal nerve palsy in a Korean child

Hypoglossal nerve palsy (HNP) is an uncommon neurological abnormality that can provoke characteristic clinical signs, including unilateral atrophy of the tongue musculature. We present the case of a healthy 11-year-old Korean male who was admitted to the outpatient department of our institution with acute onset dysarthria, tongue fasciculations, and right-sided tongue weakness upon awakening. His evaluation included a virology work-up, neck magnetic resonance imaging (MRI), brain MRI, and otorhinolaryngological physical examination; all tests were normal and showed no evidence of inflammation. Fifteen days after the onset of symptoms, the patient recovered completely. Herein, we report a case of idiopathic isolated HNP in a Korean male

Herbicidal Activities of Essential Oils from Pine, Nut Pine, Larch and Khingan Fir in Korea

ABSTRACT. The objective of this research was to understand herbicidal activity of essential oils isolated from leaves of pine (Pinus densiflora), nut pine (Pinus koraiensis), larch (Larix kaempferi) and khingan fir (Abies nephrolepsis) in Korea. In a seed bioassay, essential oils of nut pine, larch and khingan fir inhibited the growth of rapeseed (Brassica napus) seedlings by 50% at 4,766, 1,865, 5,934 µg ml , respectively, however, that of pine did not show any herbicidal effect. In a green house experiment, fall panicum, Southern crabgrass, sorghum, barnyardgrass, quackgrass, black nightshade, Indian jointvetch, velvet leaf, and Japanese morningglory were controlled in 24 hours by the foliar application of 10% essential oils from pine, nut pine, larch and khingan fir. The treated plant parts showed burndown effect, however, new shoots appeared 3 days after treatment. Results of GC-MS analysis showed that essential oils from pine, nut pine, larch and khingan fir contained 16, 25, 25, and 16 compounds, respectively, with hydrocarbons, alcohols, ketones, and esters. The major compounds of the essential oils were 3-carene, bornyl acetate, camphene, limonene, α-pinene, β-pinene and β-phellandrene