Unilateral Recession-Resection Surgery with Inferior Displacement Combined with Augmented Anterior Transposition of Inferior Oblique Muscle

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia

Rationale of decreasing low-density lipoprotein cholesterol below 70 mg/dL in patients with coronary artery disease: A retrospective virtual histology-intravascular ultrasound study

Background: The associations between statin and coronary plaque compositional changes were re­ported according to the use of high dose or not. An evaluation of the impact of low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL by using real world dosages of statin on coronary plaque composition was undertaken. Methods: The study subjects consisted of 61 patients (mean 59.9 years old, 45 males) who underwent percutaneous coronary intervention, baseline and follow-up (F/U; mean 8.4 months) virtual histology- -intravascular ultrasound (VH-IVUS) examination. Change of plaque composition at peri-stent area, which was selected in order to measure the identical site at F/U study, was compared according to the F/U LDL-C level. Results: Body mass index, prevalence of dyslipidemia, baseline total cholesterol and baseline LDL-C were significantly lower in F/U LDL-C < 70 mg/dL group (14 segments in 10 patients) than F/U LDL-C ≥ 70 mg/dL group (79 segments in 51 patients). F/U high-density lipoprotein cholesterol (HDL-C, OR 1.06, 95% CI 1.00–1.11, p = 0.054) and F/U LDL-C < 70 mg/dL (OR 3.43, 95% CI 0.97–12.17, p = 0.056) showed strong tendency of regression of necrotic core volume (NCV) ≥ 10%. In multivariable logis­tic regression analysis, F/U HDL-C (OR 1.07, 95% CI 1.01–1.14, p = 0.020) and F/U LDL-C < 70 mg/dL (OR 8.02, 95% CI 1.58–40.68, p = 0.012) were the independent factors for regression of NCV ≥ 10%. Conclusions: Follow-up LDL-C level < 70 mg/dL with any types of statins and increase of HDL-C were associated with regression of NCV ≥ 10% in patients with coronary artery disease

Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

BackgroundFirst suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults.MethodsBetween 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm.ResultsOf a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results.ConclusionsA composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results

Public Key Encryption with Equality Test in the Standard Model

Public key encryption with equality test (PKEET) is a cryptosystem that allows a tester who has trapdoors issued by one or more users $U_i$ to perform equality tests on ciphertexts encrypted using public key(s) of $U_i$. Since this feature has a lot of practical applications including search on encrypted data, several PKEET schemes have been proposed so far. However, to the best of our knowledge, all the existing proposals are proven secure only under the hardness of number-theoretic problems and the random oracle heuristics. In this paper, we show that this primitive can be achieved not only generically from well-established other primitives but also even without relying on the random oracle heuristics. More precisely, our generic construction for PKEET employs a two-level hierarchical identity-based encryption scheme, which is selectively secure against chosen plaintext attacks, a strongly unforgeable one-time signature scheme and a cryptographic hash function. Our generic approach toward PKEET has several advantages over all the previous works; it directly leads the first standard model construction and also directly implies the first lattice-based construction. Finally, we show how to extend our approach to the identity-based setting

Comparison of infarct-related artery vs multivessel revascularization in ST-segment elevation myocardial infarction with multivessel disease: Analysis from Korea Acute Myocardial Infarction Registry

Background: Many ST-segment elevation myocardial infarction (STEMI) patients have multivessel disease. There is still controversy in treatment strategy in STEMI patients with multivessel disease. We compared clinical outcomes of multivessel revascularization with infarct- related artery (IRA) revascularization in STEMI patients. Methods: The 1,644 STEMI patients with multivessel disease (1,106 in IRA group, 538 in multivessel group) who were received primary percutaneous coronary intervention (PCI) were analyzed from a nationwide Korea Acute Myocardial Infarction Registry. Primary endpoint was 12-month major adverse cardiac events (MACE, defined as death, myocardial infarction, and repeated revascularization). Secondary endpoints were 1-month MACE and each component, stent thrombosis during 12 month follow-up, and each components of the 12-month MACE. Results: There were more patients with unfavorable baseline conditions in IRA group. 12-month MACE occurred in 165 (14.9%) patients in IRA group, 81 (15.1%) patients in multivessel group (p = 0.953). There were no statistical significance in the rate of 1-month MACE, each components of 1-month MACE, and stent thrombosis during 12 month follow-up. Each components of 12-month MACE were occurred similarly in both groups except for target lesion revascularization (2.4% in IRA group vs 5.9% in multivessel group, p < 0.0001). After adjusting for confounding factors, multivessel revascularization was not associated with reduced 12-month MACE (OR 1.096, 95% CI 0.676&#8211;1.775, p = 0.711). Conclusions: There were no significant differences in clinical outcomes between both groups except for high risk of target lesion revascularization in multivessel revascularization group

Characteristics of Body Fat, Body Fat Percentage and Other Body Composition for Koreans from KNHANES IV

Accurate measurement of fat mass has become increasingly important with the increasing incidence of obesity. We assessed fat and muscle mass of Koreans with the Korea National Health and Nutrition Examination Survey IV (KNHANES IV). We studied 10,456 subjects (aged 20 to 85 yr; 4,476 men, 5,980 women). Fat and muscle mass were measured by dual-energy x-ray absorptiometry. Reference values of body compositions were obtained using the LMS method. The fat mass index (FMI, body fat mass/height2; kg/m2) of Korean men did not correlate with age (P = 0.452), but those of Korean women (P < 0.001) did. The ratio of percentage of fat in the trunk and legs was positively related with age in both the genders. The appendicular lean mass/height2 (kg/m2) of Korean men was negatively related to age (P < 0.001). In women, this ratio increased with age (P < 0.001). When we defined obesity according to the FMI classification, the rates of obesity were 6.1% (FMI > 9 kg/m2) in men and 2.7% (FMI > 13 kg/m2) in women. It is concluded that the muscle mass decreases and obesity increases with aging in Korean men, whereas both fat mass and obesity increase with aging in Korean women

Urachal Actinomycosis Mimicking a Urachal Tumor

A 26-year-old man presented with lower abdominal discomfort and a palpable mass in the right lower quadrant. An abdominal computed tomography (CT) scan revealed an abdominal wall mass that extended from the dome of the bladder. Fluorine-18 fluorodeoxyglucose (FDG) positron-emission tomography/CT (PET/CT) showed hypermetabolic wall thickening around the bladder dome area that extended to the abdominal wall and hypermetabolic mesenteric infiltration. Differential diagnosis included a urachal tumor with invasion into adjacent organs and chronic inflammatory disease. Partial cystectomy with abdominal wall mass excision was performed, and the final pathologic report was consistent with urachal actinomycosis

In-stent restenosis-prone coronary plaque composition: A retrospective virtual histology-intravascular ultrasound study

  Background: The mechanism of in-stent restenosis (ISR) is multifactorial, which includes biological, mechanical and technical factors. This study hypothesized that increased inflammatory reaction, which is known to be an important atherosclerotic process, at a culprit lesion may lead to higher restenosis rates. Methods: The study population consisted of 241 patients who had undergone percutaneous coronary intervention with virtual histology-intravascular ultrasound (VH-IVUS) and a 9-month follow-up coronary angiography. Compared herein is the coronary plaque composition between patients with ISR and those without ISR. Results: Patients with ISR (n = 27) were likely to be older (66.2 ± 9.5 years vs. 58.7 ± 11.7 years, p = 0.002) and have higher levels of high-sensitivity C-reactive protein (hs-CRP, 1.60 ± 3.59 mg/dL vs. 0.31 ± 0.76 mg/dL, p &lt; 0.001) than those without ISR (n = 214). VH-IVUS examination showed that percent necrotic core volume (14.3 ± 8.7% vs. 19.5 ± 9.1%, p = 0.005) was higher in those without ISR than those with ISR. Multivariate analysis revealed that hs-CRP (odds ratio [OR] 3.334, 95% con­fidence interval [CI] 1.158–9.596, p = 0.026) and age (OR 3.557, 95% CI 1.242–10.192, p = 0.018) were associated with ISR. Conclusions: This study suggests that ISR is not associated with baseline coronary plaque composition but is associated with old age and increased expression of the inflammatory marker of hs-CRP. (Cardiol J 2018; 25, 1: 7–13