Multimodality cardiovascular imaging in pulmonary embolism

Acute pulmonary embolism (APE) is one of the leading causes of cardiovascular (CV) morbidity andmortality. To select appropriate therapeutic strategy and/or to minimize the mortality and morbidity,rapid and correct identification of life-threatening APE is very important. Also, right ventricular (RV)failure usually precedes acute hemodynamic compromise or death, and thus the identification of RVfailure is another important step in risk stratification or treatment of APE. With advances in diagnosisand treatment, the prognosis of APE has been dramatically improving in most cases, but inadequatetherapy or recurrent episodes of pulmonary embolism (PE) may result in negative outcomes or, so called,chronic thromboembolic pulmonary hypertension (CTEPH). CTEPH is a condition characterized byremaining chronic thromboembolic material in the pulmonary vasculature and subsequent chronicpulmonary hypertension.Various imaging modalities include chest computed tomography pulmonary angiography (CTPA),echocardiography, magnetic resonance imaging, and nuclear imaging and each are used for the assessmentof varying status of PE. Assessment of thromboembolic burden by chest CTPA is the first step inthe diagnosis of PE. Hemodynamic assessment can be achieved by echocardiography and also by chestCTPA. Nuclear imaging is useful in discriminating CTEPH from APE.Better perspectives on diagnosis, risk stratification and decision making in PE can be provided bycombining multimodality CV imaging. Here, the advantages or pitfalls of each imaging modality indiagnosis, risk stratification, or management of PE will be discussed

Severe bimaxillary protrusion with adult periodontitis treated by corticotomy and compression osteogenesis

This paper describes the case of a 50-year-old female with a Class 11 malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy (ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy (Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery. (Korean J Orthod 2009;39(1):54-65)This study was partly supported by the Korean Society of Speedy Orthodontics, Alumni fund of the Department of Dentistry and Graduate School of Clinical Dental Science, The Catholic University of Korea.1

Treatment-Seeking Behaviors and Related Epidemiological Features in Korean Acne Patients

Little is known about the treatment-seeking behaviors of acne patients, especially Asian acne patients. This study was performed to obtain detailed information about the treatment-seeking behaviors in Korean acne patients. Patients who visited the dermatology departments at 17 university hospitals completed a self-administered questionnaire. Most patients obtained information about acne from doctors or the Internet. The most important criteria for selecting a treatment method or choosing a particular clinic were effectiveness and accessibility. Patients used traditional medicine, visited beauty clinics, drank more water, and used over-the-counter topical agents more frequently than they sought doctors during the worsening period. The degree of satisfaction in treatment was found to depend on the total cost of treatment, number of places visited, site affected by acne, and emotional stress. Those who had experienced a side effect tended to have been treated for longer, to have paid more for treatment, and to have an associated skin disease. Treatments prescribed by dermatology clinics had the lowest aggravating rate, although improvement rates for family medicine clinics were also fairly high. This is the first study to investigate in detail the demographic features and characteristics of the treatment-seeking behaviors of acne patients in Asia

Identifying genetic variants underlying medication-induced osteonecrosis of the jaw in cancer and osteoporosis: a case control study

Background Bisphosphonate-induced osteonecrosis of the jaw (BRONJ) presents with a typical pattern of jaw necrosis in patients who have been prescribed bisphosphonates (BPs) and other antiangiogenetic drugs to treat osteoporosis or bone-related complications of cancer. Methods This study divided 38 patients with BRONJ into two groups according to the prescribing causes: cancer (n = 13) and osteoporosis (n = 25), and underwent whole exome sequencing and compared them with normal controls (n = 90). To identify candidate genes and variants, we conducted three analyses: a traditional genetic model, gene-wise variant score burden, and rare-variant analysis methods. Results The stop-gain mutation (rs117889746) of the PZP gene in the BRONJ cancer group was significantly identified in the additive trend model analysis. In the cancer group, ARIDS, HEBP1, LTBP1, and PLVAP were identified as candidate genes. In the osteoporosis group, VEGFA, DFFA, and FAM193A genes showed a significant association. No significant genes were identified in the rare-variant analysis pipeline. Biologically accountable functions related to BRONJ occurrence-angiogenesis-related signaling (VEGFA and PLVAP genes), TGF-β signaling (LTBP1 and PZP genes), heme toxicity (HEBP1) and osteoblast maturation (ARIDS)-were shown in candidate genes. Conclusion This study showed that the candidate causative genes contributing to the development of BRONJ differ according to the BP dose and background disease.This work was supported by the Education and Research Encouragement Fund of Seoul National University Hospital and the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF2018R1D1A1A02086109). There are no conficts of interest to declare

Hepatoprotective and Antioxidative Activities of Cornus officinalis against Acetaminophen-Induced Hepatotoxicity in Mice

The fruit of Cornus officinalis Sieb. et Zucc. is commonly prescribed in Asian countries as a tonic formula. In this study, the hepatoprotective effect of ethanolic extracts of the fruit of C. officinalis (ECO) was investigated in a mouse model of acetaminophen- (APAP-) induced liver injury. Pretreatment of mice with ECO (100, 250, and 500 mg/kg for 7 days) significantly prevented the APAP (200 mg/kg) induced hepatic damage as indicated by the serum marker enzymes (AST, ALT, and LDH). Parallel to these changes, ECO treatment also prevented APAP-induced oxidative stress in the mice liver by inhibiting lipid peroxidation (MDA) and restoring the levels of antioxidant enzymes (SOD, CAT, and HO-1) and glutathione. Liver injury and collagen accumulation were assessed using histological studies by hematoxylin and eosin staining. Our results indicate that ECO can prevent hepatic injuries associated with APAP-induced hepatotoxicity by preventing or alleviating oxidative stress