Incheon Catholic University

Background: Ultrasound is increasingly used in plastic surgery for real-time guidance in minimally invasive procedures. However, standardized approaches for targeting the facial nerve (FN) trunk, particularly for motor nerve interventions, remain limited. This study aimed to evaluate the anatomical feasibility of an ultrasound-guided approach to the FN trunk using the posterior belly of the digastric muscle (PBDM) as a landmark. Methods: An exploratory feasibility design was used with a single fresh-frozen cadaver to perform ultrasound-guided dye injections targeting the anterior and posterior surfaces of the PBDM. Subsequent layer-by-layer dissection evaluated dye distribution relative to the facial and hypoglossal nerves. Additionally, real-time Doppler ultrasound in a live participant was conducted to visualize adjacent vascular structures, including the occipital and vertebral arteries. Results: The FN trunk was located deep to the PBDM and near the stylomastoid foramen. Anterior injections reached the FN trunk, whereas posterior injections followed the trajectory of the hypoglossal nerve. Doppler ultrasound enabled clear visualization of major vascular structures, supporting safe needle trajectory planning. Conclusions: This cadaveric feasibility study demonstrates a potentially reproducible ultrasound-guided anatomical approach to the FN trunk using consistent musculoskeletal and vascular landmarks. Incorporating Doppler vascular mapping enhances procedural safety and accuracy, providing a practical framework to facilitate clinical translation of image-guided motor nerve interventions in plastic and reconstructive surgery.

Introduction: Acute myocarditis is extremely heterogenous in causal agents, clinical courses, and geographic regions. There is little long-term outcomes data for acute myocarditis prior to the COVID-19 pandemic. Hypothesis: The clinical profile of acute myocarditis would differ according to age at presentation. Methods: A retrospective nationwide cohort study was performed. All patients aged 20-79 who were hospitalized for acute myocarditis without underlying cardiac diseases from 2006 to 2018 in Korea. Complicated phenotype was defined as requiring hemodynamic or major organ support. Over 10 years, all-cause mortality and acute myocarditis-driven excess mortality were evaluated according to young-adult (20-39 years), mid-life (40-59 years), and older-adult (60-79 years) age groups. Results: Among 2988 patients (mean age 51.0 years), 362 (12.1%) were of complicated phenotype. All-cause death at 30 days occurred in 40 (4.7%), 52 (4.8%), and 105 (10.0%) patients in the young-adult, mid-life, and older adult groups, respectively (Figure A). Most short-term deaths occurred within 37 days of admission, primarily in the complicated phenotype. However, higher excess mortality compared to the age- and sex-matched general population remained over the 10-year follow-up even in younger patients with non-complicated phenotypes (Figure B). Conclusions: In patients with de novo acute hospitalized myocarditis, short-term mortality is high both in young and older adults, particularly those with advanced age, non-cardiac comorbidities, and severe clinical presentation. Furthermore, long-term excess mortality remains high over 10 years after index hospitalization. A cardiac monitoring strategy should be discussed for post-myocarditis patients against the long-term risk.

Purpose: This study identifies the individual and community level factors affecting the health-related quality of life (QOL) of the elderly based on an ecological model using multilevel analysis.Methods: As a secondary research, this study used the raw data, community health survey results, and database 1.0 data on community health outcomes and determinants from the same year. Survey participants were 62,710 respondents age ≥65 of 228,558, and database 1.0 data on community health outcomes and determinants were established targeting 254 regions nationally.Results: The health-related QOL showed differences according to the individual and community level factors. Additionally, estimating the effects of the community level factors through multilevel analysis was needed. In a model in which the individual and community level factors were simultaneously inserted, the significant community characteristic factor controlling the individual level factors was the number of hospital beds per thousand population (p=.028).Conclusion: In the multilevel analysis considering the individual and community level factors, the number of hospital beds per thousand population, which is a factor concerning medical access, was identified as a factor significantly affecting health-related QOL. The results should be considered in allocating and developing community- based healthcare resources and establishing strategies to improve the health-related QOL.

BackgroundTo investigate the dose‐response association between physical activity and lower respiratory tract infection (LoRI) outcomes in patients with cardiovascular disease.Methods and ResultsUsing the Korean National Health Insurance data, we identified individuals aged 18 to 99 years (mean age, 62.6±11.3 years; women, 49.6%) with cardiovascular disease who participated in health screening from January 1, 2009, to December 31, 2012 (n=1 048 502), and were followed up until 2018 for mortality and until 2019 for hospitalization. Amount of physical activity was assessed using self‐reported questionnaires and categorized into 5 groups: 0 (completely sedentary), <500, 500 to 999, 1000 to 1499, and ≥1500 metabolic equivalents of task min/wk. After controlling for various confounders, adjusted hazard ratios (95% CIs) were 1.00 (reference), 0.74 (0.70–0.78), 0.66 (0.62–0.70), 0.52 (0.47–0.57), and 0.54 (0.49–0.60) for LoRI mortality, and 1.00 (reference), 0.84 (0.83–0.85), 0.77 (0.76–0.79), 0.72 (0.70–0.73), and 0.71 (0.69–0.73) for LoRI hospitalization among those engaging in physical activity of 0, <500, 500 to 999, 1000 to 1499, and ≥1500 metabolic equivalents of task min/wk, respectively. Assuming linear association between 0 and 2000 metabolic equivalents of task min/wk, each 500–metabolic equivalents of task min/wk increase of physical activity was associated with reduced LoRI mortality and hospitalization by 22% and 13%, respectively. The negative association was stronger in the older population than in the younger population (P for interaction <0.01).ConclusionsIn patients with cardiovascular disease, engaging in even a low level of physical activity was associated with a decreased risk of mortality and hospitalization from LoRI than being completely sedentary, and incremental risk reduction was observed with increased physical activity.

This study was carried out to survey the flora of Hongdo Island in Sinan-gun, Jeollanam-do, South Korea. Specimens collected from previous Hongdo flora studies were reexamined using a relevant biodiversity database, and field surveys were carried out 22 times from April of 2003 to October of 2020. Based on the specimens collected during both previous studies and this study, the identified vascular plants of Hongdo consisted of 472 taxa comprising 102 families, 296 genera, 425 species, 6 subspecies, and 41 varieties. Among them, 111 taxa are newly recorded in this study, and 6 taxa are described in detail in terms of their morphological characteristics and habitat. Also, 29 taxa were reviewed or re-identified with corresponding taxonomic annotations. In Korea, Hongdo represents the northern distributional limit of the 4 taxa of Goodyera biflora, Damnacanthus major, Calanthe aristulifera, and Hemerocallis hongdoensis. Moreover, Hosta yingeri and Saussurea polylepis are endemic to Hongdo and nearby islands in Korea. Distribution maps of these species were prepared. Protected species designated by the Ministry of Environment were 7 taxa consisting of 2 taxa of level I, specifically Sedirea japonica and Neofinetia falcata, and 5 taxa of level II, which were Cymbidium macrorhizon, Woodwardia japonica, Dendrobium moniliforme, Calanthe aristulifera, and Bulbophyllum inconspicuum. Red list plants as designated by the National Institute of Biological Resources numbered 11 taxa. Naturalized plants numbered 40 taxa.

Botulinum toxin is usually injected into the muscles and glands, except during intradermal injection procedures. Botulinum toxin injection requires thorough anatomical understanding because even though target muscles for each indication are specific, we can only rely on the surface anatomy when injecting. In the last 15 years, anatomical research related to minimally invasive aesthetic treatments has greatly contributed to improving the precision compared to blind injection techniques.

The perioral area includes several anatomical regions: the upper lip including the philtrum area, lower lip, nasolabial fold region, mouth corner, cheek, and chin. The appearance of the perioral region changes with the aging process, repeated movements, loss of bony support, and sagging of the fat tissue. Other environmental factors, such as smoking, sunlight hazard, and poor oral hygiene, can accelerate the aging process. Rejuvenation of the perioral region can be challenging. However, the perioral region is a high risky area in minimally invasive procedures; therefore, anatomical understanding is critical to prevent serious complications.

Since treatment indications for fillers have developed beyond past extent, a broader comprehension regarding the facial anatomy is required. The advent of filler injection into practically any facial area has introduced a plethora of complications. Complications such as skin necrosis, blindness, and embolism can be detrimental, thus leaving practitioners wondering for a novel method that can reduce vessel-related complications. Incessant research on the vessel anatomy and distribution has been thoroughly executed, leading to fewer complications. Still, distinguishing every variation in each individual is impossible, and there will always be a limitation with blind injection. Implementing US imaging with fillers will be a revolutionary introduction to the field.