Sequential Assessment of External Nasal Deviation Angle Changes in Patients With a Deviated Nose Who Underwent Bilateral Osteotomy.

OBJECTIVE: A deviated nose is traditionally classified as bony, cartilaginous, or combined deviation. Osteotomy is commonly used to correct bony deviation, and accurate surgical techniques and postoperative patient management are important for favorable outcomes. The authors investigated the change in the external nasal deviation angle over time using sequential clinical photographs to identify the optimal postoperative follow-up duration. METHODS: Medical records and sequential standardized clinical photographs of 22 patients who underwent bilateral medial and lateral osteotomies without dorsal augmentation from January 1, 2014 to May 31, 2021, were retrospectively reviewed. Clinical photographs were classified into 4 periods: "a" preoperative, "b" postoperative day (POD) ≤3 weeks, "c" POD ≤9 weeks, and "d" POD >9 weeks. The angle of deviation (AoD) was measured in both frontal and chin-on-chest views for each period. Differences in AoD between temporally adjacent periods were analyzed. RESULTS: Nineteen men and 3 women (mean age: 28.8 y) were included. Thirteen patients showed rightward deviation, whereas 9 showed leftward deviation. Eleven patients underwent surgery through an endonasal approach, whereas the other 11 underwent surgery through an external approach. In the frontal view, AoD differences (mean ± SD) between periods "a" and "b," "b" and "c," and "c" and "d" were 5.79 ± 3.36 degrees (P < 0.001), 1.44 ± 1.14 degrees (P < 0.001), and 1.07 ± 1.24 degrees (P < 0.05), respectively. In the chin-on-chest view, the values were 5.17 ± 2.69 degrees (P < 0.001), 2.06 ± 2.63 degrees (P < 0.001), and 1.46 ± 1.31 degrees (P < 0.001), respectively. No statistically significant difference in AoD differences was observed between the two approaches. CONCLUSIONS: Angle of deviation can change even 9 weeks after bilateral osteotomy. Thus, long-term follow-up using sequential clinical photographs is mandatory. If needed, close follow-up with early postoperative interventions may be required. The chin-on-chest view showed better sensitivity for assessing AoD than the frontal view.

Solitary Sphenoid Sinus Lesion Presenting as Chronic Headache.

BACKGROUND AND OBJECTIVES: Headache is a common symptom with etiologies that are difficult to distinguish, 1 of which is sinusitis. A solitary sphenoid lesion, which is rare, can also cause acute or chronic headaches. The authors investigated whether endoscopic sinus surgery (ESS) for solitary sphenoid lesions could reduce headache symptoms. SUBJECTS AND METHODS: The authors reviewed the charts of patients who underwent ESS from 2012 to 2017, whose main symptom was a chronic headache for several years. There were no remarkable pathologic findings in the nasal cavity upon endoscopic examination. Medications for reducing headaches had transient effect. Brain magnetic resonance imaging or computed tomography scans showed a solitary sphenoid lesion and the patients underwent ESS by the same otolaryngologist. In total, 16 out of 547 ESS cases that met the above conditions were included in this study. The authors evaluated the duration, character, and degree of the headaches pre- and post-operatively. The authors also determined if there was a correlation between headaches, sphenoidal lesions, and pathologic outcomes. RESULTS: There were significant improvements in headaches after surgery. The pre- and post-operative mean visual analog scale score for headaches was 7.27 ±â€Š1.67 and 3.80 ±â€Š1.82, respectively. The pathologic outcomes revealed chronic inflammation in 11 patients, nasal polyp in 1 patient, inverted papilloma in 1 patient, and fungal infections in 3 patients, but there was no clinical correlation between the headache, lesion site, and pathology. CONCLUSIONS: A solitary sphenoid lesion can be the cause of acute or chronic headaches. Headaches from a solitary sphenoid sinus lesion, which were not controlled by medical treatments, could be improved by surgical procedures.

The Role of Orthography in Lexical Processing of the Phonological Variants in Second Language.

There is evidence that orthographic knowledge can influence on-line spoken-word recognition. Interestingly, when graphic and phonetic codes are not congruent due to the application of phonological alternation processes, people report hearing sounds that are matched to graphic (underlying), not phonetic codes (Hallé et al. in J Mem Lang 43:618-639, 2000). It is, however, not known whether the same effect arises in the processing of a non-native language (L2). In the present study, advanced Mandarin learners of Korean as well as native Korean listeners performed a phoneme monitoring task using words undergoing obstruent nasalization in Korean. The results showed that orthographic information dominated the phonetic judgments of the native Korean listeners, while the Mandarin learners' judgments relied more on the phonetic input. These results suggest that even the lexical access of highly experienced L2 learners differs from that of native speakers and that advanced learners still have difficulty employing orthographic information to access the L2 lexicon.

Saddle Deformity After Septoplasty and Immediate Correction.

OBJECTIVE: The aim of this study is to assess the saddle deformity after septoplasty and the usefulness of immediate correction. DESIGN: Retrospective study. SETTING: University medical center. PATIENTS: Of 658 patients who underwent endonasal septoplasty from January 2011 to July 2018, 14 underwent immediate cartilage dorsal augmentations following septoplasty for saddle deformity and were enrolled in this study. MAIN OUTCOME MEASURES: A total of 14 patients received immediate cartilage augmentation and were followed for >3 months after surgery. External nose status, patterns of septal deformity, and surgical results were investigated with profile view photographs, paranasal sinus computed tomography scans, and nasal endoscopy. Symptom improvement was measured using the Nasal Obstruction Symptom Evaluation scale. RESULTS: All patients had middle to high site septal deviation. Anterior deviation and central deviation have statistical significance compared to posterior part deviation (P = 0.025, P = 0.002) and mid part deviation has statistical significance compared to basal part deviation (P = 0.005). Postoperative subjective nasal symptoms of the 14 patients were improved from preoperation (18.54 ±â€Š2.46) to 1 month (7.54 ±â€Š2.16) and 3 months (1.72 ±â€Š1.55) postoperatively. CONCLUSIONS: Immediate endonasal cartilage augmentation for iatrogenic saddle deformity after septoplasty is easy, safe, and effective. Furthermore, this corrective treatment for post op complication is very important for both of surgeon and patient. Predispositions to postoperative saddle deformity included site and severity of preoperative nasal septal deviation.

Cartilage Trap-Door Flap Technique for Correction of High Nasal Septum Deflection.

OBJECTIVE: To introduce a novel cartilage trap-door flap technique in endonasal septoplasty to correct high dorsal deviation of the cartilaginous septum, and confirm its effectiveness. DESIGN: Prospective observational study. SETTING: Medical center. METHODS: 46 patients who had underwent septoplasty using the cartilage island flap technique to correct the high dorsal deviation from November 2014 to November 2015. The subjective symptoms were measured using the Nasal Obstruction Symptom Evaluation scale. The objective evaluations of the surgical results were analyzed using acoustic rhinometry. Post-operative status of the nasal septum was estimated by nasal endoscopic examination. RESULTS: Among 46 patients, 32 cases (69.57%) were "complete correction", 14cases (30.43%) were "improved" with residual deviation and there was not "no-change" or "even worse" case based on endoscopic examination. Minimal cross-sectional area in convex side of nasal cavity was significantly changed from 0.22cm to 0.56cm after the surgery, and nasal volume in narrower side of nasal cavity was significantly changed from 2.44mL to 6.22 mL. The patients' nasal obstruction symptoms significantly reduced from 10.43 before the surgery to 1.45 after the surgery. During the follow-up period, the authors have not experienced any obvious complications such as saddle nose, septal perforation, and bleeding. CONCLUSION: The proposed cartilage trap-door flap technique provides easy and effective results for dorsal deviations of the cartilaginous septum in selected cases without significant complications.

Novel Application of Ultrasonic Bone Aspirator for Hump Nose.

OBJECTIVE: This study was conducted to introduce and evaluate the efficacy of an ultrasonic bony aspirator in rhinoplasty for hump removal. DESIGN: Retrospective study. SETTING: University medical center. PATIENTS: Twenty patients who underwent hump removal using an ultrasonic bone aspirator from October 2013 to November 2016 were enrolled in the study. MAIN OUTCOME MEASURES: Patients were followed for >3 months after surgery. External nose status and surgical results were investigated using photographs. Postoperative complications were evaluated. RESULTS: Of the 30 patients enrolled in this study, 11 were females and 19 were males. Preoperative nasal deformities of all patients were characterized as bony humps. Postoperative dorsal status was significantly improved. There were no obvious complications such as over or under correction, delayed healing, infection, soft tissue injury, or deformity of the nasal dorsum. CONCLUSION: Application of an ultrasonic bone aspirator to remove humps in rhinoplasty is easy, safe, and effective.

PICOT alleviates myocardial ischemia-reperfusion injury by reducing intracellular levels of reactive oxygen species.

Excessive generation of reactive oxygen species (ROS) is one of the main causes of myocardial ischemia-reperfusion (I/R) injury. In this study, we investigated the role of protein kinase C-interacting cousin of thioredoxin (PICOT; Grx3) during myocardial I/R using PICOT transgenic (TG) and knockdown (KD) mice. Infarction and apoptosis were attenuated in PICOT TG mice but exacerbated in PICOT KD mice upon I/R. In parallel, I/R-induced generation of ROS was attenuated in PICOT TG mice but exacerbated in PICOT KD mice. Angiotensin II (AngII)-mediated increases in ROS and free iron levels were also attenuated in cardiomyocytes isolated from PICOT TG mice but exacerbated in cardiomyocytes from PICOT KD mice. Accordingly, H2O2-mediated cell death was attenuated in cardiomyocytes isolated from PICOT TG mice but exacerbated in cardiomyocytes from PICOT KD mice. Taken together, these data show that PICOT alleviates myocardial I/R injury by regulating intracellular ROS and free iron levels. We suggest that PICOT presents a novel therapeutic strategy for myocardial I/R injury.

The Influence of Orthography on the Production of Alphabetic, Second-Language Allophones by Speakers of a Non-alphabetic Language.

This study investigated the influence of orthographic information on the production of allophones in a second language (L2). Two proficiency levels of native Mandarin speakers learned novel Korean words with potential variants of /h/ based on auditory stimuli, and then they were provided various types of spellings for the variants, including the letters for [[Formula: see text]] and ø. Subsequently, picture-naming and spelling recall tasks were given to the Mandarin-speaking learners. The results showed that Mandarin-speaking learners, after exposure to the spellings, began to produce and lexically store the /h/ variants following the given forms of the spellings of words, which provides support for the impact of spellings in the production and lexical storage of L2 allophones. However, the effect of L2-learning experience was not shown to be strong, which suggests difficulty in the native-like attainment of the production of L2 allophones.

A carcinoid tumor arising from a mature cystic teratoma in a 25-year-old patient: a case study.

BACKGROUND: Mature cystic teratomas (MCTs) are common benign tumors occurring in the ovaries. Malignant transformation of teratomas (TMT) occurs in 1-3% of all MCTs, usually in postmenopausal women. Squamous cell carcinoma is the most common tumor type. Primary carcinoid tumors of the ovary are uncommon, representing only 0.3% of all carcinoid tumors and less than 0.1% of all ovarian cancers. CASE PRESENTATION: A carcinoid tumor of the trabecular type arising from a MCT is presented in a 25-year-old woman. TMT was detected incidentally. Histologically, uniform, polygonal cells were arranged in a cord and trabecular pattern. Immunohistochemical staining showed positivity for neuro-specific enolase, synaptophysin, and CD56. CONCLUSIONS: This case represents a very rare example of carcinoid tumor occurring in a woman younger than 30 years of age. Our findings suggest that sufficient tumor sampling is necessary to avoid overlooking small lesions, which, in our case, were not detected on either radiologic or gross examination.

Comparative analysis of Cutanplast and Spongostan nasal packing after endoscopic sinus surgery: a prospective, randomized, multicenter study.

Commercial gelatin-based packing materials are available under different names and compositions to be used after endoscopic sinus surgery (ESS). The purpose of this study was to investigate the efficacy of Spongostan and Cutanplast nasal packing on patients' subjective symptoms, hemostasis, and wound healing following ESS. One hundred adult patients with chronic sinusitis requiring the same extent of ESS were included. Following surgery, one nasal cavity was packed with Cutanplast and the other one with Spongostan. Patients' subjective symptoms while the packing was in situ, hemostatic properties, degree of remaining amount of packing materials, postoperative wound healing, and the cost of the pack were evaluated. Cutanplast and Spongostan are equally effective in the control of postoperative bleeding following ESS. However, Cutanplast packing was significantly more comfortable than Spongostan for nasal obstruction, postnasal drip, rhinorrhea, and headache. Furthermore, the Cutanplast packing was significantly less painful at all time points. The remaining amount of the pack was significantly lower in the Cutanplast than Spongostan packing. Spongostan packing appears to impair wound healing within the sinus cavities up to 3 months postoperatively. Cutanplast was less expensive than Spongostan as used in this study. Cutanplast may be more useful gelatin-based packing material than Spongostan in terms of efficacy and cost-benefit after ESS.

Ablation of cereblon attenuates myocardial ischemia-reperfusion injury.

Cereblon (CRBN) was originally identified as a target protein for a mild type of mental retardation in humans. However, recent studies showed that CRBN acts as a negative regulator of AMP-activated protein kinase (AMPK) by binding directly to the AMPK catalytic subunit. Because AMPK is implicated in myocardial ischemia-reperfusion (I-R) injury, we reasoned that CRBN might play a role in the pathology of myocardial I-R through regulation of AMPK activity. To test this hypothesis, wild-type (WT) and crbn knockout (KO) mice were subjected to I-R (complete ligation of the coronary artery for 30 min followed by 24h of reperfusion). We found significantly smaller infarct sizes and less fibrosis in the hearts of KO mice than in those of WT mice. Apoptosis was also significantly reduced in the KO mice compared with that in WT mice, as shown by the reduced numbers of TUNEL-positive cells. In parallel, AMPK activity remained at normal levels in KO mice undergoing I-R, whereas it was significantly reduced in WT mice under the same conditions. In rat neonatal cardiomyocytes, overexpression of CRBN significantly reduced AMPK activity, as demonstrated by reductions in both phosphorylation levels of AMPK and the expression of its downstream target genes. Collectively, these data demonstrate that CRBN plays an important role in myocardial I-R injury through modulation of AMPK activity.

Does clear cell carcinoma of stomach exist? Clinicopathological and prognostic significance of clear cell changes in gastric adenocarcinomas.

AIMS: In contrast to clear cell carcinomas developing in other organs (e.g. ovary and uterus), gastric adenocarcinomas with clear cell features are not well characterized. METHODS AND RESULTS: We evaluated a series of 762 gastric adenocarcinomas for the presence of clear cell changes; and investigated the nature of the changes using several histochemical and immunohistochemical markers, their association with various clinicopathological features, and their prognostic significance. Clear cell changes were observed in 8.5% (n = 65) of gastric cancers. Cases with clear cell changes (GCC) were associated significantly with older age, intestinal type histology, body/fundic location, greater depth of invasion, lymph node metastases and lymphovascular invasion. An increasing proportion of clear cell changes indicated a worsening prognosis, and was identified as an independent marker of poor prognosis using the Cox proportional hazard model (hazard ratio, 0.462; P = 0.003). Of 62 GCCs subjected to special staining, 35 cases (55.6%) displayed cytoplasmic accumulation of glycogen, while 21 (33.3%) contained mucin. GCCs showing glycogen accumulation expressed AFP, glypican-3 and CD10 more commonly than those with mucin, which commonly expressed Muc5AC and Muc6. CONCLUSION: Clear cell gastric adenocarcinoma is a unique subgroup of gastric cancer which, although heterogeneous, has a poor prognosis.

Attenuated facial movement in depressed women is associated with symptom severity, and nucleus accumbens functional connectivity.

It is assumed that mood can be inferred from one's facial expression. While this association may prove to be an objective marker for mood disorders, few studies have explicitly evaluated this linkage. The facial movement responses of women with major depressive disorder (n = 66) and healthy controls (n = 46) under emotional stimuli were recorded using webcam. To boost facial movements, the naturalistic audio-visual stimuli were presented. To assess consistent global patterns across facial movements, scores for facial action units were extracted and projected onto principal component using principal component analysis. The associations of component for facial movements with functional brain circuitry was also investigated. Clusters of mouth movements, such as lip press and stretch, identified by principal component analysis, were attenuated in depressive patients compared to those in healthy controls. This component of facial movements was associated with depressive symptoms, and the strengths of resting brain functional connectivity between nucleus accumbens and both posterior insular cortex and thalamus. The evaluation of facial movements may prove to be a promising quantitative marker for assessing depressive symptoms and their underlying brain circuitry.

Transcription coactivator Eya2 is a critical regulator of physiological hypertrophy.

Despite its significant clinical implications, physiological hypertrophy remains poorly understood. In this study, the transcription coactivator Eya2 was shown to be up-regulated during physiological hypertrophy. Transgene- or adenovirus-mediated overexpression of Eya2 led to up-regulation of mTOR, a critical mediator of physiological hypertrophy. Luciferase reporter and chromatin immunoprecipitation assays revealed that Eya2 directly binds to and activates mTOR expression. The phosphorylation of mTOR downstream molecules was significantly enhanced in Eya2 transgenic (TG) hearts, implying that the Eya2-mediated induction of mTOR expression leads to an elevated mTOR activity. The transcription factor Six1 was also up-regulated during physiological hypertrophy and formed a complex with Eya2. Luciferase reporter and electrophoretic mobility shift assays revealed that the Eya2-Six1 complex binds to and enhances the expression of mTOR in a synergistic manner. Under pressure overload, Eya2 transgenic hearts developed hypertrophy which exhibited important molecular signatures of physiological hypertrophy, as assessed by gene expression profiling and measurements of expression levels of physiological hypertrophy-related genes by quantitative (q) RT-PCR. Examination of heart sections under electron microscopy revealed that the mitochondrial integrity remained largely intact in Eya2 transgenic mice, but not in wild-type littermates, under pressure overload. This finding was confirmed by measurements of mitochondrial DNA contents and the expression levels of mitochondrial function-related genes by qRT-PCR. These data suggest that Eya2 in a physical complex with Six1 plays a critical role in physiological hypertrophy. The cardioprotective effect of Eya2 appears to be due, at least in part, to its preservation of mitochondrial integrity upon pressure overload.

Comparing reliability between 3D imaging and 2D photography for external nasal anthropometry.

This study investigates and compares the reliability and reproducibility of two facial anthropometric methods about external nasal angles, 3D imaging and conventional 2D photography. 2D photograph images and 3D images about external nose of 30 volunteers were taken using digital camera and Morpheus 3D scanner. To evaluate intra-rater reliability, each images were taken over two different days for each subject by the same researcher. To evaluate inter-rater reliability, another researcher took each images for each subject on the first day. The reliability of each method for measuring 4 external nasal angle is obtained using intraclass correlation coefficient (ICC) and compared. Inter-rater and intra-rater reliability of both 3D imaging and 2D photography had excellent agreement in all 4 nasal angles. In the nasofacial angular parameter, Inter-rater ICC, 2D photography was significantly higher than 3D imaging. Result of intra-rater ICC also showed both 3D imaging and 2D photography had good reliability in all 4 nasal angles. Similar to those of inter-rater ICC, nasofacial angular parameter showed statistically significant differences between 3D imaging and 2D photography. In terms of reliability, both 2D and 3D showed appropriate anthropometric results and considering its own advantage, each methods can be used complementarily.

The Degree of Stress in Patients With Empty Nose Syndrome, Compared With Chronic Rhinosinusitis and Allergic Rhinitis.

BACKGROUND: Depression is a mental health disease of growing public health concern because depressive mood affects the sufferer's daily life and is also associated with productivity decline. Depression that is caused by other diseases or substances is referred to as secondary depression, which is an important distinction because curing the underlying cause could subsequently regulate depressive mood. Empty nose syndrome (ENS), also known as "paradoxical obstruction of the nose," is a condition in which the major symptom is difficulty breathing, despite having sufficient breathing space in the nose. Empty nose syndrome has been increasing in prevalence in Korea. We found that patients with this ENS have a tendency toward depressive mood, which can escalate so far as to lead to suicide attempts. Thus, herein, we aimed to investigate the psychological burden on patients with ENS. METHODS: We divided patients into 4 groups: ENS (group A), chronic rhinosinusitis with polyp (CRS c polyp, group B), chronic rhinosinusitis without polyp (CRS s polyp, group C), and allergic rhinitis (AR, group D). We estimated and compared Beck Depression Inventory (BDI) scores among the 4 groups, and we investigated the relationship between depression index and nasal cavity area in patients with ENS. RESULTS: The ENS group (A) had depression prevalence of 71% with varying severity, which was much higher than group B (19%), group C (15%), and group D (27%). The correlation between nasal cavity volume and BDI score for the ENS group was not statistically significant. CONCLUSION: The degree and severity of depression in patients with ENS was higher than in patients with CRS or AR. Furthermore, there was no relationship between depression severity and nasal cavity volume in the patients with ENS. Thus, physicians should be careful not to dismiss the accompanying mental health problems of patients with ENS.

The opposing effects of CCN2 and CCN5 on the development of cardiac hypertrophy and fibrosis.

CCN family members are matricellular proteins with diverse roles in cell function. The differential expression of CCN2 and CCN5 during cardiac remodeling suggests that these two members of the CCN family play opposing roles during the development of cardiac hypertrophy and fibrosis. We aimed to evaluate the role of CCN2 and CCN5 in the development of cardiac hypertrophy and fibrosis. In isolated cardiomyocytes, overexpression of CCN2 induced hypertrophic growth, whereas the overexpression of CCN5 inhibited both phenylephrine (PE)- and CCN2-induced hypertrophic responses. Deletion of the C-terminal (CT) domain of CCN2 transformed CCN2 into a CCN5-like dominant negative molecule. Fusion of the CT domain to the Carboxy-terminus of CCN5 transformed CCN5 into a CCN2-like pro-hypertrophic molecule. CCN2 transgenic (TG) mice did not develop cardiac hypertrophy at baseline but showed significantly increased fibrosis in response to pressure overload. In contrast, hypertrophy and fibrosis were both significantly inhibited in CCN5 TG mice. CCN2 TG mice showed an accelerated deterioration of cardiac function in response to pressure overload, whereas CCN5 TG mice showed conserved cardiac function. TGF-beta-SMAD signaling was elevated in CCN2 TG mice, but was inhibited in CCN5 TG mice. CCN2 is pro-hypertrophic and -fibrotic, whereas CCN5 is anti-hypertrophic and -fibrotic. CCN5 lacking the CT domain acts as a dominant negative molecule. CCN5 may provide a novel therapeutic target for the treatment of cardiac hypertrophy and heart failure.

Effects of Autonomous Sensory Meridian Response on the Functional Connectivity as Measured by Functional Magnetic Resonance Imaging.

Autonomous sensory meridian response (ASMR) is a sensory phenomenon in which audio-visual stimuli evoke a tingling sensation and is accompanied by a feeling of calm and relaxation. Therefore, there has been an increasing interest in using stimuli that elicit ASMR in cognitive and clinical neuroscience studies. However, neurophysiological basis of sensory-emotional experiences evoked by ASMR remain largely unexplored. In this study, we investigated how functional connectivity is changed while watching ASMR video, compared to resting state, and assessed its potential association with affective state induced by ASMR. 28 subjects participated in fMRI experiment consisting of 2 sessions (resting-state and task of viewing ASMR-eliciting video). Using a seed-based correlation analysis, we found that functional connections between the posterior cingulate cortex, and superior/middle temporal gyri, cuneus, and lingual gyrus were significantly increased during ASMR compared to resting state. In addition, we found that with the pregenual anterior cingulate cortex seed region, functional connectivity of the medial prefrontal cortex was increased during ASMR condition, relative to resting state. These results imply that ASMR can be elicited and maintained by ongoing interaction between regional activity that are mainly involved in the mentalizing and self-referential processing. We also found that ASMR-induced affective state changes (high activation negative and high activation positive state) were negatively correlated with functional connectivity involved in visual information processing, suggesting that visual information processing in response to high arousal states can be weakened by ASMR-eliciting stimuli.

Effectiveness of a school-based intervention in Guatemala to increase knowledge of sexual and reproductive health.

OBJECTIVES: Adolescent pregnancy in Guatemala is a multifactorial issue contributing to maternal and child mortality as well as negative social and economic outcomes. While multiple organizations have identified this as an important area for improvement, little has been published on methods for reducing rates of adolescent pregnancy in resource-limited settings. We characterized the effects of a brief intervention on the knowledge and attitudes towards sexual health of high schoolers in a rural Guatemalan community. METHODS: We created a condensed, 2-h sexual education course, which was taught to over 500 high school students in San Juan Sacatepequez, Guatemala. Students completed pre- and post-intervention surveys assessing their knowledge about pregnancy prevention and attitudes toward contraception use. Chi-square tests were used to assess the difference between the pre- and post-intervention responses as well as the responses between male and female participants. RESULTS: Analysis of the survey results revealed significant improvements in all questions assessing knowledge regarding pregnancy prevention (p<0.01). Our pre-intervention survey revealed that male participants possessed greater knowledge regarding pregnancy prevention (p<0.01). Following the intervention, several areas of initial difference between male and female students' knowledge disappeared, including knowledge of what a contraceptive is, awareness that one sexual relation is sufficient for pregnancy, and recognition that condoms can prevent sexually transmitted infections. CONCLUSIONS: This study demonstrates that brief, school-based sexual health courses are low-resource, feasible interventions to significantly increase knowledge about contraception and sexual health in resource-limited settings and improve the disparities in knowledge between male and female participants.

Changes in cortical thickness and volume of cerebellar subregions in patients with bipolar disorders.

BACKGROUND: Numerous studies have suggested that structural changes in the cerebellum are implicated in the pathophysiology of bipolar disorder (BD). We aimed to investigate differences in the volume and cortical thickness of the cerebellar subregions between patients with BD and healthy controls (HCs). METHODS: Ninety patients with BD and one hundred sixty-six HCs participated in this study and underwent T1-weighted structural magnetic resonance imaging. We analyzed the volume and cortical thickness of each cerebellar hemisphere divided into 12 subregions using T1-weighted images of participants. One-way analysis of covariance was used to evaluate differences between the groups, with age, sex, medication, and total intracranial cavity volume used as covariates. RESULTS: The BD group had significantly increased cortical thickness of the cerebellum in all cerebellar subregions compared to the HC group. The cortical thicknesses of the whole cerebellum and each hemisphere were also significantly thicker in the BD group than in the HC group. The volume of the left lobule IX was significantly lower in patients with BD than in HCs, whereas no significant differences in the volumes were observed in the other subregions. LIMITATIONS: Our cross-sectional design cannot provide a causal relationship between the increased cortical thickness of the cerebellum and the risk of BD. CONCLUSIONS: We observed widespread and significant cortical thickening in all the cerebellar subregions. Our results provide evidence for the involvement of the cerebellum in BD. Further studies are required to integrate neurobiological evidence and structural brain imaging to elucidate the pathophysiology of BD.