Seojeon Byungwon, Jutlandia, and NORMASH: UN's Scandinavian Allies at the Korean War and Beyond (1950s-1960s).

The Korean War (1950-1953) was one of the most calamitous and brutal wars in modern history. It was fought by the post-colonial people of the peninsula, and it culminated in the creation of two ideologically opposed states, but the three years' military clash in East Asia (or the Far East) is often labelled simply as a "Forgotten War" in the West including North America. The ensuing ethnic division has been interpreted through the various geopolitical lenses of military strategy, politics, international relations, and power games. What about the situation of casualties? Which particular nations in the United Nations (UN) dispatched medical aid for the treatment of war victims? How did the Scandinavian allies participate the non-European war? What were their unique characteristics among non-military supporting nations? What legacy they left for the post-war Koreans? This paper explores the military-historical backgrounds by which each of the following Northern European nation, namely, Sweden, Denmark, and Norway, decided to send unarmed skilled personnel to aid South Korea. The paper argues the social voluntarism of the neutral group in the critical insight that the field activities of Swedish Seojeon Byungwon, Danish Jutlandia, and Norwegian NORMASH individually promoted the Red Cross spirit of advanced humanitarianism on the top of mandatory duty, in giving special attention on children (orphans), women, civilians, POWs, and medical education, as well as the post-war collaboration for the initial Korean public health system in the 1960s.

A large scale high-throughput screen identifies chemical inhibitors of phosphatidylinositol 4-kinase type II alpha.

The minor phospholipid, phosphatidylinositol 4-phosphate (PI4P), is emerging as a key regulator of lipid transfer in ER-membrane contact sites. Four different phosphatidylinositol 4-kinase (PI4K) enzymes generate PI4P in different membrane compartments supporting distinct cellular processes, many of which are crucial for the maintenance of cellular integrity but also hijacked by intracellular pathogens. While type III PI4Ks have been targeted by small molecular inhibitors, thus helping decipher their importance in cellular physiology, no inhibitors are available for the type II PI4Ks, which hinders investigations into their cellular functions. Here, we describe the identification of small molecular inhibitors of PI4K type II alpha (PI4K2A) by implementing a large scale small molecule high-throughput screening. A novel assay was developed that allows testing of selected inhibitors against PI4K2A in intact cells using a bioluminescence resonance energy transfer approach adapted to plate readers. The compounds disclosed here will pave the way to the optimization of PI4K2A inhibitors that can be used in cellular and animal studies to better understand the role of this enzyme in both normal and pathological states.

Revision Functional Surgery: Salvaging Function.

Reduction rhinoplasty techniques include maneuvers that weaken the nasal osseocartilaginous framework. The structurally compromised anatomy remaining after reductive surgery may be left with inadequate strength to withstand postoperative contractile forces. Significant aesthetic and functional deformities requiring revision rhinoplasty may develop. This article reviews common causes of nasal obstruction after primary rhinoplasty. The discussion of etiology is based on both the anatomic description of nasal subsites (middle vault and lateral walls) as well as an explanation of why certain techniques lead to functional problems in these areas. Revision rhinoplasty techniques for correcting these problems are discussed in detail.

Outcome of Nasal Valve Obstruction After Functional and Aesthetic-Functional Rhinoplasty.

INTRODUCTION: Nasal valve insufficiency is distinct from other anatomic causes of nasal obstruction. Functional rhinoplasty refers to the collective techniques used to reconstruct the lateral nasal wall, typically achieved with the use of spreader and alar grafts. Patients undergoing functional rhinoplasty can also have aesthetic desires and goals achievable with combined aesthetic-functional rhinoplasty. OBJECTIVE: To evaluate the improvement in nasal obstruction symptoms after cartilage graft reconstruction in patients with nasal valve insufficiency and to compare the postoperative improvement between patients undergoing functional and aesthetic-functional rhinoplasty. DESIGN, SETTING, AND PARTICIPANTS: In this prospective multicenter cohort study, 12 participating surgeons enrolled 79 consecutive patients diagnosed as having nasal valve insufficiency as the primary cause of nasal obstruction. Patients underwent functional or aesthetic-functional rhinoplasty. The study collected demographic, clinical, and surgical data from March 2006 to September 2008. Nasal symptoms were evaluated using a validated, disease-specific, quality-of-life instrument. The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered to participants at baseline and 3, 6, and 12 months postoperatively. Follow-up was completed on September 2008, and data were analyzed in September 2009 and in September 2013. MAIN OUTCOMES AND MEASURES: Changes in NOSE scale score (range, 0 to 100, with a higher score indicating greater severity of obstruction) at 3 months between the functional and aesthetic-functional groups. RESULTS: Of the 79 patients, 31 underwent functional and 48 underwent aesthetic-functional rhinoplasty. Overall, an improvement was found in nasal breathing, with a mean decrease of 48.6 points (95% CI, 41.9-55.2; P < .001) at the 3-month assessment compared with the preoperative baseline NOSE scale score (mean [SD], 67.1 [19.7]). The improvement in nasal breathing was similar whether patients underwent functional or aesthetic-functional rhinoplasty (mean [95% CI] NOSE scale score change, 51.4 [42.1-60.7] and 46.6 [37.1-56.1], respectively; P = .49). CONCLUSIONS AND RELEVANCE: Nasal valve reconstruction with spreader and alar grafts is effective in treating patients with nasal valve insufficiency. Combining aesthetic interventions with functional rhinoplasty did not seem to affect the magnitude of improvement in nasal breathing outcome. LEVEL OF EVIDENCE: 2.

Potent DGAT1 Inhibitors in the Benzimidazole Class with a Pyridyl-oxy-cyclohexanecarboxylic Acid Moiety.

We report the design and synthesis of a series of novel DGAT1 inhibitors in the benzimidazole class with a pyridyl-oxy-cyclohexanecarboxylic acid moiety. In particular, compound 11A is a potent DGAT1 inhibitor with excellent selectivity against ACAT1. Compound 11A significantly reduces triglyceride excursion in lipid tolerance tests (LTT) in both mice and dogs at low plasma exposure. An in vivo study in mice with des-fluoro analogue 10A indicates that this series of compounds appears to distribute in intestine preferentially over plasma. The propensity to target intestine over plasma could be advantageous in reducing potential side effects since lower circulating levels of drug are required for efficacy. However, in the preclinical species, compound 11A undergoes cis/trans epimerization in vivo, which could complicate further development due to the presence of an active metabolite.

The optimization of pyridazinone series of glucan synthase inhibitors.

A detailed structure-activity relationship study of a novel series of pyridazine-based small molecule glucan synthase inhibitors is described. The optimization of the PK profile of this series led to the discovery of compound 11g, which demonstrated in vivo potency ip in a lethal fungal infection model.

Lead optimization of a sulfonylurea-based piperazine pyridazinone series of glucan synthase inhibitors.

The structure-activity relationship studies of a novel sulfonylurea series of piperazine pyridazine-based small molecule glucan synthase inhibitors is described. The optimization of PK profiles within the series led to the discovery of several compounds with improved pharmacokinetic profiles which demonstrated in vitro potency against clinically relevant strains. However, the advancement of compounds from this series into a non-lethal systemic fungal infection model failed to show in vivo efficacy.

SAR studies of pyridazinone derivatives as novel glucan synthase inhibitors.

A novel series of pyridazinone analogs has been developed as potent ß-1,3-glucan synthase inhibitors through structure-activity relationship study of the lead 5-[4-(benzylsulfonyl)piperazin-1-yl]-4-morpholino-2-phenyl-pyridazin-3(2H)-one (1). The effect of changes to the core structure is described in detail. Optimization of the sulfonamide moiety led to the identification of important compounds with much improved systematic exposure while retaining good antifungal activity against the fungal strains Candida glabrata and Candida albicans.

The synthesis and structure-activity relationship of pyridazinones as glucan synthase inhibitors.

A structure-activity relationship study of the lead 5-[4-(benzylsulfonyl)piperazin-1-yl]-4-morpholino-2-phenyl-pyridazin-3(2H)-one 1 has resulted in the identification of 2-(3,5-difluorophenyl)-4-(3-fluorocyclopentyloxy)-5-[4-(isopropylsulfonyl)piperazin-1-yl]-pyridazin-3(2H)-one 11c as a ß-1,3-glucan synthase inhibitor. Compound 11c exhibited significant efficacy in an in vivo mouse model of Candida glabrata infection.

Traumatic rhinoplasty in the non-Caucasian nose.

Traumatic injury resulting in nasal deformity poses unique challenges to the surgeon. Optimal management requires careful preoperative analysis and thoughtful surgical planning. The goals of rhinoplasty are to correct both cosmetic and functional problems that may not have otherwise been an issue prior to the injury. Although it is overly simplistic to group all individuals from one ethnicity as having one type of nose, the rhinoplasty surgeon must understand the common variations of nasal anatomy seen in various races of individuals. This article discusses ethnic anatomic differences in the non-Caucasian nose in the context of posttraumatic nasal deformity. The various rhinoplasty techniques and strategies to address these issues are reviewed.

A contemporary assessment of facial aesthetic preferences.

OBJECTIVES: To compare and characterize the ideal nasolabial angle, nasal tip width, and location of the eyebrow apex for Asian and white women. METHODS: From approximately January 1, 2005, to June 30, 2005, we photographed the faces of 2 Asian women and 2 white women of differing ages. Each model's image was modified to create different eyebrow shapes, unique nasolabial angles, and varying nasal tip widths. We subsequently recruited, and obtained demographic information from, volunteers from the general public to rate the modified images based on their aesthetic preferences. RESULTS: We found that neither the ethnicity of the models nor the ethnicity of the volunteers who rated them played a significant role in determining the ideal eyebrow apex location, nasolabial angle, or nasal tip width. However, generally speaking, a more lateral brow apex is preferable in younger faces, whereas a more medial apex is favored in older ones. Other preferences include a moderate nasolabial angle and a narrow nasal tip. As a result of individual variability, it has been difficult to establish a method to calculate a nasolabial angle that adequately portrays the apparent rotation of the nose in most people. We found that the angle formed by the line from the anterior columella to the subnasale and the line exactly perpendicular to the Frankfurt horizontal plane provides the best estimate. CONCLUSIONS: When planning facial plastic surgery, the goals of the patient are of paramount importance. Although it is important to understand the ways in which people of different ethnicities and ages differ in their facial proportions as a group, facial harmony must be pursued on an individual basis.

Functional rhinoplasty.

The complete rhinoplasty surgeon must possess an understanding of functional nasal airway obstruction. An increasingly sophisticated grasp of the pathophysiology of fixed nasal obstruction has led surgeons to develop and refine surgical techniques aimed toward alleviating nasal valve insufficiency. This article reviews an assortment of techniques within nasal valve surgery, highlighting the underlying pathophysiology, anatomy, and technical considerations.

Modified retrograde approach to upper eyelid static loading.

OBJECTIVES/HYPOTHESIS: Upper eyelid static weight loading is a technique commonly used to treat paralytic lagophthalmos. The traditional approach using the pretarsal crease incision leads to interruption of the anterior levator muscle fibers that attach to the face of the tarsus at its upper two thirds. This disruption can lead to permanent upper eyelid blepharoptosis. The retrograde approach avoids this problem but results in an incision at the lid margin, the dependent aspect of the weight. This increases the risk of implant extrusion. We hypothesize that a newly described modified retrograde approach is a safe and effective approach that avoids the pitfalls of previously described techniques. STUDY DESIGN: Retrospective review. METHODS: Eight patients were evaluated with preoperative and 3 to 6 month postoperative photographs with the eyes in the open and closed positions for the degree of lagophthalmos and blepharoptosis present. Patients were also evaluated for development of complications such as implant extrusion, pain, or infection. The surgical technique uses a supratarsal skin crease incision, supramuscular dissection to the lid margin, entry into the tarsal plane at its inferior-most aspect, creation of a pocket for implant insertion, and layered closure. RESULTS: All patients had complete correction of lagophthalmos. No patients experienced infection, extrusion, or eye pain after surgery. All patients had less than 2-mm ptosis after surgery, with no patients experiencing any visual field disruption. CONCLUSIONS: The modified retrograde approach to upper eyelid static loading for paralytic lagophthalmos provides advantages over other techniques described. It is a safe, efficacious procedure, well tolerated by patients.

Cadaveric and engineering analysis of the septal L-strut.

OBJECTIVES: To identify patterns of failure of the L-strut, to identify elements of the nasal framework that support the L-strut, and to investigate the effect of altering L-strut design on its stability. STUDY DESIGN: Laboratory study with human cadaveric heads and computational modeling. METHODS: Directional forces were applied to cadaveric L-struts and patterns of failure with incremental force were noted. Computational modeling using the finite element method (FEM) was employed to determine quantitatively the effect of various modifications on the stability of the L-strut. RESULTS: The L-strut was found to respond to frontal force initially by buckling. This buckling was reversible until the force exceeded a certain threshold when the L-strut broke at the bony-cartilaginous junction. The threshold force varied depending on the length of the overlap with the bony vault. Intact mucoperichondrium provided significant stability. Modeling with FEM showed that the preservation of a triangular piece of cartilage at the dorsal anchor of a narrowed L-strut can offset some of the loss in mechanical stability. CONCLUSIONS: Intrinsic elasticity of the septal cartilage, the mucoperichondrial flap, and overlap with the bony vault all contribute to the stability of the L-strut, which is enhanced by preserving a small segment of cartilage at the bony-cartilaginous junction of the dorsal L-strut.

Upper blepharoplasty in the Asian eyelid.

Upper-eyelid blepharoplasty in the Asian patient poses unique challenges. The anatomy is complex and highly variable, and the esthetic goals vary from patient to patient. The surgeon must perform more complicated maneuvers than in Caucasian blepharoplasty in an anatomic field with features that predispose for complications. The successful surgeon must identify the features of the eyelid to be modified through a detailed consultation with the patient, formulate a sound surgical plan based on a mastery of the complex anatomy, and execute all maneuvers with conservatism and exact precision.

Applications of porcine dermal collagen (ENDURAGen) in facial plastic surgery.

The facial plastic and reconstructive surgeon has a variety of options for tissue augmentation and soft tissue support. These options include autologous materials such as fat and cartilages, solid implant materials, and injectable materials. Recently, malleable sheets of collagen-based matrix have become available. This review focuses on the potential applications of acellular collagen matrices and their various applications in rhinoplasty, facial slings for static reanimation, scar revision, soft tissue volume restoration, and periorbital reconstruction.

Modification of the Zitelli bilobed flap: a comparison of flap dynamics in human cadavers.

OBJECTIVE: To investigate the effects on overall flap dynamics of altering the length of the primary flap in the Zitelli bilobed flap procedure, because the standard Zitelli design can result in distortion of the alar margin after repair of cutaneous nasal alar defects. METHODS: Identical 1.5-cm circular cutaneous defects were made on the nasal alae and cheeks of 6 fresh human cadavers. A rectangle was inked around each cheek defect in a standardized fashion. A standard-design Zitelli bilobed flap was used to close the nasal and cheek defects on 1 side of each specimen (n = 6). The contralateral defect was closed with a modified design in which the primary flap was either 10% longer (n = 3) or 10% shorter (n = 3) than the standard primary flap as measured from the pivot point. Alar margin retraction and cheek defect distortion were measured from standardized photographs obtained before and after the repair. RESULTS: The long-flap design resulted in alar retraction that was 1.33 mm less in the nasal reconstructions (P = .02) and distal defect distortion that was 2.17 mm less in the cheek reconstructions (P = .01) compared with the standard Zitelli bilobed flap. The short-flap design caused more distortion than did the standard design for both types of defect. CONCLUSION: Lengthening the primary flap in the Zitelli bilobed flap design may reduce distal wound distortion and alar retraction in the closure of certain cutaneous defects.