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Objective: To examine the changes in visual attention influenced by facial angles and smile during the evaluation of facial attractiveness. Materials and Methods: Thirty-three young adults were asked to rate the overall facial attractiveness (task 1 and 3) or to select the most attractive face (task 2) by looking at multiple panel stimuli consisting of 0°, 15°, 30°, 45°, 60°, and 90° rotated facial photos with or without a smile for three model face photos and a self-photo (self-face). Eye gaze and fixation time (FT) were monitored by the eye-tracking device during the performance. Participants were asked to fill out a subjective questionnaire asking, “Which face was primarily looked at when evaluating facial attractiveness?” Results: When rating the overall facial attractiveness (task 1) for model faces, FT was highest for the 0° face and lowest for the 90° face regardless of the smile (P < .01). However, when the most attractive face was to be selected (task 2), the FT of the 0° face decreased, while it significantly increased for the 45° face (P < .001). When facial attractiveness was evaluated with the simplified panels combined with facial angles and smile (task 3), the FT of the 0° smiling face was the highest (P < .01). While most participants reported that they looked mainly at the 0° smiling face when rating facial attractiveness, visual attention was broadly distributed within facial angles. Conclusions: Laterally rotated faces and presence of a smile highly influence visual attention during the evaluation of facial esthetics.

Objective: One of the main characteristics of social anxiety disorder is excessive fear of social evaluation. In such situations, anxiety can influence gaze behaviour. Thus, the current study adopted virtual reality to examine eye gaze pattern of social anxiety disorder patients while presenting different types of speeches. Methods: A total of 79 social anxiety disorder patients and 51 healthy controls presented prepared speeches on general topics and impromptu speeches on self-related topics to a virtual audience while their eye gaze was recorded. Their presentation performance was also evaluated. Results: Overall, social anxiety disorder patients showed less eye gaze towards the audience than healthy controls. Types of speech did not influence social anxiety disorder patients’ gaze allocation towards the audience. However, patients with social anxiety disorder showed significant correlations between the amount of eye gaze towards the audience while presenting self-related speeches and social anxiety cognitions. Conclusion: The current study confirms that eye gaze behaviour of social anxiety disorder patients is aversive and that their anxiety symptoms are more dependent on the nature of topic.

First impressions follow a complex process that is greatly influenced by the facial attributes and the sex of the displayer. This study aimed to evaluate whether the initial impression formed in friendship decisions is processed differently between the same-sex and opposite-sex targets in women. Twenty-four healthy female volunteers participated in a functional magnetic resonance imaging experiment, in which they appraised a given face and decided whether they wanted to befriend the target. Then, a post-scan subjective rating was performed for facial components such as cheerfulness, good-looks, and uniqueness. The data were used to perform univariate whole-brain analysis to identify the neural substrates of sex bias in impression formation, and exploratory parametric modulation analysis to examine the parametric effects of facial components. Results showed that a composite of diverse areas including the dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, anterior cingulate cortex, and posterior superior temporal sulcus were more engaged when viewing male faces than female faces. Parametric analysis revealed that bilateral lingual gyrus activities showed a negative parametric effect with cheerfulness for male faces, whereas left inferior parietal lobule activity showed a positive parametric effect with good-looks for female faces. During the formation of first impressions, diffuse areas related to emotion processing and conflict-monitoring were utilized when a person of the opposite sex was encountered compared to encounters with a person of the same sex. The perceived cheerfulness of a male face also showed a negative relationship with the identification of facial emotion in the male face; the more a female face was considered good-looking, a greater feeling of uneasiness appeared to be elicited. The findings from this study provide further evidence of sex bias in women during friendship encounters.

Virtual reality (VR) neuropsychological assessments have the potential for the ecological measurement of attention. We analyzed the newly developed VR continuous performance test (VR-CPT) for Korean children with attention-deficit/hyperactivity disorder (ADHD) and typically developing children (TDC). To identify specific features of a virtual environment that influence the attention performance of children, we investigated whether the presence of a virtual teacher and social cues in the VR environment affects their attention performance. A total of 38 participants (18 TDC and 20 ADHD children and adolescents) were recruited for VR-CPT testing. Bivariate correlational analysis was conducted to examine the associations between the results of the VR-CPT and ADHD questionnaires to determine the capacity of VR-CPT to mirror real-life attention behaviors. Mixed-design analysis of variables was conducted to compare the effects of the social aspects of the VR-CPT on attention performance in groups. There were significant associations between ADHD rating scores and the omission error, commission error, reaction time (RT), reaction time variability (RTV), and total accuracy of the VR-CPT in the ADHD group. In addition, the ADHD group exhibited comparable performance with the TDC group for all measures of the VR-CPT. Also there seemed to be a trend of decreasing RTV when a virtual teacher with social cues was present compared with the equipment control condition in the ADHD group. Performance in the VR-CPT program was associated with behavioral measures of ADHD symptoms. Adding social aspects to a VR environment commonly encountered by children and adolescents has the potential to make a difference in the attention performance of youths with ADHD.

Patients with schizophrenia have difficulties in real life due to impairment in ability to make decisions. The purpose of this study was to elucidate the relationship between impaired decision-making processes with real life stimuli and abnormal eye gaze patterns in patients with schizophrenia. Each of 23 patients with schizophrenia and 23 healthy controls performed an apparel purchase decision task including the influencing factors such as preference, fit, and price, during which the eye gaze was traced. Fixation time and fixation time ratio on areas of interest, which were set for participant faces and clothing, were compared between the two groups. Compared with controls, patients made purchase decisions at a higher rate and showed significantly shorter fixation time on clothing in the preference, fit, and price phases and on faces in the purchase phase. Fixation time ratio of face over clothing did not change over purchase decisions in patients, whereas controls showed significantly higher fixation time ratio in not-to-buy decisions than in to-buy decisions. These results suggest that aberrant decision-making behaviors in patients with schizophrenia are closely related to inflexible visual information gathering patterns because they apportion the same amount of attention to objects regardless of purchase intention.

The divergent synthesis of some novel aminocyclopentitol analogues was concisely achieved from readily available d-galactose via the highly diastereoselective amination of carbocyclic polybenzyl ether using chlorosulfonyl isocyanate, diastereoselective dihydroxylation, and epoxidation as the key steps.

Asymmetric total synthesis of (+)-neplanocin A was concisely achieved from readily available d -galactose via the regioselective and diastereoselective amination of carbocyclic polybenzyl ether using chlorosulfonyl isocyanate and intramolecular olefin metathesis using second-generation Grubbs catalyst.

A mobile virtual reality system, equipped with built-in variables such as heart rate (HR), gaze-down data, and subjective fear rating, can allow individuals with a fear of heights to overcome it by self-training. This study aimed to verify the efficacy and safety of the training program. Forty-eight volunteers completed the four-session self-training program over 2 weeks. They were allocated into either low- or high-fear group by the Acrophobia Questionnaire (AQ)-anxiety scores, and then the changes of the built-in variables and AQ-anxiety scores were analyzed between the groups. The safety was assessed using the Simulator Sickness Questionnaire (SSQ). The AQ-anxiety scores were significantly decreased after self-training in both groups, and the degree of decrease was significantly greater in the high-fear group than in the low-fear group. Gaze-down percentage and subjective fear rating showed a significant group difference, but HR did not. The SSQ scores were within the acceptable level. These results suggest that the training effect was greater in the high-fear group than in the low-fear group. This mobile program may be safely applicable to self-training for individuals with high scores on the fear of heights by repeated exposure to virtual environments with the embedded feedback system.

A kinetic study is reported on nucleophilic substitution reactions of 4-nitrophenyl nicotinate 5 and isonicotinate 6 with alkali metal ethoxide EtOM (M = K, Na, and Li) in anhydrous ethanol at . Plots of pseudo-first-order rate constant vs. EtOM concentration exhibit upward curvature for the reactions of 5 and 6 with EtOK and EtONa but are almost linear for those with EtOLi. Dissection of into and (i.e., the second-order rate constant for the reaction with dissociated and ion-paired EtOM, respectively) has shown that > but . It has been concluded that and ions catalyze the reactions by increasing the electrophilicity of the carbonyl carbon atom through formation of a 4-membered cyclic transition state or . However, ion catalysis has been found to be much less significant for the reactions of 5 and 6 than for the corresponding reactions of 4-nitrophenyl picolinate 4, which was reported to proceed through a 5-membered cyclic transition state . Although 5 and 6 are significantly more reactive than 4-nitrophenyl benzoate 3, the reactions of 5 and 6 result in smaller ratios than those of 3. The electron-withdrawing ability of the nitrogen atom in the acyl moiety of 5 and 6 has been suggested to be responsible for the increase in reactivity and the decrease in the ratio.

Summary of second-order rate constants from ion-pairingtreatment of kinetic data for reactions of 6 with EtOM in anhydrousEtOH at 25.0 ± 0.1 o C. EtOM ‒ k EtO‒ /M 1 s ‒1 k EtOM /M ‒1 s k EtOM / k EtO‒ EtOK 48633706.93EtONa 385664017.2EtOLi 43613503.10 tively. Alkali metal ethoxides have been reported to exist as dimmers or other aggregates in a high concentration region (e.g., [EtOM] > 0.1 M). 14 However, it has been suggested that EtOM exists as dissociated and ion-paired species in concentration below 0.1 M. 14 Since the current reactions were performed in a low concentration region (e.g., [EtOM] < 0.012 M), one might expect that both dissociated EtO ‒ and ion-paired EtOM react with substrate 6 as shown in Scheme 2. EtOM Products + 6 EtO- + One M + EtO + 6 Products k EtOM k - K d Scheme 2 One can derive a rate equation as eq (1) based on the mecha-nism proposed in Scheme 2. Since the reactions were performed under pseudo-first-order conditions

Background Concrete thinking is one of the common clinical features of patients with schizophrenia, especially chronic and symptomatically severe patients. Until now, neuropsychological tests or proverb tests have been used to measure the difficulty of abstract thinking in patients with schizophrenia, but these methods have been difficult to know how concrete thinking patterns affect daily living of schizophrenia patients. In this study, we constructed a task that supposes the purchase of clothes in order to realize a situation close to the decision making of everyday life and tried to visualize the thinking process through eye-tracking method. Methods Each twenty of healthy controls and schizophrenia patients performed the task of purchasing clothes. In serial, subjects are asked whether the clothes are fancy, suitable for themselves, affordable and whether they would buy the clothes. The eye gaze information was obtained by using the eye tracking system of the SensoMotoric Instrument, and the fixation time in the face and the clothes areas was measured. The changes of the fixation time ratio of the face to the clothes between the matching and the purchasing decision blocks for each group were compaired using repeated-measure ANOVA and the change of the ratio in patients with schizophrenia was analyzed with the PANSS concrete thinking score using generalized estimating equations. To investigate the relationship between the fixation time ratio and the answer of the purchasing block, two-way ANOVA with post hoc independent T-test was used. Results There was a significant interaction effect between the groups on the change of the fixation time ratio(p

The concise synthesis of the lentiginosine analogues pyrrolizidine alkaloid 2 and pyrroloazepine alkaloid 3 has been achieved from inexpensive and readily available D -lyxose. The key steps in the synthesis included regio- and diastereoselective amination, inter- or intramolecular olefin metathesis, and Appel cyclization. The anti-3,4-amino alcohol 6, essential for the preparation of the title compounds 2 and 3, was synthesized by the regio- and diastereoselective amination of anti-3,4-tribenzyl ether 7 using chlorosulfonyl isocyanate. The reaction of 7 with chlorosulfonyl isocyanate in toluene at 0 °C afforded 6 exclusively with a diastereoselectivity of 26:1 in 84 % yield. These results can be explained by the neighboring-group effect, which leads to retention of the stereochemistry.

Pseudo-first-order rate constants (k obsd ) have been measured spectrophotometrically for nucleophilic substitution reactions of 4-nitrophenyl benzoate (5a), 4-nitrophenyl 4-methoxybenzoate (5b), and 4-nitrophenyl 4-hydroxybenzoate (5c) with alkali metal ethoxides, EtO - M + (M + =Li + , Na + and K + ) in anhydrous ethanol (EtOH) at 25.0 ± 0.1 °C. The plots of k obsd vs. [EtO - M + ] exhibit upward curvatures in all cases, indicating that M + ions catalyze the reactions and ion-paired EtO - M + species are more reactive than dissociated EtO - . Second-order rate constants for reactions with dissociated EtO - and ion-paired EtO - M + (i.e., k EtO - and k EtO - M +, respectively) have been calculated from ion-pair treatment for the reactions of 5a and 5b. However, such ion-pair treatment has failed to determine k EtO - and k EtO - M + values for the reactions of 5c. It has been concluded that reactions of 5a and 5b are catalyzed by one metal ion, which increases electrophilicity of the reaction center through coordination on the carbonyl oxygen. In contrast, reactions of 5c have been suggested to involve two metal ions, i.e., the one coordinated on the carbonyl oxygen increases the electrophilicity of the reaction center while the other one associated on the phenoxy oxygen decreases the charge repulsion between the anionic reagents (i.e., EtO - and deprotonated 5c). It has been found that the rate equation derived from the mechanism involving two metal ions fits nicely to the kinetic results obtained for the reactions of 5c.

from ion-pairing treatments. The kEtO– and kEtO–M+ values decrease in the order kEtO–Na+ > kEtO–K+ > kEtO–Li+ > kEtO– , indicating that ion-paired EtO – M + species are more reactive than the dissociated EtO – ion, and Na + ion exhibits the largest catalytic effect. The M + ions in this study form stronger complex with the transition state than with the ground state. Coordination of the M + ions with the O and N atoms in the leaving group of 5 has been suggested to be responsible for the catalytic effect shown by the alkali metal ions in this study.

The title compound (+)-(I), enantiomer of the antitumor/antiviral constituent of Ampullariella regularis, is prepared starting from D-galactose.

Dermatofibrosarcoma protuberans (DFSP) is a slowly growing dermal spindle cell tumor and its myxoid variant, a rare type of DFSP, is characterized by extensive myxoid degeneration. We present the case of a 69-year-old woman with a multinodular reddish plaque on her trunk. Histopathologically, the tumor was located in the dermis and consisted of uniform spindle-shaped cells, showing strongly positive reaction for CD34, and negative for both S-100 and desmin. In addition to the typical storiform pattern, prominent myxoid stromal changes were demonstrated. Herein, we report an interesting case of myxoid DFSP, rarely reported in the dermatology literature.

Red ginseng (RG) has been widely used to treat various diseases in East Asian countries. Previous studies have shown the anti-oxidative and anti-diabetic effects of RG. This study aimed to investigate the effects of RG on oxidative stress and insulin resistance in postmenopausal women.We performed a randomized, double-blind, placebo-controlled trial in 82 postmenopausal women aged 45-60 years. Participants were randomized to receive 3g red ginseng daily or placebo for 12 weeks. Antioxidant enzymes activity (superoxide dismutase, glutathione peroxidase) and oxidative stress markers (malondialdehyde, 8-hydroxydeoxyguanosine) were assessed, and the homeostatic model assessment of insulin resistance index was calculated at the baseline and at the end of the trial.A total of 71 postmenopausal women completed the study. Serum superoxide dismutase activity was significantly increased after the 12-week RG supplementation (P0.001), and these changes were statistically significant compared with the placebo group (P=0.004). Serum malondialdehyde levels showed a tendency to decrease after the 12-week RG supplementation (P=0.001), but these changes were not statistically significant compared with the placebo group (P=0.064). No statistically significant changes in serum glutathione peroxidase and 8-hydroxydeoxyguanosine were noted. Further, RG supplementation showed no effects on fasting glucose, fasting insulin, and insulin resistance.The results suggest that RG may reduce oxidative stress by increasing antioxidant enzyme activity in postmenopausal women.

Acid dissociation constants of 10 substituted phenols have been measured by a kinetic method together with second-order rate constants for the reactions of aryl benzoates (X-C6H4CO-OC6H4-Y) with Z-substituted phenoxide (Z-C6H4O−) and EtO in absolute ethanol at 25.0±0.1°C. The kinetic results support a stepwise mechanism for the present acyl-transfer reaction.

Eccrine porocarcinoma (EP) is a rare malignant tumor arising from the intraepidermal eccrine duct. The tumor cells frequently contain glycogen, but prominent clear cell changes in EP are rarely reported. A 78-year-old woman presented with a slightly pruritic, erythematous, verrucous plaque on her left thigh. Histopathological examination revealed intraepidermal tumor cell nests composed of small basaloid cells and duct-like structures lined by periodic acid-Schiff (PAS)-positive cuticles. Besides the typical findings of EP, clear cell changes were predominantly observed in the tumor cell aggregations. Herein we report a case of the clear cell variant of EP rarely reported in previous literature.

Background: The scales of bony fish represent a significant reservoir of calcium and calcification of the elasmoid scale is known to be associated with deposition of mineral crystals from the epidermis to dermis. However, little is known about the exact mechanisms of calcium deposition, mobilization and regeneration occurring in the zebrafish skin. Objective: The purpose of this study was to investigate the expression of calcification-related molecular mediators in both the epidermis and dermis of the zebrafish (Danio rerio), using immunohistochemical study. Methods: We examined the skin of zebrafish in four populations of different ages (i.e. 20 days post-fertilization (dpf), 35 dpf, 50 dpf, and the adult zebrafish), using several immuno- histochemical markers, including bone morphogenetic protein 4 (BMP-4), β -catenin, osteocalcin, osteopontin and osteonectin. Results: BMP-4, osteopontin and osteonectin were moderately expressed in the epidermis of zebrafish after 35 dpf. Also, some of the cells in the upper dermis showed strong positivity for BMP-4, osteocalcin, osteopontin and osteonetin. Conclusion: Our results suggest that BMP-4, osteocalcin, osteopontin and osteonectin may play a role in the process of calcification of the elasmoid scale. (Ann Dermatol 23(3) 299∼303, 2011)

Objectives : Disturbance in self-experience has been considered to be a core feature of schizophrenia. Evidence from mirror face- recognition tasks supports the connection between self-face recognition and self-awareness which is a part of self-experience. The aim of this study was to investigate the self-other boundary recognition using morphed face pictures in patients with schizophrenia. Methods : Twenty-one patients with schizophrenia and twenty-three healthy controls completed the self-face recognition task that consisted of various morphed pictures. Participant's own picture was morphed with each of three different, unknown, gender-matched facial identities in steps of 10% ; each pair producing 11 images with graded blending of facial features. Thirty-three images in to- tal were randomly presented as stimuli in a run, which was repeated three times. Participants were instructed to choose whether the stimulus was self-face or not. Results : Self-face proportion was significantly lower in the schizophrenia group at both recognition start point I and II (33.33% vs. 53.04%, p

목적 본연구는 선천성 무질증 환자에서 복강경하에서 복막을 이용한 질재건수술 환자에서 수술 후 추적기간 동안 재건된 질의 해부학적 및 성기능을 연구한다. 연구방법 2005년과 2011년 사이에 연세의료원과 안양샘병원 산부인과에 내원한 47명의 무질증 환자(로키탄스키증후군)에서 복강경하에서 복막을 이용한 질재건술(laparoscopic Davydov technique)을 시행하였으며, 수술 후 3-12개월의 추적기간 동안 재건된 질의 길이, 넓이, 편평상피세포 전환과 세포성숙도를 알기위해 Schiller test을 시행하였다. 이 중 성교활동이 활발한 25명의 환자에서 성적만족도를 알기위해, 비슷한 년령의 일반대조군 기혼여성 15명과 성만족도(Female Sexual Function Index)를 비교조사하였다. 수술전 환자는 염색체검사, 호르몬검사, 및 MRI을 시행하였으며, 기타 비뇨기계 및 골격계기형유무를 알기위해 신우조영술 및 기타 방사선촬영을 시행하였다. 결과 평균수술 시간은 117 ± 35.3분이었으며, 수술 중 합병증으로서 2예에서 직장손상, 1예에서 방광손상이 있었으며, 그 이후 3-12개월 추적기간 동안, 경등도의 탈장 및 질육아조직미란이 각각 1예씩 관찰되었으며, 그 외 직장질루 또는 방광질루 등은 관찰되지 않았다. 추적환자의 평균 질길이는 8.3 ± 1.1 cm이었으며, 질의 넓이는 전환자에서 최소한 두 손가락(3 cm)이 통과되었으며, 성만족도는 일반 대조군과 차이가 없었다. 결론 복강경 Davydov 수술은 매우 안전하고, 합병증이 적으며, 해부학적 및 기능적으로도 우수한 결과를 얻었다. 이 수술법은 복강경하에서 최소침습시술을 함으로써 신체외부에도 보기 흉한 흉터를 남기지 않으며, 복막을 이용함으로써 자연적인 골반축을 유지할 수 있으며, 또한 자연질상피세포로의 전환이 용이하게 일어나 질건조나 위축이 적어 성적 만족도도 우수하였다. 또한 특별한 수술기구가 필요하지 않았으며, 부인과 의사가 단독으로 시행할 수 있는 좋은 수술법으로 생각된다.

940 A COMPARISON OF TWO-PORT AND CONVENTIONAL LAPAROSCOPIC HYSTERECTOMY IN TERMS OF SURGICAL OUTCOMES AND FEASIBILITY Yeon Hong, MD, Young Eun Jeon, MD, Ji Ann Jung, MD, Hye Yeon Kim, MD, Seok Kyo Seo, MD, SiHyun Cho, MD, Young Sik Choi, MD, Byung Seok Lee, MD Department of Obstetrics and Gynecology, 1 Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; Severance Hospital, Yonsei University College of Medicine, Seoul; Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea

목적: 본 연구는 촉지되지 않는 임플라논의 제거에 실패하여 연세대학교 강남세브란스 병원으로 전원 된 환자를 대상으로 초음파 기기를 이용한 임플라논 제거법의 성과에 대해 알아보고자 하였다. 연구 방법: 2004년 3월부터 2009년 3월까지 촉지되지 않는 임플라논을 제거하려 하였으나 실패하여 강남 세브란스 병원으로 전원되어 초음파 기기를 이용하여 임플라논을 제거한 환자들의 의무기록을 분석하였다. 결과: 총 32명의 환자를 대상으로 하였으며 초음파상 18예는 임플라논이 피하지방층에 위치하였으며 10예는 근막층, 4예는 근육층에서 임플라논이 확인되었다. 시행 초기 정중 신경 손상이 있었던 1예를 제외하고 특별한 합병증 없이 연구 대상 전원 초음파 임플라논 제거에 성공하였다. 결론: 초음파 기기를 이용한 촉지되지 않는 임플라논의 제거는 효율적이고 안전한 방법이다.