Development and Roll-Out of A Coronavirus Disease 2019 Clinical Pathway for Standardized Qualified Care in Public Hospitals in Korea

Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients’ care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed.

Anomalous right coronary artery from pulmonary artery discovered incidentally in an asymptomatic young infant / 소아과

Isolated anomalous right coronary artery originating from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly that is asymptomatic and discovered incidentally in most cases. ARCAPA is generally not considered a fatal defect in infancy or childhood, although cases of sudden death have been reported. Here, we report a 2-month-old female infant who presented with a prolonged fever that was determined to be caused by rhinovirus infection. Myocardial ischemia of the left ventricular posterior wall was already seen on echocardiography, and ARCAPA was discovered incidentally. The patient underwent successful surgical reimplantation of the right coronary artery to the aortic root to re-establish dual ostial circulation.

Effect of Food Waste Compost on the Antler-Type Fruiting Body Yield of Ganoderma lucidum

The effects of the composition of a mixture containing food waste compost (FWC), rice bran (RB), and oak sawdust (SD) on the antler-type fruiting body (FB) yield of Ganoderma lucidum were studied. Experiments were performed using 0 (control), 5, 10, 15, 20, 25, 30, 35, and 40% (w/w) FWC added to a basal growth medium consisting of 20% (w/w) RB and 80% (w/w) SD. The content of 15% FWC gave the highest FB yield (27.0 +/- 1.3 g/bottle), which was 44% higher than the yield (18.6 +/- 2.8 g/bottle) of the control treatment. However, FWC contents of 20~40% showed reduced yield (2.4~23.0 g/bottle), partly because FWC had a high Na concentration (0.6%). These results demonstrate the potential for use of FWC as a component of a growth medium for production of G. lucidum FBs.

Influence of Food Waste Compost on the Yield and Mineral Content of Ganoderma lucidum, Lentinula edodes, and Pholiota adipose Fruiting Bodies

The objectives of this study were to evaluate applicability of food waste compost (FWC) as a substrate for cultivation of Ganoderma lucidum, Lentinula edodes, and Pholiota adipose, and to determine contents of Ca, Mg, Na, and K in fruiting bodies (FB). FB yield per substrate in FWC-free controls was 53 +/- 4 g/kg for G. lucidum, 270 +/- 90 g/kg for L. edodes, and 1,430 +/- 355 g/kg for P. adipose. Substrates supplemented with FWC showed the highest FB production at FWC content of 10% for G. lucidum (64 +/- 6 g/kg), and 13% for L. edodes (665 +/- 110 g/kg) and P. adipose (2,345 +/- 395 g/kg), which were 1.2~2.5 times higher than the values for the controls. P. adipose contained higher amounts of mineral elements than the other species. Ca, Mg, Na, and K content in FB did not show a significant relation to FWC content.

Macroamylasemia and macrolipasemia in patient with alcoholic liver cirrhosis / 대한내과학회지

Macroenzymes are high molecular weight complexes formed in the serum by self-polymerization or by association with other proteins. Macroenzymes are filtered with difficulty by normal renal glomeruli. Clinically, it is important to detect macroenzymes, because they frequently interfere with the interpretation of serum enzyme results, and as a result they can cause diagnostic and therapeutic errors. Macroamylasemia and macrolipasemia have been found to occur in apparently healthy humans, as well as in a variety of disease states, including liver disease, diabetes, cancer, malabsorption, and autoimmune disorders. We report a patient with alcoholic liver cirrhosis and macroamylasemia and macrolipasemia, the latter two of which were discovered using a screening test.

The Usefulness of Mesalazine Suppositories for the Treatment of Lymphoid Follicular Proctitis / 대한소화기학회지

BACKGROUND/AIMS: Lymphoid follicular proctitis (LFP) is an uncommon inflammatory condition confined to the rectum. Patients with LFP constitute a special group with clinical, endoscopic, and histological features unrelated to other types of inflammatory bowel diseases, and have been reported to be refractory to local steroid and/or oral sulfasalazine therapy. The aim of this study was to clarify whether mesalazine suppositories have a therapeutic effect in LFP. METHODS: The histologic slides of 8 cases indexed in our pathology files as "lymphoid follicular proctitis of the rectal mucosa" from January 2001 to November 2003 were reviewed retrospectively. RESULTS: The most common symptom in the patients with LFP was rectal bleeding. The endoscopic mucosal changes were discontinuous, sparing whole circumferential involvement, and were strictly confined to the rectum. Average period of medication was 12 months. All the symptomatic patients with LFP responded to mesalazine suppository therapy. In addition, these patients did not progress to other disease including ulcerative proctitis or lymphoma. CONCLUSIONS: Mesalazine suppository treatment is a useful therapeutic option for symptomatic patients with LFP.

The Usefulness of Mesalazine Suppositories for the Treatment of Lymphoid Follicular Proctitis / 대한소화기학회지

BACKGROUND/AIMS: Lymphoid follicular proctitis (LFP) is an uncommon inflammatory condition confined to the rectum. Patients with LFP constitute a special group with clinical, endoscopic, and histological features unrelated to other types of inflammatory bowel diseases, and have been reported to be refractory to local steroid and/or oral sulfasalazine therapy. The aim of this study was to clarify whether mesalazine suppositories have a therapeutic effect in LFP. METHODS: The histologic slides of 8 cases indexed in our pathology files as "lymphoid follicular proctitis of the rectal mucosa" from January 2001 to November 2003 were reviewed retrospectively. RESULTS: The most common symptom in the patients with LFP was rectal bleeding. The endoscopic mucosal changes were discontinuous, sparing whole circumferential involvement, and were strictly confined to the rectum. Average period of medication was 12 months. All the symptomatic patients with LFP responded to mesalazine suppository therapy. In addition, these patients did not progress to other disease including ulcerative proctitis or lymphoma. CONCLUSIONS: Mesalazine suppository treatment is a useful therapeutic option for symptomatic patients with LFP.

A Case of Congenital Hepatic Fibrosis Presented with Symptom of Acute Cholangitis / 대한소화기학회지

Congenital hepatic fibrosis (CHF) is an autosomal recessive disease, presenting principally in children or young adults with portal hypertension, and infrequently associated with cholangitis. It is associated with renal malformation and Caroli's disease. The diagnosis of CHF is usually confirmed by its typical histological features. Cholangitis is a severe and frequently fatal complication. We report a 22-year-old man with congenital hepatic fibrosis who showed the cholangitis without radiological features of cystic dilatation or stone of intrahepatic ducts.

A Case of Intracranial Lipoma

Intracranial lipomas are rare lesions, which represent 0.1-1.7% of all intracranial tumors. They preferentially occur near the midline, most frequently in the pericallosal cistern, and are often associated with various neurologic and systemic anomalies. Magnetic resonance imaging and computerized tomography together with clinical trials are of crucial importance for diagnosis. We report a rare case of intracranial lipoma of the body of corpus callosum in a child, who has had cyclic headache, vertigo, with a review of the literature.

A Case of MALT-lymphoma of the Ampulla of Vater / 대한소화기내시경학회지

Primary gastrointestinal lymphomas originating from the mucosa-associated lymphoid tissue (MALT) have been reported with increasing frequency. The stomach is the most frequent site of MALT lymphoma, and a relationship with Helicobacter pylori infection has been studied. However, primary MALT lymphoma arising from the ampulla of Vater is extremely rare, and its relationship with Helicobacter pylori infection is still obscure. We report here a case of a 71-year-old man with marginal zone B cell lymphoma of MALT with large B cell lymphoma of the ampulla of Vater that was not associated with Helicobacter pylori. A pancreaticoduodenectomy was performed, and the pathologic examination of the resected specimen confirmed the diagnosis. The patient tolerated just one course of systemic chemotherapy, but has been doing well for 18 months after surgery.

The accuracy of the radiographic method in root canal length measurement / 대한구강악안면방사선학회지

For the successful endodontic treatment, root canal should be cleaned thoroughly by accurate mechanical and chemical canal preparation and sealed completely with canal filling material without damaging the periapical tissues. The accuracy of the root canal length measurement is a prerequisite for the success of the endodontic treatment, and the root canal length is often determined by the standard periapical radiographs and digital tactile sense. In this study, the accuracy and the clinical usefulness of Digora(R), an intraoral digital imaging processor and the conventional standard radiographs were compared by measuring the length from the top of the file to the root apex. 30 single rooted premolars were invested in a uniformly sized blocks and No.25 K-file was inserted into and fixed in each canal. Each block was placed in equal distance and position to satisfy the principle of the bisecting angle and paralleling techniques and Digora(R) system's image and standard periapical radiographs were taken. Each radiograph was examined by 3 different observers by measuring the length from top of the file to the root apex and each data was compared and analyzed. The results were as follows; 1. In the bisecting angle technique, the average difference between the Digora(R) system and standard periapical radiograph was 0.002 mmand the standard deviation was 0.341 mmwhich showed no statistically significant difference between the two systems(p>0.05). Also, in the paralleling technique, the average difference between these two system was 0.007 mmand the standard deviation was 0.323 mmwhich showed no statistically significant difference between the two systems(p>0.05). 2. In Digora(R) system, the average difference between the bisecting angle and paralleling technique was -0.336 mmand the standard deviation was 0.472 mmwhich showed a statistically significant difference between the two techniques(p 3. In Digora(R) system and the standard periapical radiographs, there was a statistically significant difference between the measurement using the bisecting angle technique and the actual length(p0.05). In conclusion, the determination of the root canal length by using the Digora(R) system can give us as good an image as the standard periapical radiograph and using the paralleling technique instead of the bisecting angle technique can give a measurement closer to the actual canal length, thereby contributing to a successful result. Also, considering the advantages of the digital imaging processor such as decreasing the amount of exposure to the patient, immediate use of the image, magnification of image size, control of the contrast and brightness and the ability of storing the image can give us good reason to replace the standard periapical radiographs.

The clinical and radiologic consideration of cementifying and ossifying fibroma of the jaws / 대한구강악안면방사선학회지

The purpose of this study was to know the proper diagnosis and to establish the treatment plan of cementifying and ossifying fibroma in the jaws through the clinical, raiological, and histopathologic considerations. The authors compared and analyzed the clinicoradiologic features of the thirteen cases of cementifying and ossifying fibroma, diagnosed at the Dental college hospital in Yonsei university, Seoul, Korea, during the period from 1980 to 1995. The obtained results were as follows: 1. Cementifying and ossifying fibroma occured in the mean age, 44 years, ranged from 29 to 65 years and the male to female ratio was approximately 1:5. 2. Swelling was the most common frequent presenting complaints. Other reported symptoms included pain, tooth mobility and asymptom. 3. The frequency of the lesions was twelve cases in the mandible and one case in the maxilla. And eleven of thirteen cases were distributed on the premolar and molar region. 4. Radiologically, eight of thirteen cases were well defined lesions, five cases were relatively well defined lesions. And nine of thirteen cases were mixed lesions, three cases were radiopaque lesions, and only one case was purely radiolucenct lesion. 5. Histologically, seven of thirteen cases were classified ossifying fibroma, four cases were cemento-ossifying fibroma, and two cases were cementifying fibroma.

CT of head and neck lymphoma

Lymphoma is the second most common neoplasm in the head and neck, and is the most common cause of unilateral neck mass in patients between 21 and 40 years of age. This report is a retrospective review of histologically proven lymphomas in 42 patients regarding histologic type, clinical stage, and CT imaging patterns. CT imaging plays an important role in making diagnosis, planning treatment, and evaluating recurrence after treatment. CT imaging patterns are classified into 4 types: Type 1 is nodal lymphoma, Type 2 extranodal lymphoma, Type 3 combined nodal and extranodal lymphoma, and Type 4 multifocal extranodal lymphoma. In conclusion, Lymphoma should be considered when multiple, nonnecrotic, homogenous lymph nodes are located in deep lymphatic chains (especially when they are large and bilateral or when both are the superficial and deep lymph node chains are involved simultaneously) and no mucosal abnormality of the aerodigestive tract is observed. Additionary, when a large nasopharyngeal mass lesion shows limited or equivocal bone destruction or a mass is identified on two sides of a nasal bone without frank destruction and when multiple sites of disease are identified in extranodal tissues.