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Objectives@#With the recent global mpox outbreak, the JYNNEOS vaccine (Modified VacciniaAnkara-Bavarian Nordic) was developed as a third-generation smallpox vaccine and initiallyfavored for mpox immunization. Vaccine-associated side effects contribute to vaccinehesitancy. Consequently, tracking adverse events post-immunization is crucial for safety management. This study used data from the national active vaccine safety surveillance conducted in Korea from August 25 to November 24, 2022 to detect potential safety signals and adverse events. @*Methods@#Data on health conditions following vaccination were gathered from web-based surveys and reported via active surveillance through the Immunization Registry Information System. This follow-up system functioned via a text message link, surveying adverse events and health conditions beginning on the second day post-vaccination. Information aboutspecific adverse events, including both local and systemic reactions, was collected. @*Results@#The study included 86 healthcare workers who had received at least 1 dose of the JYNNEOS vaccine. Among the respondents, 79.1% reported experiencing at least 1 adverse event, with the majority being local reactions at the injection site. The incidence of adverse events was higher following the first dose (67.9%) than after the second dose (34.4%). The most frequently reported adverse event for both doses was mild pain at the injection site. @*Conclusion@#The study provides crucial information on the safety of the JYNNEOS vaccine, demonstrating that most adverse events were manageable and predominantly localized to the injection site. Nonetheless, additional research is needed on the safety of various vaccineadministration techniques and the vaccine’s effects on broader demographics.
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Background@#Ogden type IV tibial tuberosity fractures, defined as a type of fracture with posterior–inferior metaphyseal extension (Salter-Harris type II variant), are uncommon but challenging pediatric fractures. The purpose of this study was to investigate the clinical and radiological presentation and associated surgical outcomes. @*Methods@#Ten previously healthy patients who had been surgically treated at the authors’ institution between 2015 and 2018 with at least 2 years of postoperative follow-up were included. Demographic, clinical, and radiological characteristics and treatment/ follow-up data were investigated. @*Results@#All included patients were male. All injuries resulted from jump-landings. Unacceptable remaining angular deformity after closed reduction, particularly increased posterior tibial slope angle, was the leading cause of surgery. All preoperative magnetic resonance images (MRIs) showed entrapped periosteum on the anteromedial side of the proximal tibial physis. Surgical removal of the entrapped periosteum achieved successful reduction. Metaphyseal fracture angles between the fracture plane of the metaphyseal beak and the posterior tibial condyle on the axial image of MRI were relatively constant, with an average of 24.3° ± 6.0°. Mean bone age at the time of trauma was older than mean chronological age (16.4 ± 1.0 years vs. 14.6 ± 1.1 years, respectively; p = 0.005).All patients reached skeletal maturity within 2 postoperative years, with little posttraumatic residual height growth (mean, 1.6 ± 0.7 cm from injury to skeletal maturity). At final follow-up, no patients showed significant angular deformity, tibial length discrepancy, or functional deficit. @*Conclusions@#In healthy adolescents, Ogden type IV tibial tuberosity fractures typically occur by jump-landing injuries, when they have little residual growth remaining. Therefore, accurate fracture reduction was required because of limited remodeling potential.Patients with unacceptable reduction should be investigated for entrapped periosteum on the anteromedial side of the physis because it was the primary obstacle in achieving adequate reduction.
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Background@#Many studies have reported injury characteristics of individual traumatic situations. However, a comparative analysis of specific risks is meaningful to better understand injury characteristics and help establish injury-prevention measures. This study was conducted to investigate and compare injury characteristics in children and adolescents by various outdoor traumatic situations. @*Methods@#Outdoor traumatic situations were determined and classified into physical activity-related injury (n = 3,983) and pedestrian (n = 784) and passenger (n = 1,757) injuries in traffic accidents. Home injury (n = 16,121) was used as the control group. Then, the characteristics of each outdoor trauma were compared with 1:1 matched indoor trauma (among home injuries); each outdoor traumatic situation’s predisposing risk for the injured body part, injury type, and injury severity were analyzed; and changes by age of frequency ranking among physical activity-related injuries were investigated. @*Results@#Outdoor trauma showed higher risks for limb injuries (injured body part), fracture and muscle/tendon injuries (injury type), and severe injuries (severity) than indoor trauma. Various outdoor traumatic situations presented different predisposing effects on injury characteristics. Among physical activity-related injuries, bicycle injury was commonest across all ages, and playing activities were common causes for injury for individuals of age < 9 years, whereas sports activities overwhelmed the common causes thereafter. @*Conclusions@#The findings would help to better understand the specific injury risk of various outdoor traumatic situations and may potentially facilitate the establishment of more effective injury-prevention measures.
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Background@#Many studies have reported injury characteristics of individual traumatic situations. However, a comparative analysis of specific risks is meaningful to better understand injury characteristics and help establish injury-prevention measures. This study was conducted to investigate and compare injury characteristics in children and adolescents by various outdoor traumatic situations. @*Methods@#Outdoor traumatic situations were determined and classified into physical activity-related injury (n = 3,983) and pedestrian (n = 784) and passenger (n = 1,757) injuries in traffic accidents. Home injury (n = 16,121) was used as the control group. Then, the characteristics of each outdoor trauma were compared with 1:1 matched indoor trauma (among home injuries); each outdoor traumatic situation’s predisposing risk for the injured body part, injury type, and injury severity were analyzed; and changes by age of frequency ranking among physical activity-related injuries were investigated. @*Results@#Outdoor trauma showed higher risks for limb injuries (injured body part), fracture and muscle/tendon injuries (injury type), and severe injuries (severity) than indoor trauma. Various outdoor traumatic situations presented different predisposing effects on injury characteristics. Among physical activity-related injuries, bicycle injury was commonest across all ages, and playing activities were common causes for injury for individuals of age < 9 years, whereas sports activities overwhelmed the common causes thereafter. @*Conclusions@#The findings would help to better understand the specific injury risk of various outdoor traumatic situations and may potentially facilitate the establishment of more effective injury-prevention measures.
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Background@#In the Korean medical system, the severity classification for a specific disease depends primarily on its nationwide admission rate in tertiary hospitals. Inversely, one of the important designation criteria for a tertiary hospital is the hospital's treatment ratio of patients classified as having a specific severe disease. Most diseases requiring pediatric orthopaedic surgery (POS) are not currently classified as high severity in terms of disease severity. We investigated the admission rates for the representative POS diseases in tertiary hospitals and compared these rates with those for adult orthopaedic surgery (AOS) diseases. @*Methods@#Seven POS diagnoses and three AOS diagnoses were selected based on frequency of admission. Nationwide sample data were used to investigate the admission rates for these representative diagnoses from 2008 to 2017. @*Results@#Six of the seven frequent POS diagnoses presented high admission rates in tertiary hospitals (62.5–92.3%). In contrast, all frequent AOS diagnoses presented low admission rates in tertiary hospitals. @*Conclusion@#The admission rates of frequent POS diagnoses in tertiary hospitals are high.Considering that these rates are the most important factors for the classification of disease severity, POS diseases seem to be underestimated in terms of severity. This may lead to a tendency for tertiary hospitals to intentionally reduce the admission of children with POS diseases. As a result, these children may not receive appropriate professional care. Therefore, for the disease severity, POS diseases should be classified differently from general AOS diseases by using different criteria reflecting the patient's age.
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Purpose@#For this study the effect of skin disinfection according to the disinfection frequency in peripheral intravenous therapy was examined. @*Methods@#One hundred and twenty skin disinfections, three sections on the right forearm and three sections on the left forearm, were performed on each of 20 seniors in the school of nursing, and 240 microbial cultures were performed before and after the skin disinfection at each site. Single-use sterile packaged 83% alcohol cotton was used to disinfect. The skin was disinfected once, twice, or three times for 5 seconds per session and then allowed to dry for one minute. The data were analyzed using the Kruskal-Wallis test and the Generalized Estimation Equation (GEE). @*Results@#There was no significant difference in the number of microbial colonies by the number of disinfections (p=.599) as well as the number of microbial colonies among those disinfected the same number of times (p=.440). However, the number of microbial colonies after disinfection was significantly lower than that before disinfection (p<.001). The interaction effect, which was the difference in the decrease of microbial colonies by the number of disinfections, was not significant (p=.101). @*Conclusion@#Prior to peripheral intravenous injection, disinfecting the skin once for five seconds with an 83% alcohol swab was as effective as disinfecting it twice for 10 seconds or three times for 15 seconds. Therefore, disinfecting the skin thoroughly for 5 seconds or more with an 83% alcohol cotton swab is sufficient for peripheral vein injections in the clinical field.
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PURPOSE: This study was done to evaluate the adequacy of nurse staffing in integrated nursing care. METHODS: Statistical data on integrated nursing care from the National Health Insurance Corporation was used in this study. We extracted hospital data and patient data related to patient needs for nursing care. We analyzed the differences in patient needs by staffing level of each type of medical institution. RESULTS: Approximately 70% of medical institutions provided nursing care by the mid level of nurse staffing, which was 1:6, 1:10 and 1:12 in the tertiary hospital, general hospital and semi-hospital, respectively. The patients' characteristics were significantly different by hospital type. Especially, the distribution of the main diagnosis was completely different between the tertiary hospital and semi-hospital. In the tertiary hospital, the patient needs measured by severity and activities of daily living dependency were higher at higher staffing level than at lower staffing level. However, the nurse staffing was less relevant to the patient needs in the general hospital and semi-hospital. CONCLUSION: To provide high-quality nursing care, accurate workload forecasting is required at the start, and then the standard nurse staffing level can established based on workload forecasting.
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Humans , Activities of Daily Living , Diagnosis , Forecasting , Hospitals, General , National Health Programs , Nursing Care , Nursing , Tertiary Care CentersABSTRACT
Prostate-specific antigen (PSA) is a glycoprotein produced by prostatic duct and acinar epithelial cells and the most commonly used marker for diagnosing prostate cancer, and for monitoring its progression and recurrence. Here, we describe a 76-year-old patient with recurrent prostate cancer who developed isolated hematogenous pulmonary metastases with a normal serum PSA level 5 years after radical prostatectomy. Immunohistochemical (IHC) analysis of a transbronchial lung biopsy specimen revealed tumor cells positive for PSA and prostatic acid phosphatase. After 2 months of maximal androgen blockade, the metastatic pulmonary nodules showed near-complete regression. In conclusion, metastases of prostate adenocarcinoma may occur despite low serum PSA levels, and, if warranted clinically, IHC staining or other serological markers for prostate adenocarcinoma should be considered when evaluating metastatic carcinoma from an unknown primary lesion in males with low serum PSA levels.
Subject(s)
Aged , Humans , Male , Acid Phosphatase , Adenocarcinoma , Biopsy , Epithelial Cells , Glycoproteins , Lung , Neoplasm Metastasis , Prostate , Prostate-Specific Antigen , Prostatectomy , Prostatic Neoplasms , RecurrenceABSTRACT
Lymphomatoid granulomatosis (LYG) is an angiocentric and angiodestructive neoplastic proliferation of B and T lymphocytes commonly involving the lungs. Epstein-Barr virus is commonly detected in lesional cells. We report a case of a 54-year-old female with underlying monoclonal gammopathy of unknown significance who presented with a 4 week history of dyspnea and cough. Computed tomography scan of the chest showed multiple lung nodules as well as endobronchial narrowing causing atelectasis at the left upper lobe. Bronchoscopic findings revealed obstruction at the lingula segment due to endobronchial mass as a rare presentation. Bronchoscopic biopsy was diagnosed with LYG grade 1. After treatment, the endobronchial mass and lung lesions were completely resolved. However, the patient eventually evolved to malignant lymphoma after 1 year.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Cough , Dyspnea , Herpesvirus 4, Human , Lung , Lymphoma , Lymphomatoid Granulomatosis , Paraproteinemias , Pulmonary Atelectasis , T-Lymphocytes , ThoraxABSTRACT
Clopidogrel is an antiplatelet agent prescribed widely to prevent stent thrombosis after coronary or peripheral vascular interventions and for stroke prophylaxis. The side effects of this drug include gastrointestinal symptoms, such as nausea, abdominal pain, vomiting, and bleeding. Thrombotic thrombocytopenia purpura (TTP) is a rare complication of this drug. Here, we report a case of clopidogrel-associated TTP in a patient with cerebral infarction. To our knowledge, it is first reported case of clopidogrel-associated TTP in Korea.
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Humans , Abdominal Pain , Cerebral Infarction , Hemorrhage , Korea , Nausea , Purpura , Purpura, Thrombotic Thrombocytopenic , Stents , Stroke , Thrombocytopenia , Thrombosis , VomitingABSTRACT
Clopidogrel is an antiplatelet agent prescribed widely to prevent stent thrombosis after coronary or peripheral vascular interventions and for stroke prophylaxis. The side effects of this drug include gastrointestinal symptoms, such as nausea, abdominal pain, vomiting, and bleeding. Thrombotic thrombocytopenia purpura (TTP) is a rare complication of this drug. Here, we report a case of clopidogrel-associated TTP in a patient with cerebral infarction. To our knowledge, it is first reported case of clopidogrel-associated TTP in Korea.
Subject(s)
Humans , Abdominal Pain , Cerebral Infarction , Hemorrhage , Korea , Nausea , Purpura , Purpura, Thrombotic Thrombocytopenic , Stents , Stroke , Thrombocytopenia , Thrombosis , VomitingABSTRACT
Massive bleeding hemobilia occurs rarely in patients with hepatocellular carcinoma (HCC) without any invasive procedure. Upper gastrointestinal bleeding in patient with cirrhosis and abdominal pain with progressive jaundice in patient with HCC were usually thought as variceal bleeding and HCC progression respectively. We experienced recently massive bleeding hemobilia in patient with HCC who was a 73-year old man and showed sudden abdominal pain, jaundice and hematochezia. He had alcoholic cirrhosis and history of variceal bleeding. One year ago, he was diagnosed as HCC and treated with transarterial chemoembolization periodically. Sudden right upper abdominal pain occurred then subsided with onset of hemotochezia. Computed tomography showed bile duct thrombosis spreading in the intrahepatic and extrahepatic ducts, while an ampulla of vater bleeding was observed during duodenoscopy. Hemobilia could be one of the causes of massive bleeding in patients with cirrhosis and HCC especially when they had sudden abdominal pain and abrupt elevation of bilirubin.
Subject(s)
Aged , Humans , Male , Bile Ducts, Extrahepatic , Bile Ducts, Intrahepatic , Bilirubin/analysis , Carcinoma, Hepatocellular/complications , Duodenoscopy , Embolization, Therapeutic , Hemobilia/etiology , Jaundice/etiology , Liver Cirrhosis/complications , Liver Neoplasms/complications , Severity of Illness Index , Thrombosis/diagnosis , Tomography, X-Ray ComputedABSTRACT
The purpose of this study was to examine whether ginsenoside Rg3 (GRg3) could improve learning and memory impairments and inflammatory reactions induced by injecting lipopolysaccharide (LPS) into the brains of rats. The effects of GRg3 on proinflammatory mediators in the hippocampus and the underlying mechanisms of these effects were also investigated. Injection of LPS into the lateral ventricle caused chronic inflammation and produced deficits in learning in a memory-impairment animal model. Daily administration of GRg3 (10, 20, and 50 mg/kg, i.p.) for 21 consecutive days markedly improved the LPS-induced learning and memory disabilities demonstrated on the step-through passive avoidance test and Morris water maze test. GRg3 administration significantly decreased expression of pro-inflammatory mediators such as tumor necrosis factor-alpha, interleukin-1beta, and cyclooxygenase-2 in the hippocampus, as assessed by reverse transcription-polymerase chain reaction analysis and immunohistochemistry. Together, these findings suggest that GRg3 significantly attenuated LPS-induced cognitive impairment by inhibiting the expression of pro-inflammatory mediators in the rat brain. These results suggest that GRg3 may be effective for preventing or slowing the development of neurological disorders, including Alzheimer's disease, by improving cognitive and memory functions due to its anti-inflammatory activity in the brain.
Subject(s)
Animals , Rats , Alzheimer Disease , Brain , Cyclooxygenase 2 , Hippocampus , Immunohistochemistry , Inflammation , Interleukin-1beta , Lateral Ventricles , Learning , Memory , Models, Animal , Nervous System Diseases , Tumor Necrosis Factor-alpha , WaterABSTRACT
Baicalein (BA), a plant-derived active flavonoid present in the root of Scutellaria baicalensis, has been widely used for the treatment of stress-related neuropsychiatric disorders including depression. Previous studies have demonstrated that repeated restraint stress disrupts the activity of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in depression. The behavioral and neurochemical basis of the BA effect on depression remain unclear. The present study used the forced swimming test (FST) and changes in brain neurotransmitter levels to confirm the impact of BA on repeated restraint stress-induced behavioral and neurochemical changes in rats. Male rats received 10, 20, or 40 mg/kg BA (i.p.) 30 min prior to daily exposure to repeated restraint stress (2 h/day) for 14 days. Activation of the HPA axis in response to repeated restraint stress was confirmed by measuring serum corticosterone levels and the expression of corticotrophin-releasing factor in the hypothalamus. Daily BA administration significantly decreased the duration of immobility in the FST, increased sucrose consumption, and restored the stress-related decreases in dopamine concentrations in the hippocampus to near normal levels. BA significantly inhibited the stress-induced decrease in neuronal tyrosine hydroxylase immunoreactivity in the ventral tegmental area and the expression of brain-derived neurotrophic factor (BDNF) mRNA in the hippocampus. Taken together, these findings indicate that administration of BA prior to the repeated restraint stress significantly improves helpless behaviors and depressive symptoms, possibly by preventing the decrease in dopamine and BDNF expression. Thus, BA may be a useful agent for the treatment or alleviation of the complex symptoms associated with depression.
Subject(s)
Animals , Male , Rats , Brain , Brain-Derived Neurotrophic Factor , Corticosterone , Depression , Dopamine , Flavanones , Hippocampus , Hypothalamus , Neurons , Neurotransmitter Agents , RNA, Messenger , Physical Exertion , Scutellaria baicalensis , Sucrose , Tyrosine 3-Monooxygenase , Ventral Tegmental AreaABSTRACT
PURPOSE: The purpose of this study was to determine gender differences in attitudes towards sleeping in separate rooms (SSR) a means of dealing with marital conflict and to explore the reasons why participants agreed or disagreed with SSR. MATERIALS AND METHODS: Research participants were 616 married people (300 men, 316 women) aged 30 to 89 years and currently lived with their spouses in the same house. They were asked to assess their attitudes towards SSR using a Likert scale from 0 (strongly disagree) to 10 (strongly agree). Two separate SSR questions were given to them: one for the respondents themselves and the other for couples in general. RESULTS: There were significant gender differences in attitudes towards SSR. Men generally disagreed with SSR, with a negligible difference between the two separate SSR cases (p>.05). However, women agreed with SSR, especially with the question about the respondents themselves (p<.01). The most frequent reason from agreeing with SSR was to alleviate conflict, while the most frequent reason for disagreeing was related to sexual issues, which showed significant gender differences. CONCLUSIONS: Gender differences in attitudes towards the SSR were found, and the differences were examined in the context of social exchange theory. The limitation of this study was that the sexual interactive and communicative patterns of the couples who were sleeping in separate rooms were not explored.
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Aged , Female , Humans , Male , Surveys and Questionnaires , Family Characteristics , Family Conflict , SpousesABSTRACT
Bovine tuberculosis (TB) is a major zoonosis that's caused by Mycobacterium bovis (M. bovis). Being able to detect M. bovis is important to control bovine TB. We applied a molecular technique, the variable number tandem repeat (VNTR) typing method, to identify and distinguish the M. bovis isolates from Gyeonggi-do, Korea. From 2003 to 2004, 59 M. bovis clinical strains were isolated from dairy cattle in Gyeonggi-do, Korea, and these cattle had tuberculosis-like lesions. Twenty-four published MIRUVNTR markers were applied to the M. bovis isolates and ten of them showed allelic diversity. The most discriminatory locus for the M. bovis isolates in Korea was QUB 3336 (h = 0.64). QUB 26 and MIRU 31 also showed high discriminative power (h = 0.35). The allelic diversity by the combination of all VNTR loci was 0.86. Six loci (MIRU 31, ETR-A and QUB-18, -26, -3232, -3336) displayed valuable allelic diversity. Twelve genotypes were identified from the 59 M. bovis isolates that originated from 20 cattle farms that were dispersed throughout the region of Gyenggi-do. Two genotypes [designation index (d.i.) = e, g] showed the highest prevalence (20% of the total farms). For the multiple outbreaks on three farms, two successive outbreaks were caused by the same genotype at two farms. Interestingly, the third outbreak at one farm was caused by both a new genotype and a previous genotype. In conclusion, this study suggests that MIRU-VNTR typing is useful to identify and distinguish the M. bovis isolates from Gyeonggi-do, Korea.