Effect of coronavirus disease 2019 on febrile children’s visits to the emergency department of a tertiary hospital

Purpose@#During the coronavirus disease 2019 pandemic, many countries have reported sharp drops in the numbers of patients, especially children, seeking emergency care unrelated to the disease. The author investigated the patterns of febrile children’s visits to the emergency department (ED) of a tertiary hospital from 2017 through 2020. @*Methods@#We compared the data of febrile children aged 15 years or younger who visited the ED in 2017-2019 and in 2020 (February through August, each year). Information on the children’s baseline characteristics, the Korean Triage and Acuity Scale 1-2 indicating a high severity, and ED disposition, such as hospitalization, were collected. In addition, we determined the number of children who underwent cancellation, defined as the leave of children without treatment, and the rates of respiratory virus polymerase chain reaction performance and its positivity. @*Results@#In 2020, we noted decreases in the median monthly fever-related ED visits (2017-2019, 326 [interquartile range, 292-425] vs. 2020, 149 [132-182]; P < 0.001) with a shorter median fever duration (2017-2019, 11 [3-27] days vs. 2020, 9 [2-23] days; P < 0.001). However, in the same year, we noted increases in rates of the Korean Triage and Acuity Scale 1-2 (2017-2019, 5.7% vs. 2020, 16.4%; P < 0.001) and hospitalization (2017-2019, 23.5% vs. 2020, 35.7%; P < 0.001). We also noted increases in the number of cancellation and the rate of respiratory virus polymerase chain reaction performance rate, along with a decrease in its positive rate in 2020. @*Conclusion@#During the pandemic, the febrile children’s visits to the ED decreased in number. However, the severity remarkably increased, requiring more medical attention.

Effect of coronavirus disease 2019 on febrile children’s visits to the emergency department of a tertiary hospital

Purpose@#During the coronavirus disease 2019 pandemic, many countries have reported sharp drops in the numbers of patients, especially children, seeking emergency care unrelated to the disease. The author investigated the patterns of febrile children’s visits to the emergency department (ED) of a tertiary hospital from 2017 through 2020. @*Methods@#We compared the data of febrile children aged 15 years or younger who visited the ED in 2017-2019 and in 2020 (February through August, each year). Information on the children’s baseline characteristics, the Korean Triage and Acuity Scale 1-2 indicating a high severity, and ED disposition, such as hospitalization, were collected. In addition, we determined the number of children who underwent cancellation, defined as the leave of children without treatment, and the rates of respiratory virus polymerase chain reaction performance and its positivity. @*Results@#In 2020, we noted decreases in the median monthly fever-related ED visits (2017-2019, 326 [interquartile range, 292-425] vs. 2020, 149 [132-182]; P < 0.001) with a shorter median fever duration (2017-2019, 11 [3-27] days vs. 2020, 9 [2-23] days; P < 0.001). However, in the same year, we noted increases in rates of the Korean Triage and Acuity Scale 1-2 (2017-2019, 5.7% vs. 2020, 16.4%; P < 0.001) and hospitalization (2017-2019, 23.5% vs. 2020, 35.7%; P < 0.001). We also noted increases in the number of cancellation and the rate of respiratory virus polymerase chain reaction performance rate, along with a decrease in its positive rate in 2020. @*Conclusion@#During the pandemic, the febrile children’s visits to the ED decreased in number. However, the severity remarkably increased, requiring more medical attention.

Scales for Spinal Cord Disorders

Clinical scales are important tools for quantitatively evaluating impairments and disabilities related to diseases. Clinical scales are also used in many clinical studies to assess therapeutic effects. Spinal cord disorders cause neurological deterioration, which leads to functional and social disabilities. For many neurological disorders that cause myelopathy, including multiple sclerosis and other inflammatory demyelinating diseases, numerous drugs are being developed and studied for clinical use. Thus, clinical scales for myelopathy are important for both the medical field and general public. This review article describes the clinical scales for myelopathy, especially those that are widely used and established. We expect that this review will help readers choose the scales appropriate for their purposes.

Scales for Spinal Cord Disorders

Clinical scales are important tools for quantitatively evaluating impairments and disabilities related to diseases. Clinical scales are also used in many clinical studies to assess therapeutic effects. Spinal cord disorders cause neurological deterioration, which leads to functional and social disabilities. For many neurological disorders that cause myelopathy, including multiple sclerosis and other inflammatory demyelinating diseases, numerous drugs are being developed and studied for clinical use. Thus, clinical scales for myelopathy are important for both the medical field and general public. This review article describes the clinical scales for myelopathy, especially those that are widely used and established. We expect that this review will help readers choose the scales appropriate for their purposes.

Gender differences in characteristics of adolescents with suicide attempt at the emergency department

Purpose@#This study was performed to investigate the gender differences in suicide attempts in adolescents. @*Methods@#We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. @*Results@#A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). @*Conclusion@#Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.

Gender differences in characteristics of adolescents with suicide attempt at the emergency department

Purpose@#This study was performed to investigate the gender differences in suicide attempts in adolescents. @*Methods@#We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. @*Results@#A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). @*Conclusion@#Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.

Thoracic Spinal Cord Infarction Presenting as Isolated Monoplegia

No abstract available.

Hyperglycemic hyperosmolar state associated with invasive rhino-orbital aspergillosis in a patient with end-stage renal disease

No abstract available.

Repetitive Questioning and Writing in a Patient with Transient Global Amnesia

No abstract available.

Women's Health Status Working at Traditional Marketplaces and Their Needs for Public Health Care Services

PURPOSE: The purpose of this study is to analyze health status of women working in traditional marketplace and their needs for public healthcare services. METHODS: A descriptive survey of 500 women working at three traditional marketplaces was conducted. RESULTS: street vendors' health status were much poorer than store merchants'. Furthermore, psychosocial factors like job stress and depression were increased in street venders. Thus, the public healthcare programs required by them included exercise programs (28.2%) and health checkup (26.8%). In addition, 31.2% of the participants reported that they needed visiting nursing care services. The rate of occupational health and safety or employment insurances was as low as 10.8%. CONCLUSION: Effective interventions including psychosocial factors for women workers at traditional marketplaces need to be developed based on these results. Also, it is recommended that public health care services such as outreach services and visiting nursing care services for women working at traditional marketplaces be provided. Furthermore, institutional provisions such as insurances for protecting these vulnerable groups' health are needed.

Enterocolic Fistula caused by Acute Colitis in a Hemodialysis Patient / 대한내과학회지

Enterocolic fistulas are commonly associated with previous surgery, Crohn's disease, diverticulitis, radiation therapy, and malignancy. Here, we report a rare case of enterocolic fistula caused by acute colitis in a hemodialysis patient. A 62-year-old man on maintenance hemodialysis underwent a radical nephrectomy via a paramedian incision due to spontaneous right kidney rupture and was treated with prophylactic antibiotics. On the 16th day of antibiotic therapy, he complained of abdominal pain and diarrhea. Abdominal computed tomography (CT) and ascitic fluid culture revealed acute bacterial peritonitis and sigmoidoscopy showed acute colitis. After treating these diseases with adequate antibiotics, the abdominal pain and ascites were relieved, but the diarrhea persisted. Abdominal CT obtained 7 days later showed an enterocolic fistula. To our knowledge, this is the first case of enterocolic fistula due to acute colitis in Korea.

Excellent outcome of medical treatment for Kasabach-Merritt syndrome: a single-center experience

BACKGROUND: Kasabach-Merritt syndrome (KMS) is a rare but life-threatening illness. The purpose of this study is to report our single-center experience with KMS. METHODS: We reviewed the medical records of 13 patients who were diagnosed with KMS between 1997 and 2012 at Samsung Medical Center. Treatment response was defined as follows: 1) hematologic complete response (HCR) – platelet count >130×10⁹/L without transfusion; 2) clinical complete response (CCR) – complete tumor disappearance or small residual vascular tumor displaying lack of proliferation for at least 6 months after treatment discontinuation. RESULTS: Participants included 7 male and 6 female patients. The median initial hemoglobin levels and platelet counts were 9.7 g/dL (range, 6.6–11.6 g/dL) and 11×10⁹/L (range, 3–38×10⁹/L), respectively. Twelve patients received corticosteroid and interferon-alpha as initial treatment, and the remaining patient received propranolol instead of corticosteroid. Two patients with unsatisfactory response to the initial treatment received weekly vincristine. Successful discontinuation of medication was possible at a median of 301 days (range, 137–579) in all patients except one who was lost to follow-up. The median times to achieve HCR and CCR were 157 days and 332 days, respectively. The probabilities of achieving HCR and CCR were 77% and 54% at 1 year, and 88% and 86% at 2.5 years, respectively. CONCLUSION: The prognosis of KMS in our cohort was excellent. Our data suggest that individualized treatment adaptation according to response may be very important for the successful treatment of patients with KMS.

Hepatocellular carcinoma hidden by multiple infarcted regenerative nodules

No abstract available.

A Systematic Review of Interventions for Workers with Cardiovascular Disease Risk Factors: Using an Ecological Model / 한국직업건강간호학회지

PURPOSE: The purposes of this study were to review the research trends and to identify developmental direction of studies on community interventions according to the ecological model for workers with cardiovascular diseases (CVD) risk factors. METHODS: Electronic databases including PsycINFO, PubMed, EMBASE, CINAHL, and Cochrane Library and the reference lists of articles were searched. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 29 researches being reviewed. Each review was critically appraised by two authors using a guideline of PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses). RESULTS: Nowadays, interventions in organizational level, integrated and web-based interventions are increasing to prevent CVD risk factors for workers. Even though the importance of psychosocial aspects to prevent CVD, the only 2 studies included psychosocial factors in the outcome variables. Also, 14% among 29 researches were based on theories. CONCLUSION: Psychosocial factors such as job stress, depression, and emotional labor could be CVD risk factors. Therefore, interventions including psychosocial aspects are needed to prevent workers' CVD risks more effectively. Theory-based interventions are needed to support interventions' effects and to develop the nursing science.

NgR1 Expressed in P19 Embryonal Carcinoma Cells Differentiated by Retinoic Acid Can Activate STAT3

NgR1, a Nogo receptor, is involved in inhibition of neurite outgrowth and axonal regeneration and regulation of synaptic plasticity. P19 embryonal carcinoma cells were induced to differentiate into neuron-like cells using all trans-retinoic acid and the presence and/or function of cellular molecules, such as NgR1, NMDA receptors and STAT3, were examined. Neuronally differentiated P19 cells expressed the mRNA and protein of NgR1, which could stimulate the phosphorylation of STAT3 when activated by Nogo-P4 peptide, an active segment of Nogo-66. During the whole period of differentiation, mRNAs of all of the NMDA receptor subtypes tested (NR1, NR2A-2D) were consistently expressed, which meant that neuronally differentiated P19 cells maintained some characteristics of neurons, especially central nervous system neurons. Our results suggests that neuronally differentiated P19 cells expressing NgR1 may be an efficient and convenient in vitro model for studying the molecular mechanism of cellular events that involve NgR1 and its binding partners, and for screening compounds that activate or inhibit NgR1.

Eradication Rates of First-line and Second-line Therapy for Helicobacter pylori Infection in Gyeongnam Province

BACKGROUND/AIMS: The eradication rates of Helicobacter pylori has been decreasing over the years and it is different among the regions. The aim of this study was to investigate the rates of first-line and the second-line eradication of H. pylori over the last 5 years in a single institute of Changwon and Gyeongsangnam-do, Korea. MATERIALS AND METHODS: Eradication rates of first-line triple regimen in 1,164 patients and second-line quadruple regimen in 223 patients who received H. pylori eradication treatment from January 2008 to December 2012 at Changwon Fatima Hospital were evaluated retrospectively. The patients for second-line quadruple therapy were divided into three groups according to the dosage of medications. RESULTS: The overall eradication rates of first-line and second-line therapy were 70.5% and 81.2%, respectively. There was no decreasing tendency in the eradication rate of first-line therapy for 5 years (P=0.573). However, annul eradication rates of second-line therapy significantly decreased (P=0.001, linear by linear association). In second-line therapy, patients treated with high dose bismuth and metronidazole had higher eradication rates than those treated with low dose bismuth and metronidazole (P=0.039). CONCLUSIONS: The effectiveness of the first-line and second-line therapy for H. pylori was suboptimal. In addition, there was a decreasing tendency in the eradication rates of second-line therapy over the past 5 years in Changwon and Gyeongsangnam-do province. Alternative regimens or high dose therapy should be considered for first-line and second-line therapy.

Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

PURPOSE: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. METHODS: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. RESULTS: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. CONCLUSIONS: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.

Evaluation of the Readability of Teacher's Guide Book for Nutrition Education-Sugar, Na, Trans Fat / 대한지역사회영양학회지

This study is attempted to propose a quality evaluation method of the materials for nutrition education by applying readability test of printed materials for nutrition education. It is significantly important for the teaching class with nutrition education materials to consider students understanding level and education materials topics or choosing words in developed printed materials. This study performed an evaluation of the readability of text in teachers' guidebook, which is devised for elementary school students' education material about sugar, sodium and trans-fat and attempted to estimate the developing materials through analyzing difficulty level of the text. We utilized "The Teacher's Guidebook for Cooking Activity" that had been developed for elementary school by Ministry Education Science and Technology, as the readability evaluation standard. Compared with the average score of readability about "The Teacher's Guidebook for Cooking Activity", 72.94 +/- 6.85, "Sugar Guidebook" was 70.94 +/- 7.46, "Sodium Guidebook" was 68.76 +/- 14.50, and "Trans-fat Guidebook" was 58.87 +/- 10.79. Considering the subjects careers or ages, "The Teacher's Guidebook for Cooking Activity" has little deviation by the subjects careers or ages and was "intermediate" or "easy" level; however, "Sugar Guidebook", "Sodium Guidebook", "Trans-fat Guidebook" was "intermediate" or "difficult" level (p < 0.05). Readability score was especially low when the contents of some particular subjects were too professionalized or scientific terms were frequently used, and thes results were definitely seen in the "Sodium Guidebook" and "Trans-fat Guidebook". With Cloze test score, the readability evaluation will be using as an evaluation tool for the nutrition education materials.

A Case of Miliary Osteoma Cutis on the Face / 대한피부과학회지

Osteoma cutis is a rare disorder characterized by compact bone formation in the dermis or subcutaneous tissue. According to the absence or presence of previous cutaneous lesions, it is classified as primary and secondary forms. Miliary osteoma of the face is a form of primary osteoma cutis that generally occurs in middle-aged to older adult women. A 50-year-old woman presented with asymptomatic, multiple, 2~3 mm-diameter, skin-colored, firm papules on both cheeks for 5 years. The histopathologic specimen of the papule showed compact bone formation in the dermis. We herein report a rare case of military osteoma cutis on the face.

A Case of Internal Jugular Vein Thrombosis Associated with Severe Ovarian Hyperstimulation Syndrome / 대한산부인과학회잡지

Thromboembolic disease associated with superovulation is extremely rare, but severe ovarian hyperstimulation syndrome is considered as one of the most important risk factors. We recently experienced a case of deep vein thrombosis occurring at left internal jugular, subclavian, and innominate vein combined with severe ovarian hyperstimulation syndrome. She experienced a miscarriage, and the thrombi were resolved completely after anticoagulant therapy. Although thromboembolic phenomenon is hard to predict, and occurs in spite of appropriate management of severe ovarian hyperstimulation syndrome, the measurement of factors associated with thrombophilia and prophylactic use of low dose heparin are recommended.