Clinical features of croups caused by severe acute respiratory syndrome coronavirus 2 and by other respiratory viruses: analysis in a tertiary hospital in Jinju, Korea during the period of dominance of the Omicron variant (B.1.1.529)

Purpose@#Croup is a clinical manifestation of coronavirus disease 2019 (COVID-19) in children. The Omicron variant of severe acute respiratory syndrome coronavirus 2 usually causes an upper respiratory tract infection. We investigated the differences between croups caused by COVID-19 and by other respiratory viruses (ORV). @*Methods@#We reviewed clinical characteristics, therapeutic measures, and the Westley Croup Score of children with croup who visited the emergency department of Gyeongsang National University Hospital from January 1 through April 7, 2022. According to the laboratory-confirmed viruses, they were divided into 2 groups: COVID-19 and ORV. Between the 2 groups, we compared the abovementioned features. Moderate-to-severe croup was defined by a Westley Croup Score of 3 or higher. @*Results@#A total of 20 children were diagnosed with croup caused by COVID-19 (n = 11; median age, 18 months) or by ORV (n = 9; 7 months). Median Westley Croup Score was higher in the COVID-19 group than in the ORV group (5.0 [range, 0-10.0] vs. 2.0 [1.0-5.0]; P = 0.031). Among the components of the scoring system, only stridor showed a significant difference (e.g., “stridor at rest”: COVID-19, 8 of 11 vs. ORV, 2 of 9; P = 0.046). Median C-reactive protein concentration was higher in the COVID-19 group (3.2 vs. 0.4 mg/L; P = 0.007). Severity of the COVID-19 group was marginally higher than that of the ORV group in terms of the median oxygen saturation (95% vs. 98%; P = 0.056) and the proportions of moderate-to-severe croup (9 of 11 vs. 3 of 9; P = 0.065) and application of high-flow nasal cannula (4 of 11 vs. 0 of 9; P = 0.094). @*Conclusion@#Croup caused by COVID-19 during the period of dominance of the Omicron variant outbreak might be more severe than croup caused by ORV.

The Relationship among Powerlessness, Social Support and Life Satisfaction in the Elderly People

PURPOSE: The purpose of this study was to identify the correlation between the feeling of powerlessness, social support and life satisfaction in the elderly. METHODS: The subjects were 158 old people aged over 65 who were attending one of one college and three settlement houses for senior citizens located in B city. RESULTS: The relationship between the feeling of powerlessness and life satisfaction was in a moderate negative correlation with each other (r=-.433, p=.000). The relationship between social support and life satisfaction was in a moderate positive correlation with each other (r=.410, p=.000). It was found that the higher social support was, the higher life satisfaction was. There was remarkable difference in the form of family (F=2.69, p=.023), the form of residence (F=5.29, p=.002), whether to belong to a group (F=2.26, p=.025). CONCLUSION: For the reasons stated above, as the feeling of powerlessness is lower and social support is higher, life satisfaction is higher. The results clearly show that in order to improve life satisfaction of the elderly, we need to ease their feeling of powerlessness and enhance social support to them. Therefore, it is necessary to develop a nursing intervention program to reduce powerlessness and to improve social support for the elderly.

The Analgesic Effect of Intraarticular Morphine in Osteoarthritis of Knee

OBJECTIVE: This study was conducted to assess the analgesic effect of intraarticular injection with morphine and hyaluronic acid in comparison with intraarticular injection with hyaluronic acid only in the patients with osteoarthritis of knee. METHOD: Twenty four patients with degenerative osteoarthritis of the knee were assigned randomly to a morphine group (morphine+hyaluronic acid) and a hyaluronic acid group. In the morphine group, intraarticular injection with morphine and hyaluronic acid at first was applied to the knee 2 times. Then intraarticular injection with hyaluronic acid without morphine was applied in the remaining 3times. In the hyaluronic acid group, intraarticular injection with hyaluronic acid was applied to the knee 5 times. Effects were assessed on the 1st week, 5th week after treatment, and on the last follow up day by pain rating score (PRS). RESULTS: Significant change of PRS improvement was noticed in the morphine group in the 1st week after treatment compared with the hyaluronic acid group. CONCLUSION: These results showed that intraarticular injection with morphine and hyaluronic acid was a more effective treatment method than intraarticular injection with hyaluronic acid only for pain control in patients with osteoarthritis of knee.

Effect of Percutaneous Vertebroplasty in Chronic Osteoporotic Compression Fracture of Thoracic and Lumbar Vertebra

OBJECTIVE: This study was conducted to assess the effect of percutaneous vertebroplasty in the patients with chronic osteoporotic compression fracture at the thoracic and the lumbar vertebra. METHOD: Twelve patients with chronic osteoporotic compression fracture of thoracic and lumbar vertebra were engaged in this study. Treated levels were from the ninth thoracic vertebra to the fifth lumbar vertebra. Effects were assessed on the first day, 1 month after treatment and the last follow up (average 164 days after vertebroplasty; range 60 days to 302 days) by visual analogue scale (VAS), McGill pain questionnaire (MPQ), and compression ratio of vertebral body. Complication rate was assessed. RESULTS: Significant improvement by VAS and MPQ was noticed on the first day, 1 month after treatment and the last follow up. Further vertebral height loss was not noticed on follow-up. CONCLUSION: Percutaneous vertebroplasty can be an effective treatment method in patients with chronic back pain due to osteoporotic compression fracture at the thoracic and the lumbar vertebra.

Effects of Intramuscular Stimulation in Myofascial Pain Syndrome of Upper Trapezius Muscle

objective: This study was conducted to assess effects of intramuscular stimulation (IMS) in comparison with that of dry needling and intramuscular electrical stimulation (IMES) in the patients with myofascial pain syndrome (MPS) of upper trapezius. METHOD: Thirty patients with MPS were assigned randomly to three groups, such as dry needling group (n=10), IMES group (n=10), and IMS group (n=10). In dry needling group, dry needling was applied to the trigger point of upper trapezius muscle. In IMES group, IMES was applied to the trigger point of upper trapezius muscle. In IMS group, IMS was applied to the trigger point of upper trapezius and parcervical muscles. Treatment were done three times a week for 2 weeks. Effects were assessed on 3rd day, 7th day and 14th day after treatment by visual analogue scale (VAS), McGill pain questionnaire (MPQ), and passive range of motion (PROM) of cervical spine. RESULTS: Significant changes of VAS and PROM were noticed in IMS group, compared with other groups. No significant difference of MPQ was noticed in IMS group, compared with other groups. CONCLUSION: IMS may be more effective treatment modality than dry needling and IMES in patients with MPS of upper trapezius muscle.

Processing Mechanism of Sensory Information Originated from the Oral Cavity in the Trigeminal Nucleus Oralis / 대한해부학회지

To analyze the synaptic characteristics of axon terminals originated from the tooth pulp in the trigeminal nucleus oralis, labeling of tooth pulp afferents with wheat-germ agglutinin conjugated horseradish peroxidase and morphometric analysis with electron microscopic photographs were performed. The results obtained from 23 labeled endings were as follows. All of the labeled boutons contained clear and round synaptic vesicles (dia. 45~55 nm). 3 (13.64%) out of 23 labeled endings have 20~105 dense cored vesicles and do not make synaptic contacts with p-endings. But remaining 20 labeled endings (86.36%) almost do not have dense cored vesicles and 12 of them make synaptic contacts with p-endings. The mean number of synaptic contacts was 2.61+/-2.06 and the postsynaptic profiles were usually middle or distal dendrite and dendritic spine (1.74+/-1.36) rather than soma or proximal dendrite. The mean number of synaptic contacts with pendings was 0.87+/-1.01. And the frequency of the synaptic triads were 0.39+/-0.58. The vesicle density was 993.23+/-267.41/mum(2). The volume of labeled bouton was 3.54+/-2.20 mum(3) and highly correlated (P < 0.01) with surface area (11.78+/-4.92 mum(2), r = 0.95), total apposed surface area (2.90+/-1.56 mum(2), r=0.72), total active zone area (0.61+/-0.37 mum(2), r = 0.82), mitochondrial volume (0.75+/-0.53 mum(3), r = 0.94), the number of synaptic vesicles (2621.30+/-1473.61, r= 0.91) and the number of synaptic contacts (r = 0.76). These results suggest that there are two groups of tooth pulp afferent terminals according to the presence of dense cored vesicles in the trigeminal nucleus oralis. And the sensory processing mechanism of each groups may be different. And the "size principle" of Pierce & Mendell (1993) is also applicable to these terminals.

The Effect of the Length of the Lingual Frenum and the Tongue Motion on Speech

PURPOSE: The objective of this study is to ascertain whether the positive relationship exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. MATERIALS AND METHODS: 180 patients were evaluated. We divided 180 patients into 6 groups by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 13-15, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive, both(right, left) laterotrusive, superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurements of the anterior, inferior segment of the tongue, including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual caruncles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A+B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test (PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. CONCLUSION: As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.

A Case Report of Multiple odontogenic keratocysts associated with basal cell nevus syndrome

The basal cell nevus syndrome is a well recognized entity, the major symptoms of which are basal cell nevi, multiple jaw cysts, skeletal anomalies, and ectopic calcification. The syndrome follows a hereditary pattern, which is characterized by a highly penetrant, autosomal dominant gene with multiple and variable effects. The patient often has a characteristic face, with frontal and temporoparietal bossing, which results in an increased cranial circumference. The eyes may appear widely separated, and 40 percent of patients have true ocular hypertelorism. Jaw cysts are one of the most constant features of the syndrome and are present in at least 75 percent of the patients. The cysts are odontogenic keratocysts and frequently multiple. Radiographically, the cysts in patients with basal cell nevus syndrome do not differ significantly from isolated keratocysts. The cysts in patients with this syndrome are often associated with the crowns of unerupted teeth; on radiographs they may mimic dentigerous cysts. We report a case of multiple odontogenic keratocysts associated with basal cell nevus syndrome with the literature of review.

A Case of Stickler Syndrome with Large Eyeballs

Stickler syndrome is an autosomal dominant disorder of connective tissue with a wide range of expressivity and incomplete penetrance which is called hereditary progressive arthro-ophthalmopathy. Affected neohates may present with the Pierre-Robin syndrome, progressive myopia, retinal detachment, flat face, hypertelorism, progressive arthritis. Early recognition of the syndrome is important, not only for genetic counselling but also to offer a more precise prognosis and proper treatment of many serious disorders that may occur in affected children. We experienced a case of Stickler syndrome with large eyeballs in a 3-day-old female baby who showed Pierre-Robin anomaly, flat face, hypertelorism, epicanthal folds, long philtrum, micrognathia, deft palate, high congenital myopia, chorioretinal degeneration, thin habitus and hyperextensible joints.

The detection of subgingival plaque microflora using 16S rRNA analysis in Korean adult periodontitis / 대한치주과학회지

The 16S rRNA analyzing method is a bacterial identification method that is useful in identifying bacteria which is difficult to do by other means. The following 7 types of bacteria which are Treponema, A. actinomycetemcomitans, P. gingivalis, Fusobacterium, B. forsythus, P. intermedia, P. micros were evaluated in order to study their distribution among patients with adult periodontitis. The 16S rRNA analyzing method was used to compare bacterial distribution among 3 groups. Subgingival plaque acquired from the affected sites(pocket depth > or =6mm)of 29 patients with adult periodontitis were grouped as the experimental group while plaque from the non-affected sites(pocket depth< or =3mm)were grouped as control 2 and finally plaque acquired from students with healthy periodontal tissues were grouped as control 1. The results are as follows; 1. The distribution of Treponema was 12.5% for control 1, 21.4% for control 2 and 75.4% for the experimental group. For A. actinomycetemcomitans the distribution was 0.5%, 19.0%, 44.4% in respect to the order of groups mentioned above. P.gingivalis showed 10.5%, 43.1%, 94.0% distribution, Fusobacterium 33.0%, 48.3%, 81.0% distribution, B. forsythus 9.5%, 17.2%, 65.9% distribution, P. intermedia 1.0%, 12.1%, 26.3% distribution and finally P. micros 5.0%, 19.0%, 48.7% respectively. In all 7 types of bacteria, the experimental group showed higher bacterial distribution compared to the other two groups with statistically significant difference. 2. In the case of Treponema, A. actinomycetemcomitans, P. gingivalis,Fusobacterium, B. forsythus, P. intermedia, P. micros showed significant difference between control 1 and 2. These results suggest that the 16S rRNA analyzing method which was applied on Koreans for the first time could be utilized and useful in finding potential pathogens of periodontal disease.

A Case of Aplasia Cutis Congenita Group 4

Aplasia cutis congenita is a rare disorder characterized by localized or generalized absence of skin at birth. Group 4 in Friden's classification, which is associated with embryologic malformations including myelomeningocele, encephalomeningocele, omphalocele, gastroschisis. The authors have experienced a case of aplasia cutis congenita of right frontal scalp associated with bony defect, forming encephalocele in a newborn. We reported this case with brief review of literatures.

A Case of Congenital Hemangiopericytoma of Small Bowel Associated with Intestinal Obstruction

Hemangiopericytoma was first described by Stout & Murray in 1942 and was an uncommon soft tissue tumor thought to be derived from vascular pericytes. Approximately 10-15% of the cases occur in children have a propensity to develop in the region of head, neck and lower extremities. We experienced a case of congenital hemangiopericytoma of small bowel in a male neonate who showed vomiting and abdorninal distension. We reported a case of congenital hemangiopericytoma of small bowel with brief review of related literature.

Comparison of Propofol and Midazolam for Patient Controlled Sedation during Local Anesthesia / 대한마취과학회지

BACKGROUND: Surgical procedures carried out under local anesthesia are associated with patient discomfort and apprehension. The purpose of this study is to compare propofol and midazolam with regard to their suitability for the patient controlled sedation (PCS) technique during local anesthesia. METHODS: Forty unpremedicated, ASA physical status I day surgery patients undergoing elective minor surgery were randomly divided into two equal groups of patients who self-administered either propofol or midazolam intraoperatively. All patients initially received 0.5 g.kg-1 fentanyl. The bolus dose was either 20 mg (2 ml over 25 sec) of self-administered propofol or 0.5 mg (2 ml over 25 sec) of midazolam and lock-out period was 1 min. RESULTS: The onset of sedation following propofol was significantly faster than midazolam (p<0.05) and demands of propofol was significantly less than midazolam (p<0.05). There were no significant differences for postoperative recovery, sedation and comfort scale. CONCLUSIONS: Propofol was judged the more suitable agent for PCS than midazolam, because of its more rapid onset of sedation and less demands of drug.