Coronavirus Disease Outbreak in Call Center, South Korea.

We describe the epidemiology of a coronavirus disease (COVID-19) outbreak in a call center in South Korea. We obtained information on demographic characteristics by using standardized epidemiologic investigation forms. We performed descriptive analyses and reported the results as frequencies and proportions for categoric variables. Of 1,143 persons who were tested for COVID-19, a total of 97 (8.5%, 95% CI 7.0%-10.3%) had confirmed cases. Of these, 94 were working in an 11th-floor call center with 216 employees, translating to an attack rate of 43.5% (95% CI 36.9%-50.4%). The household secondary attack rate among symptomatic case-patients was 16.2% (95% CI 11.6%- 22.0%). Of the 97 persons with confirmed COVID-19, only 4 (1.9%) remained asymptomatic within 14 days of quarantine, and none of their household contacts acquired secondary infections. Extensive contact tracing, testing all contacts, and early quarantine blocked further transmission and might be effective for containing rapid outbreaks in crowded work settings.

Feasibility of Powered Intracapsular Tonsillectomy in Pediatric Patients with Tonsil Problem, Including Recurrent Tonsillitis: A Single Surgeon's Experience.

INTRODUCTION: Powered intracapsular tonsillectomy (PIT) is a technique that protects the tonsillar capsule by using a microdebrider, resulting in faster wound-healing and reduced suffering. Many studies have found PIT to be effective, particularly in pediatric patients with obstructive sleep apnea (OSA). However, previous studies have not included patients with a history of recurrent tonsillitis. OBJECTIVE: The aim of this study was to determine the efficacy of PIT in pediatric patients even with a history of recurrent tonsillitis, and therefore, we want to expand the indication for PIT and reveal its safety. METHODS: A total of 886 pediatric patients underwent PIT between February 2013 and March 2016. All patients rated their postoperative pain using a visual analog scale (VAS) and completed the Korean obstructive sleep apnea (KOSA)-18 questionnaire for assessment of their quality of life (QOL). There were 539 males and 347 females. Their mean age was 6.2 years (range 2-14 years). The majority (77.7%) underwent the operation for OSA, and the rest (22.3%) had a history of recurrent tonsillitis. To compare the efficacy of PIT with traditional tonsillectomy, we selected 191 patients who underwent extracapsular tonsillectomy (ECT), a conventional technique, during the same time period. The median follow-up period was 16.7 months. During the follow-up period, instances of delayed bleeding and recurrent pharyngitis were monitored. RESULTS: In comparison to the patients who underwent ECT, the PIT group showed significantly fewer cases of postoperative bleeding (p = 0.027). Thirteen patients in the PIT group (1.5%) visited the hospital during the follow-up period for pharyngitis, while 8 in the ECT group (4.2%) visited for pharyngitis. The mean postoperative pain score, as assessed by a VAS, was 4.6 ± 3.2, and pain improved within an average of 2.9 days after surgery in the PIT group. The mean KOSA-18 score for the QOL of the patients was 65.9 preoperatively and 35.6 postoperatively in the PIT group. CONCLUSIONS: Pediatric tonsillectomy using PIT is valid for reducing postoperative pain and improving the QOL of OSA patients. PIT is also effective and safe for patients with a history of recurrent tonsillitis.

Optimization of a wheat small red bean double cropping system in South Korea.

Wheat (Triticum aestivum L.) and small red bean [Vigna angularis (Willd. Ohwi & Ohashi)] are the main ingredients of walnut-shaped "Hodugwaja". An innovative wheat small red bean double cropping system was evaluated in a rice field in the Cheonan region (Korea) to determine its effect on land use. The effects of different nitrogen levels, sowing dates, and density on growth, yield, and quality of wheat and small red bean were also investigated using selected wheat ('Keumgang', 'Sooan', and 'Goso') and small red bean ('Hongeon', 'Chungju', and 'Arari') varieties. The effect of different fertilizer treatments [N1 (50%, 6.6 kg/10a), N2 (100%, 8.8 kg/10a), and N3 (200%, 13.2 kg/10a)] were investigated for wheat, while the effect of sowing date and density were investigated for the small red beans. Our findings revealed that the best variety, sowing date, and nitrogen level combination for wheat small red bean double cropping system in Cheonan area is 'Goso' sown on October 26, N3 nitrogen application, and 'Chungju' sown on July 10 with high ridge cultivation, at a density of 60 × 15 cm. This system was the most ideal yielding 521.6 kg/10a (1000 m2) and 275 kg/10a of 'Goso' and 'Chungju', respectively. This pioneering research provides a reliable cultivation plan and theoretical basis for implementing the double cropping system of wheat small red beans in central Korea. Undeniably, this study also provides a basis for future field experiments on wheat planting patterns and small red bean fertilization.

Nonsurgical management of a tricuspid valvular pedunculated papillary fibroelastoma.

A 25-year-old woman with a history of kidney transplantation for lupus nephritis was referred for the evaluation and management of a mass incidentally found on echocardiography. An oval and pedunculated mass attached to the tricuspid valve was managed with nonsurgical treatment. No symptoms and complications attributable to the mass developed. Three years later, the size of the mass decreased. Here we report the case of a probable cardiac papillary fibroelastoma (PFE), a mobile mass, with a stalk on the septal leaflet of the tricuspid valve that was managed for three years without surgical treatment.

Adherence to Pap test guidelines: variation among Asians in California.

OBJECTIVES: To compare Pap screening in the previous 3 years among subgroups of Asian American women, aged 18 to 65 years. DESIGN: Analysis of data from the 2001 and 2003 California Health Interview Survey (CHIS), a cross-sectional population-based telephone survey. MAIN MEASURES: The survey elicited information from major Asian subgroups, including Chinese, Filipina, Japanese, Korean, South Asian, and Vietnamese. Surveys were administered in several languages, including Mandarin, Cantonese, Korean, and Vietnamese. Employing the Andersen behavioral model of health services utilization, this study fits logistic regression models to identify correlates of Pap screening within and across Asian American subgroups. These analyses use time living in the United States and English proficiency as acculturation measures. RESULTS: There were different independent correlates of Pap test receipt for the six Asian subgroups. English proficiency and income were independently associated with Pap screening among only one subgroup; education, time in the US, and insurance among three; and age and usual source of care among four subgroups. Unmarried women were more likely to report not having a Pap test in the past three years across all six subgroups. CONCLUSIONS: Based on these differences, programs and policies targeting the health of Asian American women should consider tailoring interventions to match the needs of different ethnic groups. Specifically, program materials should strive to be both culturally sensitive and linguistically appropriate for all target populations.

Cancer coverage in a mainstream and Korean American online newspaper: lessons for community intervention.

OBJECTIVE: Korean Americans have higher incidence of stomach, liver, and cervical cancer than most groups in CA, USA, and generally lower rates of cancer screening. To better target community interventions, we evaluated the cancer content in a leading Korean American newspaper, the Korea Daily, compared to a mainstream newspaper from the same metropolitan area, the Los Angeles (LA) Times. METHODS: Using the online versions of each newspaper for the year 2006, we counted articles mentioning cancer and evaluated the content in a random sample of 300 articles from each newspaper. Articles were categorized by relevance of cancer content and topic(s) covered. RESULTS: Although the LA Times had a higher proportion of articles mentioning cancer, the Korea Daily had more articles that primarily focused on cancer and addressed specific types of cancer. Articles in the Korea Daily were more likely to discuss prevention, while those in the LA Times more often focused on people, politics, or research. CONCLUSIONS: Smaller, ethnic newspapers may be more amenable to messages about prevention and appropriate places to target community-focused interventions. PRACTICE IMPLICATIONS: Health practitioners should consider submitting articles to ethnic newspapers and forming partnerships with journalists to cultivate this potential.

Distribution characteristics of polychlorinated biphenyls in crucian carp (Carassius auratus) from major rivers in Korea.

Polychlorinated biphenyls (PCBs) levels in crucian carp were determined at 20 locations along four major river systems, several small-scale rivers and a wetland in Korea. Twenty-eight congeners, ranging from tri- to hepta-CBs were detected. A gas chromatograph with a mass selective detector was used to quantify the individual PCB congeners. The objectives of this study were to investigate the levels of contamination of PCBs in freshwater fish and to observe the pattern of their distribution. The sampling locations were chosen among 31 sampling sites that are currently used as environmental residue checkpoints by the Korean Ministry of Environment. Concentrations of individual congeners ranged from not detectable (n.d.) to 0.75 ng g(-1) on a wet weight basis. The total concentrations of PCBs at each site ranged from n.d. to 5.41 ng g(-1) of wet weight. The most heavily contaminated site was the Nakdong estuary located near the Shinpyung-Janglim factory district. The PCB 153 and 138 were the principal congeners and penta- and hexa-chlorinated biphenyls comprised the main congener groups.

Tongkyutang inhibits mast cell-dependent allergic reactions and inflammatory cytokines secretion.

BACKGROUND: Tongkyutang (TKT) is an Oriental herbal prescription, which has been successfully applied for the treatment of allergic disorders, mainly allergic-rhinitis in clinical medicine. However, its effect in experimental models remains unknown. METHODS: In a mouse model, the role of TKT was examined in mast cell-dependent allergic reactions and secretion of inflammatory cytokines. RESULTS: TKT concentration-dependently inhibited the ear-swelling response induced by intradermal injection of compound 48/80. TKT inhibited the compound 48/80-induced degranulation from mast cells in ear tissue. TKT dose-dependently inhibited the histamine release from the rat peritoneal mast cells by compound 48/80. TKT also showed inhibition of anti-dinitrophenyl IgE antibody-induced passive cutaneous anaphylaxis reaction by oral administration. Furthermore, TKT inhibited both IL-1beta and TNF-alpha secretion induced by PMA and A23187, respectively. CONCLUSIONS: Our findings provide evidence that TKT inhibits the mast cell-dependent allergic reactions and inflammatory cytokines secretion.

Unusual presentation of a metastatic tumor to the temporal bone: severe otalgia and facial paralysis.

Metastatic temporal bone tumors are rare diseases and they are usually clinically asymptomatic, so it is difficult to diagnose them. Breasts are the most common sites of temporal bone metastasis. Tumors of lung, kidney, gastrointestinal tract, prostate gland, larynx and thyroid gland are the other sites. The pathogenesis of the temporal bone is most commonly related to the hematogenous route. We present the case of a 78-year-old man with facial paralysis combined with severe otalgia. This patient was initially diagnosed with Bell's palsy. However, based on the radiologic findings, the patient was diagnosed with lung cancer with temporal bone metastasis.

Parathyroid hormone 1-34(teriparatide) treatment in pelvic insufficiency fractures - a report of two cases -.

As a result of aging population, the incidence of pelvic insufficiency fracture has been increasing. Pain-related immobility caused by pelvic insufficiency fractures may result in a serious dependency and high mortality with preexisting comorbidities. We present two cases of pelvic insufficiency fracture in elderly patients which had good clinical outcome by parathyroid hormone 1-34(teriparatide) treatment as well as a literature review.

Delayed diagnosed stage 1, 2 distractive flexion injury of the cervical spine.

STUDY DESIGN: Retrospective study. PURPOSE: To examine the clinical and radiologic characteristics of patients with stage 1 and 2 distractive flexion injury according to Allen's classification and who were not diagnosed immediately after injury, and to analyze the outcomes of surgical treatments. OVERVIEW OF LITERATURE: For the diagnosis of stage 1 and 2 distractive flexion injury in the lower cervical spine, attention should be paid when performing radiographs as well as when interpreting the radiographs. METHODS: The study was conducted on 10 patients (group 1) with stage 1 or 2 distractive flexion injury and who were not diagnosed immediately after injury from January 2003 to January 2009. The control group (group 2), 16 distractive flexion injury patients who were diagnosed immediately were selected. The simple radiographs, the degree of soft tissue swelling and the magnetic resonance imaging findings of the two groups were compared, and the clinical and radiologic results were examined. RESULTS: The degree of the prevertebral soft tissue swelling of group 1 was lower in group 1, and it was statistically significant (p = 0.046). The fusion was achieved in all cases (100%) in group 1, however, re-displacement as well as the loss of reduction occurred in one case, despite of delayed fusion and good clinical result. In group 2, bone fusion was achieved in 15 cases of 16 cases (94%). CONCLUSIONS: For the diagnosis of stage 1 and 2 distractive flexion injury in the lower cervical spine, it is desirable to perform computed tomography if diagnosis is not clear. Even if the diagnosis is delayed, stage 1 and 2 distractive flexion injury could be readily reduced by traction, and the treatment outcomes are considered to be comparable to those of the patients diagnosed immediately after injury.

Successful percutaneous coronary intervention for acute coronary syndrome in a patient with severe hemophilia a.

Patients with hemophilia generally have a reduced frequency of coronary artery disease compared to the general population. As advances in the management of hemophilia have increased their life expectancy, the prevalence of coronary artery disease also has increased. However, there are no standard treatment guidelines for coronary artery disease in patients with hemophilia, especially in the field of coronary intervention. We report the case of a patient with severe hemophilia A who presented with acute coronary syndrome and was successfully treated with percutaneous coronary intervention.

Multiple sequential complications after sirolimus-eluting stent implantation: very late stent thrombosis, stent fracture, in-stent restenosis, and peri-stent aneurysm.

A 55-year-old male patient presented with an acute myocardial infarction. A sirolimus-eluting stent (SES) was implanted in the proximal left anterior descending artery (LAD). Eight months later, there was a newly developed distal LAD lesion. An additional SES was implanted. Twenty-eight months after the index procedure of primary coronary intervention, the electrocardiogram showed ST elevation in the precordial leads and an emergency coronary angiogram showed diffuse stent thrombosis (ST) in the proximal LAD. Thirty-four months after the index procedure, coronary angiography showed a large peri-stent coronary aneurysm in the proximal LAD and focal in-stent restenosis (ISR) at the proximal edge of the distal LAD stent. On fluoroscopy, a fracture was noted in the middle part of the distal SES. A zotarolimus- eluting stent (ZES) was deployed and overlapped the restenosis and fracture sites. Forty months after the index procedure, there were no changes in the size of the aneurysm or in the other stent complications including the fracture and restenosis. At present, the patient has remained asymptomatic for eight months.

Long-term clinical outcomes after angiographically defined very late stent thrombosis of drug-eluting stent.

BACKGROUND: The advent of drug-eluting stent (DES) use has raised concerns regarding later occurring stent thrombosis, especially very late stent thrombosis (VLST), and little is known about long-term clinical outcomes after VLST occurrence. HYPOTHESIS: Long-term clinical outcomes after detection of VLST may be poor. METHOD: We evaluated 3572 consecutive patients who received DES implantation from May 2004 to July 2007 at 3 hospitals. The primary outcomes were a composite of major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target-lesion revascularization (TLR), and target-vessel revascularization (TVR) after VLST occurrence. RESULTS: We identified 19 patients (0.53%) with angiographically documented stent thrombosis developing over 1 year after DES implantation. The mean time to VLST occurrence was 899 days (899 +/- 353). Discontinuation of antiplatelet drugs was noted in 4 (21%) patients and the average duration of discontinuation was 4 days. Clinical presentations of VLST were mainly MI (17 patients, 89%). Balloon angioplasty was only performed in 12 patients (63%) and stent implantation in 7 patients (37%). Mean follow-up duration from VLST occurrence was 620 days (620+/-256). During clinical follow-up after VLST occurrence, no cardiac deaths or MIs were detected. Target-vessel revascularization was done in 2 (11%) patients and TLR in 1 patient (6%). Major adverse cardiac events occurred in 3 (16%) patients during long-term clinical follow-up. CONCLUSIONS: Clinical presentation of VLST after DES implantation is associated with serious adverse events, such as MI. Long-term follow-up outcomes after VLST occurrence appear unfavorable and more data from larger studies are warranted.