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Epidural Abscess Caused by Eikenella corrodens in a Previously Healthy Child

  • Kim, Ye Kyung;Han, Mi Seon;Yang, Song I;Yun, Ki Wook;Han, Doo Hee;Kim, Jae Yoon;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.26 no.2
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    • pp.112-117
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    • 2019
  • Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to $5.6{\times}3.4cm$ with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.

DENTAL TREATMENT OF A PATIENT WITH BARTTER SYNDROME: CASE REPORT (Bartter 증후군 환아의 치아우식 치료: 증례보고)

  • Kim, Minji;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.45-49
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    • 2019
  • Bartter syndrome is an inherited renal tubular disorder characterized by hypokalemia, hypochloremic metabolic alkalosis, hyperreninemia, hyperprostaglandinism, and normal blood pressure. Bartter syndrome is classified by neonatal and classic type. Clinical manifestation of Bartter syndrome considered in dental treatment include tendency to dehydration, vomiting and erosion, attrition and abrasion of the teeth. A 2-year-4 month old boy with Bartter syndrome type III was referred to the Seoul National University Dental Hospital for dental evaluation and treatment. He showed hypokalemic hypochloremic metabolic alkalosis and had been treated with indomethacin and potassium chloride. He had hypocalcified teeth with or without multisurface caries lesions in all dentition and the erosion of maxillary teeth was detected. Dental procedure under general anesthesia was scheduled due to multiple caries and his medical condition. The dental procedure was successfully performed. This case suggests that electrolyte imbalances need to be treated prior to dental treatment and complete coverage restoration is necessary to protect the eroded teeth. An appropriate management plan for the patients with Bartter syndrome should include considerations of the need for close interaction with the pediatrician for pre- and post-operative care. General anesthesia may be recommendable to manage the patients having multiple caries with Bartter syndrome.

Antidepressant Effects of JG02 on Chronic Restraint Stress Animal Model (만성구속스트레스 동물모델에 대한 JG02의 항우울 효과)

  • You, Dong Keun;Seo, Young Kyung;Lee, Ji-Yoon;Kim, Ju Yeon;Jung, Jin-Hyeong;Choi, Jeong June;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.3
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    • pp.209-220
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    • 2019
  • Objectives: As a general emotion, everyone can temporarily experience depression, but depressive disorder is a disease that excessively affects daily life. Among the various causes of depression, the deficiency of monoamine-based neurotransmitters such as serotonin and epinephrine are considered significant. Thus, antidepressants that target monoamines are used frequently. However, side effects such as nausea, vomiting, insomnia, anxiety, and sexual dysfunction are observed. Thus, it is necessary to develop a new therapeutic agent with fewer side effects. In this study, we investigated the antidepressant effect of JG02, used to treat depression by normalizing the flow of qi (氣) in Korean medicine. Methods: C57BL/6 mice were selected and randomly divided into six groups: normal, control, amitriptyline, and JG02 (50, 125, 250 mg/kg), respectively. Except for normal, depression was induced by applying restraint stress at the same time for six hours daily for 14 consecutive days. Saline, amitriptyline or JG02 samples were orally administered two hours before applying the stress. After that, a forced swimming test and an open field test were performed. Additionally, serum corticosterone, serotonin mRNA, BDNF mRNA, and protein in the hippocampal region were measured and compared. Results: JG02 decreased immobility time rate in the FST and increased the zone transition number and travel distance in the OFT. Also, JG02 inhibited the release of serum corticosterone, and increased serotonin, BDNF gene expression, and BDNF protein in the hippocampus. Conclusions: In this study, JG02 showed significant antidepressant effects on the chronic restraint stress mice model. When further research is performed based on JG02, the development of a new antidepressant is considered highly possible.

Campylobacter Enteritis: Clinical Features and Laboratory Findings in Children Treated at a Single Hospital

  • Jang, Won Tae;Jo, Na Hyun;Song, Mi Ok;Eun, Byung Wook;Ahn, Young Min
    • Pediatric Infection and Vaccine
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    • v.26 no.1
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    • pp.22-31
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    • 2019
  • Purpose: Campylobacter species are common causes of bacterial enteritis. There is limited knowledge on its prevalence and clinical features because of its fastidious culture conditions. The purpose of this study was to identify the clinical features of Campylobacter enteritis in children. Methods: We obtained stool specimens from patients diagnosed with acute gastroenteritis in the Department of Pediatrics, Nowon Eulji Medical Center (NEMC) and identified the pathogens by performing cultures or polymerase chain reactions (PCR). We retrospectively reviewed the medical records of patients with Campylobacter enteritis at NEMC between January 2012 and December 2017. Results: Overall, 123 patients were diagnosed with Campylobacter enteritis (60 by culture and PCR in EnterNet and 110 by multiplex PCR). The median (interquartile range [IQR]) age of patients was 12 years (IQR, 8 to 16 years). The disease occurred all year round, but 69.9% from June to September. Symptoms included diarrhea (97.6%), fever (96.7%), abdominal pain (94.3%), vomiting (37.4%), and headache (34.1%). Compared with other treatments, treatment with azithromycin was associated with a shorter hospitalization period (P<0.05). Conclusions: Campylobacter enteritis is common during summer and mostly infects adolescent patients. It causes severe abdominal pain and fever preceding the onset of diarrhea. Prompt diagnosis and appropriate use of antibiotics reduces the duration of the disease.

Management of prosthodontic patients with severe gag reflex using the questionaire and behavior technique: A case report (심한 구역반사를 보이는 환자에서 문진표와 행동 요법을 이용한 임플란트 고정성 보철 수복 증례)

  • Sohn, Changmo;Kim, Yu-Jin;Lee, Cheon-Seo;Choi, Na-Rae;Kwon, Eun-Young;Kim, So-Yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.333-340
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    • 2021
  • Although gag reflex is an essential function and a useful physiological defense mechanism, it can become an obstacle in a dental treatment. In this case, a questionnaire was designed and used in consultations to objectify the factors associated with gag reflex. Based on the questionnaire, various treatment protocols were planned, such as behavioral control, which is a systematic desensitization that adapts by placing dental instruments in the oral cavity, and habit control to eliminate vomiting habits after drinking. Except for the placement of the implant fixture under general anesthesia, all restoration procedures were performed in the outpatient clinic in the same manner as the conventional implant fixed prosthetic restoration. The systematic desensitization and behavior technique were repeated until the patient was able to endure discomfort and relieve gag reflex in dental treatment. The patient was successfully received the implant-fixed prosthetic restoration in the partial edentulous region.

An Analysis of the Trends of Aromatherapy Researches in Chinese Literatures

  • Sun, Jiao-Jing;Kim, Kyeong-Ran
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.1
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    • pp.239-251
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    • 2021
  • Traditional Chinese medicine has treated diseases and improved health in nature-based experience. Advanced nations began to be interested in naturopathic therapy in the late 19th century and it led China to research aromatherapy. This study searched previous researches related with aromatherapy and generally analyzed aroma oil, applied body parts, methods of use, and period of use. For research contents, scientific and society journals from 2000 to 2019 related with aromatherapy were searched in CNKI(www.cnki.com) and WANFANG DATE(www.wanfang.com). Finally, 30 papers were selected through 5-step qualitative evaluation and expert review and analyzed. Frequency and percentage(%) were calculated by means of the Excel 2013 Program and represented by a chart. The results of analyzing aromatherapy trends are as follows. All 30 papers were researched in the medical society. The most common symptom was irritation and anxiety that appeared in 13 papers. Lavender oil and bergamot oil were commonly used aroma oil. Commonly applied part and method were nose and nasal inhalation. For aroma oil associated with symptoms, lavender oil was the best in irritative, anxious, and negative emotion, depression, labor pain, sleep disorder, migraine, tension, and vomiting, pain, and fatigue after operation. Lemon, ginger, and peppermint oil was good for nausea. Based on the findings, this study derived applied body parts, methods of use, and period of use in aromatherapy. However, most aromatherapy was used for patients in the nursing and medical fields in the simple form of inhalation and local massage. This study will suggest a standard ground that aromatherapy is good for pain, colic pain, and tension in a short period but needs a long period for the efficacy of psychological and neurological symptoms.

A Case Report of Korean Medicine Treatment of Non-small Cell Lung Cancer with Pleural Metastasis Following Targeted Chemotherapy with Afatinib (Afatinib 표적항암치료를 시행 중인 흉막 전이된 비소세포폐암 환자의 한방치료 증례보고)

  • Kim, Kyun Ha;Kang, Hee-kyung;Kim, So-yeon;Han, Chang-woo;Park, Seong-ha;Yun, Young-ju;Lee, In;Kwon, Jung-nam;Hong, Jin-woo;Choi, Jun-Yong
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1255-1264
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    • 2020
  • Objective: The purpose of this study was to report the effect of Korean medicine on a patient with non-small cell lung cancer with pleural metastasis who had been treated with afatinib. Method: A 61-year old female patient with non-small cell lung cancer with pleural metastasis was treated with acupuncture and herbal medicines, including Yijung-tang, Haengso-tang, Samchulkunbi-tang, Paeamju-bang (Feiai zhu fang), to control various symptoms caused by afatinib. The degree of pain was assessed by a numeric rating scale (NRS) and the quality of life was determined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and the EORTC 13-item lung cancer-specific module (EORTC LC-13). Results: After receiving acupuncture and herbal medicines, the patient showed improvement in her back and chest pain, according to the NRS score. Similarly, the Korean medicinal treatments significantly relieved her nausea, vomiting, diarrhea, hemoptysis, and alopecia. However, the EORTC QLQ-C30 assessment suggested that Korean medicinal treatments did not significantly improve the global health status of this patient. Conclusion: Korean medicine could be useful in relieving some of the symptoms occurring after conventional afatinib treatments.

The efficacy of ultrasound-guided erector spinae plane block after mastectomy and immediate breast reconstruction with a tissue expander: a randomized clinical trial

  • Park, Sukhee;Park, Joohyun;Choi, Ji Won;Bang, Yu Jeong;Oh, Eun Jung;Park, Jiyeon;Hong, Kwan Young;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.106-113
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    • 2021
  • Background: We aimed to investigate the analgesic efficacy of an erector spinae plane block (ESPB) in immediate breast reconstruction (IBR) with a tissue expander. Methods: Adult women undergoing IBR with a tissue expander after mastectomy were randomly assigned to either intravenous patient-controlled analgesia (IV-PCA) alone (group P) or IV-PCA plus ESPB (group E). The primary outcome was the total amount of opioid consumption during 24 hours postoperatively between the two groups. Secondary outcomes were patient satisfaction, pain score at rest and on shoulder movement using numerical rating scale, incidences of postoperative nausea and vomiting (PONV), and a short form of the brief pain inventory (BPI-SF) at 3 and 6 months after surgery between the groups. Results: Fifty eight patients completed the study. At 24 hours postoperatively, total opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95% confidence interval [CI]: 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI: 191.5 to 254.9, P = 0.005). Intraoperative and cumulative PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively). Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The incidences of PONV was similar. Conclusions: The ESPB decreased postoperative opioid consumption and increased patient satisfaction without significant complications after IBR with a tissue expander after mastectomy.

Isolation and Identification of Fungi and Yeast Contaminated in Rice Cake (Garaetteok) (가래떡에 오염된 곰팡이와 효모의 분리 동정)

  • Jo, Ah-Hyeon;Kim, Jung-Beom
    • Journal of Food Hygiene and Safety
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    • v.37 no.1
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    • pp.9-14
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    • 2022
  • The purpose of this study was to analyze the hazard of fungi in Garaetteok (Korean rice cake) by isolating and identifying of fungi contaminated with Garaetteok and investigating the possibility of mycotoxin production. Garaetteok used in this study were the ones that were returned back to the manufacturers in Jeollanam-do due to the presence of foreign matters presumed to be fungi. The fungi foreign matter was collected and inoculated on Potato dextrose agar, Malt extract agar, and Czapek yeast extract agar, and then cultured at 25℃ for 7 days. The micro-structure was observed under an optical microscope for the colonies in which pure isolation was confirmed. The gene sequencing of the product of amplified PCR was analyzed using the ITS primer. Colony-1 and 2 maintained the same properties in each tray, confirming that they were purely isolated. Budding cells were observed from the Colony-1, thus, it was determined to be yeast. Colony-2 was determined to be a fungus that belongs to Fusarium spp. as fusiform conidia were observed. As a result of gene sequencing, a total of 76 cases of fungi of Fusarium spp. were found, among which Fusarium solani was the most observed cases (53 cases). From the morphological and genetic identification, Colony-2 was identified as Fusarium spp., specifically, Fusarium solani. The fungi found in Fusarium spp. produce mycotoxins such as nivalenol, zearalenone, and fumonisin, which may cause vomiting, diarrhea, and cancer. Conclusively, the results confirm the possibility of mycotoxin production by Fusarium spp. isolated from Garaetteok. Consequently, when an unknown fungus was found, it is necessary to isolate and identify the fungus, determine whether it is a mycotoxin producing species, and strengthen relative administrative measures, accordingly.

Actual situation and prescribing patterns of opioids by pain physicians in South Korea

  • Kim, Min Jung;Kim, Ji Yeon;Lim, Yun Hee;Hong, Sung Jun;Jeong, Jae Hun;Choi, Hey Ran;Park, Sun Kyung;Kim, Jung Eun;Lee, Min Ki;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.475-487
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    • 2022
  • Background: Use of opioids for chronic intractable pain is increasing globally, and their proper use can improve patients' quality of life. In contrast, opioid use disorders, such as abuse or addiction, caused by prescribing opioids, are a worldwide issue. This study aimed to understand current opioid prescribing patterns and pain physicians' experiences with opioid use in South Korea. Methods: Pain physicians in 42 university hospitals in South Korea were asked to complete anonymous questionnaires regarding opioid prescriptions. Results: A total of 69 surveys were completed. Most pain physicians started prescribing opioids at a pain score of 7/10 and aimed to reduce pain by 50%. Most physicians (73.1%) actively explained the prescribed medications and possible side effects, and 61.2% of physicians preferred the prescription interval of 4 weeks. Immediate-release opioids were the most popular treatment for breakthrough pain (92.6%). The most common side effect encountered by physicians was constipation (43.3%), followed by nausea/vomiting (34.3%). Of the physicians, 56.5% replied that addiction and misuse prevalences were less than 5%. However, the most concerning side effect was addiction (33.0%). Conclusions: The survey results showed that the prescribing patterns of pain physicians generally followed Korean guidelines. Physicians were most interested in the safety and effectiveness of opioid prescriptions. They were most concerned about respiratory depression and abuse or addiction. A significant number of physicians agreed that the NHIS regulations needed improvement for patient convenience and safe and effective treatment, though there were pros and cons of the NHIS restrictions on prescription conditions.