The aim of this study was to analyze the changes and improvements in symptoms of sleep-disordered breathing (SDB) using semi-rapid maxillary expansion (SRME) in children with narrow maxilla and SDB symptoms. Subjects were 15 patients with sleep disorder (apnea-hypopnea index, AHI ≥ 1) and narrow maxillary arch between 7 and 9 years of age. Before the SRME was applied, all subjects underwent pediatric sleep questionnaires (PSQ), lateral cephalometry, and portable sleep monitoring before expansion (T0). All subjects were treated with SRME for 2 months, followed by maintenance for the next 3 months. All subjects had undergone PSQ, lateral cephalometry, and portable sleep monitoring after expansion (T1). Adenoidal-nasopharyngeal ratio (ANR), upper airway width and hyoid bone position were measured by lateral cephalometry. The data before and after SRME were statistically analyzed with frequency analysis and Wilcoxon signed rank test. As reported by PSQ, the total PSQ scale was declined significantly from 0.45 (T0) to 0.18 (T1) (p = 0.001). Particularly, snoring, breathing, and inattention hyperactivity were significantly improved (p = 0.001). ANR significantly decreased from 0.63 (T0) to 0.51 (T1) (p = 0.003). After maxillary expansion, only palatopharyngeal airway width was significantly increased (p = 0.035). There was no statistically significant difference in position of hyoid bone after expansion (p = 0.333). From analysis of portable sleep monitoring, changes in sleep characteristics showed a statistically significant decrease in AHI and ODI, and the lowest oxygen desaturation was significantly increased after SRME (p = 0.001, 0.004, 0.023).In conclusion, early diagnosis with questionnaires and portable sleep monitoring is important. Treatment using SRME will improve breathing of children with SDB.
Cephalometry ; Child ; Diagnosis ; Early Diagnosis ; Humans ; Hyoid Bone ; Maxilla ; Oxygen ; Palatal Expansion Technique ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Snoring

PURPOSE: The purpose of this study was to identify the effect of head nurse's emotional leadership on nurse's job satisfaction & organizational commitment. METHODS: The subjects of this study were 385 nurses from four general hospitals and one university hospital. SPSS WIN 14.0 was used for data analysis. RESULTS: Stepwise multiple regression analyses were used to examine the influences of research variables. The variable which predict nurse's job satisfaction were head nurse's emotional leadership (F=76.027, p<.01, adjusted R square=.166). The variables which predict organizational commitment were emotional leadership (F=27.839, p<.01, adjusted R square=.066), marital status (F=20.928, p<.01 adjusted R square=.03), respectively. CONCLUSIONS: As a result of this study, head nurse's emotional leadership was defined as a important influential on both job satisfaction and organizational commitment of nurses. Therefore, it is needed to develop education programs for activating head nurse's emotional leadership.
Head ; Hospitals, General ; Job Satisfaction ; Leadership ; Marital Status ; Statistics as Topic

Background: Group A streptococcus (GAS) is the most common cause of bacterial pharyngitis. This study aimed to characterize the molecular epidemiology of GAS infection using an emm-typing and emm-clustering approach. Methods: A total of 372 patients from Changwon who showed pharyngitis symptoms were recruited during the sampling period of 2018–2019 and throat cultures were obtained from them. emm typing was performed using polymerase chain reaction (PCR) and direct sequencing. emm genotypes and GAS clusters were classified based on a web-based database. Results: Of the 372 throat swab specimens, 101 (27.2%) were positive for GAS. emm typing analysis was performed on 59 GAS isolates. The most prevalent emm type was emm89 (20.3%), followed by emm12 (16.9%). Seven emm clusters were identified: E4 (emm89/ emm28, 32.2%), A-C4 (emm12, 16.9%), E1 (emm4, 13.6%), A-C5 (emm3, 10.2%), E6 (emm75, 8.5%), M6 (emm6, 8.5%), and A-C3 (emm1, 6.8%). Conclusion Diverse and temporal changes were observed in the distribution of emm types and clusters of GAS. Continuous surveillance based on emm genotyping is needed to monitor the epidemiological characteristics of GAS pharyngitis.

There are more than 10 million visits to primary care clinics annually due to pharyngitis or tonsillitis. The antibiotic prescription rate for these patients is more than 50%. An optimal diagnosis is necessary to avoid antibiotic misuse or overuse. Here, we compared the benefits and pitfalls of three currently available laboratory methods, such as throat culture, rapid antigen detection test (RADT), and molecular tests. We also reviewed the current American and Korean guidelines for bacterial pharyngitis. Although throat culture is regarded as a gold standard, it requires high technical expertise and culture facilities. In addition, the turn-around time (TAT) is 1 day-2 days causing possible inadequate prescription as well as the inconvenience of a second clinical visit to check results. The RADT does not require culture facilities and the TAT is noticeably short (5-10 min). The initial low sensitivity of the RADT has been improved these days. Though molecular tests are the most advanced, there remains a lack of clinical data. Therefore, we recommend judicious use of the RADT for diagnosing bacterial pharyngitis as well as effective antibiotic prescriptions at primary care clinics.

This study aims to identify the clinical characteristics for diagnosing streptococcal pharyngitis. The correlation between eighteen clinical manifestations and rapid antigen detection test results was analyzed. Among 205 patients, five clinical manifestations, pharyngeal hemorrhage (odds ratio [OR] = 11.85), palatal hemorrhage (OR = 9.32), tonsillar swelling (OR = 4.37), rash (OR = 3.02), and enlarged cervical nodes (OR = 1.91), were significantly correlated with group A Streptococcus (GAS) pharyngitis. Traditional indicators such as fever, pharyngeal redness, acute onset, headache, rhinorrhea, cough, tonsillar exudate, and cervical tenderness were not statistically related to GAS pharyngitis. Therefore, physicians should be cautious in using these traditional indicators

This study aims to identify the clinical characteristics for diagnosing streptococcal pharyngitis. The correlation between eighteen clinical manifestations and rapid antigen detection test results was analyzed. Among 205 patients, five clinical manifestations, pharyngeal hemorrhage (odds ratio [OR] = 11.85), palatal hemorrhage (OR = 9.32), tonsillar swelling (OR = 4.37), rash (OR = 3.02), and enlarged cervical nodes (OR = 1.91), were significantly correlated with group A Streptococcus (GAS) pharyngitis. Traditional indicators such as fever, pharyngeal redness, acute onset, headache, rhinorrhea, cough, tonsillar exudate, and cervical tenderness were not statistically related to GAS pharyngitis. Therefore, physicians should be cautious in using these traditional indicators

There are more than 10 million visits to primary care clinics annually due to pharyngitis or tonsillitis. The antibiotic prescription rate for these patients is more than 50%. An optimal diagnosis is necessary to avoid antibiotic misuse or overuse. Here, we compared the benefits and pitfalls of three currently available laboratory methods, such as throat culture, rapid antigen detection test (RADT), and molecular tests. We also reviewed the current American and Korean guidelines for bacterial pharyngitis. Although throat culture is regarded as a gold standard, it requires high technical expertise and culture facilities. In addition, the turn-around time (TAT) is 1 day-2 days causing possible inadequate prescription as well as the inconvenience of a second clinical visit to check results. The RADT does not require culture facilities and the TAT is noticeably short (5-10 min). The initial low sensitivity of the RADT has been improved these days. Though molecular tests are the most advanced, there remains a lack of clinical data. Therefore, we recommend judicious use of the RADT for diagnosing bacterial pharyngitis as well as effective antibiotic prescriptions at primary care clinics.

No abstract available.
Granuloma, Foreign-Body* ; Mesotherapy*

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare, autosomal recessive disorder; affected patients are characterized by inability to feel pain and to sweat over the entire body, as well as by mental retardation. Because, in the oral examination, no specific findings on soft or hard tissue may be found except possible lesions due to self-mutilation, early recognition and diagnosis are essential for these patients. Pediatric dentists must be aware of the clinical manifestations and treatment considerations related to uncontrolled body temperature, tactile hyperesthesia and lack of pain reflex. In this case report, dental management of CIPA was suggested by presenting a 6-year follow-up of young patient.
Body Temperature ; Dentists ; Diagnosis ; Diagnosis, Oral ; Follow-Up Studies ; Hereditary Sensory and Autonomic Neuropathies ; Humans ; Hyperesthesia ; Hypohidrosis ; Intellectual Disability ; Pain Insensitivity, Congenital ; Reflex ; Sweat

The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018.Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2(nd) referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2(nd) referral was relatively delayed with increased ratio of ‘during treatment’.These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.
Child ; Dental Clinics ; Dentists ; Electronic Health Records ; Female ; Humans ; Intellectual Disability ; Jeollabuk-do ; Minor Surgical Procedures ; Outpatients ; Pediatric Dentistry ; Referral and Consultation