Diffuse alveolar hemorrhage (DAH) is associated with severe outcomes. We report a case of acute respiratory failure that required mechanical ventilation and was clinically and pathologically diagnosed as DAH related to exposure to organic dust. A 39-year-old man, who had visited a warehouse to grade beans for purchase, was referred to our hospital for impending respiratory failure. His initial radiographic examinations revealed diffuse bilateral ground-glass opacities in his lungs and bronchoalveolar lavage resulted in progressively bloodier returns, which is characteristic of DAH. He underwent bedside open lung biopsy of his right lower lobe in the intensive care unit. Biopsy results revealed DAH and organization with accumulation of hemosiderin-laden macrophages and a few fibroblastic foci. The patient was treated with empirical antibiotics and high-dose corticosteroids and successfully weaned from mechanical ventilation. DAH might be considered in the differential diagnosis of patients with acute respiratory failure after exposure to organic particles.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Biopsy ; Bronchoalveolar Lavage ; Diagnosis, Differential ; Dust* ; Fibroblasts ; Hemoptysis ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Macrophages ; Respiration, Artificial ; Respiratory Insufficiency*

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternalewborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
Adenoidectomy ; Adenoids ; Child ; Continuous Positive Airway Pressure ; Enuresis ; Failure to Thrive ; Follow-Up Studies ; Humans ; Hypertension ; Hypertrophy ; Palatine Tonsil ; Pulmonary Heart Disease ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy

Rosacea is a chronic inflammatory condition characterized by recurrent episodes of flushing, persistent erythema, inflammatory papules, pustules, and telangiectasia that usually affects the centrofacial region. Conventional oral and topical agents primarily target inflammatory papules and pustules, but limited evidence supports their ability to manage background facial erythema and telangiectasia. Instead, recommendations favor intense pulsed light (IPL) or vascular lasers, such as the pulsed dye laser (PDL), for treating erythematotelangiectatic rosacea (ETR). Previous studies have confirmed the effectiveness of PDL and IPL as treatments for facial erythema and telangiectasia. This report details the case of a 66-year-old Korean female with ETR successfully treated with IPL and highlights its potential as an alternative treatment option for ETR patients refractory to PDL and conventional medications.

With the increasing use of hyaluronic acid (HA) fillers in aesthetic medicine, hyaluronidase has been widely used for the correction of HA fillers and the treatment of related complications. A 24-year-old female presented with a whitish papule beneath her right eye. She had previously undergone triamcinolone and HA filler injections with subsequent hyaluronidase treatment. Despite an initial suspicion of triamcinolone residue, observation revealed the persistence of the lesion. A single session of treatment with the pinhole method using a carbon dioxide laser successfully removed the residual hyaluronidase powder, without complications, and the lesion completely resolved after 7 months. By creating microscopic holes and inducing dermal remodeling, the pinhole method is effective in treating various skin lesions. This case highlights the importance of thorough mixing of hyaluronidase solutions and demonstrates the utility of the pinhole method in treating such cases, suggesting its broader applicability in dermatological interventions.

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital malformation syndrome that is characterized by a triad of uterine didelphys, blind hemivagina, and ipsilateral renal agenesis. There is a wide variety of phenotypic presentation which is recognized as a spectrum of disease rather than a separate entity. The exact incidence and pathogenesis of HWW syndrome are yet to be investigated. While this disease typically involves adolescent girls who present with abdominal pain or a pelvic mass that is secondary to hematocolpos, nowadays, a majority of potential patients with HWW are being prenatally screened for renal anomalies. Therefore, it is recommended to search for uterovaginal anomalies whenever a multicystic dysplastic kidney or the absence of a kidney is noted in a newborn female, and the role of pediatric nephrologists has become ever more important for early recognition of the disease.
Abdominal Pain ; Adolescent ; Female ; Hematocolpos ; Humans ; Incidence ; Infant, Newborn ; Kidney ; Multicystic Dysplastic Kidney

Purpose: The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. Methods: We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. Results: The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p < .001), forced expiratory volume in one second (t = 6.02, 6.26, p < .001), and peak expiratory flow (t = 5.35, 5.68, p < .001) were significantly higher during breathing exercises using the VR-BRES. User evaluation was also significantly higher for the VR-BRES in terms of efficiency (Z = 3.86, p < .001), entertainingness (Z = 5.00, p < .001), and intention to use (Z = 3.22, p = .001) compared to CDB. However, there was no difference in convenience between the two methods (Z = −0.90, p = .369). Conclusion The VR-BRES has the potential to be an efficient breathing exercise solution. We recommend a clinical study that evaluates the effects of the VR-BRES for a certain period of time for people who need breathing exercises.

Purpose: The purpose of this study was to explore and deeply understand the essential meaning of international students' healthcare management experiences in Korea. Methods: This study applied Colaizzi‘s phenomenological research method to identify the meanings and needs related to health care management experienced by international students during their academic stay in Korea. Data were collected through unstructured interviews, in which open-ended questions were asked to 12 international students. The interviews were conducted from May 10, 2024, to the end of July 2024, followed by an analysis based on Colaizzi’s six-step approach. The criteria set by Lincoln and Guba were used to enhance the reliability and validity of qualitative research. Results: Regarding the meaning of international students' healthcare management experiences in Korea, this study identified four categories, 11 themes, 27 sub-themes, and 108 significant statements. The four categories of international students' health care management experiences were: “neglecting health care management due to unresolved economic difficulties,” “choosing better healthcare management options than those in their home country,” “acquiring a new perspective on healthcare management during their stay in Korea,” and “suggesting directions for improvement and expectations based on their healthcare management experiences in Korea.” This study enabled an understanding of health management practices, with implications for ensuring the successful academic lives of international students. Conclusion This study implies that a deep understanding of international students' healthcare management experiences would contribute to the development of effective health promotion policies and programs for them in the future.