Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi . Although early diagnosis and appropriate antibiotic therapy improve the prognosis for the majority of patients, life-threatening complications are not uncommon. Here, we present a case of successful veno-veno-type extracorporeal membrane oxygenation for scrub typhus-induced complications, including acute respiratory distress syndrome, myocarditis and multi-organ dysfunction. To our knowledge, this is the first case report of successful extracorporeal membrane oxygenation in complicated scrub typhus in Korea.
Communicable Diseases ; Early Diagnosis ; Extracorporeal Membrane Oxygenation* ; Humans ; Korea ; Myocarditis ; Orientia tsutsugamushi ; Prognosis ; Respiratory Distress Syndrome, Adult ; Scrub Typhus*

Objective: To compare the inhibitory effects of acetone extracts from the stem bark of three Acacia species (Acacia dealbata, Acacia ferruginea and Acacia leucophloea) on nitric oxide production. Methods: The lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophage cells were used to investigate the regulatory effect of acetone extracts of three Acacia stem barks on nitric oxide production and the expression of inducible nitric oxide synthase, cyclooxygenase-2 and tumor necrosis factor-α. Further, the phenolic profile of acetone extracts from the Acacia barks was determined by liquid chromatography-mass spec-trometry/mass spectrometry analysis. Results: All the three extracts significantly decreased LPS-induced NO production as well as the expression of inducible nitric oxide synthase, cyclooxygenase-2 and tumor necrosis factor-α in a concentration dependent manner (25, 50 and 75 μg/mL). In the liquid chromatography-mass spectrometry/mass spectrometry analysis, acetone extract of Acacia ferruginea bark revealed the presence of 12 different phenolic components including quercetin, catechin, ellagic acid and rosmanol. However, Acacia dealbata and Acacia leucophloea barks each contained 6 different phenolic components. Conclusions: The acetone extracts of three Acacia species effectively inhibited the NO production in LPS-stimulated RAW 264.7 cells and the presence of different phenolic components in the bark extracts might be responsible for reducing the NO level in cells.

Stem rot was found for the first time on the Asiatic dayflower plant (Commelina communis L.) in Korea. A detailed description of this Korean specimen is given, along with its rDNA internal transcribed spacer sequence. The fungus was identified as Sclerotium rolfsii Saccardo based on mycological characteristics and molecular data.
Commelina ; DNA, Ribosomal ; Fungi ; Korea ; Plants

The tulip tree (Liriodendron chinense) has been widely cultivated in Korea as a street or garden tree for its large flowers, which have a superficial resemblance to tulips. Occurrence of anthracnose disease on the leaves of tulip trees growing on the campus of Gyeongsang National University, Jinju, Korea, has been observed. Based on mycological characteristics, pathogenicity, and internal transcribed spacer sequence, the causal fungus was identified as Colletotrichum gloeosporioides. This is the first report on anthracnose disease caused by C. gloeosporioides on tulip trees in Korea.
Colletotrichum ; Flowers ; Fungi ; Korea ; Liriodendron ; Trees ; Tulipa

Soft rot in apple caused by Rhizopus oryzae was found for the first time in Korea. A detailed description of the specimen is given along with its internal transcribed spacer rDNA sequence. The fungus was identified as Rhizopus oryzae based on the mycological characteristics, molecular data, and pathogenicity testing.
DNA, Ribosomal ; Fungi ; Korea ; Oryza ; Rhizopus

Purpose: The purpose of this study was to investigate the masseter muscle thickness before and after treatment using ultrasound sonography in patients with parafunctional habits. Materials and Methods: From September 2019 to March 2020, a total of 27 patients who visited the Department of Oral and Maxillofacial Surgery at Ewha Womans University Seoul Hospital were collected. The thickness of both masseter muscles was measured using a tablet ultrasound scanner. Statistical analysis was performed by using the IBM SPSS version 26.0 statistical package (IBM Corp) with significance level at 0.05.Result: According to the statistical results, the thickness of the masseter muscle was thicker on the right side than on the left, with no correlation with sex or age. The severity and duration of pain did not have a significant correlation with the thickness of the masseter muscle. Botulinum A toxin injection in the masseter muscle was the most effective way to reduce pain and reduce the thickness of the masseter muscle. Splint treatment also showed some effects in reducing the thickness of the masseter muscle. Conclusion Based on the findings, it can be claimed that ultrasonography is simple, inexpensive and easily repeatable method to get real-time diagnosis and treatment results for masseter muscles.

PURPOSE: Addressing a patient's chief complaint is the first and key element of treating patients. This study determined the effectiveness of emergency medical technician and residents of an emergency department in addressing a patient's chief complaints. If emergency and hospital personnel misunderstand the chief symptoms of patients it could result in erroneous transport and treatment, thus losing precious time in finding the proper treatment. METHODS: A retrospective chart review study was performed in 1137 patients (at least 18 years of age), who visited one university hospital, for a period of 3 months. Patients who were did not undergo trauma, addiction, and cardiac arrest were included. RESULTS: A total of 150 cases (13.2%) did not match the chief symptoms reported by 119 emergency medical personnel and emergency medicine residents. Systemic symptoms, nervous system symptoms, and psychiatric symptoms were the main categories inconsistently assessed. The rank and certification of emergency medical technicians did not make a difference, but older patients (59 years of age or older) were statistically different. The assessment fo chief symptoms by an emergency medical resident tended to be more accurate than assessment of emergency medical technicians in the final diagnosis. CONCLUSION: Systemic symptoms, nervous symptoms, and psychiatric symptoms, were chief complaines easily misreported for older patients. This likely reflects a difficulty in the evaluation of obscure symptoms in older patients. It will require specific additional training programs to improve the response to these chief complaints.
Certification ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Heart Arrest ; Humans ; Nervous System ; Personnel, Hospital ; Retrospective Studies

Black spot of sweet persimmon, caused by Alternaria alternata, occurred in an orchard in Gyeongnam province, Korea in 2012. The symptom was appearance of 0.5 to 4 cm black spots on the surface of fruit. The pathogen was isolated from flesh of disease lesions. The causal agent was identified as A. alternata by morphological characteristics and sequencers of the internal transcribed spacer (ITS) 1 and ITS4 regions of rRNA. Artificial inoculation of the pathogen resulted in development of disease symptoms and the re-isolated pathogen showed characteristics of A. alternata.
Alternaria* ; Diospyros* ; Fruit* ; Korea

Varying degrees of complications can occur after hyaluronic acid filler injections. Tissue necrosis due to interruption of the vascular supply is an early complication that can be severe. If the site of tissue necrosis due to the filler injection is the forehead, successfully reconstructing the region without distorting the key landmarks is challenging. We describe the case of a 50-year-old man who experienced widespread forehead skin necrosis after hyaluronic acid filler injection in the glabellar area. We successfully covered the forehead area with a 3×4-cm² midline necrotic tissue using the modified double-opposing rotation-advancement flap method. Although modified double-opposing rotation-advancement flap closure has the disadvantage of leaving a longer scar compared to conventional double-opposing rotation-advancement flap closure, the additional incision line made along the superior border of the eyebrow aids in camouflaging the scar and decreases eyebrow distortion. Therefore, it is believed that the modified double-opposing rotation-advancement flap technique is an excellent tool for providing adequate soft tissue coverage and minimal free margin distortion when reconstructing widespread skin necrosis in the central mid-lower forehead that can occur after filler injection in the glabellar area.
Cicatrix ; Dermal Fillers ; Eyebrows ; Forehead* ; Humans ; Hyaluronic Acid ; Methods ; Middle Aged ; Necrosis* ; Skin* ; Surgical Flaps

Restoring lost teeth is very important in terms of both function and aesthetics. If tooth loss occurs in the posterior region and the loss of support is persistent, it may cause a gradual shift in the position of the mandible and a change in occlusion. This clinical case attempted to restore support for the posterior teeth with a fixed prosthesis using implants in a patient whose opposing teeth were erupted and the occlusal plane collapsed due to long-term loss of the maxillary left posterior teeth and mandibular right first molars. To correct the occlusal plane of remaining dentition, wax-up of maxillary left posterior teeth was duplicated with acrylic resin and placed on maxilla. Surgical template for implant placement were fabricated using digital technology. After the support of the posterior teeth was restored with the placement of the implant, stable occlusion with temporary restorations was observed for a sufficient time. Afterwards, monolithic zirconia prosthesis was placed on the patient to ensure functional and aesthetic improvement.