Recently the incidence of coronary artery diseases in young patients has been increased in Korea, which may be related with the changes in dietary habits, stress and smoking. This report presents an 18-year-old male patient who suffered from acute non-ST elevation myocardial infarction. He had a history of 1.5 pack-years smoking, but no other risk factors. Depression of ST segments more than 3 mm in V1-6, I and aVL was documented on a twelve-lead electrocardiogram. Two-Dimensional echocardiography revealed hypokinetic anteroseptal wall motion, and myocardial SPECT demonstrated severe, reversible perfusion defects in the anteroseptal wall. A diagnostic coronary angiogram and an intravascular ultrasound revealed total occlusion in the proximal left anterior descending coronary artery due to heavy atheromatous plaque. The lesion was treated successfully by a coronary balloon and stent. He has no major adverse cardiovascular event on nine-month clinical follow-up after discharge.
Adolescent ; Coronary Artery Disease ; Coronary Vessels ; Depression ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Food Habits ; Humans ; Incidence ; Korea ; Male* ; Myocardial Infarction* ; Perfusion ; Risk Factors ; Smoke ; Smoking ; Stents ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography

STUDY DESIGN: This is a retrospective study OBJECTIVES: This study compared the clinical outcomes of posterior lumbar interbody fusion (PLIF) using hydroxyapatite blocks with PLIF using a metal or poly-ether-ether-ketone (PEEK) cage. SUMMARY OF THE LITERATURE REVIEW: There are few reports on the clinical outcomes of PLIF using a hydroxyapatite block for treating lumbar degenerative disease. MATERIALS AND METHODS: The 27 PLIF cases (62 units, HA block) that were followed up for 1-year were compared with 13 cases using a metal cage and 13 cases using a PEEK cage. Pedicle screw fixation was performed for all the cases. If the local bone is deficient, then an additional bone graft with autogeous iliac bone or bone substitute was used. The visual analog scale(VAS) for low back pain and radiating pain, the Oswestry disability index (ODI), the intervertebral height and the halo sign around the cages and pedicle screws were comparatively analyzed. RESULTS: The mean VAS score for low back pain before PLIF and using the HA block, the metal cage and the PEEK cage was 7.5, 8.3 and 6.2, respectively, and this was 3.3, 2.9 and 4.8 after PLIF (P<0.05 with using the HA block and the metal cage (Wilcoxon test). The mean VAS score for radiating pain before PLIF was 7.9, 8.3 and 8.5, respectively, and the VAS score was 3.5, 3.1 and 3.9, respectively, after PLIF (P<0.05 for all cases, Wilcoxon test). For the ODI, the means before PLIF were 60.3, 51.2 and 53.8, respectively, and they changed to 30.5, 24.9 and 29.7, respectively, after PLIF (P<0 .05 for all cases, Wilcoxon test). On the X-ray images, there was no halo sign greater than 2 mm near the pedicle screws or greater than 1 mm near the cages and no breakage of the HA block. No additional bone graft was needed for the PLIF using the HA block and local bone. There was no statistically significant differences among the groups (P>0.05, One-way ANOVA). CONCLUSION: PLIF using a HA block showed improvements, including the back pain, and the ODI was satisfactory and this didn't fall below those ODIs of using metal or PEEK cages. Although a HA block may have higher tendency to break, there was no breakage at the 1-year follow up.
Back Pain ; Bone Substitutes ; Durapatite ; Follow-Up Studies ; Ketones ; Low Back Pain ; Polyethylene Glycols ; Retrospective Studies ; Transplants

Background: Even amid the coronavirus disease-19 (COVID-19) pandemic, the spread of multidrug-resistant bacteria and infection control are still important tasks. After recognizing the carbapenem-resistant Acinetobacter baumannii (CRAB) outbreak that occurred in the isolation room for COVID-19, we would like to introduce what infection control measures were implemented to eradicate it. Materials and Methods: All COVID-19 patients with CRAB in any specimen admitted to the COVID-19 isolation ward of the tertiary hospital in Korea from October to November 2021 were analyzed. Results: During the outbreak, 23 patients with COVID-19 and CRAB infections were identified. The index case was an 85-year-old female referred from a long-term care facility. CRAB was identified in sputum culture in most patients (91.3%). The CRAB outbreak occurred mainly in the rooms around the index case. Environmental cultures on the floor, air inlet, air outlet, and window frame of the rooms were performed. The antimicrobial resistance patterns of CRAB from patients and the environment were identical; whole-genome sequencing analyses revealed isolated clonality. Infection control measures with enhanced environmental cleaning using 1,000 ppm sodium hypochlorite and phenolic compounds, enhanced hand hygiene, additional education, and mandatory additional gowning and gloving of COVID-19 personal protective equipment (PPE) were applied on 29 October. No CRAB infection cases occurred from 2 November for two weeks. Conclusion In addition to applying PPE and COVID-19 precautions in COVID-19 isolation wards, adhering to strict contact precautions along with environmental control can help prevent the spread of multidrug-resistant bacteria.