No abstract available.
Lymphocele*

In this report, we describe the case of a SARS-CoV-2 infection (COVID-19) in an infant with mild fever and diarrhea in the absence of respiratory distress. A 45-day-old male infant with COVID-19 was transferred to our pediatric department. He had mild fever and diarrhea at admission. Positive-to-negative nasal swab conversion occurred on the 21st day from the onset of symptoms. However, stool swab positivity persisted during the 6-week admission period and for 7 weeks during follow-up at an outpatient clinic after discharge. Negative conversion in a stool specimen occurred on the 142nd day from the onset of symptoms. This case highlights the potential of fecal virus shedding as an important feature of viral transmission in infants and young children.

A 36-year-old female patient presented with shoulder pain experienced over a period of one year and progressive weakness in both legs for one month. A magnetic resonance imaging scan revealed an intradural extramedullary (IDEM) fusiform mass about 9.8 cm in length, heterogeneously enhanced at the level of C6-T4 with spinal cord compression. At the time of surgery, the surgeon found an encapsulated IDEM tumor with spinal root attachment. The tumor was completely resected and the histologic diagnosis revealed ependymoma. The patient showed a favorable outcome with no recurrence at the 6-month follow-up. This paper reports a rare case of intradural extramedullary ependymoma with spinal root attachment.
Adult ; Ependymoma ; Female ; Follow-Up Studies ; Humans ; Leg ; Magnetic Resonance Imaging ; Recurrence ; Shoulder Pain ; Spinal Cord Compression ; Spinal Nerve Roots

OBJECTIVES: It is well established that primary insomnia affects the activity of autonomic nervous system. We tried to know how the activity of autonomic nervous system during night sleep changes by analyzing correlation between heart rate variability (HRV) index and the variables related with sleep structure in primary insomnia. METHODS: Thirty three subjects (mean age:36.2+/-14.2 years, male:female=15:18) who were diagnosed with primary insomnia were selected for the study. Nocturnal polysomnography (NPSG) was carried out on each subject and correlation was analyzed between high frequency/low frequency ratio (LF/HF ratio), one of HRV indices and the variables related with sleep structure which were calculated from NPSG. RESULTS: When age and sex were controlled, LF/HF ratio showed negative correlations with slow wave sleep and stage 2 sleep, respectively (r(p)=-0.43, p=0.01;r(p)=-0.37, p=0.04). On the other hands LF/HF ratio showed a positive correlation with arousal index (r(p)=0.65, p<0.001). The activity of autonomic nervous system responded differentially depending on the change of sleep structure in primary insomnia. Especially the increase of arousal index and the decrease of slow wave sleep and stage 2 sleep which are the components of non-REM sleep provoked hyperactivity of sympathetic nervous system. CONCLUSION: This study suggests that the typical change of sleep structure in primary insomnia can negatively impact on cardiovascular system.
Arousal ; Autonomic Nervous System ; Cardiovascular System ; Hand ; Heart ; Heart Rate ; Polysomnography ; Sleep Initiation and Maintenance Disorders

The nasal manifestations of the Wegener's granulomatosis commonly results in destruction of the cartilaginous support of the nose and a severe saddle nose deformity. It is so difficult to correct the saddle nose deformity because surgeons have fear about relapse of the Wegener's granulomatosis and cannot use the septal cartilage as a donor site. However we reconstructed the deformity with chondro-osseous rib graft successfully. A 49-year-old woman had a saddle nose deformity after resecting Wagener's granulomatosis, and suffered from not only aesthetic problem but also dyspnea and nasal airway obstruction while physical exercise. She underwent a rhinoplasty with rib graft. The correction came out to be successful and the nasal airway complaint was resolved. She had a recurrence of Wegener's granulomatosis at postoperative 6 months and was admitted for medical treatment of the inflammation at the nasal septum. The follow-up computed tomographic image study revealed good maintenance of the graft. Saddle nose deformity that arises from Wagener's granulomatosis should be reconstructed with chondro-osseous rib graft. Even though the disease might recur, influence to the grafted cartilage is minimal. Active treatment with plastic surgery is thought to be no problem for reconstruction.
Bone Transplantation ; Cartilage ; Congenital Abnormalities ; Dyspnea ; Exercise ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Middle Aged ; Nasal Obstruction ; Nasal Septum ; Nose ; Nose Deformities, Acquired ; Porphyrins ; Recurrence ; Rhinoplasty ; Ribs ; Surgery, Plastic ; Tissue Donors ; Transplants ; Wegener Granulomatosis

OBJECTIVES: To investigate the pattern of subclinical hypothyroidism (SCH) in patients with bipolar disorders managed by lithium or valproic acid. METHODS: The study participants were 106 patients with DSM-IV bipolar disorders receiving planned maintenance treatment at the Mood Disorders Clinic of Seoul National University Bundang Hospital (aged between 17 and 64, mean duration of follow-up = 875.65 days). Using the bipolar disorder registry, thyroid function data were analyzed to assess the frequency of and the risk factors for SCH in patients managed by lithium (n = 64) or valproic acid (n = 42) for more than 5 months. RESULTS: Overall frequencies of SCH were 20.3% (13/64) in the lithium group, 14.3% (6/42) in the valproic acid group, and between the two groups there is no difference (p = 0.43). No differences were observed in the potential risk factors for SCH between the two groups including age, sex, subtype of bipolar disorder, baseline TSH, and concomitant antipsychotic use. In cases with SCH, thyroid-stimulating hormone (TSH) showed a tendency to increase at 3 month after the initiation of lithium or valproic acid. A gradual increase in the number of patients showing SCH was found within the first 3 years of medication. CONCLUSIONS: With regular monitoring and careful assessment, there was no difference in the risk of SCH between lithium and valproic acid maintenance. The risk of mood stabilizer-associated SCH may gradually increase within 3 years following the commencement of medication, thereby mandating close monitoring for the first 3 years of treatment. Further studies with large sample size would be needed to confirm these findings.
Bipolar Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Follow-Up Studies ; Humans ; Hypothyroidism* ; Lithium* ; Mood Disorders ; Risk Factors ; Sample Size ; Seoul ; Thyroid Gland ; Thyrotropin ; Valproic Acid*

OBJECTIVE: Vertebral distraction is routinely performed during anterior cervical discectomy and fusion (ACDF). Overdistraction can injure the facet joints and may cause postoperative neck pain consequently. The purpose of this study was to investigate the clinical relevance of distraction force during ACDF. METHODS: This study included 24 consecutive patients with single level cervical disc disease undergoing single level ACDF. We measure the maximum torque just before the the arm of the Caspar retractor was suspended by the rachet mechanism by turning the lever on the movable arm using a torque meter. In order to turn the lever using the torque driver, we made a linear groove on the top of the lever. We compared the neck disability index (NDI) and visual analogue scale (VAS) scores between the high torque group (distraction force>6 kgf.cm) and the low torque group (distraction force< or =6 kgf.cm) at routine postoperative intervals of 1, 3, 5 days and 1, 3, 6 months. RESULTS: The VAS scores for posterior neck pain had a linear correlation with torque at postoperative 1st and 3rd days (y=0.99x-1.1, r2=0.82; y=0.77x-0.63, r2=0.73, respectively). VAS scores for posterior neck pain were lower in the low torque group than in the high torque group on both 1 and 3 days postoperatively (3.1+/-1.3, 2.6+/-1.0 compared with 6.0+/-0.6, 4.9+/-0.8, p<0.01). However, the difference in NDI scores was not statistically significant in all postoperative periods. CONCLUSION: Vertebral distraction may cause posterior neck pain in the immediate postoperative days. We recommend not to distract the intervertebral disc space excessively with a force of more than 6.0 kgf.cm.
Arm ; Diskectomy ; Humans ; Intervertebral Disc ; Neck ; Neck Pain ; Pain, Postoperative ; Spinal Fusion ; Torque ; Zygapophyseal Joint

No abstract available.
Lymphadenitis*

No abstract available.
Humans ; Referral and Consultation*

Several ways of curing are being tried to improve material's properties and reduce marginal gap. However, all are considering about the pattern of light intensity. It was noted from the preliminary study the change of light wavelength from filter changing may give an impact on material's property and microleakage. The object of this study was to verify the effect of filters with various wavelength width on the microhardness and microleakage of composite resin; hybrid type of DenFil and submicron hybrid type of Esthet X. Composite resins were cured using 3 kinds of filter; narrow-banded(465-475 nm), mid-banded(430-470 nm), wide-banded(400-500 nm). After the estimation of microhardness, degree of dye penetration and the maximum gap from SEM evaluation were done between 4 groups that showed no difference in microhardness value of the lower surface. The results were as follows: 1. Adequate microhardness could not be gained with a narrow-banded filter irrespective of curing time. At the upper surface, DenFil should be polymerized with middle or wide-banded filter for 20 seconds at least, while Esthet X be cured with middle or wide-banded filter for 30 seconds at least to get similar hardness value to control group. 2. There was little dye penetration in enamel margin, but all dentin margins showed much more dye penetration irrespective of curing conditions. Although there was no statistical difference, groups cured with mid-banded filter for 40 seconds and with wide-width filter for 20 seconds showed relatively less dye penetration. 3. It was revealed from the SEM examination that group cured with wide-banded filter had the smallest gap without statistical significance. Spearman's rho test showed that the correlation between the results of dye penetration and SEM examination was very low. From these results, it could be concluded that curing with wide-width filter would be better than the other techniques, even though the curing technique using mid-width filter seems to have its own unique advantage.
Chimera ; Composite Resins ; Dental Enamel ; Dentin ; Hardness ; Imidazoles ; Light ; Nitro Compounds ; Polymers