Objectives: The purpose of this study was to identify the effectiveness of COVID-19 vaccinations on deaths of the COVID-19 cases in some elderly long-term care facilities (LTCF) in Gwangju Metropolitan City. Methods: The study subjects were 659 COVID-19 cases in residents of 7 elderly LTCF, Gwangju, from 21 Dec. 2021 to 28 Jan. 2022. The used variables were confirmed dates for COVID-19, demographic characteristics, co-morbidities, presentation of symptoms, death and vaccination related characteristics including type of vaccine, doses and dates. Vaccination status were classified as not vaccinated, partially and fully vaccinated. The associations of vaccination status and deaths of COVID-19 cases were tested by chi-square test and multiple logistic regression analysis. Results: The rates of not vaccinated, partially vaccinated and fully vaccinated were 19.4%, 10.2% and 70.4%, respectively. The mortality rate of the cases was 6.4%.The death rate by vaccination status was 16.4% in not vaccinated, 15.4% in partially vaccinated and 2.6% in fully vaccinated, showing a statistically significant difference. The adjusted odds ratios (ORs) (95% confidence intervals, CIs) of death compared to fully vaccinated were 7.64 (3.87-16.34) in non-vaccinated, and 6.97 (3.44-14.14) in partially vaccinated. Conclusions COVID-19 vaccination seems to work effectively in preventing deaths of COVID-19 cases of elderly LTCF residents. This finding support that fully vaccinations in high risk group such as elderly LTCF residents is very important for one of strategies of COVID-19 management.

PURPOSE: Encephalitis is a cranial nervous system infection that is caused by various etiologies. Most of the patients with encephalitis undergo severe or fatal clinical course with sequelae. This study was conducted to estimate the clinical outcomes and to evaluate factors which can be used to predict clinical outcomes among pediatric patients with encephalitis METHODS: We retrospectively reviewed 46 patients with encephalitis who were admitted to the Department of Pediatrics of Chonbuk National University Hospital, from July 1995 to July 2003. Encephalitis was diagnosed based on the presence of neurologic abnormalities, CSF, Brain CT or MRI findings. Information on sequelae was obtained in the outpatient clinic. RESULTS: In this study, five patients(11.6%) were expired, 17 patients(39.5%) developed neurologic sequelaes and 21 patients(46.5%) were recovered without sequelae. Infants had poorer outcomes compared to older age groups. Twenty nine cases who had seizures showed high morbidity rate(48.3%) compared to the seizure-free group(17.6%). Among six patients with status epilepticus, four(66.7%) developed neurologic sequelae and two(33.3%) expired. The group with normal brain MRI findings had better outcomes (70%) than the group with abnormal MRI findings(55.5%). Gray matter involved patients on MRI had poorer recovery rate(33.3%) than white matter involved patients(69.2%). The group treated with intravenous immunoglobulin(IVIG) had better outcomes(64.7%) than the other group(37.9%). CONCLUSION: The presence of seizure, younger patients, and presence of abnormal findings of brain MRI, especially gray matter lesions were associated with poor clinical outcomes in children with encephalitis.
Ambulatory Care Facilities ; Brain ; Child ; Encephalitis ; Encephalitis, Viral* ; Humans ; Infant ; Jeollabuk-do ; Magnetic Resonance Imaging ; Nervous System ; Pediatrics ; Retrospective Studies ; Seizures ; Status Epilepticus

A 36-year-old male patient with no remarkable medical history was admitted to our hospital for a health check up. On chest radiography, bilateral aortic notches at the level of aortic arch were shown suggesting aortic arch anomaly without any clinical symptoms. Two aortic arches were almost same-in-size on suprasternal view of transthoracic echocardiography. In addition, multidetector computed tomography showed balanced type double aortic arch forming a complete vascular ring which encircled the trachea and esophagus. The trachea was slightly compressed by the vascular ring whereas the esophagus was intact. Nevertheless, the pulmonary function test was normal. The patient was discharged from hospital with instructions for periodic follow-up.
Adult ; Aorta, Thoracic ; Echocardiography ; Esophagus ; Follow-Up Studies ; Humans ; Male ; Multidetector Computed Tomography ; Respiratory Function Tests ; Thorax ; Trachea

The aim of this in vitro study was to evaluate the cleaning efficacy of various irrigation methods in the mandibular mesial roots. The forty five mesial root canals were shaped by Profile .06 instruments to apical size #30 and irrigated with 5 ml of 3.5% NaOCl. The teeth were divided into 3 groups and irrigated finally for 1 minute; Group 1: syringe irrigation, Group 2: ultrasonic irrigation, Group 3: RinsEndo irrigation. After histological processing, the cross sections of apical 1, 3, and 5 mm level were examined with an optical microscope. The cleanliness values of canals and isthmuses were calculated and analyzed by Mann-Whitney U test. 1. There were no significant differences in both canal and isthmus cleanliness between syringe irrigation and ultrasonic irrigation except 5 mm level of isthmus. 2. RinsEndo irrigation had significantly higher canal cleanliness values than syringe irrigation at 1 mm and 3 mm levels (p < 0.05). Also, RinsEndo irrigation had significantly higher isthmus cleanliness values than syringe irrigation at all levels evaluated (p < 0.05). 3. There were no statistical differences in both canal and isthmus cleanliness between ultrasonic irrigation and RinsEndo irrigation except 3 mm level of canal. From this study, RinsEndo irrigation can be useful as an additional irrigation procedure.
Dental Pulp Cavity ; Molar ; Syringes ; Tooth ; Ultrasonics

PURPOSE: A graft patency is influenced by various factors; the degree of preoperative ischemia, type of procedure, kinds of the conduit and the stati of inflow and outflow vessels. The aim of this study was to evaluate the patency rate according to the distal anastomosis level, kinds of conduit and the impact of runoff score. METHODS: Between August 1998 and August 2003, 141 lower extremity arterial bypass operations were performed. The runoff scores of the outflow arteries were graded according to the system proposed by the Ad Hoc Committee on Reporting Standards, SVS/ISCVS. The graft patency was determined by clinical examination, and ABI measurements, and with a Duplex scan if required, and assessed by a regular follow-up schedule. RESULTS: The primary patency rates according to the level of distal anastomosis at 1, 3 and 5 years were as follows; femoral artery (FA) 94.8, 87.1 and 87.1%, above-knee popliteal artery (AKPA) 83.7, 79.3 and 68.0%, below-knee popliteal artery (BKPA) 85.9, 64.4 and 42.9%, respectively, and the secondary patency rates; FA 95, 87.6 and 87.6%, AKPA 91.6, 68.3 and 38.6%, BKPA 83.8, 69.9 and 46.6%, respectively. The patency rates of below-knee popliteal bypass showed no statistical difference between each conduit, but showed a tendency to increase in the order: PTFE, vein patch and vein graft. No significant difference in the patency rate was shown except between a runoff score of 1 and above 1 at each level. CONCLUSION: The patency rates for the relatively proximal site of the distal anastomosis were superior to those of the distal site. The choice of conduit influenced the patency of infrapopliteal bypass grafts. The patent outflow vessels and the autogenous vein graft at infrapopliteal artery were more favorable for good graft patency. The recommended runoff score system seems to be revision in order to improve the predictability of a graft patency.
Appointments and Schedules ; Arteries ; Femoral Artery ; Follow-Up Studies ; Ischemia ; Lower Extremity* ; Polytetrafluoroethylene ; Popliteal Artery ; Transplants* ; Veins

This report describes clinical and parasitological findings of an 82-yr-old female patient who lived in a local rural village and suffered from severe chronic anemia for several years. She was transferred to the National Police Hospital in Seoul for management of severe dyspnea and dizziness. At admission, she showed symptoms or signs of severe anemia. Gastroduodenoscopy observed hyperemic mucosa of the duodenum and discovered numerous moving roundworms on the mucosa. Endoscopy isolated seven of them, which were identified as Necator americanus by characteristic morphology of cutting plates in the buccal cavity. The patient was treated with albendazole and supportive measures for anemia, and her physical condition much improved. This case suggests the possibility that hookworm N. americanus is still transmitted in a remote local mountainous area in Korea.
Aged, 80 and over ; Albendazole/therapeutic use ; Anemia/*diagnosis/parasitology ; Animals ; Anthelmintics/therapeutic use ; Duodenoscopy ; Female ; Gastroscopy ; Humans ; *Necator americanus/isolation & purification ; Necatoriasis/*diagnosis/drug therapy ; Republic of Korea

PURPOSE: This study was conducted to investigate the relationship between cultural competency and the importance of nurses' qualities perceived by undergraduate nursing students. METHODS: Researchers developed two tools for this study after reviewing the related literature and conducting research team workshops: questionnaire of cultural competency and the importance of nurses' qualities. 200 nursing students were recruited in convenient sampling to respond to these questionnaires. Of nurses' 10 qualities, major affecting factors on the cultural competency were identified by stepwise multiple regression analysis. RESULTS: The nursing students perceived technical nursing skills and professional nursing knowledge as nurses' most important qualities. However, 'having a passion for patient care', 'demonstrating strong nursing profession's code of ethics??and 'teaching and research ability' were found as significant influencing factors on the variance of the cultural competency. These three factors explained 16% of the total variances of the cultural competency (F=13.98, p<.001). CONCLUSION: The educational strategies to improve cultural nursing competency need to incorporate students' expectations for the professional nurses' roles. Also, further studies need to develop reliable and valid measurement tools for cultural competency
Cultural Competency* ; Cultural Diversity ; Education ; Education, Nursing ; Humans ; Nursing* ; Students, Nursing*

The definition of refractory status epilepticus (RSE) is the state of epilepticus that persists for longer than 60 minutes despite an adequate dose of benzodiazepine and an antiepileptic drug. Topiramate is a broad-spectrum antiepileptic drug used as a monotherapy as well as an adjunctive therapy in the treatment of epilepsy. We encountered a 32-month-old girl with RSE, who showed spastic quadriplegia, hydrocephalus and a previous history of 3 times recurrence of status epilepticus in the presence of global development. Although the girl was treated with lorazepam, phenytoin, phenobarbital and even with midazolam, seizure lasted for more than 60 minutes. Through pentobarbital coma, seizure was controlled clinically on the state of EEG. However, it recurred. Therefore, the patient was treated with an overdose amount of topiramate (10 mg/kg/day) by nasogastric tube without titration as an add-on therapy and then treated with a reduced amount of topiramate (4 mg/kg/day). Finally, the seizure became controlled.
Benzodiazepines ; Child, Preschool ; Coma ; Electroencephalography ; Epilepsy ; Female ; Humans ; Hydrocephalus ; Lorazepam ; Midazolam ; Pentobarbital ; Phenobarbital ; Phenytoin ; Quadriplegia ; Recurrence ; Seizures ; Status Epilepticus*

PURPOSE: Vitamin D levels are known to be associated with development of allergic diseases. However, existing data are controversial. The aim of this study was to investigate whether vitamin D levels are associated with food sensitization (FS) in young children with atopic dermatitis (AD). METHODS: We performed a medical record review of all patients under 2 years presenting to pediatric allergic clinic in Hallym University Sacred Heart Hospital for atopic dermatitis between March 1, 2012 and February 28, 2013. Serum 25-hydroxyvitamin D (25(OH)D)levels and six specific immunoglobulin E (IgE) to common food allergens were measured in 132 young children with AD. We defined vitamin D insufficiency was 25(OH)D <30 ng/mL, and FS as specific IgE > or =0.35 IU/mL to any of six common food allergens. Associations between serum 25(OH)D levels and FS were examined by using multiple logistic regression, adjusting for potential risk and confounding factors. RESULTS: The mean age was 10.1 months. Among the 132 children with AD, 65.9% had FS. In this group, there was a negative correlation between 25(OH)D levels and serum eosinophil percentage (correlation coefficient [r]=-0.335, P<0.01), but not correlated with serum total IgE levels. Children with vitamin D insufficiency were more likely to have FS (adjusted odds ratio, 17.1; 95% confidence interval, 1.36 to 215; P=0.028) than those with adequate vitamin D levels. CONCLUSION: Vitamin D insufficiency is associated with FS in young children with AD. Further research is needed to confirm these findings.
Allergens ; Child ; Dermatitis ; Dermatitis, Atopic ; Eosinophils ; Heart ; Humans ; Immunoglobulin E ; Immunoglobulins ; Logistic Models ; Medical Records ; Odds Ratio ; Vitamin D ; Vitamins

PURPOSE: The purposes of this study were to evaluate the marginal and internal gaps, and the potential clinical applications of three different methods of dental prostheses fabrication, and to compare the prostheses prepared using the silicone replica technique (SRT) and those prepared using the three-dimensional superimposition analysis (3DSA). MATERIALS AND METHODS: Five Pekkton, lithium disilicate, and zirconia crowns were each manufactured and tested using both the SRT and the two-dimensional section of the 3DSA. The data were analyzed with the nonparametric version of a two-way analysis of variance using rank-transformed values and the Tukey's post-hoc test (α = .05). RESULTS: Significant differences were observed between the fabrication methods in the marginal gap (P < .010), deep chamfer (P < .001), axial wall (P < .001), and occlusal area (P < .001). A significant difference in the occlusal area was found between the two measurement methods (P < .030), whereas no significant differences were found in the marginal gap (P > .350), deep chamfer (P > .719), and axial wall (P > .150). As the 3DSA method is three-dimensional, it allows for the measurement of arbitrary points. CONCLUSION: All of the three fabrication methods are valid for measuring clinical objectives because they produced prostheses within the clinically acceptable range. Furthermore, a three-dimensional superimposition analysis verification method such as the silicone replica technique is also applicable in clinical settings.
Crowns ; Dental Prosthesis* ; Lithium ; Methods ; Prostheses and Implants ; Replica Techniques* ; Silicon* ; Silicones*