OBJECTIVES: Since the report of the first confirmed case in Daegu on February 18, 2020, local transmission of coronavirus disease 2019 (COVID-19) in Korea has continued. In this study, we aimed to identify the pattern of local transmission of COVID-19 using mathematical modeling and predict the epidemic size and the timing of the end of the spread. METHODS: We modeled the COVID-19 outbreak in Korea by applying a mathematical model of transmission that factors in behavioral changes. We used the Korea Centers for Disease Control and Prevention data of daily confirmed cases in the country to estimate the nationwide and Daegu/Gyeongbuk area-specific transmission rates as well as behavioral change parameters using a least-squares method. RESULTS: The number of transmissions per infected patient was estimated to be about 10 times higher in the Daegu/Gyeongbuk area than the average of nationwide. Using these estimated parameters, our models predicts that about 13,800 cases will occur nationwide and 11,400 cases in the Daegu/Gyeongbuk area until mid-June. CONCLUSIONS We mathematically demonstrate that the relatively high per-capita rate of transmission and the low rate of changes in behavior have caused a large-scale transmission of COVID-19 in the Daegu/Gyeongbuk area in Korea. Since the outbreak is expected to continue until May, non-pharmaceutical interventions that can be sustained over the long term are required.

Purpose: The purpose of our study is to examine early radiographic findings and clinical signs of failure of the microstructure surface HA-coated acetabular cup. Material and methods: This study included 41 revisions of 204 THA with hydroxyapatite-coated acetabular cup from April 1992 to November 1996. Radiolucent line around cups, change in the cup angle and osteolysis were evaluated in serial radiographs. Acetabular cup was defined as loosening if any movement occurred at the bone and socket interface by manual rotation and extension force intraoperatively or migration of more than 2 mm and change of the cup angle by more than 5 degrees in radiographs. Results: The radiolucent line was observed in 12 of the 41 hips at an average of 55.4 months postoperatively and was most commonly located in zone III. All of the 12 hips showing radiolucent lines were classified as loosening by radiographically in 8 cases and intraoperatively in 4 cases. Radiographic loosening occurred at an average of 28.8 months after the appearance of a radiolucent line. Inguinal pain was noted in 18 of the 19 cases revised for acetabular cup loosening. Conclusion: The most important radiographic finding for the early diagnosis of loosening was progressive radiolucent lines, which occurred most frequently in zone 3.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Early Diagnosis ; Hip ; Osteolysis

OBJECTIVES: Since the report of the first confirmed case in Daegu on February 18, 2020, local transmission of coronavirus disease 2019 (COVID-19) in Korea has continued. In this study, we aimed to identify the pattern of local transmission of COVID-19 using mathematical modeling and predict the epidemic size and the timing of the end of the spread. METHODS: We modeled the COVID-19 outbreak in Korea by applying a mathematical model of transmission that factors in behavioral changes. We used the Korea Centers for Disease Control and Prevention data of daily confirmed cases in the country to estimate the nationwide and Daegu/Gyeongbuk area-specific transmission rates as well as behavioral change parameters using a least-squares method. RESULTS: The number of transmissions per infected patient was estimated to be about 10 times higher in the Daegu/Gyeongbuk area than the average of nationwide. Using these estimated parameters, our models predicts that about 13,800 cases will occur nationwide and 11,400 cases in the Daegu/Gyeongbuk area until mid-June. CONCLUSIONS We mathematically demonstrate that the relatively high per-capita rate of transmission and the low rate of changes in behavior have caused a large-scale transmission of COVID-19 in the Daegu/Gyeongbuk area in Korea. Since the outbreak is expected to continue until May, non-pharmaceutical interventions that can be sustained over the long term are required.

Purpose: This study was undertaken to evaluate the health, nutritional status and metabolic syndrome risk according to the dietary pattern of adult single-person households, using information obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data were collected from the 2013–2016 KNHANES, of adults aged 19–64 years, belonging to single-person households. Based on cluster analysis, the dietary patterns of subjects were classified into three groups. The dietary behavior factors, health-related factors, nutritional status, and prevalence of metabolic syndrome obtained from KNHANES questionnaires were compared according to the individual dietary pattern. The nutrient intake data of the subjects were calculated using the semi-food frequency questionnaire.Moreover, blood and physical measurement data of the subjects were analyzed to obtain the prevalence of metabolic syndromes. Results: The major dietary intakes of subjects were classified as ‘Rice and kimchi’, ‘Mixed’, and ‘Milk·dairy products and fruits’ patterns. Characteristics of subjects based on their dietary pattern, gender, age, and education level were significantly different. The ‘Milk and fruits’ pattern showed low frequency of skipping breakfast and eating out, and had higher intake of dietary supplements. Frequency of alcohol intake and smoking rates were highest in the ‘Mixed’ pattern. Maximum nutrient intake of fat, vitamin A, riboflavin, vitamin C, niacin, calcium, phosphorus, and potassium was obtained in the ‘Milk·dairy products and fruits’ pattern. According to dietary patterns adjusted for age and gender, the risk of metabolic syndrome was 0.380 times lower in the ‘Milk·dairy products and fruit’ pattern than in the ‘Rice and kimchi’ pattern. However, when adjusted for other confounding factors, no significant difference was obtained between dietary patterns for metabolic syndrome risk. Conclusion These results indicate that the health and nutritional status of a single-person household is possibly affected by the dietary intake of subjects.

BACKGROUND AND PURPOSE: Negative findings on diffusion-weighted imaging (DWI) does not exclude the possibility of brainstem infarction, particularly in the acute stage of medullary lesion. Our aim was to investigate the false-negative rate of DWI in patients with acute lateral medullary infarction. METHODS: We applied DWI to 26 patients with a clinical diagnosis of lateral medullary infarction within 72 h of the onset. We assessed relationships between initial DWI findings and time-to-MRI (the time between onset of symptoms and initial DWI), number of clinical symptoms and signs, and final lesion volume. RESULTS: There were 8 cases (31%) of false negatives in the initial DWI results. The occurrence of false-negative DWI findings decreased significantly as the time-to-MRI increased (P=0.014). However, the false-negative rate was not significantly correlated with the number of clinical symptoms and signs or the final lesion volume. CONCLUSIONS: The diagnosis of lateral medullary infarction should not be ruled out on the basis of early negative DWI. To confirm the lesion, follow-up DWI or further MRI should be performed in cases with early negative DWI results
Brain Stem Infarctions ; Diagnosis ; Diffusion* ; Follow-Up Studies ; Humans ; Infarction* ; Magnetic Resonance Imaging

No abstract available.
Infarction*

PURPOSE: The axillary reverse mapping (ARM) technique to identify and preserve arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) was developed to prevent lymphedema. The purpose of this study was to investigate the location and metastatic rate of the arm node, and to evaluate the short term incidence of lymphedema after arm node preserving surgery. METHODS: From January 2009 to October 2010, 97 breast cancer patients who underwent ARM were included. Blue-dye (2.5 mL) was injected into the ipsilateral upper-inner arm. At least 20 minutes after injection, SLNB or ALND was performed and blue-stained arm nodes and/or lymphatics were identified. Patients were divided into two groups, an arm node preserved group (70 patients had ALND, 10 patients had SLNB) and an unpreserved group (13 patients had ALND, 4 patients had SLNB). The difference in arm circumference between preoperative and postoperative time points was checked in both groups. RESULTS: The mean number of identified blue stained arm nodes was 1.4+/-0.6. In the majority of patients (92%), arm nodes were located between the lower level of the axillary vein and just below the second intercostobrachial nerve. In the arm node unpreserved group, 2 patients had metastasis in their arm node. Among ALND patients, in the arm node preserved group, the difference in arm circumference between preoperative and postoperative time points in ipsilateral and contralateral arms was 0.27 cm and 0.07 cm, respectively, whereas it was 0.47 cm and -0.03 cm in the unpreserved group; one case of lymphedema was found after 6 months. No difference was found between arm node preserved and unpreserved group among SLNB patients. CONCLUSION: Arm node preserving was possible in all breast cancer patients with identifiable arm nodes, during ALND or SLNB, except for those with high surgical N stage, and lymphedema did not develop in patients with arm node preserving surgery.
Arm ; Axillary Vein ; Breast ; Breast Neoplasms ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema ; Neoplasm Metastasis ; Nitriles ; Pyrethrins ; Sentinel Lymph Node Biopsy

Pneumocystis carinii causes serious pulmonary infection in immunosuppressed patients. This study was undertaken to observe the cytoskeletal proteins of P. carinii by immuno-electron microscopy. P. carinii infection was experimentally induced by immunosuppression of Sprague-Dawley rats for seven weeks, and their lungs were used for the observations of this study. The gold particles localized actin, tropomyosin, and tubulin. The actin was irregularly scattered in the cytoplasm of the trophic forms but was much more concentrated in the inner space of the cell wall of the cystic forms called the inner electron-lucent layer. No significant amount of tropomyosin was observed in either trophic forms or cystic forms. The tubulin was distributed along the peripheral cytoplasm and filopodia of both the trophic and cystic forms rather than in the inner side of the cytoplasm. Particularly, in the cystic forms, the amount of tubulin was increased and located mainly in the inner electron-lucent layer of the cell wall where the actin was concentrated as well. The results of this study showed that the cell wall of P. carinii cystic forms is a structure whose inner side is rich in actin and tubulin. The location of the actin and tubulin in P. carinii suggests that the main role of these proteins is an involvement in the protection of cystic forms from the outside environment by maintaining rigidity of the cystic forms.
Actins/analysis ; Animals ; Cytoskeletal Proteins/*analysis ; Fungal Proteins/*analysis ; Histocytochemistry ; Microscopy, Immunoelectron ; Pneumocystis/*chemistry/cytology ; Rats ; Rats, Wistar ; Support, Non-U.S. Gov't ; Tropomyosin/analysis ; Tubulin/analysis

The aim of the present study was to examine the effect of provinol, which is a mixture of polyphenolic compounds from red wine, on the secretion of catecholamines (CA) from isolated perfused rat adrenal medulla, and to elucidate its mechanism of action. Provinol (0.3~3 microgram/ml) perfused into an adrenal vein for 90 min dose- and time-dependently inhibited the CA secretory responses evoked by ACh (5.32 mM), high K+ (a direct membrane-depolarizer, 56 mM), DMPP (a selective neuronal nicotinic NN receptor agonist, 100 micrometer) and McN-A-343 (a selective muscarinic M1 receptor agonist, 100 micrometer). Provinol itself did not affect basal CA secretion. Also, in the presence of provinol (1 microgram/ml), the secretory responses of CA evoked by Bay-K-8644 (a voltage-dependent L-type dihydropyridine Ca2+ channel activator, 10 microgram), cyclopiazonic acid (a cytoplasmic Ca2+-ATPase inhibitor, 10 microgram) and veratridine (an activator of voltage-dependent Na+ channels, 10 microgram) were significantly reduced. Interestingly, in the simultaneous presence of provinol (1 microgram/ml) plus L-NAME (a selective inhibitor of NO synthase, 30 micrometer), the CA secretory responses evoked by ACh, high K+, DMPP, McN-A-343, Bay-K-8644 and cyclpiazonic acid recovered to the considerable extent of the corresponding control secretion in comparison with the inhibition of provinol-treatment alone. Under the same condition, the level of NO released from adrenal medulla after the treatment of provinol (3 microgram/ml) was greatly elevated in comparison to its basal release. Taken together, these data demonstrate that provinol inhibits the CA secretory responses evoked by stimulation of cholinergic (both muscarinic and nicotinic) receptors as well as by direct membrane-depolarization from the perfused rat adrenal medulla. This inhibitory effect of provinol seems to be exerted by inhibiting the influx of both calcium and sodium into the rat adrenal medullary cells along with the blockade of Ca2+ release from the cytoplasmic calcium store at least partly through the increased NO production due to the activation of nitric oxide synthase.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Medulla ; Animals ; Calcium ; Catecholamines ; Cytoplasm ; Dihydropyridines ; Dimethylphenylpiperazinium Iodide ; Indoles ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Rats ; Receptor, Muscarinic M1 ; Receptors, Cholinergic ; Sodium ; Veins ; Veratridine ; Wine

BACKGROUND/OBJECTIVES: The aim of this study was to analyze the factors related to sarcopenic obesity among the elderly in South Korea. SUBJECTS/METHODS: A total of 3,367 elderly (≥ 65 years) from the Korea National Health and Nutrition Examination Survey (2008–2011) were included in this analysis. The subjects were assessed to determine their sarcopenia and obesity status. Sarcopenia was assessed by determining their appendicular skeletal muscle mass (ASM). Obesity was defined by the waist circumference. An association of sarcopenic obesity and the related factors was analyzed using multiple logistic regression models. RESULTS: The risk of sarcopenic obesity of the subjects was decreased by active physical activity. After adjusting for age, smoking, and alcohol consumption, the risk of sarcopenic obesity in men of the highest level group (Q4) decreased by 45% (OR = 0.550, 95% CI = 0.334–0.905, P trend 0.018) compared to that in the reference group (Q1). Among the women, the risk of sarcopenic obesity in the Q3 and Q4 groups decreased by 29.0% (OR = 0.710, 95% CI = 0.512–0,984) and 56.7% (OR = 0.433, 95% CI = 0.281–0.668), respectively, compared to that in the Q1 group (P trend < 0.001). The mean daily energy intake was higher in the non-sarcopenia group than in the sarcopenia group. The risk of sarcopenic obesity in subjects not meeting the recommended intakes of energy, riboflavin, and vitamin C increased significantly by 25.4%, and 36.6%, and 32.6%, respectively, compared to that in the subjects meeting the recommended nutrient intake. CONCLUSION: Active physical activity as well as an adequate intake of energy and some vitamins might be negatively associated with the development of sarcopenia and sarcopenic obesity in the elderly.
Aged ; Alcohol Drinking ; Ascorbic Acid ; Energy Intake ; Female ; Humans ; Korea ; Logistic Models ; Male ; Motor Activity ; Muscle, Skeletal ; Nutrition Surveys ; Obesity ; Riboflavin ; Sarcopenia ; Smoke ; Smoking ; Vitamins ; Waist Circumference