OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.
Abdominal Pain ; Child ; Diabetic Nephropathies ; Endoscopy ; Gastrectomy ; Humans ; Hyphae ; Infant ; Kidney Failure, Chronic ; Kidney Transplantation ; Kidney* ; Middle Aged ; Mucor ; Mucormycosis* ; Mucous Membrane ; Stomach ; Tissue Donors ; Transplant Recipients* ; Transplants

PURPOSE: Patients in the intensive care unit (ICU) are more susceptible to nosocomial infections, including central line-associated bloodstream infection (CLABSI), surgical site infection, urinary tract infection or ventilator-associated pneumonia. This study is a comparative analysis of how central venous catheter (CVC) management staff affects CLABSI. METHODS: We performed a two-phase review of all patients transferred to the surgical ICU (SICU) from January 2013 to June 2014. CVC management staff was introduced in October 2013. Electronic medical records provided the data for a comparative analysis of incidence rates and risks of CLABSI, as well as the subjects' general characteristics. RESULTS: This study included 248 patients before the introduction of a CVC management staff member and 196 patients after the introduction. General patient characteristics before and after the CVC management staff was in place did not differ significantly. The CLABSI rate decreased by 4.61 cases/1,000 device days after the introduction (6.26 vs. 1.65; odds ratio, 4.47; 95% confidence interval, 1.39~14.37; p=0.009). However, the mortality rate and length of ICU stay did not change after CVC management staff was in place (12.9% vs. 10.7%, p=0.480; 16.00±24.89 vs. 15.87±18.80, p=0.954; respectively). CONCLUSION: In this study, the introduction of CVC management staff effectively reduced CLABSI rates in current ICU system.
Central Venous Catheters* ; Critical Care* ; Cross Infection ; Electronic Health Records ; Humans ; Incidence ; Intensive Care Units ; Mortality ; Odds Ratio ; Pneumonia, Ventilator-Associated ; Surgical Wound Infection ; Urinary Tract Infections

PURPOSE: This study evaluated fracture resistance with regard to ferrule lengths and post reinforcement on endodontically treated mandibular premolars incorporating a prefabricated post and resin core. MATERIALS AND METHODS: One hundred extracted mandibular premolars were randomly divided into 5 groups (n=20): intact teeth (NR); endodontically treated teeth (ETT) without post (NP); ETT restored with a prefabricated post with ferrule lengths of either 0 mm (F0), 1 mm (F1), or 2 mm (F2). Prepared teeth were restored with metal crowns. A thermal cycling test was performed for 1,000 cycles. Loading was applied at an angle of 135 degrees to the axis of the tooth using a universal testing machine with a crosshead speed of 2.54 mm/min. Fracture loads were analyzed by one-way ANOVA and Tukey HSD test using a statistical program (α=.05). RESULTS: There were statistical differences in fracture loads among groups (P<.001). The fracture load of F2 (237.7 ± 83.4) was significantly higher than those of NP (155.6 ± 74.3 N), F0 (98.8 ± 43.3 N), and F1 (152.8 ± 78.5 N) (P=.011, P<.001, and P=.008, respectively). CONCLUSION: Fracture resistance of ETT depends on the length of the ferrule, as shown by the significantly increased fracture resistance in the 2 mm ferrule group (F2) compared to the groups with shorter ferrule lengths (F0, F1) and without post (NP).
Bicuspid* ; Crowns ; Tooth

The spectrum of physically challenged patients who visit to a dental clinic for treatments are diverse: from ones of mild disabilities, who lead their lives in a similar way of ordinary people, to others who suffer from diseases that are difficult to be diagnosed, and need medical expertise due to systemic care or special techniques and instruments because of behavior management and difficulty of treatments. The patient in this case was 25-year-old autistic male patient who visited the clinic on account of overall treatment for multiple carious lesions. He could perform normal daily life to some degree under the care of a guardian. This case report describes predicaments of making a treatment plan resulted from lack of information about disabled patients, and difficulties of proceeding treatment procedures under general anesthesia. It is considered that sufficient consultation and history taking are needed before treatment for disabled patients.
Anesthesia, General ; Dental Clinics ; Disabled Persons ; Humans ; Male ; Mouth ; Mouth Rehabilitation

BACKGROUND: We have investigated the possibility of rocuronium 0.6 mg/kg and timing principle application with the same dose for rapid sequence induction (RSI) in 65 children, aged 4-8 yr. METHODS: Sixty five patients were randomly assigned to one of two groups; Group A (n = 31, timing principle application) received rocuronium (0.6 mg/kg) followed by administration of propofol (2.5 mg/kg), and group B (n = 36) received rocuronium (0.6 mg/kg) after administration of propofol. Intubation was assessed at 60 seconds just after administration of last injectants. Intubating conditions (jaw relaxation, vocal cord movement, and response to tracheal intubation) were evaluated as excellent, good, fair and poor. RESULTS: Excellent intubation conditions were obtained in 87% in group A and 61% in group B. However, clinically acceptable intubation conditions which means excellent and good did not show any significant difference as 100% (group A) and 99% (group B). CONCLUSIONS: In cases of pediatiric patients undergoing elective surgery, RSI was possible irrespective of the use of timing principle.
Aged ; Androstanols ; Child ; Humans ; Intubation ; Propofol ; Relaxation ; Vocal Cords

BACKGROUND: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this would demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis. METHODS: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe (DT(pre), DT(post), degrees C), and the DTnet were calculated as follows. DT(net) = DT(post) - DT(pre). RESULTS: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the DT(post) (6.1 +/- 1.2degrees C, P = 0.021), and the DTnet (6.0 +/- 1.0degrees C, p = 0.023), as compared to group C. CONCLUSIONS: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD, compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C.
Ganglia, Sympathetic ; Humans ; Skin ; Skin Temperature ; Spinal Stenosis ; Stress, Psychological ; Sympatholytics ; Toes ; Walking

BACKGROUND: Ischemic postconditioning (Post-C), brief cycles of myocardial ischemia and reperfusion during the early phase of reperfusion, is considered as a novel adjunct strategy to protect myocardium.However, the exact mechanism remains unclear and should be determined. METHODS: The hearts of male Wistar rats were subjected to 30 min ischemia and 2 hrs reperfusion.Control rats had no intervention either before or after left coronary artery occlusion.Post-C was elicited by 6 cycles of 10s reperfusioninterspersed by 10s ischemia immediately after onset of reperfusion.Subsets of postconditioning rats were treated with drugs as followings; naloxone (non-selective opioid receptor antagonist), naltrindole (a delta-opioid receptor antagonist), SB216763 (a glycogen synthase kinase 3beta inhibitor, GSK-3beta inhibitor), or atractyloside (a mitochondrial permeability transition pore opener, mPTP opener). RESULTS: Post-C significantly reduced infarct size (15.9 +/- 2.4%, P = 0.003) compared to control (29.9 +/- 3.7%).The anti-infarct effect by Post-C was blocked by both naloxone (25.5 +/- 3.9%, P = 0.044) and naltrindole (26.9 +/- 2.3%, P = 0.022).Infarct size limiting effect by Post-C was also abolished by atractyloside (30.6 +/- 3.6%, P = 0.003).In SB216763 with naloxone treated animals, the infarct size was decreased (17.4 +/- 3.2%, P = 0.007) but not in SB216763 with atractyloside treated animals (27.4 +/- 2.6%) compared to control. CONCLUSIONS: These data suggest that Post-C may protect myocardium by inhibiting mPTP opening via delta-opioid receptor activation.GSK-3beta is a downstream mediator of opioid receptors and an upstream mediator of mPTP opening in Post-C.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Atractyloside ; Coronary Vessels ; Glycogen Synthase Kinase 3 ; Glycogen Synthase Kinases ; Heart ; Humans ; Indoles ; Ischemia ; Ischemic Postconditioning ; Male ; Maleimides ; Mitochondria ; Mitochondrial Membrane Transport Proteins ; Myocardial Ischemia ; Myocardium ; Naloxone ; Naltrexone ; Permeability ; Rats ; Rats, Wistar ; Receptors, Opioid ; Reperfusion

BACKGROUND: This study was undertaken to assaythe effectiveness of transforaminal epidural steroid injections (TFESIs) for sciatica and to identify potential predictors related to treatment outcome. METHODS: TFESIs were performed in 150 patients between August 2006 and March 2007. Seventy-five patients (35 women, 40 men; mean age, 59.1 years), who met the inclusion criteria, were studied. Therapeutic effects were evaluated twoweeks after injection. The following potential outcome predictors analyzed were as follows: one level vs. two level injection, Beck depression inventory score (<13, 14-19, >20), Beck anxiety inventory score (<7, 8-15, >16), cause of radiculopathy (spinal stenosis vs. herniated disk), gender, duration of radiculopathy (<6 months, 6-12 months, >6 months), and Oswestry disability index score (<30, 31-60, >60). The relationships between possible outcome predictors and therapeutic effects were evaluated. RESULTS: Forty-nine of the 75 patients (65.3%) had a satisfactory result two weeks after TFESIs. Of these, twenty-four of the 46 patients (52.2%) were treated by a one level injection and 25 (89.3%) of the 29 patients were treated by a two level injection. This outcome was statistically significant (P < 0.01). None of the other potential outcome predictors showed any statistical difference. CONCLUSIONS: TFESI is recommended as an effective method of managing radiculopathy. Two-level injectionsmay result in a better outcome than a one-level injection.
Anxiety ; Constriction, Pathologic ; Depression ; Female ; Humans ; Radiculopathy ; Sciatica

BACKGROUND: Depression is a frequent comorbid disease of chronic pain patients. This study was conducted to evaluate the prevalence of depression and to correlate associated factors and depression in patients with lumbar spinal stenosis. METHODS: The data of this survey was collected from 97 patients that visited our pain clinic for the management of lumbar spinal stenosis. Depression was examined by a self-reported survey using the Korean version of the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) and the life satisfaction scale score were also obtained. Demographic and clinical characteristics (including spouse status, employment status, smoking status, the number of patients with multiple painful areas, the number of patients with combined disease, pain duration, visual analogue scale, Roland 5-point scale and walking distance) were obtained from an interview with the patient. The patients were divided into group N (BDI < or = 14, n = 43) and group D (BDI > 14, n = 54) according to the BDI scale. Of the 97 patients, 55.7% had a high BDI score. RESULTS: The patients in group N had a higher rate of employment (48.0%, P < 0.05) and had higher life satisfaction scale scores (9.4 +/- 2.5, P < 0.01) as compared to group D patients. The BDI score showed a close correlation with employment status and the life satisfaction scale. CONCLUSIONS: Many lumbar spinal stenosis patients had high BDI scores. Employment status and the life satisfaction scale were closely correlated with the BDI score.
Chronic Pain ; Depression* ; Employment ; Humans ; Pain Clinics ; Prevalence ; Smoke ; Smoking ; Spinal Stenosis* ; Spouses ; Walking