Decontamination ; Disinfection ; Manikins ; Protective Clothing ; Personal Protective Equipment ; Health Personnel

Humans ; Protective Clothing

Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
China ; Clothing ; Commerce ; Coronavirus ; Fever ; Hospitalization ; Humans ; Korea ; Male ; Pneumonia ; Thorax ; Viral Load

PURPOSE: Wet wrap therapy is a well-known treatment for severe atopic dermatitis (AD). However, wet wrap therapy with usual bandage was a troublesome and time-consuming process of application. The aim of this study was to evaluate the efficacy, safety and convenience of wet wrap therapy with new garments in children with moderate-to-severe AD. METHODS: We compared 56 AD children treated with wet wrap therapy and 14 AD children treated with only conventional therapy. We retrospectively reviewed the clinical features, change of SCORing Atopic Dermatitis (SCORAD) index, adverse effects and parent's reports. RESULTS: The initial mean SCORAD index was 60.3±15.3 points. No significant differences in sex, age, initial SCORAD index, total eosinophil count, total IgE level, food allergen sensitization, inhalant allergen sensitization or associated allergic diseases were found between the wet wrap and conventional groups. The pharmacological and nonpharmacological interventions except wet wrap therapy were same in the 2 groups. Wet wrap therapy with garments or tubular bandage was easily done one time per day overnight in 10.6±3.5 days by parents. Improvement in total SCORAD index, intensity, subjective symptoms and pruritus were significantly higher in the wet wrap group than in the conventional group (36.2 vs. 26.9, 6.0 vs. 4.0, 9.9 vs. 7.4, and 4.8 vs. 3.6 points). No folliculitis and serious adverse effects were reported. CONCLUSION: Wet wrap therapy with new garments could be easily done by parents. Wet wrap therapy may be effective and safe in controlling moderate-to-severe AD in children.
Bandages ; Child* ; Clothing ; Dermatitis, Atopic* ; Eosinophils ; Folliculitis ; Humans ; Immunoglobulin E ; Parents ; Pruritus ; Retrospective Studies

Secretory carcinoma of the salivary gland (SC) is a newly introduced rare salivary gland tumor that shares histological, immunohistochemical, and genetic characteristics with secretory carcinoma of the breast. Here, we report the cytologic features of two cases of SC confirmed by surgical resection. In these two cases, SC was incidentally detected in a 64-year-old female and a 56-yearold male. Fine needle aspiration cytology revealed nests of tumor cells with a papillary or glandular structure floating in mucinous secretions. The tumor cells demonstrated uniform, round, smooth nuclear contours and distinct nucleoli. Multiple characteristic cytoplasmic vacuoles were revealed. Singly scattered tumor cells frequently showed variable sized cytoplasmic vacuoles. The cytopathologic diagnosis of SC should be considered when characteristic cytological findings are revealed. Further immunohistochemistry and gene analyses are helpful to diagnose SC.
Biopsy, Fine-Needle ; Breast ; Clothing ; Cytoplasm ; Diagnosis ; Female ; Humans ; Immunohistochemistry ; Male ; Mammary Analogue Secretory Carcinoma ; Middle Aged ; Mucins ; Salivary Glands ; Vacuoles

PURPOSE: Complete removal of air bubbles from balloons for neurovascular angioplasty is cumbersome. We compared the preparation difficulty, air removal efficiency, and air collection pattern of six different balloon catheter preparation methods to propose a better preparation method for both initial and second balloon uses, especially for small-profile angioplasty balloon catheters. MATERIALS AND METHODS: A total of 18 neurovascular angioplasty balloon catheters with nominal diameters of 2 mm were prepared to test six different preparation methods: the instruction for use method (method A), simplified method using a syringe (method B) and four newly devised preparation methods using inflating devices (methods C–F). Serial radiographs were obtained while the balloons were gradually inflated. We measured the time for each preparation and the bubble number, analyzed their distribution in the balloon, and calculated the contrast filling ratio (contrast filling area/total balloon area) for initial and second ballooning. The whole process was repeated three times. RESULTS: The preparation time varied widely (11.5 seconds [method D] to 73.3 seconds [method A]). On initial inflation, the contrast filling ratio at 8 atm was the highest (100%) with methods A and F. On second inflation, the ratio was again highest with method A (99.5%), followed by method F (99.2%). Initial ballooning tended to show a uniform pattern of single bubble in the distal segment of the balloon; in contrast, second ballooning showed varying patterns in which the bubbles were multiple and randomly distributed. CONCLUSION: None of the six methods were able to completely exclude air bubbles from the balloon catheters including the second ballooning; however, the method of repeating aspiration with high-volume inflating device (method F) could be a practical option considering the simplicity and efficiency of preparation.
Angioplasty ; Angioplasty, Balloon ; Catheters ; Clothing ; Embolism, Air ; Equipment Failure ; Inflation, Economic ; Intracranial Arteriosclerosis ; Methods ; Syringes

PURPOSE: This study was to evaluate the wear resistance of 3D printed, milled, and conventionally cured provisional resin materials. MATERIALS AND METHODS: Four types of resin materials made with different methods were examined: Stereolithography apparatus (SLA) 3D printed resin (S3P), digital light processing (DLP) 3D printed resin (D3P), milled resin (MIL), conventionally self-cured resin (CON). In the 3D printed resin specimens, the build orientation and layer thickness were set to 0° and 100 µm, respectively. The specimens were tested in a 2-axis chewing simulator with the steatite as the antagonist under thermocycling condition (5 kg, 30,000 cycles, 0.8 Hz, 5℃/55℃). Wear losses of the specimens were calculated using CAD software and scanning electron microscope (SEM) was used to investigate wear surface of the specimens. Statistical significance was determined using One-way ANOVA and Dunnett T3 analysis (α = .05). RESULTS: Wear losses of the S3P, D3P, and MIL groups significantly smaller than those of the CON group (P < .05). There was no significant difference among S3P, D3P, and MIL group (P > .05). In the SEM observations, in the S3P and D3P groups, vertical cracks were observed in the sliding direction of the antagonist. In the MIL group, there was an overall uniform wear surface, whereas in the CON group, a distinct wear track and numerous bubbles were observed. CONCLUSION: Within the limits of this study, provisional resin materials made with 3D printing show adequate wear resistance for applications in dentistry.
Clothing ; Dentistry ; In Vitro Techniques ; Mastication ; Methods ; Printing, Three-Dimensional

BACKGROUND: Management of atopic dermatitis (AD) involves the regular use of emollients together with topical steroids or calcineurin inhibitors for acute flares. However, the long-term use of oral medications in young children may have certain limitations. Wet wrap dressing (WWD) is an interesting alternative therapy for the short-term control of severe or refractory flares, thus avoiding the use of systemic treatments. OBJECTIVE: This study aimed to compare the efficacy between WWD and topical steroid agents and to control and estimate the utility of WWD in pediatric AD. METHODS: A total of 40 patients with mild-to-severe AD (eczema area and severity index of ≥3) aged <13 years were included in this study. Twenty patients were treated with WWD using two layers of cotton bandages or garments (Tubifast™), and the remaining were applied with topical steroid agents without cotton bandages. Improvement in severity of atopic dermatitis was evaluated using the eczema area and severity index (EASI). Improvement in skin barrier dysfunction was evaluated by measuring the transepidermal water loss (TEWL). We compared the two groups after 1 week of treatment using analysis of covariance and t-test. Furthermore, we surveyed the study groups using a questionnaire to estimate the utility of WWD and its adverse effects as well as to evaluate subjective outcomes of WWD. RESULTS: There were significant reductions in the mean EASI (−6.3, 95% confidence interval [CI]: −7.5 to −5.1, p=0.013) and TEWL (−26.7, 95% CI: −31.2 to −22.3, p=0.002) after 1 week of WWD treatment compared with the mean EASI (−4.0, 95% CI: −5.2 to −2.9) and TEWL (−15.4, 95% CI: −19.8 to −10.9) of the control group. Results of patient self-assessment and scores in the visual analogue scale (VAS) for pruritus were improved in both groups, but the differences were not statistically significant. Usefulness of WWD as an alternative therapy for the conventional therapy was satisfactory. CONCLUSION: This study is meaningful in that it estimates both the subjective and objective efficacy of WWD. In view of these findings, WWD showed superior therapeutic effects than conventional steroid application in the treatment of AD in children, with good compliance of patients and parent-caregivers.
Bandages ; Calcineurin Inhibitors ; Child ; Clothing ; Compliance ; Dermatitis, Atopic ; Eczema ; Emollients ; Humans ; Pruritus ; Self-Assessment ; Skin ; Steroids ; Therapeutic Uses ; Water

This study examines how Choe Han-gi (崔漢綺, 1803–1879) developed his medical discourse which integrated the concepts of traditional Chinese medicine with modern Western anatomy, based on the philosophy of Seo Gyeong-deok (徐敬德, 1489–1546), a scholar of the Neo-Confucianism of Joseon (1392–1910). Seo emphasized gi (氣, C. qi, vital, material force) rather than yi (理, C. li, the principle of things) as a way of understanding the world. Since Choe's early academic interests pertained to Neo-Confucianism, it is reasonable to examine his philosophy in this context. Similar to Seo, Choe assumed that the most essential component of the world was the intrinsic and mysterious gi. Although Seo spoke of gi as a damil cheongheo ji gi (湛一淸虛之氣, the gi which is profound, uniform, clear, invisible, and empty), Choe preferred to use the word singi (神氣, C. shenqi, the intrinsic, invisible, and mysterious gi). He believed that the earth, moon, and stars operated through the action of singi and that all creatures could only exist by relying on it. Singi was the most important premise in Choe's medical discourse, a fact demonstrating that although he could be very critical of traditional Chinese medicine, his perspective was part of that tradition. He believed that singi integrated and operated the entire human body and that it perceived external objects. He also emphasized the role of hyeongjil (形質, C. xingzhi, a visible object with a form and quality; here it means all human bodies). This was the medium through which singi could appear in reality. Choe thought that singi could not reveal itself in reality without hyeongjil, and that hyeongjil became a dead thing without singi. His perception of the role of hyeongjil was expressed in his interest in modern Western anatomy, an interest that complemented his focus on singi. In light of his understanding of the singi-hyeongjil relationship, Choe criticized both modern Western anatomy and traditional Chinese medicine. He thought that modern Western anatomy lacked awareness of singi and that traditional Chinese medicine lacked accurate knowledge of human anatomy. Although he was not completely sympathetic toward any forms of medicine, he was open to ideas from both Western and Chinese medicine. Choe could not accept Western anatomy as fully as Japanese intellectuals did. The study of anatomy in Japan had developed in relation to the idea of Ancient Learning (古學, C. guxue), which denied such theories of systematic correspondence as Yin and Yang and the Five Elements (陰陽 五行, C. yinyang wuxing) and tended to focus on the action of hyeongjil itself. Because Choe accepted modern Western anatomy without accepting Ancient Learning, his perspective was unique in the history of East Asian anatomy. From a medical history perspective, how does Choi Han-gi's medical discourse distinguish itself from other medical discourses, and what are its characteristics? In addition to other explanations, focusing on the political imagination associated with medicine can help illuminate the differences between the medical discourse of Choe and those of others. Discussion of medicine and the human body was tied to political thought, manifesting the political imagination of the society in which that discussion took place. The development of Western and Japanese anatomy reflected a vertical and hierarchical political order, exemplified by the belief that the brain was the center of the body. However, Choe doubted that organs like the brain or heart dominated the body. In his view, the singi ruled the body; it was not a specific organ, and it was equally inherent in all people. His political thought also emphasized the horizontal and equal order among people. His view of singi simultaneously influenced both his perspective on medicine and his perspective on society. Choe Han-gi's belief in this horizontal and equal political order was inherent in his singi-centered medical discourse.
Asian Continental Ancestry Group ; Brain ; Clothing ; Complement System Proteins ; Heart ; Human Body ; Humans ; Imagination ; Japan ; Learning ; Medicine, Chinese Traditional ; Moon ; Philosophy ; Qi

PURPOSE: To compare the efficacy and safety of Botox and Neuronox in the management of benign essential blepharospasm (BEB). METHODS: We performed a triple-masked, randomized control study to compare Botox and Neuronox in 48 eyes of 24 patients with BEB. All 24 patients randomly received Botox or Neuronox in the periorbital region in a masked, randomized split-face manner, keeping the injection sites and doses uniform. The toxin preparation, injection, and clinical evaluations were done by three independent observers. Objective outcome measures included improvement in the severity of spasm, grading of the functional visual status, changes in palpebral fissure height, lagophthalmos, superficial punctate keratitis and Schirmer's test at 2 weeks, 6 weeks, and upon conclusion of the effect of the toxin. Subjective outcome measures included duration of the effect and a forced choice stating which half of the face was better. Evaluations were performed through clinical measurements, external digital photography, and high-definition videography. RESULTS: The mean duration of relief from spasms was 3.78 months (standard deviation, 1.58 months; range, 1 to 6 months). The improvement in the objective parameters like severity of spasm and functional visual status was statistically significant at the 2-week and 6-week follow-up visits (p < 0.001). The changes in palpebral fissure height, lagophthalmos, and superficial punctate keratitis were equally observed in both groups. At 2 and 6 weeks, three of 24 (12.5%) and one of 24 (4%) patients, respectively, reported an unequal effect between the two sides of the face, but this difference was not statistically significant. At final follow-up (conclusion of the toxin effect), patients reported equal effect with no preference for either hemiface. No statistically significant differences were found in the comparative analysis between the Neuronox and Botox groups. CONCLUSIONS: Neuronox and Botox are comparable in terms of their safety and efficacy in the management of BEB.
Blepharospasm ; Botulinum Toxins ; Botulinum Toxins, Type A ; Clothing ; Follow-Up Studies ; Humans ; Keratitis ; Masks ; Outcome Assessment (Health Care) ; Photography ; Spasm