Background: This study aimed to determine the effect of ramen sauce on tooth tone changes over time, after selecting three different ramen colors from the ramens sold in the market, and applying the sauce to bovine teeth. Methods: Healthy bovine teeth were selected, and cutting discs were used to produce 60 specimens (5×5×3 mm), with 15 specimens distributed per county. Three types of ramen (buldak, chacharoni black bean sauce, and ottogi curry noodle) were used as the experimental group, and water was used as the negative control group. Tooth tone measurement was performed using a spectrophotometer (CM-700d) to measure the color before and after 1 (3 h 44 min), 2 (7 h 28 min), 3 (11 h 12 min), and 4 weeks (14 h 56 min). Analysis of the color tone change was performed using Statistical Package for the Social Sciences version 28. Results: In the experimental group, there was a significant color tone change before and after immersion. L* indicated the largest change in black bean sauce ramen, a* indicated buldak ramen, and b* indicated the largest change in curry ramen. The amount of color change (ΔE*) was the largest in curry ramen, followed by buldak and black bean sauce ramens. The results of the post-hoc analysis showed significant differences between all groups except buldak and black bean sauce ramens. Conclusion All three types of ramen revealed significant color change before and after immersion, and curry ramen showed the largest amount of color change among them.

Purpose: Gait evaluation in patients with dizziness is essential during both initial evaluation and vestibular rehabilitation. Inertial measurement unit (IMU)-based gait analysis systems are clinically applicable in patients with dizziness. Since dizzy patients can utilize visual inputs to compensate for vestibular deficits, it is more difficult for them to walk with their eyes closed (EC). In this study, we compared gait characteristics during forward walking with both eyes open (EO) and EC between healthy subjects and dizzy patients. Materials and Methods: Forty-nine healthy controls (mean age 37.18±10.71 years) and 23 patients with dizziness (mean age 49.25± 15.16 years) were subjected to vestibular and gait analyses. Medical histories, physical examinations, and vestibular function tests ruled out possible vestibular deficits in the controls. Subjects were instructed to walk at a comfortable pace for 10 m under two conditions (EO or EC). Spatiotemporal parameters, kinematics, and simulated kinetics of each gait recording were recorded using a shoe-type IMU system and analyzed. Results: Although gait speeds were slower, stride lengths were smaller, and double support times were increased under the EC, compared to the EO condition, in both healthy subjects and dizzy patients, the difference was more prominent in dizzy patients.Phase coordination index values did not differ significantly in either group. Gait asymmetry (GA) increased significantly under the EC condition, compared to the EO condition, in dizzy patients. Conclusion GA during forward walking was greater in dizzy patients under an EC condition than under an EO condition.

Background/Aims: Membranous nephropathy (MN) is a major cause of nephrotic syndrome in adults. This study aimed to evaluate the effect of rituximab (RTX) in patients with idiopathic MN (iMN) who have a high risk of progression. Methods: We retrospectively analyzed data of 13 patients with iMN, who received RTX treatments from January 2014 to July 2020. RTX was indicated in patients with iMN with severe proteinuria and decreasing estimated glomerular filtration rate (eGFR) in the previous 6 months despite other immunosuppressive therapies. Results: The patients were predominantly males (n = 11) and with a mean age of 55.3 years; median eGFR, 37.0 mL/min/1.73 m2 (interquartile range [IQR], 26.3 to 66.5); serum albumin level, 2.6 g/dL (IQR, 1.9 to 3.1); and spot urine protein-to-creatinine ratio at baseline, 6.6 g/g (IQR, 5.7 to 12.9). In a median follow-up of 22 months, eight patients (61.5%) achieved complete or partial remission. In responder group (n = 8), median eGFR increased from 31.5 to 61.5 mL/min/1.73 m2 (p = 0.049) and serum albumin level increased from 2.3 to 4.2 g/dL (p = 0.017) from RTX initiation to last follow-up. Antiphospholipase A2 receptor antibody (anti-PLA2R-Ab) was positive in six among seven tested patients, which markedly decreased in the responder group. There were no adverse events after RTX. Conclusions This study suggests that RTX is a safe and effective treatment option for patients with iMN who have a high risk of progression. Individualized therapy based on anti-PLA2R-Ab titer would be needed for better outcomes.

Background/Aims: Adequate bowel preparation is important for successful colonoscopy. We aimed to evaluate the clinical feasibility and effectiveness of abdominal vibration stimulation in bowel preparation before therapeutic colonoscopy. Methods: A single center, prospective, randomized, investigator-blinded study was performed between January 2016 and December 2016. Patients for therapeutic colonoscopy were prospectively enrolled and assigned to either the vibrator group or walking group. Patients who refused to participate in this study as part of the experimental group consented to register in the control group instead. During the preparation period, patients assigned to the walking group walked ≥3,000 steps, whereas those assigned to the vibrator group received abdominal vibrator stimulation and restricted walking. All patients received the same colon cleansing regimen: 4-L split-dose polyethylene glycol (PEG) solution. Results: Three hundred patients who received PEG solution for therapeutic colonoscopy were finally enrolled in this study (n=100 per group). Bowel cleansing with abdominal vibration stimulation showed almost similar results to that with walking exercise (Boston Bowel Preparation Scale score for the entire colon: vibrator vs walking vs control, 7.38±1.55 vs 7.39±1.55 vs 6.17±1.15, p<0.001). There were no significant differences between the vibrator group and walking group regarding instances of diarrhea after taking PEG, time to first diarrhea after taking PEG, total procedure time, and patient satisfaction. Conclusions This study indicates that, compared with conventional walking exercise, abdominal vibration stimulation achieved similar rates of bowel cleansing adequacy and colonoscopy success without compromising safety or patient satisfaction.

Serosurveillance studies reveal the actual disease burden and herd immunity level in the population. In Seoul, Korea, a cross-sectional investigation showed 0.07% anti-severe acute respiratory syndrome coronavirus-2 antibody seropositivity among 1,500 outpatients of the university hospitals. Low seroprevalence reflects well-implemented social distancing.Serosurveillance should be repeated as the pandemic progresses.

Background: Patients with coronavirus disease 2019 (COVID-19) can unknowingly spread the virus to several people during the early subclinical period. Methods: We evaluated the viral dynamics in various body fluid specimens, such as nasopharyngeal swab, oropharyngeal swab, saliva, sputum, and urine specimens, of two patients with COVID-19 from hospital day 1 to 9. Additional samples of the saliva were taken at 1 hour, 2 hours, and 4 hours after using a chlorhexidine mouthwash. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load was determined by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Results: SARS-CoV-2 was detected from all the five specimens of both patients by rRT-PCR. The viral load was the highest in the nasopharynx (patient 1 = 8.41 log10 copies/mL; patient 2 = 7.49 log10 copies/mL), but it was also remarkably high in the saliva (patient 1 = 6.63 log10 copies/mL; patient 2 = 7.10 log10 copies/mL). SARS-CoV-2 was detected up to hospital day 6 (illness day 9 for patient 2) from the saliva of both patients. The viral load in the saliva decreased transiently for 2 hours after using the chlorhexidine mouthwash. Conclusion SARS-CoV-2 viral load was consistently high in the saliva; it was relatively higher than that in the oropharynx during the early stage of COVID-19. Chlorhexidine mouthwash was effective in reducing the SARS-CoV-2 viral load in the saliva for a short-term period.

Among metastatic pancreatic tumors, malignant melanomas are rare. Here, we report a very rare case of a malignant melanoma that involved only the pancreas and liver, and was difficult to differentiate from a neuroendocrine tumor of the pancreas with a liver metastasis. A 65-year-old- male with no history of a malignant melanoma exhibited hypervascular hepatic and pancreatic tumors on computed tomography and contrast-enhanced endoscopic ultrasonography. He lacked lesions of the skin, eye, and gastrointestinal tract on physical examination, upper endoscopy, and a whole-body positron emission tomography-computed tomography scan; these sites are common primary sites of malignant melanoma. Finally, endoscopic ultrasound-guided pancreatic core biopsy and percutaneous ultrasonography-guided liver biopsy confirmed malignant melanoma of the pancreas and liver.
Biopsy ; Electrons ; Endoscopy ; Endosonography ; Gastrointestinal Tract ; Humans ; Liver ; Male ; Melanoma ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Pancreas ; Pancreatic Neoplasms ; Physical Examination ; Skin

Among metastatic pancreatic tumors, malignant melanomas are rare. Here, we report a very rare case of a malignant melanoma that involved only the pancreas and liver, and was difficult to differentiate from a neuroendocrine tumor of the pancreas with a liver metastasis. A 65-year-old- male with no history of a malignant melanoma exhibited hypervascular hepatic and pancreatic tumors on computed tomography and contrast-enhanced endoscopic ultrasonography. He lacked lesions of the skin, eye, and gastrointestinal tract on physical examination, upper endoscopy, and a whole-body positron emission tomography-computed tomography scan; these sites are common primary sites of malignant melanoma. Finally, endoscopic ultrasound-guided pancreatic core biopsy and percutaneous ultrasonography-guided liver biopsy confirmed malignant melanoma of the pancreas and liver.

OBJECTIVE: This study examined the characteristics of febrile young infants with a serious bacterial infection (SBI) who visited emergency centers in Korea and validated the Philadelphia criteria and modified Philadelphia criteria to predict the risk of SBI. METHODS: This was a retrospective study conducted on 450 infants aged 31 days to 56 days who visited three emergency centers with fever from September 2014 to August 2017. The characteristics of the SBI patients were analyzed, and the validation of the Philadelphia and modified Philadelphia criteria sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were checked. RESULTS: Of 450 patients, 165 patients (36.7%) had SBI, such as urinary tract infection (33.3%), bacteremia (4.0%), acute osteomyelitis (0.2%), and bacterial meningitis (BM) in two patients (0.4%). The most common pathogen of invasive bacterial infection was Escherichia coli. In the Philadelphia criteria, the sensitivity, specificity, PPV, NPV, and accuracy were 73.9%, 47.0%, 44.7%, 75.7%, and 56.9%, respectively. In the modified Philadelphia criteria that excluded lumbar puncture as a predictor, the sensitivity, specificity, PPV, NPV, and accuracy were 93.3%, 31.9%, 44.3%, 89.2%, and 54.4%, respectively. The most common failed low risk criteria was appearance (43.3%). Two patients with bacterial meningitis were excluded from low risk group by the modified Philadelphia criteria. Although one out of 2 patients met the failed low risk criteria due to their poor condition, this factor is not objective, so BM can be missed. CONCLUSION: Bacterial meningitis was too rare in this study. New criteria are needed to predict SBI. The Philadelphia and modified Philadelphia criteria were not useful for predicting SBI in this study. Other prediction models will be needed to predict SBI in the vaccination era.
Bacteremia ; Bacterial Infections ; Emergencies ; Emergency Service, Hospital ; Escherichia coli ; Fever ; Fibrinogen ; Humans ; Infant ; Korea ; Meningitis ; Meningitis, Bacterial ; Osteomyelitis ; Retrospective Studies ; Sensitivity and Specificity ; Spinal Puncture ; Urinary Tract Infections ; Vaccination

BACKGROUND: This study aimed to investigate the association between physical fitness and cardiometabolic health of Korean children and adolescents. METHODS: In total, 168 participants (89 boys and 79 girls) aged 10–16 years were recruited for the Intervention for Childhood and Adolescent Obesity via Activity and Nutrition Study in 2016. The subjects were categorized into two groups using the definition of metabolic syndrome by the International Diabetes Federation: metabolically unhealthy (with at least two of the five criteria) and healthy groups (with less than one criterion). Correlation analysis of the participants' general characteristics was performed. Odds ratios (ORs) of physical fitness for cardiometabolic risk were evaluated via logistic regression. RESULTS: Metabolically unhealthy children showed greater weight, height, and body mass index, higher Children's Depression Inventory score, and longer screen time than did the metabolically healthy children. Metabolically healthy children showed greater upper and lower extremity muscular strength than did the metabolically unhealthy children (P=0.04 and P<0.001, respectively). In the multiple logistic regression analysis, lower extremity muscle strength was inversely related to the clustered cardiometabolic risk of the children and adolescents with or without adjustment for confounders (OR, 4.32; 95% confidence interval [CI], 1.87–9.97; OR, 7.64; 95% CI, 1.55–37.74, respectively). CONCLUSION: Physical fitness, especially lower extremity muscle strength, is significantly inversely associated with individual and clustered cardiometabolic risks in Korean children and adolescents.
Adolescent ; Body Mass Index ; Child ; Depression ; Humans ; Korea ; Logistic Models ; Lower Extremity ; Muscle Strength ; Odds Ratio ; Pediatric Obesity ; Physical Fitness