Neurocritical patients who can self-report pain use the 0-10 numerical rating scale (NRS, verbal or visual form). However, critically ill patients whose nervous systems cannot express pain use the behavioral pain scale (BPS) and the critical care pain observation tool (CPOT) behavioral pain assessment tools. These tools reveal pain-related changes in movement, facial expression, posture, and physiological indicators such as heart rate, blood pressure, and respiratory rate. In pain control, it is first essential to reduce unnecessary painkillers through non-drug therapy and maximize the effect of the administered analgesics. For nonneuropathic pain, narcotic analgesics such as fentanyl, hydromorphone, morphine, and remifentanil are administered intravenously. Gabapentin, pregabalin, and carbamazepine are recommended along with narcotic analgesics for neuropathic pain control. In addition, nonnarcotic analgesics for multi-modal analgesia are used to reduce the use of narcotic analgesics or the side effects of narcotic analgesics. In the intensive care unit (ICU), the sedation-agitation scale (SAS) and the Richmond agitation-sedation scale (RASS) are used to determine the depth of sedation to be maintained during shallow or deep sedation, considering the condition of the critically ill patient. When selecting sedatives for critically ill patients, preferentially consider nonbenzodiazepines such as propofol or dexmedetomidine rather than benzodiazepines such as midazolam or lorazepam. In addition, patients use painkillers or sedatives for over a week, and neurological changes or physiological dependence may occur. Therefore, clinicians should evaluate the critically ill patient’s condition, and sedatives and painkillers should be reduced or discontinued.

After tooth extraction, alveolar bone is resorbed over time. Loss of alveolar bone and reduction of upper soft tissue poses difficulties in future implant placement and long-term survival of the implant. This case report focuses on increasing the soft and hard tissues at the implant placement site by using alveolar ridge augmentation and a xenogeneic collagen matrix as a soft tissue substitute in an extraction socket affected by periodontal disease. In each case, the width of the alveolar bone increased to 6 mm, 8 mm, and 4 mm, and regeneration of the interdental papilla around the implant was shown, as well as buccal keratinized gingiva of 4 mm, 6 mm, and 4 mm, respectively. Enlarged alveolar bone facilitates implant surgery, and interdental papillae and keratinized gingiva enable aes-thetic prosthesis. This study performed alveolar ridge augmentation on patients with extraction sockets affected by periodontal dis-ease and additionally used soft tissue substitutes to provide a better environment for implant placement and have positive effects for aesthetic and predictive implant surgery.

Cerebral venous thrombosis (CVT) is a rare form of cerebrovascular attack and its predisposing factors commonly co-exist. In the coronavirus disease 2019 (COVID-19) era, various side effects of COVID-19 vaccine have been reported, and CVT is one of the well-known types. It is usually explained as prothrombotic immune thrombocytopenia by an antibody binding to platelet factor 4 receptor. However, some cases are irrelevant to thrombocytopenia and calls for a new explanation. Here we report a case of CVT without thrombocytopenia after COVID-19 vaccination.

Background and Objectives: Natural and synthetic speech signals effectively stimulate cortical auditory evoked potential (CAEP). This study aimed to select the speech materials for CAEP and identify CAEP waveforms according to gender of speaker (GS) and gender of listener (GL). Subjects and Methods: Two experiments including a comparison of natural and synthetic stimuli and CAEP measurement were performed of 21 young announcers and 40 young adults. Plosive /g/ and /b/ and aspirated plosive /k/ and /p/ were combined to /a/. Six bisyllables–/ga/-/ka/, /ga/-/ba/, /ga/-/pa/, /ka/-/ba/, /ka/-/pa/, and /ba/-/pa/–were formulated as tentative forwarding and backwarding orders. In the natural and synthetic stimulation mode (SM) according to GS, /ka/ and /pa/ were selected through the first experiment used for CAEP measurement. Results: The correction rate differences were largest (74%) at /ka/-/ pa/ and /pa/-/ka/; thus, they were selected as stimulation materals for CAEP measurement. The SM showed shorter latency with P2 and N1-P2 with natural stimulation and N2 with synthetic stimulation. The P2 amplitude was larger with natural stimulation. The SD showed significantly larger amplitude for P2 and N1-P2 with /pa/. The GS showed shorter latency for P2, N2, and N1-P2 and larger amplitude for N2 with female speakers. The GL showed shorter latency for N2 and N1-P2 and larger amplitude for N2 with female listeners. Conclusions Although several variables showed significance for N2, P2, and N1-P2, P1 and N1 did not show any significance for any variables. N2 and P2 of CAEP seemed affected by endogenous factors.

Background and Objectives: This study aimed to investigate the occupational performance of Korean workers with and without hearing loss and analyze the hearing-related difficulties in the working environment. Subjects and Methods: The Amsterdam checklist for hearing and work was used for the analyses and the occupational environments of the Korean workers were investigated. Out of 129 total participants, 86 workers experienced severe to profound hearing loss and 43 had the normal hearing ability. The hearing-impaired workers were recruited from two leading vocational centers and normal-hearing workers were their colleagues. Results: The hearing-impaired workers were found to take fewer sick leaves and exhibited higher rates of permanent job statuses compared to the normal-hearing workers. Workers with hearing loss rarely detected background sound; however, they could perceive reverberation more frequently. They felt more satisfied with their careers than the normal hearing workers as they received social support and needed to put their effort into hearing for most hearing activities. Furthermore, the effort in hearing increased with the increase in job demand, job control, social support, and career satisfaction. The working hours per week increased with the increase in age, education level, job demand, job control, and social support. Different trends were observed in 9 out of 12 variables while comparing the data from the present study with that obtained from the hearing-impaired workers of the Netherlands, indicating a large difference between countries. Conclusions Although the hearing-impaired Korean workers operate diligently with good job positions, it is necessary to enhance their acoustic environment and provide them social support. Considering the cultural background of the hearing-impaired workers, the development of suitable vocational rehabilitation programs and specific questionnaires is strongly recommended worldwide.

Nitrous oxide (N2O), an anesthetic gas, has been abused by some people for entertainment purposes. Recently, N2O (under the name of "Happy Balloon") abuse has become problematic among young people in Korea. N2O intoxication can develop a neuropathy, as well as other systemic disorders, either by inactivating vitamin B12 or by a direct neurotoxic mechanism. Here, we report a case of peripheral neuropathy with possible coexisting myelopathy following N2O abuse.

An endolichenic fungus Xylaria grammica EL000614 produces grammicin, a potent nematicidal pyrone derivative that can serve as a new control option for root-knot nematodes. We optimized an Agrobacterium tumefaciens-mediated transformation (ATMT) protocol for X.grammica to support genetic studies. Transformants were successfully generated after co-cultivation of homogenized young mycelia of X.grammica with A. tumefaciens strain AGL-1 carrying a binary vector that contains the bacterial hygromycin B phosphotransferase (hph) gene and the eGFP gene in T-DNA. The resulting transformants were mitotically stable, and PCR analysis showed the integratin of both genes in the genome of transformants.Expression of eGFP was confirmed via fluorescence microscopy. Southern analysis showed that 131 (78.9%) out of 166 transformants contained a single T-DNA insertion. Crucial factors for producing predominantly single T-DNA transformants include 48 h of co-cultivation, pretreatment of A. tumefaciens cells with acetosyringone before co-cultivation, and using freshly prepared mycelia. The established ATMT protocol offers an efficient tool for random insertional mutagenesis and gene transfer in studying the biology and ecology ofX.grammica.

Far-infrared rays (FIR) are known to have various effects on atoms and molecular structures within cells owing to their radiation and vibration frequencies. The present study examined the effects of FIR on gene expression related to glucose transport through microarray analysis in rat skeletal muscle cells, as well as on mitochondrial biogenesis, at high and low glucose conditions. FIR were emitted from a bio-active material coated fabric (BMCF). L6 cells were treated with 30% BMCF for 24 h in medium containing 25 or 5.5 mM glucose, and changes in the expression of glucose transporter genes were determined. The expression of GLUT3 (Slc2a3) increased 2.0-fold (p < 0.05) under 5.5 mM glucose and 30% BMCF. In addition, mitochondrial oxygen consumption and membrane potential (ΔΨm) increased 1.5- and 3.4-fold (p < 0.05 and p < 0.001), respectively, but no significant change in expression of Pgc-1a, a regulator of mitochondrial biogenesis, was observed in 24 h. To analyze the relationship between GLUT3 expression and mitochondrial biogenesis under FIR, GLUT3 was down-modulated by siRNA for 72 h. As a result, the ΔΨm of the GLUT3 siRNA-treated cells increased 3.0-fold (p < 0.001), whereas that of the control group increased 4.6-fold (p < 0.001). Moreover, Pgc-1a expression increased upon 30% BMCF treatment for 72 h; an effect that was more pronounced in the presence of GLUT3. These results suggest that FIR may hold therapeutic potential for improving glucose metabolism and mitochondrial function in metabolic diseases associated with insufficient glucose supply, such as type 2 diabetes.