Pheochromocytoma Presenting with Hypertensive Encephalopathy in a 12-Year-Old Boy

Although pheochromocytoma is rare in children, it could result in hypertensive emergency. We describe the case of a 12-year-old boy with pheochromocytoma. His clinical manifestations indicated hypertensive encephalopathy; however, there were no space-occupying lesion in the brain and definitive evidence of secondary cause of hypertension. Knowing that he had extremely high blood pressure, headache, palpitation, and perspiration rendered sympathetic crisis a presumptive diagnosis. Subsequently, pheochromocytoma was diagnosed by computed tomography and catecholamine assay. After stabilizing the blood pressure with antihypertensive medications, such as phenoxybenzamine, laparoscopic adrenalectomy was performed, and he was discharged without residual discomfort. We would like to highlight expeditious diagnosis and proper management of pheochromocytoma with hypertensive encephalopathy

The Distribution Strategy Of A Representative Fair Trade Organization In Korea: The Case Of Beautiful Coffee

This case study analyzes the distribution strategy of Beautiful Coffee, a leading fair trade organization in Korea. Because of their focus on matters of public interest, fair trade organizations often face financial difficulties, and such difficulties can limit their growth and force them to pursue differentiated distribution strategies. The results indicate that Beautiful Coffee can serve as a good role model for fair trade organizations and have important practical implications for firms pursuing sustainable growth as a social enterprise

Risk factors for acute bronchiolitis-related return visits to the emergency department

Purpose Acute bronchiolitis (AB)-related return visits incur overuse of emergency medicine resources, crowding of emergency departments (EDs), and deterioration of rapport with the guardians. The authors aimed to analyze factors associated with the return visits to the ED. Methods This study was conducted based on the medical records of 447 children aged 24 months or younger with AB who visited the ED from January 2019 through December 2020. A return visit was defined as an AB-related visit to the ED within 7 days of index visit. According to the return visit, we compared the clinical features. Multivariable logistic regression was conducted to identify independent factors for the return visit. Results Of the 323 children with AB, 77 (23.8%) made return visits. The returning children showed a younger median age (6 [interquartile range, 2-10] vs. 8 months [3-14]; P < 0.001), a lower mean oxyhemoglobin saturation (92.9 ± 4.3% vs. 97.1 ± 1.8%; P < 0.001), and higher frequencies of congenital heart diseases (22.1% vs. 10.6%; P = 0.009) and bronchopulmonary dysplasia (11.7% vs. 5.7%; P = 0.013), and respiratory syncytial virus infection (57.1% vs. 37.0%; P = 0.002). No other variables, such as the hospitalization rate, differed as per return visits. The factors associated with return visits were respiratory syncytial virus infection (adjusted odds ratio, 9.41; 95% confidence interval, 2.13-41.57), lower oxygen saturation (2.00; 1.64-2.43), and age younger than 3 months (1.25; 1.07-1.24). Conclusion AB-related return visits may be associated with age younger than 3 months, lower oxygen saturation, and respiratory syncytial virus infection

Age group characteristics of clinical features and use of epinephrine in children with anaphylaxis who visited the emergency department

Purpose Diagnosis of anaphylaxis depends on clinical manifestations and a high index of suspicion, and a misdiagnosis can lead to a preventable death. We aimed to investigate age group characteristics of clinical features and epinephrine use in children with anaphylaxis who visited the emergency department (ED). Methods We performed a retrospective chart review of 138 children who visited a tertiary care hospital ED from January through December 2018, and were discharged with anaphylaxis as the diagnosis. Anaphylaxis was defined according to the National Institutes of Allergy and Infectious Disease criteria. The children were divided into 4 age groups; infants (< 1 year), preschoolers (1-5 years), schoolers (6-11 years), and adolescents (12-18 years). Clinical features and epinephrine use were compared among the age groups. Results Of the 138 children with presumed anaphylaxis, 108 met the criteria. The most common cause was food (74%), followed by drugs (10.2%). Epinephrine was used in 82 children (75.9%). The infants and preschoolers reported less frequent cardiovascular symptoms (0%-3.6% vs. 26.5%, P = 0.020) and epinephrine use (33.3%-70.9% vs. 91.2%, P = 0.037) compared to the adolescents. The former 2 age groups reported food as triggers more frequent, and often reported food-associated and respiratory or gastrointestinal symptoms. Conclusion Infants and preschoolers with anaphylaxis may undergo less frequent cardiovascular symptoms and epinephrine use compared to adolescents. This feature prompts to increased epinephrine use in the former age groups even without age-adjusted hypotension

Chronicle of a Soil Bacterium: Paenibacillus polymyxa E681 as a Tiny Guardian of Plant and Human Health

The Gram-positive rhizosphere bacterium Paenibacillus polymyxa promotes plant growth and produces various antibiotics. Herein, we review research on this species over the past two and a half decades, and focus on the mechanisms of P. polymyxa strain E681, isolated from barley roots in the South Korea in 1995. Strain E681 has outstanding growth-promoting effects on barley, cucumber, pepper, sesame, and Arabidopsis thaliana and produces antimicrobial compounds that protect plants against pathogenic fungi, oomycetes, and bacteria. Induced systemic resistance elicited by treating seeds or roots with strain E681 is a possible mechanism for protecting systemic plant tissues from biotic and other environmental stresses. Genome sequencing has broadened our horizons for antibiotic development and other industrial applications beyond agricultural use. At least six gene clusters for the biosynthesis of antibiotics have been discovered, including polymyxin (pmx), which was recently re-instated as an antibiotic of last resort against Gram-negative drug-resistant bacteria. Three groups of antibiotic synthetases include the gene clusters that encode one for the non-ribosomal peptide polymyxin, fusaricidin, and tridecaptin, another for the lantibiotic paenilan, and the third for a polyketide. We successfully introduced the pmx gene cluster into the surrogate host Bacillus subtilis and created polymyxin derivatives by domain swapping. Furthermore, various E681 derivatives, including a high fusaricidin producer and strains lacking multi-antibiotics production, have been constructed by random mutagenesis and genome engineering. Thus, E681 is an important bacterium that contributes to both plant and human health

Full sequence analysis and characterization of the South Korean Norovirus GII-4 variant CUK-3

<p>Abstract</p> <p>Background</p> <p>Many of researchers have focused on the emerging pathogen, Norovirus, since its first identification as the causing agent of nonbacterial acute gastroenteritis in humans. One of the virulence factors of norovirus, the great genetic diversity attributed to point mutations and recombinations, has brought forth the result of significant changes in the circulating norovirus genotype patterns.</p> <p>Findings</p> <p>In recognition of the necessity for tracking and monitoring of genetic diversity, a norovirus variant among the most prevalent genotype GII-4, Norovirus Hu/GII-4/CUK-3/2008/KR (CUK-3), was isolated from stool samples and analyzed on the level of whole genome sequence. Whole genome sequence analysis revealed three ORF composites of the whole genome, ORF1 (5100 bp), ORF2 (1623 bp), and ORF3 (807 bp). Each genetic relationship of CUK-3 variant analysis located the ORF1 (5,100 bp) in Cluster I, ORF2 (1623 bp) in Cluster I (2006b), ORF3 (807 bp) in Cluster I, and the whole genome sequence (about 5.1 kb) in Cluster I in the phylogenetic tree. And the phylogenetic analyses showed the same location of CUK-3 strain with the GII-4/2006b cluster in the phylogenetic tree.</p> <p>Conclusions</p> <p>In This study, a first concerning the full-length sequence of a NoV variant in South Korea is meaningful in that it can be used not only as a full-length NoV variant sequence standard for future comparison studies, but also as useful material for the public health field by enabling the diagnosis, vaccine development, and prediction of new emerging variants.</p

A tracheoinnominate artery fistula presenting with massive hemorrhage in a 13-year-old boy

Despite its rarity, a tracheoinnominate artery fistula can result in catastrophic hemorrhage. Here, we describe a case of a 13-year-old boy with such a condition following tracheostomy. After identification of pulsatile bleeding from the tracheostoma, temporary control of hemorrhage was obtained using hyperinflation of the tracheostomy tube cuff. Subsequently, a lesion indicative of a tracheoinnominate artery fistula was found on a computed tomography scan, and the diagnosis was confirmed at surgery. After surgery, he was discharged with no recurrent bleeding. This case highlights the importance of high suspicion and prompt management of tracheoinnominate artery fistula

CHARACTERIZATION OF THERMOMECHANICAL PULP MADE FROM PINE TREES INFECTED WITH NEMATODES

Pine wilt is a lethal disease caused by the nematode Bursaphelenchus xylophilus. It causes tree death by blocking water and nutrient uptake in pine trees. Pine trees infected by these nematodes are used as fertilizer or fuel for thermal power plants, but their utilization is still only about 37%. To increase the utilization of the infected trees, this study investigated whether the shredded wood chips prepared from them could be used as raw materials for manufacturing thermomechanical pulp (TMP) and chemithermomechanical pulp (CTMP). TMP and CTMP prepared from the infected pine chips showed fewer pitch contents and better strength properties than those made from domestic pine. In conclusion, if the nematode-infected pine was used as raw materials for manufacturing TMP and CTMP, it is expected that it would contribute to the diversification of raw materials along with a high-temperature insecticidal effect. Keywords: Pine wilt, nematode disease, thermomechanical pulp, chemithermomechanical pulp, pulp strength, insecticidal effect &nbsp