Clinical features of Epstein-Barr virus-associated infectious mononucleosis in hospitalized Korean children

PurposeFew studies have been conducted on the recent status of infectious mononucleosis (IM) in Korean children. The aim of this study was to evaluate the recent trend in the clinical manifestations of Epstein-Barr virus (EBV)-associated IM as well as the clinical differences according to age.MethodsA retrospective study was performed on 81 children hospitalized with EBV-associated IM who fulfilled the serological criteria for the diagnosis of EBV infection (viral capsid antigen immunoglobulin M positive). The patients were divided into 3 age groups: <5 years, 5 to 9 years, and ≥10 years. We evaluated the recent trend in clinical manifestations and the differences in clinical and laboratory findings among the 3 age groups.ResultsThirty (37%) children were under 5 years of age, 38 (46.9%) were 5 to 9 years of age, and 13 (16%) were 10 years of age or older. The differences in the symptoms and signs among the 3 age groups were not statistically significant, except for headache. The mean duration of fever was 7.7 days (range, 0 to 18 days). A comparison of liver enzyme elevation among the age groups showed an association with advancing age (26.6%, 63.1%, and 76.9%, respectively, P=0.04)ConclusionThis study showed that EBV-associated IM in Korean children continues to occur mostly in children under 10 years of age. In children with EBV-associated IM, the incidence of headache and liver enzyme elevation, the duration of fever, and the proportion of females to males were all positively associated with advancing age

Development of Korean Academy of Medical Sciences Guideline on the Skin and Related System: Impairment Evaluation of Disfigurement in Skin and Appearance

The purpose of this study is to develop new standards for the disability evaluation with reference to existing laws and other study reports regarding disabilities for the rational evaluation of the diverse kinds of disfigurement in appearance and skin. Three plastic surgery specialists and 3 dermatology specialists developed a new standard for the disability evaluation which is appropriate for circumstances in Korea. Disability rate does not take into account the social occupation, gender or age of the patient, but instead, evaluate the Activity of Daily Living and the social adaptability of the appearance and skin disfigurement regardless of the balance between different disabilities. We tried to include most cutaneous disorders and categorized them into 3 types; congenital (Type 1), acquired (Type 2) as well as any permanent skin impairment sequelae of disease, trauma or treatment process (Type 3). For type 3 disorders, we tried to rate the score according to the size of involved skin lesion. The disability rate is determined by dividing the disability class into 8 steps based on the seriousness of each type of disability

Self-Isolated Dual-Mode High-Pass Birdcage RF Coil for Proton and Sodium MR Imaging at 7 T MRI

This study presents the feasibility of a dual-mode high-pass birdcage RF coil to acquire MR images at both 1H and 23Na frequencies at ultra-high-field MR scanner, 7 T. A dual-mode circuit (DMC) in the dual-mode birdcage (DMBC) RF coil operates at two frequencies, addressing the limitations of sensitivity reduction and isolation between two frequencies as in traditional dual-tuned RF coil. Finite-difference time-domain (FDTD) based electromagnetic (EM) simulations were performed to verify the RF coil at each frequency on the three-dimensional human head model. The DMBC RF coil resonated at proton (1H) and sodium (23Na) frequencies, and also single-tuned high-pass birdcage RF coils were constructed for both 1H and 23Na frequencies. The bench test performance of the RF coils was evaluated using network analysis parameters, including the measurement of scattering parameters (S-parameters) and quality factors (Q-factors). Q-factor of the DMBC coil at 1H port was 10.2% lower than that of 1H single-tuned birdcage (STBC) coil, with a modest SNR reduction of 6.5%. Similarly, the Q-factor for the DMBC coil at 23Na port was 12.3% less than that of 23Na STBC coil, and the SNR showed a minimal reduction of 5.4%. Utilizing the DMBC coil, promising 1H and 23Na MR images were acquired compared to those by using STBC coils. In conclusion, deploying a DMBC 1H/23Na coil has been demonstrated to overcome traditional constraints associated with dual-tuned RF coils, achieving this with only nominal signal attenuation across both nuclei operational frequencies

The Occurrence and Speed of CMEs Related to Two Characteristic Evolution Patterns of Helicity Injection in Their Solar Source Regions

Long-term (a few days) variation of magnetic helicity injection was calculated for 28 solar active regions which produced 47 CMEs to find its relationships with the CME occurrence and speed using SOHO/MDI line-of-sight magnetograms. As a result, we found that the 47 CMEs can be categorized into two different groups by two characteristic evolution patterns of helicity injection in their source active regions which appeared for about 0.5-4.5 days before their occurrence: (1) a monotonically increasing pattern with one sign of helicity (Group A; 30 CMEs in 23 active regions) and (2) a pattern of significant helicity injection followed by its sign reversal (Group B; 17 CMEs in 5 active regions). We also found that CME speed has a correlation with average helicity injection rate with linear correlation coefficients of 0.85 and 0.63 for Group A and Group B, respectively. In addition, these two CME groups show different characteristics as follows: (1) the average CME speed of Group B (1330km/s) is much faster than that of Group A (870km/s), (2) the CMEs in Group A tend to be single events, whereas those in Group B mainly consist of successive events, and (3) flares related to the CMEs in Group B are relatively more energetic and impulsive than those in Group A. Our findings therefore suggest that the two CME groups have different pre-CME conditions in their source active regions and different CME characteristics.Comment: 25 pages, 7 figures, accepted for publication in Ap

The Significance of Lumbar Probing Combined with Continuous Irrigation and Undercutting Posterior Vertebral Body for Highly Upward Migrated Disc Herniation in ACDF: Case Reports and technical notes

The purpose of this report was to present successful cases and technical notes of the patients with up migrated cervical disc herniation to the upper level who were successfully treated using anterior cervical discectomy and fusion (ACDF), describing the evaluation of treatment outcomes and perioperative complications. The cases of two patients who had ACDF in symptomatic up migrated cervical disc herniation to the upper level in February 2021 and November 2021 were reviewed. Two patients presented with a six-week history of posterior neck pain and radiating pain. Preoperative magnetic resonance imaging (MRI) confirmed a diagnosis of up migrated cervical disc extrusion. The patients were admitted to Daegu Wooridul Spine Hospital in Daegu, Korea. ACDF was performed under general anesthesia. Treatment outcomes were examined by comparing pre and postoperative Numeric Rating Scale (NRS), and MRI. Treatment outcomes were favorable: posterior neck pain and radiating pain showed a significant reduction in NRS. Postoperative MRI showed that the up migrated discs were successfully removed in both cases. Neither patient developed perioperative complications. Anterior cervical discectomy can be feasible in patients with symptomatic up migrated cervical disc herniation to the upper level

Only Surgical Decompression Is Sufficient for Multilevel Lumbar Spinal Stenosis with Calcified Disc Protrusion and Vacuum Disc: Case Reports

This report was aimed to share our successful cases of only surgical decompression for multilevel lumbar spinal stenosis, by assessing treatment outcomes. Two patients who had only surgical decompression for multilevel lumbar spinal stenosis were investigated. They were diagnosed with the calcified disc protrusion and vacuum disc in the intervertebral space by magnetic resonance imaging (MRI) and computed tomography (CT). The chief complaints were severe low back pain and bilateral sciatica 2 or 3 months ago. The patients also reported difficulty walking due to sciatica. Unilateral laminotomy for bilateral decompression was performed and discectomy was not done on the stenosis levels. Treatment outcomes were analyzed by visual analog scale for low back pain and sciatica (Back VAS, Leg VAS), improvement in walking, and postoperative MRI. Treatment outcomes were favorable: Low back pain and bilateral sciatica showed a VAS score improvement (Back VAS =3, Leg VAS=3), the patient’s walking was improved, and on a postoperative MRI of the two patients, the thecal sac was released sufficiently. The patients developed no perioperative complications. Only surgical decompression is an effective method for multilevel lumbar spinal stenosis with calcified disc protrusion and vacuum disc in the intervertebral space