BACKGROUND/AIMS: Despite the clinical importance anaphylaxis and the recent increase in its occurrence, studies regarding the epidemiology of anaphylaxis, risk factors for anaphylaxis, and epinephrine auto-injector (EAI) prescription status for patients with anaphylaxis remain poorly described. Thus, we investigated the prevalence of anaphylaxis and prescription rates of EAI in urban and rural areas in Korea. METHODS: We used data from the 2010 to 2014 Health Insurance Review and Assessment database. Anaphylaxis was identified through physician-certified diagnoses using the International Classification of Diseases 10th (ICD-10) codes (T780, T782, T805, T886). Data on prescription rates of EAI were collected from the Korea Orphan & Essential Drug Center, the only pharmacy exclusively dealing with EAI in Korea. The prescription rates of EAI were defined as the number of EAI prescribed against the number of patients with anaphylaxis. RESULTS: The prevalence of anaphylaxis over the 5-year period was 0.023%. The annual prevalence of anaphylaxis increased over the 5-year period. Anaphylaxis was more common in males than in females (54% vs. 46%) and in the population aged 50 to 59 years old. For regional analysis, urban areas showed a relatively lower prevalence of anaphylaxis (17.3 per 100,000 individuals) along with higher prescription rates (12.0%) of EAI for patients with anaphylaxis. In contrast, rural areas showed a relatively higher prevalence of anaphylaxis (28.8 per 100,000 individuals) along with lower prescription rates (3.1%) of EAI. CONCLUSIONS The prevalence of anaphylaxis has increased annually in Korea. There were regional differences in the prevalence of anaphylaxis and prescription rates of EAI between urban and rural areas in Korea.

Tetanus immunoglobulin (TIG) and tetanus vaccination are in general use for tetanus prophylaxis in patients with trauma based on their personal history of tetanus vaccinations. However, the conventional injection of only TIG has been used for tetanus prophylaxis due to difficulties in verifying the known vaccination histories of Korean patients. We evaluated the effect of introducing an immunization information system (IIS) on tetanus prophylaxis. TIG-injected trauma patients (≥20 years old) who were registered at a single hospital from January 1, 2013 to December 31, 2015 were enrolled in this study. IIS was introduced to all doctors in that hospital starting on January 1, 2015. IIS information and medical records were used to assess histories of tetanus vaccination and TIG administration. Comparisons were made between the number of tetanus and TIG shots (inadequate TIG administrations) given before and after the introduction of the IIS. The number of TIG-injected patients varied during the study period (362 in 2013, 387 in 2014, and 235 in 2015). The proportion of tetanus-vaccinated patients relative to TIG-injected patients increased from 2.21% in 2013 to 4.13% in 2014 and 44.26% in 2015 (P <0.001). The proportions of cases that were recorded as having received inadequate TIG administration decreased from 3.59% (13 of 362) in 2013 for patients with ≥3 tetanus vaccinations to 4.39% (17 of 387) in 2014 and 1.28% (3 of 235) in 2015 for the same group P = 0.043). The introduction of IIS could increase the number of patients with trauma who have proper tetanus vaccinations and decrease the number who undergo inadequate TIG administrations. The introduction of IIS can improve clinical practice in terms of enhancing proper tetanus prophylaxis for appropriate patients.
Humans ; Immunization* ; Immunoglobulins ; Information Systems* ; Medical Records ; Tetanus* ; Vaccination

Background: With the increase in meals at home due to coronavirus disease 2019 (COVID-19), the pattern and incidence of enteritis seemed to change. Some types of enteritis, such as Campylobacter enteritis, appear to have increased. Our study aimed to evaluate the change in the trend of enteritis, especially Campylobacter enteritis, before COVID-19 (2016– 2019) and at the present time during COVID-19 in South Korea. Methods: We analyzed data from the Health Insurance Review and Assessment Service. From 2016 to 2020, the International Classification of Diseases codes related to enteritis were examined to distinguish bacterial and viral enteritis and the trends of each were analyzed.The aspects of enteritis, before and after the COVID-19 outbreak, were compared. Results: Both bacterial and viral enteritis declined in all age groups from 2016 to 2020 (P< 0.001). In 2020, the reduction rate of viral enteritis was higher than that of bacterial enteritis. However, unlike other causes of enteritis, even after COVID-19, Campylobacter enteritis increased in all age groups. An increase of Campylobacter enteritis in 2020 was particularly noticeable in children and adolescents. The prevalence of viral and bacterial enteritis was higher in urban areas than in rural areas (P < 0.001). Campylobacter enteritis was more common in the rural areas (P< 0.001). Conclusion Although the prevalence of bacterial and viral enteritis have decreased in COVID-19, Campylobacter enteritis has increased in all age groups and in rural areas compared to urban areas. Recognizing that the trend of Campylobacter enteritis before and during COVID-19 is helpful for future public health measures and interventions.

Background and Objectives: Burning mouth syndrome (BMS) is a chronic pain disorder involving a burning sensation of the oral cavity without any identifiable oral lesion. According to the recent studies, the pathogenesis of BMS is presumed to be caused by a neuropathic condition. Gabapentin and pregabalin have been used for various neuropathic pains, but pregabalin has several pharmacokinetic advantages over gabapentin. To our best knowledge, there are no recent studies reported on the administration of pregabalin in treating BMS in Korea. Therefore, in this study, we investigated the therapeutic effect of pregabalin in treating BMS.Subjects and Method We chose as candidates 33 patients diagnosed as BMS and took pregabalin for more than four weeks. Pregabalin was administered at 75 mg once a day for 2 to 4 weeks at first, and then the dose was modified depending on whether or not symptoms improved. Effectiveness of treatment was evaluated in the way that the patients subjectively answered whether or not symptoms were improved. Results: A total of 21 (63.6%) out of 33 patients were responsive to the treatment. Among those, at the last follow-up, 8 patients (38.1%) showed slight improvement, and 13 patients (61.9%) showed mostly improvement or disappearance of symptoms. The average time interval from starting pregabalin to the first symptom improvement was 50.1 days, and most patients showed symptom improvement within 8 weeks. Conclusion This study concludes that pregabalin can be added as a meaningful option in the treatment of BMS. The additional double-blind clinical study should be followed to further prove the effectiveness of pregabalin.

Purpose: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis. In Korea, ESD was included in the National Health Insurance (NHI) coverage in 2011, which was expanded in 2018. In the present study, we investigated the status and trends of ESD for EGC over the past decade since its incorporation into the NHI system. Materials and Methods: We analyzed the data from the National Health Insurance Service (NHIS) database from 2011 to 2021, focusing on patient characteristics, number of ESD procedures, in-hospital length of stay (LOS), and total medical cost (TMC) per admission. In addition, we conducted an interrupted time series analysis to assess the impact of changes in insurance coverage on these variables. Results: Overall, 95,348 cases of ESD for EGC were identified. A consistent annual increase in ESD procedures was observed, particularly in tertiary care hospitals and among patients aged >60 years. The overall median LOS and TMC were 4 days and 2,123,000 KRW, respectively. The 2018 insurance coverage expansion did not significantly affect the number of ESD procedures or LOS; however, the TMC increased significantly. Conclusions Our study illustrates decade-long trends in the ESD for EGC in Korea. The policy needs to be revised continuously to optimize ESD use and improve resource allocation within healthcare systems.

Purpose: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis. In Korea, ESD was included in the National Health Insurance (NHI) coverage in 2011, which was expanded in 2018. In the present study, we investigated the status and trends of ESD for EGC over the past decade since its incorporation into the NHI system. Materials and Methods: We analyzed the data from the National Health Insurance Service (NHIS) database from 2011 to 2021, focusing on patient characteristics, number of ESD procedures, in-hospital length of stay (LOS), and total medical cost (TMC) per admission. In addition, we conducted an interrupted time series analysis to assess the impact of changes in insurance coverage on these variables. Results: Overall, 95,348 cases of ESD for EGC were identified. A consistent annual increase in ESD procedures was observed, particularly in tertiary care hospitals and among patients aged >60 years. The overall median LOS and TMC were 4 days and 2,123,000 KRW, respectively. The 2018 insurance coverage expansion did not significantly affect the number of ESD procedures or LOS; however, the TMC increased significantly. Conclusions Our study illustrates decade-long trends in the ESD for EGC in Korea. The policy needs to be revised continuously to optimize ESD use and improve resource allocation within healthcare systems.

Purpose: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis. In Korea, ESD was included in the National Health Insurance (NHI) coverage in 2011, which was expanded in 2018. In the present study, we investigated the status and trends of ESD for EGC over the past decade since its incorporation into the NHI system. Materials and Methods: We analyzed the data from the National Health Insurance Service (NHIS) database from 2011 to 2021, focusing on patient characteristics, number of ESD procedures, in-hospital length of stay (LOS), and total medical cost (TMC) per admission. In addition, we conducted an interrupted time series analysis to assess the impact of changes in insurance coverage on these variables. Results: Overall, 95,348 cases of ESD for EGC were identified. A consistent annual increase in ESD procedures was observed, particularly in tertiary care hospitals and among patients aged >60 years. The overall median LOS and TMC were 4 days and 2,123,000 KRW, respectively. The 2018 insurance coverage expansion did not significantly affect the number of ESD procedures or LOS; however, the TMC increased significantly. Conclusions Our study illustrates decade-long trends in the ESD for EGC in Korea. The policy needs to be revised continuously to optimize ESD use and improve resource allocation within healthcare systems.

Purpose: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis. In Korea, ESD was included in the National Health Insurance (NHI) coverage in 2011, which was expanded in 2018. In the present study, we investigated the status and trends of ESD for EGC over the past decade since its incorporation into the NHI system. Materials and Methods: We analyzed the data from the National Health Insurance Service (NHIS) database from 2011 to 2021, focusing on patient characteristics, number of ESD procedures, in-hospital length of stay (LOS), and total medical cost (TMC) per admission. In addition, we conducted an interrupted time series analysis to assess the impact of changes in insurance coverage on these variables. Results: Overall, 95,348 cases of ESD for EGC were identified. A consistent annual increase in ESD procedures was observed, particularly in tertiary care hospitals and among patients aged >60 years. The overall median LOS and TMC were 4 days and 2,123,000 KRW, respectively. The 2018 insurance coverage expansion did not significantly affect the number of ESD procedures or LOS; however, the TMC increased significantly. Conclusions Our study illustrates decade-long trends in the ESD for EGC in Korea. The policy needs to be revised continuously to optimize ESD use and improve resource allocation within healthcare systems.

Background and Objectives: Injection laryngoplasty is a common method for treatment of unilateral vocal fold paralysis. Unilateral vocal fold paralysis has various causes, including idiopathic, infection, stroke, neurologic condition, surgery and nerve invasion by cancer. To the knowledge of the authors, there was no study on the relationship between the causes of vocal cord paralysis and the outcome of injection laryngoplasty. Therefore, we tried to investigate the difference in the outcomes of injection laryngoplasty between vocal cord paralysis after surgery group and nerve invasion by cancer group.Materials and Method A retrospective analysis was performed for 24 patients who underwent vocal cord injection due to unilateral vocal cord paralysis caused by surgery or nerve invasion by cancer. The objective quality of the voice was assessed by acoustic voice analysis with the Multi-Dimensional Voice Program. Results: Both group showed an improvement of fundamental frequemcy (F0), jitter percent, shimmer (percent), and noise to hearmonic ratio (NHR) after injection laryngoplasty. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of F0, shimmer percent and NHR than the vocal cord paralysis due to surgery group, but there was not statistically significant. Conclusion Our study did not show a statistically significant difference in outcome between vocal cord paralysis due to cancer invasion group and surgery group, but statistically tendency was suggested. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of acoustic voice analysis than surgery group.

BACKGROUND: Cordyceps militaris has been used in traditional medicine to treat numerous diseases and has been reported to possess both antitumor and immunomodulatory activities in vitro and in vivo. However, the pharmacological and biochemical mechanisms of Cordyceps militaris extract (CME) on macrophages have not been clearly elucidated. In the present study, we examined how CME induces the production of proinflammatory cytokines, transcription factor, and the expression of co-stimulatory molecules. METHODS: We confirmed the mRNA and protein levels of proinflammatory cytokines through RT-PCR and western blot analysis, followed by a FACS analysis for surface molecules. RESULTS: CME dose dependently increased the production of NO and proinflammatory cytokines such as IL-1beta, IL-6, TNF-alpha, and PGE(2), and it induced the protein levels of iNOS, COX-2, and proinflammatory cytokines in a concentration-dependent manner, as determined by western blot and RT-PCR analysis, respectively. The expression of co-stimulatory molecules such as ICAM-1, B7-1, and B7-2 was also enhanced by CME. Furthermore, the activation of the nuclear transcription factor, NF-kappaB in macrophages was stimulated by CME. CONCLUSION: Based on these observations, CME increased proinflammatory cytokines through the activation of NF-kappaB, further suggesting that CME may prove useful as an immune-enhancing agent in the treatment of immunological disease.
Blotting, Western ; Cordyceps ; Cytokines ; Immune System Diseases ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Macrophages ; Medicine, Traditional ; NF-kappa B ; RNA, Messenger ; Transcription Factors ; Tumor Necrosis Factor-alpha