1.Is the immediate blood pressure control using parenteral antihypertensive drug needed for patients with severe high blood pressure with epistaxis in the emergency department?
Kyunghoon SHIN ; Kyunghoon PARK ; Heekyung LEE ; Changsun KIM ; Laurie Seiwon KIM ; Ji Won YOO
Journal of the Korean Society of Emergency Medicine 2022;33(5):471-479
Objective:
This study aimed to assess whether the conventional treatments administered in the emergency department (ED) for hypertensive urgencies (observed or peroral [PO]-controlled) in severe high blood pressure (BP) patients with epistaxis increase the incidence of epistaxis recurrence and the mortality rate as compared to immediate BP control using intravenous (IV) antihypertensive medication
Methods:
A retrospective study over 7 years was conducted at the ED of a tertiary university hospital. Among adult patients with spontaneous epistaxis, subjects with severe high BP (systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg) were included in the study. Participants were divided into three groups determined by the methods used to control BP: non-controlled, PO-controlled, and IV-controlled groups. The incidence of epistaxis recurrence and mortality rate within 6 months were compared.
Results:
Among the 380 patients enrolled, 238 were discharged from the ED without any pharmacological antihypertensive treatment (non-controlled group), 83 received PO antihypertensive medication (PO-controlled group), and 59 received IV antihypertensive medication (IV-controlled group). Of these, 29 (12.2%), nine (10.8%), and seven (11.9%) patients from the non-controlled, PO-controlled, and IV-controlled groups, respectively, experienced epistaxis recurrence within 24 hours, which was statistically not different among the three groups (P=0.948). The 6-month mortality rates were determined to be 0.8%, 2.4%, and 3.4% in the non-controlled, PO-controlled, and IV-controlled groups, respectively. The difference was also not significant among the groups (P=0.294).
Conclusion
The conventional treatments of hypertensive urgencies (observed or PO-controlled) in patients with severe high BP with epistaxis in the ED did not increase the incidence of epistaxis recurrence and short-term mortality rate when compared to immediate BP control using IV antihypertensive medication.
2.Laboratory Diagnosis of COVID-19 in Korea
The Ewha Medical Journal 2021;44(1):1-10
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is a type of human coronavirus that causes severe pneumonia, similar to SARS-CoV-1 and Middle East respiratory syndrome coronavirus. In Korea, the SARS-CoV-2 testing has started quickly from February 2020 to respond to the COVID-19 pandemic. In this article, I would like to introduce the characteristics of coronavirus and PCR test methods that play a large role in COVID-19 quarantine measures. Real-time reverse transcription (RT)-PCR is one of the molecular diagnostic method, and it detect SARS-CoV-2 RNA by amplifying SARS-CoV-2 specific RdRp(RNA-dependent RNA polymerase) gene and E (envelope) gene at the same time. Real-time RT-PCR is currently the most reliable test that confirming COVID-19 and is in use worldwide. Real-time RT-PCR test is recommended for COVID-19 confirmatory diagnosis in Korea, but this test requires dedicated equipment, reagents, experienced technicians and laboratory medicine specialists, and it takes about a few hours to a day to report. Rapid molecular testing results in one to two hours with a simple procedure. Antigen test is less sensitive than real-time RT-PCR and can only be used as a secondary role of diagnosis. As the global COVID-19 pandemic progresses, diagnostic testing guidelines and recommendations may vary and will be updated as scientific evidence and experience of the COVID-19 accumulates.
3.Laboratory Diagnosis of COVID-19 in Korea
The Ewha Medical Journal 2021;44(1):1-10
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is a type of human coronavirus that causes severe pneumonia, similar to SARS-CoV-1 and Middle East respiratory syndrome coronavirus. In Korea, the SARS-CoV-2 testing has started quickly from February 2020 to respond to the COVID-19 pandemic. In this article, I would like to introduce the characteristics of coronavirus and PCR test methods that play a large role in COVID-19 quarantine measures. Real-time reverse transcription (RT)-PCR is one of the molecular diagnostic method, and it detect SARS-CoV-2 RNA by amplifying SARS-CoV-2 specific RdRp(RNA-dependent RNA polymerase) gene and E (envelope) gene at the same time. Real-time RT-PCR is currently the most reliable test that confirming COVID-19 and is in use worldwide. Real-time RT-PCR test is recommended for COVID-19 confirmatory diagnosis in Korea, but this test requires dedicated equipment, reagents, experienced technicians and laboratory medicine specialists, and it takes about a few hours to a day to report. Rapid molecular testing results in one to two hours with a simple procedure. Antigen test is less sensitive than real-time RT-PCR and can only be used as a secondary role of diagnosis. As the global COVID-19 pandemic progresses, diagnostic testing guidelines and recommendations may vary and will be updated as scientific evidence and experience of the COVID-19 accumulates.
4.The Effect of Cold Water Immersion on Physiological Indices, Inflammatory and Immune Responses during a Soccer Match
Suntae PARK ; Sunghoon HUR ; Kyungjun AN ; Youngwoo KWON ; Kyunghoon PARK ; Junho KIM ; Jongsam LEE
The Korean Journal of Sports Medicine 2021;39(4):170-180
Purpose:
We investigated the effects of cold water immersion (CWI) treatment during half-time break on performance related physiological indices during second half soccer match.
Methods:
Twenty-two collegiate soccer players participated in the study. Subjects undertook 3 minutes head out seated with whole body immersion at 19 o C to 21 o C. Total four venous blood samples were collected and analyzed for markers of ionic regulations and inflammatory (interleukin [IL]-1b, IL-6, IL-8, IL-10, tumor necrosis factor-α , and vascular endothelial growth factor) and immune functions (immunoglobulin [Ig] G, IgG2, IgG2, IgG3, IgG4, IgA, and IgM).
Results:
Partial oxygen concentration and %SO 2 level was lowered in CWI. Hemoglobin and hematocrit values were not significantly different between experimental groups. While there was no notable effect was shown in Na + and Ca 2+ , K + concentration was higher in CWI during second half match. There were no effects in any of inflammatory and/or anti-inflammatory cytokines and Ig.
Conclusion
These results suggest that CWI during half time break exert positively affects in buffering capacity and promote oxygen delivery to the actively recruited skeletal muscle, possibly results in improve soccer performance during second half match.
6.The Positive Aspects of Attention-Deficit/Hyperactivity Disorder among Famous People
Jong Won LEE ; Kyunghoon SEO ; Geon Ho BAHN
Psychiatry Investigation 2020;17(5):424-431
Objective:
The shortage of clinical data regarding adult patients with often results in adults with ADHD being stigmatized and being inadequately treated. In this paper, famous people who potentially have ADHD were analyzed to understand better, the life-long progression of ADHD.
Methods:
131 people were analyzed as potential candidates for ADHD. A grading system for the candidates was developed: class 1, compatible with ADHD; class 2, likely; class 3, less likely; class 4, uncertain with a shortage of data; and class 5, not compatible. Initially, 39 subjects in class 4 and 12 in class 5 were excluded from the analysis. Finally, 80 subjects (30 in class 1, 33 in class 2, and 17 in class 3) were analyzed for sociodemographic data and psychiatric comorbidities.
Results:
88.8% were men and 47.5% of the subjects were married once. In terms of occupation, 45.0% of the subjects were cultural professionals and 25.0% were chief executives. Narcissistic personality disorder was the most frequently noted comorbidity, followed by substance-related and addictive disorder.
Conclusion
Famous people with ADHD in this study revealed high skill levels in occupation, offering positive aspects of ADHD in adults.
7.A Multiplex Phytosterol Assay Utilizing Gas Chromatography-Mass Spectrometry for Diagnosis of Inherited Lipid Storage Disorders
Joon Hee LEE ; Kyunghoon LEE ; Sun Hee JUN ; Sang Hoon SONG ; Choong Ho SHIN ; Junghan SONG
Annals of Laboratory Medicine 2019;39(4):411-413
No abstract available.
Diagnosis
;
Gas Chromatography-Mass Spectrometry
8.Evaluation of Stability of Thiopurine Metabolites Using a Validated LC-MS/MS Method.
In Young YOO ; Kyunghoon LEE ; Ok Ja JI ; Hye In WOO ; Soo Youn LEE
Annals of Laboratory Medicine 2018;38(3):255-260
Measurement of thiopurine metabolites is helpful to monitor adverse effects and assess compliance in patients on thiopurine treatment. The purpose of this study was to develop and validate an analytical method for measurement of thiopurine metabolites, thioguanine nucleotides (6-TGN) and 6-methylmercaptopurine nucleotide (6-MMPN), in RBCs. We developed and validated a liquid chromatography–tandem mass spectrometry (LC-MS/MS) method for the quantification of 6-TGN and 6-MMPN and evaluated the stability of the thiopurine metabolites in RBC and whole blood states without any preprocessing at various storage conditions. The linear range was 0.1–10 µmol/L and 0.5–100 µmol/L for 6-TGN and 6-MMPN, respectively. The mean extraction recovery at the two concentrations was 71.0% and 75.0% for 6-TGN, and 102.2% and 96.4% for 6-MMPN. Thiopurine metabolites in preprocessed RBC samples were stable at 25℃ and 4℃ after storage for 4 hours and at −70℃ for up to 6 months. However, 6-TGN decreased by 30% compared with the initial concentration when stored at −20℃ for 180 days. In whole blood states, 6-TGN decreased by about 20% at four days after storage at 4℃. We validated a reliable LC-MS/MS method and recommend that the patient's whole blood sample be preprocessed as soon as possible.
Compliance
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Humans
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Mass Spectrometry
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Methods*
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Nucleotides
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Thioguanine
9.Accuracy-Based Proficiency Testing of Creatinine Measurement: 7 Years' Experience in Korea
Tae Dong JEONG ; Hye Ah LEE ; Kyunghoon LEE ; Yeo Min YUN
Journal of Laboratory Medicine and Quality Assurance 2019;41(1):13-23
BACKGROUND: Standardization of creatinine assay is consistently performed and much effort has been put into improving the accuracy of the results. We aimed to analyze the results of accuracy-based proficiency testing of creatinine assays performed by the Korea Association of External Quality Assessment Service from 2011 to 2017 to assess the current state of creatinine assays in Korea. METHODS: From 2011 to 2017, the accuracy-based proficiency testing of creatinine was performed twice a year. We analyzed the results obtained from the participating laboratories and calculated the year-wise bias. The acceptable limit of bias was as follows: ±11.4% for creatinine concentration >1.0 mg/dL, and 0.114 mg/dL for creatinine concentration ≤1.0 mg/dL. The trend of bias with the major instruments and reagent manufacturers were analyzed. RESULTS: The number of participating laboratories was 54 in 2011, which gradually increased to 146–178 after 2015. For each of the three samples used in the survey, the percentage of laboratories whose biases in the results were within the acceptable limits was 33.3% for the first time in 2011, which gradually increased to 74.7%–85.0% after 2014. The mean biases in all the results of the participating laboratories were 11.1% in 2011 (1st trial) and 2.4% in 2017 (2nd trial). The biases in the results with the major instruments and reagents differed according to the manufacturers. CONCLUSIONS: The mean bias in the results obtained from the participating laboratories in the accuracy-based proficiency testing of creatinine surveys showed a decreasing trend.
Bias (Epidemiology)
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Creatinine
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Indicators and Reagents
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Korea
10.Schemes and Performance Evaluation Criteria of Korean Association of External Quality Assessment (KEQAS) for Improving Laboratory Testing
Sollip KIM ; Kyunghoon LEE ; Hyung-Doo PARK ; Yong-Wha LEE ; Sail CHUN ; Won-Ki MIN
Annals of Laboratory Medicine 2021;41(2):230-239
External quality assessment (EQA) is important for evaluating clinical laboratories and enhancing their testing quality. EQA schemes are variable; thus, it is crucial that the EQA organizers share their experiences to continuously improve the EQA scheme. The Korean Association of External Quality Assessment Service (KEQAS) has been the leading, authorized EQA institute for the standardization and quality management of laboratory testing in Korean medical institutions since 1976. The EQA scheme underwent a major change in 2016, and the number of EQA programs increased significantly since then. The key changes implemented in EQA scheme include a fully computerized assessment to accelerate feedback and unification of the testing and reporting methods. We provide an overview of the EQA schemes and performance evaluation criteria of the KEQAS and suggest directions for achieving the global harmonization of EQA.