The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.
Evidence-Based Practice* ; Fundoplication ; Gastroesophageal Reflux* ; Hernia, Hiatal ; Korea ; Prevalence ; Proton Pumps ; Surgeons

BACKGROUND: The BC-6800 (Mindray, China) is a recently developed hematology analyzer that utilizes 'SF Cube Technology' to improve the reliability of complete blood counts (CBC), white blood cell (WBC) differentials, and erythroblast counts. In this study, we evaluated the performance of the BC-6800 for CBC, WBC differentials, reticulocyte counts, and erythroblast counts and analyzed the efficiency of its flag system. METHODS: Specimens from 100 healthy controls and 95 patients were used. We performed precision and correlation studies of CBC, WBC differentials, reticulocyte counts, and erythroblast counts. We also analyzed the efficiency of the flag system in detecting abnormal blood cells. RESULTS: The coefficients of variation (CVs) of precision were <2% for most CBC parameters and <5% for neutrophil, eosinophil, and reticulocyte counts. The results obtained using the BC-6800 were well correlated with those of the ADVIA 2120 (Siemens, USA) and LH 750 (Beckman Coulter Corporation, USA). The correlation coefficients (r) were >0.9800 for CBC except erythrocyte indices, and >0.9500 for WBC differentials except monocyte and basophil. The WBC differentials and erythroblast counts obtained using the BC-6800 were well correlated with those of manual counts. The efficiencies of the flag system were 77.9% for Blasts, 82.1% for Immature Gran, 86.3% for Atypical Lymph, and 92.6% for NRBC present. CONCLUSIONS: The BC-6800 showed good precision and correlation with pre-existing hematology analyzers. The flag systems were quite efficient for detecting abnormal blood cells. Our study demonstrated that the BC-6800 hematology analyzer exhibits suitable performance and is helpful in routine laboratories.
Basophils ; Blood Cell Count ; Blood Cells ; Eosinophils ; Erythroblasts ; Erythrocyte Indices ; Hematology ; Humans ; Leukocytes ; Monocytes ; Neutrophils ; Reticulocyte Count ; Statistics as Topic

The aims of this study were to determine the occurrence and variables associated with the initial intravenous immunoglobulin (IVIG) treatment failure in Kawasaki disease (KD) and to categorize differences in clinical characteristics between responders and nonresponders to initial IVIG treatment. Patients were classified into two groups. Group A included 33 patients who received a single dose of IVIG treatment and responded. Group B included 18 patients who received more than two doses of IVIG due to failure of the initial treatment. The mean duration of fever after initial treatment in group B was significantly longer than it was in group A. In group B, we found that higher bilirubin, aspartate aminotransferase (AST), polymorphonuclear cells (PMN) (%), and lower platelet values at baseline were independent predictors of persistent or recurrent fever in patients with KD. Coronary artery abnormalities were found in 8 patients (44.4%) in group B and in two patients (6.1%) in group A. We found that abnormal liver function tests and a lower platelet count at baseline were possible predictors of nonresponders to IVIG in patients with KD. There is a need for a prospective study focused on baseline hepatobiliary parameters.
C-Reactive Protein/analysis ; Child, Preschool ; Female ; Humans ; Immunoglobulins, Intravenous/*therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome/*drug therapy ; Risk Factors ; Treatment Failure

BACKGROUND: The XN-20 (Sysmex, Japan) is a recently developed hematology analyser, which adopts new technologies to improve the accuracy of complete blood count (CBC) and white blood cell (WBC) differentials and the efficiency of the flag system. In this study, we evaluated the performance of the XN-20 for CBC, WBC differentials, and reticulocyte counts. We also analysed the efficiency of its flag system. METHODS: We evaluated the precision and linearity of CBC and reticulocyte counts. In the correlation study, the results of XN-20 were compared with those obtained using ADVIA 2120 (Siemens, USA). The performance was also evaluated in the 'low WBC mode.' We analysed the efficiency of the flag system in detecting abnormal blood cells using 43 abnormal samples. RESULTS: The CVs for precision were <2% for most of the CBC parameters. Linearity was good for WBC, red blood cell (RBC), Hb, Hct, and platelet. The results of XN-20 were well correlated with those of ADVIA 2120. The correlation coefficients (r) was >0.9800 for all CBC parameters except for erythrocyte indices, and it was >0.9500 for WBC differentials except for monocyte and basophil. In the 'low WBC mode,' XN-20 could reliably analyse the WBC differentials in samples with low WBC count. The efficiencies of the flag systems were 95.3% for blasts, 83.7% for left-shifted neutrophils, 97.7% for atypical lymphocytes, and 86.0% for nucleated RBCs. CONCLUSIONS: The XN-20 showed good precision and its results were well correlated with those obtained using ADVIA 2120. In particular, in the 'low WBC mode,' it could provide reliable WBC differentials for samples with low WBC counts, and the flag systems detected abnormal blood cells with high efficiency.
Basophils ; Blood Cell Count* ; Blood Cells ; Blood Platelets ; Erythrocyte Indices ; Erythrocytes ; Hematology ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Reticulocyte Count ; Statistics as Topic

BACKGROUND: The XN-20 (Sysmex, Japan) is a recently developed hematology analyser, which adopts new technologies to improve the accuracy of complete blood count (CBC) and white blood cell (WBC) differentials and the efficiency of the flag system. In this study, we evaluated the performance of the XN-20 for CBC, WBC differentials, and reticulocyte counts. We also analysed the efficiency of its flag system. METHODS: We evaluated the precision and linearity of CBC and reticulocyte counts. In the correlation study, the results of XN-20 were compared with those obtained using ADVIA 2120 (Siemens, USA). The performance was also evaluated in the 'low WBC mode.' We analysed the efficiency of the flag system in detecting abnormal blood cells using 43 abnormal samples. RESULTS: The CVs for precision were <2% for most of the CBC parameters. Linearity was good for WBC, red blood cell (RBC), Hb, Hct, and platelet. The results of XN-20 were well correlated with those of ADVIA 2120. The correlation coefficients (r) was >0.9800 for all CBC parameters except for erythrocyte indices, and it was >0.9500 for WBC differentials except for monocyte and basophil. In the 'low WBC mode,' XN-20 could reliably analyse the WBC differentials in samples with low WBC count. The efficiencies of the flag systems were 95.3% for blasts, 83.7% for left-shifted neutrophils, 97.7% for atypical lymphocytes, and 86.0% for nucleated RBCs. CONCLUSIONS: The XN-20 showed good precision and its results were well correlated with those obtained using ADVIA 2120. In particular, in the 'low WBC mode,' it could provide reliable WBC differentials for samples with low WBC counts, and the flag systems detected abnormal blood cells with high efficiency.
Basophils ; Blood Cell Count* ; Blood Cells ; Blood Platelets ; Erythrocyte Indices ; Erythrocytes ; Hematology ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Reticulocyte Count ; Statistics as Topic

Hemolysis frequently causes preanalytical errors in laboratory measurements. We aimed to develop a quality improvement indicator for evaluating the extent of inappropriate procedures causing hemolysis in clinical samples collected in medical care units. We defined the threshold value of the hemolysis index (H index) causing significant interference with analyte measurement and analyzed the H index values of clinical samples in relation to the threshold. The H index threshold value causing a 10% bias in the measurement of lactate dehydrogenase was found to be 25. The monthly mean H index and monthly frequency of samples with an H index >25 were significantly different among the types of ward (P=0.001, respectively), and significantly decreased after replacement of a laboratory centrifuge lacking temperature control (20.6±0.58 vs 23.30±1.08, P=0.01; 23.4±1.69% vs 32.6±1.78%, P=0.01). The monthly mean H index and the monthly frequency of samples with an H index above a threshold value may be useful quality improvement indicators for detection of inappropriate procedures in the acquisition and handling of blood samples in medical care units.
Hemoglobins/analysis ; Hemolysis ; Humans ; L-Lactate Dehydrogenase/analysis ; Laboratories, Hospital/*standards ; Quality Improvement/*standards ; Specimen Handling

Since the confirmation of the first coronavirus disease 2019 (COVID-19) patient on January 20 2020, COVID-19 infection rate ramped up between February and March in South Korea. This study aimed to provide information on the characteristics of the first two months of COVID-19 prevalence in South Korea and attempted to comprehend preliminary evidence from various sources. We used public data available from the Korea Center for Disease Control and Prevention and situation reports from the World Health Organization from February to March 2020. For additional information, health utilization data from the Organization for Economic Co-operation and Development was used for subgroup analysis. A proportion of meta-analysis was performed. We searched literatures from PubMed, KoreaMed, and CNKI (China National Knowledge Infrastructure) for identifying epidemiological characteristics of COVID-19 and treatment strategies. We monitored domestic and global disease control institutions’ recommendations. The search results and reports were updated every two weeks. In South Korea, the ratio of confirmed cases is divided into two groups; before and after the occurrence of a large cluster infection explosion on February 17 2020 from a religious group called the Shincheonji Church. After the global pandemic announcement by World Health Organization on March 11 2020, the fatality rate of COVID-19 seems to be related to the number of beds and general hospitals. From the literature review, we identified a strong reproduction rate, asymptomatic period or infection, rate of exacerbation, and current treatments. The COVID-19 pandemic in South Korea was inevitable, but the early explosion of infection showed the decline curve afforded by the rigorous tracing, widespread testing, and well-organized health care system.

Purpose: To evaluate the efficacy and safety of coronavirus disease 2019 (COVID-19) vaccines in children aged 5–11 years, a rapid systematic review was conducted on published clinical trials of COVID-19 vaccines and studies that analyzed real-world data on adverse events after COVID-19 vaccination. Methods: A systematic search was conducted on medical literature in international (Ovid-MEDLINE) and pre-published literature databases (medRxiv), followed by handsearching up to January 4, 2022. We used terms including COVID-19, severe acute respiratory syndrome coronavirus 2, and vaccines, and the certainty of evidence was graded using the GRADE approach. Results: A total of 1,675 studies were identified, of which five were finally selected. Among the five studies, four consisted of data from clinical trials of each of the four types of COVID-19 vaccines (BNT162b2, mRNA-1273, CoronaVac, and BBIBP-CorV). The remaining study consisted of real-world data on the safety of the BNT162b2 vaccine in children aged 5–11 years. This systematic review identified that COVID-19 vaccines in recipients aged 5–11 years produced a favorable immune response, and were vaccines were effective against COVID-19. The safety findings for the BNT162b2 vaccine in children and early adolescents aged 5–11 years were similar to those data noted in the clinical trial. Conclusions There is limited data on COVID-19 vaccines in children aged 5–11 years.Consequently continuous and comprehensive monitoring is necessary for the evaluation of the safety and effectiveness of the COVID-19 vaccines.

Background: Automated hematology analyzers report various research parameters. Certain parameters may have clinical implications, whereas others are used to set flags in automated hematology analyzers. In this study, we established sex-specific reference intervals for one reticulocyte parameter and two platelet clump parameters in Korean adults and examined the necessity of separate reference intervals for each sex. Methods: A total of 264 healthy adults (157 men and 107 women) aged between 18 and 65 years who underwent regular health check-ups were enrolled. Complete blood cell count was measured using Advia2120i (Siemens, Germany) within 4 hours of phlebotomy. Reference intervals were established according to the Clinical and Laboratory Standards Institute EP28-A3 guideline, and the necessity of separate sex-specific reference intervals was examined according to the method outlined by Harris and Boyd. Results: The reference intervals for each parameter were as follows:reticulocyte hemoglobin (g/L), 132.8–172.0 (men), 96.7–162.8 (women); the number of platelet clumps (# platelet clumps), 10.8–61.0 (men), －22.5–64.4 (women); and %platelet clumps, 0.20–1.49 (men), －0.57–1.53 (women).Reticulocyte hemoglobin showed a significant difference between men and women, whereas # platelet clumps and %platelet clumps did not; however, all three parameters needed separate sex-specific reference intervals. Conclusions We established sex-specific reference intervals for a reticulocyte parameter and platelet clumps parameters in Korean adults for the first time.The results could provide helpful information in clinical decision-making and instrument setting.

Background: s/Aims: Despite advances in antiviral therapy for hepatitis C virus (HCV) infection, hepatocellular carcinoma (HCC) still develops even after sustained viral response (SVR) in patients with advanced liver fibrosis or cirrhosis. This meta-analysis investigated the predictive performance of vibration-controlled transient elastography (VCTE) and fibrosis 4-index (FIB-4) for the development of HCC after SVR. Methods: We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library for studies examining the predictive performance of these tests in adult patients with HCV. Two authors independently screened the studies’ methodological quality and extracted data. Pooled estimates of sensitivity, specificity, and area under the curve (AUC) were calculated for HCC development using random-effects bivariate logit normal and linear-mixed effect models. Results: We included 27 studies (169,911 patients). Meta-analysis of HCC after SVR was possible in nine VCTE and 15 FIB-4 studies. Regarding the prediction of HCC development after SVR, the pooled AUCs of pre-treatment VCTE >9.2–13 kPa and FIB-4 >3.25 were 0.79 and 0.73, respectively. VCTE >8.4–11 kPa and FIB-4 >3.25 measured after SVR maintained good predictive performance, albeit slightly reduced (pooled AUCs: 0.77 and 0.70, respectively). The identified optimal cut-off value for HCC development after SVR was 12.6 kPa for pre-treatment VCTE. That of VCTE measured after the SVR was 11.2 kPa. Conclusions VCTE and FIB-4 showed acceptable predictive performance for HCC development in patients with HCV who achieved SVR, underscoring their utility in clinical practice for guiding surveillance strategies. Future studies are needed to validate these findings prospectively and validate their clinical impact.