1.Prophylactic Antibiotics Therapy after Splenectomy
Miju RYU ; Namhee KWON ; Young Bae KIM ; Jikyoung PARK ; Soonyong LEE
Clinical Pediatric Hematology-Oncology 2013;20(2):95-101
BACKGROUND: Patients who are born without spleen or who have impaired splenic function due to disease or splenectomy become vulnerable to sepsis caused by bacteria. Overwhelming post-splenectomy infection (OPSI) occurs at an estimated incidence of 0.23-0.42% per year with a lifetime risk of 5%. The risk of OPSI with encapsulated bacteria is generally considered greatest in the first 2 years after splenectomy but the increased risk remains lifelong. Because vaccination doesn't completely protect against infection with encapsulated bacteria that prevent OPSI, use of prophylactic antibiotics are recommended for prevention of infection after splenectomy.METHODS: A retrospective review of 41 patients who underwent splenectomy from January 1990 to December 2012 in Inje University Busan Paik Hospital were identified through the medical records.RESULTS: Of 41 patients, 100% (41/41) were vaccinated in pneumococcal vaccines, 27% (11/41) were vaccinated in HIB vaccines. Prophylactic antibiotics (penicillin G benzathine IM every 4 weeks) were prescribed in 73% (30/41) of patients. We could not find any septic events.CONCLUSION: Because of the high mortality, the fulminant course, and the refractoriness to common treatment of overwhelming infections caused by encapsulated bacteria, prevention through vaccination and antibiotic prophylaxis is the basis of the management of patients who have had splenectomy or have hyposplenism. Prophylactic antibiotics using Penicillin G benzathine every 4 weeks is effective for preventing septic events in splenectomized patients. But further improvement in coverage of recommended vaccines and continuous prophylactic antibiotics after splenectomy is needed to reduce the risk of serious infection.
Anti-Bacterial Agents
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Antibiotic Prophylaxis
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Bacteria
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Ethylenediamines
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Haemophilus influenzae type b
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Humans
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Incidence
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Medical Records
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Mortality
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Penicillin G Benzathine
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Pneumococcal Vaccines
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Retrospective Studies
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Sepsis
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Spleen
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Splenectomy
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Vaccination
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Vaccines
2.Missense Variant c.3301C>T (p.R1101W) in von Willebrand Factor A Sequence in a Patient with Recessive Dystrophic Epidermolysis Bullosa Pruriginosa with Compound Heterozygous COL7A1 Variants
Hyeok-Jin KWON ; Dong-Wha YOO ; Jung-Ho YOON ; Namhee KIM ; Ki-Ho KIM
Annals of Dermatology 2023;35(Suppl2):S195-S200
Dystrophic epidermolysis bullosa (DEB) pruriginosa is a rare subtype of DEB characterized by multiple, violaceous, and severe pruritic lichenified nodules along with blisters. Here, we report the case of a Korean male who, since the age of 3 years, had multiple pruritic nodules with blisters on both lower extremities. Genetic testing is required to diagnose DEB pruriginosa because its clinical and histologic features are inconclusive. We identified compound heterozygous COL7A1 variants of c.5797C>T (p.R1933*) and c.3301C>T (p.R1101W) in the patient, leading to a diagnosis of recessive DEB pruriginosa. Among the variants identified, c.3301C>T is a novel missense variant that has not been reported previously. This variant is in exon 26, which encodes von Willebrand factor A (vWFA) in collagen type VII. vWFA is known to preserve normal dermal structures by interacting with dermal collagens and basement membranes. Considering that this variant contradicts the general concept that autosomal dominant inheritance is more common and that variants typically occur in the triple helical collagenous domain of COL7A1 in DEB pruriginosa, we focus on the rarity of this case and the possible pathogenic role of the c.3301C>T (p.R1101W) variant.
3.Strong SARS-CoV-2 Antibody Response After Booster Dose of BNT162b2 mRNA Vaccines in Uninfected Healthcare Workers
Seok Ryun KWON ; Seok Ryun KWON ; Namhee KIM ; Hyunwoong PARK ; Dohsik MINN ; Seungman PARK ; Eun Youn ROH ; Jong Hyun YOON ; Sue SHIN
Journal of Korean Medical Science 2022;37(19):e135-
Despite strict guidelines for coronavirus disease 2019 (COVID-19), South Korea is facing its fourth pandemic wave. In this study, by using an automated electrochemiluminescence immunoassay assay, we tracked anti-spike protein receptor-binding domain (anti-S-RBD) antibody titer from the second dose to 2 weeks after the booster dose vaccination. After the second dose, 234 participants had their anti-S-RBD antibody titers decrease over time. We also showed the booster dose (the third dose) increased antibody titer by average 14 (min–max, 2–255)-fold higher compared to the second dose among the 211-booster group participants, therefore, the booster dose could be recommended for low responders to the second dose. Our findings showed a distinct humoral response after booster doses of BNT162b2 mRNA vaccines and may provide further evidence of booster vaccination efficacy. These data will also be helpful in vaccination policy decisions that determine the need for the booster dose.
4.Efficacy and safety of mepolizumab in Korean patients with severe eosinophilic asthma from the DREAM and MENSA studies
Mi-Kyeong KIM ; Hae-Sim PARK ; Choon-Sik PARK ; Soung-Jun MIN ; Frank C. ALBERS ; Steven W. YANCEY ; Bhabita MAYER ; Namhee KWON
The Korean Journal of Internal Medicine 2021;36(2):362-370
Background/Aims:
The efficacy and safety of mepolizumab in patients with severe eosinophilic asthma has been evaluated in a global clinical trial programme. This post hoc analysis assesses the efficacy and safety of mepolizumab in Korean patients.
Methods:
Data from Korean patients in the Phase III, placebo-controlled, randomised DREAM (MEA112997/NCT01000506) and MENSA (MEA115588/ NCT01691521) studies were included. Patients ≥ 12 years old with severe eosinophilic asthma received mepolizumab (DREAM: 75, 250 or 750 mg intravenously [IV]; MENSA: 75 mg IV or 100 mg subcutaneously [SC]), or placebo every 4 weeks for 52 weeks (DREAM) or 32 weeks (MENSA). The primary outcome was the rate of clinically significant asthma exacerbations. Secondary outcomes included forced expiratory volume in 1 second (FEV1), Asthma Control Questionnaire (ACQ) and St George’s Respiratory Questionnaire (SGRQ) scores (MENSA only). Blood eosinophil counts (BEC) and safety were assessed throughout.
Results:
Reductions in the rate of clinically significant asthma exacerbations were observed with the approved (100 mg SC) and bioequivalent (75 mg IV) doses of mepolizumab in Korean patients who participated in DREAM and MENSA. In MENSA, trends for improvements from baseline at week 32 in pre-bronchodilator FEV1 (75 mg IV group), ACQ-5 and SGRQ scores (in both treatment groups) were seen versus placebo in Korean patients. Incidence of on-treatment adverse events was similar in Korean patients versus non-Korean patients as were observed reductions from baseline in BEC.
Conclusions
Mepolizumab treatment provided clinical benefits for Korean patients with severe eosinophilic asthma; the safety profile is consistent with the overall population.
5.Guidelines for Laboratory Diagnosis of Coronavirus Disease 2019 (COVID-19) in Korea
Ki Ho HONG ; Sang Won LEE ; Taek Soo KIM ; Hee Jae HUH ; Jaehyeon LEE ; So Yeon KIM ; Jae-Sun PARK ; Gab Jung KIM ; Heungsup SUNG ; Kyoung Ho ROH ; Jae-Seok KIM ; Hyun Soo KIM ; Seung-Tae LEE ; Moon-Woo SEONG ; Namhee RYOO ; Hyukmin LEE ; Kye Chul KWON ; Cheon Kwon YOO
Annals of Laboratory Medicine 2020;40(5):351-360
The outbreak of coronavirus disease 2019 (COVID-19), which began in December 2019, is still ongoing in Korea, with >9,000 confirmed cases as of March 25, 2020. COVID-19 is a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, and real-time reverse transcription-PCR is currently the most reliable diagnostic method for COVID-19 around the world. Korean Society for Laboratory Medicine and the Korea Centers for Disease Prevention and Control propose guidelines for diagnosing COVID-19 in clinical laboratories in Korea. These guidelines are based on other related domestic and international guidelines, as well as expert opinions and include the selection of test subjects, selection of specimens, diagnostic methods, interpretation of test results, and biosafety.
6.Workload of Healthcare Workers During the COVID-19 Outbreak in Korea: A Nationwide Survey
Hae Suk CHEONG ; Ki Tae KWON ; Soyoon HWANG ; Shin-Woo KIM ; Hyun-Ha CHANG ; Se Yoon PARK ; Bongyoung KIM ; Shinwon LEE ; Jiho PARK ; Sang Taek HEO ; Won Sup OH ; Yeonjae KIM ; Kyung-Hwa PARK ; Chang Kyung KANG ; NamHee OH ; Su Jin LIM ; Seongcheol YUN ; Ji Woong SON
Journal of Korean Medical Science 2022;37(6):e49-
Background:
As the coronavirus disease 2019 (COVID-19) pandemic is ongoing, heavy workload of healthcare workers (HCWs) is a concern. This study investigated the workload of HCWs responding to the COVID-19 outbreak in South Korea.
Methods:
A nationwide cross-sectional survey was conducted from September 16 to October 15, 2020, involving 16 healthcare facilities (4 public medical centers, 12 tertiary-care hospitals) that provide treatment for COVID-19 patients.
Results:
Public medical centers provided the majority (69.4%) of total hospital beds for COVID-19 patients (n = 611), on the other hand, tertiary care hospitals provided the majority (78.9%) of critical care beds (n = 57). The number of beds per doctor (median [IQR]) in public medical centers was higher than in tertiary care hospitals (20.2 [13.0, 29.4] versus 3.0 [1.3, 6.6], P = 0.006). Infectious Diseases physicians are mostly (80%) involved among attending physicians. The number of nurses per patient (median [interquartile range, IQR]) in tertiarycare hospitals was higher than in public medical centers (4.6 [3.4–5] vs. 1.1 [0.8–2.1], P =0.089). The median number of nurses per patient for COVID-19 patients was higher than the highest national standard in South Korea (3.8 vs. 2 for critical care). All participating healthcare facilities were also operating screening centers, for which a median of 2 doctors, 5 nurses, and 2 administrating staff were necessary.
Conclusion
As the severity of COVID-19 patients increases, the number of HCWs required increases. Because the workload of HCWs responding to the COVID-19 outbreak is much greater than other situations, a workforce management plan regarding this perspective is required to prevent burnout of HCWs.
7.Erratum: COVID-19 Molecular Testing in Korea:Practical Essentials and Answers From Experts Based on Experiences of Emergency Use Authorization Assays
Heungsup SUNG ; Kyoung Ho ROH ; Ki Ho HONG ; Moon-Woo SEONG ; Namhee RYOO ; Hyun Soo KIM ; Jaehyeon LEE ; So Yeon KIM ; Sook Won RYU ; Mi-Na KIM ; Myung Guk HAN ; Sang Won LEE ; Hyukmin LEE ; Cheon Kwon YOO ;
Annals of Laboratory Medicine 2021;41(1):126-127
8.Guidelines for the Laboratory Diagnosis of Monkeypox in Korea
Ki Ho HONG ; Gab Jung KIM ; Kyoung Ho ROH ; Hyukmin LEE ; Ok Kyu PARK ; Taek Soo KIM ; Jae-Seok KIM ; Jaehyeon LEE ; Moon-Woo SEONG ; So Yeon KIM ; Jae-Sun PARK ; Younhee PARK ; Hee Jae HUH ; Namhee RYOO ; Hyun Soo KIM ; Heungsup SUNG ; Cheon Kwon YOO ;
Annals of Laboratory Medicine 2023;43(2):137-144
While the coronavirus disease 2019 pandemic is ongoing, monkeypox has been rapidly spreading in non-endemic countries since May 2022. Accurate and rapid laboratory tests are essential for identifying and controlling monkeypox. Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have proposed guidelines for diagnosing monkeypox in clinical laboratories in Korea. These guidelines cover the type of tests, selection of specimens, collection of specimens, diagnostic methods, interpretation of test results, and biosafety. Molecular tests are recommended as confirmatory tests. Skin lesion specimens are recommended for testing in the symptomatic stage, and the collection of both blood and oropharyngeal swabs is recommended in the presymptomatic or prodromal stage.
9.COVID-19 Molecular Testing in Korea: Practical Essentials and Answers From Experts Based on Experiences of Emergency Use Authorization Assays
Heungsup SUNG ; Kyoung Ho ROH ; Ki Ho HONG ; Moon-Woo SEONG ; Namhee RYOO ; Hyun Soo KIM ; Jaehyeon LEE ; So Yeon KIM ; Sookwon YOO ; Mi-Na KIM ; Myung Guk HAN ; Sang Won LEE ; Hyukmin LEE ; Cheon Kwon YOO ;
Annals of Laboratory Medicine 2020;40(6):439-447
10.Prevalence and Associated Factors of Depression and Anxiety Among Healthcare Workers During the Coronavirus Disease 2019 Pandemic:A Nationwide Study in Korea
Shinwon LEE ; Soyoon HWANG ; Ki Tae KWON ; EunKyung NAM ; Un Sun CHUNG ; Shin-Woo KIM ; Hyun-Ha CHANG ; Yoonjung KIM ; Sohyun BAE ; Ji-Yeon SHIN ; Sang-geun BAE ; Hyun Wook RYOO ; Juhwan JEONG ; NamHee OH ; So Hee LEE ; Yeonjae KIM ; Chang Kyung KANG ; Hye Yoon PARK ; Jiho PARK ; Se Yoon PARK ; Bongyoung KIM ; Hae Suk CHEONG ; Ji Woong SON ; Su Jin LIM ; Seongcheol YUN ; Won Sup OH ; Kyung-Hwa PARK ; Ju-Yeon LEE ; Sang Taek HEO ; Ji-yeon LEE
Journal of Korean Medical Science 2024;39(13):e120-
Background:
A healthcare system’s collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs.
Methods:
A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed.
Results:
A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety.
Conclusion
In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.