Purpose: The coronavirus disease 2019 (COVID-19) pandemic has affected people's daily lives and increased their time spent at home. This study aims to investigate the changes in lifestyle factors and obesity among Korean adolescents before and during the COVID-19 outbreak. Methods: We used the data of 109,282 adolescents aged 12–18 years, from the Korea Youth Risk Behavior Survey conducted in 2019 and 2020 before and during the COVID-19 pandemic, respectively. The changes in the prevalence of obesity and lifestyle factors (diet, exercise, sitting time, and sleep duration) were assessed. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of predictors for obesity were calculated. Results: The prevalence of overweight (10% to 10.5%) and obesity (11.5% to 12.7%) increased significantly, especially among males younger than 15 years, whereas significant differences were absent among females. The mean body mass index z-score increased from 0.28 to 0.39 in males but decreased from 0.08 to 0.04 in females. Fruit consumption, regular exercise, and average sleep duration decreased, whereas sitting time increased. After controlling for covariates, a short sleep duration (OR, 1.14) and an increased sitting time (OR, 1.14) were significantly associated with an elevated risk for overweight/obesity. Conclusion During the COVID-19 pandemic, the prevalence of obesity and overweight increased, particularly in males, as did unfavorable trends in related lifestyle factors. Sex- and age-specific strategies to improve lifestyle factors associated with obesity are needed, especially during the COVID-19 pandemic.

The incidence and prevalence rates of inf lammatory bowel disease (IBD) have been increasing in East Asian countries over the past few decades. Accordingly, the general understanding and awareness of IBD among healthcare professionals has increased considerably in this region. This increase is ultimately associated with the evolving focus of IBD clinicians devoted to comprehensive patient care, especially in establishing IBD clinics/centers capable of providing multidisciplinary counseling. Comprehensive IBD care at IBD clinics/centers usually includes surgical and medication decision-making, transition from pediatric to adult clinics, care of extraintestinal manifestations, care of infectious diseases in patients undergoing immunomodulatory or biologic therapies, and nutritional, psychosocial, socioeconomic, and pharmacological care. Team members comprise specialists from various departments related to IBD and can be divided into core and ad hoc members. Usually, the scope of work in IBD clinics/centers involves patient care, patient outreach, and system management. Considering the environmental changes in IBD treatment, it is necessary to perform comprehensive IBD patient care in the form of a program based on competencies, rather than simply following the organization of previous IBD centers. The present review summarizes recent trends in IBD patient care and offers perspectives regarding IBD center management.

The incidence and prevalence rates of inf lammatory bowel disease (IBD) have been increasing in East Asian countries over the past few decades. Accordingly, the general understanding and awareness of IBD among healthcare professionals has increased considerably in this region. This increase is ultimately associated with the evolving focus of IBD clinicians devoted to comprehensive patient care, especially in establishing IBD clinics/centers capable of providing multidisciplinary counseling. Comprehensive IBD care at IBD clinics/centers usually includes surgical and medication decision-making, transition from pediatric to adult clinics, care of extraintestinal manifestations, care of infectious diseases in patients undergoing immunomodulatory or biologic therapies, and nutritional, psychosocial, socioeconomic, and pharmacological care. Team members comprise specialists from various departments related to IBD and can be divided into core and ad hoc members. Usually, the scope of work in IBD clinics/centers involves patient care, patient outreach, and system management. Considering the environmental changes in IBD treatment, it is necessary to perform comprehensive IBD patient care in the form of a program based on competencies, rather than simply following the organization of previous IBD centers. The present review summarizes recent trends in IBD patient care and offers perspectives regarding IBD center management.

BACKGROUND: The domestic quantity of blood components consumed has been decreasing since 2002, but the rate of a single unit RBC transfusion (SUT) has been on the increase. In the past, a SUT was regarded as an uncesssary procedure, but currently is considered as an effective method to maintain a minimal hemoglobin concentration for physiological needs. We investigated the actual conditions of a SUT. METHODS: We analyzed 800 cases of SUTs performed at a tertiary care university hospital between March 2006 March and February 2007. The subjects of the study were divided into a surgical group (n=561) and medical group (n=239) for the purpose of RBC unit usage and were analyzed by groups and ordering departments, with an analysis of the pre and post-transfusion hemoglobin concentration and hematocrit values. The distribution according to the pre and post-transfusion hemoglobin ranges were calculated. RESULTS: The mean hemoglobin concentration increment of the surgical group was significantly lower than that of the medical group (P<0.0001) and the mean pre and post-transfusion hemoglobin concentrations of the medical group were lower than that of the surgical group (P<0.0001). Approximately 26% cases of the SUTs performed in the surgical group were appropriate, based on a post-transfusion hemoglobin concentration below 10 g/dL. In the medical group, about 75% of the SUTs were appropriate based on a pre-transfusion hemoglobin concentration below 9 g/dL. CONCLUSION: Most transfusions are decided based on various clinical situations and opinions of the clinicians. Therefore, continuous evaluation of the appropriateness of transfusion is necessary. In our study, the appropriateness of a SUT was estimated indirectly based on the pre and post-transfusion hemoglobin concentration. Consequently, policies and strategies for performing asingle unit RBC transfusion are required.
Hematocrit ; Tertiary Healthcare

BACKGROUND: Due to the slowing of population growth, population ageing, and more aggressive medical treatment, Korea will be faced with the challenge of blood shortage. One solution to the blood shortage problem is to take advantage of the multicomponent collection technique. However, clinical application is limited due to the low prices of blood products. In this study, we compared the prices of blood products in 6 major countries. METHODS: Prices of leukoreduced red blood cells (RBC), platelet concentrate (PC), fresh frozen plasma (FFP), cryoprecipitate (CRYO), and apheresis platelets (AP) were compiled from US, United Kingdom, Japan, Australia, Spain, and Korea. Adjusted prices using per capita gross domestic product (GDP) and purchasing power parity (PPP) were estimated and analyzed. RESULTS: The RBC price in Korea was only 30% of the mean RBC price of the other 5 countries. Considering per capita GDP and PPP, the RBC prices in Korea were estimated up to 41% and 46%, respectively. The PPP adjusted price of PC, FFP, and AP of Korea was 70%, 72%, and 70% of mean price of the other 5 countries. Price ratios of PC, FFP, and CRYO to RBC were 0.59, 0.63, and 0.57, which were higher than the means of the other 5 countries (0.38, 0.47, and 0.32). CONCLUSION: Considering per capita GDP and PPP, blood product prices in Korea were cheaper than the mean prices of the other 5 countries. For adoption of multicomponent collection, the prices of blood products should be raised, especially the price of RBCs.
Adoption ; Australia ; Blood Component Removal ; Blood Platelets ; Erythrocytes ; Female ; Great Britain ; Gross Domestic Product ; Guanosine Diphosphate ; Imidazoles ; Japan ; Korea ; Nitro Compounds ; Parity ; Plasma ; Population Growth ; Spain

BACKGROUND: ABO antibody titration is important in cases such as ABO incompatible hemolytic disease of the fetus and newborn (HDFN), ABO incompatible bone marrow, or solid organ transplantation. This study was conducted in order to evaluate usability of ORTHO VISION (Ortho Clinical Diagnostics, Raritan, USA) designed automated ABO antibody titration equipment. METHODS: The isoagglutination titers were determined in 80 subjects (20 A, 20 B, 40 O (anti-A 20, anti-B 20)) using a conventional tube technique, including a 30 minute room temperature phase (CTT), Dithiothreitol treated manual column agglutination technique (MCAT), and automated column agglutination technique (ACAT) by ORTHO VISION. The concordance of titer was compared within one dilution step between the two methods. RESULTS: The isoagglutinin titers measured by the ACAT with anti-human globulin poly cassette (ACAT_Poly) and anti-human globulin IgG cassette (ACAT_IgG) were the highest and the isoagglutinin titer measured by the MCAT was also higher than that by the CTT. The isoagglutinin titer measured by the ACAT with reverse diluents cassette (ACAT_Reverse) was similar to that measured by the CTT. The concordance of anti-A and anti-B titers between CTT and ACAT_Reverse was 83% and 68%. The concordance of anti-A and anti-B titers between MCAT and ACAT_Poly was 100% and 83%. The concordance of anti-A and anti-B titers between MCAT and ACAT_IgG was 98% and 88%. CONCLUSION: Automated isoagglutinin titration using ACAT_Poly or ACAT_IgG without DTT showed reliable concordance with DTT treated MCAT, and it appears to be a possible replacement for the conventional MCAT method.
ABO Blood-Group System ; Agglutination ; Automation ; Bone Marrow ; Dithiothreitol ; Fetus ; Humans ; Immunoglobulin G ; Infant, Newborn ; Organ Transplantation ; Transplants

BACKGROUND: Buffy coat method is one of the blood components processing methods widely used in many countries including Europe and Canada. For the first time in Korea, we evaluated the qualities of blood components manufactured by buffy coat method. METHODS: We collected 400 mL whole bloods using the quadruple top and bottom blood bag from thirty-five donors. Whole bloods were processed into leukoreduced RBC, leukoreduced pooled platelet, and 24 hr frozen plasma by the buffy coat method with blood bags and instruments of Fenwal and Fresenius. The qualities of each blood component were analyzed at each scheduled day, and compared with the standard guidelines of quality control in Korean Red Cross. RESULTS: The volume and hemoglobin of RBCs were lower than the standard guidelines. Comparing with the standard of apheresis platelets, leukoreduced pooled platelets showed higher total platelet yield with the median 3.70x10(11)/unit. Frozen plasma showed increased volume recovery than the standard guideline, but the activity of factor VIII at Day 35 was decreased to 0.66+/-0.14 IU/mL. CONCLUSION: We have found that the yields of pooled platelet and the frozen plasma processed by buffy coat method were higher than the standard guidelines. To introduce the buffy coat method to routine blood component separation process in Korea, further evaluations about the cost-effectiveness of buffy coat method are required.
Blood Component Removal ; Blood Platelets ; Canada ; Erythrocytes ; Europe ; Factor VIII ; Hemoglobins ; Humans ; Korea ; Plasma ; Quality Control ; Tissue Donors

BACKGROUND: The indocyanine green (ICG) finger monitoring method is a newly developed noninvasive method for the ICG clearance test. This study was performed to determine its clinical usefulness compared with the conventional blood sampling method. METHODS: The ICG clearance test was performed on 270 patients using both the conventional blood sampling method and the finger monitoring method simultaneously. The plasma disappearance rate of the ICG and the 15-minute retention ratio (ICG R15) were analyzed and compared with the conventional blood sampling method. RESULTS: The plasma disappearance rate using the finger monitoring method was slightly lower than that of the conventional blood sampling method with good correlation (r=0.840, P<0.001). ICG R15 using finger monitoring method was slightly higher than that of the conventional blood sampling method with good correlation (r=0.839, P<0.001). CONCLUSIONS: As there was a good correlation between the conventional blood sampling method and the finger monitoring method, the latter method seemed to be clinically useful due to its convenience and accuracy.
Fingers* ; Humans ; Indocyanine Green* ; Plasma

Approximately 80-85% of D-negative (D-) persons produce anti-D antibodies after exposure to D-positive (D+) red blood cells (RBCs). Previously, anti-D was the most commonly detected Rh antibody, but its incidence has greatly decreased due to the prophylactic use of Rh immunoglobulin (RhIG). Anti-D antibody formation may occur following RhD-incompatible organ transplantation when D- recipients are exposed to D+ RBCs that originate from a donor organ. As a large volume of donor blood may be contained within the transplanted organ, the use of a large amount of RhIG is required in RhD-incompatible liver transplantation. Here, we describe the use of a large amount of RhIG to treat a patient following RhD-incompatible liver transplantation. This patient was a 71-yr-old woman with hepatitis C virus-related liver cirrhosis, who had an A/D- blood type. The donor was her grandson, whose blood type was O/D+. The recipient's preoperative anti-D antibody test was negative. One unit of O/D- irradiated leukoreduced RBCs and three units of A/D- fresh frozen plasma were transfused during liver transplantation. An equal amount (12,000 IU) of RhIG was infused intravenously, immediately after liver transplantation and a second time on post-operation day 1. The anti-D titer was 1:64 on the first post-operation day, and had increased to 1:128 by the following day. By 1 month after the surgery, the titer had decreased to 1:4. In this case of liver transplantation, RhIG was actively used to prevent RhD sensitization and the subsequent occurrence of adverse events associated with RhD-incompatible liver transplantation.
Antibodies ; Antibody Formation ; Erythrocytes ; Female ; Hepatitis C ; Humans ; Immunoglobulins* ; Incidence ; Liver Cirrhosis ; Liver Transplantation* ; Organ Transplantation ; Plasma ; Tissue Donors ; Transplants

BACKGROUND: The amount of blood components "on hold" preoperatively is usually determined by the surgeon's experiences or habits, and is often an amount in excess of the amount actually transfused. This method could diminish the effective use of blood components and result in an excessive workload for the blood bank, a shortage of blood products, and an increase in the quantity of discarded blood products. We quantified the amount of RBC components transfused during surgeries to establish the maximal surgical blood order schedule (MSBOS). METHODS: We analyzed the number of RBC component units transfused to patients >17 years of age who underwent elective surgeries performed at a university hospital between November 2005 and February 2007. RESULTS: There were 48,007 elective surgeries performed during the investigated period. The Departments of Surgery, Ophthalmology, Otolaryngology, and Urology carried out 8,317, 7,407, 5,928, and 5,268 surgical cases, respectively. The MSBOS values for 60 types of surgeries categorized into 7 surgical fields are listed. CONCLUSION: In the current study, we analyzed a greater number of surgical cases than previous studies in an effort to generate accurate and practical data. The mean amount of transfused RBC units was less in most types of surgeries compared to previous studies; this finding is presumed to be the result of improvements in surgical techniques and advances in medical science. A regular and comprehensive revision of the MSBOS is required to correspond to the changes in the medical environment and the shifting characteristics of patients, and to maximize the utility of blood products. A committee to supervise transfusion practices is also essential to coordinate different policies of the laboratory, surgical,and anesthesiology departments.
Anesthesiology ; Appointments and Schedules ; Blood Banks ; Humans ; Ophthalmology ; Otolaryngology ; Urology