Children have dynamic process of maturation and substantial changes in growth and development which eventually make the drug safety profiles different from adults. Medication errors (MEs) in pediatrics are reported to occur three times more likely than adults. The aims of this study were to identify the characteristics of pediatric MEs in Korea at national level and help raise awareness of risks from the MEs in pediatrics. We conducted a descriptive analysis with the pediatric ME reports in Korea Adverse Event Reporting System (KAERS) database from 1989 to 2012 and 208 ME reports in pediatrics were found. Based on KAERS database, the proportion of reported pediatric ME in adverse drug event (ADE) reports was 2.73 times (95% CI, 2.35-3.17) higher than that of adult ME. In 208 ME reports, we found a total of 236 ME-related terms within 19 types of MEs. The most common type of MEs was "accidental overdose" (n = 58, 24.6%), followed by "drug maladministration" (n = 50, 21.2%) and "medication error" (n = 41, 17.4%). After the narratives of ME reports were reviewed, we noticed that most of them did no harm to patients, but some cases were needed for medical treatment. Our data suggest that MEs in pediatrics are not negligible in Korea. We expect that this study would increase the awareness of the problem in pediatric MEs and induce the need for further development of an effective national ME preventing system in Korea.
Adult ; *Adverse Drug Reaction Reporting Systems ; Child ; *Databases, Factual ; Humans ; Medication Errors/*statistics & numerical data ; Republic of Korea/epidemiology ; Time Factors

BACKGROUND: We evaluated the diagnostic rate of diabetes using fasting plasma glucose (FPG), 2-hour plasma glucose (2h PG) after 75 g oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) levels, and we elucidated the pathophysiologic characteristics and risk factors that give rise to diabetes in patients with prediabetes. METHODS: The data of 236 patients who had the OGTT at Konkuk University Hospital were analyzed. Fasting, 30, and 120 minutes blood glucose levels and insulin levels were measured. The diagnostic rate of diabetes was assessed using FPG, 2h PG, and HbA1c levels. The clinical data and insulin resistance and secretion evaluations were compared using indexes according to the fasting glucose level. RESULTS: Among 236 subjects, 97 (41.1%) were diabetics and 102 (43.2%) were prediabetics. The rate of diabetes diagnosis by one of the individual criteria was 56.7%, 53.6%, and 84.5% for FPG, HbA1c, and 2h PG, respectively. When two criteria were used to diagnose diabetes, 72.2% of the diabetic patients were identified by FPG and HbA1c, while 100% were identified by FPG and 2h PG, and 91.7% were identified by 2h PG and HbA1c. The HbA1c cut-off value for 2h PG ≥200 mg/dL was 6.1%, and the FPG cut-off value was 115 mg/dL. In impaired fasting glucose subjects, the HbA1c level, Matsuda index, and insulinogenic index were associated with risk of occurrence of overt diabetes (P<0.01). CONCLUSION: This study suggests that performing additional OGTT for patients with FPG ≥110 mg/dL or HbA1c ≥6.1% is helpful to reclassify their glucose tolerance status and evaluate their potential for progressing to overt diabetes.
Blood Glucose ; Diabetes Mellitus* ; Diagnosis ; Fasting ; Glucose ; Glucose Tolerance Test* ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Insulin Resistance ; Prediabetic State ; Risk Factors

We made a mistake in presenting ORCID of Chorong Kim.

PURPOSE: Changes in eating habits and malnutrition due to dysphagia are important health problems for older adults. This study investigated the effects of an educational program aimed at improving diet quality in community-dwelling older adults at risk for dysphagia in South Korea. METHODS: We assessed 27 individuals in the experimental group and 26 individuals in the control group between September and October 2015. All participants were aged 65 years or older and were at risk for dysphagia. A combined diet and exercise program was applied to the experimental group (n = 27) for six weeks. We examined changes in participants' eating habits and their knowledge and attitudes concerning dysphagia risk. The nutrition intake of all participants was measured before and after the intervention using 24-hr dietary recall. RESULTS: There was a significant increase in knowledge of dysphagia risk in the experimental group, with scores increasing from 3.7 to 7.1, out of 10 points (p < 0.001). There were also significant improvements in eating habits after the intervention in the experimental group, with scores increasing from 21.9 to 28.3, out of 36 points (p < 0.001). The attitude score of participants in the experimental group increased significantly, from 15.2 to 16.7, out of 20 points (p = 0.016). CONCLUSION: Developing educational programs can help older adults living in the community lead a healthier lifestyle and improve their ability to manage their diet.
Adult* ; Deglutition Disorders* ; Diet ; Eating ; Humans ; Korea* ; Life Style ; Malnutrition

Many biobanks were established as biorepositories for biomedical research, and a number of biobanks were founded in the 1990s. The main aim of the biobank is to store and to maintain biomaterials for studying chronic disease, identifying risk factors of specific diseases, and applying personalized drug therapies. This report provides a review of biobanks, including Korean biobanks and an analysis of sample volumes, regulations, policies, and ethical issues of the biobank. Until now, the top 6 countries according to the number of large-scale biobanks are the United Kingdom, United States, Sweden, France, the Netherlands, and Italy, and there is one major National Biobank of Korea (NBK) and 17 regional biobanks in Korea. Many countries have regulations and guidelines for the biobanks, and the importance of good management of biobanks is increasing. Meanwhile, according to a first survey of 456 biobank managers in the United States, biobankers are concerned with the underuse of the samples in their repositories, which need to be advertised for researchers. Korea Biobank Network (KBN) project phase II (2013-2015) was also planned for the promotion to use biospecimens in the KBN. The KBN is continuously introducing for researchers to use biospecimens in the biobank. An accreditation process can also be introduced for biobanks to harmonize collections and encourage use of biospecimens in the biobanks. KBN is preparing an on-line application system for the distribution of biospecimens and a biobank accreditation program and is trying to harmonize the biobanks.
Accreditation ; Biocompatible Materials ; Bioethics* ; Chronic Disease ; Drug Therapy ; Ethics ; France ; Great Britain ; Humans ; Italy ; Korea ; Netherlands ; Risk Factors ; Social Control, Formal ; Sweden ; United States

BACKGROUND/OBJECTIVES: To encourage healthier food choices for children in fast-food restaurants, many initiatives have been proposed. This study aimed to examine the effect of disclosing nutritional information on parents' meal choices for their children at fast-food restaurants in South Korea. SUBJECTS/METHODS: An online experimental survey using a menu board was conducted with 242 parents of children aged 2-12 years who dined with them at fast-food restaurants at least once a month. Participants were classified into two groups: the low-calorie group (n = 41) who chose at least one of the lowest calorie meals in each menu category, and the high-calorie group (n = 201) who did not. The attributes including perceived empowerment, use of provided nutritional information, and perceived difficulties were compared between the two groups. RESULTS: The low-calorie group perceived significantly higher empowerment with the nutritional information provided than did the high-calorie group (P = 0.020). Additionally, the low-calorie group was more interested in nutrition labeling (P < 0.001) and considered the nutritional value of menus when selecting restaurants for their children more than did the high-calorie group (P = 0.017). The low-calorie group used the nutritional information provided when choosing meals for their children significantly more than did the high-calorie group (P < 0.001), but the high-calorie group had greater difficulty using the nutritional information provided (P = 0.012). CONCLUSIONS: The results suggest that improving the empowerment of parents using nutritional information could be a strategy for promoting healthier parental food choices for their children at fast-food restaurants.
Child* ; Food Labeling ; Humans ; Korea ; Meals* ; Nutritive Value ; Parents ; Power (Psychology) ; Restaurants*

Protein S deficiency is one of the several risk factors for thrombophilia and can cause blood clotting disorders such as deep vein thrombosis and pulmonary embolism. A 54-year-old man was admitted with the complaint of dyspnea and was diagnosed with pulmonary embolism. The patient had very low level of free protein S, total protein S antigen, and protein S activity (type I protein S deficiency). In history taking, we found that his mother, 78 year old, had a history of same disease 10 years ago, and confirmed the pronounced low level of protein S. The patient's son also had very low level of protein S, however there had not been any history of pulmonary embolism yet. This case study suggests that asymptomatic persons with a family history of protein S deficiency and pulmonary embolism should be checked regularly for early detection of the disease, as protein S deficiency can be suspected.
Blood Coagulation ; Dyspnea ; Humans ; Middle Aged ; Mothers ; Protein S ; Protein S Deficiency* ; Pulmonary Embolism* ; Risk Factors ; Thrombophilia ; Venous Thrombosis

BACKGROUND: Elevated levels of cortisol and growth hormone are critical counterregulatory responses to severe hypoglycemia. However, the proportion and clinical characteristics of patients with type 2 diabetes mellitus (DM) who fail to show appropriate cortisol and/or growth hormone secretion in response to severe hypoglycemia have not been investigated. METHODS: We measured plasma cortisol and growth hormone levels in type 2 DM patients with severe hypoglycemia who visited the emergency department between 2006 and 2015. RESULTS: Of 112 hypoglycemic patients, 23 (20.5%) had an impaired cortisol response (<18 µg/dL) and 82 patients (73.2%) had an impaired growth hormone response (<5 ng/mL). Nineteen patients (17.0%) had impaired responses to both cortisol and growth hormone. The patients with impaired responses of cortisol, growth hormone, and both hormones were significantly older and more likely to be female, and had higher admission rates, lower growth hormone levels, and lower adrenocorticotropic hormone levels than the patients with a normal hormonal response. Multivariate logistic regression analysis indicated that an impaired growth hormone response was significantly associated with advanced age, shorter DM duration, a higher admission rate, and a higher body mass index (BMI). An impaired cortisol response was significantly associated with growth hormone levels. Patients with an impaired growth hormone response had higher admission rates than patients with a normal response. CONCLUSION: A considerable number of type 2 DM patients had impaired cortisol and/or growth hormone responses to severe hypoglycemia. Advanced age, shorter DM duration, and higher BMI were independently associated with an abnormal growth hormone response.
Adrenocorticotropic Hormone ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Emergency Service, Hospital ; Female ; Growth Hormone ; Humans ; Hydrocortisone ; Hypoglycemia ; Logistic Models ; Plasma

BACKGROUND: Although heart transplantation is the only therapeutic modality for patients with end-stage heart disease, immunosuppressive therapy to reduce organ rejection may increase the risk of infection in transplant patients. Little is known regarding infectious complications in heart transplant recipients in Korea. Thus, this study was performed to evaluate the clinical features and outcome of infectious complications in patients receiving heart transplantation. MATERIALS AND METHODS: A retrospective cohort study was performed by reviewing medical records of patients who underwent heart transplantation from December 1996 to October 2008 in Samsung Medical Center, Seoul, Korea. RESULTS: A total of 72 cardiac allograft recipients were included in the analysis. Median follow-up duration was 417 (range, 2-3995) days. During the follow-up period, 75 infectious complications occurred in 39 (54.2%) recipients, of which 31 cases (41.3%) were caused by bacteria, 28 (37.3%) by viruses, 10 (13.3%) by fungi, 4 (5.4%) by Pneumocystis jirovecii, and 2 (2.7%) by Mycobacterium tuberculosis. Median onset time of bacterial, viral and fungal infection were 153, 106 and 68 days, respectively. The most common site of infection was lung (n=26, 34.7%), followed by gastrointestinal tract (n=11, 14.7%) and oral cavity (n=9, 12%). All patients were sero-positive for cytomegalovirus (CMV)-specific IgG before transplantation and received preemptive therapy of CMV infection. After heart transplantation, 44 (63.8%) patients experienced CMV reactivation identified by CMV antigenemia and 9 (13%) patients had organ-specific CMV diseases. The overall mortality rate was 33.3% (24/72). Infectious complications were the most common cause of death (n=10, 41.7%). The operative risk factors for death were lung infection, fungal infection and bloodstream infection. CONCLUSIONS: In the current study, the lung was the most common site of infection and bacteria were the most frequent etiologic pathogens among heart transplant recipients. Infectious complications, especially fungal infections were the most common causes of death. Prevention strategies against fungal infections should be evaluated in the future studies.
Bacteria ; Cause of Death ; Cohort Studies ; Cytomegalovirus ; Follow-Up Studies ; Fungi ; Gastrointestinal Tract ; Heart ; Heart Diseases ; Heart Transplantation ; Humans ; Immunoglobulin G ; Korea ; Lung ; Medical Records ; Mouth ; Mycobacterium tuberculosis ; Pneumocystis jirovecii ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Transplants

BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28–2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69–3.42), having a lower education level (OR = 2.29, 95% CI = 1.33–3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32–3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43–46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75–4.23), lowered appetite (OR = 3.27, 95% CI = 2.16–4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83–4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.
Aged* ; Appetite ; Deglutition Disorders* ; Eating ; Education ; Female ; Food Habits ; Gwangju ; Gyeonggi-do ; Humans ; Korea* ; Logistic Models ; Malnutrition ; Mastication ; Nutrition Assessment ; Nutritional Status ; Risk Assessment ; Seoul