PURPOSE: The aim of this study was to assess the clinical usefulness and added diagnostic value of specific IgE antibodies to wheat, gluten, and ω-5 gliadin in diagnosing wheat allergy and distinguishing wheat anaphylaxis. METHODS: This study included 196 children who visited Ajou University Hospital for suspicious food allergy. The subjects were divided into 2 groups: the wheat allergy (WA) and non-wheat allergy (non-WA) groups. Patients with wheat allergy were further divided into 2 subgroups according to their symptoms: the wheat allergy with anaphylaxis (WA(Ana)) and wheat allergy without anaphylaxis (WA(Non-Ana)) groups. Serum concentrations of total IgE and specific IgE antibodies to wheat, gluten and ω-5 gliadin were measured. RESULTS: The median values of specific IgE antibodies to wheat, gluten and ω-5 gliadin were significantly higher in the WA group than in the non-WA group, and the positive decision points (95% specificity) were at 3.12, 2.61, and 0.21 kUA/L, respectively. The combination of specific IgE antibodies to wheat and ω-5 gliadin resulted in the highest accuracy of 93.9% in diagnosing wheat allergy. In differentiating the WA(Ana) group from the WA(Non-Ana) group, only specific IgE antibody to ω-5 gliadin showed a significant difference at the optimal cutoff point of 1.56 kUA/L. CONCLUSION: Our results show that the individual levels of specific IgE antibodies to wheat, gluten or ω-5 gliadin may have a considerably high accuracy in diagnosing wheat allergy and that specific IgE antibody to ω-5 gliadin may be particularly useful in predicting wheat anaphylaxis.
Anaphylaxis ; Antibodies ; Child* ; Food Hypersensitivity ; Gliadin* ; Glutens* ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Triticum* ; Wheat Hypersensitivity*

OBJECTIVES: An era of deindustrialization has begun in Korea after the industrial development that occurred up until the 1990's. Post industrialization dictates the development of the service industry and information technology with the associated musculoskeletal disorders in such industries. The association between musculoskeletal symptoms and psychosocial factors has been investigated by several researchers. The aims of this study was to characterize the relationship between musculoskeletal symptoms and psychosocial factors including occupational stress and depressive symptoms, and to provide basic data to group health practices for the prevention of musculoskeletal symptoms in the service industry. METHODS: Musculoskeletal symptoms, depressive symptoms and occupational stress were surveyed in 311 female call center employees. The prevalence of musculoskeletal symptoms, depressive symptoms and occupational stress scores were assessed. The odds ratio of the high risk occupational stress group into musculoskeletal symptom group was assessed in an effort to determine the associations between occupational stress and musculoskeletal symptoms. RESULTS: The overall prevalence of musculoskeletal and depressive symptoms was 53.7% and 20.6% respectively. The high risk occupational stress group of the total scores (p=0.049), physical environment (p=0.022), job demand (p=0.014) and interpersonal conflict (p=0.032) to musculoskeletal symptom were significant. The depression group was also significant (p=0.015). The adjusted odds ratio of the high risk stress group into the musculoskeletal symptom group inclusion was 1.687 (95% CI; 1.014~2.808) for the physical environment, and 1.948 (95% CI; 1.031-3.683) for depression. CONCLUSIONS: Overall, the relationship between musculoskeletal symptom and the psychosocial factors was not significant. Only the physical environmental stress factor and depression showed marginal significance, which suggests the possibility of an increased risk of musculoskeletal symptoms. However, since the group in this study was a homogeneous occupational population, further study with a reference group will be needed.
Depression ; Female ; Humans ; Korea ; Odds Ratio ; Prevalence ; Psychology

OBJECTIVES: The objectives of this study were to estimate the continuity of care for all Koreans with diabetes and to identify factors affecting the continuity of care. METHODS: We obtained National Health Insurance claims data for patients with diabetes who visited health-care providers during the year 2004. A total of 1,498,327 patients were included as study subjects. Most Frequent Provider Continuity (MFPC) and Modified, Modified Continuity Index (MMCI) were used as indexes of continuity of care. A multiple linear regression analysis was used to identify factors affecting continuity of care. RESULTS: The average continuity of care in the entire population of 1,498,327 patients was 0.89+/-0.17 as calculated by MFPC and 0.92+/-0.16 by MMCI. In a multiple linear regression analysis, both MFPC and MMCI were lower for females than males, disabled than non-disabled, Medicaid beneficiaries than health insurance beneficiaries, patients with low monthly insurance contributions, patients in rural residential areas, and patients whose most frequently visited provider is the hospital. CONCLUSIONS: The continuity of care for patients with diabetes is high in Korea. However, women, the disabled and people of low socio-economic status have relatively low continuity of care. Therefore, our first priority is to promote a diabetes management program for these patients.
Poverty ; National Health Programs ; Middle Aged ; Medical Assistance ; Male ; Linear Models ; Korea/epidemiology ; Insurance Claim Review ; Humans ; Female ; Diabetes Mellitus/economics/epidemiology/*therapy ; Continuity of Patient Care/economics/*statistics & numerical data ; Aged ; Adult

OBJECTIVES: The cost of psychiatric service is increasing every year in Korea. The length of inpatient stay (LOS) is an important factor determining in-patient service cost. This study was aimed to find the factors that influence LOS in a psychiatric open ward of a general hospital. METHODS: The study includes 134 inpatients who were consecutively admitted to a psychiatric open ward in a general hospital from January 1st to June 30th in 2001. Demographic data, clinical characteristics on admission and discharge, global functioning, social support levels and life stressors were collected. RESULTS: The mean LOS for the 134 patients was 15.5 days (S.D 9.2). The occupation of housekeeper and those secred high in phobic anxiety subscale on SCL-90-R were statistically significant predictor for longer LOS in the univariate analysis. No significant differences in LOS were found by diagnostic groups and social support. In multiple regression analysis, the scores of phobic anxiety subscale, occupation and presence of physical illness were statistically significant predictor for LOS. CONCLUSION: This study failed to find the significant variables to account for substantial proportion of variance for LOS.
Anxiety ; Diagnosis ; Hospitals, General* ; Humans ; Inpatients ; Korea ; Length of Stay* ; Occupations

Data from the Korean National Health Insurance Service (NHIS) have been widely used to provide real-world evidence. Due to the nature of claims data, researchers use operational definitions to define patients with specific diseases. This study aimed to conduct a systematic review of the operational definitions of liver cancer used in studies based on the NHIS database and to suggest the most appropriate operational definition. Literature search was completed on January 6, 2021, using PubMed and KoreaMed.We applied the most frequently used operational definitions of liver cancer to the NHIS–National Sample Cohort and calculated age-standardized incidence rates (ASRs) of liver cancer by year. The ASRs using each operational definition were compared with the ASR from the Korea Central Cancer (KCCR) data. Among 236 articles, 90 were selected for review, covering histologically various kinds of liver cancer and varied by study subjects. Most studies (n = 79) did not mention whether the codes for the operational definition were from only the main diagnosis or from both the main and sub-diagnosis. The most frequently used operational definition was C22 (n = 39); however, the most similar operational definition was the ASR using “C22.0 or C22.9” for men and “C22.0” for women as the main diagnosis to the ASR from the KCCR. Based on the comparison with KCCR data, we suggest using “C22.0 or C22.9” for men and “C22.0” for women as the main diagnosis for the operational definition of liver cancer when using the NHIS data.

BACKGROUND/AIMS: Olmesartan, a widely used angiotensin II receptor blocker (ARB), has been linked to sprue-like enteropathy. No cases of olmesartan-associated enteropathy have been reported in Northeast Asia. We investigated the associations between olmesartan and other ARBs and the incidence of enteropathy in Korea. METHODS: Our retrospective cohort study used data from the Korean National Health Insurance Service to identify 108,559 patients (58,186 females) who were initiated on angiotensin converting enzyme inhibitors (ACEis), olmesartan, or other ARBs between January 2005 and December 2012. The incidences of enteropathy were compared among drug groups. Changes in body weight were compared after propensity score matching of patients in the ACEis and olmesartan groups. RESULTS: Among 108,559 patients, 31 patients were diagnosed with enteropathy. The incidences were 0.73, 0.24, and 0.37 per 1,000 persons, in the ACEis, olmesartan, and other ARBs groups, respectively. Adjusted rate ratios for enteropathy were: olmesartan, 0.33 (95% confidential interval [CI], 0.10 to 1.09; p = 0.070) and other ARBs, 0.34 (95% CI, 0.14 to 0.83; p = 0.017) compared to the ACEis group after adjustment for age, sex, income level, and various comorbidities. The post hoc analysis with matched cohorts revealed that the proportion of patients with significant weight loss did not differ between the ACEis and olmesartan groups. CONCLUSIONS: Olmesartan was not associated with intestinal malabsorption or significant body weight loss in the general Korean population. Additional large-scale prospective studies of the relationship between olmesartan and the incidence of enteropathy in the Asian population are needed.
Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Asia ; Asian Continental Ancestry Group ; Body Weight ; Cohort Studies* ; Comorbidity ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Incidence ; Insurance Claim Review ; Intestinal Diseases ; Korea ; National Health Programs ; Propensity Score ; Prospective Studies ; Receptors, Angiotensin ; Retrospective Studies ; Weight Loss

Objectives: OxyMask, a novel product, has recently been used to administer oxygen postoperatively to patients who have undergone general anesthesia. This study aimed to evaluate the incidence of hypoxia in patients under general anesthesia upon arrival to the post-anesthesia care unit (PACU) using arterial blood gas analysis, and to compare the effectiveness of OxyMask with a non-rebreathing oxygen mask for oxygen administration. Methods: We retrospectively investigated anesthesia-related data from the electronic medical records of 460 patients treated from April to November 2021. We analyzed patients aged 20 years or older who had undergone general anesthesia and whose perioperative arterial blood gas analysis results were available upon arrival to the PACU. These patients were grouped into the non-rebreathing oxygen mask (n=223) and OxyMask (n=237) groups, and statistical analysis was performed utilizing their anesthesia records. Results: No patients exhibited hypoxia upon arrival to the recovery room. The oxygen concentration increased after oxygen administration; its concentration during the recovery room period (Δ2 PaO2 ) was 10.7±42.3 and 13.9±38.5 mmHg in the non-rebreathing oxygen mask and OxyMask groups, respectively.This difference was not statistically significant. Moreover, the arterial oxygen saturation between the end of surgery and upon arrival to the PACU (Δ1 SaO2 ) and the arterial oxygen saturation 20 minutes after oxygen administration at the PACU (Δ2 SaO2 ) did not significantly differ between the groups. Conclusion OxyMask was not superior to a non-rebreathing oxygen mask in terms of the effectiveness of oxygen supply.

BACKGROUND: Hypoplastic acute leukemia is rare and most cases reported were of older age group. We reviewed our cases of hypoplastic acute leukemia and their hematologic and clinical findings. METHOD: The bone marrow biopsy slides and the reports of patients diagnosed as having acute leukemia during recent ten years were reviewed. The medical records of patients who had blast cells of greater than 30% and marrow cellularity less than or equal to 50% were reviewed. RESULTS: Of 308 patients analyzed, 17 (5.5%) fulfilled the above mentioned criteria. Ten patients were women and seven men. The median age was 44 with a range of 18-71. Chief complaints were fever, headache, general weakness and abdominal pain. Two patient presented hepatomegaly. One patient was diagnosed as granulocytic sarcoma. Ten patients were pancytopenic with median leukocyte count of 1,500/ L, hemoglobin of 8.3 g/dL, and platelet count of 27,000/ L. Circulating blast cells were 0-76%. FAB classification revealed one to be M0, three M1, seven M2, three M4, one M5, one M6 and one L1. Seven patients were not followed, and three were treated conservatively. Of seven patients receiving chemotherapy, four achieved durable complete remission. One achieved complete remission by using G-CSF. CONCLUSION: Most cases of reported hypoplastic acute leukemia were acute myelogenous leukemia of older age but our cases included leukemia of younger age and one acute lymphoblastic leukemia. Of seven patients who received chemotherapy, four achieved complete remission and one showed complete remission only by G-CSF.
Abdominal Pain ; Biopsy ; Bone Marrow ; Classification ; Drug Therapy ; Female ; Fever ; Granulocyte Colony-Stimulating Factor ; Headache ; Hepatomegaly ; Humans ; Leukemia* ; Leukemia, Myeloid, Acute ; Leukocyte Count ; Male ; Medical Records ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sarcoma, Myeloid

Purpose: Recent studies of food allergy (FA) at all ages are scanty in Korea. We performed this study to better understand severity-related and age-stratified causes of FA from infants to older adults in a single tertiary hospital in Korea. Methods: A retrospective medical record review was performed on patients of all ages diagnosed with immediate-type FA between March 2008 and February 2018 in Ajou University Hospital. Results: A total of 4,680 cases of FA among 2,733 patients were reported. The distribution of onset ages of the first FA symptom was as follows: 45.3% below 2 years, 16.2% at 2–6 years, 5.5% at 7–12 years, 4.0% at 13–18 years, 16.9% at 19–40 years, 10.4% at 41–65 years, and 1.8% above 65 years of age. The major 10 causative foods were hen’s eggs (17.2%), cow’s milk (16.7%), wheat (8.6%), crustaceans (8.5%), fish (4.6%), walnuts (4.4%), pork (3.2%), peanuts (3.2%), shellfish (3.0%), and peach (2.2%). The culprits ranked from the 11th to the 20th were as follows: soybean, apple, chicken, buckwheat, beef, kiwi, almonds, perilla seeds, tomato, and squid. The top 3 causative foods in children were hen’s eggs, cow’s milk, and wheat, while those in adults were crustaceans, wheat, and fish. Food-induced anaphylaxis was reported in 29.2% of all cases, with cow’s milk, hen’s eggs, wheat, crustaceans, fish, walnuts, pork, shellfish, buckwheat, and peanuts being the major 10 causes. Conclusion This study could provide a better understanding of the detailed ranks of the causes of FA according to severity and age in Korea.