OBJECTIVES: This study investigated the reporting rates of adverse events following immunization (AEFIs) to the spontaneous reporting system (SRS) and its predictors among individuals with AEFIs after coronavirus disease 2019 (COVID-19) vaccination. METHODS: A cross-sectional, web-based survey was conducted from December 2, 2021 to December 20, 2021, recruiting participants >14 days after completion of a primary COVID-19 vaccination series. Reporting rates were calculated by dividing the number of participants who reported AEFIs to the SRS by the total number of participants who experienced AEFIs. We estimated adjusted odds ratios (aORs) using multivariate logistic regression to determine factors associated with spontaneous AEFIs reporting. RESULTS: Among 2,993 participants, 90.9% and 88.7% experienced AEFIs after the first and second vaccine doses, respectively (reporting rates, 11.6 and 12.7%). Furthermore, 3.3% and 4.2% suffered moderate to severe AEFIs, respectively (reporting rates, 50.5 and 50.0%). Spontaneous reporting was more prevalent in female (aOR, 1.54; 95% confidence interval [CI], 1.31 to 1.81); those with moderate to severe AEFIs (aOR, 5.47; 95% CI, 4.45 to 6.73), comorbidities (aOR, 1.31; 95% CI, 1.09 to 1.57), a history of severe allergic reactions (aOR, 2.02; 95% CI, 1.47 to 2.77); and those who had received mRNA-1273 (aOR, 1.25; 95% CI, 1.05 to 1.49) or ChAdOx1 (aOR, 1.62; 95% CI, 1.15 to 2.30) vaccines versus BNT162b2. Reporting was less likely in older individuals (aOR, 0.98; 95% CI, 0.98 to 0.99 per 1-year age increment). CONCLUSIONS Spontaneous reporting of AEFIs after COVID-19 vaccination was associated with younger age, female sex, moderate to severe AEFIs, comorbidities, history of allergic reactions, and vaccine type. AEFIs under-reporting should be considered when delivering information to the community and in public health decision-making.

Peptic ulcer bleeding is a common complication of peptic ulcer disease and the most common cause of upper gastrointestinal bleeding. Despite advances in drug usage and endoscopic modalities, no significant improvement is observed in the mortality rate of bleeding ulcers. The purpose of this review is to discuss various endoscopic hemostatic methods to treat peptic ulcer bleeding. Endoscopic hemostatic techniques can be classified into injection, mechanical, electrocoagulation, hemostatic powder, and endoscopic Doppler-guided hemostatic therapies (the last mentioned being a newly developed technique). Endoscopic hemostasis can be performed as mono or combination therapy using the aforementioned methods. Endoscopic hemostasis is the most important treatment for patients with peptic ulcer bleeding. Endoscopists should consider the treatment approach for peptic ulcer bleeding based on patient characteristics, the size and shape of the lesion, the endoscopist's expertise, and the resources and circumstances at each hospital. Follow-up studies are needed to evaluate the efficacy of newly developed hemostatic powder therapy and endoscopic Doppler-guided hemostasis.
Duodenum ; Electrocoagulation ; Follow-Up Studies ; Hemorrhage ; Hemostasis ; Hemostasis, Endoscopic ; Hemostatic Techniques ; Humans ; Mortality ; Peptic Ulcer Hemorrhage ; Peptic Ulcer ; Stomach ; Ulcer

PURPOSE: Poor living conditions such as overcrowding and sharing a bed are reported to be significant risk factors for H. pylori infection throughout childhood. We investigated the prevalence of Helicobacter pylori infection in Korean athletes who are obliged to live together in training camps over six months a year. METHODS: Blood sampling and surveying through questionnaire were performed on 440 regular high school students (228 boys and 212 girls) and 220 athletes (148 boys and 72 girls) of a physical education high school. We measured serum IgG Ab to H. pylori in order to compare the prevalence of H. pylori infection between normal adolescents and athletes. In addition, we conducted a nutritional analysis and questionnaire survey for socioeconomic status in order to compare other risk factors that might influence H. pylori infection between groups. RESULTS: The prevalence (43.2%) of H. pylori infection in athletes was higher than that (22.7%) in the controls. No significant differences in the nutritional factors or socioeconomic status, such as Hollingshead index, type of house, and crowding index, were found between the groups. Multivariate analysis showed that crowding and the difference in school type were the significant predictors of H. pylori seropositivity after controlling for dietary and socioeconomic factors. CONCLUSION: Living together in training camps might be a significant risk factor for H. pylori infection in athletes.
Adolescent* ; Athletes* ; Crowding ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Multivariate Analysis ; Physical Education and Training ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Seroepidemiologic Studies* ; Social Class ; Social Conditions ; Socioeconomic Factors

PURPOSE: Helicobacter pylori has been known to have diverse vacA allelic types. The purpose of the study was to identify vacA diversity in Korea and design new primers for signal sequence alleles indigenous to Korea. METHODS: Fifty antral biopsy specimens, which had been proven to be H. pylori-positive, were examined for vacA status; signal sequence and mid-region. After PCR amplification and DNA sequencing, vacA alleles of Korean H. pylori strains were compared with those from other countries. RESULTS: Among Korean H. pylori strains vacA alleles with all combinations of signal sequence and mid-region were found, with the exception of s1b or s2. vacA genotype s1c/m1 was predominant in Korea. We found that GGGAGCGTTR in s1a and GGGGYTATTG in s1c were the indigenous sequences to Korea and constructed the new Korean specific primers for the vacA signal sequence; VASK-F, VASK-R, S1AK-F, and S1CK-F. CONCLUSION: This study showed that s1c/m1 is the predominant type of vacA allele in Korea. We designed new primers for the vacA signal sequence.
Alleles ; Biopsy ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Korea* ; Mosaicism* ; Polymerase Chain Reaction ; Protein Sorting Signals* ; Sequence Analysis, DNA

PURPOSE: Staphylococcus aureus causes a variety of infections, ranging from benign skin infections to fatal invasive infections. Recently, methicillin-resistant S. aureus (MRSA) infections have emerged in patients who do not have established risk factors. This study was conducted to characterize S. aureus infections in children with an emphasis on community- associated MRSA infections at a tertiary care pediatric facility during a 3-year period. METHODS: Four hundred twenty-nine cases of S. aureus infections diagnosed at the Seoul National University Children's Hospital between January 2004 and December 2006 were retrospectively reviewed. The cases were classified as hospital- onset (HO) or community-onset (CO), healthcare-associated (HA), or community-associated (CA) infections. RESULTS: Among the 206 cases <1 year of age, 72%, 7%, and 21% were HO-HA, CO-HA, and CA infections, respectively, as compared to 48%, 28%, and 24% among the 223 cases >1 year of age. The proportion of CO-HA infections among HA infections (8.6% vs. 37.1%, P<0.001) and the proportion of HA infections among the CO infections (24.5% vs. 54.3%, P<0.001) were greater in older children than in infants. Overall, 57% of the isolates were methicillin-resistant. Twenty-nine (30%) of 96 CA strains were MRSA, and the most common site of CA-MRSA infection was the skin and soft tissues (26 cases). CONCLUSION: The methicillin resistance rate of S. aureus from CA infections was high and CA-MRSA was most often associated with skin and soft tissue infections.
Child ; Humans ; Infant ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Retrospective Studies ; Risk Factors ; Skin ; Soft Tissue Infections ; Staphylococcus ; Staphylococcus aureus ; Tertiary Healthcare

Kabuki syndrome is characterized by peculiar facial features, developmental delay, and mental retardation. Congenital hepatic abnormalities in Kabuki syndrome patients have been sporadically reported in the literature and consist of extrahepatic biliary atresia, neonatal sclerosing cholangitis, and transient neonatal cholestasis. We report here a case of congenital hepatic fibrosis in a patient with Kabuki syndrome. To our knowledge, only one case of congenital hepatic fibrosis has been reported in the setting of Kabuki syndrome.
Abnormalities, Multiple ; Biliary Atresia ; Cholangitis, Sclerosing ; Cholestasis ; Face ; Fibrosis ; Hematologic Diseases ; Humans ; Intellectual Disability ; Vestibular Diseases

OBJECTIVES: Vaccination is one of the most important strategies to contain the spread of coronavirus disease 2019 (COVID-19). Vaccination in children is dependent on their parents, making it important to understand parents’ awareness and attitudes toward vaccines in order to devise strategies to raise vaccination rates in children. METHODS: A web-based nationwide survey was conducted among Korean parents of 7-year-old to 18-year-old children in August 2021 to estimate parents’ intention to vaccinate their children against COVID-19 and identify key factors affecting parental acceptance and hesitancy through regression analysis. RESULTS: Approximately 56.4% (575/1,019) were willing to vaccinate their children against COVID-19. Contributing factors to COVID-19 vaccine hesitancy were being a mother (adjusted odds ratio [aOR], 0.36; 95% confidence interval [CI], 0.25 to 0.52), a lower education level (aOR, 0.83; 95% CI, 0.70 to 0.97), hesitancy to other childhood vaccines (aOR, 0.78; 95% CI, 0.64 to 0.96), and refusal to vaccinate themselves (aOR, 0.08; 95% CI, 0.02 to 0.20). Having older children (aOR, 1.20; 95% CI, 1.13 to 1.28), trusting the child’s doctor (aOR, 1.19; 95% CI, 1.07 to 1.32), positive perceptions of the COVID-19 vaccine’s effectiveness (aOR, 2.60; 95% CI, 1.90 to 3.57) and perceiving the COVID-19 vaccine as low-risk (aOR, 1.68; 95% CI, 1.27 to 2.24) were associated with COVID-19 vaccine acceptance. Concerns about adverse reactions were the most common cause of hesitancy. CONCLUSIONS Providing parents with accurate and reliable information on vaccine effectiveness and safety is important to increase COVID-19 vaccine uptake in children. Differential or targeted approaches to parents according to gender, age, and their children’s age are necessary for effective communication about vaccination in children.

A new CT-based diagnostic method of protrusio acetabuli (PA) was introduced. However, prevalence of PA by this method and correlation between PA and other manifestations of Marfan syndrome (MFS) is unknown in Korean MFS patients. This study aimed to investigate the prevalence of PA diagnosed by a CT-based method in Korean patients with MFS, the association of PA with other manifestations of MFS, and the contribution of PA to MFS diagnosis. We retrospectively reviewed the records of 146 MFS patients with the presence of a causative FBN1 mutation and 146 age- and sex-matched controls from a single tertiary care center. All MFS patients underwent a complete assessment of criteria based on the revised Ghent nosology. PA was assessed quantitatively using a CT-based circle-wall distance (CWD) method. PA was diagnosed in 77.4% of patients in the MFS group and in 11.0% of the control group. CWD was significantly different between the two groups (1.50 mm vs. -0.64 mm, P<0.001). The presence of PA did not correlate with the presence of ectopia lentis, aortic root diameter, or history of aortic dissection. The presence of PA did not have a significant impact on the final diagnosis of MFS. Even though the presence of PA does not related to the cardinal clinical features of MFS or influence MFS diagnosis, its presence may be helpful for the suspicion of MFS when aortic dissection or aneurysm is found on CT angiography of the aorta because of the high frequency of PA in MFS patients.
Acetabulum/*abnormalities/radiography ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aortic Aneurysm/*epidemiology/radiography ; Comorbidity ; Female ; Humans ; Male ; Marfan Syndrome/*epidemiology/*radiography ; Middle Aged ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods/*statistics & numerical data ; Young Adult

Background/Aims: As the novel coronavirus (coronavirus disease 2019 [COVID-19]) outbreak progresses rapidly, staying home is recommended for suspected patients; however, the safety of this recommendation is uncertain. In Korea, non-hospital facilities called “living and treatment centers (LTCs)” have been established since 5 March 2020. The LTCs provided a unique opportunity to evaluate the safety of selection criteria for low-risk groups. Methods: Between 5 March and 9 April 2020, patients with COVID-19 who met the following criteria were admitted to the LTC; alert, age below 65 years old, no underlying disease or well-controlled underlying disease, body temperature below 38.0°C, whether taking antipyretics or not, and no dyspnea. Patients were closely observed by doctors or nurses’ interviews twice a day and transferred to hospitals when symptoms worsened. Results: A total of 113 patients were admitted to the LTC; 52.2% were female, with a median age of 25 years (interquartile range, 21.5 to 39.5). Of 113 patients, 54 (47.8%) were asymptomatic at diagnosis, and 15 (13.3%) had no symptoms until they were released from isolation. During the follow-up period, two (1.8%) patients were transferred to a hospital but did not progress to severe status during hospitalization. Conclusions The risk of progression was negligible in COVID-19 patients who met the admission criteria for LTC at the time of diagnosis. LTCs could be a safe alternative considering shortage of hospital beds.

Background: There is difference in the incidence of multi-system inflammatory syndrome in children (MIS-C) in patients with different variants of severe acute respiratory syndrome coronavirus 2, however, little is known about the epidemiology in Asian countries. We investigated and compared the epidemiology of the MIS-C during omicron-dominant period with that of previous periods in South Korea. Methods: We obtained clinical, epidemiological and laboratory data on MIS-C cases from national MIS-C surveillance in South Korea. We defined pre-delta period as January 2020–May 2021; delta period as June 2021–December 2021; and omicron period as January 2022–April 2022. We describe the clinical characteristics and outcomes of MIS-C patients by period. Results: A total of 91 cases were assessed to be MIS-C cases. Number of MIS-C cases have increased from six cases during pre-delta period to 66 cases during omicron period, while the incidence rate (the number of MIS-C cases per 100,000 cases of reported coronavirus disease 2019) has decreased from 38.5 cases per 100,000 (95% confidence interval [CI], 14.1–83.9) during pre-delta period to 1.6 cases per 100,000 (95% CI, 1.2–2.0) during omicron periods. During pre-delta period, 66.7% and 100% had hypotension and gastrointestinal involvement, respectively; while during omicron period, 12.1% and 6.1% had such clinical manifestations. Fifty percent of pre-delta MIS-C patients were taken intensive care unit (ICU) cares, while 10.6% of patients during omicron periods were in ICUs. Conclusion Omicron period were associated with less severe clinical manifestation compared to pre-delta and delta periods. Although incidence rate of MIS-C was lower for the omicron period than pre-delta and delta periods, number of patients reported with MIS-C may pose a substantial clinical burden.