OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Background/Aims: Although statins are widely used to reduce the risk of cardiovascular disease (CVD) including stroke and myocardial infarction (MI), it is reported that statin use increases the incidence of herpes zoster (HZ) that is associated with increased risk of CVD. So, we evaluated the mediation effect of HZ caused by statin use on CVD. Methods: We analyzed a prospective cohort from the National Health Insurance Service-database of South Korea. All individuals received a medical check-up and were followed-up from 2002 to 2013. Results: A total of 275,382 individuals > 40 years old were followed up for 11 years from 2003. Of these, 11,415 people (4%) were classified as statin users and 263,967 (96%) as non-statin users. Those who used statins had significantly lower risks of cardiovascular events, stroke, and MI compared with non-statin users; the adjusted hazard ratios in the multivariate analysis were 0.90 (95% confidence interval [CI], 0.82 to 0.98), 0.88 (95% CI, 0.80 to 0.98), and 0.91 (95% CI, 0.79 to 1.07), respectively. When we calculated the mediating effect of cardiovascular events by statin use through HZ, 11.6% of the total beneficial effect of cardiovascular events by statin use was mitigated through the occurrence of HZ caused by statin use. This mediating effect was higher in the younger age group (< 60 years). Conclusions This study showed that statin use reduced CVD by 10%, but the protective effect of statin use against CVD was mitigated by approximately 10% through the development of HZ caused by statin use.

PURPOSE: Assessing the immunogenicity of a single dose of hepatitis A virus (HAV) vaccines is important because some people receive only a single dose. However, previous studies have shown variable results and have not examined the effects of demographic characteristics other than gender. This study was performed to examine the immunogenicity of a single dose of HAV vaccine according to the vaccine type and demographic characteristics in young adults. MATERIALS AND METHODS: Seronegative medical school students were randomly allocated to receive either Havrix or Epaxal. RESULTS: After approximately 11 months, the seroconversion rate in 451 participants was 80.7%. In men, the Havrix group showed a significantly higher seroconversion rate (81.9%) than the Epaxal group (69.2%), whereas both vaccine groups showed similarly high immunogenicity in women (Havrix: 90.1%, Epaxal: 92.9%; P for interaction=0.062). According to the results of a multivariate analysis, Epaxal showed significantly lower immunogenicity than Havrix only in men. Age, obesity, drinking, smoking, and follow-up time did not significantly affect seroconversion in either gender. CONCLUSION: The seroconversion rate of single-dose HAV vaccines was low in men, particularly in those who received Epaxal. Our results suggest that gender effects should be considered when comparing the immunogenicity of different HAV vaccines.
Adolescent ; Adult ; Female ; Hepatitis A/*immunology/*prevention & control ; Hepatitis A Vaccines ; Hepatitis A Virus, Human/*immunology/*pathogenicity ; Humans ; Male ; Young Adult

We report a case of a 44-year-old patient with paralysis of the left leg who had a thoracic epidural catheterization after general anesthesia for abdominal surgery. Sensory losses below T10 and motor weakness of the left leg occurred after the surgery. Magnetic resonance image study demonstrated a well-defined intramedullary linear high signal intensity lesion on T2-weighted image and low-signal intensity on T1-weighted image in the spinal cord between T9 and L1 vertebral level, and enhancements of the spinal cord below T8 vertebra and in the cauda equina. Electrodiagnostic examination revealed lumbosacral polyradiculopathy affecting nerve roots below L4 level on left side. We suggest that the intrinsic spinal cord lesion and nerve root lesion can be caused by an epidural catheterization with subsequent local anesthetic injection.
Analgesia, Epidural ; Anesthesia, General ; Catheterization ; Catheters ; Cauda Equina ; Humans ; Leg ; Magnetic Resonance Spectroscopy ; Paralysis ; Polyradiculopathy ; Spinal Cord ; Spinal Cord Injuries ; Spine

Amiodarone is an antiarrhythmic drug known to have adverse effects on multiple organs. Most studies have reported the side effects of the drug, which may result from rapid administrations or from long-term, high dosage administrations. However, toxicity issues have also been reported from patients administered with low doses of the drug for a long period of time. Here we report a case of an 82-year-old female who had shown symptoms and signs of pulmonary, hepatic, and neurotoxicity after taking amiodarone for 14 months in order to treat her atrial fibrillation without regular outpatient follow-up. We highlight the importance of the recommended evaluations, including lung, liver, and thyroid functions, as well as the neurological examinations in patients treated with amiodarone for a long period of time during regular follow-up.
Aged, 80 and over ; Amiodarone* ; Atrial Fibrillation* ; Cardiomyopathy, Hypertrophic* ; Female ; Follow-Up Studies ; Humans ; Liver ; Lung ; Neurologic Examination ; Outpatients ; Thyroid Gland

BACKGROUND/AIMS: Twenty-four-hour ambulatory esophageal pH monitoring is considered the gold standard for diagnosing gastroesophageal reflux disease. The aim of this study was to quantify normal distal esophageal acid parameters in healthy Koreans. METHODS: Thirty healthy adults who were not on medication and were free from gastrointestinal symptoms were analyzed. Ambulatory esophageal acid (pH <4) exposure parameters were recorded at 5 cm above the lower esophageal sphincter. RESULTS: The 95th percentiles for reflux parameters assessed in the distal esophagus were as follows: percentage of total time with pH <4, 5.10%; percentage of upright time with pH <4, 7.88%; percentage of supine time with pH <4, 4.00%; number of reflux episodes, 62.7; number of reflux episodes with pH <4 for >5 minutes, 5.3; and the longest single acid-exposure episode, 21.3 minutes. CONCLUSIONS: Physiological gastroesophageal reflux occurs frequently in healthy Koreans. These data provide a reference range that could be utilized in studies involving Korean subjects.
Adult ; Esophageal pH Monitoring ; Esophageal Sphincter, Lower ; Esophagus ; Gastroesophageal Reflux ; Humans ; Hydrogen-Ion Concentration ; Reference Values

OBJECTIVES: Delirium is a common postoperative complication in old adults associated with adverse events including functional decline, longer lengths of stay, and risk of institutionalization. The purpose of this study is to evaluate the incidence, preoperative, intraoperative, and postoperative risk factors of postoperative delirium in spine surgery. METHODS: Seventy-nine patients who underwent spine surgery were included. Preoperative assessments included current medical illness, number of comorbid problems, and the number of medications by past medical history, medical record, and interview with patients and caregivers. Intraoperative risk factors were evaluated. Laboratory data were checked preoperatively and postoperatively. The presence of delirium was determined by the Korean version of Delirium Rating Scale (K-DRS). RESULTS: Postoperative delirium was found in patients (7.6%). There was an association suggested between older age and postoperative delirium in spine surgery (p<0.05). An association was suggested between increasing numbers of medical conditions and postoperative delirium (p<0.05). Preoperative hemoglobin, hematocrit, sodium, potassium, calcium, albumin levels and postoperative hemoglobin and total protein levels were in the delirium group was significantly lower than those in control group (p<0.05). CONCLSION: This study showed that the postoperative delirium in spine surgery is not rare and several preoperative and postoperative factors are involved in the development of delirium. This pilot study is the first prospective trial in the area of postoperative delirium in spine surgery with a small sample size and short-term period, so further research with large sample size will be necessary.
Adult ; Aged ; Calcium ; Caregivers ; Delirium* ; Hematocrit ; Humans ; Incidence ; Institutionalization ; Medical Records ; Pilot Projects* ; Postoperative Complications ; Potassium ; Prospective Studies ; Risk Factors ; Sample Size ; Sodium ; Spine*

We observed one patient with large pleural effusion causing severe dyspnea, tachycardia, and severe right atrial collapse, which findings were completely resolved after thoracentesis. Our report shows that massive pleural effusion also can make severe right atrial collapse and symptom like cardiac tamponade, and thoracentesis can improve this condition.
Cardiac Tamponade ; Dyspnea ; Humans ; Pericardial Effusion ; Pleural Effusion* ; Tachycardia*

OBJECTIVES: To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale: SSS) for routinely assessing the quality of service in psychiatric ward inpatients. METHODS: A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and university hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. RESULTS: Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. CONCLUSION: SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring satisfaction of psychiatric inpatients in Korea.
Age of Onset ; Alcoholics ; Attitude of Health Personnel ; Education ; Employment ; Hospitalization ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Humans ; Inpatients* ; Korea ; Length of Stay ; Marital Status ; Mood Disorders ; Patient Satisfaction ; Principal Component Analysis ; Psychotic Disorders ; Surveys and Questionnaires ; Reproducibility of Results ; Somatoform Disorders

PURPOSE: The aims of this study were to immunohistochemically identify lymph node micormetastases in Dukes' B colorectal cancer patients, and determine the relationship between lymph node micrometastases and other prognostic factors and recurrence rates. METHODS: A retrospective analysis was conducted of 990 lymph nodes from Dukes' B 42 patients who had undergone radical colorectal resection. These lymph nodes were immunohistochemically examined with monoclonal antibodies against cytokeratin-19. The prognostic factors and recurrent rates were compared between patients with and without lymph node micrometastases. RESULTS: Micrometastases were confirmed in 19 nodes (1.9%) from 9 patients (21.4%). No correlations were observed between micrometastases and the prognostic factors, with the exception of the preoperative CEA level. 8 of the 9 (88.9%) patients with micrometastases had preoperative CEA levels significantly elevated above 5 ng/ml (P<0.0001). There were no significant differences in the recurrent rates (P=0.0572) between patients with and without micrometastases during the short term follow up period (14.8 months) at the 95% confidence interval, but there were significant differences at the 90% confidence interval. CONCLUSION: High preoperative CEA levels increase the risk for micrometastases, and the presence of micrometastases might increase the possibility of recurrence. Thus, a routine immunohistochemical technique for identifying micrometastases is recommended in the patients with a high preoperative CEA level. However, a more definite clinical significance of lymph node micrometastases awaits further extensive prospective studies.
Antibodies, Monoclonal* ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Keratin-19* ; Lymph Nodes* ; Neoplasm Micrometastasis* ; Recurrence ; Retrospective Studies