The Korean Society of Infectious Diseases has been regularly developing guidelines for adult immunization since 2007. In 2023, the guidelines for the following seven vaccines were revised: influenza, herpes zoster, pneumococcal, tetanus-diphtheria-pertussis (Tdap), human papillomavirus (HPV), meningococcal, and rabies vaccines. For the influenza vaccine, a recommendation for enhanced vaccines for the elderly was added. For the herpes zoster vaccine, a recommendation for the recombinant zoster vaccine was added. For the pneumococcal vaccine, the current status of the 15-valent pneumococcal conjugate vaccine and 20-valent PCV was described. For the Tdap vaccine, the possibility of using Tdap instead of tetanus-diphtheria vaccine was described. For the HPV vaccine, the expansion of the eligible age for vaccination was described. For the meningococcal vaccine, a recommendation for the meningococcal B vaccine was added. For the rabies vaccine, the number of pre-exposure prophylaxis doses was changed. This manuscript documents the summary and rationale of the revisions for the seven vaccines. For the vaccines not mentioned in this manuscript, the recommendations in the 3rd edition of the Vaccinations for Adults textbook shall remain in effect.

BACKGROUND: The need of efficient resource management and full-time accessibility to resources has increased with the development of industry, resulting in the increase of shift workers. Previous researches of past decades show that there are various health effects on shift workers. However, the definition and the form of shift work have varied from each research and occupational harmful factors except for shift work have not been excluded completely in previous researches. Therefore, in this research, we tried to find out the effect of shift work focusing on the hypertension. To complement previously mentioned weakness of other researches, we performed our research on participants to whom we could minimize other risk factors excluding shift work. METHODS: This research examined 1,953 petrochemical plant male workers (shift work 1,075, day worker 878) who did medical checkup from 1st Jan. 2014 to 31th Dec. 2014 in a general hospital located in Ulsan, based on their medical records and questionnaires. With the questionnaire, we found out their basic information including age, social status, occupational history, and we took their physical measurements. RESULTS: Compared to day workers, shift workers' odds ratio of developing hypertension was 1.31 (95% CI 0.98–1.75). After adjusting confounding variables, adjusted odds ratio for entire subjects was 1.51 (95% CI 1.11–2.06). Also, for subjects who were in continuous service for over 20 years, odds ratio was 1.51 (95% CI 1.08–2.11). CONCLUSIONS: Shift workers had a higher chance of hypertension than day workers do. Particularly, the longer the workers work continuously, the risk of hypertension getting higher.
Complement System Proteins ; Confounding Factors (Epidemiology) ; Employment ; Hospitals, General ; Humans ; Hypertension* ; Male ; Medical Records ; Odds Ratio ; Plants ; Risk Factors ; Ulsan

BACKGROUND/AIMS: This study aimed to evaluate the efficacy of computed tomography (CT)-guided bone biopsy for the diagnosis of spinal infection and compared the clinical outcomes between tuberculous and pyogenic spinal infections. METHODS: The retrospective cohort study included patients who received CT-guided bone biopsy at a tertiary hospital over the 13 years. RESULTS: Among 100 patients, 67 had pyogenic spondylitis and 33 had tuberculous spondylitis. Pathogens were isolated from bone specimens obtained by CT-guided biopsy in 42 cases, with diagnostic yields of 61% (20/33) for tuberculous spondylitis and 33% (22/67) for pyogenic spondylitis. For 36 culture-proven pyogenic cases, Staphylococcus aureus was the most commonly isolated organism. Patients with pyogenic spondylitis more frequently presented with fever accompanied by an increase in inflammatory markers than did those with tuberculosis. Among all patients who underwent surgery, the incidence of late surgery performed one month after diagnosis was higher in patients with tuberculous infection (56.3%) than in those with pyogenic disease (23.3%, p = 0.026). CONCLUSIONS: Results obtained by CT-guided bone biopsy contributed to prompt diagnoses of spinal infections, especially those caused by tuberculosis. Despite administration of anti-tuberculous agents, patients with tuberculous spondylitis showed an increased tendency to undergo late surgery.
Biopsy* ; Cohort Studies ; Diagnosis ; Fever ; Humans ; Incidence ; Retrospective Studies ; Spondylitis* ; Staphylococcus aureus ; Tertiary Care Centers ; Tuberculosis

BACKGROUND: The purpose of this study was to investigate hearing threshold changes of workers with unilateral conductive hearing loss who were exposed to workplace noise for 8-years. METHODS: Among 1819 workers at a shipyard in Ulsan, 78 subjects with an air-bone gap ≥10 dBHL in unilateral ears were selected. Factors that could affect hearing were acquired from questionnaires, physical examinations, and biochemistry examinations. Paired t-test was conducted to compare the hearing threshold changes over time between conductive hearing loss (CHL) ear and sensorineural hearing loss (SNHL) ear. RESULTS: The study included male subjects aged 48.7 ± 2.9, having worked for 29.8 ± 2.7 years. Hearing thresholds increased significantly in CHL ears and SNHL ears at all frequencies (0.5–6 kHz) during follow-up period (p < 0.05). The threshold change at 4 kHz was 3.2 dBHL higher in SNHL ears which was statistically significant (p < 0.05). When workers were exposed to noise levels of 85 dBA and above, threshold change at 4 kHz was 5.6 dBHL higher in SNHL ears which was statistically significant (p < 0.05). Among workers aged below 50, the threshold change values were lower in low-frequency (0.5–2 kHz) in SNHL ears, with a small range of changes, whereas in high-frequency (3–6 kHz), the range of changes was greater SNHL ears (p < 0.05). Among workers aged 50 and above, SNHL ears showed a wider range of changes in both high- and low-frequency areas (p < 0.05). CONCLUSIONS: At high-frequencies, particularly at 4 kHz, the range of hearing threshold changes was lower in ears with conductive hearing loss than in contralateral ears. This is suggested as a protective effect against noise exposure.
Biochemistry ; Cohort Studies* ; Ear ; Follow-Up Studies ; Hearing Loss, Conductive* ; Hearing Loss, Noise-Induced ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Male* ; Noise* ; Physical Examination ; Retrospective Studies* ; Ulsan

PURPOSE: Carbon monoxide (CO) poisoning can cause rhabdomyolysis and acute kidney injury (AKI). However, until recently, studies regarding CO-induced rhabdomyolysis were rarely reported. This study was conducted in order to determine the risk factors for prediction of development of CO-induced rhabdomyolysis. METHODS: We retrospectively reviewed the medical records of 70 CO poisoned patients who presented to an emergency department from January 2010 to December 2012. CO poisoning related parameters, patient demographics, and laboratory data were analyzed. RESULTS: Rhabdomyolysis and AKI were observed in 11 patients (15.7%) and six (8.6%) patients, respectively. Time of exposure to CO, age, Glasgow coma scale, and leukocyte count differed significantly between patients who developed rhabdomyolysis and patients who did not. Exposure time to CO was the only risk factor for predicting development of rhabdomyolysis (odds ratio, 1.365; 95% confidence interval, 1.014-1.836; p=0.040). CONCLUSION: The frequency of rhabdomyolysis in CO poisoning was 15.7% and fluid therapy was very effective in treatment of CO-induced rhabdomyolysis and prevention of AKI progression. An exposure time to CO of over 5 hours was a factor with high potential for predicting development of CO-induced rhabdomyolysis. Along with patients' symptoms and signs, this factor should be considered in assessment of patients with CO poisoning.
Acute Kidney Injury ; Carbon Monoxide ; Carbon Monoxide Poisoning* ; Demography ; Emergency Service, Hospital ; Fluid Therapy ; Glasgow Coma Scale ; Humans ; Leukocyte Count ; Medical Records ; Poisoning ; Retrospective Studies ; Rhabdomyolysis* ; Risk Factors

PURPOSE: This study investigated the compliance of the general public to the guidance conveyed by hospital emergency medical information centers. METHODS: This study included the incidences of inquiry on hospitals and clinics to Busan Emergency Medical Information Center by the general public for a 2-week period from January 4-17, 2009. Information obtained included general characteristics, time of hospital arrival and departure, length of hospitalization, hospitals visited, and treatment outcome. RESULTS: A total of 939 incidences of hospital guidance to the general public were examined. The degree of compliance was 71.2%, the ratio of the primary and secondary facility that the participants visited were 88.6% and 93.5% of the participants in this study were discharged from hospitals after their visit. Patients who complied with the information received displayed a shorter period of hospitalization than non-compliant patients. CONCLUSION: Emergency medical information centers may help ease the unnecessary use of emergency rooms by providing information on diseases to the general public and effectively distributing medical resources with guidance to proper hospitals according to the degree of symptoms.
Access to Information ; Compliance ; Emergencies ; Emergency Medical Services ; Hospitalization ; Humans ; Incidence ; Information Centers

PURPOSE: This study investigated the compliance of the general public to the guidance conveyed by hospital emergency medical information centers. METHODS: This study included the incidences of inquiry on hospitals and clinics to Busan Emergency Medical Information Center by the general public for a 2-week period from January 4-17, 2009. Information obtained included general characteristics, time of hospital arrival and departure, length of hospitalization, hospitals visited, and treatment outcome. RESULTS: A total of 939 incidences of hospital guidance to the general public were examined. The degree of compliance was 71.2%, the ratio of the primary and secondary facility that the participants visited were 88.6% and 93.5% of the participants in this study were discharged from hospitals after their visit. Patients who complied with the information received displayed a shorter period of hospitalization than non-compliant patients. CONCLUSION: Emergency medical information centers may help ease the unnecessary use of emergency rooms by providing information on diseases to the general public and effectively distributing medical resources with guidance to proper hospitals according to the degree of symptoms.
Access to Information ; Compliance ; Emergencies ; Emergency Medical Services ; Hospitalization ; Humans ; Incidence ; Information Centers

PURPOSE: We performed this study to determine how the emergency trauma team affects the treatment of patients with multiple severe trauma and to discuss the effect and the direction of the emergency trauma team's management. METHODS: We performed a retrospective analysis of 518 patients who visited our emergency department with severe trauma from August 2006 to July 2008. We divided the severe trauma patients into 2 groups : patients before and after trauma team management (Group 1 and Group 2). Then, we compared demographic characteristics, mechanisms of injury, and treatment outcomes (lengths of stay in the ED, admission ratio, and in-hospital mortality) between the 2 groups. In the same way, patients with multiple severe trauma were divided into 2 groups, that are patients before and after trauma team management (Group 3 and Group 4) and analyzed. RESULTS: There was no significant difference, except mean age, between groups 1 and 2. In group 4 patients, compared to group 3 patients, the lengths of stay in the ED were lower (p value < 0.001), and the admission ratio were higher (p value = 0.017), but there was no significant difference in the in-hospital mortality between the groups 3 and 4. CONCLUSION: When patients with multiple severe trauma visit the ED, the emergency trauma team's management can decrease the lengths of stay in the ED and increase the admission ratio, but does not produce a decrease in the in-hospital mortality rate. Further investigations of emergency trauma team management are needed to improve treatment outcomes for patients with multiple severe trauma.
Emergencies ; Hospital Mortality ; Humans ; Retrospective Studies

Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) is a tumor suppressor. Although it is well known to have various physiological roles in cancer, its inhibitory effect on inflammation remains poorly understood. In the present study, a human PTEN gene was fused with PEP-1 peptide in a bacterial expression vector to produce a genetic in-frame PEP-1-PTEN fusion protein. The expressed and purified PEP-1-PTEN fusion protein were transduced efficiently into macrophage Raw 264.7 cells in a time- and dose- dependent manner when added exogenously in culture media. Once inside the cells, the transduced PEP-1-PTEN protein was stable for 24 h. Transduced PEP-1-PTEN fusion protein inhibited the LPS-induced cyclooxygenase 2 (COX-2) and iNOS expression levels in a dose-dependent manner. Furthermore, transduced PEP-1-PTEN fusion protein inhibited the activation of NF-kappa B induced by LPS. These results suggest that the PEP-1-PTEN fusion protein can be used in protein therapy for inflammatory disorders.
Animals ; Cell Line ; Cyclooxygenase 2/*metabolism ; Cysteamine/*analogs & derivatives ; Enzyme Activation ; Humans ; Lipopolysaccharides/*pharmacology ; Macrophages/*metabolism ; Mice ; NF-kappa B/metabolism ; Nitric Oxide/*biosynthesis ; Nitric Oxide Synthase Type II/metabolism ; PTEN Phosphohydrolase/*genetics ; Peptides/*genetics ; Recombinant Fusion Proteins/*biosynthesis/genetics ; Signal Transduction

Peroneal tendon dislocation in association with calcaneal fracture is not common and difficult to diagnose and is often overlooked. It can result in peroneal tendon tear and tenosynovitis which in turn lead to ankle pain and dysfunction. Early detection with through physical examination and CT scan is important to reduce the subsequent tendon dysfunction. We experienced 6 cases of peroneal tendon dislocation associated with calcaneal fracture, and treated 3 of them at the time of fracture operation and treated the other 3 after calcaneal fracture surgery due to sustained pain. We report the results with a review of the literature.
Animals ; Ankle ; Dislocations ; Physical Examination ; Tendons ; Tenosynovitis