Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To provide reference data for the study and treatment of thoracic scoliosis. SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea. MATERIALS AND METHODS: From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined. RESULTS: The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13. CONCLUSIONS: This study could be used as a reference point for the study and treatment of thoracic scoliosis.
Cross-Sectional Studies ; Female ; Humans ; Korea ; Male ; Osteophyte ; Prevalence ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Scoliosis ; Spine ; Thoracic Vertebrae ; Thorax

OBJECTIVES: To provide reference data for the study and treatment of thoracic scoliosis.SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea. MATERIALS AND METHODS: From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined. RESULTS: The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13. CONCLUSIONS This study could be used as a reference point for the study and treatment of thoracic scoliosis.

OBJECTIVES: The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.METHODS: Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.RESULTS: The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.CONCLUSIONS: The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.
Asymptomatic Infections ; Coronavirus ; Coronavirus Infections ; Cross Infection ; Delivery of Health Care ; Epidemiology ; Fluorescent Antibody Technique ; Humans ; Hypertension ; Inpatients ; Korea ; Middle East Respiratory Syndrome Coronavirus ; Middle East ; Osteoarthritis

OBJECTIVES: The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status. METHODS: Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results. RESULTS: The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis. CONCLUSIONS: The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.
Asymptomatic Infections ; Coronavirus ; Coronavirus Infections* ; Cross Infection ; Delivery of Health Care ; Epidemiology ; Fluorescent Antibody Technique ; Humans ; Hypertension ; Inpatients ; Korea* ; Middle East Respiratory Syndrome Coronavirus* ; Middle East* ; Osteoarthritis

OBJECTIVES: The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status. METHODS: Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results. RESULTS: The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis. CONCLUSIONS The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.

Postweaning multisystemic wasting syndrome (PMWS), which was first identified in western Canada in 1991 and more recently in the United States, Europe and Asia, is an emerging disease in pigs. Porcine circovirus type 2 (PCV-2) is the primary infectious viral agent causing PMWS, but the full expression of the disease may require the presence of other agents. It is reported that there is apparent synergism between PCV-2 and porcine parvovirus (PPV) in increasing the severity of the clinical signs and lesions of PMWS. From January 2006 to May 2008, a total of the 154 lymph node samples were collected from 4~12 weeks old pigs which had been submitted to the College of Veterinary Medicine, Jeju National University, Korea. These pigs were diagnosed as PMWS on the basis of clinical and pathological examination from 48 commercial herds in Jeju Island. Based on the immunohistochemistry, porcine parvovirus was detected in 69 cases (44.8%) from 154 weaned or grower pigs. PPV antigens were detected in the cytoplasm of histiocytic cells multifocally infiltrated in the cortex and paracortex of lymph nodes. The results of this study clarify that PPV is prevalent in pigs with PMWS on Jeju Island. Therefore PPV is one of the most important co-agents in the development of naturally acquired PMWS. This study may be helpful to the control of this disease and to epidemiological aspects.
Asia ; Canada ; Circovirus ; Coinfection ; Cytoplasm ; Europe ; Immunohistochemistry ; Korea ; Lymph Nodes ; Parvovirus, Porcine ; Prevalence ; Swine ; United States ; Veterinary Medicine ; Wasting Syndrome

BACKGROUND/AIMS: Fabry disease is an X-linked recessive and progressive disease caused by alpha-galactosidase A (alpha-GaL A) deficiency. We sought to assess the prevalence of unrecognized Fabry disease in dialysis-dependent patients and the efficacy of serum globotriaosylceramide (GL3) screening. METHODS: A total of 480 patients of 1,230 patients among 17 clinics were enrolled. Serum GL3 levels were measured by tandem mass spectrometry. Additionally, we studied the association between increased GL3 levels and cardiovascular disease, cerebrovascular disease, or left ventricular hypertrophy. RESULTS: Twenty-nine patients had elevated serum GL3 levels. The alpha-GaL A activity was determined for the 26 patients with high GL3 levels. The mean alpha-GaL A activity was 64.6 nmol/hr/mg (reference range, 45 to 85), and no patient was identified with decreased alpha-GaL A activity. Among the group with high GL3 levels, 15 women had a alpha-GaL A genetics analysis. No point mutations were discovered among the women with high GL3 levels. No correlation was observed between serum GL3 levels and alpha-GaL A activity; the Pearson correlation coefficient was 0.01352 (p = 0.9478). No significant correlation was observed between increased GL3 levels and the frequency of cardiovascular disease or cerebrovascular disease. CONCLUSIONS: Fabry disease is very rare disease in patients with end-stage renal disease. Serum GL3 measurements as a screening method for Fabry disease showed a high false-positive rate. Thus, serum GL3 levels determined by tandem mass spectrometry may not be useful as a screening method for Fabry disease in patients with end stage renal disease.
Adult ; Aged ; Fabry Disease/blood/*diagnosis ; Female ; Humans ; Kidney Failure, Chronic/blood/*therapy ; Male ; Middle Aged ; *Renal Dialysis ; Trihexosylceramides/*blood ; alpha-Galactosidase/genetics/metabolism