1.Risk Factors Related to COVID-19Reinfection and Fatality During the Omicron (BA.1/BA.2) Period in Korea
Ju Hee LEE ; Ji Hae HWANG ; Eun Jung JANG ; Ryu Kyung KIM ; Kil Hun LEE ; Seon Kyeong PARK ; Jin GWACK ; Young Joon PARK
Journal of Korean Medical Science 2023;38(34):e269-
Background:
This study aimed to investigate the deaths due to coronavirus disease 2019 (COVID-19) reinfection and related risk factors.
Methods:
National cohort data were collected for a six-month period when omicron BA.1/BA.2 variant was dominant in South Korea.
Results:
The long-term care facility residents (adjusted odds ratio, 3.11; 95% confidence interval [CI], 2.98–3.25) had significantly higher risk of reinfection than the general population. The risk of reinfection was significantly lower for persons with 2 or more vaccine doses compared to the unvaccinated. The risk of death was significantly higher in the reinfection group than in the primary infection group for persons in the 60–74 years age group (adjusted relative risk [aRR], 1.62; 95% CI, 1.19–2.20), and immunocompromised group (aRR, 4.56; 95% CI, 2.34–8.90).
Conclusion
In these data, vaccination history was significantly related to reduced COVID-19 reinfection and severe progression, and scheduled vaccinations were important even with a history of infection.
2.Estimating the number of severe COVID-19 cases and COVID-19-related deaths averted by a nationwide vaccination campaign in Republic of Korea
Ji Hae HWANG ; Ju Hee LEE ; Eun Jung JANG ; Ryu Kyung KIM ; Kil Hun LEE ; Seon Kyeong PARK ; Sang Eun LEE ; Chungman CHAE ; Sangwon LEE ; Young Joon PARK
Osong Public Health and Research Perspectives 2023;14(3):164-172
Objectives:
The Korea Disease Control and Prevention Agency promotes vaccination by regularly providing information on its benefits for reducing the severity of coronavirus disease 2019 (COVID-19). This study aimed to analyze the number of averted severe COVID-19 cases and COVID-19-related deaths by age group and quantify the impact of Republic of Korea’s nationwide vaccination campaign.
Methods:
We analyzed an integrated database from the beginning of the vaccination campaign on February 26, 2021 to October 15, 2022. We estimated the cumulative number of severe cases and COVID-19-related deaths over time by comparing observed and estimated cases among unvaccinated and vaccinated groups using statistical modeling. We compared daily age-adjusted rates of severe cases and deaths in the unvaccinated group to those in the vaccinated group and calculated the susceptible population and proportion of vaccinated people by age.
Results:
There were 23,793 severe cases and 25,441 deaths related to COVID-19. We estimated that 119,579 (95% confidence interval [CI], 118,901–120,257) severe COVID-19 cases and 137,636 (95% CI, 136,909–138,363) COVID-19-related deaths would have occurred if vaccination had not been performed. Therefore, 95,786 (95% CI, 94,659–96,913) severe cases and 112,195 (95% CI, 110,870–113,520) deaths were prevented as a result of the vaccination campaign.
Conclusion
We found that, if the nationwide COVID-19 vaccination campaign had not been implemented, the number of severe cases and deaths would have been at least 4 times higher. These findings suggest that Republic of Korea’s nationwide vaccination campaign reduced the number of severe cases and COVID-19 deaths.
3.Diagnosis for Pheochromocytoma and Paraganglioma: A Joint Position Statement of the Korean Pheochromocytoma and Paraganglioma Task Force
Eu Jeong KU ; Kyoung Jin KIM ; Jung Hee KIM ; Mi Kyung KIM ; Chang Ho AHN ; Kyung Ae LEE ; Seung Hun LEE ; You-Bin LEE ; Kyeong Hye PARK ; Yun Mi CHOI ; Namki HONG ; A Ram HONG ; Sang-Wook KANG ; Byung Kwan PARK ; Moon-Woo SEONG ; Myungshin KIM ; Kyeong Cheon JUNG ; Chan Kwon JUNG ; Young Seok CHO ; Jin Chul PAENG ; Jae Hyeon KIM ; Ohk-Hyun RYU ; Yumie RHEE ; Chong Hwa KIM ; Eun Jig LEE
Endocrinology and Metabolism 2021;36(2):322-338
Pheochromocytoma and paraganglioma (PPGLs) are rare catecholamine-secreting neuroendocrine tumors but can be life-threatening. Although most PPGLs are benign, approximately 10% have metastatic potential. Approximately 40% cases are reported as harboring germline mutations. Therefore, timely and accurate diagnosis of PPGLs is crucial. For more than 130 years, clinical, molecular, biochemical, radiological, and pathological investigations have been rapidly advanced in the field of PPGLs. However, performing diagnostic studies to localize lesions and detect metastatic potential can be still challenging and complicated. Furthermore, great progress on genetics has shifted the paradigm of genetic testing of PPGLs. The Korean PPGL task force team consisting of the Korean Endocrine Society, the Korean Surgical Society, the Korean Society of Nuclear Medicine, the Korean Society of Pathologists, and the Korean Society of Laboratory Medicine has developed this position statement focusing on the comprehensive and updated diagnosis for PPGLs.
4.Changes in Korean National Healthcare Insurance Policy and Breast Cancer Surgery Trend in Korea
Musaed RAYZAH ; Jai Min RYU ; Jun-Hee LEE ; Seok Jin NAM ; Seok Won KIM ; Se Kyung LEE ; Jonghan YU ; Kyeong-Tae LEE ; Sa-Ik BANG ; Goo-Hyun MUN ; Jai-Kyong PYON ; Byung-Joon JEON ; Jeong Eon LEE
Journal of Korean Medical Science 2021;36(29):e194-
Background:
Since April 2015, the Korean National Health Insurance (NHI) has reimbursed breast cancer patients, approximately 50% of the cost of the breast reconstruction (BR) procedure. We aimed to investigate NHI reimbursement policy influence on the rate of immediate BR (IBR) following total mastectomy (TM).
Methods:
We retrospectively analyzed breast cancer data between April 2011 and June 2016. We divided patients who underwent IBR following TM for primary breast cancer into “uninsured” and “insured” groups using their NHI statuses at the time of surgery. Univariate analyses determined the insurance influence on the decision to undergo IBR.
Results:
Of 2,897 breast cancer patients, fewer uninsured patients (n = 625) underwent IBR compared with those insured (n = 325) (30.0% vs. 39.8%, P < 0.001). Uninsured patients were younger than those insured (median age [range], 43 [38–48] vs. 45 [40–50] years; P < 0.001).Pathologic breast cancer stage did not differ between the groups (P = 0.383). More insured patients underwent neoadjuvant chemotherapy (P = 0.011), adjuvant radiotherapy (P < 0.001), and IBR with tissue expander insertion (P = 0.005) compared with those uninsured.
Conclusion
IBR rate in patients undergoing TM increased after NHI reimbursement.
5.Diagnosis for Pheochromocytoma and Paraganglioma: A Joint Position Statement of the Korean Pheochromocytoma and Paraganglioma Task Force
Eu Jeong KU ; Kyoung Jin KIM ; Jung Hee KIM ; Mi Kyung KIM ; Chang Ho AHN ; Kyung Ae LEE ; Seung Hun LEE ; You-Bin LEE ; Kyeong Hye PARK ; Yun Mi CHOI ; Namki HONG ; A Ram HONG ; Sang-Wook KANG ; Byung Kwan PARK ; Moon-Woo SEONG ; Myungshin KIM ; Kyeong Cheon JUNG ; Chan Kwon JUNG ; Young Seok CHO ; Jin Chul PAENG ; Jae Hyeon KIM ; Ohk-Hyun RYU ; Yumie RHEE ; Chong Hwa KIM ; Eun Jig LEE
Endocrinology and Metabolism 2021;36(2):322-338
Pheochromocytoma and paraganglioma (PPGLs) are rare catecholamine-secreting neuroendocrine tumors but can be life-threatening. Although most PPGLs are benign, approximately 10% have metastatic potential. Approximately 40% cases are reported as harboring germline mutations. Therefore, timely and accurate diagnosis of PPGLs is crucial. For more than 130 years, clinical, molecular, biochemical, radiological, and pathological investigations have been rapidly advanced in the field of PPGLs. However, performing diagnostic studies to localize lesions and detect metastatic potential can be still challenging and complicated. Furthermore, great progress on genetics has shifted the paradigm of genetic testing of PPGLs. The Korean PPGL task force team consisting of the Korean Endocrine Society, the Korean Surgical Society, the Korean Society of Nuclear Medicine, the Korean Society of Pathologists, and the Korean Society of Laboratory Medicine has developed this position statement focusing on the comprehensive and updated diagnosis for PPGLs.
6.Changes in Korean National Healthcare Insurance Policy and Breast Cancer Surgery Trend in Korea
Musaed RAYZAH ; Jai Min RYU ; Jun-Hee LEE ; Seok Jin NAM ; Seok Won KIM ; Se Kyung LEE ; Jonghan YU ; Kyeong-Tae LEE ; Sa-Ik BANG ; Goo-Hyun MUN ; Jai-Kyong PYON ; Byung-Joon JEON ; Jeong Eon LEE
Journal of Korean Medical Science 2021;36(29):e194-
Background:
Since April 2015, the Korean National Health Insurance (NHI) has reimbursed breast cancer patients, approximately 50% of the cost of the breast reconstruction (BR) procedure. We aimed to investigate NHI reimbursement policy influence on the rate of immediate BR (IBR) following total mastectomy (TM).
Methods:
We retrospectively analyzed breast cancer data between April 2011 and June 2016. We divided patients who underwent IBR following TM for primary breast cancer into “uninsured” and “insured” groups using their NHI statuses at the time of surgery. Univariate analyses determined the insurance influence on the decision to undergo IBR.
Results:
Of 2,897 breast cancer patients, fewer uninsured patients (n = 625) underwent IBR compared with those insured (n = 325) (30.0% vs. 39.8%, P < 0.001). Uninsured patients were younger than those insured (median age [range], 43 [38–48] vs. 45 [40–50] years; P < 0.001).Pathologic breast cancer stage did not differ between the groups (P = 0.383). More insured patients underwent neoadjuvant chemotherapy (P = 0.011), adjuvant radiotherapy (P < 0.001), and IBR with tissue expander insertion (P = 0.005) compared with those uninsured.
Conclusion
IBR rate in patients undergoing TM increased after NHI reimbursement.
7.Xanthone and Flavonoid Derivatives from the Leaves of Maclura tricuspidata with Antioxidant and Anti-tyrosinase Activity
Yang Hee JO ; Solip LEE ; Se Hwan RYU ; Sang Won YEON ; Ayman TURK ; Bang Yeon HWANG ; Mi Kyeong LEE
Natural Product Sciences 2021;27(4):234-239
Masclura tricuspidata, also called as Cudrania tricuspidata, is one of the most common Moraceae family plants in East Asia. Its trivial name follows mulberry due to the similar morphology. Investigation of the bioactive constituents of M. tricuspidata leaves yielded a new xanthone derivative along with twenty known compounds through various chromatographic techniques. A new compound was defined as mascluraxanthone (3), a prenylated xanthone glucoside on the basis of 1D and 2D NMR and MS data. Twenty known compounds were identified as four xanthone derivatives (1-2 and 4-5), two flavans (6-7), six flavanol derivatives (8-13), a flavonone (14) and seven flavonol derivatives (15-21). Among the isolated compounds, flavanol and flavonoid derivatives with 3′,4′-OH groups showed antioxidant and anti-tyrosinase activities. Conclusively, the leaves of M.tricuspidata are rich in aromatic compounds including xanthones and flavonoids. In addition, these constituents showed antioxidant and anti-tyrosinase potentials, which might be useful for oxidative stress related diseases.
8.A Position Statement of the Utilization and Support Status of Continuous Glucose Monitoring in Korea
Won Jun KIM ; Jae Hyun KIM ; Hye Jin YOO ; Jang Won SON ; Ah Reum KHANG ; Su Kyoung KWON ; Ji Hye KIM ; Tae Ho KIM ; Ohk Hyun RYU ; Kyeong Hye PARK ; Sun Ok SONG ; Kang-Woo LEE ; Woo Je LEE ; Jung Hwa JUNG ; Ho-Chan CHO ; Min Jeong GU ; Jeongrim LEE ; Dal Lae JU ; Yeon Hee LEE ; Eun Kyung KIM ; Young Sil EOM ; Sung Hoon YU ; Chong Hwa KIM ;
Journal of Korean Diabetes 2021;22(4):225-237
The accuracy and convenience of continuous glucose monitoring (CGM), which efficiently evaluates glycemic variability and hypoglycemia, are improving. There are two types of CGM: professional CGM and personal CGM. Personal CGM is subdivided into real-time CGM (rt-CGM) and intermittently scanned CGM (isCGM). CGM is being emphasized in both domestic and foreign diabetes management guidelines. Regardless of age or type of diabetes, CGM is useful for diabetic patients undergoing multiple insulin injection therapy or using an insulin pump. rt-CGM is recommended for all adults with type 1 diabetes (T1D), and can also be used in type 2 diabetes (T2D) treatments using multiple insulin injections. In some cases, short-term or intermittent use of CGM may be helpful for patients with T2D who use insulin therapy other than multiple insulin injections and/or oral hypoglycemic agents. CGM can help to achieve A1C targets in diabetes patients during pregnancy. CGM is a safe and cost-effective alternative to self-monitoring blood glucose in T1D and some T2D patients. CGM used in diabetes management works optimally with proper education, training, and follow up. To achieve the activation of CGM and its associated benefits, it is necessary to secure sufficient repetitive training and time for data analysis, management, and education. Various supports such as compensation, insurance coverage expansion, and reimbursement are required to increase the effectiveness of CGM while considering the scale of benefit recipients, policy priorities, and financial requirements.
9.The Effects of a Simulation-Based High Flow Nasal Cannula Oxygen Therapy Training Program on the Knowledge, Clinical Performance and Educational Satisfaction of Clinical Nurses
Kyung Soon JANG ; Kyeong Hee RYU ; Hyeon Mo KANG ; In Hwa KANG ; Jeong Hui KWON ; Gyeong Mi LEE ; Yun Jung NAM ; Mi Hye SEO ; Ji Yeon KIM ; Ji Yun JUNG ; Hyun Ji KIM ; Hye Min BAE
Journal of Korean Clinical Nursing Research 2020;26(1):47-58
Purpose:
The aim of this study was to develop a simulation-based High Flow Nasal Cannula Oxygen Therapy training program based on NLN/ISF to identify the effect on knowledge, clinical performance, and educational satisfaction compared to a group who had traditional High Flow Nasal Cannula Oxygen Therapy training after applying it to clinical nurses.
Methods:
31 experimental groups and 33 control groups were conducted from August 2019 to September 2019 for inexperienced nurses over 4 months to 5 years with no experience using high-flow oxygen therapy. Educational programs were developed in scenarios according to Airvo2 and Optiflow, such as facilitator, participant, educational condition, design, characteristics, and educational outcomes. The education application was conducted in advanced for knowledge and clinical performance ability after watching therapy video. Since then, a total of 90 minutes have been conducted for respiratory failure theory training, airvo2 and optiflow simulation training, and debriefing. After applying the education, the medical institution measured nurses’ knowledge, clinical performance, and education satisfaction. Data were analyzed using descriptive statistics, with the SPSS/WIN 22.0 program.
Results:
Both knowledge and educational satisfaction were higher in the experimental group than in the control group (t=-14.09, p<.001), (t=-12.99, p<.001). The clinical performance for both use of Optiflow and Airvo2 were higher in the experimental group than in the control group (t=-11.39, p<.001), (t=-11.38, p<.001) .
Conclusion
Results showed that the simulation-based High Flow Nasal Cannula Oxygen Therapy training was effective with the experimental group having increased scores for every area of this study.
10.Clinical Characteristics and Outcomes of Patients with Culture-Negative Pyogenic Spondylitis according to Empiric Glycopeptide Use
Yong Dae LEE ; Yoon Hee JEON ; Young Hoon KIM ; Kee Yong HA ; Jung Woo HUR ; Kyeong Sik RYU ; Jin Sung KIM ; Youn Jeong KIM
Infection and Chemotherapy 2019;51(3):274-283
BACKGROUND:
The optimal choice of antibiotics is challenging in culture-negative pyogenic spondylitis (PS). The empiric use of glycopeptides is suggested depending on various risk factors, although clinical data are sparse. This study aimed to analyze the clinical characteristics and outcomes of patients with culture-negative PS and evaluate the effect of empiric glycopeptide use on clinical outcomes in these patients.
MATERIALS AND METHODS:
Data on the characteristics, treatment, and outcomes of 175 patients diagnosed with PS were retrospectively obtained from the electronic database of a tertiary referral hospital from 2009 to 2016. Patients with negative culture results were grouped by the duration of glycopeptide treatment: glycopeptide therapy <28 days (Group A) and glycopeptide therapy ≥28 days (Group B).
RESULTS:
Of 89 patients with negative culture results, 78 were included in the analysis (Group A, n = 66; Group B, n = 12). The mean age of patients with negative culture results was 65.5 years, and 52.6% were male. The median follow-up duration was 573 (interquartile range [IQR], 83 – 1,037) days. The duration of intravenous glycopeptide therapy was 0.0 (IQR, 0.0 – 0.0) days and 55.5 (IQR, 37.0 – 75.7) days for Groups A and B, respectively. Patients who used glycopeptide longer empirically (Group B) had more commonly undergone a previous spinal procedure, including surgery (P = 0.024). The length of hospitalization, erythrocyte sedimentation rate, and C-reactive protein level were significantly higher in Group B compared with those in Group A (P <0.001, P <0.001, and P = 0.006, respectively). Regarding treatment modalities, patients in Group B underwent surgery more frequently (P = 0.017). The duration of parenteral antibiotic treatment was longer in Group B (P <0.001). Recurrence was noted in 7 patients (9.0%), and the recurrence rate was not significantly different between the 2 groups (Group A, 5/66 [7.6%]; Group B, 2/12 [16.7%]; P = 0.293).
CONCLUSION
The recurrence rate among patients with culture-negative PS was not different based on the duration of empiric glycopeptide use. However, considering the small sample size and heterogeneity of our study population, we suggest that it is reasonable to administer glycopeptide antibiotics in these patients depending on clinical risk factors. Further large-scale prospective studies are needed to obtain more evidence for appropriate antibiotic treatment.

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