Background: The fatality rate of patients with coronavirus disease 2019 (COVID-19) varies among countries owing to demographics, patient comorbidities, surge capacity of healthcare systems, and the quality of medical care. We assessed the clinical outcomes of patients with COVID-19 during the first wave of the epidemic in Korea. Methods: Using a modified World Health Organization clinical record form, we obtained clinical data for 3,060 patients with COVID-19 treated at 55 hospitals in Korea. Disease severity scores were defined as: 1) no limitation of daily activities; 2) limitation of daily activities but no need for supplemental oxygen; 3) supplemental oxygen via nasal cannula; 4) supplemental oxygen via facial mask; 5) non-invasive mechanical ventilation; 6) invasive mechanical ventilation; 7) multi-organ failure or extracorporeal membrane oxygenation therapy; and 8) death. Recovery was defined as a severity score of 1 or 2, or discharge and release from isolation. Results: The median age of the patients was 43 years of age; 43.6% were male. The median time from illness onset to admission was 5 days. Of the patients with a disease severity score of 3–4 on admission, 65 (71.5%) of the 91 patients recovered, and 7 (7.7%) died due to illness by day 28. Of the patients with disease severity scores of 5–7, 7 (19.5%) of the 36 patients recovered, and 8 (22.2%) died due to illness by day 28. None of the 1,324 patients who were < 50 years of age died; in contrast, the fatality rate due to illness by day 28 was 0.5% (2/375), 0.9% (2/215), 5.8% (6/104), and 14.0% (7/50) for the patients aged 50–59, 60–69, 70–79, and ≥ 80 years of age, respectively. Conclusion In Korea, almost all patients of < 50 years of age with COVID-19 recovered without supplemental oxygen. In patients of ≥ 50 years of age, the fatality rate increased with age, reaching 14% in patients of ≥ 80 years of age.

PURPOSE: The aim of this study was to investigate the changes in occlusal force after loss of the lower first molar depending on the inclination and extrusion of the adjacent and opposing teeth by using a strain gauge. MATERIALS AND METHODS: Anatomic teeth were used to reconstruct the normal dental arch with loss of the lower right first molar. A uniformly thick layer of silicone was applied to the root to mimic the periodontal ligament. Four stages of dies with varying degrees of inclination and extrusion of the adjacent and opposing teeth were constructed and attached to master model interchangeably by using a CAD/CAM fabricated customized die system. The strain gauges were attached to teeth and a universal testing machine was used to determine the changes in occlusal force. An independent t-test and one-way ANOVA were performed (α = .05). RESULTS: While simulating chewing food, the upper first, second premolar and lower second molar showed greater occlusal force than before extraction. When the change of adjacent teeth's occlusal force with their progressive movement after molar loss was evaluated, the difference among four die models was significant and was in the decreasing aspect (P < 0.05). CONCLUSION: When the lower first molar was lost and the adjacent teeth did not move yet, the occlusal force in adjacent teeth was higher than that when the lower first molar still existed. In addition, the occlusal force in the upper premolars and lower second molar decreased significantly with the progressive movement of adjacent teeth.
Bicuspid ; Bite Force* ; Dental Arch ; Mastication ; Molar* ; Periodontal Ligament ; Silicon ; Silicones ; Tooth*

BACKGROUND: Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. METHODS: Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG > or =126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c > or =6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. RESULTS: When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c > or =6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. CONCLUSION: We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.
Aged ; Blood Glucose* ; Diabetes Mellitus ; Diagnostic Tests, Routine ; Fasting* ; Female ; Glomerular Filtration Rate ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Humans ; Korea ; Nutrition Surveys ; Prediabetic State* ; Prevalence*

BACKGROUND: Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests. METHODS: Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG > or =126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c > or =6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%. RESULTS: When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c > or =6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate. CONCLUSION: We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.
Aged ; Blood Glucose* ; Diabetes Mellitus ; Diagnostic Tests, Routine ; Fasting* ; Female ; Glomerular Filtration Rate ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Humans ; Korea ; Nutrition Surveys ; Prediabetic State* ; Prevalence*

PURPOSE: Influenza virus is one of the most important viruses that cause the respiratory infection seasonally. In April 2009, H1N1 was detected in America and Mexico and then there was pandemic in Korea. We investigated the difference of clinical and laboratory findings between the infections of H1N1 and Influenza B. METHODS: We have retrospectively studied the patients under age of 15 years who visited Inje University Sanggye Paik Hospital from August 2009 to April 2010. Evaluation for influenza infection was performed by rapid antigen test or multiplex reverse transcriptase polymerase chain reaction. Complete blood count with differential counts, C-reactive protein and chest X-ray were checked. RESULTS: Enrolled patients were 2,226 in H1N1-infected group and 288 in influenza B-infected group. Seasonal variation was that H1N1 in autumn and winter but influenza B in spring. The male-to-female sex ratio was same as 1.23 in each group. The mean age of H1N1-infected group was higher than influenza B-infected group (P<0.001). Fever was developed similarly in both groups (P=0.114). However, cough, sputum, rhinorrhea, vomiting, diarrhea, and headache were more prevalent in influenza B infection compared to H1N1 infection (P<0.001). Pneumonia development and admission rate were higher in influenza B infection compared to H1N1 infection (P<0.001, respectively). CONCLUSION: Although H1N1 infection spread rapidly, H1N1 caused not so severe symptoms than influenza B. Because of the possibility that influenza epidemic will develop repeatedly in the future, we need to evaluate more about different characteristics depending on the virus subtype and prepare for them.
Americas ; Blood Cell Count ; C-Reactive Protein ; Cough ; Diarrhea ; Fever ; Headache ; Humans ; Influenza, Human ; Korea ; Mexico ; Orthomyxoviridae ; Pandemics ; Pneumonia ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons ; Sex Ratio ; Sputum ; Thorax ; Viruses ; Vomiting

OBJECTIVES: This study estimated the magnitude of malignant mesothelioma and its epidemiologic features in Korea. We collected data on 160 cases for the 5-year period from 2001 to 2005. METHODS: We established a surveillance system for malignant mesothelioma in 2001. The important participants were pathologists, and respiratory and occupational physicians. We reclassified these cases according to the date of diagnosis and calculated fatality by comparing National Mortality Data. We actively surveyed 18 cases which were diagnosed in 2004 and 2005 to evaluate their work-relatedness. RESULTS: Among 160 cases, 18 were initially diagnosed before 1995, 57 from 1996 to 2000, 11 in 2001, 18 in 2002, 11 in 2003, 29 in 2004 and 16 in 2005. After 2001, 17cases were reported annually. Among the 86 cases which were diagnosed before 2003, 60 cases (69.8%) had died and 46(53.5%) had died within 1 year. Among the 18 cases which we surveyed, 5 were related with the construction industry, 2 with asbestos textile manufacturing industries and 1 with asbestos painting. There was no evident work relatedness in the other 10 cases, but 6 were related to environmental exposure. CONCLUSIONS: Although this surveillance system revealed the magnitude of malignant mesothelioma in Korea, it needs to be supplemented by an active surveillance system using death certificate data and cancer registry data etc.
Asbestos ; Construction Industry ; Death Certificates ; Diagnosis ; Environmental Exposure ; Korea* ; Mesothelioma* ; Mortality ; Paint ; Paintings ; Textiles

BACKGROUND/AIMS: The long-term virologic and biochemical changes in patients with HBeAg negative HBV infection, especially in Asia, remain unclear. To address this issue, we conducted a 3 year- retrospective, cohort study. METHODS: A total of 157 patients with HBeAg negative HBV infection who were monitored without treatment were reviewed between January 1999 and March 2004. Those patients were followed up every 3 months with liver function tests and serologic tests. All patients were stratified into 3 groups; inactive carrier (IC), viremic carrier (VC) and chronic hepatitis (CH). Serum HBV DNA was measured by a hybridization assay (sensitivity: 1.4 x 10(5) genomes/mL, Digene Diagnostics, Silver Spring, USA). RESULTS: The median age of enrolled patients was 42.7 years (M:F=2.3:1). By single time-point observations, the 3 year-cohort prevalence of HBeAg negative CH varied from 12.7 to 35.8% (median 20.7%) HBeAg negative CH was accumulated over time (P=0.002) and transition rates among three groups after 3 years of follow-up are as follows: IC to CH, 6.0%; IC to VC, 4.1%; VC to CH, 23.2%. VC seems to be a disease state in the middle of transition from IC to CH. CONCLUSIONS: We demonstrated the dynamic changing patterns of HBeAg negative CH with time, of which the change from IC or VC to CH was dominant.
Middle Aged ; Male ; Humans ; Hepatitis B, Chronic/*immunology/virology ; Hepatitis B e Antigens/*blood ; Female ; Carrier State/immunology ; Adult

BACKGROUND: Screening tests for hepatocellular carcinoma (HCC) in the high risk population can detect tumors at an earlier stage and thus confer a higher chance of receiving treatment. However, the usefulness, frequency and cost-effectiveness of screening for HCC may differ in different areas, possibly reflecting differences in risk factors. Last decade, we have identified risk factors for HCC in 4339 Korean patients. The aim of this study was to investigate the efficacy and usefulness of individual prediction model for the early diagnosis of HCC. METHODS: We studied a total of 833 patients who visited Yonsei University Medical Center for regular check-up including ultrasonography and alpha-fetoprotein from January 1999 to December 2000. The patients were classified into a low risk group (< 5%), an intermediate risk group (5~15%), and an high risk group (> 15%) by the probability of HCC development according to individual prediction model (IPM). The patients who developed HCC during the follow-up periods were analyzed using IPM. All the detailed data of clinical parameters were obtained by our self-exploited data base system prospectively and analyzed by SAS program. RESULTS: 44 (5.3%) out of 833 patients developed HCC during mean follow-up periods of 36 months. According to IPM, 2 (0.62%) of 324 patients in the low risk group, 20 (4.84%) of 413 patients in the intermediate risk group, and 22 (22.9%) of 96 patients in the high risk group were diagnosed as HCC. In 29 of 44 HCC patients (65.9%), initial presentation of tumor size was less than 3 cm in diameter. CONCLUSION: We confirmed the reliability of established IPM for screening of HCC and this model may help screening program to be done effectively by focusing high risk groups for HCC.
Academic Medical Centers ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Early Diagnosis* ; Follow-Up Studies ; Humans ; Mass Screening ; Prospective Studies ; Risk Factors ; Ultrasonography

PURPOSE: Nursing has evolved as a unique and independent field over the last decades. Unfortunately, many nurses in Korea express concern that they lack appropriate background knowledge in bioscience necessary to practice nursing competently. To determine the reasons of their concerns, we examined the perceptions of RNs regarding bioscience courses in their undergraduate (Baccalaureate and 3 year diploma program) and their perceived relations to the practice of nursing. METHODS: The structured questionnaires were sent to 3 university-affiliated tertiary hospitals in Seoul, Korea. RESULTS: The responses given by the nurses in the two groups were similar. The nurses in this study reported that the bioscience courses they took as undergraduates had little relation to their professional tasks. This lack of link between bioscientific knowledge and nursing practice may be partly due to the fact that the courses are taught by non-nursing faculties who are not familiar with nursing tices. It also appears that bioscience knowledge deficit was most prominent during nursing assessment regardless of the program they attended or the unit they are currently working. CONCLUSION: Bioscience courses should be integrated into the nursing curriculum properly and taught by nursing faculty who have a strong background in biological sciences.

BACKGROUND: Vascular endothelial growth factor (VEGF) is a potent angiogenic peptide with biologic effects that include regulation of hematopoietic stem cell development, extracellular matrix remodeling, and inflammatory cytokine generation. VEGF plasma levels are elevated in circulation during tumor growth and bone marrow proliferative status. In this study, to investigate the role of VEGF expression in patients with aplastic anemia (AA), VEGF protein expression and microvessel density (MVD) were evaluated. METHODS: Immunohistochemical staining for detecting VEGF protein was performed by the labeled avidin-biotin method on the formalin-fixed and paraffin embedded bone marrow biopsy samples of 25 patients with severe AA and 10 normal controls. Microvessels were scored in at least 3 areas (x200 fields) of the highest MVD in representative sections of each bone marrow biopsy specimen using immunohistochemistry for CD34 antigen. RESULTS: In AA, megakaryocytes and histiocytes expressed less intense cytoplasmic VEGF than in control (P < 0.05). However, plasma cells had higher VEGF immunoreactivity in AA than in control. MVD was significantly lower in patients with AA (21.43+/-7.24), compared to controls (27.65+/-3.44) (P < 0.05). MVD had a strong correlation with bone marrow cellularity. Also, the degree of VEGF immunoreactivity was correlated with bone marrow cellularity and MVD. CONCLUSION: Angiogenesis as assessed by MVD and VEGF expression seems to have a role in the pathogenesis of AA.
Anemia, Aplastic* ; Antigens, CD34 ; Biopsy ; Bone Marrow ; Cytoplasm ; Extracellular Matrix ; Hematopoietic Stem Cells ; Histiocytes ; Humans ; Immunohistochemistry ; Megakaryocytes ; Microvessels ; Paraffin ; Plasma ; Plasma Cells ; Vascular Endothelial Growth Factor A*