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.

Purpose: This study aimed to validate the Korean version of the Global Interprofessional Therapeutic Communication Scale (K-GITCS), with the ultimate goal of improving therapeutic communication and patient engagement among Korean nurses. Methods: The study rigorously adhered to the original authors’ translation guidelines. A sample of 300 registered nurses from a tertiary hospital in South Korea participated in this research. Confirmatory factor analysis was conducted to verify the tool’s validity, and Cronbach’s ⍺ coefficients were calculated to evaluate the internal consistency of the K-GITCS. Results: The instrument’s reliability was substantiated by an adequate comparative fit index (0.984) and a high Cronbach’s ⍺ coefficient (0.94). The empirical results supported the three-factor structure of the K-GITCS, which comprised trust and rapport building, power sharing, and empathy. Conclusion The study confirms that the K-GITCS is a valid, reliable, and culturally sensitive instrument for assessing therapeutic communication skills among nurses in Korea. It also highlights the importance of culturally tailored therapeutic communication training, particularly for promoting empathy in patient care. The study emphasizes the potential of the K-GITCS to significantly enhance nurses’ therapeutic communication practices, thereby improving the quality and safety of patient care. It is recommended to apply this tool among nursing students, academic institutions, and interprofessional healthcare providers to facilitate structured educational interventions that will improve therapeutic communication.

Purpose: This study aimed to validate the Korean version of the Global Interprofessional Therapeutic Communication Scale (K-GITCS), with the ultimate goal of improving therapeutic communication and patient engagement among Korean nurses. Methods: The study rigorously adhered to the original authors’ translation guidelines. A sample of 300 registered nurses from a tertiary hospital in South Korea participated in this research. Confirmatory factor analysis was conducted to verify the tool’s validity, and Cronbach’s ⍺ coefficients were calculated to evaluate the internal consistency of the K-GITCS. Results: The instrument’s reliability was substantiated by an adequate comparative fit index (0.984) and a high Cronbach’s ⍺ coefficient (0.94). The empirical results supported the three-factor structure of the K-GITCS, which comprised trust and rapport building, power sharing, and empathy. Conclusion The study confirms that the K-GITCS is a valid, reliable, and culturally sensitive instrument for assessing therapeutic communication skills among nurses in Korea. It also highlights the importance of culturally tailored therapeutic communication training, particularly for promoting empathy in patient care. The study emphasizes the potential of the K-GITCS to significantly enhance nurses’ therapeutic communication practices, thereby improving the quality and safety of patient care. It is recommended to apply this tool among nursing students, academic institutions, and interprofessional healthcare providers to facilitate structured educational interventions that will improve therapeutic communication.

Purpose: Fish allergy is rare in children, and there have been few studies on childhood fish allergy. This study aims to investigate the clinical characteristics and laboratory findings of white meat fish (WMF) allergy in Korean children. Methods: In this study, we enrolled 150 children with a history of WMF consumption who underwent serum specific immunoglobulin E to cod (cod-sIgE) at Ajou University Hospital from January 2019 to December 2022. The demographic characteristics, clinical symptoms, history of consuming 6 major Korean WMF (cod, cutlass, yellow croaker, brown sole, olive flounder, and anchovy), and cod-sIgE were investigated. Results: Sixty-five subjects (43.3%) had clinical responses to at least 1 of the 6 WMF (WMF-allergic), and 85 subjects had no allergic reaction to all 6 WMF (WMF-tolerant). The median age of first symptom onset in the WMF-allergic group was 15 months. Major causative WMF were yellow croaker (30.6%), cutlass (28.7%), cod (26.1%), brown sole (20.4%), anchovy (14.7%), and olive flounder (6.5%). Twenty-three of 65 WMF-allergic children (35.4%) had anaphylaxis. The median level of cod-sIgE was 4.61 kUA/L (range, 0.04–100.10 kUA/L) in the WMF-allergic group, and this value was significantly higher (P < 0.001) than that of the WMF-tolerant group (0.04 kUA/L; range, 0.04–3.08 kUA/L). The positive rates ( ≥ class 2, 0.7 kUA/L) of cod-sIgE for the 6 individual WMF ranged from 69% to 90%. Conclusion We propose that WMF allergy can develop in young children, with 35.4% experiencing anaphylaxis. Cod-sIgE is considered a useful tool for diagnosing not only cod allergy but also other WMF allergy in children.

Purpose: Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children.However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod. Methods: Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed. Results: Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish. Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, patients with myasthenia gravis (MG) were more susceptible to poor outcomes owing to respiratory muscle weakness and immunotherapy. Several studies conducted in the early stages of the COVID-19 pandemic reported higher mortality in patients with MG compared to the general population. This study aimed to investigate the clinical course and prognosis of COVID-19 in patients with MG and to compare these parameters between vaccinated and unvaccinated patients in South Korea. Methods: This multicenter, retrospective study, which was conducted at 14 tertiary hospitals in South Korea, reviewed the medical records and identified MG patients who contracted COVID-19 between February 2022 and April 2022. The demographic and clinical characteristics associated with MG and vaccination status were collected. The clinical outcomes of COVID-19 infection and MG were investigated and compared between the vaccinated and unvaccinated patients. Results: Ninety-two patients with MG contracted COVID-19 during the study. Nine (9.8%) patients required hospitalization, 4 (4.3%) of whom were admitted to the intensive care unit. Seventy-five of 92 patients were vaccinated before contracting COVID-19 infection, and 17 were not. During the COVID-19 infection, 6 of 17 (35.3%) unvaccinated patients were hospitalized, whereas 3 of 75 (4.0%) vaccinated patients were hospitalized (P < 0.001). The frequencies of ICU admission and mechanical ventilation were significantly lower in the vaccinated patients than in the unvaccinated patients (P = 0.019 and P = 0.032, respectively). The rate of MG deterioration was significantly lower in the vaccinated patients than in the unvaccinated patients (P = 0.041). Logistic regression after weighting revealed that the risk of hospitalization and MG deterioration after COVID-19 infection was significantly lower in the vaccinated patients than in the unvaccinated patients. Conclusion This study suggests that the clinical course and prognosis of patients with MG who contracted COVID-19 during the dominance of the omicron variant of COVID-19 may be milder than those at the early phase of the COVID-19 pandemic when vaccination was unavailable. Vaccination may reduce the morbidity of COVID-19 in patients with MG and effectively prevent MG deterioration induced by COVID-19 infection.

Purpose: This study aimed to validate the Korean version of the Global Interprofessional Therapeutic Communication Scale (K-GITCS), with the ultimate goal of improving therapeutic communication and patient engagement among Korean nurses. Methods: The study rigorously adhered to the original authors’ translation guidelines. A sample of 300 registered nurses from a tertiary hospital in South Korea participated in this research. Confirmatory factor analysis was conducted to verify the tool’s validity, and Cronbach’s ⍺ coefficients were calculated to evaluate the internal consistency of the K-GITCS. Results: The instrument’s reliability was substantiated by an adequate comparative fit index (0.984) and a high Cronbach’s ⍺ coefficient (0.94). The empirical results supported the three-factor structure of the K-GITCS, which comprised trust and rapport building, power sharing, and empathy. Conclusion The study confirms that the K-GITCS is a valid, reliable, and culturally sensitive instrument for assessing therapeutic communication skills among nurses in Korea. It also highlights the importance of culturally tailored therapeutic communication training, particularly for promoting empathy in patient care. The study emphasizes the potential of the K-GITCS to significantly enhance nurses’ therapeutic communication practices, thereby improving the quality and safety of patient care. It is recommended to apply this tool among nursing students, academic institutions, and interprofessional healthcare providers to facilitate structured educational interventions that will improve therapeutic communication.

Rare diseases are predominantly genetic or inherited, and patients with these conditions frequently exhibit neurological symptoms. Diagnosing and treating many rare diseases is a complex challenge, and their low prevalence complicates the performance of research, which in turn hinders the advancement of therapeutic options. One strategy to address this issue is the creation of national or international registries for rare diseases, which can help researchers monitor and investigate their natural progression. In the Republic of Korea, we established a registry across 5 centers that focuses on 3 rare diseases, all of which are characterized by gait disturbances resulting from motor system dysfunction. The registry will collect clinical information and human bioresources from patients with amyotrophic lateral sclerosis, spinocerebellar ataxia, and hereditary spastic paraplegia. These resources will be stored at ICreaT and the National Biobank of Korea. Once the registry is complete, the data will be made publicly available for further research. Through this registry, our research team is dedicated to identifying genetic variants that are specific to Korean patients, uncovering biomarkers that show a strong correlation with clinical symptoms, and leveraging this information for early diagnosis and the development of treatments.