Chronic kidney disease (CKD) patients are hospitalized for various conditions. Hospitalization increases the readmission rate and mortality rate, seriously deteriorating patients’ quality of life. Consequently, it is crucial to analyze the reasons for hospitalization in CKD patients from a broader perspective according to CKD grade. Methods: This is a prospective cohort study of CKD patients entitled the KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD). A total of 2,238 patients were examined, and the reasons for hospitalization were classified into 16 disease categories. The incidence rate ratio (IRR) according to CKD stage was compared using negative bimodal regression analysis. Results: The all-cause hospitalization incidence was 184.96 per 1,000 person-years. The most common reason for hospitalization was circulatory system disease, followed by infection and digestive system disease. Among hospitalizations for acute kidney injury, endocrine-nutrition-metabolic–related illness, blood-related disease, and diseases of the nervous system and sensory organs, IRR increased as CKD grade advanced. The incidence of ophthalmologic surgery during hospitalization increased according to the CKD stage. The IRR of KNOW-CKD patients was 6.19 (95% confidence interval, 5.92–6.48; p < 0.001) compared with the general population. Conclusion: This in-depth analysis of hospitalizations among CKD patients confirmed that CKD patients were hospitalized for various reasons, such as metabolic, ophthalmic, and hematologic diseases. Early detection and intervention regarding causative diseases of CKD are important to reduce the hospitalization burden and improve patients’ quality of life.

Background: Hepatitis A is an acute type of hepatitis caused by the hepatitis A virus (HAV), which is mainly transmitted through the fecal-oral route and also rarely through blood transfusion. Studies on the seroprevalence of HAV immunoglobulin G in blood donors are necessary to predict the risk of releasing HAV infected blood products during epidemic and to establish effective transfusion recipient safety strategies. However, studies on the seroprevalence of HAV IgG in Korean blood donors have been rare. Methods: Blood samples from 10,000 plasmapheresis donors collected from 6th March to 23rd May 2024, were tested for the HAV IgG and analyzed based on age, region, and gender. The test was performed by chemiluminescence microparticle immunoassay on an Alinity i system (Abbott Laboratories, Lake Forest, IL, USA). Results: The overall seroprevalence of HAV IgG was 57.6% (5,759/10,000) for the research subjects. Significant differences between age cohorts or gender were found (16∼19 years, 65.6%; 20∼29 years, 65.5%; 30∼39 years, 28.4%; 40∼49 years, 41.5%; 50∼59 years, 82.6%; >60 years, 97.9% and Men, 59.6%; Women, 51.5%). However, there was no significant difference according to region. Conclusion To prepare for a potential outbreak of HAV, it is recommended that HAV vaccination be prioritized for Korean blood donors in their 30s and 40s, alongside the continued surveillance of HAV IgG seroprevalence among them.

In this study, the Ti6Al4V specimens were fabricated using selective laser melting (SLM) method (Ti6Al4V-AS group). These specimens were performed to heat treatment at 950℃ and 550℃ using vacuum electric furnace (Ti6Al4V-HT group). The mechanical properties, metallographic shape, crystalline structure, and chemical compositions of the alloy specimens before and after heat treatment were analyzed. The Ti6Al4V-AS group showed ultimate tensile strength (UTS) and low elongation values. Acicular crystal grains were observed in metallographic image and the α'-Ti phase was dominant. After heat treatment (Ti6Al4V-HT group), the UTS was lowered and the elongation was increased. In addition, a lamellar structure in which columnar crystal grains are arranged was observed, α+β-Ti phase was formed, and crystallinity increased. As a result of analyzing the chemical composition, the Ti6Al4V-AS specimen contained a higher carbon content than the Ti6Al4V-HT specimen. This high carbon content could be related to the formation of α'-phase, high strength and low elongation of the Ti6Al4V-AS specimen. Ti6Al4V-HT specimen showed that the overall carbon content was low, but the carbon content was locally high in the α-Ti phase region. Therefore, it is necessary to control effectively the incorporation of carbon gas in the production of Ti6Al4V specimens using SLM.

Objective: Mood disorder and borderline personality pathology (BPP) are frequently comorbid and relate to childhood trauma. We investigated the relationship between childhood trauma and BPP features in mood disorder patients versus controls. Methods: A total of 488 mood disorder patients, particularly major depressive disorder (MDD), bipolar I disorder (BD I), and bipolar II disorder (BD II), and 734 controls were included. We examined between-group BPP-related differences and correlated between BPP and childhood trauma using the Childhood Trauma Questionnaire-Short Form (CTQ) and the Personality Assessment Inventory–Borderline Features Scale. Results: BD II patients showed significantly higher BPP. Emotional abuse and neglect were prominently associated with BPP, while affective instability and negative relationships exhibited a stronger association with childhood trauma. We also found a positive relationship between childhood trauma and BPP in MDD, BD I, and BD II patients. Conclusion The findings of the present study imply that BPP features are more likely to be found in patients with BD II than BD I or MDD. Mood disorder patients with severe childhood trauma may have higher BPP features. Thus, further study of the relationship between childhood trauma and BPP features could improve the therapeutic approaches and help understand patients with mood disorders.

Morning glory syndrome (MGS) is a rare congenital optic disc anomaly with a characteristic fundal finding with severe visual impairment. It may occur in association with various systemic manifestations, even though most of the reported cases were isolated. A 6-year-old male visited the nephrology clinic with a history of microscopic hematuria and at the age of 12 years, he was diagnosed thin glomerular basement membrane nephropathy by kidney biopsy. After the following years, the patient had progressive deterioration of visual acuity, and diagnosed as MGS. Whole Exome Sequencing of this patient and his mother revealed heterozygous COL4A4 mutations [c.81_86del (p.Ile29_Leu30del)]. It is more reasonable to consider MGS seen in this patient as a coincidental finding of autosomal dominant Alport syndrome. To our knowledge, this case represents the first case report of autosomal dominant Alport syndrome associated with MGS.

Background: The coronavirus disease 2019 (COVID-19) pandemic is an emerging threat worldwide. It remains unclear how comorbidities affect the risk of infection and severity of COVID-19. Methods: This is a nationwide retrospective case-control study of 219,961 individuals, aged 18 years or older, whose medical costs for COVID-19 testing were claimed until May 15, 2020. COVID-19 diagnosis and infection severity were identified from reimbursement data using diagnosis codes and on the basis of respiratory support use, respectively. Odds ratios (ORs) were estimated using multiple logistic regression, after adjusting for age, sex, region, healthcare utilization, and insurance status. Results: The COVID-19 group (7,341 of 219,961) was young and had a high proportion of female. Overall, 13.0% (954 of 7,341) of the cases were severe. The severe COVID-19 group had older patients and a proportion of male ratio than did the non-severe group. Diabetes (odds ratio range [ORR], 1.206–1.254), osteoporosis (ORR, 1.128–1.157), rheumatoid arthritis (ORR, 1.207–1.244), substance use (ORR, 1.321–1.381), and schizophrenia (ORR, 1.614–1.721) showed significant association with COVID-19. In terms of severity, diabetes (OR, 1.247; 95% confidential interval, 1.009–1.543), hypertension (ORR, 1.245–1.317), chronic lower respiratory disease (ORR, 1.216–1.233), chronic renal failure, and end-stage renal disease (ORR, 2.052–2.178) were associated with severe COVID-19. Conclusion We identified several comorbidities associated with COVID-19. Health care workers should be more careful while diagnosing and treating COVID-19 when patients have the abovementioned comorbidities.

PURPOSE: The purpose of this study was to identify factors related to family health and develop a prediction model with an ability to explain family health in families of patients with schizophrenia.METHODS: A hypothesized model with twelve pathway forms was developed based on literature review. Family stress and social stigma were included as two exogenous variables; whereas family resilience, family empowerment, self-esteem, community integration, and family health were included as endogenous variables. Data were collected using a self-report questionnaire from 206 families of patients with schizophrenia living in Republic of Korea. Data were analyzed with PASW/WIN 18.0 and AMOS 18.0 programs.RESULTS: Social stigma had a negatively indirect and total effect on family health. Family resilience, self-esteem, and community integration had positive and direct and overall effects on family health.CONCLUSION: A prediction model for families of patients with schizophrenia is proposed and social stigma, family resilience, self-esteem, and community integration are presented as predicting factors for family health. Nursing interventions and support programs should be developed to overcome social stigma and improve family resilience, self-esteem, and community integration.
Community Integration ; Family Health ; Humans ; Nursing ; Power (Psychology) ; Republic of Korea ; Schizophrenia ; Social Stigma

BACKGROUND: Friedewald equation is the most widely used method for estimating low-density lipoprotein cholesterol (LDL-C) level. However, due to potential over- or underestimation, many studies have used a modified equation. This study aimed to compare estimates by 4 different equations to directly measured LDL-C concentrations in order to propose the most appropriate method for LDL-C estimation in the Korean population. METHODS: We studied data of 4,350 subjects that included total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and LDL-C concentrations that had been measured at one university hospital in Seoul. We investigated 4 equations: LDL-C by Friedewald's original equation (LDL-C(F)) and its 3 modifications. Pearson correlation analysis was performed to compare these estimates to the direct measurement. RESULTS: Pearson correlation analysis revealed a good correlation among all 4 estimated LDL-C values and the directly measured LDL-C value. The Pearson coefficients were 0.951 for LDL-C(F), 0.917 for LDL-C by Hatta equation (LDL-C(H)), 0.968 for LDL-C by Puavilai equation (LDL-C(P)), and 0.983 for LDL-C by Martin equation (LDL-C(M)). Martin equation (LDL-C(M)) resulted in the best approximation (mean difference from the direct measurement, 5.5 mg/dL; mean percentage difference from the direct measurement, 5.1%) and the best agreement with the direct measurement (86.1%). LDL-C(P) resulted in the second-best approximation (mean difference, 7.0 mg/dL; mean percentage difference, 6.2%; concordance, 82.5%). LDL-C(M) was found to be less influenced by TG and HDL-C levels than by LDL-C(F). CONCLUSION: Estimates by Martin equation had the best agreement with direct LDL-C concentrations and both Martin and Puavilai equations were superior to Friedewald equation for estimating LDL-C concentrations in Korean adults.
Adult* ; Cholesterol* ; Dyslipidemias ; Humans ; Lipoproteins* ; Methods* ; Seoul ; Triglycerides

BACKGROUND: To investigate the national molecular epidemiology and resistance profiles of vancomycin-intermediate Staphylococcus aureus (VISA), we analyzed the characteristics of methicillin-resistant Staphylococcus aureus (MRSA) collected from clinical samples at tertiary or general hospitals participating in a nationwide surveillance program for VISA and vancomycin-resistant Staphylococcus aureus (VRSA) in Korea during an 12-week period in each year from 2007 to 2013. METHODS: VISA was defined by agar dilution, broth dilution and E-test methods with vancomycin minimum inhibitory concentrations of >2 μg/mL. All VISA isolates were characterized by multilocus sequence typing, staphylococcal cassette chromosome mec typing, spa typing, accessory gene regulator typing, Diversilab analysis, and antibiogram analysis. RESULTS: Of 109,345 MRSA isolates, 87,354 were screened and 426 isolates were identified as positive on brain heart infusion agar containing 4 μg/mL vancomycin (BHI-V4). Of 426 isolates, 76 isolates were identified as VISA. No VRSA isolates were detected among the isolates. Overall, a total of 6 genotypes were identified among VISA strains and the predominant clones were ST5-II-t2460, ST72-IV-t324, and ST239-III-t037 (44.7%, 15.8%, and 10.5%, respectively). Of note, ST72-IV-t324 clones are known to be a typical community-associated MRSA. ST239-III-t037 strains were more resistant to trimethoprim-sulfamethoxazole than any other type of strain. ST72-IV-t324 strains were susceptible to all of the antimicrobial agents tested except erythromycin and daptomycin. All of the VISA isolates were susceptible to linezolid and quinupristin-dalfopristin. CONCLUSION: Although VRSA is still rare, continuous monitoring of VRSA occurrence is needed, as well as VISA prevalence, epidemic clonal shift, and antimicrobial resistance.
Agar ; Anti-Infective Agents ; Brain ; Clone Cells ; Daptomycin ; Erythromycin ; Genotype ; Heart ; Hospitals, General ; Korea* ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Molecular Typing* ; Multilocus Sequence Typing ; Prevalence ; Staphylococcus aureus* ; Staphylococcus* ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin

Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency of the enzyme α-galactosidase A, resulting in the accumulation of glycosphingolipids within the lysosomes of various cell types. It has a wide spectrum of clinical phenotypes, and renal failure is a serious complication. Fabry disease is confirmed either by measurement of α-galactosidase A activity or by genetic testing for GLA mutations. Renal biopsy findings on light microscopy, specifically enlarged podocytes with foamy cytoplasm, and osmiophilic inclusion bodies in the cytoplasm in all types of renal cells on electron microscopy, are characteristic of this disease. The predominant differential diagnosis is iatrogenic phospholipidosis in association with certain drugs that can cause cellular injuries indistinguishable from Fabry disease. Here, we report the case of a 10-year-old boy with microscopic hematuria who underwent a renal biopsy that showed morphological findings consistent with Fabry disease, although the patient had neither a GLA mutation nor a history of drug consumption. Six years later, spontaneous regression of this renal pathology was observed in a second renal biopsy examination.
Biopsy* ; Child* ; Cytoplasm ; Diagnosis, Differential ; Fabry Disease* ; Genetic Testing ; Glycosphingolipids ; Hematuria* ; Humans ; Inclusion Bodies ; Lysosomes ; Male* ; Microscopy ; Microscopy, Electron ; Pathology ; Phenotype ; Podocytes ; Renal Insufficiency