BACKGROUND: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. MATERIALS AND METHODS: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. RESULTS: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. CONCLUSION: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.
Antiviral Agents ; Aspartate Aminotransferases ; Coronavirus Infections* ; Disease Outbreaks ; Dyspnea ; Extracorporeal Membrane Oxygenation ; Fever ; Humans ; Hypotension ; Leukocytosis ; Leukopenia ; Lung Diseases ; Middle East Respiratory Syndrome Coronavirus ; Middle East* ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Republic of Korea* ; Respiration, Artificial ; Thrombocytopenia

BACKGROUND: Nutrition labels provide various information on the nutrient contents of food. However, despite the recent increase in the interest in dietary intake and expansion of related policies, studies on the association between nutrition label reading and dietary intake are lacking in Korea. METHODS: This study analyzed the 2007-2009 KNHANES (Korean National Health and Nutrition Examination Survey) data. To examine macronutrients and micronutrients intake according to nutrition label reading, analysis of covariance was used. Multiple logistic regression analysis was also used to examine the association between adherence to dietary reference intake and nutrition label reading. RESULTS: Nutrition label reading was significantly high among women, youth, and those with high education and high household income. Nutrition label reading was associated with higher intake of calcium and vitamin C in men and the lower intake of calorie, carbohydrates and higher energy ratio of protein in women. Additionally, male nutrition label readers were associated with adherence to dietary reference intake of fiber (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.23 to 3.26) and calcium (OR, 1.26; 95% CI, 1.03 to 1.54). In women, there were no significant differences in the adherence to the dietary reference intake in fat, fiber, sodium, potassium, and calcium according to the nutrition label reading. CONCLUSION: In men, nutrition label reading was associated with healthier intake of several micronutrients, although this was not observed in women. Consideration for clearly reporting vulnerable micronutrients in nutrition labels is necessary.
Adolescent ; Adult* ; Ascorbic Acid ; Calcium ; Carbohydrates ; Education ; Family Characteristics ; Female ; Food Habits ; Food Labeling ; Humans ; Korea ; Logistic Models ; Male ; Micronutrients ; Potassium ; Recommended Dietary Allowances ; Sodium

PURPOSE: It is widely recognized that good quality control (QC) program is essential for adequate imaging diagnosis using gamma camera. The purpose of this study is to survey the current status of QC of gamma cameras in Republic of Korea for implementing appropriate nationwide quality control guidelines and programs. METHODS: A collection of data is done for personnel, equipment and appropriateness of each nuclear medicine imaging laboratory's quality control practice. This survey is done by collection of formatted questionnaire by mails, emails or interviews. We also reviewed the current recommendations concerning quality assurance by international societies. RESULTS: This survey revealed that practice of quality control is irregular and not satisfactory. The irregularity of the QC practice seems due partly to the lack of trained personnel, equipment, budget, time and hand-on guidelines. CONCLUSION: The implementation of QC program may cause additional burden to the hospitals, patients and nuclear medicine laboratories. However, the benefit of a good QC program is obvious that the hospitals can provide good quality nuclear medicine imaging studies to the patients. It is important to use least cumbersome QC protocol, to educate the nuclear medicine and hospital administrative personnel concerning QC, and to establish national QC guidelines to help each individual nuclear medicine laboratory.
Administrative Personnel ; Budgets ; Electronic Mail ; Gamma Cameras ; Humans ; Nuclear Medicine ; Postal Service ; Quality Control ; Surveys and Questionnaires ; Republic of Korea

Neck fracture is a major cause of death in traffic accidents and this injury pattern occurred normally in a frontal collision or overturn process. This study investigates a case of neck fracture from a low speed collision. In this case examined, the passenger in the front seat of the car was pulled back and did not have the seat belt on. As the vehicle slipped on a frozen road surface in a downward hill and crashed into the shoulder of the road at low speed. But strangely, even though his neck is fracture there were not any collision marks on interior of the car. This study applied computer simulation to analyze this case and we found out that the upper part of the person was rotated and raised at the time of collision and his neck was fully bent by interference with roof and we also know that the seat belt did not resist the passenger who pulled back his seat.
Accidents, Traffic ; Cause of Death ; Computer Simulation ; Humans ; Neck Injuries ; Neck* ; Seat Belts ; Shoulder

It is a frequently asked question who was the driver of a vehicle when a traffic accident occur. To give an expert opinion who was the driver of vehicle, expert witness must inspect not only trace evidences remained in vehicle and occupant's clothing but also occupant's injuries. Thus, the collaboration of forensic engineering and forensic medicine is very fruitful in this kind of case. Due to open sitting position of occupants, deciding the driver of motorcycle is a very difficult and case dependent problem and it is very rare that the driver of motorcycle can be decided only by the estimation of occupant's injuries. In this report, we introduce the case that the driver of motorcycle can be decided by the collaboration of forensic engineering and forensic medicine.
Accidents, Traffic ; Clothing ; Cooperative Behavior ; Expert Testimony ; Forensic Medicine ; Fruit ; Motorcycles*

BACKGROUND AND OBJECTIVES: The intrapulmonary shunt, after a liver transplantation, is expected to improve, but the frequency, and predictors, of improvement are not well known. We studied the frequency of the improvement in the intrapulmonary shunt, and the relation between this improvement and the clinical parameters, using contrast echocardiography in liver transplant candidates. SUBJECTS AND METHODS: Preoperative and postoperative contrast echocardiography, with intravenous agitated saline, was performed in 25 liver transplant candidates(M:F=9:6, mean age=6+/-10). The extent of the intrapulmonary shunt was semi-quantitatively assessed on a grade scale from 0 to 4+, according to the degree of appearance of the contrast in the left heart chambers. The etiology of the underlying chronic liver disease, Child-Pugh classification scores, pulmonary function tests and arterial blood gas analyses were all evaluated. The change in the shunt grade after the liver transplantation, and the association of these changes, with clinical parameters, were also evaluated. RESULTS: Twenty-four(6%) f the 25 patients showed positive results for the intrapulmonary shunt on preoperative contrast echocardiography. At follow up, the shunt was visible in only 5(1%) atients. All 24 patients whose preoperative echocardiography revealed a positive intrapulmonary shunt showed an improvement in the intrapulmonary shunt after the liver transplantation. There was a significant correlation between the improvements in the shunt and the Child-Pugh classification scores(r=0.59, p=0.02). CONCLUSION: Contrast echocardiography is a feasible, noninvasive, method for the detection of changes in the intrapulmonary shunt before and after a liver transplantation, and the intrapulmonary shunt is improved after a liver transplantation in most patients.
Blood Gas Analysis ; Classification ; Dihydroergotamine ; Echocardiography ; Follow-Up Studies ; Heart ; Humans ; Liver Diseases* ; Liver Transplantation* ; Liver* ; Respiratory Function Tests

Solid organ transplantation has been established as an accepted treatment modality for end-stage diseases. Although the prognosis for organ recipients has improved with the development of surgical technical skills and the application of newly developed immunosuppressive agents, opportunistic infections remain the major cause of death in these patients. Invasive aspergillosis is one of the most common fungal infections in solid organ transplantation, and it carries a high mortality rate. In Korea, eight sporadic cases of invasive aspergillosis after kidney or heart transplantation have been reported. Recently, we experienced five cases of invasive aspergillosis after liver or heart transplantation over a four year period. Among these five patients, three died of uncontrollable aspergillosis and one died of heart failure and graft rejection. Early diagnosis and treatment are essential for the improvement of the prognosis for invasive aspergillosis after solid organ transplantation.
Aspergillosis* ; Cause of Death ; Early Diagnosis ; Graft Rejection ; Heart Failure ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; Kidney ; Korea ; Liver ; Mortality ; Opportunistic Infections ; Organ Transplantation* ; Prognosis ; Transplants*

BACKGROUND: Vitiligo is an acquired depigmentary disorder of the skin and hair. The etiology is unknown, however an autoimmune hypothesis is favored. OBJECTIVE: We performed this study to develop a better understanding of the clinical features of vitiligo patients. METHOD: We evaluated clinical manifestations of 1203 vitiligo patients(556 males and 647 females). RESULTS AND CONCLUSIONS: 1. The mean age of onset and that of the first visits made by patients were 22.9+/-18 and 27.9+/-19 years, respectively. 2. The face(37.4%) was the most common site of initial involvement. In decreasing order of frequency, the common sites of involvement were the face and neck(65.9%), thorax and abdomen(42.9%), upper extremities(42.3%). 44.5% of the cases had the vulgaris type, 26.1% the focal type, and 21.1% the segmental type. During the three months before a visit, 44% of patients experienced progression of disease. Within one year, about 75% of patients reported that the disease had progressed. 3. Precipitating or aggravating factors such as trauma(13.1%), psychological stress(9.2%), sun light (2.8%) and pregnancy(2.5%), were found in 30.9% of patients. Thyroid disease was the most common associated disease.
Age of Onset ; Hair ; Humans ; Male ; Skin ; Solar System ; Thorax ; Thyroid Diseases ; Vitiligo*