1.Validation of I71.3 code for ruptured abdominal aortic aneurysm in Korea: misplaced diagnosis in claims data
Eun-Ah JO ; Sujeong SEONG ; Sanghyun AHN ; Hyejin MO ; In-Mok JUNG ; Hyo Kee KIM ; Hyunmin KO ; Ahram HAN ; Sangil MIN ; Seung-Kee MIN
Annals of Surgical Treatment and Research 2023;104(3):170-175
Purpose:
Studies in western countries have shown a decline in the incidence of ruptured abdominal aortic aneurysm (rAAA) with advancements in endovascular repair and screening. However, according to health insurance data in Korea based on rAAA code (I71.3), overall rAAA has been increasing. This study aimed to validate the I71.3 code for rAAA and attempt to define the true incidence of rAAA in Korea.
Methods:
A 20-year multicenter retrospective review of rAAA was undertaken from the period of January 1, 2000 to December 31, 2020. All patients were diagnosed with the rAAA code I71.3 in each of the 4 hospitals. The CT images and surgical records of these patients were reviewed to differentiate true rAAA and misdiagnosis. Further data on true rAAA patient outcomes including mortality and treatment success were also collected.
Results:
A total of 305 rAAA (I71.3) codes were identified in the 4 centers. However, medical record review showed true rAAA in only 131 (43.0%). The remaining 174 cases (57.0%) were misdiagnosed. Impending ruptures were the most common misdiagnoses (37.9%). The total in-hospital mortality including deaths before treatment was 38.9% (n = 51), while mortality of treated patients was 24.4% (n = 15).
Conclusion
The analysis of I71.3 code for rAAA showed that only 43.0% were true rAAA and the remaining 57.0% were misdiagnosed. This indicates that the I71.3 code is overestimated in National Health Insurance-based data and that the true incidence of rAAA could be much lower.
2.The Incidence and Care Cascade of the Hepatitis C Virus in Korea
Young Eun CHON ; Aejeong JO ; Eileen L. YOON ; Jonghyun LEE ; Ho Gyun SHIN ; Min Jung KO ; Dae Won JUN
Gut and Liver 2023;17(6):926-932
Background/Aims:
The 2030 hepatitis C virus (HCV) elimination targets of the World Health Organization are an 80% reduction in incidence and 65% reduction in mortality compared to the 2015 rates. However, information on the nationwide incidence and treatment rates of HCV infection are limited. We aimed to investigate the nationwide incidence and status of the care cascade for HCV infection in Korea.
Methods:
This study used data from the Korea Disease Control and Prevention Agency linked with the data of the Korea National Health Insurance Service. Linkage to care was defined as visiting hospitals twice or more due to HCV infection within 1.5 years of the index date. The treatment rate was the number who had been prescribed antiviral medication within 1.5 years from the index date out of patients newly diagnosed with HCV.
Results:
The new HCV infection rate was 17.2 per 100,000 person-years (n=8,810) in 2019. The number of new HCV infections was the highest in patients aged 50 to 59 years (n=2,480), and the new HCV infection rate significantly increased with age (p<0.001). Among newly infected patients with HCV, the linkage to care rate was 78.2% (78.2% men, 78.2% women) and the treatment rate was 58.1% (56.8% men, 59.3% women) within 1.5 years.
Conclusions
The new HCV infection rate was 17.2 per 100,000 person-years in Korea. It is necessary to continuously monitor the incidence and care cascade of HCV to establish proper strategies to reach the goal of HCV elimination by 2030.
3.Quick Sequential Organ Failure Assessment Score and the Modified Early Warning Score for Predicting Clinical Deterioration in General Ward Patients Regardless of Suspected Infection
Ryoung-Eun KO ; Oyeon KWON ; Kyung-Jae CHO ; Yeon Joo LEE ; Joon-myoung KWON ; Jinsik PARK ; Jung Soo KIM ; Ah Jin KIM ; You Hwan JO ; Yeha LEE ; Kyeongman JEON
Journal of Korean Medical Science 2022;37(16):e122-
Background:
The quick sequential organ failure assessment (qSOFA) score is suggested to use for screening patients with a high risk of clinical deterioration in the general wards, which could simply be regarded as a general early warning score. However, comparison of unselected admissions to highlight the benefits of introducing qSOFA in hospitals already using Modified Early Warning Score (MEWS) remains unclear. We sought to compare qSOFA with MEWS for predicting clinical deterioration in general ward patients regardless of suspected infection.
Methods:
The predictive performance of qSOFA and MEWS for in-hospital cardiac arrest (IHCA) or unexpected intensive care unit (ICU) transfer was compared with the areas under the receiver operating characteristic curve (AUC) analysis using the databases of vital signs collected from consecutive hospitalized adult patients over 12 months in five participating hospitals in Korea.
Results:
Of 173,057 hospitalized patients included for analysis, 668 (0.39%) experienced the composite outcome. The discrimination for the composite outcome for MEWS (AUC, 0.777;95% confidence interval [CI], 0.770–0.781) was higher than that for qSOFA (AUC, 0.684;95% CI, 0.676–0.686; P < 0.001). In addition, MEWS was better for prediction of IHCA (AUC, 0.792; 95% CI, 0.781–0.795 vs. AUC, 0.640; 95% CI, 0.625–0.645; P < 0.001) and unexpected ICU transfer (AUC, 0.767; 95% CI, 0.760–0.773 vs. AUC, 0.716; 95% CI, 0.707–0.718; P < 0.001) than qSOFA. Using the MEWS at a cutoff of ≥ 5 would correctly reclassify 3.7% of patients from qSOFA score ≥ 2. Most patients met MEWS ≥ 5 criteria 13 hours before the composite outcome compared with 11 hours for qSOFA score ≥ 2.
Conclusion
MEWS is more accurate that qSOFA score for predicting IHCA or unexpected ICU transfer in patients outside the ICU. Our study suggests that qSOFA should not replace MEWS for identifying patients in the general wards at risk of poor outcome.
4.Nobiletin Exhibits Neuroprotective Effects against Mitochondrial Complex I Inhibition via Regulating Apoptotic Signaling
Khulan AMARSANAA ; Hye-Ji KIM ; Eun-A KO ; Jaemin JO ; Sung-Cherl JUNG
Experimental Neurobiology 2021;30(1):73-86
Nobiletin, a polymethoxylated flavonoid found in citrus, has been studied because of its modulatory functions in cellular signaling cascades, and effects to prevent mitochondrial calcium overload and neuronal cell death. Particularly, we previously reported that nobiletin induced changes in the mitochondrial membrane potential through K + channel regulation, suggesting that nobiletin might exert neuroprotective effects via regulating mitochondrial functions associated with the electron transport chain (ETC) system. This study investigated whether nobiletin regulated mitochondrial dysfunction mediated by ETC system downregulation by inhibiting complex I (CI) and complex III (CIII) in pure mitochondria and the cortical neurons of rats. The results showed that nobiletin significantly reduced mitochondrial reactive oxygen species (ROS) production, inhibited apoptotic signaling, enhanced ATP production and then restored neuronal viability under conditions of CI inhibition, but not CIII inhibition.These effects were attributed to the downregulation of translocation of apoptosis-induced factor (AIF), and the upregulation of CI activity and the expression of antioxidant enzymes such as Nrf2 and HO-1. Together with our previous study, these results indicate that the neuroprotective effects of nobiletin under mitochondrial dysfunction may be associated with its function to activate antioxidant signaling cascades. Our findings suggest the possibility that nobiletin has therapeutic potential in treating oxidative neurological and neurodegenerative diseases mediated by mitochondrial dysfunction.
5.Methodology and Rationale for Ophthalmic Examinations in the Seventh and Eighth Korea National Health and Nutrition Examination Surveys (2017–2021)
Su Jeong SONG ; Kyung Seek CHOI ; Jong Chul HAN ; Donghyun JEE ; Jin Wook JEOUNG ; Young Joon JO ; Jae Yong KIM ; Ko Eun KIM ; Seong Taeck KIM ; Ji Woong LEE ; Tae Eun LEE ; Dong Hui LIM ; Chan Yun KIM ; Hyun Woong KIM ; Sang Woo PARK ; Ki Ho PARK ; Sang Jun PARK ; Min SAGONG ; Jae Pil SHIN ; Chungkwon YOO ; Yoonjung KIM ; Kyungwon OH ; Kyu Hyung PARK
Korean Journal of Ophthalmology 2021;35(4):295-303
This report provides a detailed description of the methodology for ophthalmic examinations according to the Korea National Health and Nutrition Examination Survey (KNHANES) VII and VIII (from 2017 to 2021). The KNHANES is a nationwide survey which has been performed since 1998 in representatives of whole Korean population. During the KNHANES VII and VIII, in addition to the ophthalmic questionnaire, intraocular pressure measurement, visual field test, auto refractometry, axial length and optical coherence tomography measurements were included. This new survey will provide not only provide normative and pathologic ophthalmic data including intraocular pressure, refractive error, axial length, visual field and precise measurement of anterior segment, macula and optic nerve with optical coherence tomography, but also a more accurate diagnosis for major adult blindness diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other ocular diseases, for the national Korean population.
6.Methodology and Rationale for Ophthalmic Examinations in the Seventh and Eighth Korea National Health and Nutrition Examination Surveys (2017–2021)
Su Jeong SONG ; Kyung Seek CHOI ; Jong Chul HAN ; Donghyun JEE ; Jin Wook JEOUNG ; Young Joon JO ; Jae Yong KIM ; Ko Eun KIM ; Seong Taeck KIM ; Ji Woong LEE ; Tae Eun LEE ; Dong Hui LIM ; Chan Yun KIM ; Hyun Woong KIM ; Sang Woo PARK ; Ki Ho PARK ; Sang Jun PARK ; Min SAGONG ; Jae Pil SHIN ; Chungkwon YOO ; Yoonjung KIM ; Kyungwon OH ; Kyu Hyung PARK
Korean Journal of Ophthalmology 2021;35(4):295-303
This report provides a detailed description of the methodology for ophthalmic examinations according to the Korea National Health and Nutrition Examination Survey (KNHANES) VII and VIII (from 2017 to 2021). The KNHANES is a nationwide survey which has been performed since 1998 in representatives of whole Korean population. During the KNHANES VII and VIII, in addition to the ophthalmic questionnaire, intraocular pressure measurement, visual field test, auto refractometry, axial length and optical coherence tomography measurements were included. This new survey will provide not only provide normative and pathologic ophthalmic data including intraocular pressure, refractive error, axial length, visual field and precise measurement of anterior segment, macula and optic nerve with optical coherence tomography, but also a more accurate diagnosis for major adult blindness diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other ocular diseases, for the national Korean population.
7.Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0
Sunho KIM ; Royoung KIM ; Ryeo-Gyeong KIM ; Enjin KO ; Han-Su KIM ; Jihye SHIN ; Daeun CHO ; Yurhee JIN ; Soyeon BAE ; Ye Won JO ; San Ah JEONG ; Yena KIM ; Seoyeon AHN ; Bomi JANG ; Jiheyon SEONG ; Yujin LEE ; Si Eun SEO ; Yujin KIM ; Ha-Jeong KIM ; Hyeji KIM ; Hye-Lynn SUNG ; Hyoyoung LHO ; Jaywon KOO ; Jion CHU ; Juwon LIM ; Youngju KIM ; Kyungyeon LEE ; Yuri LIM ; Meongeun KIM ; Seonjeong HWANG ; Shinhye HAN ; Sohyeun BAE ; Sua KIM ; Suhyeon YOO ; Yeonjeong SEO ; Yerim SHIN ; Yonsoo KIM ; You-Jung KO ; Jihee BAEK ; Hyejin HYUN ; Hyemin CHOI ; Ji-Hye OH ; Da-Young KIM ; Hee-Jo NAM ; Hyun-Seok PARK
Genomics & Informatics 2020;18(3):e33-
This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.
8.Improved immune responses and safety of foot-and-mouth disease vaccine containing immunostimulating components in pigs
Joo-Hyung CHOI ; Su-Hwa YOU ; Mi-Kyeong KO ; Hye Eun JO ; Sung Ho SHIN ; Hyundong JO ; Min Ja LEE ; Su-Mi KIM ; Byounghan KIM ; Jong-Soo LEE ; Jong-Hyeon PARK
Journal of Veterinary Science 2020;21(5):e74-
Background:
The quality of a vaccine depends strongly on the effects of the adjuvants applied simultaneously with the antigen in the vaccine. The adjuvants enhance the protective effect of the vaccine against a viral challenge. Conversely, oil-type adjuvants leave oil residue inside the bodies of the injected animals that can produce a local reaction in the muscle. The longterm immunogenicity of mice after vaccination was examined. ISA206 or ISA15 oil adjuvants maintained the best immunity, protective capability, and safety among the oil adjuvants in the experimental group.
Objectives:
This study screened the adjuvant composites aimed at enhancing foot-andmouth disease (FMD) immunity. The C-type lectin or toll-like receptor (TLR) agonist showed the most improved protection rate.
Methods:
Experimental vaccines were fabricated by mixing various known oil adjuvants and composites that can act as immunogenic adjuvants (gel, saponin, and other components) and examined the enhancement effect on the vaccine.
Results:
The water in oil (W/O) and water in oil in water (W/O/W) adjuvants showed better immune effects than the oil in water (O/W) adjuvants, which have a small volume of oil component. The W/O type left the largest amount of oil residue, followed by W/O/W and O/W types. In the mouse model, intramuscular inoculation showed a better protection rate than subcutaneous inoculation. Moreover, the protective effect was particularly weak in the case of inoculation in fatty tissue. The initial immune reaction and persistence of long-term immunity were also confirmed in an immune reaction on pigs.
Conclusions
The new experimental vaccine with immunostimulants produces improved immune responses and safety in pigs than general oil-adjuvanted vaccines.
9.Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0
Sunho KIM ; Royoung KIM ; Ryeo-Gyeong KIM ; Enjin KO ; Han-Su KIM ; Jihye SHIN ; Daeun CHO ; Yurhee JIN ; Soyeon BAE ; Ye Won JO ; San Ah JEONG ; Yena KIM ; Seoyeon AHN ; Bomi JANG ; Jiheyon SEONG ; Yujin LEE ; Si Eun SEO ; Yujin KIM ; Ha-Jeong KIM ; Hyeji KIM ; Hye-Lynn SUNG ; Hyoyoung LHO ; Jaywon KOO ; Jion CHU ; Juwon LIM ; Youngju KIM ; Kyungyeon LEE ; Yuri LIM ; Meongeun KIM ; Seonjeong HWANG ; Shinhye HAN ; Sohyeun BAE ; Sua KIM ; Suhyeon YOO ; Yeonjeong SEO ; Yerim SHIN ; Yonsoo KIM ; You-Jung KO ; Jihee BAEK ; Hyejin HYUN ; Hyemin CHOI ; Ji-Hye OH ; Da-Young KIM ; Hee-Jo NAM ; Hyun-Seok PARK
Genomics & Informatics 2020;18(3):e33-
This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.
10.Reliability and Validity of the Korean version of Short-Form Health Literacy Scale for Adults
Young Joo SEO ; Eun-Mi KWAK ; Mirae JO ; A-Ra KO ; Soon Hwan KIM ; Heeyoung OH
Journal of Korean Academy of Community Health Nursing 2020;31(4):416-426
Purpose:
The aim of this study was to evaluate the validity and reliability of the Korean version of Short-form Health Literacy Scale (HLS-SF-K12) for Adults.
Methods:
The English HLS-SF12 was translated into Korean with forward and backward translation. Survey data were collected from 204 adults who visited two hospitals in Korea. Content validity, construct validity, and known-groups validity were evaluated. Cronbach's ⍺ for internal consistency and test-retest were used to assess reliability. SPSS 21.0 and AMOS 21.0 software were used for data analysis.
Results:
The HLS-SF-K12 was composed of 12 items, and three subscales (health care, disease prevention, and health promotion). The instrument explained reliable internal consistency with Cronbach’s ⍺ for the total scale of .89, and .74~.81 for subscales. The model of three subscales for the HLS-SF-K12 was validated by confirmatory factor analysis (Normed x 2 =2.14 (p<.001), GFI=.92, RMR=.04, RMSEA=.08, CFI=.94, TLI=.92, IFI=.94). The hypothesis testing which analyzed the differences in health literacy by age and education level was satisfied.
Conclusion
The HLS-SF-K12 is a valid and reliable instrument for measuring health information comprehension for adults in Korea.

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