OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a potential cause of hyponatremia of the central nervous system (CNS). Although SIADH has been reported to be associated with many other central nervous disorders, its association with neuromyelitis optica (NMO) or NMO spectrum disorders are rare. NMO is a demyelinating disorder characterized by optic neuritis and transverse myelitis. Aquaporin-4 (AQP4), which is the target antigen for a NMO autoantibody, is the predominant CNS water channel. However, some NMO patients show seronegative AQP4 antibody results. The spectrum of NMO has been changed, and new findings about the disease have been reported. Here, we report a case of seronegative NMO spectrum disorder associated with SIADH.
Central Nervous System ; Demyelinating Diseases ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Myelitis, Transverse ; Neuromyelitis Optica* ; Optic Neuritis ; Water

PURPOSE: Adverse drug events (ADEs) are associated with high health and financial costs and have increased as more elderly patients treated with multiple medications emerge in an aging society. It has thus become challenging for physicians to identify drugs causing adverse events. This study proposes a novel approach that can improve clinical decision making with recommendations on ADE causative drugs based on patient information, drug information, and previous ADE cases. MATERIALS AND METHODS: We introduce a personalized and learning approach for detecting drugs with a specific adverse event, where recommendations tailored to each patient are generated using data mining techniques. Recommendations could be improved by learning the associations of patients and ADEs as more ADE cases are accumulated through iterations. After consulting the system-generated recommendations, a physician can alter prescriptions accordingly and report feedback, enabling the system to evolve with actual causal relationships. RESULTS: A prototype system is developed using ADE cases reported over 1.5 years and recommendations obtained from decision tree analysis are validated by physicians. Two representative cases demonstrate that the personalized recommendations could contribute to more prompt and accurate responses to ADEs. CONCLUSION: The current system where the information of individual drugs exists but is not organized in such a way that facilitates the extraction of relevant information together can be complemented with the proposed approach to enhance the treatment of patients with ADEs. Our illustrative results show the promise of the proposed system and further studies are expected to validate its performance with quantitative measures.
Aged ; Aging ; Clinical Decision-Making ; Complement System Proteins ; Data Mining ; Decision Trees ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Learning* ; Prescriptions

Peritonitis is one of the major complications of CAPD (continuous ambulatory peritoneal dialysis). Among its causative organisms, vancomycin-resistant enterococcus (VRE) is rare, but serious causative organism, because it is refractory to antibiotics commonly used for CAPD peritonitis. Some drugs such as linezolid and dalfopristin have been introduced for VRE infections nowadays, but reports about usefulness of those drugs in VRE peritonitis are rare. We experienced a case of CAPD peritonitis caused by VRE, which was treated successfully with removal of CAPD catheter and use of linezolid. We report our experience with review of the literature.
Anti-Bacterial Agents ; Catheters ; Enterococcus ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Linezolid

BACKGROUND: Ross procedure is the pulmonary valve autograft in the aortic valve disease, and its use trends to increase after introduced by Ross in 1967, firstly. The most important point is that it is a permanent valve replacement. It is to be ideal method to the young patient because the graft is a viable tissue to be able to grow, and hemodynamically, most similar to the normal aortic valve, and doesn't need to do anticoagulation therapy due to not having the thromboembolism, but not popular because it has a lot of technical problem and doesn't have the long-term follow-up METHODS: The patients were 8 admitted between October 1997 and October 1998, the age from 15 to 39 ; 6 males and 2 females. The causes of disease were 4 patients of rheumatic disease, 1 of a infective endocarditis with the aortic annular abscess,1 of recurred severe aortic insufficiency 2 years after replacement. Two patients used the homograft and 6 patients switched a diseased aortic valve with the pulmonary autograft. RESULTS: There were no death and the preoperative dyspnea nearly disappeared (NYHA FC III-IV -> I-II). The diastolic diameter of left ventricle decreased significantly when we compared to the previous echocardiography 1 month after the operation, and we observed the mild aortic valve insufficiency in 3 patients, severe in 4, mild pulmonary valve insufficiency in 4, severe in 1, and mild pulmonary valve stenosis in 4. CONCLUSION: The operative death rate of Ross procedure in the aortic valve disease was not higher than the artificial valve replacement. Therefore, if we find the appropriate indication of operation, we can expect better results and think that we should have the long-term follow-up furthermore.
Allografts ; Aortic Valve ; Aortic Valve Insufficiency ; Autografts* ; Dyspnea ; Echocardiography ; Endocarditis ; Female ; Follow-Up Studies ; Heart Ventricles ; Humans ; Male ; Mortality ; Pulmonary Valve ; Pulmonary Valve Insufficiency ; Pulmonary Valve Stenosis ; Rheumatic Diseases ; Thromboembolism ; Transplantation, Autologous ; Transplants

Coronary artery and valvular injuries after blunt chest trauma are an unusual condition. This diagnosis is very difficult to estabilish, but prompt diagnosis and proper management are important in life saving. We report one patient who develop left main coronary artery dissection, tricuspid insufficiency, mitral insufficiency and pericardial rupture following blunt chest trauma. One year ago, he had suffered a frontal impact in a traffic accident and recieved anti-tuberculosis medication for 10 months for chest discomfort. The correct diagnosis was confirmed noninvasively by transesophageal echocardiography and the patient was treated left main coronary artery dissection flap removal, mitral valve replacement, tricuspid valvuloplasty and repair of ruptured pericardium. The postoperative course was uneventful and the patient was fully recovered.
Accidents, Traffic ; Coronary Vessels* ; Diagnosis ; Echocardiography, Transesophageal ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Pericardium ; Rupture* ; Thorax*

To determine the optimal administration route of calcitriol in CAPD patients with secondary hyperparathyroidism, we conducted a prospective study on 33 patients who performed CAPD for more than 6 months an d whose intact parathyroid hormone(iPTH) level was higher than 250pg/mL. The patients were randomized into 3 groups:IP(n=11); 1.0 microgram of calcitriol once daily via intraperitoneal route by overnight retention with dialysate, SC(n=11); 1.0 microgram of calcitriol three times a week via subcutaneous route, and PO (n=11); 1.0 microgram of calcitriol three times a week by ingestion. 11 out of 33 patients(6 in IP, 4 in SC, and 1 in PO) dropped out during the 6-months study period, and 5 among the 6 patients in IP were due to recurrent peritonitis. Biochemical data including calcium, phosphorus, iPTH, alkaline phosphatase, bone-specific alkaline phosphatase, osteocalcin and 1,25(OH)2D3 were measured regularly, and the data of 22 patients who had completed the 6-months study were analyzed. There was a statistically significant decrease in iPTH level(pg/mL) in the three groups after 6-months calcitriol therapy(IP; 812.0+/-276.7 vs. 354.7+/-129.4, PO; 571.8+/-330.7 vs. 159.6+/-192.3, SC; 786.1+/-535.0 vs. 551.8+/-729.9, respectively, P<0.05), but there were no differences in the percentage of decrease in iPTH from baseline values among the three groups. Alkaline phosphatase, bone- specific alkaline phosphatase and osteocalcin also decreased significantly in all three groups(IP; 50.1+/-14.6, 33.5+/-11.6, 52.3+/-10.9% of baseline value; SC; 80.9+/-14.8, 67.4+/-20.80, 54.4+/-11.1% of baseline value; PO; 48.8+/-24.4, 36.6+/-23.5, 54.2+/-11.6% of baseline value, respectively, P<0.05), but they were not different with each other. Among 22 patients who completed the 6-months study, hypercalcemia(Ca>=10.5 mg/dL) occurred in 7 patients(31.8%). IP(2/5, 40%) and SC groups(5/7, 71.4%) had significantly higher incidence of hypercalcemia than PO group(0/10, 0%) (P<0.05). IP group(2/5, 40%) also experienced significantly higher incidence of hyperphosphatemia than SC(1/7, 14.3%) and PO groups(1/10, 10%). Peritonitis occurred significantly more in IP than in SC and PO groups(P<0.05). In conclusion, calcitriol treatment resulted in a significant decrement in iPTH levels in CAPD patients and no significant differences were noted in the iPTH-suppressive effect of calcitriol according to the administration route. Because of higher incidence of peritonitis and hypercalcemia in IP and SQ groups, oral ingestion may be the most optimal route for calcitriol treatment in CAPD patients with secondary hyperparathyroidism.
Alkaline Phosphatase ; Calcitriol* ; Calcium ; Eating ; Humans ; Hypercalcemia ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Incidence ; Osteocalcin ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Phosphorus ; Prospective Studies*

Protein-calorie malnutrition is common in CAPD patients and is associated with increased morbidity and mortality. To evaluate the effect of an oral nutritional supplement(Greenbia RDplus, DR. CHUNG'S FOOD CO., LTD, Seoul, Korea) providing 800Cal and 24g of protein daily in addition to their usual diet on the nutritional status, we conducted a prospective study in malnourished CAPD patients (N=26). Subjects were randomised into 2 groups: group I(N=15) taking Greenbia RDplus for 3 months, group II(N=11) as control. In group I, the data of 12 patients who completed the 3-months study period were analyzed. There were no statistically significant changes in biochemical parameters including total protein, serum albumin, prealbumin, transferrin during the study period in both groups, but IGF-I increased significantly in group I(129.2+/-88.8 vs. 174.1+/-109.3ng/mL, P<0.05). Total calorie (1349+/-272 vs. 1720+/-251Cal/day, P<0.05) and protein intake(1.05+/-0.29 vs. 1.24+/-0.25g/kg/day, P<0.05) assessed by 72-hours dietary recall method increased significantly in group I with oral supplement. Body weight(52.4+/-8.3 vs. 54.2+/-8.8kg, P<0.05), body mass index(18.7+/-1.8 vs. 19.5+/-2.0kg/m2, P<0.05), % body fat(13.2+/-4.2 vs. 15.4+/-3.9%, P<0.05), total body muscle(16.8+/-3.7 vs. 18.2+/-3.3kg, P<0.05), midarm circumference(22.8+/-2.1 vs. 23.7+/-2.2cm, P<0.05) and calculated arm muscle area(25.9+/-7.1 vs. 28.9+/-6.1 cm2, P<0.05) increased significantly in group I after 3 months. Biceps and triceps skinfold thickness tended to increase following oral nutritional supplement but there was no statistical significance. Anthropometric parameters remained unchanged in group II. Kt/Vurea, normalized protein catabolic rate and standardized creatinine clearance did not change in both groups. In conclusion, oral nutritional supplement in malnourished CAPD patients well tolerated and was effective in improving the anthropometric parameters.
Arm ; Creatinine ; Diet ; Humans ; Insulin-Like Growth Factor I ; Mortality ; Nutritional Status ; Peritoneal Dialysis, Continuous Ambulatory* ; Prealbumin ; Prospective Studies ; Protein-Energy Malnutrition ; Seoul ; Serum Albumin ; Skinfold Thickness ; Transferrin

RNA fingerprinting using on arbitrary primed polymerase chain reaction (RAP-PCR) was carried out to identify differentially expressed genes in HL-60 cell after treatment of methylmethane sulfonate (MMS). Twenty differentially expressed PCR products were cloned and analyzed. We have successfully obtained eight partial cDNA sequences by TA cloning method. Among these, six cDNAs were up-regulated and two cDNAs were down-regulated after the MMS treatment. Of these six up-regulated cDNAs, 3 cDNAs were equivalent to known genes in the GenBank/EMBL databases with 98~100% homology searched by BLAST program: genomic DNA fragment containing CpGg island (clone 26h8), Human Rev interacting protein-1 (RIP-1), and human zinc finger protein-4 (HZF4). The sequences of the three remaining cDNA were entirely new genes, but we didn't try to identify a full cDNA sequence. Two clones called KIAA0060 and KIAA0065, were down-regulated in HL-60 cells after the MMS treatment. These findings suggest that the RNA fingerprinting method using RAP-PCR is an effective method which can identify and separate the differentially expressed cDNAs and that the isolated cDNAs might involve in regulation mechanism of apoptosis and/or cell cycle delay, especially a p53-independent pathway, in the cells after DNA damage. But the nature of cDNAs that we have isolated remains to be elucidated.
Apoptosis ; Cell Cycle ; Clone Cells ; Cloning, Organism ; Dermatoglyphics* ; DNA Damage* ; DNA* ; DNA, Complementary ; HL-60 Cells ; Humans ; Methyl Methanesulfonate ; Polymerase Chain Reaction ; RNA* ; Zinc Fingers

To evaluate the clinical efficacy and safety of newly developed recombinant human erythropoietin (Epokine(R)), a phase III clinical trial was performed in patients with end-stage renal disease undergoing maintenance hemodialysis. Epokine(R)was given initially at a dosage of 50unit/kg, intravenously, three times a week after each dialysis session and the dosage was adjusted according to the changes in hemoglobin level. Out of total 79 patients who were enrolled initially, data of 64 patients who have completed 12 weeks study period were analyzed. The results were as following: 1) Hemoglobin(g/dL) and hematocrit(%) increased significantly from baseline levels beginning from 2 weeks after Epokine(R) administration. Hemoglobin increased significantly from 6.8+/-0.8 to 10.4+/-1.3 and hematocrit increased significantly from 20.9+/-2.2 to 31.1+/-5.2 after 12 weeks(P<0.05). Corrected reticulocyte count(%) increased significantly from 0.6+/-0.4 to 1.4+/-0.7 after 2 weeks and to 1.3+/-0.6 after 12 weeks(P<0.05). 2) A significant increase in platelet count was observed from 2 weeks after Epokine(R) administration (P<0.05). 3) Serum ferritin and serum iron decreased significantly and total iron binding capacity increased significantly after 2 weeks(P<0.05). 4) The mean of pre-hemodialysis systolic blood pressure(mmHg) increased significantly from 148+/-21 to 154+/-25 at 12 weeks(P<0.05). Also, post-hemodialysis blood pressure(systolic/diastolic) at 12 weeks increased significantly from baseline levels(146+/-28/ 82+/-15 vs. 153+/-25/87+/-14mmHg, P<0.05). 5) Anti-erythropoietin antibody was not detected in all subjects. 6) Side effects observed in this study were similar to those reported by earlier reports. Headache(9 cases), and flu-like syndrome(7 cases) were the most common side effects. These side effects were not severe and disappeared without discontinuation of Epokine(R) administration in most of the patients. In conclusion, Epokine(R) is safe and effective in treating anemia of hemodialysis patients with end stage renal disease.
Anemia ; Dialysis ; Erythropoietin ; Ferritins ; Hematocrit ; Humans* ; Iron ; Kidney Failure, Chronic ; Platelet Count ; Renal Dialysis* ; Reticulocytes