Purpose: We aimed to investigate changes in visiting patterns after the lifting of mask mandates in a single pediatric emergency medical center in Seoul, Korea. Methods: This retrospective study was based on the data of patients’ (≤ 18 years) visits to the emergency department (ED) of the center from January 1, 2022 through June 30, 2023. Clinical characteristics, Korean Triage and Acuity Scale (KTAS) level, ED outcomes, and length of stay were compared between before (March 20-June 30, 2022) and after (March 20-June 30, 2023) the lifting of mask mandates. The comparisons were iterated in the patients with infectious disease. Results: During the study period, a total of 18,654 children visited the ED. After the lifting of mask mandates, ED visits increased from 7,146 to 11,508 (61.0%; 95% confidence interval, 59.5-62.6; P < 0.001). The increase was more prominent in the age of 2-5 years (82.9%), infectious diseases (175.3%), KTAS level 3 (127.7%), and length of stay shorter than 3 hours (78.8%-92.6%). The number of patients per hour increased by 151.2% for 5 patients or more and over 3,000% for 10 or more. Median length of stay decreased (2.3 hours [interquartile range, 1.2-4.1] to 1.9 hours [1.1-3.5]; P < 0.001). The patients with infectious disease (n = 7,139) showed similar patterns of increase in the age of 2-5 years, KTAS level 3, and length of stay shorter than 3 hours, with an additional increase in the age of 6-18 years. Conclusion After the lifting of mask mandates, pediatric visits increased by 61%, with the highest increase in children with mild infectious diseases on weekends and at night, and the proportion of more than 10 visits per hour significantly increased. We need urgent and realistic support measures from health authorities.

Purpose: This study aimed to evaluate the clinical infrastructure and utilization of radiotherapy (RT) services in Korea between 2017 and 2019. Materials and Methods: We extracted the data of patients who underwent RT between 2017 and 2019 from the Health Insurance Review and Assessment Service. We further analyzed this data according to the diagnosis and treatment modalities of patients diagnosed with International Classification of Disease 10 (ICD-10) diagnostic codes C00–C97 and D00–D48. In addition, we collected statistics on RT facilities in Korea using a nationwide survey. Results: The total number of patients who received RT in 2017, 2018, and 2019 were 77,901, 81,849, and 87,460, respectively. The number of patients diagnosed with ICD 10 C- and D-codes in 2019 was 86,339, of whom 39,467 were men and 46,872 women. The rate of utilization of RT among cancer patients was 30.4% in 2017 and 2018 and 30.9% in 2019. In 2019, the most common types of cancers treated with RT were breast, lung, prostate, colorectal, and liver cancers. Regarding the RT infrastructure in Korea, there were 95 radiation oncology centers, 237 megavoltage (MV) teletherapy units, 35 brachytherapy units, and two proton accelerators in 2019. There were 4.5 MV teletherapy machines per million. Conclusion The number of patients treated with RT has increased consistently from 2017 to 2019. As the number of patients with cancer increases, it is expected that the RT infrastructure will be further expanded in Korea.

Background: As the number of large-scale studies involving multiple organizations producing data has steadily increased, an integrated system for a common interoperable format is needed. In response to the coronavirus disease 2019 (COVID-19) pandemic, a number of global efforts are underway to develop vaccines and therapeutics. We are therefore observing an explosion in the proliferation of COVID-19 data, and interoperability is highly requested in multiple institutions participating simultaneously in COVID-19 pandemic research. Results: In this study, a laboratory information management system (LIMS) approach has been adopted to systemically manage various COVID-19 non-clinical trial data, including mortality, clinical signs, body weight, body temperature, organ weights, viral titer (viral replication and viral RNA), and multiorgan histopathology, from multiple institutions based on a web interface. The main aim of the implemented system is to integrate, standardize, and organize data collected from laboratories in multiple institutes for COVID-19 non-clinical efficacy testings. Six animal biosafety level 3 institutions proved the feasibility of our system. Substantial benefits were shown by maximizing collaborative high-quality non-clinical research. Conclusions This LIMS platform can be used for future outbreaks, leading to accelerated medical product development through the systematic management of extensive data from non-clinical animal studies.

Background: This study was performed to identify acute tinnitus and evaluate the efficacy of steroids for noise-induced acute tinnitus by measuring the gap-prepulse inhibition of the acoustic startle (GPIAS) value in an animal model. Methods: Nineteen rats (the noise group [n = 7] and the noise + dexamethasone [DEX] group [n = 12]) were exposed to narrow-band noise centered at 16 kHz from a sound generator for 4 hours. The noise + DEX group received intraperitoneal steroid administration daily for 5 days (1.5 mg/kg/day) after completing noise exposure. Auditory brainstem response and GPIAS value were measured just prior to, and 1 day after noise exposure and on days 1 and 10 days after completing steroid administration. The changes in cochlear structure were evaluated by histological analysis. Results: The threshold shift was checked 1 and 10 days after intraperitoneal steroid injection, and no differences in threshold shift were observed between the two groups in each frequency except for 32 kHz 1 day after steroid injection. The mean GPIAS value in the noise + DEX group (36.4% ± 14.1%) was significantly higher than that in the noise group (16.4% ± 18.8%) 10 days after intraperitoneal steroid administration (P = 0.017). There were no pathological changes associated with noise trauma in the two groups as determined on hematoxylin and eosin and immunohistochemical staining. Conclusion An acute tinnitus model with minimal structural changes by noise exposure was set up, and used to verify tinnitus objectively by measuring the GPIAS value. Steroid therapy for control of tinnitus was validated in this animal model.

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.
Advisory Committees ; Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Counseling ; Expert Testimony ; Humans ; Mouth Neoplasms ; Neck ; Republic of Korea

Oncocytic lipoadenoma is a rare salivary gland tumor composed of adipose tissue and oncocytic epithelial cells in varied proportions. We report a case of an oncocytic lipoadenoma of the submandibular gland, which presented as a submandibular gland mass. The patient was a 65-year-old woman with a right submandibular mass measuring 2 × 2 × 1.6 cm. As a sonographic evaluation and computed tomograph scan gave us the impression of benign submandibular gland tumor such as pleomorphic adenoma, we resected the right side submandibular gland. Grossly, the tumor was well circumscribed with yellow to brown cut surface. Microscopically, the tumor was surrounded by a thin, fibrous capsule and composed of oncocytic epithelial cells admixed with mature adipose tissue. Final diagnosis was an oncocytic lipoadenoma. We discussed here radiologic and pathologic finding of this rare salivary gland tumor.
Adenoma, Pleomorphic ; Adipose Tissue ; Aged ; Diagnosis ; Epithelial Cells ; Female ; Humans ; Salivary Glands ; Submandibular Gland ; Ultrasonography

Eosinophilic myenteric ganglionitis is a disorder characterized by infiltration of the Auerbach myenteric plexus by eosinophils. As a cause of chronic intestinal pseudo-obstruction (CIPO), eosinophilic myenteric ganglionitis has been rarely reported and the majority of the reported cases in the literature were children. We experienced a case of eosinophilic myenteric ganglionitis associated with CIPO in a 53-year-old female patient. Histologic examination of the resected descending colon showed moderate eosinophilic infiltrates with hypogangliosis in the myenteric plexus. Immunohistochemical study revealed increased number of CD4-positive lymphocytes and stronger but scantier glial fibillary acid protein expression in the inflamed myenteric plexus.
CD4-Positive T-Lymphocytes ; Child ; Colon, Descending ; Eosinophils* ; Female ; Ganglion Cysts* ; Humans ; Intestinal Pseudo-Obstruction ; Middle Aged ; Myenteric Plexus

The present study aimed to investigate the distribution of total serum immunoglobulin E (IgE) levels in Korean schoolchildren and to evaluate its utility in the prediction of atopy and allergic diseases. A nationwide, cross-sectional survey was conducted in first grade students from randomly selected elementary and middle schools. Total IgE levels were measured by ImmunoCAP. Skin prick tests were performed for 18 common inhalant allergens to determine the presence of atopy. Children aged 12–13 years and parents of children aged 6–7 years were asked to complete questionnaire assessing allergic diseases. The cut-off levels of total IgE were determined by analyzing receiver operating characteristic curves. The median total IgE level was 86.7 kU/L (range: 1.5–4,523.1) in 3,753 children aged 6–7 years and 94.7 kU/L (range: 1.5–3,000.0) in 3,930 children aged 12–13 years. Total IgE concentrations were higher in children with atopy or allergic diseases than in those without (all P < 0.001). At the cut-off value of 127.7 kU/L, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were 67.1%, 75.4%, 65.4%, and 76.7%, respectively, in elementary schoolchildren. At the cut-off value of 63.0 kU/L, sensitivity, specificity, PPV, and NPV were 81.9%, 66.6%, 75.0%, and 75.1%, respectively, in middle schoolchildren. PPV and NPV were ≥ 70% when cut-offs of 258.8 kU/L and 38.4 kU/L were used for the diagnosis of atopy in 6–7 year-olds and 12–13 year-olds, respectively. This nationwide population-based study provided the first normal reference ranges of total IgE in Korean schoolchildren.
Allergens ; Child ; Cross-Sectional Studies ; Diagnosis ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulins* ; Korea ; Parents ; Reference Values* ; ROC Curve ; Sensitivity and Specificity ; Skin

Norovirus is an important cause of acute nonbacterial gastroenteritis in communities worldwide. It was evaluated the prevalence of norovirus infections in patients with acute gastroenteritis occurring in Seoul from May 2013 to April 2015, with regular surveillance. 7.3% (252/3,485) of the fecal specimens were determined to be positive for noroviruses by reverse transcription-polymerase chain reaction (RT-PCR). Norovirus genogroup distribution was 19.1% (48/252) genogroup GI, 71.4% (180/252) genogroup GII, and 9.5% (24/252) genogroup G1+GII respectively. It was most norovirus detection rates from November 2013 to March 2015. And it was rotavirus 0.2% (7/3,485), astrovirus 0.03% (1/3,485), sapovirus 0.03% (1/3,485) and, it was non-detective on adenovirus. Norovirus genotypes identified were nine kinds of genogroup GI (GI-1, GI-2, GI-3, GI-4, GI-6, GI-7, GI-8, GI-12, GI-14) and eight kinds of genogroup GII (GII-2, GII-3, GII-4, GII-5, GII-6, GII-7, GII-14, GII-16, GII-17). The genetic characteristics of norovirus and the epidemiological patterns of a viral pathogen from acute gastroenteritis patients may give potentially effective data for epidemiological studies in Seoul, Korea.
Adenoviridae ; Epidemiologic Studies ; Gastroenteritis* ; Genotype* ; Humans* ; Korea ; Norovirus* ; Prevalence ; Rotavirus ; Sapovirus ; Seoul*

Korea declared in 2006 that measles had been eliminated; however, a measles outbreak occurred in the southeastern area of Korea in 2011. Active surveillance of measles patients was conducted in Seoul 3 cases were detected in 2013 and 103 cases in 2014. Of 106 confirmed measles patients, 32 cases were within one university in Seongbukgu, and 23 were within three schools in Yongsangu. Students 14~29 years old comprised 78.3% (83/106) of the cases, and 75.5% (80/106) of the measles viruses were of genotype B3. One foreign traveler played an important role in the measles outbreak in Seoul. This measles outbreak in Seoul may provide useful data for future epidemiological studies of measles.
Epidemiologic Studies ; Genotype ; Humans ; Korea ; Measles virus ; Measles* ; Seoul*