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.

Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

PURPOSE: Anaphylaxis is an acute, life-threatening systemic reaction which should be treated by epinephrine, and patients should be prescribed epinephrine auto-injector after the event. The purpose of this study was to investigate the clinical features of pediatric anaphylaxis, including the rate of using epinephrine at hospital and prescribing epinephrine auto-injector. METHODS: We performed a retrospective study of 68 anaphylactic patients at in-hospital, out-hospital, and Emergency Department of Soonchunhyang University Cheonan Hospital, Cheonan, Korea, who were under 15 years of age, from January 2013 through December 2014. We reviewed their clinical features, doctor's treatment methods, rate of follow-up and prescribing epinephrine auto-injectors. RESULTS: Causes of anaphylaxis were food (76.5%), drug (10.3%), and idiopathic (13.2%). The involved organs were the skin (86.8%), respiratory tract (80.9%), cardiovascular system (23.5%), and gastrointestinal tract (17.7%). Patients were treated with systemic steroids (91.2%), antihistamines (88.2%), and epinephrine (75.0%). Fifty-three patients (77.9%) revisited our pediatric allergy clinic and epinephrine auto-injectors were prescribed for 25 patients (36.8%). CONCLUSION: Physicians should make an effort to use epinephrine as an initial treatment of anaphylaxis, to prescribe epinephrine auto-injectors, and to give proper information about disease.
Anaphylaxis* ; Cardiovascular System ; Child ; Chungcheongnam-do ; Emergency Service, Hospital ; Epinephrine* ; Follow-Up Studies ; Gastrointestinal Tract ; Histamine Antagonists ; Humans ; Hypersensitivity ; Korea ; Respiratory System ; Retrospective Studies ; Skin ; Steroids

Children with autism are often medicated to manage emotional and behavioral symptoms; yet, data on such pharmacotherapy is insufficient. In this study, we investigated the Korean National Health Insurance Claims Database (NHICD) information related to autism incidence and psychotropic medication use. From the 2010–2012 NHICD, we selected a total of 31,919,732 subjects under 19 years old. To examine the diagnostic incidence, we selected patients who had at least one medical claim containing an 10th revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for pervasive developmental disorder, F84, not diagnosed in the previous 360 days. Psychotropics were categorized into seven classes. Then, we analyzed the data to determine the mean annual diagnostic incidence and psychotropic prescription trends. Diagnostic incidence was 17,606 for the 3 years, with a mean annual incidence per 10,000 population of 5.52. Among them, 5,348 patients were prescribed psychotropics. Atypical antipsychotics were the most commonly used, followed by antidepressants. An older age, male sex, and the availability of medical aid were associated with a higher rate of prescription than observed for a younger age, female sex, and the availability of health insurance. Psychotropic drugs were used for less than one-third of patients newly diagnosed with autism, and prescription differed by sex and age. Increased diagnostic incidence is associated with an increased prescription of psychotropic drugs. Therefore, medication-related safety data and policies for psychotropic drugs in autism should be prepared.
Adolescent* ; Antidepressive Agents ; Antipsychotic Agents ; Autistic Disorder* ; Behavioral Symptoms ; Central Nervous System Stimulants ; Child* ; Drug Therapy ; Drug Utilization ; Female ; Humans ; Incidence ; Insurance, Health* ; International Classification of Diseases ; Male ; National Health Programs ; Prescriptions* ; Psychotropic Drugs

OBJECTIVE: Onion and garlic are a commonly consumed food in the Korean population. But these food materials have rarely been studied for their allergenic potentials. We analyzed the sensitization rate of garlic and onion using multiple allergen simultaneous test (MAST)-immunoblot assay. METHODS: From January 2009 to December 2013, we analyzed the results of the MAST immunoblot assay performed in 2,691 allergy patients at Soonchunhyang University Cheonan Hospital, retrospectively. RESULTS: Among 2,691 patients, 1,063 were under 18 years old, and 1,628 were over 18 years old. In the all age groups, 29 patients (1.08%) were positive to garlic, 54 patients (2.01%) were positive to onion and one patient was positive to garlic and onion and others. A total of 84 patients (3.12%) were positive to garlic or onions. In infants under the age of 2 years, garlic was the seventh and onion was the nineteenth common food allergen, and onion was more common than rice. While getting older, the sensitization rate of garlic decreased (P<0.001), but onion increased (P<0.01). CONCLUSION: Using one of the semi-quantitative methods, MAST immunoblot assay, we realized that the sensitization rate of garlic was higher than rice or wheat in infants. We presume further studies on the role of garlic and onion in food allergy are needed.
Chungcheongnam-do ; Food Hypersensitivity ; Garlic* ; Humans ; Hypersensitivity ; Immunoassay ; Infant ; Onions* ; Retrospective Studies ; Triticum

PURPOSE: Pulmonary function test (PFT) plays a key role in the diagnosis and management of asthma in adolescents. But, it is not clear whether adolescents with asthma have significantly reduced lung function when compared with adolescents without asthma. The purpose of this study was to determine the effect of atopy and allergic diseases on pulmonary function and bronchial hyperresponsiveness (BHR) in Korean adolescents. METHODS: A questionnaire survey was conducted on 647 middle school students (male, 264; female, 383) from Seoul city to determine the prevalence of symptoms and diagnosed allergic diseases. We also performed the PFT, methacholine challenge test, skin prick tests and serum total immunoglobulin E. Current atopic dermatitis was diagnosed by doctor's medical examination. RESULTS: Female showed higher values of forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) and higher numbers of BHR (PC20 less than 25 mg/dL) compared to male (P<0.01). BHR was more common in atopy group (P<0.01), but PFT was not significant difference between atopy and nonatopy. Mean values for all spirometric parameters for asthmatic adolescents were in the normal range. Adolescents with asthma symptoms had slightly lower FEV1/FVC and forced expiratory flow 25%-75% than that of adolescents with no history of wheeze ever, asthma diagnosis and current asthma, but there was no statistically significance. CONCLUSION: The majority of adolescents recruited from the general population who reported having asthma symptoms or other allergic diseases had normal lung function. Sex, atopy, and current atopic dermatitis may affect BHR in Korean adolescents.
Adolescent* ; Asthma ; Dermatitis, Atopic ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Immunoglobulin E ; Immunoglobulins ; Lung ; Male ; Methacholine Chloride ; Prevalence ; Reference Values ; Respiratory Function Tests ; Seoul ; Sinusitis ; Skin Tests ; Vital Capacity ; Surveys and Questionnaires

BACKGROUND/AIMS: There are no proper guidelines for the management of gastric low-grade dysplasia (LGD). We evaluated clinical parameters, histological results and follow-up endoscopies to find a management strategy of LGD. MATERIALS AND METHODS: A total of 590 patients with LGD, high-grade dysplasia (HGD), functional dyspepsia (FD), early or advanced gastric cancer (early gastric cancer [EGC] or advanced gastric cancer [AGC]) were consecutively enrolled. We examined the association of clinical parameters including low serum pepsinogen (PG) I/II ratio < or =3.0 with the disease phenotypes. Histological results between initial forceps-biopsy and endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) specimens were compared. RESULTS: The PG I/II ratio in FD was 4.2+/-1.7, but was significantly low in LGD (2.8+/-1.6, P<0.0001). The ratio was not further decreased in the HGD, EGC, and AGC groups. In FD patients with the ratio of < or =3.0, smoking habits and high salt intake were independent risk factors for gastric dysplasia or gastric cancer. In about 11% (n=8/70) of LGD lesions, the pathologic diagnoses were upgraded to HGD or EGC after endoscopic resection. Neither serious complications nor recurrence at the primary site were found. CONCLUSIONS: It is proposed that endoscopic resection followed by endoscopic surveillance might be a beneficial strategy for patients with LGD having a PG I/II ratio of < or =3.0.
Dyspepsia ; Follow-Up Studies ; Humans ; Pepsinogen A ; Phenotype ; Recurrence ; Risk Factors ; Smoke ; Smoking ; Stomach Neoplasms

BACKGROUND: The clinical manifestation of M. tuberculosis infection ranges from asymptomatic latent infection, to focal forms with minimal symptoms and low bacterial burdens, and finally to advanced tuberculosis (TB) with severe symptoms and high bacillary loads. We investigated the diagnostic sensitivity of the whole-blood interferon-gamma release assay according to the wide spectrum of clinical phenotypes. METHODS: In patients diagnosed with active TB that underwent QuantiFERON(R) (QFT) testing, the QFT results were compared with patients known to be infected with pulmonary tuberculosis (P-TB) and extra-pulmonary TB (EP-TB). In addition, the results of the QFT test were further analyzed according to the radiographic extent of disease in patients with P-TB and the location of disease in patients with EP-TB. RESULTS: There were no statistical differences in the overall distribution of QFT results between 177 patients with P-TB and 84 patients with EP-TB; the positive results of QFT test in patients with P-TB and EP-TB were 70.1% and 64.3%, respectively. Among patients with P-TB, patients with mild extents of disease showed higher frequency of positive results of QFT test than that of patients with severe form (75.2% vs. 57.1%, respectively; p=0.043) mainly due to an increase of indeterminate results in severe P-TB. Patients with TB pleurisy showed lower sensitivity by the QFT test than those with tuberculous lymphadenitis (48.8% vs. 78.8%, respectively; p=0.019). CONCLUSION: Although QFT test showed similar results between overall patients with P-TB and EP-TB, individual sensitivity was different according to the radiographic extent of disease in P-TB and the location of disease in EP-TB.
Humans ; Interferon-gamma ; Interferon-gamma Release Tests ; Pleurisy ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: Healthcare-associated pneumonia (HCAP) occurs outside hospitals, but its characteristics are similar to those of hospital-acquired pneumonia (HAP). We evaluated the clinical and microbial characteristics of HCAP in Korea. METHODS: Of 130 subjects with suspected pneumonia, 49 were classified as HCAP and 81 as HAP. We retrospectively examined the clinical presentations, outcomes, pathogens, and drug resistance rates of Pseudomonas aeruginosae in both groups. RESULTS: The clinical presentations, including the symptoms and laboratory findings, at the time of hospitalization were comparable in both groups. The hospital mortalities of HCAP (28.6%) and HAP (34.6%) did not differ significantly; the length of the hospital stay was similar for all of the survivors (14 vs. 17 days, respectively). Of the identified pathogens, methicillin-resistant Staphylococcus aureus was significantly less common in HCAP than in HAP (two vs. 18 cases, respectively, p<0.01), whereas Klebsiella pneumoniae was more common in HCAP (five vs. zero cases, respectively, p<0.01). The frequency of other Gram-negative rods was similar in both groups. The rate of resistance to antibiotics in P. aeruginosae in both groups was substantial, with the highest resistant rate to ciprofloxacin (50% and 61.5% in HCAP and HAP, respectively). CONCLUSIONS: Although the clinical features and outcomes of HCAP were comparable to those of HAP in the study population, the frequency of methicillin-resistant S. aureus was significantly lower in HCAP compared to HAP.
Anti-Bacterial Agents ; Ciprofloxacin ; Drug Resistance ; Hospital Mortality ; Hospitalization ; Humans ; Klebsiella pneumoniae ; Korea ; Length of Stay ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Retrospective Studies ; Survivors

OBJECTIVE: This work was demonstrated the induction of apoptosis in response to adriamycin, we checked the cell cycle of adriamycin-induced apoptosis and to investigate whether differential expression is associated with adriamycin-induced genes in human cervical carcinoma HeLa cells. METHODS: Apoptosis was measured by flow cytometry for cell cycle analysis in Hela cells. Differential expression is associated with adriamycin-induced genes in HeLa cells, it was performed to purifiy the RNA, cDNA probe and hybridization. The various different overexpressed genes were determined by gene array analysis (GDA). Analysis were referenced Incyte Genomics Co. (http://www.ncbi.nlm.nih.gov/). RESULTS: We found that adriamycin was induced apoptosis in a dose- and time-dependent manner, as demonstrated by sub-G0/G1 peaks in DNA content histogram of cell cycle. The cells of G2/M phase by treatment of 0.1 microgram/mL adriamycin had been arrested. G2/M peaks in DNA content was decreased in a dose and time-dependent manner. It had been observed 6 group, 16 genes. The group I contained thioredoxin and cytochrome c oxidase subunit IV gene, group II were p53 and excision repair protein (ERCC-1) gene. Group III was metabolic regulated gene, glucosidase, AMP deaminase isoform L (AMPD2), glutamine synthetase, cholesterol 25-hydroxylase, and steryl-sulfatase precursor. Group IV was cell skeleton constructed gene, heparan sulfate proteoglycan (HSPG2), and microfibrillar-associated protein (MFAP2), group V was oncogene group, v-yes-1 Yamaguchi sarcoma viral oncogene homolog-1 (YES1) and tyrosine kinase ELK1. The other group 6 contained NOD1 protein gene interleukine-1 receptor accessory protein (IL1RAP), pregnancy-specific glycoprotein-11 (PSG11), and pregnancy-specific protein-1a (PSG-1a). CONCLUSION: The present findings indicating that adriamycin was revealed apoptosis in Hela cell. Differential gene expression is related in various metabolism by adriamycin.
AMP Deaminase ; Apoptosis* ; Cell Cycle* ; Cholesterol ; DNA ; DNA Repair ; DNA, Complementary ; Doxorubicin ; Electron Transport Complex IV ; Flow Cytometry ; Gene Expression* ; Genomics ; Glucosidases ; Glutamate-Ammonia Ligase ; HeLa Cells* ; Heparan Sulfate Proteoglycans ; Humans* ; Metabolism ; Oncogenes ; Protein-Tyrosine Kinases ; RNA ; Sarcoma ; Skeleton ; Steryl-Sulfatase ; Thioredoxins