1.Clinical data on treatment regimen and use of medication among patients with hemophilia B in Korea
Young Shil PARK ; Ji Kyoung PARK ; Jeong A PARK ; Hee Jo BAEK ; Jae Hee LEE ; Chur Woo YOU ; Chuhl Joo LYU ; Eun Jin CHOI
Blood Research 2024;59():27-
Background:
To investigate the clinical treatment status, such as treatment regimen, bleeding events, and drug dose, in patients with hemophilia B in South Korea.
Methods:
In this retrospective chart review, data of patients with hemophilia B from eight university hospitals were collected. Demographic and clinical data, treatment data, such as regimen and number of injections, dose of factor IX concentrate, and bleeding data were reviewed. Descriptive analyses were performed with annual data for 2019, 2020, and 2021, as well as the three years consecutively.
Results:
The medical records of 150 patients with hemophilia B between January 1, 2019, and December 31, 2021, were collected. Among these, 72 (48.0%) were severe, 47 (31.3%) were moderate, and 28 (18.7%) were mild. The results showed approximately two times more patients receiving prophylaxis as those receiving on-demand therapy, with 66.1% of patients receiving prophylaxis in 2019, 64.9% in 2020, and 72.1% in 2021. Annualized bleeding rates were 2.2% (± 3.1) in 2019, 1.8% (± 3.0) in 2020, and 1.8% (± 2.9) in 2021 among patients receiving prophylaxis.For the doses of factor IX concentrate, patients receiving prophylaxis received an average of 41.6 (± 11.9) IU/Kg/Injection in 2019, 45.7 (± 12.9) IU/Kg/Injection in 2020, and 60.1 (± 24.0) IU/Kg/Injection in 2021.
Conclusions
Clinically, prophylaxis is more prevalent than reported. Based on insights gained from current clinical evidence, it is expected that the unmet medical needs of patients can be identified, and physicians can evaluate the status of patients and actively manage hemophilia B using more effective treatment strategies.
2.Clinical data on treatment regimen and use of medication among patients with hemophilia B in Korea
Young Shil PARK ; Ji Kyoung PARK ; Jeong A PARK ; Hee Jo BAEK ; Jae Hee LEE ; Chur Woo YOU ; Chuhl Joo LYU ; Eun Jin CHOI
Blood Research 2024;59():27-
Background:
To investigate the clinical treatment status, such as treatment regimen, bleeding events, and drug dose, in patients with hemophilia B in South Korea.
Methods:
In this retrospective chart review, data of patients with hemophilia B from eight university hospitals were collected. Demographic and clinical data, treatment data, such as regimen and number of injections, dose of factor IX concentrate, and bleeding data were reviewed. Descriptive analyses were performed with annual data for 2019, 2020, and 2021, as well as the three years consecutively.
Results:
The medical records of 150 patients with hemophilia B between January 1, 2019, and December 31, 2021, were collected. Among these, 72 (48.0%) were severe, 47 (31.3%) were moderate, and 28 (18.7%) were mild. The results showed approximately two times more patients receiving prophylaxis as those receiving on-demand therapy, with 66.1% of patients receiving prophylaxis in 2019, 64.9% in 2020, and 72.1% in 2021. Annualized bleeding rates were 2.2% (± 3.1) in 2019, 1.8% (± 3.0) in 2020, and 1.8% (± 2.9) in 2021 among patients receiving prophylaxis.For the doses of factor IX concentrate, patients receiving prophylaxis received an average of 41.6 (± 11.9) IU/Kg/Injection in 2019, 45.7 (± 12.9) IU/Kg/Injection in 2020, and 60.1 (± 24.0) IU/Kg/Injection in 2021.
Conclusions
Clinically, prophylaxis is more prevalent than reported. Based on insights gained from current clinical evidence, it is expected that the unmet medical needs of patients can be identified, and physicians can evaluate the status of patients and actively manage hemophilia B using more effective treatment strategies.
3.Clinical data on treatment regimen and use of medication among patients with hemophilia B in Korea
Young Shil PARK ; Ji Kyoung PARK ; Jeong A PARK ; Hee Jo BAEK ; Jae Hee LEE ; Chur Woo YOU ; Chuhl Joo LYU ; Eun Jin CHOI
Blood Research 2024;59():27-
Background:
To investigate the clinical treatment status, such as treatment regimen, bleeding events, and drug dose, in patients with hemophilia B in South Korea.
Methods:
In this retrospective chart review, data of patients with hemophilia B from eight university hospitals were collected. Demographic and clinical data, treatment data, such as regimen and number of injections, dose of factor IX concentrate, and bleeding data were reviewed. Descriptive analyses were performed with annual data for 2019, 2020, and 2021, as well as the three years consecutively.
Results:
The medical records of 150 patients with hemophilia B between January 1, 2019, and December 31, 2021, were collected. Among these, 72 (48.0%) were severe, 47 (31.3%) were moderate, and 28 (18.7%) were mild. The results showed approximately two times more patients receiving prophylaxis as those receiving on-demand therapy, with 66.1% of patients receiving prophylaxis in 2019, 64.9% in 2020, and 72.1% in 2021. Annualized bleeding rates were 2.2% (± 3.1) in 2019, 1.8% (± 3.0) in 2020, and 1.8% (± 2.9) in 2021 among patients receiving prophylaxis.For the doses of factor IX concentrate, patients receiving prophylaxis received an average of 41.6 (± 11.9) IU/Kg/Injection in 2019, 45.7 (± 12.9) IU/Kg/Injection in 2020, and 60.1 (± 24.0) IU/Kg/Injection in 2021.
Conclusions
Clinically, prophylaxis is more prevalent than reported. Based on insights gained from current clinical evidence, it is expected that the unmet medical needs of patients can be identified, and physicians can evaluate the status of patients and actively manage hemophilia B using more effective treatment strategies.
4.Clinical significance and outcomes of adult living donor liver transplantation for acute liver failure: a retrospective cohort study based on 15-year single-center experience
Geun-hyeok YANG ; Young-In YOON ; Shin HWANG ; Ki-Hun KIM ; Chul-Soo AHN ; Deok-Bog MOON ; Tae-Yong HA ; Gi-Won SONG ; Dong-Hwan JUNG ; Gil-Chun PARK ; Sung-Gyu LEE
Annals of Surgical Treatment and Research 2024;107(3):167-177
Purpose:
This study aimed to describe adult living donor liver transplantation (LDLT) for acute liver failure and evaluate its clinical significance by comparing its surgical and survival outcomes with those of deceased donor liver transplantation (DDLT).
Methods:
We retrospectively reviewed the medical records of 267 consecutive patients (161 LDLT recipients and 106 DDLT recipients) aged 18 years or older who underwent liver transplantation between January 2006 and December 2020.
Results:
The mean periods from hepatic encephalopathy to liver transplantation were 5.85 days and 8.35 days for LDLT and DDLT, respectively (P = 0.091). Among these patients, 121 (45.3%) had grade III or IV hepatic encephalopathy (living, 34.8% vs. deceased, 61.3%; P < 0.001), and 38 (14.2%) had brain edema (living, 16.1% vs. deceased, 11.3%; P = 0.269) before liver transplantation. There were no significant differences in in-hospital mortality (living, 11.8% vs. deceased, 15.1%; P = 0.435), 10-year overall survival (living, 90.8% vs. deceased, 84.0%; P = 0.096), and graft survival (living, 83.5% vs. deceased, 71.3%;P = 0.051). However, postoperatively, the mean intensive care unit stay was shorter in the LDLT group (5.0 days vs. 9.5 days, P < 0.001). In-hospital mortality was associated with vasopressor use (odds ratio [OR], 3.40; 95% confidence interval [CI], 1.45–7.96; P = 0.005) and brain edema (OR, 2.75; 95% CI, 1.16–6.52; P = 0.022) of recipient at the time of transplantation. However, LDLT (OR, 1.26; 95% CI, 0.59–2.66; P = 0.553) was not independently associated with in-hospital mortality.
Conclusion
LDLT is feasible for acute liver failure when organs from deceased donors are not available.
5.A 10-Gene Signature to Predict the Prognosis of Early-Stage Triple-Negative Breast Cancer
Chang Min KIM ; Kyong Hwa PARK ; Yun Suk YU ; Ju Won KIM ; Jin Young PARK ; Kyunghee PARK ; Jong-Han YU ; Jeong Eon LEE ; Sung Hoon SIM ; Bo Kyoung SEO ; Jin Kyeoung KIM ; Eun Sook LEE ; Yeon Hee PARK ; Sun-Young KONG
Cancer Research and Treatment 2024;56(4):1113-1125
Purpose:
Triple-negative breast cancer (TNBC) is a particularly challenging subtype of breast cancer, with a poorer prognosis compared to other subtypes. Unfortunately, unlike luminal-type cancers, there is no validated biomarker to predict the prognosis of patients with early-stage TNBC. Accurate biomarkers are needed to establish effective therapeutic strategies.
Materials and Methods:
In this study, we analyzed gene expression profiles of tumor samples from 184 TNBC patients (training cohort, n=76; validation cohort, n=108) using RNA sequencing.
Results:
By combining weighted gene expression, we identified a 10-gene signature (DGKH, GADD45B, KLF7, LYST, NR6A1, PYCARD, ROBO1, SLC22A20P, SLC24A3, and SLC45A4) that stratified patients by risk score with high sensitivity (92.31%), specificity (92.06%), and accuracy (92.11%) for invasive disease-free survival. The 10-gene signature was validated in a separate institution cohort and supported by meta-analysis for biological relevance to well-known driving pathways in TNBC. Furthermore, the 10-gene signature was the only independent factor for invasive disease-free survival in multivariate analysis when compared to other potential biomarkers of TNBC molecular subtypes and T-cell receptor β diversity. 10-gene signature also further categorized patients classified as molecular subtypes according to risk scores.
Conclusion
Our novel findings may help address the prognostic challenges in TNBC and the 10-gene signature could serve as a novel biomarker for risk-based patient care.
6.Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey
Chaeeun KIM ; Haeun LEE ; Kyunghee JUNG-CHOI ; Hyesook PARK
Journal of Preventive Medicine and Public Health 2024;57(1):18-27
Objectives:
This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents.
Methods:
We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs).
Results:
Severe exacerbation of a family’s economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status.
Conclusions
The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.
7.Exploration of Factors Affecting Pro-social Intention to Disclose Information in Healthcare Settings
Kyunghee CHUN ; Young-soon PARK ; Young Jun CHO ; You Jung LEE
Korean Medical Education Review 2024;26(3):198-206
This study investigated the relationships of situational factors, motivational assessment–related factors, and situationally induced personal characteristics with pro-social intention to disclose patient information among health and medical students. In total, 210 students from Konyang University participated in the survey, including 116 medical students and 94 other health students. To measure the influence of variables on pro-social intention to disclose information related to health information security, a 27-item questionnaire was used. The reliability of the survey was shown by Cronbach’s α values of 0.859 to 0.917. According to students’ perceptions, higher disease severity was significantly related to higher impacts on the patient, family, and themselves (p<0.01), as well as higher situational empathy (p<0.05). Pro-social intention to disclose showed negative correlations with health information security awareness, information education experience, perceived impact on the self, responsibility to disclose, and personal norms (r=-0.136 to -0.647, p<0.05). Responsibility to disclose and situational empathy explained approximately 44% of the variance in pro-social intention to disclose. Additionally, students who received information security training perceived a significantly higher responsibility to disclose, exhibited higher health information security awareness, and had lower pro-social intention to disclose. This study confirmed the need for information security education for health and medical students, and suggested that pro-social characteristics such as empathy and responsibility need to be carefully addressed in information security education.
8.Design and Implementation of a Cohort for Quality Management of Medical Education: A Case Study from Konyang University College of Medicine
Kyunghee CHUN ; Tae Hee LEE ; Soojin JUNG ; Young-soon PARK
Korean Medical Education Review 2023;25(2):102-108
This study shares details on the operating process and results of the cohort of students and graduates that was designed and implemented at Konyang University College of Medicine in Daejeon and discusses future directions for cohort establishment and improvement. First, Konyang University College of Medicine established the necessity and defined the purpose of cohort design and implementation. A task force was formed to establish guidelines for analysis targets, procedures, reports, and data management, and cohort operation was classified as a quality control activity. Data were collected through surveys of current students and graduates, and data generated during the curriculum were collected, analyzed, and reported every 2 years. The cohort data collection and analysis methods are designed by the Department of Medical Education, and data collection is carried out by the administrative team and each committee. Data management and analysis are handled by the Center for Medical Education Support, and analysis and reporting are conducted by the Department of Medical Education. Various members of the medical school are working to collect and analyze data, report findings, provide feedback, and improve. In the future, we plan to advance database computerization and work toward more effective data analysis. Cohort operation should not be another burden for medical schools; instead, it is hoped that operating cohorts will be a meaningful activity to increase the effectiveness of medical education and help in the operation and policy decisions of medical schools.
9.A Proactive Testing Strategy to COVID-19 for Reopening University Campus during Omicron Wave in Korea: Ewha Safe Campus (ESC) Project
Whanhee LEE ; Kyunghee JUNG-CHOI ; Hyunjin PARK ; Seunghee JUN ; Nackmoon SUNG ; Sun-Hwa LEE ; Misun CHANG ; Hee Jung CHOI ; Chung-Jong KIM ; Hyesook PARK ; Eunhee HA
The Ewha Medical Journal 2023;46(3):e7-
Objectives:
Ewha Womans University launched an on-campus Coronavirus disease-19 (COVID-19) response system called Ewha Safety Campus (ESC) Project in collaboration with the Seegene Inc. RTPCR diagnostic tests for COVID-19 were proactively provided to the participants. This study examines the effectiveness of the on-campus testing strategy in controlling the reproduction number (Rt ) and identifying student groups vulnerable to infection.
Methods:
The ESC project was launched on March 2, 2022, with a pilot period from Feb 22 to March 1, 2022—the peak of the Omicron variant wave. We collected daily data on the RT-PCR test results of the students of Ewha Womans University from Mar 2 to Apr 30, 2022. We daily calculated Rt and compared it with that of the general population of Korea (women, people aged 20–29 years, and Seoul residents). We also examined the students vulnerable to the infection based on the group-specific Rt and positivity rate.
Results:
A lower Rt was observed about 2 weeks after the implementation of the ESC Project than that of the general population. The lower Rt persisted during the entire study period. Dormitory residents had a higher Rt . The positivity rate was higher in students who did not comply with quarantine guidelines and did not receive the second dose of the vaccine.
Conclusion
The study provides scientific evidence for the effectiveness of the on-campus testing strategy and different infection vulnerabilities of students, depending on dormitory residence, compliance with the quarantine guidelines, and vaccination.
10.Report on the methacholine bronchial provocation test protocol: An updated statement of Korean Academy of Asthma, Allergy and Clinical Immunology
Kyoung-Hee SOHN ; Hwan Soo KIM ; Byung-Keun KIM ; Joo-Hee KIM ; Sang Min LEE ; Jae-Hyun LEE ; Sung-Il WOO ; Cheol Hong KIM ; Jae Won JUNG ; Sae-Hoon KIM
Allergy, Asthma & Respiratory Disease 2023;11(2):56-62
The Korean Academy of Asthma, Allergy, and Clinical Immunology task force report aims to provide new protocols for methacholine challenge test (MCT). Although new devices have different delivery system compared to old ones, previous protocols are still used, which cannot guarantee adequate diagnoses of asthma. Another important issue is the recent recommendation in European Respiratory Society (ERS) technical standard guideline to use a delivered methacholine dose that causes a 20% decrease in forced expiratory volume in 1 second (FEV1) (PD 20). Although the previous protocol based on the methacholine concentration causing a 20% decrease in FEV1 (PC 20) has been used globally, several studies have reported that PD 20 is more reliable and applicable for new protocols of MCT. Indeed, a tidal breathing inhalation protocol using a breath-actuated or continuous nebulizer is recommended. Herein, we recommend 3 protocols for the MCT using new devices and provide a brief summary of the change in strategy based on the updated ERS guideline.

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