Although WHO declared the end of the public health emergency for coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), XBB lineages continue to evolve and emerge globally. In particular, XBB.1.5 and XBB.1.16 are raising concerns because of their high immune evasion, leading to apprehensions regarding vaccine efficacy reduction and potential reinfection. We aimed to investigate the COVID-19 outbreak in Korea and predict the likelihood of reinfection by testing neutralizing activity against live viruses from the S clade and 19 Omicron sublineages.We found a significant risk of infection with the currently prevalent XBB lineage for individuals who were either vaccinated early or infected during the initial Omicron outbreak. Vaccinated individuals were better equipped than unvaccinated individuals to produce neutralizing antibodies for other SARS-CoV-2 variants upon infection. Therefore, unvaccinated individuals do not easily develop neutralizing activity against other variants and face the highest risk of reinfection by the XBB lineage. Our study provides important information to facilitate the development of strategies for monitoring populations that would be the most susceptible to new COVID-19 outbreaks.

Since a novel beta-coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019, there has been a rapid global spread of the virus. Genomic surveillance was conducted on samples isolated from infected individuals to monitor the spread of genetic variants of SARS-CoV-2 in Korea. The Korea Disease Control and Prevention Agency performed whole genome sequencing of SARS-CoV-2 in Korea for 1 year (January 2020 to January 2021). A total of 2,488 SARSCoV-2 cases were sequenced (including 648 cases from abroad). Initially, the prevalent clades of SARSCoV-2 were the S and V clades, however, by March 2020, GH clade was the most dominant. Only international travelers were identified as having G or GR clades, and since the first variant 501Y.V1 was identified (from a traveler from the United Kingdom on December 22 nd , 2020), a total of 27 variants of 501Y.V1, 501Y.V2, and 484K.V2 have been classified (as of January 25 th , 2021). The results in this study indicated that quarantining of travelers entering Korea successfully prevented dissemination of the SARS-CoV-2 variants in Korea.

Purpose: This study explored nursing students’ experiences of attending clinical practicum courses in 2020 during the COVID-19 pandemic era, focusing on their confidence in clinical competency and job readiness. Methods: The data for this study were collected using online questionnaires that were uploaded to a free online survey website and distributed via a link to the survey to 334 nursing students attending four-year nursing colleges at four national universities. Data analysis was done with descriptive statistics, independent t-tests, and ANOVA. Results: The participants were mostly female (83.2%) college seniors (78.1%). About 60% of the participants practiced between 40% to 100% of their clinical practicum hours in alternative ways. Almost a third of the participants reported that they were not ready for a job (30.2%). However, participants’ confidence in clinical competency and job readiness was not related to the rate of alternative practice, but rather to both achievement of educational outcomes and satisfaction in the nursing practicum. Conclusion Due to COVID-19, it is evident that effective and efficient materials and ways of delivering clinical courses are constantly to be sought and developed. In particular, recently graduated nurses who experienced abrupt and considerable alterations in their clinical practicum courses due to COVID-19 are in need of attention while they strive to make clinical adaptations.

BACKGROUND: Hepatitis B virus (HBV) infection leads to hepatic and extrahepatic manifestations including chronic kidney disease (CKD). However, the association between HBV and CKD is not clear. This study investigated the association between chronic HBV infection and CKD in a nationwide multicenter study. METHODS: A total of 265,086 subjects who underwent health-check examinations in 33 hospitals from January 2015 to December 2015 were enrolled. HBV surface antigen (HBsAg) positive cases (n = 10,048), and age- and gender-matched HBsAg negative controls (n = 40,192) were identified. CKD was defined as a glomerular filtration rate (GFR) < 60 mL/min/1.73 m² or proteinuria as at least grade 2+ of urine protein. RESULTS: HBsAg positive cases showed a significantly higher prevalence of GFR < 60 mL/min/1.73 m² (3.3%), and proteinuria (18.9%) than that of the controls (2.6%, P < 0.001, and 14.1%, P < 0.001, respectively). In the multivariate analysis, HBsAg positivity was an independent factor associated with GFR < 60 mL/min/1.73 m² along with age, blood levels of albumin, bilirubin, anemia, and hemoglobin A1c (HbA1c). Likewise, HBsAg positivity was an independent factor for proteinuria along with age, male, blood levels of bilirubin, protein, albumin, and HbA1c. A subgroup analysis showed that HBsAg positive men but not women had a significantly increased risk for GFR < 60 mL/min/1.73 m². CONCLUSION: Chronic HBV infection was significantly associated with a GFR < 60 mL/min/1.73 m² and proteinuria (≥ 2+). Therefore, clinical concern about CKD in chronic HBV infected patients, especially in male, is warranted.
Anemia ; Antigens, Surface ; Bilirubin ; Case-Control Studies* ; Female ; Glomerular Filtration Rate ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Male ; Multivariate Analysis ; Prevalence ; Proteinuria ; Renal Insufficiency, Chronic*

BACKGROUND/AIMS: Infliximab was approved for the treatment of ulcerative colitis (UC) in 2006 and has recently been used as rescue therapy in steroid-refractory UC. The aim of this study was to investigate the differences of medication use and prognosis in UC patients according to the periods of diagnosis. METHODS: From 1987 to 2012, a total of 1,422 patients with UC were retrospectively reviewed in 12 hospitals. The study population was divided into two groups according to the periods of diagnosis as follows; group A: 1987-2005, group B: 2006-2012. Analyzed variables were compared by using chi-square test and logistic regression analysis. RESULTS: Mean age of the subjects was 42.2 years, and the mean follow-up period was 4.7 years. In univariate analysis, the use of infliximab in group B was significantly higher than group A (4.5% vs. 7.6%, p=0.016), and UC-related hospitalization (45.8% vs. 40.1%, p=0.031) and UC-related surgery (6.4% vs. 3.5%, p=0.010) in group B was significantly lower than that of group A. The use of oral steroid in surgery group was significantly higher than non-surgery group in multivariate analysis (OR 1.85, 95% CI 1.03-3.30, p=0.039). CONCLUSIONS: Infliximab might play an important role for the treatment of steroid-refractory UC. Well-designed prospective trials based on the efficacy and safety of infliximab are required in the future.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Colitis, Ulcerative/*diagnosis/drug therapy/pathology ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Infliximab/therapeutic use ; Logistic Models ; Male ; Mesalamine/therapeutic use ; Middle Aged ; Odds Ratio ; Prognosis ; Retrospective Studies ; Time Factors

PURPOSE: The purpose of this study was to evaluate the effects of clinical practice and simulation-based practice for obstetrical nursing in terms of self-efficacy, practice satisfaction, and practice stress. METHODS: A non-equivalent control group post test design was used. The participants were 171 junior nursing students, 103 in the experimental group, and 68 in the control group. Simulation-based practice consisted of nursing assessment during labor, nursing assessment and intervention for normal and high risk mother, nursing education for mother and family during labor, and open lab. The experimental group participated in simulation-based practice for two days and the control group participated in clinical practice at delivery room for two weeks. RESULTS: The experimental group showed higher level of self-efficacy (p=.043), practice satisfaction (p<.001) and practice stress (p=.003) compared to the control group. CONCLUSION: Simulation-based practice is an effective learning method for obstetrical nursing and can be used as the alternative for clinical practice. However, stress management strategies are needed for simulation-based practice.
Delivery Rooms ; Education, Nursing ; Humans ; Learning ; Mothers ; Nursing Assessment ; Obstetrical Nursing ; Personal Satisfaction ; Pyridines ; Students, Nursing ; Thiazoles

BACKGROUND: The aim of the present study was to determine the population-based prevalence of diabetes mellitus (DM) and prediabetes in a rural district of Daegu City, Korea. METHODS: Between August and November 2003, a community-based health survey of adults aged 20 years and older was performed in the rural district of Dalseong-gun in Daegu City. A total of 1,806 of all eligible individuals agreed to participate. Fasting plasma glucose was measured in all participants. Two hour oral glucose tolerance was measured in the 1,773 participants for whom there was neither an established diagnosis of DM nor evidence of DM according to fasting glucose levels. The prevalence of DM and prediabetes was determined according to the 2003 criteria of the American Diabetes Association. Subjects with prediabetes were classified into one of three categories of glucose intolerance: isolated impaired fasting glucose (IFG); isolated impaired glucose tolerance (IGT); or combined IFG and IGT. RESULTS: The prevalence of DM was 12.2%. The highest prevalence rates were observed in subjects in their seventies. A total of 34.7% of all subjects who were assigned a diagnosis of DM in the present study had not been diagnosed previously. The prevalence of prediabetes was 22.7%. The highest prevalence rates were observed in subjects in their fifties. CONCLUSION: The present study identified prevalence rates of 12.2% for DM (age-standardized prevalence rate [ASR], 6.8%), and 22.7% for prediabetes (ASR 18.5%). These results emphasize the need for community health promotion strategies to prevent or delay the onset of DM in individuals with prediabetes.
Adult ; Aged ; Diabetes Mellitus ; Fasting ; Glucose ; Glucose Tolerance Test ; Health Promotion ; Health Surveys ; Humans ; Korea ; Plasma ; Prediabetic State ; Prevalence

BACKGROUND: Clinical experience with the continuous glucose monitoring systems (CGMS) is limited in Korea. The objective of this study is to evaluate the accuracy of the CGMS and the correlation between interstitial fluid and venous plasma glucose level in Korean healthy male subjects. METHODS: Thirty-two subjects were served with glucose solution contained same amount of test food's carbohydrate and test foods after separate overnight fasts. CGMS was performed over 3 days during hopitalization for each subjects. Venous plasma glucose measurements were carried out during 4 hours (0, 0.25, 0.5, 0.75, 1, 2, 4 hours) just before and after glucose solution and test food load. The performance of the CGMS was evaluated by comparing its readings to those obtained at the same time by the hexokinase method using the auto biochemistry machine (Hitachi 7600-110). Also, correlations between glucose recorded with CGMS and venous plasma glucose value were examined. RESULTS: CGMS slightly underestimated the glucose value as compared with the venous plasma glucose level (16.3 +/- 22.2 mg/dL). Correlation between CGMS and venous plasma glucose values throughout sensor lifetime is 0.73 (regression analysis: slope = 1.08, intercept = 8.38 mg/dL). Sensor sensitivity can deteriorate over time, with correlations between venous blood glucose and CGMS values dropping from 0.77 during 1st day to 0.65 during 2nd and 3rd day. CONCLUSION: The accuracy of data provided by CGMS may be less than expected. CGMS sensor sensitivity is decreased with the passage of time. But, from this study, CGMS can be used for glucose variability tendency monitoring conveniently to the Korean.
Biochemistry ; Blood Glucose ; Extracellular Fluid ; Glucose ; Hexokinase ; Humans ; Korea ; Male ; Plasma ; Reading

BACKGROUND: This study was performed to compare the effectiveness of prophylactic dexamethasone and postintubation dexamethasone in reducing the incidence and severity of postoperative sore throat (POST). METHODS: This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 60 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the prophylactic and postintubation groups received intravenous injection of 10 mg of dexamethasone 30 min before or after tracheal intubation, respectively. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. RESULTS: The severity scores of POST at 1 and 6 h after the operation were significantly lower in the prophylactic group than in the postintubation group. There were no significant differences in the incidence of POST during the 24 h after the operation between the two groups (22/32 in the prophylactic group vs. 27/34 in the postintubation group, P = 0.403). CONCLUSIONS: Intravenous injection of 10 mg of dexamethasone was more effective in reducing the severity of POST when administered before tracheal intubation compared with after tracheal intubation.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Dexamethasone ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Pharyngitis ; Prospective Studies

BACKGROUND/AIMS: Gastrointestinal bleeding (GIB) in patients with chronic renal failure (CRF) is a common complication with a high mortality. However, the cause or mechanism of this condition is unclear. Therefore, this study investigated the clinical features of GIB in patients with CRF. METHODS: The clinical features of 35 patients with CRF who were admitted to the Uijeongbu St. Mary's Hospital for GIB from January 1998 to August 2003 were examined retrospectively. RESULTS: Thirty-five out of 803 patients had CRF (4.4%). The mean age of those with CRF was 62+/-11 years and 16 patients were male. The treatment for CRF was hemodialysis in 22 (62.9%), pre-dialysis in 10 (28.6%) and peritoneal dialysis in 3 (8.6%). The cause of GIB in CRF patients was an ulcer (45.7%), vascular disease (37.1%), hemorrhagic gastritis (8.6%), and Mallory-Weiss laceration (2.9%), etc. Rebleeding after the first treatment occurred in 5 patients (14.3%). Three of these patients (60%) had vascular disease. Surgical treatment for rebleeding was performed in 3 patients (60%) and the mortality rate in rebleeding patients was 60%. CONCLUSIONS: The most common cause of GIB in CRF patients is an ulcer followed by vascular disease. Vascular disease in cases with rebleeding is high with a high mortality rate.
Gastritis ; Hemorrhage* ; Humans ; Kidney Failure, Chronic* ; Male ; Mallory-Weiss Syndrome ; Mortality ; Peritoneal Dialysis ; Renal Dialysis ; Retrospective Studies ; Ulcer ; Vascular Diseases