While the coronavirus disease 2019 pandemic is ongoing, monkeypox has been rapidly spreading in non-endemic countries since May 2022. Accurate and rapid laboratory tests are essential for identifying and controlling monkeypox. Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have proposed guidelines for diagnosing monkeypox in clinical laboratories in Korea. These guidelines cover the type of tests, selection of specimens, collection of specimens, diagnostic methods, interpretation of test results, and biosafety. Molecular tests are recommended as confirmatory tests. Skin lesion specimens are recommended for testing in the symptomatic stage, and the collection of both blood and oropharyngeal swabs is recommended in the presymptomatic or prodromal stage.

Monitored anesthesia care (MAC) has been used as a specific anesthesia service for diagnostic or therapeutic procedures performed under local anesthesia along with sedation and analgesia. Procedures such as trans arterial chemoembolization (TACE) or uterine artery embolization (UAE) performed in interventional radiology are typically accompanied by post-embolization syndrome (PES). While in TACE for hepatocellular carcinoma treatment, the severity of PES tends to be milder due to the liver’s dual blood supply, the degree is notably more severe in the case of UAE. Furthermore, the symptoms of PES after UAE procedure tend to follow a typical pattern. Most UAE patients do not develop pain until after the procedure has concluded. It is during the recovery period that patients frequently need significant doses of narcotics and analgesics to alleviate the pain. This report elucidates the application of MAC using dexmedetomidine in UAE, aimed to maintain adequate sedation during procedure and reduce severe pain after procedure.

Purpose: This study was conducted to explore the healthcare experience of residents participating in the CommunityBased Hypertension and Diabetes Registry Program. Methods: This study used qualitative content analysis. Data were collected from in depth interviews of fifteen participants, who either participated in the program hosted by the Training Center for Hypertension and Diabetes for more than two years or participated in an intensive one-on-one education program. Results: The results showed that the core theme in healthcare of participants was ‘Proactive healthcare with attention and systematic guidance of experts’. The positive reinforcement of staffs and the improvement of self-efficacy through effective close management were found to be positive influencing factors of participation. The theme consisted of the following categories: ‘Participation in the program with positive expectations on healthcare’, ‘Interest in body and health’, ‘Vitality in life’, ‘Confidence in dealing with disease’, ‘Thankfulness for close care and attention’, and ‘Desire for continuous care’. Conclusion When establishing policies on managing chronic diseases, a strategy that reflects the results of the study is required. It is necessary to build up emotional relationship among stakeholders, and expand opportunities for close healthcare such as one-on-one customized training, and mutual cooperation with various organizations in the local community.

Background: Nasotracheal intubation is the most commonly used method to secure the field of view when performing surgery on the oral cavity or neck. Like orotracheal intubation, nasotracheal intubation uses a laryngoscope. Hemodynamic change occurs due to the stimulation of the sympathetic nervous system. Recently, video laryngoscope with a camera attached to the end of the direct laryngoscope blade has been used to minimize this change. In this study, we investigated the optimal effect-site concentration (Ce) of remifentanil for minimizing hemodynamic responses during nasotracheal intubation with a video laryngoscope. Methods: Twenty-one patients, aged between 19 and 60 years old, scheduled for elective surgery were included in this study. Anesthesia was induced by slowly injecting propofol. At the same time, remifentanil infusion was initiated at 3.0 ng/ml via target-controlled infusion (TCI). When remifentanil attained the preset Ce, nasotracheal intubation was performed using a video laryngoscope. The patient's blood pressure and heart rate were checked pre-induction, right before and after intubation, and 1 min after intubation. Hemodynamic stability was defined as an increase in systolic blood pressure and heart rate by 20% before and after nasotracheal intubation. The response of each patient determined the Ce of remifentanil for the next patient at an interval of 0.3 ng/ml. Results: The Ce of remifentanil administered ranged from 2.4 to 3.6 ng/ml for the patients evaluated. The estimated optimal effective effect-site concentrations of remifentanil were 3.22 and 4.25 ng/ml, that were associated with a 50% and 95% probability of maintaining hemodynamic stability, respectively. Conclusion Nasotracheal intubation using a video laryngoscope can be successfully performed in a hemodynamically stable state by using the optimal remifentanil effect-site concentration (Ce50 , 3.22 ng/ml; Ce95 , 4.25 ng/ml).

Background: We purposed to evaluate the seasonality and associated factors of the incidence of gout attacks in Korea. Methods: We prospectively enrolled patients with gout attacks who were treated at nine rheumatology clinics between January 2015 and July 2018 and followed them for 1-year. Demographic data, clinical and laboratory features, and meteorological data including seasonality were collected. Results: Two hundred-five patients (men, 94.1%) were enrolled. The proportion of patients with initial gout attacks was 46.8% (n = 96). The median age, body mass index, attack duration, and serum uric acid level at enrollment were 50.0 years, 25.4, 5.0 days, and 7.4 mg/dL, respectively. Gout attacks were most common during spring (43.4%, P < 0.001) and in March (23.4%, P < 0.001). A similar pattern of seasonality was observed in the group with initial gout attacks. Alcohol was the most common provoking factor (39.0%), particularly during summer (50.0%). The median diurnal temperature change on the day of the attack was highest in the spring (9.8°C), followed by winter (9.3°C), fall (8.6°C), and summer (7.1°C) (P = 0.027). The median change in humidity between the 2 consecutive days (the day before and the day of the attack) was significantly different among the seasons (3.0%, spring; 0.3%, summer; −0.9%, fall; −1.2%, winter; P = 0.015). One hundred twenty-five (61%) patients completed 1-year follow-up (51% in the initial attack group). During the follow-up period, 64 gout flares developed (21 in the initial attack group). No significant seasonal variation in the follow-up flares was found. Conclusion In this prospective study, the most common season and month of gout attacks in Korea are spring and March, respectively. Alcohol is the most common provoking factor, particularly during summer. Diurnal temperature changes on the day of the attack and humidity changes from the day before the attack to the day of the attack are associated with gout attack in our cohort.

PURPOSE: This study aimed to estimate the prevalence, prescription pattern and burden of pediatric asthma in Korea by analyzing the National Health Insurance (NHI) claims data. METHODS: We retrospectively analyzed the insurance claim records from the Korean NHI claims database from January 2010 to December 2014. Asthmatic patients were defined as children younger than 18 years, with appropriate 10th Revision of the International Classification of Diseases codes (J45 or J46) and a prescription for 1 or more asthma maintenance medications at the same date. Hospitalization and emergency department visits for asthma were defined as use of short-acting beta2-agonists during hospital visits among asthmatic patients. RESULTS: There were 1,172,807 asthmatic children in 2010, which increased steadily to 1,590,228 in 2014 in Korea. The prevalence showed an increasing trend annually for all ages. The mean prevalence by age in those older than 2 years decreased during the study period (from 39.4% in the 2–3 year age group to 2.6% in the 15–18 year age group). In an outpatient prescription, leukotriene receptor antagonists were the most commonly prescribed medication for all ages. Patients older than 6 years for whom inhaled corticosteroids were prescribed comprised less than 15% of asthmatic patients. The total direct medical cost for asthma between 2010 and 2014 ranged from $376 to $483 million. Asthma-related medical cost per person reached its peak in $366 in 2011 and decreased to $275 in 2014. CONCLUSIONS: The prevalence of pediatric asthma increased annually and decreased with age. Individual cost of asthma showed a decreasing trend in Korean children.
Adrenal Cortex Hormones ; Asthma ; Child ; Cost of Illness ; Emergency Service, Hospital ; Hospitalization ; Humans ; Insurance ; International Classification of Diseases ; Korea ; Leukotriene Antagonists ; National Health Programs ; Outpatients ; Prescriptions ; Prevalence ; Retrospective Studies

PURPOSE: The purpose of this study was to investigate relationships between the symptom of restless legs syndrome (RLS), somatic symptom, depression, and activities of daily living (ADL) among the elderly. METHODS: A descriptive approach was taken in this study. Data were collected from May 23 to July 5, 2019 and 140 elderly people replied to the questionnaire. The data were analyzed by descriptive statistics, t-test, One-way ANOVA, Pearson's correlation coefficient, and χ² test. RESULTS: 48.6% of the respondents had RLS symptom and the severity of RLS symptom was 9.57±11.55. RLS symptom had a positive correlation with depression (r=.538, p<.001), with somatic symptom (r=.528, p<.001), with ADL (r=.308, p<.001), and with IADL (r=.360, p<.001). Depression had the most significant correlation with RLS symptoms. There were significant differences in depression, somatization, ADL, and IADL according to the RLS severity. CONCLUSION The results of this study showed that many elders experienced mild to severe RLS symptom. Also, the elderly with RLS symptom had more severe depression, somatic symptom, ADL, and IADL than those without RLS symptom in this study. Depression, somatic symptom, and ADL could be deteriorated if the RLS symptom is not diagnosed early.

BACKGROUND: Research on next-generation sequencing (NGS)-based HLA typing is active. To resolve the phase ambiguity and long turn-around-time of conventional high resolution HLA typing, this study developed a NGS-based high resolution HLA typing method that can handle large-scale samples within an efficient testing time. METHODS: For HLA NGS, the condition of nucleic acid extraction, library construction, PCR mechanism, and HLA typing with bioinformatics were developed. To confirm the accuracy of the NGS-based HLA typing method, the results of 192 samples HLA typed by SSOP and 28 samples typed by SBT compared to NGS-based HLA-A, -B and -DR typing. RESULTS: DNA library construction through two-step PCR, NGS sequencing with MiSeq (Illumina Inc., San Diego, USA), and the data analysis platform were established. NGS-based HLA typing results were compatible with known HLA types from 220 blood samples. CONCLUSION: The NSG-based HLA typing method could handle large volume samples with high-throughput. Therefore, it would be useful for HLA typing of bone marrow donation volunteers.
Bone Marrow ; Computational Biology ; Gene Library ; Histocompatibility Testing ; HLA-A Antigens* ; Methods* ; Polymerase Chain Reaction ; Statistics as Topic ; Volunteers

PURPOSE: This study was to explore the level of core nursing activities performed by long-term care hospital nurses and to investigate the frequency and educational needs of major nursing activities. METHODS: A cross-sectional descriptive research design was used. The subjects were 155 nurses working at seven long-term care hospitals in Korea. Data were collected in 2018 from September 15 to October 16 using a structured questionnaire. Data were analyzed using the SPSS program. RESULTS: The mean age of nurses was 45.19±10.99 years and the mean career of long-term care hospital was 49.84±40.52 months. Monitoring activity was shown as the highest score in the performance level and frequency, whereas infection control received the highest score in educational needs. A scatter plot revealed that physical examination, respiratory care, wound care, communication and education showed overall high scores in the performance level, frequency, and educational needs. Emergency care and infection control were the activities that were performed less frequently but had high performance level and educational needs. CONCLUSION: It is important to establish rules for requisite and delegable activities considering the performance level and frequency of nursing activities in long-term care hospitals in order to improve the quality of patient care.
Education ; Emergency Medical Services ; Infection Control ; Korea ; Long-Term Care* ; Nursing* ; Patient Care ; Physical Examination ; Research Design ; Wounds and Injuries

PURPOSE: The purpose of this study was to investigate relationships between the symptoms of Restless Legs Syndrome (RLS), sleep disturbance and depression among middle-aged women. METHODS: The study took a descriptive approach. A self-reported questionnaire was provided to women aged between 45 and 65 living in community area. The data were analyzed via SPSS program (version 25). RESULTS: 47.8% of the respondents showed moderate to severe RLS symptoms and the severity of RLS symptoms was 10.72. Depression score was 13.12 and sleep disturbance score was 4.97. There was a significant correlation between RLS symptoms and sleep disturbance (r=.423, p < .001), and RLS symptoms had a positive impact on sleep disturbance. There was also a significant correlation between RLS symptoms and depression (r=.494, p < .001) and RLS symptoms also had a positive impact on depression. CONCLUSION: Women with RLS symptoms had more severe sleep disturbance, depression and vasomotor syndrome than those without RLS symptoms. If RLS symptoms among middle-aged women is simply diagnosed as a menopausal symptom, this misdiagnosis can lead to sleep disorder and depression. Therefore, further empirical researches should be done to estimate the prevalence of RLS symptoms and to launch a program to detect RLS at the early stage.
Depression* ; Diagnostic Errors ; Empirical Research ; Female ; Humans ; Prevalence ; Restless Legs Syndrome* ; Sleep Wake Disorders ; Surveys and Questionnaires