Trends in Corneal Transplantation Revealed by KONOS and Health Insurance Review and Assessment Service Annual Reports

Purpose@#To analyze trends in corneal transplantation surgery and determine the number of domestic and imported corneal grafts used in South Korea.Method: The total number of keratoplasties and number of each individual surgical procedure conducted in 2010 and 2020 were identified using Health Insurance Review and Assessment Service data. The number of keratoplasties using domestic corneas in 2010 and 2020 was determined from the annual report of the Korean Network for Organ Sharing (KONOS). The number of keratoplasties using imported corneas was calculated by subtracting the number of keratoplasties using domestic corneas from the total number of keratoplasties. @*Results@#In 2010, 802 keratoplasties were performed in Korea, of which 299 (37.3%) used imported corneas; 715 (89.2%) were penetrating keratoplasties and 87 (10.8%) were anterior lamellar keratoplasties. In 2020, 911 keratoplasties were done in Korea and 564 (61.9%) used imported corneas; 541 (59.4%) were penetrating keratoplasties, 60 (6.6%) were anterior lamellar keratoplasties, and 310 (34.0%) were endothelial keratoplasties. From 2010 to 2020, the number of penetrating keratoplasties in Korea decreased, while the numbers of endothelial keratoplasties and keratoplasties using imported corneas increased. @*Conclusions@#There was a 30% decrease in the number of penetrating keratoplasties from 2010 to 2020, and a 30% increase in the numbers of endothelial keratoplasties and keratoplasties using imported corneas. The proportions of endothelial keratoplasties and imported corneas have increased steadily in Korea over the last 10 years.

Bacterial Co-Infection and Empirical Antibacterial Therapy in Patients With COVID-19

Background@#The rate and composition of bacterial co-infection in patients with coronavirus disease 2019 (COVID-19) were evaluated when microbiological testing was conducted on the majority of patients. We also evaluated whether the use of empirical antibacterials was associated with mortality. @*Methods@#In this retrospective study, all of the adult patients with COVID-19 hospitalized in a single tertiary hospital in South Korea between February 2020 and December 2021 were included. Bacterial co-infection was assessed by sputum cultures, blood cultures, and molecular testing, including polymerase chain reaction sputum testing and urinary antigen tests. Mortality was compared between patients who received empirical antibacterials and those who did not. @*Results@#Of the 367 adult patients admitted during the study period, 300 (81.7%) had sputum culture results and were included in the analysis. Of these 300 patients, 127 (42.3%) had a history of antibiotic exposure. The co-infection rate within 48 hours was 8.3% (25/300):6.4% (11/173) of patients without prior antibiotic exposure and 11% (14/127) of patients with prior antibacterial exposure. The co-infected bacteria were different according to antibacterial exposure before admission, and multi-drug resistant pathogens were detected exclusively in the antibacterial exposed group. Among the patients without positive results for the microbiological tests, empirical antibacterials were used in 33.3% of cases (100/300). Empirical antibacterial therapy was not significantly related to the 30-day mortality or inhospital mortality rates in the study cohort before or after the propensity score-matching. @*Conclusion@#In this study including only patients underwent microbiological testing, bacterial co-infection was not frequent, and the co-infected organisms varied depending on previous antibacterial exposures. Given the rarity of co-infection and the lack of potential benefits, empiric antibacterial use in COVID-19 should be an important target of antibiotic stewardship.

Clinical and Genetic Risk Factors Associated With the Presence of Lupus Nephritis

Objective@#To elucidate whether clinical features and the weighted genetic risk score (wGRS) were associated with the presence of lupus nephritis (LN). @*Methods@#We retrospectively divided patients with systemic lupus erythematosus (SLE, n=1,078) into biopsy-proven LN (n=507) and non-LN groups (non-LN, n=571). Baseline clinical features, serologic markers, and the wGRS were collected. The wGRS was calculated from 112 non-human leukocyte antigen (non-HLA) loci and HLA-DRβ1 amino acid haplotypes for SLE. Associations among clinical features, wGRS, and the presence of LN were identified. @*Results@#In the multivariate analysis, patients with LN were younger at diagnosis (odds ratio [OR]=0.97, p＜0.001), had more pleuritis (OR=2.44, p＜0.001) and pericarditis (OR=1.62, p=0.029), had a higher detection rate of anti-double stranded deoxyribonucleic acid (anti-dsDNA antibodies, OR=2.22, p＜0.001), anti-Smith antibodies (anti-Sm antibodies, OR=1.70, p=0.002), low level of complement (OR=1.37, p=0.043) and absence of antiphospholipid antibodies (aPL antibodies, OR=1.60, p=0.002), and had higher wGRS (OR=1.16, p=0.012). Mediation analysis suggested that anti-Sm antibodies and low complement could be mediators in the relationship between high wGRS and the presence of LN. @*Conclusion@#Onset age, pleuritis, pericarditis, several serologic markers, and wGRS were associated with the presence of LN. Anti-Sm antibodies and low complement appeared to mediate the indirect relationship between wGRS and the presence of LN.

Clinical and Genetic Risk Factors Associated With the Presence of Lupus Nephritis

Objective@#To elucidate whether clinical features and the weighted genetic risk score (wGRS) were associated with the presence of lupus nephritis (LN). @*Methods@#We retrospectively divided patients with systemic lupus erythematosus (SLE, n=1,078) into biopsy-proven LN (n=507) and non-LN groups (non-LN, n=571). Baseline clinical features, serologic markers, and the wGRS were collected. The wGRS was calculated from 112 non-human leukocyte antigen (non-HLA) loci and HLA-DRβ1 amino acid haplotypes for SLE. Associations among clinical features, wGRS, and the presence of LN were identified. @*Results@#In the multivariate analysis, patients with LN were younger at diagnosis (odds ratio [OR]=0.97, p＜0.001), had more pleuritis (OR=2.44, p＜0.001) and pericarditis (OR=1.62, p=0.029), had a higher detection rate of anti-double stranded deoxyribonucleic acid (anti-dsDNA antibodies, OR=2.22, p＜0.001), anti-Smith antibodies (anti-Sm antibodies, OR=1.70, p=0.002), low level of complement (OR=1.37, p=0.043) and absence of antiphospholipid antibodies (aPL antibodies, OR=1.60, p=0.002), and had higher wGRS (OR=1.16, p=0.012). Mediation analysis suggested that anti-Sm antibodies and low complement could be mediators in the relationship between high wGRS and the presence of LN. @*Conclusion@#Onset age, pleuritis, pericarditis, several serologic markers, and wGRS were associated with the presence of LN. Anti-Sm antibodies and low complement appeared to mediate the indirect relationship between wGRS and the presence of LN.

Epigenetic Approaches to the Treatment of Renal Cell Cancer

To summarize the epigenetics in renal cell carcinoma (RCC) and discuss the potential use of epigenetic modifiersas RCC biomarkers and treatments. Pertinent articles available on PubMed and google scholar database pertainingto kidney cancer and epigenetics were reviewed. Metastatic RCC is one of the most difficult cancers to treat.Although RCC is commonly known to be caused by VHL mutations, it is not enough to understand the completepathophysiology of RCC. Epigenetic factors can play a fundamental role in the pathogenesis of RCC. Epigeneticregulators are classified as epigenetic writers, readers, and erasers according to their role. In this review, wediscuss the potential role of epigenetic regulators as a biomarker for RCC. We also review medications thattarget epigenetic enzymes and are currently tried in RCC therapy.

Anti-Allodynic Effects of Polydeoxyribonucleotide in an Animal Model of Neuropathic Pain and Complex Regional Pain Syndrome

Background@#Spinal nerve ligation (SNL) model is one of the representative models of the neuropathic pain model. Neuropathic pain in a chronic post-ischemic pain (CPIP) mimics the symptoms of complex regional pain syndrome (CRPS). The administration of polydeoxyribonucleotide (PDRN), which has regenerative and anti-inflammatory effects, has been studied and is used in clinical practice treating various diseases. However, the analgesic effect of PDRN in a neuropathic pain or CRPS model remains unknown. @*Methods@#PDRN (3.3, 10, and 20 mg/kg) was administered into the subcutaneous (SC) layer of the hind paws of SNL and CPIP models. Mechanical anti-allodynic effects were then investigated using the von Frey test. In the immunohistochemical examination, dorsal root ganglia (DRG) and the spinal cord were harvested and examined for the expression of glial fibrillary acidic protein (GFAP) after the 20 mg PDRN injection. @*Results@#Mechanical allodynia was significantly alleviated by administration of PDRN in SNL and CPIP mice at all of the time point. As the dose of PDRN increased, the effect was greater. The 20 mg PDRN injection was found to have the most effective anti-allodynic effect. The increased expression of GFAP in DRG and the spinal cord of SNL and CPIP model decreased following the administration of PDRN than vehicle. @*Conclusion@#SC administration of PDRN results in the attenuation of allodynia and activation of astrocytes in neuropathic pain or CRPS models. We propose that PDRN can have significant potential advantages in neuropathic pain treatment.

Synovial Cell Migration is Associated with B Cell Activating Factor Expression Increased by TNFα or Decreased by KR33426

Fibroblast-like synoviocytes (FLS) play a crucial role in initiating rheumatoid arthritis. B-cell activating factor (BAFF) plays a role in FLS survival as well as in B cell maturation and maintenance. Here, we investigated whether tumor necrosis factor (TNF)-α-induced BAFF expression controls FLS migration and whether BAFF expression in FLS could be regulated by KR33426 which is the inhibitor of BAFF binding to BAFF receptors (BAFF-R) by using MH7A synovial cells transfected with the SV40 T antigen. More TNF-α-treated cells migrated compared to the control. TNF-α increased BAFF expression in FLS, significantly. FLS migration was inhibited by the transfection with BAFF-siRNA. KR33426 also inhibited BAFF expression increased by TNF-α treatment in FLS as judged by western blotting, PCR, and transcriptional activity assay. Kinases including JNK, p38 and Erk were activated by TNF-α treatment. While JNK and p38 were inhibited by KR33426 treatment, no changes in Erk were observed. Transcription factors including p65, c-Fos, CREB and SP1 were enhanced by TNF-α treatment. Among them, c-Fos was inhibited by KR33426 treatment.Small interference(si)-RNA of c-fos decreased BAFF transcriptional activity. FLS migration induced by TNF-α was inhibited by the transfection with BAFF-siRNA. KR33426 increased Twist, Snail, Cadherin-11 and N-Cadherin. In contrast, KR33426 decreased E-cadherin and TNF-α-enhanced CCL2. Taken together, our results demonstrate that synovial cell migration via CCL2 expression could be regulated by BAFF expression which is decreased by KR33426 and c-Fos-siRNA. It suggests for the first time that the role of BAFF-siRNA on FLS migration might be matched in the effect of KR33426 on BAFF expression.

Association between Cigarette Smoking and Sarcopenia according to Obesity in the Middle-Aged and Elderly Korean Population: The Korea National Health and Nutrition Examination Survey (2008–2011) / 가정의학회지

BACKGROUND: The definition of sarcopenia focuses on muscle mass and function. Sarcopenic obesity is the relative excess of fat tissue with decreased muscle mass. We examined the association between cigarette smoking and sarcopenia according to obesity in middle-aged and elderly Koreans. METHODS: We conducted a cross-sectional study of 9,385 subjects (age ≥50 years) based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (2008–2011). Smoking groups were categorized by smoking status and the number of cigarettes smoked daily. Sarcopenia was defined as weight-adjusted appendicular skeletal muscle mass of 2 standard deviations below the sex-specific mean for young adults. Obesity was defined as fat mass ≥30% for men and ≥40% for women. Subjects were categorized into three groups: sarcopenic obese (SO), sarcopenic non-obese (SNO), and normal. Multiple logistic regression analysis was performed to assess the association between smoking and SNO and SO. RESULTS: Among men, current smokers were more associated with SNO than never-smokers (adjusted odds ratio [OR], 3.34; 95% confidence interval [CI], 1.09–10.26). However, there was no significant association between smoking status and SNO in women or SO in either sex. Among current smokers, moderate smokers (11–20 cigarettes/d) were more likely to be SNO (adjusted OR, 5.81; 95% CI, 1.12–30.31) and heavy smokers (>20 cigarettes/d) were more likely to be SO (adjusted OR, 9.53; 95% CI, 1.65–55.01) than light smokers (<11 cigarettes/d). CONCLUSION: In men, smoking was positively associated with SNO, and heavy smokers were more likely to be SO than light smokers.

Comparison of Retinal Ganglion Cell Damage in Glaucoma and Retinal Vein Occlusion by Visual Field

PURPOSE: We analyzed and compared retinal ganglion cell damage between patients with glaucoma and those with branched retinal vein occlusion (BRVO). We performed two types of visual field examinations. METHODS: We retrospectively reviewed the medical records of 40 glaucoma eyes and 40 BRVO eyes. We compared the median deviation (MD), the pattern standard deviation (PSD), and sensitivity of damaged visual hemifield from frequency-doubling technology (FDT) C24-2 and standard automated perimetry (SAP) C24-2 visual field tests evaluation. We sought correlations between the MDs and retinal nerve fiber layer thickness as revealed by optical coherence tomography. RESULTS: MDs did not differ between the groups. PSD value was higher in glaucoma patients with FDT C24-2 test (p = 0.022), but no difference between two groups with SAP C24-2 test (p = 0.144). In terms of the sensitivity of the damaged visual hemifield, glaucoma patients had larger areas of damage in the FDT C24-2 test (p < 0.01). In regression analyses, the log R2 values of both tests were higher in glaucoma patients. CONCLUSIONS: Glaucoma patients had a greater damaged visual field area in the FDT C24-2 test than the SAP C24-2 test. The BRVO patients exhibited similar extents of damage in both tests. Thus, the subtypes and distributions of damaged retinal ganglion cells may differ between the conditions, facilitating differential diagnosis.

Correlation between Smoking and Depression in Korean Adult Group: The Korean National Health and Nutrition Examination Survey (2014)

BACKGROUND: Though several factors have been found to be associated with depression, yet many others remain uncovered. A few studies have focused on the correlation between smoking and depression. This study was designed to explore whether there was a relationship between smoking and depression in a Korean adult group.METHODS: This study was based on the 2014 data of 17,780 Koreans obtained from the sixth Korea National Health and Nutrition Examination Survey (KNHNES, 2013–2015). The participants' depression status was evaluated based on their responses to survey. The correlation between smoking and depression was examined using multiple linear regression analysis after adjusting confounders. The result was represented as correlation factors, and a P-value of less than 0.05 was considered statistically significant.RESULTS: Our study revealed higher depression prevalence in the current smoker group as compared to non-smokers and ex-smokers and this difference was statistically significant.CONCLUSION: Smoking status was statistically significantly related to depression. Among the three smoking status groups, the current smoker group had the highest prevalence of depression. Hence s stopping smoking was considered to be effective and important to prevent depression.

Factors associated with time to diagnosis from symptom onset in patients with early rheumatoid arthritis

BACKGROUND/AIMS@#To identify the factors associated with time to diagnosis after symptom onset in patients with early rheumatoid arthritis (RA).@*METHODS@#Early RA patients with ≤ 1 year of disease duration in the KORean Observational study Network for Arthritis (KORONA) database were included in this analysis. Patients were further divided into two groups according to the time to diagnosis from symptom onset: the early diagnosis group (time to diagnosis ≤ 1 year) and the late diagnosis group (time to diagnosis > 1 year). Using the multivariable regression model, we identified factors associated with early diagnosis.@*RESULTS@#Among 714 early RA patients, 401 patients (56.2%) and 313 patients (43.8%) were included in the early diagnosis and late diagnosis groups, respectively. The mean disease duration was 0.47 years in the early diagnosis group and 0.45 years in the late diagnosis group. In multivariable model analysis, greater age at onset (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02 to 1.05), high school education or higher (OR, 1.68; 95% CI, 1.14 to 2.47), higher income (OR, 1.48; 95% CI, 1.05 to 2.08), and initial small joint involvement (OR, 1.42; 95% CI, 1.02 to 1.98) were factors associated with early diagnosis. At diagnosis, disease activity scores using 28 joints on diagnosis (3.81 ± 1.44 vs. 3.82 ± 1.42, p = 0.92) and functional disability (0.65 ± 0.61 vs. 0.57 ± 0.62, p = 0.07) did not different between the two groups. However, hand joint erosion on X-ray (37.8% vs. 25.6%, p < 0.01) was more common in the late diagnosis group than the early diagnosis group.@*CONCLUSIONS@#Older onset age, higher educational level and income, and initial small joint involvement were positive factors for early diagnosis of RA.

Atypical Teratoid/Rhabdoid Tumor of Lumbar Spine in an Infant: A Case Report

Atypical teratoid/rhabdoid tumor (AT/RT) of spine usually reported to develop in the brain, while it rarely manifest in the spine. It consists of rhabdoid cells and is highly malignant. AT/RT appears at various sites throughout the body, such as in the central nervous system, liver, kidneys, abdomen, and soft tissues. Among them, spinal AT/RT is rare, and AT/RT of lumbar spine is extremely rare; only a few cases have been reported. We present the case of an AT/RT of lumbar spine in a 16-month-old boy.

Current Status of Parents' Monitoring of and Level of Trust in School Lunch Programs / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the current status of parents' monitoring of school lunch programs and to examine the relationship of parents' school lunch monitoring with their level of trust in school lunch programs. METHODS: During November 2016, a web survey was conducted with 1,283 parents who had participated in monitoring of school lunch programs. A total of 621 parents completed the questionnaires (48.4% response rate) and the responses from 442 parents were analyzed (34.5% analysis rate) for elementary (n=196) and middle/high school parents (n=246), respectively. RESULTS: Both the elementary and middle/high school parents most wanted to participate in monitoring 1~2 times per month, which was less frequent than their current practice. They showed the highest experience rate in ‘food sanitation’ area in both the prior training and actual practice of school lunch monitoring. They most responded ‘increasing trust in school lunch programs’ as a merit and ‘lack of parents participating in monitoring’ as a problem of school lunch monitoring. The average levels of trust did not differ between elementary and middle/high school parents. Multiple regression analyses showed that elementary school parents' level of satisfaction in the monitored school lunch programs was positively associated with the parents' level of trust in general school lunch programs. Monitoring frequency and parents' age, in addition to level of satisfaction in the monitored school lunch program, were associated with level of trust in general school lunch programs among middle/high school parents. CONCLUSIONS: There was room for change in parents' school lunch monitoring programs to meet parents' needs better. Well-managed school lunch monitoring programs contributing to parents' satisfaction with school lunch programs could increase parents' level of trust in school lunch programs.

The Relationship between Subjective Sleep, Emotions, Social Support and Excessive Daytime Sleepiness in Female Undergraduate Students

OBJECTIVES: The current study aimed to explore the relationship between subjective sleep, emotions, social support and excessive daytime sleepiness (EDS), and extract the strongest predictor of EDS in female undergraduate students. METHODS: Our subjects consisted of 168 female undergraduate students (mean age 21.64±1.66). All participants completed Epworth Sleepiness Scale (ESS), Insomnia Severity Index, Hospital Anxiety and Depression Scale, Social Support Scale, and the Munich Chronotype Questionnaire. RESULTS: There were significant associations between insomnia, anxiety, depression with EDS, but not with subjective total sleep time of workdays and freedays. Also, 23.8% (n=40) of subjects endorsed clinical levels of EDS (ESS>10). Insomnia, anxiety, and depression were higher, and social support was lower in the EDS group compared to the normal group. Finally, we explored factors that influenced EDS, resulting in anxiety and social support being the strongest predictors of EDS. Social support was the strongest predictor of EDS compared to other predictors (β=-0.276, p<0.001). CONCLUSIONS: Results suggest that social support may be important to consider in female undergraduate students who experience EDS.

Impact of early diagnosis on functional disability in rheumatoid arthritis

BACKGROUND/AIMS: To determine whether early diagnosis is beneficial for functional status of various disease durations in rheumatoid arthritis (RA) patients. METHODS: A total of 4,540 RA patients were enrolled as part of the Korean Observational Study Network for Arthritis (KORONA). We defined early diagnosis as a lag time between symptom onset and RA diagnosis of ≤ 12 months, whereas patients with a longer lag time comprised the delayed diagnosis group. Demographic characteristics and outcomes were compared between early and delayed diagnosis groups. Logistic regression analyses were performed to identify the impact of early diagnosis on the development of functional disability in RA patients. RESULTS: A total of 2,597 patients (57.2%) were included in the early diagnosis group. The average Health Assessment Questionnaire-Disability Index (HAQ-DI) score was higher in the delayed diagnosis group (0.64 ± 0.63 vs. 0.70 ± 0.66, p < 0.01), and the proportion of patients with no functional disability (HAQ = 0) was higher in the early diagnosis group (22.9% vs. 20.0%, p = 0.02). In multivariable analyses, early diagnosis was independently associated with no functional disability (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40). In a subgroup analysis according to disease duration, early diagnosis was associated with no functional disability in patients with disease duration < 5 years (OR, 1.37; 95% CI, 1.09 to 1.72) but not in patients with longer disease duration (for 5 to 10 years: OR, 1.07; 95% CI, 0.75 to 1.52; for ≥ 10 years: OR, 0.92; 95% CI, 0.65 to 1.28). CONCLUSIONS: Early diagnosis is associated with no functional disability, especially in patients with shorter disease duration.

The Effects of Equine-assisted Activities and Therapy on Resting-state Brain Function in Attention-deficit/Hyperactivity Disorder: A Pilot Study

OBJECTIVE: Equine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates. METHODS: Ten participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals. RESULTS: After the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul’s ADHD Rating Scale-Korean version. CONCLUSION: Our results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement.

Development of a More Effective Hearing Screening Questionnaire for Infants and Children during Medical Check-Ups / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To improve hearing screening, we developed a more effective hearing screening questionnaire for infants and children to be utilized during medical check-ups. SUBJECTS AND METHOD: Through literature review and discussions with an advisory council, we selected 10 questions to ask parents at each of the seven screening periods for their infants and children. In total, 223 parents of infants and children with and without hearing impairment (119 normal hearing, 104 hearing impaired) answered questionnaires at seven university hospitals in Korea. The advisory council modified questions with regard to sensitivity, specificity, positive, and negative prediction rate, preventing duplication among screening periods, and to address other questions related to development. RESULTS: For hearing screens, we asked five questions per screening period. Collectively, these questions had 40-100% sensitivity and 45-90% specificity at each of the seven screening periods. CONCLUSION: Although we do not advise that hearing questionnaires replace hearing tests, we developed in this study a more effective questionnaire that we suggest could be utilized during medical check-ups to enhance the hearing screening process.

Prevalence and antimicrobial resistance of Salmonella spp. and Escherichia coli isolated from ducks in Korea

This study was conducted to investigate the prevalence and antimicrobial resistance of Salmonella spp. and Escherichia (E.) coli isolated from ducks in Korea. A total of 400 cecal content samples were collected from 40 duck farms in Korea. Isolated Salmonella spp. and E. coli strains were 83 and 364 of the 400 cecal samples, respectively. The most prevalent serotype among the 83 Salmonella isolates was Salmonella Typhimurium (51 isolates: 61.45%). Resistance to the tested antimicrobial agents by Salmonella isolates was low except for erythromycin, while the resistance of the E. coli isolates to the other tested antimicrobial agents was high and 90.9% (331/364) of E. coli isolates showed multiantimicrobial resistance. Antimicrobial resistance in duck zoonotic pathogens should be of concern to the Korean duck industry, as these pathogens exhibit a high rate of antimicrobial resistance and pose a potential hazard to public health.

Reporting System of Transfusion Adverse Reaction Using Electronic Medical Records Data / 대한수혈학회지

BACKGROUND: Rapid and sensitive detection of transfusion adverse reaction is fundamental to reducing transfusion-related morbidity and mortality. The aim of this study was to develop an effective system for reporting of transfusion adverse reaction. METHODS: Inpatient lists with transfusion adverse reaction on a nurse electronic medical records (EMR) from December 4th, 2014 to May 21st, 2015 were automatically selected and displayed to the computer screen of the blood bank data management system. After review of clinical and laboratory data of suspected patients with transfusion reaction, frequency of transfusion adverse reaction according to blood components was calculated. RESULTS: The frequency of transfusion adverse reactions according to blood components was, in decreasing order, red blood cells (RBC) 0.91% (58/6,404), frozen fresh plasma (FFP) 0.20% (5/2,549), and platelets 0.10% (6/5,728). Of 47 allergic reactions, the relative ratio by blood components was RBC 76.6%, platelets 12.8%, and FFP 10.6%. All of 22 febrile nonhemolytic transfusion reactions were RBC related reactions. CONCLUSION: The online transfusion adverse reaction reporting system based on a nurse EMR is helpful in easy and accurate estimation of transfusion adverse reaction incidence.

The Effect of Hippotherapy and Medication on Children with Attention Deficit Hyperactivity Disorder: A Pilot Study / 신경정신의학

OBJECTIVES: This study researched the clinical effects of hippotherapy and medication in attention deficit hyperactivity disorder (ADHD) children. METHODS: The study employed an open label randomized controlled trial. Participants were 10 children of ages between 6 and 12 years. These subjects were placed in 2 groups : the hippotherapy group and the medication group. Evaluation tools used in this study include Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version, the Wechsler Intelligence Scale for Children-IV, Korean Child Behavior Check List (K-CBCL), ADHD rating scale (ARS), Clinical Global Impression (CGI), and Quantitative electroencephalography (QEEG). RESULTS: Grossly scores of investigator-administered ADHD rating scale (ARS-I), K-CBCL, and CGI-Severity of Illness scale were improved in both the hippotherapy and the medication group. The ARS-I scores of the Hippotherapy group were not significantly different from baseline after 12 weeks. In the QEEG, theta/beta ratio of Pz area in the hippotherapy group was significantly different from baseline. Children treated with medication showed significant difference from baseline in ARS-I, K-CBCL subscales, and QEEG. CONCLUSION: The use of hippotherapy could be a viable treatment strategy as a part of a multimodal therapy for children with ADHD. This pilot study provides good prospects for future studies to document these positive trends on larger samples.