Alcohol Problems and Related Service Needs in Urban Korean Community / 정신신체의학

OBJECTIVES: The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. METHODS: Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. RESULTS: The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities( 50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). CONCLUSIONS: These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.

The Effect of Pomegranate on Postmenopausal Syndrome: A Randomized, Double-blind, Placebo-controlled Trial / 대한폐경학회지

OBJECTIVES: To investigate the safety and effect of pomegranate extract on postmenopausal syndrome. METHODS: One hundred twelve women participated in a randomized, double-blind, placebo-controlled trial conducted in a tertiary university hospital in Korea. Women were treated with pomegranate extract or placebo for 12 weeks. The primary end point was menopausal symptoms, which were evaluated based on the Kupperman Index. The secondary end point was the serum estradiol (E2, pg/ml) level. Statistical analysis was performed. RESULTS: Menopausal symptoms as the Kupperman Index were significantly improved in the pomegranate group compared to placebo during the 12 weeks of intervention (P < 0.0001). Melancholia did not differ between the two groups. There was also no difference in serum E2 levels. There were no differences between the two groups in age, body weight, height, systolic and diastolic blood pressures, serum white and red blood cell counts, and fasting blood glucose, hemoglobin, aspartic transaminase, alanine transaminase, total cholesterol, triglycerides, high- and low-density lipoprotein-cholesterol, creatinine, and E2 levels. The side effects of pomegranate extract were negligible. CONCLUSION: Pomegranate extract is safe and effective in the treatment of menopausal symptoms. Further studies on whether or not the beneficial effect of pomegranate extract is due to the estrogen component are needed.

The Effect of Pomegranate on Postmenopausal Syndrome: A Randomized, Double-blind, Placebo-controlled Trial / 대한폐경학회지

OBJECTIVES: To investigate the safety and effect of pomegranate extract on postmenopausal syndrome. METHODS: One hundred twelve women participated in a randomized, double-blind, placebo-controlled trial conducted in a tertiary university hospital in Korea. Women were treated with pomegranate extract or placebo for 12 weeks. The primary end point was menopausal symptoms, which were evaluated based on the Kupperman Index. The secondary end point was the serum estradiol (E2, pg/ml) level. Statistical analysis was performed. RESULTS: Menopausal symptoms as the Kupperman Index were significantly improved in the pomegranate group compared to placebo during the 12 weeks of intervention (P < 0.0001). Melancholia did not differ between the two groups. There was also no difference in serum E2 levels. There were no differences between the two groups in age, body weight, height, systolic and diastolic blood pressures, serum white and red blood cell counts, and fasting blood glucose, hemoglobin, aspartic transaminase, alanine transaminase, total cholesterol, triglycerides, high- and low-density lipoprotein-cholesterol, creatinine, and E2 levels. The side effects of pomegranate extract were negligible. CONCLUSION: Pomegranate extract is safe and effective in the treatment of menopausal symptoms. Further studies on whether or not the beneficial effect of pomegranate extract is due to the estrogen component are needed.

A case of acute gastric anisakiasis provoking severe clinical problems by multiple infection

Acute gastric anisakiasis with multiple anisakid larvae infection is reported. A 68-year-old woman residing in Busan, Korea, had epigastric pain with severe vomiting about 5 hours after eating raw anchovies. Four nematode larvae penetrating the gastric mucosae in the great curvature of the middle body and fundus were found and removed during gasteroendoscopic examination. Another one thread-like moving larva was found in the great curvature of upper body on the following day. On the basis of their morphology, the worms were identified as the 3rd stage larvae of Anisakis simplex. This case is acute gastric anisakiasis provoking severe clinical problems by the multiple infection and the greatest number of anisakid larvae found in a patient in Korea.

Experience of HLA Antibody Testing in the International Serum Exchange Program / 대한진단검사의학회지

BACKGROUND: When organ transplantation or HLA-matched platelet transfusion is considered, accu-rate identification of HLA antibody specificity in the recipient's serum is very important. In this study, we report our experience in an international quality control program. METHODS: For external quality control in a HLA antibody test, the International Serum Exchange Program distributes serum samples, generally showing polyspecific reactivity for cross-reactive epitope groups (CREGs), to participating laboratories: 4 samples per survey, 10 surveys per year. Participating in the program from May 1998 to August 2000 (24 surveys), we performed HLA antibody identification of 96 serum samples by the AHG-CDC (anti-human globulin-complement dependent cytotoxicity) method using frozen lymphocyte trays (36 lymphocyte panels). We compared the results of our laboratory with those of the total participants (all methods combined, 72 to 92 laboratories per survey) using the analyzed survey results distributed by the program organizer. RESULTS: We analyzed the survey results for the antibodies to relatively common HLA antigens in Koreans (antigen frequency >1%). For the HLA antibodies detected in >or=20% of participants, our detection rate was higher by 10-15% than that of all laboratories (HLA-A, 76% vs 65%; HLA-B, 73% vs 57%). And for the HLA antibodies detected in >or=50% of the participants, our detection rate was as high as 88% for HLA-A and 87% for HLA-B. Our detection rate for a few antibody specificities was lower than that of all laboratories, namely HLA-A1, A3, B35, and B55. Among these, A1, A3, and B55 were of lower incidence antigens in Koreans (antigen frequency 3-4%), indicating that the low detection rate was due to a limitation in the composition of lymphocyte panels. CONCLUSIONS: In general, our detection rate of HLA antibodies was superior to the average detection rate of the total participant laboratories. We would be able to improve the low detection rate for a few antibody specificities to lower incidence antigens by refining the composition of lymphocyte panels.

Analysis of Ambiguities of HLA-DR Typing using the Dynal RELI(TM) SSO HLA-DRB Kit and Development of an 'Interpretation Program for Koreans' / 대한진단검사의학회지

BACKGROUND: HLA-DR typing kits using reverse-SSO (sequence specific oligonucleotide) method show considerable ambiguities in HLA-DRB1 generic typing. We analyzed the ambiguities of the Dynal RELI(TM) SSO HLA-DRB test (Dynal DRB test) and developed an 'Interpretation Program for Koreans'. METHODS: A total of 3,000 Koreans were typed for HLA-DRB1/B3/B4/B5 using the 36 probe Dynal DRB test and all of the cases showing ambiguities in HLA-DRB1 generic typing were subjected to confirmatory typing using the PCR-single strand conformation polymorphism (SSCP) method. On the basis of these results, an 'Interpretation Program for Koreans'was developed for the 45 probe Dynal DRB test. RESULTS: Among 3,000 Koreans tested by the 36 probe Dynal DRB test, 456 cases (15.2%) showed ambiguities. In 95% of the ambiguity cases (433/456) and 99.2% of the total cases tested (433/3,000), the'most probable type'could be expected from the DRB1 gene frequencies and DRB1-B3/B4/B5 associations in Koreans and these results were in accordance with the confirmatory typing results as well as the results given by the 'Interpretation Program for Koreans'. Similarly, the 'Most Probable'could be assigned by the program in 99.4% (348/350) of the cases tested with the 45 probe Dynal DRB test. CONCLUSIONS: Ambiguity in the Dynal DRB test was observed in >15% of the Korean samples tested. The majority (95%) of the ambiguities could be resolved on the basis of HLA-DRB1 gene frequencies and DRB1-B3/B4/B5 associations in Koreans. Furthermore, using the program developed in this study, the correct assignment of DRB1 generic types was possible without additional typing in the majority (>99%) of the cases tested.

Positive Rate of HLA Class I Antibodies in Multiparous Korean Women / 대한임상병리학회지

BACKGROUND: Anti-HLA antibodies are most frequently induced by transfusion or pregnancy, and these anibodies can be used as antisera for HLA typing. However these antibodies may elicit adverse reactions such as transfusion reaction or rejection of transplanted organs. In this study, frequency and specificities of antibodies against HLA class I antigens were determined in multiparous Korean women. METHODS: Sera from 671 multiparous women were tested for anti-HLA antibody screening by standard microlymphocytotoxicity test using 49~50 lymphocyte panels. PRA(panel reactive antibody) values were calculated as percentage of postive panels among total lymphocyte panels tested. HLA antibody specificities and reaction strengths were determined by analysis of serologic reaction patterns. RESULTS: A total of 671 sera were tested and 124 sera(18.5%) were positive for HLA antibodies. Among HLA antibody-positive sera(n=124), 117(94.4%) showed PRA values of 50%. Specificities of HLA antibodies were identified in 51 sera(41.1%) and 18 sera(14.5%) contained reagent quality antibodies(r> or =0.8, SI> or =70%), corresponding to 2.7% of total multiparous women. Among these, 4 sera had monospecific HLA antibodies and 14 sera had HLA antibodies against two or more antigens: 4 sera containing HLA antibodies against 7 CREG(cross reactive group), 5 sera containing antibodies against 5 CREG. CONCLUSION: Through the analysis of frequency and specificity of HLA antibodies in 671 multiparous women, it is concluded that HLA antisera can be obtained from multiparous women as effectively as from pregnant women. The frequency of high level of sensitization(PRA>50%), which can elicit problems in relation to transfusion or organ transplantation, is very low(1.0%).

Comparison of NIH-CDC and AHG-CDC methods for the Detection of Panel Reactive Antibodies / 대한임상병리학회지

BACKGROUND: Panel reactive antibody (PRA) test is used for anti-HLA antibody screening and characterization in patients awaiting organ transplantation. Complement-dependent cytotoxicity (CDC) is the most widely used standard procedure and addition of antihuman globulin (AHG) reagent to the basic (NIH) CDC method increases the sensitivity of detection of HLA antibodies. We compared NIH-CDC and AHG-CDC methods for the detection of HLA class I panel reactive antibodies. METHODS: A total of 314 sera from 253 patients were analysed for the detection of HLA class I antibodies by NIH-CDC and AHG-CDC methods using a panel of 50 lymphocytes. PRA% and reaction strength (mean score) were calculated and antibody specificities were identified with r value calculated for antibody specificity. RESULTS: A total of 46 (15%) out of 314 sera were PRA-positive (PRA%> or =10%) by either NIH-CDC (33 sera) or AHG-CDC (43 sera). Concordance of PRA test results between these two methods was 96% (301/314). AHG-CDC was more sensitive in the detection of HLA antibodies compared with NIH-CDC, showing significantly higher PRA% (44% vs 29%, P=0.0001) and reaction strength (mean score 7.3 vs 6.1, P=0.0015) for PRA-positive samples. Among 46 PRA-positive sera, HLA antibody specificities were identified in 21 samples (46%) by NIH-CDC and in 32 samples (70%) by AHG-CDC. AHG-CDC methods frequently detected a wider range of antibody specificities compared with NIH-CDC and provided a more accurate assessment of the antibody specificities. Follow up PRA tests were useful providing information on change of alloimmunization status and antibody specificities in prospective organ transplantation patients. CONCLUSIONS: Compared with NIH-CDC, AHG-CDC method is more sensitive in the detection of panel reactive antibodies and provides a more accurate assessment of the HLA antibody specificities.

A Study of the core curriculum of family medicine residency Program in Korea

BACKGROUND: In order to provide basic data which are necessary for the standard reference of residency training program in family medicine, we analysed of family practice residency program in Korea(the core curriculum) which has 313 items - diseases and problems - proposed by the Korea Academy of Family Medicine. METHOD: Each items of the core curriculum of family practice residency program In Korea were sorted according to ICD-10. They were the mogt compared to common 100 diseases and clinical cases in family medicine department. of a tertiary hospital in one year. The most common 100 diseases were listed according to ICD-10, also. But some items which were difficult to sort were excluded. Eighty eight types of diseases were sorted.7inical data of a tertiary hospital included 9138 cases. RESULTS: Comparing to clinical cases of a tertiary hospital, the core curriculum includes 93.2% cases of family medicine department of a tertiary hospital. Among the 17 fields of the core curriculum, 12 fields were found in about 50% or more among cases of the clinic and 5 fields were in less than 50% Among 88 diseases, the core curriculum includes 78 diseases. 10 diseases were excluded. In the most common 100 diseases, 12 diseases were related to trauma and the core curriculum did not include them. CONCLUSION: Generally the core curriculum included highly prevalent diseases, but did not include some diseases which is important. Revision to make up for the weak points in the current core curriculum may be necessary.