SARS-CoV-2 Omicron Mutation Is Faster than the Chase: Multiple Mutations on Spike/ACE2 Interaction Residues

Recently, a new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (B.1.1.529) Omicron variant originated from South Africa in the middle of November 2021. SARS-CoV-2 is also called coronavirus disease 2019 (COVID-19) since SARS-CoV-2 is the causative agent of COVID-19. Several studies already suggested that the SARS-CoV-2 Omicron variant would be the fastest transmissible variant compared to the previous 10 SARS-CoV-2 variants of concern, interest, and alert. Few clinical studies reported the high transmissibility of the Omicron variant but there is insufficient time to perform actual experiments to prove it, since the spread is so fast. We analyzed the SARS-CoV-2 Omicron variant, which revealed a very high rate of mutation at amino acid residues that interact with angiostatin-converting enzyme 2. The mutation rate of COVID-19 is faster than what we prepared vaccine program, antibody therapy, lockdown, and quarantine against COVID-19 so far. Thus, it is necessary to find better strategies to overcome the current crisis of COVID-19 pandemic.

The Progression of SARS Coronavirus 2 (SARS-CoV2): Mutation in the Receptor Binding Domain of Spike Gene

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is a positive-sense singlestranded RNA (+ssRNA) that causes coronavirus disease 2019 (COVID-19). The viral genome encodes twelve genes for viral replication and infection. The third open reading frame is the spike (S) gene that encodes for the spike glycoprotein interacting with specific cell surface receptor – angiotensin converting enzyme 2 (ACE2) – on the host cell membrane. Most recent studies identified a single point mutation in S gene. A single point mutation in S gene leading to an amino acid substitution at codon 614 from an aspartic acid 614 into glycine (D614G) resulted in greater infectivity compared to the wild type SARS-CoV2. We were interested in investigating the mutation region of S gene of SARS-CoV2 from Korean COVID-19 patients. New mutation sites were found in the critical receptor binding domain (RBD) of S gene, which is adjacent to the aforementioned D614G mutation residue. This specific sequence data demonstrated the active progression of SARS-CoV2 by mutations in the RBD of S gene.The sequence information of new mutations is critical to the development of recombinant SARS-CoV2 spike antigens, which may be required to improve and advance the strategy against a wide range of possible SARS-CoV2 mutations.

The Progression of SARS Coronavirus 2 (SARS-CoV2): Mutation in the Receptor Binding Domain of Spike Gene

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is a positive-sense singlestranded RNA (+ssRNA) that causes coronavirus disease 2019 (COVID-19). The viral genome encodes twelve genes for viral replication and infection. The third open reading frame is the spike (S) gene that encodes for the spike glycoprotein interacting with specific cell surface receptor – angiotensin converting enzyme 2 (ACE2) – on the host cell membrane. Most recent studies identified a single point mutation in S gene. A single point mutation in S gene leading to an amino acid substitution at codon 614 from an aspartic acid 614 into glycine (D614G) resulted in greater infectivity compared to the wild type SARS-CoV2. We were interested in investigating the mutation region of S gene of SARS-CoV2 from Korean COVID-19 patients. New mutation sites were found in the critical receptor binding domain (RBD) of S gene, which is adjacent to the aforementioned D614G mutation residue. This specific sequence data demonstrated the active progression of SARS-CoV2 by mutations in the RBD of S gene.The sequence information of new mutations is critical to the development of recombinant SARS-CoV2 spike antigens, which may be required to improve and advance the strategy against a wide range of possible SARS-CoV2 mutations.

Guideline for the prevention and management of particulate matter/Asian dust particle-induced adverse health effect on the patients with pulmonary diseases

The aim of this study was to develop guidelines for the prevention and management of particulate matter (PM)/Asian dust particle (ADP)-induced adverse effects in patients with pulmonary diseases. The guideline development committee reviewed the literature on particulate matter, ADP, and pulmonary diseases. In adults, exposure to particulate matter with a diameter of 10 microm or less (PM10) induces a decline in lung function. PM exposure confers an increased risk of lung cancer, and PM10 is associated with increased hospital admission and mortality due to chronic obstructive pulmonary disease. ADP exposure is associated with increased hospital admission and emergency room visits due to chronic obstractive pulmonary disease exacerbation. Idiopathic pulmonary fibrosis exacerbation may also be induced by pollution, although the evidence for this is very weak. There is no published study on the proper prevention or management of the exacerbation of pulmonary diseases due to PM or ADP exposure. The preventive use of a facial mask with a filter in patients with pulmonary disease should be considered carefully because there have been no clinical study of the efficacy and adverse effects of masks in pulmonary diseases. The committee created guidelines based on a discussion of the peer-reviewed literature. The proper management of PM- and ADP-induced exacerbation of pulmonary disease and the efficacy of facial mask use should be evaluated in future studies.

Concept and importance of patient identification for patient safety

Patient identification (PI) errors have been one of the most serious global healthcare quality issues for patient safety. Errors in PI are the root causes of many adverse events. Patient identification is the very first International Patient Safety Goal; however the current healthcare system is not culturally or structurally organized for preventing PI errors. The general procedures for the prevention of PI errors include using at least two identifiers, checking of accurate wristbands, standardizing the PI process, and eliminating shortcuts. Standardized protocols such as a good surgical site mark, a surgical checklist, the mandatory 'time-out', and the rule of the five rights for safe medication should be applied. For example, the surgical checklists have significantly improved mortality and decreased complications from surgery. During patient interactions, patients should be treated as partners in efforts to prevent all avoidable harm in healthcare. For example, patients should state their identifiers rather than be asked to confirm their identifiers. All healthcare professionals should receive training in patient safety concepts and strategies to enhance patient participation. For the future prevention of PI errors, patient photographs on wristbands, barcodes, biometric markers, fingerprints, retina scans, radiofrequency identification chips, and framework checklists for identifying a range of clinical care processes will ideally be available to healthcare professionals for improving patient safety and clinical outcomes. The changes are sometimes not pleasant but if we have to accept the changes, the changes should be started from me for the safety of everyone and every time in all healthcare services.

Concept and importance of patient identification for patient safety

Patient identification (PI) errors have been one of the most serious global healthcare quality issues for patient safety. Errors in PI are the root causes of many adverse events. Patient identification is the very first International Patient Safety Goal; however the current healthcare system is not culturally or structurally organized for preventing PI errors. The general procedures for the prevention of PI errors include using at least two identifiers, checking of accurate wristbands, standardizing the PI process, and eliminating shortcuts. Standardized protocols such as a good surgical site mark, a surgical checklist, the mandatory 'time-out', and the rule of the five rights for safe medication should be applied. For example, the surgical checklists have significantly improved mortality and decreased complications from surgery. During patient interactions, patients should be treated as partners in efforts to prevent all avoidable harm in healthcare. For example, patients should state their identifiers rather than be asked to confirm their identifiers. All healthcare professionals should receive training in patient safety concepts and strategies to enhance patient participation. For the future prevention of PI errors, patient photographs on wristbands, barcodes, biometric markers, fingerprints, retina scans, radiofrequency identification chips, and framework checklists for identifying a range of clinical care processes will ideally be available to healthcare professionals for improving patient safety and clinical outcomes. The changes are sometimes not pleasant but if we have to accept the changes, the changes should be started from me for the safety of everyone and every time in all healthcare services.

Two Cases of Adenoid Cystic Carcinoma of Trachea / 결핵

Adenoid cystic carcinoma formerly called cylindroma is rare tracheal tumor. Characteristics of adenoid cystic carcinoma are infiltrative nature with local recurrence tendency and long natural course of the disease. Adenoid cystic carcinomas develop most commonly in the trachea. Primary resection and end-to-end anastomosis of the involved airway are treatment of choice. And postoperative radiation therapy might be useful, particularly when the surgical margins are not ample. We report two cases of adenoid cystic carcinoma of trachea diagnosed by flow-volume curve.