Effectiveness of Convalescent Plasma Therapy in Severe or Critically Ill COVID-19 Patients:A Retrospective Cohort Study

Purpose@#Coronavirus disease-2019 (COVID-19) is a novel respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); there are few specific treatments. Convalescent plasma (CP), donated by people who have recovered from COVID-19, is an investigational therapy for severe or critically ill patients with COVID-19. @*Materials and Methods@#This retrospective cohort study evaluated the effectiveness of CP therapy in patients with severe or lifethreatening cases of COVID-19 at two hospitals in Seoul, Korea, between May and September 2020. Clinical outcomes were evaluated in 20 patients with CP therapy in a descriptive manner. Additionally, the changes in cycle threshold (Ct) values of 10 patients with CP therapy were compared to those of 10 controls who had the same (±0.8) initial Ct values but did not receive CP. @*Results@#Of the 20 patients (mean age 66.6 years), 18 received high-dose oxygen therapy using mechanical ventilators or high-flow nasal cannulas. Systemic steroids were administered to 19 patients who received CP. The neutralizing antibody titers of the administered CP were between 1:80 and 1:10240. There were two ABO-mismatched transfusions. The World Health Organization ordinal scale score and National Institutes of Health severity score improved in half of the patients within 14 days. Those who received CP showed a higher increase in Ct values at 24 h and 72 h after CP therapy compared to controls with similar initial Ct values (p=0.002).No transfusion-related side effects were observed. @*Conclusion@#CP therapy may be a potential therapeutic option in severe or critically ill patients with COVID-19.

Early Life Events and Development of Gut Microbiota in Infancy / 대한소화기학회지

With its dynamic composition and function, the gut microbiome plays a key role in human development and long-term health. The first 2 years of life are crucial to the early establishment of the gut microbiome. During early life, the gut microbial composition rapidly changes and multiple factors influence the initial colonization, development, and function of the neonatal gut microbiome. In addition, alterations in early-life gut microbial composition linked to necrotizing enterocolitis in infancy, as well as some chronic diseases in later, including obesity, inflammatory bowel disease, cancer, allergies, asthma, and neurological diseases associated with the gut-brain axis. In this review, we focus on both maternal and infant factors known to influence early-life gut colonization.

Effectiveness of Convalescent Plasma Therapy in Severe or Critically Ill COVID-19 Patients:A Retrospective Cohort Study

Purpose@#Coronavirus disease-2019 (COVID-19) is a novel respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); there are few specific treatments. Convalescent plasma (CP), donated by people who have recovered from COVID-19, is an investigational therapy for severe or critically ill patients with COVID-19. @*Materials and Methods@#This retrospective cohort study evaluated the effectiveness of CP therapy in patients with severe or lifethreatening cases of COVID-19 at two hospitals in Seoul, Korea, between May and September 2020. Clinical outcomes were evaluated in 20 patients with CP therapy in a descriptive manner. Additionally, the changes in cycle threshold (Ct) values of 10 patients with CP therapy were compared to those of 10 controls who had the same (±0.8) initial Ct values but did not receive CP. @*Results@#Of the 20 patients (mean age 66.6 years), 18 received high-dose oxygen therapy using mechanical ventilators or high-flow nasal cannulas. Systemic steroids were administered to 19 patients who received CP. The neutralizing antibody titers of the administered CP were between 1:80 and 1:10240. There were two ABO-mismatched transfusions. The World Health Organization ordinal scale score and National Institutes of Health severity score improved in half of the patients within 14 days. Those who received CP showed a higher increase in Ct values at 24 h and 72 h after CP therapy compared to controls with similar initial Ct values (p=0.002).No transfusion-related side effects were observed. @*Conclusion@#CP therapy may be a potential therapeutic option in severe or critically ill patients with COVID-19.

Early Life Events and Development of Gut Microbiota in Infancy / 대한소화기학회지

With its dynamic composition and function, the gut microbiome plays a key role in human development and long-term health. The first 2 years of life are crucial to the early establishment of the gut microbiome. During early life, the gut microbial composition rapidly changes and multiple factors influence the initial colonization, development, and function of the neonatal gut microbiome. In addition, alterations in early-life gut microbial composition linked to necrotizing enterocolitis in infancy, as well as some chronic diseases in later, including obesity, inflammatory bowel disease, cancer, allergies, asthma, and neurological diseases associated with the gut-brain axis. In this review, we focus on both maternal and infant factors known to influence early-life gut colonization.

Effects of Physical Activity on Fractures in Adults: A Community-Based Korean Cohort Study / 대한스포츠의학회지

Regular exercise and a certain level of physical activity reduce the mortality rate in the elderly. The purpose of this study was to investigate the effect of physical activity on the prevention of fracture in the middle aged or older in Korea. The basic data are based on the Ansan and Ansung community cohort studies of the Korean Genome and Epidemiology Study conducted by the Korea Centers for Disease Control and Prevention in 2001, and the fracture data from the third survey in 2005 to the sixth survey in 2011. The physical activity of the aged in the 40s was mostly distributed in the World Health Organization (WHO) recommended range of 7.5 to 30.0 metabolic equivalent·hr/wk, and the activity was gradually divided into the low and high groups in the 50s and 60s. In the 60s, the risk of fracture was reduced to 0.63 times compared to that of the 50s when physical activity was the recommended level (odds ratio, 0.63; p<0.001). For Korean adults, there was no significant difference in fracture incidence according to the amount of physical activity in the middle-aged people. However, for the elderly aged 60 and over, the risk of fracture decreased when the WHO recommended level of activity was performed, and the risk increased when less or more activities were performed.

Homicidal Paraquat Poisoning in Exhumed Case / 대한법의학회지

Paraquat is a nonselective herbicide, but its lethal and toxic effects are well known. Although its chemical additives have an unpleasant taste, this can be shrouded in spicy foods or drinks with strong tastes, and some symptoms and signs of paraquat poisoning can be mistaken as natural disease. For this reason, it is not easy to consider the possibility of homicidal paraquat poisoning for a clinician or even for a forensic pathologist. We present a case of homicidal poisoning by paraquat with significant forensic findings from postmortem examination and with a review of relevant literature.

Comparison of the Clinical Manifestations and Prognosis of Henoch-Schonlein Purpura in Children with and without Abdominal Pain / 대한소아소화기영양학회지

PURPOSE: We compared the clinical manifestations and prognosis of Henoch-Schonlein Purpura (HSP) in children with and without abdominal pain to investigate the usefulness of endoscopy. METHODS: We retrospectively studied 185 HSP inpatients (group A [with abdominal pain] and group N [without abdominal pain]) who had been admitted to the BundangCHA hospital between 2001 and 2010. We compared clinical manifestations, laboratory findings and endoscopic and ultrasonographic findings. RESULTS: Of the 185 children, 112 (60.5%) had abdominal pain and 31 (16.8%) presented with abdominal pain before developing cutaneous purpura. Group A patients were older (6.9+/-3.5 vs. 5.3+/-3.3 years), had higher rates of positive results for stool occult blood (53.8%, p<0.001), and had longer hospital stays (5.2+/-4.2 vs. 3.6+/-2.5 days) than group N patients. Group A had a higher frequency of renal involvement than group N on admission (p=0.047). Ultrasonography showed small bowel wall thickening in 31 cases (43.7%) and increased Doppler flow in the bowel wall in 22 cases (31%) in Group A. Upper gastrointestinal endoscopy revealed HSP - related lesions in the stomach (25 cases) and duodenum (19 cases). The second portion of the duodenum was a more common lesion site than the duodenal bulb. Ultrasonography showed abnormalities in 13 of 19 patients with duodenal lesions. Recurrence was more common in Group A. CONCLUSION: These results suggest that recurrence and renal involvement are more common in HSP patients with abdominal pain. Upper gastrointestinal endoscopy could be a useful diagnostic tool for HSP patients who develop abdominal pain before cutaneous purpura.

Death After Accidental Injection of Tranexamic Acid During Spinal Anesthesia / 대한법의학회지

Medication errors such as administration of wrong drugs, wrong dosage and erroneous route of administration are not rare among medical misadventures. We present an autopsy case of accidental injection of tranexamic acid instead of bupivacaine during spinal anesthesia, accompanying the quantitative result of the tranexamic acid in the blood, cerebrospinal fluid and each internal organs. We think that warning signs on syringes and ampoules, simple and unified guideline for drug administration, separative documentation of drug administration and interpersonal communication on drug information should be done to prevent this type of medical errors.