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Background/Aims This study aimed to investigate the timing and predictors of death during treatment among patients with multidrug/rifampin-resistant tuberculosis (MDR/RR-TB) in South Korea. Methods This was a retrospective cohort study that included MDR/RR-TB cases notified between 2011 and 2017 in South Korea. Results Among 7,226 MDR/RR-TB cases, 699 (9.7%) died at a median of 167 days (IQR 51–358 d) from the initiation of MDR-TB treatment. The cumulative proportion of all-cause death was 35.5% at 90 days and 52.8% at 180 days from treatment initiation. TB-related deaths occurred at a median of 133 days (IQR 32–366 d), which was significantly earlier than the median of 184 days (IQR 68–356 d) for non-TB-related deaths (p = 0.002). In a multivariate analysis, older age was the factor most strongly associated with death, with those aged ≥ 75 years being 68 times more likely to die (aHR 68.11, 95% CI 21.75–213.26), compared those aged ≤ 24 years. In addition, male sex, comorbidities (cancer, human immunodeficiency virus, and end stage renal disease), the lowest household income class, and TB-specific factors (previous history of TB treatment, smear positivity, and fluoroquinolone resistance) were identified as independent predictors of all-cause death. Conclusions This nationwide study highlights increased deaths during the intensive phase and identifies high-risk groups including older people and those with comorbidities or socioeconomic vulnerabilities. An integrated and comprehensive strategy is required to reduce mortality in patients with MDR/RR-TB, particularly focusing on the early stages of treatment and target populations.

Background/Aims To determine whether metformin, which is considered a host-directed therapy for tuberculosis (TB), is effective in improving the prognosis of patients with TB and diabetes mellitus (DM), who have higher mortality than those without DM. Methods This cohort study included patients who were registered as having TB in the National Tuberculosis Surveillance System. The medical and death records of matched patients were obtained from the National Health Information Database and Statistics Korea, respectively, and data from 2011 to 2017 were collected retrospectively. We classified patients according to metformin use among participants who used diabetes drugs for more than 28 days. The primary outcome was all-cause mortality during TB treatment. Double propensity score adjustment was applied to reduce the effects of confounding and multivariable Cox proportional hazard models were used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI). Results The all-cause mortality rate during TB treatment was lower (9.5% vs. 12.4%, p < 0.01) in the metformin user group. The hazard of death due to all causes after double propensity score adjustment was also lower in the metformin user group (aHR 0.76, 95% CI 0.67–0.86, p < 0.01). There was no significant difference in mortality between metformin users and non-users for TB-related deaths (p = 0.22); however, there was a significant difference in the non-TB-related deaths (p < 0.01). Conclusions Metformin use in patients with TB–DM co-prevalence is associated with reduced all-cause mortality, suggesting the potential for metformin adjuvant therapy in these patients.

Abstract Coherent light detection and ranging (LiDAR), particularly the frequency-modulated continuous-wave LiDAR, is a robust optical imaging technology for measuring long-range distance and velocity in three dimensions (3D). We propose a spatio-spectral coherent LiDAR based on a unique wavelength-swept laser to enable both axial coherent ranging and lateral spatio-spectral beam scanning simultaneously. Instead of the conventional unidirectional wavelength-swept laser, a flutter-wavelength-swept laser (FWSL) successfully decoupled bidirectional wavelength modulation and continuous wavelength sweep, which overcame the measurable distance limited by the sampling process. The decoupled operation in FWSL enabled sequential sampling of flutter-wavelength modulation across its wide spectral bandwidth of 160 nm and, thus, allowed simultaneous distance and velocity measurement over an extended measurable distance. Herein, complete four-dimensional (4D) imaging, combining real-time 3D distance and velocity measurements, was implemented by solid-state beam scanning. An acousto-optic scanner was synchronized to facilitate the other lateral beam scanning, resulting in an optimized solid-state coherent LiDAR system. The proposed spatio-spectral coherent LiDAR system achieved high-resolution coherent ranging over long distances and real-time 4D imaging with a frame rate of 10 Hz, even in challenging environments.

Abstract Objective This study ascertains the effects of the pre-entry tuberculosis (TB) screening policy, which was implemented as a strategy for managing TB among immigrants, on the treatment outcomes of immigrants in South Korea. Methods This study linked three different datasets from 2013 to 2018, namely (1) Korean National Tuberculosis Surveillance System; (2) National Health Information Database for patients diagnosed with TB with ICD code A15-A19, B90, or U84.3; and (3) Statistics Korea database related to cause of deaths. To identify the effect of the policy, cohorts comprising Korean and immigrant TB patients notified before (January 1, 2013–December 31, 2015) and after (September 1, 2016–December 31, 2018), the implementations of the policy were established. A difference-in-differences (DID) analysis of the treatment success and mortality rates was performed. Results Data from 100,262 TB patients were included in the analysis (before policy implementation: 1240 immigrants and 65,723 Koreans; after policy implementation: 256 immigrants and 33,043 Koreans). The propensity score matching-DID analysis results showed that the difference in the treatment success rate between immigrants and Koreans decreased significantly, from 16% before to 6% after the policy implementation. The difference in the mortality rate between the two groups decreased from − 3% before to − 1% after the policy implementation; however, this difference was insignificant. Conclusion The treatment outcomes of immigrant TB patients in South Korea improved after the implementation of the pre-entry active TB screening policy. Future immigrant TB policies should consider establishing active patient support strategies and a healthcare collaboration system between countries.

BackgroundUniversal health coverage and social protection are major global goals for tuberculosis. This study aimed to investigate the effects of an expanded policy to guarantee out-of-pocket costs on the treatment outcomes of patients with tuberculosis.MethodsBy linking the national tuberculosis report and health insurance data and performing covariate-adjusted propensity-score matching, we constructed data on health insurance beneficiaries (treatment group) who benefited from the out-of-pocket payment exemption policy and medical aid beneficiaries as the control group. Using difference-in-differences analysis, we analyzed tuberculosis treatment completion rates and mortality in the treatment and control groups.ResultsA total of 41,219 persons (10,305 and 30,914 medical aid and health insurance beneficiaries, respectively) were included in the final analysis (men 59.6%, women 40.4%). Following the implementation of out-of-pocket payment exemption policy, treatment completion rates increased in both the treatment and control groups; however, there was no significant difference between the groups (coefficient, −0.01; standard error, 0.01). After the policy change, the difference in mortality between the groups increased, with mortality decreasing by approximately 3% more in the treatment group compared with in the control group (coefficient: −0.03, standard error, 0.01).ConclusionThere are limitations to improving treatment outcomes for tuberculosis with an out-of-pocket payment exemption policy alone. To improve treatment outcomes for tuberculosis and protect patients from financial distress due to the loss of income during treatment, it is essential to proactively implement complementary social protection policies.

This study aims to propose a method for constructing basic digital twin data in South Korea by adhering to international standards and by utilizing publicly available data. Specifically, the study focuses on designing and proposing a digital twin data model for buildings, as building-related digital twin data are the most applicable among the basic digital twin data. To achieve this, the first section provides essential background information, introduces concepts and requirements related to basic digital twin data, and offers a brief overview of City Geography Markup Language (CityGML). The second section explains the methodology and the data used in this study. The third section presents the main findings: the selection of public data (building data) for constructing basic digital twin data, the mapping process using CityGML, and the creation of Unified Modeling Language (UML) diagrams. The fourth section discusses these findings. Finally, the conclusion and recommendations for future research are provided. This approach enhances the accuracy of building-related digital twin data and supports the use of digital twin services in both public and private sectors by enabling various spatial analyses.

Background Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

Background The fixed-dose combination (FDC) for first-line antituberculosis (TB) treatment has long been a standard practice worldwide; however, there is limited evidence on whether the use of FDC improves long-term treatment outcomes in the real-world setting.Methods We identified 32 239 newly diagnosed patients with drug-susceptible (DS) TB in 2015 and 2016 who had been prescribed FDC or non-FDC TB treatment from a multiyear (2013–2018) national TB cohort database that linked the Korean National Tuberculosis Surveillance System, the National Health Insurance Database and the Health Insurance Review and Assessment Service database. Inverse probability of treatment weighting (IPTW) with a propensity score was used to control for differences in patient characteristics between 5926 patients with TB treated with FDC and 26 313 patients with non-FDC. Multivariable logistic regression analyses were performed to assess for the factors influencing treatment outcomes between the two groups.Results After IPTW, new patients with DS-TB treated with FDC had higher treatment completion rate (83.9% vs 78.9%, p

The current study evaluated carbon dioxide (CO2) emissions from beef and pork production and distribution chains in the South Korean meat industry. Data from industrial example farms and slaughterhouses were assessed on the basis of both the guidelines from the United Kingdom’s Publicly Available Specification (PAS) 2050:2011 and the Korea Environmental Industry & Technology Institute carbon footprint calculation. The main factors for our estimations were animal feeds, manure waste, transportation, energy and water, refrigerants, and package data. Our analyses show that 16.55 kg CO2 equivalent (eq) was emitted during the production of 1 kg of live cattle. When retail yields and packing processes were considered, the CO2-eq of 1 kg of packaged Hanwoo beef was 27.86 kg. As for pigs, emissions from 1 kg of live pigs and packaged pork meat were 2.62 and 12.75 kg CO2-eq, respectively. While we gathered data from only two farms and slaughterhouses and our findings can therefore not be extrapolated to all meats produced in the South Korean meat industry, they indicate that manure waste is the greatest factor affecting ultimate CO2 emissions of packaged meats.

Objectives: Whether diabetes mellitus (DM) increases tuberculosis (TB) recurrence risk is debatable. We determined the effect of DM on TB recurrence. Methods: This retrospective nationwide cohort study included patients with TB who successfully completed TB treatment during 2011-2017 and were followed up for TB recurrence until August 2020. We performed subdistribution hazard model analyses stratified by sex to assess DM risk related to TB recurrence after successful treatment. Results: Of 199,571 participants who had received successful TB treatment, 47,952 (24%) had DM. There were more men (64.4%), positive acid-fast bacilli smears (35.9%), and positive cultures (49.5%) in the DM group. There were 6208 (3.1%) TB recurrences during 5.1 years of follow-up: 38.9% and 26.6% occurred 1 and 1-2 years after treatment completion, respectively. The recurrence rate was higher in the DM group (3.8%) than in the non-DM group (2.9%, P

Background This study evaluated the risk factors of long-term mortality in patients with multidrug/rifampicin-resistant tuberculosis (MDR/RR-TB) in South Korea who were lost to follow-up (LTFU). Methods This was a retrospective longitudinal follow-up study using an integrated database constructed by data linkage of the three national databases, which included 7226 cases of MDR/RR-TB notified between 2011 and 2017 in South Korea. Post-treatment outcomes of patients who were LTFU were compared with those of patients who achieved treatment success. Results Of the 7226 MDR/RR-TB cases, 730 (10.1%) were LTFU. During a median follow-up period of 4.2 years, 101 (13.8%) of the LTFU patients died: 25 deaths (3.4%) were TB related and 76 (10.4%) were non-TB related. In the LTFU group, the adjusted hazard ratio (aHR) of all-cause mortality (aHR 2.50, 95% CI 1.99–3.15, p55 years, fluoroquinolone resistance, cancer and no retreatment. In the LTFU patients who did not receive retreatment, the risk of non-TB-related mortality (aHR 5.00, 95% CI 1.53–16.37, p=0.008) and consequent all-cause mortality (aHR 2.18, 95% CI 1.08–4.40, p=0.030) was significantly higher than that of patients who received retreatment. Conclusion Non-TB-related mortality was the main cause of death and might be reduced by retreatment in LTFU patients with MDR/RR-TB.

Abstract Compartmentalization is a ubiquitous feature of life, with a membrane interface that regulates molecular transport and exhibits bioactivities. An artificial enzyme‐integrated membrane cascade system can mimic such interactive properties across different length scales for in vitro application. Here, it is shown that a reticulated nanoporous framework membrane with nano‐caged enzymes presents the first modular macroscale platform for the compartmentalized biocatalytic system interfaced with an external medium. Catalase (CAT)‐integrated polyurea membrane scaffold is prepared by a simple pressurization procedure for a model cyclic cascade of glucose oxidase/catalase (GOx/CAT). The bicontinuous nanoporous membrane readily constructs a compartmentalized system interfacing the glucose/GOx solution and the external environment and mediates glucose oxidation by a cascade reaction under anaerobic or aerobic conditions. Furthermore, the membrane compartment exhibits multiple bioactive capabilities and barrier properties, including hydrogen peroxide detoxification, in situ oxygen generation, and protease exclusion. This work suggests a new strategy toward a robust modular biocatalytic membranous interface to mediate biochemical reaction cascades occurring in a compartment interfaced to an external environment, promising for potential applications in biohybrid devices embedded with tissues and cells.

We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.

This study investigated the effect of localized electrical stimulation on Hanwoo beef quality. It focused on the chemical and physical properties of the Longissimus thoracis (LT) and Biceps femoris (BF) muscles, and it explored the implications of carbon dioxide (CO2) reduction achieved by accelerating tenderization via localized electrical stimulation. The results show that the application of localized electrical stimulation (45 V) had no significant impact on the TBARS (thiobarbituric acid reactive substances) of either the LT muscle or the BF muscle. Localized electrical stimulation and aging treatments had a significant effect on meat tenderness in the LT and BF muscles, but there was no interactive effect. In particular, the WBsf (Warnar–Bratzler shear force) at 2 days of aging of the electrically stimulated BF muscle was 5.35 kg, which was lower than that of the control group (5.58 kg) after 14 days of aging; however, the effect of WBsf reduction due to aging in the LT muscle was higher than the localized electrical stimulation effect. Estimating CO2 mitigation from a shorter feeding period for Hanwoo steers from 31 months to 26 months may reduce 1.04 kg of CO2-eq emissions associated with the production of a single kilogram of trimmed beef. In conclusion, localized electrical stimulation improved the tenderness of Hanwoo beef and reduced CO2 emissions.

Objectives This study aimed to identify the prevalence of diabetes mellitus (DM) among patients with tuberculosis (TB) using a nationwide cohort in South Korea.Design A retrospective cohort study.Setting This study used the Korean Tuberculosis and Post-Tuberculosis cohort, which was constructed by linking the Korean National Tuberculosis Surveillance, National Health Information Database (NHID) and Statistics Korea data for the causes of death.Participants During the study period, all notified patients with TB with at least one claim in the NHID were included. Exclusion criteria were age less than 20 years, drug resistance, initiation of TB treatment before the study period and missing values in covariates.Outcome measures DM was defined as having at least two claims of the International Classification of Diseases (ICD) code for DM or at least one claim of the ICD code for DM and prescription of any antidiabetic drugs. Newly diagnosed DM (nDM) and previously diagnosed DM (pDM) were defined as DM diagnosed after and before TB diagnosis, respectively.Results A total of 26.8% (70 119) of patients were diagnosed with DM. The age-standardised prevalence increased as age increased or income decreased. Patients with DM were more likely to be men, older, had the lowest income group, had more acid-fast bacilli smear and culture positivity, had a higher Charlson Comorbidity Index score and had more comorbidities compared with patients without DM. Approximately 12.5% (8823) patients had nDM and 87.4% (61 296) had pDM among those with TB-DM.Conclusions The prevalence of DM among patients with TB was considerably high in Korea. To achieve the goal of TB control and improve the health outcomes of both TB and DM, integrated screening of TB and DM and care delivery in clinical practice are necessary.

The coexistence of tuberculosis and other chronic diseases complicates disease management. Particularly, the lack of information on the difference in the prevalence of chronic diseases in tuberculosis based on age and gender can hinder the establishment of appropriate public health strategies. This study aimed to identify age- and gender-based differences in the prevalence of chronic diseases as comorbidities in patients with tuberculosis. An anonymized data source was established by linking the national health insurance claims data to the Korean national tuberculosis surveillance data from 2014 to 2018. The prevalence of chronic diseases was stratified by gender and age (age groups: ≤64, 65-74, and ≥75 years), and the differences in the prevalence of chronic diseases were analyzed by multinomial logistic regression and classified using the Charlson Comorbidity Index. A total of 148,055 patients with tuberculosis (61,199 women and 86,856 men) were included in this study. Among the patients aged ≥65 years, 48.2% were female and 38.1% were male. In this age group, the probability of chronic disease comorbidity was higher in female patients than in male patients. The prevalence of congestive heart failure and dementia as comorbidities in patients with tuberculosis increased more drastically with age in women than in men. Thus, the present study confirmed gender and age differences in the distribution of comorbidities among patients with tuberculosis. A more comprehensive gender-responsive approach for patients with tuberculosis and chronic diseases is required to alleviate the double burden of infectious diseases and non-communicable diseases in an aging society.

Abstract Background Approximately one-fourth of the global population is latently infected with Mycobacterium tuberculosis. An understanding of the burden of latent tuberculosis infection (LTBI) among immigrants compared with the general Korean population should be the first step in identifying priority groups for LTBI diagnosis and treatment. The study aimed to compute the age-standardized LTBI prevalence and predictors among immigrants with LTBI in South Korea. Methods In 2018, the Korea Disease Control and Prevention Agency implemented a pilot LTBI screening project for immigrants using a chest radiography and the QuantiFERON Gold In-Tube assay. A standardized prevalence ratio (SPR) was computed to compare the LTBI burden in immigrants and the general Korean population. Results During the duration of the project, a total of 8108 immigrants (5134 males and 2974 females) underwent LTBI screening. The SPR of 1.547 (95% confidence interval [CI] 1.468–1.629) in males and 1.261 (95% CI 1.177–1.349) in females were both higher than the Korean reference population. Furthermore, among the immigrants, those aged

Objective Prevention of tuberculosis (TB) recurrence is an important issue in TB control. South Korea, a country with a high average income, has been challenged with an intermediate burden of TB. We aimed to estimate the TB recurrence rate after successful completion of the first anti-TB chemotherapy, and to identify the risk factors for the TB recurrence by focusing on co-morbidities and behavioral factors. Methods This is a population-based cohort study using data from the National Health Insurance (NHI) database between 2002 and 2013. Newly diagnosed TB patients were identified using the classification of disease codes and prescription records. Final analytical subjects included people who successfully completed the first anti-TB chemotherapy. The primary outcome measure was recurrent TB 6-month after the first treatment completion. A set of associated risk factors, including demographic characteristics, co-morbidities, and health behavior factors were analyzed using Cox regression analysis. Results Among 5,446 TB patients, 2,226 (40.1%) completed the first anti-TB treatment. During the follow-up period, 150 (6.7%) patients had TB recurrence, and the crude recurrent rate was 22.6 per 1000 person-years. The majority of recurrence cases (89%) occurred within the first 2-year period. The major findings show that participants who are male (adjusted HR (aHR) = 1.81, at a 95% CI, range: 1.11–2.94), older in age (aHR = 1.07, at a 95% CI, range: 1.00–1.14), have a lower income (aHR = 1.96, at a 95% CI, range: 1.10–3.48) and who are underweight (aHR = 1.92, at a 95% CI, range 1.15–3.20) were at higher risks for TB recurrence. Conclusion People who have risk factors for recurrent TB need to improve treatment compliance through more effective TB management, and follow-up observation for one or two years after the treatment completion.

ObjectivePrevention of tuberculosis (TB) recurrence is an important issue in TB control. South Korea, a country with a high average income, has been challenged with an intermediate burden of TB. We aimed to estimate the TB recurrence rate after successful completion of the first anti-TB chemotherapy, and to identify the risk factors for the TB recurrence by focusing on co-morbidities and behavioral factors.MethodsThis is a population-based cohort study using data from the National Health Insurance (NHI) database between 2002 and 2013. Newly diagnosed TB patients were identified using the classification of disease codes and prescription records. Final analytical subjects included people who successfully completed the first anti-TB chemotherapy. The primary outcome measure was recurrent TB 6-month after the first treatment completion. A set of associated risk factors, including demographic characteristics, co-morbidities, and health behavior factors were analyzed using Cox regression analysis.ResultsAmong 5,446 TB patients, 2,226 (40.1%) completed the first anti-TB treatment. During the follow-up period, 150 (6.7%) patients had TB recurrence, and the crude recurrent rate was 22.6 per 1000 person-years. The majority of recurrence cases (89%) occurred within the first 2-year period. The major findings show that participants who are male (adjusted HR (aHR) = 1.81, at a 95% CI, range: 1.11-2.94), older in age (aHR = 1.07, at a 95% CI, range: 1.00-1.14), have a lower income (aHR = 1.96, at a 95% CI, range: 1.10-3.48) and who are underweight (aHR = 1.92, at a 95% CI, range 1.15-3.20) were at higher risks for TB recurrence.ConclusionPeople who have risk factors for recurrent TB need to improve treatment compliance through more effective TB management, and follow-up observation for one or two years after the treatment completion.

The objective of the present study was to investigate if the policy for contracting out the Korean influenza National Immunization Program (NIP) for individuals aged ≥ 65 years affects a reduction in vaccination inequality based on gender and socioeconomic position (SEP). In South Korea, initially only public health centers provided influenza vaccination for free; however, starting from the fall of 2015, the program was expanded to include private medical institutions. The policy was expected to improve overall vaccination rate and reduce its inequality, through improving access to vaccination. The present study analyzed how the gap in the vaccination rate changed between before and after contracting out. A multivariate logistic regression model stratified by gender and SEP of individuals aged ≥ 65 years was used. The study also analyzed changes in the unvaccinated rates between before and after contracting out based on an interrupted time series model. The gap in the unvaccinated rate based on SEP present prior to contracting out of the NIP for individuals aged ≥ 65 years did not decrease afterwards. In particular, the step changes were 0.94% (95% confidence interval [CI]: 0.00, 1.89) and 1.34% (95% CI: 1.17, 1.52) in men and women, respectively. In the pre-policy period, among women, the unvaccinated rate of the medical aid beneficiaries group was 1.22-fold higher (95% CI: 1.12, 1.32) than that of the health insurance beneficiaries, and the difference was not reduced post-policy implementation (odds ratio: 1.27, 95% CI: 1.20, 1.36). The findings of the study were that contracting out of the NIP was not effective in improving vaccination rate nor resolving vaccination inequality. Future studies should focus on identifying the mechanism of vaccination inequality and exploring measures for resolving such inequality.

Background: Ginsenoside Rg3, a derivative of steroidal saponins abundant in ginseng, has a range of effects on cancer cells, including anti-cell proliferation and anti-inflammation activity. Here, we investigate two long noncoding RNAs (lncRNAs), STXBP5-AS1 and RFX3-AS1, which are hypomethylated and hypermethylated in the promoter region by Rg3 in MCF-7 cancer cells. Methods: The lncRNAs epigenetically regulated by Rg3 were mined using methylation array analysis. The effect of the lncRNAs on the apoptosis and proliferation of MCF-7 cells was monitored in the presence of Rg3 or Korean Red Ginseng (KRG) extract after deregulating the lncRNAs. The expression of the lncRNAs and their target genes was examined using qPCR and Western blot analysis. The association between the expression of the target genes and the survival rate of breast cancer patients was analyzed using the Kaplan-Meier Plotter platform. Results: STXBP5-AS1 and RFX3-AS1 exhibited anti- and pro-proliferation effects, respectively, in the cancer cells, and the effects of Rg3 and KRG extract on apoptosis and cell proliferation were weakened after deregulating the lncRNAs. Of the genes located close to STXBP5-AS1 and RFX3-AS1 on the chromosome, STXBP5, GRM1, RFX3, and SLC1A1 were regulated by the lncRNAs on the RNA and protein level. Breast cancer patients that exhibited a higher expression of the target genes of the lncRNAs had a higher metastasis-free survival rate. Conclusion: The current study is the first to identify lncRNAs that are regulated by the presence of Rg3 and KRG extract and that subsequently contribute to inhibiting the proliferation of cancer cells. Keywords: CpG methylation, ginsenoside Rg3, long noncoding RNA, Korean Red Ginseng

Background: Ginsenoside Rh2 has been known to enhance the activity of immune cells, as well as to inhibit the growth of tumor cells. Although the repertoire of genes regulated by Rh2 is well-known in many cancer cells, the epigenetic regulation has yet to be determined, especially for comprehensive approaches to detect methylation changes. Methods: The effect of Rh2 on genome-wide DNA methylation changes in breast cancer cells was examined by treating cultured MCF-7 with Rh2. Pyrosequencing analysis was carried out to measure the methylation level of a global methylation marker, LINE1. Genome-wide methylation analysis was carried out to identify epigenetically regulated genes and to elucidate the most prominent signaling pathway affected by Rh2. Apoptosis and proliferation were monitored to examine the cellular effect of Rh2. Results: LINE1 showed induction of hypomethylation at specific CpGs by 1.6–9.1% (p

Chromatic confocal microscopy (CCM) has been intensively developed because it can exhibit effective focal position scanning based on the axial chromatic aberration of broadband light reflected from a target. To improve the imaging speed of three-dimensional (3D) surface profiling, we have proposed the novel concept of swept-source-based CCM (SS-CCM) and investigated the usefulness of the corresponding imaging system. Compared to conventional CCM based on a broadband light source and a spectrometer, a swept-source in the proposed SS-CCM generates light with a narrower linewidth for higher intensity, and a single photodetector employed in the system exhibits a fast and sensitive response by immediately obtaining spectrally encoded depth from a chromatic dispersive lens array. Results of the experiments conducted to test the proposed SS-CCM system indicate that the system exhibits an axial chromatic focal distance range of approximately 360 μm for the 770–820 nm swept wavelength range. Moreover, high-speed surface profiling images of a cover glass and coin were successfully obtained with a short measurement time of 5 ms at a single position.

In relation to anti-inflammatory agents from medicinal plants, we have isolated three compounds from Atractylodes macrocephala; 1, 2-[(2E)-3,7-dimethyl-2,6-octadienyl]-6-methyl-2, 5-cyclohexadiene-1, 4-dione; 2, 1-acetoxy-tetradeca-6E,12E-diene-8, 10-diyne-3-ol; 3, 1,3-diacetoxy-tetradeca-6E, 12E-diene-8, 10-diyne. Compounds 1–3 showed concentration-dependent inhibitory effects on production of nitric oxide (NO) and prostaglandin E2 (PGE2) in lipopolysaccharide (LPS)-activated RAW 264.7 macrophages. Western blotting and RT-PCR analyses demonstrated that compounds 1–3 suppressed the protein and mRNA levels of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Furthermore, compounds 1–3 inhibited transcriptional activity of nuclear factor-κB (NF-κB) and nuclear translocation of NF-κB in LPS-activated RAW 264.7 cells. The most active compound among them, compound 1, could reduce the mRNA levels of pro-inflammatory cytokines (IL-1β, IL-6 and TNF-α) and suppress the phosphorylation of MAPK including p38, JNK, and ERK1/2. Taken together, these results suggest that compounds 1–3 from A. macrocephala can be therapeutic candidates to treat inflammatory diseases.