Search

The main goal of this article is to analyze the conditions under which South Korea would decide to go nuclear. It seeks to examine the key factors that would trigger Seoul's decision for nuclear‐arming. The article contends that South Korea is likely to go nuclear under the following conditions: where South Koreans' demands for nuclear weapons continue to rise despite US security assurances; where Pyongyang's threats of its nuclear weapons attacks are increasingly directed towards Seoul as opposed to Washington; where US security assurances for South Korea become highly questionable; and where potential nearby proliferators (Japan and Taiwan, in particular) go nuclear. Any single one of these conditions might not be enough for Seoul's decision to nuclearize, but when at least any two of them are fulfilled at the same time, South Korea is highly likely to go nuclear. [ABSTRACT FROM AUTHOR]

There have been few studies comparing the clinical characteristics and outcomes of SARS-CoV-2 pneumonia in individuals with and without moderately to severely immunocompromised conditions. We reviewed adult patients with SARS-CoV-2 infection who had radiologic evidence of pneumonia at a tertiary hospital in Seoul, South Korea, from February 2020 to April 2022. Moderately to severely immunocompromised status was defined as medical conditions or treatments that resulted in increased risk of severe COVID-19 and weakened immune response to COVID-19 vaccine as recommended by Centers for Disease Control and Prevention. The time to pneumonia development was defined as the time from symptom onset to the time when radiologic evidence of pneumonia was obtained. Viral clearance was defined as a Ct value > 30. COVID-19-related death was defined as 90-day death following imaging-confirmed pneumonia without any other plausible cause of death. A total of 467 patients with SARS-CoV-2 pneumonia were analyzed. Of these, 102 (22%) were moderately to severely immunocompromised. The median (IQR) time to pneumonia development was significantly longer in moderately to severely immunocompromised patients (9.5 [6–14] days) than the comparator (6 [3–8] days), p < 0.001), as was the median time to viral clearance (21 versus 12 days, p < 0.001). Moderately to severely immunocompromised status (aOR, 18.39; 95% CI, 5.80–58.30; p < 0.001) was independently associated with COVID-19-related death. Patients with moderately to severely immunocompromised conditions are likely to experience a more protracted course of SARS-CoV-2 pneumonia and a worse outcome than those without these conditions. [ABSTRACT FROM AUTHOR]

Background: The use of beta-tricalcium phosphate (beta-TCP) in dental surgery is limited owing to its rapid absorption compared to mixed formulations of hydroxyapatite. However, newly developed pure beta-TCP crystals have demonstrated slow absorption; hence, they last longer within the defect and act as a scaffold until new bone formation. The oral environment is unique and can prove unfavorable for bone grafts due to the high infection rate in the oral cavity and the fragile condition of the oral mucosa. The aim of this study was to evaluate the feasibility of using pure beta-TCP bone grafts in various dental treatments. Methods: Panoramic X-ray images of 25 patients who underwent bone grafting during dental surgery were analyzed. A specially treated pure beta-TCP crystal, Neo Bone® (Neo Bone®, SN Biologics Co., Ltd, Seoul, Korea), was used in this study. The bone density at the graft site was compared with that of the surrounding bone using the ImageJ software (Wayne Rasband, NIH USA). Results: Six months after surgery, the bone graft density was similar to that of the surrounding bone in 20 patients and increased in 5 patients. No adverse effects, such as infection, dehiscence, or graft failure, were observed. Conclusion: The newly developed pure beta-TCP crystal was slowly absorbed and served as support until new bone formation at the defect site, thus demonstrating its potential for use in various oral conditions requiring bone grafting. [ABSTRACT FROM AUTHOR]

Insulin injections are stressful but necessary for people with diabetes. This study aimed to develop and validate the Distress of Self-Injection (DSI) scale for patients with diabetes aged ≥ 10 years. We created a questionnaire to evaluate DSI after examining each item following a literature review. The DSI scale with 20 questions in three domains (physical [4], psychosocial [7], and process [9]) was developed and tested at the Samsung Medical Center in Seoul, Korea, from April to September 2021. To verify structural validity, exploratory and confirmatory factor analyses (CFA) were conducted. Internal consistency was also calculated. To assess construct and criterion validity, the correlation between the DSI scale and Korean version of the Problem Areas in Diabetes (PAID-K) scale was obtained. Cronbach's alpha varied from 0.69 to 0.87, and the DSI score was 0.90, demonstrating acceptable internal consistency. CFA fit indices (CFI = 0.980; RMSEA = 0.033) were favorable. DSI and pertinent PAID-K domains correlated strongly. For measuring self-injection distress, the DSI score had good accuracy. For patients with diabetes aged ≥ 10 years who self-inject insulin, the DSI was a viable and accurate method for quantifying discomfort associated with insulin injection. Health practitioners should use the DSI to communicate with patients about their suffering. [ABSTRACT FROM AUTHOR]

Background: Organising pneumonia (OP) is reported in patients with haematologic malignancy suspected of having invasive mould disease, yet little is known about this relationship. Objective: To investigate molecular evidence of invasive mould pneumonia in paraffin‐embedded lung tissues from histologically diagnosed OP patients with suspected invasive mould pneumonia. Patients/Methods: Patients with haematologic malignancy suspected to have invasive pulmonary mould disease who underwent lung biopsy at a tertiary hospital, Seoul, South Korea, between 2008 and 2020, were retrospectively reviewed. To find molecular evidence of fungal infection, PCR assay was used to detect Aspergillus‐ and Mucorales‐specific DNA within OP lung tissue sections. Results: Forty‐seven patients with suspected invasive mould pneumonia underwent lung biopsy and 15 (32%) were histologically diagnosed as OP without any evidence of fungal hyphae. Of these 15 patients, 3 (20%) received allogenic haematopoietic stem cell transplantation prior to developing OP. Before biopsy, 2 and 13 patients had probably and possible invasive mould disease, respectively. The median antifungal treatment length was 81 [8–114] days, and the median steroid treatment dosage was 0.35 mg/kg/day for 36 days (methylprednisolone equivalent doses), respectively. After biopsy, three patients with possible invasive mould infection revealed probable invasive pulmonary aspergillosis. From the 15 paraffin‐embedded lung tissues, 6 (40%) exhibited positive PCR assay results for detecting Aspergillus‐ and Mucorales‐specific DNA. Conclusions: More than one third of OP cases in patients with suspected invasive mould pneumonia exhibited molecular evidence of invasive mould infection by fungus‐specific PCR in lung tissues, likely associated with concurrent or prior fungal infection. [ABSTRACT FROM AUTHOR]

Introduction: Glucose monitoring-related problems affect the social and psychological distress experienced by patients with diabetes, and this distress leads to low compliance. Consequently, it is important to be able to comprehensively assess distress due to glucose monitoring in these patients. We have developed and validated a distress of self-glucose monitoring (DSGM) scale instrument to assess patient distress from glucose monitoring. Methods: Following an extensive literature review and qualitative study, we selected 21 items for assessing the DSGM, including physical, psychosocial, and process domains. We conducted a cross-sectional study in patients with insulin-treated diabetes aged 10–40 years at Samsung Medical Center, Seoul, Korea, from April 2021 to September 2021. Exploratory and confirmatory factor analyses (CFA) were performed to confirm the structural validity of the DSGM scale. To confirm construct and criterion validity, we assumed that the Korean version of the Problem Areas in Diabetes (PAID-K) instrument, life interference, and stress due to glucose monitoring might moderately correlate with the total score and scores of all domains of the DSGM scale except for the physical domain. Results: Cronbach's alpha coefficients for the DSGM scale were 0.92, and Cronbach's alpha coefficients of the three subscales ranged from 0.69 to 0.92, indicating satisfactory internal consistency. The DSGM scale was evaluated using CFA, and the fit indices for this model were good. The PAID-K total score, life interference, and stress due to glucose monitoring were moderately correlated with the total score of the DSGM scale and with the scores of the psychosocial and process domains, and were weakly correlated with the score of the physical domain of the DSGM scale. Conclusion: The DSGM scale is a valid and reliable tool to evaluate distress due to glucose monitoring in adults, adolescents, and children with diabetes. [ABSTRACT FROM AUTHOR]

Background: Invasive fusariosis mainly affects immunocompromised patients including haematopoietic stem cell transplant recipients and those with haematologic malignancy. There are limited studies on invasive fusariosis in the Asia‐Pacific region. Objective: To describe the clinical characteristics and outcomes of invasive and non‐invasive fusariosis in South Korea. Patients/Methods: From 2005 to 2020, patients with fusariosis who met the revised European Organisation for Research and Treatment of Cancer and the Mycoses Study Group criteria for the definition of proven or probable invasive fusariosis, and those with non‐invasive fusariosis were retrospectively reviewed in a tertiary medical centre in Seoul, South Korea. Results: Overall, 26 and 75 patients had invasive and non‐invasive fusariosis, respectively. Patients with invasive fusariosis commonly had haematologic malignancy (62%), were solid organ transplant recipients (23%), and had a history of immunosuppressant usage (81%). In non‐invasive fusariosis, diabetes mellitus (27%) and solid cancer (20%) were common underlying conditions. Disseminated fusariosis (54%) and invasive pulmonary disease (23%) were the most common clinical manifestations of invasive fusariosis; skin infection (48%) and keratitis (27%) were the most common manifestations of non‐invasive fusariosis. Twenty‐eight‐day and in‐hospital mortalities were high in invasive fusariosis (40% and 52%, respectively). In multivariate analysis, invasive fusariosis (adjusted odds ratio, 9.6; 95% confidence interval 1.3–70.8; p =.03) was an independent risk factor for 28‐day mortality. Conclusions: Patients with invasive fusariosis were frequently immunocompromised, and more than half had disseminated fusariosis. Invasive fusariosis was associated with poor prognosis. [ABSTRACT FROM AUTHOR]

Background: To validate a stratification method using an inverse of treatment decision rules that can classify non-small cell lung cancer (NSCLC) patients in real-world treatment records. Methods: (1) To validate the index classifier against the TNM 7th edition, we analyzed electronic health records of NSCLC patients diagnosed from 2011 to 2015 in a tertiary referral hospital in Seoul, Korea. Predictive accuracy, stage-specific sensitivity, specificity, positive predictive value, negative predictive value, F1 score, and c-statistic were measured. (2) To apply the index classifier in an administrative database, we analyzed NSCLC patients in Korean National Health Insurance Database, 2002–2013. Differential survival rates among the classes were examined with the log-rank test, and class-specific survival rates were compared with the reference survival rates. Results: (1) In the validation study (N = 1375), the overall accuracy was 93.8% (95% CI: 92.5–95.0%). Stage-specific c-statistic was the highest for stage I (0.97, 95% CI: 0.96–0.98) and the lowest for stage III (0.82, 95% CI: 0.77–0.87). (2) In the application study (N = 71,593), the index classifier showed a tendency for differentiating survival probabilities among classes. Compared to the reference TNM survival rates, the index classification under-estimated the survival probability for stages IA, IIIB, and IV, and over-estimated it for stages IIA and IIB. Conclusion: The inverse of the treatment decision rules has a potential to supplement a routinely collected database with information encoded in the treatment decision rules to classify NSCLC patients. It requires further validation and replication in multiple clinical settings. [ABSTRACT FROM AUTHOR]

Urban floods caused by expanding impervious areas due to urban development and short-term heavy precipitation adversely affect many coastal cities. Notably, Seoul, one of the coastal cities that experiences acute urban floods, suffers annually from urban floods during the rainfall season. Consequently, to mitigate the impacts of urban floods in Seoul, we established flood-vulnerable areas as target areas where green infrastructure planning was applied using the Stormwater Runoff Reduction Module (SRRM). We selected the Gangdong, Gangbuk, and Dobong districts in Seoul, Korea, all of which demonstrate high flood vulnerability. Analyses in reducing the runoff amount and peak time delay effect were estimated by model simulation using the SRRM. The reduction in peak discharge for the whole area occurred in the following order: Gangdong district, then Gangbuk district, and lastly Dobong district. In contrast, the reduction in peak discharge per unit area was most prominent in Gangbuk district, followed by Dobong and Gangdong districts. However, the delay effect was almost identical in all target areas. Based on the simulation results in this study, we planned green infrastructure, including green roofs, infiltration storage facilities, and porous pavement. We believe that the results of this study can significantly enhance the efficiency of urban flood restoration and green infrastructure planning in coastal cities. [ABSTRACT FROM AUTHOR]

Data analysis and collection techniques now allow for detailed inventory‐building of urban rooftops for the purposes of identifying solar energy potential within geographically defined boundaries, including those of cities. The complexity and inherent diversity of a city's building stock has propelled the introduction of many so‐called "solar city" assessment methods that, with varying levels of accuracy, scalability, and ease of use, seek to characterize the citywide solar photovoltaic (PV) resource potential. A review of the landscape of available methods supports a fundamental distinction across two classes of methods. First, "solar city" assessment methods can principally rely on inference to identify and characterize rooftop solar potential. Such inferential methods can establish estimates of citywide solar potential without needing direct insight into rooftop conditions or morphology, Second, measurement‐based methods estimate rooftop solar opportunities based on the direct measurement of rooftop conditions, often conducted through remote sensing. Comparative performance testing of several inferential‐ and measurement‐based methods using case study analysis underscores the importance of measurement‐based methods. In particular, measurement‐based methods are likely better positioned to support the needs of policy‐makers and investors interested in transforming a city or metropolitan area into a sustainable city whose buildings serve as the host of a new solar PV‐powered distributed electricity service system. This article is categorized under:Sustainable Energy > Solar EnergyEnergy and Power Systems > Energy InfrastructureCities and Transportation > Smart Cities [ABSTRACT FROM AUTHOR]

This study is to evaluate the clinical characteristics and outcomes of Enterococcus raffinosus bacteremia in adults. We analyzed the medical records of adult patients with E. raffinosus bacteremia who were diagnosed and treated between 1997 and 2020 at a tertiary care teaching hospital in Seoul, Republic of Korea. The demographic, clinical, and laboratory data were collected and assessed. A total of 49 cases of E. raffinosus bacteremia were identified. E. raffinosus accounted for 0.6% of all enterococcal bacteremia events, and the incidence was 0.02 cases per 1,000 admissions. Of the 49 cases of E. raffinosus bacteremia, 35 (71.4%) had underlying malignancy. The biliary tract was the most common source of infection (81.6%, 40/49) and polymicrobial bacteremia was found in 25 cases (51.0%). The resistance rates of E. raffinosus bacteremia cases to penicillin, ampicillin, vancomycin, and linezolid were 61.2%, 49.0%, 2.0%, and 0%, respectively. In our case series, there was one case of vanA-type vancomycin-resistant E. raffinosus. The all-cause 60-day mortality rate was 22.4% (11/49), and the E. raffinosus bacteremia-related mortality rate was 4.1% (2/49). Cases of E. raffinosus bacteremia mainly originated from biliary tract infection and had a low rate of bacteremia-related mortality. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the diagnostic usefulness of real‐time (RT) polymerase chain reaction (PCR) on blood samples for diagnosis of invasive aspergillosis and mucormycosis in patients with suspected invasive mould infection. Methods: Adult patients with suspected invasive mould infection were prospectively enrolled at a tertiary referral hospital in Seoul, South Korea between 2017 and 2020. Standard tests for diagnosis of invasive mould infection and RT‐PCR for Aspergillus, Mucor and Rhizopus using blood samples were performed. We evaluated the diagnostic performance of RT‐PCR tests in patients diagnosed with proven and probable invasive aspergillosis or mucormycosis infection, according to the modified definitions of the EORTC/MSG 2019. Results: A total of 102 patients with suspected invasive mould infection were enrolled. Of these patients, 46 (45%) were classified as having proven (n = 13) or probable (n = 33) invasive aspergillosis, 21 (21%) as proven (n = 17) or probable (n = 4) invasive mucormycosis and 18 (18%) as possible invasive mould infection. The remaining 13 (13%) were classified as not having invasive mould infection. Patients with possible invasive mould infection (n = 18) and coinfection of aspergillosis and mucormycosis (n = 4) were excluded from the final analysis. The sensitivity and specificity of the Aspergillus PCR were 54.3% ([25/46], 95% confidence interval [CI]: 40.2–67.9%) and 94.1% ([32/34], 95% CI: 80.9–98.4%), respectively. The sensitivity and specificity of the Mucor or Rhizopus PCR were 57.1% ([12/21], 95% CI: 36.6–75.5%) and 76.3% ([45/59], 95% CI: 64.0–85.3), respectively. Conclusions: Our study suggests that blood PCR can be a useful adjunct test for diagnosing patients with suspected invasive mould infection. [ABSTRACT FROM AUTHOR]

Background and objectives: There are limited data in real clinical practice on the diagnostic value of a bronchoalveolar lavage (BAL) fluid galactomannan (GM) assay in patients with suspected invasive pulmonary aspergillosis (IPA) who had negative serum GM results. Thus, we investigated the diagnostic performance of a BAL GM assay in patients with negative serum GM assay results who were suspected to have IPA. Methods: This retrospective study was performed between May 2008 and April 2019 at a tertiary‐care hospital in Seoul, South Korea. All patients with suspected IPA whose serum GM assays revealed negative results who sequentially underwent BAL were enrolled in this study. Results: A total of 341 patients with suspected IPA including four cases of proven IPA, 38 cases of probable IPA, 107 cases of possible IPA and 192 patients without IPA were enrolled. Of these 341 patients, 107 (31%) with possible IPA were excluded from the final analysis. Of 42 patients with proven and probable IPA who had initial negative serum GM results, 24 (57%) had positive BAL GM results (n = 24) or BAL fungal culture results (n = 8). In addition, BAL revealed evidence of other opportunistic infections including Pneumocystis jirovecii pneumonia (14% [26/190]), cytomegalovirus (CMV) pneumonia (5% [9/188]) and respiratory viral pneumonia (6% [12/193]). Conclusion: Sequential BAL in patients with suspected IPA who had initial negative serum GM results provided additional diagnostic yield in approximately half of patients with evidence of another co‐infection. [ABSTRACT FROM AUTHOR]

Of various rodent-borne hantaviruses, Seoul orthohantavirus (SEOV) causes haemorrhagic fever with renal syndrome (HFRS), as does Hantaan orthohantavirus (HTNV). Given global-scale of cases of human infection with SEOV, it is of great clinical importance to distinguish SEOV from other HFRS-causing hantaviruses. In May 2019, a middle-aged patient who had lived in a suburban area of Chungcheong Province, Republic of Korea and enjoyed outdoor activities was transferred to Asan Medical Center in Seoul, Republic of Korea with HFRS; his symptoms included high fever and generalized myalgia. The rapid diagnostic test performed immediately after his transfer detected HTNV-specific antibodies, and the patient was treated accordingly. However, two consecutive IFAs performed at ten-day intervals showed no HTNV-specific immunoglobulin (Ig) G. During continuous supportive care, next-generation sequencing successfully identified viral genomic sequences in the patient's serum, which were SEOV and not HTNV. Phylogenetic analysis grouped the L, M, and S genes of this SEOV strain together with those of rat- or human-isolated Korean strains reported previously. Given global outbreaks and public health threats of zonotic hantaviruses, a causative pathogen of hantavirus HFRS should be identified correctly at the time of diagnosis and by point-of-care testing. Author summary: Rodent-borne Seoul orthohantavirus (SEOV) has provoked human cases from Asia to the Americas and Europe whereas most orthohantaviruses cause regional cases. Despite this, SEOV gets less attention than other orthohantaviruses. In Korea, 2019, a middle-aged man was initially diagnosed with Hantaan orthohantavirus (HTNV) and treated accordingly. However, next-generation sequencing identified SEOV, not HTNV, in the patient's serum. Given its global outbreaks and public health threats, zoonotic SEOV should be diagnosed correctly on point of care to reduce unnecessary medical costs. [ABSTRACT FROM AUTHOR]

The impact of industrial activities on atmospheric volatile organic compounds (VOCs) in the Sihwa-Banwol complexes, i.e., the largest industrial area in Korea, was investigated. More than 60 VOCs were determined from 850 samples collected from four sites in and around the complexes through a 2-year monitoring campaign from 2005 to 2007. The VOCs of particular concern found in the area were benzene, toluene, ethylbenzene, xylenes, trichloroethylene, and formaldehyde, given their toxicity, concentration, and detection frequency. Toluene was the most abundant one. The VOC concentration rankings were consistent with their emission rankings. Most VOCs had higher concentrations at the industrial sites than at residential sites, indicating a significant impact of industrial emissions. The ambient levels of benzene and formaldehyde were additionally affected by vehicular emissions and secondary formation, respectively. Overall, the VOC levels increased in winter and at night, because of the local weather conditions. In contrast, the formaldehyde concentration increased in summer, owing to its secondary formation in the atmosphere. The ambient VOC levels in Sihwa-Banwol were higher than those in other parts of Korea. Additionally, the cumulative cancer risks posed by the toxic VOCs exceeded a tolerable risk level of 1 × 10−4 in not only the industrial areas but also the residential areas. The sum of the non-cancer risks in both areas significantly exceeded the threshold criterion of 1. The large amounts of aromatic compounds emitted from the industrial complexes are believed to play a crucial role in the elevated levels of surface ozone in the Seoul metropolitan area during the summer season. Therefore, comprehensive measures for controlling the VOC emissions in the Sihwa-Banwol area need to be prioritized to reduce the health risks for residents of not only this area but also the capital Seoul and its surrounding areas. [ABSTRACT FROM AUTHOR]

Background: Pulmonary mucormycosis (PM) represents a serious burden in terms of morbidity and mortality in immunocompromised patients. Studies of prognostic factors in patients with PM are limited and have involved small numbers of patients. Methods: Adult patients diagnosed with proven and probable PM according to the modified definitions of the EORTC/MSG 2008 in a tertiary hospital in Seoul, South Korea, between 2008 and 2019 were retrospectively enrolled. Results: A total of 49 patients including 31 (63%) with proven PM and 18 (37%) with probable PM were enrolled. The 90‐day mortality rate was 49% (24/49). Neutropenia, thrombocytopenia, use of voriconazole at clinical suspicion, positivity of non‐sterile culture, use of steroid and treatment without surgery were more common in fatal cases than non‐fatal cases. Voriconazole use at clinical suspicion for invasive mould pneumonia (OR 6.91, P =.01) and prolonged neutropenia (OR 4.86, P =.03) were independent risk factors for mortality. Voriconazole use at clinical suspicion was associated with positive galactomannan (GM) assay (OR 5.93, P =.02) and history of invasive pulmonary aspergillosis (OR, 6.88, P =.05). Conclusion: About half of the patients with PM died within 90 days of diagnosis, and fatal outcomes were common in patients with prolonged neutropenia and empirical voriconazole use. Caution is needed in using voriconazole even in patients with positive GM results and prior histories of invasive pulmonary aspergillosis in whom PM cannot be ruled out by differential diagnosis. [ABSTRACT FROM AUTHOR]

Parainfluenza virus (PIV) infection is a significant cause of morbidity and mortality, especially in hematologic malignancy patients including hematopoietic stem cell transplantation (HCT) recipients. However, limited information is available for risk stratification in PIV-infected patients with hematologic malignancy with or without HCT. Patients with hematologic malignancy diagnosed with PIV from January 2009 to December 2018 were retrospectively included in a tertiary care hospital in Seoul, South Korea. Upper respiratory tract infection (URTI) was defined as the detection of PIV in a nasopharyngeal sample with URTI symptoms without new pulmonary infiltrates. Lower respiratory tract infection (LRTI) was defined as detection of PIV in either upper or lower respiratory tract samples with new pulmonary infiltrates, with or without hypoxia. PIV-associated mortality was defined as death with respiratory failure and persistent LRTI within 90 days after diagnosis. The study included 143 adult patients. Of these, 55 (38%) progressed to or initially presented with LRTI. Among these, 22 (40%) died from PIV-associated mortality. An immunodeficiency risk score was developed from associated risk factors using a multivariable Cox regression model. Patients were stratified into low (0-2), moderate (3-5), and high risk (6-8) groups with PIV-associated mortalities of 0%, 9%, and 67%, respectively (p < 0.005, Harrell's C-index = 0.84). PIV infection can result in substantial mortality in patients with hematologic malignancy if it progresses to LRTI. The immunodeficiency risk score presented here may be useful for distinguishing moderate and high risk groups that might benefit from antiviral therapy. [ABSTRACT FROM AUTHOR]

Scabies is a highly contagious parasitic disease associated with long-term residence in nursing homes, and it is a public health burden worldwide. However, atypical skin manifestations are frequent and the widely used diagnostic test based on microscopic examinations has limited sensitivity. We evaluated the diagnostic value of polymerase chain reaction (PCR) from skin scraping in patients with suspected scabies. Adult patients with suspected scabies, unrelated diseases or healthy volunteers were enrolled at a tertiary hospital, in Seoul, South Korea, from December 2017 through October 2018. We classified participants based on the consensus criteria established by the International Alliance for the Control of Scabies in 2018; confirmed (microscopic mite detection), clinical (scabies burrow or typical lesions with two history features including itch and close contact with scabies patients), suspected scabies (typical lesion with one history feature or atypical lesion with two history features), or no scabies. PCR was performed on the skin scrapings to target the cytochrome c oxidase subunit 1 (cox1) gene of Sarcoptes scabiei. A total of 47 participants, 33 with suspected scabies, 10 with unrelated diseases, and 4 healthy volunteers were enrolled. Of the 33 patients, 22 were classified as confirmed scabies, 2 as clinical scabies, 6 as suspected scabies, and 3 as no scabies. The sensitivities of the microscopic examination were 100%, 92%, and 73% in confirmed scabies; confirmed and clinical scabies; and confirmed, clinical, and suspected scabies, respectively (p = 0.006). The sensitivities of PCR were 86%, 83%, and 80% in confirmed scabies; confirmed and clinical scabies; and confirmed, clinical, and suspected scabies, respectively (p = 0.59). The specificity of the scabies PCR in the no scabies control was 100% (95% CI = 80–100).PCR testing for scabies may be helpful in the improvement of sensitivity for the diagnosis of scabies by clinical criteria. Author summary: Scabies occasionally presents in atypical forms causing a delay in diagnosis, which can lead to the outbreaks in residential and nursing care for elderly people. We hypothesized that polymerase chain reaction (PCR) detection of Sarcoptes scabiei DNA directly has higher sensitivity than microscopic examination. Recently, clinical consensus criteria have been proposed by the International Alliance for the Control of Scabies (IACS) to overcome the low sensitivities of conventional diagnostic tests for scabies. We thus evaluated the diagnostic capability of in-house real-time PCR for the diagnosis of scabies from skin scraping in subjects with suspected scabies and with unrelated disease according to the criteria of the IACS. We found that the diagnostic sensitivity of scabies PCR maintained between 86% and 80% as the level of diagnostic certainty by the IACS criteria decreased, while the diagnostic sensitivity of microscopic examinations decreased from 100% to 73% as the level of diagnostic certainty by the IACS criteria decreased. Our data suggested that our in-house scabies PCR test was a useful adjunct in the improvement for the diagnosis of scabies by the consensus criteria. [ABSTRACT FROM AUTHOR]

Background: Due to the low sensitivity of mould culture, clinicians usually depend on the histomorphologic diagnosis of invasive mould infection for empirical antifungal therapy. However, definite diagnosis is not always possible based on the mould morphology. We thus compared the histomorphologic diagnosis with immunohistochemistry (IHC)- and culture-based diagnosis. Methods: All adult patients who underwent tissue biopsy and in whom the histomorphologic diagnosis revealed invasive mould infection were enrolled at a tertiary hospital, Seoul, South Korea, between 1992 and 2014 (retrospectively) and 2015 and 2019 (prospectively). Their histomorphologic diagnoses were classified as two categories: (1) acute-angled branching, septate hyphae with parallel walls and a uniform width ('morphologic aspergillosis') and (2) right-angled branching pauciseptate, broader and ribbon-like hyphae with nonparallel walls ('morphologic mucormycosis'). Results: A total of 113 patients were finally analysed and their histomorphologic diagnoses were classified as follows: 51 (45%) with morphologic aspergillosis, 62 (55%) with morphologic mucormycosis. Of the 51 patients with morphologic aspergillosis, 46 (90%) received the same diagnosis based on culture and/or IHC, and the remaining five (10%) gave positive IHC result for mucormycosis. Of the 62 patients with morphologic mucormycosis, 60 (97%) had the same diagnosis based on culture and/or IHC, and the remaining two (3%) yielded a positive aspergillus culture or a positive IHC result for aspergillosis, respectively. Conclusions: The majority of histomorphologic diagnoses appear to be consistent with definitive diagnoses based on sterile culture and IHC tests. However, about 10% of 'morphologic aspergillosis' diagnoses were mucormycosis cases. [ABSTRACT FROM AUTHOR]

For centuries, South Korea has been a largely homogenous society. In recent decades, however, South Korea has experienced an influx of immigrants and refugees, raising the need to understand the needs and challenges facing this vulnerable population and the extent to which nongovernmental organizations (NGOs) play a role in the integration process. This study explores this issue through a qualitative exploratory study of 20 NGOs in Seoul, South Korea who serve immigrants and refugees. Findings indicate that NGOs play a critical role through a diverse set of services, but their efforts are challenged by lack of support and collaboration from other cross-sector actors. [ABSTRACT FROM AUTHOR]

Background: There have been various efforts to identify less costly but still accurate methods for monitoring the response to HIV treatment. We evaluated a pooling method to determine if this could improve screening efficiency and reduce costs while maintaining accuracy in Seoul, South Korea. Methods: We conducted the first prospective study of pooled nucleic acid testing (NAT) using a 5 minipool + algorithm strategy versus individual viral load testing for patients receiving antiretroviral therapy (ART) between November 2011 and August 2012 at an urban hospital in Seoul, South Korea. The viral load assay used has a lower level of detection of 20 HIV RNA copies/ml, and the cost per assay is US$ 136. The 5 minipool +algorithm strategy was applied and 43 pooled samples were evaluated. The relative efficiency and accuracy of the pooled NAT were compared with those of individual testing. Results: Using the individual viral load assay, 15 of 215 (7%) plasma samples had more than 200 HIV RNA copies/ml. The pooled NAT using the 5 minipool + algorithm strategy was applied to 43 pooled samples; 111 tests were needed to test all samples when virologic failure was defined at HIV RNA ≥ 200 copies/ml. Therefore, 104 tests were saved over individual testing, with a relative efficiency of 0.48. When evaluating costs, a total of US$ 14,144 was saved for 215 individual samples during 10 months. The negative predictive value was 99.5% for all samples with HIV RNA ≥ 200 copies/ml. Conclusions: The pooled NAT with 5 minipool + algorithm strategy seems to be a very promising approach to effectively monitor patients receiving ART and to save resources. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate the dimensions of the bony cochlear nerve canal (BCNC) in congenital unilateral sensorineural hearing loss (USNHL) patients with normal inner ears, and to analyze the correlation between BCNC and hearing status. Medical records and temporal bone computed tomography (TBCT) findings of 380 patients who visited Seoul National University Hospital between January 1999 and December 2007 were reviewed retrospectively. The length and width of the BCNC at the fundus of the internal auditory canal were measured in millimeters based on the axial view of TBCT for three ear groups: normal inner ears of control group subjects (group A, 179 ears), normal inner ears on the contralateral side of USNHL patients (group B, 201 ears), and the affected inner ears in USNHL (group C, 201 ears). The mean values of length and width in group C (0.79 ± 0.36 and 1.58 ± 0.83 mm, respectively) were significantly smaller than those in group A (1.07 ± 0.10 and 2.38 ± 0.28 mm, respectively; p < 0.001) and group B (1.04 ± 0.23 and 2.33 ± 0.39 mm, respectively; p < 0.001). The receiver operating characteristic curves for BCNC were conducted to estimate the cutoff values from which the proportions of profound hearing loss increased, compared to those of mild to severe hearing loss. The areas under the curve were 0.487 ± 0.044 (p = 0.781) and 0.622 ± 0.041 (p = 0.011) for length and width, respectively. The cutoff value of width with a sensitivity of 90% for profound USNHL was 1.16 mm in otherwise normal inner ears. Clinicians would be recommended to take a close look at BCNC as one of the possible causes of hearing loss in otherwise normal inner ears of USNHL on TBCT. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In 2009, a survey of 177 samples of fish and fishery products from the markets in Seoul was carried out to investigate total mercury and organic mercury (methylmercury) concentrations and to establish a correlation, if any, between total and organic mercury levels. Concentrations of total and organic mercury in canned tuna ranged 0.001–2.581 and 0.003–1.307 mg/kg, respectively; those for fish, such as cod or salmon, ranged 0.012–2.529 and 0.021–0.507 mg/kg, respectively. Ethylmercury was not detected. More than 50% of total mercury in the samples existed as organic mercury. The correlation coefficients (r 2) between total mercury and methylmercury concentrations of fish and fishery products found to have methylmercury were 0.844 and 0.976, respectively, which was statistically significant. There was a higher correlation in fishery products than in fish. Although there was no product in which mercury exceeded the standard set by the Food Code in 2008, with the exception of marlin steak, a processed food, which contained 1.307 mg/kg methylmercury. None exceeded the provisional tolerable weekly intake (PTWI) for mercury. Collectively, the results indicate that fish or fishery products marketed in Seoul, with the exception of marlin, have low levels of total or organic mercury and, thus, intake of these products is not a risk to public health. [ABSTRACT FROM PUBLISHER]

Background Candidemia is one of the fatal causes of nosocomial infection, requiring prompt recognition and treatment. Echinocandins are recommended for the treatment of invasive candidiasis and candidemia. Although similar clinical efficacy and safety are well known between caspofungin and micafungin, there are few studies comparing micafungin and anidulafungin. The objective of this study was to evaluate the clinical efficacy and safety between micafungin and anidulafungin treatment for adult patients with candidemia. Methods This retrospective cohort study was performed on adult candidemia patients diagnosed from January 2006 through December 2018 at a tertiary medical center, Seoul, South Korea. The study subjects included adult patients ≥19 years with candidemia who were only treated with micafungin or anidulafungin for more than 3 days. Baseline and clinical characteristics were reviewed through electrical medical records. Liver function was assessed according to Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Hepatotoxicity was defined as the elevation of more than CTCAE grade 1 and severe hepatotoxicity was defined as the CTCAE grade 3 or higher elevations. Results A total of 98 patients with candidemia was treated with micafungin (n = 46, 46.9%) or anidulafungin (n = 52, 53.1%). In the univariate analysis, there were no significant differences in age, sex, source of candidemia, and comorbidities between the micafungin and anidulafungin groups. Although the clearance time of candidemia after echinocandin treatment was shorter in the anidulafungin than in the micafungin (5.64 ± 2.79 vs. 8.06 ± 5.30 days, P = 0.009) group, there was no significant difference in terms of clinical response (51.9% vs. 46.7%), mycological response (76.9% vs. 67.4%), and mortality (54.3% vs. 55.8%) between these two groups. The overall incidence of hepatotoxicity was similar. Also, there was no difference in the development of hepatotoxicity or severe hepatotoxicity between micafungin and anidulafungin groups for patients with normal baseline liver function test(LFT) and abnormal baseline LFT. Conclusion Our results suggest that clinical efficacy and hepatotoxicity may be similar between micafungin and anidulafungin treatment for adult patients with candidemia. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease often accompanied by immune catastrophic course and subsequent fatal outcome. More than 90% of patients with SFTS had leukopenia and about one-third of those need the admission of intensive care unit (ICU) during the hospital course. So, there has been growing concern about the complications such as invasive pulmonary aspergillosis (IPA) in critical SFTS patients. We thus investigate the incidence and clinical characteristics of IPA in patients with SFTS. Methods All patients who were confirmed as SFTS in a tertiary care hospital, Seoul, South Korea, between January 2013 and October 2018 were enrolled. The modified AspICU algorithm was used to identify cases of putative invasive pulmonary aspergillosis (PIPA) and discriminate these invasive diseases from colonization. Results Of the 45 PCR-confirmed SFTS patients, 16 (36%) received ICU care. Of these 16 patients, 9 (56%) developed PIPA during hospitalization. The median duration from admission to the first evidence of PIPA was 8 days (range, 2–11 days). None of the PIPA cases met the revised EORTC/MSG criterion. Septic shock and corticosteroid administration preceded more frequently in PIPA group than non-PIPA group (100% vs. 19%, P < 0.0001 and 67% vs. 14%, P = 0.003, respectively). Patients complicated by PIPA showed significantly higher mortality than non-PIPA patients (44% vs. 8%, P = 0.048 by log-rank test). Mortality was lower in patients with PIPA who received antifungal treatment (17% [1/6]) than in those with PIPA who did not (100% [3/3]) (log-rank test, P = 0.002). Conclusion More than half of patients with SFTS in ICU were complicated by IPA during early hospital course. Cautious scrutiny for IPA in patients with SFTS followed by early appropriate antifungal therapy for IPA is needed. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

The purpose of this study is to develop a "PCM cool roof system", and to evaluate its performance by applying the PCM cool roof system to the roof envelop. The study methods and procedures are as follows: First, the optimal PCM and finish materials were selected utilizing the indoor artificial climate chamber. Second, the PCM cool roof system was applied to the testbed, and the changes in surface temperatures were measured to determine the effect on the reduction of the heat island phenomenon. Third, the air currents in Gangdong-gu Seoul Korea were analyzed through a numerical analysis based on the data derived from the testbed to verify the reduction in the UHI. The experimental groups were set to A: WPC, B: WPC+PCM, and the control group to C: PCM cool roof system in the testbed experiment. The experimental environments were divided into winter, intermediate, and summer periods to increase the performance evaluation reliability in Seoul, where there are four distinct seasons. The study results showed that all seasons saw an effect of a reduction of roof surface temperatures when using the PCM cool roof system. The maximum temperature difference for each season was 2.5°C in winter, 4.7°C in intermediate season, and 5.7°C in summer. The a numerical analysis results showed that the reduction in roof surface temperature due to the "PCM cool roof system" was effective in the mitigation of the heat island phenomenon. [ABSTRACT FROM AUTHOR]

The Satellite Integrated Joint Monitoring of Air Quality (SIJAQ) field campaign, carried out from October 10 to November 25, 2021, included the measurement of detailed heat flux and air pollutants. In this study, we interpreted interactions between particulate matter (PM 2.5) and sensible heat flux (SHF) in the planetary boundary layer (PBL) over the Seoul metropolitan area during the SIJAQ campaign based on measurements and on- and offline WRF-Chem model simulations. Heat flux data obtained during the SIJAQ campaign was varied, depending on meteorological variables, including cloud cover, and revealed meaningful interactions between PM 2.5 and SHF. Throughout the campaign, the measured PM 2.5 –SHF during the daytime (10:00–16:00 LST) showed overall negative correlation with the correlation coefficient (R) of −0.38. During the campaign, the measured SHF on average was 68 ± 38 W/m2 on high PM 2.5 days (daily mean PM 2.5 ≥ 50 μg/m3), which is significantly lower (35% decrease) compared to the SHF of 105 ± 57 W/m2 on low PM 2.5 days (daily mean PM 2.5 < 50 μg/m3). Both on- and offline WRF-Chem simulation also showed that SHF and PM 2.5 were negatively correlated throughout the campaign with R of −0.49, in good agreement with the observations. As the comparative case study, we selected two extreme cases of 3-day periods with the lowest and highest PM 2.5 concentrations and aerosol effects were estimated based on both on- and offline WRF-Chem simulation and the case-specific aerosol–cloud–SHF–PBL relationship was explored. The results showed that the simulated aerosol-induced SHF was ∼14% (15 W/m2) lower on the highest PM 2.5 case during the campaign, whereas there was little or no significant relationship on the lowest PM 2.5 concentration case. Our modeling study also revealed the underlying impact of PM 2.5 concentrations on reducing SHF (with a slope = −0.41), and this reduction follows a specific sequence of processes: elevated PM 2.5 level led to a decrease in SHF, weakening the PBL evolution and reducing vertical mixing, ultimately resulting in high PM 2.5 concentrations accumulated in the PBL over the Seoul metropolitan area. • Aerosol-Heat flux-PBL relations are presented during the SIJAQ campaign. • A sequential process of PM 2.5 –Heat flux–PBL relation was found during the campaign. • The measured SHF-PM 2.5 showed strong negative correlation with R of −0.38 • WRF-Chem showed that the aerosol-induced SHF was up to 14% (15 W/m2). [ABSTRACT FROM AUTHOR]

We investigated the prevalence of fusidic acid (FA) resistance in MSSA and MRSA stratified by sequence (ST) and spa types, and determined the prevalence of FA resistance mechanisms. From August 2014 to April 2020, S. aureus blood isolates were collected in Asan Medical Center, Seoul, South Korea. Antimicrobial susceptibility tests were performed using broth microdilution and interpreted according to EUCAST's FA criteria. We performed spa typing for fusA mutation presence and acquired FA resistance determinants (fusB , fusC , and fusD) by PCR. Of the 590 MRSA isolates, 372 were FA resistant, and among 425 MSSA isolates, 136 were resistant. Of the 380 ST5-MRSA isolates, 350 were FA resistant, whereas only 1 of 14 ST5-MSSA isolates was FA resistant. Conversely, of the 163 ST72-MRSA isolates, only 8 were resistant, whereas 37 of 42 ST72-MSSA were resistant. The fusA mutation (80%) was the most common determinant. The one FA resistant ST5-MSSA isolate belonged to the t 2460 spa type, the most common spa type (24 of 35 isolates) of FA resistant ST5-MRSA. In addition, t 324 and t 148, which are minor spa types of ST72-MSSA, were susceptible to FA, in contrast to other ST72-MSSA spa types, and the major spa type of ST72-MRSA (110 of 163 isolates). FA resistance was common in ST5-MRSA and ST72-MSSA, and rare in ST5-MSSA and ST72-MRSA. Our findings suggest that minor clones of ST5-MSSA isolates, with the fusA mutation and minor clones of ST72-MSSA susceptible to FA, may have evolved to harbor the mecA gene. • Fusidic acid (FA) resistance was more common in MRSA than MSSA, and the most common determinant was the fusA mutation (80%). • The majority (92%) of ST5-MRSA strains were FA resistant, while only 7% of ST5-MSSA isolates were resistant. • Conversely, most ST72-MRSA isolates (95%) were susceptible to FA, while most ST72-MSSA strains (88%) were resistant. • The only FA resistant ST5-MSSA isolate belonged to the t 2460 spa type, which is the most common spa type among FA resistant ST5-MRSA. • The minor spa types t 324 and t 148 of ST72-MSSA (which are susceptible to FA) were the major spa type of ST72-MRSA. [ABSTRACT FROM AUTHOR]

Eight microwave links operating at frequencies ranging from 6 to 8 GHz and with path lengths ranging from 5.7 to 37.4 km traversing the city of Seoul, Korea are used to detect rainfall and estimate path-averaged rainfall rates. Rainfall detection using rain-induced attenuation (dB) was validated by rain detectors installed at automatic weather stations, and the results confirmed that microwave links can be used to detect rainfall with an accuracy ≥80%. The power-law R-k relationships between rain-induced specific attenuation, k (dB km−1), and the rainfall rate, R (mm h−1), were established and cross-validated by estimating the path-averaged rainfall rate. The mean bias of the path-averaged rainfall rate, as compared to the rainfall rate from ground rain gauges, was between −3 and 1 mm h−1. The improved accuracy of rainfall detection led to the improved accuracy of the path-averaged rainfall rate. Hence, it was confirmed that microwave links, used for broadcasting and media communications, can identify rainy or dry periods (rain spells or dry spells) in a way comparable to rain detectors and provide high time-resolution rainfall rates in real time. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a major impact on liver transplantation (LT) and living donor programs globally. In this study, we aimed to present the principles and strategies of our LT program during the pandemic period and describe its achievements. We retrospectively reviewed the outcomes of 1417 LTs performed at Asan Medical Center, Seoul, Korea, from 2020 to 2022. Of these, 216 recipients who received transplants from deceased donors were excluded, and 1201 recipients who received transplants from 1268 live donors were included in the study, including 38 children <18 years old. Among the 1201 living donor LT (LDLT) recipients, the most common indication for LT was unresectable hepatocellular carcinoma (315/1163, 27.1%) in adults and biliary atresia (29/38, 76.3%) in pediatric recipients. Emergency LDLT was performed in 40 patients (3.3%). The median model of end-stage liver disease and pediatric end-stage liver disease scores were 13.9 ± 7.2 and 13.8 ± 7.1, respectively. In-hospital mortality of recipients was higher than usual at 2.2%, but the cause of death was not related to COVID-19 infection. Of the 1268 live donors who underwent hepatectomy for liver donation, 660 (52.1%) underwent hepatectomy using a minimally invasive approach. Although 17 (1.3%) live donors experienced major complications, there were no serious life-threatening complications and no mortality. Even in a pandemic era, a team with well-established infection control protocols, patient-tailored surgical strategies, and thorough perioperative care can maintain LDLT at a similar quantitative and qualitative level as in a non-pandemic era. [ABSTRACT FROM AUTHOR]

Abstract: Measurements of 56 volatile organic compounds (VOC) were undertaken at a monitoring site in Seoul, Korea in 2004. The VOC pollution at the site was evaluated for both functional groups and individual compounds. The highest concentrations for the functional groups were recorded by aromatic (AR: 430ppbC) followed by paraffin (PR), olefin (OF), and alkyne (AK). The mean concentrations of individual VOCs ranged from 0.05ppb (1-hexene) to 39.8ppb (toluene). For the VOC groups, there were peak concentrations during winter (AK and OF) and summer (AR). Although most aromatic VOCs generally peaked during summer, this was not true for benzene (e.g., winter peak). The distribution of VOCs at the study site was characterized by significantly enhanced concentrations of toluene and aromatic VOCs from local industrial and mobile sources. Despite excursions that were occasionally observed from aromatic groups or benzene, strong correlations occurred frequently between different groups and between individual components. The overall results of this study suggest that anthropogenic emissions have contributed greatly to increases in VOC pollution at the study site. [Copyright &y& Elsevier]

We aimed to compare clinical outcomes of patients with Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales and those with New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales. We performed a retrospective cohort study of all adult patients with KPC- or NDM-producing Enterobacterales isolates in a 2700-bed tertiary referral hospital in Seoul, South Korea, between 2010 and 2019. The primary outcome was 30-day mortality after first isolation of KPC- or NDM-producing Enterobacterales. The secondary outcome was the development of infection within 30 days by the colonizing isolates, among colonized patients. We performed Cox regression analysis for 30-day mortality and competing risk analysis for development of infection. A total of 859 patients were identified during the study period; 475 (55%) had KPC and 384 (45%) had NDM. Thirty-day mortality was significantly higher in the KPC group than in the NDM group (17% (81/475) vs 9% (33/384); p < 0.001). The KPC group developed infection within 30 days from the initial colonization after first isolation more frequently than the NDM group (8% (27/353) vs. 3% (10/295); p 0.02). Multivariable analysis revealed that independent risk factors for 30-day mortality were solid cancer (adjusted hazard ratio (aHR) 2.51; 95% confidence interval (CI) 1.66–3.79; p < 0.001), solid organ transplant (aHR 0.32; 95% CI 0.17–0.61; p < 0.001), a high APACHE II score (aHR 1.11; 95% CI 1.08–1.13; p < 0.001), KPC-producing Enterobacterales (aHR 1.69; 95% CI 1.02–2.79; p 0.04), previous carbapenem use within 3 months (aHR 1.86; 95% CI 1.26–2.75; p < 0.001) and site of KPC- or NDM-producing Enterobacterales infection at the time of the first culture (p < 0.001). Our study suggests that KPC-producing Enterobacterales is significantly associated with poorer outcomes than NDM-producing Enterobacterales. [ABSTRACT FROM AUTHOR]

Abstract: In this study, the environmental behavior of two major airborne pollutants, ozone and nitrogen dioxide, was investigated with respect to their exceedance patterns of air quality criteria. For this purpose, we used data sets collected from a total of 31 air quality monitoring stations dispersed across the Seoul metropolitan city between 1990 and 2000. In the case of NO2, the frequency of hourly exceedance data sets exhibited little changes in the early 90s. However, it increased dramatically after 1995, probably in compliance with a rapid increase in the total number of automobiles. Likewise, the daily exceedance of O3 in the early 90s was not significant, approaching 100 cases (except in 1994). However, its total quantity began to surpass 300 cases since around 1996. Comparison of those exceedance data was also made among spatially divided data groups. In the case of NO2, the occurrence of exceedance data was dominated by the western part of the city in both magnitude and frequency. On the other hand, that for O3 was characterized by notably strong occurrences in the eastern counterpart. The overall results of our analysis of the NO2 and O3 exceedance data sets indicate an inextricable linkage between the two pollutants in association with geographical and meteorological factors. [Copyright &y& Elsevier]

[Display omitted] This study was aimed to develop a fixed dose combination (FDC) tablet containing a low dose of evogliptin tartrate (6.87 mg) for immediate release combined with a high dose (1000 mg) of sustained-release (SR) metformin HCl appropriate for once daily dosing the treatment of type 2 diabetes. To prepare the FDC tablets, an active coating was used in this study, whereby evogliptin tartrate film was layered on a matrix core tablet containing metformin HCl. To overcome the problem caused by a low-dose drug in combination with a relatively large matrix tablet containing high-dose drug, it was also aimed to confirm the formulation and coating operation for satisfactory content uniformity, and to describe the chemical stability during storage of the amorphous active coating layer formulation in relation to molecular mobility. Furthermore, the in vitro release and in vivo pharmacokinetic profiles of metformin HCl and evogliptin tartrate in the FDC active coating tablet were compared to those of the commercially marketed reference drugs, Diabex XR® (Daewoong, Seoul, Korea) containing metformin HCl and Suganon® (Donga ST, Seoul, Korea) containing evogliptin tartrate. In conclusion, the newly developed FDC active coating tablet in this study was confirmed to be bioequivalent to the reference marketed products in beagle dogs, with satisfactory content uniformity and stability. [ABSTRACT FROM AUTHOR]

Abstract: Previously, we demonstrated that the concentrations of DDTs were greater in breast milk collected from Chinese mothers than from Japanese and Korean mothers. To investigate dicofol as a possible source of the DDTs in human breast milk, we collected breast milk samples from 2007 to 2009 in China (Beijing), Korea (Seoul, Busan) and Japan (Sendai, Takarazuka and Takayama). Using these breast milk samples, we quantified the concentrations of dichlorobenzophenone, a pyrolysis product of dicofol (simply referred to as dicofol hereafter), dichlorodiphenyltrichloroethane and its metabolites (DDTs) using GC–MS. Overall, 12 of 14 pooled breast milk samples from 210 mothers contained detectable levels of dicofol (>0.1ngg−1 lipid). The geometric mean concentration of dicofol in the Japanese breast milk samples was 0.3ngg−1 lipid and significantly lower than that in Chinese (9.6ngg−1 lipid) or Korean breast milk samples (1.9ngg−1 lipid) (p <0.05 for each). Furthermore, the ΣDDT levels in breast milk from China were 10-fold higher than those from Korea and Japan. The present results strongly suggest the presence of extensive emission sources of both dicofol and DDTs in China. However, exposure to dicofol cannot explain the large exposure of Chinese mothers to DDTs because of the trace levels of dicofol in the ΣDDTs. In the present study, dicofol was confirmed to be detectable in human breast milk. This is the first report to identify dicofol in human samples. [ABSTRACT FROM AUTHOR]

Abstract: Human breast milk samples collected in 2007–2008 from four countries, Vietnam (Hanoi), China (Beijing), Korea (Seoul) and Japan (Sendai, Kyoto and Takayama), were analyzed for persistent organic pollutants (POPs) such as dichlorodiphenyltrichloroethane and its metabolites (DDTs), chlordane-related compounds (CHLs), hexachlorocyclohexanes (HCHs), hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs). Comparing with previous surveys, the present study indicates that the DDTs in breast milk from China and Vietnam had gradually decreased during the last decade, but were still 5–10 times higher than those in other nations. The ratios of p,p′-DDE/p,p′-DDT and o,p′-DDT/p,p′-DDT were higher in Beijing than in the other countries, suggesting that there is less fresh intake of commercial DDT products and a possible exposure to dicofol in China. CHL and PCB levels were relatively higher in mothers from Japan, whereas β-HCH and HCB were more common in Chinese women. In Japan, it is suspected that mothers in the urban/coastal area (Sendai) were more continuously exposed to organochlorine pesticides (OCPs) than mothers in the rural/inland area (Takayama). In addition, OCP levels in primiparae were significantly higher than those in multiparae from Japan and Korea. These indicate that both parity and regional factors are major determinants of the levels of OCPs and PCBs in human milk. On the other hand, higher concentrations of PBDEs were observed in mothers'' milk from Korea. The congener was dominated by BDE-47 (43–54%), followed by BDE-153 (23–33%) in all regions except for Beijing where BDE-28 (23%) was relatively abundant. In Japanese breast milk, regional and parity-dependent distributions were not observed for PBDEs. Among PBDE congeners, age-dependency was observed for BDE-153, which was negatively correlated (p <0.05) to the age of mothers in Kyoto (17 participants were housewives), while it increased with age in Sendai (10 participants were clerks). No such correlation was seen for BDE-47, indicating that BDE-47 was ingested and assimilated via different kinetics or routes from BDE-153 in Japan. [Copyright &y& Elsevier]

Abstract: In order to incorporate correctly the large or local scale circulation in the model, a nudging term is introduced into the equation of motion. Nudging effects should be included properly in the model to reduce the uncertainties and improve the air flow field. To improve the meteorological components, the nudging coefficient should perform the adequate influence on complex area for the model initialization technique which related to data reliability and error suppression. Several numerical experiments have been undertaken in order to evaluate the effects on air quality modeling by comparing the performance of the meteorological result with variable nudging coefficient experiment. All experiments are calculated by the upper wind conditions (synoptic or asynoptic condition), respectively. Consequently, it is important to examine the model response to nudging effect of wind and mass information. The MM5–CMAQ model was used to assess the ozone differences in each case, during the episode day in Seoul, Korea and we revealed that there were large differences in the ozone concentration for each run. These results suggest that for the appropriate simulation of large or small-scale circulations, nudging considering the synoptic and asynoptic nudging coefficient does have a clear advantage over dynamic initialization, so appropriate limitation of these nudging coefficient values on its upper wind conditions is necessary before making an assessment. The statistical verifications showed that adequate nudging coefficient for both wind and temperature data throughout the model had a consistently positive impact on the atmospheric and air quality field. On the case dominated by large-scale circulation, a large nudging coefficient shows a minor improvement in the atmospheric and air quality field. However, when small-scale convection is present, the large nudging coefficient produces consistent improvement in the atmospheric and air quality field. [Copyright &y& Elsevier]

Abstract: In this study, long-term monitoring of gaseous elemental mercury (Hg(0), GEM) was carried out at an urban site in Seoul, Korea from September 1997 to January 2005. There was no discernible long-term trend to predict the future direction of Hg(0) concentration shift across a 9-year study period. In contrast, seasonal trend analysis indicated that maximum Hg(0) concentrations occurred in the winter, while the minimum occurred in the fall. In addition, Hg(0) concentrations varied diurnally with the nighttime dominance, especially in the winter. It was suggested that the distribution of Hg(0) was controlled mainly by anthropogenic sources and in part by interplay of photochemical oxidation (through OH and O3), meteorological conditions (e.g., precipitation), and dry deposition during the study period. The contribution of the O3-dependent photochemical oxidation leading to Hg(0) loss was significantly larger than its OH counterpart. The photochemical lifetime of Hg(0), when induced based on the oxidation by O3 and OH, was estimated to vary from 1.1 to 2.4 years. [Copyright &y& Elsevier]