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Background: The aim of this work was to evaluate factors that influence local recurrence and survival after surgical resection of sinonasal malignant melanoma, using a large population-based multicenter study in Korea., Methods: Retrospective analysis was performed for 155 newly diagnosed sinonasal malignant melanoma patients gathered from 15 university hospitals throughout Korea. Demographic data, tumor characteristics, surgical approach, adjuvant treatment, recurrence, and outcomes were analyzed., Results: Three-year and 5-year overall survival rates were 48.8% and 40.1%, respectively. Local recurrence rate was 46.6%, with a mean recurrence time of 15.5 months. On multivariate analysis, patients who underwent surgery that included an endoscopic approach showed decreased local recurrence rate (p = 0.042) and increased survival rate (hazard ratio [HR], 1.702; 95% confidence interval [CI], 1.007 to 2.875; p = 0.047) compared to those who underwent an external approach. Patients with postoperative radiotherapy showed a decreased local recurrence rate (p = 0.001), but without impact on survival rate. Male gender, tumor beyond the nasal cavity, and presence of distant metastasis were associated with poor survival., Conclusion: An endoscopic-including surgical approach was associated with improved local control and survival in sinonasal malignant melanoma patients. Postoperative radiotherapy helped increase the local control rate., (© 2015 ARS-AAOA, LLC.)

Tomato yellow leaf curl virus (TYLCV), a member of the genus Begomovirus, has a single-stranded DNA genome. TYLCV can induce severe disease symptoms on tomato plants, but other hosts plants such as cucurbits and peppers are asymptomatic. A full-length DNA clone of a Korean TYLCV isolate was constructed by rolling-circle amplification from TYLCV-infected tomatoes in Korea. To assess relative susceptibility of sweet pepper varieties to TYLCV, 19 cultivars were inoculated with cloned TYLCV by agro-inoculation. All TYLCV-infected sweet peppers were asymptomatic, even though Southern hybridization and polymerase chain reaction analysis showed TYLCV genomic DNA accumulation in roots, stems, and newly produced shoots. Southern hybridization indicated that TYLCV replicated and moved systemically from agro-inoculated apical shoot tips to roots or newly produced shoots of sweet peppers. Whitefly-mediated inoculation experiments showed that TYLCV can be transmitted to tomatoes from TYLCV-infected sweet peppers. Taken together, these results indicate that sweet pepper can be a reservoir for TYLCV in nature.

Human papillomavirus (HPV) infection is considered to play a critical role in the development of cervical carcinoma, which is the third most common cancer among Korean females. Here, we performed a baseline study of HPV infection and genotyping using an HPV DNA chip, which is a type of oligonucleotide microarray. A total of 6,855 cervical swab specimens from 5,494 women attending Dankook University Hospital Health Improvement Center in Cheonan, Korea between 2006 and 2012, originally collected for HPV infection screening, were genotyped for HPV. The extracted DNA from the cervical specimens was investigated by an HPV DNA chip designed to detect 41 different HPV types. HPV was identified as positive in 1,143 (16.7%) of the 6,855 samples. The most frequently detected HPV genotypes were HPV types 16, 53, 56, 58, 39, 52, 70, 84, 68, 62, 35, 54, 81, 18, and 30, in descending order of incidence. The proportions of single and multiple HPV infections in the HPV-positive specimens were 78.1% and 21.9%, respectively. The average age of HPV-positive patients was 39.9 years, with the positive rate of HPV being the highest in the 10-29 age group (20.6%). We report here on the prevalence and distribution of 41 different genotypes of HPV according to age among women in Cheonan, Korea. These data may be of use as baseline data for the assessment of public health-related issues and for the development of area-specific HPV vaccines.

Aim: Leukoaraiosis and high intraocular pressure are strongly associated with cardiovascular disease, vascular angiopathy, and geriatric syndrome. Until now, little is known about the relationship between intraocular pressure and leukoaraiosis in its preclinical stage. The aim of this study was to evaluate the association between intraocular pressure and leukoaraiosis among middle-aged and elderly Koreans without glaucoma or dementia., Methods: We examined the relationship of intraocular pressure with leukoaraiosis at a preclinical stage in 753 Korean adults (474 men, 279 women; mean age 57.8 ± 6.6 years). A multiple logistic regression analysis was performed in order to determine whether intraocular pressure is an independent determinant for leukoaraiosis., Results: The overall prevalence of leukoaraiosis was 7.3%. Mean ocular pressure (±SD) was significantly higher in the leukoaraiosis group than the control group (14.3 ± 2.9 and 13.5 ± 2.9, respectively; P=0.028). In multiple logistic regression analysis, the odds ratio for leukoaraiosis was 1.18 (95% confidence interval: 1.06-1.31) for each 1 mm Hg increase in intraocular pressure., Conclusion: Intraocular pressure was found to be independently and positively associated with leukoaraiosis. This finding indicates that higher intraocular pressure may be a useful additional measure in assessing the risk of leukoaraiosis in the clinical setting.

Soybean mosaic virus (SMV), a member of the family Potyviridae, is an important viral pathogen affecting soybean production in Korea. Variations in helper component proteinase (HC-Pro) sequences and the pathogenicity of SMV samples from seven Korean provinces were compared with those of previously characterized SMV isolates from China, Korea and the United States. Phylogenetic analysis separated 16 new Korean SMV isolates into two groups. Fourteen of the new Korean SMV samples belonged to group II and were very similar to U.S. strain SMV G7 and Chinese isolate C14. One isolate in group II, A297-13, differed at three amino acid positions (L54F, N286D, D369N) in the HC-Pro coding sequence from severe isolates and SMV 413, showed very weak silencing suppressor activity, and produced only mild symptoms in soybean. To test the role of each amino acid substitution in RNA silencing and viral RNA accumulation, a series of point mutations was constructed. Substitution of N for D at position 286 in HC-Pro of SMV A297-12 significantly reduced silencing suppression activity. When the mutant HC-Pro of A297-13 was introduced into an infectious clone of SMV 413, accumulation of viral RNA was reduced to less than 3 % of the level of SMV 413 containing HC-Pro of A297-12 at 10 days post-inoculation (dpi) but increased to 40 % of SMV 413(HC-Pro A297-12) at 40 dpi. At 50 dpi RNA accumulation of SMV 413(HC-Pro A297-13) was similar to that of SMV 413(HC-Pro A297-12). However, at 50 dpi, the D at position 286 of HC-Pro in SMV 413(HC-Pro A297-13) was found to have reverted to N. The results showed that 1) a naturally occurring mutation in HC-Pro significantly reduced silencing suppression activity and accumulation of transgene and viral RNAs, and 2) that there was strong selection for revision to wild type when the mutation was introduced into an infectious clone of SMV.

Phenolic compounds from a wide collection of mungbean [Vigna radiata (L.) Wilczek] germplasm (56 varieties) were characterised to determine the diversity among these phytochemicals and to analyse the relationships among their contents. The profiles of 25 phenolic compounds identified from the grains were subjected to data-mining processes, including principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), Pearson's correlation analysis, and hierarchical clustering analysis (HCA). The IT212105 and IT104818 varieties separated from the others in the first two principal components of PCA. PLS-DA showed significant separation between extracts of mungbean originating from three countries: China, Japan, and Korea. HCA of these phytochemicals resulted in clusters derived from common or closely related biochemical pathways. Significant positive relationships were observed between coumaric acid and resveratrol (r=0.7195, p<0.0001). Catechin content was positively correlated with rutin (r=0.6291, p<0.0001). The IT104818 variety appears to be a good candidate for future breeding programs, as it contains high levels of phenolic compounds. These results demonstrate the use of metabolic profiling combined with chemometrics as a tool for assessing the quality of food., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

A novel β-1,3-1,4-glucanase gene was identified in Bacillus sp. SJ-10 (KCCM 90078) isolated from jeotgal, a traditional Korean fermented fish. We analysed the β-1,3-1,4-glucanase gene sequence and examined the recombinant enzyme. The open reading frame of the gene encoded 244 amino acids. The sequence was not identical to any β-glucanases deposited in GenBank. The gene was cloned into pET22b(+) and expressed in Escherichia coli BL21. Purification of recombinant β-1,3-1,4-glucanase was conducted by affinity chromatography using a Ni-NTA column. Enzyme specificity of β-1,3-1,4-glucanase was confirmed based on substrate specificity. The optimal temperature and pH of the purified enzyme towards barley β-glucan were 50 °C and pH 6, respectively. More than 80 % of activity was retained at temperatures of 30-70 °C and pH values of 4-9, which differed from all other bacterial β-1,3-1,4-glucanases. The degradation products of barley β-glucan by β-1,3-1,4-glucanase were analysed using thin-layer chromatography, and ultimately glucose was produced by treatment with cellobiase.

A novel α-L-arabinofuranosidase (Abf22-3) that could biotransform ginsenoside Rc into Rd was obtained from the ginsenoside converting Leuconostoc sp. strain 22-3, isolated from the Korean fermented food kimchi. The gene, termed abf22-3, consisting of 1,527 bp and encoding a protein with a predicted molecular mass of 58,486 Da was cloned into the pMAL-c2x (TEV) vector. A BLAST search using the Abf22-3's amino acid sequence revealed significant homology to that of family 51 glycoside hydrolases. The over-expressed recombinant Abf22-3 in Escherichia coli BL21 (DE3) catalyzed the hydrolysis of the arabinofuranoside moiety attached to the C-20 position of ginsenoside Rc under optimal conditions of pH 6.0 and 30 °C. This result indicated that Abf22-3 selectively converts ginsenoside Rc into Rd, but did not catalyze the hydrolysis of glucopyranosyl groups from Rc or other ginsenosides such as Rb1 and Rb2. Over-expressed recombinant enzymes were purified by two steps with amylose-affinity and DEAE-cellulose chromatography and then characterized. The kinetic parameters for α-L-arabinofuranosidase showed apparent Km and Vmax values of 0.95 ± 0.02 μM and 1.2 ± 0.1 μmol min(-1) mg of protein(-1) against p-nitrophenyl-α-L-arabinofuranoside, respectively. Using a purified MBP-Abf22-3 (10 μg/ml), 0.1 % of ginsenoside Rc was completely converted to ginsenoside Rd within 20 min.

Multiplex RT-PCR was used to detect respiratory viruses in 5,318 clinical samples referred to the laboratory of a tertiary teaching hospital from December 2006 to November 2010. The acquired data were analyzed with respect to types, ratio, and co-infection trends of infected respiratory viruses. Trends in respiratory viral infection according to sex, age, and period of infection were also analyzed. Of the 5,318 submitted clinical samples, 3,350 (63.0%) specimens were positive for at least one respiratory virus. The infection rates were 15.8% for human rhinovirus, 14.4&percnt; for human respiratory syncytial virus A, 9.7% for human respiratory syncytial virus B, 10.1% for human adenovirus, 5.4% for influenza A virus, 1.7% for influenza B virus, 4.7% for human metapneumovirus, 2.3% for human coronavirus OC43, 1.9% for human coronavirus 229E/NL63, 3.7% for human parainfluenza virus (HPIV)-1, 1.1% for HPIV-2, and 5.3% for HPIV-3. The co-infection analysis showed 17.1% of double infections and 1.8% of triple infections. The median age of virus-positive patients was 1.3 years, and 91.5% of virus-positive patients were under 10 years old. Human respiratory syncytial virus was the most common virus in children under 5 years of age, and the influenza A virus was the most prevalent virus in children over 5 years of age. These results help in elucidating the tendency of respiratory viral infections.

Immunogenicity of erythropoietin (EPO) is related with pure red cell aplasia (PRCA). We sought to determine the prevalence of antibody (Ab)-mediated PRCA in Korea and threshold diagnostic criteria by dual parameters: Ab titer and neutralizing activity. This study was a multi-center, cross-sectional study for two years. In the first year study (1 YS), 209 samples suspected to be EPO resistance were collected. In the second year study (2 YS), all the patients who consented to participate (N = 946) were enrolled. In 1 YS, we found three and six serum samples that were positive and borderline for anti-EPO Abs, respectively. The first three patients had neutralizing activity (NT) and were diagnosed as PRCA. In 2 YS, seven patients were anti-EPO positives and six had borderline levels. Among them, one patient with NT was diagnosed as PRCA and one with NT as aplastic anemia. The prevalence of PRCA was 0.106%. The correlation analysis of the 22 patients who had anti-EPO Ab showed that dual crossed cut-off lines (anti-EPO Ab titer ≥ 40 ng/ml, % NT ≥ 25%) were able to clearly isolate red cell aplasia. We suggest novel diagnostic criteria for diagnosis and prediction of Ab-mediated PRCA with data from both Ab titer assays and NT bioassays., (Copyright © 2012 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.)

Background: A potential independent association was recently demonstrated between high red blood cell distribution width (RDW) and the risk of all-cause mortality in patients with cardiovascular disease, although the mechanism remains unclear. However, there have been no reports on the relationship between RDW and mortality in acute kidney injury (AKI) patients treated with continuous renal replacement therapy (CRRT). In this study, we assessed whether RDW was associated with mortality in AKI patients on CRRT treatment in the intensive care unit (ICU)., Methods: We enrolled 470 patients with AKI who were treated with CRRT at the Yonsei University Medical Center ICU from August 2007 to September 2009 in this study. We performed a retrospective analysis of demographic, biochemical parameters and patient outcomes. Following CRRT treatment, 28-day all-cause mortality was evaluated., Results: At the initiation of CRRT treatment, RDW level was significantly correlated with white blood cell count, hemoglobin (Hb) and total cholesterol. Patients with high RDW levels exhibited significantly higher 28-day mortality rates than patients with low RDW levels (P < 0.01). Baseline RDW level, Sequential Organ Failure Assessment (SOFA) score, low mean arterial pressure (MAP) and low cholesterol levels were independent risk factors for mortality. In multivariate Cox proportional hazard analyses, RDW at CRRT initiation was an independent predictor for 28-day all-cause mortality after adjusting for age, gender, MAP, Hb, albumin, total cholesterol, C-reactive protein and SOFA score., Conclusion: Our study demonstrates that RDW could be an additive predictor for all-cause mortality in AKI patients on CRRT treatment in the ICU.

Background: Soft-tissue filler injections have become popular, and injections of even illegal materials are widespread. Complications such as foreign body granuloma often occur in such cases, and appropriate treatment is mandatory but no optimal treatment has been established., Methods: We treated 173 patients who underwent surgical excision of foreign body granulomas via direct approach to the lesion (n = 121) or injection therapies (n = 52) at Kangbuk Samsung Hospital over a period of 7 years from April 2004 to February 2011. A retrospective chart review found that 104 patients had a history of treatment failure at other hospitals. Among these 104 patients, 83 had a history of prior injection therapy and 21 patients had a history of prior surgical therapy. Patient satisfaction was evaluated at our hospital on a scale of 1-5 using an in-house questionnaire. Comparisons between patients receiving injection therapy and patients receiving surgical therapy were made using the Mann-Whitney test., Results: Patients who underwent surgical therapy via direct approach to the lesion reported statistically higher satisfaction scores 4(3-4) than those who underwent injection therapy 3(2-3) (p < 0.001)., Conclusions: Our novel surgical technique results in better outcomes and patient satisfaction in cases of severe foreign body granuloma., (Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: The MAST-CLA system (Hitachi Chemical Diagnostics, Inc., Mountain View, CA) is an in vitro diagnostic test for the simultaneous determination of specific IgE to different allergens. Recently, a new generation of MAST-CLA was developed (OPTIGEN; Hitachi Chemical Diagnostics). The purpose of this study was to determine the performance of these two tests for the diagnosis of allergic rhinitis., Methods: Suspicious allergic rhinitis patients were divided into four groups and their medical records were reviewed: group 1 patients were tested with the MAST-CLA and skin-prick tests (251 patients), group 2 patients were tested with the OPTIGEN and skin-prick tests (319 patients), group 3 patients were tested with the MAST-CLA and CAP (104 patients) tests, and group 4 patients were tested with the OPTIGEN and CAP tests (270 patients). The correlation between MAST-CLA and OPTIGEN to skin-prick and CAP tests was determined., Results: The positivity percentage of MAST-CLA results was higher than with skin-prick and CAP tests, and the results for the OPTIGEN test were comparable with skin-prick test and CAP. This suggests that the MAST-CLA test might have a slightly higher rate of giving false positive results. The OPTIGEN test correlated better with the skin-prick test and CAP., Conclusion: The OPTIGEN test performed better than the MAST-CLA test for diagnosing allergic rhinitis.

Background: The ratio of triglycerides (TG, mg/dl) to high-density lipoprotein cholesterol (HDL-C, mg/dl) is a reliable indicator of insulin resistance and atherosclerotic diseases. The purpose of this study was to examine the association between TG/HDL-C and chronic kidney disease (CKD) in a nationally representative sample of Korean adults., Methods: This cross-sectional study included 5,503 subjects (≥19 years of age) who participated in the 2005 Korean National Health and Nutrition Examination Survey. CKD was defined as an estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m(2) as calculated by the abbreviated formula from the Modification of Diet in Renal Disease study., Results: The overall prevalence of CKD in our sample was 9.0%. eGFR was negatively correlated with logarithm-transformed TG/HDL-C in Pearson's correlation. The prevalence of CKD in increasing TG/HDL-C quintiles was 4.4, 6.6, 9.5, 11.9, and 12.8%. In comparison with the lowest quintile of TG/HDL-C (<1.38), the odds ratio (95% confidence interval) for CKD in the highest quintile of TG/HDL-C (≥4.50) was 2.15 (1.38-3.37), after adjustment for multiple covariates (p value for trend = 0.036)., Conclusions: TG/HDL-C was independently associated with increased prevalence of CKD in a sample of Korean adults., (Copyright © 2011 S. Karger AG, Basel.)

Flavonoids and carotenoids of pigmented rice ( Oryza sativa L.), including five black cultivars and two red cultivars, from Korea were characterized to determine the diversity among the phytochemicals and to analyze the relationships among their contents. Black cultivars were higher in flavonoids and carotenoids than the red and white cultivars. The profiles of eight phytochemicals identified from the rice grains were subjected to principal component analysis (PCA) to evaluate the differences among cultivars. PCA could fully distinguish between these cultivars. The Heugjinjubyeo (BR-1) and Heugseolbyeo (BR-2) cultivars were separated from the others based on flavonoid and carotenoid concentrations. Flavonoid contents had a positive correlation with carotenoid contents among all rice grains. The BR-1 and BR-2 cultivars appear to be good candidates for future breeding programs because they have simultaneously high flavonoid and carotenoid contents.

Cornelia de Lange syndrome (CdLS; OMIM #122470) is a multiple congenital anomaly with characteristic facial features, growth delay, mental retardation, limb defects, behavioral problems, ocular and hearing impairments, and gastrointestinal or cardiac abnormalities. Although the NIPBL gene has been identified as a causative gene for CdLS, there has hitherto been no genetically confirmed case of CdLS in Korea. Herein, we report a clinical and genetic analysis of three Korean patients with clinical features consistent with CdLS. A male neonate had distinctive facial features, malformations of the upper extremities, genital abnormalities, and bilateral hearing loss, while a 6-yr-old boy and a 10-yr-old girl had distinctive facial features, short stature, and mental retardation. There were no chromosomal abnormalities in the three children. Sequence analysis of the NIPBL gene revealed three novel NIPBL variations including c.6108+2T>C, c.4028A>C (p.His1343Pro), and c.218C>T (p.Ser73Leu) in each patient, respectively. The first two variations appear to be de novo mutations causing CdLS in the patients because they are absent in the patients' parents. The p.Ser73Leu variation, however, seems to be a polymorphism since it is found both in the patient and in her asymptomatic mother. To the best of our knowledge, this is the first report of genetically confirmed cases of CdLS in Korea and extends the mutation spectrum of the NIPBL gene.

End-stage renal disease (ESRD) caused by diabetic nephropathy is increasing throughout the world. The survival of diabetic patients treated by transplantation has improved nowadays. Although recent studies have demonstrated preemptive kidney transplantation to be associated with better graft survival in CKD patients, the effect of pre-transplantation dialysis on graft outcomes among diabetic ESRD patients is unclear. This analysis summarized our experience with preemptive kidney transplantation in diabetic ESRD patients by retrospectively comparing 70 such patients transplanted between 1995 and 2009. These 70 patients were divided into two groups: 30 patients underwent preemptive and the other 40 transplantation after maintenance hemodialysis or peritoneal dialysis. We compared graft survivals, acute rejection episodes, postoperative complications, and delayed graft function rates. The 10-year patient survival of 100% in the preemptive group was similar to that of the nonpreemptive group (85%, P = .11). But the 10 year graft survival was higher among the preemptive than the nonpreemptive group (100% vs 75%, P = .02). Pre-transplantation modality did not affect graft survival. Therefore, preemptive kidney transplantation should be applied to eligible patients with diabetic ESRD., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Organic acids are formed in food as a result of metabolism of large molecular mass compounds. These organic acids play an important role in the taste and aroma of fermented food products. Doenjang is a traditional Korean fermented soybean paste product that provides a major source of protein. The quantitative data for volatile and non-volatile organic acid contents of 18 samples of Doenjang were determined by comparing the abundances of each peak by gas (GC) and high performance liquid chromatography (HPLC). The mean values of volatile organic acids (acetic acid, butyric acid, propionic acid and 3-methyl butanoic acid), determined in 18 Doenjang samples, were found to be 91.73, 29.54, 70.07 and 19.80 mg%, respectively, whereas the mean values of non-volatile organic acids, such as oxalic acid, citric acid, lactic acid and succinic acid, were noted to be 14.69, 5.56, 9.95 and 0.21 mg%, respectively. Malonic and glutaric acids were absent in all the tested samples of Doenjang. The findings of this study suggest that determination of organic acid contents by GC and HPLC can be considered as an affective approach to evaluate the quality characteristics of fermented food products., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Biogenic amines, produced by bacterial decarboxylation of amino acids, have been associated with toxicological symptoms in food products. Twenty-three samples of traditionally available Korean fermented soybean paste samples (Doenjang) were analyzed in order to determine the content of biogenic amines. Amines were extracted with 0.4M perchloric acid and derivatized with dansyl chloride. Nine biogenic amines were separated from Doenjang samples by high performance liquid chromatography using gradient elution (acetonitrile and ammonium acetate), and detected with spectrophotometric UV-vis detection at 254 nm. The pH value of all the samples was ranged from 4.8 to 6.0, and the strong amino acid decarboxylase activity was found to be in an acidic environment. The mean values of biogenic amines (tryptamine, 2-phenyl-ethylamine, putrescine, cadaverine, agmatine, histamine, tyramine, spermidine and spermine) determined in 23 Doenjang samples were found to be 18.37, 82.03, 70.84, 34.24, 47.32, 26.79, 126.66, 74.41 and 244.36 mg%, respectively. The findings of this study enhance the safety of not only Doenjang but other salted and/or fermented food products., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

The prevalence of sleep disturbance among 400 patients, diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN), was assessed via structured interviews. Sleep disturbance was reported in 50.3% of patients, especially among those with the binge-eating/purging subtype. Patients with sleep disturbance had more disturbing symptoms; including higher binge frequency and vomiting frequency. Additional differences were also identified., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Hepatitis B virus (HBV) infection is the one of the most common causes of the liver diseases in Korea. Since the discovery of Australia antigen (hepatitis associated antigen, or HBsAg later), hepatitis associated antigen was tested widely. HBsAg was detected in 6.6-8.6% in 1980's. Later, it decreased to 5.7% in 1990's. Remarkably, seropositivity of the children deceased to 0.2% after the nationwide vaccination program. Although hepatitis B vaccines are highly effective, the failure rate of perinatal prophylaxis in babies born to HBsAg positive mother was reported to be 4.25%. Treatment of chronic hepatitis B was initiated after the introduction of interferon alpha. Lamivudine opened a new era of oral antiviral agent, and it has been widely used in Korea since 1999. Adefovir was proven to have a good efficacy for lamivudine-resistant chronic hepatitis B. Newer potent antiviral agents such as entecavir, clevudine, and telbivudine are available currently. Further studies are warranted for understanding factors influencing natural history, improving treatment outcomes, and overcoming vaccine non-response.

In this study, we investigated the antifungal activity of three different forms of silver nanoparticles against the unidentified ambrosia fungus Raffaelea sp., which has been responsible for the mortality of a large number of oak trees in Korea. Growth of fungi in the presence of silver nanoparticles was significantly inhibited in a dosedependent manner. We also assessed the effectiveness of combining the different forms of nanoparticles. Microscopic observation revealed that silver nanoparticles caused detrimental effects not only on fungal hyphae but also on conidial germination.

Recently, hepatitis B virus (HBV) genotypes and mutations have been reported to be related to hepatocellular carcinoma (HCC). This cross-sectional case-control study examined the relationship between HCC and mutations in the enhancer II/core promoter and precore regions of HBV by comparing 135 Korean HCC patients infected with HBV genotype C2 (HBV/C2; HCC group) with 135 age-, sex-, and hepatitis B e antigen (HBeAg) status-matched patients without HCC (non- HCC group). Age and sex were also matched between HBeAg-positive and -negative patients. The prevalence of T1653, A1689, V1753, T1762/A1764, T1846, A1850, C1858, and A1896 mutations was evaluated in this population. The prevalence of the T1653 mutation in the box alpha region, the T1689 [corrected] mutation in between the box alpha and beta regions, and the T1762/A1764 mutations in the basal core promoter region was significantly higher in the HCC group compared to the non-HCC group (8.9% vs. 2.2%, P = 0.017; 19.3% vs. 4.4%, P < 0.001; and 60.7% vs. 22.2%; P < 0.001). Among HBeAg-negative patients, the frequency of the T1653 mutation was higher in the HCC group. Regardless of HBeAg status, the prevalence of the T1689, [corrected] and T1762/A1764 mutations was higher in the HCC group than in the non-HCC group. However, no association was observed between mutations in the precore region and HCC. Upon multivariate analysis, the presence of the T1653, T1689, [corrected] and T1762/A1764 mutations was an independent predictive factor for HCC. The addition of the T1653 or T1689 [corrected] mutation to T1762/A1764 increased the risk of HCC. In conclusion, the T1653, T1689, [corrected] and/or T1762/A1764 mutations were associated with the development of HCC in Korean patients infected with HBV/C2.

Background: Vascular access failure is a major cause of morbidity and hospitalization in hemodialysis populations worldwide. Erythropoietin (EPO) potentially can contribute to vascular access stenosis and occlusion by promoting intimal hyperplasia and thrombosis. Intravenous administration of EPO results in a severe, but transient, increase in drug concentration within the vascular access, whereas subcutaneous administration leads to a mild, but sustained, increase in the systemic circulation. The effect of route of administration of EPO on vascular access outcomes is uncertain., Study Design: Randomized controlled trial., Setting & Participants: 78 Korean hemodialysis patients were randomly assigned to receive either intravenous (n = 40) or subcutaneous (n = 38) EPO., Interventions: EPO was administered during dialysis, and the dose was titrated to maintain hemoglobin levels between 9 to 12 g/dL. All patients received EPO 2 or 3 times/wk. Study duration was 4 to 77 months., Outcomes & Measurements: The primary end point was time to vascular access failure. Analysis was performed using Cox regression analysis., Results: The incidence of access failure was 4.7%/patient-year in the intravenous-therapy group and 12.0%/patient-year in the subcutaneous-therapy group, with an unadjusted hazard ratio of 3.24 (95% confidence interval, 1.31 to 8.00; P = 0.01). After adjustment for dialysis access type, vascular access age, previous intervention, serum phosphorus level, and diabetes mellitus, subcutaneous EPO administration was independently associated with increased vascular access failure (hazard ratio, 3.56; 95% confidence interval, 1.20 to 10.58; P = 0.02). There were no significant differences in either hemoglobin concentration or EPO dosage between the 2 groups during the study period., Limitations: Relatively small sample size and lack of complete symmetry between the 2 groups with respect to some baseline characteristics., Conclusions: This study suggests that the risk of vascular access failure may be greater with subcutaneous compared with intravenous administration of EPO in hemodialysis patients.

The e-health infrastructure in Korea has come a long way within a short period since the establishment of the Korea e-Health Association in 2003 by the Korean Ministry of Commerce, Industry and Energy. Since then, four related government departments in the Ministry of Health and Welfare, Ministry of Information and Communication, Ministry of National Defense, and the Ministry of Science and Technology have also started planning and promoting their own strategies for e-Health applications. We have defined standardization, law and policy planning, human resources development, research and development for e-health products, and international collaboration as the five core pillars for the development of a successful e-health industry. In 2008, through the reorganization of government ministries, e-health has become an even more important growth industry for the Korean economy. Consequently, relevant government ministries have more concrete and robust action plans for realization of e-health in effect.

Most patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B have variants of the hepatitis B virus (HBV) that include mutations in the precore or core promoter regions of the HBV genome. The aim of this study was to investigate the patterns of precore and core promoter mutations and their relationship to HBeAg expression in Korean patients. Four hundred seventy-five Korean patients with chronic HBV infection between February 1995 and December 2003 were enrolled in this study. There were 236 HBeAg-positive and 239 HBeAg-negative patients. Blood samples were tested for HBsAg, anti-HBs, HBeAg, hepatitis B e antibody (anti-HBe), liver function tests, and serum HBV DNA. Mutations in the precore and core promoter regions were determined by direct sequencing. In the core promoter region, the C1740, C1753, T1762/A1764, and T1766 mutations were associated with HBeAg escape (all; P < 0.05). In the precore region, a higher frequency of the C1802, A1828, T1846, A1850, C1858, T1862, and A1896 mutations was found in HBeAg-negative patients (all; P < 0.05). In particular, the A1896 mutation was associated with high serum levels of ALT and HBV DNA in HBeAg-negative patients (P = 0.014 and 0.026, respectively). Mutations around the Kozak sequence (nucleotides 1809-1812) were found in 6.7% of patients and were not associated with undetectable HBeAg (P = 0.13). In Korean patients, various mutations in the precore and core promoter regions were associated with HBeAg escape and amelioration of hepatic inflammation in HBeAg- negative patients. Only the A1896 mutation contributed to HBeAg-negative chronic hepatitis B., ((c) 2009 Wiley-Liss, Inc.)

Background: C-reactive protein (CRP) has emerged as an important predictor for cardiovascular disease (CVD). To facilitate clinical and public health interventions, CRP thresholds have been defined as follows: low-risk (<1.0 mg/L), average-risk (1.0-3.0 mg/L), and high-risk (>3.0 mg/L). However, these cut-off thresholds are based on distributions in Western populations, and do not distinguish between men and women., Methods: We examined CRP distribution, gender difference, and determinants of CRP concentrations ranging from 0.02 mg/L to 10.0 mg/L, in 4923 Korean adults (2248 men; 2675 women) who received health checkups at Gangnam Severance Hospital from March 2006 to May 2007., Results: The distribution of CRP was highly skewed toward lower concentrations. CRP was higher in men than women, and the cut-off thresholds for the high-risk tertile of CRP concentrations corresponded to 1.01 mg/L in men and 0.62 mg/L in women, based on the current study population. Age, male gender, cigarette smoking, physical activity, body mass index, total cholesterol, high density lipoprotein cholesterol, gamma-glutamyltransferase, and uric acid were independently associated with CRP concentrations., Conclusions: CRP distribution and gender difference in Korean adults were found to be different from previous Western studies, although similar risk factors influence CRP concentrations. Our results suggest that ethnicity and gender specific cut-off thresholds for CRP concentrations should be taken into consideration in CVD risk assessment.

The increasing prevalence of Klebsiella pneumoniae liver abscess in Asian countries is attributable to virulent strains of the K1 serotype. We investigated the risk factors for the K1 serotype K. pneumoniae liver abscess. A case-control study was performed using the database of a nationwide study of liver abscess in Korea. Multivariate logistic regression analysis was performed for 78 cases of the K1 serotype K. pneumoniae liver abscess and 81 controls with non-Klebsiella. Diabetes mellitus was the significant risk factor (OR 2.13; 95% CI 1.026 approximately 4.428; P = 0.042) for the K1 serotype K. pneumoniae liver abscess. Biliary disorders had a strong negative association (OR 0.18; 95% CI 0.078 approximately 0.410; P < 0.001). This study suggests that diabetes mellitus is a more significant risk factor for the K1 serotype K. pneumoniae liver abscess than for the non-Klebsiella liver abscess.

In 1945, many Koreans, in addition to Japanese, were killed or injured by the atomic bombs dropped on Hiroshima and Nagasaki, Japan. This study compared the biological profiles of Korean atomic bomb survivors in residence at Daegu and Kyungbuk, Republic of Korea with those of a representative sample of Koreans obtained during a similar period. We evaluated anthropometric measurements, blood pressure, blood cell counts, blood chemistry, and urinalysis of survivors (n=414) and age- and sex-matched controls (n=414) recruited from the third Korea National Health and Nutrition Examination Survey conducted in 2005. Univariate analyses revealed significantly higher systolic blood pressure, white blood cell count, and serum total cholesterol, triglycerides, high-density lipoprotein-cholesterol, and aspartate aminotransferase levels (p<0.01) in the survivors. Conversely, hemoglobin concentration, hematocrit, red blood cell count, and the proportion of positive urine occult blood (p<0.01) were lower in the survivors. Our findings suggest that biological profiles of Korean atomic bomb survivors were adversely affected by radiation exposure.

Objectives: The aims of this study were to obtain data on the frequency with which Korean patients with autoimmune myasthenia gravis (MG) present solely with ocular disturbances and progress to develop generalized disease and to identify the prognostic factors associated with secondary generalization., Methods: We conducted a retrospective multicenter survey in which a total of 376 adult patients who were newly diagnosed with MG from 2000 through 2005 were reviewed for analysis. Patients with ocular MG at the time of symptom presentation (n=202, 53.7%) were divided into two subgroups according to their prognosis: the patients whose disease remained ocular throughout the follow-ups were placed in the OMG-R group, and the patients who progressed to develop generalized disease were placed in the OMG-G group. Clinical characteristics and laboratory findings were compared between the two subgroups., Results: Secondary generalization developed in 47 (23.3%) of the 202 study subjects, mostly within the first 6 months after symptom presentation, while the disease remained ocular throughout the follow-up duration (median 11.8 months) in the remaining 155 patients (76.7%). AChR antibody, abnormal repetitive nerve stimulation tests (RNST) and thymoma were more frequently observed in the patients in the OMG-G group than in those in the OMG-R group (p<0.01 in all). In seropositive cases, the titers of AChR antibody were also significantly higher in the OMG-G group than in the OMG-R group (median, 3.8 nM vs. 6.4 nM; p<0.05). Cox proportional hazards regression analyses showed that early oral prednisolone treatment significantly reduced the risk of secondary generalization (HR, 0.24; 95% CI, 0.11-0.56), whereas abnormal AChR antibody (HR, 5.34; 95% CI, 1.60-17.8) and thymoma (HR, 2.32; 95% CI, 1.21-4.45) were predictive of the development of secondary generalization., Conclusions: Our findings suggest that several factors, including the AChR antibody, thymoma, early corticosteroid treatment, and possibly latent neuromuscular abnormality revealed by RNST, may have an impact on the risk of developing generalized disease in Korean patients presenting with ocular myasthenia.

The water around Jeju Island was characterized by the Tsushima warm current (TWC) being high temperature and salinity and the Yellow sea cold bottom water (YSCBW) being low temperature and salinity We investigated the diversity indices, community structures and trophic level of fish species collected by trawl net in the waters around Jeju Island during April 2004-August 2005. We also presented ecosystem structure estimated by combination of trophic level and the oceanographic condition. There were totally distributed 301 species in the survey area during April 2004-August 2005, regionally 151-229 species in TWC and 75-154 in YSCBW. Shannon's diversity indices (H') of TWC were 2.95-3.39, being higher than those of YSCBW (2.11-2.40), and species richness (R) of TWC were 10.93-18.33, being also higher than those of YSCBW (6.96-12.48), except the values of October 2004. A total of 7429 individuals of 98 species was seasonally examined for their dietary composition in the survey area during 2004-2005. Of which, 3,682 individuals were observed with prey organisms. Standardized diet composition and trophic level estimates were calculated for predators in the survey area being influenced by TWC and YSCBW Trophic level values were diverged with range from 3.23 of the small pelagic to 4.39 of the goose fish, depending on the taxonomic group. The analysis of trophic level values showed that ecosystem structure was different between TWC and YSCBW during April 2004-August 2005.

The rate of dependence among ever-users of a drug indicates the risk of developing dependence once an individual has been exposed to the drug. This is the first study to investigate 12-month tobacco dependence (TD) among ever-smokers in a community-based population. Analyses were based on two national studies of representative samples aged 18-64 in 1984 (n=5,025) and in 2001 (n=6,275), conducted with household visits and face-to-face interviews. The rates of 12-month TD among ever-smokers in men showed no significant difference between 51.6% in 1984 and 50.6% in 2001. On the contrary, the rates in women significantly increased from 33.3% in 1984 to 52.8% in 2001. After adjusting for the sociodemographic variables, 'male gender' was significantly associated with 12-month TD among eversmokers in 1984, but not in 2001. 'Unmarried' was significantly associated in 2001 but not in 1984. 'Alcohol dependence' was the only psychiatric disorder associated with 12-month TD in both study years. In conclusion, 12-month TD was found in about 50% of ever-smokers, and gender differences between the rates of 12-month TD which was observed in 1984 disappeared in 2001. Individuals with 12-month TD showed higher comorbidity with alcohol dependence than ever-smokers without TD.

Background/aims: Although the natural seroclearance rate of Hepatitis B surface antigen (HBsAg) is reported to be 0.4-2% in western countries, this is not well known in Korea. This study aimed to elucidate the rate of natural HbsAg seroclearance, factors associated with seroclearance and prognosis after seroclearance., Methodology: In 1999, 250 chronic HBsAg carriers without any history of antiviral treatment and without any evidence of liver cirrhosis or hepatocellular carcinoma were selected. Follow-up HBsAg/ anti-HBs tests were performed annually till 2004. During a mean follow-up period of 48 months, 24 patients were lost and 11 received antiviral treatment. Finally, 215 patients completed the study., Results: HBsAg seroclearance was observed in 11 patients (6 males, 5 females). One-year seroclearance rate was 1.4%. All patients who achieved seroclearance were HBeAg (-)/HBV DNA (-) at the time of enrollment. Additionally, old age and normal serum alanine aminotransferase (ALT) level were the factors associated with seroclearance (p < 0.05, respectively). During the follow-up period, only mild transient elevations of ALT were observed in 4 patients and no serious complications were observed., Conclusions: Natural seroclearance occurred exclusively in patients who were HBeAg (-)/HBV-DNA (-), and annual rate of natural HBsAg seroclearance was 1.4%. No significant complications were observed after seroclearance.

We have investigated the characteristics of algal blooms in relation to the marine environment since their first known occurrence in the southern coastal waters of Korea. The algal blooms occurred most frequently in Masan and Jinahe bays, suggesting that they were related to the development of anoxic water masses. Skeletonema costatum, Heterosigma akashiwo and Prorocentrum sp. commonly occurred as the dominant organisms causing the blooms in all regions, although the conditions of their appearance differed from place to place. Algal blooms in all regions were more likely to occur when precipitation ten days prior to the bloom was greater than the long-term mean values. However, the factors that relate to the development of the algal blooms in Gamak Bay differed depending upon the causative species while they were largely identical in Jinhae Bay, regardless of the species.

Background: Endometrial carcinoma is a well known complex gynecological disorder. Our team suggests that this tumor is related to immortalization-up-regulated protein 1 and 2 (imup-1, imup-2), which are known to be involved in SV40-mediated immortalization., Patients and Methods: RT-PCR and immunohistochemical staining were used to examine the mRNA expression levels and intracellular localization of imup-1 and imup-2 in endometrial carcinomas from Korean and Japanese patients., Results: The imup-1 (4.1- and 23.6-fold) and imup-2 (4.8- and 2.7-fold) mRNA expression levels in endometrial carcinomas from both Korean and Japanese women were significantly higher than in normal endometrial tissues (p < 0.01). Strong expression of the IMUP-1 and IMUP-2 proteins were found in the tumor cytoplasm as well as in the nuclei., Conclusion: These findings demonstrate the up-regulation of imup-1 and imup-2 in human endometrial carcinomas and indicate that these molecules play a role in endometrial carcinogenesis in both Korean and Japanese patients.

Anti-bone resorption properties of the Korean herbal formulation, Gami-Honghwain (HJ), which comprises Carthamus tinctorius L. seed and hominis placenta, were investigated. We demonstrate that the production of PGE2 is inhibited by 20-100 microg/ml HJ in nontransformed osteoblastic cells (MC3T3-E1 cells), indicating that HJ inhibits PGE2 production. The effect of HJ on the proliferation and osteoblastic differentiation in MC3T3-E1 was also studied. HJ dose-dependently increased DNA synthesis (significant at 20-100 microg/ml), and increased alkaline phosphatase (ALP) and prolyl hydroxylase activities of MC3T3-E1 cells (20-100 microg/ml), while anti-estrogen tamoxifen eliminated the stimulation of proliferation and ALP activity of MC3T3-E1 which was induced by HJ. These results indicate that HJ directly stimulates cell proliferation and differentiation of osteoblasts. Also, when we assessed the effects of HJ on osteoblastic differentiation in MC3T3-E1, HJ enhanced ALP activity and mineralization in a dose- and time-dependent fashion. This stimulatory effect of the HJ was observed at relatively low doses (significant at 20-100 microg/ml and maximal at 100 microg/ml). Northern blot analysis showed that the HJ (60 microg/ml) increased in bone morphogenetic protein-2 as well as ALP mRNA concentrations in MC3T3-E1 cells. HJ (100 microg/ml) slightly increased in type I collagen mRNA abundance throughout the culture period, whereas it markedly inhibited the gene expression of collagenase-1 between days 15 and 20 of culture. These results indicate that HJ has anabolic effect on bone through the promotion of osteoblastic differentiation, suggesting that it could be used for the treatment of common metabolic bone diseases.

Objective: The incidence of colorectal cancer throughout the Republic of Korea has been rising over the last 25 years. The change in incidence is supposed to be due to the westernized life style. We evaluated the anatomical distribution of colorectal cancer and the properties of synchronous adenomatous polyps in the Korean population which were known to be different from those in Western countries., Materials and Methods: From January 1997 to December 2006, 896 cases of colorectal cancer were reviewed retrospectively., Results: A total of 25.1% were proximally located cancer with a modest female predominance (odds ratio 1.5). Synchronous adenomatous lesions were accompanied in 31.9% of all colorectal cancer cases. In the distal colorectal cancer patients, 18.8% had proximally located synchronous adenomas. In those with proximal colon cancer, only 20.5% of patients had distally located adenomas. The likelihood of a proximal colon cancer without distal sentinel lesions was higher in females (odds ratio 3.0)., Conclusion: There has been a steep rise in the incidence of colorectal cancer in Korea and distal colon cancer is more prevalent than in Western countries. However, as over 20% of proximal colon cancers can exist without distal colonic synchronous or sentinel lesions, a total colonoscopic examination should be considered first in surveillance.

Investigation of the lower molecular weight phenolics from the needles of Taxus cuspidata led to the isolation and structural elucidation of (+)-catechin, (-)-epicatechin and (+)-catechin-(5,6-bc)-4beta-(4''-hydroxyphenyl)-dihydro-2(H)-pyranone (1), a new phenylpropanoid flavan-3-ol. The structures of these compounds were established on the basis of chemical and spectroscopic evidence.

Background: Elevated gamma-glutamyltransferase (GGT) has emerged as an independent predictor of cardiovascular disease (CVD) which is increasingly viewed as an inflammatory disease. Thus, the mechanism underlying the link between elevated GGT and CVD may be inflammation., Methods: We examined the relationship between GGT and C-reactive protein (CRP) levels and white blood cell (WBC) count in 4562 Korean adults (2104 men, 2458 women). The odds ratio (OR) and 95% confidence interval (CI) for high CRP and WBC count (> or = 75th percentile) for both men and women were calculated across each quartile of serum GGT., Results: Results for the OR (95% CI) for high CRP levels by GGT quartiles were 1.00, 1.67 (1.21-2.29), 2.10 (1.51-2.93) and 2.51 (1.81-3.60) in men, and 1.00, 1.05 (0.65-1.68), 1.45 (0.79-2.02) and 2.16 (1.37-3.41) in women after adjustment for age, smoking status, alcohol intake, exercise, body mass index, blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein-cholesterol, and uric acid. Similarly, positive associations between serum GGT and WBC count were also observed., Conclusions: The present study demonstrates a positive correlation between GGT and two markers of inflammation, serum CRP and WBC count. Our findings suggest that serum GGT may be a surrogate inflammatory marker and a useful additional measure in assessing cardiovascular risk.

Background: In general, Korean women with breast cancer are younger than white women. We have compared the clinicopathologic characteristics and prognosis in very young and less young premenopausal Korean women with breast cancer., Methods: Of the breast cancer patients treated at the Asan Medical Center in Seoul, Korea, from 1989 to 2002, 381 (9.6%) were younger than 35 years of age (the "very young" group) and 2320 were 35 to 50 years of age (the "less young" group). We retrospectively compared the clinicopathologic factors and survival rates of these two groups., Results: The very young group with lymph node metastases had poorer 5-year survival (69.9% vs. 82.7%, P = .0063) and disease-free survival (58.1% vs. 74.1%, P < .0001) rates than their older counterparts. In addition, the very young group had more advanced-stage disease (P = .001), higher T stage (P = .001), and more positive lymph nodes (P = .024) than did their older counterparts, as well as higher percentages of estrogen receptor-negative disease (48.2% vs. 42.1%, P = .047), progesterone receptor-negative disease (53.5% vs. 44.1%, P = .002), and grade 3 histology (52.1% vs. 43.5%, P = .011) tumors., Conclusions: Compared with older premenopausal Korean women with breast cancer, those younger than 35 years old had a poorer prognosis as a result of a higher rate of recurrence, a later stage at diagnosis, and more aggressive disease. Thus, in Korean breast cancer patients, age younger than 35 years was an independent predictor of recurrence.

Background/objective: It is generally recommended that patients with chronic viral hepatitis should be vaccinated against hepatitis A virus (HAV) infection. We intended to evaluate the prevalence of IgG anti-HAV according to age in patients chronically infected with hepatitis B virus or hepatitis C virus in Korea., Methods: From June to October 2006, 303 patients (226 male, 77 female) with chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma were recruited (mean age 50.8+/-14.4 years; range 16-84). The sera were tested for antibodies to HAV, and overall and age-specific seroprevalence of anti-HAV was assessed., Results: Hepatitis B virus infection was the etiology of liver diseases in 267 patients (88.1%), with hepatitis C virus infection in 36 (11.9%). The distribution of clinical diagnosis was chronic hepatitis in 86 patients (28.4%), liver cirrhosis in 36 (11.9%), and hepatocellular carcinoma in 181 (57.9%). The patients were categorized by decade of age and the distribution was as follows: nine patients (2.5%) in their teens, 23 (6.2%) in their 20s, 36 (12.4%) in their 30s, 78 (25.7%) in their 40s, 72 (24.1%) in their 50s, and 85 (29%) >or=61 years. The overall seroprevalence of anti-HAV was 87.8% (266/303), and no difference was observed in sex (86.7 vs. 90.9%, P=0.42). The seroprevalence in each age group was 22.2, 26.1, 72.2, 97.4, 100 and 98.8%, respectively, showing marked increase in those over 40 years of age (P<0.001)., Conclusion: Our study demonstrates that most Korean patients over 40 years of age with chronic liver disease have already been exposed to HAV.

Objectives: It has been known that it takes a long time for methicillin-resistant Staphylococcus aureus (MRSA) to introduce and become endemic within a hospital. During the last decade, widespread use of broad-spectrum antibiotics might have affected the time required for MRSA to spread and become endemic in hospitals. However, there has been no report on this issue. We investigated how fast MRSA has spread and become endemic in a hospital opened in the broad-spectrum antibiotic era., Methods: The study was performed at a Korean hospital, which opened in 1999. We examined the change of antimicrobial susceptibility and antimicrobial use density (AUD) for 6 years since hospital opening., Results: S. aureus susceptibility to oxacillin decreased from 64% in the first month to 33% in the second month (P=.05), and then has maintained around 30%. AUD was remarkably high from the first year, in which total AUD and those of aminopenicillins, second-generation cephalosporins, fluoroquinolones, and macrolides were 4674.6, 1444.6, 1700.9, 421.3, and 520.0 DDD/1000 patient-days, respectively., Conclusions: MRSA has spread within a few months in a hospital opened in the broad-spectrum antibiotic era. Excessively high use of broad-spectrum antibiotics seems to be responsible for rapid spread of MRSA in the hospital.

The objective was to estimate the prevalence and correlates of psychiatric disorders in a nationwide sample of Korean adults. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview 2.1/DSM-IV (N = 6275, response rate 79.8%). The lifetime and 12-month prevalences for all types of DSM-IV disorders were 33.5% and 20.6%, respectively. Those of specific disorders were as follows: 17.2% and 7.1% for alcohol use disorder, 11.2% and 7.4% for nicotine use disorder, 5.2% and 4.2% for specific phobia, 4.3% and 1.7% for major depressive disorder, and 2.3% and 1.0% for generalized anxiety disorder. Among the sociodemographic variables, widowed status, higher income, and rural residence were the risk factors for both lifetime major depressive disorder and alcohol use disorder after controlling for gender, age, and education. The prevalence of psychiatric disorders was higher than those observed in other East-Asian countries and most European countries, but lower than that in the United States. Alcohol use disorder was particularly high in Korea.

The effects on memory and learning ability of the Korean herbal medicine, Saenhyetang (SHT), which is consisted of nine herbs, were investigated. Hot water extracts (HWE-SHT) and ethanol extracts (EE-SHT) were used for the studies. It was shown that N-methyl-d-aspartate (NMDA) receptor 2B (NR2B) was increased in the forebrains of SHT-administrated mice (HWE-SHT), leading to enhanced activation of NMDA receptors, facilitating synaptic potentiation in response to stimulation at 10-100Hz. These HWE-SHT-treated mice exhibit superior ability in learning and memory in various behavioral tasks, showing that NR2B is enhanced by HWE-SHT treatment and also is critical in gating the age-dependent threshold for plasticity and memory formation. NMDA receptor-dependent modifications, which were mediated in part by HWE-SHT administration, of synaptic efficacy, therefore, represent a mechanism for associative learning and memory. Results suggest that oriental medical enhancement of NR2B attributes such as intelligence and memory in mammals is feasible. On the other hand, to examine the effects of EE-SHT on the learning and memory in experimental mice, the passive and active avoidance responses were studied. The EE-SHT ameliorated the memory retrieval deficit induced by ethanol, but not other memory impairment in mice. EE-SHT (10, 20mg/100g, p.o.) did not affect the passive avoidance responses of normal mice in the step through and step down tests, the conditioned and unconditioned avoidance responses of normal mice in the shuttle box and lever press performance tests, and the ambulatory activity of normal mice in normal condition. However, EE-SHT was shown to significantly decrease the spontaneous motor activity during the shuttle box test, and also to prolong the sleeping time induced by pentobarbital in mice at 20mg/kg. These results suggest that EE-SHT has an ameliorating effect on memory retrieval impairment and a weak tranquilizing action.

This study revealed the presence of various rickettsial agents in mites from wild rodents collected in Southern Jeolla Province, Korea, by nested polymerase chain reaction (PCR) and sequence analysis of a partial citrate synthase and rickettsia outer membrane protein B genes. Rickettsial agents closely related to the Rickettsia species TwKM02, R. australis, and the Rickettsia species Cf15 were successfully identified in this study, for the first time in Korea, and R. japonica, R. akari, R. conorii, R. felis, and R. typhi were also detected, as previously described. The data presented in this paper extend knowledge on the geographic distribution of SFG rickettsiae in eastern Asia and it may necessary to consider the role of mites in rickettsial transmission.

Immunogenetic factors may play a role in determining the susceptibility of an individual to viral infection. The aim of current study was to investigate the association of clearance of hepatitis B virus (HBV) with promoter polymorphisms within the CC chemokine receptor 5 (CCR5) and its major ligand, regulated upon activation, normal T cells expressed and secreted (RANTES) genes. Five chemokine system polymorphisms (CCR5 Delta32, CCR5 promoter 59029G/A, 59353C/T, RANTES -403G/A, and -28C/G) were studied in a total of 698 subjects. The carriage of each genetic variant was compared among "spontaneously recovered" group (n = 243), "chronic carrier" group (n = 349), and "unexposed" group (n = 106). CCR5 59029G promoter variant was associated with clearance of HBV infection in an acute phase (OR = 1.71, P = 0.006, dominant model; OR = 2.17, P < 0.001, recessive model) and amelioration of hepatic inflammation (P = 0.003) with the control of HBV replication (P = 0.04) in chronic carriers. Interestingly, CCR5 59029 was linked completely to CCR5 59353, and CCR5 Delta32 homozygosity or heterozygosity was not found in any Korean patient. No association was seen with RANTES polymorphisms at position -403 and -28. The CCR5 59029G/CCR5 59353T polymorphism may play a role in the clearance of HBV infection., ((c) 2006 Wiley-Liss, Inc.)

Objective: To evaluate the prevalence of specific frontal recess cells in Korean and Caucasian populations; to evaluate and compare the relationship between anterior skull base length and frontal recess pneumatization in these two populations., Materials and Methods: Frontal recess anatomy was studied with high resolution sinus CT scans obtained in 60 Korean adults and 41 Caucasian adults. None of the subjects had a history of frontal sinus disease or trauma. The anterior cranial base length (ACBL, distance between the nasion and center of the pituitary fossa) and anterior ethmoid length (AEL, distance between the nasion and upper attachment of basal lamella) was also measured on each side., Results: Supraorbital ethmoid cells were more common in Caucasians whereas suprabullar cells and recessus terminalis were more common in Koreans. The prevalence of some frontal recess pneumatization patterns (specifically supraorbital ethmoid cell, suprabullar cell, and recessus terminalis) were more commonly associated with race rather than with ACBL or AEL., Conclusion: Frontal recess pneumatization patterns differ in the Korean and Caucasian adult populations. Because corresponding differences in skull base length were not identified, these differences seem likely to reflect other factors. Such information has clinical significance for frontal recess surgery in these patient populations.

A mail questionnaire survey on the present status and health of children of Korean survivors of the 1945 atomic bombing of Japan was conducted in 2004. In total, 1,115 Korean A-bomb survivors' reports on demographic factors and the health of their children (n = 4,079) were analysed. In 2004, 293 of their children were reported to have died and 3,786 children still living. Among the deceased children, the cause of death was unidentified in 64 per cent of cases. The most frequently reported cause of death was infectious disease (9.6%). Most of the deaths (51%) were reported to have occurred in children less than ten years old. The most frequently reported congenital disorders among living children were mental retardation (0.18%) and congenital bone disorders (0.18%). Further study and administrative support are needed to more accurately determine the status of Korean A-bomb survivors and their children.

Many Koreans, in addition to Japanese, were killed or injured by the atomic bombs detonated over Hiroshima and Nagasaki, Japan, in 1945. Our study examined noncancer diseases of Korean A-bomb survivors in residence at Hapcheon, Republic of Korea and evaluated whether they had significantly higher prevalence of noncancer diseases than non-exposed people. We evaluated a number of tests, including anthropometric measurements, blood pressure, blood chemistry, hepatitis B surface antigen, and urinalysis, of survivors (n=223) and controls (n=372). Univariate analysis revealed significantly lower fasting glucose and creatinine, and higher diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase, and blood urea nitrogen levels in the survivors than in the controls. The calculation of crude prevalence ratios (PRs) revealed that A-bomb survivors had a significantly higher prevalence of hypertension (PR, 1.16; 95% CI, 1.00-1.35) and chronic liver disease (2.20; 1.59-3.06) than controls. After adjusting for covariates (age, sex, body mass index, marital status, education, alcohol consumption, and smoking), A-bomb survivors had a significantly higher prevalence of hypertension (1.24; 1.06-1.44), chronic liver disease (2.07; 1.51-2.84), and hypercholesterolemia (1.79; 1.11-2.90) than controls. This study suggests that A-bomb exposure is associated with a higher prevalence of non-cancer diseases in Korean survivors.

The addition of rituximab to cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) has been shown to improve the outcome in all age groups with newly diagnosed diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective analysis to evaluate the impact of this combination therapy on DLBCL outcomes in Korea. From October 2001 to June 2004, newly diagnosed DLBCL patients in nine Korean institutes were included. All of these 81 patients were treated with three or more cycles of rituximab plus CHOP (R-CHOP) combination chemotherapy (R group), and followed for a minimum of 12 months. For comparison, a historical cohort of patients was used and analyzed for "Clinicopathologic characteristics of Korean non-Hodgkin's lymphomas (NHLs) based on Revised American Lymphoma (REAL) classification" in 1999. Among the 1,098 NHL patients, the data of 214 DLBCL patients, who were treated with CHOP chemotherapy in first-line, were analyzed (C group). We compared outcomes between the C group and the R group. A total of 295 patients were evaluated (C group, 214; R group, 81). The complete response (CR) rate was higher in R group (73 vs 91%, p=0.001). The 2-year event-free survival (EFS) rate was significantly higher in R group (78 vs 85%, p=0.0194). This survival benefit was maintained in high-risk patients according to the international prognostic index (IPI) (p=0.0039), regardless of age. However, there was no significant difference in low-risk patients. The addition of rituximab to CHOP combination chemotherapy for DLBCLs showed improved outcomes, particularly in high-risk group according to the IPI. Long-term follow-up results will be needed to confirm these results.