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The IB DP is widely perceived as a globally recognised, outstanding international curriculum by a growing number of education scholars and policymakers in South Korea. Recently, education authorities from certain provinces have taken steps to adopt the IB DP in public high schools, contending that the programme will improve and galvanise teaching practices to be student-centred and inquiry-based. It is important to emphasise, however, that this ambitious belief lacks empirical research evidence. To address such research gaps, this study interviewed 13 Korean graduates who participated in the IB DP from a wide range of international schools and currently attend higher education institutes in Korea. Major findings revealed that, contrary to the dominant perceptions in Korea (and probably elsewhere), the participants had ambivalent feelings about the curriculum and instructions of the IB DP. Findings also demonstrated that the participants' experiences of the international curriculum were affected by local contextual factors such as school ethos, academic culture and belief systems, not just by the educational philosophy of the IB DP. As findings portrayed gaps between the academic principles of the IB DP and experiences of students, this study contends both Korean policymakers and international scholars to carefully consider the potential implications of enacting the IB DP in local school systems. As curriculum change is nestled within a web of global-local dynamics, more context-specific knowledge is needed to understand how students will participate in the IB DP.

Empirical studies focused on cultural capital only emerged since the 2000s in South Korea. This article is the first to conduct a systematic review aiming to shed light on how the theory of cultural capital has been applied in South Korea. Our main goal is to understand: how the cultural capital-students' achievement association in South Korea differs from research in western industrialized contexts; and how cultural capital has been defined, and which dimensions have been highlighted as core elements of social reproduction in South Korea. Based on an examination of both quantitative and qualitative studies published since 2000, our analysis suggests that, contrary to the focus on the highbrow culture or classed-based parenting practices in western literature, the institutionalized striving for upward social mobility through education and a popular desire to acquire globally convertible cultural capital is key to unpacking the notion of cultural capital in the South Korean context.

Using interview data from secondary teachers, this study examines conflicting perspectives on the effects of the new national curriculum in South Korea, which was intended to grant more autonomy to individual schools and teachers. Contrary to the general belief that teachers want more autonomy to customize their curricula to meet students' needs, this study found that the participating teachers did not welcome the enhanced curricular autonomy nor did they believe it would diversify the school curriculum. The primary causes of this contradiction are the gap between the desired and the granted autonomy, the new national curriculum's negative impact on the relationships among teachers and their job security, and the prevalent credential culture in South Korea. Based on these findings, this study suggests wider implications for curriculum scholars and policymakers in other contexts concerning the nature and effects of teacher autonomy in curriculum development.

By examining teacher interviews and student survey data through the lens of multiculturalism and post-colonialism, this study investigates how the USA is taught in secondary school social studies in South Korea. Specifically, the study examines the teachers' goals, the representation of the USA in Korean textbooks and its influence on the instruction, the effect on the instruction by the dominant discourse on the USA in South Korea, and the conceptions of the USA held by Korean students in social studies classes. Our findings show that while the teachers strive to present diverse and complex aspects of the USA and its culture, for several reasons they rarely achieve these goals: the textbooks do not support these goals, the teachers lack relevant knowledge and experience, and administrators resist instruction that challenges the generally positive opinion of the USA among South Koreans. Consequently, the students often end up having complex, contradictory ideas about the USA. Based on these findings, this study argues that educators in Korea (and elsewhere) would benefit from curriculum re-evaluations aimed at helping their students acquire a more refined understanding of other cultures and other peoples, in particular the understanding of the values associated with human equality and diversity.

The primary purpose of this study is to investigate how key competencies can be incorporated into school curricula, what relevant instructional methods are needed and what institutional support is required to make school curricula based more on key competencies. For this, the study uses qualitative data from three schools (one each in South Korea, Australia, and New Zealand). The results indicate that a transformative approach, not an additive approach, is required. That is, teachers tend to restructure existing curricula to develop students' key competencies instead of considering the latter as a new teaching component. In terms of instructional methods, teachers are likely to believe that more engaging and participatory instructional methods would help their students to practice and develop diverse aspects of their competencies. Further, the principal's efforts to enhance communication and interaction with teachers is crucial to constructing local definitions of key competencies and shared visions for integrating such competencies with school curricula and instruction. The results indicate a need for redirecting the role of school curricula from transmitting content knowledge of academic subjects to developing students' key competencies.

The purpose of this paper is to investigate the origin and evolution of multicultural education in Korea, remaining issues, and global implications that the Korean case may provide to educators in other contexts, especially to those in Asia-Pacific countries. To address these topics, this paper analyzes government documents, various survey data, and research literature related to historical, theoretical, and practical aspects of multicultural education in Korea. Major findings show that, despite substantial achievements in a short period of time, significant structural barriers against minority groups still remain, while an assimilationist approach tends to dominate multicultural education in Korea. It is also suggested that reforming teacher education programs to produce culturally competent teachers is crucial for the further development of multicultural education in Korea. Based on the Koran case, this paper calls for collective efforts among educators in the Asia-Pacific region to explore more diversified approaches to multicultural education, as theories and practices based on Western experiences may have limited application to this region.

This study was conducted to investigate the pesticide residue concentrations and assess potential human health risks from vegetable consumption in Incheon. A total of 960 samples were collected from the Incheon areas of Korea in 2019. The pesticide residues were analyzed by the multi-residue method of the Korean Food Code for 373 different pesticides using GC–MS/MS, LC–MS/MS, GC-ECD/NPD, and HPLC-UVD. Among the vegetable samples, 869 samples (90.5%) were free from detectable residues, while 91 samples (9.5%) contained residues, and 16 samples (1.7%) had residues exceeding the Korean maximum residue limit (MRLs). A total of 33 different pesticide residues were found, and 11 residues exceeded MRLs. The most frequently detected pesticide residues were chlorfenapyr, fludioxonil, pyridalyl, hexaconazole, and procymidone. Samples exceeding the MRLs were found in aster scaber, coastal hog fennel, lettuce (leaves), mustard green, mustard leaf, perilla leaves, Pimpinella brachycarpa, radish leaves, shepherd' purse, spinach, and winter-grown cabbage. The potential health risk assessment of pesticides was estimated by calculating the estimated daily intake (EDI) and the acceptable daily intake (ADI). The range of HQs was 0.002–90.621%, which was below 100%. Therefore, the results of this study show that the detected pesticide could not be considered a serious public health problem through the consumption of vegetables. [ABSTRACT FROM AUTHOR]

Pueraria lobata (Willd.) Ohwi. is a widely used medicinal plant in Korea, China, and Japan. The flower of P. lobata (Puerariae Flos) contains various bioactive substances such as triterpenoidal saponins and isoflavonoids. In this study, we developed a quantitative analysis of the isoflavones of Puerariae Flos by quantitative proton nuclear magnetic resonance (qHNMR) spectroscopy using the internal calibrant (IC). From the qHNMR results, the isoflavone content was found to be 7.99% and 10.57% for the MeOH sonication extract (PLs) and the MeOH reflux extract (PLr) of Puerariae Flos, respectively. The quantified isoflavone content was validated using the conventional analytical method, high-performance liquid chromatography with ultraviolet detection (HPLC-UV). The present study shows that validated qHNMR spectroscopy is a reliable method for quantifying and standardizing the isoflavone content in Puerariae Flos. [ABSTRACT FROM AUTHOR]

One long-standing goal in the emerging neuromorphic field is to create a reliable neural network hardware implementation that has low energy consumption, while providing massively parallel computation. Although diverse oxide-based devices have made significant progress as artificial synaptic and neuronal components, these devices still need further optimization regarding linearity, symmetry, and stability. Here, we present a proof-of-concept experiment for integrated neuromorphic computing networks by utilizing spintronics-based synapse (spin-S) and neuron (spin-N) devices, along with linear and symmetric weight responses for spin-S using a stripe domain and activation functions for spin-N. An integrated neural network of electrically connected spin-S and spin-N successfully proves the integration function for a simple pattern classification task. We simulate a spin-N network using the extracted device characteristics and demonstrate a high classification accuracy (over 93%) for the spin-S and spin-N optimization without the assistance of additional software or circuits required in previous reports. These experimental studies provide a new path toward establishing more compact and efficient neural network systems with optimized multifunctional spintronic devices. Neuromorphic computing: A new spin on synapses and neurons An array of low-power devices that mimic the behavior of the brain has been constructed by researchers in South Korea. The brain works by passing chemical and electrical signals across a network of cells called neurons, which are connected via synapses. Scientists want to create an artificial neural network to take advantage of the parallel way in which the brain processes information. YeonJoo Jeong from the Korea Institute of Science and Technology, Jin Pyo Hong from Hanyang University, both in Seoul, and their colleagues have demonstrated a proof-of-principle neuromorphic computing network using so-called spintronic devices. Spintronics are low-power devices that use the property of an electron called spin rather than its charge as in conventional electronics. The team's neural network of electrically connected spin-synapses and spin-neurons successfully performed a simple pattern classification task. We introduced spintronics-based synapses (spin-S) by utilizing a stripe domain ensuring its highly linear and symmetric weight responses, together with domain-wall motion-based neurons (spin-N) for activation functions. In addition, a crossbar array architecture for the spin-S/N has been proposed and experimentally demonstrated. A simple pattern-classification task was tested using an integrated network of electrically connected spin-S and spin-N to mimic a human brain. Our experimental findings provide a new avenue toward establishing more efficient neural network systems with spintronic devices. [ABSTRACT FROM AUTHOR]

Purpose: To investigate age-related differences in the relationships among at-risk alcohol consumption, alcohol use disorder (AUD), and psychological distress with a special focus on older adults.Methods: We used a nationwide cross-sectional study of a representative sample of community-dwelling adults from the Korean Epidemiologic Catchment Area study for psychiatric disorders conducted by door-to-door interviews. The Korean version of the Composite International Diagnostic Interview was applied. Subjects were categorized into four age groups: young-to-middle-aged (20-54 years), near-old (55-64 years), early-old (65-74 years), and late-old (≥ 75 years). The associations among at-risk drinking, alcohol use disorder, and psychological distress were examined according to age groups.Results: Among a total of 5102 individuals, half of them drank alcohol in the previous year, of whom 20.5% were at-risk drinkers (≥ 100 g/week). Older people were less often diagnosed with AUD than young-to-middle-aged adults with a similar degree of at-risk drinking. They were less likely to meet the DSM-5 AUD criteria in terms of social and vocational role disruption or creation of a physically hazardous situation. However, at-risk drinking showed a stronger association with subjective psychological distress in older adults, particularly in the near-old group (adjusted odds ratio 1.82, 95% confidence interval 1.09-3.03; p = 0.023).Conclusions: These findings indicate the importance of screening for mental health problems in older adults, especially near-old adults, who drink more than 100 g of alcohol per week even when they do not satisfy the criteria for a diagnosis of AUD. [ABSTRACT FROM AUTHOR]

Background: Conflicting results have been reported concerning the progression of medial meniscal extrusion (MME) after arthroscopic transtibial pull-out repair of medial meniscus posterior root tear (MMRT), and no study has evaluated the relevant factors affecting the progression of MME. Purpose: To (1) evaluate the subjective and objective surgical outcomes of arthroscopic transtibial pull-out repair of MMRT and (2) identify relevant factors affecting the progression of MME after surgery. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 63 patients who underwent isolated arthroscopic transtibial pull-out repair of MMRT between January 2010 and June 2017 were evaluated retrospectively. Clinical scores and various radiographic parameters were evaluated to assess the surgical outcomes. The patients were classified into 2 groups according to the change in medial meniscal extrusion ratio (MMER) at 1 year after surgery compared with before surgery (group 1 consisted of 21 patients with reduced or maintained MMER; group 2 consisted of 42 patients with increased MMER). Variables including baseline demographics, radiographic parameters, and arthroscopic findings were compared to identify relevant factors affecting the progression of MME after surgery. Results: In the overall cohort, clinical outcomes at postoperative 2 years improved significantly (P <.001 for visual analog scale score, International Knee Documentation Committee subjective score, and Lysholm score), whereas radiographic parameters showed an overall deterioration compared with the preoperative level. In subgroup comparisons, a significant difference was seen in the time from the onset of symptoms until surgery (P <.001), defined as preoperative symptom duration, which a subsequent logistic regression analysis revealed to be a relevant factor associated with the progression of MMER (P =.015). Both groups showed progression of radiographic osteoarthritis, but the progression was significantly higher in group 2 compared with group 1 at postoperative 2 years (P =.032). On receiver operating characteristic curve analysis, the cutoff point for preoperative symptom duration associated with the progression of MMER was 13 weeks (sensitivity, 52.4%; specificity, 76.2%; accuracy, 72.4%). Conclusion: The arthroscopic transtibial pull-out repair of MMRT showed clinical improvement but did not prevent the progression of knee osteoarthritis, MME, or MMER. Although the preservation of MMER was not capable of completely preventing the progression of knee degeneration, MMER still has a potential clinical value in delaying the rate of progression of knee degeneration. Early surgical repair of MMRT, within 13 weeks from the onset of symptoms, might be helpful to prevent the progression of MME. [ABSTRACT FROM AUTHOR]

This study compared perceived trajectories of life satisfaction (LS) between North Korean defectors' (NKDs') and the general South Korean population and examined psychosocial factors associated with future LS. Data were obtained from 300 NKDs residing in South Korea and 5089 South Koreans using self-questionnaires and face-to-face interviews. LS values from 5 years ago (3.46 vs. 6.18) and at present (5.30 vs. 5.91) were lower in NKDs than the control group, but the inverse was true for expected LS score in 5 years (7.82 vs. 6.87). NKDs' LS trajectory showed a more statistically positive trend than that of the control group. Among NKDs, subjective sense of loneliness and satisfaction with one's sense of autonomy were associated with expected future LS. NKDs experience higher life satisfaction and expect an optimistic future relative to the control group. Social policies and therapeutic approaches to loneliness and improving a sense of autonomy may be beneficial. [ABSTRACT FROM AUTHOR]

To prepare for the potential of extreme drought caused by climate change, both physical and socioeconomic factors need to be considered. In this study, three general circulation models were selected: IPSL‐CM5A‐LR, HadGEM2‐AO, and CanESM2 as representative scenarios for severe, moderate, and relatively weak droughts to assess the risk of droughts for future climate projections. Drought hazard was estimated using the meteorological drought index to determine drought frequency, severity, and probability. Population density, agricultural land area, and municipal, agricultural, and industrial water demand were used as drought vulnerability indicators. The Analytical Hierarchy Process technique was applied to determine the weight of each indicator, and the integrated drought risk was then estimated. HadGEM2‐AO and CanESM2 projected that drought risk would be reduced in the far future. IPSL‐CM5A‐LR projected an increased drought risk in the near and far future in the downstream area of the Nakdong River Basin. This study presented a quantitative approach to identify high drought‐risk areas that should be the focus of future extreme drought assessments and mid‐ to long‐term drought mitigation strategies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the association between coronary angiography (CAG) with and without percutaneous coronary intervention (PCI) after out-of-hospital cardiac arrest (OHCA) and neurological recovery and to determine the influence of primary electrocardiogram or patient age on the effects of CAG. Methods: Adult patients with OHCA with cardiac etiology who were admitted to PCI-capable hospitals from 2016 to 2017 were enrolled in this study from the nationwide OHCA registry of Korea. Coronary intervention was categorized into three groups: No CAG, CAG without PCI, and CAG with PCI. The endpoint was good neurological recovery. Multivariable logistic regression and interaction analyses (intervention × electrocardiogram and intervention × age) were conducted by calculating adjusted odds ratios (aORs) and 95% confidence intervals (CI). Results: Of a total of 6,802 eligible OHCA patients, 1,218 (17.9%) underwent CAG without PCI and 1,136 (16.7%) underwent CAG with PCI. The CAG without PCI and CAG with PCI groups were more likely to have good neurological recovery than the No CAG group (57.4% vs. 61.6% vs. 16.3%; 3.39 [2.83–4.06] for CAG without PCI and 3.32 [2.74–4.01] for CAG with PCI). Interaction analysis showed that although the effect size differed according to patient characteristics, both CAG groups were associated with an increased likelihood of good neurological recovery, regardless of primary electrocardiogram and age group. In younger patients, CAG with PCI had greater outcome benefits than CAG without PCI (8.54 [4.31–16.95] vs. 4.10 [2.69–6.24]), whereas CAG without PCI had a larger effect size than CAG with PCI in elderly patients (4.46 [2.59–7.68] vs. 2.92 [1.80–4.73]) (p value for interaction 0.02). Conclusions: Post-resuscitation CAG with and without PCI are associated with better neurological recovery in patients with OHCA, regardless of primary electrocardiogram and patient age. [ABSTRACT FROM AUTHOR]

Even though South Korea's universal health care system was established in 1989, many South Koreans continue to encounter obstacles in their attempts to access health care. Previous studies have not investigated the relationship between health care access and utilization and perceived health in the context of a universal health care system that implements a mandatory social health insurance policy. The objective of this study was to evaluate the influence of health care access and use of preventive health care services on self-rated health among young and middle-aged adults in Korea. The sample consisted of 1242 young adults aged 20-39 years and 2389 middle-aged adults aged 40-64 years who had participated in the cross-sectional 2015 Korea National Health and Nutrition Examination Survey. Using multiple logistic regression analysis, the association between health care access and use of preventive health care services and perceived poor health among young adults and middle-aged adults was assessed. The main finding was that a history of unmet health care requirements during the past 12 months was strongly associated with fair and poor self-rated health, especially among young adults. Additionally, middle-aged adults who had attended medical check-ups during the preceding 2 years reported poorer self-rated health. This study's findings suggest that, despite South Korea's universal public insurance system, there remains the need to improve access to health care services, especially among young adults. As a health improvement strategy, it is imperative that measures be taken to promote the availability of health care services when they are required and to solve any of the various individual accessibility problems, such as cost, particularly with young adults in mind. [ABSTRACT FROM AUTHOR]

This study assessed the association between experiencing physical or sexual intimate partner violence (IPV) and mental health among women in the general Korean population. A total of 3160 South Korean women aged 18 to 74 responded to the Korean version of the WHO-Composite International Diagnostic Interview (K-CIDI), version 2.1., and questions about IPV. Multiple logistic regression was used to examine the odds of developing mental disorders associated with each type of IPV. Victimization by any type of IPV was associated with significantly increased odds of experiencing any mental disorders in the lifetime (OR 4.4, 95% CI 2.4–8.0). Participants who experienced sexual IPV had the highest odds of having mental disorders (OR 14.3, 95% CI 4.1–54.8). Sexual IPV experience among participants was associated with higher odds of major depressive disorder, anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, specific phobias, agoraphobia, and nicotine dependence. Alcohol use disorder was highly associated with experiencing physical IPV (OR 3.8, 95% CI 1.7–8.0). Among women who experienced IPV, the youngest age group, from 18 to 35 years old (2.6%, 95% CI 1.4–3.8), and the never married group (2.7%, 95% CI 1.2–4.2) experienced the highest proportion of any form of IPV. Mental disorders throughout the lifetime are highly associated with the experience of IPV among women and are most prevalent among those who experienced sexual IPV. Thus, to prevent mental disorders among female IPV victims, treatment specific to each type of IPV should be provided early. [ABSTRACT FROM AUTHOR]

Objective: Fungal rhinosinusitis occurs in different forms depending on race and region. While allergic fungal rhinosinusitis is common in Caucasians, fungal ball (FB) is more common in Asians. However, most cases are reported as unilateral, and clinical data on bilateral FB (BFB) are rare. Therefore, the purpose of this study was to analyze and to compare the clinical characteristics of BFB and unilateral FB (UFB) in Koreans. Methods: We retrospectively analyzed medical records and computed tomography (CT) images of 434 patients diagnosed with FB. The patients were divided into two groups: BFB and UFB. Demographic data, multiple allergen simultaneous test including total or specific immunoglobulin E (IgE) levels, symptoms, CT findings, treatment, and outcomes were analyzed. Results: Among the patients, 26 had BFB and 408 had UFB. Hypertension was noted in 61.5% of the BFB and 39% of the UBF individuals (p = 0.023). While total IgE levels were similar between the two groups, Dermatophagoides pteronyssinus (p = 0.004), Cladosporium (p = 0.017), and Aspergillus-specific IgE positivity (p = 0.025) were significantly higher in the BFB than in the UFB group. Not only symptoms such as postnasal drip (p = 0.013), mucopurulent rhinorrhea (p = 0.009), and foul odor (p = 0.037), but also sphenoid sinus involvement on CT images were more common in the BFB than in the UFB group (p = 0.011). Conclusion: Patients with BFB in Korea showed more common hypertension and symptoms of foul odor, mucopurulent rhinorrhea, and postnasal drip with allergy positivity compared to those with UFB. Therefore, understanding clinical characteristics of BFB will allow clinicians to approach BFB more appropriately. [ABSTRACT FROM AUTHOR]

For more than 10 years, the suicide rate in South Korea has been the highest among members of the Organization for Economic Cooperation and Development. Suicide-prevention strategies, such as restricting access to lethal suicide methods, have been implemented in Korea. In this paper, we discuss suicide-prevention strategies that restrict access to the five leading methods for committing suicide: pesticide ingestion, inhalation of charcoal fumes, jumping from heights, placing oneself in front of moving subway trains, and hanging oneself by the neck. Of the five suicide-prevention strategies outlined in our study, prohibition of the herbicide paraquat and installation of screen doors were proven to be effective, while others need further assessments. Yet, the overall decline in suicide rate from 31.7 per 100,000 people in 2011 to 27.3 per 100,000 people in 2014 suggests that these suicide-prevention strategies have successfully decreased the suicide rate in Korea. [ABSTRACT FROM AUTHOR]

Pleiotropy has important implications for understanding the genetic basis and risk assessment of osteoporosis. Our aim was to identify pleiotropic genetic variants associated with the development of osteoporosis and predict osteoporosis risk by leveraging pleiotropic variants. We evaluated the effects of 21 conventional risk factors and 185 single-nucleotide polymorphisms (SNPs) in 63 inflammation- and metabolism-related genes on osteoporosis risk in a community-based Korean cohort study of 1025 participants, the Hallym Aging Study. Ten nongenetic factors, including sex (female) and hematocrit level, and 12 SNPs across ten genes showed evidence of association with incident osteoporosis in 270 initially osteoporosis-free subjects who completed a 6-year follow up. Three gene variants, rs1801282 (PPARG-Pro12Ala, hazard ratio (HR) = 3.26, P = 0.008), rs1408282 (near EPHA7, HR = 1.87, P = 0.002), and rs2076212 (PNPLA3-Gly115Cys, HR = 2.24, P = 0.024), were associated with significant differences in survival among the three genotype groups (Pdiff = 0.042, 0.003, and 0.048, respectively). Individuals in the highest polygenic risk score tertile were 27.9 fold more likely to develop osteoporosis than those in the lowest tertile (P = 0.004). The PPARG gene in particular was a hub pleiotropic gene in the epistasis network. Our findings highlight pleiotropic modulations of metabolism- and inflammation-related genes in the development of osteoporosis and demonstrate the contribution of pleiotropic genetic variants in prediction of osteoporosis risk. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) is a type of clinical depression that can affect women after childbirth. Few previous studies have explored the association of depressive and physical symptoms among women with PPD in a nationwide community study.Method: A total of 18,807 adults, randomly selected, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) (response rate 80.2%). PPD was defined as a major depressive episode that began within 4 weeks after delivery.Results: Of 679 female subjects with major depressive disorder (MDD), 14.0% (n=95) experienced PPD. Subjects with PPD were significantly more likely to have higher income, education, and reside in an urban area, compared to those with non-PPD. No significant differences were found in number of children. Multiple logistic regression revealed that the loss of sexual interest was the only symptom among 23 depressive symptoms that was significantly associated with depressive episodes among individuals with PPD (AOR=1.91, 95% CI 1.01-3.60) when compared with non-PPD. Loss of sexual interest was also significantly associated with the subjects with lifetime PPD regardless of depressive episode (AOR=1.93, 95% CI 1.12-3.31). Conversely, loss of confidence and loss of pleasure were less frequent in subjects with PPD. Premenstrual mood change (χ(2)=5.57, p=0.0036) and comorbid alcohol use disorder (χ(2)=5.11, p=0.031) showed a valid association with PPD.Conclusions: Loss of sexual interest and premenstrual mood change were associated with women with PPD, whereas those with non-PPD were not, thereby suggesting the possible link between sexual hormones and PPD. [ABSTRACT FROM AUTHOR]

Objective Suicide is a major cause of premature mortality in patients with epilepsy. We aimed to identify the clinical correlates of suicide in these patients. Methods We conducted a matched, case-control study based on a clinical case registry of epilepsy patients (n = 35,638) treated between January 1994 and December 2011 at an academic tertiary medical center in Seoul, Korea. Each epilepsy patient in the suicide group (n = 74) was matched with three epilepsy patients in the nonsuicide group (n = 222) by age, gender, and approximate time at first treatment. The clinical characteristics of the patients in both groups were then compared. Results In a univariate analysis, seizure frequency during the year before suicide, use of antiepileptic drug polytherapy, lack of aura before seizure, diagnosis of temporal lobe epilepsy, use of levetiracetam, psychiatric comorbidity, and use of antidepressants were all significantly higher in the suicide group than in the nonsuicide group. Multivariate analysis revealed that a high seizure frequency (odds ratio [ OR] 3.3, 95% confidence interval [ CI] 1.04-10.2), a lack of aura before seizure ( OR 4.0, 95% CI 1.7-9.3), temporal lobe epilepsy ( OR 3.7, 95% CI 1.6-8.6), and use of levetiracetam ( OR 7.6, 95% CI 1.1-53.7) and antidepressants ( OR 7.2, 95% CI 1.5-34.1) were all associated with a higher probability of suicide. Significance Patients with temporal lobe epilepsy who experience seizures weekly or more frequently, experience a lack of aura, use levetiracetam, or take antidepressants are all at a higher risk of suicide and should be monitored closely. [ABSTRACT FROM AUTHOR]

We assessed the association between nonalcoholic fatty liver disease (NAFLD) and carotid artery inflammation measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography. Participants were 755 consecutive otherwise healthy adult males who underwent a general health screening program. Carotid FDG uptake, represented as maximum target-to-background ratio, was increased with mild (n = 237; 1.61 ± 0.14; P = .033) and moderate NAFLD (n = 145; 1.63 ± 0.16; P = .005) compared with controls (n = 373; 1.58 ± 0.15). In patients aged >50 years, moderate NAFLD was the only independent risk factor for high carotid FDG uptake (odds ratio, 2.12; 95% confidence interval, 1.10-4.07; P = .001). Apparently healthy adult males with NAFLD have elevated carotid FDG uptake as well as increased carotid intima–media thickness, suggesting that they may be at an increased risk of having inflammatory atherosclerotic plaques in the carotid arteries. [ABSTRACT FROM PUBLISHER]

Despite the high prevalence of alcohol use disorders (AUDs) in Korea, few studies have been conducted on the temporal priority with comorbid mental disorders. We investigated the temporal priority of lifetime AUDs and comorbid mood and anxiety disorders among the general population of Korea. Data of 18,807 respondents aged 18 years or older, collected from three national epidemiological surveys comprising face-to-face interviews using the Korean version of the Composite International Diagnostic Interview for DSM-IV mental disorders. For each mood or anxiety disorder, the extent to which one mental disorder precedes another was investigated by calculating the proportion of primary AUDs by that of primary mood or anxiety disorder. Regarding alcohol dependence, dysthymic disorder is 5.6 times more likely to occur before alcohol dependence. Moreover, generalized anxiety disorder, social phobia, and specific phobia are 3.6 times, 4.5 times, and 6.3 times more likely to occur before, respectively. Regarding alcohol abuse, specific phobia is 6.3 times more likely to occur before, whereas major depressive disorder is two times more likely to occur after. Moreover, the lag times between primary alcohol abuse and subsequent mood or anxiety disorders were longer than those between primary alcohol dependence and the latter. The age of onset might be subject to recall bias. The presence of non-respondents could have influenced the results. We need to recognize that one of the mental disorders could lead to another and consider it in the management of people with AUDs or mood and anxiety disorders. • We studied the temporal priority of AUDs and comorbid mood and anxiety disorders. • Phobias are more likely to occur before than after AUDs. • MDD is more likely to occur after than before alcohol abuse. • Notably, each disorder represents a risk of the subsequent disorder. [ABSTRACT FROM AUTHOR]

Background The lethality of the suicide method is a strong risk factor for completed suicide. We examined whether the annual change in the pattern of suicide methods was related to the annual change in suicide rates among adolescents in South Korea and the United States. Methods We analyzed annual data for the 2000-2009 period for South Korea and the 2000-2008 period for the United States to examine time trends in the suicide rates and suicide methods of adolescents aged 10-19 years in two countries. Data on suicide methods were obtained from the World Health Organization ( WHO) mortality database. Results Suicide rates among adolescents in the United States have remained relatively steady since 2000, whereas the suicide among Korean adolescents has increased. Between 2000 and 2009, the most common suicide method among Korean adolescents was jumping for boys and girls, whereas it was hanging for girls and firearms for boys in the United States. Along with the annual increase in suicide rates in South Korea, the incidences of jumping among males and hanging (and recently jumping) among females have increased steadily, whereas suicide by self-poisoning steadily decreased. In the United States, between 2000 and 2008, the proportion of suicides committed by hanging increased, whereas those committed using firearms steadily decreased, particularly among adolescent females. Conclusions These findings suggest that the increased use of lethal suicide methods is reflected in the increase in suicide rates in Korean adolescents. The most fruitful approach to addressing the rises in jumping suicides among Korean adolescents and hanging suicides among adolescents in the United States may be through population-based initiatives to reduce the physical availability (e.g., limiting access to or fencing off tall structures) and the social acceptability (e.g., effective and responsible regulations for reporting suicide) of these methods. [ABSTRACT FROM AUTHOR]

Although previous studies have shown that childhood parental death influences suicide attempts of their offspring, few studies have examined influence of gender and age at exposure. Koreans show the third highest suicide rate in the world, and many children and adolescents lost their parents during and after the Korean War. A total of 12,532 adults, randomly selected through a one-person-per-household method, completed the Korean version of the Composite International Diagnostic Interview and questionnaire for suicidal ideation, plan, and attempt (response rate 80.2%). A total of 2,332 subjects experienced biological parental death in childhood (18.6%). Male suicide attempts were associated with age of exposure to maternal death from 0 to 4 years (adjusted OR = 4.48, 95% CI 1.32-15.18) and from 5 to 9 years (adjusted OR = 5.52, 95% CI 1.97-16.46), but not with paternal death, after adjusting for age, education years, marital status, monthly income, and psychiatric comorbidities. Female suicide attempts were associated with paternal death from 5 to 9 years (adjusted OR = 2.20, 95% CI 1.13-4.27), but not with maternal death. Childhood parental death is significantly associated with lifetime suicide attempt in the opposite-gender offspring, especially when exposure occurs before age 10. [ABSTRACT FROM AUTHOR]

South Korea (hereafter Korea) has had a later start than advanced Western countries in the use of performance management methods. However, over the past 15 years or so, Korea has had experience in using various performance management systems in many different areas. This study first explains the development of performance management and the level of its application in the Korean public sector. After that, this study attempts to identify the constraining factors (the competitive environment, incentives and discipline, management governance, value orientation, and the time frame of the performance process) on the effectiveness of performance management in the public sector and seeks ways to overcome such limitations, based on the diverse experience of performance management systems in the Korean public sector. [ABSTRACT FROM PUBLISHER]

Background: A recent national survey in South Korea indicated that the 12-month prevalence rate of major depressive disorder was 2.5%. Depressive disorders may lead to disability, premature death, and severe suffering of patients and their families. This study estimates the economic burden of depression in Korea from a societal perspective. Methods: Annual direct healthcare costs associated with depression were calculated based on the National Health Insurance database. Annual direct non-healthcare costs were estimated for transport. Annual indirect costs were estimated for the following components of productivity loss due to illness such as morbidity (absenteeism and presenteeism) and premature mortality. Indirect costs were estimated using the large national psychiatric epidemiological surveys in Korea. The human capital approach was used to estimate indirect costs. Result: The total cost of depression was estimated to be $4,049 million, of which $152.6 million represents a direct healthcare cost. Total direct non-healthcare costs were estimated to be $15.9 million. Indirect costs were estimated at $3,880.5 million. The morbidity cost was $2,958.9 million and the mortality cost was $921.6 million. The morbidity cost was identified as the largest component of overall cost. Conclusion: Depression is a considerable burden on both society and the individual, especially in terms of incapacity to work. The Korean society should increase the public health effort to prevent and detect depression in order to ensure that appropriate treatment is provided. Such actions will lead to a significant reduction in the total burden resulting from depression. [ABSTRACT FROM AUTHOR]

Background: Recently, abdominal-breathing or diaphragmatic-breathing methods have increased in popularity. Little is known how abdominal breathing affects the circulatory system. This study was designed to determine the impact of the respiratory pattern on central venous flow using echocardiography. Methods: The superior vena cava (SVC) and inferior vena cava (IVC) were observed in people who had practiced abdominal breathing for at least 2 years, while they were breathing in three different techniques: slow respiration, slow respiration with inspiratory pause, or normal respiration. In addition, the observation during normal respiration was compared with that of a control group. Results: The abdominal-breathing group consisted of 20 people with mean duration of training of 9.6 years. The respiratory collapsibility index of IVC during slow respiration with inspiratory pause was 62±19% compared with 48±19% during normal respiration ( p=0.012) in the abdominal-breathing group. The abdominal-breathing group had a higher IVC collapsibility index compared to the control group during normal respiration (48±19% versus 26±12%, p<0.001), assuming a similar respiratory rate of about 10/min. Neither the size nor the minute flow of SVC differed among breathing patterns or between groups. Conclusions: The IVC of people who practice abdominal breathing has a greater degree of collapse than those of normal people, suggesting that abdominal-breathing exercise can positively affect venous return via IVC. For those who practice abdominal breathing, the collapsibility of the IVC is the best during slow respiration with inspiratory pause. The SVC did not seem to be affected by abdominal-breathing training. [ABSTRACT FROM AUTHOR]

The goal of this study was to investigate the association of prehospital oxygen administration flow with clinical outcome in severe traumatic brain injury (TBI) patients. This was a cross-sectional observational study using an emergency medical services-assessed severe trauma database in South Korea. The sample included adult patients with severe blunt TBI without hypoxia who were treated by EMS providers in 2013 and 2015. Main exposure was prehospital oxygen administration flow rate (no oxygen, low-flow 1~5, mid-flow 6~14, high-flow 15 L/min). Primary outcome was in-hospital mortality. A total of 1842 patients with severe TBI were included. The number of patients with no oxygen, low-flow oxygen, mid-flow oxygen, high-flow oxygen was 244, 573, 607, and 418, respectively. Mortality of each group was 34.8%, 32.3%, 39.9%, and 41.1%, respectively. Compared with the no-oxygen group, adjusted odds (95% CI) for mortality in the low-, mid-, and high-flow oxygen groups were 0.86 (0.62–1.20), 1.15 (0.83–1.60), and 1.21 (0.83–1.73), respectively. In the interaction analysis, low-flow oxygen showed lower mortality when prehospital saturation was 94–98% (adjusted odds ratio (AOR): 0.80 (0.67–0.95)) and ≥99% (AOR: 0.69 (0.53–0.91)). High-flow oxygen showed higher mortality when prehospital oxygen saturation was ≥99% (AOR: 1.33 (1.01~1.74)). Prehospital low-flow oxygen administration was associated with lower in-hospital mortality compared with the no-oxygen group. High-flow administration showed higher mortality. [ABSTRACT FROM AUTHOR]

Background: The leading causes of death among the elderly with cognitive impairment are unknown. This study aims to estimate the suicide and accidental death rates on the basis of a clinical case registry of patients diagnosed with cognitive impairment. Methods: The target sample consisted of 10,169 patients diagnosed with dementia or mild cognitive impairment (MCI), who were evaluated at the Clinical Research Center for Dementia of Korea (CREDOS) from January 2005 to December 2013. Information about whether the patients had died from suicide or in any kind of accident by December 31, 2016, was obtained from the database of the National Statistical Office (NSO). The standardized mortality ratio (SMR) and Cox-regression analysis were performed for evaluating the risk of suicide and accidental death as identified by the ICD-10. Results: The average of the Clinical Dementia Rating Scale (CDR) score (0.68 vs 0.93) was lower, and the age at the time of study registration (71.42 vs 75.68 years) was younger in the suicidal death group, as compared to the accidental death group. The overall SMR for accidental death in cognitively impaired patients (1.44, 95% CI 1.22–1.71) was significantly higher than the general population. Later onset (1.43, 95% CI 1.20–1.71) and older age (2.21, 95% CI 1.04–4.68) increased the risk of accidental death in cognitively impaired patients. According to the dementia subtypes, the SMR for accidental death was higher in both Alzheimer's disease (1.72, 95% CI 1.36–2.14) and vascular dementia (2.14, 95% CI 1.27–3.38). Additionally, the SMR for accidental death showed an increasing tendency as the CDR score increased (mild 1.80, 95% CI 1.32–2.42, moderate 1.86, 95% CI 1.07–3.03, severe 3.32, 95% CI 1.08–7.76). Unemployment increased the risks of both suicide (3.71, 95% CI 1.54–8.95) and accidental death (2.09, 95% CI 1.20–3.63). Conclusions: Among people with cognitive impairment, the risk of death by suicide did not increase, whereas that of accidental death increased significantly. Preventive strategies for premature mortality in those with cognitive impairment should be implemented from the early stages and should include careful evaluation of the individual risk factors for each type of death. [ABSTRACT FROM AUTHOR]

Background: Subthreshold hypomania is defined as a distinct period of elevated, expansive or irritable mood lasting for at least four days, but insufficient to fulfill the criteria of hypomania. This study aimed to investigate the association between suicidality and subthreshold hypomania in subjects with and without major depressive disorder (MDD).Methods: Face-to-face interviews were completed for 12,526 adults, randomly selected through a one-person-per-household method, using the Korean version of the Composite International Diagnostic Interview (K-CIDI) and a questionnaire relative to lifetime suicide attempts (LSA).Results: Of the 12,526 participants, 11,701 did not have MDD, and 825 were diagnosed with MDD. The MDD with subthreshold hypomania group (n = 72) revealed significantly higher rates of LSA and post-traumatic stress disorder (PTSD) than those without (n = 753). Compared to the no MDD without subthreshold hypomania group (n = 11,571), the no MDD with subthreshold hypomania group (n = 130) showed a significantly higher prevalence of suicidality and comorbid conditions. In multivariate logistic regression analyses of depressive symptoms, subthreshold hypomania was significantly associated with morning worsening of mood. The MDD with subthreshold hypomania group was significantly associated with LSA (AOR=16.82, 95% CI 9.81-28.83, p< 0.001), compared to the no MDD group without subthreshold hypomania. Compared to the MDD without subthreshold hypomania group, the MDD with subthreshold hypomania group revealed a significant association with LSA (AOR=2.08, 95% CI 1.20-3.62, p< 0.001).Conclusions: A history of subthreshold hypomania doubled the risk of LSA in patients with MDD compared to those without subthreshold hypomania. [ABSTRACT FROM AUTHOR]

Background: Alcohol-induced disinhibition (AID) is defined as a "loss of restraint over some form of behavior after drinking alcohol regardless of its amount". Although many previous studies have investigated on alcohol use disorder and suicide attempt, few studies have focused on AID and suicide.Methods: A total of 9461 adults who had a history of drinking completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) with the Suicide Module, and Barratt Impulsiveness Scale 11 (BIS-11). In this study, we defined the AID group as those who had been involved with the two antisocial behaviors, including fights, being arrested or dangerous driving, according to the K-CIDI.Results: Among 9461 subjects, 564 were classified as the AID group (5.96%). The AID group had a significantly higher number of lifetime suicidal ideation, plan, attempt, and multiple attempts, and higher BIS-11 scores than non-AID group. The total scores of BIS-11 of the AID group reported the highest score compared with other psychiatric disorders. The AID group experienced more frequently three types of alcohol withdrawal symptoms, including nervousness, heart beating fast, and feeling weak. Compared with subjects without both AID and MDD, subjects with both AID and MDD showed significant association with a lifetime suicide attempt (AOR = 6.86, p < 0.001) and showed stronger association with multiple attempts (AOR = 10.38, p < 0.001).Conclusion: AID was associated with suicide attempt and impulsivity, and the both AID and MDD showed much stronger association with lifetime suicide attempt and multiple attempts. [ABSTRACT FROM AUTHOR]

Background: Patients with subthreshold bipolar disorder (Sub-BP) experience severe clinical courses and functional impairments which are comparable to those with bipolar I and II disorders (BP-I and -II). Nevertheless, lifetime prevalence, socioeconomic correlates and diagnostic overlaps of bipolar spectrum disorder (BPS) have not yet been estimated in the general population of South Korean adults.Methods: A total of 3013 adults among the 2011 Korean Epidemiologic Catchment Area survey (KECA-2011) completed face-to-face interviews using the Korean versions of the Composite International Diagnostic Interview 2.1 and Mood Disorder Questionnaire (K-CIDI and K-MDQ).Results: The lifetime prevalence of BPS in the South Korean adults was measured to be 4.3% (95% CI 2.6-6.9). Nearly 80% of the subjects with BPS were co-diagnosed with other DSM-IV non-psychotic mental disorders: 35.4% (95% CI 24.2-48.5) for major depression and dysthymic disorder, 35.1% (95% CI 27.7-43.3) for anxiety disorders, and 51.9% (95% CI 40.5-63.1) for alcohol and nicotine use disorders. Younger age (18-34 years) was the only sociodemographic predictor of BPS positivity (P=0.014), and the diagnostic overlap patterns were different between men and women.Limitations: The prevalence of BPS and other mental disorders could have been influenced by recall bias due to the retrospective nature of this study.Conclusions: Positivity for BPS was estimated to be much greater than the prevalence of DSM-IV BP in South Korea. Most of the respondents with BPS were diagnosed with other major mental disorders and this might be related with mis- and/or under-diagnosis of clinically relevant Sub-BP. [ABSTRACT FROM AUTHOR]

• We studied associations between game use and mental health in early adulthood. • Risky game users self-reported low satisfaction and happiness. • High prevalence of major depressive disorder and suicidal ideation in risky users. • Happiness mediated game use and lifetime suicidal ideation in risky users. : The number of digital game users is increasing, and so is attention to digital gaming's effects on mental health. We aimed to reveal if risky (game addiction) and usual game use (non-risky) are associated with mental health in early adulthood. : Using data from the nationwide cross-sectional Korean Epidemic Catchment Area study for psychiatric disorders, 415 participants aged 18–30 years were divided into "non-game," "usual game," and "risky game" user groups based on the previous month's game use and cut-off value of game overuse screening questionnaire. Multiple linear and logistic regressions revealed the association between game use groups, perceived mental health, and lifetime prevalence of clinical mental disorders including suicidal ideation. : Among the 415 participants, 167 were non-game users, 175, usual game users, and 73, risky game users. Risky game users self-reported decreased satisfaction and happiness, and a significantly higher lifetime prevalence of major depressive disorder, alcohol dependence, and suicidal ideation. Usual game users were significantly associated with higher lifetime prevalence of alcohol dependence and suicidal ideation. Self-reported happiness partially mediated between game use and lifetime suicidal ideation in risky, but not usual game users. : This study is a cross-sectional observational study which was not possible to define the temporal relationship. : Both risky and usual game use are associated with mental health problems in early adulthood, indicating the need for careful mental health screening on not only risky game users but also usual game users. [ABSTRACT FROM AUTHOR]

Per- and polyfluoroalkyl substances (PFASs) are ubiquitous contaminants found worldwide, including in South Korea. As a result, they are frequently detected in Koreans. However, there is limited representative data and information on potential sources in Korea. Therefore, we measured the serum concentrations of ten PFASs in nationally representative samples of the Korean population (n=1874, 18-69 years) and evaluated the factors associated with their exposure. Serum PFOS, PFDA, PFOA, and PFNA were detected in nearly all participants (83.1-99.9%). However, serum PFPA, PFHxA, and PFHpA were almost undetected (<0.5% of participants). PFOS had the highest population-weighted geometric mean of 10.23ng/mL (95% CI: 9.99-10.47), which was followed by PFOA with 2.85ng/mL (95% CI: 2.73-2.97) and PFDA with 2.17ng/mL (95% CI: 2.12-2.23). PFNA, PFDA, PFHxS, PFOA, and PFOS concentrations were higher in males (p<0.001) and older adults (p<0.001). PFNA was higher in those who used wax, polish, and water-resistant materials (adjusted proportional change=1.14; 95% CI: 1.08-1.22), and those who ate cooked fish (1.16; 95% CI: 1.03-1.31) compared to those who ate nearly no fish. PFDA was higher in those who used herbicides and pesticides (1.05; 95% CI: 1.02-1.09), those who drank beverages in a plastic bag on a daily basis (1.10; 95% CI: 1.03-1.19), and those who ate raw fish (1.15; 95% CI: 1.03-1.29) or cooked fish (1.13; 95% CI: 1.05-1.23) compared to those who ate nearly no fish. PFHxS was higher in those who used traditional Korean health supplement foods (1.08; 95% CI: 1.01-1.15). PFOA was higher in those who used plastic wrap in a microwave daily or weekly (1.08; 95% CI: 1.00-1.16), and those who used disposable paper cups (1.07; 95% CI: 1.01-1.13). PFOS was lower in underweight participants (0.84; 95%CI: 0.75-0.93) compared to those who were obese, and higher in those who exercised regularly (1.08; 95% CI: 1.03-1.14) or irregularly (1.06, 95% CI: 1.01-1.12) compared to those who did not exercise. Subjects who used severely damaged Teflon appliances had lower concentrations of PFOA (0.78, 95% CI: 0.65-0.95), while regular use of Gore-Tex goods was related to higher PFNA (1.15, 95% CI: 1.03-1.28) and PFDA (1.11; 95% CI: 1.02-1.20) levels. These findings suggest that most Koreans are frequently exposed to PFASs, and that serum concentrations of PFASs vary with age, sex, and exposure factors. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the association between adult Internet game addiction (IGA) and mental disorders. A total of 1401 adults aged between 18 and 74 years participated in this study. The IGA group had significantly younger patients, and it showed a higher proportion of unmarried and unemployed adults, and higher rates of suicidal ideation, plan, and attempt than the non-IGA group. Multivariate logistic regression indicated that IGA was significantly associated with major depressive disorder, dysthymia, and depressive disorders adjusting for all variables. The Patient Health Questionnaire-9 score was significantly higher in the IGA group than in the non-IGA group for both young adults and middle groups. "Escape from negative emotions like nervousness, sadness, and anger" was the only significant item associated with depression among symptoms of IGA. This study suggests that adults with IGA and depression may use Internet games to escape from negative emotions. [ABSTRACT FROM AUTHOR]

PERFORM-K was a cross-sectional observational study that investigated functional disability, productivity and quality of life in MDD outpatients in South Korea, and the associations of these with depressive symptoms, perceived cognitive dysfunction and other factors. A total of 312 outpatients who started antidepressant monotherapy underwent a single study interview. Physicians and patients assessed depression severity. Patients also assessed: perceived cognitive dysfunction, functional disability, impaired productivity and quality of life. Patients had moderate to severe depression (MADRS mean total score: 28.9±7.3), and reported marked functional disability (SDS mean total score: 16.7±8.6), impaired productivity (WPAI mean overall work productivity loss: 52.4±31.8%), perceived cognitive dysfunction (PDQ-D mean total score: 29.9±18.6) and impaired quality of life (EQ-5D mean utility index score of 0.726±0.192). Greater functional disability and impairment in daily activities were associated with more severe depression and greater perceived cognitive dysfunction. Irrespective of depression severity, patients with more severe perceived cognitive dysfunction reported worse work-related productivity outcomes (higher presenteeism and greater overall work productivity loss). PERFORM-K confirms the impact of MDD on functional status and well-being in South Korean patients, and highlights the importance of recognising cognitive dysfunction in clinical practice. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: The rhizomes of Cyperus rotundus (Cyperaceae) have been used in Asian traditional medicine for the treatment of several inflammatory diseases. However, the anti-inflammatory effects of α-cyperone, a major active compound of Cyperus rotundus, are poorly understood. Materials and methods: PGE2 and cytokines released from cells were measured using an EIA assay kit. The expression of iNOS, COX-2, TNF-α, and IL-6 was measured by real-time RT-PCR and/or Western blot analysis. A luciferase assay was performed to measure the effect of α-cyperone on NFκB activity. Results: The n-hexane fraction of the 80% EtOH extract from the rhizomes of Cyperus rotundus was found to inhibit both NO and PGE2 production in RAW 264.7 cells. α-Cyperone isolated from the n-hexane fraction significantly inhibited PGE2 production by suppressing the LPS-induced expression of inducible COX-2 at both the mRNA and the protein levels. In contrast, α-cyperone had little effect on NO production and iNOS expression. Additionally, α-cyperone downregulated the production and mRNA expression of the inflammatory cytokine IL-6. Moreover, treatment with α-cyperone suppressed the transcriptional activity of NFκB and the nuclear translocation of the p65 NFκB subunit in LPS-induced RAW 264.7 cells. Conclusion: The anti-inflammatory activity of α-cyperone is associated with the down-regulation of COX-2 and IL-6 via the negative regulation of the NFκB pathway in LPS-stimulated RAW 264.7 cells. [Copyright &y& Elsevier]

Abstract: The continued spread of a highly pathogenic avian influenza (HPAI) H5N1 virus among wild birds and poultry has posed a potential threat to human public health. In the present study, we report the isolation of HPAI H5N1 viruses (A/Md/Korea/W401/11 and A/Md/Korea/W404/11) from fecal samples of migratory birds. Genetic and phlyogenetic analyses demonstrated that these viruses are genetically identical possessing gene segments from avian virus origin and showing highest sequence similarities (as high as 99.8%) to A/Ws/Hokkaido/4/11 and 2009–2010 Mongolian-like clade 2.3.2 isolates rather than previous Korean H5N1 viruses. Both viruses possess the polybasic motif (QRERRRK/R) in HA but other genes did not bear additional virulence markers. Pathogenicity of A/Md/Korea/W401/11 was assessed and compared with a 2006 clade 2.2 HPAI H5N1 migratory bird isolate (A/EM/Korea/W149/06) in chickens, ducks, mice and ferrets. Experimental infection in these hosts showed that both viruses have high pathogenic potential in chickens (2.3–3.0LD50s) and mice (3.3–3.9LD50s), but A/Md/Korea/W401/11 was less pathogenic in duck and ferret models. Despite recovery of both infection viruses in the upper respiratory tract, efficient ferret-to-ferret transmission was not observed. These data suggest that the 2011 Korean HPAI wild bird H5N1 virus could replicate in mammalian hosts without pre-adaptation but could not sustain subsequent infection. This study highlights the role of migratory birds in the perpetuation and spread of HPAI H5N1 viruses in Far-East Asia. With the changing pathobiology caused by H5N1 viruses among wild and poultry birds, continued surveillance of influenza viruses among migratory bird species remains crucial for effective monitoring of high-pathogenicity or pandemic influenza viruses. [Copyright &y& Elsevier]

Abstract: Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) were measured in ambient air samples collected from different parts of South Korea in 2008, and the measured levels were used for assessing the spatial and temporal distribution of atmospheric PCDDFs and DL-PCBs in South Korea. The average concentrations of atmospheric PCDD/Fs and DL-PCBs among the 37 sites were 28fg I-TEQm−3 (ND∼617) and 1fg WHO-TEQm−3 (ND∼0.016). Elevated atmospheric levels of PCDD/Fs and DL-PCBs observed at residential/industrial sites and in the north-west of Korea, indicated a potential contribution and impacts of anthropogenic sources of PCDD/Fs and DL-PCBs. These levels were similar or lower than those previously reported in other ambient air surveys. Average concentrations of PCDD/Fs showed small seasonal variations (ANOVA analysis, p =0.144). The highest concentrations of PCDD/Fs were observed during winter, followed by spring, autumn and summer. Atmospheric PCDD/Fs and DL-PCBs in South Korea rapidly decreased during the last 10years (1998–2008), demonstrating the efficiency of stricter regulations and the application of best available technologies/best environmental practices at emission sources. Comparison of the congener profiles and principal component analysis showed that current atmospheric PCDD/Fs are mostly influenced by industrial sources and PCBs from old commercial PCB uses. Nationwide POPs monitoring will continue and allows an effective evaluation of the implementation of the Stockholm Convention on POPs. [Copyright &y& Elsevier]

Abstract: Aim of this study: Citrus unshiu (Satsuma mandarin, SM) is a citrus fruit the peel of which has been used as a traditional Chinese medicine to treat common cold, relieve exhaustion, and cancer. In this study, we examined how effectively the content and peel extracts of SM can suppress cancer growth. The mechanism underlying cancer-suppressing properties of SM was investigated in tumor-bearing mice with renal carcinoma cell, Renca. Materials and methods: Effectiveness of SM in tumor suppression was evaluated by measuring size of tumor mass in tumor-bearing mice treated with various doses of SM content and peel extracts. Proliferation of tumor cells and splenocytes was determined by MTT assay and [3H]TdR uptake, respectively. Relevant immunological mechanisms were chased by assaying cytokines including TGF-β, IL-6, IFN-γ, and TNF-α by ELISA. Results: The content and peel extracts of SM inhibited the growth of tumor cells in tumor-bearing mice. Especially, average tumor volume of two groups treated with 3 and 30mg peel extracts per mouse weight (kg) were significantly decreased to 52.32% (p <0.05) and 68.72% (p <0.01), respectively. To identify tumor regression mechanism, anti-tumor cytokines measured in Con A-activated splenocytes from tumor-bearing mice. IFN-γ was increased in both of the peel extract-treated groups, while TNF-α, which had been decreased by tumor growth, was rescued to the normal level in SM content and peel extracts-treated groups. However, SM content and peel extracts did not inhibit proliferation and tumor-proliferative cytokines including TGF-β and IL-6 production of tumor cells. Conclusion: These results indicate that SM content and peel extracts have anti-tumor properties in the tumor-bearing murine model. The mechanism underlying the anti-tumor effects of SM extracts is strongly suggested to be via boosting cytokines such as IFN-γ and TNF-α, enhancing immune-mediated anti-tumor properties. [Copyright &y& Elsevier]