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Phasmatodea, commonly known as stick insects, are recognized as noteworthy pests globally, impacting agriculture and forest ecosystems. Among them, the outbreak of Ramulus mikado has emerged as a notable concern in East Asian forests. Recently, Metarhizium phasmatodeae has been identified as utilizing stick insects as hosts. We have observed evidence of this entomopathogenic fungus infecting stick insects. Given the increase in these occurrences during the rainy period, this study investigated the relationship between the survival of R. mikado and the M. phasmatodeae infection during the rainy seasons of 2022 and 2023. We collected stick insects in two representative forests of the Republic of Korea and examined insect survival, fungal infection, and various environmental factors. No infections were detected in specimens collected in June before the rainy season, but from July onwards, both the mortality of R. mikado and the fungal infection substantially increased. By the last sampling date of each year, 75% (2022), 71.4% (2023) of the specimens were infected, and over 90% of the total individuals succumbed as a result. Fungi isolated from deceased R. mikado were successfully identified as M. phasmatodeae using morphological and taxonomic approaches. Various statistical analyses, including principal component analysis and modeling, revealed a robust association between fungal infection and the survival of stick insects. The results highlight the correlation between mass deaths of stick insects and fungal infection, particularly during the summer rainy season. These findings offer valuable insights for forecasting R. mikado population in the upcoming year and developing effective pest control strategies. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) lacks disease-modifying drugs or sustainable interventions, creating an unmet treatment need. Investigating complementary and alternative medicines aims to improve PD patients' quality of life by alleviating symptoms and delaying the course of the disease. Objectives: In this single-center, prospective, observational, single-arm study, we aimed to assess the effectiveness and safety of acupuncture combined with exercise therapy and the Meridian Activation Remedy System (MARS). Methods: From March to October 2021, 13 PD patients with Hoehn and Yahr stages 1 to 3 were recruited. For 8 weeks, MARS intervention was carried out twice a week. T-statistics were used to evaluate functional near-infrared spectroscopy (fNIRS) and GAITRite outcomes. All of the remaining outcome variables were evaluated using the Wilcoxon signed-rank test. Results: The MARS intervention significantly reduced PD patients' Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDSUPDRS) Part III score (from 20.0 ± 11.8 to 8.8 ± 5.5, p = 0.003), 10-meter walk test speed (from 9.5 ± 1.8 to 8.7 ± 1.3 seconds, p = 0.040), and timed up and go time (from 9.8 ± 1.8 to 8.9 ± 1.4 seconds, p = 0.040). Moreover, the MDS-UPDRS Part II, fNIRS hemodynamics, 360-degree turn test, fall efficacy scale, and Parkinson's Disease Questionnaire 39 scores improved but not significantly. All participants completed the 8-week intervention without any adverse reactions. Conclusion: An 8-week MARS intervention improved motor symptoms in PD patients. In particular, improvements in UPDRS Part III scores exhibited large clinically important differences. The findings are encouraging, and a randomized controlled trial will be conducted to determine the efficacy and cost-effectiveness of MARS intervention. [ABSTRACT FROM AUTHOR]

Acetogenic bacteria can utilize C1 compounds, such as carbon monoxide (CO), formate, and methanol, via the Wood-Ljungdahl pathway (WLP) to produce biofuels and biochemicals. Two novel acetogenic bacteria of the family Eubacteriaceae ES2 and ES3 were isolated from Eulsukdo, a delta island in South Korea. We conducted whole genome sequencing of the ES strains and comparative genome analysis on the core clusters of WLP with Acetobacterium woodii DSM1030T and Eubacterium limosum ATCC8486T. The methyl-branch cluster included a formate transporter and duplicates or triplicates copies of the fhs gene, which encodes formyltetrahydrofolate synthetase. The formate dehydrogenase cluster did not include the hydrogenase gene, which might be replaced by a functional complex with a separate electron bifurcating hydrogenase (HytABCDE). Additionally, duplicated copies of the acsB gene, encoding acetyl-CoA synthase, are located within or close to the carbonyl-branch cluster. The serum bottle culture showed that ES strains can utilize a diverse range of C1 compounds, including CO, formate, and methanol, as well as CO2. Notably, ES2 exhibited remarkable resistance to high concentrations of C1 substrates, such as 100% CO (200 kPa), 700 mM formate, and 500 mM methanol. Moreover, ES2 demonstrated remarkable growth rates under 50% CO (0.45 h-1) and 200 mM formate (0.34 h-1). These growth rates are comparable to or surpassing those previously reported in other acetogenic bacteria. Our study introduces novel acetogenic ES strains and describes their genetic and physiological characteristics, which can be utilized in C1-based biomanufacturing. [ABSTRACT FROM AUTHOR]

Background: In the porcine industry, Escherichia coli (E. coli) infections have been causing post-weaning diarrhea (PWD) and edema disease (ED) for many years. It is classified into pathotypes and serotypes in animals according to virulence factors. Serotyping is performed for O, K, H, and F antigens, essential for discriminating pathogenicity and epidemiology. Furthermore, E. coli strains that produce F18 fimbriae are major sources of ED and PWD associated with Shiga-toxin producing E. coli (STEC) expressing F18ab and enterotoxigenic E. coli (ETEC) expressing F18ac, respectively. Aim: To investigate the pathogenicity potential and infection characteristics of experimental infection and confirm the pathological features of the Korean STEC/ETEC strains F18ab and F18ac in piglets. Methods: Three-week-old pigs were randomized into three experimental groups: infected G1 (F18ab), infected G2 (F18ac), and G3 (control). General health status was monitored daily, and pathological changes were evaluated. Results: Diarrhea occurred in all infected piglets. Pathological changes were only observed in the small intestine and regional lymph nodes. In G1, mucosal necrosis, inflammatory cell infiltration with hemorrhagic lesions, and apoptotic cell death in the tunica media of arterioles in the small intestine were observed. In contrast, the mucosa and epithelium appeared almost intact, with no abnormal vessel lesions in G2. Conclusion: Both strains, isolated from pigs in Korea, could be infected and did not spread from the alimentary tract to other organs. The pathological features were quite different among the F18 subtypes. The F18ab strain was more virulent than F18ac, and the virulence characteristics of the F18ac strain were more similar to ETEC than STEC. [ABSTRACT FROM AUTHOR]

Background: The emergence of next-generation sequencing (NGS) is currently leading the diagnosis of acute myeloid leukemia (AML) and its treatment using a more genetic-level approach. The study aimed to find clinical and prognostic correlations with genomic mutation profiles in Korean patients with AML using NGS. Methods: This retrospective study enrolled a total of 30 patients who were newly diagnosed with AML from February 2021 to October 2022 in Korea. NGS was used to identify the genetic profiles of 40 genes relevant to AML. The clinical and laboratory data of the patients were analyzed with their genomic mutation profiles. Results: NGS revealed at least one mutation in all patients, with a range of one to seven mutations (median of three mutations). Mutations were commonly associated with TET2, CEBPA, RUNX1, FLT3, IDH2, NPM1, and SRSF2 genes. The TET2 mutation correlated with older (77 vs. 72) patients, and the FLT3 mutation was associated with a higher WBC count (33.4 x 109/L vs. 6.4 x 109/L). The RUNX1 mutation correlated with a lower (44.0 x 109/L vs. 65.5 x 109/L) platelet count, and the NPM1 mutation showed a higher number of blasts in peripheral blood (56.5% vs. 13.0%). Among 16 patients who received induction chemotherapy, mutations in SRSF2, ASXL1, PHF6, SF3B1, and PTPN11 were detected only in patients who failed to achieve complete remission (CR). Meanwhile, mutations in NRAS, TP53, IKZF1, DNMT3A, SH2B3, U2AF1, and WT1 were detected in patients who achieved CR. Conclusions: Clinical and prognostic correlations were observed according to genomic mutation profiles detected by NGS in Korean patients with AML. An NGS study with a larger cohort of patients would be beneficial to establish the significant prognostic impact on patients with AML. [ABSTRACT FROM AUTHOR]

Background: Rapid screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was important in the emergency department during the coronavirus disease 2019 (COVID-19) pandemic. Real-time polymerase chain reaction (RT-PCR) is the standard method for detecting SARS-CoV-2, but it requires several hours to provide results. Instead, the rapid antigen test (RAT) has a short turnaround time and can be used at the bedside but shows low sensitivity. To overcome these shortcomings, the clinical utility of stepwise testing of RAT with RTPCR in the emergency department was analyzed. Methods: Patients who underwent SARS-CoV-2 RAT (SD Biosensor or Abbott) and RT-PCR (Seegene Allplex or GeneXpert) testing simultaneously at the emergency department in South Korea from January 2021 to March 2022 were enrolled. We compared the performance status of RAT with that of RT-PCR and evaluated the clinical utility of RAT as a screening tool for patients visiting the emergency department. Results: A total of 7,574 patients were included. The overall prevalence of COVID-19 was 1.9% (146/7,574). The sensitivity and specificity of the RAT were 69.2% and 99.9%, respectively, and the positive and negative predictive values were 96.2% and 99.4%, respectively. Based on the cycle threshold (Ct) of the E gene, the sensitivity was 86.0% in patients with Ct < 26, but the sensitivity was 9.3% in patients with Ct ≥ 26. Conclusions: In the COVID-19 pandemic, RAT can be used as supplement test for the screening strategy using RT-PCR in the emergency department because it is rapid, highly specific, and relatively sensitive in patients with high viral load. [ABSTRACT FROM AUTHOR]

Phytophthora species, classified under Oomycota, cause significant damage to various crops and trees. The present study introduced Phytophthora species, P. nagaii and P. tentaculata, new to Korea, which pose notable risks to their respective host plants. Our research provided a comprehensive description of these species taking into account their cultural features, morphological characteristics, and molecular phylogenetic analysis using the internal transcribed spacer rDNA region and cytochrome c oxidase subunit mtDNA genes (cox1 and cox2) sequences. In addition, this study first evaluated the sensitivity of P. nagaii and P. tentaculata to five anti-oomycete fungicides, finding both species most responsive to picarbutrazox and P. tentaculata resistant to fluazinam. The data can guide targeted treatment strategies and offer insights into effective control methods. The findings expand our understanding of the diversity, distribution, and management of Phytophthora species in Korea. [ABSTRACT FROM AUTHOR]

Purpose: Completely edentulous arches can be restored using various prosthetic modalities, and the treatment outcome may include masticatory and speech discomforts. This study aimed to investigate the current status of prosthetic restoration modalities used for completely edentulous patients and investigate the association between prosthetic restoration modalities and subjective discomfort in mastication and speech by analyzing nationwide big data. Methods: Of 97,622 individuals, data from 1,576 adults aged =40 years with no natural teeth and no requirement for additional prosthetic treatments were included. Oral examination data were analyzed, and the prostheses of the edentulous arches were categorized as follows: CD, removable complete denture; OD, implant-retained overdenture; and IF, implant-supported fixed dental prosthesis. Discomforts in mastication and speech according to the prosthetic restorative modality groups was statistically analyzed using analysis of covariance (a = 0.05). Results: The maxillary/mandibular prosthetic restorative modality most commonly used was CD/CD, followed by CD/OD, IF/IF, OD/OD, and CD/IF, with weighted percentages of 93.23%, 2.48%, 1.83%, 1.46%, and 0.84%, respectively. Even after adjusting for various covariates, masticatory discomfort in the CD/CD group was significantly greater than that in the OD/OD (P = 0.0004) and IF/IF (P = 0.0002). The CD/CD group also had significantly greater discomfort in speech than did the IF/IF group (P = 0.0119). Conclusions: Most completely edentulous patients were rehabilitated with bimaxillary removable complete dentures; however, the discomforts in mastication and speech were the lowest when both arches were restored with implantsupported fixed restorations. [ABSTRACT FROM AUTHOR]

INTRODUCTION Although previous studies have addressed the association between smoking and obstructive sleep apnea (OSA), there are few studies on the association between electronic cigarette use and OSA. Thus, we aimed to evaluate the association between the dual use of electronic and conventional cigarettes and OSA. METHODS Data from 7350 participants of the 2019-2021 Korean National Health and Nutrition Examination Survey were analyzed in this population-based study. The STOP-Bang score was calculated using eight items: snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and sex. The main independent variable was smoking behavior. A multiple logistic regression analysis was performed. Subgroup analysis was conducted to analyze the association between smoking behavior in detail and OSA, and stratified analyses were additionally performed. RESULTS Of the 7350 participants, 417 (5.7%) had a high risk of OSA, according to the STOP-Bang score. Compared to the non-smoker group, the dual user group had a 2.46-fold increase in the odds of OSA (adjusted odds ratio, AOR = 2.45; 95% CI: 1.04-5.79). Current non-smokers who were dual users in the past had increased odds of having OSA (AOR=3.61; 95% CI: 1.32-9.92). In the stratified analyses, dual cigarette use was significantly associated with OSA in females and those with a low physical activity level. CONCLUSIONS Dual users and cigarette-only users had an increased probability of developing OSA. Even if they are not currently smoking or vaping, individuals who were dual users in the past were associated with a higher risk of OSA. The association between dual cigarette use and OSA was more pronounced in females and those with a low physical activity level. While intervening for obstructive sleep apnea or investigating risk factors, new smoking methods such as vaping and dual use should be considered along with conventional smoking. [ABSTRACT FROM AUTHOR]

배경: Infective endocarditis (IE) remains a major medical problem with high morbidity and mortality. Appropriate antibiotic treatment lowers the risk of embolism, recurrence, and long-term mortality. However, there are concerns about adverse drug reactions and resistant strains due to long-term use of antibiotics. Therefore, we compared the difference in overall mortality according to the duration of postoperative antibiotics therapy in patients with IE. 방법: From 2005 to 2017, we retrospectively reviewed 416 patients with IE at a 2400-bed tertiary hospital in South Korea. A total of 234 IE patients who underwent valve surgery and appropriate duration of antibiotics were enrolled. They were divided into two groups based on the 2 weeks of postoperative antibiotic therapy. The primary outcome was long-term overall all-cause mortality. The secondary outcomes were reoperation rate, recurrence rate, and postoperative complications. 결과: The median follow-up duration was 71 (interquartile range [IQR], 46–109) months. The duration of postoperative antibiotic therapy was less than 2 weeks in 62 patients (26.5%) and more than 2 weeks in 172 patients (73.5%). The median age was 53 ([IQR], 39–63) years. The overall mortality was 12.8% (30/234). There were no statistical differences in overall mortality (12.9% vs. 12.8%, p=0.982), reoperation (6.5% vs. 4.1%, p=0.488), and recurrence (8.1% vs. 2.9%, p=0.135) between patients with postoperative antibiotic therapy less than 2 weeks and for ≥2 weeks, respectively. The duration of postoperative antibiotic therapy based on 2 weeks in the Kaplan-Meier curve was not associated with overall mortality (log-rank test, p=0.877). 결론: In conclusion, there was no statistically significant difference in the overall mortality, recurrence, and reoperation rate according to the duration of postoperative antibiotic therapy. If surgery and recommended total antibiotic duration are properly performed, a shorter duration of postoperative antibiotics might be considered. [ABSTRACT FROM AUTHOR]

This study reports the concentrations of As, Cd, Hg, and Pb in commonly consumed crustaceans collected from South Korea. The samples were prepared by wet digestion using HNO3 and H2O2 by microwave-assisted combustion. For the determination of As, Cd, and Pb, inductively coupled plasma-mass spectrometry was used, while Hg was determined by gold amalgamation direct mercury analysis. The techniques were validated by determining quality parameters of correlation coefficients, limits of detection and quantification, coefficient of variance, recovery, and accuracy by analyzing an oyster tissue certified reference material (NIST CRM-1566b). The distribution of toxic metals was determined in whole, muscle, and digestive tracts of the crustaceans. Also, to provide information concerning consumer safety, risk assessment in terms of estimated dietary daily/weekly intake, target hazard quotient, and hazard index values was carried out. The concentration ranges (mg/kg) of the analyzed elements were in the decreasing order of As (4.0-25.2) > Cd (0.154-4.57) > Pb (0.033-0.128) > Hg (0.011-0.086). The estimated dietary daily/weekly intake, target hazard quotient, and hazard index values were compared with the standard limits set by United States Environmental Protection Agency and Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives. In general, the analyzed crustaceans were found not to cause any threat to consumers under normal circumstances. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this nationwide age- and sex-matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. Methods: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex-stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. Results: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). Conclusions: The risk rate of IS increased in patient with pyogenic spondylitis. [ABSTRACT FROM AUTHOR]

The blue-tailed damselfly, Ischnura elegans Van der Linden, 1820 (Odonata: Coenagrionidae), is a climate-sensitive indicator species in South Korea. In this study, we sequenced the complete mitochondrial genome (mitogenome) of I. elegans collected from South Korea for subsequent population genetic analysis, particularly to trace population movements in response to climate change. The 15,963 base pair (bp)-long complete mitogenome of I. elegans has typical sets of genes including a major non-coding region (the A+T-rich region), and an arrangement identical to that observed in ancestral insect species. The ATP6, ND3 and ND1 genes have the TTG start codon, which, although rare, is the canonical start codon for animal mitochondrial tRNA. The A/T content was 71.4% in protein-coding genes, 72.1% in tRNAs, 72.9% in the whole genome, 74.7% in srRNA, 75.3% in lrRNA, and 83.8% in the A+T-rich region. The A+T-rich region is unusually long (1,196 bp) and contains two subunits (192 bp and 176–165 bp), each of which is tandemly triplicated and surrounded by non-repeat sequences. Comparison of the sequence divergence among available mitogenomes of I. elegans, including the one from the current study, revealed ND2 as the most variable gene, followed by COII and COI, suggesting that ND2 should be targeted first in subsequent population-level studies. Phylogenetic reconstruction based on all available mitogenome sequences of Coenagrionidae showed a strong sister relationship between I. elegans and I. senegalensis. [ABSTRACT FROM AUTHOR]

Purpose: The incidence of early tumor detection is increasing due to popularization of breast cancer screening and the development of imaging techniques. Thus, suitable preoperative localization is required for proper diagnosis and treatment of non-palpable breast lesions. The purpose of this study was to evaluate the efficacy and safety of indocyanine green (ICG)-hyaluronic acid (HA) mixture for lesion localization compared to activated charcoal. Methods: This was a multicenter, randomized, open-label, parallel phase 3 clinical trial performed at four centers in Korea. Female patients scheduled for surgery to remove non-palpable breast lesions were enrolled. One hundred and nine patients were randomly assigned to a control group (activated charcoal: 0.3. – 1 mL) or a study group (ICG-HA mixture, 0.2 mL) for the localization of a breast lesion. The primary endpoint was the accuracy of resection. Secondary endpoints included the technical success rate, histopathological accuracy, skin pigmentation rate, and adverse event rate. Results: A total of 104 patients were eligible for per-protocol analysis (control group, n = 51; study group, n = 53). The accuracy of resection in the study group was not inferior to that of the control group (90.57% vs. 98.04%, 95% confidence interval (CI): -2.31 – 18.91, p = 0.21). There was no statistically significant difference in technical success rate between the two groups (marking on breast skin: p = 0.11, marking on the excised specimen: p = 0.12). However, there were statistically significant differences in histopathological accuracy (0.26 ± 0.13 vs. 0.33 ± 0.17, p = 0.01) and skin pigmentation rate (0.00% vs. 30.77%, p< 0.01). Adverse events were not reported in either group. Conclusions: When localization was performed using ICG-HA, the accuracy of resection was not inferior to that of activated charcoal. However, skin pigmentation rate was significantly lower. In conclusion, ICG-HA is effective and safe for localizing of non-palpable breast lesions. [ABSTRACT FROM AUTHOR]

Context: Kinesiology tape (KT), multidirectional resistance exercise, and interventions for decreased ankle dorsiflexion range of motion are gaining popularity in the treatment of patients with chronic ankle instability (CAI). However, there is limited evidence of the effectiveness of combined interventions in patients with CAI. Objectives: To compare the effects of KT alone, KT with resistance exercise (KT + resistance), and KT with resistance and heel raise-lower exercise (KT + resistance + heel) on the results of the dynamic balance test (star excursion balance test [SEBT]), functional performance (lateral step-down test), and ankle muscle activation in patients with CAI. Design and Setting: This study used a repeated-measures design in a laboratory setting. Main Outcome Measures: The participants completed 3 different interventions with a 24-hour rest period between interventions. The SEBT, lateral step-down test, and ankle muscle activation results were used as the outcome measures. All outcomes were assessed before and immediately after the 3 interventions. Results: The results of the SEBT-anteromedial direction significantly increased with KT + resistance (78.61 [16.11] cm, P = .01, ES = 0.50) and KT + resistance + heel (76.94 [16.00] cm, P = .03, ES = 0.33) in comparison with the baseline values (73.68 [12.84] cm). Additionally, the result of the SEBT-anteromedial direction was significantly greater with KT + resistance (78.61 [16.11] cm) than with KT alone (76.00 [14.90] cm, P = .05, ES = 0.18). The number of errors during the lateral step-down test was significantly lower for the KT alone (2.16 [0.90] errors, P = .02, ES = 0.46), KT + resistance (2.10 [0.79] errors, P = .01, ES = 0.54), and KT + resistance + heel (2.03 [0.75] errors, P = .003, ES = 0.61) interventions than the baseline values (2.55 [0.85] errors). Conclusions: Patients with CAI should be encouraged to perform KT + resistance to improve balance. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We examined the associations of socioeconomic factors, health behaviors, and comorbidities with early-onset lung cancer. METHODS: The study included 6,794,287 individuals aged 20-39 years who participated in a Korean national health check-up program from 2009 to 2012. During the follow-up period, 4,684 participants developed lung cancer. Multivariable Cox regression analysis was used to estimate the independent associations of potential risk factors with incident lung cancer. RESULTS: Older age (multivariable hazard ratio [mHR], 1.13; 95% confidence interval [CI], 1.12 to 1.14) and female sex (mHR, 1.62; 95% CI, 1.49 to 1.75) were associated with increased lung cancer risk. Current smoking was also associated with elevated risk (<10 pack-years: mHR, 1.12; 95% CI, 1.01 to 1.24; =10 pack-years: mHR, 1.30; 95% CI, 1.18 to 1.45), but past smoking was not. Although mild alcohol consumption (<10 g/day) was associated with lower lung cancer risk (mHR, 0.92; 95% CI, 0.86 to 0.99), heavier alcohol consumption (=10 g/day) was not. Higher income (highest vs. lowest quartile: mHR, 0.86; 95% CI, 0.78 to 0.94), physical activity for at least 1,500 metabolic equivalent of task-min/wk (vs. non-exercisers: mHR, 0.83; 95% CI, 0.69 to 0.99) and obesity (vs. normal weight: mHR, 0.89; 95% CI, 0.83 to 0.96) were associated with lower lung cancer risk, whereas metabolic syndrome was associated with increased risk (mHR, 1.13; 95% CI, 1.03 to 1.24). CONCLUSIONS: In young adults, age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer, while high income, physical activity, and obesity displayed protective effects. [ABSTRACT FROM AUTHOR]

Atopic dermatitis is a chronically relapsing inflammatory skin condition that has profound impacts on quality of life of patients and their family. The aim of this study is to investigate the psychological stress in parents of children with atopic dermatitis in Korea, using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included parents of participants under 19 years of age (970 with atopic dermatitis and 5,733 without atopic dermatitis after excluding those who meet the exclusion criteria) from the 2009 to 2012 KNHANES. The psychological stress state was evaluated with the following four questionnaire items: self-perception of stress, depressed mood, suicidal ideation, and diagnosis of depression by a physician. After adjusting for age, gender, education level, occupation, and marital status, logistic regression analyses indicated that mothers of children with atopic dermatitis had a higher frequency of stress perception (adjusted odds ratio (aOR) 1.46 (95% confidence interval (95% CI) 1.22– 1.74), p<0.01) and suicidal ideation (aOR 1.40 (95% CI 1.1–1.79), p<0.01) than those without atopic dermatitis. In contrast, fathers of children with atopic dermatitis did not show a significant difference in all items compared with those of children without atopic dermatitis. Understanding the psychological stress in parents of children with atopic dermatitis is important for clinicians, since evaluation, management and support for parents, especially mothers, of children with atopic dermatitis are required. [ABSTRACT FROM AUTHOR]

To facilitate globalization, universities exchange human resources with overseas institutions by fostering synergies in research. This paper aimed to examine academic synergy gained from international collaborations in the Korean context, analyzing the government meta-data on global partnerships and research outcomes of 140 South Korean universities. Results from the proposed pilot model show that the number of partners in non-English speaking countries significantly affected international publications (IP) conceptualized as academic synergy; the numbers of outbound resources and the numbers of enrollees to graduate schools were also influential to IP; and IP from the private universities in rural areas appeared relatively lower. This pilot study using publicly available sources is noteworthy because it examines synergetic effects from international academic connections with overseas institutions. [ABSTRACT FROM AUTHOR]

배경: Dagnosis of invasive aspergillosis (IA) is often difficult due to need for invasive procedures. Next-generation sequencing of plasma microbial cell free DNA (cfDNA) can be a novel non-invasive diagnostic method. We evaluated the clinical accuracy and utility of microbial cfDNA whole genome sequencing (WGS) for diagnosis of IA in patients with hematologic malignancy (HM) or coronavirus disease (COVID-19). 방법: A single-center prospective cohort study was conducted in a tertiary hospital in Korea. We enrolled adult patients with HM or severe COVID-19, who suspected of IA and collected plasma samples. cfDNA was extracted from plasma and WGS was performed. IA diagnosis was retrospectively confirmed according to EORTC/MSG definitions in patients with HM, and modified AspICU criteria in patients with severe COVID-19. The final diagnosis of IA was compared to the results of microbial cfDNA WGS. 결과: Between Mar 2021 and Feb 2022, a total of 64 microbial cfDNA WGS was performed on the plasma samples from 37 participants (19 with HM and 19 with COVID-19) and 7 controls who didn’t have any evidence of fungal infection. In participants with HM, aspergillus cfDNA was detected in 100% (1/1) of proven and 84.6% (11/13) of probable IA cases. In participants with COVID-19, 46.7% (7/15) of probable IA showed positive aspergillus cfDNA. Positive agreement of detection of aspergillus cfDNA versus conventional diagnosis of proven/probable IA was significantly higher in participants with HM compared to COVID-19 (85.7% vs. 46.7%, p=0.011). Fifteen of 19 (78.9%) participants with positive aspergillus cfDNA had exposure to antifungal agents. In 7 participants, non-aspergillus pathogens detected by microbial cfDNA WGS were in accordance with those identified through conventional culture. 결론: Detection of aspergillus cfDNA showed high concordance with conventional diagnostic methods of proven/probable IA in patients with HM and could be a helpful non-invasive approach to IA diagnosis in those populations. [ABSTRACT FROM AUTHOR]

배경: Computed tomography (CT) is a very useful tool for evaluating the etiology of patients with sepsis or septic shock. However, it is difficult to obtain contrast-enhanced CT images due to concerns about nephrotoxicity caused by contrast media, especially in patients with septic acute kidney injury (AKI). In this study, we aim to investigate the relationship between contrast media administration and long-term mortality and chronic kidney disease in patients with septic AKI. 방법: A total of 1,521 patients with septic shock admitted to a tertiary hospital in South Korea from July 2008 to November 2019 were retrospectively reviewed. A total of 609 adult septic shock patients with AKI who underwent contrast or non-contrast CT scans were enrolled. The primary outcome was 90-day mortality rate. The secondary outcomes were worsening AKI, 28-day mortality rate, chronic kidney disease, and maintain dialysis at 90 days between contrast CT group and non-contrast CT group. 결과: Of 609 septic AKI patients, 220 patients (36.1%) underwent contrast CT and 389 patients (63.9%) underwent non-contrast CT. The median age was 70.9 years, and 305 (50.1%) were male. There were no statistically significant differences in the outcomes between the contrast and non-contrast CT groups: 90-day mortality, 55.3% vs. 57.4%, p=0.682; worsening AKI, 1.8% vs. 2.1%, p=0.999; 28-day mortality, 41.4% vs. 42.3%, p=0.898; chronic kidney disease, 13.2% vs. 15.3%, p=0.73; and maintain dialysis at 90day, 0.0% vs. 0.8%, p=0.482. 결론: In conclusion, intravenous contrast media administration was not associated with long-term mortality, chronic renal impairment, and dialysis in patients with septic AKI. [ABSTRACT FROM AUTHOR]

배경: This study aimed to investigate the prognosis and prognostic factors for mortality in progressive multifocal leukoencephalopathy (PML) patients through a long observation period. 방법: This retrospective study was conducted in two tertiary hospitals in South Korea from 1999 to 2021. Patients diagnosed with PML were reviewed according to the American Academy of Neurology diagnostic criteria. The primary endpoint was long-term overall mortality. Each patient was followed up till death or the end of the study period. 결과: Total of 47 PML patients were included. Of 27 patients (57.4%) were diagnosed with HIV. Median last follow-up modified Rankin Scale (mRS) score was higher in the non-HIV PML group than that in the HIV group (5 vs. 4, p=0.020). Median survival duration was lower in the non-HIV group (184 vs. 1,564 days). The 1-year and overall mortality rates of PML patients were significantly higher in the non-HIV group than that in HIV group (60.0% vs. 25.9%, p=0.019; 80.0% vs. 40.7%, p=0.007). Initial mRS score (HR 1.685, p=0.038) and highly active antiretroviral therapy (HAART) in HIV patients (HR 0.374, p=0.013) had a significant effect on overall mortality. 결론: Survival duration of HIV-positive PML patients receiving HAART improved; however, the mortality rate is still high. Introduction of HAART in HIV patients and initial mRS score are significant prognostic factors for overall mortality in PML patients. [ABSTRACT FROM AUTHOR]

Background/Aims: The prospective Crohn’s Disease Clinical Network and Cohort Study is a nationwide multicenter cohort study of patients with Crohn’s disease (CD) in Korea, aiming to prospectively investigate the clinical features and long-term prognosis associated with CD. Methods: Patients diagnosed with CD between January 2009 and September 2019 were prospectively enrolled. They were divided into two cohorts according to the year of diagnosis: cohort 1 (diagnosed between 2009 and 2011) versus cohort 2 (between 2012 and 2019). Results: A total of 1,175 patients were included, and the median follow-up duration was 68 months (interquartile range, 39.0 to 91.0 months). The treatment-free durations for thiopurines (p<0.001) and anti-tumor necrosis factor agents (p=0.018) of cohort 2 were shorter than those of cohort 1. Among 887 patients with B1 behavior at diagnosis, 149 patients (16.8%) progressed to either B2 or B3 behavior during follow-up. Early use of thiopurine was associated with a reduced risk of behavioral progression (adjusted hazard ratio [aHR], 0.69; 95% confidence interval [CI], 0.50 to 0.90), and family history of inflammatory bowel disease was associated with an increased risk of behavioral progression (aHR, 2.29; 95% CI, 1.16 to 4.50). One hundred forty-one patients (12.0%) underwent intestinal resection, and the intestinal resection-free survival time was significantly longer in cohort 2 than in cohort 1 (p=0.003). The early use of thiopurines (aHR, 0.35; 95% CI, 0.23 to 0.51) was independently associated with a reduced risk of intestinal resection. Conclusions: The prognosis of CD in Korea appears to have improved over time, as evidenced by the decreasing intestinal resection rate. Early use of thiopurines was associated with an improved prognosis represented by a reduced risk of intestinal resection. [ABSTRACT FROM AUTHOR]

Ascidians are sessile marine invertebrates and many are invasive. One notorious example is the solitary species Microcosmus squamiger, which has spread from a hypothesized native region in southeastern Australia to temperate waters worldwide and is considered a global marine invader. This study is the first report of M. squamiger from Jeju Island, South Korea. We collected specimens (N = 20) from Unjin and Wimi harbors on Jeju Island and dissected them to characterise their siphons, pharynx, and dorsal tubercle using stereomicroscopy and scanning electron microscopy. The shape of the dorsal tubercle (the peritubercular area filled with two spiral coils) and the length (15-20 µm) and shape (roof tile or fingernail) of the siphon spine were consistent with previous identifications of the species. Additionally, molecular verification was performed by extracting genomic DNA from four specimens, two each from Unjin and Wimi harbors. By sequencing a section of the mitochondrial cytochrome oxidase subunit I gene and analysing the generated sequences using a maximum likelihood-based phylogenetic tree, we compared to individuals previously identified as M. squamiger and confirmed the existence of two clades. Therefore, the presence of M. squamiger was verified by morphological and phylogenetic identification. Although M. squamiger is currently distributed globally (except in Antarctica), records from India (2006), Okinawa, and Japan (2007 and 2014) suggest that it was introduced into Asia in the last decade. Though no economic or biological damage caused by this species has been reported in South Korea, the high density of M. squamiger (50-60 individuals/rope-meter) is a potential hazard to other native species via fouling and competition for food and space. Therefore, further research is needed to determine the possible vectors and to continue to monitor its possible spread. [ABSTRACT FROM AUTHOR]

As the pet industry continues to grow worldwide, reptile species have become increasingly popular, which has increased the trade of these species. However, as various species are bred, some are discovered in the wild after being lost or abandoned, which can result in ecosystem disturbances. Accordingly, in this study, we report a black-headed python (Aspidites melanocephalus) that was found in the wild for the first time, in the Republic of Korea. At the time of discovery, the deceased python was ascertained to be roadkill, and it appeared to have been killed a few days prior to discovery. The reptile was identified as a black-headed python through its appearance (head color, body stripes, etc.) and DNA analysis. It is suspected that the snake was a lost or abandoned pet. The occurrence of exotic reptiles in the wild may disturb Korean ecosystems. Thus, it is necessary to evaluate the current status of potentially exotic reptiles and improve the management of abandoned animals, especially reptiles. [ABSTRACT FROM AUTHOR]

A pyloric gland adenoma is a rare neoplasm that occurs most frequently in the stomach and should be removed because of its precancerous potential. Although there have been case reports of pyloric gland adenomas in extragastric areas such as the duodenum, pancreas, and bile duct, esophageal pyloric gland adenoma has never been reported in Korea. Herein, we report a case of esophageal pyloric gland adenoma that was successfully treated by endoscopic submucosal dissection. [ABSTRACT FROM AUTHOR]

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Such cardiopulmonary complications are usually temporary, and most patients recover without sequelae. However, these events may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk. [ABSTRACT FROM AUTHOR]

배경 Patients with cancer are at greater risk of severe COVID-19 and have been prioritized for COVID-19 vaccination including booster doses. We aimed to assess the immunogenicity and safety of COVID-19 vaccination and analyze factors associated with the immunogenicity of the vaccine among actively treat- ed solid cancer patients (CPs) in Korea. 방법 A prospective cohort was established among CPs undergoing anticancer treatment in a tertiary hospital in Korea. Patients in this cohort had no history of previous SARS-CoV-2 infection confirmed by baseline serological testing and received at least one dose of COVID-19 vaccine in accordance with the vaccine strategy. Blood samples were collected before prime vaccination, and beyond 2 weeks for each dose of vaccine administration. Spike (S)- specific IgG antibodies were analyzed on each sample. Adverse events (AEs) within 7 days following each vaccine dose were collected. Data from age-matched healthcare workers (HCWs) recruited into a separate study are included as a comparison cohort. 결과 Between April 2021 to November 2021, we enrolled 134 CPs; 118 were eligible for analysis. The demographics of CPs and HCWs are described in Table 1. CPs were treated with cytotoxic agents (78.8%), immunotherapy (16.9%), target therapy (18.6%), and others (5.9%), that were given either alone or in combinations. The rate of seroconversion after 1st vaccination in CPs was significantly lower than in HCWs (p value=0.001), however, all CPs and HCWs revealed seroconversion after 2nd vaccination (Figure 1). Antibody response was significantly increased following each dose of vaccination in both CPs and HCWs (Figure 2A). The geometric mean titer (GMT) of S-specific IgG antibodies after 2nd vaccination in CPs who received a primary set of adenovirus vector vaccine were significantly lower than that in HCWs, whereas CPs who received a primary set of mRNA vaccines showed comparable GMT with HCWs after 2nd vaccination (Figure 2B). After the 3rd vaccination, there was no statistical difference in GMT of S-specific antibodies between CPs and HCWs regardless of the type of primary vaccine. In age-matched analysis between good responders (defined as those with higher antibody titers after 2nd vaccination than the mean of age-stratified HCW cohort) and poor responders (defined as those with lower titers) among CPs, there was no significant difference in other factors including the type of vaccine, cancer or anticancer treatment except lower leukocyte counts in poor responders treated with cytotoxic agents. The incidence and severity of AEs were similar between CPs and HCWs without any severe vaccine-related AEs. 결론 Patients with solid cancer had delayed antibody response compared to HCWs after the 1st vaccination but all CPs showed seroconversion after 2nd vaccination. Antibody responses similar to that of HCWs were achieved after the 3rd dose of vaccination in actively treated CPs in this study. [ABSTRACT FROM AUTHOR]

Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68). Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to develop a model for estimating the carcass weight of Hanwoo cattle as a function of body measurements using three different modeling approaches: i) multiple regression analysis, ii) partial least square regression analysis, and iii) a neural network. Methods: Data from a total of 134 Hanwoo cattle were obtained from the National Institute of Animal Science in South Korea. Among the 372 variables in the raw data, 20 variables related to carcass weight and body measurements were extracted to use in multiple regression, partial least square regression, and an artificial neural network to estimate the cold carcass weight of Hanwoo cattle by any of seven body measurements significantly related to carcass weight or by all 19 body measurement variables. For developing and training the model, 100 data points were used, whereas the 34 remaining data points were used to test the model estimation. Results: The R2 values from testing the developed models by multiple regression, partial least square regression, and an artificial neural network with seven significant variables were 0.91, 0.91, and 0.92, respectively, whereas all the methods exhibited similar R2 values of approximately 0.93 with all 19 body measurement variables. In addition, relative errors were within 4%, suggesting that the developed model was reliable in estimating Hanwoo cattle carcass weight. The neural network exhibited the highest accuracy. Conclusion: The developed model was applicable for estimating Hanwoo cattle carcass weight using body measurements. Because the procedure and required variables could differ according to the type of model, it was necessary to select the best model suitable for the system with which to calculate the model. [ABSTRACT FROM AUTHOR]

This study determined the concentrations of toxic metals including As, Cd, Hg and Pb in commonly consumed crustaceans collected from South Korea. The samples were prepared by wet digestion using HNO3 and H2O2 by microwave assisted combustion. For As, Cd, and Pb, inductively coupled plasma–mass spectrometry (ICP-MS) was used. Hg content was determined using gold amalgation direct mercury analysis (DMA). The analytical techniques were validated by determining the correlation coefficients, limits of detection and quantification, coefficients of variance, spiking, and accuracy by analysis of an oyster tissue certified reference material (NIST CRM-1566b). The distribution of toxic metals was determined in whole, muscles, and digestive tracts of crustaceans. Furthermore, to provide information on consumer safety, risk assessment in terms of estimated dietary daily/weekly intake, target hazard quotient, and hazard index values was performed. The concentration (mg/kg) was in decreasing order of As (2.17–6.05) > Cd (0.154–4.57) > Pb (0.033–0.128) > Hg (0.011–0.086). The estimated dietary daily/weekly intake, target hazard quotient, and hazard indices were compared with the standards established by United States Environmental Protection Agency, and Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives and were below the threshold values. The analyzed crustaceans are not expected cause threats to consumers upon normal consumption. [ABSTRACT FROM AUTHOR]

배경: Interest in complications and sequelae following COVID-19 is increasing. Several articles have reported COVID-19-associated autoimmune diseases and the association of autoantibodies with the severity of COVID-19. Thromboembolic complications frequently occur in COVID-19 patients, and the anti-phospholipid antibody (aPL) is frequently detected. We conducted this study to investigate the prevalence, clinical significance, and persistence of anti-nuclear antibody (ANA) and aPL in COVID-19. 방법: This study enrolled the patients diagnosed with COVID-19 with oxygen demand, admitted to Severance Hospital, running a critical care unit for COVID-19 in South Korea from July 2020 to March 2022. ANA and aPLs were assessed using the immuno-assay kit. 결과: A total of 250 patients were enrolled during the study period. Among them, five patients showed ANA-positive, and 41 showed aPL-positive (IgM anti-Cardiolipin (aCL) antibody for seven patients, IgG aCL for seven patients, IgM anti-β2Glycoprotein1 antibody (aβ2-GPI) for 32 patients, and IgG aβ2-GPI for one patient). Two of the five ANA-positive patients, 13 of the 32 IgM aβ2-GPI-positive patients, 5 of the 7 IgM aCL-positive patients, and 2 of the 7 IgG aCL-positive patients were eligible for follow-up analysis, and 100%, 69.2%, 40%, and 50% of the patients remained autoantibody-positive, respectively. Except for the IgG aCL group, there were no differences in clinical outcomes, including thromboembolic complications, between the autoantibody-positive and negative groups. 결론: Our study demonstrated that a significant proportion of COVID-19 patients with oxygen demand showed autoantibody-positive and persisted several months after symptom onset. Whether these autoantibodies are related to long-term sequelae in COVID-19 patients requires further research. [ABSTRACT FROM AUTHOR]

To determine the grain size distribution and chemical characteristics of bottom surface sediments in shallow brackish lagoons, we studied sediment samples collected from the entire horizontal lake area and in vertical profiles from three stations in Lakes Youngrang and Hwajinpo, on the eastern coast of Korea. Vertical and horizontal grain size distributions of the bottom sediments indicated predominantly sand- and silt in both lakes. The vertical distribution of C/N ratios ranged from 6.14 to 11.92 in Lake Youngrang, and 6.74 to 12.34 in Lake Hwajinpo. The horizontal distribution of C/N ratios in Lake Youngrang ranged from 6.1 to 17.6, whereas they ranged from 4.4 to 12.1 in Lake Hwajinpo. C/N ratios showed locally different responses to the origin of allochthonous (partial region) and autochthonous (entire region) organic materials. Horizontally, bottom sediment with low d13C and high d15N in Lake Youngrang were likely to be influenced by autochthonous organic material derived from primary production, and would be affected by N inputs from sources. In contrast, high d13C and low d15N sediments in Lake Hwajinpo were likely to be influenced by cyanobacteria. [ABSTRACT FROM AUTHOR]

Background/Aims: We aimed to evaluate the clinical characteristics and long-term prognosis of elderly-onset ulcerative colitis (EOUC) in Korean patients over a 30-year period using a well-established population-based cohort in the Songpa-Kangdong district of Seoul, Korea. Methods: Clinical characteristics and prognosis were compared between two groups: EOUC, defined as UC diagnosed in individuals aged ≥60 years and non-EOUC (N-EOUC), defined as UC diagnosed in individuals aged 18 to 59 years. Results: We identified 99 patients with EOUC (10.3%) and 866 patients with N-EOUC (89.7%) between 1986 and 2015. During the median follow-up of 104.5 months, the overall exposure to medications was comparable between patients with EOUC and N-EOUC (p=0.091 for corticosteroids, p=0.794 for thiopurines, and p=0.095 for anti-tumor necrosis factor agents). The cumulative risks of disease outcomes were also comparable between patients with EOUC and N-EOUC (22.4% vs 30.4% for proximal disease extension [p=0.351], 11.9% vs 18.1% for hospitalization [p=0.240], and 2.3% vs 1.8% for colectomy [p=0.977]) at 10 years after diagnosis. Multivariate Cox regression analysis revealed that corticosteroid use at diagnosis was an independent predictor of proximal disease extension (hazard ratio [HR], 6.216; 95% confidence interval [CI], 1.314 to 28.826) and hospitalization (HR, 11.241; 95% CI, 3.027 to 41.742) in patients with EOUC. Conclusions: In this population-based study from Korea, the pattern of medication use seemed comparable between the EOUC and N-EOUC groups. Moreover, patients with EOUC and those with N-EOUC have a similar disease course in terms of proximal disease extension, hospitalization, and colectomy. [ABSTRACT FROM AUTHOR]

Lactifluus (Pers.) Roussel is an ectomycorrhizal genus that was recently recognized to be distinct from the genus Lactarius. To date, 226 Lactifluus species have been reported worldwide. Misidentification of Lactifluus species is common because of intraspecific morphological variation, cryptic diversity, and the limited number of taxonomic keys available. Molecular data are indispensable for species delimitation; a multilocus phylogenetic analysis showed that most Asian Lactifluus species are not conspecific with morphologically similar species present on other continents. In particular, Korea has misused European and North American Lactifluus names. In this study, we evaluated the taxonomy of Lactifluus in Korea using both morphological and multilocus molecular (ITS, nrLSU, rpb1, and rpb2) data. We examined 199 Lactifluus specimens collected between 1980 and 2016, and a total of 24 species across the four Lactifluus subgenera were identified. All Korean species are distinct and clearly separated from European and North American species. Five taxa corresponded to previously described species from Asia and the remaining 19 taxa are confirmed as new species. Herein, we provide keys to the Korean Lactifluus species within their subgenera, molecular phylogenies, a summary of diversity, and detailed description of the new species. [ABSTRACT FROM AUTHOR]

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains were first detected in hospitals in Korea between the late 2000s and early 2010s. However, there is limited information regarding the prevalence of CA-MRSA strains among hospital isolates and their phenotypic changes over the last decade. We investigated the prevalence trend of CA-MRSA strains isolated from different clinical specimens and their phenotypic changes between September 2009 and September 2019. Methods: CA-MRSA strains were phenotypically identified by confirming their resistance to penicillin (PCN) and oxacillin (OXA) and evaluating their susceptibility to trimethoprimsulfamethoxazole, rifampin, fusidic acid, tetracycline, and at least one of the following four antimicrobials: clindamycin (CLI), erythromycin (ERY), ciprofloxacin (CIP), and gentamicin (GEN). A CA-MRSA strain that exhibited resistance to ERY, CLI, CIP, or GEN was classified as having resistance pattern I, II, III, or IV, respectively, regardless of its resistance to other antimicrobial agents. Results: Of the 8,278 MRSA isolates identified in specimens obtained two days after admission, 1,385 (16.73%) were CA-MRSA strains. The prevalence of CA-MRSA strains increased from 12.2% to 26.6% (3.21% per period, P =0.05). Resistance type analysis revealed an increasing trend in the prevalence of PCN/OXA-resistant (1.84%; P =0.049) and PCN/OXA/ERY/CLI/CIP-resistant (0.98%; P =0.04) CA-MRSA strains and in resistance pattern III strains (2.08%; P =0.004). Conclusions: The prevalence of CA-MRSA strains in Korea has increased significantly over the last decade, and CA-MRSA strains have gained phenotypic diversity beyond PCN/OXAresistance, including antimicrobial resistance to non-β-lactams, especially CIP. [ABSTRACT FROM AUTHOR]

Background and Objectives: The association between chemosensory dysfunction (CSD) and coronavirus disease 2019 (COVID-19) remains unclear. The aim of the present study was to determine the incidence of olfactory and taste dysfunction in asymptomatic and mildly symptomatic patients with COVID-19 and to evaluate the symptoms associated with CSD in patients with COVID-19. Materials and Method: On March 9, 2020, 309 patients with asymptomatic or mildly symptomatic COVID-19 confirmed by real-time polymerase chain reaction (RT-PCR) were admitted to the No. 7 Community Treatment Center in Korea. An internetbased survey about symptomatology was administered to these patients, with responses obtained from 244 (79.0%). Subjects who completed the survey were enrolled in this study and were categorized into either a CSD group or a normal chemosensory group based on the presence or absence of CSD, respectively. Results: General symptoms, including fever, myalgia, and chills, were most common (29.1%), followed by upper respiratory tract infection (URI) symptoms (20.9%), CSD (20.5%), and nasal symptoms (13.5%). In patients with CSD (n=50), 10 (4.1%) reported no other symptoms. After adjustment for age, sex, past medical history, and other symptoms, general symptoms [odds ratio (OR), 3.63; confidence interval (CI), 1.70-7.76] and nasal symptoms (OR, 7.00; CI, 2.61-18.80) were significantly associated with CSD. Conclusion: The incidence of CSD was relatively high (20.5%) in asymptomatic and mildly symptomatic patients with COVID-19. General symptoms were independent risk factors of CSD, suggesting a sensorineural mechanism for the observed olfactory and taste dysfunction. [ABSTRACT FROM AUTHOR]

배경 The superinfection of multidrug-resistant bacteria is an important complication in critically ill COVID-19 patients. An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAB) occurred in an isolation ward for COVID-19. We performed an outbreak investigation, and successfully controlled the outbreak with the enhanced environmental cleaning and additional gowning and gloving. 방법 This study analyzed all COVID-19 patients with CRAB in any specimen, who admitted to an isolation ward for COVID-19 of a tertiary hospital in South Korea from October to November 2021. 결과 During the outbreak period, a total of 23 patients with COVID-19 and CRAB were identified. Index case was 85-year old female patient who was referred from a long-term care facility. The mean age of cases was 72.9 and 14 (60.9%) patients were male. In most patients (91.3%), CRAB were identified in sputum culture, two were identified in blood culture at initial, and four patients were identified in sputum and blood culture at the same time. Most of the patients were applying high flow nasal cannula (26.1%) or mechanical ventilation (60.9%)(Table1). As shown in figure2, CRAB outbreak occurred mainly in the wards around the index case, and in particular, environmental culture was carried out in the area marked with a rectangle. CRAB was cultured on the floor, air inlet, air outlet, and window frame of the ward except for wards 3305 and 3319. Phenotypic antimicrobial resistance patterns of CRAB isolates from patients and environment were identical, and additional whole genome sequencing analyses are ongoing to find the clonality of isolates. We applied the infection control measures with the en- hanced environmental cleaning using sodium hypochlorite (NaClO) 1000ppm and phenolic compounds more than twice a day, enhanced hand hygiene, and additional gowning and gloving over personal protective equipment (PPE) mandatory for COVID-19 on 29th October. No additional CRAB cases occurred since 2nd November 2021 for two weeks. 결론 Even when PPEs and precautions for COVID-19 are applied to isolation wards for COVID-19, it is helpful for preventing transmission of multidrug-resistant bacteria to apply additional contact precautions and environmental cleaning [ABSTRACT FROM AUTHOR]

Hearing-impaired people need more stringent acoustic and noise requirements than normal-hearing people in terms of speech intelligibility and listening effort. Multiple guidelines recommend a maximum reverberation time of 0.4 s in classrooms, signal-to-noise ratios (SNRs) greater than 15 dB, and ambient noise levels lower than 35 dBA. We measured noise levels and room acoustic parameters of 12 classrooms in two schools for hearing-impaired pupils, a dormitory apartment for the hearing-impaired, and a church mainly for the hearing-impaired in the Republic of Korea. Additionally, subjective speech clarity and quality of verbal communication were evaluated through questionnaires and interviews with hearing-impaired students in one school. Large differences in subjective speech perceptionwere found between younger primary school pupils and older pupils. Subjective data from the questionnaire and interview were inconsistent; major challenges in obtaining reliable subjective speech perception and limitations of the results are discussed. [ABSTRACT FROM AUTHOR]

Background: As the genetic variants of trabecular bone microarchitecture are not well-understood, we performed a genome-wide association study to identify genetic determinants of bone microarchitecture analyzed by trabecular bone score (TBS). Methods: TBS-associated genes were discovered in the Ansung cohort (discovery cohort), a community-based rural cohort in Korea, and then validated in the Gene-Environment Interaction and Phenotype (GENIE) cohort (validation cohort), consisting of subjects who underwent health check-up programs. In the discovery cohort, 2,451 participants were investigated for 1.42 million genotyped and imputed markers. Results: In the validation cohort, identified as significant variants were evaluated in 2,733 participants. An intronic variant in iroquois homeobox 3 (IRX3), rs1815994, was significantly associated with TBS in men (P=3.74E-05 in the discovery cohort, P=0.027 in the validation cohort). Another intronic variant in mitogen-activated protein kinase kinase 5 (MAP2K5), rs11630730, was significantly associated with TBS in women (P=3.05E-09 in the discovery cohort, P=0.041 in the validation cohort). Men with the rs1815994 variant and women with the rs11630730 variant had lower TBS and lumbar spine bone mineral density. The detrimental effects of the rs1815994 variant in men and rs11630730 variant in women were also identified in association analysis (β=--0.0281, β=--0.0465, respectively). Conclusion: In this study, the rs1815994 near IRX3 in men and rs11630730 near MAP2K5 in women were associated with deterioration of the bone microarchitecture. It is the first study to determine the association of genetic variants with TBS. Further studies are needed to confirm our findings and identify additional variants contributing to the trabecular bone microarchitecture. [ABSTRACT FROM AUTHOR]

Context: Gluteus medius (Gmed) weakness is associated with some lower-extremity injuries. People with Gmed weakness might compensate by activating the tensor fasciae latae (TFL). Different hip rotations in the transverse plane may affect Gmed and TFL muscle activity during isometric side-lying hip abduction (SHA). Objectives: To compare Gmed and TFL muscle activity and the Gmed:TFL muscle-activity ratio during SHA exercise with 3 different hip rotations. Design: The effects of different hip rotations on Gmed, TFL, and the Gmed:TFL muscle-activity ratio during isometric SHA were analyzed with 1-way, repeated-measures analysis of variance. Setting: University research laboratory. Participants: 20 healthy university students were recruited in this study. Interventions: Participants performed isometric SHA: frontal SHA with neutral hip (frontal SHAN), frontal SHA with hip medial rotation (frontal SHA-MR), and frontal SHA with hip lateral rotation (frontal SHA-LR). Main Outcome Measures: Surface electromyography measured the activity of the Gmed and the TFL. A 1-way repeated-measures analysis of variance assessed the statistical significance of Gmed and TFL muscle activity. When there was a significant difference, a Bonferroni adjustment was performed. Results: Frontal SHA-MR showed significantly greater Gmed muscle activation than frontal SHA-N (P = .000) or frontal SHA-LR (P = .015). Frontal SHA-LR showed significantly greater TFL muscle activation than frontal SHA-N (P = .002). Frontal SHA-MR also resulted in a significantly greater Gmed:TFL muscle-activity ratio than frontal SHA-N (P = .004) or frontal SHA-LR (P = .000), and frontal SHA-N was significantly greater than frontal SHA-LR (P = .000). Conclusions: Frontal SHA-MR results in greater Gmed muscle activation and a higher Gmed:TFL muscle ratio. [ABSTRACT FROM AUTHOR]

Russula subsection Amoeninae is morphologically defined by a dry velvety pileus surface, a complete absence of cystidia with heteromorphous contents in all tissues, and spores without amyloid suprahilar spot. Thirty-four species within subsection Amoeninae have been published worldwide. Although most Russula species in South Korea have been assigned European or North American names, recent molecular studies have shown that Russula species from different continents are not conspecific. Therefore, the present study aims to: 1) define which species of Russula subsection Amoeninae occur on each continent using molecular phylogenetic analyses; 2) revise the taxonomy of Korean Amoeninae. The phylogenetic analyses using the internal transcribed spacer (ITS) and multilocus sequences showed that subsection Amoeninae is monophyletic within subgenus Heterophyllidiae section Heterophyllae. A total of 21 Russula subsection Amoeninae species were confirmed from Asia, Australia, Europe, North America, and Central America, and species from different continents formed separate clades. Three species were recognized from South Korea and were clearly separated from the European and North American species. These species are R. bella, also reported from Japan, a new species described herein, Russula orientipurpurea, and a new species undescribed due to insufficient material. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to examine the causes of death in Korean patients who underwent radical prostatectomy for prostate cancer and investigate the relationship between comorbidity and mortality. Materials and Methods We conducted a retrospective multicenter cohort study including 4,064 consecutive patients who had prostate cancer and underwent radical prostatectomy between January 1998 and June 2013. The primary endpoint of this study was all-cause mortality, and the secondary endpoints were cancer-specific mortality (CSM) and other-cause mortality (OCM). Charlson comorbidity index (CCI) was calculated to assess the comorbidities of each patient. Results Of 4,064 patients, 446 (11.0%) died during follow-up. The cause of death was prostate cancer in 132 patients (29.6%), other cancers in 121 patients (27.1%), and vascular disease in 57 patients (12.8%) in our cohort. The overall 10-year CSM rate was lower than the OCM rate (4.6% vs. 10.5%). The 10-year CSM rate was lower than the OCM rate in low- to intermediate-risk group patients (1.2% vs. 10.6%), whereas they were similar in high-risk group patients (11.8% vs. 10.1%). In the multivariable analysis, CCI was independently associated with all-cause mortality after radical prostatectomy, regardless of age and pathologic features. Conclusion Death from prostate cancer was rare in Korean men who underwent radical prostatectomy. Clinicians should be aware of the possibility of overtreatment of low-risk prostate cancer in men with significant comorbidity. Our findings may help to facilitate counseling and plan management in this patient group. [ABSTRACT FROM AUTHOR]

Background: The clindamycin-resistant erythromycin-susceptible (CRES) phenotype is rare in Streptococcus agalactiae (group B streptococci). We aimed to determine the molecular characteristics of CRES S. agalactiae using whole genome sequencing (WGS). Methods: Sixty-six S. agalactiae isolates obtained from blood (N=26), cerebrospinal fluid (N=10), urine (N=17), and vaginal discharge (N=13) between 2010 and 2017 in Korea were subjected to WGS. Based on the WGS data, we analyzed antimicrobial resistance (AMR) determinants, sequence types (STs), capsular polysaccharide (CPS) genotypes, and virulence gene profiles, and constructed a phylogenetic tree. We included the clindamycin-susceptible erythromycin-resistant (CSER) phenotype for comparison. Results: We identified seven CRES S. agalactiae isolates from urine (N=5) and vaginal discharge (N=2) collected between 2010 and 2011. All CRES isolates harbored AMR determinants of lnu(B), lsa(E), and aac(6')-aph(2"), revealed ST19 and CPS genotype III, and had a virulence gene profile of rib-lmb-cylE. Phylogenetic tree analysis revealed that all CRES isolates belonged to the same cluster, suggesting a clonal distribution. In contrast, seven CSER isolates showed a diverse distribution and clustered separately from the CRES isolates. Conclusions: CRES isolates collected between 2010 and 2011 showed a unique cluster with ST19 and CPS genotype III in Korea. This is the first report on WGS-based characteristics of S. agalactiae in Korea. [ABSTRACT FROM AUTHOR]

Environmental DNA (eDNA) metabarcoding is a cost-effective novel approach to estimate biodiversity in an ecosystem. In this study, the MiFish pipeline was employed to test if the system methodology is sufficiently reliable to estimate fish biodiversity in Korean rivers. A total of 125 unique haplotypes and 73 species were identified at the species level from 16 water samples collected from a single survey in four Korean rivers (Hyeongsan, Taehwa, Seomjin, and Nakdong). Among the four rivers, the highest species richness was recorded in the Seomjin River (52 species), followed by the Taehwa (42 species) and Hyeongsan (40 species) rivers. The Nakdong River (26 species) presented the lowest species richness and number of endemic species, presumably due to its metropolitan location and anthropogenic impacts, such as dams or weirs. We were also able to detect that five exotic species (Carassius cuvieri, Cyprinus carpio, Cyprinus megalophthalmus, Lepomis macrochirus, and Micropterus salmoides) are widely distributed in all surveyed rivers, a situation that might be problematic in terms of conservation. Our findings indicate that the eDNA metabarcoding technique is one of the most cost-effective scientific tools available for the management and conservation of the freshwater fish resources available in Korea. However, the low number of 12S sequences of endemic species in the database and low resolution of the MiFish region for differentiating several taxa should be upgraded for their wide use. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to determine the rate and outcomes of pregnancies subsequent to breast cancer in Korea, and the effect of such pregnancies on the prognosis of women who survived breast cancer and subsequently conceived. Materials and Methods We followed a total of 31,761 Korean women 45 years of age or younger who were treated for primary breast cancer from 2002 to 2010. We also included follow-up surveys that were conducted through December 2011. We identified recurrence and mortality from breast cancer using data linked to the Korea National Health Insurance database. We used propensity score matching of the study cohort to analyze the risks of recurrence and mortality from breast cancer depending on pregnancy. Results Within our sample, 992 women (3.1%) became pregnant after receiving treatment for breast cancer. Of those, 622 (67.5%) successfully delivered; the remaining 370 (32.5%) failed to deliver. After propensity score matching, we found that the women who became pregnant after breast cancer did not have a different risk of recurrence (hazard ratio [HR], 0.503; 95% confidence interval [CI], 0.434 to 0.584) and death (HR, 0.520; 95% CI, 0.397 to 0.681), compared with those who did not conceive after breast cancer treatment. Conclusion Our study is the first to report outcomes for Korean women who survived breast cancer and subsequently conceived. Women who survived breast cancer and subsequently became pregnant did not show a poorer survival outcome, compared with those who did not become pregnant. [ABSTRACT FROM AUTHOR]

This paper discusses the future development of air ambulance operations in Korea. Helicopter emergency medical services are a useful means of transporting critically ill patients to the right hospital, at the right time. It is an important element of the emergency medical system to treat acute diseases at the scene, or in transit. For more efficient operations of the emergency medical helicopters (air ambulances or the so-called 'Doctor Helgi' in Korea), various challenges are faced. These include, the expansion of air ambulance bases, proper placement of rendezvous points (landing point), increase of field transport requests, and the operation of night missions. First, it is necessary to reduce the disparity in the benefits of emergency medical care for critically ill patients through the expansion of helicopter bases. Second, through the advancement of joint operations of the pan-ministerial emergency medical helicopters, the time from dispatch to helicopter take-off should be minimized, and a quality improvement program for air transportation should be carried out. Third, it is necessary to increase the number of insufficient rendezvous points and ensure the safety of the helicopters during takeoff and landing, to activate field transportation. Finally, the safety of patients and medical staff should be secured through the systematic preparation of the air transport system for future night missions. To solve these tasks, an appropriate legal system for helicopter emergency medical service is required. Based on the improved system, it is expected that everyone will enjoy equal rights for health, regardless of the regions. [ABSTRACT FROM AUTHOR]

Background: With the increasing prevalence of chronic disease due to aging, many older adults experience multimorbidity and polypharmacy. Medications with anticholinergic properties are particularly associated with adverse cognitive outcomes, including functional decline and mortality. We assessed the clinical impact of anticholinergic cognitive burden (ACB) on clinical outcomes of older patients acutely admitted to a single, hospitalist-operated medical unit of a tertiary hospital in Korea. Methods: This retrospective study reviewed electronic medical records of 318 patients aged 65 years or older admitted to the hospitalist-operated medical unit through the emergency department of Seoul National University Hospital. The analyzed clinical outcomes were the length of hospital stay, in-hospital mortality, unplanned intensive care unit admission, and unexpected readmission within 30 days. Results: The clinical outcomes did not differ between patients who took five or more drugs and those who did not. Patients with an ACB score of 3 or higher had a higher in-hospital mortality rate and longer hospital stay than those who did not. After adjusting for confounding factors, an ACB score of 3 or higher was an independent predictive factor for in-hospital mortality (odds ratio=3.09; 95% confidence interval, 1.18-8.06). Conclusion: ACB rather than the number of medications was associated with in-hospital mortality in acutely ill older patients. Further analytic and interventional studies are required to assess potentially inappropriate medication use and ACB in older inpatients. [ABSTRACT FROM AUTHOR]

Background/Objectives: In this study, four conditions of visual and noises were examined to determine the inferior limb muscle activity after walking for 10 minutes on a treadmill. Method/Statistical Analysis: Nine males and nine females, who agreed to participate in the study, were recruited. Participants were asked to walk on a treadmill for 10 minutes on each of the four conditions (a), (b), (c), and (d) depending on visual acuity and noise. Electromyograph was used to measure and compare muscle activity. Findings: There was no significant difference in biceps femoris muscle(p>.05). The comparison of the tibialis anterior muscle resulted in a significant difference between the conditions a-c, a-d, b-c and b-d (p<.05). This indicates that conditions in those visually impaired became more vital in comparison to those that were not visually impaired. The muscle activation by condition was d>c>b>a, followed by de-conditioned vision and dB was the highest when it was higher 90. The comparison of the lateral gastrocnemius muscle resulted in a significant difference between the a-c, b-c and b-d conditions (p<.05).This indicates that conditions without vision have become more vital than those with vision. The muscle activation by condition was d>c>b>a, followed by de-conditioned vision and dB was the highest when it was > 90. The comparison of the medial gastrocnemius muscle showed that not all four conditions differed significantly (p>.05). Improvements/Applications: There was significant difference in muscle activity between TA, LGM than when vision was blocked, that the muscle activity has improved when walking over 90 dB than 60 dB. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD. [ABSTRACT FROM AUTHOR]