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Purpose We aimed to determine the trends in the use of radiotherapy (RT) and the expenses associated with it in South Korea. Materials and Methods The statistical data of the claims and reimbursement records provided on the Health and Insurance Review and Assessment Service website were utilized. This included information such as the number of patients, fractions, medical expenses according to treatment codes, in/outpatient, sex, age, and regions of hospitals. We analyzed data from 2016 to 2020. Results With a growing RT infrastructure and an increase in the number of radiation oncologists, the expenses for RT were 605.5 million USD in 2020, which had increased 1.5 times from 394.7 million USD in 2016. This growth was mainly because of the increased usage of advanced RT techniques. Furthermore, the proportion of intensity-modulated radiation therapy (IMRT) expenses in the total expenses increased by 1.6 times from 48.8% in 2016 to 76.9% in 2020. Advanced techniques were used more commonly in older individuals or children. However, the proportion of IMRT expenses increased mostly in young women. Additionally, geographical differences in RT use and expense were observed, although the gap in the IMRT fractions decreased among the regions. Conclusion Recent medical expenses associated with RT in Korea have increased in tandem with technological advances and changes in demographics. [ABSTRACT FROM AUTHOR]

Environmental crises caused by climate change and human-induced disturbances have become urgent challenges to the sustainability of human beings. These issues can be addressed based on a data-driven understanding and forecasting of ecosystem responses to environmental changes. In this study, we introduce a long-term ecological monitoring system in Korean Long-Term Ecological Research (KLTER), and a plan for the Korean Ecological Observatory Network (KEON). KLTER has been conducted since 2004 and has yielded valuable scientific results. However, the KLTER approach has limitations in data integration and coordinated observations. To overcome these limitations, we developed a KEON plan focused on multidisciplinary monitoring of the physiochemical, meteorological, and biological components of ecosystems to deepen process-based understanding of ecosystem functions and detect changes. KEON aims to answer nationwide and long-term ecological questions by using a standardized monitoring approach. We are preparing three types of observatories: two supersites depending on the climate-vegetation zones, three local sites depending on the ecosystem types, and two mobile deployment platforms to act on urgent ecological issues. The main observation topics were species diversity, population dynamics, biogeochemistry (carbon, methane, and water cycles), phenology, and remote sensing. We believe that KEON can address environmental challenges and play an important role in ecological observations through partnerships with international observatories. [ABSTRACT FROM AUTHOR]

Purpose Although osimertinib is the standard-of-care treatment of epidermal growth factor receptor (EGFR) T790M mutation–positive non–small cell lung cancer, real-world evidence on the efficacy of osimertinib is not enough to reflect the complexity of the entire course of treatment. Herein, we report on the use of osimertinib in patients with EGFR T790M mutation–positive non–small cell lung cancer who had previously received EGFR tyrosine kinase inhibitor (TKI) treatment in Korea. Materials and Methods Patients with confirmed EGFR T790M after disease progression of prior EGFR-TKI were enrolled and administered osimertinib 80 mg daily. The primary effectiveness outcome was progression-free survival, with time-to-treatment discontinuation, treatment and adverse effects leading to treatment discontinuation, and overall survival being the secondary endpoints. Results A total of 558 individuals were enrolled, and 55.2% had investigator-assessed responses. The median progression-free survival was 14.2 months (95% confidence interval [CI], 13.0 to 16.4), and the median time-to-treatment discontinuation was 15.0 months (95% CI, 14.1 to 15.9). The median overall survival was 36.7 months (95% CI, 30.9 to not reached). The benefit with osimertinib was consistent regardless of the age, sex, smoking history, and primary EGFR mutation subtype. However, hepatic metastases at the time of diagnosis, the presence of plasma EGFR T790M, and the shorter duration of prior EGFR-TKI treatment were poor predictors of osimertinib treatment. Ten patients (1.8%), including three with pneumonitis, had to discontinue osimertinib due to severe adverse effects. Conclusion Osimertinib demonstrated its clinical effectiveness and survival benefit for EGFR T790M mutation–positive in Korean patients with no new safety signals. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to provide the clinical characteristics, prognostic factors, and 5-year relative survival rates of lung cancer diagnosed in 2015. Materials and Methods The demographic risk factors of lung cancer were calculated using the KALC-R (Korean Association of Lung Cancer Registry) cohort in 2015, with survival follow-up until December 31, 2020. The 5-year relative survival rates were estimated using Ederer II methods, and the general population data used the death rate adjusted for sex and age published by the Korea Statistical Information Service from 2015 to 2020. Results We enrolled 2,657 patients with lung cancer who were diagnosed in South Korea in 2015. Of all patients, 2,098 (79.0%) were diagnosed with non–small cell lung cancer (NSCLC) and 345 (13.0%) were diagnosed with small cell lung cancer (SCLC), respectively. Old age, poor performance status, and advanced clinical stage were independent risk factors for both NSCLC and SCLC. In addition, the 5-year relative survival rate declined with advanced stage in both NSCLC (82%, 59%, 16%, 10% as the stage progressed) and SCLC (16%, 4% as the stage progressed). In patients with stage IV adenocarcinoma, the 5-year relative survival rate was higher in the presence of epidermal growth factor receptor (EGFR) mutation (19% vs. 11%) or anaplastic lymphoma kinase (ALK) translocation (38% vs. 11%). Conclusion In this Korean nationwide survey, the 5-year relative survival rates of NSCLC were 82% at stage I, 59% at stage II, 16% at stage III, and 10% at stage IV, and the 5-year relative survival rates of SCLC were 16% in cases with limited disease, and 4% in cases with extensive disease. [ABSTRACT FROM AUTHOR]

Epidemiological information on hepatitis A among people living with HIV (PLHIV) in Korea is scarce. This retrospective study was performed at a tertiary care hospital and included 756 PLHIV with anti- hepatitis A virus (HAV) IgG tests. Between 2012 and 2021, the age at antiHAV IgG seroconversion is gradually delayed, and the proportion of individuals susceptible to HAV infection increased among adult PLHIV in Korea. The independent risk factors for HAV seropositivity were female sex and HBs antigen (Ag) positivity. Therefore, HAV vaccination is highly recommended for young PLHIV, especially for women or HBsAg-positive individuals. [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]

Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients’ care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed. Despite the coronavirus disease 2019 (COVID-19) vaccination roll-out, variant-related outbreaks have occurred repeatedly in Korea. Although public hospitals played a major role in COVID-19 patients’ care, difficulty incorporating evolving COVID-19 treatment guidelines called for a clinical pathway (CP). Eighteen public hospitals volunteered, and a professional review board was created. CPs were formulated containing inclusion/exclusion criteria, application flow charts, and standardized order sets. After CP roll-out, key parameters improved, such as increased patient/staff five-point satisfaction scores (0.41/0.57) and decreased hospital stays (1.78 days)/medical expenses (17.5%). The CPs were updated consistently after roll-out as new therapeutics drugs were introduced and quarantine policies changed. [ABSTRACT FROM AUTHOR]

Background: Recent data suggests the inoculum effect ofmethicillin-susceptible Staphylococcus aureus (MSSA) against beta-lactam antibiotics and their association with functionality or genotypic variation of agr locus. Methods: MSSA blood isolates were collected at a tertiary care hospital in Korea from June 2014 to December 2017. The functionality of the agr operon was measured by 5-hemolysin assays. Multiplex PCRwas performed to determine the agr genotype. The cefazolin minimum inhibitory concentrations (MICs) at a high inoculum concentration (-5 x 107 CFU/ml) were compared to the MICs at a standard inoculum concentration (-5 x 105 CFU/ml) to identify strains with the cefazolin inoculum effect (CIE). The DNA sequencing of blaZ gene was performed to classify the blaZ genotype. R e su lts Among the 195 MSSA blood isolates, agr genotype I was most common (68.2%), followed by type III (16.4%), type IV (9.2%), and type II (6.2%). Sixty-seven (34.3%) MSSA isolates had dysfunctional agr, but neither CIE nor blaZ genotype was associated with dysfunctional agr. The MSSA with agr type III genotype exhibited significantly higher CIE positivity (agrIII 43.8% vs. non -a g rlll 5.5%, P<0.01) and erythromycin/clindamycin resistance. In the subgroup analysis of type A blaZ possessing MSSA, almost all of the agr III MSSA isolates exhibited CIE, while only 20% of not\-agr\W isolates had CIE (P <0.01). Conclusion In MSSA blood isolates, CIE might be associated with agr genotype rather than with dysfunctional agr. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to investigate epidemiology, clinical characteristics and sex differences of patients with lung cancer using nationwide registry in Korea. Materials and Methods The Korean Association for Lung Cancer developed a registry in cooperation with the Korean Central Cancer Registry, and surveyed about 10% of lung cancer cases. For this first survey of cases diagnosed in 2014, cases were selected through a systematic sampling method. Results Total 2,621 lung cancer patients were surveyed, and the median patient age was 70 years. During the study period, adenocarcinoma was the most frequent histologic type, the proportion of female patients was 28.4%, and women had a better prognosis (median survival, not reached vs. 13 months; p<0.001) than did men for non-small cell lung cancer. The proportion of never-smokers was 36.4%, and never-smoking was more prevalent in women than in men (87.5 vs. 16.0%, p<0.001). Epidermal growth factor receptor (EGFR) mutations were found in 36.8% of stage IV adenocarcinoma patients, and higher in female compared to male patients (51.2 vs. 26.6%, p<0.001). In addition, patients with EGFR mutation showed better survival (median survival, 18 vs. 8 months; p<0.001) than patients without EGFR mutation in these patients. Conclusion This is the first survey to gather unbiased nationwide lung cancer statistics in Korea. More than one-third of lung cancer patients had no smoking history. Female had a high proportion of non-smoker, more adenocarcinoma with EGFR mutation and generally better prognosis than male. [ABSTRACT FROM AUTHOR]

Background: The Korean Society oflnfectious Diseases recommends non-mandatory vaccination of newly employed healthcare workers (HCWs) with 2 measles-mumps-rubella (MMR) vaccine doses. Here, we aimed to investigate the seroprevalence of mumps among HCWs exposed to index patients with mumps and the efficacy of MMR vaccination as postexposure prophylaxis (PEP) when a mumps outbreak was encountered among HCWs in a tertiary university hospital in Korea. Materialsand Me thods : Four HCWs were diagnosed with mumps over a 4-day period in January 2016. Three were working at a dental clinic and one visited the clinic on the day of symptoms onset of the first patient. We investigated all HCWs who either worked in that dental clinic, visited the clinic, or being within 1.5 meter of the patients with mumps without wearing surgical masks. Seventy HCWs were exposed to 4 HCWs with mumps. We interviewed all the exposed HCWs to investigate mumps infection and MMR vaccination history; they were all tested for mumps IgG. Results: Of the 70 exposed HCWs, 56 (80%) were females; the median age was 34 years (range 21-59 years) and 3 had a history of mumps infection. The vaccination status verification of mumps among the HCWs was unavailable. As for serologic testing, 54 (77.1%) were seropositive. Seropositivity rate for the mumps virus in males was significantly lower than that in females (50.0% vs. 83.9% respectively, P = 0.007). A lower seroprevalence of mumps was observed among HCWs aged >40 years than those aged <40 years; however, this difference was not significant (65.2% vs. 83.0%, P = 0.096). During the initial intervention, all exposed HCWs were vaccinated because the turnaround time for serologic testing was expected to be >2 days. Thirty-four (62.9%) of 54 seropositive HCWs and 16 seronegative HCWs were administered MMR vaccines as PEP and following this, no additional cases of mumps were encountered during the maximum incubation period. Conclusion : Of the exposed HCWs, 77.1% were mumps-seropositive. Seropositive rates differed according to factors such as age and sex. Eligible HCWs received a MMR vaccine as PEP and no additional mumps cases occurred during the incubation period. It was useful in our infection control activities during the mumps outbreak. [ABSTRACT FROM AUTHOR]

BACKGROUND: The reports about fertility desire and pregnancy outcome among women infected with human immunodeficiency virus (HIV) in Korea are scarce. This study aimed to determine the changing trend in pregnancy incidence among women infected with HIV in Korea. MATERIALS AND METHODS: We retrospectively reviewed the medical records of women infected with HIV visiting Pusan National University Hospital between January 1990 and October 2018. RESULTS: A total of 149 women with HIV infection visited the study hospital. Among them, 33 pregnancies in 24 (16.1%) women were identified. There were 17 live births (51.5%) and 13 abortions (39.4%), whereas 3 women (9.1%) were transferred to another hospital or were lost to follow-up. The number of live birth rose from 0 in 1990-1998 to 17 in 1999-2018. The proportion of repeated pregnancies after HIV diagnosis also increased steeply, from 14.3% in 1999-2008 to 50% in 2009-2018. However, the number of abortions also increased over time. There were 8 induced abortions, 7 (87.5%) of them were diagnosed with HIV infection during pregnancy and 3 (37.5%) were unplanned pregnancies. Eighteen babies, including 1 twin case, were born from 17 births. There was no mother-to-child HIV transmission in our study. CONCLUSION: The number of pregnancies among women with HIV infection and repeated pregnancies after HIV diagnosis has been increasing in Korea, probably due to the desire of HIV patients to have more children. However, the number of abortions also increased, probably due to health concerns and uncertain pregnancy outcome. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the effects that the use of a booklet for intensive care unit nurses had on radiation safety management education (knowledge about and behaviors in radiation safety management, and awareness of anxiety caused by radiation hazards). Methods: A randomized control group pretest-posttest design was used. A booklet about radiation safety management developed by the authors was used as educational material. Participants (N=42) were intensive care unit nurses of P hospital in B city. Training was provided to the experimental group (N=21). Knowledge about and behaviors in radiation safety management and awareness of anxiety caused by radiation hazards were measured by questionnaires before and after the intervention. Data was analyzed by an X2-test, non-paired t-test, and paired t-test. Results: There was a significant difference between groups in knowledge of (t=-14.932, p<.001) and behaviors in (t=-8.297, p<.001) radiation safety management and awareness of anxiety caused by radiation hazards (t=9.378, p<.001). Conclusion: The levels of knowledge about and behaviors in radiation safety management and awareness of anxiety generated by radiation hazards of intensive care unit nurses increased after receiving one session of radiation safety management education using the booklet. Therefore, providing radiation safety management training is suggested as an effective strategy for improving radiation safety management. [ABSTRACT FROM AUTHOR]

The purpose of this study is to evaluate the impacts of the upstream Soyanggang and Chungju multi-purpose dams on the frequency of downstream floods in the Han River basin, South Korea. A continuous hydrological model, SWAT (Soil and Water Assessment Tool), was used to individually simulate regulated and unregulated daily streamflows entering the Paldang Dam, which is located at the outlet of the basin of interest. The simulation of the regulated flows by the Soyanggang and Chungju dams was calibrated with observed inflow data to the Paldang Dam. The estimated daily flood peaks were used for a frequency analysis, using the extreme Type-I distribution, for which the parameters were estimated via the L-moment method. This novel approach was applied to the study area to assess the effects of the dams on downstream floods. From the results, the two upstream dams were found to be able to reduce downstream floods by approximately 31% compared to naturally occurring floods without dam regulation. Furthermore, an approach to estimate the flood frequency based on the hourly extreme peak flow data, obtained by combining SWAT simulation and Sangal's method, was proposed and then verified by comparison with the observation-based results. The increased percentage of floods estimated with hourly simulated data for the three scenarios of dam regulation ranged from 16.1% to 44.1%. The reduced percentages were a little higher than those for the daily-based flood frequency estimates. The developed approach allowed for better understanding of flood frequency, as influenced by dam regulation on a relatively large watershed scale. [ABSTRACT FROM AUTHOR]

The article focuses on the study which presents a method to estimate runoff curve numbers (CNs) through the use of soil and water assessment tool (SWAT) model which is can take into account watershed heterogeneities such as climate conditions, land use and soil types in South Korea. The simulation flow data by SWAT is used by the proposed CN estimation method. The SWAT-based CN estimation method combined with the asymptotic CN method was used to the Chungju dam watershed in the country.