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Objective: This study aimed to compare and characterize the safety profiles of new antiseizure medications (ASMs) using a nationwide pharmacovigilance database from a long-term perspective in Korea., Methods: We reviewed adverse event reports from the Korea Adverse Event Reporting System database between January 2013 and December 2022 for descriptive analysis of six new ASMs (lacosamide, levetiracetam, lamotrigine, oxcarbazepine, topiramate, and zonisamide). We investigated the frequency and characteristics of adverse drug reactions (ADRs) based on the MedDRA terminology, system organ classes, and modified WHO classification., Results: We identified 5,733 reported cases of ADRs. The commonly reported ADRs associated with total ASMs were rash/urticaria (1,822, 31.8 %), dizziness (409, 7.1 %), somnolence/drowsiness (311, 5.4 %), and hepatotoxic effects (273, 4.8 %). Type B (idiosyncratic) effects (2,932; 51.1 %) were more commonly reported than Type A (related to known drug mechanisms) effects (2,613; 45.6 %). Skin and subcutaneous tissue disorders and type B effects were most commonly reported for lamotrigine and oxcarbazepine, whereas nervous system disorders and type A effects were most commonly reported for lacosamide, topiramate, and zonisamide. The pediatric group (<18 years) exhibited skin and subcutaneous tissue disorders and type B effects relatively more frequently than the adult and older adult groups., Conclusion: Hypersensitivity skin reactions and type B effects remained significant ADRs in the new ASMs; however, type A effects were more commonly reported in some ASMs. The pediatric group showed a higher rate of type B effects. Overall, new ASMs should also be used with caution., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: To explore the decision-making experiences of older patients with end-stage renal disease who chose to undergo kidney transplantation., Methods: This was a qualitative descriptive study.Twelve participants aged over 60 years who underwent kidney transplantation were recruited from a kidney transplant clinic in a hospital in South Korea. Individual in-depth interviews were conducted from March to April 2021. The data were analysed using inductive thematic analysis., Results: Four main themes were identified: 1) hesitation towards complex and risky kidney transplant, 2) internal suffering due to social prejudice and limits, 3) taking a step back from the decision-making process, and 4) being rushed into a decision on the brink of death., Conclusion: Older patients with end-stage renal disease experience hesitation and difficulties and are passive in the decision-making process for a kidney transplant. They lacked sufficient relevant information and decided to receive transplant surgery, feeling pressured by the recommendations of family and healthcare providers., Practice Implications: Healthcare professionals should help older patients with end-stage renal disease make proactive decisions by providing tailored education programs and improving communication between the patients and their family members. Changing negative social perceptions and implementing supportive policies are necessary to resolve the difficulties experienced by such patients., Patient or Public Contribution: Patients were involved in the data collection as interview participants in this study., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Scope: Mild cognitive impairment is associated with a high prevalence of dementia. The study examines the benefits of a modified Korean MIND (K-MIND) diet and explores biomarkers using multi-omics analysis., Methods and Results: The K-MIND diet, tailored to the elderly Korean population, includes perilla oil, milk, or fermented milk, and avoids alcohol consumption. As a result, the K-MIND diet significantly improves subjects "orientation to place" in the Korean version of the Mini-Mental State Examination, 2nd edition test. According to multi-omics analysis, the K-MIND diet upregulates genes associated with mitochondrial respiration, including ubiquinone oxidoreductase, cytochrome C oxidase, and ATP synthase, and immune system processes, and downregulates genes related to nuclear factor kappa B activity and inflammatory responses. In addition, K-MIND affects the metabolic pathways of glycine, serine, threonine, tryptophan, and sphingolipids, which are closely linked to cognitive function through synthesis of neurotransmitters and structures of brain cell membranes., Conclusion: The findings imply that the K-MIND diet improves cognitive function by upregulating key genes involved in oxidative phosphorylation and downregulating pro-inflammatory cytokines., (© 2023 Wiley-VCH GmbH.)

Abstract: This study aimed to describe sleep disturbances and identify associated factors in adolescent smokers in South Korea. This study adopted a cross-sectional design and recruited 520 students aged 12-17 years from 35 schools to participate in a smoking cessation program. To compare demographic, smoking-related, psychological, and problem behavior characteristics between adolescent smokers with sleep disturbances and without sleep disturbances, chi-square tests and independent t tests were used. Logistic regression analysis was performed to identify the factors associated with sleep disturbances in adolescent smokers. Approximately 45.8% of adolescent smokers reported sleep disturbances. Sleep disturbances were more frequent among girls than among boys and more frequent among high school students than among middle school students. Other factors included cigarette use within 1 month, nicotine dependence, smoking cessation self-efficacy, depression, Internet addiction, and suicidal ideation. Gender (girls), school level (high school), depression, Internet addiction, and daily cigarette use (11 or more cigarettes) were significantly associated with sleep disturbances in adolescent smokers. To improve the sleep quality of adolescent smokers, health professionals should focus on sleep disturbances and associated factors and develop appropriate intervention programs., Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article., (Copyright © 2022 International Nurses Society on Addictions.)

Despite the increase in older adults receiving kidney transplantation (KT), little is known about their experience and adaptation process after KT. The current study aimed to explore the process of adaptation after KT in older adult recipients using a qualitative design and grounded theory methodology. Sixteen recipients who had KT at age ≥60 years and received follow-up care were recruited at a university hospital in South Korea. Data were collected from July to December 2017 through in-depth interviews with individual participants. The core theme of the adaptation process after KT in older adult recipients was A Journey of Straining to Save the Last Lifeline . The adaptation process comprised three stages: confusion, depression, and compromise. Tailored interventions based on the in-depth understanding of the adaptation process found in the current study are needed to improve adaptation after KT in older adult recipients. [ Research in Gerontological Nursing, 16 (4), 183-193.].

We investigated the incidence and risk factors of seizures related to progressive multifocal leukoencephalopathy (PML) in Korean patients infected with HIV. Of the 34 patients, 14 (41.2%) developed epileptic seizures during a median follow-up of 82 months. The median time from PML diagnosis to seizure onset was 44 months, ranging from 0 to 133 months. Patients with PML who developed seizures more commonly had cognitive impairment and multiple or diffuse lesions on brain MRI. These findings highlight the increased seizure risk among HIV-infected patients with PML at any stage of the disease, particularly in cases with extensive involvement., (© 2023. The Author(s) under exclusive licence to The Journal of NeuroVirology, Inc.)

Background: Although uterine leiomyoma causes many problems, including infertility, there are few studies that have investigated the epidemiologic characteristics of uterine leiomyoma in South Korea. The aim of this study is to estimate the prevalence and incidence of uterine leiomyoma in South Korea and analyze the treatment trends. Materials and Methods: Women of reproductive age (15-54 years) were selected from the Korean National Health Insurance Service (NHIS) sample cohort dataset, which was collected from 2002 to 2013. Patients with uterine leiomyoma were identified by ICD-10 ( International Codes of Disease , 10th Edition) and intervention codes. Prevalence and incidence were calculated from the NHIS cohort dataset and the treatment trends were analyzed for diagnosed patients. Results: The prevalence in overall age groups increased from 0.96% in 2002 to 2.43% in 2013, and the 1-year incidences of all age groups increased. The 26-30 age group showed the highest rate of 1-year incidence increase (2.14-folds, 0.33% in 2003 to 0.70% in 2013). The proportion of myomectomy increased from 22% in 2002 to 49% in 2013, whereas the proportion of hysterectomy decreased from 78% to 45%. Conclusions: The prevalence and incidence of uterine leiomyoma are increasing in South Korea as time progresses, and the rate of incidence increase is higher in younger reproductive women. Overall trends in uterine leiomyoma treatment are shifting to the methods of the saving uterus.

Background: The look-back period is needed to define baseline population for estimating incidence. However, short look-back period is known to overestimate incidence of diseases misclassifying prevalent cases to incident cases. The purpose of this study is to evaluate the impact of the various length of look-back period on the observed incidences of uterine leiomyoma, endometriosis and adenomyosis, and to estimate true incidences considering the misclassification errors in the longitudinal administrative data in Korea., Methods: A total of 319,608 women between 15 to 54 years of age in 2002 were selected from Korea National Health Insurance Services (KNHIS) cohort database. In order to minimize misclassification bias incurred when applying various length of look-back period, we used 11 years of claim data to estimate the incidence by equally setting the look-back period to 11 years for each year using prediction model. The association between the year of diagnosis and the number of prevalent cases with the misclassification rates by each look-back period was investigated. Based on the findings, prediction models on the proportion of misclassified incident cases were developed using multiple linear regression., Results: The proportion of misclassified incident cases of uterine leiomyoma, endometriosis and adenomyosis were 32.8, 10.4 and 13.6% respectively for the one-year look-back period in 2003. These numbers decreased to 6.3% in uterine leiomyoma and - 0.8% in both endometriosis and adenomyosis using all available look-back periods (11 years) in 2013., Conclusion: This study demonstrates approaches for estimating incidences considering the different proportion of misclassified cases for various length of look-back period. Although the prediction model used for estimation showed strong R-squared values, follow-up studies are required for validation of the study results.

Background: Severe and life-threatening drug eruptions include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). One class of medications that has been highly associated with such drug eruptions is antiepileptic drugs (AEDs). We attempt to investigate drug eruptions associated with AEDs as a class, as well as with individual AEDs, in Korea., Methods: We used the Korea Institute of Drug Safety and Risk Management - Korea Adverse Event Reporting System (KIDS-KAERS) database, a nationwide database of adverse events reports, between January 2008 and December 2017 to investigate the reporting count of all drug eruptions and calculated the ratio of DRESS/SJS/TEN reports for each AED., Results: Among a total of 2,942 reports, most were of rash/urticaria (2,702, 91.8%), followed by those of DRESS (109, 3.7%), SJS (106, 3.6%), and TEN (25, 0.85%). The common causative AEDs were lamotrigine (699, 23.8%), valproic acid (677, 23%), carbamazepine (512, 17.4%), oxcarbazepine (320, 10.9%), levetiracetam (181, 6.2%), and phenytoin (158, 5.4%). In limited to severe drug eruptions (DRESS, SJS, and TEN; total 241 reports), the causative AEDs were carbamazepine (117, 48.8%), lamotrigine (57, 23.8%), valproic acid (20, 8.3%), phenytoin (15, 6.3%), and oxcarbazepine (10, 4.2%). When comparing aromatic AED with non-aromatic AED, aromatic AEDs were more likely to be associated with severe drug eruption (aromatic AEDs: 204/1,793 versus non-aromatic AEDs: 37/1,149; OR, 3.86; 95% CI, 2.7-5.5). Death was reported in 7 cases; DRESS was the most commonly reported adverse event (n = 5), and lamotrigine was the most common causative AED (n = 5)., Conclusion: Although most cutaneous drug eruptions in this study were rash or urticaria, approximately 8% of reports were of severe or life-threatening adverse drug reactions, such as SJS, TEN, or DRESS. When hypersensitivity skin reactions occurred, aromatic AEDs were associated with 4 fold the risk of SJS/TEN/DRESS compared with non-aromatic AEDs. Our findings further emphasize that high risk AEDs should be prescribed under careful monitoring, and early detection and prompt interventions are needed to prevent severe complications., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2020 The Korean Academy of Medical Sciences.)

Purpose: To identify the NANDA-I-NOC-NIC (NNN) linkages for inpatients of the obstetrics nursing unit using electronic nursing records., Methods: In this retrospective, descriptive survey, the electronic nursing records for 220 adult patients aged ≥18 years who were discharged after obstetrics nursing unit were analyzed., Findings: The 7 most frequent nursing diagnoses were found to be associated with 9 nursing outcomes and 26 nursing interventions., Conclusions: Herein, the list of nursing diagnoses was observed to comprise the safety/protection domain, the list of nursing outcomes the physiological health domain, and the list of nursing interventions the physiological: complex domain., Implications for Nursing Practice: This result can contribute to improving the nursing quality and will help continuing education and documentation system refinement., (© 2017 NANDA International, Inc.)

Aim: This study aimed to identify health-related quality of life (HRQoL) and its determinants in outpatients with acute coronary syndrome (ACS) after percutaneous coronary intervention., Methods: A cross-sectional design was used and a total of 124 Korean participants was enrolled. The HRQoL (physical limitations, treatment satisfaction, and disease perception), symptom experience (frequency, severity, and distress), physiological (left ventricular ejection fraction and lipids), psychological (depression and anxiety), and situational (social support) factors were measured, selected on the basis of the theory of unpleasant symptoms. The HRQoL was assessed by using the Seattle Angina Questionnaire-Korean, designed to evaluate disease-specific health outcomes in patients with coronary artery disease. Descriptive statistics and multiple linear regression analyses were conducted., Results: The mean age of the participants was 61.73 years. The HRQoL was moderate. Among the HRQoL domains, disease perception showed the lowest level. The most intense symptoms that were experienced by the participants were fatigue, shortness of breath, and chest discomfort. More than half of the participants had depression and anxiety. The determinants of worse HRQoL were severe symptom experience, higher depression, higher low-density lipoprotein cholesterol, a lower educational level, and lower social support., Conclusion: This study proposes a comprehensive approach to health care that incorporates symptom experience, as well as the physiological, psychological, and situational aspects based on the theory of unpleasant symptoms, to improve the HRQoL among outpatients with ACS. Nurses should play a key role to help patients with ACS to deal with the symptoms, low-density lipoprotein cholesterol, and depression and to promote social support, particularly in less-educated patients, in order to improve their HRQoL., (© 2018 Japan Academy of Nursing Science.)

Purpose: This study aimed to examine the impact of alcohol use on the antiretroviral therapy (ART) adherence of Koreans living with human immunodeficiency virus (HIV)., Methods: A total of 144 HIV-infected Koreans older than the age of 19 years who had been receiving antiretroviral drugs for at least 3 months were surveyed. Alcohol use was identified as nonhazardous, binge, hazardous, and alcohol dependent as determined by the Alchol Use Disorder Identification Test-Korea (AUDIT-K). ART adherence was defined according to the components of adherence motivation, adherence knowledge, and 95% medication adherence using the modified Morisky scale. Collected data were analyzed using logistic regression analysis for each component of therapy adherence., Results: Of all participants, 13.9% were binge drinkers, 17.4% were hazardous drinkers, and 4.2% were alcohol dependent. For low adherence motivation, the odds ratio for the hazardous drinkers was 7.47 [95% confidence interval (CI): 1.72-32.41; p = .007] and for the alcohol dependent, it was 12.61 (95% CI: 1.38-115.38; p = .025) when compared with the nonhazardous drinkers. For medication adherence under 95%, the odds ratio for binge drinkers was 4.65 (95% CI: 1.15-18.92; p = .032), for hazardous drinkers was 8.05 (95% CI: 2.08-31.20; p = .003), and for the alcohol dependent was 27.67 (95% CI: 2.12-360.51; p = .011)., Conclusion: It is recommended that Korean institutions and governments develop specific mediation and counseling programs that include alcohol use-related monitoring for the improvement of the ART adherence of people living with HIV., (Copyright © 2018. Published by Elsevier B.V.)

Kidney transplantation (KT) patients are at a higher risk than the general population for influenza virus infection. Although vaccination is primarily recommended for KT patients, little is known about the influenza vaccination rate and related health beliefs in South Korea. The influence of health beliefs on influenza vaccination among KT patients has never been explored. This study aimed to identify influenza vaccine acceptance and association with health beliefs among KT patients. A total of 180 patients who underwent a KT were recruited from an organ transplant center in Korea. Data were collected through structured questionnaires, which were analyzed using descriptive statistics and binary logistic regression. Approximately 47.2% of the participants received influenza vaccination. Previous influenza vaccination, lower perceived barriers, higher perceived benefits, older age, and longer duration after transplantation influenced influenza vaccine acceptance. The results suggest that various strategies are needed for increasing acceptance of influenza vaccination among KT patients. Getting vaccinated for influenza after KT might be crucial for the annual vaccinations. Improving benefits and decreasing barriers perceived by KT patients may contribute to increasing the acceptance. Education on influenza vaccination should be emphasized particularly for young patients under 45 years and up to 10 years after KT.

Lily (Lilium longiflorum Thunb.) is the most representative bulb flower, and it is the third most important flower in the flower industry of South Korea after rose and chrysanthemum. To determine the efficacy of X-ray irradiation for use in quarantine processing, two species of flower thrips (Frankliniella intonsa (Trybom) and Frankliniella occidentalis (Pergande)) were placed in the top, middle, and bottom locations of lily boxes and irradiated with different X-ray doses. After irradiation with an X-ray dose of 150 Gy, the egg hatching of the two flower thrips was completely inhibited at every location in the lily boxes, and the irradiated F. intonsa and F. occidentalis nymphs failed to emerge as adult in every location of the lily boxes. When the adults were irradiated at 150 Gy, the fecundity of the two flower thrips was markedly lower than that of the untreated control groups. The F1 generation failed to hatch at the top and middle locations, whereas the F1 generation of both F. intonsa and F. occidentalis was not suppressed at the bottom locations, even at 200 Gy. However, hatching was perfectly inhibited at 300 Gy of X-ray irradiation. Also, X-rays did not affect the postharvest physiology of cut lilies. Therefore, a minimum dose of 300 Gy is recommended for the control of F. intonsa and F. occidentalis for the exportation of lily., (© The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Two clinical scoring systems, the status epilepticus severity score (STESS) and the epidemiology-based mortality score in status epilepticus (EMSE), are used to predict mortality in patients with status epilepticus (SE). The aim of this study was to compare the outcome-prediction function of the two scoring systems regarding in-hospital mortality using a multicenter large cohort of adult patients with SE. Moreover, we studied the potential role of these two scoring systems in predicting the functional outcome in patients with SE., Methods: The SE cohort consisted of patients from the epilepsy centers of eight academic tertiary medical centers in South Korea. The clinical and electroencephalography data for all adult patients with SE from January 2013 to December 2014 were derived from a prospective SE database. The primary outcome variable was defined as in-hospital death. The secondary outcome variable was defined as a poor functional outcome, i.e., a score of 1-3 on the Glasgow Outcome Scale, at discharge., Results: Among the 120 non-hypoxic patients with SE recruited into the study, 16 (13.3%) died in the hospital and 64 (53.3%) were discharged with a poor functional outcome. The receiver-operating characteristic (ROC) curve for prediction of in-hospital death based on the STESS had an area under the curve of 0.673 with an optimal cutoff value for discrimination (best match for both sensitivity (0.56) and specificity (0.70)) that was ≥ 4 points. The two combinations of elements of the EMSE system (EMSE-ALDEg and EMSE-ECLEg) predicted not only in-hospital mortality with the best match for sensitivity (more than 0.6) and specificity (more than 0.6), but also a poor functional outcome with the best match for both sensitivity (>0.7) and specificity (>0.6). STESS did not predict a poor functional outcome (area under the ROC, 0.581; P = 0.23)., Conclusion: Although the EMSE is a clinical scoring system that focuses on individual mortality, we did not find differences between the EMSE and STESS in the prediction of in-hospital death. The EMSE was useful in predicting poor functional outcome, as it was significantly better than STESS.

Purpose: This study aimed to investigate symptom experience and identify the predictors of symptom experience in cancer patients undergoing chemotherapy., Method: This study was a cross-sectional and descriptive design. A total of 167 participants were recruited from the outpatient department of a university hospital in South Korea. Symptom experience (symptom prevalence, severity, and interference with daily activities), physiological factors (absolute neutrophil count, hemoglobin), psychological factors (depression, fighting spirit), and a situational factor (social support), based on the Theory of Unpleasant Symptoms, were measured. Descriptive statistics and multiple regression analyses were performed., Results: Symptom prevalence ranged from 74.3% to 98.8% of patients. The five most severe symptoms were fatigue, numbness/tingling, dry mouth, sleep disturbance, and drowsiness. General activity and work were the most affected areas of daily life. Symptom experience was significantly related to hemoglobin, depression, fighting spirit, and social support. In the multiple regression analysis, higher level of depression and lung cancer accounted for 20.2% of the variance in symptom severity. Higher level of depression, lower level of fighting spirit and third or fourth-line chemotherapy accounted for 31.0% of the variance in symptom interference., Conclusions: Attention is drawn to developing a comprehensive approach which considers relevant physiological, psychological and social factors in assessment and management of concurrent symptoms in cancer patients undergoing chemotherapy. Health care professionals need to play a key role in helping patients deal with depressive mood and promote fighting spirit, particularly in patients with lung cancer or patients treated with higher-line chemotherapy, for controlling their symptom experience., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Patients with human immunodeficiency virus (HIV) infection have a higher burden of seizures, but few studies have examined seizures in HIV-infected individuals in Korea. A retrospective study was conducted to determine the epidemiology and clinical characteristics of seizures in patients with HIV infection. Among a total of 1,141 patients, 34 (3%) had seizures or epilepsy; 4 of these individuals had epilepsy before HIV infection, and the others showed new-onset seizures. Most patients exhibited moderate (200 to 500, n = 13) or low (below 200, n = 16) CD4 counts. The most common seizure etiology was progressive multifocal leukoencephalopathy (n = 14), followed by other HIV-associated central nervous system (CNS) complications (n = 6). Imaging studies revealed brain lesions in 21 patients. A total of 9 patients experienced only one seizure during the follow-up period, and 25 patients experienced multiple seizures or status epilepticus (n = 2). Multiple seizures were more common in patients with brain etiologies (P = 0.019) or epileptiform discharges on EEG (P = 0.032). Most seizures were controlled without anticonvulsants (n = 12) or with a single anticonvulsant (n = 12). Among patients with HIV infection, seizures are significantly more prevalent than in the general population. Most seizures, with the exception of status epilepticus, have a benign clinical course and few complications.

The toxicities of 10 insecticides were examined against late third instar Culex tritaeniorhynchus Giles (Diptera: Culicidae) using the direct-contact mortality bioassay. Six geospatially-distant field mosquitoes were collected from Chuncheon-si, Hwaseong, Seosan. Jeonju, Daegu, and Busan in the Republic of Korea. Marked regional variations of insecticide susceptibility were observed. Field populations of Seosan, Jeonju, and Daegu from agricultural areas showed higher to extremely higher insecticide susceptibility to pyrethroids than those of Chuncheon-si, Hwaseong, and Busan strains from non-agricultural areas. Extremely high to low levels of susceptibility were measured: bifenthrin, susceptible ratio (SR) = 2.7-896.3; β-cyfluthrin, SR = 1.8-633.3; α-cypermethrin, SR = 1.2-1,051.9; deltamethrin, SR = 1.3-711.1; permethrin, SR = 1.5-1,053.4; etofenprox, SR = 2.2-29.3; chlorfenapyr, SR = 5.1-103.6; chlorpyrifos, SR = 2.3- 337.0; fenitrothion, SR = 2.0-142.3; and fenthion, SR = 1.4-186.2. Cx. tritaeniorhynchus populations from rice paddies had been under heavy selection pressure due to the agricultural insecticides, and that's why the mosquito species demonstrated high resistance to pyrethroids, which were used for a long time to control agricultural pests in the localities. These results indicate that careful selection and rotational use of these insecticides may result in continued satisfactory control against field populations of Japanese encephalitis vector mosquitoes.

Vivax malaria is a significant military and civilian health threat in northern Republic of Korea (ROK). Mosquito collections were performed at two ROK army installations, Paju near the demilitarized zone (DMZ) using black light traps in 2011. The DMZ, a 4 km wide border, is the northernmost point of the ROK and separates the ROK from the Democratic People's Republic of Korea (DPRK). Anopheles spp. were identified by polymerase chain reaction and screened for Plasmodium vivax sporozoites. Of 4,354 female Anopheles mosquitoes identified, Anopheles kleini (61.8%) was the most frequently collected, followed by Anopheles pullus (16.0%), Anopheles belenrae (9.0%), Anopheles sinensis (7.4%), Anopheles sineroides (4.2%), and Anopheles lesteri (1.6%). Anopheles kleini, An. pullus, and An. sineroides showed the highest population densities in June, whereas population densities were highest for An. belenrae, An. lesteri, and An. sinensis in August. The maximum likelihood estimation (estimated number of positive mosquitoes/1,000) for P. vivax was highest for An. lesteri (28.9), followed by An. sineroides (23.3), An. belenrae (15.8), An. sinensis (9.6), An. pullus (5.8) and An. kleini (4.2). The seasonal maximum likelihood estimation (MLE) values were variable among Anopheles species. Anopheles belenrae, An. Pullus, and An. sineroides showed the highest seasonal MLE's in July, whereas An. lesteri and An. sinensis exhibited the highest seasonal MLEs in September and An. kleini during August. This is the first report implicating An. sineroides as a vector of P. vivax in the ROK, and extends our knowledge of the distribution and potential role in malaria transmission.

Background/aims: We investigated the clinical characteristics and prognosis of elderly patients with acute lymphoblastic leukemia (ALL)., Methods: We reviewed the clinical data, laboratory findings, bone marrow findings, and cytogenetic analysis of elderly patients (≥ 60 years) with ALL, and data of an additional 101 younger adult patients (< 60 years) with ALL were reviewed for comparison., Results: Twenty-six elderly patients (≥ 60 years) and 101 younger adult patients (< 60 years) with ALL were retrospectively enrolled. The median follow-up duration was 6.0 months (range, 0.4 to 113.2) in the elderly patients and 21.7 months (range, 1.0 to 122.7) in the adult patients. In total, 34.6% (9 patients) of the elderly patients and 24.8% (25 patients) of the adult patients had Philadelphia chromosome positive ALL. The overall complete remission (CR) rate was much higher in the younger than in the elderly patients (94.1% vs. 57.7%, p < 0.001). The median overall survival (OS) of the younger patients (< 60 years) was 26.3 months, whereas that of the elderly patients (≥ 60 years) was 10.3 months (p = 0.003). In the elderly patients with ALL, T cell lineage and the presence of lymphadenopathy were significant prognostic factors for OS in a univariate analysis (p = 0.033 and 0.041, respectively)., Conclusions: The outcomes of Korean elderly patients with ALL were poor, and the shorter OS was mainly due to the low CR rate. T-cell lineage and the presence of lymphadenopathy were significant prognostic factors in Korean elderly patients with ALL.

Aim: This study aimed to examine gender differences in physical activity and its determinants among rural adults in Korea., Background: Only limited studies exist that examined gender differences in physical activity in Korean adults. Major determinants for physical activity such as self-efficacy, benefits and barriers have been studied, but little is known about their gender differences. Nurses promoting and teaching adults to increase physical activity need data for evidence-based practice., Design: A cross-sectional descriptive design was used., Method: Participants were 481 adults living in a rural area of Korea. The physical activity status, exercise self-efficacy, benefits, barriers and sociodemographics were compared between men and women. Descriptive statistics, t-test and binary logistic regression were used for data analysis., Results: The physical activity status, perceived self-efficacy and benefits of physical activity in women were significantly lower than those of men. For men, only self-efficacy was statistically significant in explaining recommended physical activity as well as physical activity participation. However, for women, benefits and barriers as well as self-efficacy significantly explained their participation of physical activity, but not the recommended physical activity. Unlike men, women's physical activity was significantly associated with sociodemographic factors., Conclusion: Gender differences found in this study should be the basis for evidence-based nursing practice. Tailored nursing interventions based on gender would improve physical activity of rural adults in Korea and beyond., Relevance to Clinical Practice: Nurses providing care for rural adults should know the gender differences in the determinants of physical activity and provide gender-specific interventions to improve their physical activity.

Oriental medical herbs are mainly natural products that are generated by simple processes, and therefore there is the possibility of contamination with various pollutants, including heavy metals. Heavy metals produce adverse effects in humans, and the toxicities of lead (Pb) and cadmium (Cd) are well established. This study evaluated the effects of exposure to Pb and Cd via the intake of the frequent prescriptions of oriental medicines, and assessed the risk to the Korean population based on domestic data. The average daily exposures to Pb and Cd were estimated. This is the first study to evaluate exposure and risk of heavy metal intoxication through intake of oriental medicines in Korea. Despite the uncertainties and limits of the data, these results simulate realistic exposure levels.