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Background/Aims: Tegoprazan is a novel potassium-competitive acid blocker that has beneficial effects on acid-related disorders such as gastroesophageal reflux and peptic ulcer diseases. This study aimed to validate the effect of tegoprazan on endoscopic submucosal dissection (ESD)-induced artificial ulcers. Methods: Patients from 16 centers in Korea who underwent ESD for gastric neoplasia were enrolled. After ESD, pantoprazole was administered intravenously for 48 hours. The patients were randomly allocated to either the tegoprazan or esomeprazole group. Tegoprazan 50 mg or esomeprazole 40 mg were administered for 4 weeks, after which gastroscopic evaluation was performed. If the artificial ulcer had not healed, the same dose of tegoprazan or esomeprazole was administered for an additional 4 weeks, and a gastroscopic evaluation was performed. Results: One hundred sixty patients were enrolled in this study. The healing rates of artificial ulcers at 4 weeks were 30.3% (23/76) and 22.1% (15/68) in the tegoprazan and esomeprazole groups, respectively (p=0.006). At 8 weeks after ESD, the cumulative ulcer healing rates were 73.7% (56/76) and 77.9% (53/68) in the tegoprazan and esomeprazole groups, respectively (p=0.210). Delayed bleeding occurred in two patients in the tegoprazan group (2.6%) and in one patient in the esomeprazole group (1.5%). Other adverse events were negligible in both groups. Conclusions: Tegoprazan showed similar effects on post-ESD artificial ulcer healing in comparison with esomeprazole. [ABSTRACT FROM AUTHOR]

Background: Out-of-hospital cardiac arrest (OHCA) affects more than 25,000 cases each year in Korea. The rate of survival and neurological recovery tend to increase in Korea, but less than other developed countries. Despite the increase in bystander cardiopulmonary resuscitation (CPR), the number of patients who have an automated external defibrillator (AED) applied by a bystander remains low. We studied the effect of bystander CPR on survival of OHCA in Korea. Methods: This study was conducted using the 'Sudden Cardiac Arrest (SCA) Survey' of Korea Centers for Disease Control & Prevention (KCDC) in 2009 to 2018. A total of 45,719 cases of OHCA patients were analyzed. We used a chi-square test, log-rank test, multivariable logistic regression and cox-regression analysis to determine the effect of bystander CPR on survival of OHCA, depending on various factors. Results: The rate of survival of OHCA was significantly affected by age, past medical history, initial cardiac rhythm, pre-hospital CPR and defibrillation, transport time and a type of bystander CPR. The survival rate of patients who received bystander CPR was 44.3%, compare with those who did not (43.4%). In cases where bystander CPR was received, the survival rate of patients with AED (63.1%) was higher than patients with only chest compression (44.2%). Conclusions: With the increase in bystander CPR rates, it is difficult to expect the effect of intervention of bystanders in Korea. Even though the education on AED and the devices itself has been spread throughout the country since 2008, the use of AED remains low. Nevertheless, the use of AED has a positive effect on the survival of OHCA. Improvements on the rate of AED use by bystander in Korea needs to be further elaborated on. [ABSTRACT FROM AUTHOR]

Background/Aims: This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management. Methods: From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46). Results: No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality. Conclusions: UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness. [ABSTRACT FROM AUTHOR]

Background: Analyzing the current trends in meniscal allograft transplant (MAT) is important. However, no recent descriptive epidemiological study based on a national registry database has been reported. Purpose: To assess serial trends in the incidence of MAT in the Republic of Korea between 2010 and 2018, stratified by age and sex. Study Design: Descriptive epidemiology study. Methods: The number of MAT procedures between 2010 and 2018 was assessed using the Korean National Health Insurance claims database. We used code N0825 for isolated MAT and code N0820 for MAT combined with other procedures, such as ligament reconstruction, realignment surgery, and cartilage procedures. The incidence of MAT was calculated using the general population data of the Republic of Korea, and Poisson log-linear regression analysis was used to assess statistical serial trends. Results: A total of 369 patients underwent MAT in 2010 and 774 in 2018, with an increase of 47.6%. The incidence of MAT per 100,000 person-years in the Republic of Korea increased significantly during the period studied, from 0.75 in 2010 to 1.50 in 2018 (annual relative risk ¼ 1.09; 95% CI, 1.08-1.10; P < .001), whereas the rate of MAT combined with other procedures increased from 5.1% in 2014 to 16.0% in 2018. MAT was mostly performed in men in their early 20s. Most MAT procedures were performed in the summer and winter, with distinct seasonal variances. Conclusion: In the Republic of Korea, the incidence of MAT in 2018 was 1.50 per 100,000 person-years, with an average annual increase of 10% since 2010. MAT was mostly performed in men in their early 20s, and the rate of MAT combined with other procedures has increased since 2014. [ABSTRACT FROM AUTHOR]

Routine measurements of carbonaceous species in PM2.5 inculidng organic carbon (OC), elemental carbon (EC), water-soluble organic carbon (WSOC), and humiclike- substance carbon (HULIS-C) in PM2.5 were performed at Anmyeon Island (AI) to clarify the seasonal variation and carbonaceous aerosol concentrations at a background site in Korea between 2015 and 2016. The annual average OC and EC concentrations were 4.52±3.25 µg/m3 and 0.46±0.28 µg/m3, respectively, and there were no clear seasonal variations in OC and EC concentrations. The average concentrations of WSOC and waterinsoluble organic carbon (WISOC) were 2.56±1.95 µg/m3 and 1.96±1.45 µg/m3, respectively, and their composition in OC showed high temporal variations. A low correlation between WISOC and EC was observed, while WSOC concentrations were highly correlated with secondary organic carbon concentrations, which were estimated using the EC tracer method. The results indicate that the formation of secondary organic aerosols is a major factor for the determination of WSOC concentrations in this region. HULIS-C was the major component of WSOC, accounting for 39-99% of WSOC and the average concentration was 1.88±1.52 µg/m3. Two distinct periods with high carbonaceous speciess in PM2.5 were observed and characterized by their OC/EC ratios. The high concentration of OC with high ratio of OC/EC was due to the influence of a mixture of emissions from biomass burning and secondary formation transported from outside AI. While, the high concentrations of OC and EC with low OC/EC ratio were related to local vehicular emissions. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Porcine deltacoronavirus (PDCoV) has emerged in several pig-raising countries and has been a causative pathogen associated with diarrheal diseases in South Korea since 2014. In the present study, we were able to isolate and cultivate a Korean PDCoV strain (KNU16-07) in cell culture and investigate its pathogenicity. PDCoV-inoculated piglets showed watery diarrhea accompanied by acute enteritis in the natural host. Sequencing analysis demonstrated the genetic stability of KNU16-07 for at least thirty serial passages. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to analyze changes in hematologic parameters in the residents of the areas highly contaminated by the Hebei Spirit Oil Spill in 2007 and those who participated in the clean-up activities. Methods: According to demographic characteristics, health status and behavior, and level of exposure to oil, we compared the hematologic results in 2009 and 2012 among 701 residents. The hematologic parameters were composed of white blood cell (WBC) count, and levels of hemoglobin, hematocrit (Hct), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glucose, glycosylated hemoglobin (HbA1c), blood urea nitrogen (BUN), creatinine (Cr), total cholesterol (T-chol), high-density lipoprotein (HDL), and triglyceride (TG). Results: Paired t-test revealed that the WBC count and levels of Hct, AST, ALT, glucose, and HbA1c significantly increased, whereas the BUN, Cr, HDL, and TG levels significantly decreased. Multiple linear regression modelling showed a relationship between the level of exposure to oil and temporal changes in Hct, glucose, HbA1c, and BUN levels. Conclusion: Our results suggest a relationship between level of exposure to oil and changes in hematologic parameters over 3 years. Further studies should be conducted to determine the impact of oil spill on health such as the occurrence of diseases. [ABSTRACT FROM AUTHOR]

Background: Clinical outcomes after meniscal allograft transplantation (MAT) in arthritic knees are unclear, and objective estimates of graft survival according to the articular cartilage status have not been performed. Hypothesis: MAT should provide clinical benefits in knees with high-grade cartilage damage, but their graft survivorship should be inferior to that in knees with low-grade chondral degeneration after MAT. Study Design: Cohort study; Level of evidence, 3. Methods: The records of 222 consecutive patients who underwent primary MAT were reviewed to compare clinical outcomes and graft survivorship. The patients were grouped according to the degree and location of articular cartilage degeneration: low-grade chondral lesions (International Cartilage Repair Society [ICRS] grade ≤2) on both the femoral and tibial sides (ideal indication), high-grade lesions (ICRS grade 3 or 4) on either the femoral or tibial side (relative indication), and high-grade lesions on both sides (salvage indication). Kaplan-Meier survival analysis with the log-rank test was performed to compare the clinical survival rates and graft survival rates between the groups. A Lysholm score of <65 was considered a clinical failure, and graft failure was defined as a meniscal tear or meniscectomy of greater than one-third of the allograft, objectively evaluated by magnetic resonance imaging (MRI) and second-look arthroscopic surgery. Results: The mean (±SD) Lysholm score significantly improved from 63.1 ± 15.1 preoperatively to 85.1 ± 14.3 at the latest follow-up of a mean 44.6 ± 19.7 months (P < .001). However, the postoperative scores were not significantly different between the 3 groups (85.7 ± 14.2 for ideal indication, 84.7 ± 17.0 for relative indication, and 84.7 ± 14.2 for salvage indication; P = .877). On MRI at the latest follow-up of a mean 23.0 ± 19.9 months and second-look arthroscopic surgery of a mean 19.3 ± 20.7 months, there were 25 (11.3%) failed MAT procedures (4 medial, 21 lateral); of these, 5 lateral MAT procedures (2.3%) went on to allograft removal. Clinical survival rates were not significantly different between the groups (P = .256). However, on objective evaluation, the estimated cumulative graft survival rate at 5 years in the salvage indication group (62.2% [95% CI, 41.6-82.8]) was significantly lower than that in the other 2 groups (ideal indication: 93.8% [95% CI, 88.5-99.1]; relative indication: 90.9% [95% CI, 81.1-100.0]) (P = .006). Conclusion: Our findings showed that MAT was an effective symptomatic treatment in knees with advanced bipolar chondral lesions. However, better graft survival can be expected when articular cartilage is intact or if chondral damage is limited to a unipolar lesion. MAT should be considered before the progression of chondral damage to a bipolar lesion for better graft survivorship and should be performed cautiously in arthritic knees. [ABSTRACT FROM AUTHOR]

A recent study reported that the construction management market has grown more competitive. In this environment, identifying a company's competitive position enables a study of competitor strategies and the ability to select the most suitable path to profitability. This study suggests a methodology to analyze topological competiveness based on social relationships between firms modeled according to four subnetworks: Joint contract networks linked directly between firms, public and private networks linked indirectly by owners, and building and civil networks linked indirectly by work type. This study proposes an analytical framework measuring topological competiveness from four perspectives: The network topology among each subnetwork, centralities and structural positions among the firms, cohesive subgroups and strong relations in the subnetwork, and the structural equivalence among firms. Using 2,984 cases of Korean construction management projects from 1997 to 2013, an empirical analysis of topological competiveness validated the methodology to diagnose competitiveness and select the most suitable relationships with competitors to create company growth. [ABSTRACT FROM AUTHOR]

Most research on sentencing outcomes reveals that legally relevant factors such as the seriousness of the offense and prior criminal record are primary determinants. There is, however, a substantial body of research that finds that extralegal factors such as a defendant’s sex also influence these outcomes. Most of these latter studies conclude that female defendants receive less severe outcomes compared to their male counterparts. Most of this research, however, is limited to Western societies. To extend this body of research, the current study examines sex differences in sentencing practices for a sample of narcotics offenders in South Korea. Results support previous research; female drug offenders in South Korea are generally treated more leniently than their male counterparts. Tests for interaction effects reveal that the defendant’s sex also interacts with other constellations of factors to produce lenient treatment for certain female defendants. These tests, however, also reveal that lenient sentence outcomes are not extended to all female defendants; those with prior drug convictions do not fare better than their male counterparts at the incarceration decision. [ABSTRACT FROM PUBLISHER]

We investigated the accuracy of liver stiffness measurement (LSM) in chronic hepatitis C (CHC) in a multicenter, prospective study in South Korea. Between June 2005 and July 2009, 91 CHC patients without a previous history of antiviral treatment, clinical evidences of cirrhosis, coinfection with other viruses, and heavy alcohol consumption and with alanine aminotransferase (ALT) ≤ 5x upper limit of normal, total bilirubin ≤ 1.5 mg/dL, sufficient liver biopsy quality (≥ 15 mm and more than six portal tracts), interquartile range to median liver stiffness (LS) value ratio ≤ 0.21, and more than 10 valid measurements, were recruited. The Batts and Ludwig scoring system was used for histologic assessment. Age-platelet index (API), aspartate aminotransferase (AST)-to-platelet ratio index (APRI), and age-spleen-platelet ratio index (ASPRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of LSM and other noninvasive models. The mean age was 47.9 years, and the mean LS value was 7.7 kPa (44 men and 47 women). LS value was highly correlated to the fibrosis stages ( r = 0.835, P < 0.001). The AUROCs of LSM were 0.909 for ≥ F2, 0.993 for ≥ F3, and 0.970 for F = 4 and were superior to those of API (0.72, 0.858, and 0.948, respectively), APRI (0.780, 0.887, and 0.904, respectively), and ASPRI (0.713, 0.862, and 0.957, respectively). The optimal cutoff LS values were 6.2 kPa for ≥ F2, 7.7 kPa for ≥ F3, and 11.0 kPa for F = 4. Our data suggest that LSM can accurately assess liver fibrosis in patients with CHC and be applied in South Korea. [ABSTRACT FROM AUTHOR]

This study explored the level of knowledge and attitudes toward hepatitis B virus (HBV) infection and vaccination of adolescents in juvenile detention facilities and in schools in South Korea. A cross-sectional comparison design with a convenient sampling method was used. Participants in the study were 301 delinquent and 410 school adolescents. The results showed that knowledge of HBV infection among juvenile detention adolescents was significantly lower but there was no difference between groups in attitudes toward infection and vaccination. [ABSTRACT FROM AUTHOR]

The amplification and overexpression ofHer2proto-oncogene have been found to be associated with the development and progression of human breast cancer. A polymorphic valine allele at codon 655 of theHer2gene (Her2V655) was suggested by some authors to be a susceptible genetic factor for the development of breast cancer. TheHer2polymorphism at codon 655 was investigated in 304 Korean women including 177 patients with breast cancer. The association betweenHer2genotype andHer2protein overexpression was also examined in breast cancers by immunohistochemistry.Her2V655 was not associated with a significant breast cancer risk (odds ratio (OR), 1.792; 95% confidence interval (CI), 0.459–6.991). The frequency of homozygous or heterozygous valine allele increased in stage 2 patients (OR, 1.67; 95% CI, 0.67–4.19), and patients in stages 3 and 4 (OR, 3.36; 95% CI, 0.85–13.42) compared to patients in stage 0. However, an association between the presence of the valine allele and the overexpression ofHer2protein could not be demonstrated. These results suggest thatHer2polymorphism at codon 655 is not associated with the development of breast cancer in Korean women. However, there is a possibility that the valine allele at codon 655 might be related to increased risk of breast cancer progression. [ABSTRACT FROM AUTHOR]

Background/Aims With the development of treatment for colorectal cancer, stenting is used with increasing as a treatment for malignant colorectal obstruction. Compared with surgery, colorectal stent insertion shows similar result and less complications, successful colorectal stent insertion will improve quality of life in curative and palliative treatment patients. The aim of this study is to predict factors related to technical/clinical success in colorectal stent insertion for improvement of the success rate. Methods From January 2013 to December 2019, we retrospectively identified 479 patients with malignant colorectal obstruction who underwent placement of colorectal self-expandable metal stent (SEMS) at Chonnam National University Hwasun Hospital, Korea. Main outcome measures included technical success, clinical success, complications, and predictors of outcome. Results The incidence Technical success was achieved in 86.4% (414/479) and clinical success in 74.3% (356/479) of the cases. Pain and tenderness were present in 75.8% (363/479) and 44.1% (211/379), there were statistically related factor to technical failure of SEMS insertion (odds ratio [OR], 3.041; p=0.029 and OR, 2.358; p=0.012). Also, metastasis and microperforation were present in 306 of 479 (63.9%), 17 of 479 (3.6%) and it was a statistically significant factor associated with technical failure (OR, 7.128; p=0.04 and OR, 4.413; p=0.008). But there were no statistically factor associated with clinical failure in multivariate analysis. Conclusions Pain, tenderness, microperforation, and metastasis were a predict factor of technical failure of colorectal SEMS insertion in malignant colorectal obstruction. [ABSTRACT FROM AUTHOR]

Background: Older females have less dynamic postural control and muscle strength than do middle-aged females. Aging-related strength losses may limit balancing performance. Objective: The purpose of this study was to investigate the ability of the Y Balance Test (YBT) and lower limb strength to discriminate between females in 2 age groups, the relationship between YBT distance and the Berg Balance Scale (BBS), and the degree to which performance on YBT distance is related to lower limb strength in middle-aged and older females. Method: The 40 healthy, independently active females were divided into 2 groups: older and middle-aged. The participants underwent measurements of YBT distance using the YBT, maximal muscular strength of the lower limbs using a handheld dynamometer, and the BBS. Results: The YBT distance in 3 directions and lower limb muscle strength for both lower limbs were significantly lower in the older adults than in the middle-aged group. A moderate correlation but insignificant correlation was found between the YBT composite distance and the BBS score. In the older females, YBT distance was significantly positively correlated with strength of the knee flexor and hip abductor. In the middle-aged group, YBT distance was significantly positively correlated with strength of the knee flexor and hip extensor. Conclusions: Performance on the YBT was influenced by the strength of lower limb. We suggested that YBT can be used to alternative as a measurement of dynamic balance. Proper training programs for older people could include not only strengthening exercises but also YBT performance to improve balance. [ABSTRACT FROM AUTHOR]