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Supplementary Figure 3: Adhesion assay after treatment of RAV-18.

Supplementary Figure Legends

This article discusses how US military payment certificates (MPC) escaped from US military bases during the Korean War to become common currency in local economies. The MPC program was intended to control the mixing of US currency in local economies, yet the worldwide use of MPC on all overseas US bases between 1946 and 1973 facilitated black market circulation of military notes globally by allowing trading differentials among dollars, MPC, and local currencies. As soldiers, goods, and money moved through the US base network across Korea and Japan during the war, MPC were commonly used as a medium of exchange for sexual transactions between US soldiers and local women in both countries. The cross-border sexual markets were central to the everyday economies of Korea and Japan, of which black markets trading US Army supplies and currencies were major components. An analysis of this off-base monetization process of MPC offers a new perspective on the global history of war and occupation by highlighting how the sexual economy of illicit and informal transactions has been integral to US military expansion abroad since the end of World War II.

Supplementary Methods, Figures Legends 1-5 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Supplementary Figure 3 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Supplementary Figure 2 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Gastric cancer ranks second among the most common causes of cancer deaths worldwide. Recent studies reported target molecules that are candidates for new therapeutic interventions; however, their molecular mechanism has not been clearly defined. In this study, we found that ZNF312b plays a role in tumor progression and metastasis in gastric cancer via transcriptional activation of the K-ras oncogene. ZNF312b seems to be specifically overexpressed in gastric cancer tissues and cell lines. The overexpression of ZNF312b induces cancer-like phenotypes, including accelerated proliferation and increased tumor masses in nude mice, which are completely reversed by its knockdown in gastric cancer cell lines, implying direct involvement in gastric tumor progression. From analyses using deletion mutants of ZNF312b and K-ras promoter-driven luciferase reporters, we found that it translocates into the nucleus via the proline-rich domain of its COOH terminus to activate transcription of the K-ras gene, resulting in an enhancement of the extracellular signal-regulated kinase signaling pathway that governs cell proliferation. Taken together, these results suggest that ZNF312b contributes to the promotion of gastric cancer by triggering K-ras oncogene expression. The current study is the first to report that ZNF312b, a novel transcription factor, was associated with tumorigenicity of gastric cancer. This might be a valuable target that could provide new insight into the development of new therapeutic modalities for patients with gastric cancer. [Cancer Res 2009;69(7):3131–9]

Supplementary Figure 1 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Supplementary Figure 4 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Supplementary Figure 5 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Supplementary Table 1 from Human ZNF312b Promotes the Progression of Gastric Cancer by Transcriptional Activation of the K-ras Gene

Introduction: Suboptimal sleep duration and poor sleep quality have been proposed to increase stroke risk. However, their significance in young ischemic stroke is unclear. We aimed to investigate the importance of sleep duration and quality on young ischemic stroke patients. Methods: A multicenter matched case-control study was performed to evaluate under-recognized risk factors in young (

Viral infections are a common cause of encephalitis. This study investigated the relationship between the incidence of encephalitis and that of respiratory and enteric viral infections in all age groups from 2015 to 2019, using the Health Insurance Review and Assessment (HIRA) Open Access Big Data Platform. We identified monthly incidence patterns and seasonal trends using the autoregressive integrated moving average (ARIMA). The Granger causality test was used to analyze correlations between encephalitis incidence and the positive detection rate (PDR) at 1-month intervals. A total of 42,775 patients were diagnosed with encephalitis during the study period. The incidence of encephalitis was highest in the winter (26.8%). The PDRs for respiratory syncytial virus (HRSV) and coronavirus (HCoV) were associated with the trend in encephalitis diagnosis in all age groups, with a 1-month lag period. In addition, an association with norovirus was observed in patients aged over 20 years, and with influenza virus (IFV) in patients aged over 60 years. This study found that HRSV, HCoV, IFV, and norovirus tended to precede encephalitis by 1 month. Further research is required to confirm the association between these viruses and encephalitis.

Introduction: Although the association between vertebral artery or posterior inferior cerebellar artery dissection and lateral medullary infarction (LMI) has been established, the actual prevalence of dissection among patients with LMI may still be underestimated. Methods: Consecutive patients with acute pure LMI admitted between 2010 and 2021 were included. High-resolution vessel wall MRI (VWMRI) and/or transfemoral cerebral angiography (TFCA) were performed in a part of patients and were regarded as gold standard tests for diagnosis of dissection. Factors associated with definite dissection based on VWMRI or TFCA findings were assessed. Risk scoring for dissection was created based on multivariate logistic regression and applied to estimate the number of possible dissection. Results: Eighty-seven LMI patients were eligible and 47 (54.0%) of them underwent VWMRI (n=43) and/or TFCA (n=7). Among these 47 cases, 24 were definite dissection. Three out of 40 patients without gold standard tests were diagnosed with definite dissection based on conventional MRI findings. Preceding headache and normal body weight were independently associated with dissection in LMI patients. A risk scoring which includes age, body mass index, and headache predicted dissection with 91.7% sensitivity and 69.6% specificity (area under the receiver operating characteristic curve, 0.889; 95% confidence intervals, 0.802-0.977) in our population. Additional nine out of 37 patients without gold standard tests nor diagnosis of definite dissection in conventional MRI could be considered as possible dissection based on the scoring. Definite and possible dissections together comprised 41.4% (n=36) of LMI in our study. Conclusions: Arterial dissection may be more prevalent among LMI patients than reported before. Thorough diagnostic effort for dissection is necessary based on scrutinizing risk stratification.

Introduction: White matter hyperintensities (WMH) are reportedly increased in moyamoya disease (MMD); however, their clinical importance is not well-established owing to their pathophysiological heterogeneity by distribution. This study aimed to evaluate the burden and pattern of WMH and its clinical implications in the MMD trajectory. Methods: Adult MMD patients without significant structural lesions were 1:1 propensity score-matched with healthy controls for sex and vascular risk factors. The total, periventricular, and subcortical WMH volumes were segmented and quantified fully automatically. WMH volumes were detrended by age and compared between the two groups. MMD severity based on Suzuki stage and future ischemic events were assessed for their association with WMH volumes. Results: A total of 190 pairs of patients with MMD and controls were analyzed. MMD significantly correlated with increased total (B, 0.086; standard error [SE], 0.027; p=0.002) and periventricular WMH volumes (B, 0.079; SE, 0.025; p=0.002). In the MMD subgroup, advanced MMD had an independent positive association with the total (B, 0.124; SE, 0.034; p Conclusions: Periventricular WMH, but not subcortical WMH, may represent the main pathophysiology of MMD. Periventricular WMH may be used as a marker for ischemic vulnerability in patients with MMD.

Introduction: Alteration of the gastrointestinal (GI) tract by resection or bypass surgery might affect the absorption of both warfarin and direct oral anticoagulants (DOACs). The clinical trials of DOACs excluded individuals with altered GI tract, hence there are limited pharmacokinetic data for them. Only several cases have been reported suggesting atrial fibrillation-related stroke due to reduced absorption of DOACs after GI surgery. We aimed to investigate the efficacy of warfarin and DOACs who underwent GI surgery using nationwide population-based data. Methods: This was a retrospective cohort study using claim-based national data from 2013 to 2020 from Korean Health Insurance Review and Assessment Service (HIRA). Patients with nonvalvular AF (NVAF) taking oral anticoagulants (OACs) were included. The patients taking OACs due to other indications than NVAF were excluded. Cox proportional hazard models with time-varying covariates were used to investigate the impact of GI surgery in patients taking warfarin and DOACs. Results: Of the 311,782 patients (mean age 72, male 56.7%) with NVAF, 3,807 underwent GI surgery. Warfarin and DOACs were prescribed in 14.3% and 85.7% of the patients, respectively. Overall, warfarin was associated with a higher risk of ischemic stroke compared with DOACs (hazard ratio [HR] 1.51, 95% confidence interval [CI] 1.44-1.59). In the GI surgery group, the hazard ratio for ischemic stroke for warfarin compared with DOACs was 2.70 (95% CI, 1.63-4.45, Figure). In the no GI surgery group, warfarin also had a higher risk of ischemic stroke compared with DOACs (HR 1.51, 95% CI 1.44-1.59). Among DOAC-treated patients, GI surgery was not associated with a risk of ischemic stroke (HR 0.87, 95% CI 0.67-1.12). Conclusions: DOACs were more effective for stroke prevention than warfarin in patients with NVAF whose GI tracts were altered due to previous surgery. GI surgery did not affect the risk of stroke in patients with NVAF taking DOAC.

Introduction: Clonal hematopoiesis of indeterminate potential (CHIP) has been linked with incident cardiovascular disease and its outcome. However, the association between CHIP and acute ischemic stroke is not yet fully elucidated. Methods: This retrospective, observational cohort study included 366 acute ischemic stroke patients from a single center prospective stroke registry and 4,628 general population control (age over 40 years old). We compared the prevalence of CHIP between stroke patients and control groups. A multivariable linear or logistic regression model was used to assess the association between CHIP and initial stroke severity, hemorrhagic transformation and functional disability at 90-day (modified Rankin scale score >1) after stroke. The contribution of individual CHIP driving genes was also evaluated. Results: When comparing the acute ischemic stroke patients (N=366) and the general population (N=4,628), the prevalence of CHIP was significantly higher in stroke patients than in the general population (32.0% vs. 13.9% with variant allele frequencies of 1.5%, p Conclusion: CHIP was obviously increased in ischemic stroke patients. Furthermore, CHIP was significantly associated with stroke severity, hemorrhagic transformation, and functional disability at 90 days.

Two Gram-stain-negative, strictly aerobic, catalase- and oxidase-positive and non-motile rod-shaped bacteria, strains D2-3T and G9-8T, were isolated from a marine red alga. Both strains contained ubiquinone-10 as the sole isoprenoid quinone. As the major cellular fatty acids (>5.0 %), D2-3T contained C16 : 0, 11-methyl-C18 : 1ω7c, summed feature 3 (C16 : 1ω7c and/or C16 : 1ω6c), and summed feature 8 (C18 : 1ω7c and/or C18 : 1ω6c), whereas G9-8T contained C16 : 0, 11-methyl-C18 : 1ω7c, C12 : 1 3-OH, and summed feature 8. The DNA G+C contents of D2-3T and G9-8T were 54.4 % and 56.0 %, respectively. As the major polar lipids, phosphatidylglycerol, diphosphatidylglycerol and unidentified phospholipid, aminolipid and lipid were identified from both strains, and phosphatidylcholine was additionally detected from G9-8T only. The 16S rRNA gene sequence similarity of D2-3T and G9-8T was 98.5 % and their digital DNA–DNA hybridization (DDH) value was 19.1 %. Phylogenetic analyses based on 16S rRNA gene and genome sequences revealed that D2-3T and G9-8T formed respectively distinct phylogenetic lineages within the genus Octadecabacter . D2-3T and G9-8T were most closely related to Octadecabacter ascidiaceicola RA1-3T and Octadecabacter antarcticus 307T, with 98.9 % and 98.5 % 16S rRNA gene sequence similarities, respectively, and digital DDH values between D2-3T and O. ascidiaceicola and between G9-8T and O. antarcticus were 18.3 % and 19.5 %, respectively. Phenotypic, chemotaxonomic and molecular features support the hypothesis that D2-3T and G9-8T represent two novel species of the genus Octadecabacter , for which the names Octadecabacter algicola sp. nov. and Octadecabacter dasysiphoniae sp. nov. are proposed. The type strains of O. algicola and O. dasysiphoniae are D2-3T (=KACC 22493T =JCM 34969T) and G9-8T (=KACC 22488T =JCM 34973T), respectively.

Two Gram-negative, moderately halophilic, and motile rod bacteria, strains G2-23T and J2-29T, showing catalase- and oxidase-positive activities were isolated from marine algae. Both strains optimally grew at 30°C, pH 7.0, and 2% (w/v) NaCl. Both strains contained ubiquinone-10 as the sole isoprenoid quinone. As major cellular fatty acids and polar lipids, strain G2-23T contained summed feature 8 (C18:1 ω7c and/or C18:1 ω6c), C16:0, and summed feature 3 (iso-C15:0 2-OH and/or C16:1 ω7c/ω6c) and phosphatidylethanolamine (PE), phosphatidyl-N-monomethylethanolamine (PME), phosphatidylglycerol (PG), diphosphatidylglycerol, sulfoquinovosyl diacylglycerol (SQDG), and an unidentified phospholipid (PL), respectively, while strain J2-29T contained summed feature 8, C18:1 ω7c 11-methyl, and C16:0 and PE, PME, PG, SQDG, and PL, respectively. The genomic DNA G + C contents of strains G2-23T and J2-29T were 59.5 and 62.2 mol%, respectively. Both strains shared 97.9% 16S rRNA gene sequence similarity, 79.8% average nucleotide identity (ANI), and 22.8% digital DNA-DNA hybridisation (DDH) value, indicating that they are different species. Phylogenetic and phylogenomic analyses by 16S rRNA gene and genome sequences, respectively, revealed that strains G2-23T and J2-29T formed different phylogenic lineages within the genus Hoeflea. ANI and digital DDH values between strains G2-23T and J2-29T and other Hoeflea type strains were less than 79.0 and 22.1% and 80.5 and 23.3%, respectively, representing that they are novel species of the genus Hoeflea. Based on the phenotypic, chemotaxonomic, and molecular properties, strains G2-23T and J2-29T represent two different novel species of the genus Hoeflea, for which the names Hoeflea algicola sp. nov. (G2-23T = KACC 22714T = JCM 35548T) and Hoeflea ulvae sp. nov. (J2-29T = KACC 22715T = JCM 35549T), respectively, are proposed.

Background: Elevated metabolic activity of amygdala is known to be related to atherosclerotic cardiovascular event by increasing inflammatory cell production from bone marrow. We tried to identify the factors of metabolic activity in the amygdala, vertebrae, liver, spleen, and internal carotid artery related to the future vascular events after stroke. Methods: A total of 110 patients with acute stroke were included (72±10 years of age, 39% women) and underwent whole-body 18 F-fluorodeoxyglucose (FDG) positron emission tomography between August 1, 2015 and February 28, 2020. We compared the FDG uptake in the amygdala, vertebrae, liver, spleen, and internal carotid artery between patients with and without recurrent vascular event. Cox proportional hazards model was used to identify factors related to recurrent stroke and vascular event. Results: During the median follow-up period of 18 months, 22 patients experienced vascular events, including 15 stroke recurrence. Patients with recurred vascular event had a significantly higher FDG uptake in the amygdala and vertebrae than those without. The Cox proportional hazard model including diabetes, renal function, and carotid stenosis showed that a higher FDG uptake in the amygdala was independently associated with total vascular events (hazard ratio, 3.11 [95% CI, 1.11–8.70]) and higher FDG uptake in the vertebrae with stroke recurrence (hazard ratio, 4.94 [95% CI, 1.29–18.9]). Conclusions: The increased metabolic activities of the vertebrae and amygdala are related to future vascular event among stroke survivors.

Although it is not recognized as essential to test for antiphospholipid antibody (aPL) in stroke of unknown cause, aPL-related stroke may account for a considerable number of cryptogenic strokes. We aimed to assess the current status and diagnostic value of aPL testing in cryptogenic stroke patients.Consecutive patients admitted with acute ischemic stroke were examined to confirm the factors associated with performing aPL testing and with positive aPL test results in real-world practice. Cryptogenic stroke patients were separately examined in the same manner. The antibody profiles of cryptogenic stroke patients with aPL positivity were compared by age.Among 2947 patients, 606 (20.6%) were tested for aPLs and 129 (21.3%) were positive. Physicians tended to perform aPL testing in patients aged50 years and in cryptogenic stroke patients. Cryptogenic stroke was a strong predictor of positive aPL results (adjusted odds ratio 3.70, 95% confidence interval 2.38-5.76). However, aPL positivity did not differ by age in stroke patients. Among 283 cryptogenic stroke patients, 136 (48.1%) were tested for aPLs and 56 (41.2%) were positive. aPL tests were performed predominantly in patients aged50 years rather than in older patients, even among cryptogenic stroke patients. The two age groups had similar positivity rates of40% (50 years: 43.2%; ≥50 years: 40.4%; p = 0.92) and their antibody profiles were similar.A significant number of patients with cryptogenic stroke had positive aPL results regardless of age. aPL testing may offer additional diagnostic opportunities in cryptogenic stroke patients, and thus may reduce the incidence of cryptogenic stroke.

We report the response process of the Laboratory Analysis Task Force (LATF) for Unknown Disease Outbreaks (UDOs) at the Korea Disease Control and Prevention Agency (KDCA) during January 2020 to coronavirus disease 2019 (COVID-19), which developed as a UDO in Korea. The advanced preparedness offered by the laboratory diagnostic algorithm for UDOs related to respiratory syndromes was critical for the rapid identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enabled us to establish and expand the diagnostic capacity for COVID-19 on a national scale in a timely manner.

Post-stroke cognitive impairment can affect up to one third of stroke survivors. Since cognitive function greatly contributes to patients’ quality of life, an objective quantitative biomarker for early prediction of dementia after stroke is required. We developed a deep-learning (DL)-based signature using positron emission tomography (PET) to objectively evaluate cognitive decline in patients with stroke. We built a DL model that differentiated Alzheimer’s disease (AD) from normal controls (NC) using brain fluorodeoxyglucose (FDG) PET from the Alzheimer’s Disease Neuroimaging Initiative database. The model was directly transferred to a prospectively enrolled cohort of patients with stroke to differentiate patients with dementia from those without dementia. The accuracy of the model was evaluated by the area under the curve values of receiver operating characteristic curves (AUC-ROC). We visualized the distribution of DL-based features and brain regions that the model weighted for classification. Correlations between cognitive signature from the DL model and clinical variables were evaluated, and survival analysis for post-stroke dementia was performed in patients with stroke. The classification of AD vs. NC subjects was performed with AUC-ROC of 0.94 (95% confidence interval [CI], 0.89–0.98). The transferred model discriminated stroke patients with dementia (AUC-ROC = 0.75). The score of cognitive decline signature using FDG PET was positively correlated with age, neutrophil–lymphocyte ratio and platelet-lymphocyte ratio and negatively correlated with body mass index in patients with stroke. We found that the cognitive decline score was an independent risk factor for dementia following stroke (hazard ratio, 10.90; 95% CI, 3.59–33.09; P

Two Gram-stain-negative, catalase- and oxidase-positive, and aerobic bacteria, strains MSW7T and MSW13T, were isolated from seawater. Cells of strains MSW7T and MSW13T are motile and non-motile rods, respectively. Strain MSW7T optimally grew at 25 °C and pH 7.0 and in the presence of 3 % (w/v) NaCl, whereas strain MSW13T optimally grew at 25 °C and pH 6.0–7.0 and in the presence of 2 % NaCl. As the sole respiratory quinone and the major fatty acids and polar lipids, strain MSW7T contained ubiquinone-8, C16 : 0, C15 : 1 ω8c, C17 : 1 ω8c and summed feature 3 (C16 : 1 ω7c and/or C16 : 1 ω6c), and phosphatidylethanolamine and phosphatidylglycerol, respectively, whereas strain MSW13T contained menaquinone-6, C15 : 1 ω6c, iso-C15 : 0, anteiso-C15 : 0, and iso-C15 : 0 3-OH, and phosphatidylethanolamine, respectively. The DNA G+C contents of strains MSW7T and MSW13T were 37.3 and 29.9 %, respectively. Phylogenetic analyses based on 16S rRNA gene sequences showed that strains MSW7T and MSW13T were most closely related to Colwellia echini A3T and Polaribacter atrinae WP25T with 98.8 and 98.1 % sequence similarities, respectively. The average nucleotide identity and digital DNA–DNA hybridization values between strain MSW7T and C. echini A3T and between strain MSW13T and P. atrinae KACC 17473T were 73.6 and 22.6 % and 80.4 and 23.8 %, respectively. Based on phenotypic, chemotaxonomic and phylogenetic data, strains MSW7T and MSW13T represent novel species of the genera Colwellia and Polaribacter , respectively, for which the names Colwellia maritima sp. nov. and Polaribacter marinus sp. nov. are proposed, respectively. The type strains of C. maritima sp. nov. and P. marinus sp. nov. are MSW7T (=KACC 22339T=JCM 35001T) and MSW13T (=KACC 22341T=JCM 35021T), respectively.

Background: For an objective and quantitative evaluation for videofluosroscopic swallowing study (VFSS), temporal parameters during swallowing are analyzed for both clinical and research purposes. However, because it is time-consuming and is complicated to analyze manually by clinicians, automated analysis using deep learning has been attempted. This study aimed to develop a model for automatic measurement of various temporal parameters of swallowing using deep learning. Methods: Five-hundred and forty-seven VFSS video clips were included in this study. Seven temporal parameters were manually measured by two physiatrists as ground-truth data: oral phase duration, pharyngeal delay time, pharyngeal response time, pharyngeal transit time, laryngeal vestibule closure reaction time, laryngeal vestibule closure duration and upper esophageal sphincter opening duration. ResNet3D was chosen as the base model for deep learning of temporal parameters. Specifically, we proposed several architectural variants of ResNet3D to improve the estimation of temporal parameters. The performance of ResNet3D variants was compared with that of the VGG and I3D models which were used in the previous studies. Results: The average accuracy of the proposed ResNet3D variants in measuring the temporal parameter of VFSS was from 0.864 to 0.981. F1 score ranged from 0.707 to 0.924, and average precision ranged from 0.643 to 0.865. In comparison with the VGG and I3D models, our model achieved the best results in terms of accuracy, F1 score and average precision values. Conclusion: We proposed deep learning models for automatically measuring temporal parameters of VFSS. The proposed ResNet3D variants outperformed the existing models in detecting all phases of the swallowing process. Through the clinical application of this automatic model,, temporal analysis of VFSS will be easier and more accurate.

Allium L. is a perennial plant in the Amaryllidaceae family and includes 1,000 species. There are 24 indigenous Allium species in Korea, and they have a high value as genetic resources. However, there is a lack of research on indigenous Allium species and little research on recently classified or unknown Allium species, such as A. pseudojaponicum, A. dumebuchum, and A. ulleungense. Therefore, this study determined the effects of environmental control (temperature and light) on germination responses of four indigenous Allium seeds (A. longistylum, A. taquetii, A. pseudojaponicum, and A. thunbergii). Germination responses were evaluated by germination percentage (GP), days to 50% of germination of final germination rates (T50), mean germination time (MGT), germination uniformity (GU), and germination speed (GS). GP of A. longistylum and A. pseudojaponicum was more than 50% at 5°C, but A. taquetii and A. thunbergii did not germinate at 5°C. A. pseudojaponicum inhabits beaches in the southern region, and but A. longistylum inhabits near rivers and streams. However, A. taquetii and A. thunbergii mainly inhabit mountainous areas. Therefore, this difference is estimated to be in accordance with the environmental conditions of their habitat. At 5°C, the GP of A. longistylum was improved in dark conditions (90.0%) than in light conditions (68.3%); T50 and MGT were also shortened. The GP of A. taquetti increased at 15°C in the dark than light conditions, and T50 and MGT were shortened at 15°C and 20°C. Also, the GP and GU increased. At 5°C, the GP of A. pseudojaponicum was higher in the dark (83.3%) than in light conditions (70.0%); T50 and MGT were shortened at 15°C, and GS increased in the dark. At 15°C and 20°C of A. thunbergii, T50 and MGT were shortened, and GP increased in the dark. Therefore, in the relatively low-temperature group, dark conditions improved some germination responses than the light condition. Most of the four Allium seeds used in the experiment showed more than 90% GP at 15°C - 25°C, but other germination responses showed differences according to temperature and light. The T50, MGT, and GS of A. longistylum and A. thunbergii were the most improved at 20°C and 25°C, while A. taquetii and A. pseudojaponicum had the shortest T50 and MGT at 25°C, and the GS was the fastest. As a result, regardless of light, the proper temperature was 20°C – 25°C for A. longistylum, 25°C for A. taquetii, 25°C for A. pseudojaponicum, and 25°C in darkness and 20°C – 25°C in light for A. thunbergii.

Background After the detection of the first case of coronavirus disease 2019 (COVID-19) in South Korea on January 20, 2019, it has triggered three major outbreaks. To decrease the disease burden of COVID-19, social distancing and active mask wearing were encouraged, reducing the number of patients with influenza-like illness and altering the detection rate of influenza and respiratory viruses in the Korea Influenza and Respiratory Viruses Surveillance System (KINRESS). We examined the changes in respiratory viruses due to COVID-19 in South Korea and virological causes of the high detection rate of human rhinovirus (hRV) in 2020. Methods We collected 52 684 oropharyngeal or nasopharyngeal swab samples from patients with influenza-like illness in cooperation with KINRESS from 2016 to 2020. Influenza virus and other respiratory viruses were confirmed using real-time RT-PCR. The weekly detection rate was used to compare virus detection patterns. Results Non-enveloped virus (hRV, human bocavirus, and human adenovirus) detection rates during the COVID-19 pandemic were maintained. The detection rate of hRV significantly increased in 2020 compared with that in 2019 and was negatively correlated with number of COVID-19-confirmed cases in 2020. The distribution of strains and genetic characteristics in hRV did not differ between 2019 and 2020. Conclusions The COVID-19 pandemic impacted the respiratory virus detection rate. The extremely low detection rate of enveloped viruses resulted from efforts to prevent the spread of COVID-19 in South Korea. The high detection rate of hRV may be related to resistance against environmental conditions as a non-enveloped virus and the long period of viral shedding from patients.

Positron emission tomography with 18F-sodium fluoride (NaF) radioligand has been actively investigated in atherosclerosis research because it is known to detect microcalcification activity within atheroma. We studied whether NaF shows any uptake in the brain tissue of patients with acute ischemic stroke. This is a post-hoc analysis of previously reported cerebral atherosclerosis research with positron emission tomography which applied the two radioligands, 18F-fluorodeoxyglucose and NaF for the detection of culprit atheroma among 20 acute cerebral infarction patients (mean age = 75.1 ± 9.0 years; 10 women). In this study, we measured the maximum and mean standardized uptake value (SUVmax and SUVmean) of NaF uptake level in the cerebral infarct region between lesions with and without diffusion weighted image (DWI) positivity, indicating acute ischemic cell death. Correlation analysis was performed between NaF uptake levels and imaging and clinical variables, including neurological severity. The NaF uptake levels were significantly higher in DWI positive lesions than in negative lesions (SUVmax: 2.0 [0.60–4.2] versus 0.20 [0.10–0.40], p = 0.021 by Mann–Whitney U test). The intensity of NaF uptake (SUVmax) was significantly correlated with the initial neurological severity (Spearman's ρ = 0.579, p= 0.007) and white blood cell count (Spearman's ρ = 0.626, p p 0.003). During ischemic stroke NaF was concentrated in brain tissue undergoing acute cell death and its uptake intensity was correlated with neurological severity, suggesting that NaF could reflect acute ischemic cell death after stroke.

Background Higher pulsatility of the middle cerebral artery (MCA) is known to be associated with stroke progression. We investigated whether pulsatility index (PI) of the basilar artery (BA) can predict neurological deterioration (ND) after acute cerebral infarction. Methods A total of 708 consecutive patients with acute ischemic stroke who had undergone transcranial Doppler (TCD) ultrasonography were included. ND was defined as an increase in the National Institutes of Health Stroke Scale scores by two or more points after admission. The patients were categorized into quartiles according to BA PI. Multivariable logistic regression analysis was performed to examine whether BA PI is independently associated with ND. Results BA PI was well correlated with the right (n = 474, r2 = 0.573, P < 0.001) by Pearson correlation analysis although MCA PI could not be measured from right MCA (n = 234, 33.05%) and left MCA (n = 252, 35.59%) by TCD owing to insufficient temporal bone window. Multivariable logistic regression analysis including age, sex, cerebral atherosclerosis burden, National Institutes of Health Stroke Scale at admission, and the proportion of patients with current smoking status, hypertension, diabetes mellitus, atrial fibrillation revealed that the higher BA PI (odds ratio, 3.28; confidence interval, 1.07–10.17; P = 0.038) was independently associated with ND. Conclusions BA PI, which would be identified regardless of temporal window, could predict ND among acute stroke patients.

Recognizing the lesion pattern of antiphospholipid antibody-related stroke (aPL-stroke) may contribute to establishing the cause in patients with cryptogenic stroke. We aimed to describe the neuroimaging features of aPL-stroke compared with atrial fibrillation-related stroke (AF-stroke), a major hidden cause of cryptogenic stroke. Using a prospective stroke registry, we identified consecutive aPL- and AF-stroke patients without other potential causes of stroke. Neuroimaging features based on diffusion-weighted imaging and angiographic findings at admission were compared. A total of 56 and 333 patients were included in the aPL- and AF-stroke groups, respectively. aPL-stroke patients more often presented with single small lesions (aPL-stroke, 30.4% vs. AF-stroke, 7.5%, p p p p p = 0.44). In comparison only including patients with multi-territory lesions as well, aPL-stroke patients showed small lesion dominance and smaller infarct volume. Multivariate analyses showed independent associations between mild neuroimaging features (small lesion prevalence, smaller infarct volume, and absence of relevant artery occlusion) and aPL-stroke. Patterns of small lesion prevalence, small infarct volume, and absence of relevant artery occlusion were suggestive of aPL-stroke rather than AF-stroke. Cryptogenic stroke patients with such neuroimaging features may benefit from aPL testing for a precise diagnosis.

Background and Purpose: Data on the effect on vascular outcomes of concomitant atherosclerotic vascular disease (ASVD) with atrial fibrillation (AF) after stroke are limited. This study evaluated the effect of ASVD with AF versus AF only on the risk of vascular events. Methods: We retrospectively analyzed a prospectively registered multicenter database involving 3213 stroke patients with AF. ASVD included extracranial atherosclerosis measured in the proximal portion of the internal carotid artery, intracranial atherosclerosis (all ≥50% stenosis), coronary artery disease, and peripheral artery disease and was categorized into 4 strata depending on the number of ASVDs (0, 1, 2, and 3–4). The independent associations of ASVD with major adverse cardiovascular events, stroke, and all-cause death were assessed. Results: A total of 2670 patients were included (mean age, 73.5±9.8 years; median CHA 2 DS 2 -VASc score, 5; interquartile range, 4−6). During the follow-up (mean, 1.7 years), a total of 672 (25.2%) major adverse cardiovascular events, 170 (6.4%) stroke events, and 501 (18.8%) all-cause deaths were noted. The adjusted hazard ratio for major adverse cardiovascular events versus no ASVD was 1.25 (95% CI, 1.00–1.56) for ASVD 1, 1.34 (95% CI, 1.02–1.76) for ASVD 2, and 1.93 (95% CI, 1.24–2.99) for ASVD 3–4. The adjusted hazard ratio for all-cause death versus no ASVD was 1.32 (1.01–1.74), 1.47 (1.06–2.03), and 2.39 (1.47–3.89), respectively. Among ASVD components, the presence of symptomatic or asymptomatic extracranial atherosclerosis was a more potent predictor of major adverse cardiovascular events (1.27 [1.05–1.54]) and all-cause death (1.45 [1.17–1.81]). Conclusions: ASVD burden with AF can be a cumulative marker of a high risk for untoward vascular outcomes. Among ASVD components, extracranial atherosclerosis seems to have a predominant effect.

BackgroundThrombi retrieved from patients with acute ischemic stroke may contain prognostic information.ObjectiveTo investigate the relationship between the immunologic phenotype of thrombi and future vascular events in patients with a stroke.MethodsThis study included patients with acute ischemic stroke who underwent endovascular thrombectomy at Chung-Ang University Hospital in Seoul, Korea, between February 2017 and January 2020. Laboratory and histological variables were compared between patients with and without recurrent vascular events (RVEs). Kaplan–Meier analysis followed by the Cox proportional hazards model was used to identify factors related to RVE. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of the immunologic score by combining immunohistochemical phenotypes to predict RVE.ResultsA total of 46 patients were included in the study with 13 RVEs (mean±SD age, 72.8±11.3 years; 26 (56.5%) men). Thrombi with a lower percentage of programmed death ligand-1 expression (HR=11.64; 95% CI 1.60 to 84.82) and a higher number of citrullinated histone H3 positive cells (HR=4.19; 95% CI 0.81 to 21.75) were associated with RVE. The presence of high-mobility group box 1 positive cell was associated with reduced risk of RVE, but the association was lost after adjustment for stroke severity. The immunologic score, which consists of the three immunohistochemical phenotypes, showed good performance in predicting RVE (area under the ROC curve, 0.858; 95% CI 0.758 to 0.958).ConclusionsThe immunological phenotype of thrombi could provide prognostic information after stroke.

To crossbreed wild Allium species with imported Allium and obtain new varieties, it is necessary to understand the flowering physiology of Allium species Native to Korea. In this study, we examined the flowering response of four Allium species to photoperiod adjustments. We started the experiment on June 28 using plants with four leaves and one inflorescence. To determine the photoperiodic response, the plants were subjected to long-day (16 h, LD), short-day (9 h, SD), or open field conditions. LD and SD conditions were conducted in a controlled environment with a Phyto-Garden System maintained at 25°C, 70% humidity, and 296 ± 13 μmol･m-2 ･s-1 light intensity. Day extension (DE) treatment was conducted with additional time with 5 μmol･m-2 ･s-1 fluorescent light intensity. The growth parameters (plant height, plant width, leaf length, leaf width, and number of leaves) and flowering characteristics (number of inflorescence and number of days to flowering) were assessed. Under SD condition, the plant height, plant width, leaf length, and leaf width of A. taquetii were higher than those under LD and open field conditions. Among the four Allium species, A. taquetii was the most grown under SD condition after bolting. Under SD condition, the first flower of A. longistylum, A. thunbergii var. teretifolium, A. linearifolium, and A. taquetii bloomed after 51.8 days, 46.5 days, 43.7 days, and 52 days, respectively. Under LD condition, not all species had complete flowering at the end of the experiment. Under open field conditions, the flowers of four A. species bloomed after 97.2 days on average. These results indicate that the four Allium species have an obligate flowering response to photoperiod.

Since a novel beta-coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019, there has been a rapid global spread of the virus. Genomic surveillance was conducted on samples isolated from infected individuals to monitor the spread of genetic variants of SARS-CoV-2 in Korea. The Korea Disease Control and Prevention Agency performed whole genome sequencing of SARS-CoV-2 in Korea for 1 year (January 2020 to January 2021). A total of 2,488 SARS-CoV-2 cases were sequenced (including 648 cases from abroad). Initially, the prevalent clades of SARS-CoV-2 were the S and V clades, however, by March 2020, GH clade was the most dominant. Only international travelers were identified as having G or GR clades, and since the first variant 501Y.V1 was identified (from a traveler from the United Kingdom on December 22nd, 2020), a total of 27 variants of 501Y.V1, 501Y.V2, and 484K.V2 have been classified (as of January 25th, 2021). The results in this study indicated that quarantining of travelers entering Korea successfully prevented dissemination of the SARS-CoV-2 variants in Korea.

Background: Stroke risk scores (CHADS2 and CHA2DS2-VASc) not only predict the risk of stroke in atrial fibrillation (AF) patients, but have also been associated with prognosis after stroke. Objective: The aim of this study was to evaluate the relationship between stroke risk scores and early neurological deterioration (END) in ischemic stroke patients with AF. Methods: We included consecutive ischemic stroke patients with AF admitted between January 2013 and December 2015. CHADS2 and CHA2DS2-VASc scores were calculated using the established scoring system. END was defined as an increase ≥2 on the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 on the motor NIHSS score within the first 72 h of admission. Results: A total of 2,099 ischemic stroke patients with AF were included. In multivariable analysis, CHA2DS2-VASc score (adjusted odds ratio [aOR] = 1.17, 95% confidence interval [CI] = 1.04–1.31) was significantly associated with END after adjusting for confounders. Initial NIHSS score, use of anticoagulants, and intracranial atherosclerosis (ICAS) were also found to be closely associated with END, independent of the CHA2DS2-VASc score. Multivariable analysis stratified by the presence of ICAS demonstrated that both CHA2DS2-VASc (aOR = 1.20, 95% CI = 1.04–1.38) and CHADS2 scores (aOR = 1.24, 95% CI = 1.01–1.52) were closely related to END in only patients with ICAS. In patients without ICAS, neither of the risk scores were associated with END. Conclusions: High CHA2DS2-VASc score was associated with END in ischemic stroke patients with AF. This close relationship is more pronounced in patients with ICAS.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is triggered by herpesvirus encephalitis. Human herpesvirus type 7 (HHV-7) is a recently described herpesvirus for which neuroinvasion has been reported rarely. We report a case of anti-NMDAR encephalitis detected 8 years after recurrent herpes encephalitis associated with herpes simplex virus type 1 and HHV-7 in an immunocompetent host. Our case suggests that anti-NMDAR encephalitis may be triggered by HHV-7 meningoencephalitis in immunocompetent adults, and patients with a history of herpesvirus encephalitis should be vigilantly monitored.

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic since 2019. Variants of concern (VOCs) declared by the World Health Organization require continuous monitoring because of their possible changes in transmissibility, virulence, and antigenicity. The Omicron variant, a VOC, has become the dominant variant worldwide since November 2021. In the Republic of Korea (South Korea), the number of confirmed cases increased rapidly after the detection of Omicron VOC on November 24, 2021. In this study, we estimated the underlying epidemiological processes of Omicron VOC in South Korea using time-scaled phylodynamic analysis. Three distinct phylogenetic subgroups (Kor-O1, Kor-O2, and Kor-O3) were detected in South Korea. The Kor-O1 subgroup circulated in the Daegu region, whereas Kor-O2 and Kor-O3 circulated in Incheon and Jeollanam-do, respectively. The viral population size and case number of the Kor-O1 subgroup increased more rapidly than those of the other subgroups, indicating the rapid spread of the virus. The results indicated the multiple introductions of Omicron sub-lineages into South Korea and their subsequent co-circulation. The evolution and transmission of SARS-CoV-2 should be continuously monitored, and control strategies need to be improved to control the multiple variants.

Background Both anti-Saccharomyces cerevisiae antibody (ASCA) and anti-neutrophil cytoplasmic antibody (ANCA) are associated with inflammatory bowel disease (IBD); however, the clinical role of these serological biomarkers in pediatric IBD has been poorly investigated. Therefore, this study aimed to evaluate the diagnostic utility and phenotypic correlation of serological biomarkers in pediatric IBD. Methods A retrospective review was performed on all pediatric subjects diagnosed with IBD between March 2004 and July 2021. Pediatric patients were recruited and classified as Crohn’s disease (CD), ulcerative colitis (UC), and IBD unclassified (IBD-U) based on the revised Porto criteria. The Paris classification was used to evaluate disease phenotypes. Laboratory markers including fecal calprotectin were also evaluated. Serum levels of ASCA IgG and IgA, anti-proteinase-3 with cytoplasmic ANCA (PR3-ANCA), and anti-myeloperoxidase with perinuclear ANCA (MPO-ANCA) using ELISA, and serum ANCA titer using immunofluorescent test were measured. Results In all, 229 pediatric patients with IBD (CD: 147, UC: 53, IBD-U: 29) were included. The ASCA IgG seropositivity was significantly different among the three groups (CD: 75.4%, UC: 17.5%, and IBD-U: 60.0%; p p p p p vs. P0 29.4 U/mL, p = 0.001), while showing no differences in age, disease location, and behavior. Using optimal cutoffs determined by ROC analysis, serum IgG and IgA ASCAs showed 68.0% and 63.1% sensitivity, and 67.7% and 64.6% specificity, respectively, in distinguishing CD. Conclusions Serological biomarkers of ASCAs IgG and IgA, pANCA, and PR3-ANCA may be effective in the diagnosis and clinical evaluation of disease phenotypes in an Asian pediatric IBD cohort.