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Background: Cytosine arabinoside-based chemotherapy coupled with anthracycline is currently the first-line treatment for acute myeloid leukaemia (AML), but diverse responses to the regimen constitute obstacles to successful treatment. Therefore, outcome prediction to chemotherapy at diagnosis is believed to be a critical consideration.Methods: The mRNA expression of 12 genes closely involved in the actions of cytosine arabinoside and anthracycline was evaluated by real-time reverse transcriptase PCR (RT-PCR), in 54 diagnostic bone marrow specimens of M2-subtype AML.Results: Low expression levels of ribonucleotide reductase M2 (RRM2) and high expression levels of topoisomerase 2 beta (TOP2B) were correlated with longer survival in a univariate analysis. Another interesting finding is that high ratios of TOP2B/RRM2 and TOP2B/TOP2 alpha (TOP2A) in a combined analysis were also shown to have a prognostic impact for longer survival with improved accuracy. Among the four markers, when adjusted for the influence of other clinical factors in multivariate analysis, the TOP2B/TOP2A ratio was significantly correlated with treatment outcomes; patients with high ratios trended toward longer disease-free survival (HR, 0.24; P=0.002) and overall survival (HR, 0.29; P=0.005).Conclusion: Genes with distinct expression profiles such as TOP2B/TOP2A expression ratio at diagnosis can be employed for outcome prediction after the treatment with standard regimens in AML patients with M2 subtype. [ABSTRACT FROM AUTHOR]

Apoptosis is an important phenomenon for investigating the efficacy of anti-cancer drug candidates. The conventional assays for cellular apoptosis, such as enzyme-linked immunosorbent assay, absorbance monitoring for the activity of caspase, and flow cytometric assay, have focused only on biochemical events. We investigated the staurosporine (STS)-induced apoptosis of the murine macrophage RAW-264.7 cell using a cell based bioimaging technique. Using time-lapse confocal microscopy, we monitored caspase-3 activation during apoptosis by imaging the translocation of green fluorescent protein from the cytosol to the nuclei. Five hours after 1 μμM STS treatment, caspase-3 was observed to be activated and membrane blebbing was observed simultaneously. Also, the loss of phosphatidylserine (PS) asymmetry in the phospholipid bilayer of plasma membrane during early apoptosis was monitored by imaging annexin-V labeled with fluorescein isocyanate binding to the externalized PS at various concentrations of STS. Moreover, disintegration of the plasma membrane during late apoptosis was confirmed using a nuclear dye, propidium iodide. The single cell based bioimaging data agreed well with those of the biochemical assays for caspase activation and morphological observation for membrane integrity. [ABSTRACT FROM AUTHOR]

This cross-sectional descriptive study was conducted to identify the factors associated with health-related quality of life (HRQoL) in low-compliant Korean adults with asthma. The sample consisted of 178 patients referred by a physician to the education clinic at a University hospital in Korea. Stepwise multiple regression analysis revealed that previous hospital admissions, recent asthma-related symptoms within the previous week, lower peak expiratory flow rate, and lower level of asthma knowledge were independently associated with lower HRQoL and accounted for 46% of the total variance. Health care providers should focus on these factors to increase perceptions of HRQoL among low-compliant patients. Interventional strategies need to be developed to emphasize the importance of compliance to the self-monitoring regimen and management protocols. [ABSTRACT FROM AUTHOR]

PURPOSE: This study assessed the knowledge of heart attack symptoms and risk factors in a convenience sample of Korean immigrants. METHOD: A total of 116 Korean immigrants in a Midwestern metropolitan area were recruited through Korean churches and markets. Knowledge was assessed using both open-ended questions and a structured questionnaire. Latent class cluster analysis and Chi-square tests were used to analyze the data. RESULTS: About 76% of the sample had at least one self-reported risk factor for cardiovascular disease. Using an open-ended question, the majority of subjects could only identify one symptom. In the structured questionnaire, subjects identified a mean of 5 out of 10 heart attack symptoms and a mean of 5 out of 9 heart attack risk factors. Latent class cluster analysis showed that subjects clustered into two groups for both risk factors and symptoms: a high knowledge group and a low knowledge group. Subjects who clustered into the risk factor low knowledge group (48%) were more likely than the risk factor high knowledge group to be older than 65 years, to have lower education, to not know to use 911 when a heart attack occurred, and to not have a family history of heart attack. CONCLUSION: Korean immigrants' knowledge of heart attack symptoms and risk factors was variable, ranging from high to very low. Education should be focused on those at highest risk for a heart attack, which includes the elderly and those with risk factors. [ABSTRACT FROM AUTHOR]

Objectives: To identify the independently associating factors on physical inactivity in Korean men and women. Methods: The data of 5554 men and women (18-74 years) were analyzed using national health and nutritional examination survey data that included questionnaires and physical examinations. Results: Multiple logistic regression analyses showed that significant factors were low monthly income, low education, current smoking, increased waist-to-hip ratio, and low health concern among men; living in rural areas, low monthly income, low education, perceived poor health status, low health concern, and emotional stress among women. Conclusions: Health care providers should focus on education and counseling regarding the factors that influence physical inactivity. [ABSTRACT FROM AUTHOR]

Cancer is primarily a disease of older adults. However, little data is available on the clinical features of cervical cancer in elderly patients. We investigated the trends in incidence and clinical features associated with cervical cancer among the elderly in Korea during the period of 1993-2002. We obtained data from the National Cervical Cancer Incidence Database, which was constructed in collaboration with the Korea Central Cancer Registry (KCCR) and Korea Gynecologic Cancer Registry (KGCR). A total of 44 191 women with cervical cancer were diagnosed between 1993 and 2002. Patients were divided into three groups based on age: /=70 years (Group 3). During this period, upward incidence trends were noted in Group 3 while constant and downward incidence trends were noted in Groups 1 and 2, respectively. Pooled analysis across years revealed that squamous cell carcinoma and advanced stage (IIB, III, and IV) were more common in Group 3 than in Groups 1 and 2. With regard to primary treatments in the elderly patients, surgery appeared to be performed increasingly despite the fact that advanced stage (IIB, III, and IV) was more common in Group 3 than in Groups 1 and 2. Our findings suggest that the incidence of cervical cancer in the elderly is increasing in Korea, while it is decreasing overall. The current health service must emphasize education for the elderly about cervical cancer prevention while concentrating on screening. [ABSTRACT FROM AUTHOR]

Korean immigrant's knowledge of stroke symptoms and risk factors was assessed in a convenience sample (n = 119) in a Midwestern metropolitan area. Knowledge ranged from very low to moderate. Cluster analysis showed that there were two groups. One cluster had higher knowledge of stroke symptoms and risk factors, but lower knowledge of symptoms and risk factors not associated with stroke. Participants who were older, were not married, and had a history of hypertension had significantly lower knowledge of stroke symptoms and stroke risk factors. Lower knowledge among older adults and/or those who had hypertension is a particular concern because such individuals are at highest risk for stroke. [ABSTRACT FROM AUTHOR]

This study examined the effects of a Web-based teaching method (versus a traditional lecture method) on undergraduate nursing students' learning of electrocardiography (ECG). The Web-based learning program was developed by the authors and implemented for 4 weeks. The study used a pretest-posttest experimental design. A total of 105 senior nursing students were recruited at a university in Korea. Fifty-four students were assigned to an experimental group in 2002, and 51 were assigned to a control group in 2003. Knowledge about ECG among students in the Web-based group was significantly lower than that of students in the control group (p < .01). Conversely, the ability to interpret ECG recordings was significantly higher among students in the Web-based group (p < .05). No significant differences were found between the two groups in level of motivation or satisfaction with learning. The self-directed, Web-based ECG learning program appears to be effective in helping nursing students to interpret ECG recordings. [ABSTRACT FROM AUTHOR]

The following study evaluated blood loss in patients undergoing navigation-assisted minimally invasive total knee arthroplasty. The study included 100 patients divided into two groups. Group A consisted of patients with an immediate drain release, and group B consisted of patients with a 1-hour delayed drain release after surgery. The surgeon used a mini-midvastus approach with the OrthoPilot navigation system. The mean blood drainage was 465 mL in group A and 409 mL in group B. The mean hemoglobin loss was 2.59 g/dL in group A and 2.43 g/dL in group B. [ABSTRACT FROM AUTHOR]

Background: Since its introduction, telemedicine for patients with chronic diseases has been studied in various clinical settings. However, there is limited evidence of the effectiveness and medical safety of the nationwide adoption of telemedicine., Objective: This study aimed to analyze the effects of telemedicine on chronic diseases during the COVID-19 pandemic under a temporary telemedicine policy in South Korea using national claims data., Methods: Health insurance claims data were extracted over 2 years: 1 year before (from February 24, 2019, to February 23, 2020) and 1 year after the policy was implemented (from February 24, 2020, to February 23, 2021). We included all patients who used telemedicine at least once in the first year after the policy was implemented and compared them with a control group of patients who never used telemedicine. The comparison focused on health care use; the medication possession ratio (MPR); and admission rates to general wards (GWs), emergency departments (EDs), and intensive care units (ICUs) using difference-in-differences analysis. A total of 4 chronic diseases were targeted: hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and common mental disorders., Results: A total of 1,773,454 patients with hypertension; 795,869 patients with DM; 37,460 patients with COPD; and 167,084 patients with common mental disorders were analyzed in this study. Patients diagnosed with hypertension or DM showed increased MPRs without an increase in GW, ED, or ICU admission rates during the policy year. Moreover, patients in the DM group who did not use telemedicine had higher rates of ED, GW, and ICU admissions, and patients in the hypertension group had higher rates of GW or ICU admissions after 1 year of policy implementation. This trend was not evident in COPD and common mental disorders., Conclusions: The temporary telemedicine policy was effective in increasing medication adherence and reducing admission rates for patients with hypertension and DM; however, the efficacy of the policy was limited for patients with COPD and common mental disorders. Future studies are required to demonstrate the long-term effects of telemedicine policies with various outcome measures reflecting disease characteristics., (©Ji Ye Kang, Weon Jung, Hyun Ji Kim, Ji Hyun An, Hee Yoon, Taerim Kim, Hansol Chang, Sung Yeon Hwang, Jong Eun Park, Gun Tak Lee, Won Chul Cha, Sejin Heo, Se Uk Lee. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 20.11.2024.)

Background: Neuromyelitis optica spectrum disorder (NMOSD) is the central nervous system demyelinating disease differentiated from multiple sclerosis by the presence of anti-aquaporin 4-antibody (AQP4-ab), which is sometimes accompanied by non-organ-specific autoantibodies., Methods: We prospectively collected clinical information and profiles of non-organ-specific autoantibodies such as fluorescent antinuclear (FANA), anti-Sjögren's syndrome A (SSA)/Ro, anti-SS B (SSB)/La, anti-neutrophil cytoplasmatic (ANCA), lupus anticoagulant (LA), anti-cardiolipin (ACA), anti-double-stranded DNA (dsDNA), rheumatoid factor (RF), anti-thyroperoxidase, and anti-thyroglobulin antibodies in patients with NMOSD. Clinical characteristics and laboratory findings of patients with NMOSD with or without autoantibodies were analyzed. Cox proportional hazard models were used to identify independent risk factors predicting high disability in patients with NMOSD., Results: A total of 158 patients with NMOSD (Female: Male = 146:12; age, 36.11 ± 14.7) were included. FANA was observed most frequently (33.3 %), followed by anti-SSA (28.6 %), anti-SSB (10.0 %), RF (8.5 %), anti-dsDNA (7.0 %), LA (4.7 %), ACA (4.8 %), and ANCA (2.4 %). High disability (Expanded Disability Status Scale (EDSS) score ≥ 6) was observed more frequently in patients with RF (45.5 %) than in those without RF (14.5 %) (p = 0.02). RF was a significant predictive factor for the high disability (hazard ratio [HR], 3.763; 95 % confidence interval [CI], 1.086-13.038; p = 0.037), age at onset (HR, 1.093; 95 % CI, 1.05-1.14; p ≤0.001), and annual relapse rate (ARR) (HR, 4.212; 95 % CI, 1.867-9.503; p = 0.001)., Conclusion: Organ-specific and non-organ-specific autoantibodies are frequently observed in Korean patients with AQP4-ab-positive NMOSD. RF may be an independent predictor of high disability, along with age at onset and ARR., Competing Interests: Declaration of competing interest Min J-H lectured, consulted, and received Honoria from Bayer Schering Pharma, Merck Serono, Biogen Idec, Sanofi Genzyme, Teva-Handok, UCB, Samsung Bioepis and Mitsubishi Tanabe Pharma, Roche and Janssen, and received a National Research Foundation of Korea grant and an SMC Research and Development Grant., (Copyright © 2024 Elsevier B.V. All rights reserved.)

We developed a modified cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score using an emergency department-based cohort data, incorporating norepinephrine equivalent dose and lactate to represent current clinical practice patterns for vasopressor utilization and the diagnostic significance of lactate, respectively. In this study, we sought to validate this modified CV-SOFA score in intensive care unit patients with suspected infection using the Marketplace for Medical Information in Intensive Care (MIMIC)-IV database. This was a retrospective study that utilized data from the MIMIC-IV database. Modified CV/total SOFA score and original CV/total SOFA score were compared for predicting in-hospital mortality. Area under the receiver operating characteristic curve (AUROC) and the calibration curve were employed to evaluate discrimination and calibration, respectively. A total of 29,618 ICU patients with suspected infections was analyzed. The in-hospital mortality rate was 12.4% (n = 3,675). Modified CV-SOFA score (AUROC 0.667; 95% confidence interval [CI] 0.657-0.677 vs. 0.663; 95% CI 0.654-0.673; p = 0.283) and modified total SOFA score (0.784 [95% CI 0.776-0.793] vs. 0.785 [95% CI 0.777-0.793], p = 0.490) did not differ significantly from the original CV-SOFA score and original total SOFA score, respectively. The calibration curve of the original CV-SOFA score was inferior to that of the modified CV-SOFA score. The modified CV- and total SOFA scores were better calibrated than the original CV- and total SOFA scores, but their discriminative performance was not significantly different. Further studies of the modified CV-SOFA score in different settings and populations are required to assess the generalizability of this score., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hwang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Understanding microscopic mechanisms of polarization retention characteristics in ferroelectric thin films is of great significance for exploring unusual physical phenomena inaccessible in the bulk counterparts and for realizing thin-film-based functional electronic devices. Perovskite (K,Na)NbO 3 is an excellent class of lead-free ferroelectric oxides attracting tremendous interest thanks to its potential applications to nonvolatile memory and eco-friendly energy harvester/storage. Nonetheless, in-depth investigation of ferroelectric properties of (K,Na)NbO 3 films and the following developments of nano-devices are limited due to challenging thin-film fabrication associated with nonstoichiometry by volatile K and Na atoms. Herein, ferroelectric (K,Na)NbO 3 films of which the atomic-level geometrical structures strongly depend on thickness-dependent strain relaxation are epitaxially grown. Nanopillar crystal structures are identified in fully relaxed (K,Na)NbO 3 films to the bulk states representing a continuous reduction of switchable polarization under air environments, that is, polarization retention failures. Protonation by water dissociation is responsible for the humidity-induced retention loss in nano-columnar (K,Na)NbO 3 films. The protonation-driven polarization retention failure originates from domain wall pinning by the accumulation of mobile hydrogen ions at charged domain walls for effective screening of polarization-bound charges. Conceptually, the results will be utilized for rational design to advanced energy materials such as photo-catalysts enabling ferroelectric tuning of water splitting., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

As part of the National Water Management Basic Plan, this study conducted research to identify priority management watersheds in the Yeongsan River basin to respond to changes in water environmental conditions and improve water quality. Analysis of water quality over the past decade revealed that points located in the middle and lower of the Yeongsan River exceeded the target water quality standards. As based on the results, pollution sources and loads indicated that the W-1 watershed, classified as urban areas, exhibited high levels in residential, industrial, and urban landuse characteristics, whereas the W-6 watershed, classified as rural areas, showed high levels in livestock farming, aquaculture, and agricultural landuse (wet and dry filed) categories. To understand the impact of point source (PS) and non-point source (NPS) pollution within the watershed, load duration curve (LDC) analysis was conducted, indicating that downstream segments of all flow ranges exceeded the target water quality standards, necessitating management of both PS and NPS. Multivariate log-linear analysis also confirmed the influence of PS and NPS, suggesting that watershed management should concurrently address both types of pollution. Based on the results, priority management watershed rankings were derived through the calculation of standard and integrated indicators, with the analysis indicating the following order: W-1 > W-6 > W-3 > W-4 > W-2 > W-5 > W-7 > W-8. PRACTITIONER POINTS: Priority management watersheds that urgently need water environment management can be identified. The priority management watershed rankings were derived through the calculation of integrated indicators data on BOD, TP concentration, and loads. Serve as a guide for future diagnostic assessments of pollution sources and the development of effective management strategies. Anticipated to significantly contribute to the establishment of robust water quality management practices in the basin., (© 2024 Water Environment Federation.)