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Microplastic (MP) contamination has become a pervasive global issue, affecting terrestrial and aquatic environments, and its potential health hazards are of widespread concern. This review examined the intricate relationship between animal exposure to MPs and their health effects, revealing that MP contamination affects a broad spectrum of animal species across terrestrial and aquatic habitats. Crucially, interspecies differences in ingestion, accumulation, and responses to MPs emerge as central themes arising from various factors, including feeding behavior, physiology, and ecological niches. The health implications of MP exposure are multifarious; animals may suffer physical harm, endure chemical exposure to adsorbed contaminants, provoke inflammatory responses, and undergo behavioral modifications. Chronic exposure to MPs raises concerns about their long-term health consequences, and the ability of MPs to adsorb and transport chemicals has implications for the bioaccumulation of pollutants within food webs. The ecological ramifications of MP contamination are profound, impacting animal behavior, population dynamics, and ecosystem processes. The intricate interplay between animals and MPs underscores the need for interdisciplinary research that unites fields such as biology, ecology, chemistry, and toxicology. Recognizing the relationship between animal exposure to MPs and their health effects has significant implications, particularly as the potential for MPs to enter the human food chain through animals underscores the need for research on human health risks.

Transmission of microplastics (MPs) through aerosolization has been recently realized as an important route. Inspite of the reports of the ubiquitous MP presence in aerosols, the spatio-temporal information is inadequate and has very limited practicality in assessing if aerosol can be a significant source of MPs to the marine environment. Data on marine contribution to atmospheric MPs is exceptionally scarce, and the ocean-air exchange is considered an emerging research area. Evidence of MPs entering the oceans via atmospheric deposition has been recently produced. The idea of ocean-air exchange emanates from the fact that beach sediments can get suspended under sand and dust storms, bubble bursts and sea sprays due to wind and waves in surf zones can lead to the ejection of particles into aerosols. In this succinct review, we have tried compiling the data on atmospheric MPs that can shed some light on the flux from and to the aquatic environment. While the information is too limited never the less its incorporation into the marine MP cycle cannot be neglected.

In this study, the current state of groundwater development and use and groundwater quality has been examined based on official groundwater data collected from the Republic of Korea. The groundwater data indicate a steady increase in the number of groundwater wells and an increase in groundwater pumping. The well diameters also increase with increasing well depth, owing to the development of drilling technology. Although groundwater is predominantly used for agricultural and living purposes, the former has recently outnumbered the latter. According to the groundwater quality monitoring stations covering the entire country, the groundwater levels, dissolved oxygen, and oxidation–reduction potential decrease with a steady increase in the water temperature, pH, and electrical conductivity, indicating an aggravating groundwater environment in this region. The most concerning contaminants found are nitrate, ammonia, arsenic, zinc, toluene, xylene, chloroform, and fluoride. Thus, based on these observations, we propose three essential tasks for sustainable groundwater use: a paradigm shift in groundwater management, conjunctive use and integrated management of groundwater and stream water, and groundwater governance and data quality control. HIGHLIGHTS Groundwater development and use have steadily increased in Korea.; Groundwater wells are becoming bigger and deeper.; Groundwater quality is gradually deteriorating.; Groundwater management strategies are required for sustainable use.;

Cadmium (Cd) is an environmental pollutant that damages various tissues. Cd may cause a depletion of iron stores and subsequently an iron deficiency state in the liver. However, the molecular mechanism of decreased iron accumulation in the liver induced by long-term exposure to Cd is unknown. In this study, we investigated the hepatic accumulation of iron and the proximal duodenal expression of the genes involved in iron transport using mice chronically exposed to Cd. Five-week-old female C57BL/6J mice were fed a diet containing 300 ppm Cd for 12, 15, 19 and 21 months. The iron concentration in the liver was markedly decreased by Cd. Among iron-transport-related genes in the proximal duodenum, the gene expression of HCP1 and Cybrd1 was significantly decreased by Cd. HCP1 is an influx transporter of heme iron. Cybrd1 is a reductase that allows non-heme iron to enter cells. The expression of iron-transport-related genes on the duodenal basolateral membrane side was hardly altered by Cd. These results suggest that long-term exposure to Cd suppresses the expression of HCP1 and Cybrd1 in the proximal duodenum, resulting in reduced iron absorption and iron accumulation in the liver.

Biofouling is a significant means for introducing non-indigenous marine species internationally, which can alter habitats and disturb marine ecosystems. This study estimated the flux of ships’ wetted surface area (WSA) to Korea in 2020 to assess the risks of biological invasion via biofouling on ships’ hulls. The annual total WSA flux entering Korea was estimated to be 418.26 km2, with short-stay vessels (

Abstract We report unique observations from drilling and hydraulic stimulation at a depth of approximately 4.3 km in two Enhanced Geothermal System (EGS) wells at the Pohang EGS site, South Korea. We surveyed drilling logs and hydraulic stimulation data, simulated pore pressure diffusion around the fault delineated by seismic and drilling log analyses, conducted acoustic image logging through the EGS wells, observed significant water level drops (740 m) in one of the two EGS wells, and obtained hydrochemical and isotopic variation data in conjunction with the microbial community characteristics of the two EGS wells. We discuss the hydraulic and hydrochemical responses of formation pore water to a few key seismic events near the hypocenter. We focused on how the geochemistry of water that flowed back from the geothermal wells changed in association with key seismic events. These were (1) a swarm of small earthquakes that occurred when a significant circulation mud loss occurred during well drilling, (2) the MW 3.2 earthquake during hydraulic stimulation, and (3) the MW 5.5 main shock two months after the end of hydraulic stimulation. This study highlights the value of real-time monitoring and water chemistry analysis, in addition to seismic monitoring during EGS operation.

Abstract Methylmercury is an environmental pollutant that causes neurotoxicity. Recent studies have reported that the ubiquitin-proteasome system is involved in defense against methylmercury toxicity through the degradation of proteins synthesizing the pyruvate. Mitochondrial accumulation of pyruvate can enhance methylmercury toxicity. In addition, methylmercury exposure induces several immune-related chemokines, specifically in the brain, and may cause neurotoxicity. This summary highlights several molecular mechanisms of methylmercury-induced neurotoxicity.

Abstract Background To evaluate the facial asymmetry, three-dimensional computed tomography (3D-CT) has been used widely. This study proposed a method to quantify facial asymmetry based on 3D-CT. Methods The normal standard group consisted of twenty-five male subjects who had a balanced face and normal occlusion. Five anatomical landmarks were selected as reference points and ten anatomical landmarks were selected as measurement points to evaluate facial asymmetry. The formula of facial asymmetry index was designed by using the distances between the landmarks. The index value on a specific landmark indicated zero when the landmarks were located on the three-dimensional symmetric position. As the asymmetry of landmarks increased, the value of facial asymmetry index increased. For ten anatomical landmarks, the mean value of facial asymmetry index on each landmark was obtained in the normal standard group. Facial asymmetry index was applied to the patients who had undergone orthognathic surgery. Preoperative facial asymmetry and postoperative improvement were evaluated. Results The reference facial asymmetry index on each landmark in the normal standard group was from 1.77 to 3.38. A polygonal chart was drawn to visualize the degree of asymmetry. In three patients who had undergone orthognathic surgery, it was checked that the method of facial asymmetry index showed the preoperative facial asymmetry and the postoperative improvement well. Conclusions The current new facial asymmetry index could efficiently quantify the degree of facial asymmetry from 3D-CT. This method could be used as an evaluation standard for facial asymmetry analysis.

Cadmium (Cd) is a toxic heavy metal that is widely present in the environment. Renal proximal tubule disorder is the main symptom of Cd chronic poisoning. Our previous study demonstrated that Cd inhibits the total activities of peroxisome proliferator-activated receptor (PPAR) transcription factors in human and rat proximal tubular cells. In this study, we investigated the involvement of PPAR in Cd renal toxicity using the HK-2 human proximal tubular cell line. Among PPAR isoform genes, only PPARD knockdown significantly showed resistance to Cd toxicity in HK-2 cells. The transcriptional activity of PPARδ was decreased not only by PPARD knockdown but also by Cd treatment. DNA microarray analysis showed that PPARD knockdown changed the expression of apoptosis-related genes in HK-2 cells. PPARD knockdown decreased apoptosis signals and caspase-3 activity induced by Cd treatment. PPARD knockdown did not affect the intracellular Cd level after Cd treatment. These results suggest that PPARδ plays a critical role in the modification of susceptibility to Cd renal toxicity and that the apoptosis pathway may be involved in PPARδ-related Cd toxicity.

Efforts to reduce the toxic effects of microplastics (MPs) on the environment have increased globally in recent years. However, the existing models used for the simulation of contaminant transport in groundwater are meant for dissolved substances, which is not suitable for studying MPs. Therefore, in this study, the transport of MPs in a saturated porous medium was modeled by establishing governing equations. Simulations were performed using the finite element method to examine the effects of the parameters of the governing equations on the transport of MPs. The results suggest that it is necessary to reduce the diffusivity of MPs and increase the water flow velocity, porosity, and first-order attachment coefficient to effectively contain this environmental hazard. From the simulation results, it can be derived that a combination of low diffusivity, fast water flow velocity, and high soil porosity may reduce the amount of MPs that are leaked into groundwater environments. The modeling and simulations performed in this study provide a clear understanding of the transport phenomena of MPs with applications in combating water pollution.

Karst regions cover approximately 10% of the Korean Peninsula and are highly vulnerable to contamination. In this study, five field surveys were conducted between 2017 and 2019 to examine the monthly and seasonal changes in the hydro-environment of a characteristic karst region in Samchoek, South Korea. During the surveys, a total of 24 surface water samples were collected and analyzed for field water quality parameters, major and minor ions, and stable isotopes. The results indicate that the water quality in the study area is significantly affected by precipitation. Overall, the water was classified as a Ca-Mg-HCO3 type, and correlation analysis of the major ions detected in the water samples indicates that the inflow of nitrate to the surface water originated from agricultural activities in the region. Furthermore, variations caused by climate were verified using the relationships between the various ions. In addition, high precipitation rates during the rainy season cause the active exchange of surface material, which was verified using stable isotope outliers. The results provide a scientific basis for studying the connectivity of water systems in complex karst hydrogeological regions and can aid future sustainable management of water resources in these regions.

This study analyzed the hydrochemical characteristics and microbial communities of karst water in Samcheok, Korea, and compared water quality results to identify the seasonal characteristics and hydrogeological connectivity of the study areas of Hamaengbang-ri, Gyogok-ri, Yeosam-ri, and the downtown area of Samcheok. Field survey and water quality analysis were performed in July 2019, February 2020, and April 2020. Hydrochemical analysis of karst water (groundwater and surface water) showed that most samples were comprised of Ca-HCO3 and that water–rock interactions were a dominant factor compared to precipitation and evaporation (crystallization). For seasonal characteristics, water–rock interactions appeared more active in the dry season than in the rainy season. Calcite weathering was dominant in the dry season, whereas dolomite weathering dominated the rainy season. Moreover, the saturation indexes for the dry and rainy seasons were less than and greater than 0, respectively, corresponding to an unsaturation (oversaturation) state; thus, white precipitate distributed in the study areas was deposited in the rainy season. Finally, as a result of analyzing the hydraulic characteristics between regions, hydrogeological similarities were identified between Hamaengbang-ri and Yeosam-ri, and between Gyogok-ri and downtown Samcheok, which suggested hydrogeological connectivity between each of the pairs.

It has been recognized that p-Coumaric acid (p-CA) has protective effects as an antioxidant, anti-inflammatory agent. A sensitive and efficient Liquid Chromatography-Mass Spectrometry (LC-MS) method for maximum determination of p-CA in human plasma has been established using Ultra-performance liquid Chromatography-tandem mass Spectrometry (UPLC-MS/MS). This study provides the developed analysis of p-CA extracted from Bambusae Caulis in Taeniam (BC) to examine the improvement of the treatment p-CA, IGF-1 and Osteocalcin level in human children which are important factors on the growth of children’s height through Pharmacokinetics/Pharmacodynamics (PK/PD) model. p-CA and internal standard in a plasma sample were detected by the Multiple Reaction Monitoring (MRM) scan mode with positive ion detection. The sample participating in the study was made of 34 subjects (placebo = 18, treatment = 16). The subjects were enrolled to be randomized to the control group and BC group. Randomized subjects took tested treatment twice a day, three capsules with oral administration (258 mg/capsule) each time after a meal. Standard calibration curves (reproducibility) were constructed and the lower limit of quantitation (LLOQ) for p-CA was found to be 0.2 ng/mL on injection of the sample into the UPLC-MS/MS system. Accuracy and precision were evaluated and the intra-accuracy was 99.2–103.8% with precision of 1.0–5.6% and inter-accuracy was 99.6–108.4% and precision of 1.3–6.4% for p-CA. The method has been successfully applied to PK/PD studies of p-CA in human plasma. The p-CA, BC in Taeniam extract increased the level of IGF-1 and Osteocalcin, and changed the height from baseline, which suggested that the p-CA could play an important role in longitudinal bone growth. Therefore, the p-CA extracted from BC in Taeniam might be a good alternative medicine to growth hormone (GH) therapy.

The effects of the unpredictability of the flow system in a karst area, with respect to bacterial communities in the aquatic environment, were evaluated. Bacterial communities from two different types of flow conditions (spring and sinkhole) were characterized and compared in the karst area. Proteobacteria, Bacteroidetes, and Verrucomicrobia were the major phyla present in the sampled spring and sinkhole waters. The water samples from the spring points were heavily loaded with Actinobacteria, especially Firmicutes, which accounted for 4.3% of the bacterial content. Furthermore, Actinobacteria were prevalent in some water samples, serving as indicators of the effects of seawater inundation. The richness and diversity of bacterial species were evaluated at the spring and sinkhole water points. The spring waters showed a higher bacterial richness and diversity compared to the sinkhole waters. Our results provide valuable information for the evaluation and investigation of microbial compositions in karst areas, which are characterized by heterogeneous hydrological conditions. The microbial species in karst areas are already exposed to changing hydrogeological conditions, and are likely to be confronted with future changes; thus, their spatiotemporal variations reflect the shifting baselines of physicochemical and ecosystem processes.

Under changing climate, increasing groundwater use has risen the concern for groundwater quality variations over recent years, to maintain a healthy ecosystem. The objectives were to identify trend of temporal variations in groundwater quality and its suitability for different uses in Republic of Korea. Water quality data were collected from 198 monitoring stations of Groundwater Quality Monitoring Network (GQMN), annually for the period of ten years (2008–2017). Non-parametric trend analysis of a Mann–Kendall test and Theil–Sen’s slope was done on groundwater physico-chemical data of ten years. Groundwater suitability evaluation was done for use in main sectors including domestic (drinking) and agriculture (irrigation). For drinking suitability analysis, results were compared with World Health Organization (WHO) and Korean Ministry of Environment (KME) established guidelines. For irrigation suitability evaluation, electrical conductivity (EC), Sodium Adsorption Ratio (SAR), percent of Na+, Residual Sodium Carbonate (RSC), US Salinity Laboratory (USSL), and Wilcox diagram were used. Most significantly, water type belongs to Ca-HCO3 and Ca-SO4 types, but a small proportion belongs to Na-CO3 and Na-Cl types. Approximately, 96% and 93% of groundwater samples are suitable for drinking, based on WHO and KME guidelines, respectively. Around 98% and 83% of groundwater samples are in suitable range for irrigation use, based on USSL and Wilcox diagrams, respectively.

Homeobox protein B13 (HOXB13), a transcription factor, is related to methylmercury toxicity; however, the downstream factors involved in enhancing methylmercury toxicity remain unknown. We performed microarray analysis to search for downstream factors whose expression is induced by methylmercury via HOXB13 in human embryonic kidney cells (HEK293), which are useful model cells for analyzing molecular mechanisms. Methylmercury induced the expression of oncostatin M (OSM), a cytokine of the interleukin-6 family, and this was markedly suppressed by HOXB13 knockdown. OSM knockdown also conferred resistance to methylmercury in HEK293 cells, and no added methylmercury resistance was observed when both HOXB13 and OSM were knocked down. Binding of HOXB13 to the OSM gene promoter was increased by methylmercury, indicating the involvement of HOXB13 in the enhancement of its toxicity. Because addition of recombinant OSM to the medium enhanced methylmercury toxicity in OSM-knockdown cells, extracellularly released OSM was believed to enhance methylmercury toxicity via membrane receptors. We discovered tumor necrosis factor receptor (TNF) receptor 3 (TNFR3) to be a potential candidate involved in the enhancement of methylmercury toxicity by OSM. This toxicity mechanism was also confirmed in mouse neuronal stem cells. We report, for the first time, that HOXB13 is involved in enhancement of methylmercury toxicity via OSM-expression induction and that the synthesized OSM causes cell death by binding to TNFR3 extracellularly.

The study of medicinal plants for treatment of periodontitis is of great value to establish their efficacy as sources of new antimicrobial drugs. Five hundred and fifty eight Korean local plant extracts were screened for antibacterial activity against representative periodontopathic bacteria such as Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum. Among the various medicinal plants, the alcohol extract of Pittosporum tobira, which significantly exhibited antibacterial effect for all tested strains, showed the highest activity in the antimicrobial assays. NMR analyses revealed that R1-barrigenol, a triterpene sapogenin, was the most effective compound in P. tobira. These results demonstrated that P. tobira possesses antimicrobial properties and would be beneficial for the prevention and treatment of periodontitis.

Groundwater samples were collected from the tubular wells of a groundwater heat pump (GWHP), and the psychrophilic, mesophilic, and thermophilic bacteria inhabiting the collected groundwater were cultured and isolated. Using the isolated bacteria, we analyzed temperature-dependent changes in autochthonous bacteria based on the operation of the GWHP. Microbial culture identified eight species of bacteria: five species of thermophilic bacteria (Anoxybacillus tepidamans, Bacillus oceanisediminis, Deinococcus geothermalis, Effusibacillus pohliae, and Vulcaniibacterium thermophilum), one species of mesophilic bacteria (Lysobacter mobilis), and two species of psychrophilic bacteria (Paenibacillus elgii and Paenibacillus lautus). The results indicated A. tepidamans as the most dominant thermophilic bacterium in the study area. Notably, the Anoxybacillus genus was previous reported as a microorganism capable of creating deposits that clog above-ground wells and filters at geothermal power plants. Additionally, we found that on-site operation of the GWHP had a greater influence on the activity of thermophilic bacteria than on psychrophilic bacteria among autochthonous bacteria. These findings suggested that study of cultures of thermophilic bacteria might contribute to understanding the bio-clogging phenomena mediated by A. tepidamans in regard to GWHP-related thermal efficiency.

Variations in stream water, streambed, adjacent stream sediment, and groundwater temperatures in the Haean basin, Korea were examined using time series analyses including auto-correlation, spectral density, and cross-correlation functions. The temperatures of the ambient air, stream water, streambed (depth = 10 cm), and adjacent stream sediment (depth = 10 cm) showed distinctive diurnal variations with long-term seasonal cooling trends, while groundwater temperature showed only a seasonal decreasing trend with little diurnal variations. Auto-correlations and spectral densities of the stream water, streambed, and sediment temperatures also revealed strong daily cyclical behaviors, with longer periodic cycles varying from weekly to monthly. Amplitudes and lag times of the streambed thermal signals were also affected by the hydraulic conductivities of the sediments. Lower hydraulic conductivity indicates a more attenuated and slower thermal response for the streambed. The calculated vertical water flow velocities of the streambed revealed that the investigated stream locations were under losing or gaining conditions, depending on the location and time.

Mercury compounds are known to cause central nervous system disorders; however the detailed molecular mechanisms of their actions remain unclear. Methylmercury increases the expression of several chemokine genes, specifically in the brain, while metallothionein-III (MT-III) has a protective role against various brain diseases. In this study, we investigated the involvement of MT-III in chemokine gene expression changes in response to methylmercury and mercury vapor in the cerebrum and cerebellum of wild-type mice and MT-III null mice. No difference in mercury concentration was observed between the wild-type mice and MT-III null mice in any brain tissue examined. The expression of Ccl3 in the cerebrum and of Cxcl10 in the cerebellum was increased by methylmercury in the MT-III null but not the wild-type mice. The expression of Ccl7 in the cerebellum was increased by mercury vapor in the MT-III null mice but not the wild-type mice. However, the expression of Ccl12 and Cxcl12 was increased in the cerebrum by methylmercury only in the wild-type mice and the expression of Ccl3 in the cerebellum was increased by mercury vapor only in the wild-type mice. These results indicate that MT-III does not affect mercury accumulation in the brain, but that it affects the expression of some chemokine genes in response to mercury compounds.

To predict biotic responses to disturbances in forest environments, it is important to examine both the thermophysical properties of forest soils and the diversity of microorganisms that these soils contain. To predict the effects of climate change on forests, in particular, it is essential to understand the interactions between the soil surface, the air, and the biological diversity in the soil. In this study, the temperature and thermal properties of forest soil at three depths at a site in the Haean basin of Korea were measured over a period of four months. Metagenomic analyses were also carried out to ascertain the diversity of microorganisms inhabiting the soil. The thermal diffusivity of the soil at the study site was 5.9 × 10−8 m2·s−1. The heat flow through the soil resulted from the cooling and heating processes acting on the surface layers of the soils. The heat productivity in the soil varied through time. The phylum Proteobacteria predominated at all three soil depths, with members of Proteobacteria forming a substantial fraction (25.64 to 39.29%). The diversity and richness of microorganisms in the soil were both highest at the deepest depth, 90 cm, where the soil temperature fluctuation was the minimum.

Hesperetin (3',5,7-trihydroxy-4-methoxyflavanone) is a metabolite of hesperidin (hesperetin-7-O-rutinoside), which belongs to the flavanone subgroup and is found mainly in citrus fruits. Hesperetin has been reported to be an effective osteoinductive compound in various in vivo and in vitro models. However, how hesperetin effects osteogenic differentiation is not fully understood. In this study, we investigated the capacity of hesperetin to stimulate the osteogenic differentiation of periodontal ligament stem cells (PDLSCs) and to relieve the anti-osteogenic effect of high glucose. Osteogenesis of PDLSCs was assessed by measurement of alkaline phosphatase (ALP) activity, and evaluation of the mRNA expression of ALP, runt-related gene 2 (Runx2), osterix (OSX), and FRA1 as osteogenic transcription factors, as well as assessment of protein expression of osteopontin (OPN) and collagen type IA (COLIA). When PDLSCs were exposed to a high concentration (30 mM) of glucose, osteogenic activity decreased compared to control cells. Hesperetin significantly increased ALP activity at doses of 1, 10, and 100 µM. Pretreatment of cells with hesperetin alleviated the high-glucose-induced suppression of the osteogenic activity of PDLSCs. Hesperetin scavenged intracellular reactive oxygen species (ROS) produced under high glucose condition. Furthermore, hesperetin increased the activity of the PI3K/Akt and β-catenin pathways. Consistent with this, blockage of Akt or β-catenin diminished the protective effect of hesperetin against high glucose-inhibited osteogenic differentiation. Collectively, our results suggest that hesperetin alleviates the high glucose-mediated suppression of osteogenic differentiation in PDLSCs by regulating ROS levels and the PI3K/Akt and β-catenin signaling pathways.

Korea has been operating groundwater monitoring systems since 1996 as the Groundwater Act enacted in 1994 enforces nationwide monitoring. Currently, there are six main groundwater monitoring networks operated by different government ministries with different purposes: National Groundwater Monitoring Network (NGMN), Groundwater Quality Monitoring Network (GQMN), Seawater Intrusion Monitoring Network (SIMN), Rural Groundwater Monitoring Network (RGMN), Subsidiary Groundwater Monitoring Network (SGMN), and Drinking Water Monitoring Network (DWMN). The Networks have a total of over 3500 monitoring wells and the majority of them are now equipped with automatic data loggers and remote terminal units. Most of the monitoring data are available to the public through internet websites. These Networks have provided scientific data for designing groundwater management plans and contributed to securing the groundwater resource particularly for recent prolonged drought seasons. Each Network, however, utilizes its own well-specifications, probes, and telecommunication protocols with minimal communication with other Networks, and thus duplicate installations of monitoring wells are not uncommon among different Networks. This mini-review introduces the current regulations and the Groundwater Monitoring Networks operated in Korea and provides some suggestions to improve the sustainability of the current groundwater monitoring system in Korea.

Purpose: Acute myocardial infarction (AMI) and stroke are leading global causes of death and can be used to assess acute care quality. We examined the 30-day mortality trends after emergency department admission for AMI and stroke in Korea from 2008 to 2019, focusing on regional and income disparities. Materials and Methods: The AMI and stroke patients admitted to hospitals in Korea were collected from the claims data. We analyzed age and sex-standardized 30-day mortality for AMI, as well as hemorrhagic and ischemic strokes. Disparities in mortality were analyzed using absolute differences and relative ratios between the Organization for Economic Cooperation Development (OECD) and Korea, and among income levels and regions in Korea. A 12-year joinpoint regression was used to determine the annual percent change and the average annual percent change. Results: The trends in the 30-day AMI mortality of Korea were not significantly changed from 2008 to 2019; the gap remained at 1.2 between the OECD and Korea. Korea maintained lower mortality rates for hemorrhagic and ischemic stroke than the mean of OECD. In Korea, the 30-day hemorrhagic stroke mortality showed a constant decreasing trend for the higher-income group living in urban areas; it led to a widened gap based on income levels in urban areas. The 30-day mortality for ischemic stroke tended to decrease in the higher-income group and urban areas. Conclusion: National-level intervention is needed to manage regional and income-based disparities in AMI and stroke 30-day mortality. It is important to understand the variance in mortality rate by different geographical regions and income levels to establish an appropriate public health strategy. [ABSTRACT FROM AUTHOR]

Background: There have been few studies on the outcome of acute coronary syndrome (ACS) in human immunodeficiency virus (HIV) infection in the era when antiretroviral therapy (ART) is generalized and most of them have achieved viral suppression. Using claims data, we aimed to assess the mortality after atherosclerotic cardiovascular events in people with HIV (PWH) who maintain optimal adherence to ART. Materials and Methods: We used claims data from the National Health Insurance of the Korea to confirm newly diagnosed PWH from 2009 to 2019, and measured ART adherence. ACS and mortality were confirmed in PWH who showed optimal adherence to ART. Results: Among 7,100 PWH with optimal adherence and during 27,387 person-year of follow-up duration, ACS was confirmed in 140 (2.0%) cases, which was 1.3 times greater than statistics of the Korean general population (511.0 vs. 383.1 per 100,000). Acquired immunodeficiency syndrome, hypertension, dyslipidemia, and diabetes mellitus were associated with the development of ACS in PWH with optimal adherence. Mortality was confirmed in 10 cases, which is 7.1% overall and 2.9% when limited to myocardial infarction. It was comparable with the mortality rate of the Korean general population after myocardial infarction (8.9%). Conclusion: ACS prevalence was higher in PWH even when optimal adherence was maintained. However, mortality after ACS was comparable to that in the HIV-negative population. [ABSTRACT FROM AUTHOR]