Background: There are regional variations in the incidence of coronavirus disease 2019 (COVID-19), which means that some regions are more exposed to the risk of COVID-19 than others. Therefore, this study aims to investigate regional variations in the incidence of COVID-19 in Korea and identify risk factors associated with the incidence of COVID-19 using community-level data. Methods: This study was conducted at the districts (si·gun ·gu) level in Korea. Data of COVID-19 incidence by districts were collected from the official website of each province. Data was also obtained from the Korean Statistical Information Service and the Community Health Survey; socio-demographic factor, transmission pathway, healthcare resource, and factor in response to COVID-19. Community risk factors that drive the incidence of COVID-19 were selected using a least absolute shrinkage and selection operator regression. Results: As of June 2021, the incidence of COVID-19 differed by more than 80 times between districts. Among the candidate factors, sex ratio, population aged 20–29, local financial independence, population density, diabetes prevalence, and failure to comply with the quarantine rules were significantly associated with COVID-19 incidence. Conclusion This study suggests setting COVID-19 quarantine policy and allocating resources, considering the community risk factors. Protecting vulnerable groups should be a high priority for these policies.

Background: In monitoring exposure to environmental smoke (ETS), biomarkers can overcome the subjectivity and inaccuracy of self-reporting measurements, and have the advantage of reflecting ETS exposure in all places. This study aims to evaluate the effectiveness of ETS exposure measurement using biomarkers such as urine cotinine. Methods: This study used the Korea National Health and Nutrition Survey data from 2009 to 2018. A total of 28,574 non-smokers with urine cotinine data were selected for the study. The cotinine concentration and ETS exposure rate using urine cotinine was estimated and then compared with the self-reporting measurements. The degree of agreement among measurements of ETS exposure was confirmed. Results: As a result of measuring ETS exposure with urine cotinine, 23,594 (83.8%) out of 28,574 subjects were classified as to exposure groups. This estimate differs significantly from measurements made by self-reporting. In addition, the average concentration of cotinine in non-smokers has decreased to a 10th level over the past 10 years. Based on the biomarker, the sensitivity of the self-reporting was 8.5%–29.0%, the specificity was 16.4%–19.5%, and the kappa value was 2.0%–5.8%. Conclusion The findings of our study show that self-reporting measurement does not well reflect the extent to which non-smoker’s exposure to smoking materials. Whereas cotinine concentration has decreased significantly over the past 10 years, the ETS exposure rate has not reduced. It strongly suggests the need for intervention in the group of non-smokers exposed to low concentrations of smoke. Therefore, an assessment using biomarkers such as cotinine-based measurement should be made in the Health Plan 2030.

Animal poisoning has been occurred in Korea. However, the lack of the data about animal poisoning in Korea makes clinicians and diagnostician difficult to obtain information on poisoning cases. In this paper, we tried to gather information about animal poisoning from 1974 to June 2013 in Korea. Animal and Plant Quarantine Agency (QIA) record database were used to examine recent trends in animal poisoning. The analysis showed that the cattle was reported to be the most common species involved in animal poisoning and botulinum toxin constituted the primary group of toxicants. Animal poisoning occurred frequently on January and in Gyenggi-do. Although the data present in this manuscript is a little, it will be helpful to understand the general trend of animal poisoning in Korea.
Animals* ; Botulinum Toxins ; Cattle ; Korea* ; Plants ; Poisoning* ; Quarantine

Purpose: Asthma is a chronic airway inflammatory disorder and is associated with macrophages. Statin, a well-known lipid-lowering agent, has recently been noted for its anti-inflammatory effect on macrophage. This study was designed to evaluate the antiasthmatic effect of atorvastatin via modulation of macrophage activation by using an animal model of allergic asthma. Methods: Atorvastatin 40 mg/kg was given by gavage once a day for 3 days before challenge of ovalbumin (OVA); airway hyperresponsiveness (AHR), airway inflammatory cells, and cytokines were evaluated in the murine asthma model. The direct effect of atorvastatin on the activation of macrophages In vitro was determined using the alveolar macrophage cell line CRL-2456. Results: Administration of atorvastatin reduced the numbers of total inflammatory cells, macrophages, and eosinophils as well as lung histology enhanced in the murine asthma model. AHR measured by enhanced pause was significantly reduced after atorvastatin administration in the murine asthma model (P< 0.05). Atorvastatin administration resulted in the reduction in serum OVA-specific IgE levels and the increase in serum OVA-specific IgG2a levels (P< 0.05). The mRNA levels of Ccr3, Il-17, and Muc5ac enhanced by OVA challenge were decreased by treatment with atorvastatin (P< 0.05). Along with these improvement in allergic inflammatory changes, the population of CD11c-CD206+ macrophages as well as the expression of Ym-1 and Relm-α in the lungs were reduced with atorvastatin (P< 0.05). In vitro test with CRL-2456 showed that atorvastatin reduced the expression of Cd206, Arg-1, and Fgf-2 induced by IL-4 stimulation (P< 0.05). Conclusion This study highlighted the antiasthmatic effect of atorvastatin on the suppression of M2 macrophage activation in allergic asthma.

Background: Common bile duct (CBD) stone is one of the most prevalent gastroenterological diseases, but the role played by biliary microbiota in the pathogenesis of CBD stones remains obscure. The aim of this study was to investigate the characteristics of the biliary tract core microbiome and its potential association with the formation of pigment stones. Methods: Twenty-eight patients with biliary obstruction of various causes were enrolled.Thirteen had new-onset pigment CBD stone. Of the remaining 15, four had benign biliary stricture, four had gallbladder cancer, three had pancreatic cancer, 3 had distal CBD cancer, and one had hepatocellular carcinoma. Endoscopic retrograde cholangiopancreatography was used to collect bile samples for DNA extraction, 16S ribosomal RNA gene sequencing, and bile microbiota composition analysis. Results: Proteobacteria (61.7%), Firmicutes (25.1%), Bacteroidetes (5%), Fusobacteria (4.6%), and Actinobacteria (2.6%) were the most dominant phyla in the bile of the 28 study subjects. A comparison between new-onset choledocholithiasis and other causes of biliary obstruction (controls) showed Enterococcus was found to be significantly abundant in the CBD stone group at the genus level (linear discriminant analysis score = 4.38; P = 0.03). However, no other significant compositional difference was observed. Conclusion This study demonstrates an abundance of microbiota in bile juice and presents a biliary microbiome composition similar to that of duodenum. The study also shows Enterococcus was significantly abundant in the bile juice of patients with a brown pigment stone than in controls, which suggests Enterococcus may play an important role in the development of pigment stones.

Background: Common bile duct (CBD) stone is one of the most prevalent gastroenterological diseases, but the role played by biliary microbiota in the pathogenesis of CBD stones remains obscure. The aim of this study was to investigate the characteristics of the biliary tract core microbiome and its potential association with the formation of pigment stones. Methods: Twenty-eight patients with biliary obstruction of various causes were enrolled.Thirteen had new-onset pigment CBD stone. Of the remaining 15, four had benign biliary stricture, four had gallbladder cancer, three had pancreatic cancer, 3 had distal CBD cancer, and one had hepatocellular carcinoma. Endoscopic retrograde cholangiopancreatography was used to collect bile samples for DNA extraction, 16S ribosomal RNA gene sequencing, and bile microbiota composition analysis. Results: Proteobacteria (61.7%), Firmicutes (25.1%), Bacteroidetes (5%), Fusobacteria (4.6%), and Actinobacteria (2.6%) were the most dominant phyla in the bile of the 28 study subjects. A comparison between new-onset choledocholithiasis and other causes of biliary obstruction (controls) showed Enterococcus was found to be significantly abundant in the CBD stone group at the genus level (linear discriminant analysis score = 4.38; P = 0.03). However, no other significant compositional difference was observed. Conclusion This study demonstrates an abundance of microbiota in bile juice and presents a biliary microbiome composition similar to that of duodenum. The study also shows Enterococcus was significantly abundant in the bile juice of patients with a brown pigment stone than in controls, which suggests Enterococcus may play an important role in the development of pigment stones.

OBJECTIVE: We investigated low dose digital tomosynthesis (DT) for the evaluation of the paranasal sinus (PNS), and compared its diagnostic accuracy with a PNS radiography series (XR). MATERIALS AND METHODS: We enrolled 43 patients for whom XR, PNS DT, and OMU CT were performed. We measured effective doses (EDs) of XR, DT, and OMU CT using Monte Carlo simulation software. Two radiologists performed independent observation of both XR and DT. For seven PNSs, they scored anatomic conspicuity of sinuses and confidence on the presence of sinusitis using nine point scales. OMU CT was observed by the third radiologist and the findings were regarded as reference standard. We compared scores for conspicuity and sinusitis confidence between XR and DT. RESULTS: Mean EDs were 29 +/- 6 microSv, 48 +/- 10 microSv, and 980 +/- 250 microSv, respectively, for XR, DT, and CT. Mean scores for conspicuity were 6.3 and 7.4, respectively, for XR and DT. Sensitivity per patient basis for sinusitis detection were 52% and 96%, respectively, for XR and DT in observer 1 (p = 0.001) and 80% and 92% for observer 2 (p = 0.25). Specificities for sinusitis exclusion were 100% for both XR and DT for observer 1 and 89% and 100% for observer 2 (p = 0.50). Accuracies for sinusitis diagnosis were 72% and 98%, respectively, for XR and DT for observer 1 (p = 0.001) and 84% and 95% for observer 2 (p = 0.125). CONCLUSION: Patient radiation dose from low dose DT is comparable with that of PNS XR. Diagnostic sensitivity of DT for sinusitis was superior to PNS XR.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Monte Carlo Method ; Paranasal Sinuses/*radiography ; ROC Curve ; Radiation Dosage ; Radiographic Image Enhancement/*methods ; Sensitivity and Specificity ; Sinusitis/*radiography ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods

Purpose: Asthma is a common chronic lung disease, in which interleukin (IL)-13 is implicated as a central regulator of IgE synthesis, mucus hypersecretion, airway hyperresponsiveness (AHR), and fibrosis. This study was designed to determine the anti-inflammatory effect of atorvastatin, a widely used lipid-lowering agent, on the IL-13-induced lung pathology through the modulation of macrophages. Methods: Atorvastatin (40 mg/kg) was given to transgenic mice overexpressing IL-13 (IL-13 TG mice) and their wild type littermates by oral gavage for 2 weeks. AHR, numbers of inflammatory cells in the airway, and cytokine levels in IL-13 TG mice were measured.Using the alveolar macrophage cell line CRL-2456, the direct effect of atorvastatin on macrophages activated by recombinant IL-13 was assessed. Results: Significant reduction in total leukocytes and alleviation of AHR were observed with administration of atorvastatin in IL-13 TG mice compared to those without atorvastatin treatment (P< 0.05). Atorvastatin administration resulted in upregulation of IL-10 in the lungs of IL-13 TG mice (P< 0.05). In addition, mRNA expression of connective tissue growth factor, fibronectin, and type III collagen as well as chord length enhanced by IL-13 overexpression were reduced by atorvastatin administration (P< 0.05). M2 macrophage markers, such as Ym-1 and CD206, were decreased, while M1 macrophage marker, inducible nitric oxide synthase, was increased upon atorvastatin treatment (P< 0.05). Administration of atorvastatin resulted in improved removal of apoptotic cells (P< 0.05). Conclusion The results of this study reveal a potential of atorvastatin as an effective antiasthmatic agent by reducing IL-13-induced lung inflammation via the modulation of macrophage polarization.

Purpose: To evaluate the applicability of Greulich-Pyle (GP) standards to bone age (BA) assessment in healthy Korean children using manual and deep learning-based methods. Materials and Methods: We collected 485 hand radiographs of healthy children aged 2–17 years (262 boys) between 2008 and 2017. Based on GP method, BA was assessed manually by two radiologists and automatically by two deep learning-based BA assessment (DLBAA), which estimated GP-assigned (original model) and optimal (modified model) BAs. Estimated BA was compared to chronological age (CA) using intraclass correlation (ICC), Bland-Altman analysis, linear regression, mean absolute error, and root mean square error. The proportion of children showing a difference >12 months between the estimated BA and CA was calculated. Results: CA and all estimated BA showed excellent agreement (ICC ≥0.978, p<0.001) and significant positive linear correlations (R2 ≥0.935, p<0.001). The estimated BA of all methods showed systematic bias and tended to be lower than CA in younger patients, and higher than CA in older patients (regression slopes ≤-0.11, p<0.001). The mean absolute error of radiologist 1, radiologist 2, original, and modified DLBAA models were 13.09, 13.12, 11.52, and 11.31 months, respectively. The difference between estimated BA and CA was >12 months in 44.3%, 44.5%, 39.2%, and 36.1% for radiologist 1, radiologist 2, original, and modified DLBAA models, respectively. Conclusion Contemporary healthy Korean children showed different rates of skeletal development than GP standard-BA, and systemic bias should be considered when determining children’s skeletal maturation.

PURPOSE: The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010. RESULTS: We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081). CONCLUSION: PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Radiotherapy* ; Recurrence ; Retrospective Studies*