OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Background/Aims: Although statins are widely used to reduce the risk of cardiovascular disease (CVD) including stroke and myocardial infarction (MI), it is reported that statin use increases the incidence of herpes zoster (HZ) that is associated with increased risk of CVD. So, we evaluated the mediation effect of HZ caused by statin use on CVD. Methods: We analyzed a prospective cohort from the National Health Insurance Service-database of South Korea. All individuals received a medical check-up and were followed-up from 2002 to 2013. Results: A total of 275,382 individuals > 40 years old were followed up for 11 years from 2003. Of these, 11,415 people (4%) were classified as statin users and 263,967 (96%) as non-statin users. Those who used statins had significantly lower risks of cardiovascular events, stroke, and MI compared with non-statin users; the adjusted hazard ratios in the multivariate analysis were 0.90 (95% confidence interval [CI], 0.82 to 0.98), 0.88 (95% CI, 0.80 to 0.98), and 0.91 (95% CI, 0.79 to 1.07), respectively. When we calculated the mediating effect of cardiovascular events by statin use through HZ, 11.6% of the total beneficial effect of cardiovascular events by statin use was mitigated through the occurrence of HZ caused by statin use. This mediating effect was higher in the younger age group (< 60 years). Conclusions This study showed that statin use reduced CVD by 10%, but the protective effect of statin use against CVD was mitigated by approximately 10% through the development of HZ caused by statin use.

Purpose: This preliminary in-vitro study was designed to evaluate the risk factors of compression injury from use of a circular stapler for end-to-end anastomosis. Methods: Transparent collagen plates were prepared in dry and wet conditions. Physical properties of collagen plates and porcine colon tissue were examined using a rheometer. Adjustable and fixed-type circular staplers were applied on the collagen plates and the gap distance and compressive pressure were measured during anvil approximation. Tissue injury was evaluated using a compression injury scale. Compression properties were accessed to optimal or overcompression based on gap distance. Results: Unacceptable injuries were rarely observed on the dry collagens, regardless of compression device. In the adjustable compression, the compressibility ratio was similar between dry and wet collagen. Overcompression and unacceptable injury increased on the wet collagens. In the fixed compression, the compressibility ratio increased significantly and unacceptable injuries were observed in more than 50% of wet collagens. Peak pressure was significantly higher in the fixed-compression types than those of adjustable type. On bivariate correlation analysis, fixed-compression type and wet collagens were respectively associated with overcompression. On multivariate analysis, edematous collagen condition was the most important risk factor and proximal anvil side, fixed compression type, and overcompression were also independent risk factors for unacceptable compression injury. Conclusion In the edematous tissue condition, unintentional overcompression could be increased and result in tissue injury on the compression line of the circular stapler.

One of the primary goals of epidemiology is to quantify various aspects of a population’s health, illness, and death status and the determinants (or risk factors) thereof by calculating health indicators that measure the magnitudes of various conditions. There has been some confusion regarding health indicators, with discrepancies in usage among organizations such as the World Health Organization the, Centers for Disease Control and Prevention (CDC), and the CDC of other countries, and the usage of the relevant terminology may vary across papers. Therefore, in this review, we would like to propose appropriate terminological definitions for health indicators based on the most commonly used meanings and/or the terms used by official agencies, in order to bring clarity to this area of confusion. We have used appropriate examples to make each health indicator easy for the reader to understand. We have included practical exercises for some health indicators to help readers understand the underlying concepts.
Centers for Disease Control and Prevention (U.S.) ; Epidemiology ; Exercise ; Reproduction ; World Health Organization

One of the primary goals of epidemiology is to quantify various aspects of a population’s health, illness, and death status and the determinants (or risk factors) thereof by calculating health indicators that measure the magnitudes of various conditions. There has been some confusion regarding health indicators, with discrepancies in usage among organizations such as the World Health Organization the, Centers for Disease Control and Prevention (CDC), and the CDC of other countries, and the usage of the relevant terminology may vary across papers. Therefore, in this review, we would like to propose appropriate terminological definitions for health indicators based on the most commonly used meanings and/or the terms used by official agencies, in order to bring clarity to this area of confusion. We have used appropriate examples to make each health indicator easy for the reader to understand. We have included practical exercises for some health indicators to help readers understand the underlying concepts.

OBJECTIVES: The aim of this study was to compare the tooth brushing methods recommended by dental associations and toothbrush manufacturers in various countries including South Korea. METHODS: Eighteen countries-6 Asian, 2 North American, 2 Oceanian, and 8 European-were selected from members of the OECD, EU, and APEC, using information obtained from the primary email address of each dental association and information obtained from the websites of the associations regarding the officially recommended tooth brushing methods. In addition, 12 major toothbrush manufacturers were selected based on their market share, including 4 Asian manufacturers, 2 North American, and 2 European. Information about recommended tooth brushing methods was obtained from their websites. RESULTS: The countries recommending a particular tooth brushing method by name were South Korea, Hong Kong, and Taiwan. While South Korea recommended the "rolling" technique, Hong Kong and Taiwan recommended the "bass" technique. Except for these countries, the other countries presented their recommended methods by explaining the initial position or motion of the toothbrush. The most commonly recommended method was tilting the brush head at an angle of 45 degrees to the gingival margin; this was recommended by 8 countries (44%) and 6 toothbrush manufacturers (75%). Brushing with a vibrating motion was also recommended by 9 countries (50%) and 4 manufacturers (50%). CONCLUSIONS: The most recommended brushing method was initially positioning the toothbrush at an angle of 45 degrees to the gingival margin and using a vibrating motion, which is effective against periodontal diseases. However, South Korea recommended the rolling technique, which is effective for controlling dental plaque. Given the high frequency with which periodontal disease occurs in South Korea, vibrating the toothbrush on the gingival margin should be recommended in addition to the rolling technique.
Asian Continental Ancestry Group ; Dental Plaque ; Electronic Mail ; Head ; Hong Kong ; Humans ; Korea ; Methods* ; Oral Hygiene ; Periodontal Diseases ; Taiwan ; Tooth*

PURPOSE: The present pilot study was conducted to detect putative cancer stem cell (CSC) from the hepatic portal system and peripheral blood in the colorectal cancer patients and to compare them to healthy donor and diverticulitis patients. METHODS: Laboratory study was performed to identify the expression of cell surface markers, epithelial cell adhesion molecule (EpCAM), cytokeratin (CK) 18, CK20, CD44, and CD133, on several colon cancer cell lines. Clinical pilot study was conducted to detect putative circulating CSC as EpCAM+CD133+ cell in colorectal cancer (n = 10), diverticulitis (n = 5), and four healthy donors, by using flow cytometry. Blood was drawn from the hepatic portal system and peripheral vein. RESULTS: On laboratory study, EpCAM was expressed in whole colon cancer cell lines, and CD44 and CD133 were simultaneously expressed in 50% of the cell lines with stemness phenotype, but CK18 and CK20 were not expressed in most of the cell lines. On clinical study, the mean EpCAM+CD133+ cell counts of 11.6/105 in the hepatic portal system were somewhat lower than 15.4/105 in peripheral vein (P = 0.241). As for diverticulitis patients, EpCAM+CD133+ cells were also detected to have steeper dropped to near zero, after the surgery. CONCLUSION: The numbers of putative CSC were not statistically different between the detection sites of the portal vein and peripheral vein in the colon cancer patients. Therefore, we may not have benefitted by getting the cells from the hepatic portal system. In addition, the CD133+EpCAM+ cells in the colon cancer patients might contain normal stem cells from cancer inflammation similar to diverticulitis.
Cell Count ; Cell Line ; Colonic Neoplasms ; Colorectal Neoplasms* ; Diverticulitis ; Epithelial Cells ; Flow Cytometry ; Humans ; Inflammation ; Keratins ; Neoplastic Stem Cells* ; Phenotype ; Pilot Projects ; Portal System* ; Portal Vein ; Stem Cells ; Tissue Donors ; Veins

BACKGROUND/AIMS: This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. METHODS: We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. RESULTS: In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. CONCLUSIONS: A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori.
2-Pyridinylmethylsulfinylbenzimidazoles ; Amoxicillin ; Bismuth ; Clarithromycin ; Helicobacter ; Helicobacter pylori ; Humans ; Metronidazole ; Ofloxacin ; Rifamycins ; Tetracycline

BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) occasionally fails due to surgically altered anatomy, difficult cannulation, or poor general condition. This study evaluated the safety and effectiveness of percutaneous transhepatic papillary balloon dilatation (PTPBD) for managing extrahepatic bile duct stones. METHODS: Between 2001 and 2010, 17 out of 509 patients with extrahepatic bile duct stones and acute cholangitis were enrolled retrospectively. After PTPBD of the sphincter, the stones were extracted using an occlusion balloon to push the stone over a guidewire into the duodenum. The procedure success was evaluated based on residual stones. In addition, the size and number of stones and complications were analyzed. RESULTS: Of the 17 patients, nine had a previous gastrectomy, four had poor general condition, and four had unsuccessful cannulation. The stone diameter ranged from 8 to 25 mm. Seven, five, and five patients had one, two, or three or more stones, respectively. The results were successful in 16 out of 17 patients, with no residual stones. Treatment failed in one patient, who was then treated with the rendezvous technique with endoscopy. No procedure-related major complication occurred. Three patients had mild transient elevations of the serum amylase levels. CONCLUSIONS: PTPBD was safe and effective for managing extrahepatic bile duct stones in patients with unsuccessful or contraindicated ERCP.
Amylases ; Bile Ducts, Extrahepatic ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledocholithiasis ; Dilatation ; Duodenum ; Endoscopy ; Gastrectomy ; Humans ; Retrospective Studies

BACKGROUND: Necrotizing fasciitis (NF) is an infrequent but potentially lethal infection characterized by rapid progressive destruction of fascia and fat, concomitant systemic toxicity, and high fatality. In spite of the clinical significance of NF, only limited data is available regarding the clinical characteristics of patients with NF in Korea. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who had been diagnosed as community-acquired NF in 9 centers of the Republic of Korea between January 2000 and November 2010. RESULTS: During the study period, a total of 103 patients had a community-acquired NF. Of sixty six cases with causative microorganisms identified, the majority (55, 83.3%) had monomicrobial infections. Whereas streptococci were the most common cause of NF in patients without underlying diseases (16/24, 66.7%), variable organisms, such as staphylococci, streptococci, Enterobacteriaceae, and non-fermentative Gram-negative bacilli were causative organisms of NF in patients with underlying diseases. The majority of patients with NF caused by Vibrio vulnificus or Aeromonas hydrophila (7/9, 77.8%) had liver cirrhosis or alcoholism. Surgery to counteract NF was performed in 60.2% of patients with NF (62/102), and mean time to surgery was 3 days. In-hospital mortality was observed in 21 of 99 patients with available data (21.2%). In multivariate analysis, the presence of solid tumors (adjusted OR [aOR]=63.88, 95% CI=2.58-1580.61, P=0.011), shock (aOR= 24.19, 95% CI=2.00-292.19, P=0.012), bacteremia (aOR=87.53, 95% CI=3.99-1921.46, P=0.005), and Gram-negative bacilli infections (aOR=437.11, 95% CI=4.67-40956.82, P=0.009) were associated with in-hospital mortality. CONCLUSIONS: Streptococci were predominant causative organisms of community-acquired NF in patients without underlying diseases. However, in patients with underlying diseases, variable organisms such as staphylococci, streptococci, Enterobacteriaceae, or non-fermentative Gram-negative bacilli were isolated. NF caused by V. vulnificus or A. hydrophila occurred frequently in patients with liver cirrhosis or alcoholism.
Aeromonas hydrophila ; Alcoholism ; Bacteremia ; Enterobacteriaceae ; Fascia ; Fasciitis, Necrotizing ; Hospital Mortality ; Humans ; Liver Cirrhosis ; Medical Records ; Multivariate Analysis ; Republic of Korea ; Retrospective Studies ; Shock ; Vibrio vulnificus