Background: The current conventional drug susceptibility test (DST) for Mycobacterium tuberculosis (Mtb) takes several weeks of incubation to obtain results. As a rapid method, molecular DST requires only a few days to get the results but does not fully cover the phenotypic resistance. A new rapid method based on the ability of viable Mtb bacilli to hydrolyze fluorescein diacetate to free fluorescein with detection of fluorescent mycobacteria by flow cytometric analysis, was recently developed. Methods: To evaluate this cytometric method, we tested 39 clinical isolates which were susceptible or resistant to isoniazid (INH) or rifampin (RIF), or ethambutol (EMB) by phenotypic or molecular DST methods and compared the results. Results: The susceptibility was determined by measuring the viability rate of Mtb and all the isolates which were tested with INH, RIF, and EMB showed susceptibility results concordant with those by the phenotypic solid and liquid media methods. The isolates having no mutations in the molecular DST but resistance in the conventional phenotypic DST were also resistant in this cytometric method. These results suggest that the flow cytometric DST method is faster than conventional agar phenotypic DST and may complement the results of molecular DST. Conclusion In conclusion, the cytometric method could provide quick and more accurate information that would help clinicians to choose more effective drugs.

BACKGROUND: This study evaluated the association between nicotine dependence and depressive mood in patients who visited a secondary hospital for smoking cessation treatment.METHODS: From March 2016 to February 2017, a total of 48 patients who visited the smoking cessation clinic of a secondary hospital in Seoul were surveyed through questionnaires. Nicotine dependence was assessed by the Fagerström Test for Nicotine Dependence. The Beck Depression Inventory (BDI) was used to assess depressive mood.RESULTS: The mean BDI score was positively associated with nicotine dependence (P=0.01). In multivariable logistic regression analysis, increasing BDI was associated with higher odds (1.21, 95% confidence interval; 1.02–1.44) of high nicotine dependence after adjusting for all confounding variables.CONCLUSION: Depressive mood was positively associated with nicotine dependence among patients who visited a smoking cessation clinic. Consideration of depressive mood in smoking cessation treatment may be helpful for smoking cessation among patients with a willingness to quit smoking.
Confounding Factors (Epidemiology) ; Depression ; Humans ; Logistic Models ; Nicotine ; Seoul ; Smoke ; Smoking Cessation ; Smoking ; Tobacco Use Disorder

Background: The clinical significance of low-level donor-specific anti-HLA antibody (low-DSA) remains controversial. We investigated the impact of low-DSA on posttransplant clinical outcomes in kidney transplant (KT) recipients. Methods: We retrospectively reviewed 1,027 KT recipients, namely, 629 living donor KT (LDKT) recipients and 398 deceased donor KT (DDKT) recipients, in Seoul St. Mary’s Hospital (Seoul, Korea) between 2010 and 2018. Low-DSA was defined as a positive anti-HLA-DSA result in the Luminex single antigen assay (LABScreen single antigen HLA class I - combi and class II - group 1 kits; One Lambda, Canoga Park, CA, USA) but a negative result in a crossmatch test. We compared the incidence of biopsy-proven allograft rejection (BPAR), changes in allograft function, allograft survival, patient survival, and posttransplant infections between subgroups according to pretransplant low-DSA. Results: The incidence of overall BPAR and T cell-mediated rejection did not differ between the subgroups. However, antibody-mediated rejection (ABMR) developed more frequently in patients with low-DSA than in those without low-DSA in the total cohort and the LDKT and DDKT subgroups. In multivariate analysis, low-DSA was identified as a risk factor for ABMR development. Its impact was more pronounced in DDKT (odds ratio [OR]: 9.60, 95% confidence interval [CI]: 1.79–51.56) than in LDKT (OR: 3.76, 95% CI: 0.99–14.26) recipients. There were no significant differences in other outcomes according to pretransplant low-DSA. Conclusions Pretransplant low-DSA has a significant impact on the development of ABMR, and more so in DDKT recipients than in LDKT recipients, but not on long-term outcomes.

In September 1994, residents of Gozan-dong, Incheon City, made a petition to the government about their health problems which might be caused by previous glass fibre landfill nearby "H" company. In February 1995, at regular academic meeting of occupational and environmental medicine, a research team of "D" University presented that they had found glass fibres in groundwater of the area through their survey. They were suspicious of probable association between ingestion of groundwater contaminated with glass fibres and skin tumors among residents. A joint research team was formed and carried out the survey of environment concerning groundwater and its glass fibre existence, and health assessment of residents in the area and industrial workers of "H" company during May to November, 1995. Analysis of groundwater flow system indicates that the flow lines from the glass fibre landfill pass through or terminate at the 6 houses around the landfill. This means that the groundwater of the 6 houses around the glass fibre landfill could be affected by some possible contaminants from the landfill, but the groundwater quality of the other houses was irrelevant to the landfill. The qualitative and quatitative analyses for glass fibres in 54 groundwater samples including those from the nearby 6 houses, were carried out using SEM equipped with EDS, resulting in no evidence for the presence of glass fibres in the waters. Major precipitates, formed in waters while boiling, were identified as calcium carbonates, in particulary, aragonites in needle form. The results of health assessments of 889 residents in Gozan-dong, participated in this study, showed statistically significant differences in past medical histories of skin tumor and respiratory disease between the exposed group (31 persons who inhabited in 6 houses around the landfill) and the control group, but no significant differences in past medical histories of other diseases, such as cancer mortality, current gastroscopic findings, current skin diseases and respiratory diseases, etc. Also, we could not prove any glass fibres in excised specimens of 9 skin tumors in both groups and there were no health problems possibly associated with glass fibres in employees of the "H" company. After all, we could not authenticate the association, raised by prior investigators, between groundwater streams, assumedly contaminated with glass fibres or not, and specific disease morbidities or common disease/symptom prevalences. That is, we could not find any glass fibres in groundwater as the only exposure factor of this study hypothesis, and there were not enough certain evidences such as increasing disease prevalences, for examples, skin, respiratory and gastrointestinal diseases etc, possibly related to glass fibre exposure, in exposed group. As a matter of course, the conditions for confirming causal association, for example, strength of the association, consistency of the association, specificity of the association, temporality of the association and dose-response relationship etc, have not been satisfied. In conclusion, we were not able to certify the hypothesis that contamination of groundwater with glass fibres might cause any hazardous health effects in human who used it for drinking.
Calcium ; Carbon ; Carbonates ; Drinking ; Eating ; Environmental Medicine ; Gastrointestinal Diseases ; Glass* ; Groundwater ; Humans ; Incheon* ; Joints ; Mortality ; Needles ; Prevalence ; Research Personnel ; Rivers ; Sensitivity and Specificity ; Skin ; Skin Diseases ; Waste Disposal Facilities* ; Water

Whether advanced age is associated with poor outcomes of elderly patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is controversial. This study aimed to evaluate age effect and predictors for mortality in elderly AKI patients undergoing CRRT. Methods: Data of 480 elderly AKI patients who underwent CRRT were retrospectively analyzed. Subjects were stratified into two groups according to age: younger-old (age, 65–74 years; n = 205) and older-old (age, ≥75 years; n = 275). Predictors for 28-day and 90-day mortality and age effects were analyzed using multivariable Cox regression analysis and propensity score matching. Results: Urine output at the start of CRRT (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.99–1.00; p = 0.04), operation (aHR, 0.53; 95% CI, 0.30–0.93; p = 0.03), and use of an intra-aortic balloon pump (aHR, 3.60; 95% CI, 1.18–10.96; p = 0.02) were predictors for 28-day mortality. Ischemic heart disease (aHR, 1.74; 95% CI, 1.02–2.98; p = 0.04) and use of a ventilator (aHR, 0.56; 95% CI, 0.36–0.89; p = 0.01) were predictors for 90-day mortality. The older-old group did not exhibit a higher risk for 28- day or 90-day mortality than the younger-old group in multivariable or propensity score-matched models. Conclusion: Advanced age was not a risk factor for mortality among elderly AKI patients undergoing CRRT, suggesting that advanced age should not be considered for therapeutic decisions in critically ill elderly patients with AKI requiring CRRT.

BACKGROUND: Eating breakfast is important for optimal growth and development in adolescence, and is associated with academic achievement as well as nutrition and health status. This study aimed to investigate the relationship between breakfast consumption frequency and high school students' academic achievement.METHODS: We used data from the 2017 Korea Youth's Risk Behavior Web-Based Study, conducted by the Korean Center for Disease Control (64,991 students). The relationship between academic achievement and breakfast consumption frequency was examined using logistic regression.RESULTS: Students who consumed breakfast frequently exhibited higher academic achievement as compared to their counterparts. There was a significant correlation between awareness of appropriate eating habits and breakfast consumption frequency. Further, students who had not received any education about eating habits exhibited low academic achievement.CONCLUSION: To improve the academic achievement of students, they should be motivated to eat breakfast every day. Additionally, appropriate education about eating habits need to be implemented at schools and at home to increase students' breakfast consumption frequency.
Adolescent ; Breakfast ; Centers for Disease Control and Prevention (U.S.) ; Eating ; Education ; Feeding Behavior ; Growth and Development ; Humans ; Korea ; Logistic Models ; Risk-Taking

Background: Controlled-release oxycodone/naloxone (OXN-CR) maintains the effect of opioid-induced analge-sia through oxycodone while reducing the occurrence rate of opioid-induced constipation through naloxone. The present study was designed to assess the non-inferiority of OXN-CR to controlled-release oxycodone (OX-CR) for the control of cancer-related pain in Korean patients. Methods: In this randomized, open-labeled, parallel-group, phase IV study, we enrolled patients aged 20 years or older with moderate to severe cancer-related pain [numeric rating scale (NRS) pain score≥4] from seven Korean oncology/hematology centers. Patients in the intention-to-treat (ITT) population were randomized (1:1) to OXN-CR or OX-CR groups. OXN-CR was administered starting at 20 mg/10 mg per day and up-titrated to a maximum of 80 mg/40 mg per day for 4 weeks, and OX-CR was administered starting at 20 mg/day and up-titrated to a maximum of 80 mg/day for 4 weeks. The primary efficacy endpoint was the change in NRS pain score from baseline to week 4, with non-inferiority margin of?1.5. Secondary endpoints included analgesic rescue medication intake, patient-reported change in bowel habits, laxative intake, quality of life (QoL), and safety assessments. Results: Of the ITT population comprising 128 patients, 7 with missing primary efficacy data and 4 who violated the eligibility criteria were excluded from the efficacy analysis. At week 4, the mean change in NRS pain scores was not significantly different between the OXN-CR group (n= 58) and the OX-CR group (n= 59) (?1.586 vs.?1.559, P= 0.948). The lower limit of the one-sided 95％ confidence interval (?0.776 to 0.830) for the difference exceeded the non-inferiority margin (P < 0.001). The OXN-CR and OX-CR groups did not differ significantly in terms of analgesic rescue medication intake, change in bowel habits, laxative intake, QoL, and safety assessments. Conclusions: OXN-CR was non-inferior to OX-CR in terms of pain reduction after 4 weeks of treatment and had a similar safety profile. Studies in larger populations of Korean patients with cancer-related pain are needed to further investigate the effectiveness of OXN-CR for long-term pain control and constipation alleviation.