Ethnicity might be associated with treatment outcomes in advanced prostate cancer. This study aimed to evaluate the efficacy and safety of androgen deprivation therapy (ADT) combined with apalutamide in East Asians with metastatic castration-sensitive prostate cancer (mCSPC). The original phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial was conducted at 260 sites in 23 countries. This subgroup analysis included patients enrolled in 62 participating centers in China, Japan, and Korea. Radiographic progression-free survival (PFS), time to prostate-specific antigen (PSA) progression, and PSA changes from baseline were compared between groups in the East Asian population. The intent-to-treat East Asian population included 111 and 110 participants in the apalutamide and placebo groups, respectively. The 24-month radiographic PFS rates were 76.1% and 52.3% in the apalutamide and placebo groups, respectively (apalutamide vs placebo: hazard ratio [HR] = 0.506; 95% confidence interval [CI], 0.302-0.849; P = 0.009). Median time to PSA progression was more favorable with apalutamide than placebo (HR = 0.210; 95% CI, 0.124-0.357; P < 0.001). Median maximum percentages of PSA decline from baseline were 99.0% and 73.9% in the apalutamide and placebo groups, respectively. The most common adverse event (AE) was rash in the apalutamide group, with a higher rate than that in the placebo group (37.3% vs 9.1%). The most common grade 3 or 4 AEs were rash (12 [10.9%]) and hypertension (12 [10.9%]) for apalutamide. The efficacy and safety of apalutamide in the East Asian subgroup of the TITAN trial are consistent with the global results.
Androgen Antagonists/adverse effects* ; Exanthema/chemically induced* ; Far East ; Humans ; Male ; Prostate-Specific Antigen ; Prostatic Neoplasms, Castration-Resistant/pathology* ; Thiohydantoins/adverse effects*

East Asia including the Republic of Korea (ROK). Although gastrointestinal colonization of K. pneumoniae may cross the intestinal barrier to invade the liver, characteristics of gastrointestinal carriage K. pneumoniae of hvKP liver abscess patients in the ROK are not well known.METHODS: Characteristics of K. pneumoniae isolated from stool samples and liver aspirate samples of patients with hvKP liver abscess at a tertiary care hospital in the ROK between 2017 and 2018 were evaluated.RESULTS: Out of 37 patients with hvKP liver abscess, 11 patients were noted to have K. pneumoniae isolated from stool samples and were enrolled for analysis. The median age was 71 years. For hvKP isolates from the liver aspirate samples, the most common serotype was K1 (72.7%) followed by K2 (27.3%). For K. pneumoniae isolates from the stool sample, the majority was non-K1/K2 serotype (72.7%). Among non-K1/K2 serotype isolates, high variability of sequence type (ST; ST15, ST307, ST37, ST273, ST2622, and ST42) with high rate of presence of extended-spectrum beta-lactamase (100.0%) was noted. The concordance rate of the K. pneumoniae isolates between the liver aspirate samples and the stool samples from the primary hvKP liver abscess was low (27.3%).CONCLUSION: This study suggests that significant heterogeneity of K. pneumoniae colonizing intestinal tract of the hvKP liver abscess patients. Further studies involving a larger number of hvKP liver abscess patients with continuing surveillance are needed to define the changing epidemiology and the role of gastrointestinal K. pneumoniae in the hvKP liver abscess patients in the ROK.]]>
beta-Lactamases ; Colon ; Epidemiology ; Far East ; Humans ; Klebsiella pneumoniae ; Klebsiella ; Liver Abscess ; Liver ; Pneumonia ; Population Characteristics ; Republic of Korea ; Serogroup ; Tertiary Healthcare

The Emergency Medicine Recipes in Local Medicinals (鄕藥救急方, Hyang'yak Kugŭpbang) (c. 14th century) is known to be one of the oldest Korean medical textbooks that exists in its entirety. This study challenges conventional perceptions that have interpreted this text by using modern concepts, and it seeks to position the medical activities of the late Koryŏ Dynasty 高麗 (918–1392) to the early Chosŏn Dynasty 朝鮮 (1392–1910) in medical history with a focus on this text. According to existing studies, Emergency Medicine Recipes in Local Medicinals is a strategic compromise of the Korean elite in response to the influx of Chinese medical texts and thus a medical text from a “periphery” of the Sinitic world. Other studies have evaluated this text as a medieval publication demonstrating stages of transition to systematic and rational medicine and, as such, a formulary book 方書 that includes primitive elements. By examining past medicine practices through “modern” concepts based on a dichotomous framework of analysis — i.e., modernity vs. tradition, center vs. periphery, science vs. culture — such conventional perceptions have relegated Emergency Medicine Recipes in Local Medicinals to the position of a transitional medieval publication meaningful only for research on hyangchal 鄕札 (Chinese character-based writing system used to record Korean during the Silla Dynasty 新羅 [57 BC–935 AD] to the Koryŏ Dynasty). It is necessary to overcome this dichotomous framework in order to understand the characteristics of East Asian medicine. As such, this study first defines “medicine 醫”, an object of research on medical history, as a “special form of problem-solving activities” and seeks to highlight the problematics and independent medical activities of the relevant actors. Through this strategy (i.e., texts as solutions to problems), this study analyzes Emergency Medicine Recipes in Local Medicinals to determine its characteristics and significance. Ultimately, this study argues that Emergency Medicine Recipes in Local Medicinals was a problem-solving method for the scholar-gentry 士人層 from the late Koryŏ Dynasty to the early Chosŏn Dynasty, who had adopted a new cultural identity, to perform certain roles on the level of medical governance and constitute medical praxis that reflected views of both the body and materials and an orientation distinguished from those of the so-called medicine of Confucian physicians 儒醫, which was the mainstream medicine of the center. Intertwined at the cultural basis of the treatments and medical recipes included in Emergency Medicine Recipes in Local Medicinals were aspects such as correlative thinking, ecological circulation of life force, transformation of materiality through contact, appropriation of analogies, and reasoning of sympathy. Because “local medicinals 鄕藥” is understood in Emergency Medicine Recipes in Local Medicinals as referring to objects easily available from one's surroundings, it signifies locality referring to the ease of acquisition in local areas rather than to the identity of the state of Koryŏ or Chosŏn. As for characteristics revealed by this text's methods of implementing medicine, Korean medicine in terms of this text consisted largely of single-ingredient formulas using diverse medicinal ingredients easily obtainable from one's surroundings rather than making use of general drugs as represented by materia medica 本草 or of multiple-ingredient formulas. In addition, accessible tools, full awareness of the procedures and processes of the guidelines, procedural rituals, and acts of emergency treatment (first aid) were more important than the study of the medical classics, moral cultivation, and coherent explanations emphasized in categorical medical texts. Though Emergency Medicine Recipes in Local Medicinals can be seen as an origin of the tradition of emergency medicine in Korea, it differs from medical texts that followed which specializing in emergency medicine to the extent that it places toxicosis 中毒 before the six climatic factors 六氣 in its classification of diseases.
Asian Continental Ancestry Group ; Ceremonial Behavior ; Classification ; Emergencies ; Emergency Medicine ; Emergency Treatment ; Far East ; Humans ; Korea ; Materia Medica ; Medicine, East Asian Traditional ; Methods ; Publications ; Thinking ; Writing

How do classical texts, such as Hwangdi Neijing and Shanghanlun, continuously play significant roles in medical practices in the history of East Asian medicine? Although this is a significant question in interpreting the position of written texts in the medical history and even for understanding the structure of East Asian medical knowledge, it has been conspicuously underexamined in the studies of East Asian medicine. In order to explore this underrepresented question, this study focuses on currents of tradition in contemporary South Korea. Drawing on anthropological fieldwork at three Donguibogam (Treasured Mirror of Eastern Medicine) currents, it delves into the interaction of text and practice in East Asian medicine. Even though all three currents (Hyun-dong, Byeong-in, Hyung-sang) are based on Donguibogam, their ways of reading the text and organizing clinical practices are diverse. Each current sets up a keyword, such as pulse diagnosis, cause of disease, and appearance-image, and attempts to penetrate the entire Donguibogam through the keyword. This means that the classical medical text is open to plural approaches. This study found that there is a visible gap between a medical text and the reader of the text in East Asia. Masters and currents of tradition are the actors who fill up the gap, continuously interpreting and reinterpreting classical texts, and guiding medical practices of new readers. Adding the history of practice to the body of literature that have focused on the history of written texts, this study will contribute to the history of East Asian medicine.
Asian Continental Ancestry Group ; Diagnosis ; Far East ; Humans ; Korea ; Medicine, East Asian Traditional

Although Mycoplasma pneumoniae pneumonia (MPP) has been generally susceptible to macrolides, the emergence of macrolide-resistant MPP (MRMP) has made its treatment challenging. MRMP rapidly spread after the 2000s, especially in East Asia. MRMP is more common in children and adolescents than in adults, which is likely related to the frequent use of macrolides for treating M. pneumoniae infections in children. MRMP is unlikely to be related to clinical, laboratory, or radiological severity, although it likely prolongs the persistence of symptoms and the length of hospital stay. Thereby, it causes an increased burden of the disease and poor quality of life for the patient as well as a societal socioeconomic burden. To date, the only alternative treatments for MRMP are secondary antimicrobials such as tetracyclines (TCs) or fluoroquinolones (FQs) or systemic corticosteroids; however, the former are contraindicated in children because of concerns about potential adverse events (i.e., tooth discoloration or tendinopathy). A few guidelines recommended TCs or FQs as the second-line drug of choice for treating MRMP. However, there have been no evidence-based guidelines. Furthermore, safety issues have not yet been resolved. Therefore, this article aimed to review the benefits and risks of therapeutic alternatives for treating MRMP in children and review the recommendations of international or regional guidelines and specific considerations for their practical application.
Adolescent ; Adrenal Cortex Hormones ; Adult ; Child ; Drug Resistance ; Far East ; Fluoroquinolones ; Humans ; Length of Stay ; Macrolides ; Mycoplasma pneumoniae ; Mycoplasma ; Pneumonia ; Pneumonia, Mycoplasma ; Quality of Life ; Risk Assessment ; Tetracycline ; Tetracyclines ; Tooth Discoloration

Worldwide, avian influenza H9N2 viruses of different lineages are the most widespread viruses in poultry. However, to date, cases in Russia have not been documented. In this study, we report the first detection of a G1-like H9N2 virus from poultry sampled at live-bird markets in Russia (Far East region) during the winter of 2018 (isolate A/chicken/Amur_Russia/17/2018). We assume there has been further circulation of the A/chicken/Amur_Russia/17/2018 H9N2 virus in the Russian Far East with possible distribution to other regions or countries in 2018–2019.
Animals ; Far East ; Genotype ; Influenza A Virus, H9N2 Subtype ; Influenza in Birds ; Poultry ; Russia

Candelariella is a widespread lineage of lichenized ascomycetes with ambiguous relationships among species that have not solved completely. In this study, several specimens belonging to Candelariella were collected from China and South Korea, and the internal transcribed spacer region was generated to confirm the system position of the newly collected specimens. Combined with a morphological examination and phylogenetic analysis, two new areolate species, Candelariella rubrisoli and C. subsquamulosa, are new to science. Detail descriptions of each new species are presented. In addition, C. canadensis is firstly reported from China mainland.
Ascomycota ; China ; Classification ; Far East ; Korea ; Lichens ; Phylogeny

BACKGROUND/OBJECTIVES: Excessive production of reactive oxygen species (ROS) such as hydroxyl (·OH), nitric oxide (NO), and hydrogen peroxide (H2O2) is reported to induce oxidative stress. ROS generated by oxidative stress can potentially damage glial cells in the nervous system. Cordyceps militaris (CM), a kind of natural herb widely found in East Asia. In this study, we investigated the free radical scavenging activity of the CM extract and its neuroprotective effects in H2O2-induced C6 glial cells. MATERIALS/METHODS: The ethanol extract of CM (100–1,000 µg/mL) was used to measure DPPH, ·OH, and NO radical scavenging activities. In addition, hydrogen peroxide (H2O2)-induced C6 glial cells were treated with CM at 0.5–2.5 µg/mL for measurement of cell viability, ROS production, and protein expression resulting from oxidative stress. RESULTS: The CM extract showed high scavenging activities against DPPH, ·OH, and NO radicals at concentration of 1,000 µg/mL. Treatment of CM with H2O2-induced oxidative stress in C6 glial cells significantly increased cell viability, and decreased ROS production. Cyclooxygenase-2 and inducible nitric oxide synthase protein expression was down-regulated in CM-treated groups. In addition, the protein expression level of phospho-p38 mitogen-activated protein kinase (p-p38 MAPK), phospho-c-Jun N-terminal kinase (p-JNK), and phospho-extracellular regulated protein kinases (p-ERK) in H2O2-induced C6 glial cells was down-regulated upon CM administration. CONCLUSION: CM exhibited radical scavenging activity and protective effect against H2O2 as indicated by the increased cell viability, decreased ROS production, down-regulation of inflammation-related proteins as well as p-p38, p-JNK, and p-ERK protein levels. Therefore, we suggest that CM could play the protective role from oxidative stress in glial cells.
Cell Survival ; Cordyceps ; Cyclooxygenase 2 ; Down-Regulation ; Ethanol ; Far East ; Free Radicals ; Hydrogen Peroxide ; Hydrogen ; In Vitro Techniques ; Nervous System ; Neuroglia ; Neuroprotective Agents ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Oxidative Stress ; Phosphotransferases ; Protein Kinases ; Reactive Oxygen Species

OBJECTIVES: It was supposed to analyze status and affecting factors in water and food-borne communicable disease by screening entrants with diarrhea symptom at the point of entry in Korea METHODS: Symptomatic travelers with water and food-borne communicable diseases who entered Korea were diagnosed by a health declaration and detection of causative agents in water and food using laboratory tests. Among those entered in 2017, the affecting factors in the incidence of communicable diseases among those who had diarrhea at the entry into Korea, were analyzed, with frequency and chi-square test. RESULTS: The number of travel entrants with gastrointestinal communicable diseases increased by 40.19% from 2013 to 2017. The percentage of causative agents of water and food-borne communicable diseases was the highest at 69.2% from July to September. The rate of detection of causative agents of communicable disease pathogens in travelers from Southeast Asia entering Korea was 70.2%, which was higher than people arriving from East Asia and Central Asia (57.5%; p < 0.001). CONCLUSION: The positive ratio of causative agents of water and food-borne communicable diseases was high among travelers that had entered Korea from July to September, with a high number among entrants from Southeast Asia. Based on the positive detection of causative agents, the entry period and countries visited were statistically significant affecting factors (p < 0.001).
Asia ; Asia, Southeastern ; Communicable Diseases ; Diarrhea ; Far East ; Foodborne Diseases ; Incidence ; Korea ; Mass Screening ; Quarantine ; Water ; Waterborne Diseases

PURPOSE: Half of the world's gastric cancer cases and the highest gastric cancer mortality rates are observed in Eastern Asia. Although several genome-wide association studies (GWASs) have revealed susceptibility genes associated with gastric cancer, no GWASs have been conducted in the Korean population, which has the highest incidence of gastric cancer. MATERIALS AND METHODS: We performed genome scanning of 450 gastric cancer cases and 1,134 controls via Affymetrix Axiom Exome 319 arrays, followed by replication of 803 gastric cancer cases and 3,693 healthy controls. RESULTS: We showed that the rs2976394 in the prostate stem cell antigen (PSCA) gene is a gastriccancer-susceptibility gene in a Korean population, with genome-wide significance and an odds ratio (OR) of 0.70 (95% confidence interval [CI], 0.64 to 0.77). A strong linkage disequilibrium with rs2294008 was also found, indicating an association with susceptibility. Individuals with the CC genotype of the PSCA gene showed an approximately 2-fold lower risk of gastric cancer compared to those with the TT genotype (OR, 0.47; 95% CI, 0.39 to 0.57). The effect of the PSCA gene on gastric cancer was more prominent in the female population and for diffuse type gastric cancer. CONCLUSION: Our result confirmed that the PSCA gene may be the most important susceptibility gene for gastric cancer risk in a Korean population.
Exome ; Far East ; Female ; Genetic Variation ; Genome ; Genome-Wide Association Study ; Genotype ; Humans ; Incidence ; Linkage Disequilibrium ; Mortality ; Odds Ratio ; Prostate ; Stem Cells ; Stomach Neoplasms