Purpose: High-cost novel therapies for multiple myeloma (MM) require evaluation of efficacy and cost-effectiveness. Materials and Methods: This study developed a methodology to assess cost-effectiveness using nationwide data from 11,450 newly diagnosed MM patients. A novel algorithm was applied to identify lines of therapy (LoT). Results: The number of newly diagnosed MM patients increased significantly, from 873 in 2010 to 1,464 in 2019 (p < 0.001). Advancing LoT was associated with shorter time to next treatment (TTNT) and overall survival (OS) (p < 0.001), while all-cause medical costs increased with each LoT (p < 0.001). Bortezomib-melphalan-prednisolone was the most common frontline regimen for transplant-ineligible patients (29.2%), while bortezomib-thalidomide-dexamethasone was most used for transplant-eligible patients (11.3%). Daratumumab monotherapy demonstrated superior second TTNT (7.8 vs. 5.2 months) and OS (8.5 vs. 5.3 months) compared to standard care in heavily treated MM patients, with statistical significance maintained after cost adjustment. For subsequent therapies following daratumumab, a methodology was developed to estimate required medical costs using the incremental cost-effectiveness ratio (ICER): Expected cost ($)=ICER×(Expected life expectancy–0.567)+35,601. Conclusion This study provides a novel cost-effectiveness framework linking treatment efficacy and real-world costs, supporting predictions of societal costs for future MM therapies.

Aromadendrin is a phenolic compound with various biological effects such as anti-inflammatory properties. However, its protective effects against acute lung injury (ALI) remain unclear. Therefore, this study aimed to explore the ameliorative effects of aromadendrin in an experimental model of lipopolysaccharide (LPS)-induced ALI. In vitro analysis revealed a notable increase in the levels of cytokine/chemokine formation, nuclear factor kappa B (NF-κB) activation, and myeloid differentiation primary response 88 (MyD88)/toll-like receptor (TLR4) expression in LPS-stimulated BEAS-2B lung epithelial cell lines that was ameliorated by aromadendrin pretreatment. In LPS-induced ALI mice, the remarkable upregulation of immune cells and IL-1β/IL-6/TNF-α levels in the bronchoalveolar lavage fluid and inducible nitric oxide synthase/cyclooxygenase-2/CD68 expression in lung was decreased by the oral administration of aromadendrin. Histological analysis revealed the presence of cells in the lungs of ALI mice, which was alleviated by aromadendrin. In addition, aromadendrin ameliorated lung edema. This in vivo effect of aromadendrin was accompanied by its inhibitory effect on LPS-induced NF-κB activation, MyD88/TLR4 expression, and signal transducer and activator of transcription 3 activation. Furthermore, aromadendrin increased the expression of heme oxygenase-1/ NAD(P)H quinone dehydrogenase 1 in the lungs of ALI mice. In summary, the in vitro and in vivo studies demonstrated that aromadendrin ameliorated endotoxin-induced pulmonary inflammation by suppressing cytokine formation and NF-κB activation, suggesting that aromadendrin could be a useful adjuvant in the treatment of ALI.

Purpose: Recently, we developed allele-discriminating priming system (ADPS) technology. This method increases the sensitivity of conventional quantitative polymerase chain reaction up to 100 folds, with limit of detection, 0.01%, with reinforced specificity. This prospective study aimed to develop and validate the accuracy of ADPS epidermal growth factor receptor (EGFR) Mutation Test Kit using clinical specimens. Materials and Methods: In total 189 formalin-fixed paraffin-embedded tumor tissues resected from patients with non–small cell lung cancer were used to perform a comparative evaluation of the ADPS EGFR Mutation Test Kit versus the cobas EGFR Mutation Test v2, which is the current gold standard. When the two methods had inconsistent results, next-generation sequencing–based CancerSCAN was utilized as a referee. Results: The overall agreement of the two methods was 97.4% (93.9%-99.1%); the positive percent agreement, 95.0% (88.7%-98.4%); and the negative percent agreement, 100.0% (95.9%-100.0%). EGFR mutations were detected at a frequency of 50.3% using the ADPS EGFR Mutation Test Kit and 52.9% using the cobas EGFR Mutation Test v2. There were 10 discrepant mutation calls between the two methods. CancerSCAN reproduced eight ADPS results. In two cases, mutant allele fraction was ultra-low at 0.02% and 0.06%, which are significantly below the limit of detection of the cobas assay and CancerSCAN. Based on the EGFR genotyping by ADPS, the treatment options could be switched in five patients. Conclusion The highly sensitive and specific ADPS EGFR Mutation Test Kit would be useful in detecting the patients who have lung cancer with EGFR mutation, and can benefit from the EGFR targeted therapy.

This study evaluated the effectiveness of an obesity program developed to solve ‘obesity’, which was selected as the top priority for urgent improvement among the dietary problems of elementary school students in Busan. The program aimed to practice four health rules every day (sleep early, eat two vegetables with each meal, reduce sugary snacks, and exercise for 30 minutes every day). The participants were trained to practice the four rules online in real time every day for three weeks, and their performance in nutrition education tasks was monitored using Padlet. The anthropometric measurements showed no change in the overall average weight before and after participating in the program, but all students grew in height (z=–6.978, P＜0.001), and the number of obese students decreased significantly (z=–3.317, P＜0.001). This obesity program was effective in improving height growth and obesity in elementary school students. In terms of dietary changes, after participating in the program, the frequency of vegetable consumption increased significantly (z= –4.849, P＜0.001), the frequency of sweet snack consumption decreased significantly (z=–4.298, P＜0.001), and the bedtime improved (z=–1.000). Therefore, the non-face-to-face, self-directed obesity program developed in this study is expected to reduce the workload of nutrition teachers carrying a heavy workload such as meal service and nutrition classes, and can be used as an efficient nutrition counseling program.

This study was undertaken to analyze the growth, nutritional, and dietary risk factors of elementary school students belonging to the Busan Metropolitan City Office of Education and provide the basic data needed to develop an underweight and obesity prevention program. In 2021, BMI and Dietary Screening Test (DST) data of 4,046 children surveyed by the Nutrition Education Experience Center’s “Diagnosis System” of the Busan Regional Office of Education were analyzed. The DST consists of 36 questions about lifestyle habits, meal quality, meal regularity, snack quality, and eating behavior. Of the children included, 6.8% were underweight, 65.4% were normal weight, 13.4% were overweight, and 14.4% were obese. Children in the obesity group had shorter sleep and meal times (P＜0.001), lower vegetable and fruit consumption frequencies (P＜0.001), higher fast food consumption frequencies (P＜0.001), higher rates of skipping meals (P＜0.01) and breakfast (P＜0.001), and more frequently used smartphones and watched TV during meals (P＜0.001). The underweight group had the highest scores for all eating development factors but more frequently had chewing and swallowing difficulties (P＜0.001). The study confirms underweightedness and obesity are present different problems and indicates that nutrition teachers should conduct accurate studies on the eating habits and behaviors of obese and underweight students and provide individually tailored nutritional counseling.

Purpose: Generally, patients are noticed to store denture in water when removed from the mouth. However, few studies have reported the advantage of volumetric change in underwater storage over dry storage. To be a reference in defining the proper denture storage method, this study aims to evaluate the volumetric change and dimensional deformation in case of underwater and dry storage. Materials and methods: Definitive casts were scanned by a model scanner, and denture bases were designed with computer-aided design (CAD) software. Twelve denture bases (upper 6, lower 6) were printed with 3D printer. Printed denture bases were invested and flasked with heat-curing method. 6 upper and 6 lower dentures were divided into group A and B, and each group contains 3 upper and 3 lower dentures. Group A was stored dry at room temperature, group B was stored underwater. Group B was scanned at every 24 hours for 28 days and scanned data was saved as stereolithography (SLA) file. These SLA files were analyzed to measure the difference in volumetric change of a month and Kruskal-Wallis test were used for statistical analysis. Best-fit algorithm was used to overlap and 3-dimensional color-coded map was used to observe the changing pattern of impression surface. Results: No significant difference was found in volumetric changes regardless of the storage methods. In dry-stored denture base, significant changes were found in the palate of upper jaw and posterior lingual border of lower jaw in direction away from the underlying tissue, maxillary tuberosity of upper jaw and retromolar pad area of lower jaw in direction towards the underlying tissue. Conclusion Storing the denture underwater shows less volumetric change of impression surface than storing in the dry air.

PURPOSE: This study was conducted to identify the factors affecting on unmet healthcare needs of married immigrant women, especially who are working in South Korea. METHODS: It is designed as a cross-sectional descriptive study. We analyzed data from 8,142 working married immigrant women to the ‘National Survey of Multicultural Families 2015.’ Based on Andersen's health behavior model, logistic regression was conducted to determine the predictors of unmet healthcare need. RESULTS: The prevalence of unmet healthcare needs among the subjects was 11.6%. In multivariate analysis, significant predictors of unmet needs included existence of preschooler, country of origin, period of residence in predisposing factors, monthly household income, helpful social relationship, social discrimination, Korean proficiency, working hour per week in enabling factors, and self-rated health, experience of grief or desperation in need factors. CONCLUSION: The association between labor-related factors and unmet healthcare needs of marriage immigrant women currently working was found from nationally representative sample. Support policies for immigrant women working more than legally defined hours and having preschooler should be supplemented to reduce unmet healthcare needs. In addition, eradicating discrimination in workplace, enlarging social relationship, and developing culturally competent nursing services tailored to health problems caused by labor are needed.
Causality ; Delivery of Health Care ; Discrimination (Psychology) ; Emigrants and Immigrants ; Family Characteristics ; Female ; Grief ; Health Behavior ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Korea ; Logistic Models ; Marriage ; Multivariate Analysis ; Nursing Services ; Prevalence ; Social Discrimination ; Women, Working

The identification of circulating tumor cells (CTCs) is clinically important for diagnosing cancer. We have previously developed a size-based filtration platform followed by epithelial cell adhesion molecule immunofluorescence staining for detecting CTCs. To characterize CTCs independently of cell surface protein expression, we incorporated a chromosomal fluorescence in situ hybridization (FISH) assay to detect abnormal copy numbers of chromosomes in cells collected from peripheral blood samples by the size-based filtration platform. Aneuploid cells were detected in the peripheral blood of patients with lung cancer. Unexpectedly, aneuploid cells were also detected in the control group, which consisted of peripheral blood samples from patients with benign lung diseases, such as empyema necessitatis and non-tuberculous mycobacterial lung disease. These findings suggest that chromosomal abnormalities are observed not only in tumor cells, but also in benign infectious diseases. Thus, our findings present new considerations and bring into light the possibility of false positives when using FISH for cancer diagnosis.
Aneuploidy* ; Chromosome Aberrations ; Communicable Diseases ; Diagnosis ; Empyema ; Epithelial Cells ; Filtration ; Fluorescence ; Fluorescent Antibody Technique ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Lung Diseases* ; Lung Neoplasms ; Lung* ; Neoplastic Cells, Circulating

There was an error in the article. Chung-Hee Sonn (Ph.D.) should have been listed as a co-corresponding author but Jhingook Kim was listed as the sole corresponding author of the article. Therefore, we ask to correct that both Chung-Hee Sonn and Jhingook Kim are co-corresponding authors.

This study aimed to examine influenza vaccination coverage of North Korean defectors (NKD) in the Republic of Korea (Korea) and explore the factors affected the vaccination coverage. Total 378 NKD were analyzed. Four Korean control subjects were randomly matched by age and gender from the Korea National Health and Nutrition Examination Survey V (n = 1,500). The adjusted vaccination coverage revealed no statistical difference between the defectors group and indigenous group (29.1% vs. 29.5%, P = 0.915). In the aged under 50 group, the vaccination coverage of NKD was higher than that of Korean natives (37.8% vs. 25.8%, P = 0.016). However in the aged 50 yr and over group, the vaccination coverage of North Korean defectors was lower than that of the natives (28.0% vs. 37.6%, P = 0.189). Even the gap was wider in the aged 65 yr and over group (36.4% vs. 77.8%, P = 0.007). Gender and medical check-up experience within 2 yr showed association with the vaccination coverage of NKD. Influenza vaccination coverage of aged defectors' group (aged 50 yr and over) was lower than indigenous people though overall vaccination coverage was similar. Further efforts to increase influenza vaccination coverage of this group are needed.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Democratic People's Republic of Korea/epidemiology ; Female ; Humans ; Influenza Vaccines/*therapeutic use ; Influenza, Human/*epidemiology/*prevention & control ; Male ; Middle Aged ; Refugees/*statistics & numerical data ; Republic of Korea/epidemiology ; Sex Distribution ; Vaccination/*utilization ; Young Adult