The purpose of this study was to investigate the effects of activities of daily living, depression, and social support on the meaning in life in older adults using services under the long-term care insurance system. Methods: This was a cross-sectional study. A total of 121 older adults were recruited from seven senior daycare centers in two cities in Korea. Data collection was performed between September and October 2023. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression analysis. Results: The results of this study showed that social support (β=.45, p<.001) and depression (β=-.16, p=.048) were significantly affecting factors to the meaning in life in older adults using services under the long-term care insurance system. Conclusion: Efforts to enhance social support and reduce depressive symptoms are critical to improve the meaning in life of older adults utilizing services under the long-term care insurance system. Specifically, it is necessary to closely identify older adults’ depressive symptoms and further strengthen social support, including policy support and individualized support from healthcare professionals in the facilities to improve older adults’ meaning in life.

Dengue, a mosquito-borne viral infection, is rapidly increasing worldwide and affects over half of the world’s population in at-risk areas. Factors such as globalization, urbanization, and climate change have fueled its rapid geographical expansion. Although no indigenous dengue cases have been identified in Korea, the number of imported dengue cases has increased from travel to endemic regions. In Korea, dengue diagnosis relies mainly on detecting antidengue antibodies or viral nucleic acids using real-time polymerase chain reaction. Although specific antiviral treatments for dengue are currently unavailable, promising progress has been made in developing antiviral agents that target viral replication. Single-dose tetravalent live-attenuated dengue vaccine candidates are currently being evaluated for their safety and efficacy. Innovative vector control methods, including Wolbachia-infected and genetically modified species of Aedes mosquitos, have demonstrated promising results. Owing to the limited therapeutic options, vector control strategies remain a primary focus for preventing transmission, alongside ongoing research on antiviral drugs and vaccine development. This review provides insight into dengue fever transmission, clinical manifestations, and diagnosis.Additionally, it covers current global control measures, emerging treatment options, and the status of vaccines in development.

Background: Dengue virus (DENV) is transmitted by mosquitoes and is becoming a global threat owing to an increase in the number of cases and mortality, especially in low- and middle-income tropical countries. Rapid and easy-to-use diagnostic tests are required to differentiate dengue fever from other febrile illnesses. Methods: We evaluated the clinical performance of the ImmuneMed Dengue NS1 Ag Rapid I test (ImmuneMed, Inc.) using positive and negative sera collected from patients with confirmed DENV infection and healthy individuals, respectively. The AccuPower® ZIKV (DENV, CHIKV) multiplex real-time reverse transcription polymerase chain reaction (RT-PCR) assay (Bioneer) was used as the reference standard to confirm DENV infection. Results: One hundred DENV-positive and 161 DENV-negative samples were evaluated. Overall, the sensitivity and specificity were 100% (95% confidence interval [CI], 96%–100%) and 100% (95% CI, 98%–100%), respectively. The sensitivity and specificity were 100% for both DENV-1 and DENV- 2. The sensitivity was the same (100%) for sera collected ＜ 3 days and ≥ 3 days from symptom onset. The performance of the ImmuneMed Dengue NS1 Ag Rapid I and realtime RT-PCR tests showed strong overall agreement. Conclusion The ImmuneMed Dengue NS1 Ag Rapid I test was highly specific for DENV and as sensitive as RT-PCR. These findings suggest that the ImmuneMed Dengue NS1 Ag Rapid I test may be a useful point-of-care test for dengue fever.

Purpose: This study aimed to develop and assess the feasibility and effectiveness of digital therapeutics for supportive care after gastrectomy.Materials and Method: The study included 39 patients with gastric cancer who underwent minimally invasive gastrectomy and were able to use a mobile application (app) on their smartphones. The developed research app automatically calculates and provides daily targets for calorie and protein intake based on the patient’s body mass index (BMI). Patients recorded their daily diets, weights, and symptoms in the app and completed special questionnaires to assess the feasibility of the app in real-world clinical practice. Results: At the 10-week follow-up, the mean questionnaire scores for ease of learning, usability, and effectiveness of the app (primary endpoint) were 2.32±0.41, 2.35±0.43, and 2.4±0.39 (range: 0–3), respectively. Patients were classified as underweight (<18.5, n=4), normal (18.5–24.9, n=24), or overweight (≥25.0, n=11) according to predischarge BMI.Underweight patients showed higher compliance with app usage and a higher rate of achieving the target calorie and protein intake than normal weight and overweight patients (98% vs. 77% vs. 81%, p=0.0313; 102% vs. 75% vs. 61%, P=0.0111; 106% vs. 79% vs. 64%, P=0.0429). Two patients transitioned from underweight to normal weight (50.0%), one patient (4.3%) transitioned from normal weight to underweight, and two patients (22.2%) transitioned from overweight to normal weight. Conclusions The mobile app is feasible and useful for postoperative supportive care in terms of ease of learning, usability, and effectiveness. Digital therapeutics may be an effective way to provide supportive care for postgastrectomy patients, particularly in terms of nutrition.

Purpose: De novo malignancy is common after liver transplantation (LT); however, there are limited reports on the clinical outcomes of gastric cancer surgery after LT. Our study aimed to investigate the feasibility and safety of gastric cancer surgery after LT. Methods: Seventeen patients underwent gastric cancer surgery after LT at a single institution between January 2013 and June 2021. We retrospectively collected data on surgical complications, survival, and recurrence status of these cases. Results: Fifteen patients (88.2%) underwent curative gastrectomy, with 10 open distal (66.7%) and 5 laparoscopic distal (33.3%) gastrectomies. Surgical and severe complication rates were 3 of 15 (20.0%) and 1 of 15 (6.7%), respectively. There were no significant differences between laparoscopic (33.3%) and open surgery (66.7%) in terms of operation time and complication rate. No surgery-related mortalities occurred. Immunosuppressants could be maintained without difficulty, and no suspicious acute rejection was identified during the perioperative period. There was 1 recurrence after curative surgery (recurrence rate, 6.7%), and the 5-year cancer-specific survival rate after curative surgery was 93.3%. Conclusion Laparoscopic gastrectomy can be safely done even after LT in terms of postoperative complications and graft safety.

Background: The epidemiology of pathogenic bacteria varies according to the socioeconomic status and antimicrobial resistance status. However, longitudinal epidemiological studies to evaluate the changes in species distribution and antimicrobial susceptibility of pathogenic bacteria nationwide are lacking. We retrospectively investigated the nationwide trends in species distribution and antimicrobial susceptibility of pathogenic bacteria over the last 20 years in Korea. Methods: From 1997 to 2016, annual cumulative antimicrobial susceptibility and species distribution data were collected from 12 university hospitals in five provinces and four metropolitan cities in South Korea. Results: The prevalence of Staphylococcus aureus was the highest (13.1%) until 2012 but decreased to 10.3% in 2016, consistent with the decrease in oxacillin resistance from 76.1% in 2008 to 62.5% in 2016. While the cefotaxime resistance of Escherichia coli increased from 9.0% in 1997 to 34.2% in 2016, E. coli became the most common species since 2013, accounting for 14.5% of all isolates in 2016. Pseudomonas aeruginosa and Acinetobacter baumannii rose to third and fifth places in 2008 and 2010, respectively, while imipenem resistance increased from 13.9% to 30.8% and 0.7% to 73.5% during the study period, respectively.Streptococcus agalactiae became the most common pathogenic streptococcal species in 2016, as the prevalence of Streptococcus pneumoniae decreased since 2010. During the same period, pneumococcal penicillin susceptibility decreased to 79.0%, and levofloxacin susceptibility of S. agalactiae decreased to 77.1% in 2016. Conclusion The epidemiology of pathogenic bacteria has changed significantly over the past 20 years according to trends in antimicrobial resistance in Korea. Efforts to confine antimicrobial resistance would change the epidemiology of pathogenic bacteria and, consequently, the diagnosis and treatment of infectious diseases.

Group A streptococci (GAS) cause diverse diseases ranging from mild to severe illnesses, and the global burden of GAS infections is enormous. Serological typing has been replaced by emm genotyping for the epidemiological study of GAS. Acute bacterial pharyngitis is a common illness, which requires either throat culture or rapid Ag test for diagnosis. Moreover, molecular point-of-care tests have been introduced owing to their higher sensitivity. Optimal diagnosis of bacterial pharyngitis is necessary for the adequate use of antibiotics. Although antimicrobial resistance (AMR) to erythromycin or clindamycin does not seem serious in Korea, it is very high in China, being reported at over 90%. Antibiotic surveillance and relevant education are necessary for primary clinical physicians and pediatricians. It is necessary to monitor AMR and develop a system for reporting the appearance of highly virulent diseases, such as necrotizing fasciitis or streptococcal toxic-shock syndrome, to the government authority.

Group B Streptococcus (GBS, Streptococcus agalactiae) is a pathogen that causes sepsis and meningitis, particularly in newborns, as well as severe infections in the elderly and those at high risk. For many years, the administration of intrapartum antimicrobial prophylaxis (IAP) has been a standard method to prevent neonatal GBS infection. However, IAP may be unsuitable in low-income settings due to its high cost and difficult accessibility to medical institutions. Additionally, IAP may lead to the emergence of antimicrobial-resistant bacteria. Hence, an alternative method for the control of GBS, such as a vaccine, is needed. An effective vaccine will likely prevent the further spread of GBS and be cost-effective compared with IAP. GBS vaccines have been under development for the past two decades, and several candidates have shown potential. In this review, we discuss the current development of GBS vaccines, including types and their implementation in different target populations.

Background: Streptococcus pneumoniae is a serious pathogen causing various infections in humans. We evaluated the serotype distribution and antimicrobial resistance of S. pneumoniae causing invasive pneumococcal disease (IPD) after introduction of pneumococcal conjugate vaccine (PCV)13 in Korea and investigated the epidemiological characteristics of multidrug-resistant (MDR) isolates. Methods: S. pneumoniae isolates causing IPD were collected from 16 hospitals in Korea between 2017 and 2019. Serotyping was performed using modified sequential multiplex PCR and the Quellung reaction. Antimicrobial susceptibility tests were performed using the broth microdilution method. Multilocus sequence typing was performed on MDR isolates for epidemiological investigations. Results: Among the 411 S. pneumoniae isolates analyzed, the most prevalent serotype was 3 (12.2%), followed by 10A (9.5%), 34 (7.3%), 19A (6.8%), 23A (6.3%), 22F (6.1%), 35B (5.8%), 11A (5.1%), and others (40.9%). The coverage rates of PCV7, PCV10, PCV13, and pneumococcal polysaccharide vaccine (PPSV)23 were 7.8%, 7.8%, 28.7%, and 59.4%, respectively. Resistance rates to penicillin, ceftriaxone, erythromycin, and levofloxacin were 13.1%, 9.2%, 80.3%, and 4.1%, respectively. MDR isolates accounted for 23.4% of all isolates. Serotypes 23A, 11A, 19A, and 15B accounted for the highest proportions of total isolates at 18.8%, 16.7%, 14.6%, and 8.3%, respectively. Sequence type (ST)166 (43.8%) and ST320 (12.5%) were common among MDR isolates. Conclusions Non-PCV13 serotypes are increasing among invasive S. pneumoniae strains causing IPD. Differences in antimicrobial resistance were found according to the specific serotype. Continuous monitoring of serotypes and antimicrobial resistance is necessary for the appropriate management of S. pneumoniae infections.