Background: This study aimed to investigate the effects of applying the hot spring water exercise for 8 weeks to middle-aged females with knee osteoarthritis. Methods: To investigate this, body composition, isokinetic muscle function, and the knee flexion angle K-WOMAC were evaluated before and after the 8-week hot spring water exercise program and analyzed using a mixed-design two-way ANOVA. After analysis, if a significant difference was observed, the Bonferroni method was used as a post hoc method, and the following results were obtained. Results: First, among the body composition parameters, the body fat percentage showed a statistically significant reduction after the 8-week hot spring water exercise program in the exercise group (EG) (p = .031).However, there was no significant difference in body weight, muscle mass, body fat mass, and body mass index. Among the isokinetic muscle functions, the peak torque (p = .003, p = .001) and total work (p = .003, p = .003) of the flexion and extension movements, and the average power (p = .007) of the flexion movement significantly increased in the EG, while the average power of the extension movement did not change. The range of joint motion significantly increased after the exercise. The K-WOMAC index significantly decreased after the exercise. Conclusion Thus, the 8-week aquatic exercise program utilizing hot springs improved knee extension and flexion muscle strength. Hence, it is believed that it can be used as an interventional therapy for low back pain in the elderly and for obese people who have difficulty with land-based exercises.

Objective: To clearly identify the symptoms of sciatica in patients with piriformis syndrome, we retrospectively reviewed patients whose symptoms significantly improved over long-term postoperative follow-up. Methods: Among patients who underwent sciatic nerve decompression for piriformis syndrome over the past 3 years, the preoperative sciatic pain symptoms of 32 patients whose symptoms were confirmed to have improved by more than 50% during more than 1 year of follow-up were analyzed. To identify the characteristics of sciatic pain in piriformis syndrome, we investigated pain when sitting, pain when resting, pain when standing or walking, and pain when resting at night. In addition, the distribution of sciatic pain in the lower back, buttocks, lower extremities, and feet was investigated. Results: The most common symptom was pain when sitting, which was present in 25 patients (81%). Pain characteristically occurred even at rest, occurring in 62.5% of patients while lying down at night and in 53.1% of patients during daytime rest. Sciatic pain from piriformis syndrome was most commonly distributed in the buttock (90.6%) and also present in the lower back (37.5%). Pain was present in the posterior thigh in 23 patients (71.9%), in the calf in 68.8% of patients, and in the foot in 50% of patients. Conclusion Buttock pain exacerbated by sitting was the most common pattern of pain in patients with piriformis syndrome. However, the sciatic pain of this disease was also found to be characterized by pain that persisted even at rest.

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.

Background: This study aimed to identify the most cost-effective strategy for colorectal cancer screening using the fecal immunochemical test (FIT), focusing on screening initiation age in Korea. Methods: We designed Markov simulation models targeting individuals aged 40 years or older. Twelve strategies combining screening initiation ages (40, 45, or 50 years old), termination ages (80 or no limit), and intervals (1 or 2 years) were modeled, and the most cost-effective strategy was selected. The robustness of the results was confirmed using one-way and probabilistic sensitivity analyses. Furthermore, the cost-effectiveness of the qualitative and quantitative FIT methods was verified using scenario analysis. Results: The 2-year interval strategy with a screening age range of 45–80 years was the most cost-effective (incremental cost-utility ratio = KRW 7,281,646/quality adjusted life years). The most sensitive variables in the results were transition rate from advanced adenoma to local cancer and discount rate. The uncertainty in the model was substantially low. Moreover, strategies starting at the age of 40 years were also cost-effective but considered suboptimal. The scenario analysis showed that there was no significant difference in cost-effectiveness between strategies with various relative screening ratio of quantitative and qualitative method. Conclusion The screening method for advancing the initiation age, as presented in the 2015 revised national screening recommendations, was superior regarding cost-effectiveness. This study provides a new paradigm for the development of a national cancer screening system in Korea, which can be utilized as a scientific basis for economic evaluations.

Background/Aims: We examined the efficacy and safety of tegoprazan as a part of first-line triple therapy for Helicobacter pylori eradication. Methods: A randomized, double-blind, controlled, multicenter study was performed to evaluate whether tegoprazan (50 mg)-based triple therapy (TPZ) was noninferior to lansoprazole (30 mg)-based triple therapy (LPZ) (with amoxicillin 1 g and clarithromycin 500 mg; all administered twice daily for 7 days) for treating H. pylori. The primary endpoint was the H. pylori eradication rate. Subgroup analyses were performed according to the cytochrome P450 (CYP) 2C19 genotype, the minimum inhibitory concentration (MIC) of amoxicillin and clarithromycin, and underlying gastric diseases. Results: In total, 350 H. pylori-positive patients were randomly allocated to the TPZ or LPZ group. The H. pylori eradication rates in the TPZ and LPZ groups were 62.86% (110/175) and 60.57% (106/175) in an intention-to-treat analysis and 69.33% (104/150) and 67.33% (101/150) in a per-protocol analysis (non-inferiority test, p=0.009 and p=0.013), respectively. Subgroup analyses according to MICs or CYP2C19 did not show remarkable differences in eradication rate. Both first-line triple therapies were well-tolerated with no notable differences. Conclusions TPZ is as effective as proton pump inhibitor-based triple therapy and is as safe as first-line H. pylori eradication therapy but does not overcome the clarithromycin resistance of H. pylori in Korea

Background: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job DemandsResources (JD-R) model and was used in the 5 th Korean Working Conditions Survey (KWCS). Methods: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. Results: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2 : 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. Conclusions The results of our study confirm that the WES-3 has acceptable reliability and validity.

Background: The purpose of this study was to assess the reliability and validity of the 3-item version of the Work Engagement Scale (WES-3), which is based on the Job DemandsResources (JD-R) model and was used in the 5 th Korean Working Conditions Survey (KWCS). Methods: This study used data from the 5th KWCS (n = 50,205), which was conducted in 2017 with a sample of the Korean working population. The survey gathered comprehensive information on working conditions to define workforce changes and the quality of work and life. The reliability and internal consistency of the WES-3 were assessed using the corrected item-total correlation and Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was used to test the construct validity of work engagement. The convergent validity was assessed using the correlation with the WHO-5 well-being index. Correlations between work engagement and JD-R factors were also calculated. Results: The Cronbach's alpha for work engagement was 0.776, indicating acceptable internal consistency. The model comprising 3 work engagement and 2 burnout items showed an excellent fit (χ2 : 382.05, Tucker-Lewis index: 0.984, comparative fit index: 0.994, root mean square error of approximation: 0.043). The convergent validity was significant (correlation coefficient: 0.42). Correlations with burnout and job demands were negligible, whereas correlations with job resources and job satisfaction were weakly positive. Conclusions The results of our study confirm that the WES-3 has acceptable reliability and validity.