盐酸达泊西汀联合他达拉非治疗原发性早泄的临床研究

目的:探讨盐酸达泊西汀联合他达拉非治疗原发性早泄的疗效。方法:将100例患者随机分成治疗组和对照组,每组50例。治疗组口服他达拉非片5 mg,每天1次,性交前按需口服盐酸达泊西汀片30 mg。对照组只按需口服盐酸达泊西汀片30 mg。疗程2个月。治疗期间嘱患者进行规律的性生活,每周1-2次,并做好相关记录。治疗前后行阴道内射精潜伏期(intravaginal ejaculation latency,IELT)IELT测评、患者及配偶性生活满意度评分。结果:与治疗前相比,两组治疗后IELT、患者及配偶满意度均有明显改善,差异具有统计学意义(P0.05)。而且治疗后治疗组与对照组比较,治疗组的IELT、患者及配偶满意度改善更为明显,差异亦具有统计学意义(P0.05)。常见不良反应有颜面潮红、头晕、鼻塞,无需特殊处理,症状均自行缓解。结论:盐酸达泊西汀联合他达拉非治疗原发性早泄安全有效。     

The Impact of Improving Suicide Death Classification in South Korea: A Comparison with Japan and Hong Kong

IntroductionThe suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death.MethodWe compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated.ResultsWe found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes.ConclusionOur data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.     

Korea–Japan JDZ to End in Deadlock?: The Potential for Unilateral Korean Exploration and Exploitation

Abstract

The Korea–Japan Joint Development Zone (JDZ) Agreement of 30 January 1974 was one of a number of innovative arrangements for cooperation in an overlapping maritime area. Nevertheless, four decades after its entry into force in 1978, the Agreement has not produced a single drop of oil. In contrast with Korea’s positive view on an oil discovery, Japan has held a negative stance since its concessionaires’ release of rights under the Agreement in 1992. Without Japan’s cooperation, the Agreement is a dead instrument. This article looks, from a Korean perspective, for the solutions whereby the Korea–Japan JDZ Agreement can operate.     

A History of and Recent Developments Concerning the Korean Peninsula Northern Limit Line (NLL)

Abstract

Measures to ease tensions and prevent military conflicts adjacent to the Korean Peninsula Northern Limit Line (NLL) are an integral part of the ongoing reconciliatory efforts between the South and the North. Despite controversies over the validity of the NLL, it has served as a de facto maritime demarcation line in the absence of an agreed-upon maritime demarcation line under the Armistice Agreement. North Korea has persistently attempted to invalidate the NLL, while South Korea has supported the status quo of the NLL as a military demarcation line. The South and North have recently created a buffer zone across the NLL in the West Sea amid talks for North Korea’s denuclearization.     

Models of spouse influence and their application to smoking behavior

Abstract

Probability models are used to study changes which take place in smoking behavior of married couples over time, especially changes which take place from baseline levels existing at the time the couples first began dating each other. The models focus on the observable effects or outcomes of spouse influence rather than on actual mechanisms, which are remote from our observations. Our analysis of smoking behavior suggests that the spouses do not change independently. Moreover, there is a suggestion that spouses who are initially alike tend either to be more stable in their behavior or more likely to return to their initial status than spouses who are initially dissimilar. This process could tend to perpetuate initial similarity, and therefore stabilize spouse correlation estimates, or may increase levels of similarity if there is a background of considerable cultural change.     

Descriptive epidemiology of cancer of unknown primary in South Korea, 1999–2017

BackgroundCancers of unknown primary (CUPs) are tumors found after metastasizing from unidentified primary sites; these tumors generally have unknown treatment strategies, expected treatment results, and prognosis. We assessed the epidemiological characteristics of CUPs in Korea.MethodsWe extracted records for 1999 through 2017 from the Korea Central Cancer Registry using the International Statistical Classification of Diseases and Related Health Problems (10th revision) codes for CUP as defined by the International Agency for Research on Cancer. Age-standardized rates and relative survival rates were calculated.ResultsThe CUPs constituted 2.1 % of the total number of cancer registrations in 1999, declining to 0.7 % in 2017. The incidence rate decreased for both sexes (5.35 to 2.20 for men, 3.15 to 1.77 for women). Patients aged 80 years and older had the highest incidence rate at 40.2, and 86.3 % of CUPs occurred in those 50 years of age or older. The cases of retroperitoneum and peritoneum sites increased over time. Cases diagnosed by microscopic methods and death certification only were 62.3 % and 7.9 %, respectively. The malignant neoplasm of the retroperitoneum and peritoneum and unknown primary site had the highest and lowest survival rates, respectively. The 5-year relative survival rate increased over time from 14.2 % (1999–2002) to 27.3 % (2013–2017).ConclusionsOur analysis of data from the Korea Central Cancer Registry found decreasing rates of CUP, although with consistent disparities by patient age and sex. Advancements in diagnostic technology may be decreasing the number of CUP diagnoses. Expanding the amount of information recorded in the registry may further improve diagnostic accuracy.     

Cost-Effectiveness Analysis of Hepatitis B Vaccination Strategies to Prevent Perinatal Transmission in North Korea: Selective Vaccination vs. Universal Vaccination

BackgroundTo tackle the high prevalence of Hepatitis B virus (HBV) infection in North Korea, it is essential that birth doses of HBV vaccines should be administered within 24 hours of birth. As the country fails to provide a Timely Birth Dose (TBD) of HBV vaccine, the efforts of reducing the high prevalence of HBV have been significantly hampered.MethodsTo examine the cost-effectiveness of vaccination strategies to prevent perinatal transmission of HBV in North Korea, we established a decision tree with a Markov model consisting of selective, universal, and the country’s current vaccination program against HBV. The cost-effectiveness analysis was performed from societal and payer’s perspectives and evaluated by Disability Adjusted Life Year (DALY).ResultsThe results suggest that introducing the universal vaccination would prevent 1,866 cases of perinatal infections per 100,000 of the birth cohort of 2013. Furthermore, 900 cases of perinatal infections per 100,000 could be additionally averted if switching to the selective vaccination. The current vaccination is a dominated strategy both from the societal and payer’s perspective. The Incremental Cost-Effectiveness Ratio (ICER) between universal and selective vaccination is $267 from the societal perspective and is reported as $273 from the payer’s perspective.ConclusionBased on the assumption that the 2012 Gross Domestic Product (GDP) per capita in North Korea, $582.6 was set for cost-effectiveness criteria, the result of this study indicates that selective vaccination may be a highly cost-effective strategy compared to universal vaccination.     

Serological Detection of Borrelia burgdorferi among Horses in Korea

Lyme disease is a tick-borne zoonotic infectious disease caused by Borrelia burgdorferi. The present study assessed the infection status of B. burgdorferi among horses reared in Korea using ELISA and PCR. Between 2009 and 2013, blood samples were collected from 727 horses throughout Korea. Data for each animal including age, gender, breed, and region of sample collection were used for epidemiological analysis. Overall, 38 (5.2%; true prevalence: 5.5%) of 727 horses were seropositive by ELISA. There were statistically significant differences according to breed and region (P<0.001) whose differences might be attributed to the ecology of vector ticks and climate conditions. Using 2 nested PCR, none of the samples tested positive for B. burgdorferi. Thus, a positive ELISA result can indicate only that the tested horse was previously exposed to B. burgdorferi, with no certainty over the time of exposure. Since global warming is likely to increase the abundance of ticks in Korea, continuous monitoring of tick-borne diseases in Korean horses is needed.     

Incidencia y factores explicativos de las caídas en ancianos que viven en la comunidad

Introductionfalls in the elderly are a significant health problem that can be prevented once risk factors have been identified. The objective of this study was to determine the rate of falls among elderly persons living in the community and their risk factors.Patients and methodstwo hundred ambulatory individuals aged 75 years or older attending an outpatient clinic were evaluated by personal interview. Demographic and social variables, health characteristics, use of healthcare resources and falls were studied. Bivariate analysis was performed and significant variables were entered into a conditional logistic regression analysis.Resultsthe rate of falls per year was 56.5% and rate of recurrent falls was 10.5%. The factors associated with falls in the logistic regression model were living with a spouse (OR = 0.37), taking three or more drugs (OR = 5.30), cardiovascular diseases (OR = 0.29), and taking nitrates (OR = 0.21). The factors associated with recurrent falls were change of home (OR = 11.10), living with a spouse (OR = 0.20), respiratory (OR = 6.44) and cardiovascular diseases (OR = 0.27), and taking laxatives (OR = 9.55).Conclusionsin our study the rate of falls and recurrent falls was similar to that described in other studies in western countries. Our results suggest that taking at least three medications and the use of laxatives were potentially preventable risk factors. Living with a spouse seemed to protect from both falls and recurrent falls in elderly people living in the community.     

Characteristics of Korean patients with suspected Creutzfeldt-Jakob disease with 14-3-3 protein in cerebrospinal fluid: Preliminary study of the Korean Creutzfeldt-Jakob disease active surveillance program

Abstract

Although Korea had a national surveillance system for Creutzfeldt-Jakob disease (CJD), it was mainly dependent on attending physician's reports. Thus, little prospective data about the epidemiology, characteristics, and final diagnoses of suspected patients were available. We have established a nationwide network for the active surveillance of patients with suspected CJD. When the requested cerebrospinal fluid (CSF) samples tested positive for 14-3-3 protein, we investigated the clinical characteristics of the corresponding patients and followed them until their final diagnoses were confirmed. A total of 218 samples were requested for CSF assays from May 2010 to August 2012, and 106 (48.6%) were positive for 14-3-3 protein. In 89 patients with complete clinical data, 38 (42.7%) were diagnosed with probable CJD and the estimated annual occurrence of CJD was 16.3 persons-per-year. The most common diagnoses of the remainder were central nervous system infection and any-cause encephalopathy. Non-CJD subjects showed worse initial consciousness levels than CJD patients. This preliminary study showed that the number of reported cases of CJD and the true positivity rates of CSF 14-3-3 protein assays were both low in Korea. An active surveillance system is urgently needed to provide the latest nationwide epidemiological data of CJD.     

Genetic and Environmental Risk for Chronic Pain and the Contribution of Risk Variants for Major Depressive Disorder: A Family-Based Mixed-Model Analysis

BackgroundChronic pain is highly prevalent and a significant source of disability, yet its genetic and environmental risk factors are poorly understood. Its relationship with major depressive disorder (MDD) is of particular importance. We sought to test the contribution of genetic factors and shared and unique environment to risk of chronic pain and its correlation with MDD in Generation Scotland: Scottish Family Health Study (GS:SFHS). We then sought to replicate any significant findings in the United Kingdom Biobank study.ConclusionsGenetic factors, as well as chronic pain in a partner or spouse, contribute substantially to the risk of chronic pain for an individual. Chronic pain is genetically correlated with MDD, has a polygenic architecture, and is associated with polygenic risk of MDD.     

Repeatability and reproducibility of a handheld quantitative G6PD diagnostic

BackgroundThe introduction of novel short course treatment regimens for the radical cure of Plasmodium vivax requires reliable point-of-care diagnosis that can identify glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. While deficient males can be identified using a qualitative diagnostic test, the genetic make-up of females requires a quantitative measurement. SD Biosensor (Republic of Korea) has developed a handheld quantitative G6PD diagnostic (STANDARD G6PD test), that has approximately 90% accuracy in field studies for identifying individuals with intermediate or severe deficiency. The device can only be considered for routine care if precision of the assay is high.Methods and findingsCommercial lyophilised controls (ACS Analytics, USA) with high, intermediate, and low G6PD activities were assessed 20 times on 10 Biosensor devices and compared to spectrophotometry (Pointe Scientific, USA). Each device was then dispatched to one of 10 different laboratories with a standard set of the controls. Each control was tested 40 times at each laboratory by a single user and compared to spectrophotometry results.When tested at one site, the mean coefficient of variation (CV) was 0.111, 0.172 and 0.260 for high, intermediate, and low controls across all devices respectively; combined G6PD Biosensor readings correlated well with spectrophotometry (r_s = 0.859, p<0.001). When tested in different laboratories, correlation was lower (r_s = 0.604, p<0.001) and G6PD activity determined by Biosensor for the low and intermediate controls overlapped. The use of lyophilised human blood samples rather than fresh blood may have affected these findings. Biosensor G6PD readings between sites did not differ significantly (p = 0.436), whereas spectrophotometry readings differed markedly between sites (p<0.001).ConclusionsRepeatability and inter-laboratory reproducibility of the Biosensor were good; though the device did not reliably discriminate between intermediate and low G6PD activities of the lyophilized specimens. Clinical studies are now required to assess the devices performance in practice.     

Epidemiological investigation and physician awareness regarding the diagnosis and management of Q fever in South Korea, 2011 to 2017

BackgroundIn South Korea, the number of Q fever cases has rapidly increased since 2015. Therefore, this study aimed to characterize the epidemiological and clinical features of Q fever in South Korea between 2011 and 2017.Methods/Principal findingsWe analyzed the epidemiological investigations and reviewed the medical records from all hospitals that had reported at least one case of Q fever from 2011 to 2017. We also conducted an online survey to investigate physicians’ awareness regarding how to appropriately diagnose and manage Q fever. The nationwide incidence rate of Q fever was annually 0.07 cases per 100,000 persons. However, there has been a sharp increase in its incidence, reaching up to 0.19 cases per 100,000 persons in 2017. Q fever sporadically occurred across the country, with the highest incidences in Chungbuk (0.53 cases per 100,000 persons per year) and Chungnam (0.27 cases per 100,000 persons per year) areas. Patients with acute Q fever primarily presented with mild illnesses such as hepatitis (64.5%) and isolated febrile illness (24.0%), whereas those with chronic Q fever were likely to undergo surgery (41.2%) and had a high mortality rate (23.5%). Follow-up for 6 months after acute Q fever was performed by 24.0% of the physician respondents, and only 22.3% of them reported that clinical and serological evaluations were required after acute Q fever diagnosis.ConclusionsQ fever is becoming an endemic disease in the midwestern area of South Korea. Given the clinical severity and mortality of chronic Q fever, physicians should be made aware of appropriate diagnosis and management strategies for Q fever.     

Socioeconomic Status and Other Related Factors of Seasonal Influenza Vaccination in the South Korean Adult Population Based on a Nationwide Cross-Sectional Study

PurposeWe investigated the association between seasonal influenza vaccination in South Korea and socioeconomic status (SES) as well as other potential related factors.MethodsThe study was based on data obtained in the Korea National Health and Nutrition Examination Survey from 2010 to 2011. Education level and household income were used as indicators for SES. Univariate and multiple logistic regression analyses were used to evaluate SES and other demographic variables as related factors for influenza vaccination, the primary outcome.ResultsHigher household income was positively associated with higher vaccine uptake in the younger (19–49 years) group [adjusted odds ratio (aOR) 1.55, 95% confidence interval (CI) 1.08–2.23], whereas the low-income and low-education group had increased vaccination coverage than the middle-income and middle-education group in the older (≥ 50 years) group (aOR 1.36, 95% CI 1.09–1.69). Current smokers tend to be unvaccinated in all age groups. Among individuals aged ≥ 50, older age, mild to moderate alcohol consumption, regular exercise, and having co-morbidities were positively associated with vaccination, while those who self-reported their health status as good were less likely to be vaccinated.ConclusionsThe relationship between SES and seasonal influenza vaccination coverage differed between the age groups throughout the adult South Korean population. Public health policies need to address these inequalities.     

Seasonal trends of diagnosis of childhood malignant diseases and viral prevalence in South Korea

BackgroundSeveral studies have reported a seasonal trend in the diagnosis of childhood cancer suggesting seasonal factors such as infection. The present study aimed to analyze the diagnosis pattern of childhood malignant diseases using public health data, and to compare this pattern with seasonal viral infection trends.MethodUsing the open data source of the Health Insurance Review and Assessment Service, we extracted data regarding all patients under 21 years of age and who had any cancer, aplastic anemia or myelodysplastic syndrome between September 2009 and December 2013. The positive detection rates of 11 viruses was collected from the surveillance data of Korea Centers for Disease Control and Prevention, and seasonality analysis were conducted with both data.ResultsIn total, 9085 patients were diagnosed with malignant disease during the study period; there were about 175 new cases per month on average. Monthly stacked time series by year showed an apparent seasonal variation with the highest monthly average in January as 236, and the lowest in September as 120. In winter, significantly more patients were diagnosed with acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and Hodgkin’s lymphoma than in other seasons. There was a temporal correlation with the diagnostic trends of several diseases and the prevalence of recent human parainfluenza virus.ConclusionThis study tentatively suggests that the diagnosis of childhood malignancy follows a seasonal trend in Korea, and has a possible correlation with viral prevalence in several diseases. Further long-term analysis of epidemiological data is needed to explore possible causality.     

Chemical constituents of Hericium erinaceum associated with the inhibitory activity against cellular senescence in human umbilical vascular endothelial cells

Abstract

Hericium erinaceum is an edible and medicinal mushroom widely used in Korea, Japan, and China. On the search for biologically active compounds supporting the medicinal usage, the MeOH extract of the fruiting bodies of H. erinaceum was investigated for its chemical constituents. Six compounds were isolated and identified as hericenone D (1), (22E,24R)-5α,8α-epidioxyergosta-6,22-dien-3β-ol (2), erinacerin B (3), hericenone E (4), hericenone F (5) and isohericerin (6) by comparing their spectroscopic data with previously reported values. The inhibitory effects on adriamycin-induced cellular senescence in human dermal fibroblasts (HDFs) and human umbilical vein endothelial cells (HUVECs) of the isolates (1–6) were studied. Among the isolated compounds, ergosterol peroxide (2) reduced senescence associated β-galactosidase (SA-β-gal) activity increased in HUVECs treated with adriamycin. According to experimental data obtained, the active compound may inspire the development of a new pharmacologically useful substance to be used in the treatment and prevention of age-related diseases.     

Ancestry-related assortative mating in Latino populations

Background

While spouse correlations have been documented for numerous traits, no prior studies have assessed assortative mating for genetic ancestry in admixed populations.

Results

Using 104 ancestry informative markers, we examined spouse correlations in genetic ancestry for Mexican spouse pairs recruited from Mexico City and the San Francisco Bay Area, and Puerto Rican spouse pairs recruited from Puerto Rico and New York City. In the Mexican pairs, we found strong spouse correlations for European and Native American ancestry, but no correlation in African ancestry. In the Puerto Rican pairs, we found significant spouse correlations for African ancestry and European ancestry but not Native American ancestry. Correlations were not attributable to variation in socioeconomic status or geographic heterogeneity. Past evidence of spouse correlation was also seen in the strong evidence of linkage disequilibrium between unlinked markers, which was accounted for in regression analysis by ancestral allele frequency difference at the pair of markers (European versus Native American for Mexicans, European versus African for Puerto Ricans). We also observed an excess of homozygosity at individual markers within the spouses, but this provided weaker evidence, as expected, of spouse correlation. Ancestry variance is predicted to decline in each generation, but less so under assortative mating. We used the current observed variances of ancestry to infer even stronger patterns of spouse ancestry correlation in previous generations.

Conclusions

Assortative mating related to genetic ancestry persists in Latino populations to the current day, and has impacted on the genomic structure in these populations.     

Deciphering the Nnorth Korean‐Soviet (Russian) maritime boundary agreements

Abstract

North Korea and the Soviet Union delimited their land and sea boundaries in two treaties, signed in 1985 and 1986. A warming bilateral relationship, joint plans to develop an economic zone near the Tumen River land boundary, and the desire to exploit marine resources, especially offshore oil, probably accelerated the negotiations. The two countries’ straight baseline claims affected the bearing of the negotiated boundaries. The territorial sea boundary may have given half‐effect to the natural coastline, and inexplicably, its terminus falls short of extending a full 12 nautical miles from the respective straight baseline claims. The 1986 continental shelf/exclusive economic zone boundary reflects the baselines and appears to delimit the South Korea—Soviet Union continental shelf, as well as the tri‐point with Japan. It ignores the presence of Liancourt Rocks (Takeshima/Tok‐do), islets disputed between Japan and South Korea. Neither South Korea nor Japan has publicly commented on the treaties.     

Characterization of Heterodera sojae Virulence Phenotypes in Korea

The white soybean cyst nematode Heterodera sojae, isolated from the roots of soybean in Korea, is widespread in most provinces of the country and has the potential to be as harmful to soybean as H. glycines. Determining the virulence phenotypes of H. sojae is essential to devising management strategies that use resistant cultivars. Consequently, virulence phenotypes of 15 H. sojae populations from Korea were determined on seven soybean lines and one susceptible check variety. Two different HS types were found to be present in Korea; the more common HS type 2.5.7, comprising 73.3% of the H. sojae populations and the less common HS type 0, constituting only 26.7% of the tested populations. Considering the high frequency of H. sojae adaptation to soybean indicator lines, the PI 88788 group may not be a possible source of resistance while PI 548402, PI 90763, PI 437654, and PI 89772 can be used as resistance sources for soybean breeding programs aimed at developing H. sojae-resistant soybean cultivars in Korea.