1.A Case of Primary Hyperparathyroidism with Concomitant Papillary Thyroid Carcinoma
Sang Yoon KIM ; Eun Yeong HA ; Sun Young KWON ; Jihyoung CHO ; Ho Chan CHO
Clinical Ultrasound 2025;10(1):16-22
Primary hyperparathyroidism (PHPT) with concomitant thyroid cancer is rare and is usually caused by a parathyroid adenoma rather than parathyroid carcinoma. Although an association between PHPT and well-differentiated thyroid carcinoma has been reported, it is often considered coincidental. We report a case of a 50-year-old female presenting with tingling, shoulder pain, muscle weakness, and elevated serum calcium and parathyroid hormone levels. Neck ultrasonography revealed a hypoechoic nodule in the left inferior region to the thyroid gland and thyroid nodules in both lobes. A Tc99m-MIBI parathyroid scan showed a focal hot nodule, and fine-needle aspiration confirmed papillary thyroid carcinoma, later verified by histopathology. The patient underwent surgery and was diagnosed with PHPT and papillary thyroid carcinoma. This case highlights the importance of evaluation for concomitant thyroid malignancy in PHPT patients with suspicious thyroid nodules.
2.Does the outcome of acupuncture differ according to the location of sham needling points in acupuncture trials for migraine? A systematic review and network meta-analysis.
Boram LEE ; Chan-Young KWON ; Hye Won LEE ; Arya NIELSEN ; L Susan WIELAND ; Tae-Hun KIM ; Stephen BIRCH ; Terje ALRAEK ; Myeong Soo LEE
Frontiers of Medicine 2025;19(1):53-63
Various acupuncture clinical trials have been conducted on migraine; however, the conclusions remain controversial especially when acupuncture was compared with sham acupuncture. Sham acupuncture is sometimes performed at the same acupuncture points used for verum acupuncture despite the evidence on acupuncture point specificity. Four databases were searched for sham acupuncture or waiting list-controlled acupuncture trials for migraine on December 25, 2023. Sham acupuncture was classified according to the needling points: sham acupuncture therapy at verum points (SATV) or at sham points (SATS). Network meta-analysis was performed based on the frequentist framework for headache pain intensity and response rate. A total of 18 studies involving 1936 participants were analyzed. Headache pain intensity and response rate were significantly improved in verum acupuncture compared with SATS. However, there was no significant difference between SATV and verum acupuncture. When comparing SATS and SATV, there was no significant difference in headache pain intensity and response rate; however, the results were in favor of SATV. The effect of the risk of bias on the certainty of evidence between verum and sham acupunctures was judged to be generally low. SATV should not be misused as a placebo control to evaluate the efficacy of acupuncture.
Humans
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Migraine Disorders/therapy*
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Acupuncture Therapy/methods*
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Acupuncture Points
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Treatment Outcome
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Randomized Controlled Trials as Topic
3.Closed intensive care units and sepsis patient outcomes: a secondary analysis of data from a multicenter prospective observational study in South Korea
Kyeongman JEON ; Jin Hyoung KIM ; Kyung Chan KIM ; Heung Bum LEE ; Hongyeul LEE ; Song I LEE ; Jin-Won HUH ; Won Gun KWACK ; Youjin CHANG ; Yun-Seong KANG ; Won Yeon LEE ; Je Hyeong KIM ;
Acute and Critical Care 2025;40(2):209-220
Background:
Sepsis is a leading cause of intensive care unit (ICU) admission. However, few studies have evaluated how the ICU model affects the outcomes of patients with sepsis.
Methods:
This post hoc analysis of data from the Management of Severe Sepsis in Asia’s Intensive Care Units II study included 537 patients with sepsis admitted to 27 ICUs in Korea. The outcome measures of interest were compared between the closed ICU group, patients admitted under the full responsibility of an intensivist as the primary attending physician, and the open ICU group. The association between a closed ICU and ICU mortality was evaluated using a logistic regression analysis.
Results:
Altogether, 363 and 174 enrolled patients were treated in open and closed ICUs, respectively. Compliance with the sepsis bundles did not differ between the two groups; however, the closed ICU group had a higher rate of renal replacement therapy and shorter duration of ventilator support. The closed ICU group also had a lower ICU mortality rate than the open ICU group (24.7% vs. 33.1%). In a logistic regression analysis, management in the closed ICU was significantly associated with a decreased ICU mortality rate even after adjusting for potential confounding factors (adjusted odds ratio, 0.576; 95% CI, 0.342–0.970), and that association was observed for up to 90 days.
Conclusions
Sepsis management in closed ICUs was significantly associated with improved ICU survival and decreased length of ICU stay, even though the compliance rates for the sepsis bundles did not differ between open and closed ICUs.
4.Primary Cutaneous CD30+ Lymphoproliferative Disorders in South Korea: A Nationwide, Multi-Center, Retrospective, Clinical, and Prognostic Study
Woo Jin LEE ; Sook Jung YUN ; Joon Min JUNG ; Joo Yeon KO ; Kwang Ho KIM ; Dong Hyun KIM ; Myung Hwa KIM ; You Chan KIM ; Jung Eun KIM ; Chan-Ho NA ; Je-Ho MUN ; Jong Bin PARK ; Ji-Hye PARK ; Hai-Jin PARK ; Dong Hoon SHIN ; Jeonghyun SHIN ; Sang Ho OH ; Seok-Kweon YUN ; Dongyoun LEE ; Seok-Jong LEE ; Seung Ho LEE ; Young Bok LEE ; Soyun CHO ; Sooyeon CHOI ; Jae Eun CHOI ; Mi Woo LEE ; On behalf of The Korean Society of Dermatopathology
Annals of Dermatology 2025;37(2):75-85
Background:
Primary cutaneous CD30+ lymphoproliferative disorders (pcCD30-LPDs) are a diseases with various clinical and prognostic characteristics.
Objective:
Increasing our knowledge of the clinical characteristics of pcCD30-LPDs and identifying potential prognostic variables in an Asian population.
Methods:
Clinicopathological features and survival data of pcCD30-LPD cases obtained from 22 hospitals in South Korea were examined.
Results:
A total of 413 cases of pcCD30-LPDs (lymphomatoid papulosis [LYP], n=237; primary cutaneous anaplastic large cell lymphoma [C-ALCL], n=176) were included. Ninety percent of LYP patients and roughly 50% of C-ALCL patients presented with multiple skin lesions. Both LYP and C-ALCL affected the lower limbs most frequently. Multiplicity and advanced T stage of LYP lesions were associated with a chronic course longer than 6 months. Clinical morphology with patch lesions and elevated serum lactate dehydrogenase were significantly associated with LPDs during follow-up in LYP patients. Extracutaneous involvement of C-ALCL occurred in 13.2% of patients. Lesions larger than 5 cm and increased serum lactate dehydrogenase were associated with a poor prognosis in C-ALCL. The survival of patients with C-ALCL was unaffected by the anatomical locations of skin lesions or other pathological factors.
Conclusion
The multiplicity or size of skin lesions was associated with a chronic course of LYP and survival among patients with C-ALCL.
5.Consensus-Based Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Biologics and JAK inhibitors
Hyun-Chang KO ; Yu Ri WOO ; Joo Yeon KO ; Hye One KIM ; Chan Ho NA ; Youin BAE ; Young-Joon SEO ; Min Kyung SHIN ; Jiyoung AHN ; Bark-Lynn LEW ; Dong Hun LEE ; Sang Eun LEE ; Sul Hee LEE ; Yang Won LEE ; Ji Hyun LEE ; Yong Hyun JANG ; Jiehyun JEON ; Sun Young CHOI ; Ju Hee HAN ; Tae Young HAN ; Sang Wook SON ; Sang Hyun CHO
Annals of Dermatology 2025;37(4):216-227
Background:
Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed.
Objective:
This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations.
Methods:
The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved.
Results:
This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women.
Conclusion
KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.
6.Consensus-Based Guidelines for the Treatment of Atopic Dermatitis in Korea (Part I): Basic Therapy, Topical Therapy, and Conventional Systemic Therapy
Hyun-Chang KO ; Yu Ri WOO ; Joo Yeon KO ; Hye One KIM ; Chan Ho NA ; Youin BAE ; Young-Joon SEO ; Min Kyung SHIN ; Jiyoung AHN ; Bark-Lynn LEW ; Dong Hun LEE ; Sang Eun LEE ; Sul Hee LEE ; Yang Won LEE ; Ji Hyun LEE ; Yong Hyun JANG ; Jiehyun JEON ; Sun Young CHOI ; Ju Hee HAN ; Tae Young HAN ; Sang Wook SON ; Sang Hyun CHO
Annals of Dermatology 2025;37(4):201-215
Background:
Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed.
Objective:
This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices.
Methods:
The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved.
Results:
The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD.
Conclusion
KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.
7.2023 Consensus Korean Diagnostic Criteria for Atopic Dermatitis
Ji Hyun LEE ; Sul Hee LEE ; Youin BAE ; Young Bok LEE ; Yong Hyun JANG ; Jiyoung AHN ; Joo Yeon KO ; Hyun-Chang KO ; Hye One KIM ; Chan Ho NA ; Young-Joon SEO ; Min Kyung SHIN ; Yu Ri WOO ; Bark Lyn LEW ; Dong Hun LEE ; Sang Eun LEE ; Jiehyun JEON ; Sun Young CHOI ; Tae Young HAN ; Yang Won LEE ; Sang Wook SON ; Young Lip PARK
Annals of Dermatology 2025;37(1):12-21
Background:
In 2006, the Korean Atopic Dermatitis Association (KADA) working group released the diagnostic criteria for Korean atopic dermatitis (AD). Recently, more simplified, and practical AD diagnostic criteria have been proposed. Objective: Based on updated criteria and experience, we studied to develop and share a consensus on diagnostic criteria for AD in Koreans.
Materials and Methods:
For the diagnostic criteria, a questionnaire was constructed by searching the English-language literature in MEDLINE and the Cochrane Database of Systematic Reviews. A modified Delphi method composed of 3 rounds of email questionnaires was adopted for the consensus process. Fifty-four KADA council members participated in the 3 rounds of votes and expert consensus recommendations were established.
Results:
Diagnostic criteria for AD include pruritus, eczema with age-specific pattern, and chronic or relapsing history. Diagnostic aids for AD encompass xerosis, immunoglobulin E reactivity, hand–foot eczema, periorbital changes, periauricular changes, perioral changes, nipple eczema, perifollicular accentuation, and personal or family history of atopy.
Conclusion
This study streamlined and updated the diagnostic criteria for AD in Korea, making them more practicable for use in real-world clinical field.
8.The First Korean Case of MAN1B1-Congenital Disorder of Glycosylation Diagnosed Using Whole-Exome Sequencing and Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry
Kyoung Bo KIM ; Gi Su LEE ; Soyoung SHIN ; Dong-Chan KIM ; Donggun SEO ; Hyeongjin KWEON ; Hyein KANG ; Sunggyun PARK ; Do-Hoon KIM ; Namhee RYOO ; Soyoung LEE ; Jung Sook HA
Annals of Laboratory Medicine 2025;45(1):112-115
9.Clinical Utility of Monitoring Circulating Tumor DNA Using a Targeted Next-generation Sequencing Panel in Patients with Colorectal Cancer
Hyoeun SHIM ; Soobeen HEO ; Jiyu SUN ; Moon Ki CHOI ; Sung Chan PARK ; Chang Won HONG ; Seong Hoon KIM ; Seog-Yun PARK ; Sun-Young KONG ; Ji Yeon BAEK
Annals of Laboratory Medicine 2025;45(4):450-458
Background:
Circulating tumor DNA (ctDNA) profiling from peripheral blood allows relatively noninvasive monitoring of solid tumors; however, its utility post-surgery or chemotherapy in colorectal cancer remains underexplored. We evaluated the clinical implications of a ctDNA next-generation sequencing (NGS) panel post-surgery or chemotherapy in patients with colorectal cancer.
Methods:
We collected samples from 23 patients with colorectal cancer (17 men, median age 65 yrs) at baseline and post-surgery or chemotherapy at the National Cancer Center, Korea, between January 2021 and September 2023. ctDNA was analyzed using an NGS panel including 46 genes, and variant allele frequencies (VAFs) were determined. Followup samples were analyzed using the NGS panel or droplet digital PCR (ddPCR) when probes were available. Clinical status was compared with ctDNA results, and survival was analyzed using a time-dependent Cox model.
Results:
Mutations were identified in 13 out of 14 patients (92.8%) with stage II/III cancer and in all nine patients (100%) with stage IV cancer. Mutations were detected in KRAS (N = 15, 65%), APC (N = 8, 35%), TP53 (N = 7, 30%), PIK3CA (N = 5, 22%), and RET (N = 4, 17%). A 1% increase in KRAS and TP53 VAFs was associated with 48% and 32% increased mortality risk, respectively. Changes in VAF correlated well with clinical findings.
Conclusions
The detection of and an increase in KRAS and TP53 VAFs were associated with poor prognosis. ddPCR-based ctDNA monitoring results were comparable to those obtained with the NGS panel. ctDNA monitoring during treatment is clinically informative in managing colorectal cancer.
10.Can Reference Materials Prepared Following CLSI C37-A Be Utilized Without Commutability Assessment?Perspectives Based on Lipid Measurements
Jong Do SEO ; Gye Cheol KWON ; Jeong-Ho KIM ; Sang-Guk LEE ; Junghan SONG ; Pil-Whan PARK ; Dongheui AN ; Qute CHOI ; Chan-Ik CHO ; Sollip KIM ; Yeo-Min YUN
Annals of Laboratory Medicine 2025;45(6):562-573
Background:
Ensuring reference material (RM) commutability is crucial for evaluating measurement traceability in order to standardize laboratory tests. However, commutability assessment is not routinely performed. We assessed whether RMs prepared following CLSI C37-A guidelines could be used without assessing commutability by evaluating their commutability for four lipid measurements using the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and CLSI EP14 protocols.
Methods:
We analyzed total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in frozen sera from 20 individuals and 11 RMs, prepared by the Korea Disease Control and Prevention AgencyLaboratory Standardization Project (per CLSI C37-A), using six routine measurement procedures (MPs). Regression equations and 95% prediction intervals derived from single-donor sera were analyzed following CLSI EP14. The IFCC protocol was used to assess differences in inter-MP biases between RM and clinical samples. The effect of the TG concentration on commutability was evaluated by analyzing biases between MP results and reference procedure-assigned values.
Results:
RMs were commutable for most MP pairs for TC and TG. Commutability for HDL-C and LDL-C varied across RMs, with RM10 and RM11 showing higher TG levels (2.38 and 2.95 mmol/L, respectively) and lower commutability. Increased bias percentages from assigned values were observed for RMs with higher TG levels.
Conclusions
RMs prepared per CLSI C37-A were commutable with most MP pairs for TC and TG. Elevated TG levels affected HDL-C and LDL-C commutability, highlighting the need to consider TG concentrations during RM preparation and assess commutability to standardize laboratory tests.

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