BACKGROUND: Korea has high prescribing rate and rising antibiotic resistance. This study was conducted to understand why primary physicians prescribe antibiotics for acute respiratory infections and to explore the factors that influence antibiotic resistance, and so to suggest strategy to reduce antibiotic resistance. METHODS: A qualitative exploratory approach was used using 4 focus groups composed of physicians from different area. A semi-structured guide was applied in obtaining the physicians' opinions. Common themes were extracted by authors, which were used to gather results and draw conclusion. RESULTS: Participants acknowledged multiple factors such as clinical factor and competitive environment are involved in physicians' decision of antibiotic prescribing. They identified that causes of rising antibiotic resistance were shortage of information, discontinuation of taking antibiotics, and other system factors. CONCLUSION: Participants were certain that less prescribing antibiotics and selecting appropriate antibiotics might be method to reduce antibiotic resistance. To change the prescribing behavior, it should be provided periodically for community physicians with prescribing information and specific guidelines for antibiotics resistance. Patients should be also noticed about antibiotic medication information more accurately. Including prescription incentive policy, improvement of healthcare system will be carried out at the same time.
Anti-Bacterial Agents* ; Delivery of Health Care ; Drug Resistance, Microbial ; Focus Groups ; Humans ; Information Dissemination ; Korea ; Methods ; Motivation ; Prescriptions* ; Respiratory Tract Infections

Extracellular vesicles (EVs) are sub-micrometer lipid vesicles secreted from parental cells with their information such as DNA, RNA, and proteins. EVs can deliver their cargo to recipient cells and regulate the signaling pathway of the recipient cells to determine their destiny. Depending on the cargo of EVs, the recipient cells can be changed into abnormal state or be relieved from diseases. Therefore, EVs has been spotlighted as emerging therapeutics in biomedical research. However, slow EV secretion rate is the major limitation for the clinical applications of EVs. EV secretion is highly environmental dependent and can be regulated by various stimulants such as chemicals, oxygen levels, pH, radiation, starvation, and culture methods. To overcome the limitation of low productivity of EVs, EV stimulation methods have been widely studied and applied to massive EV productions. Another strategy is the synthesis of artificial EVs from cells by physical methods such as nitrogen cavitation, extrusion via porous membrane, and sonication. These physical methods disrupt cellular membrane and reassemble the membrane to lipid vesicles containing proteins or drugs. In this review, we will focus on how EV generation can be enhanced and recent advances in large scale EV generation strategies.

Extracellular vesicles (EVs) are sub-micrometer lipid vesicles secreted from parental cells with their information such as DNA, RNA, and proteins. EVs can deliver their cargo to recipient cells and regulate the signaling pathway of the recipient cells to determine their destiny. Depending on the cargo of EVs, the recipient cells can be changed into abnormal state or be relieved from diseases. Therefore, EVs has been spotlighted as emerging therapeutics in biomedical research. However, slow EV secretion rate is the major limitation for the clinical applications of EVs. EV secretion is highly environmental dependent and can be regulated by various stimulants such as chemicals, oxygen levels, pH, radiation, starvation, and culture methods. To overcome the limitation of low productivity of EVs, EV stimulation methods have been widely studied and applied to massive EV productions. Another strategy is the synthesis of artificial EVs from cells by physical methods such as nitrogen cavitation, extrusion via porous membrane, and sonication. These physical methods disrupt cellular membrane and reassemble the membrane to lipid vesicles containing proteins or drugs. In this review, we will focus on how EV generation can be enhanced and recent advances in large scale EV generation strategies.

Transporting substances such as gases, nutrients, waste, and cells is the primary function of blood vessels. Vascular cells use membrane proteins to perform crucial endothelial functions, including molecular transport, immune cell infiltration, and angiogenesis.A thorough understanding of these membrane receptors from a clinical perspective is warranted to gain insights into the pathogenesis of vascular diseases and to develop effective methods for drug delivery through the vascular endothelium. This review summarizes stateof-the-art single-molecule imaging techniques, such as super-resolution microscopy, singlemolecule tracking, and protein–protein interaction analysis, for observing and studying membrane proteins. Furthermore, recent single-molecule studies of membrane proteins such as cadherins, integrins, caveolins, transferrin receptors, vesicle-associated protein-1, and vascular endothelial growth factor receptor are discussed.

Valosin-containing protein (VCP)-related multisystem proteinopathy (MSP1) is a rare genetic disorder marked by abnormal protein accumulation. This study presents the case of a 52-year-old woman with MSP1, showing progressive weakness, gait disturbances, and respiratory muscle weakness over five years. The clinical examination revealed diverse presentations, including neurogenic changes in electrophysiologic study, multifocal fatty changes of muscle, and cognitive impairment with a confirmed VCP gene mutation through genetic testing. Notably, we identified lobulated myofibers in the muscle biopsy, an unusual finding in MSP1. This is the first report of lobulated myofibers in MSP1 with multisystem involvement. Identifying unique muscle biopsy results in suspected MSP1 patients through careful neurological examinations and timely genetic testing may help in early diagnosis and appropriate management.

Acrokeratoelastoidosis (AKE) is a rare skin disorder initially described by Costa, which is inherited by autosomal dominant, but also may be sporadic. Clinically, it consists of small, firm papules with occasional keratosis or umbilication, characteristically along the margins of hands and feet. Histopathologically, it shows hyperkeratosis, acanthosis in the epidermis and fragmentation and rarefaction of elastic fibers-elastorrhexis-in the dermis. A 32-year-old man presented with multiple papules along the border of the hands and feet, and from histopathology, AKE was diagnosed. Herein we report a case of acrokeratoelastoidosis and review the clinical and histopathologic features, etiology, differential diagnosis and treatment.
Adult ; Dermis ; Diagnosis, Differential ; Epidermis ; Foot ; Hand ; Humans ; Keratosis ; Skin

BACKGROUND: Tinea pedis is the most common dermatophytosis which is usually treated by antifungal agent. Recently, there has been a resurgence of interest in potential phototherapy for the local treatment of bacterial and fungal infection. OBJECTIVE: The aim of this study is to evaluate the therapeutic effect of full spectrum light (F.S.L) phototherapy for patients with tinea pedis. METHODS: Lesions were irradiated for 20 minutes, 2 times a week for 4 consecutive weeks with F.S.L. emitting wavelengths from 320 nm to 5000 nm. Clinical symptoms were observed and KOH direct smear and fungal culture were done. RESULTS: Global assessment score was improved after the application of eight sessions of F.S.L phototherapy. 18% of total patient were cleared, 45.4% a marked improvement, 27.3% a mild improvement and 9.1% of patients had no effect. And the fungal exams, KOH direct smear and culture, were conversion to negative in 7 out of 11 patients. Significant adverse effects were not observed. CONCLUSION: F.S.L phototherapy might be another treatment option for the tinea pedis patients.
Enzyme Multiplied Immunoassay Technique ; Humans ; Light ; Phototherapy ; Tinea ; Tinea Pedis

Urticaria pigmentosa (UP) is the most common variant of cutaneous mastocytosis. Primarily a disease of childhood, in over one-half of the cases onset is before 2 years of age, and in 90%, the disease is confined to the skin. UP precedes the diagnosis of systemic mastocytosis and is more common in adults than in children. Therefore, systemic examination should be performed in patients with UP. We report a case of adult-onset UP with systemic involvement.
Adult ; Child ; Humans ; Mastocytosis, Cutaneous ; Mastocytosis, Systemic ; Skin ; Urticaria ; Urticaria Pigmentosa

BACKGROUND: Keratosis pilaris (KP) is a keratinization disorder that is characterized by follicular hyperkeratosis, with surrounding erythema. Topical treatments are widely used, but their effects are limited. OBJECTIVE: To evaluate the effectiveness of the Q-switched 1064-nm Nd:YAG laser for the treatment of KP. METHODS: Total of 12 patients with KP were treated with a Q-switched 1064-nm Nd:YAG laser. Ten sessions of laser treatment were delivered once every two weeks. The entire lesions were treated with the following laser settings: 4.0~5.0 J/cm2, 4-mm spot size, and three passes. Two dermatologists' clinical evaluations and patients' satisfaction were assessed between before treatment (baseline) and at 1 month after the last treatment. RESULTS: Eleven of the twelve patients showed more than grade 2 (>25%) improvement in texture and dyspigmentation in KP lesions, respectively. A half of the patients (50%) showed more than 50% improvement in the skin texture. Regarding dyspigmentation, five patients (41.7%) showed more than 50% improvement. Eleven out of twelve participants were satisfied (>25% of the Patients' self assessment) with the procedure. No significant adverse effect was observed. CONCLUSION: Although the Q-switched 1064-nm laser treatment may not be the first line therapy for KP, it might be a new treatment option for the patients with recalcitrant KP.
Abnormalities, Multiple ; Darier Disease ; Erythema ; Eyebrows ; Humans ; Keratins ; Keratosis ; Laser Therapy ; Pilot Projects ; Skin

Hyperhidrosis is an eccrine sweat gland disease that results from sympathetic hyperactivity, usually occurring on the axilla, palm, sole, or groin. It causes not only cosmetic problems, but also social stress in affected patients. Until now, several modalities have been used to treat focal hyperhidrosis, with variable clinical outcomes and complications, including skin irritation, neurological problems, and nonesthetic scar formation. Botulinum toxin type A has been used widely and successfully in the treatment of hyperhidrosis since 1981. Botulinum toxin type B has recently been introduced for off-label use after being approved by the Food and Drug Administration in 2000 for the treatment of cervical dystonia. However, there has been no report of Botulinum toxin type B treatment for palmoplantar hyperhidrosis in the Koreandermatologic literature. Herein, we report the first case of palmoplantar hyperhidrosis successfully treated with Botulinum Toxin B in Korea, along with a review of the literature.
Axilla ; Botulinum Toxins ; Botulinum Toxins, Type A ; Cicatrix ; Cosmetics ; Groin ; Humans ; Hyperhidrosis ; Korea ; Off-Label Use ; Skin ; Sweat Gland Diseases ; Torticollis ; United States Food and Drug Administration