BACKGROUND: Therapeutic education is important for successful management of atopic dermatitis (AD). OBJECTIVE: To provide effective therapeutic education, clear common misunderstandings, and answer questions regarding AD among patients and caregivers. METHODS: A questionnaire survey was conducted for patients and caregivers who visited the Department of Dermatology at Seoul National University Hospital, Seoul, Korea, regarding the course, etiology, and management of AD. RESULTS: Among the 327 subjects who participated in the study, only 35.2% were aware of the natural course of AD, which usually improves with age. Many subjects (53.2%) misinterpret AD relapse as resistance to topical steroids. We found that 87.8% of subjects were under the impression that improvement in a patient's immunity can improve the symptoms of AD. Dietary restriction was considered an essential management strategy, and 59.0% of subjects agreed to delay the initiation of weaning foods. Most subjects did not have accurate information about cleansing methods, and 30.9% of subjects reported that they used only water without any cleanser. We noted that 47.5% of subjects obtained information regarding AD from medical doctors who they considered the most reliable sources (82.5%). Subjects preferred printed materials (41.3%) over seminars or video-clips to obtain educational information. CONCLUSION: Therapeutic education regarding the course, etiology, and management of AD using printed materials put together by physicians would be a valuable tool for the effective management of AD. Institutional support such as educational programs covered by the National Health Insurance Service is required.
Caregivers ; Dermatitis, Atopic* ; Dermatology ; Education* ; Humans ; Korea ; National Health Programs ; Recurrence ; Seoul ; Steroids ; Water ; Weaning

BACKGROUND: Therapeutic education is important for successful management of atopic dermatitis (AD). OBJECTIVE: To provide effective therapeutic education, clear common misunderstandings, and answer questions regarding AD among patients and caregivers. METHODS: A questionnaire survey was conducted for patients and caregivers who visited the Department of Dermatology at Seoul National University Hospital, Seoul, Korea, regarding the course, etiology, and management of AD. RESULTS: Among the 327 subjects who participated in the study, only 35.2% were aware of the natural course of AD, which usually improves with age. Many subjects (53.2%) misinterpret AD relapse as resistance to topical steroids. We found that 87.8% of subjects were under the impression that improvement in a patient's immunity can improve the symptoms of AD. Dietary restriction was considered an essential management strategy, and 59.0% of subjects agreed to delay the initiation of weaning foods. Most subjects did not have accurate information about cleansing methods, and 30.9% of subjects reported that they used only water without any cleanser. We noted that 47.5% of subjects obtained information regarding AD from medical doctors who they considered the most reliable sources (82.5%). Subjects preferred printed materials (41.3%) over seminars or video-clips to obtain educational information. CONCLUSION: Therapeutic education regarding the course, etiology, and management of AD using printed materials put together by physicians would be a valuable tool for the effective management of AD. Institutional support such as educational programs covered by the National Health Insurance Service is required.
Caregivers ; Dermatitis, Atopic* ; Dermatology ; Education* ; Humans ; Korea ; National Health Programs ; Recurrence ; Seoul ; Steroids ; Water ; Weaning

Intense pulsed light (IPL) is a high-intensity pulsed light source emitting polychromatic, non-coherent, and defocused light with a broad wavelength spectrum. However, IPL can similarly work as a conventional laser with the help of variable cut-off filters. It enables selective destruction of target chromophores based upon the theory of selective photothermolysis. Clinicians can combine variable factors including wavelengths, pulse durations, and fluences in IPL systems, which allow great versatility in treating wide ranges of dermatologic diseases and flexibility in optimizing individual treatment parameters according to different skin types or indications. These properties are of great advantage for skilled and experienced clinicians but can be a source of unwanted serious adverse effects for untrained ones at the same time. Therefore, we summarized the basic principles and clinical application of IPL devices to provide the practical guidance. In addition, critical diagnostics, a great deal of experience, and a thorough knowledge of skin pathology and physiology are required for an effective and safe IPL treatment.
Enzyme Multiplied Immunoassay Technique ; Imidazoles ; Light ; Nitro Compounds ; Pliability ; Skin

Valuable natural compounds produced by a variety of microorganisms can be used as lead molecules for development of new agrochemicals. Furthermore, high-throughput in vitro screening systems with specific modes of action can increase the probability of discovery of new fungicides. In the current study, a rapid assay tested with various microbes was developed to determine the degree of respiratory inhibition of Saccharomyces cerevisiae in two different liquid media, YG (containing a fermentable carbon source) and NFYG (containing a non-fermentable carbon source). Based on this system, we screened 100 fungal isolates that were classified into basidiomycetes, to find microbial secondary metabolites that act as respiratory inhibitors. Consequently, of the 100 fungal species tested, the culture broth of an IUM04881 isolate inhibited growth of S. cerevisiae in NFYG medium, but not in YG medium. The result is comparable to that from treatment with kresoxim-methyl used as a control, suggesting that the culture broth of IUM04881 isolate might contain active compounds showing the inhibition activity for respiratory chain. Based on the assay developed in this study and spectroscopic analysis, we isolated and identified an antifungal compound (-)-oudemansin A from culture broth of IUM04881 that is identified as Oudemansiella venosolamellata. This is the first report that (-)-oudemansin A is identified from O. venosolamellata in Korea. Taken together, the development of this assay will accelerate efforts to find and identify natural respiratory inhibitors from various microbes.

BACKGROUND: Adverse cutaneous drug reactions (ACDRs) are common and are responsible for increased morbidity, mortality, and socioeconomic costs. OBJECTIVE: The purpose of our study was to investigate the common drugs and clinical patterns related to ACDRs using an electronic drug adverse reaction reporting system at a single secondary referral center. METHODS: We conducted a retrospective analysis of the ACDR database between January 2014 and April 2016 at the Ilsan Paik Hospital. RESULTS: The study analyzed 320 patients with ACDRs (male:female ratio=93:227; mean age 50.8±17.8 years). Using a Korean causality evaluation algorithm, the percentage of drugs with a possible relationship with ACDRs was calculated to be 50.6%, while the percentage with a probable relationship was 44.7%. Antibiotics (44.0%), radiocontrast media (15.1%), and non-steroidal anti-inflammatory drugs (NSAIDs) (14.3%) were the most commonly implicated drugs. Antibiotics, including cephalosporins (30.6%) and quinolones (10.2%), were responsible for the majority of the ACDRs. Acetic acid (5.9%) and propionic acid (5.9%) derivatives of NSAIDs were also common causative agents. The most common clinical presentations were maculopapular exanthema (33.4%), pruritus (30.9%), and urticaria (25.7%). Severe ACDRs were significantly associated with older age, eosinophilia, and underlying heart and renal diseases (p<0.05). CONCLUSION: Antibiotics, radiocontrast media, and NSAIDs were identified as common causes of ACDRs. Older age, eosinophilia, heart disease, and renal disease were associated with severe ACDRs.
Acetic Acid ; Adverse Drug Reaction Reporting Systems ; Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Cephalosporins ; Contrast Media ; Diethylpropion ; Drug-Related Side Effects and Adverse Reactions ; Eosinophilia ; Exanthema ; Heart ; Heart Diseases ; Humans ; Mortality ; Pruritus ; Quinolones ; Retrospective Studies* ; Secondary Care Centers* ; Urticaria

Purpose: This study aimed to compare the long-term functional and patient-reported outcomes between intra-corporeal delta-shaped gastroduodenostomy and gastrojejunostomy after laparoscopic distal gastrectomy for gastric cancer. Materials and Methods: We retrospectively reviewed clinicopathological data from 616 patients who had undergone laparoscopic distal gastrectomy for stage I gastric cancer between January 2015 and September 2020. Among them, 232 patients who had undergone delta-shaped anastomosis and another 232 who had undergone Billroth II anastomosis were matched using propensity scores. Confounding variables included age, sex, body mass index, physical status classification, tumor location, and T classification. Postoperative complications, nutritional outcomes, endoscopic findings, and quality of life (QoL) were compared between the 2 groups. Results: No significant differences in postoperative complications or nutritional parameters between the two groups were observed. Annual endoscopic findings revealed more residual food and less bile reflux in the delta group (P<0.001) than in the Billroth II group. Changes of QoL were significantly different regarding emotional function, insomnia, diarrhea, reflux symptoms, and dry mouth (P=0.007, P=0.002, P=0.013, P=0.001, and P=0.03, respectively).Among them, the delta group had worse insomnia, reflux symptoms, and dry mouth within three months postoperatively. Conclusions Long-term nutritional outcomes and QoL were comparable between the delta and Billroth II groups. However, more residual food and worse short-term QoL regarding insomnia, reflux symptoms, and dry mouth were observed in the delta group. Longer fasting time before endoscopic evaluation and short-term symptom management would have been helpful for the delta group.

Purpose: This study’s aim was to confirm the importance and performance of the clinical practice of nurses working in the general wards of a tertiary hospital and to analyze their educational needs. Methods: The study employed a descriptive research design, and a self-reported questionnaire was developed and used for nurses in a tertiary hospital. Data were collected from July 22 to July 29, 2022, analyzed by an independent t-test, paired t-test, and one-way ANOVA for the importance and performance of each clinical nursing practice according to general characteristics, and then a post hoc verification was performed by Scheffé’s test. An Importance-Performance Analysis and Borich needs assessment model were used to analyze clinical nursing education needs. Results: Clinical nursing practice performance showed a significant difference according to length of total clinical career, time working in current department, and preceptor experience. According to the results of the Importance-Performance Analysis, neurological evaluation, and nursing intervention, artificial respirator and high-flow oxygen inhalation nursing, chemotherapy, emergency nursing, and cardiopulmonary resuscitation were identified as belonging to the “concentrate here” quadrant. All these items ranked in the top 10 in the Borich needs assessment model. Conclusion Based on these results, the current education system should be reviewed, and short and long term education strategies based on educational needs should be established to strengthen the competence of nurses.

BACKGROUND: The diagnosis of bullous pemphigoid is made based on clinical, histologic, and immunofluorescence features. OBJECTIVE: The purpose of this study was to analyze the factors that may affect the positivity and intensity of direct immunofluorescence (DIF) in patients with bullous pemphigoid. METHODS: We performed a retrospective review of 41 cases of bullous pemphigoid at Ilsan Paik Hospital between January 2008 and December 2014. We investigated the positivity of DIF, immunofluorescence intensity of C3, age, sex, biopsy sites, extent of disease, duration of disease, and the degree of inflammatory cell infiltration. RESULTS: Twenty-seven of 41 (65.9%) cases had positive DIF results for either IgG or C3, and 14 of 41 (34.1%) had negative DIF results for both IgG and C3. Twenty-one cases (51.2%) of IgG and 25 cases (61.0%) of C3 had characteristic linear C3 deposition on the dermo-epidermal junction. Disease duration influenced DIF positivity (p<0.05). Although a higher positive rate of DIF was observed in biopsy specimens taken from the upper extremities than in those from other sites, the difference was not statistically significant. Sex, age, extent of disease, and the degree of inflammatory cell infiltration were not significantly associated with the positivity of DIF. There was no relationship between fluorescence intensity of C3 and the degree of inflammatory cell infiltration. CONCLUSION: This study suggests that the long duration of disease (more than 10 days) may increase the positivity of DIF. Age, sex, biopsy site, extent of disease, and the degree of inflammatory cell infiltration had no influence on DIF positivity.
Biopsy ; Diagnosis ; Fluorescence ; Fluorescent Antibody Technique ; Fluorescent Antibody Technique, Direct* ; Humans ; Immunoglobulin G ; Pemphigoid, Bullous* ; Retrospective Studies ; Upper Extremity

Bioelectrical impedance analysis (BIA) models must be validated against a reference method in a representative population sample before they can be accepted as accurate and applicable. The purpose of this study was to compare the eight-electrode BIA method with DEXA as a reference method in the assessment of body composition in Korean adults and to investigate the predictive accuracy and applicability of the eight-electrode BIA model. A total of 174 apparently healthy adults participated. The study was designed as a cross-sectional study. FM, %fat, and FFM were estimated by an eight-electrode BIA model and were measured by DEXA. Correlations between BIA_%fat and DEXA_%fat were 0.956 for men and 0.960 for women with a total error of 2.1%fat in men and 2.3%fat in women. The mean difference between BIA_%fat and DEXA_%fat was small but significant (P < 0.05), which resulted in an overestimation of 1.2 +/- 2.2%fat (95% CI: -3.2-6.2%fat) in men and an underestimation of -2.0 +/- 2.4%fat (95% CI: -2.3-7.1%fat) in women. In the Bland-Altman analysis, the %fat of 86.3% of men was accurately estimated and the %fat of 66.0% of women was accurately estimated to within 3.5%fat. The BIA had good agreement for prediction of %fat in Korean adults. However, the eight-electrode BIA had small, but systemic, errors of %fat in the predictive accuracy for individual estimation. The total errors led to an overestimation of %fat in lean men and an underestimation of %fat in obese women.
Adult ; Body Composition ; Cross-Sectional Studies ; Electric Impedance ; Female ; Humans ; Male

Purpose: We evaluated whether there is an association between sequential changes in kinetic profiles by computer-aided detection (CAD) during neoadjuvant chemotherapy (NAC) and pathologic complete response (pCR) and residual cancer burden (RCB) in dynamic contrast-enhanced MRI (DCE-MRI) of patients with invasive breast cancer. Materials and Methods: This retrospective study involved 51 patients (median age, 48 years; range, 33–60 years) who underwent pre-, interim-, and post-NAC DCE-MRIs at 3 T. The tumor size and CAD-generated kinetic profiles (peak enhancement and delayed enhancement [persistent, plateau, and washout] components) were measured. Percentage changes in pre- and interim-NAC (ΔMRI value1) and pre- and post-NAC (ΔMRI value2) were compared between pCR and non-pCR cases, and according to RCB. Receiver operating characteristic curve analysis was performed to evaluate the association between pCR and MRI parameters (including CAD-generated kinetic profiles). Results: The pCR rate was 19.6% (10/51). There were statistically significant differences in Δtumor size2 (p < 0.01), Δpeak enhancement2 (p = 0.01), Δpersistent2 (p = 0.01), Δplateau2 (p = 0.02), and Δwashout2 (p = 0.03) between pCR and non-pCR. ΔTumor size2 provided very good diagnostic accuracy for pCR (cut-off, -90%; area under the curve, 0.88). There were differences in Δtumor size2, Δpeak enhancement2, Δplateau2, and Δwashout2 between RCB classes (p < 0.01). Conclusion DCE-MRI using CAD has the potential for predicting pCR and RCB classes.