Background: Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals. Methods: A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase. Results: Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates. Conclusions Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.

Background: Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals. Methods: A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase. Results: Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates. Conclusions Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.

Background: Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals. Methods: A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase. Results: Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates. Conclusions Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.

Background: Carbapenem resistance in Pseudomonas aeruginosa is a serious global health problem. We investigated the clonal distribution and its association with the carbapenem resistance mechanisms of carbapenem-non-susceptible P. aeruginosa isolates from three Korean hospitals. Methods: A total of 155 carbapenem-non-susceptible P. aeruginosa isolates collected between 2011 and 2019 were analyzed for sequence types (STs), antimicrobial susceptibility, and carbapenem resistance mechanisms, including carbapenemase production, the presence of resistance genes, OprD mutations, and the hyperproduction of AmpC β-lactamase. Results: Sixty STs were identified in carbapenem-non-susceptible P. aeruginosa isolates.Two high-risk clones, ST235 (N = 41) and ST111 (N = 20), were predominant; however, sporadic STs were more prevalent than high-risk clones. The resistance rate to amikacin was the lowest (49.7%), whereas that to piperacillin was the highest (92.3%). Of the 155 carbapenem-non-susceptible isolates, 43 (27.7%) produced carbapenemases. Three metalloβ-lactamase (MBL) genes, blaIMP-6 (N = 38), blaVIM-2 (N = 3), and blaNDM-1 (N = 2), were detected. blaIMP-6 was detected in clonal complex 235 isolates. Two ST773 isolates carried blaNDM-1 and rmtB. Frameshift mutations in oprD were identified in all isolates tested, regardless of the presence of MBL genes. Hyperproduction of AmpC was detected in MBL gene–negative isolates. Conclusions Frameshift mutations in oprD combined with MBL production or hyperproduction of AmpC are responsible for carbapenem resistance in P. aeruginosa. Further attention is required to curb the emergence and spread of new carbapenem-resistant P. aeruginosa clones.

Alopecia areata (AA) is common causes of non-scarring hair loss. Recently, a relationship with inflammatory bowel disease (IBD) was observed. Herein, we introduced cases of AA in patients with IBD. Six patients were diagnosed with AA and IBD. Three presented with alopecia totalis (AT), two presented with patchy-type AA, and one demonstrated acute diffuse and total alopecia. The most frequent type of IBD was ulcerative colitis (UC), except for one Crohn’s disease. The onset of AA relative to that of IBD was mixed; AA developed previously in all adolescents. Only one was receiving anti-tumor necrosis factor-alpha agents for IBD treatment and the hair loss worsened. Patients with patchy-type AA demonstrated favorable outcomes rather than patients with AT. This study confirmed that the ratio of AT and UC was high, suggesting that alopecia is more strongly associated with UC.Also, we emphasize the importance of careful observation of IBD symptoms in patients with AA, especially in adolescents.

Accessory extensor pollicis longus tendons are rare tendon anomalies. This report describes the case of a 54-year-old man who presented with pain and difficulty extending his thumb. Upon initial examination, despite a history of trauma, he could extend the interphalangeal joint, but with limited range. During the surgical exploration, an accessory extensor pollicis longus tendon was unexpectedly discovered. This tendon ran parallel to the extensor pollicis longus on the radial side and then attached to the distal phalanx of the thumb. Accessory extensor tendons are more commonly found on the ulnar side than on the radial side of the hand; therefore, this case is notable due to the unusual location of the tendon. After appropriate repair surgery, the patient successfully regained a normal range of motion. While previous classifications of extensor tendon anomalies have focused on the relationship between the extensor indicis proprius and extensor digitorum communis, this case suggests that it is also necessary to consider the relationship with the extensor pollicis brevis tendon. This case highlights the importance of recognizing tendon variations, especially in trauma situations. Detecting such variations preoperatively using imaging can significantly impact the treatment plan and surgical approach.

BACKGROUND/OBJECTIVES: Recently, herbal medicines have gained attention for the treatment of benign prostatic hyperplasia (BPH), a common disease in elderly men. In this study, we aimed to determine the effect of ethanol extract of Asparagi radix (EAR), which is traditionally used to treat various diseases, on BPH development using a testosteroneinduced BPH model.MATERIALS/METHODS: Testosterone propionate (TP)-treated Sprague–Dawley rats were used to establish a BPH model in vivo. EAR was orally administered along with TP, and finasteride was used as a positive control. All rats were sacrificed at the end of the experiment, and pathological changes in the prostate tissue and levels of key biomarkers associated with BPH pathogenesis were assessed. RESULTS: Oral administration of EAR significantly inhibited TP-induced BPH by reducing the prostate weight, lumen size, and epithelial thickness in a concentration-dependent manner. EAR also significantly abrogated the expression of 5α-reductase type 2 (SRD5A2), proliferating cell nuclear antigen, and prostate-specific antigen (PSA) induced by TP.Additionally, serum levels of testosterone, dihydrotestosterone, and PSA were elevated in the TP-induced group but decreased in the EAR-treated group. EAR also decreased the expression levels of the androgen receptor (AR) and its coactivators in TP-induced BPH model rats. CONCLUSION Our findings revealed that EAR protected against BPH by inhibiting 5α-reductase activity and AR signaling pathway, suggesting its potential for BPH treatment.

BACKGROUND/OBJECTIVES: Recently, herbal medicines have gained attention for the treatment of benign prostatic hyperplasia (BPH), a common disease in elderly men. In this study, we aimed to determine the effect of ethanol extract of Asparagi radix (EAR), which is traditionally used to treat various diseases, on BPH development using a testosteroneinduced BPH model.MATERIALS/METHODS: Testosterone propionate (TP)-treated Sprague–Dawley rats were used to establish a BPH model in vivo. EAR was orally administered along with TP, and finasteride was used as a positive control. All rats were sacrificed at the end of the experiment, and pathological changes in the prostate tissue and levels of key biomarkers associated with BPH pathogenesis were assessed. RESULTS: Oral administration of EAR significantly inhibited TP-induced BPH by reducing the prostate weight, lumen size, and epithelial thickness in a concentration-dependent manner. EAR also significantly abrogated the expression of 5α-reductase type 2 (SRD5A2), proliferating cell nuclear antigen, and prostate-specific antigen (PSA) induced by TP.Additionally, serum levels of testosterone, dihydrotestosterone, and PSA were elevated in the TP-induced group but decreased in the EAR-treated group. EAR also decreased the expression levels of the androgen receptor (AR) and its coactivators in TP-induced BPH model rats. CONCLUSION Our findings revealed that EAR protected against BPH by inhibiting 5α-reductase activity and AR signaling pathway, suggesting its potential for BPH treatment.

Alopecia areata (AA) is common causes of non-scarring hair loss. Recently, a relationship with inflammatory bowel disease (IBD) was observed. Herein, we introduced cases of AA in patients with IBD. Six patients were diagnosed with AA and IBD. Three presented with alopecia totalis (AT), two presented with patchy-type AA, and one demonstrated acute diffuse and total alopecia. The most frequent type of IBD was ulcerative colitis (UC), except for one Crohn’s disease. The onset of AA relative to that of IBD was mixed; AA developed previously in all adolescents. Only one was receiving anti-tumor necrosis factor-alpha agents for IBD treatment and the hair loss worsened. Patients with patchy-type AA demonstrated favorable outcomes rather than patients with AT. This study confirmed that the ratio of AT and UC was high, suggesting that alopecia is more strongly associated with UC.Also, we emphasize the importance of careful observation of IBD symptoms in patients with AA, especially in adolescents.

Objectives: The study aim was to analyze smoking knowledge and smoking cessation intentions according to the stage of change in smoking cessation behavior among smokers in their 20s. This program was implemented to prepare smoking cessation educational content in order to increase the success rate of smoking cessation. Methods: The analysis included 99 smokers in their 20s who lived in Seoul and Gyeonggi; the study period was February 14-16, 2024. After explaining the study purpose and obtaining consent for participation in the study, an online Google Forms survey was conducted. Results: Smoking cessation intention and smoking knowledge according to the smoking cessa-tion behavior change stage were significantly different depending on the presence of smokers and whether they attempted smoking cessation in the pre-contemplation period (P<0.05). In addition, the intention to quit smoking significantly increased in the pre-contemplation, contemplation, and preparation periods in the smoking cessation behavior change stage (P<0.001). Conclusions By operating a smoking cessation intervention program for smokers in their 20s, pro-viding correct smoking knowledge and finding ways to increase smoking cessation intention, smok-ers’ behavior can change and they can form a quitting habit. Therefore, we can expect that even middle-aged or older people can quit smoking.