Background: Primary cicatricial alopecia (PCA) is a group of disorders causing irreversible hair loss because of hair follicle destruction. Although bacterial colonization is suspected to contribute to PCA pathogenesis, its role remains unclear. Objective: To investigate bacterial colonization patterns and antibiotic susceptibility profiles in patients with PCA compared to those with non-inflammatory scalp conditions. Methods: This retrospective study analyzed bacterial cultures from scalp swabs of 161 subjects (68 patients with PCA and 93 controls) at a tertiary hospital between June 2011 and December 2023. Bacterial species and antibiotic resistance rates were evaluated using subgroup analyses of neutrophilic PCA (NCA). Results: PCA cultures showed a higher prevalence of Staphylococcus aureus (24.3%) and S. lugdunensis (8.1%) than controls, where S. capitis (54.5%) was predominant. Gram-negative bacteria were more frequent in the PCA group (13.5%) than in the control group (9.9%), with Klebsiella spp.(10.9%) being the most prevalent. Resistance rates were significantly higher in PCA for benzylpenicillin, fusidic acid, erythromycin, clindamycin, oxacillin, and telithromycin (p<0.05). Methicillin-resistant S. aureus was identified in 15% of S. aureus isolates from NCA cases. Gram-negative bacteria in PCA also exhibited increased resistance to ampicillin and ampicillin/sulbactam. Conclusion PCA exhibits distinct bacterial colonization and elevated antibiotic resistance, particularly in the neutrophilic subtypes. Bacterial culture and susceptibility testing are essential for targeted therapies in clinical practice. Further multicenter microbiome analyses with mechanistic studies are needed to elucidate bacterial contributions to PCA pathogenesis.

Chronic kidney disease (CKD)-associated pruritus is a severe distressing condition that frequently occurs in patients undergoing dialysis. In this study, the profile of the skin microbiome was analyzed to understand the underlying etiology and potential treatments. Methods: Seventy-six end-stage kidney disease (ESKD) patients (hemodialysis, 40; peritoneal dialysis, 36) and 15 healthy controls were enrolled and swabbed at three sites: back, antecubital fossa, and shin. The pruritus severity of the enrolled subjects was validated by the Worst Itch Numeric Rating Scale (WI-NRS), 5-D itch scale, and Uremic Pruritus in Dialysis Patients (UP-Dial). The 16S genebased metagenomics method was applied to skin microbiome analysis. Results: In the comparison of bacterial communities of ESKD patients and the control group, there was a significant difference on back. Specifically, the average composition ratio of the Cutibacterium in the back samples was significantly lower in ESKD patients than in healthy controls (p < 0.01). In further analysis of ESKD patients, Cutibacterium was significantly lower in the high pruritus group than in the low pruritus group (p < 0.05), even though other clinical parameters such as age, calcium-phosphorus product, and intact parathyroid hormone showed no significance difference between the groups. Conclusion: In ESKD patients, the skin microbiome of the back was significantly altered, and the severity of itching was related to the reduction of Cutibacterium. This research reveals the relationship between skin microbiota and CKD-associated pruritus in multiple skin sites for the first time. The results of this study suggest a potential data basis for the diagnosis and treatment of CKD-associated pruritus.

Purpose: Although the prevalence of a discoid lateral meniscus is relatively rare, estimated at approximately 0.4% to 5.0% in the Western world, studies have shown that the incidence is significantly higher in Asia, particularly in South Korea and Japan, ranging from 10.5% to 16.6%. On the other hand, previous studies that reported the incidence of discoid lateral meniscus mainly relied on patients who underwent arthroscopic or open surgery. This study examined the incidence of discoid lateral meniscus using a magnetic resonance imaging-based diagnostic approach. Materials and Methods: This study conducted a retrospective review of the prevalence of discoid lateral meniscus in 10,810 male patients with knee pain who underwent magnetic resonance imaging at the author’s single institution between January 2013 and January 2023. The mean age of the patients was 42.55±15.93 years old (range: 12 to 82). The patient demographics, including age, were analyzed.The characteristics of the discoid lateral meniscus were also analyzed, including the subtype and presence of a combined lateral meniscus tear. Results: This study identified 1,025 patients (9.5%) with a discoid lateral meniscus, including 129 with the complete subtype, 893 with the incomplete subtype, and 3 with the Wrisberg-type subtype. Although there was no significant difference in prevalence between sexes, the highest diagnosis rate of discoid lateral meniscus was observed in the 41–60-year-old (10.1%) age group, which was statistically significant (p=0.025). Among the 164 patients with a concurrent lateral meniscus tear, the horizontal type (80 patients, 48.8%) was the most frequently observed. Conclusion While the incidence in the present study was slightly lower than that reported in previous arthroscopic-based studies, the findings still suggest a relatively high prevalence of discoid lateral meniscus in Korea compared to other countries. In contrast to earlier research that suggested a decline in incidence with age, this study found that the incidence of discoid lateral meniscus was highest among individuals aged 41–60 years.

Purpose: Although the prevalence of a discoid lateral meniscus is relatively rare, estimated at approximately 0.4% to 5.0% in the Western world, studies have shown that the incidence is significantly higher in Asia, particularly in South Korea and Japan, ranging from 10.5% to 16.6%. On the other hand, previous studies that reported the incidence of discoid lateral meniscus mainly relied on patients who underwent arthroscopic or open surgery. This study examined the incidence of discoid lateral meniscus using a magnetic resonance imaging-based diagnostic approach. Materials and Methods: This study conducted a retrospective review of the prevalence of discoid lateral meniscus in 10,810 male patients with knee pain who underwent magnetic resonance imaging at the author’s single institution between January 2013 and January 2023. The mean age of the patients was 42.55±15.93 years old (range: 12 to 82). The patient demographics, including age, were analyzed.The characteristics of the discoid lateral meniscus were also analyzed, including the subtype and presence of a combined lateral meniscus tear. Results: This study identified 1,025 patients (9.5%) with a discoid lateral meniscus, including 129 with the complete subtype, 893 with the incomplete subtype, and 3 with the Wrisberg-type subtype. Although there was no significant difference in prevalence between sexes, the highest diagnosis rate of discoid lateral meniscus was observed in the 41–60-year-old (10.1%) age group, which was statistically significant (p=0.025). Among the 164 patients with a concurrent lateral meniscus tear, the horizontal type (80 patients, 48.8%) was the most frequently observed. Conclusion While the incidence in the present study was slightly lower than that reported in previous arthroscopic-based studies, the findings still suggest a relatively high prevalence of discoid lateral meniscus in Korea compared to other countries. In contrast to earlier research that suggested a decline in incidence with age, this study found that the incidence of discoid lateral meniscus was highest among individuals aged 41–60 years.

Purpose: This study assessed the clinical outcomes of a modified Broström operation using all-suture anchors for patients with chronic lateral ankle instability. Methods: A comprehensive analysis was conducted on 22 cases with a minimum follow-up of 1 year. Clinical outcomes were assessed using the Karlsson scores and Sefton’s grading system. Results: Significant improvement was observed in patients’ symptoms postoperatively. Karlsson scores increased markedly from preoperative levels, indicating substantial clinical improvement. Most patients (20 of 22, 90.9%) were categorized as ‘excellent’ or ‘good’ according to Sefton’s grading. There was no anchor related complication. Conclusion The modified Broström operation employing all-suture anchors demonstrated favorable clinical outcomes for patients with chronic lateral ankle instability. This technique can be promising alternative for traditional modified Broström operation, offering improved stability and symptom relief.

Purpose: Although the prevalence of a discoid lateral meniscus is relatively rare, estimated at approximately 0.4% to 5.0% in the Western world, studies have shown that the incidence is significantly higher in Asia, particularly in South Korea and Japan, ranging from 10.5% to 16.6%. On the other hand, previous studies that reported the incidence of discoid lateral meniscus mainly relied on patients who underwent arthroscopic or open surgery. This study examined the incidence of discoid lateral meniscus using a magnetic resonance imaging-based diagnostic approach. Materials and Methods: This study conducted a retrospective review of the prevalence of discoid lateral meniscus in 10,810 male patients with knee pain who underwent magnetic resonance imaging at the author’s single institution between January 2013 and January 2023. The mean age of the patients was 42.55±15.93 years old (range: 12 to 82). The patient demographics, including age, were analyzed.The characteristics of the discoid lateral meniscus were also analyzed, including the subtype and presence of a combined lateral meniscus tear. Results: This study identified 1,025 patients (9.5%) with a discoid lateral meniscus, including 129 with the complete subtype, 893 with the incomplete subtype, and 3 with the Wrisberg-type subtype. Although there was no significant difference in prevalence between sexes, the highest diagnosis rate of discoid lateral meniscus was observed in the 41–60-year-old (10.1%) age group, which was statistically significant (p=0.025). Among the 164 patients with a concurrent lateral meniscus tear, the horizontal type (80 patients, 48.8%) was the most frequently observed. Conclusion While the incidence in the present study was slightly lower than that reported in previous arthroscopic-based studies, the findings still suggest a relatively high prevalence of discoid lateral meniscus in Korea compared to other countries. In contrast to earlier research that suggested a decline in incidence with age, this study found that the incidence of discoid lateral meniscus was highest among individuals aged 41–60 years.

Background/Aims: Changing trends in the Helicobacter pylori (H. pylori) eradication protocol have not been investigated after the publication of the third-revised Korean guideline in 2013. We aimed to analyze the clinical characteristics of H. pylori-infected patients alongside their treatment protocols using a common data model (CDM). Materials and Methods: A 16-year electronic health record (of 1,689,604 patients from 2004 to 2019) was converted into a CDM in Kangdong Sacred Heart Hospital. We extracted records of patients who underwent the rapid urease test or serum anti-H. pylori IgG assay. The treatment protocols were visualized using a sunburst plot. We investigated the clinical characteristics and medication history of patients who underwent a urea breath test after clarithromycin-based eradication therapy. Results: Out of 29,458 patients tested for H. pylori infection, 7,647 received a treatment protocol. Among them, 72.5% received a 7~14 days protocol comprising a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. The proportion of patients treated with the first-line protocol (PPI, bismuth, tetracycline, and metronidazole) slightly increased from 1.9% (before 2014) to 3.3% (after 2014) (P<0.001). The percentages of patients with of previous exposure to macrolides (14.7% vs. 5.5%, P<0.001) or amoxicillin (10.6% vs. 7.3%, P=0.006) were higher in patients with previous clarithromycin-based eradication failure. Conclusions The H. pylori treatment protocol was not significantly modified despite the updates in the clinical guideline. There was only 1.4 percentage point increase in bismuth-based quadruple therapy as first-line eradication therapy even after the announcement of revised Korean guideline in 2013.

Helicobacter pylori infection is one of the most common infectious diseases worldwide. Although the prevalence of H. pylori is gradually decreasing, approximately half of the world's population still becomes infected with this disease. H. pylori is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the H. pylori clinical practice guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of H. pylori were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of H. pylori infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future.

Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.

Background/Aims: Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for Helicobacter pylori infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea. Methods: PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model. Results: Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (P<0.01). Conclusions These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.