Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background: Healthcare-associated infections (HAI) caused by multidrug-resistant organisms have emerged as a significant global issue, posing substantial challenges to healthcare systems. Low- and intermediate-level disinfectants are extensively utilized for cleaning and disinfecting surfaces in hospitals to mitigate environmental transmission of HAI. Therefore, the need for more effective and environmentally safe disinfectants is increasing.This study aimed to assess the effect of antimicrobial wipes used for surface cleaning and disinfection in healthcare environments. Materials and Methods: A microbe library comprising 188 bacterial and fungal isolates, including multidrug-resistant strains, was established and used to evaluate the antimicrobial effect of three types of antimicrobial wipes:A (didecyldimethylammonium chloride [DDAC] 0.31% and 3-(trimethoxysilyl)-propyldimethyloctadecyl ammonium chloride [Si-QAC] 0.45%); B (benzalkonium chloride [BAK] 0.63%); and C (DDAC 0.5% and BAK 0.9%). The antimicrobial effect of the wipes was assessed and compared in three assays: rapid bactericidal effect assay of the three wipes, minimum inhibitory concentration (MIC) assay of DDAC and BAK, and a time-kill assay of the DDAC and Si-QAC combination. Results: The rapid antimicrobial effect evaluation showed that both wipes A and C, which contain a combination of two quaternary ammonium compounds (QACs), exhibited similar antimicrobial effect (P=0.8234). Antimicrobial wipe A demonstrated better effect against Gram-positive bacteria and fungi than wipe C (P <0.05). The antimicrobial efficacy of the A wipe against Mycobacterium strains was superior to that of both the B and C wipes. Moreover, DDAC exhibited MIC50 values that were 2 to 3-fold lower than those of BAK for Gram-negative bacteria and fungi.The time-kill assay results for the DDAC and Si-QAC combination exhibited a growth reduction of >3 logs for Staphylococcus aureus and Enterococcus faecium, whereas approximately 2 logs of reduction was observed for Escherichia coli and Pseudomonas aeruginosa at 3 hour. Conclusion The results suggest that antimicrobial wipes containing relatively lower concentrations of QAC (wipe A) achieve similar rapid bactericidal effect as that of those with higher concentrations (wipe C). For Gram-negative bacteria, including multidrug-resistant strains and fungal isolates, DDAC presented lower MICs compared with BAK. Furthermore, the combination therapy with DDAC and Si-QAC demonstrated enhanced efficacy compared to treatment with either agent alone, except in the case of Klebsiella strains. Further research is needed to develop antimicrobial wipes that minimize the environmental impact while ensuring effective disinfection.

Background: Healthcare-associated infections (HAI) caused by multidrug-resistant organisms have emerged as a significant global issue, posing substantial challenges to healthcare systems. Low- and intermediate-level disinfectants are extensively utilized for cleaning and disinfecting surfaces in hospitals to mitigate environmental transmission of HAI. Therefore, the need for more effective and environmentally safe disinfectants is increasing.This study aimed to assess the effect of antimicrobial wipes used for surface cleaning and disinfection in healthcare environments. Materials and Methods: A microbe library comprising 188 bacterial and fungal isolates, including multidrug-resistant strains, was established and used to evaluate the antimicrobial effect of three types of antimicrobial wipes:A (didecyldimethylammonium chloride [DDAC] 0.31% and 3-(trimethoxysilyl)-propyldimethyloctadecyl ammonium chloride [Si-QAC] 0.45%); B (benzalkonium chloride [BAK] 0.63%); and C (DDAC 0.5% and BAK 0.9%). The antimicrobial effect of the wipes was assessed and compared in three assays: rapid bactericidal effect assay of the three wipes, minimum inhibitory concentration (MIC) assay of DDAC and BAK, and a time-kill assay of the DDAC and Si-QAC combination. Results: The rapid antimicrobial effect evaluation showed that both wipes A and C, which contain a combination of two quaternary ammonium compounds (QACs), exhibited similar antimicrobial effect (P=0.8234). Antimicrobial wipe A demonstrated better effect against Gram-positive bacteria and fungi than wipe C (P <0.05). The antimicrobial efficacy of the A wipe against Mycobacterium strains was superior to that of both the B and C wipes. Moreover, DDAC exhibited MIC50 values that were 2 to 3-fold lower than those of BAK for Gram-negative bacteria and fungi.The time-kill assay results for the DDAC and Si-QAC combination exhibited a growth reduction of >3 logs for Staphylococcus aureus and Enterococcus faecium, whereas approximately 2 logs of reduction was observed for Escherichia coli and Pseudomonas aeruginosa at 3 hour. Conclusion The results suggest that antimicrobial wipes containing relatively lower concentrations of QAC (wipe A) achieve similar rapid bactericidal effect as that of those with higher concentrations (wipe C). For Gram-negative bacteria, including multidrug-resistant strains and fungal isolates, DDAC presented lower MICs compared with BAK. Furthermore, the combination therapy with DDAC and Si-QAC demonstrated enhanced efficacy compared to treatment with either agent alone, except in the case of Klebsiella strains. Further research is needed to develop antimicrobial wipes that minimize the environmental impact while ensuring effective disinfection.

Background: Healthcare-associated infections (HAI) caused by multidrug-resistant organisms have emerged as a significant global issue, posing substantial challenges to healthcare systems. Low- and intermediate-level disinfectants are extensively utilized for cleaning and disinfecting surfaces in hospitals to mitigate environmental transmission of HAI. Therefore, the need for more effective and environmentally safe disinfectants is increasing.This study aimed to assess the effect of antimicrobial wipes used for surface cleaning and disinfection in healthcare environments. Materials and Methods: A microbe library comprising 188 bacterial and fungal isolates, including multidrug-resistant strains, was established and used to evaluate the antimicrobial effect of three types of antimicrobial wipes:A (didecyldimethylammonium chloride [DDAC] 0.31% and 3-(trimethoxysilyl)-propyldimethyloctadecyl ammonium chloride [Si-QAC] 0.45%); B (benzalkonium chloride [BAK] 0.63%); and C (DDAC 0.5% and BAK 0.9%). The antimicrobial effect of the wipes was assessed and compared in three assays: rapid bactericidal effect assay of the three wipes, minimum inhibitory concentration (MIC) assay of DDAC and BAK, and a time-kill assay of the DDAC and Si-QAC combination. Results: The rapid antimicrobial effect evaluation showed that both wipes A and C, which contain a combination of two quaternary ammonium compounds (QACs), exhibited similar antimicrobial effect (P=0.8234). Antimicrobial wipe A demonstrated better effect against Gram-positive bacteria and fungi than wipe C (P <0.05). The antimicrobial efficacy of the A wipe against Mycobacterium strains was superior to that of both the B and C wipes. Moreover, DDAC exhibited MIC50 values that were 2 to 3-fold lower than those of BAK for Gram-negative bacteria and fungi.The time-kill assay results for the DDAC and Si-QAC combination exhibited a growth reduction of >3 logs for Staphylococcus aureus and Enterococcus faecium, whereas approximately 2 logs of reduction was observed for Escherichia coli and Pseudomonas aeruginosa at 3 hour. Conclusion The results suggest that antimicrobial wipes containing relatively lower concentrations of QAC (wipe A) achieve similar rapid bactericidal effect as that of those with higher concentrations (wipe C). For Gram-negative bacteria, including multidrug-resistant strains and fungal isolates, DDAC presented lower MICs compared with BAK. Furthermore, the combination therapy with DDAC and Si-QAC demonstrated enhanced efficacy compared to treatment with either agent alone, except in the case of Klebsiella strains. Further research is needed to develop antimicrobial wipes that minimize the environmental impact while ensuring effective disinfection.

Objective: To establish the reference standard of the median nerve conduction study (NCS) in Korea. Methods: A total of 648 median motor and 602 median sensory NCSs from 349 Korean healthy volunteers were tested and analyzed prospectively. Equipment calibration, assessment of intraand inter-rater reliability, and the NCSs per se were conducted according to a predetermined protocol. A reference standard was established from uncertainty components for the following parameters: the onset and peak latencies; the baseline-to-peak and peak-to-peak amplitudes; the area and duration of the negative wave; and the nerve conduction velocity. The effects of sex, age and stimulation intensity were analyzed. Results: Each measured value of 648 median motor and 602 median sensory nerves were obtained and presented with both mean and expanded uncertainties, as well as mean and standard deviations. The cut-off values with expanded uncertainty were determined for different age and sex groups. After adjusting for anthropometric covariates, all parameters except duration were affected by age, and sex appeared to influence both duration and area. While stimulation intensity significantly affected some parameters including latencies, the effect sizes were negligible. Conclusion We propose the median NCS reference standard using the largest Korean dataset ever available. The use of the traceable and reliable reference standard is anticipated to promote more accurate and dependable diagnosis and appropriate management of median neuropathies in Korea.

Background: CD14 recognizes lipopolysaccharide (LPS), and presepsin is a fragment of soluble CD14. Still, it remains uncertain whether Gram-negative bacteria induce higher presepsin levels than other microorganisms. To address this question, this study aimed to analyze presepsin levels based on microorganisms isolated in blood cultures. Materials and Methods: This study was a single-center study comprising suspected sepsis patients enrolled from July 2020 to September 2020. A total of 95 patients with a single isolate confirmed in blood culture were analyzed to evaluate if there are any differences in presepsin levels according to microbial isolates. Plasma presepsin level was measured using PATHFAST assay kit and analyzer (LSI Medience Corporation, Tokyo, Japan). Results: There were 26 Gram-positive bacteremia, 65 Gram-negative bacteremia, and 3 fungemia patients with median presepsin levels of 869, 1,439, and 11,951 pg/mL, respectively. Besides, one case of algaemia demonstrated a presepsin level of 1,231 pg/mL. Our results showed no statistically significant difference in presepsin levels among patients with Gram-positive bacteremia, Gram-negative bacteremia, and fungemia. Furthermore, presepsin levels did not differ significantly among bloodstream infections caused by bacteria that were isolated from at least three different patients. In particular, Gram-positive bacteria such as Staphylococcus aureus and Enterococcus faecalis were able to induce presepsin levels comparable to those induced by Gram-negative bacteria. Conclusion We demonstrated that there were no significant differences in plasma presepsin levels according to microbial isolates in blood culture. The major cause of the variability in presepsin levels during bloodstream infection might be the immunogenicity of each microorganism rather than the presence of LPS in the microorganism.

Background/Aims: We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists. Methods: In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed. Results: In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years. Conclusions A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.