Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women. Conclusion KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD. Conclusion KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.

Background: In 2006, the Korean Atopic Dermatitis Association (KADA) working group released the diagnostic criteria for Korean atopic dermatitis (AD). Recently, more simplified, and practical AD diagnostic criteria have been proposed. Objective: Based on updated criteria and experience, we studied to develop and share a consensus on diagnostic criteria for AD in Koreans. Materials and Methods: For the diagnostic criteria, a questionnaire was constructed by searching the English-language literature in MEDLINE and the Cochrane Database of Systematic Reviews. A modified Delphi method composed of 3 rounds of email questionnaires was adopted for the consensus process. Fifty-four KADA council members participated in the 3 rounds of votes and expert consensus recommendations were established. Results: Diagnostic criteria for AD include pruritus, eczema with age-specific pattern, and chronic or relapsing history. Diagnostic aids for AD encompass xerosis, immunoglobulin E reactivity, hand–foot eczema, periorbital changes, periauricular changes, perioral changes, nipple eczema, perifollicular accentuation, and personal or family history of atopy. Conclusion This study streamlined and updated the diagnostic criteria for AD in Korea, making them more practicable for use in real-world clinical field.

A pleurobiliary fistula is an abnormal communication between the biliary system and the pleural space. It has rarely been reported after percutaneous transhepatic gallbladder drainage (PTGBD). Here, we report the case of an 88-year-old man with bilious pleural infection via pleurobiliary fistula following PTGBD. The patient had a fever, dyspnea and right pleuritic chest pain. The PTGBD was performed 2 months prior to treat acute cholecystitis with large gallstones. Chest radiography demonstrated a right pleural effusion and a computed tomography of the abdomen showed a pleurobiliary fistula tract associated with the previous PTGBD. A drainage tube was inserted into the right pleural effusion, and the bilious pleural fluid infected with Escherichia coli was drained. Careful approach to PTGBD procedure and reducing duration of catheter placement should prevent fistula formation. As a rare complication of PTGBD, practitioners should be aware of the potential of pleural infection by a pleurobiliary fistula tract.
Abdomen ; Aged, 80 and over ; Biliary Fistula ; Biliary Tract ; Catheters ; Chest Pain ; Cholecystitis, Acute ; Drainage* ; Dyspnea ; Escherichia coli ; Fever ; Fistula* ; Gallbladder* ; Gallstones ; Humans ; Pleural Effusion ; Radiography ; Thorax

Posttransplant lymphoproliferative disorder (PTLD) is a group of heterogeneous lymphoid diseases that cause serious complications after organ or stem cell transplantation. The onset of PTLD is mostly due to EBV infection-induced B-cell proliferation and a defect in cytotoxic T cell function that occurs with immunosuppression. The usual treatment strategy for PTLD is reduction or withdrawal of immunosuppressive drugs with or without the administration of antiviral agents. Recently, various studies on the efficacy of rituximab or chemotherapy have been reported. We report two cases of rapidly progressing and complicated PTLDs after kidney transplantation that were successfully treated with a combination regimen consisting of rituximab, cyclophosphamide, adriamycin, vincristine and prednisolone (R-CHOP).
Antibodies, Monoclonal, Murine-Derived ; Antiviral Agents ; B-Lymphocytes ; Cyclophosphamide ; Doxorubicin ; Herpesvirus 4, Human ; Immunosuppression ; Kidney Transplantation ; Korea ; Lymphoproliferative Disorders ; Prednisolone ; Stem Cell Transplantation ; Vincristine ; Rituximab

BACKGROUND: Notch is a gene family encoding receptors to transduce intercellular signals involved in cell-fate determination. Although several lines of evidence indicate that abnormal Notch signaling may contribute to neoplastic transformation, little is known regarding the role of Notch in the pathogenesis of leukemia. METHODS: To explore the functional significance of Notch1 in acute myeloid leukemia (AML), the expression of Notch1 and its association with survivin and p27Kip1 expression was examined in 50 patients with de novo AML. RESULTS: Notch1 transcripts were expressed in 40 (80%) cases with a variable degree of expression, and the fraction of AML cells in the G0/G1 phase was higher in Notch1-positive cases than in Notch1-negative cases. Survivin was shown to be present in 38 (76.0%) cases, and Notch1 expression highly correlated with survivin mRNA expression (r=0.7170, P<0.001). p27Kip1 was present in 40 (80.0%) cases of AML and p27Kip1 expression was significantly associated with Notch1 expression (r=0.8770, P<0.001). Except for one case, the simultaneous expression of survivin and p27Kip1 was not seen in all cases that were negative for Notch1 expression. There were no differences in clinical outcomes according to Notch1 expression. CONCLUSION: Notch1 expression was a frequent event and has functional significance in the alteration of the cell cycle in AML cells. Notch1 expression was also significantly associated with survivin and p27kip1 expression in AML cells. To evaluate the clinical significanceand functional role of Notch1 expression in the aberrant regulation of survivin and p27Kip1 expression in de novo AML, a further study with a larger number of patients is necessary.
Cell Cycle ; Genes, vif ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; RNA, Messenger

PURPOSE: Neck masses, in pediatric population, derive from a multitude of congenital, inflammatory, or neoplastic diseases. The majority of these masses represent benign conditions. However, thorough clinical evaluation is required to rule out malignant diseases. We evaluated the causes, clinical characteristics and outcomes of children with neck masses who underwent tissue biopsy. METHODS: A total of 28 medical records of children with neck mass who underwent tissue biopsy at Chungnam National University Hospital, from January 2000 to March 2004 were retrospectively analyzed. The methods of biopsy were ultrasonography guided core biopsy (CB), fine needle aspiration biopsy (FNAB) and excisional biopsy. RESULTS: Out of 28 patients, half were boys. The most common location of the mass was the posterior cervical area (N=19, 67.9%). Laboratory findings of peripheral blood and serologic studies were nonspecific. In 25 (89.3%) cases, CB or FNAB was initially performed for neck masses. Among them 10 cases (40%) were reactive hyperplasia, 8 (32%) inflammatory granulation tissues, 4 (16%) necrotizing lymphadenitis, and 3 (12%) acute suppurative inflammations. Initially, excisional biopsy was performed for diagnosis in 3 (10.7%) cases. Diagnosis of these cases was thyroglossal duct cyst, dermoid cyst and lymphoblastic lymphoma, respectively. CONCLUSION: Most neck masses in children were benign. CB and FNAB were safe methods for tissue sampling, without need for general anesthesia.
Anesthesia, General ; Biopsy* ; Biopsy, Fine-Needle ; Child* ; Chungcheongnam-do ; Dermoid Cyst ; Diagnosis ; Granulation Tissue ; Humans ; Hyperplasia ; Inflammation ; Lymphadenitis ; Medical Records ; Neck* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies ; Thyroglossal Cyst ; Ultrasonography

PURPOSE: Fatty acid synthase (FAS) is a multi-enzyme molecule that plays a role in the de novo biosynthesis of fatty acids. FAS is expressed at low levels in most normal human tissues because, cells preferentially utilize circulating lipids for the synthesis of new structural lipids. Recent studies have demonstrated that high levels of FAS occur in a subset of human cancers (such as breast, ovary, and prostate cancer etc) and these high FAS levels are associated with a poor prognosis. The aim of this study was to investigate the expression of FAS in breast cancer and to examine the relationship between FAS and the clinicopathological data. METHODS: We reviewed clinical profiles [clinical data and short term outcome (recurrence)] of 67 breast cancer patients by reviewing their medical records. The average followed-up period was 22.6 month. FAS expressions were evaluated by immunohistochemistry on the formalin-fixed paraffin-embedded tissues. RESULTS: FAS expression of breast cancer was nonspecifically high, but there was no statistical importance between the FAS expression, the clinicopathological data and the short term recurrence (p > 0.05). CONCLUSION: The overexpression of FAS in breast cancer patients may not be a reliable marker for a poor prognosis. However, further studies are required in order to define the biological significance and the specific role of FAS in breast cancer development, growth, and invasion. Also, inhibition of FAS may be a target treatment for breast cancer.
Breast Neoplasms* ; Breast* ; Fatty Acids ; Female ; Humans ; Immunohistochemistry ; Medical Records ; Ovary ; Prognosis ; Prostatic Neoplasms ; Recurrence

PURPOSE: Fatty acid synthase (FAS) is a multi-enzyme molecule that plays a role in the de novo biosynthesis of fatty acids. FAS is expressed at low levels in most normal human tissues because, cells preferentially utilize circulating lipids for the synthesis of new structural lipids. Recent studies have demonstrated that high levels of FAS occur in a subset of human cancers (such as breast, ovary, and prostate cancer etc) and these high FAS levels are associated with a poor prognosis. The aim of this study was to investigate the expression of FAS in breast cancer and to examine the relationship between FAS and the clinicopathological data. METHODS: We reviewed clinical profiles [clinical data and short term outcome (recurrence)] of 67 breast cancer patients by reviewing their medical records. The average followed-up period was 22.6 month. FAS expressions were evaluated by immunohistochemistry on the formalin-fixed paraffin-embedded tissues. RESULTS: FAS expression of breast cancer was nonspecifically high, but there was no statistical importance between the FAS expression, the clinicopathological data and the short term recurrence (p > 0.05). CONCLUSION: The overexpression of FAS in breast cancer patients may not be a reliable marker for a poor prognosis. However, further studies are required in order to define the biological significance and the specific role of FAS in breast cancer development, growth, and invasion. Also, inhibition of FAS may be a target treatment for breast cancer.
Breast Neoplasms* ; Breast* ; Fatty Acids ; Female ; Humans ; Immunohistochemistry ; Medical Records ; Ovary ; Prognosis ; Prostatic Neoplasms ; Recurrence

BACKGROUND: The limit and the optimal method of the cryopreservation of platelets have not been determined. Moreover, the functional changes platelets after cryopreservation were not clearly defined. This study was conducted to determine the limit and optimal method for cryopreservation of platelet concentrates. METHODS: We compared the recovery, expression of membrane GpIb, GpIIb/IIIa, and aggregatory function of the platelets preserved in three different conditions. Platelet samples were collected from four healthy volunteer donors by apheresis, and placed in 22degrees C agitator for standard preservation. For cryopreservation, after treating 5% DMSO, platelets were either inserted directly in -80degrees C freezer or in liquid nitrogen after computer-controlled rate freezing. After storage for 5 days, 1 week, 2 weeks, 3 weeks, 4 weeks, and 12 weeks, platelets were thawed and analyzed for the evaluation of in vitro functions. RESULTS: Platelets preserved at 22degrees C or cryopreserved with each condition displayed equivalent recovery (90%). With each cryopreservation procedures, platelets showed moderate loss of GpIb and retained more than 90% of GpIIb/IIIa in comparison with fresh platelets. At the third week, loss of GpIb in the directly frozen platelets was augmented compared with those of controlled rate frozen group. The aggregatory response to ristocetin began to decrease drastically after storage for 5 days in platelets frozen by each procedures and to less than 5% at 12 weeks of storage. However, controlled rate frozen platelets retained more aggregatory response to ristocetin and surface GpIb expression than those of directly frozen platelets at 3, 4, 12 weeks of storage. CONCLUSION: This study showed the possibility of moderate preservation of in vitro functions of frozen-thawed platelets after 12 weeks of storage compared with those of the liquid stored 5-day old platelets.
Blood Component Removal ; Blood Platelets ; Cryopreservation* ; Dihydroergotamine ; Dimethyl Sulfoxide ; Freezing ; Healthy Volunteers ; Humans ; Membrane Glycoproteins ; Membranes ; Nitrogen ; Ristocetin ; Tissue Donors