Background: We aimed to investigate the factors associated with neurological manifestations of post-coronavirus disease 2019 (COVID-19) conditions. Methods: We retrospectively collected data from 440 patients who visited our post-COVID-19 clinic more than 4 weeks after severe acute respiratory syndrome coronavirus 2 infection. We analyzed the prevalence of different neurological symptoms (brain fog, memory impairment, headache, and dizziness) and assessed the associated factors. Results: Brain fog was the most common symptom, observed in 170 patients (38.6%), followed by headaches (n = 137, 31.1%), dizziness (n = 128, 29%), and memory impairment (n = 104, 23.6%). Brain fog was associated with hyposmia or hypogeusia (odds ratio [OR], 2.54; P < 0.001), Fatigue Severity Scale (FSS) (OR, 1.06; P < 0.001), and Hospital Anxiety and Depression Scale-Anxiety (OR, 1.09; P = 0.037). Memory impairment was associated with sleep problems (OR, 2.83; P < 0.001), FSS (OR, 1.05; P < 0.001), and age (OR, 1.02; P = 0.015). Headache was associated with sleep problems (OR, 2.28; P= 0.001), sex (OR, 1.68; P = 0.042), and FSS (OR, 1.04; P < 0.001). Dizziness was associated with sleep problems (OR, 2.88; P < 0.001), and FSS (OR, 1.04; P < 0.001). The incidence of brain fog ( P < 0.001), memory impairment ( P < 0.001), dizziness (P = 0.007), and headache (P = 0.045) accompanied by hyposmia and hypogeusia was higher in patients with the aforementioned symptoms than in those without. Conclusion This study suggests that there is a relationship between neurological symptoms and other clinical factors, such as fatigue, depression, anxiety, hyposmia, and hypogeusia.

This study focuses on the importance of non-face-to-face healthcare, based on the experience with the COVID-19 pandemic, and proposes a model for oral health management services utilizing personal data, known as “my data.” The model aims to develop a comprehensive system that collects and integrates individual health records for easy access. It includes assessing oral health through oral examination records and surveys, creating risk assessment algorithms tailored to various population groups, and standardizing medical terms and data. The goal is to accurately evaluate individual oral health conditions and provide personalized services. However, the success of the model requires considerations such as platform management, user experience enhancement, and medical data security. The research proposes possibilities for further investigation to enhance the oral health service model. This study introduces a novel approach to individual health management, establishing the foundation of effective health management even in non-face-to-face settings.

Background: We aim to compare the clinical characteristics and subjectively reported symptoms of the acute coronavirus disease (COVID) phase and those of the post-acute COVID phase to examine varying factors that affect the number of persistent symptoms and their categories. Methods: We categorized 1,122 patients who visited the post coronavirus disease 2019 (COVID-19) clinic into two groups: “acute group” (< 4 weeks following diagnosis of COVID-19) and “post-acute group” (> 4 weeks following diagnosis of COVID-19). We statistically compared clinical characteristics between the two groups and determined which factors are associated with the number of persistent symptoms and their categories. Results: The persistent symptoms of post COVID-19 conditions were classified into three categories as follows: Category A (the prevalence of symptoms is higher in the acute-visit group than in the post-acute-visit group), Category B (the prevalence of symptoms is not different between the two groups) and Category C (the prevalence of symptoms is higher in the post-acute-visit group than in the acute-visit group). Category A mainly included respiratory symptoms. Category B had generalized weakness, weight loss, cardiologic symptoms, hypogeusia, hyposmia, anxiety, and various gastrointestinal symptoms. Category C included fatigue, decreased attention, depression, blurred vision, hair loss, and sexual dysfunction.Anxiety, depression, fatigue and age were also associated with the number of symptoms and their categories, and anxiety is the most correlated factor (P < 0.001) among them. Conclusion The persistent symptoms of post COVID-19 condition involve multi-organ and continue for four weeks or greater. Therefore, long-term observation and multidisciplinary interventions are essential for patients with post COVID-19 conditions.

Objective: This study was carried out to establish a basis for understanding and correcting the problems of the emergency physicians (EP) in Korea by examining the current status through the 2020 emergency physician survey conducted by the Korean Society of Emergency Medicine (KSEM). Methods: An online survey was conducted from January 15 to February 26, 2021, through a website and mobile application. The final questionnaire was classified into three types based on the clinical work in the emergency department (ED), current position, and the year of board certification. The contents of the questionnaire were organized into eight themes, and a subcommittee was put in charge of each. Results: Of the 400 emergency medical institutions surveyed, 295 hospitals (74.2%) had board-certified EPs, and 1,453 EPs (72.5%) out of 2,000 were working in the ED. Of these, on average, 7.2 EPs worked together, and they worked 11.6 days/153.1 hours per month and did night shifts 5.9 days per month. 30.7% showed excessive sleepiness during the day, and only 9.6% said that they could adhere to mealtimes. 27.1% responded that they suffered from depression. The level of satisfaction was 3.2 points, and 43.0% responded that they would choose emergency medicine (EM) again as their major. The most important factor in choosing EM was the availability of adequate free time. Their responses indicated that the retirement age was 59.7 years, and the upper age limit for the night shift was 54.3 years. Conclusion Though there have been improvements since the first survey in 2010, there was no notable increase in EP satisfaction. Therefore, appropriate future policies should be formulated and implemented based on these survey results.

Purpose: We aimed to refine the radiotherapy (RT) volume and dose for intracranial germinoma considering recurrences and long-term toxicities. Materials and Methods: Total 189 patients with intracranial germinoma were treated with RT alone (n=50) and RT with upfront chemotherapy (CRT) (n=139). All cases were confirmed histologically. RT fields comprised the extended-field and involved-field only for primary site. The extended-field, including craniospinal, whole brain (WB), and whole ventricle (WV) for cranial field, is followed by involved-field boost. The median follow-up duration was 115 months. Results: The relapses developed in 13 patients (6.9%). For the extended-field, cranial RT dose down to 18 Gy exhibited no cranial recurrence in 34 patients. In CRT, 74 patients (56.5%) showed complete response to chemotherapy and no involved-field recurrence with low-dose RT of 30 Gy. WV RT with chemotherapy for the basal ganglia or thalamus germinoma showed no recurrence. Secondary malignancy developed in 10 patients (5.3%) with a latency of 20 years (range, 4 to 26 years) and caused mortalities in six. WB or craniospinal field rather than WV or involved-field significantly increased the rate of hormone deficiencies, and secondary malignancy. RT dose for extended-field correlated significantly with the rate of hormone deficiencies, secondary malignancy, and neurocognitive dysfunction. Conclusion De-intensifying extended-field rather than involved-field or total scheme of RT will be critical to decrease the late toxicities. Upfront chemotherapy could be beneficial for the patients with complete response to minimize the RT dose down to 30 Gy. Prospective trials focused on de-intensification of the extended-field RT are warranted.

BACKGROUND: Mutation in the gene encoding filaggrin (FLG) is a major predisposing factor for atopic dermatitis (AD), in association with distinct features such as increased allergic sensitization, higher severity, and frequent skin infections. Genetic diversity in FLG mutations exists across ethnicities. OBJECTIVE: This study aimed to investigate the clinical features of AD according to the presence of FLG mutation in Korean individuals. METHODS: We performed reverse blot hybridization assay to detect FLG mutation in Korean patients with AD. Classifying subjects into AD with or without FLG mutation, clinical features of AD and patch test results were compared between the two groups. RESULTS: Among a total of 281 subjects, 39 (13.9%) were found to have FLG mutation. AD with FLG mutation was associated with higher risk of impetigo and eczema herpeticum but lower risk of prurigo nodularis. In the patch test, there was no difference in positive reactions of major contact allergens between the groups. CONCLUSION: In Korean patients with AD, FLG mutation was associated with more frequent skin infections but not with personal or family history of atopic diseases, allergic sensitization, contact allergy, and protracted course. It is important to consider other skin-barrier-related genes, such as KLK7 and SPINK5, and immune response-related genes in conjunction.
Allergens ; Causality ; Dermatitis, Atopic ; Genetic Variation ; Humans ; Hypersensitivity ; Impetigo ; Kaposi Varicelliform Eruption ; Patch Tests ; Prurigo ; Skin

No abstract available.
Korea* ; Uropathogenic Escherichia coli*

PURPOSE: Variations in barrier- or immune response-related genes are closely related to the development of atopic dermatitis (AD). This study was designed to identify genetic variations and clinical features to predict ‘recalcitrant AD.’ METHODS: AD patients were classified as treatable and recalcitrant. Treatable AD patients showed satisfactory clinical improvement with basic and topical treatments. Recalcitrant AD patients used systemic immune-suppressants for over 4 weeks as they had not shown clinical improvement with basic and topical treatments. The frequency of gene variations in barrier- (FLG 3321delA, FLG K4022X, KLK7, SPINK 1156, SPINK 1188, SPINK 2475) and immune response- (DEFB1, KDR, IL-5RA, IL-9, and IL-12RB1a, b) related genes were compared between each AD group and the controls. RESULTS: Of all, 249 treatable AD and 32 recalcitrant AD were identified. Heterozygous mutations (Hetero) in KLK7 was more frequent in recalcitrant AD patients than treatable AD, without statistical significance. Hetero in DEFB1 was more frequent in treatable AD patients. However, no other significant genetic differences between treatable and recalcitrant AD was observed. Instead, higher initial Eczema Area Severity Index (EASI) score, serum immunoglobulin E (IgE) level, allergen specific IgE for house dust mites, and family history of atopic diseases were associated with recalcitrant AD with statistical significance. CONCLUSIONS: According to our study, no genetic variation to predict recalcitrant AD was identified, suggesting that clinical manifestation, rather than genetic variations of AD patients is more likely to be an important factor in predicting the prognosis of AD. Further large-scale studies on the correlation between genetic variation and recalcitrant AD are needed.
Dermatitis, Atopic* ; Eczema ; Genetic Variation* ; Humans ; Immunoglobulin E ; Immunoglobulins ; Interleukin-9 ; Polymorphism, Single Nucleotide ; Prognosis ; Pyroglyphidae