Background: Laser procedures are integral to dermatologic practice, yet safety measures- particularly regarding ocular protection and plume control- are poorly studied in real-world settings. Objective: To evaluate current practices in eye protection, infection control, and occupational risk awareness among Korean dermatologists performing laser treatments. Methods: A cross-sectional survey was conducted among board-certified dermatologists at the 2024 Korean Society for Dermatologic Laser Surgery meeting. The questionnaire covered demographics, laser frequency, use of goggles and masks, infection control strategies, ophthalmologic monitoring, and history of warts or cancer. Results: Seventy-nine respondents completed the survey. All reported using protective goggles, but only 26.6% and 22.8% did so for CO 2 and erbium-doped yttrium aluminium garnet lasers, respectively. Only 24.1% underwent regular eye exams, and 13.9% reported eye conditions after starting laser practice. While 89.9% used masks, 40.8% used dental masks, which are inadequate for plume protection. Suction devices were used by 94.9%, though performance specifications were unclear. Warts were reported by 46.8% of respondents; two reported cancer diagnoses after initiating laser work. Conclusion Despite high overall adherence to basic safety practices, critical gaps remain. Our findings highlight the need for standardized guidelines and long-term occupational health monitoring to ensure safe laser practice.

Purpose: Central serous chorioretinopathy (CSC) has been associated with psychological stress and personality traits. This study investigated the distribution of Myers–Briggs Type Indicator (MBTI) personality types in CSC patients compared with the general population and explored their association with disease chronicity. Methods: Thirty patients diagnosed with CSC completed the MBTI questionnaire. Four MBTI dichotomies (Extraversion/Introversion [E/I], Sensing/Intuition [S/N], Thinking/Feeling [T/F], Judging/Perceiving [J/P]), attitude combinations (IJ, IP, EJ, EP), and function combinations (ST, SF, NT, NF) were analyzed. Overall distributions were compared with a Korean representative sample (n = 19,070) using chi-square tests with Monte Carlo simulation. Individual types and dimensions were assessed using exact binomial tests with Bonferroni correction, and acute–chronic subgroup comparisons were performed using Fisher’s exact test. Results: Among CSC patients, 70% were classified as Introversion (vs. Extraversion) and 87% as Judging (vs. Perceiving) within their respective MBTI dichotomies. ISFJ was significantly more prevalent in the CSC group compared with the Korean general population (23.3% vs. 8.3%, p = 0.009), whereas INFJ showed a higher prevalence that did not remain significant after Bonferroni correction (13.3% vs. 3.0%, adjusted p = 0.058). The IJ attitude combination (53.3% vs. 27.4%, p = 0.005) and the SF function combination (50.0% vs. 30.3%, p = 0.027) were also more frequent in CSC patients, while the EP combination was not observed. No significant differences were observed between acute and chronic CSC subgroups. Conclusions CSC patients demonstrated distinctive MBTI distribution patterns compared with the general population, including an overrepresentation of the ISFJ type and higher frequencies of the IJ attitude and SF function combinations. To our knowledge, this study represents the first application of an MBTI-based personality framework in patients with CSC. However, given the cross-sectional pilot design and limitations of MBTI-based assessment, these findings should be interpreted cautiously as exploratory rather than causal.

Purpose: Chronic myeloid leukemia (CML) in children, adolescents, and young adults is rare and differs from older adults. This study evaluated the outcomes of allogeneic hematopoietic stem cell transplantation (HSCT) in young Korean CML patients during the tyrosine kinase inhibitor (TKI) era. Materials and Methods: A retrospective analysis of 35 CML patients aged < 40 years who underwent allogeneic HSCT from 2009 to 2019 was conducted using Korean Blood and Marrow Transplantation Registry data. Patients were grouped by age < 20 years at HSCT (group 1, n=15) and 20-40 years at HSCT (group 2, n=20). Survival outcomes including overall survival (OS), relapse-free survival (RFS), and event-free survival (EFS) were analyzed using the Kaplan-Meier method. Results: The median time between diagnosis and HSCT was 8.9 months. All the patients achieved engraftment but platelet recovery was significantly slower in group 1 (p=0.034). Acute and chronic graft-versus-host disease occurred in 54.3% and 34.3%, respectively. Five-year OS, RFS, and EFS rates of total patients were 66.8%, 50.8%, and 47.6%, with better OS was observed in group 1 by multivariable analysis (p=0.048). Disease status at HSCT was a significant predictor of OS (p=0.028), RFS (p=0.003), and EFS (p=0.004). Disease progression occurred in 13 out of 35 patients (37.1%); treatment-related mortality accounted for 63.6% of deaths (7 out of 11). Conclusion When performed at a younger age, allogeneic HSCT result in superior outcome in CML. Achieving remission before HSCT is critical for improved outcomes, highlighting the importance of pretransplant remission via optimal TKI strategies and minimal residual disease monitoring.

Limited data exist regarding the real-world practices and clinical outcomes in patients with ischemic heart failure with reduced left ventricular ejection fractions (LVEFs).Using nationwide registry data from South Korea, we aimed to investigate long-term outcomes and clinical practices, especially implantable cardioverter defibrillators (ICDs) implantation, in patients with reduced LVEFs at least 40 days after acute myocardial infarction (AMI). Of 13,056 patients with AMI between 2011 and 2015, we analyzed 350 (median age, 66 years [interquartile range, 56-75]) who had LVEFs <40% on follow-up transthoracic echocardiogram 40 days after the index event. The primary outcome was cardiac-cause mortality at 3 years. Secondary outcomes comprised major cardiovascular events as well as outcomes defined by the use of ICDs, cardiac resynchronization therapy defibrillators (CRT-Ds), and electrophysiology studies. Among 350 patients, 39 (11.1%) died from cardiac causes during 3 years of follow-up. Eleven (3.1%) were hospitalized for ventricular tachycardia. The rate of ICD or CRT-D implantation up to 3 years was 5.7% (20/350). Cox time-to-event analysis revealed older age, LVEF <30%, diabetes mellitus, and previous MI or revascularization as positively associated with cardiac death, whereas the use of statins and body weight <67 kg were negatively associated. This nationwide Korean registry demonstrated that only 5.7% of patients who had reduced LVEFs after 40 days of AMI underwent ICD implantations over 3 years. Considering the high mortality, concerted efforts are needed to improve clinical outcomes for patients who may have been candidates for ICD implantation.

Objectives: Allergic rhinitis (AR) is a chronic inflammation of the nasal mucosa triggered by environmental allergens. Although its pathophysiology has been extensively investigated, the influence of environmental aggravating factors—particularly combined pollutant exposure—remains insufficiently characterized. This study aimed to assess the impact of coexposure to PM2.5, formaldehyde, and Zn on allergic inflammation in a murine AR model and to delineate the associated immunological and histopathological responses. Methods: Female BALB/c mice were sensitized with ovalbumin (OVA) and challenged intranasally to induce AR. On days 21–24, the mice were exposed to PM2.5, formaldehyde, and Zn, either individually or in combination with OVA. Allergic symptoms were evaluated through behavioral observation, while immune responses were assessed by analyzing nasal and bronchoalveolar lavage fluids (NALF and BALF), serum immunoglobulin levels, nasal histopathology, and cytokine profiles. Results: Combined exposure to PM2.5, formaldehyde, and Zn significantly intensified allergic inflammation compared with single exposures. Coexposure to PM2.5 and Zn led to synergistic increases in total and OVA-specific immunoglobulin E levels, eosinophilic infiltration, nasal rubbing, sneezing, and Th2/Th17 cytokine levels in NALF and BALF. Histological analysis demonstrated epithelial thickening and goblet cell hyperplasia after combined exposure. Other combinations, including PM2.5 with formaldehyde, also produced additive or modestly amplified inflammatory responses. Conclusions Coexposure to PM2.5, formaldehyde, and Zn aggravated allergic inflammation in an OVA-induced murine model, with PM2.5+Zn yielding the strongest synergistic effects. These findings emphasize the role of pollutant–pollutant interactions in allergic airway diseases and highlight the need for further research to clarify long-term health effects and relevance to human disease.

Purpose: Radiotherapy (RT) remains a cornerstone of curative treatment for localized and locally advanced prostate cancer. However, dose escalation to improve tumor control is often constrained by the proximity of the rectum, which increases the risk of gastrointestinal (GI) and genitourinary toxicities. Biodegradable rectal spacers inserted between the prostate and rectum have emerged as an effective approach to reduce rectal radiation exposure. This guideline provides evidence-based recommendations on indications, contraindications, procedural standards, and clinical management for biodegradable rectal spacer insertion during prostate cancer RT. Materials and Methods: This guideline was developed by a multidisciplinary expert panel through a systematic review of the literature, analysis of international guidelines (National Comprehensive Cancer Network, European Association of Urology, American Society for Radiation Oncology), and expert consensus among radiation oncologists, radiologists, and urologists with clinical experience in spacer insertion. The strength of each recommendation and the level of evidence were classified according to the modified GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. Results: Spacer insertion is conditionally recommended (Grade C, Level I) for patients receiving definitive external-beam RT without rectal invasion. It reduces the high-dose rectal irradiation volume (V70–75) by >50%, decreases acute GI toxicity, and helps maintain bowel-related quality of life. However, the benefit for late severe toxicity (grade 2 or higher) remains debated in recent meta-analyses. Contraindications include rectal invasion, anatomical inaccessibility, infection, and material hypersensitivity. Procedures should be performed under local anesthesia in a sterile environment by trained physicians. Short-course antibiotics and simulator-based training, including completion of multiple supervised cases, are advised. Conclusion Biodegradable rectal spacer insertion is clinically validated and effective in reducing acute rectal toxicity. Although pivotal trials demonstrated a favorable procedural safety profile, real-world postmarket data include reports of rare but severe procedural complications. This guideline provides standardized recommendations tailored to Korean clinical practice while remaining consistent with international standards, emphasizing the importance of operator training and careful patient selection.

Objective: To characterize toxin gene profiles and antimicrobial resistance among Clostridium perfringens isolated from diarrheic piglets in Korea. Methods: Fecal samples (n = 1,627) were collected from 286 farms in 2023–2024. Clostridium perfringens isolates (n = 410) were recovered under anaerobic conditions. Toxin genes (cpa, cpb, cpb2, cpe, etx, and iap) were detected by multiplex real-time polymerase chain reaction.Susceptibility to 18 antimicrobials was assessed by disc diffusion. Results: Type A strains (cpa alone [24.6%] or cpa+cpb2 [46.8%]) predominated; cpb2 and cpe were detected in 73.4% and 19.0% of isolates, respectively. Resistance was highest to bacitracin (94.9%), amoxicillin/clavulanic acid (79.8%), and florfenicol (81.5%). Conclusions and Relevance: In 2023–2024, type A isolates carrying cpb2 were the predominant toxinotype among Clostridium perfringens recovered from diarrheic piglets in Korea. The high prevalence of resistance to several commonly used agents supports strengthened antimicrobial stewardship and evaluation of alternative control strategies.

Background: Clopidogrel requires several hours to achieve adequate platelet inhibition. We investigated the association of clopidogrel preloading time with 30-day clinical outcomes and post-procedural troponin elevation in patients with stable angina undergoing elective percutaneous coronary intervention (PCI). Methods: This single-center retrospective cohort study included 1,020 patients with stable angina (clopidogrel-naive) who received 300 mg clopidogrel preloading within 24 hours before elective PCI between 2012 and 2020. Patients were categorized according to clopidogrel preloading-to-balloon time ≤6 hours or >6 hours. The primary endpoint was 30-day major adverse cardiovascular events (MACE), defined as a composite of all-cause death, myocardial infarction, stroke, and any revascularization. Secondary endpoints included serial troponin T changes and troponin T elevation ≥5×, ≥25×, and ≥70× the upper reference limit. Stabilized inverse probability of treatment weighting (IPTW) was used. Results: Thirty-day MACE occurred in five patients (0.49%) and did not differ between the ≤6-hour and >6-hour groups after IPTW (0.5% vs. 0.4%, p=0.754). Post-procedural troponin T levels at 6, 24, and 48 hours were higher in the ≤6-hour group. Patients with shorter preloading-to-balloon times showed higher peak troponin T levels, with the greatest difference at the ≤1-hour cutoff (geometric mean ratio, 2.12; 95% confidence interval, 1.53–2.95; p<0.001) and progressive attenuation at longer cutoffs. Troponin T elevation ≥5× and ≥25× was more frequent in the ≤6-hour group, whereas ≥70× elevation did not differ. Conclusion Clopidogrel preloading ≤6 hours before elective PCI was not associated with increased 30-day MACE but was associated with lower-threshold post-procedural troponin T elevation.

Background: Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS); however, bleeding risk remains a major concern. Early discontinuation of aspirin due to potent P2Y12 inhibition may mitigate bleeding without increasing thrombotic events. Methods: The ASpirin-FREE therapy after successful percutaneous coronary intervention for acute coronary syndrome (ASFREE) study was an investigator-initiated, single-center, prospective, open-label, single-arm pilot study enrolling patients with ACS who underwent PCI with drug-eluting stents. All patients received a single loading dose of aspirin on the day of the PCI, followed by ticagrelor or prasugrel monotherapy. The primary efficacy endpoint was target vessel failure (TVF) at 12 months. The primary safety endpoint was definite stent thrombosis. Event rates are reported with 95% confidence intervals (CIs). Results: In total, 228 patients were enrolled. TVF occurred in 10 patients (4.4%; 95% CI, 2.1%–7.9%). Definite stent thrombosis was observed in one patient (0.4%; 95% CI, 0.01%–2.4%), with no acute or subacute events. Major bleeding (Bleeding Academic Research Consortium type 3 or 5) occurred in two patients (0.9%; 95% CI, 0.1%–3.1%). Conclusion An aspirin-free strategy following a single loading dose with continuation of potent P2Y12 inhibitor monotherapy was feasible in patients with ACS undergoing PCI and was associated with low rates of thrombotic and major bleeding events. These findings should be regarded as hypothesis-generating and supporting further evaluations in adequately powered randomized controlled trials (CRIS registration: KCT0008182).