Objectives: The use of qualitative healthcare services or its discrepancy between different income levels of the type 2 diabetes (T2D) patients has seldom been studied concurrently. The present study is unique that regarding T2D patients of early stages of diagnosis. Aimed to assess the utilization of qualitative healthcare services and influence of income levels on the inequality of care among newly diagnosed patients with T2D. Methods: A retrospective cohort study of 7590 patients was conducted by the National Health Insurance Service National Sample Cohort 2.0 from 2002 to 2015. Insured employee in 2013 with no history of T2D between 2002 and 2012 were included. The standard of diabetes care includes hemoglobin A1c (HbAlc; 4 times/y), eyes (once/y) and lipid abnormalities (once/y). Multivariate logistic regression analysis was performed to examine the difference between income levels and inequality of care. Results: From years 1 to 3, rates of appropriate screening fell from 16.9% to 14.1% (HbA1c), 15.8% to 14.5% (eye), and 59.2% to 33.2% (lipid abnormalities). Relative to income class 5 (the highest-income group), HbA1 screening was significantly less common in class 2 (year 2: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.61 to 0.99; year 3: OR, 0.79; 95% CI, 0.69 to 0.91). In year 1, lipid screening was less common in class 1 (OR, 0.84; 95% CI, 0.73 to 0.98) than in class 5, a trend that continued in year 2. Eye screening rates were consistently lower in class 1 than in class 5 (year 1: OR, 0.73; 95% CI, 0.60 to 0.89; year 2: OR, 0.63; 95% CI, 0.50 to 0.78; year 3: OR, 0.81; 95% CI, 0.67 to 0.99). Conclusions Newly diagnosed T2D patients have shown low rate of HbA1c and screening for diabetic-related complications and experienced inequality in relation to receiving qualitative diabetes care by income levels.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

The use of complementary alternative therapies in cancer patients are increasing with the increase in cancer incidence and treatment rates. Studies were conducted to find out about cancer patients’ knowledge and attitudes (treatment effect, intention to use) towards complementary and alternative therapies. 10 complementary alternative therapies (hyperthermia, ascorbate, thymosin, mistletoe, immunocyanin, selenium, Phellinus linteus, cholecalciferol, glutathione, herb remedies) were selected from evidence review. 100 patients who visited cancer care hospitals were surveyed about their knowledge and attitudes (effectiveness, treatment choices) by self-questionnaire. The total score for knowledge/attitude (effectiveness/intent to use) towards complementary and alternative therapies was 25.4 points (26.7 points/24.7 points, out of 40). Knowledge and attitude scores for hyperthermia were the highest, and knowledge and attitude scores for immunocyanin and glutathione were the lowest. Herbal remedies scored higher on knowledge but lower on attitude (effectiveness and choice). Vitamin C had moderate knowledge and effectiveness scores, but the highest intention-to-use score. There was a negative correlation between the effectiveness of complementary and alternative therapies and the choice of treatment regimen with lower scores as people aged. The use of complementary alternative therapies is increasing although the evidence has not been proven for the cancer cure rate or survival. It is necessary to recognize the effectiveness and limitations of complementary alternative therapies and educate patients so that they can choose the appropriate treatment. Further research is needed on the effects and side effects of various complementary alternative therapies used in addition to standard treatments.

OBJECTIVE: To investigate the distribution and phenotypes of hemifacial microsomia (HFM) and its association with other anomalies. METHODS: This study included 249 Korean patients with HFM, whose charts, photographs, radiographs, and/or computed tomography scans acquired during 1998–2018 were available from Seoul National University Hospital and Dental Hospital. Prevalence according to sex, side involvement, degree of mandibular deformity, compensatory growth of the mandibular body, and Angle's classification, and its association with other anomalies were statistically analyzed. RESULTS: Prevalence was not different between male and female patients (55.0% vs. 45.0%, p > 0.05). Unilateral HFM (UHFM) was more prevalent than bilateral HFM (BHFM) (86.3% vs. 13.7%, p < 0.001). Although distribution of the Pruzansky–Kaban types differed significantly in patients with UHFM (I, 53.0%; IIa, 18.6%; IIb, 24.7%; III, 3.7%; p < 0.001), no difference was observed in occurrence between the right and left sides (52.6% vs. 47.4%, p > 0.05). Among patients with BHFM, prevalence of different Pruzansky–Kaban types on the right and left sides was greater than that of the same type on both sides (67.6% vs. 32.4%, p < 0.05). Despite hypoplasia of the condyle/ramus complex, compensatory growth of the mandibular body on the ipsilateral side occurred in 35 patients (14.1%). Class I and II molar relationships were more prevalent than Class III molar relationships (93.2% vs. 6.8%, p < 0.001). Forty-eight patients (19.3%) had other anomalies, with 50.0% and 14.4% in the BHFM and UHFM groups (p < 0.001). CONCLUSIONS Patients with HFM require individualized diagnosis and treatment planning because of diverse phenotypes and associations with other anomalies.

BACKGROUND: Research into the Baumann skin type (BST) has recently expanded, with growing interest in the development of an efficient and effective skin type classification system for better understanding of this skin condition. OBJECTIVE: We aimed to identify male-specific skin type characteristics with investigation into the distribution of BST by age and region in the Korean male population and to determine the intrinsic and extrinsic factors related to skin type. METHODS: A questionnaire was administered to collect information about age, region, working behavior, drinking behavior, smoking behavior, usual habit of sun protection, medical history, and the BST which consisted of four parameters; oily (O) or dry (D), sensitive (S) or resistant (R), pigmented (P) or non-pigmented (N), and wrinkled (W) or tight (T). RESULTS: We surveyed 1,000 Korean males aged between 20 and 60 years who were divided equally by age and region. Of the total respondents, OSNW type accounted for the largest percentage and ORPW type the lowest. In terms of Baumann parameters, O type was 53.5%, S type was 56.1%, N type was 84.4% and W type was 57.5%. Several behavioral factors were found to have various relationships with the skin type. CONCLUSION: The predominant skin type in the Korean male respondents was OSNW type, and the distribution of skin types with regards to age and region was reported to be distinct. Therefore, skin care should be customized based on detailed skin types considering the various environmental factors.
Classification ; Drinking Behavior ; Humans ; Male ; Skin Care ; Skin ; Smoke ; Smoking ; Solar System ; Surveys and Questionnaires

BACKGROUND: Healthy skin is an important determinant of the quality of life and physical and mental well-being. The demand for dermatological information is increasing not only in patients with skin diseases, but also in the general population with normal/healthy skin. However, public perception and behavior with regard to skin health among Koreans are not known. OBJECTIVE: To examine public perception and behaviors with regard to skin health in Koreans visiting the Skin Health Expo 2017. METHODS: A total of 597 participants completed a questionnaire that assessed demographics, status, and behavior for skin health and Expo satisfaction. RESULTS: Respondents with higher stress levels and a history of skin diseases showed lower satisfaction with self-skin health. Most participants considered adequate sleep and water intake to be important factors associated with healthy skin. One-on-one consultation with dermatologists was the most satisfactory among participants at the Expo. CONCLUSION: Educational tools using mass media and informative activities such as the Expo planned by dermatologists and the government are necessary to spread awareness and provide proper information to improve skin health in the general population and to emphasize the key role of dermatologists in skin disorders with a social burden.
Demography ; Drinking ; Humans ; Korea* ; Mass Media ; Quality of Life ; Research Report* ; Skin Diseases ; Skin* ; Surveys and Questionnaires

BACKGROUND: There have been several therapeutic guidelines for onychomycosis in different countries and advances in its diagnosis and treatment. Optimal treatment decision-making is affected by healthcare systems and cultural backgrounds of countries. OBJECTIVE: The executive committee for onychomycosis guideline of the Korean Society for Medical Mycology aims to provide up-to-date practical guidelines for onychomycosis management in Koreans. METHODS: The committee thoroughly reviewed relevant literature and previous guidelines. The structured algorithmic guideline was developed by experts' consensus. RESULTS: The optimal treatments can be selected alone or in combination based on the nail and patient variables. Three major classes of treatment are available: standard (topical or oral antifungals), additional (nail removal), and alternative treatments (laser). Both topical and oral antifungals alone are appropriate for mild onychomycosis, while oral antifungals are primarily recommended for moderate-to-severe cases if not contraindicated. Combined topical and oral antifungals are recommended to increase the efficacy in moderate-to-severe cases. Additional infected nail removal is also considered for moderate-to-severe onychomycosis, which is unresponsive to standard medical treatment alone. Laser therapy can be an alternative without significant side effects when standard medical treatments cannot be applied regardless of onychomycosis severity. After treatment course completion, periodic therapeutic response monitoring and onychomycosis preventive measures should be rendered to reduce recurrence. CONCLUSION The Korean consensus guideline provides evidence-based recommendations to promote good outcomes of onychomycosis. The proposed algorithm is simple and easy to comprehend, allowing clinicians to facilitate optimal treatment decision-making for onychomycosis in clinical practice.

BACKGROUND: Skin laser treatment has improved significantly and has become an effective treatment approach for many skin diseases while also having applications for beauty treatments. However, since skin laser transfers energy directly to the skin, the misuse of such treatment may result in permanent damage to skin tissues. OBJECTIVE: This survey of Korean adults, conducted to obtain their perspectives on and their treatment experience with skin laser treatment, will be used to determine the current status of skin laser treatment and to identify necessary changes to ensure proper and safe conduct of skin laser treatment. METHODS: From April 5th to April 12th, 2016, a survey was conducted to obtain information regarding the perspectives and the treatment experience of adults aged 20~59 years. RESULTS: Approximately 50% of the participants had experience with skin laser treatment, and among these, 24.7% had not received treatment at a dermatology clinic. Compared to treatment at a dermatology clinic, the danger of side effects was 1.7 times higher at a non-dermatology clinic, 2 times higher at a skin care shop, and 5.3 times higher at an Oriental medical clinic. Among patients who received skin laser treatment, 16.1% experienced side effects, and among these, 1 out of 4 patients visited a non-dermatologist for treatment of these side effects. CONCLUSION: The results of the survey showed that in order for the public to receive safe and effective skin laser treatment based on professional diagnosis, there is a definitive need to provide correct information to the public and to implement changes to ensure proper understanding of skin laser treatment among this population.
Adult ; Beauty ; Dermatology ; Diagnosis ; Humans ; Skin Care ; Skin Diseases ; Skin*

Methicillin-resistant Staphylococcus aureus (MRSA) is a critical source of infections in neonatal intensive care units. Early diagnosis and treatment are important due to the significant morbidity of MRSA infection. MRSA sepsis can be disseminated despite antibiotics, therefore the extent of the infection should be evaluated. Common complications of MRSA sepsis include infective endocarditis, pneumonia, osteomyelitis, meningitis, septic shock.Urgent evaluation of other possible suppurative complications in neoate are necessary. Therefore echocardiogram, chest X-ray, ophthalmic examination, brain sonography and spinal tapping are needed. In this study, we present a case of MRSA sepsis in a preterm infant, accompanied by endophthalmitis and endocarditis in spite of the early diagnosis and treatment.
Anti-Bacterial Agents ; Brain ; Early Diagnosis ; Endocarditis* ; Endophthalmitis* ; Humans ; Infant, Newborn ; Infant, Premature* ; Intensive Care Units, Neonatal ; Meningitis ; Methicillin-Resistant Staphylococcus aureus* ; Osteomyelitis ; Pneumonia ; Sepsis* ; Spinal Puncture ; Thorax

OBJECTIVE: To investigate the clinical significance of thrombophilia in patients admitted with ovarian hyperstimulation syndrome (OHSS). METHODS: Twenty-five infertile women who were admitted into university hospital due to OHSS after ovarian hyperstimulation for intrauterine insemination or in vitro fertilization. Blood samples were drawn at the time of admission and three thrombophilic factors were assayed; antithrombin III, protein C and protein S. Subjects were divided into severe (n=18) and mild-to-moderate (n=7) OHSS, and laboratory parameters including three thrombophilic factors were compared. RESULTS: Antithrombin III level was abnormal in 40% of subjects, protein C in 12%, and protein S in 72%. There was no significant difference in the laboratory parameters between the patients with normal (n=15) and abnormal antithrombin III levels (n=10). However, the patients with abnormal antithrombin III levels had significantly more severe OHSS than those with normal value (100% vs 55.6%, P=0.013). The patients with at least one abnormal thrombophilic factor had significantly more severe OHSS than those with all normal value (94.4% vs 42.9%, P=0.012). CONCLUSIONS: Thrombophilic factors, particularly antithrombin III, may be associated with disease severity in patients with OHSS.
Antithrombin III ; Female ; Fertilization in Vitro ; Humans ; Insemination ; Ovarian Hyperstimulation Syndrome ; Protein C ; Protein S ; Reference Values ; Thrombophilia