Background: This study aimed to investigate the obstetric and perinatal outcomes of singleton deliveries following frozen embryo transfer (FET) cycles using different endometrial preparation methods. Methods: We analyzed data on 44,118 singleton pregnant women who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), resulting in delivery or abortion, from the South Korean National Health Insurance Service database. Stratification was based on the type of embryo transfer, viz. fresh embryo transfer and FET cycles, using International Classification of Diseases (Tenth Revision) diagnostic codes, national procedural codes, and prescription medication data within the IVF/ICSI pregnancy cohort. FET was subcategorized into artificial cycle-FET (AC-FET), natural cycle-FET (NC-FET), and stimulated cycle-FET (SC-FET) for comparative analyses of the pregnancy, obstetric, and perinatal outcomes. Results: AC-FET was associated with higher risks of hypertensive disorders of pregnancy, preeclampsia, placenta accreta, and postpartum hemorrhage compared with NC-FET; the risk of macrosomia showed no significant differences. SC-FET was associated with a lower risk of miscarriage and higher rate of term birth beyond 37 weeks compared with NCFET. However, SC-FET was associated with elevated risks of gestational hypertension and postpartum hemorrhage when compared to NC-FET. Conclusion The rate of adverse obstetric and perinatal outcomes was higher in AC-FET compared to NC-FET, highlighting NC-FET as a valuable option owing to better maternal and fetal safety. In cases where NC-FET is not feasible, SC-FET presented as a favorable alternative, exhibiting lower miscarriage rates than NC-FET and better obstetric outcomes than AC-FET.

Background and Objectives: Kawasaki disease (KD) is an acute vasculitis that primarily affects children under age 5 years. Approximately 20–25% of untreated children with KD and 3–5% of those treated with intravenous immunoglobulin therapy develop coronary artery aneurysms (CAAs). The prevalence of CAAs is much higher in male than in female patients with KD, but the underlying factors contributing to susceptibility to CAAs in patients with KD remain unclear. This study aimed to identify sex-specific susceptibility loci associated with CAAs in KD patients. Methods: A sex-stratified genome-wide association study (GWAS) was performed using previously obtained GWAS data from 296 KD patients and a new replication study in an independent set of 976 KD patients by comparing KD patients without CAA (controls) and KD patients with aneurysms (internal diameter ≥5 mm) (cases). Results: Six male-specific susceptibility loci, PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ (odds ratios [ORs], 2.25–9.98; p=0.00204–1.96×10−6 ), and 2 female-specific susceptibility loci, SMAD3 (OR, 4.59; p=0.00016) and IL1RAPL1 (OR, 4.35; p=0.00026), were significantly associated with CAAs in patients with KD. In addition, the numbers of CAA risk alleles additively contributed to the development of CAAs in patients with KD. Conclusions A sex-stratified GWAS identified 6 male-specific (PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ) and 2 female-specific (SMAD3 and IL1RAPL1) CAA susceptibility loci in patients with KD.

Background and Objectives: Kawasaki disease (KD) is an acute vasculitis that primarily affects children under age 5 years. Approximately 20–25% of untreated children with KD and 3–5% of those treated with intravenous immunoglobulin therapy develop coronary artery aneurysms (CAAs). The prevalence of CAAs is much higher in male than in female patients with KD, but the underlying factors contributing to susceptibility to CAAs in patients with KD remain unclear. This study aimed to identify sex-specific susceptibility loci associated with CAAs in KD patients. Methods: A sex-stratified genome-wide association study (GWAS) was performed using previously obtained GWAS data from 296 KD patients and a new replication study in an independent set of 976 KD patients by comparing KD patients without CAA (controls) and KD patients with aneurysms (internal diameter ≥5 mm) (cases). Results: Six male-specific susceptibility loci, PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ (odds ratios [ORs], 2.25–9.98; p=0.00204–1.96×10−6 ), and 2 female-specific susceptibility loci, SMAD3 (OR, 4.59; p=0.00016) and IL1RAPL1 (OR, 4.35; p=0.00026), were significantly associated with CAAs in patients with KD. In addition, the numbers of CAA risk alleles additively contributed to the development of CAAs in patients with KD. Conclusions A sex-stratified GWAS identified 6 male-specific (PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ) and 2 female-specific (SMAD3 and IL1RAPL1) CAA susceptibility loci in patients with KD.

Background: This study aimed to investigate the obstetric and perinatal outcomes of singleton deliveries following frozen embryo transfer (FET) cycles using different endometrial preparation methods. Methods: We analyzed data on 44,118 singleton pregnant women who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), resulting in delivery or abortion, from the South Korean National Health Insurance Service database. Stratification was based on the type of embryo transfer, viz. fresh embryo transfer and FET cycles, using International Classification of Diseases (Tenth Revision) diagnostic codes, national procedural codes, and prescription medication data within the IVF/ICSI pregnancy cohort. FET was subcategorized into artificial cycle-FET (AC-FET), natural cycle-FET (NC-FET), and stimulated cycle-FET (SC-FET) for comparative analyses of the pregnancy, obstetric, and perinatal outcomes. Results: AC-FET was associated with higher risks of hypertensive disorders of pregnancy, preeclampsia, placenta accreta, and postpartum hemorrhage compared with NC-FET; the risk of macrosomia showed no significant differences. SC-FET was associated with a lower risk of miscarriage and higher rate of term birth beyond 37 weeks compared with NCFET. However, SC-FET was associated with elevated risks of gestational hypertension and postpartum hemorrhage when compared to NC-FET. Conclusion The rate of adverse obstetric and perinatal outcomes was higher in AC-FET compared to NC-FET, highlighting NC-FET as a valuable option owing to better maternal and fetal safety. In cases where NC-FET is not feasible, SC-FET presented as a favorable alternative, exhibiting lower miscarriage rates than NC-FET and better obstetric outcomes than AC-FET.

Background: This study aimed to investigate the obstetric and perinatal outcomes of singleton deliveries following frozen embryo transfer (FET) cycles using different endometrial preparation methods. Methods: We analyzed data on 44,118 singleton pregnant women who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), resulting in delivery or abortion, from the South Korean National Health Insurance Service database. Stratification was based on the type of embryo transfer, viz. fresh embryo transfer and FET cycles, using International Classification of Diseases (Tenth Revision) diagnostic codes, national procedural codes, and prescription medication data within the IVF/ICSI pregnancy cohort. FET was subcategorized into artificial cycle-FET (AC-FET), natural cycle-FET (NC-FET), and stimulated cycle-FET (SC-FET) for comparative analyses of the pregnancy, obstetric, and perinatal outcomes. Results: AC-FET was associated with higher risks of hypertensive disorders of pregnancy, preeclampsia, placenta accreta, and postpartum hemorrhage compared with NC-FET; the risk of macrosomia showed no significant differences. SC-FET was associated with a lower risk of miscarriage and higher rate of term birth beyond 37 weeks compared with NCFET. However, SC-FET was associated with elevated risks of gestational hypertension and postpartum hemorrhage when compared to NC-FET. Conclusion The rate of adverse obstetric and perinatal outcomes was higher in AC-FET compared to NC-FET, highlighting NC-FET as a valuable option owing to better maternal and fetal safety. In cases where NC-FET is not feasible, SC-FET presented as a favorable alternative, exhibiting lower miscarriage rates than NC-FET and better obstetric outcomes than AC-FET.

Purpose: This study investigated the efficacy of intravesical gemcitabine as an alternative to bacillus Calmette–Guérin (BCG) therapy. Materials and Methods: Data were retrospectively collected across seven institutions from February 1999 to May 2023. Inclusion criteria included patients with intermediate- or high-risk non-muscle invasive bladder cancer (NMIBC) who underwent transurethral resection of bladder tumors (TURBT) and received at least four sessions of intravesical gemcitabine or BCG induction therapy. Patient characteristics, complete remission (CR), occurrence, and progression rates were compared. Results: In total, 149 patients were included in this study (gemcitabine, 63; BCG, 86). No differences were apparent between the two groups in baseline characteristics, except for the follow-up period (gemcitabine, 9.2±5.9 months vs. BCG, 43.9±41.4 months, p<0.001). There were no consistent significant differences observed between the two groups in the 3-month (gemcitabine, 98.4% vs. BCG, 95.3%; p=0.848), 6-month (94.9% vs. 90.0%, respectively; p=0.793) and 1-year CR rates (84.2% vs. 83.3%, respectively;p=0.950). Also, there was no significant statistical difference in progression-free survival between the two groups (p=0.953). The occurrence rates of adverse events were similar between the groups (22.2% vs. 22.1%; p=0.989); however, the rate of Clavien– Dindo grade 2 or higher was significantly higher in the BCG group (1.6% vs. 16.3%, respectively; p<0.001). Conclusions Intravesical gemcitabine demonstrated efficacy comparable to BCG therapy for the first year in patients with intermediate- and high-risk NMIBC. However, long-term follow-up studies are warranted.

Background and Objectives: Kawasaki disease (KD) is an acute vasculitis that primarily affects children under age 5 years. Approximately 20–25% of untreated children with KD and 3–5% of those treated with intravenous immunoglobulin therapy develop coronary artery aneurysms (CAAs). The prevalence of CAAs is much higher in male than in female patients with KD, but the underlying factors contributing to susceptibility to CAAs in patients with KD remain unclear. This study aimed to identify sex-specific susceptibility loci associated with CAAs in KD patients. Methods: A sex-stratified genome-wide association study (GWAS) was performed using previously obtained GWAS data from 296 KD patients and a new replication study in an independent set of 976 KD patients by comparing KD patients without CAA (controls) and KD patients with aneurysms (internal diameter ≥5 mm) (cases). Results: Six male-specific susceptibility loci, PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ (odds ratios [ORs], 2.25–9.98; p=0.00204–1.96×10−6 ), and 2 female-specific susceptibility loci, SMAD3 (OR, 4.59; p=0.00016) and IL1RAPL1 (OR, 4.35; p=0.00026), were significantly associated with CAAs in patients with KD. In addition, the numbers of CAA risk alleles additively contributed to the development of CAAs in patients with KD. Conclusions A sex-stratified GWAS identified 6 male-specific (PDE1C, NOS3, DLG2, CPNE8, FUNDC1, and GABRQ) and 2 female-specific (SMAD3 and IL1RAPL1) CAA susceptibility loci in patients with KD.

Background: The treatment of pediatric patients with latent tuberculosis infection (LTBI) is a crucial TB control strategy. LTBI is not a reportable communicable disease, and data regarding LTBI treatment in pediatric patients in Korea are scarce. This study aimed to investigate the prescription patterns and treatment completion rates among pediatric patients with LTBI in Korea by analyzing National Health reimbursement claims data. Methods: We retrospectively analyzed outpatient prescription records for pediatric patients aged 18 or younger with LTBI-related diagnostic codes from 2016 to 2020. We compared the frequency of prescriptions for the standard treatment regimen (9 months of isoniazid [9H]) and an alternative treatment regimen (3 months of isoniazid plus rifampicin [3HR]). We also assessed the treatment incompletion rates by age group, treatment regimen, treatment duration, the level of medical facility, physician’s specialty, and hospital location. We performed multivariable analysis to identify factors influencing treatment incompletion. Results: Among the 11,362 patients who received LTBI treatment, 6,463 (56.9%) were prescribed the 9H regimen, while 4,899 (43.1%) received the 3HR regimen. Patients in the 3HR group were generally older than those in the 9H group. The proportion of 3HR regimen prescriptions significantly greater in the later period (2018–2020), in primary hospitals, under the management of non-pediatric specialists, and in metropolitan regions. The overall treatment incompletion rate was 39.7% (9H group: 46.9%, 3HR group: 30.3%). In the multivariable analysis, 9H regimen prescription was the strongest factor associated with treatment incompletion (adjusted odds ratio, 2.42; 95% confidence interval, 2.20–2.66; P < 0.001). Additionally, management in a primary hospital, a hospital’s location in a nonmetropolitan region, and management by a non-pediatric specialist were also significant risk factors for treatment incompletion. Conclusion Our study results suggest that promoting the use of 3HR regimen prescriptions could be an effective strategy to enhance treatment completion. Physicians in primary hospitals, hospitals located in non-metropolitan regions, and physicians without a pediatric specialty require increased attention when administering LTBI treatment to pediatric patients to ensure treatment completion.

Background: Antimicrobial resistance (AMR) is an important global public health concern in adults and children. Laryngotracheobronchitis (croup) is a common acute respiratory infection (ARI) among children, most often caused by a virus, and should not be treated with antibiotics. Reducing the usage of unnecessary antibiotics in ARI using an antimicrobial stewardship program (ASP) is an effective measure against AMR in children.This study investigates the antibiotic prescription pattern in pediatric patients with laryngotracheobronchitis in Korea. Our results will be useful to improve the ASP. Methods: The data were obtained from the government agency Health Insurance Review and Assessment Service. We analyzed outpatient prescriptions issued to children ≤ 5 years of age with a first-listed diagnosis code for laryngotracheobronchitis, i.e., International Classification of Disease, 10th Revision, code J050 (croup), J040 (laryngitis), or J041 (tracheitis), during 2017–2020. For each prescription, demographic information and information about medical facilities visited (type of hospital, specialty of physician, location of hospital) were extracted. The overall antibiotic prescription rate was subsequently estimated, and multivariable analysis was conducted to determine the associated factors of antibiotic prescription. Prescribed antibiotics were described and classified into extendedspectrum penicillins, cephalosporin, and macrolides. Results: Of 2,358,194 prescriptions reviewed, 829,172 (35.2%) contained antibiotics. In the multivariable analysis, management in a hospital was the strongest factor associated with antibiotic prescription (adjusted odds ratio [aOR], 22.33; 95% confidence interval [CI], 20.87–23.89; P < 0.001), followed by management in a clinic (aOR, 12.66; 95% CI, 11.83–13.54; P < 0.001) and management in a general hospital (aOR, 8.96; 95% CI, 8.37–9.59; P < 0.001). Antibiotic prescription was also significantly associated with patients who were ≤ 2 years of age, managed by a pediatric specialist, and treated at a hospital located in a non-metropolitan region. Overall, extended-spectrum penicillins were the most frequently prescribed (18.6%) antibiotics, followed by cephalosporins (9.4%) and macrolides (8.5%). Conclusion The results of our study suggest that ASPs need to focus on physicians in hospitals, clinics, general hospitals, and pediatric specialties. Providing education programs to these groups to increase awareness of AMR and appropriate antibiotics use could be effective ASP policy and may help to reduce unnecessary prescriptions of antibiotics for laryngotracheobronchitis among pediatric patients and therefore potentially AMR in children in Korea.

Purpose: This retrospective study evaluated the effectiveness and healing outcomes of antibiotic-loaded dicalcium phosphate dehydrate/ β-tricalcium phosphate (β-TCP/DCPD) compared to antibiotic-loaded polymethylmethacrylate (PMMA) cement in the treatment of diabetic foot osteomyelitis (DFO). Materials and Methods: The study examined 31 patients diagnosed with DFO from 2019 to 2021. The participants underwent surgical debridement accompanied by systemic antibiotic therapy, applying either antibiotic-loaded PMMA beads (group P, n=20) or antibiotic-loaded β-TCP/DCPD beads (group N, n=11). The assessment criteria included the Cierny-Mader and C-M Host classification for osteomyelitis, Wagner Diabetic Foot Ulcer classification, and the parameters for nonvascular surgical treatment. Results: The healing rates were 95% and 100% in groups P and N, respectively (p=0.543). The median healing time was 18 and 19 weeks for groups P and N, respectively (p=0.094). Amputation was necessary for one patient (5%) in group P. The DFO recurrence rates were 10% and 9% in groups P and N, respectively (p=0.534). The median hospital stay was 34 and 31 days for groups P and N, respectively (p=0.634).In particular, postoperative antibiotic bead leakage occurred in 5% and 45% of groups P and N, respectively (p=0.006). Conclusion β-TCP/DCPD, as a drug delivery system, is an effective adjunct for treating deep diabetic foot infections. Nevertheless, the higher incidence of surgical site antibiotic bead leakage with β-TCP/DCPD necessitates careful consideration of its application.