Background: Posterior reversible encephalopathy syndrome (PRES) is a rare complication of lung transplantation with poorly understood risk factors and clinical characteristics. This study aimed to examine the occurrence, risk factors, and clinical data of patients who developed PRES following lung transplantation. Methods: A retrospective analysis was conducted on 147 patients who underwent lung transplantation between February 2013 and December 2023. The patients were diagnosed with PRES based on the clinical symptoms and radiological findings. We compared the baseline characteristics and clinical information, including primary lung diseases and immunosuppressive therapy related to lung transplantation operations, between the PRES and non-PRES groups. Results: PRES manifested in 7.5% (n=11) of the patients who underwent lung transplantation, with a median onset of 15 days after operation. Seizures were identified as the predominant clinical manifestation (81.8%, n=9) in the group diagnosed with PRES. All patients diagnosed with PRES recovered fully. Patients with PRES were significantly associated with connective tissue disease-associated interstitial lung disease (45.5% vs. 18.4%, P=0.019, odds ratio=9.808; 95% CI, 1.064–90.386; P=0.044). Nonetheless, no significant variance was observed in the type of immunotherapy, such as the use of calcineurin inhibitors, blood pressure, or acute renal failure subsequent to lung transplantation. Conclusions PRES typically manifests shortly after lung transplantation, with seizures being the predominant initial symptom. The presence of preexisting connective tissue disease as the primary lung disease represents a significant risk factor for PRES following lung transplantation.

Background: Skin rejuvenation has become an increasingly popular noninvasive approach to address age-related changes such as sagging, wrinkles, and skin laxity. Energy-based devices (EBDs) and injectables are widely used, but their application requires careful customization based on individual patient characteristics to optimize outcomes and minimize potential adverse effects. Objective: This study aimed to explore clinical practice patterns among board-certified dermatologists in South Korea, focusing on their strategies for tailoring skin rejuvenation treatments to individual patients, including the integration of EBDs, injectables, and senotherapeutics. Methods: A structured survey comprising 10 questions was administered to 13 experienced dermatologists specializing in skin rejuvenation. The survey covered treatment strategies for patients with varying facial fat volumes, pain management approaches, and the use of EBDs, injectables and senotherapeutics. Results: High-intensity focused ultrasound (HIFU) and radiofrequency (RF) were the most employed EBDs, often combined with injectables for enhanced outcomes. For patients with higher facial fat, HIFU and deoxycholic acid injections were preferred for contouring and tightening. For those with lower facial fat, biostimulatory agents such as poly-D, L-lactic acid and microneedle RF were favored to restore volume and elasticity. Pain management strategies included topical anesthetics and stepwise protocols. Although less commonly used, senotherapeutics were occasionally prescribed for specific conditions, such as melasma and extensive photoaging. Conclusion Dermatologists in South Korea employ a variety of patient-specific strategies for skin rejuvenation, combining various EBDs, injectables, and senotherapeutics. These findings highlight the importance of personalized treatment protocols and the need for further research to optimize treatment efficacy and safety.

Background: The exposome encompasses all factors people encounter through life, with the skin constantly exposed. While particulate matter (PM) and sleep deprivation are known to contribute to barrier dysfunction, their combined effects remain unclear. Objective: To evaluate the independent and combined effects of PM exposure and short-term sleep deprivation on skin barrier function. Methods: Forty healthy Korean women (aged 24–58 years) were enrolled in this study. Forearms were divided into 4 sites: control, PM exposure, sleep deprivation, and PM plus sleep deprivation. Parameters such as trans-epidermal water loss (TEWL), hydration, elasticity, roughness, and redness were measured at baseline and post-exposure. RNA sequencing and reverse transcription-polymerase chain reaction were conducted on tape-stripped skin samples. Results: PM exposure significantly increased TEWL (+25.59%, p<0.01), roughness (+21.9%, p<0.01), and redness (+13.7%, p<0.0001) while reducing elasticity (−3.98%, p<0.01). Sleep deprivation modestly reduced elasticity (−1.39%, p<0.05) without affecting other parameters.Combined PM and sleep deprivation did not further exacerbate barrier dysfunction compared to PM alone. RNA sequencing revealed reduced FLG and LORICRIN expression and upregulated endoplasmic reticulum (ER) stress markers (HSP90B1, CANX) in both PM and sleep deprivation conditions. Conclusion PM exposure impaired skin barrier function, while short-term sleep deprivation alone did not significantly affect the barrier, either independently or in combination with PM.However, it was observed that the sleep deprivation-only, while not directly causing barrier damage, induced changes in ER stress-related gene expression in tape-stripped skin samples, like the PM exposure-only. This suggests that such signaling pathways could potentially exacerbate skin barrier deterioration.

Background: Various molecular methods are used to rapidly detect gastrointestinal pathogens, highlighting the importance of understanding the performance of the associated kits in detail. We comprehensively assessed the performance of Kogene PowerChek multiplex real-time PCR kits (PowerChek Bacterial/Viral Kits) with the FilmArray GI Panel. Methods: Residual stool specimens (N = 246), initially tested utilizing the FilmArray GI Panel (May 2023–Jan 2024), were reanalyzed using PowerChek Bacterial/Viral Kits. Discrepancies were resolved by performing additional molecular assays and reviewing culture results when available. True positives (TPs)/true negatives were defined by concordant results in at least two assays. We determined cycle threshold (Ct)/crossing point (Cp) distributions between the TP and false positive (FP) groups and analyzed melting curves for the FilmArray GI Panel FPs. Results: The positive-percent agreement (PPA) of the PowerChek Bacterial/Viral Kits was 50–100%, with lower values for Salmonella spp., rotavirus, and astrovirus, whereas the FilmArray GI Panel showed 100% PPA across all targets. Both platforms demonstrated > 99% negative-percent agreement, except for enteropathogenic Escherichia coli (EPEC) and adenovirus (PowerChek Bacterial/Viral Kits) or EPEC, enteroaggregative E. coli, norovirus, and Salmonella spp. (FilmArray GI Panel). The FPs showed higher Ct/Cp values with both kits, and these values were significantly higher for adenovirus (PowerChek Viral Kit), EPEC, and norovirus (FilmArray GI Panel). Melting curve analysis of four norovirus FPs (FilmArray GI Panel) revealed atypical patterns in three cases. Conclusions The FilmArray GI Panel demonstrated higher sensitivity than the PowerChek Kits. For norovirus, melting curve analysis will help avoid FPs.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Background: The Field Epidemiology Training Program Frontline, initiated by the Korea Disease Control and Prevention Agency in 2019, aims to enhance the competencies of infectious disease practitioners across 17 regions in South Korea. With the September 2024 amendment to the Infectious Disease Prevention Act mandating infectious disease prevention and crisis response training for government employees who are associated with infectious diseases responses, there is an urgent need to assess and optimize the effectiveness and cost-efficiency of such competency-based education programs amidst constraints of budget and manpower. Methods: This study examined the educational needs and priorities of public health competencies among infectious disease practitioners. The competency framework for Infectious Disease Response Practitioners (IDRP) in South Korea was used to evaluate the validity, importance, and performance level of competencies for infectious disease response personnel. For the training needs analysis, differences in performance by group were analyzed, and an importance performance analysis (IPA) was conducted using the Borich Needs Assessment based on the IPA matrix to derive training priorities. Results: The analysis revealed a significant gap between perceived importance and selfreported performance levels in most competencies, especially epidemiologic methods.Competencies related to safety and ethics, fieldwork, and crisis management have high importance and performance ratings, indicating a need for ongoing training. Of the 27 competencies, the IPA identified specific training needs and priorities, suggesting eight competencies for focused intervention to strengthen the capacity of IDRPs. Conclusion The IDRP competency framework in South Korea plays a pivotal role in establishing a standardized, competency-based approach to training IDRP. The identified gaps and training priorities highlight the need for continued curriculum development and the integration of real-world, field-based scenarios into training programs.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Background: The Field Epidemiology Training Program Frontline, initiated by the Korea Disease Control and Prevention Agency in 2019, aims to enhance the competencies of infectious disease practitioners across 17 regions in South Korea. With the September 2024 amendment to the Infectious Disease Prevention Act mandating infectious disease prevention and crisis response training for government employees who are associated with infectious diseases responses, there is an urgent need to assess and optimize the effectiveness and cost-efficiency of such competency-based education programs amidst constraints of budget and manpower. Methods: This study examined the educational needs and priorities of public health competencies among infectious disease practitioners. The competency framework for Infectious Disease Response Practitioners (IDRP) in South Korea was used to evaluate the validity, importance, and performance level of competencies for infectious disease response personnel. For the training needs analysis, differences in performance by group were analyzed, and an importance performance analysis (IPA) was conducted using the Borich Needs Assessment based on the IPA matrix to derive training priorities. Results: The analysis revealed a significant gap between perceived importance and selfreported performance levels in most competencies, especially epidemiologic methods.Competencies related to safety and ethics, fieldwork, and crisis management have high importance and performance ratings, indicating a need for ongoing training. Of the 27 competencies, the IPA identified specific training needs and priorities, suggesting eight competencies for focused intervention to strengthen the capacity of IDRPs. Conclusion The IDRP competency framework in South Korea plays a pivotal role in establishing a standardized, competency-based approach to training IDRP. The identified gaps and training priorities highlight the need for continued curriculum development and the integration of real-world, field-based scenarios into training programs.

We updated the Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of ovarian cancer as version 5.1. The ovarian cancer guideline team of the KSGO published announced the fifth version (version 5.0) of its clinical practice guidelines for the management of ovarian cancer in December 2023. In version 5.0, the selection of the key questions and the systematic reviews were based on the data available up to December 2022.Therefore, we updated the guidelines version 5.0 with newly accumulated clinical data and added 5 new key questions reflecting the latest insights in the field of ovarian cancer between 2023 and 2024. For each question, recommendation was provided together with corresponding level of evidence and grade of recommendation, all established through expert consensus.

Background/Aims: The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H.pylori infection in Korea. Methods: This interim report describes the adherence to the revised guidelines and their impact on firstline eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form. Results: A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed.The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001). Conclusions The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.