Background/Aims: Psoriasis is a common inflammatory skin disorder following non-specific triggers. Involvement of immune system is widely accepted for pathogenesis studies have demonstrated importance of gut microbiota in pathogenesis of inflammatory skin diseases. Proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) are acid-suppressive drugs widely used for acid related gastrointestinal diseases, and prolonged use has been associated with altered gut microbiota. This study aimed to investigate association between psoriasis and acid suppressing drugs in Korean population. Methods: This study was conducted with 3,662 patients diagnosed with psoriasis between 2002 and 2013 in NHIS-NSC. A total of 14,648 controls were matched at 1:4 based on sex, age, and gastrointestinal disease. ORs were estimated to determine the association between acid suppressing drug use and psoriasis. Results: Our study found a statistically significant association between the prolonged use of acid-suppressive drugs and the development of psoriasis in the Korean population. Specifically, patients with gastrointestinal diseases who used histamine-2 receptor antagonists (H2RA) or proton pump inhibitors (PPI) for extended periods exhibited a higher risk of developing psoriasis. The adjusted odds ratio for psoriasis was 1.89 (95% CI, 1.66–2.17) with long-term use, indicating a clear dose-response relationship. Conclusions Results from our study indicate that prolonged use of H2RA or PPI is associated with the risk of psoriasis among patients with gastrointestinal diseases in Korean population. The risk was increased in dose-response trend after adjusting for confounding variables. Clinicians should be aware of risks associated with prolonged use of acid suppressing drugs.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Purpose: To investigate whether using a continuous glucose monitoring (CGM) for the second time (2nd_CGM) would be effective after using it for the first time (1st_CGM), depending on age. Materials and Methods: This study included patients aged ≥40 years who were diagnosed with type 2 diabetes and had used a CGM at least twice between 2017 and 2021. Participants were divided into two groups based on their age: those aged <60 years and those aged ≥60 years. We assessed the glycemic control status of the 1st_CGM and 2nd_CGM, along with the glycemic variability. Results: Overall, 15 patients were included in the study. The mean glucose level in users aged <60 years significantly decreased (p<0.001) owing to the CGM use, while it did not increase in those aged ≥60 years. In users aged ≥60 years, the 1st_CGM group showed a significant decrease in blood glucose levels over time (p<0.05), whereas the 2nd_CGM group only showed a non-significant decreasing trend. The time in range tended to increase in those aged <60 years but decreased in those aged ≥60 years. In those aged <60 years, the mean amplitude of glycemic excursions (p<0.001), standard deviation (p<0.05), and coefficient of variation (p<0.001) significantly decreased. In those aged ≥60 years, these parameters exhibited a non-significant decreasing trend. Conclusion Glycemic effect and variability improved as expected with 1st_CGM use. However, 2nd_CGM did not significantly improve glycemic effect or variability in users aged ≥60 years, contrary to expectations. To address this issue, further investigation is needed to understand why, compared to 1st_CGM, 2nd_CGM fails to achieve better glycemic control in individuals aged ≥60 years.

Background/Aims: Psoriasis is a common inflammatory skin disorder following non-specific triggers. Involvement of immune system is widely accepted for pathogenesis studies have demonstrated importance of gut microbiota in pathogenesis of inflammatory skin diseases. Proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) are acid-suppressive drugs widely used for acid related gastrointestinal diseases, and prolonged use has been associated with altered gut microbiota. This study aimed to investigate association between psoriasis and acid suppressing drugs in Korean population. Methods: This study was conducted with 3,662 patients diagnosed with psoriasis between 2002 and 2013 in NHIS-NSC. A total of 14,648 controls were matched at 1:4 based on sex, age, and gastrointestinal disease. ORs were estimated to determine the association between acid suppressing drug use and psoriasis. Results: Our study found a statistically significant association between the prolonged use of acid-suppressive drugs and the development of psoriasis in the Korean population. Specifically, patients with gastrointestinal diseases who used histamine-2 receptor antagonists (H2RA) or proton pump inhibitors (PPI) for extended periods exhibited a higher risk of developing psoriasis. The adjusted odds ratio for psoriasis was 1.89 (95% CI, 1.66–2.17) with long-term use, indicating a clear dose-response relationship. Conclusions Results from our study indicate that prolonged use of H2RA or PPI is associated with the risk of psoriasis among patients with gastrointestinal diseases in Korean population. The risk was increased in dose-response trend after adjusting for confounding variables. Clinicians should be aware of risks associated with prolonged use of acid suppressing drugs.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Purpose: To investigate whether using a continuous glucose monitoring (CGM) for the second time (2nd_CGM) would be effective after using it for the first time (1st_CGM), depending on age. Materials and Methods: This study included patients aged ≥40 years who were diagnosed with type 2 diabetes and had used a CGM at least twice between 2017 and 2021. Participants were divided into two groups based on their age: those aged <60 years and those aged ≥60 years. We assessed the glycemic control status of the 1st_CGM and 2nd_CGM, along with the glycemic variability. Results: Overall, 15 patients were included in the study. The mean glucose level in users aged <60 years significantly decreased (p<0.001) owing to the CGM use, while it did not increase in those aged ≥60 years. In users aged ≥60 years, the 1st_CGM group showed a significant decrease in blood glucose levels over time (p<0.05), whereas the 2nd_CGM group only showed a non-significant decreasing trend. The time in range tended to increase in those aged <60 years but decreased in those aged ≥60 years. In those aged <60 years, the mean amplitude of glycemic excursions (p<0.001), standard deviation (p<0.05), and coefficient of variation (p<0.001) significantly decreased. In those aged ≥60 years, these parameters exhibited a non-significant decreasing trend. Conclusion Glycemic effect and variability improved as expected with 1st_CGM use. However, 2nd_CGM did not significantly improve glycemic effect or variability in users aged ≥60 years, contrary to expectations. To address this issue, further investigation is needed to understand why, compared to 1st_CGM, 2nd_CGM fails to achieve better glycemic control in individuals aged ≥60 years.

Background/Aims: Psoriasis is a common inflammatory skin disorder following non-specific triggers. Involvement of immune system is widely accepted for pathogenesis studies have demonstrated importance of gut microbiota in pathogenesis of inflammatory skin diseases. Proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) are acid-suppressive drugs widely used for acid related gastrointestinal diseases, and prolonged use has been associated with altered gut microbiota. This study aimed to investigate association between psoriasis and acid suppressing drugs in Korean population. Methods: This study was conducted with 3,662 patients diagnosed with psoriasis between 2002 and 2013 in NHIS-NSC. A total of 14,648 controls were matched at 1:4 based on sex, age, and gastrointestinal disease. ORs were estimated to determine the association between acid suppressing drug use and psoriasis. Results: Our study found a statistically significant association between the prolonged use of acid-suppressive drugs and the development of psoriasis in the Korean population. Specifically, patients with gastrointestinal diseases who used histamine-2 receptor antagonists (H2RA) or proton pump inhibitors (PPI) for extended periods exhibited a higher risk of developing psoriasis. The adjusted odds ratio for psoriasis was 1.89 (95% CI, 1.66–2.17) with long-term use, indicating a clear dose-response relationship. Conclusions Results from our study indicate that prolonged use of H2RA or PPI is associated with the risk of psoriasis among patients with gastrointestinal diseases in Korean population. The risk was increased in dose-response trend after adjusting for confounding variables. Clinicians should be aware of risks associated with prolonged use of acid suppressing drugs.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Purpose: To investigate whether using a continuous glucose monitoring (CGM) for the second time (2nd_CGM) would be effective after using it for the first time (1st_CGM), depending on age. Materials and Methods: This study included patients aged ≥40 years who were diagnosed with type 2 diabetes and had used a CGM at least twice between 2017 and 2021. Participants were divided into two groups based on their age: those aged <60 years and those aged ≥60 years. We assessed the glycemic control status of the 1st_CGM and 2nd_CGM, along with the glycemic variability. Results: Overall, 15 patients were included in the study. The mean glucose level in users aged <60 years significantly decreased (p<0.001) owing to the CGM use, while it did not increase in those aged ≥60 years. In users aged ≥60 years, the 1st_CGM group showed a significant decrease in blood glucose levels over time (p<0.05), whereas the 2nd_CGM group only showed a non-significant decreasing trend. The time in range tended to increase in those aged <60 years but decreased in those aged ≥60 years. In those aged <60 years, the mean amplitude of glycemic excursions (p<0.001), standard deviation (p<0.05), and coefficient of variation (p<0.001) significantly decreased. In those aged ≥60 years, these parameters exhibited a non-significant decreasing trend. Conclusion Glycemic effect and variability improved as expected with 1st_CGM use. However, 2nd_CGM did not significantly improve glycemic effect or variability in users aged ≥60 years, contrary to expectations. To address this issue, further investigation is needed to understand why, compared to 1st_CGM, 2nd_CGM fails to achieve better glycemic control in individuals aged ≥60 years.

Purpose: Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM. Methods: Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated. Results: In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations. Conclusion The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.