In patients with recurrent spontaneous bacterial peritonitis, repeated inflammation may occasionally lead to fibrosis and adhesions within the peritoneal cavity, resulting in fibrous septations that give ascites a spider web-like appearance. These septations can interfere with the diffusion of antibiotics and hinder effective drainage of ascitic fluid, rendering standard treatment with antibiotics and paracentesis less effective—particularly when accompanied by refractory ascites. In this case, intraperitoneal administration of tissue plasminogen activator (tPA) via an indwelling catheter helped dissolve the fibrous septa and led to noticeable clinical improvement in a patient unresponsive to the standard therapy. However, intraperitoneal tPA therapy carries potential risks, including bleeding and infection. Therefore, it should be considered only after a thorough evaluation of the patient’s overall condition and bleeding risk, weighing the potential benefits against the possible complications.

Background: Despite various therapeutic modalities for keloids have been introduced; however, their therapeutic effects are limited. Therefore, the development of a new approach for inhibiting collagen production by scar fibroblasts is needed. Objective: To investigate the effect of electrical stimulation using a low-frequency and low-intensity alternating current on collagen and MMP-1 levels in human dermal fibroblasts. Methods: Low-frequency (20 kHz) and low-intensity (1 V/cm) electrical stimulations were applied to primary dermal fibroblasts. The production of type I procollagen and expression of matrix metalloproteinase-1 were evaluated. Transcriptomic analyses were conducted to explore the possible modes of action of electrical stimulation. Results: Electrical stimulation effectively suppressed type I procollagen production and increased MMP-1 expression. In addition, transcriptomic analyses revealed that electrical stimulation altered the gene expression associated with membrane permeability and the structure of cellular membranes. Validation using real-time polymerase chain reaction revealed that electrical stimulation significantly altered the expression of mechanosensitive ion channels (PIEZO2) and membrane-bound protein organizing caveolae (CAVIN2). Conclusion Electrical stimulation using low-frequency and low-intensity alternating currents effectively modulates extracellular matrix homeostasis by altering the cellular membrane structure and function. Our findings suggest a promising therapeutic approach for the management of keloids and hypertrophic scars.

Background: As the coronavirus disease (COVID-19) pandemic continues, wearing masks has become a daily routine. As the mask-wearing time increased, the mask-covered skin was more likely to be influenced. Objective: This study aimed to identify face mask-wearing behaviors and their effects on patients with facial skin diseases. Methods: Patients with facial skin disease were surveyed at two institutions. The patterns of mask use, mask-associated skin problems, and the Dermatology Life Quality Index (DLQI) were investigated. Results: A total of 174 participants were enrolled and the mean age was 42.2 years. Rosacea (35.6%) was the most common condition, followed by acne (25.3%) and contact dermatitis (17.2%). Ninety-four subjects (54.0%) reported that they wore masks for less than 6 hours a day, and 96 subjects (55.2%) wore masks to fit tightly against the face. Regarding the mask type, KF-99, 94, and 80 (62.6%) were the most common. Nearly three-quarters (n=128, 73.6%) of patients complained of mask-associated skin problems. Pimples were the most common symptom (59.4%), and the cheek was the most commonly affected area (67.2%). The mean DLQI score was 9.90. Conclusion We investigated the current patterns of mask use in patients with facial skin diseases. Moreover, it is necessary to recognize newly encountered relationships and seek strategies for relevant patients.

The diagnosis of common bile duct (CBD) stones is conducted through various imaging tests, endoscopic examinations, and the patient's clinical presentation. In patients with symptomatic gallstone disease, initial tests such as liver function tests, abdominal ultrasound, and abdominal computed tomography can be performed. Based on the results of these initial tests, symptomatic patient with cholelithiasis can be classified into low risk, intermediate risk, and high risk groups. Low risk of choledocholithiasis is characterized by normal liver function test results and absence of CBD dilation on abdominal ultrasound. For patients in this category, additional tests are not necessary unless symptoms indicating CBD stones persist. Intermediate risk of choledocholithiasis is identified by abnormal liver function test results or CBD dilation on abdominal ultrasound. Additional tests such as endoscopic ultrasound or magnetic resonance cholangiopancreatography can be performed. If CBD stones are confirmed in the additional tests, endoscopic retrograde cholangiopancreatography (ERCP) is required. High risk of choledocholithiasis is diagnosed when there is clinical evidence of cholangitis or CBD stones are identified on imaging tests. In such cases, ERCP is recommended for both diagnosis and treatment purposes without the need for further additional tests.

Objective: The increasing concern over adolescent suicide necessitates suicide prevention training for school teachers, as students spend a significant portion of their time at school. This study’s objective is to develop a suicide prevention program tailored for teachers. Methods: The program was developed by a multidisciplinary research team, drawing on a review of both domestic and international suicide prevention programs, related scholarly articles, and Korean psychological autopsy interviews of adolescents. This was complemented by a survey of teachers to assess the program’s practicality and usability. Results: The developed program comprises three parts, consistent with other versions: Careful Observation, Active Listening, and Risk Evaluation and Expert Referral. Careful Observation focuses on training teachers to recognize verbal, behavioral, and situational warning signs of suicidal ideation in students; Active Listening involves strategies for encouraging students to express their suicidal thoughts and techniques for being an empathetic and attentive listener; Risk Evaluation and Expert Referral provides instruction on how to assess suicide risk and assist students safely. Conclusion It is anticipated that this program will equip teachers with valuable knowledge and skills, contributing to a reduction in adolescents suicide rates.