Purpose: Postoperative endophthalmitis is a sight-threatening intraocular infection requiring prompt treatment. This study aimed to compare the clinical outcomes of intravitreal 0.625% povidone-iodine (PI) injection with intravitreal antibiotic injection for the treatment of postoperative endophthalmitis. Methods: A retrospective review of 40 eyes diagnosed with postoperative endophthalmitis was conducted. Patients were divided into two groups: group 1 received intravitreal 0.625% PI injection (0.1 mL), while group 2 received intravitreal antibiotic injection. Clinical data, including best-corrected visual acuity (BCVA), intraocular pressure, the number of intravitreal injections, duration of anterior chamber hypopyon, and the need for pars plana vitrectomy (PPV), were analyzed. Results: Group 1 (24 eyes) showed significant improvements in BCVA posttreatment (mean, 1.04 ± 0.95 logMAR; p < 0.001) compared to group 2 (16 eyes; mean, 1.26 ± 0.99 logMAR; p = 0.092). Severe visual impairment (BCVA < 10 / 100) was significantly less frequent in group 1 (25.0%) than in group 2 (62.5%) (p = 0.025). The mean duration of hypopyon was shorter in group 1 (2.6 ± 2.2 days) compared to group 2 (6.4 ± 7.3 days, p = 0.048). Fewer intravitreal injections (p = 0.002) and PPV (p = 0.002) were required in group 1. Conclusions Intravitreal 0.625% PI injection was associated with fewer intravitreal injections, shorter hypopyon duration, and more favorable visual outcome–related measures, including significant visual improvement from baseline and a lower frequency of severe visual impairment, compared with intravitreal antibiotic treatment. These findings suggest that PI may be considered a safe and effective initial treatment option for postoperative endophthalmitis. Further prospective studies are needed to validate these results.

Background: Combined pelvic ring and acetabular fractures are complex injuries associated with high morbidity. Despite advancements in surgical techniques, limited data are available on the long-term functional outcomes and associated factors. This study aimed to identify the factors associated with functional outcomes in surgically treated patients with combined pelvic ring and acetabular fractures. Methods: This retrospective study included 25 adult patients who underwent definitive surgical fixation for radiologically confirmed combined pelvic ring and acetabular fractures at a Level I trauma center between 2005 and 2021, with a minimum clinical and radiological follow-up of 24 months. Surgical approaches included the Kocher–Langenbeck or modified Stoppa methods, tailored to fracture morphology. Matta–Saucedo and Matta criteria assessed the pelvic ring and acetabular reduction quality, respectively. Functional outcomes at 2 years were evaluated using the Rommens–Hessmann criteria. Neurological recovery was assessed clinically and by electromyography where indicated. The association between the injury characteristics and functional recovery was evaluated using t-tests and Fisher’s exact test. Results: The mean patient age was 40.4 years, and 72% were male. Transverse acetabular fractures (58.6%) and anteroposterior compression pelvic ring injuries (64%) were the most common injuries. Anatomic or congruent acetabular reduction (within 2–3 mm) was achieved in 89.6% of fractures and was significantly associated with superior functional outcomes (p = 0.002). Conversely, the pelvic ring reduction quality did not significantly correlate with functional outcomes (p = 0.314). Transverse acetabular fractures (p = 0.046) and initial neurological deficits (p = 0.032) were associated with poorer recovery. Among the patients with neurological injury, 60% achieved partial or full recovery. Overall, bony union occurred in 96% of cases, with a mean time to union of 14.3 weeks. Reported complications included neurological deficits (40%) and infections (8%). Conclusions Functional outcomes following the surgical fixation of combined pelvic and acetabular fractures are primarily influenced by the acetabular reduction quality and neurological status at presentation. Transverse fracture patterns are complex and associated with nerve injuries, posing additional challenges. These findings emphasize the importance of precise joint reduction and early neuroassessment. Further multicenter, prospective studies are warranted to optimize the management of these complex injuries.

Sarcoidosis is an inflammatory condition affecting multiple systems in the body, distinguished by the presence of noncaseating granulomas. It is believed that specific exposures to external antigens in individuals with genetic predisposition lead to the development of these granulomas. When diagnosing sarcoidosis, tuberculosis (TB) is a potential alternative explanation for the symptoms. Our case describes a rare coexistence of cutaneous sarcoidosis and TB pleurisy in a 75-year-old male. He was diagnosed with cutaneous sarcoidosis on his face. During the investigation for possible involvement of other organs, pleural effusion was discovered, and it was determined to be caused by mycobacterial infection. The patient received a 6-month course of anti-TB drugs to treat the TB pleurisy, while a topical calcineurin inhibitor was applied to the cutaneous sarcoidosis. This case serves as a reminder to dermatologists that the coexistence of TB with sarcoidosis is possible, not just as a differential diagnosis.

This study compares biomarker levels among environmentally vulnerable residents in Korea, the general Korean population, and Asians in the United States. We selected 953 exposed residents and 204 controls from the Forensic Research via Omics Markers in Environmental Health Vulnerable Areas (FROM) study (2021-2023), 4,239 participants from the fourth Korean National Environmental Health Survey (2018-2020), and 996 Asians from the U.S. National Health and Nutrition Examination Survey (2017-March 2020). The analyzed biomarkers included blood and urinary metals, urinary metabolites of polycyclic aromatic hydrocarbons, nicotine, volatile organic compounds, and serum perfluorocarbon metabolites. The highest median biomarker levels varied by pollution source among older adults. In refineries, blood lead and cadmium (Cd), as well as urinary Cd and 2-hydroxyfluorene, were highest. Abandoned metal mines exhibited the highest blood and urinary mercury, urinary Cd, total arsenic (As), 2-naphthol, and cotinine levels. Coal-fired power plants showed the highest urinary 1- hydroxyphenanthrene levels, while cement factories had the highest urinary As3+ levels. Sprawls demonstrated the highest urinary monomethylarsonic acid, 1-hydroxypyrene, and phenylglyoxylic acid levels, and industrial areas recorded the highest levels of trans, trans-muconic acid, benzylmercapturic acid, and 2-methylhippuric acid. In general, biomarker levels were higher among exposed residents in the FROM study than in the general population; however, urinary 2-hydroxyfluorene and As5+ levels did not differ significantly. Exposure to pollution sources in environmentally vulnerable areas may elevate biomarker levels in residents.

Sarcoidosis is an inflammatory condition affecting multiple systems in the body, distinguished by the presence of noncaseating granulomas. It is believed that specific exposures to external antigens in individuals with genetic predisposition lead to the development of these granulomas. When diagnosing sarcoidosis, tuberculosis (TB) is a potential alternative explanation for the symptoms. Our case describes a rare coexistence of cutaneous sarcoidosis and TB pleurisy in a 75-year-old male. He was diagnosed with cutaneous sarcoidosis on his face. During the investigation for possible involvement of other organs, pleural effusion was discovered, and it was determined to be caused by mycobacterial infection. The patient received a 6-month course of anti-TB drugs to treat the TB pleurisy, while a topical calcineurin inhibitor was applied to the cutaneous sarcoidosis. This case serves as a reminder to dermatologists that the coexistence of TB with sarcoidosis is possible, not just as a differential diagnosis.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women. Conclusion KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD. Conclusion KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.

Background: In 2006, the Korean Atopic Dermatitis Association (KADA) working group released the diagnostic criteria for Korean atopic dermatitis (AD). Recently, more simplified, and practical AD diagnostic criteria have been proposed. Objective: Based on updated criteria and experience, we studied to develop and share a consensus on diagnostic criteria for AD in Koreans. Materials and Methods: For the diagnostic criteria, a questionnaire was constructed by searching the English-language literature in MEDLINE and the Cochrane Database of Systematic Reviews. A modified Delphi method composed of 3 rounds of email questionnaires was adopted for the consensus process. Fifty-four KADA council members participated in the 3 rounds of votes and expert consensus recommendations were established. Results: Diagnostic criteria for AD include pruritus, eczema with age-specific pattern, and chronic or relapsing history. Diagnostic aids for AD encompass xerosis, immunoglobulin E reactivity, hand–foot eczema, periorbital changes, periauricular changes, perioral changes, nipple eczema, perifollicular accentuation, and personal or family history of atopy. Conclusion This study streamlined and updated the diagnostic criteria for AD in Korea, making them more practicable for use in real-world clinical field.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.