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: Nutritional therapy (NT), such as enteral nutrition (EN) or parenteral nutrition (PN), is essential for the malnourished patients. Although the complications related to NT has been well described, multicenter data on symptoms in the patients with receiving NT during hospitalization are still lacking. METHODS: Nutrition support team (NST) consultations, on which NT-related complications were described, were collected retrospectively for one year. The inclusion criteria were patients who were (1) older than 18 years, (2) hospitalized, and (3) receiving EN or PN at the time of NST consultation. The patients' demographics (age, sex, body mass index [BMI]), type of NT and type of complication were collected. To compare the severity of each complication, the intensive care unit (ICU) admission, hospital stay, and type of discharge were also collected. RESULTS: A total of 14,600 NT-related complications were collected from 13,418 cases from 27 hospitals in Korea. The mean age and BMI were 65.4 years and 21.8 kg/m2. The complications according to the type of NT, calorie deficiency (32.4%, n=1,229) and diarrhea (21.6%, n=820) were most common in EN. Similarly, calorie deficiency (56.8%, n=4,030) and GI problem except for diarrhea (8.6%, n=611) were most common in PN. Regarding the clinical outcomes, 18.7% (n=2,158) finally expired, 58.1% (n=7,027) were admitted to ICU, and the mean hospital days after NT-related complication were 31.3 days. Volume overload (odds ratio [OR]=3.48) and renal abnormality (OR=2.50) were closely associated with hospital death; hyperammonemia (OR=3.09) and renal abnormality (OR=2.77) were associated with ICU admission; “micronutrient and vitamin deficiency” (geometric mean [GM]=2.23) and volume overload (GM=1.61) were associated with a longer hospital stay. CONCLUSION: NT may induce or be associated with several complications, and some of them may seriously affect the patient's outcome. NST personnel in each hospital should be aware of each problem during nutritional support.
Adult ; Body Mass Index ; Demography ; Diarrhea ; Enteral Nutrition ; Hospitalization ; Humans ; Hyperammonemia ; Intensive Care Units ; Korea ; Length of Stay ; Multicenter Studies as Topic ; Nutrition Therapy ; Nutritional Support ; Parenteral Nutrition ; Referral and Consultation ; Retrospective Studies ; Vitamins

PURPOSE: Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. METHODS: We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam(R) and/or Tornado(R) coils. RESULTS: The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. CONCLUSION: SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.
Child ; Cystitis ; Embolization, Therapeutic ; Hemorrhage ; Histiocytosis, Langerhans-Cell ; Humans ; Iliac Artery ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid ; Leukemia, Prolymphocytic, T-Cell ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies ; Rupture

Kasabach-Merritt syndrome is a rare thrombocytopenic consumptive coagulopathy associated with a giant hemangioma. We experienced a case of unexplained ascites with thrombocytopenia in a 32 week premature infant. An exploratory laparotomy was performed to determine the cause of the refractory ascites and thrombocytopenia. An intestinal hemangioma was found, but, surgical removal was not performed due to the extensive involvement. Hemangioma was confirmed by SPECT (single-photon emission computed tomography) and the thrombocytopenia was treated with steroid therapy. It is recommended that hemangioma of the visceral organs should be suspected when unexplained thrombocytopenia and disseminated intravascular coagulopathy persist.
Ascites ; Hemangioma ; Humans ; Infant, Newborn ; Infant, Premature ; Kasabach-Merritt Syndrome ; Laparotomy ; Thrombocytopenia ; Tomography, Emission-Computed, Single-Photon

PURPOSE: Malignant melanoma is a fatal tumor arising in the melanocytic systems of the skin. The incidence of malignant melanoma, formerly considered a rare tumor in Korea, is observed to increase. The aim of this study is to analyze the clinical and histopathological pattern of malignant melanoma in one institute. METHODS: Thirty patients with ages ranging from 33 to 80 years, diagnosed as malignant melanoma at our skin tumor department, were enrolled in a retrospective study over a 6 year period(2000. 9-2006. 7). The analyzed data included age, sex, location, duration before diagnosis, clinical type, level of invasion, and stage. RESULTS: The cases were identified and analyzed by clinical and histopathologic study. The male to female ratio was 1:1.7. Lower extremities(especially, feet) were favored sites. The majority of cases were acral lentiginous melanoma(40%), followed by nodular melanoma (36.7%), superficial spreading melanoma(20%) in this study. Clark level IV was predominant in histopathologic study. There was merely narrow gap among each stage by AJCC. CONCLUSION: The clinicopathological characteristic of melanoma in our patients is quite different with that in the West. In this retrospective study, primary lesions of the foot were predominant with melanoma, and a high percentage of these were classified pathologically as acral lentiginous melanomas. Patients had a more advanced stage of disease at first presentation and a more deeply invasive primary lesion than Western patients. These suggest that malignant melanoma has a worse prognosis in our patients than in the West. So, further organized prospective studies are needed to approach the prudent and accurate diagnosis and management of melanoma in Korea.
Diagnosis ; Female ; Foot ; Humans ; Incidence ; Korea ; Male ; Melanoma* ; Prognosis ; Retrospective Studies ; Skin

OBJECTIVE: To evaluate the learning achievement and satisfaction levels for the Field Epidemiology Specialist Training Program (FESTP), on infectious disease control between March 19 and October 31, 2002. METHODS: The FESTP was designed as a set of 84 hours curricula including lectures, discussions, self-studies, and field practicals, and organized both centrally and locally by the Division of Communicable Disease Control of the National Institute of Health and 11 universities. Before and after the program, a questionnaire survey on the educational need (49 items) and satisfaction (15 items) was conducted on 484 trainees, who were responsible for communicable disease control and immunization at 242 regional health centers. The data were analyzed with paired t-tests for comparison of the educational needs between the pre and post scores. RESULTS: The average score for satisfaction was 3.06 out of 5.0; with relatively higher scores for sincerity (4.10) and professionalism (4.01) of the tutors, adequacy (3.54) and clearness (3.51) of the evaluation criteria, usefulness (3.54) and fitness (3.52) of the contents, but with relatively lower satisfaction for schedule (2.96) and self-studies (2.91). The average for requirement for education improved, as shown by the decrease from 2.72 to 2.22 (p< .0001) with the biggest decrease in the outbreak investigation from 2.60 to 2.08. CONCLUSION: The FESTP was evaluated as being effective, the trainees showed moderate satisfaction and decrease educational needs. However, the actual schedules and self-studies should be rearranged to improve the satisfaction level.
Appointments and Schedules ; Communicable Disease Control ; Communicable Diseases ; Curriculum ; Education* ; Epidemiology* ; Immunization ; Learning ; Lectures ; Professionalism ; Specialization*

No abstract available.
Aortic Coarctation*