Purpose: This study aimed to analyze nationwide trends and regional disparities in inguinal hernia surgeries in South Korea between 2016 and 2022. Additionally, we aimed to evaluate changes in surgery frequency, including urban concentration and the introduction of robotic surgery. Methods: This retrospective review used nationwide data on inguinal hernia surgeries from the Health Insurance Review and Assessment Service database. Results: From 2016 to 2022, 254,367 inguinal hernia surgeries were performed in South Korea, with males accounting for 88.9% of cases. The annual number of surgeries fluctuated, particularly in 2020, owing to the coronavirus disease 2019 pandemic. Medical costs increased from $1,218.4 to $1,970 on average, whereas patient copayments rose from $180.2 to $293.3. Robotic inguinal hernia surgeries, introduced in 2019, increased to 226 cases in 2022. Pediatric surgeries steadily declined, whereas adult surgeries remained stable, with a slight increase in 2022. The average hospital stay did not change significantly but varied between pediatric and adult patients. Regional disparities were notable, especially in pediatric surgery rates between metropolitan areas, such as Seoul and the surrounding provinces. Conclusion This study highlights stable overall surgery rates, a decline in pediatric cases, and an increase in robotic inguinal hernia surgeries. The persistent concentration of healthcare services in metropolitan areas suggests a need for policy interventions to address regional disparities and ensure equitable healthcare access. The findings underscore the importance of ongoing efforts to improve healthcare distribution and the need for long-term strategies to address changing surgical trends.

Purpose: This study aimed to analyze nationwide trends and regional disparities in inguinal hernia surgeries in South Korea between 2016 and 2022. Additionally, we aimed to evaluate changes in surgery frequency, including urban concentration and the introduction of robotic surgery. Methods: This retrospective review used nationwide data on inguinal hernia surgeries from the Health Insurance Review and Assessment Service database. Results: From 2016 to 2022, 254,367 inguinal hernia surgeries were performed in South Korea, with males accounting for 88.9% of cases. The annual number of surgeries fluctuated, particularly in 2020, owing to the coronavirus disease 2019 pandemic. Medical costs increased from $1,218.4 to $1,970 on average, whereas patient copayments rose from $180.2 to $293.3. Robotic inguinal hernia surgeries, introduced in 2019, increased to 226 cases in 2022. Pediatric surgeries steadily declined, whereas adult surgeries remained stable, with a slight increase in 2022. The average hospital stay did not change significantly but varied between pediatric and adult patients. Regional disparities were notable, especially in pediatric surgery rates between metropolitan areas, such as Seoul and the surrounding provinces. Conclusion This study highlights stable overall surgery rates, a decline in pediatric cases, and an increase in robotic inguinal hernia surgeries. The persistent concentration of healthcare services in metropolitan areas suggests a need for policy interventions to address regional disparities and ensure equitable healthcare access. The findings underscore the importance of ongoing efforts to improve healthcare distribution and the need for long-term strategies to address changing surgical trends.

Purpose: This study aimed to analyze nationwide trends and regional disparities in inguinal hernia surgeries in South Korea between 2016 and 2022. Additionally, we aimed to evaluate changes in surgery frequency, including urban concentration and the introduction of robotic surgery. Methods: This retrospective review used nationwide data on inguinal hernia surgeries from the Health Insurance Review and Assessment Service database. Results: From 2016 to 2022, 254,367 inguinal hernia surgeries were performed in South Korea, with males accounting for 88.9% of cases. The annual number of surgeries fluctuated, particularly in 2020, owing to the coronavirus disease 2019 pandemic. Medical costs increased from $1,218.4 to $1,970 on average, whereas patient copayments rose from $180.2 to $293.3. Robotic inguinal hernia surgeries, introduced in 2019, increased to 226 cases in 2022. Pediatric surgeries steadily declined, whereas adult surgeries remained stable, with a slight increase in 2022. The average hospital stay did not change significantly but varied between pediatric and adult patients. Regional disparities were notable, especially in pediatric surgery rates between metropolitan areas, such as Seoul and the surrounding provinces. Conclusion This study highlights stable overall surgery rates, a decline in pediatric cases, and an increase in robotic inguinal hernia surgeries. The persistent concentration of healthcare services in metropolitan areas suggests a need for policy interventions to address regional disparities and ensure equitable healthcare access. The findings underscore the importance of ongoing efforts to improve healthcare distribution and the need for long-term strategies to address changing surgical trends.

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.

Systemic sclerosis is an autoimmune disease characterized by inflammatory reactions and fibrosis. Myofibroblasts are considered therapeutic targets for preventing and reversing the pathogenesis of fibrosis in systemic sclerosis. Although the mechanisms that differentiate into myofibroblasts are diverse, transforming growth factor β (TGF-β) is known to be a key mediator of fibrosis in systemic sclerosis. This study investigated the effects of extracellular vesicles derived from human adipose stem cells (ASC-EVs) in an in vivo systemic sclerosis model and in vitro TGF-β1-induced dermal fibroblasts. The therapeutic effects of ASC-EVs on the in vivo systemic sclerosis model were evaluated based on dermal thickness and the number of α-smooth muscle actin (α-SMA)-expressing cells using hematoxylin and eosin staining and immunohistochemistry. Administration of ASC-EVs decreased both the dermal thickness and α-SMA expressing cell number as well as the mRNA levels of fibrotic genes, such as Acta2, Ccn2, Col1a1 and Comp. Additionally, we discovered that ASC-EVs can decrease the expression of α-SMA and CTGF and suppress the TGF-β pathway by inhibiting the activation of SMAD2 in dermal fibroblasts induced by TGF-β1. Finally, TGF-β1-induced dermal fibroblasts underwent selective death through ASC-EVs treatment. These results indicate that ASC-EVs could provide a therapeutic approach for preventing and reversing systemic sclerosis.

Objective: This study aims to explore the opinions on the insurance coverage of artificial intelligence (AI), as categorized based on the distinct value elements offered by AI, with a specific focus on patient-centered outcomes (PCOs). PCOs are distinguished from traditional clinical outcomes and focus on patient-reported experiences and values such as quality of life, functionality, well-being, physical or emotional status, and convenience. Materials and Methods: We classified the value elements provided by AI into four dimensions: clinical outcomes, economic aspects, organizational aspects, and non-clinical PCOs. The survey comprised three sections: 1) experiences with PCOs in evaluating AI, 2) opinions on the coverage of AI by the National Health Insurance of the Republic of Korea when AI demonstrated benefits across the four value elements, and 3) respondent characteristics. The opinions regarding AI insurance coverage were assessed dichotomously and semi-quantitatively: non-approval (0) vs. approval (on a 1–10 weight scale, with 10 indicating the strongest approval). The survey was conducted from July 4 to 26, 2023, using a web-based method. Responses to PCOs and other value elements were compared. Results: Among 200 respondents, 44 (22%) were patients/patient representatives, 64 (32%) were industry/developers, 60 (30%) were medical practitioners/doctors, and 32 (16%) were government health personnel. The level of experience with PCOs regarding AI was low, with only 7% (14/200) having direct experience and 10% (20/200) having any experience (either direct or indirect). The approval rate for insurance coverage for PCOs was 74% (148/200), significantly lower than the corresponding rates for other value elements (82.5%–93.5%; P ≤ 0.034). The approval strength was significantly lower for PCOs, with a mean weight ± standard deviation of 5.1 ± 3.5, compared to other value elements (P ≤ 0.036). Conclusion There is currently limited demand for insurance coverage for AI that demonstrates benefits in terms of nonclinical PCOs.

Background: Oxidative stress is generally accepted as one of the principal pathogenesis of vitiligo, and keratinocyte-melanocyte interactions are also thought to play critical roles. It is well-known that antioxidant response and autophagy protect cells against oxidative damage, but the details and the compensatory relationship between the two mechanisms in the keratinocytes of vitiligo lesions remain unclear. Objective: To evaluate the antioxidant response and autophagy status of patients with vitiligo and to explore the interactions between these two mechanisms. Methods: Ten patients with clinicopathologically proven vitiligo and 10 normal controls were enrolled in our Department of Dermatology, Soonchunhyang University Hospital, Bucheon, Korea. Tissue samples of vitiligo lesions in the patient group and normal skin in the control group were immunohistochemically stained for nuclear factor erythroid 2-related factor 2 (Nrf2), Beclin-1, microtubule-associated protein light chain 3 (LC3)-II, and p62. The immunopositivity of epidermal keratinocytes was evaluated. Results: Keratinocytes in vitiligo lesions had a significantly lower expression of Nrf2 (p=0.002) than that in the cells of normal controls. The levels of autophagy markers did not differ significantly between the two groups, but decreases in the Beclin-1 and LC3-II levels, and an increase in the p62 level in the patient group may indicate a small decrease in autophagy of patients with vitiligo. Conclusion Decreased antioxidant response and reduced autophagy may trigger melanocyte apoptosis in vitiligo lesions.