Background: and Purpose To understand the characteristics of Korean patients with anti-3-hydroxy-3-methylglutaryl-coenxyme A reductase (HMGCR) myopathy, we measured antiHMGCR antibodies and analyzed the clinical, radiological, and pathological features of patients with anti-HMGCR myopathy. Methods: We measured titers of anti-HMGCR antibodies in the sera of 99 patients with inflammatory myopathy, 36 patients with genetic myopathy, and 63 healthy subjects using an enzyme-linked immunosorbent assay. We tested 16 myositis-specific autoantibodies (MSAs) in all patients with anti-HMGCR myopathy. Results: Positivity for the anti-HMGCR antibody was observed in 17 (4 males and 13 females) of 99 patients with inflammatory myopathy. The median age at symptom onset was 60 years.Ten (59%) of the patients with anti-HMGCR positivity had taken statins. The titer of antiHMGCR antibodies was significantly higher in the statin-naïve group (median=230 U/mL, interquartile range=170–443 U/mL) than in the statin-exposed group (median=178 U/mL, interquartile range=105–210 U/mL, p=0.045). The most common symptom was proximal muscle weakness in 15 patients (88%), followed by myalgia in 9 (53%), neck weakness in 4 (24%), dysphagia in 3 (18%), and skin lesions in 2 (12%). The median titer of anti-HMGCR antibody was 202 U/mL. We found eight different MSAs in nine (53%) patients. The median disease duration from symptom onset to diagnosis was significantly shorter in the MSA-positive group than in the MSA-negative group (p=0.027). Conclusions Our study was the first to measure anti-HMGCR antibodies in inflammatory myopathy. It has provided new findings, including the suggestion of the coexistence of other MSAs in Korean patients.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Background: With accumulating evidence that achieving a 90% improvement in the Psoriasis Area and Severity Index score (PASI90) has better correlation with improved healthrelated quality of life as compared to PASI75 achievement, there has been demand for establishing new treatment goals for psoriasis. Objective: We investigated whether the short-term PASI90 achievement would predict longer drug survival as compared to PASI75 achievement. Methods: This single-center retrospective cohort study reviewed 180 treatment series in 128 patients with plaque psoriasis, who were treated with tumor necrosis factor-alpha inhibitors (n=12), ustekinumab (n=88), secukinumab (n=23), guselkumab (n=45), and ixekizumab (n=12). The first effectiveness assessment, usually performed within 12 to 20 weeks, was considered a short-term treatment response to biologics. Results: After adjustment for covariates, time-dependent Cox proportional hazards regression analysis showed that moderate responders (short-term achievement of ≥PASI75 but Conclusion The short-term PASI90 achievement is a better predictor of longer drug survival as compared to PASI75 achievement.

Background: Factors other than efficacy and safety could influence the survival of biologics in patients with psoriasis. Little is known about whether different disease groups affect drug survival of biologics or not. Objective: This study aimed to investigate whether the availability of alternative biologics and disease groups could influence drug survival of biologics approved for psoriasis and psoriasis arthritis (PsA). Methods: A nationwide population-based retrospective cohort study was conducted using the Health Insurance and Review Assessment data in Korea between January 2009 and August 2019. Results: The drug survival analysis included 5,634 biologic episodes. Ustekinumab was the most frequently prescribed drug (n=2,488, 44.2%). Multivariable time-dependent Cox regression analysis showed that higher age, female sex, no comorbidity, concomitant cyclosporine or acitretin use, biologic-experienced and use of tumor necrosis factor (TNF)-α inhibitors were predictors of drug discontinuation. PsA was a predictor of drug persistence, particularly for TNF-α inhibitors. Ustekinumab and adalimumab discontinuation significantly increased after introducing secukinumab and ustekinumab, respectively. Conclusion The availability of alternative biologics and disease groups affect biologic drug survival in patients with psoriasis and PsA.

Background: Although the rates of illegal cosmetic procedures performed by beauticians are increasing, there is a dearth of relevant information in the literature regarding these procedures. Objective: This study was aimed to investigate illegal cosmetic procedures that were performed by beauticians with the help of judicial precedents. Methods: The Supreme Court of South Korea’s Written Judgement Management System was searched for judicial precedents regarding illegal cosmetic procedures performed by beauticians. This system included cases that were sentenced in the lower courts, the appellate courts, and the supreme court from the year 1997 to 2019. Results: Twenty-three litigation cases related to these illegal cosmetic procedures were selected. There were 21 criminal cases and two civil cases. Common illegal procedures included tattooing (n=11), use of laser and intense pulsed light device (n=6), administration of intradermal injection (n=3), and application of topical agents (n=2). Two civil cases reported facial deformity and accidental macular damage caused by illegal use of lasers by the beauticians. Conclusion In this study, illegal cosmetic procedures performed by beauticians were identified. Continuous monitoring of these illegal procedures is necessary as they can cause adverse effects in patients.

Feline calicivirus (FCV) infection results in a common upper respiratory disease associated with oral ulceration in cats.Although FCV infection has been reported in cats worldwide, the biologic and genetic features of South Korean FCV are unclear. We aimed to investigate the biological and genetic features of South Korean FCV isolates. Crandell-Rees feline kidney (CRFK) cells were used to isolate FCV from 58 organ homogenate samples. The FCV isolates were confirmed by cytopathic effects, immunofluorescence, electron microscopy, and reverse transcription polymerase chain reaction assays. Viral genetic analysis was carried out with VP2 gene and complete genomes of FCVs. Five viruses propagated in CRFK cells were confirmed to be FCVs. The FCV17D283 isolate showed the highest viral titer of 107.2TCID50 /mL at 36 h post-inoculation. Korean FCV isolates did not grow well in Vero, BHK-21, A72, or Madin-Darby canine kidney cells. The FCV17D03 and FCV17D283 isolates had the highest genetic similarity (80.1% and 86.9%) with the UTCVM-H1 and 14Q315 strains, which were isolated in the United States and South Korea in 1995 and 2014, respectively. We isolated five FCVs from cats and detected important genetic differences among them. FCV isolates did not show any virulent effects in mice.

Background: Although the rates of illegal cosmetic procedures performed by beauticians are increasing, there is a dearth of relevant information in the literature regarding these procedures. Objective: This study was aimed to investigate illegal cosmetic procedures that were performed by beauticians with the help of judicial precedents. Methods: The Supreme Court of South Korea’s Written Judgement Management System was searched for judicial precedents regarding illegal cosmetic procedures performed by beauticians. This system included cases that were sentenced in the lower courts, the appellate courts, and the supreme court from the year 1997 to 2019. Results: Twenty-three litigation cases related to these illegal cosmetic procedures were selected. There were 21 criminal cases and two civil cases. Common illegal procedures included tattooing (n=11), use of laser and intense pulsed light device (n=6), administration of intradermal injection (n=3), and application of topical agents (n=2). Two civil cases reported facial deformity and accidental macular damage caused by illegal use of lasers by the beauticians. Conclusion In this study, illegal cosmetic procedures performed by beauticians were identified. Continuous monitoring of these illegal procedures is necessary as they can cause adverse effects in patients.

Feline calicivirus (FCV) infection results in a common upper respiratory disease associated with oral ulceration in cats.Although FCV infection has been reported in cats worldwide, the biologic and genetic features of South Korean FCV are unclear. We aimed to investigate the biological and genetic features of South Korean FCV isolates. Crandell-Rees feline kidney (CRFK) cells were used to isolate FCV from 58 organ homogenate samples. The FCV isolates were confirmed by cytopathic effects, immunofluorescence, electron microscopy, and reverse transcription polymerase chain reaction assays. Viral genetic analysis was carried out with VP2 gene and complete genomes of FCVs. Five viruses propagated in CRFK cells were confirmed to be FCVs. The FCV17D283 isolate showed the highest viral titer of 107.2TCID50 /mL at 36 h post-inoculation. Korean FCV isolates did not grow well in Vero, BHK-21, A72, or Madin-Darby canine kidney cells. The FCV17D03 and FCV17D283 isolates had the highest genetic similarity (80.1% and 86.9%) with the UTCVM-H1 and 14Q315 strains, which were isolated in the United States and South Korea in 1995 and 2014, respectively. We isolated five FCVs from cats and detected important genetic differences among them. FCV isolates did not show any virulent effects in mice.

Background: Both verruca plana (VP) and seborrheic keratosis (SK) cause a major cosmetic concern. However, it is difficult to discriminate VP from SK presenting multiple tiny papules, especially those located on the face and neck. As VP and SK have different treatment strategies and prognoses, differentiation between them is important.
Objective
The objective of this study was to elucidate the clinical differential characteristics between VP and VP-like SK on the face and neck. Methods: We retrospectively investigated patients who underwent skin biopsy for differentiating between VP and VP-like SK. Multivariable logistic regression analysis was conducted to identify factors associated with the differential diagnosis. Results: Among 80 identified cases, 48.7% (n=39) was VP, and 51.3% (n=41) was VP-like SK. In the multivariable logistic regression analysis, larger than 3-mm, skin-like or pink lesion color, and confluent distribution were more likely to indicate VP than VP-like SK. Conclusion Our study proposed useful clinical differential characteristics between VP and VP-like SK on the face and neck in a large number of biopsy-proven cases. Still, there are exceptions. Therefore, in such confusing cases, skin biopsy to attain exact diagnosis is recommended.