Intervertebral disc degeneration is associated with diverse spine diseases, including spinal stenosis, facet arthropathy, and disc herniation, which have socio-economic effects. A normal intervertebral disc has consistency and homeostasis, consisting of annulus fibrosus, nucleus pulposus, notochordal cells, nucleus pulposus cells, and an endplate with an immune privilege. On the other hand, when the degenerative process has pathologic causes, the inflammatory reaction could lead to nerve sprouting and vascularization into the tissue. Histopathologically, the pathologic process involves the degradation of the extracellular matrix, apoptosis and necrosis of nucleus pulposus cells, inhibition of chondrogenic differentiation, disruption of endplate chondrogenic cells, and other processes. Various approaches for managing disc degeneration have been reported. Among them, mesenchymal stem cells (MSCs) have been regarded as representative trials. In vitro and animal studies with MSCs have reported some promising outcomes in terms of inflammatory modulation and regeneration, but several limitations have been pointed out, including the issues of graft rejection and survival. Because the paracrine mechanism would be a main therapeutic factor of MSCs, extracellular vesicles (EVs), one of the factors released from MSCs, have been considered a promising source for regenerative medicine. EVs possess nucleic acids, functional proteins, and inflammation-related factors, playing a significant role in the inflammatory reaction and regeneration. The current review article discusses the pathophysiology of disc degeneration, outcomes of conventional MSCs and EVs, and current limitations and future perspectives on EV therapeutics.

The impact of Streptococcus pneumoniae coinfection on coronavirus disease 2019 (COVID-19) prognosis remains uncertain. We conducted a retrospective analysis of patients hospitalized with COVID-19 who underwent a pneumococcal urinary antigen (PUA) test to assess its clinical utility. Results showed that PUA-positive patients required more oxygen support, high-flow nasal cannula, and dexamethasone compared to PUA-negative patients.Furthermore, the significantly higher incidence of a National Early Warning Score ≥5 in the PUA-positive group (P<0.001) suggests that a positive PUA test is associated with a severe disease course. However, no significant difference in mortality was observed between the two groups, and antibiotics were used in almost all patients (96.2%). While the PUA test may help guide antibiotic use in COVID-19 patients, its interpretation should be approached with caution.

The impact of Streptococcus pneumoniae coinfection on coronavirus disease 2019 (COVID-19) prognosis remains uncertain. We conducted a retrospective analysis of patients hospitalized with COVID-19 who underwent a pneumococcal urinary antigen (PUA) test to assess its clinical utility. Results showed that PUA-positive patients required more oxygen support, high-flow nasal cannula, and dexamethasone compared to PUA-negative patients.Furthermore, the significantly higher incidence of a National Early Warning Score ≥5 in the PUA-positive group (P<0.001) suggests that a positive PUA test is associated with a severe disease course. However, no significant difference in mortality was observed between the two groups, and antibiotics were used in almost all patients (96.2%). While the PUA test may help guide antibiotic use in COVID-19 patients, its interpretation should be approached with caution.

Intervertebral disc degeneration is associated with diverse spine diseases, including spinal stenosis, facet arthropathy, and disc herniation, which have socio-economic effects. A normal intervertebral disc has consistency and homeostasis, consisting of annulus fibrosus, nucleus pulposus, notochordal cells, nucleus pulposus cells, and an endplate with an immune privilege. On the other hand, when the degenerative process has pathologic causes, the inflammatory reaction could lead to nerve sprouting and vascularization into the tissue. Histopathologically, the pathologic process involves the degradation of the extracellular matrix, apoptosis and necrosis of nucleus pulposus cells, inhibition of chondrogenic differentiation, disruption of endplate chondrogenic cells, and other processes. Various approaches for managing disc degeneration have been reported. Among them, mesenchymal stem cells (MSCs) have been regarded as representative trials. In vitro and animal studies with MSCs have reported some promising outcomes in terms of inflammatory modulation and regeneration, but several limitations have been pointed out, including the issues of graft rejection and survival. Because the paracrine mechanism would be a main therapeutic factor of MSCs, extracellular vesicles (EVs), one of the factors released from MSCs, have been considered a promising source for regenerative medicine. EVs possess nucleic acids, functional proteins, and inflammation-related factors, playing a significant role in the inflammatory reaction and regeneration. The current review article discusses the pathophysiology of disc degeneration, outcomes of conventional MSCs and EVs, and current limitations and future perspectives on EV therapeutics.

The impact of Streptococcus pneumoniae coinfection on coronavirus disease 2019 (COVID-19) prognosis remains uncertain. We conducted a retrospective analysis of patients hospitalized with COVID-19 who underwent a pneumococcal urinary antigen (PUA) test to assess its clinical utility. Results showed that PUA-positive patients required more oxygen support, high-flow nasal cannula, and dexamethasone compared to PUA-negative patients.Furthermore, the significantly higher incidence of a National Early Warning Score ≥5 in the PUA-positive group (P<0.001) suggests that a positive PUA test is associated with a severe disease course. However, no significant difference in mortality was observed between the two groups, and antibiotics were used in almost all patients (96.2%). While the PUA test may help guide antibiotic use in COVID-19 patients, its interpretation should be approached with caution.

Intervertebral disc degeneration is associated with diverse spine diseases, including spinal stenosis, facet arthropathy, and disc herniation, which have socio-economic effects. A normal intervertebral disc has consistency and homeostasis, consisting of annulus fibrosus, nucleus pulposus, notochordal cells, nucleus pulposus cells, and an endplate with an immune privilege. On the other hand, when the degenerative process has pathologic causes, the inflammatory reaction could lead to nerve sprouting and vascularization into the tissue. Histopathologically, the pathologic process involves the degradation of the extracellular matrix, apoptosis and necrosis of nucleus pulposus cells, inhibition of chondrogenic differentiation, disruption of endplate chondrogenic cells, and other processes. Various approaches for managing disc degeneration have been reported. Among them, mesenchymal stem cells (MSCs) have been regarded as representative trials. In vitro and animal studies with MSCs have reported some promising outcomes in terms of inflammatory modulation and regeneration, but several limitations have been pointed out, including the issues of graft rejection and survival. Because the paracrine mechanism would be a main therapeutic factor of MSCs, extracellular vesicles (EVs), one of the factors released from MSCs, have been considered a promising source for regenerative medicine. EVs possess nucleic acids, functional proteins, and inflammation-related factors, playing a significant role in the inflammatory reaction and regeneration. The current review article discusses the pathophysiology of disc degeneration, outcomes of conventional MSCs and EVs, and current limitations and future perspectives on EV therapeutics.

Hyperthyroidism is a clinical condition characterized by excessive production of thyroid hormones, leading to thyrotoxicosis, with Graves’ disease being the most common underlying etiology. The treatment options for hyperthyroidism include antithyroid drug (ATD) therapy, radioactive iodine (RAI) therapy, and thyroidectomy. To establish standardized clinical recommendations specific to RAI therapy focusing on the safety, efficacy, pre- and post-treatment protocols, and follow-up monitoring, the Korean Thyroid Association convened a Task Force dedicated to developing evidence-based guidelines. Six key clinical questions were identified through expert panel discussion. A systematic review of literature published between 2013 and 2022 was conducted using PubMed and Embase with “hyperthyroidism” and “Graves’ disease” as search terms. Additional studies published during manuscript development were also included. The guideline classifies the clinical indications for RAI therapy into three categories: cases in which RAI is strongly recommended, may be considered, or not recommended. A fixed dose of 10–15 mCi is recommended for RAI therapy. While a routine low-iodine diet is not required, patients should avoid iodine-rich foods for at least one week before treatment. ATD should be discontinued 3–7 days prior to RAI and may be resumed afterward in selected cases. Prophylactic glucocorticoids are advised for patients with mild active thyroid eye disease and may be considered in those with additional risk factors. Thyroid function should be monitored at 4–6 weeks post-treatment, then every 2–3 months until stabilization, and subsequently at 6–12 month intervals or as clinically indicated. This guideline reflects recent advances in RAI therapy for hyperthyroidism and emphasizes the importance of individualized treatment decisions based on clinical characteristics, comorbidities, and patient preferences in Korea.

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.