Background: Mycoplasma pneumoniae is a major cause of community-acquired pneumonia (CAP) in children, with a rising incidence of macrolide resistance. Early diagnosis is crucial for reducing the disease burden; however, current diagnostic tools have limitations.We evaluated the diagnostic accuracy of serological assays and their performance based on symptom onset in children with CAP. Methods: From September 2023 to September 2024, we prospectively enrolled children with CAP, classified as M. pneumoniae pneumonia (MPP) or non-MPP, from 16 hospitals in Korea. Serological testing included chemiluminescence immunoassay (CLIA) and ELISA for detecting IgM and IgG, along with particle agglutination (PA) for total antibody measurements. Serological responses were analyzed at different times after symptom onset (0–4, 5–9, and 10–21 days). Results: Among 472 children with CAP (362 MPP, 110 non-MPP), 138 (29.2%) underwent PA testing, and 334 (70.8%) underwent IgM testing. PA at a 1:640 cutoff showed 48.0% sensitivity and 100% specificity. CLIA and ELISA showed comparable sensitivities (69.1% vs. 69.2%) and specificities (76.9% vs. 66.7%) for IgM testing. Seropositivity increased significantly with time since symptom onset (P for trend < 0.001), reaching 97.9% for IgM, 62.5% for IgG, and 94.7% for PA at 10–21 days. Conclusions The time post-symptom onset significantly influenced the diagnostic utility of serological tests for pediatric MPP, which showed limited value during the early stage of illness. These findings emphasize the importance of symptom onset-based interpretation of serological test results and their utility in complementing PCR when optimizing MPP diagnosis in children.

Objective: International treatment guidelines recommend psychotherapy as the first-line treatment for anorexia nervosa (AN). Adaptation of Western evidence-based treatments to different cultures through personalization has become increasingly important, but evidence remains limited. This study examined the feasibility and effectiveness of AN outpatient psychotherapies in Korea. Methods: A total of 160 adult patients diagnosed with AN (mean age = 25.3 years) were recruited from an eating disorder (ED) clinic in Korea. They received one of the following psychotherapy programs: motivational enhancement therapy with nutrition (MET with nutrition) (n = 47); Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) augmented by New Maudsley Model for Collaborative Care (NMCC) (n = 20); or Specialist Supportive Clinical Management (SSCM) (n = 93). Treatments were administered face-to-face by trained therapists, following protocols tailored to each individual. Demographic and ED‐related clinical data were collected through standardized interviews and questionnaires at baseline and at the end of treatment. Results: Overall dropout rate was 40.3%, with a lower rate observed in MANTRA augmented by NMCC and SSCM than MET with nutrition. All three psychotherapies increased body mass index (BMI), with minimal group differences.Individuals with lower baseline BMI and those who attended more sessions experienced greater BMI increases across all psychotherapies. Conclusion Psychotherapies for AN were feasible and showed promise in terms of effectiveness among Korean patients.Despite comparable BMI increases, the therapies led by experienced therapists and with greater personalization had lower dropout rates. Further studies using randomized controlled trials are needed while controlling for variables outside treatments.

Purpose: Notable effectiveness of trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer (BC) has focused pathologists’ attention. We studied the incidence and clinicopathologic characteristics of HER2-low BC, and the effects of immunohistochemistry (IHC) associated factors on HER2 IHC results. Materials and Methods: The Breast Pathology Study Group of the Korean Society of Pathologists conducted a nationwide study using real-world data on HER2 status generated between January 2022 and December 2022. Information on HER2 IHC protocols at each participating institution was also collected. Results: Total 11,416 patients from 25 institutions included in this study. Of these patients, 40.7% (range, 6.0% to 76.3%) were classified as HER2-zero, 41.7% (range, 10.5% to 69.1%) as HER2-low, and 17.5% (range, 6.7% to 34.0%) as HER2-positive. HER2-low tumors were associated with positive estrogen receptor and progesterone receptor statuses (p < 0.001 and p < 0.001, respectively). Antigen retrieval times (≥ 36 minutes vs. < 36 minutes) and antibody incubation times (≥ 12 minutes vs. < 12 minutes) affected on the frequency of HER2 IHC 1+ BC at institutions using the PATHWAY HER2 (4B5) IHC assay and BenchMark XT or Ultra staining instruments. Furthermore, discordant results between core needle biopsy and subsequent resection specimen HER2 statuses were observed in 24.1% (787/3,259) of the patients. Conclusion The overall incidence of HER2-low BC in South Korea concurs with those reported in previously published studies. Significant inter-institutional differences in HER2 IHC protocols were observed, and it may have impact on HER2-low status. Thus, we recommend standardizing HER2 IHC conditions to ensure precise patient selection for targeted therapy.

Purpose: We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. Methods: From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). Results: The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilatesadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance,moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. Conclusion This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.

Purpose: This study aims to measure the improvement of balanced ability and rapid response of 30 healthy adults by performing dynamic stretching, static stretching, and sargent jump. Methods: The sample 30 peoples without any musculoskeletal disease who volunteered to be the subject of the study. We measured all subjects on following metrics to evaluate the function and stability under the normal condition, with dynamic stretching (DS) group, static stretching (SS) group: vertical jump height and reaching distance Anterior, Posteromedial, Posterolateral and NO (Normal eye open), NC (Normal eye close), PO (Pillow with eye open), and PC (Pillow with close eye) were evaluated. All measures were analyzed using independent t-test and One-way repeated Anova. Results: There was a significant increase in SJH (Sargent jump) in both groups (p < 0.05). In Y-balance test, there was a significant increase in both groups except for the ANT (Anterior) direction, and there was a significant increase only in the SS group in the ANT (Anterior) direction (p < 0.05). There was no significant difference between the DS group and the SS group (p > 0.05). There was no significant improvement in ST (Stability Index) and WDI (Weight Distribution Index) in both groups (p > 0.05). Conclusion Both DS and SS showed significant improvement in SJH and Y-balance tests, which are dynamic functions, but had no significant effect on static balance ability.

BACKGROUND: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS. METHODS: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes. RESULTS: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients’ surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT. CONCLUSION Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.

BACKGROUND: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS.METHODS: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes.RESULTS: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients’ surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT.CONCLUSION: Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.
Anemia ; Blood Donors ; Blood Transfusion ; Humans ; Minimally Invasive Surgical Procedures ; Mortality ; Postoperative Period ; Prognosis ; Thoracic Surgery

We investigated the utility of the duck-feet collagen extraction patching procedure in the traumatic tympanic membrane (TM) perforation via a comparison with spontaneous healing or paper patch. Fifty-six ears of adult male Sprague-Dawley rats, each weighing in the range of 250 to 300 g, were used for the animal studies. Sixteen rats had one-side ear in the control group and the opposite-side ear in the treated groups. The remaining twelve rats had a one-side ear with the duck-feet collagen patch and the opposite-side ear with a paper patch. The proliferating cell nuclear antigen (PCNA) expression cells were calculated among the 200 basal cells, and the expression percentage was identified as the labeling index. The healing of the perforation in the duck-feet collagen patch group was confirmed to be more rapid compared to the healing of the other groups. PCNA staining was observed in the migrating portion of PCNA enhanced cell to collagen scaffold in Post operative day (POD) 7 of collagen patch group. Thus, the adhesive effect of the duck-feet collagen patch to perforated margin was better than that of the paper patch. After completing the healing process, the collagen patch shrank and detached from the tympanic membrane (POD 14). In this study, we confirmed that the use of a duck-feet collagen patch had the advantage of early healing, inducing natural TM contour, and disappearing ability after the patch effect is complete.
Adhesives ; Adult ; Animals ; Collagen* ; Ducks* ; Ear ; Ear, Middle ; Fibroins ; Foot* ; Humans ; Male ; Proliferating Cell Nuclear Antigen ; Rats ; Rats, Sprague-Dawley ; Tympanic Membrane Perforation* ; Tympanic Membrane*

β Blockers such as propranolol and labetalol are known to induce toxic myopathy because of their partial β₂ adrenoceptor agonistic effect. Nebivolol has the highest β1 receptor affinity among β blockers, and it has never been reported to induce rhabdomyolysis until now. We report a patient who developed rhabdomyolysis after changing medication to nebivolol. A 75-year-old woman was admitted to our hospital because of generalized weakness originating 2 weeks before visiting. Approximately 1 month before her admission, her medication was changed from carvedilol 12.5 mg to nebivolol 5 mg. Over this time span, she had no other lifestyle changes causing rhabdomyolysis. Her blood chemistry and whole body bone scan indicated rhabdomyolysis. We considered newly prescribed nebivolol as a causal agent. She was prescribed carvedilol 12.5 mg, which she was previously taking, instead of nebivolol. She was treated by hydration and urine alkalization. She had fully recovered and was discharged.
Aged ; Chemistry ; Female ; Humans ; Labetalol ; Life Style ; Muscular Diseases ; Nebivolol* ; Propranolol ; Rhabdomyolysis*

BACKGROUND/AIMS: Fragmented care in nephrology can cause treatment delays. Nephrologists are qualified to perform vascular access-related procedures because they understand the pathophysiology of renal disease and perform physical examination for vascular access. We compared treatment delays associated with tunneled hemodialysis catheter (TDC) placement between interventional radiologists and nephrologists. METHODS: We collected data by radiologists from January 1, 2011 through December 31, 2011 and by nephrologists from since July 1, 2012 through June 30, 2013. We compared the duration from the hemodialysis decision to TDC placement (D-P duration) and hemodialysis initiation (D-H duration), catheter success and the complication rate, and the frequency and the usage time of non-tunneled hemodialysis catheters (NDCs) before TDC placement. RESULTS: The study analyzed 483 placed TDCs: 280 TDCs placed by radiologists and 203 by nephrologists. The D-P durations were 319 minutes (interquartile range [IQR], 180 to 1,057) in the radiologist group and 140 minutes (IQR, 0 to 792) in the nephrologist group. Additionally, the D-H durations were 415 minutes (IQR,260 to 1,091) and 275 minutes (IQR, 123 to 598), respectively. These differences were statistically significant (p = 0.00). The TDC success rate (95.3% vs. 94.5%, respectively; p = 0.32) and complication rate (16.2% vs. 11%, respectively; p = 0.11) did not differ between the groups. The frequency (24.5 vs. 26%, respectively; p = 0.72) and the usage time of NDC (8,451 vs. 8,416 minutes, respectively; p = 0.91) before TDC placement were not statistically significant. CONCLUSIONS: Trained interventional nephrologists could perform TDC placement safely, minimizing treatment delays.
Catheters* ; Nephrology ; Physical Examination ; Renal Dialysis* ; Vascular Access Devices