3.A Survey on the Perception and Behavior Regarding Tinea Pedis among Korean Adults
Minkyung CHO ; Yang Won LEE ; Dong Hun LEE ; Ki-Heon JEONG ; Soon Hyo KWON ; Jung Eun KIM ; Hyojin KIM ; Chan Ho NA ; Hyun-Min SEO ; Min Kyung SHIN ; Jiyoung AHN ; Yu Ri WOO ; Ga-Young LEE ; Yong Hyun JANG ; Hye Jung JUNG ; Yu Sung CHOI ; Tae Young HAN ; Ha-Eun LEE ; Chan Yl BANG ; Mi Woo LEE ; Dong Hyun KIM
Korean Journal of Dermatology 2023;61(7):420-428
		                        		
		                        			 Background:
		                        			Dermatophyte infection is one of the most common skin diseases affecting the skin, hair, and nails. Despite widespread recognition of the disease, missing details and misperceptions are commonplace in the general population. 
		                        		
		                        			Objective:
		                        			This study aimed to investigate the public perception and behavior regarding dermatophytosis of the hands and feet. 
		                        		
		                        			Methods:
		                        			This results from an online survey conducted between July 2022 and August 2022. The survey included 1,000 Korean participants aged 20 to 69 years, of whom 60% experienced symptoms of tinea pedis or onychomycosis. The questionnaire focused on the awareness and personal experience of tinea pedis and perception of the treatment of dermatophytosis. 
		                        		
		                        			Results:
		                        			Of the 1,000 participants, nearly 80% regarded tinea pedis as a common skin condition by which anyone can be affected. Furthermore, 88.4% had heard that the treatment of tinea pedis could be harmful, causing skin rash (60.4%) and worsening liver function (48.5%). Among 896 participants who noticed suspicious symptoms, 81.2% did not visit the clinic because it was not severe (50.1%) and seemed easily manageable (25.7%). Of the respondents, 84.4% preferred to meet dermatologists rather than non-dermatologist doctors regarding skin diseases, mainly because of trust in experts and belief in a faster cure. 
		                        		
		                        			Conclusion
		                        			Providing accurate and detailed information via online media, educational campaigns, and medical papers can rectify misconceptions and improve patient appliance, contributing to public skin health. 
		                        		
		                        		
		                        		
		                        	
4.Clinical Characteristics of Cytomegalovirus Disease of the Upper Gastrointestinal Tract: A 10-Year Multicenter Retrospective Study
Ga-Ram YOU ; Seon-Young PARK ; Hye-Su YOU ; Seung-Young SEO ; Sung-Kyun YIM ; Byung-Chul JIN ; Jung-In LEE ; Young-Dae KIM ; Suck-Chei CHOI ; Chan-Guk PARK ; Wan-Sik LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2023;23(4):294-301
		                        		
		                        			 Objectives:
		                        			Gastrointestinal cytomegalovirus (CMV) disease is a major contributor to mortality in immunocompromised patients. Few studies have discussed upper gastrointestinal CMV (UGICMV) disease in immunocompetent patients. We compared the clinical outcomes of UGI-CMV between immunocompromised and immunocompetent patients. 
		                        		
		                        			Methods:
		                        			This retrospective study included patients with UGI-CMV disease from five tertiary hospitals across Korea (2010– 2022). Patients’ clinical data and outcomes were recorded. 
		                        		
		                        			Results:
		                        			UGI-CMV was diagnosed in 54 patients; 27 (50.0%) had esophageal, 24 (44.4%) had gastric, and 3 patients (5.6%) had duodenal involvement. Patients’ median age was 64 years (interquartile range 53–75 years), and the most common comorbidities included hypertension (57.4%) and diabetes (38.9%). The predominant symptom was abdominal pain (46.3%), and the most common endoscopic finding was ulcers (70.4%). Antiviral treatment was administered to 31 patients, and 23 patients underwent observation without treatment. We investigated 32 immunocompromised (59.3%) and 22 immunocompetent (40.7%) patients and observed no intergroup differences in comorbidities and in laboratory and endoscopic findings. Immunocompromised patients had longer length of hospitalization (median 46.2 days vs. 20.0 days, p=0.001). However, treatment outcomes, including the need for intensive care unit admission and mortality did not significantly differ. The overall mortality rate was 13.0%; one patient from the immunocompromised group died of UGI-CMV disease. The treatment success rate was higher in immunocompromised patients who received antiviral therapy (p=0.011). 
		                        		
		                        			Conclusions
		                        			UGI-CMV disease is not uncommon in immunocompetent patients, although symptoms are milder than those in immunocompromised patients. Our findings emphasize the importance of clinical vigilance for accurate diagnosis of CMV infection, particularly in susceptible symptomatic patients and highlight the need for active antiviral treatment for management of immunocompromised patients. 
		                        		
		                        		
		                        		
		                        	
5.Weight Gain, Comorbidities, and Its Associated Factors Among Korean Adults
Youn HUH ; Seung Hee KIM ; Ga Eun NAM ; Hye Soon PARK
Journal of Korean Medical Science 2023;38(12):e90-
		                        		
		                        			 Background:
		                        			Weight gain in adults is associated with an increased risk of obesity-related diseases and high healthcare costs. However, there have been limited studies on weight gain in Asians. This study investigated the prevalence, comorbidities, and associated factors of weight gain in the Korean population. 
		                        		
		                        			Methods:
		                        			This is a cross-sectional study of Korean adults aged 19–64 years who participated in the Korea National Health and Nutritional Examination Survey 2016–2019. We used data from 15,514 adults (subjects 1) to analyze the prevalence of weight gain. Finally, after excluding adults with suspicious debilitating conditions among them, 11,477 adults (subjects 2) were used to analyze comorbidities and associated factors. Weight changes and lifestyle factors were assessed using a self-report questionnaire. We analyzed odds ratios and 95% confidence intervals using multivariable logistic regression analysis to examine factors associated with weight gain. 
		                        		
		                        			Results:
		                        			The overall prevalence of weight gain was 25.7% in men and 31.3% in women and decreased significantly with age in both sexes. Weight gain of ≥ 6 kg was evident in 10.5% of men and 9.8% of women and was more pronounced with a higher baseline body mass index (BMI). Most metabolic comorbidities worsened the greater the weight gain. Young age was the strongest associated factor for weight gain. Other factors associated with weight gain were being unmarried, blue-collar job, lower income, and alcohol consumption in men;being married in women; smoking and skipping breakfast in both sexes. 
		                        		
		                        			Conclusion
		                        			Weight gain was much more pronounced in younger adults and at a higher baseline BMI in both sexes. Public education and health policies to prevent unnecessary weight gain should be strengthened by considering the associated harmful factors in Korean adults. 
		                        		
		                        		
		                        		
		                        	
6.CD103+ Cells and Chemokine Receptor Expression in Breast Cancer
Eun-Hye SEO ; Ga-Yun SONG ; Chung-Sik OH ; Seong-Hyop KIM ; Wan-Seop KIM ; Seung-Hyun LEE
Immune Network 2023;23(3):e25-
		                        		
		                        			
		                        			 Mucosal environments harbour lymphocytes, which express several adhesion molecules, including intestinal homing receptors and integrin αE/β7 (CD103). CD103 binds E-cadherin, an integrin receptor expressed in intestinal endothelial cells. Its expression not only enables homing or retention of T lymphocytes at these sites but is also associated with increased T lymphocyte activation. However, it is not yet clear how CD103 expression is related to the clinical staging of breast cancer, which is determined by factors such as the size of the tumor (T), the involvement of nearby lymph nodes (N), and presence of metastasis (M). We examined the prognostic significance of CD103 by FACS in 53 breast cancer patients and 46 healthy controls enrolled, and investigated its expression, which contributes to lymphocyte recruitment in tumor tissue. Patients with breast cancer showed increased frequencies of CD103+ , CD4+ CD103+ , and CD8+ CD103+ cells compared to controls. CD103 was expressed at a high level on the surfaces of tumor-infiltrating lymphocytes in patients with breast cancer. Its expression in peripheral blood was not correlated with clinical TNM stage. To determine the localisation of CD103+ cells in breast tissue, tissue sections of breast tumors were stained for CD103. In tissue sections of breast tumors stained for CD103, its expression in T lymphocytes was higher compared to normal breast tissue. In addition, CD103+ cells expressed higher levels of receptors for inflammatory chemokines, compared to CD103 − cells. CD103+ cells in peripheral blood and tumor tissue might be an important source of tumor-infiltrating lymphocyte trafficking, homing, and retention in cancer patients. 
		                        		
		                        		
		                        		
		                        	
7.Treatment of rituximab in patients with idiopathic membranous nephropathy: a case series and literature review
Soo-Jee JEON ; Ji-Hye KIM ; Hee-Won NOH ; Ga-Young LEE ; Jeong-Hoon LIM ; Hee-Yeon JUNG ; Jang-Hee CHO ; Ji-Young CHOI ; Chan-Duck KIM ; Yong-Lim KIM ; Sun-Hee PARK
The Korean Journal of Internal Medicine 2022;37(4):830-840
		                        		
		                        			 Background/Aims:
		                        			Membranous nephropathy (MN) is a major cause of nephrotic syndrome in adults. This study aimed to evaluate the effect of rituximab (RTX) in patients with idiopathic MN (iMN) who have a high risk of progression. 
		                        		
		                        			Methods:
		                        			We retrospectively analyzed data of 13 patients with iMN, who received RTX treatments from January 2014 to July 2020. RTX was indicated in patients with iMN with severe proteinuria and decreasing estimated glomerular filtration rate (eGFR) in the previous 6 months despite other immunosuppressive therapies. 
		                        		
		                        			Results:
		                        			The patients were predominantly males (n = 11) and with a mean age of 55.3 years; median eGFR, 37.0 mL/min/1.73 m2 (interquartile range [IQR], 26.3 to 66.5); serum albumin level, 2.6 g/dL (IQR, 1.9 to 3.1); and spot urine protein-to-creatinine ratio at baseline, 6.6 g/g (IQR, 5.7 to 12.9). In a median follow-up of 22 months, eight patients (61.5%) achieved complete or partial remission. In responder group (n = 8), median eGFR increased from 31.5 to 61.5 mL/min/1.73 m2 (p = 0.049) and serum albumin level increased from 2.3 to 4.2 g/dL (p = 0.017) from RTX initiation to last follow-up. Antiphospholipase A2 receptor antibody (anti-PLA2R-Ab) was positive in six among seven tested patients, which markedly decreased in the responder group. There were no adverse events after RTX. 
		                        		
		                        			Conclusions
		                        			This study suggests that RTX is a safe and effective treatment option for patients with iMN who have a high risk of progression. Individualized therapy based on anti-PLA2R-Ab titer would be needed for better outcomes. 
		                        		
		                        		
		                        		
		                        	
8.Feasibility of Personal Sound Amplification Products in Patients With Moderate Hearing Loss: A Pilot Study
Ga-Young KIM ; Jong Sei KIM ; Mini JO ; Hye Yoon SEOL ; Young Sang CHO ; Il Joon MOON
Clinical and Experimental Otorhinolaryngology 2022;15(1):60-68
		                        		
		                        			 Objectives:
		                        			. This study was conducted to investigate the electroacoustic characteristics of personal sound amplification products (PSAPs), to identify whether PSAPs provide adequate gain and output for three common hearing loss (HL) configurations, and to compare the benefits of a representative PSAP (RPSAP) and a conventional hearing aid (HA) for clinical hearing outcomes as a pilot study. 
		                        		
		                        			Methods:
		                        			. The study comprised three phases: electroacoustic analysis, simulated real-ear measurements (REMs), and clinical hearing experiments. Electroacoustic analysis and simulated REMs were performed for three basic PSAPs (BeethoSOL, EarJJang, and Geniesori2) and three high-end PSAPs (Hearing Able, Olive Smart Ear, and SoriIn) using the Aurical Hearing Instrument Test box with a 2-mL coupler. Four electroacoustic characteristics (maximum output sound pressure level at 90 dB SPL, frequency range, equivalent input noise, and total harmonic distortion) were investigated. By simulated REMs, appropriate levels of the six PSAPs for three common HL configurations (mild-to-moderate high-frequency HL, moderate to moderately severe sloping HL, and moderate flat HL) were determined. Clinical experiments compared the performance of RPSAP to HA, both of which were fitted by audiologists using REMs. Clinical experiments were administered using functional gain, a word recognition test, and the Korean version of the Hearing in Noise Test in six participants with bilateral moderate sensorineural HL. 
		                        		
		                        			Results:
		                        			. The two high-end devices met all tolerances. One basic and two high-end PSAPs showed appropriate levels for three common HL configurations. In the clinical experiments, the RPSAP showed better performance than unaided, but slightly worse than HA under all test conditions. 
		                        		
		                        			Conclusion
		                        			. Certain PSAPs met all specified tolerances for electroacoustic analysis and approximated prescriptive targets in well-controlled laboratory conditions. The pilot clinical experiments explored the possibility that the RPSAP could serve as a hearing assistive device for patients with moderate HL. 
		                        		
		                        		
		                        		
		                        	
9.Percutaneous Bone-Anchored Hearing Implant: Is It Clinically Useful in Korean?
Sung Min KOH ; Young Sang CHO ; Ga-Young KIM ; Mini JO ; Hye Yoon SEOL ; Il Joon MOON
Journal of Korean Medical Science 2022;37(23):e182-
		                        		
		                        			 Background:
		                        			The aim of this study is to investigate the clinical effectiveness of Ponto in Korea, a recently released percutaneous bone-anchored hearing implant. 
		                        		
		                        			Methods:
		                        			16 patients with single-sided deafness (SSD) and mixed or conductive hearing loss who underwent Ponto implantation from December 2018 to September 2020 were enrolled in the study. Puretone audiometry, the Korean version of the Hearing in Noise Test (K-HINT), sound localization test (SLT), and Pupillometry were performed pre- and three months post-operation. Standardized questionnaires, the Hearing Handicap Inventory for the Elderly (HHIE) and Speech, Spatial and Qualities of Hearing Scale (SSQ), were administered. 
		                        		
		                        			Results:
		                        			The mean age of subjects was 55.5 (range, 48–67) years. Four males and 12 females participated in the study. The mean puretone average was 73.17 dB hearing level (HL) before surgery and significantly improved to 36.72 dB HL three months after surgery. The mean word recognition score improved from 26.0% to 90.75% after implantation. In the case of K-HINT, there was a significant difference in summation (Z = −2.250, P = 0.024) and head shadow effects (Z = −3.103, P = 0.002). There was no significant difference in root mean square error degree (RMSE) and hemifield identification scores for SLT testing. Pupillometry was performed to measure listening effort and the results revealed that the degree of pupillary dilatation decreased under the condition of quiet, 0 dB signal to noise ratio (SNR) and 3 dB SNR. The total score for HHIE decreased significantly (Z = −3.130, P = 0.002) while the SSQ score increased significantly (Z = −2.216, P = 0.027). 
		                        		
		                        			Conclusions
		                        			The Ponto bone-anchored hearing system showed significant clinical benefit in Korean patients with conductive and mixed hearing loss and SSD. 
		                        		
		                        		
		                        		
		                        	
10.Hearing and Speech Perception for People With Hearing Loss Using Personal Sound Amplification Products
Ga-Young KIM ; Sunyoung KIM ; Mini JO ; Hye Yoon SEOL ; Young Sang CHO ; Jihyun LIM ; Il Joon MOON
Journal of Korean Medical Science 2022;37(12):e94-
		                        		
		                        			 Background:
		                        			Hearing loss (HL) is the most common chronic disease and has been linked to negative health outcomes. Hearing aids (HAs) are regarded as the gold standard for HL management, however, the adoption rate of HAs is relatively low for various reasons. With this background, hearing devices, such as personal sound amplification products (PSAPs) received significant attention as an alternative to conventional HAs. This study aimed to evaluate the clinical efficacy of PSAPs in patients with mild to moderately severe HL. 
		                        		
		                        			Methods:
		                        			Nineteen patients with mild hearing loss (MHL), 23 with moderate hearing loss (MDHL), and 15 with moderately severe hearing loss (MSHL) participated in the study.Electroacoustic analysis, simulated real-ear measurements (REMs), and three clinical evaluations were implemented. 
		                        		
		                        			Results:
		                        			All devices satisfied the electroacoustic tolerances. All devices provided sufficient gain for MHL and MDHL audiograms. However, in MSHL audiogram, the gains of PSAPs were insufficient, especially for high frequencies. In terms of clinical evaluations, soundfield audiometry showed significant improvements between aided and unaided thresholds in all groups for all devices (P < 0.001). Significant improvements of word recognition scores were only shown for HAs between aided and unaided conditions. The Korean version of the Hearing In Noise Test did not show any consistent findings for all devices and groups. 
		                        		
		                        			Conclusion
		                        			Certain PSAPs are beneficial for improving hearing and speech perception in patients with HL. Well-chosen PSAPs could be an alternative hearing rehabilitation option for these patients. 
		                        		
		                        		
		                        		
		                        	
            
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