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Background@#The objective of this study is to identify the working conditions and health status of Vietnamese male migrant workers in Republic of Korea, in comparison to the Korean general population. @*Methods@#We conducted our survey through the Migrant People Center, and we received completed questionnaires from 87 male Vietnamese migrant workers. The questionnaire employed was identical to those used in the Korean Working Conditions Survey and the 2020 Korea National Health and Nutrition Examination Survey. The collected data from the Vietnamese migrant workers was then compared with the Korean reference population using indirect age-standardization. @*Results@#Vietnamese male workers demonstrated a higher prevalence of health problems including hearing problems (age-standardized prevalence ratio (aSPR) 13.22, 95% confidence interval [CI]: 8.07–20.4), skin problems (aSPR 13.49, 95% CI: 8.07–20.4), and low back pain (aSPR 8.40, 95% CI: 6.50–10.69). Elevated exposure to workplace hazards such as chemicals (aSPR 2.36, 95% CI: 1.51–3.51), organic solvents (aSPR 2.22, 95% CI: 1.44–3.28), handling of heavy objects (aSPR 1.67, 95% CI: 1.24–2.21), and high temperatures (aSPR 1.96, 95% CI: 1.46–2.57) was observed among them. Additionally, they faced a higher risk of no personal protective equipment (aSPR 2.53, 95% CI: 1.26–4.52) and a greater prevalence of unmet medical needs (aSPR 7.14, 95% CI: 4.74–10.32). @*Conclusion@#Our findings highlight the elevated workplace hazards, health problems, and unmet medical needs among Vietnamese male workers compared to the Korean reference population. These findings underscores the urgency for enhanced scrutiny over working conditions and protective equipment provision, coupled with efforts to improve healthcare accessibility and worker education.
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Objective@#This study was conducted to identify factors related to loneliness during the coronavirus disease-2019 (COVID-19) pandemic and focused on how the fear of COVID-19 infection affects loneliness and the conditional effect of gratitude as a moderator in the relationship among the fear of COVID-19, anxiety, and loneliness. @*Methods@#For the analysis of this study, a survey was conducted among 1,500 individuals aged 19 to 69 years living in three metropolitan areas in South Korea. Questionnaires included sociodemographic data, psychological experience and stress associated with COVID-19, Generalized Anxiety Disorder Scale–7, UCLA Loneliness Scale–3, and Gratitude Questionnaire–6. An analysis was conducted by applying SPSS PROCESS macro models 4 and 7. @*Results@#First, anxiety mediated the relationship between the fear of COVID-19 infection and loneliness. Second, the effect of the fear of COVID-19 infection on loneliness through anxiety was moderated by gratitude. The higher the gratitude, the more the fear of COVID-19 infection is buffered in the path to anxiety, and the lower the indirect effect on loneliness. @*Conclusion@#This suggests that in the context of the COVID-19 pandemic, interventions for psychological problems such as anxiety and loneliness can be carried out through gratitude, a significant protective variable.
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Background@#Orthotopic liver transplantation is the only option for patients with end-stage liver disease and hepatocellular carcinoma. Post-transplant immunosuppressive therapy is important to prevent graft failure. We investigated the effectiveness of tacrolimus (FK506) and their mechanisms for liver transplant immune tolerance in an outbred rat LT model. @*Results@#To investigate the therapeutic effect of the FK506 on outbred rat LT model, FK506 and postoperative therapy were administered subcutaneously once or twice daily to transplanted rats. Histopathological and immunohistochemical analyses were conducted for all groups. The regulation of inflammatory cytokine signaling in the spleen was analyzed by flow cytometry. FK506 attenuated allograft rejection and increased survival in rat orthotopic liver transplantation models. The FK506-treated group had reduced serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase. Furthermore, FK506 decreased the expression of inflammatory cytokines and the activation of pathogenic Th1 and Th17 cells in the liver. @*Conclusions@#Taken together, we revealed that FK506 ameliorated strong allograft rejection in outbred liver transplantation model by anti-inflammatory effect and inhibitory peroperty of pathogenic T cells.
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Background@#This study characterized coronavirus disease 2019 (COVID-19) vaccination behavior in the Korean general population using cluster analysis and explored related psychological factors. @*Methods@#We categorized 1,500 individuals based on their attitudes toward COVID-19 vaccination using hierarchical clustering and identified their level of vaccine acceptance. We examined the associations between vaccine acceptance and behavioral and psychological characteristics. @*Results@#Clustering revealed three groups according to vaccine acceptance: ‘totally accepting’ (n = 354, 23.6%), ‘somewhat accepting’ (n = 523, 34.9%), and ‘reluctant’ (n = 623, 41.5%). Approximately 60% of all participants who belonged to the ‘totally accepting’ and ‘somewhat accepting’ groups were willing to receive a COVID-19 vaccine despite concerns about its side effects. High vaccine acceptance was associated with older age, regular influenza vaccination, and trust in formal sources of information. Participants with high vaccine acceptance had higher levels of gratitude, extraversion, agreeableness, and conscientiousness, and lower levels of depression, anxiety, and neuroticism. @*Conclusions@#People weighed the benefits of COVID-19 vaccination against the risk of side effects when deciding to receive the COVID-19 vaccine. Our findings also indicate that this vaccination behavior may be affected by coping mechanisms and psychological factors.
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Purpose@#: Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. @*Methods@#: The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. @*Results@#: A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. @*Conclusion@#: Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.
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Background@#Papillary thyroid carcinoma (PTC) can be classified into two distinct molecular subtypes, BRAF-like (BL) and RASlike (RL). However, the molecular characteristics of each subtype according to clinicopathological factors have not yet been determined. We aimed to investigate the gene signatures and tumor microenvironment according to clinicopathological factors, and to identify the mechanism of progression in BL-PTCs and RL-PTCs. @*Methods@#We analyzed RNA sequencing data and corresponding clinicopathological information of 503 patients with PTC from The Cancer Genome Atlas database. We performed differentially expressed gene (DEG), Gene Ontology, and molecular pathway enrichment analyses according to clinicopathological factors in each molecular subtype. EcoTyper and CIBERSORTx were used to deconvolve the tumor cell types and their surrounding microenvironment. @*Results@#Even for the same clinicopathological factors, overlapping DEGs between the two molecular subtypes were uncommon, indicating that BL-PTCs and RL-PTCs have different progression mechanisms. Genes related to the extracellular matrix were commonly upregulated in BL-PTCs with aggressive clinicopathological factors, such as old age (≥55 years), presence of extrathyroidal extension, lymph node metastasis, advanced tumor-node-metastasis (TNM) stage, and high metastasis-age-completeness of resection- invasion-size (MACIS) scores (≥6). Furthermore, in the deconvolution analysis of tumor microenvironment, cancer-associated fibroblasts were significantly enriched. In contrast, in RL-PTCs, downregulation of immune response and immunoglobulin-related genes was significantly associated with aggressive characteristics, even after adjusting for thyroiditis status. @*Conclusion@#The molecular phenotypes of cancer progression differed between BL-PTC and RL-PTC. In particular, extracellular matrix and cancer-associated fibroblasts, which constitute the tumor microenvironment, would play an important role in the progression of BL-PTC that accounts for the majority of advanced PTCs.
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Objective@#This study evaluated the clinical usefulness of mean platelet volume (MPV) for predicting functional outcomes in subarachnoid hemorrhage (SAH) patients. @*Methods@#This is a retrospective analysis of patients who were diagnosed with SAH in the emergency room. Based on their modified Rankin Scale (mRS) score, patients were divided into two groups: 0-2 (good outcome) and 3-6 (poor outcome). Univariable and multivariable analyses were performed to investigate whether MPV, along with other multiple factors, was associated with poor prognosis. Receiver operating characteristic (ROC) curve analysis was performed to determine the value of MPV as a predicting factor of neurological prognosis. Compared to other factors, Hunt Hess grade (HHG) and modified Fisher grade (mFG) considerably influenced the outcomes in both groups (Model 1; model including all factors). Hence, a new model (Model 2) was constructed, comprising multiple factors excluding these two factors. @*Results@#A total of 143 patients were included in this study. Although MPV was different between the two groups, it was not a significant factor in Model 1 in the multivariable analysis. In Model 2, MPV (odds ration [OR], 1.71; 95% confidence interval [CI], 1.05-2.8), age (OR, 1.06; 95% CI, 1.03-1.1), and surgical treatment (OR, 0.37; 95% CI, 0.15-0.87) were significant factors related to poor outcomes. Area under the curve (AUC) of Model 1 was 0.93, 0.85 in HHG; 0.78 in Model 2, 0.65 in mFG, and 0.62 in MPV. @*Conclusion@#Although MPV differed significantly between the good and poor outcome groups, it is insufficient to predict poor outcomes in SAH patients as an independent biomarker.
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Background@#Thyroid cancer screening has contributed to the skyrocketing prevalence of thyroid cancer. However, the true benefit of thyroid cancer screening is not fully understood. This study aimed to evaluate the impact of screening on the clinical outcomes of thyroid cancer by comparing incidental thyroid cancer (ITC) with non-incidental thyroid cancer (NITC) through a meta-analysis. @*Methods@#PubMed and Embase were searched from inception to September 2022. We estimated and compared the prevalence of high-risk features (aggressive histology of thyroid cancer, extrathyroidal extension, metastasis to regional lymph nodes or distant organs, and advanced tumor-node-metastasis [TNM] stage), thyroid cancer-specific death, and recurrence in the ITC and NITC groups. We also calculated pooled risks and 95% confidence intervals (CIs) of the outcomes derived from these two groups. @*Results@#From 1,078 studies screened, 14 were included. In comparison to NITC, the ITC group had a lower incidence of aggressive histology (odds ratio [OR], 0.46; 95% CI, 0.31 to 0.7), smaller tumors (mean difference, −7.9 mm; 95% CI, −10.2 to −5.6), lymph node metastasis (OR, 0.64; 95% CI, 0.48 to 0.86), and distant metastasis (OR, 0.42; 95% CI, 0.23 to 0.77). The risks of recurrence and thyroid cancer-specific mortality were also lower in the ITC group (OR, 0.42; 95% CI, 0.25 to 0.71 and OR, 0.46; 95% CI, 0.28 to 0.74) than in the NITC group. @*Conclusion@#Our findings provide important evidence of a survival benefit from the early detection of thyroid cancer compared to symptomatic thyroid cancer.
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Background@#To investigate the association between free fatty acid (FFA) level at mid-pregnancy and large-for-gestational-age (LGA) newborns in women with gestational diabetes mellitus (GDM). @*Methods@#We enrolled 710 pregnant women diagnosed with GDM from February 2009 to October 2016. GDM was diagnosed by a ‘two-step’ approach with Carpenter and Coustan criteria. We measured plasma lipid profiles including fasting and 2-hour postprandial FFA (2h-FFA) levels at mid-pregnancy. LGA was defined if birthweights of newborns were above the 90th percentile for their gestational age. @*Results@#Mean age of pregnant women in this study was 33.1 years. Mean pre-pregnancy body mass index (BMI) was 22.4 kg/m2. The prevalence of LGA was 8.3% (n=59). Levels of 2h-FFA were higher in women who delivered LGA newborns than in those who delivered non-LGA newborns (416.7 μEq/L vs. 352.5 μEq/L, P=0.006). However, fasting FFA was not significantly different between the two groups. The prevalence of delivering LGA newborns was increased with increasing tertile of 2h-FFA (T1, 4.3%; T2, 9.8%; T3, 10.7%; P for trend <0.05). After adjustment for maternal age, pre-pregnancy BMI, and fasting plasma glucose, the highest tertile of 2h-FFA was 2.38 times (95% confidence interval, 1.11 to 5.13) more likely to have LGA newborns than the lowest tertile. However, there was no significant difference between groups according to fasting FFA tertiles. @*Conclusion@#In women with GDM, a high 2h-FFA level (but not fasting FFA) at mid-pregnancy is associated with an increasing risk of delivering LGA newborns.
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GPR43 (also known as FFAR2), a metabolite-sensing G-protein-coupled receptor stimulated by short-chain fatty acid (SCFA) ligands is involved in innate immunity and metabolism. GPR43 couples with Gα i/o and Gα q/11 heterotrimeric proteins and is capable of decreasing cyclic AMP and inducing Ca2+ flux. The GPR43 receptor has additionally been shown to bind β-arrestin 2 and inhibit inflammatory pathways, such as NF-κB. However, GPR43 shares the same ligands as GPR41, including acetate, propionate, and butyrate, and determination of its precise functions in association with endogenous ligands, such as SCFAs alone, therefore remains a considerable challenge. In this study, we generated novel synthetic agonists that display allosteric modulatory effects on GPR43 and downregulate NF-κB activity. In particular, the potency of compound 187 was significantly superior to that of preexisting compounds in vitro. However, in the colitis model in vivo, compound 110 induced more potent attenuation of inflammation. These novel allosteric agonists of GPR43 clearly display anti-inflammatory potential, supporting their clinical utility as therapeutic drugs.
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Objective@#The HEART score is a fast and simple cardiovascular disease (CVD) prediction tool useful in the emergency department (ED). This study evaluates the predictive value of the HEART score when applying other obesity indices such as waist circumference (WC) or waist-to-height ratio (WHtR) instead of body mass index (BMI). @*Methods@#Data were prospectively collected from the pre-made registry of patients who had visited the ED with chest pain. Based on their final diagnoses and coronary imaging study results, patients were classified as acute coronary syndrome (ACS), non-ACS, significant coronary arterial stenosis (SCS), and non-SCS. We compared the HEART score for each group and modified it with variable obesity indices. Multivariable logistic regression and the area under the curve were calculated to determine the most suitable obesity index for the HEART score in predicting ACS or SCS. In addition, we compared the gender-dependent relationship between obesity and ACS or SCS. @*Results@#Of the total 689 patients examined, 281 were diagnosed with ACS. The odds ratio (OR) of the HEART score for ACS was 12.1. The ORs were 13.2 and 11.2 when the HEART score was modified with WC or WHtR, respectively. Obesity was determined as the meaningful factor to predict ACS (OR: BMI, 2.38; WC, 3.39) and SCS (OR: BMI, 3.07; WC, 4.03) in women but not men. @*Conclusion@#The HEART score showed good predictive value regardless of obesity index modification. Furthermore, obesity is associated with CVD in women with chest pain, but not in men.
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Objective@#We investigated the prognostic value of complete metabolic response (CMR) on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) after 3 cycles of neoadjuvant chemotherapy (NAC) in advanced high-grade serous ovarian cancer (HGSC). @*Methods@#PET/CT at baseline and after 3 cycles of NAC were performed; peak standardized uptakes were measured. PET parameters were compared with NAC parameter: cancer antigen-125 (CA-125) normalization before interval debulking surgery (IDS) and chemotherapy response score (CRS) to predict platinum-sensitivity. Kaplan-Meier analysis was used to determine correlations between PET parameters and survival. Prognostic factors were obtained by multivariate Cox regression analysis. @*Results@#Between 2007 and 2020, 102 patients were recruited: 19 (18.6%) were designated as CMR group and 83 (81.4%) as non-CMR group. CMR after 3 cycles of NAC showed the highest accuracy in predicting platinum-sensitivity (area under the curve [AUC]=0.729; 95% confidence interval [CI]=0.552–0.823; p=0.017), compared with CA-125 normalization before IDS (AUC=0.626; 95% CI=0.542–0.758; p=0.010) and CRS (AUC=0.613; 95% CI=0.490–0.735; p=0.080). CMR demonstrated better prognosis than non-CMR in progression-free survival (PFS) (median PFS, 23.9 months vs. 16.4 months; p=0.021) and overall survival (OS) (median OS, not reached vs. 69.7 months; p=0.025). In multivariate analysis, CMR was associated with a lower risk of recurrence (adjusted hazard ratio [aHR]=0.50; 95% CI=0.27–0.92; p=0.027) and death (aHR=0.23; 95% CI=0.05–0.99; p=0.048). @*Conclusion@#CMR after 3 cycles of NAC can be a prognostic factor for both recurrence and death in advanced HGSC.
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Purpose@#The purpose of this study was to examine the level of Person-centered Critical Care Nursing (PCCN) and the factors influencing PCCN for nurses in Intensive Care Units (ICU). Methods: This study was designed by cross-sectional descriptive correlational study. The participants included 147 ICU nurses in two general hospitals in Seoul, Korea. Demographic characteristics, PCCN, communication skills, professionalism, and work environment were measured. The collected data were analyzed using descriptive statistical analysis, independent t-test, One-way ANOVA, Pearson’s correlation coefficient, and stepwise multiple linear regression with the SPSS/Win 25.0 program. @*Results@#The average age of the participants was 29.6±4.7 years and the mean work experience in the ICU was 4.67±3.52 years. The level of PCCN was 3.70±0.41, which was moderate to high, and it significantly showed a positive correlation with therapeutic communication skills (r=.66, p<.001), global interpersonal communication competence (r=.42,p<.001), professionalism (r=.38, p<.001), and work environment (r=.16, p=.048). The factors influencing PCCN were identified as therapeutic communication skill and global interpersonal communication competence (Adj R 2 =.45, p<.001). @*Conclusion@#The findings of this study were confirmed that the strategies to promote PCCN are necessary to enhance therapeutic communication skill and global interpersonal communication competence. In addition, they may be particularly meaningful in providing basic data for nursing education and future intervention development research to promote PCCN for the ICU nurses. For improving PCCN for healthcare providers in ICU, further studies should be conducted to develop education and intervention programs.
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Background@#Scabies is a parasitic infection caused by the Sarcoptes scabiei var. hominis mite. Its incidence has been increasing in recent years; however, no study has evaluated the clinical aspects of scabies in children and adolescents in Korea. @*Objective@#To evaluate the clinical characteristics and epidemiological features of scabies among children and adolescents and to investigate the clinical efficacy of topical therapies for the treatment of scabies. @*Methods@#We retrospectively reviewed the medical records of 62 patients under 18 years of age with scabies during a 10-year-period. @*Results@#Sixty-two patients with 62 scabies were investigated. These patients showed scabies mites or eggs under microscopic examination or showed clinical improvement after treatment. There were 36 boys (58.1%) and 26 girls (41.9%). The mean age of the boys was 9.3 years and that of the girls was 8.2 years. The most common primary lesions were erythematous papules (93.5%), and the commonest sites of the skin lesions were the hand (64.5%) and the trunk (61.3%). The most common suspected mode of transmission was through contact among families living together. The mean time to complete treatment was 46.1 days using 1% gamma benzene hexachloride lotion, 37.1 days using 10% crotamiton ointment, and 22.8 days using 5% permethrin cream. @*Conclusion@#We confirmed the epidemiological features and clinical characteristics of scabies in children and adolescents, including contact sources and treatment. This study could provide useful data for the prevention and management of scabies in children and adolescents.
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Eczema herpeticum is a widespread herpes simplex infection that favors eczema-damaged skin, including skin involved with atopic dermatitis. Here we report a case of a 27-year-old woman who presented with febrile, painful, punched-out, erosive, macular eruptions and crusts on her face, upper trunk, and antecubital fossae. Polymerase chain reaction analyses of the blood and skin lesions were positive for type 1 herpes simplex virus, and blood cultures established on admission showed methicillin-sensitive Staphylococcus aureus. She was diagnosed with bacteremia superimposed on eczema herpeticum. True bacteremia rather than contaminated blood cultures was suspected because her fever did not improve after 2 days despite the administration of antivirals. Repeated scratches to the lesional skin most likely aggravated the epidermal barrier damage, enabling the penetration of the dermal vessels by colonized S. aureus.
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Background@#This study presents outcomes of management in graft failure (GF) after allogeneic hematopoietic stem cell transplantation (HCT) and provides prognostic information including rare cases of autologous reconstitution (AR). @*Methods@#We analyzed risk factors and outcomes of primary and secondary GF, and occurrence of AR in 1,630 HCT recipients transplanted over period of 18 years (January 2000– September 2017) at our center. @*Results@#Primary and secondary GF occurred in 13 (0.80%), and 69 patients (10-year cumulative incidence, 4.5%) respectively. No peri-transplant variables predicted primary GF, whereas reduced intensity conditioning (RIC) regimen (relative risk [RR], 0.97–28.0, P < 0.001) and lower CD34 + cell dose (RR, 2.44–2.84, P = 0.002) were associated with higher risk of secondary GF in multivariate analysis. Primary GF demonstrated 100% mortality, in the secondary GF group, the 5-year Kaplan-Meier survival rate was 28.8%, relapse ensued in 18.8%, and AR was observed in 11.6% (n = 8). In survival analysis, diagnosis of aplastic anemia (AA), chronic myeloid leukemia and use of RIC had a positive impact. There were 8 patients who experienced AR, which was rarely reported after transplantation for acute leukemia. Patient shared common characteristics such as young age (median 25 years), use of RIC regimen, absence of profound neutropenia, and had advantageous survival rate of 100% during follow period without relapse. @*Conclusion@#Primary GF exhibited high mortality rate. Secondary GF had 4.5% 10-year cumulative incidence, median onset of 3 months after HCT, and showed 5-year Kaplan-Meier survival of 28.8%. Diagnosis of severe AA and use of RIC was both associated with higher incidence and better survival rate in secondary GF group. AR occurred in 11.6% in secondary GF, exhibited excellent prognosis.
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Background@#Di-2-ethylhexyl phthalate (DEHP) is known to disrupt thyroid hormonal status. However, the underlying molecular mechanism of this disruption is unclear. Therefore, we investigated the direct effects of DEHP on the thyroid gland. @*Methods@#DEHP (vehicle, 50 mg/kg, and 500 mg/kg) was administered to Sprague-Dawley rats for 2 weeks. The expression of the thyroid hormone synthesis pathway in rat thyroid tissues was analyzed through RNA sequencing analysis, quantitative reverse transcription-polymerase chain reaction (RT-PCR), and immunohistochemical (IHC) staining. DEHP was treated to FRTL-5 rat thyroid cells, and an RT-PCR analysis was performed. A reporter gene assay containing the promoter of thyroid stimulating hormone receptor (TSHR) in Nthy-ori 3-1 human thyroid cells was constructed, and luciferase activity was determined. @*Results@#After DEHP treatment, the free thyroxine (T4) and total T4 levels in rats significantly decreased. RNA sequencing analysis of rat thyroid tissues showed little difference between vehicle and DEHP groups. In the RT-PCR analysis, Tshr expression was significantly lower in both DEHP groups (50 and 500 mg/kg) compared to that in the vehicle group, and IHC staining showed that TSHR expression in the 50 mg/kg DEHP group significantly decreased. DEHP treatment to FRTL-5 cells significantly down-regulated Tshr expression. DEHP treatment also reduced luciferase activity in a reporter gene assay for TSHR. @*Conclusion@#Although overall genetic changes in the thyroid hormone synthesis pathway are not clear, DEHP exposure could significantly down-regulate Tshr expression in thyroid glands. Down-regulation of Tshr gene appears to be one of potential mechanisms of thyroid disruption by DEHP exposure.
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Purpose@#Atypical teratoid/rhabdoid tumor (ATRT) is a highly aggressive malignancy with peak incidence in children aged less than 3 years. Standard treatment for central nervous system ATRT in children under the age of 3 years have not been established yet. The objective of this study was to analyze characteristics and clinical outcomes of ATRT in children aged less than 3 years. @*Materials and Methods@#A search of medical records from seven centers was performed between January 2005 and December 2016. @*Results@#Forty-three patients were enrolled. With a median follow-up of 90 months, 27 patients (64.3%) showed at least one episode of disease progression (PD). The first date of PD was at 160 days after diagnosis. The 1- and 3-year progression-free survivals (PFS) were 51.2% and 28.5%, respectively. The 1- and 3-year overall survivals were 61.9% and 38.1%, respectively. The 3-year PFS was improved from 0% in pre-2011 to 47.4% in post-2011. Excluding one patient who did not receive any further therapy after surgery, 27 patients died due to PD (n=21), treatment-related toxicity (n=5), or unknown cause (n=1). In univariate analysis, factors associated with higher 3-year PFS were no metastases, diagnosis after 2011, early adjuvant radiotherapy, and high-dose chemotherapy (HDCT). In multivariate analysis, the use of HDCT and adjuvant radiotherapy remained significant prognostic factors for PFS (both p < 0.01). @*Conclusion@#Aggressive therapy including early adjuvant radiotherapy and HDCT could be considered to improve outcomes of ATRT in children under the age of 3 years.
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Background@#Scabies is a parasitic infection caused by the Sarcoptes scabiei var. hominis mite. Its incidence has been increasing in recent years; however, no study has evaluated the clinical aspects of scabies in children and adolescents in Korea. @*Objective@#To evaluate the clinical characteristics and epidemiological features of scabies among children and adolescents and to investigate the clinical efficacy of topical therapies for the treatment of scabies. @*Methods@#We retrospectively reviewed the medical records of 62 patients under 18 years of age with scabies during a 10-year-period. @*Results@#Sixty-two patients with 62 scabies were investigated. These patients showed scabies mites or eggs under microscopic examination or showed clinical improvement after treatment. There were 36 boys (58.1%) and 26 girls (41.9%). The mean age of the boys was 9.3 years and that of the girls was 8.2 years. The most common primary lesions were erythematous papules (93.5%), and the commonest sites of the skin lesions were the hand (64.5%) and the trunk (61.3%). The most common suspected mode of transmission was through contact among families living together. The mean time to complete treatment was 46.1 days using 1% gamma benzene hexachloride lotion, 37.1 days using 10% crotamiton ointment, and 22.8 days using 5% permethrin cream. @*Conclusion@#We confirmed the epidemiological features and clinical characteristics of scabies in children and adolescents, including contact sources and treatment. This study could provide useful data for the prevention and management of scabies in children and adolescents.
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Eczema herpeticum is a widespread herpes simplex infection that favors eczema-damaged skin, including skin involved with atopic dermatitis. Here we report a case of a 27-year-old woman who presented with febrile, painful, punched-out, erosive, macular eruptions and crusts on her face, upper trunk, and antecubital fossae. Polymerase chain reaction analyses of the blood and skin lesions were positive for type 1 herpes simplex virus, and blood cultures established on admission showed methicillin-sensitive Staphylococcus aureus. She was diagnosed with bacteremia superimposed on eczema herpeticum. True bacteremia rather than contaminated blood cultures was suspected because her fever did not improve after 2 days despite the administration of antivirals. Repeated scratches to the lesional skin most likely aggravated the epidermal barrier damage, enabling the penetration of the dermal vessels by colonized S. aureus.