Development and evaluation of hot-melt-extruded diquafosol tetrasodium formulations for ophthalmic inserts: A design of experiments approach.

This study aimed to develop, optimize, and evaluate hot-melt-extruded ophthalmic inserts capable of sustained release of diquafosol tetrasodium (DQS) via a design of experiments approach. DQS, a tear stimulant for dry eye management, faces challenges of frequent administration and low bioavailability. The developed insert uses biodegradable polymers in varied proportions to achieve sustained release. Optimized through mixture design, the insert completely dissolved within 24 h and maintained a stable drug content, thickness, and surface pH over three months at room temperature. In vitro corneal permeation studies on excised rabbit corneas demonstrated increased bioavailability, suggesting a reduced dosing frequency compared with conventional eye drops. Therefore, this insert has potential to enhance treatment outcomes by improving patient compliance and providing sustained drug effects.

Prussian Blue-Type Sodium-ion Conducting Solid Electrolytes for All Solid-State Batteries.

Conventional solid electrolyte frameworks typically consist of anions such as sulphur, oxygen, chlorine, and others, leading to inherent limitations in their properties. Despite the emergence of sulphide, oxide, and halide-based solid electrolytes for all-solid-state batteries, their utilization is hampered by issues, including the evolution of H2 S gas, the need for expensive elements, and poor contact. Here, we first introduce Prussian Blue analogue (PBA) open-framework structures as a solid electrolyte that demonstrates appreciable Na+ conductivity (>10-2 mS cm-1 ). We delve into the relationship between Na+ conductivity and the lattice parameter of N-coordinated transition metal, which is attributed to the reduced interaction between Na+ and the framework, corroborated by the distribution of relaxation times and density functional theory calculations. Among the five PBAs studied, Mn-PBA have exhibited the highest Na+ conductivity of 9.1×10-2 mS cm-1 . Feasibility tests have revealed that Mn-PBA have maintained a cycle retention of 95.1 % after 80cycles at 30 °C and a C-rate of 0.2C. Our investigation into the underlying mechanisms that play a significant role in governing the conductivity and kinetics of these materials contributes valuable insights for the development of alternative strategies to realize all-solid-state batteries.

Gonadal Function in Female Adolescent and Young Adult Survivors of Childhood Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Childhood cancer survivors (CCSs) are at risk for premature ovarian insufficiency (POI). The aim of this study is to evaluate ovarian function and associated health outcomes in female adolescent and young adult survivors of childhood cancer. @*Materials and Methods@#Sixty-nine female CCSs were enrolled. Medical records of CCSs were retrospectively reviewed. The subjects were categorized into three groups according to follicular stimulating hormone (FSH) levels (cutoff, 12, 40 IU/L). Anti-müllerian hormone (AMH) level less than 1 ng/mL was considered low AMH level. @*Results@#Of 69 subjects, 14 (20.3%) had POI and 14 (20.3%) had FSH levels between 12 and 40 IU/L. Forty-one of 69 (59.4%) had normal FSH levels. Pelvic irradiation and stem cell transplantation (SCT) were more frequently performed in subjects with POI (p=0.001 and p < 0.001). AMH levels were remarkably low when FSH levels were over 12 IU/L (p < 0.001). In multivariate analysis, cyclophosphamide equivalent dose and SCT were significant treatment factors for developing low AMH levels (p=0.005 and p=0.002, respectively). Total, low-density lipoprotein cholesterol and triglyceride were significantly different in three groups according to FSH levels (p=0.047, p=0.030, and p=0.045). Z-score of femur neck bone mineral density was significantly reduced when FSH levels were increased (p=0.011). @*Conclusion@#Gonadal dysfunction is common in CCSs. Gonadal function was associated with a few treatment factors known to increase the risk of POI. Regular monitoring of gonadal function is needed for better health outcomes.

Massive Hyperostotic Meningioma En Plaque Mimicking Fibrous Dysplasia

The authors report an extremely rare case of a massive hyperostotic meningioma en plaque, which had characteristics of unique bony growth. A 34-year-old man presented with a palpable solid mass in the left cranial region that had gradually grown in size with a broad base on the calvarium for 8 years. Radiologically, the area involved by the mass ranged from the sphenoid bone to the frontal, parietal, temporal, and occipital bones. Three-dimensional CT revealed multiple growing spiculate features on the inner and outer cranial surface. Even though the radiologic features resembled fibrous dysplasia, it was histologically found to be a type of meningioma.

Oblique Lumbar Interbody Fusion with Selective Biportal Endoscopic Posterior Decompression for Multilevel Lumbar Degenerative Diseases

Oblique lumbar interbody fusion is a minimally invasive procedure for treating degenerative lumbar disease. Its advantages include correcting coronal and sagittal spinal alignment and indirect neural decompression. However, achieving a successful outcome is limited in some patients who need direct decompression for central canal lesions including hard stenotic lesions (endplate or facet articular osteophytes and ossification of posterior longitudinal ligaments) and sequestration of the disk. Biportal endoscopic spinal surgery is a minimally invasive technique, which directly decompresses the lesion. By taking advantage of two procedures, in a longlevel lumbar lesion, alignment correction and direct decompression can be both achieved. Herein, the authors introduce multilevel lumbar fusion through oblique lumbar interbody fusion and selective direct decompression through biportal endoscopic spinal surgery and discuss the surgical indications, surgical pitfalls, and recommendations for application. Consequently, it is regarded as a minimally invasive interbody fusion method for patients with multilevel lumbar degenerative degeneration.

Is the retroauricular region a suitable donor site for full-thickness skin grafting in the era of mask wearing?

Background@#During the coronavirus disease 2019 (COVID-19) pandemic, the everyday use of face masks massively increased to prevent the spread of infection. Many people complain of ear pain and erosion when wearing a mask for extended periods of time. If prolonged mask usage is uncomfortable for ordinary people, a question arises—how much more inconvenient must mask wearing be for patients with a full-thickness skin graft (FTSG) donor site in the retroauricular region? Herein, we evaluated complications related to face mask use in 27 patients with a retroauricular FTSG donor site, with the goal of clarifying whether the retroauricular region is still an appropriate FTSG donor site in the context of the COVID-19 pandemic. @*Methods@#Complications in 27 patients treated by FTSGs harvested from the retroauricular region from 2019 to 2021 were investigated. A questionnaire comparing the normal and the operated sides was administered. Pain, itching, soreness, deformity, and symmetry were further investigated. @*Results@#Pain and itching were the only observed complications. The operated side was slightly more painful than the normal side in four patients (14.8%), and four patients (14.8%) reported itching on the operated side. However, all patients who experienced complications stated that the pain or itching did not interfere with mask wearing. Most symptomatic patients were older than 60 years of age (23.8%, p=0.185) and wore masks for longer periods of time (28.5%, p=0.326). @*Conclusion@#Few retroauricular donor site-related complications occurred, and none of these complications caused inconvenience in daily life. Therefore, in the COVID-19 pandemic, the use of the retroauricular region as an FTSG donor site remains appropriate.

Separated muscle belly of the flexor digitorum brevis for the fifth toe: a case report / 대한해부학회지

This case report describes a variation of the flexor digitorum brevis (FDB) with a separated muscle belly and tendon at the fifth toe. The narrow tendon and muscle belly for the fifth toe arose from the intermuscular septum between the FDB and abductor digiti minimi adjacent to the arising fibers of the FDB, separating from its other fibers. The tendon and muscle belly for the fifth toe became wider at the base of the metatarsal bones and narrower as it coursed toward the toes in a fusiform shape. The tendon and muscle belly for the fifth toe became thin at the midfoot and coursed just beneath the flexor digitorum longus tendon and entered the digital tendinous sheath. FDB variations including that described herein should be considered when performing various surgical procedures and evaluating the biomechanics of the foot.

Ultrasonography of intrascrotal torsed appendages: size and interval between symptom onset and the ultrasonographic examination according to echogenicity

Purpose@#This study investigated the size of torsed appendages and the interval between symptom onset and the ultrasonographic examination according to the echogenicity of the torsed appendages. @*Methods@#This was a retrospective analysis of 54 cases in 46 patients with torsion of the testicular appendages between December 2008 and July 2021. Eight patients received follow-up ultrasonography 7-48 days after initial ultrasonography. The echogenicity of torsed appendages was classified into three groups: hypoechoic, hyperechoic, or isoechoic. @*Results@#The 54 torsed appendages were hypoechoic (n=40), hyperechoic (n=9), or isoechoic (n=5). The size of the torsed appendages ranged from 4 to 14 mm (8.0±3.1 mm) in hypoechoic torsed appendages and from 2.6 to 5.0 mm (3.7±0.9 mm) in hyperechoic torsed appendages. The interval between symptom onset and the ultrasonographic examination ranged from 0 to 17 days (4.2±4.4 days) in hypoechoic torsed appendages and from 8 to 48 days (29.8±16.0 days) in hyperechoic torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals between symptom onset and the ultrasonographic examination than the hypoechoic torsed appendages (P<0.05). Three hypoechoic torsed appendages and a single isoechoic torsed appendage on initial ultrasonography became hyperechoic on follow-up ultrasonography. @*Conclusion@#The size of the torsed appendages and the interval between symptom onset and the ultrasonographic examination varied according to the echogenicity of the torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals until the examination than the hypoechoic torsed appendages.

Diagnosis and Treatment of Monogenic Hypertension in Children

Although the majority of individuals with hypertension (HTN) have primary and polygenic HTN, monogenic HTN is a secondary type that is widely thought to play a key role in pediatric HTN, which has the characteristics of early onset, refractory HTN with a positive family history, and electrolyte disorders. Monogenic HTN results from single genetic mutations that contribute to the dysregulation of blood pressure (BP) in the kidneys and adrenal glands. It is pathophysiologically associated with increased sodium reabsorption in the distal tubule, intravascular volume expansion, and HTN, as well as low renin and varying aldosterone levels. Simultaneously increased or decreased potassium levels also provide clues for the diagnosis of monogenic HTN. Discovering the genetic factors that cause an increase in BP has been shown to be related to the choice of and responses to antihypertensive medications. Therefore, early and precise diagnosis with genetic sequencing and effective treatment with accurate antihypertensive agents are critical in the management of monogenic HTN. In addition, understanding the genetic architecture of BP, causative molecular pathways perturbing BP regulation, and pharmacogenomics can help with the selection of precision and personalized medicine, as well as improve morbidity and mortality in adulthood.

Comparison of Ablation Performance between Octopus Multipurpose Electrode and Conventional Octopus Electrode

Objective@#To compare Octopus multipurpose (MP) electrodes, which are capable of saline instillation and direct tissue temperature measurement, and conventional electrodes for radiofrequency ablation (RFA) in porcine livers in vivo. @*Materials and Methods@#Sixteen pigs were used in this study. In the first experiment, RFA was performed in the liver for 6 minutes using Octopus MP electrodes (n = 15 ablation zones) and conventional electrodes (n = 12 ablation zones) to investigate the effect of saline instillation. The ablation energy, electrical impedance, and ablation volume of the two electrodes were compared. In the second experiment, RFA was performed near the gallbladder (GB) and colon using Octopus MP electrodes (n = 12 ablation zones for each) with direct tissue temperature monitoring and conventional electrodes (n = 11 ablation zones for each). RFA was discontinued when the temperature increased to > 60°C in the Octopus MP electrode group, whereas RFA was performed for a total of 6 minutes in the conventional electrode group. Thermal injury was assessed and compared between the two groups by pathological examination. @*Results@#In the first experiment, the ablation volume and total energy delivered in the Octopus MP electrode group were significantly larger than those in the conventional electrode group (15.7 ± 4.26 cm3 vs. 12.5 ± 2.14 cm3 , p = 0.027; 5.48 ± 0.49 Kcal vs. 5.04 ± 0.49 Kcal, p = 0.029). In the second experiment, thermal injury to the GB and colon was less frequently noted in the Octopus MP electrode group than that in the conventional electrode group (16.7% [2/12] vs. 90.9% [10/11] for GB and 8.3% [1/12] vs. 90.9% [10/11] for colon, p < 0.001 for all). The total energy delivered around the GB (2.65 ± 1.07 Kcal vs. 5.04 ± 0.66 Kcal) and colon (2.58 ± 0.57 Kcal vs. 5.17 ± 0.90 Kcal) were significantly lower in the Octopus MP electrode group than that in the conventional electrode group (p < 0.001 for all). @*Conclusion@#RFA using the Octopus MP electrodes induced a larger ablation volume and resulted in less thermal injury to the adjacent organs compared with conventional electrodes.

Therapeutic Efficacy of Topical 5-Fluorouracil vs. Topical Imiquimod vs. Cryosurgery for Single-Lesion Actinic Keratosis in Korea / 대한피부과학회지

Background@#Actinic keratosis (AK) is a common precancerous cutaneous lesion. There are various AK treatment methods; however, no specific method is considered superior. Most existing studies on AK treatment are Caucasian-based and include patients with multiple lesions. @*Objective@#This study aimed to compare the treatment duration, financial costs, and success rates of topically applied 5% 5-fluorouracil (5-FU) solution, 5% imiquimod (IMIQ) cream, and cryosurgery in the treatment of histologically proven single-lesion AK in Korean patients. @*Methods@#We retrospectively reviewed the medical records of patients with single-lesion AK at a single Korean center from January 2018 to February 2021. Each patient was treated using the three aforementioned local treatments. @*Results@#The study included 58 patients. Nineteen of 23 (82.6%), 27 of 27 (100%), and eight of eight patients (100%) were successfully treated after topical 5-FU, topical IMIQ, and cryosurgery, respectively. Further analysis on treatment success by subgroup revealed the following: mean number of outpatient visits, 3.78 vs. 4.41 vs. 3.75;mean treatment duration, 5.79 vs. 6.00 vs. 9.38 weeks; and mean total treatment cost, 79,380 vs. 170,023 vs. 173,116 won; for the 5-FU, IMIQ, and cryosurgery subgroups, respectively. The total treatment cost was significantly different among the subgroups (p≤0.001). @*Conclusion@#Topical IMIQ and cryosurgery were superior in terms of treatment efficacy, but considering its low cost, 5-FU may also be a reasonable option. Hence, an individualized approach to treating localized AK should be taken.

Diagnosis and treatment of trigeminal neuralgia

Trigeminal neuralgia is a sudden and painful facial condition that is triggered by activities of daily living. The pain is debilitating and patients are often unable to perform routine daily tasks such as washing their face, shaving, and brushing their teeth, which in turn has an impact on their social life and mental well-being as they are often anxious and fearful of not knowing when the pain may occur.Current Concepts: Treatment for trigeminal neuralgia involves local nerve destruction surgeries, including neuroblocking, percutaneous ethanol injection therapy, percutaneous radio-frequency rhizotomy, and gamma knife surgery. Although these types of surgeries reduce pain, the side effects are unpleasant and include decreased facial sensation, which originates from the damage to the trigeminal nerve. Furthermore, these surgeries provide insufficient long-term outcomes and symptoms often recur. Microvascular decompression is a radical surgical approach that separates the blood vessels that cause pain from the nerves. In a large-scale study, microvascular decompression significantly reduced the pain in 80–96% of the patients who underwent initial treatment. Of these, 85% experienced significant pain reduction 38 months post-surgery, and 72–85% reported that they were able to manage their pain 5 years post-surgery. Currently, microvascular decompression is the most appropriate surgical approach to control pain in patients with trigeminal neuralgia, as it exhibits the highest rate of pain control and lowest rate of recurrence.Discussion and Conclusion: The accurate diagnosis of trigeminal neuralgia, through clinical symptoms and imaging, is important to obtain good treatment outcomes. Microvascular decompression should be considered when a patient responds poorly to initial treatment approaches, cannot receive surgical treatment due to side effects, or experiences pain recurrence following local nerve destruction.

Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis Associated With Mediastinal and Ovarian Teratomas: A Case Report

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most common type of autoimmune encephalitis. Approximately 80% of patients with anti-NMDAR encephalitis are women. Tumors are detected in approximately 50% of female patients with anti-NMDAR encephalitis, of which 96% are ovarian teratomas. We describe the case of a 28-year-old woman diagnosed with anti-NMDAR encephalitis with mediastinal and bilateral ovarian teratomas in July 2019. The patient recovered following surgical management of the mediastinal mass and both ovarian teratomas, and immunotherapy. This case shows that teratomas can be found at multiple sites other than ovaries. Therefore, detecting teratomas using whole-body evaluation may be helpful for diagnosis and treatment.

Impact of Role Conflict, Nursing Organizational Culture, and Nurse-Physician Collaboration on Job Embeddedness of Intensive Care Unit Nurses / 중환자간호학회지

Purpose@#: The purpose of this study is to identify the factors affecting the degree of job embeddedness by examining role conflict among intensive care unit nurses, the nursing organizational culture, nurse-physician collaboration, degree of job embeddedness, to understand the relationship between these variables.Method : Participants are 148 nurses from two hospitals in the intensive care unit. Collected data are analyzed using independent t-tests, ANOVA, Scheffé test, Pearson correlations, and multiple regressions using the SPSS 25.0 program. @*Results@#: The factors that significantly influenced the participants’ job embeddedness are role conflict (β=-.19, p =.015), innovation-oriented culture (β=.26, p =.003), and nurse-physician collaboration (β=.24, p =.002). The total explanatory power of these factors for job embeddedness is 44.5% (F=15.06, p =.001). @*Conclusion@#: This study identifies role conflict among intensive care unit nurses, innovation-oriented culture, and nurse-physician collaboration as important factors affecting job embeddedness.

Keyword Network Analysis and Topic Modeling of News Articles Related to Artificial Intelligence and Nursing

Purpose@#The purpose of this study was to identify the main keywords, network properties, and main topics of news articles related to artificial intelligence technology in the field of nursing. @*Methods@#After collecting artificial intelligence-and nursing-related news articles published between January 1, 1991, and July 24, 2022, keywords were extracted via preprocessing. A total of 3,267 articles were searched, and 2,996 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4. @*Results@#As a result of analyzing the frequency of appearance, the keywords used most frequently were education, medical robot, telecom, dementia, and the older adults living alone. Keyword network analysis revealed the following results: a density of 0.002, an average degree of 8.79, and an average distance of 2.43; the central keywords identified were ’education,’ ‘medical robot,’ and ‘fourth industry.’ Five topics were derived from news articles related to artificial intelligence and nursing: ‘Artificial intelligence nursing research and development in the health and medical field,’ ‘Education using artificial intelligence for children and youth care,’ ‘Nursing robot for older adults care,’ ‘Community care policy and artificial intelligence,’ and ‘Smart care technology in an aging society.’ @*Conclusion@#The use of artificial intelligence may be helpful among the local community, older adult, children, and adolescents. In particular, health management using artificial intelligence is indispensable now that we are facing a super-aging society. In the future, studies on nursing intervention and development of nursing programs using artificial intelligence should be conducted.

Epidemiologic and Clinical Outcomes of Pediatric Renal Tumors in Korea: A Retrospective Analysis of The Korean Pediatric Hematology and Oncology Group (KPHOG) Data / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Renal tumors account for approximately 7% of all childhood cancers. These include Wilms tumor (WT), clear cell sarcoma of the kidney (CCSK), malignant rhabdoid tumor of the kidney (MRTK), renal cell carcinoma (RCC), congenital mesoblastic nephroma (CMN) and other rare tumors. We investigated the epidemiology of pediatric renal tumors in Korea. @*Materials and Methods@#From January 2001 to December 2015, data of pediatric patients (0–18 years) newly-diagnosed with renal tumors at 26 hospitals were retrospectively analyzed. @*Results@#Among 439 patients (male, 240), the most common tumor was WT (n=342, 77.9%), followed by RCC (n=36, 8.2%), CCSK (n=24, 5.5%), MRTK (n=16, 3.6%), CMN (n=12, 2.7%), and others (n=9, 2.1%). Median age at diagnosis was 27.1 months (range 0-225.5) and median follow-up duration was 88.5 months (range 0-211.6). Overall, 32 patients died, of whom 17, 11, 1, and 3 died of relapse, progressive disease, second malignant neoplasm, and treatment-related mortality. Five-year overall survival and event free survival were 97.2% and 84.8% in WT, 90.6% and 82.1% in RCC, 81.1% and 63.6% in CCSK, 60.3% and 56.2% in MRTK, and 100% and 91.7% in CMN, respectively (p < 0.001). @*Conclusion@#The pediatric renal tumor types in Korea are similar to those previously reported in other countries. WT accounted for a large proportion and survival was excellent. Non-Wilms renal tumors included a variety of tumors and showed inferior outcome, especially MRTK. Further efforts are necessary to optimize the treatment and analyze the genetic characteristics of pediatric renal tumors in Korea.

Intramuscular Neural Distribution of the Gastrocnemius for Botulinum Neurotoxin Injection:Application to Cosmetic Calf Shaping

Purpose@#Anatomical landmarks can provide vital information on the distribution of nerves in the gastrocnemius muscle. We aimed to provide an anatomical perspective on appropriate locations for botulinum neurotoxin (BoNT) injections in the medial and lateral parts of the gastrocnemius for calf shaping. @*Materials and Methods@#A modified Sihler’s method was applied to both the medial and lateral parts of the gastrocnemius muscles (16 specimens). Intramuscular neural distributions were revealed by dissecting along a transverse line crossing the fibular head and superior margin of the calcaneal tuberosity. @*Results@#The intramuscular neural distribution for the medial and lateral parts of the gastrocnemius had the greatest arborized patterns in the 7/10–8/10 section of the medial head and 7.5/10–8.5/10 section of the lateral part of the gastrocnemius. @*Conclusion@#We propose that BoNT injections should be directed to the 7/10–8/10 section of the medial head and the 7.5/10– 8.5/10 section of the lateral part of the gastrocnemius. Following our guidelines, clinicians can ensure satisfactory results with the use of minimal doses to limit adverse effects, such as gait disturbance, antibody production, and bruising, due to multiple injections. The results can also be altered and applied to electromyography.

Three-Dimensional Cell Culture System for Tendon Tissue Engineering

Tendon, connective tissue between bone and muscle has unique component of the musculoskeletal system. It plays important role for transporting mechanical stress from muscle to bone and enabling locomotive motion of the body. There are some restoration capacities in the tendon tissue, but the injured tendons are not completely regenerated after acute and chronic tendon injury. At this point, the treatment options for tendon injuries are limited and not that successful. Therefore, biomedical engineering approaches are emerged to cope with this issue. Among them, three-dimensional cell culture platforms provided similarity to in vivo conditions and suggested opportunities for new therapeutic approaches for treatment of tendon injuries. In this review, we focus on the characteristics of tendon tissue and tendon pathologies which can be targets for tendon tissue engineering strategies. Then proof-of-concept and pre-clinical studies leveraging advanced 3-dimensional cell culture platforms for tendon tissue regeneration have been discussed.

Occupational Exposure during Intraperitoneal Pressurized Aerosol Chemotherapy Using Doxorubicin in a Pig Model

Background@#This study evaluated occupational exposure levels of doxorubicin in healthcare workers performing rotational intraperitoneal pressurized aerosol chemotherapy (PIPAC) procedures. @*Methods@#All samples were collected during PIPAC procedures applying doxorubicin to an experimental animal model (pigs). All procedures were applied to seven pigs, each for approximately 44 min. Surface samples (n = 51) were obtained from substances contaminating the PIPAC devices, surrounding objects, and protective equipment. Airborne samples were also collected around the operating table (n = 39). All samples were analyzed using ultra-high performance liquid chromatography-mass spectrometry. @*Results@#Among the surface samples, doxorubicin was detected in only five samples (9.8%) that were directly exposed to antineoplastic drug aerosols in the abdominal cavity originating from PIPAC devices. The telescopes showed concentrations of 0.48–5.44 ng/cm2 and the trocar showed 0.98 ng/cm2 in the region where the spraying nozzles were inserted. The syringe line connector showed a maximum concentration of 181.07 ng/cm2, following a leakage. Contamination was not detected on the surgeons' gloves or shoes. Objects surrounding the operating table, including tables, operating lights, entrance doors, and trocar holders, were found to be uncontaminated. All air samples collected at locations where healthcare workers performed procedures were found to be uncontaminated. @*Conclusions@#Most air and surface samples were uncontaminated or showed very low doxorubicin concentrations during PIPAC procedures. However, there remains a potential for leakage, in which case dermal exposure may occur. Safety protocols related to leakage accidents, selection of appropriate protective equipment, and the use of disposable devices are necessary to prevent occupational exposure.

Clinical Practice Guidelines for the Diagnosis and Treatment of Scabies in Korea:Part 2. Treatment and Prevention / 대한피부과학회지

For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.