The association between body mass index and molecular subtypes in endometrial carcinoma.

Objective: This study aims to investigate the relationship between body mass index (BMI) and molecular subtypes of endometrial carcinoma using an immunohistochemistry (IHC)-based classification approach. Methods: We analyzed a consecutive series of endometrial cancer cases undergoing surgical staging in southern Alberta (2019-2021). Molecular classification was determined through IHC-based molecular typing, incorporating p53 and mismatch repair (MMR), and further characterized with the addition of ER and PR. BMI associations with molecular classification were assessed using t-tests. Hormone receptor status was further examined in a separate cohort of MMRd endometrial cancer patients undergoing surgical staging at Foothills Medical Centre (Alberta, Canada). Results: Among 289 cases, comprising various histological subtypes, the pNSMP subtype exhibited the highest average BMI (33.93 kg/m2) compared to the p53 abnormal subtype (30.40 kg/m2, p = 0.02). The MMRd subtype had an average BMI of 33.22 kg/m2. While there were no significant BMI differences between FIGO grade 1 and grade 2/3 tumours in the pNSMP or MMRd, a trend toward higher BMI in grade 1 tumours versus grade 2/3 tumours in the MMRd was observed (p = 0.13). A separate cohort of 53 MMRd endometrial carcinomas revealed that FIGO grade 1 tumours were associated with higher BMI (p < 0.05) and more frequent ER/PR expression compared to grade 2/3 tumours (p < 0.05). Conclusions: This study suggests an association between obesity and NSMP endometrial carcinoma. The relationship between BMI and low-grade MMRd endometrial carcinomas with increased ER/PR expression warrants further exploration.

COVID-19 Outcome and Tobacco Product Use: Case-Control and Retrospective Cohort Studies Using Nationwide Samples

Background@#Conflicting evidence exists regarding the association between smoking and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We investigated the association between combustible cigarette (CC) smoking, noncombustible tobacco product (NCTP) use, and the use of any tobacco product with various coronavirus disease 2019 (COVID-19) outcomes. @*Methods@#A case-control study was conducted using the Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service (NHIS) cohort. A retrospective cohort study was conducted using 12,571,698 individuals from the NHIS cohort. Logistic regression evaluated the association between CC smoking, NCTP use, and use of any tobacco product with SARS-CoV-2 infection. Poisson regression evaluated the association between these forms of tobacco product use and COVID-19-related hospitalization and mortality. @*Results@#In the case-control study, we identified 30,878 cases of SARS-CoV-2 infection. The odds ratios (95% confidence intervals [CIs]) for SARS-CoV-2 infection were lower among current CC smokers (0.51, 0.48–0.54), current- and former-NCTP users (0.80, 0.74–0.88;0.82, 0.74–0.91), and current users of any tobacco product (0.52, 0.49–0.55) relative to never user controls. In retrospective cohort study, we identified 16,521 COVID-19-related hospitalization and 362 COVID-19-related deaths. The relative risks (95% CIs) for COVID-19-related hospitalization were lower among current CC smokers (0.51, 0.48–0.54) and current users of any tobacco product (0.53, 0.50–0.56) relative to never user controls. There was no association between the use of tobacco product and COVID-19-related mortality. @*Conclusion@#Current CC smokers and current users of any tobacco product showed reduced risk of SARS-CoV-2 infection and COVID-19-related hospitalization. It remains uncertain whether these relationships are causal.

Comparison between Proton Pump Inhibitor and H2 Receptor Antagonist in Relieving Cyclosporine-Associated Adverse Gastrointestinal Events: A Single Center, Randomized Controlled Trial / 대한피부과학회지

Background@#Cyclosporine (CS) has been effectively used in various skin diseases, but gastrointestinal (GI) adverse events are so common. However, there is no standardized treatment for managing CS-induced GI adverse events. @*Objective@#To analyze the effectiveness of two empirical GI medications, an H2 receptor antagonist (H2RA) and proton pump inhibitor (PPI), in relieving CS-induced GI adverse events. @*Methods@#This is a prospective, randomized clinical trial conducted at Ajou University Hospital. The patients completed a gastrointestinal symptom rating scale (GSRS) questionnaire to assess GI symptoms before and after taking the drugs. @*Results@#A total of 60 patients, divided into a PPI group (n=30) and an H2RA group (n=30), were analyzed. The onset of GI events occurred in 6.04 days on average. GSRS scores improved significantly in both groups (p＜0.01). While abdominal pain, reflux syndrome, and indigestion syndrome consistently improved, changes in diarrhea syndrome and constipation syndrome were not statistically significant. The overall change in GSRS scores was higher in the PPI group, but the difference was not significant (p=0.76). @*Conclusion@#Both PPI and H2RA significantly improved CS-induced GI side effects, with PPI showing a slight advantage over H2RA, but the cost of PPIs should be considered when deciding on first-line therapy. GI side effects typically appeared within 6.04 days of starting CS therapy, highlighting the importance of close monitoring and personalized intervention for improving patient compliance.

Facial Telangiectasia as an Initial Notable Symptom of Systemic Sclerosis / 대한피부과학회지

Systemic sclerosis (SSc), also called scleroderma, is a rare debilitating autoimmune disease of the connective tissue characterized by microvascular damage, specific immunologic abnormalities, and progressive fibrosis of the skin and internal organs. The disease may be associated with serious visceral complications involving the pulmonary, gastrointestinal, cardiac and renal systems, why early identification is important. Cutaneous telangiectasia was originally one of the diagnostic criteria of the CREST syndrome (calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasias), and is now included in the 2013 American College of Rheumatology/European League Against Rheumatism criteria for the diagnosis of SSc. We report herein three cases of SSc who presented our department for telangiectasia, because eruptive telangiectasia on exposed area associated with high titer of antinuclear antibody could be the first sign of SSc.

GPR120 Gene expression and activity in subcutaneous and intramuscular adipose tissues of Angus crossbred steers.

We hypothesized that media long-chain fatty acids (LCFA) would more greatly depress cyclic adenosine monophosphate (cAMP), glycerol, and free fatty acid (FFA) concentrations in subcutaneous (s.c.) adipose tissue than in intramuscular (i.m.) adipose tissue via G protein-coupled receptor 120 (GPR120). The GPR120 receptor binds to LCFA, which reduces cAMP production, thereby causing a depression in lipolysis. Fresh ex vivo explants of s.c. and i.m. adipose tissue from the fifth to eighth longissimus thoracic rib muscle section of 8, 22-mo-old Angus crossbred steers were transferred immediately to 6-well culture plates containing 3 mL of Krebs-Henseleit buffer/Hepes/5 mM glucose. Samples were preincubated with 0.5 mM theophylline plus 10 µM forskolin for 30 min, after which increasing concentrations of acetate or propionate (volatile fatty acids, VFA) (0, 1, 5, and 10 mM) in the absence or presence of 100 µM oleate (18:1n-9) or 100 µM palmitate (16:0) (LCFA) were added to the incubation media and incubated an additional 30 min. Main effects of adipose tissue depot (i.m. vs. s.c) and VFA (acetate vs. propionate) for adipose tissue concentrations of forskolin-stimulated cAMP were P = 0.747 and P = 0.106, respectively. The addition of LCFA to the media depressed adipose tissue concentrations of cAMP (P = 0.006) (LCFA main effects). The Tissue × VFA × LCFA interaction was not significant for any dependent variable (P ≥ 0.872). Therefore, concentrations of cAMP, glycerol, and FFA were analyzed separately for i.m. and s.c. adipose tissue by split-plot analysis. Concentrations of cAMP, glycerol, or FFA in i.m. and s.c. adipose tissue were not affected by increasing concentrations of VFA (P ≥ 0.497). Media LCFA had no effect on i.m. adipose tissue cAMP (P = 0.570) or glycerol (P = 0.470) but depressed i.m. adipose tissue FFA (P < 0.001). In s.c. adipose tissue, LCFA decreased concentrations of cAMP (P = 0.042) and glycerol (P = 0.038), but increased FFA concentration (P = 0.026). Expression of GPR120 (P = 0.804) and stearoyl-CoA desaturase (P = 0.538) was not different between s.c. adipose tissue and i.m. adipose tissue. The binding of VFA to the GPR43 receptor depresses cAMP production, thereby attenuating lipolysis, but GPR43 mRNA was undetectable in those adipose tissue samples. These results provide evidence for functional GPR120 receptors in s.c. adipose tissue but question the role of GPR43 in the accumulation of adipose tissue lipids in growing steers.

We measured the mRNA abundance and activity of the fatty acid receptor, G protein-coupled receptor 120 (GPR120) in bovine subcutaneous and intramuscular (marbling) adipose tissue. The GPR120 receptor binds to long-chain fatty acids, which reduces cyclic adenosine monophosphate (cAMP) production, thereby decreasing lipolysis. The mRNA amount of GPR120 was similar between subcutaneous and intramuscular adipose tissues. In subcutaneous and intramuscular adipose tissue incubated in vitro, the fatty acids oleic acid and palmitic acid (the most abundant fatty acids in bovine adipose tissue) strongly depressed the production of cAMP and glycerol in subcutaneous adipose tissue and decreased the concentration of free fatty acids in intramuscular adipose tissue (all measured with commercial kits). This indicates that elevations in adipose tissue or plasma fatty acids may promote fat accumulation by decreasing the breakdown of stored lipids via GPR120. The volatile fatty acids acetate and propionate, which bind to G protein-coupled receptor 43 (GPR43) had no effect on cAMP, glycerol, or free fatty acids. This questions the role of GPR43 in the accumulation of adipose tissue lipids in growing steers.

Alzheimer’s Disease Prediction Using Attention Mechanism with Dual‑Phase 18 F‑Florbetaben Images / 대한핵의학회잡지

Materials and Methods@#A total of 264 patients (74 CN and 190 AD), who underwent FBB imaging test and neuropsychological tests, were retrospectively analyzed. Early- and delay-phase FBB images were spatially normalized with an in-house FBB template. The regional standard uptake value ratios were calculated with the cerebellar region as a reference region and used as independent variables that predict the diagnostic label assigned to the raw image. @*Results@#AD positivity scores estimated from dual-phase FBB showed better accuracy (ACC) and area under the receiver operating characteristic curve (AUROC) for AD detection (ACC: 0.858, AUROC: 0.831) than those from delay phase FBB imaging (ACC: 0.821, AUROC: 0.794). AD positivity score estimated by dual-phase FBB (R: −0.5412) shows a higher correlation with psychological test compared to only dFBB (R: −0.2975). In the relevance analysis, we observed that LSTM uses different time and regions of early-phase FBB for each disease group for AD detection. @*Conclusions@#These results show that the aggregated model with dual-phase FBB with long short-term memory and attention mechanism can be used to provide a more accurate AD positivity score, which shows a closer association with AD, than the prediction with only a single phase FBB.

Case Report: Erythema Multiforme Induced by Lithium Contact

Erythema multiforme (EM) is an acute, self-limited mucocutaneous disease with diverse triggering factors, and the recurrences are quite common. A 24-year old male presented with multiple erythematous, itchy papules and plaques on multiple sites. He has worked in a lithium battery factory and experienced the chemical burn 2 weeks ago. A histopathologic examination on right wrist showed a scattered lymphocytic infiltration, vacuolar degeneration, and necrotic keratinocyte. The final diagnosis was EM after occupational lithium exposure. He was treated by oral methylprednisolone and experienced recurrences after returning to the same workplace after remission. Although the precise pathogenesis is unknown, the pathogenesis of EM by lithium is related to the effect of lithium on immune system, different from other etiologies. To our knowledge, our case is the first report of EM following the chemical burn and occupational lithium exposure. We report this as an interesting case of EM.

Multiple Eruptive Epithelioid Hemangiomas on the Right Upper Extremity in an Asian Man

Epithelioid hemangioma is a rare benign vascular neoplasm. Recently, the term “multiple eruptive epithelioid hemangioma” has been proposed for epithelioid hemangioma with distinct features. It is different from usual epithelioid hemangioma because of the multifocal distributions in various body regions with an eruptive onset. In addition, the histopathology of multiple eruptive epithelioid hemangioma shows increased cellular proliferation, mitosis, and nuclear pleomorphism and positive findings for FOS-B compared to classic epithelioid hemangioma. Herein, we report the case of a 59-year-old man with unusual manifestations suitable for multiple eruptive epithelioid hemangioma. He had multiple erythematous to purple-red dome-shaped nodules on the right hand, arm, and shoulder. The initial lesion was a solitary erythematous nodule on the right hand that abruptly extended to the right arm and shoulder. Microscopically, the tumor was a well-demarcated dermal nodule and showed capillary sized vascular structures. Vascular structures had epithelioid endothelial cells with abundant eosinophilic cytoplasm and vesicular nuclei. The tumor cells showed mild nuclear pleomorphism and a few mitosis and feature of resembling cobble stone was observed. In immunohistochemistry, CD31 and CD34 were positive in the endothelial cells.The endothelial cells showed nuclear positivity in FOS-B. Based on the clinical and histopathological findings, the final diagnosis was multiple eruptive epithelioid hemangiomas.This is the first report of multiple eruptive epithelioid hemangiomas in an Asian man after the term had been introduced.

Iatrogenic Cervical Spinal Cord Injury Associated with Acupuncture

Iatrogenic spinal cord injury resulting from direct needle injection is an exceedingly uncommon occurrence, mainly owing to the spinal cord’s protection by surrounding bony structures, with only a few exceptions, and its location a few centimeters beneath the skin. This study presents a case of a 27-year-old female who experienced cervical spinal cord injury following acupuncture treatment around the C3–4 region. The patient reported tingling paresthesia and persistent pain in her left arm for 1 month postinjection, with magnetic resonance imaging (MRI) revealing a syringomyelia in the direction of the injection.As determined at the follow-up, after undergoing 3 months of conservative treatments, including cervical intervention, medication, and education, her pain was reduced by approximately half. Cervical injections should be administered by a knowledgeable specialist well versed in musculoskeletal anatomy and potential complications, aided by radiological examination.

Cervical Myelopathy after Neck Manipulation

Spinal manipulation therapy (SMT) is commonly used to treat various musculoskeletal pains; however, it is associated with several complications. Mild complications resolve quickly; however, on rare occasions, they may cause severe complications that persist indefinitely. Here, we present a case of cervical myelopathy caused by a spinal manipulation. A 52-year-old man with a history of cervical radiculopathy at C4–7 underwent manipulation, performed by an unlicensed practitioner. After the manipulation, he explained abrupt muscle weakness in all four extremities. He was diagnosed with cervical myelopathy and had to undergo emergency surgery. Through this case, we aim to emphasize the role of doctors, with regard to spinal manipulation. Physicians must supervise the pre-evaluation of patients, manipulation, and post-manipulation monitoring, and the complications of SMT should be immediately reported.

Tuberculosis and chest radiology

Tuberculosis is still a major public health problem, although it is decreasing worldwide. The World Health Organization is working to reduce the incidence and deaths of tuberculosis globally and aims to eradicate tuberculosis.Current Concepts: The world’s gradual eradication of tuberculosis would be virtually inconceivable without the outstanding scientific works of Robert Koch and Wilhelm Conrad Röntgen. In 1882, Koch’s discovery of the tuberculosis bacillus was the most important first step towards controlling and ending this deadly disease. In 1895, Röntgen’s discovery of the X-ray revolutionized humanity as it became the first technology used to create images of the human body. X-ray images became an essential tool in modern medicine within a short period.Discussion and Conclusion: Chest radiology plays a crucial role in tuberculosis screening, diagnosis, and management. Chest radiology has contributed to the control of tuberculosis, which has plagued humanity for a long time, and will continue to contribute to eradicating tuberculosis in the world.

Effects of a Nursing Simulation Learning Module on Clinical Reasoning Competence, Clinical Competence, Performance Confidence, and Anxiety in COVID-19 Patient-Care for Nursing Students

Purpose@#This study aimed to develop a nursing simulation learning module for coronavirus disease 2019 (COVID-19) patient-care and examine its effects on clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient care for nursing students. @*Methods@#A non-equivalent control group pre- and post-test design was employed. The study participants included 47 nursing students (23 in the experimental group and 24 in the control group) from G City. A simulation learning module for COVID-19 patient-care was developed based on the Jeffries simulation model. The module consisted of a briefing, simulation practice, and debriefing. The effects of the simulation module were measured using clinical reasoning competence, clinical competence, performance confidence, and anxiety in COVID-19 patient-care. Data were analyzed using χ 2 -test, Fisher’s exact test, t-test, Wilcoxon signed-rank test, and Mann– Whitney U test. @*Results@#The levels of clinical reasoning competence, clinical competence, and performance confidence of the experimental group were significantly higher than that of the control group, and the level of anxiety was significantly low after simulation learning. @*Conclusion@#The nursing simulation learning module for COVID-19 patient-care is more effective than the traditional method in terms of improving students’ clinical reasoning competence, clinical competence, and performance confidence, and reducing their anxiety. The module is expected to be useful for educational and clinical environments as an effective teaching and learning strategy to empower nursing competency and contribute to nursing education and clinical changes.

The Prognosis of Post-Scabetic Itch / 대한피부과학회지

Background@#The primary goal of scabies treatment is to eliminate mites; however, but post-scabetic itch persists in many patients. Since long-standing itching can lead to the development of other comorbidities, appropriate interventions are necessary. @*Objective@#This study aimed to investigate the effects of inappropriate (continuous or prolonged) scabicide use and oral steroids on the duration of pruritus in patients with scabies. @*Methods@#The duration of pruritus, use of oral corticosteroids, total immunoglobulin E (IgE) levels, specific IgE levels for house dust mites, and eosinophil counts were evaluated. Post-scabetic itch was defined as itching that persisted for more than 3 weeks, although scabies was no longer detected; 208 participants with post-scabetic itch were included. @*Results@#We recruited 265 participants with confirmatory diagnosis of scabies and 116 with clinical diagnosis. We treated 124 participants with scabicides based on the guidelines, whereas 257 participants were not. The type of scabicide did not affect the duration of pruritus. Scabicide overuse did not shorten the duration of pruritus; however, its prolonged use lengthened the treatment period. Although oral corticosteroids did not shorten the duration of pruritus in the patients, they were effective when the patient had post-scabetic itch. In addition, a positive correlation between the total IgE level and duration of pruritus was observed. @*Conclusion@#This study investigated the effect of treatment modality on the clinical course of scabies. Our findings suggest that overuse of scabicides might be associated with post-scabetic itch, and short-term use of oral corticosteroids may be effective in reducing its duration.

Experience of Lifetime Health Maintenance Program: An Observational Study of a 30-Year Period of Outpatient Primary Care in a Tertiary Hospital / 가정의학회지

Background@#This study aimed to identify the clinical content of patients registered with the Lifetime Health Maintenance Program (LHMP) under the care of a single family physician who introduced and operated the program in Korea at a tertiary hospital for over 30 years. @*Methods@#We analyzed the electronic medical records of 745 patients who had registered for more than 3 times with the LHMP under the care of a single family physician between January 1, 2010 and December 31, 2019. We reviewed medical records from June 1989, when the hospital was established, to February 2022. The participants’ age at the time of LHMP enrollment, sex, initial consultation date, final consultation date, and consultation content were evaluated. @*Results@#Patients visited the LHMP for various reasons, including acute symptom management, chronic disease management, psychiatric consultation, counseling on health behaviors, health checkups, and vaccination. The top five diagnoses for acute symptom management were upper respiratory infection, abdominal pain, dizziness/vertigo, headache, and lower back pain, whereas those for chronic disease management were dyslipidemia, hypertension, osteoarthritis, osteoporosis/osteopenia, and diabetes. More than one in five patients received psychiatric consultation and counseling on health behaviors. As the duration of the program enrollment increased, the proportion of patients visiting the LHMP for acute symptoms, vaccinations, and health checkups also increased. Furthermore, the number of categories of consultation content increased for each patient. @*Conclusion@#The LHMP emphasized the need to systematize regular primary care physicians in Korea. Policy changes are necessary to strengthen primary care, and the LHMP serves as an intermediate step in organizing regular primary care physicians in Korea.

Clinical Applications of the Microbiome in Obstetrics

Human microbiome refers to the genetic material of approximately 1013 microorganisms present in the human body. These microbiomes interact significantly with the physiological, metabolic, and immune systems, particularly during pregnancy. Microbiome dysbiosis in pregnant women and their fetuses is associated with obstetric complications and poor neonatal outcomes. Oral and gut microbiomes can influence the placenta, uterus, and fetus via hematogenous translocation. Through ascending translocation, vaginal microbiota can directly affect the uterine environment. Current research focuses on the presence of the placental microbiome, which is characterized by low biomass. However, more well-controlled studies are required to specifically address the contamination issues. Use of antibiotics during pregnancy and the mode of delivery, specifically cesarean section, have been linked to the establishment of the neonatal gut microbiome. Probiotic supplementation may be beneficial during pregnancy, particularly for women receiving antibiotic treatment.

Topic Modeling for International Patients' Consultations Using Natural Language Processing.

We extracted major topic by applying natural language processing and keyword extracting using TF, TF-IDF, TextRank, Yake, KeyBERT. 1452 consultation data were collected from the website and official hospital e-mail. We found six topics categorized into "Medical opinion" related to hospital characteristics and "Non-medical service guidance". Based on this result, it is necessary to establish marketing plan and develop a digital solution for effective consultation.

Tumor immune microenvironment is influenced by frameshift mutations and tumor mutational burden in gastric cancer

PurposeImmunoscore can effectively predict prognosis in patients with colon cancer; however, its clinical application is limited. We modified the Immunoscore and created a tumor immune microenvironment (TIM) classification system for gastric carcinoma. Unlike previous studies that used small sample sizes or focused on particular immune-cell subtypes, our simplified system enables pathologists to classify gastric carcinomas intuitively using H&E-stained sections.MethodsSamples from 326 patients with advanced gastric carcinoma were reviewed and analyzed by pathologists using simple determination and digital image analysis. Comprehensive results of cancer-panel sequencing, Epstein-Barr‒virus (EBV) status, and PD-L1, HER2, ATM, PTEN, MET, FGFR2, and EGFR immunohistochemistry were evaluated with respect to the TIM class.ResultsThe TIM was classified as “hot” (n = 22), “immunosuppressed” (n = 178), “excluded” (n = 83), or “cold” (n = 43). TIM category was significantly associated with numbers of frameshift mutations (P < 0.001) and high tumor mutational burden (P < 0.004), and predicted overall survival. It was also significantly associated with age, histological type, degree of fibrosis, PD-L1 expression, loss of ATM and PTEN expression (P < 0.001), sex, EBV positivity, and HER2 overexpression (P < 0.04). “Hot” tumors were frequent in PD-L1 expressing and EBV-positive samples, and in those with ATM and PTEN loss. “Excluded” tumors were frequent in HER2-positive cases, whereas “cold” tumors were more frequent in younger patients with poorly cohesive histology and high fibrosis levels.ConclusionsTIM classification system for gastric carcinoma has prognostic significance and results in classes that are associated with molecular characteristics.

Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study

Background@#The coronavirus disease 2019 (COVID-19) pandemic caused disruptions to healthcare systems, consequently endangering tuberculosis (TB) control. We investigated delays in TB treatment among notified patients during the first wave of the COVID-19 pandemic in Korea. @*Methods@#We systemically collected and analyzed data from the Korea TB cohort database from January to May 2020. Groups were categorized as ‘before-pandemic’ and ‘during-pandemic’ based on TB notification period. Presentation delay was defined as the period between initial onset of symptoms and the first hospital visit, and healthcare delay as the period between the first hospital visit and anti-TB treatment initiation. A multivariate logistic regression analysis was performed to evaluate factors associated with delays in TB treatment. @*Results@#Proportion of presentation delay > 14 days was not significantly different between two groups (48.3% vs. 43.7%, P = 0.067); however, proportion of healthcare delay > 5 days was significantly higher in the during-pandemic group (48.6% vs. 42.3%, P = 0.012). In multivariate analysis, the during-pandemic group was significantly associated with healthcare delay > 5 days (adjusted odds ratio = 0.884, 95% confidence interval = 0.715–1.094). @*Conclusion@#The COVID-19 pandemic was associated with healthcare delay of > 5 days in Korea. Public health interventions are necessary to minimize the pandemic’s impact on the national TB control project.

Latent Tuberculosis Cascade of Care Among Healthcare Workers:A Nationwide Cohort Analysis in Korea Between 2017 and 2018

Background@#In 2017, Korea implemented nationwide latent tuberculosis infection (LTBI) project targeting healthcare workers (HCWs). We aimed to assess its performance using the cascade of care model. @*Methods@#We included 45,503 employees of medical institutions with positive interferongamma release assay result who participated between March 2017 and December 2018. We described percentages of LTBI participants completing each step in the cascade of care.Poisson regression model was conducted to assess individual characteristics and factors associated with not-visiting clinics for further care, not-initiating LTBI treatment, and notcompleting treatment. @*Results@#Proportions of visiting clinics and initiating and completing treatment in HCWs were 54.9%, 38.5%, and 32.0%, respectively. Despite of less likelihood of visiting clinics and initiating LTBI treatment, older age ≥ 65 years were more likely to complete treatment (adjusted relative risk [aRR], 0.80; 95% confidence interval [CI], 0.64–0.99), compared to young age < 35 years. Compared to nurses, doctors were less likely to visit clinic; however, were more likely to initiate treatment (aRR, 0.88; 95% CI, 0.81–0.96). Those who visited public health centers were associated with not-initiating treatment (aRR, 1.34; 95% CI, 1.29–1.40). When treated at private hospitals, 9-month isoniazid monotherapy was less likely to complete treatment, compared to 3-month isoniazid and rifampicin combination therapy (aRR, 1.33; 95% CI, 1.16–1.53). @*Conclusion@#Among employees of medical institutions with LTBI, only one third completed treatment. Age, occupation, treatment center, and initial regimen were significantly related to LTBI treatment performance indicators. Rifampicin-based short treatment regimens were effective under standard of care.

Two Cases of Patients with a Rash along the Intertriginous Area without Certain Drug History / 대한피부과학회지

We report a skin rash with a sharply demarcated erythema on the flexural area. The differential diagnoses included Baboon syndrome and symmetrical drug-related intertriginous and flexural exanthema. The diagnosis can be made based on the presence of previous cutaneous sensitization and causative agents. Our cases were consistent with a diagnosis of Baboon syndrome with no drug history.