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Background@#As the number of large-scale studies involving multiple organizations producing data has steadily increased, an integrated system for a common interoperable format is needed. In response to the coronavirus disease 2019 (COVID-19) pandemic, a number of global efforts are underway to develop vaccines and therapeutics. We are therefore observing an explosion in the proliferation of COVID-19 data, and interoperability is highly requested in multiple institutions participating simultaneously in COVID-19 pandemic research. @*Results@#In this study, a laboratory information management system (LIMS) approach has been adopted to systemically manage various COVID-19 non-clinical trial data, including mortality, clinical signs, body weight, body temperature, organ weights, viral titer (viral replication and viral RNA), and multiorgan histopathology, from multiple institutions based on a web interface. The main aim of the implemented system is to integrate, standardize, and organize data collected from laboratories in multiple institutes for COVID-19 non-clinical efficacy testings. Six animal biosafety level 3 institutions proved the feasibility of our system. Substantial benefits were shown by maximizing collaborative high-quality non-clinical research. @*Conclusions@#This LIMS platform can be used for future outbreaks, leading to accelerated medical product development through the systematic management of extensive data from non-clinical animal studies.
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Background@#Oral alitretinoin is effective in the treatment of chronic hand eczema (CHE), and ≥12 weeks of alitretinoin treatment has been shown to be effective in Korean patients.However, in the real world, a considerable number of patients discontinue alitretinoin, which leads to treatment failure. @*Objective@#To evaluate the compliance rate of alitretinoin treatment and explore common reasons for poor compliance in patients with CHE in the real world. @*Methods@#We retrospectively reviewed the electronic medical records of CHE patients treated with alitretinoin. We defined ‘poor-compliance’ as subjects who were treated with alitretinoin for ＜12 weeks and ‘good-compliance’ as subjects who were treated with alitretinoin for ≥12 weeks. We reviewed the demographics, dose, and duration of alitretinoin usage, efficacy, and reasons for poor compliance. @*Results@#A total of 137 subjects were enrolled, and 77 (56.2%) did not complete the 12-week treatment with alitretinoin. Among them, the non-improvement rate was significantly higher in the poor-compliance group than in the good-compliance group (p＜0.01). The main reasons for the alitretinoin cessation in the poor-compliance group were insufficient response (40.8%), followed by high cost (34.7%), and adverse events (24.5%). @*Conclusion@#Alitretinoin appears the preferred longterm treatment option for CHE. Although there are complaints about late efficacy, cost, and side effects, following proper explanation, these should not justify discontinuation. Physicians need to recognize the reasons for poor compliance with alitretinoin for each patient and suggest continuing alitretinoin for the successful treatment of CHE.
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Background@#The skin barrier is made of the outermost layers of skin and is responsible for preventing cutaneous water loss. Skin barrier function is easily affected by external environmental factors, such as temperature and relative humidity, especially in areas with four distinct seasons, such as Busan, Korea. @*Objective@#This study was conducted to analyze the seasonal variation in skin barrier function on the face and to determine whether it is affected by thermo-hygrostat conditioning. @*Methods@#Ten healthy female volunteers aged 28 to 34 years were enrolled in this study. Each subject was put into a thermo-hygrostat–controlled room maintained at a temperature of 22.4°C to 23.8°C with a relative humidity of 50.2% to 52.0%. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were measured before and after a 20-minute session in the room. Measurements were taken once in the middle of each season. @*Results@#Regardless of thermo-hygrostat conditioning, TEWL and SCH values changed significantly between all four seasons (both p＜0.001). With thermo-hygrostat conditioning, 1 of 6 ΔTEWL and 4 of 6 ΔSCH values showed significant seasonal differences in post-hoc analysis. Difference of TEWL and SCH obtained before and after thermo-hygrostat conditioning was significant only in summer (TEWL, p=0.009; SCH, p=0.002). @*Conclusion@#Skin barrier function differed significantly between seasons, regardless of thermo-hygrostat conditioning. Thermo-hygrostat conditioning significantly affected TEWL and SCH only during summer. However, with Busan’s excessively humid summer, even a short period of thermo-hygrostat conditioning could increase the precision of skin barrier function measurement.
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Background@#The skin barrier is made of the outermost layers of skin and is responsible for preventing cutaneous water loss. Skin barrier function is easily affected by external environmental factors, such as temperature and relative humidity, especially in areas with four distinct seasons, such as Busan, Korea. @*Objective@#This study was conducted to analyze the seasonal variation in skin barrier function on the face and to determine whether it is affected by thermo-hygrostat conditioning. @*Methods@#Ten healthy female volunteers aged 28 to 34 years were enrolled in this study. Each subject was put into a thermo-hygrostat–controlled room maintained at a temperature of 22.4°C to 23.8°C with a relative humidity of 50.2% to 52.0%. Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) were measured before and after a 20-minute session in the room. Measurements were taken once in the middle of each season. @*Results@#Regardless of thermo-hygrostat conditioning, TEWL and SCH values changed significantly between all four seasons (both p＜0.001). With thermo-hygrostat conditioning, 1 of 6 ΔTEWL and 4 of 6 ΔSCH values showed significant seasonal differences in post-hoc analysis. Difference of TEWL and SCH obtained before and after thermo-hygrostat conditioning was significant only in summer (TEWL, p=0.009; SCH, p=0.002). @*Conclusion@#Skin barrier function differed significantly between seasons, regardless of thermo-hygrostat conditioning. Thermo-hygrostat conditioning significantly affected TEWL and SCH only during summer. However, with Busan’s excessively humid summer, even a short period of thermo-hygrostat conditioning could increase the precision of skin barrier function measurement.
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Background@#Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Adapalene-benzoyl peroxide gel has been proven to be effective in the treatment of both inflammatory and comedonal acne. However, skin irritation characterized by erythema, scaling, and dryness may occur with the use of this formula. @*Objective@#This study aimed to investigate the effects and safety of a new formulation of adpalene-benzoyl peroxide in combination with multi-lamellar emulsion (MLE) for acne treatment. Methods: All patients were treated with adapalene-benzoyl peroxide with MLE once daily for 12 weeks on acne lesions. The subjects visited the hospital at baseline, 2 weeks, 4 weeks, 8 weeks, and 12 weeks, and clinical effects, patient satisfaction, and adverse effects were estimated. The severity of adverse effects was measured on a 4-point scale. @*Results@#A total of 30 subjects were enrolled. The number of lesions decreased significantly from 20.2 to 7.8 (p＜ 0.0001) after treatment. Investigator’s global assessment showed almost clear, and patient satisfaction increased from 3.57 to 4.13. The subjects had adverse effects such as tingling sensation (83.3%), scales (80.0%), erythema (63.3%), and dryness (63.3%). Severity of adverse effects had 1 point on average. Additionally, transepidermal water loss was found to be decreased. @*Conclusion@#This study suggests that adapalene-benzoyl peroxide with MLE is effective for treating acne lesions and shows high patient satisfaction. Hence, this new combination could be a safe and well-tolerated option for acne treatment.
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Background@#Compliance has an important influence on treatment outcomes. It is likely that concerns about the use of oral medications prescribed for dermatologic disease are prevalent in Korea, which may result in non-compliance and, consequently, poor treatment response. @*Objective@#This study aimed to assess the level of concern among the general population in Korea about the use of oral medications for dermatologic diseases (OMD). @*Methods@#We used a structured questionnaire consisting of three categories, general knowledge of OMD, previous experience of using OMD, and comparison of OMD use with previous experience of using oral medications for non-dermatologic diseases (OMNDs). @*Results@#A total of 100 participants were enrolled, of whom 54 expressed their concerns about the use of OMD, and these participants were predominantly women (p=0.007). Among them, nearly half (46%) did not identify a specific drug class of concern, while corticosteroids were the most commonly identified drug class of concern (64.5%) among those who cited a particular class. The side effects of OMD that were of most concern were hepatic/renal toxicity and tachyphylaxis (31.7%). Friends/acquaintances (26.2%) were the most common sources of information in relation to concerns about the use of OMD. Approximately one-third of the participants (n=35) were more concerned about the use of OMD than the use of OMND, and only three did not show any concern about the use of OMDs. @*Conclusion@#Based on the results of the present study, concerns about the use of OMD seem to be prevalent in Korea, but the underlying details regarding target and related adverse reaction were neither concrete nor coherent. Regular checkups should also be performed to confirm the level of adherence to the treatment regime. In addition, providing qualified information in easily accessible way may be necessary in reducing unfounded concerns.
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BACKGROUND: There is growing interest in alopecia among the general population. Many people obtain information from easily accessible media rather than from doctors; thus, the media can play an important role in shaping public opinion. OBJECTIVE: The goal of this study was to evaluate the content and reliability of newspaper articles on alopecia. METHODS: Newspapers were categorized into three groups: one group of print newspapers and two groups of online newspapers. Online newspapers were further divided into two groups according to type of publishing company; one publishes both print and online newspapers and the other publishes online newspapers only. The most frequently subscribed or circulated newspaper in each group was selected. Articles containing information on alopecia were selected from 3 years of each newspaper and evaluated for reliability. RESULTS: Most articles in each group used the general term “alopecia” instead of naming a specific hair loss disease. The majority of articles were based on consultation with experts. Assessment of the accuracy of articles with three grade scales showed that the percentage with high accuracy was 38.9%, 47.2%, and 23.3%. Assessment of reliability scores for five selected articles in each group showed that there were statistically significant differences between common readers and dermatologists (p < 0.05). CONCLUSION: The results of this study suggest that closer monitoring of the media is required to supply easily accessible, balanced, and trustworthy information regarding alopecia.
Subject(s)
Alopecia , Hair , Periodical , Public Opinion , Weights and MeasuresABSTRACT
BACKGROUND: Hidradenitis suppurativa is a chronic inflammatory skin disease showing recurrent painful nodules and abscesses. Many treatment modalities, such as topical antibiotics, systemic antibiotics, retinoids, immunomodulators, biologics, and surgical treatment are used to treat the disease, but there is no single effective treatment for hidradenitis suppurativa. OBJECTIVE: We conducted this study to compare the clinical outcomes of treatment with systemic antibiotics and systemic retinoids. METHODS: We analyzed the clinical features, treatment modalities, and clinical outcomes of patients with hidradenitis suppurativa and compared the clinical outcomes of treatment modalities. RESULTS: A total of 77 patients were enrolled. Male patients were predominant, and the mean age was 28.1 years. Buttock (42.0%) was the most commonly affected site and 63 patients (81.8%) had lesions at Hurley stage I. Forty-eight patients (62.3%) were treated with systemic antibiotics and 29 (37.7%) with systemic retinoid. Seventy-one patients (92.2%) showed improvement after a mean treatment duration of 8.3 weeks, and 69 (89.6%) experienced recurrence after improvement. Systemic antibiotics showed a relatively high improvement rate, short mean treatment duration, and low recurrence rate compared with systemic retinoids, but the differences were not statistically significant. Among systemic antibiotics, both tetracycline and macrolide showed good therapeutic effects for HS, but the differences were also not statistically significant. CONCLUSION: In this study, systemic antibiotics were associated with superior treatment outcomes compared to systemic retinoids, though without statistical significance. In the case of mild lesions, treatment with systemic retinoids appears to show comparable effectiveness to systemic antibiotics.
Subject(s)
Humans , Male , Abscess , Anti-Bacterial Agents , Biological Products , Buttocks , Hidradenitis Suppurativa , Hidradenitis , Immunologic Factors , Isotretinoin , Recurrence , Retinoids , Skin Diseases , Tetracycline , Therapeutic UsesABSTRACT
The quadrivalent meningococcal conjugate vaccine (MenACWY-CRM) has been introduced for military recruits in Korea since 2012. This study was performed to evaluate the immunogenicity of MenACWY-CRM in Korean military recruits. In addition, the influence of tetanus-diphtheria toxoids (Td) vaccination on the vaccine response to MenACWY-CRM was analyzed. A total of 75 military recruits were enrolled. Among them, 18 received a dose of MenACWY-CRM only (group 1), and 57 received Td three days before MenACWY-CRM immunization (group 2). The immunogenicity of MenACWY-CRM was compared between the two groups. The serum bactericidal activity with baby rabbit complement was measured before and three weeks after immunization against serogroups A, C, W-135, and Y. The geometric mean titers (GMTs) against four serogroups were significantly increased in both groups after immunization. Compared to group 2, group 1 exhibited significantly higher vaccine responses in several aspects: post-immune GMTs against serogroup A and C, seroresponse rates against serogroup A, and a fold increases of titers against serogroup A, C, and Y. MenACWY-CRM was immunogenic against all vaccine-serogroups in Korean military recruits. Vaccine response to MenACWY-CRM was influenced by Td administered three days earlier.
Subject(s)
Humans , Complement System Proteins , Immunization , Korea , Meningococcal Vaccines , Military Personnel , Neisseria meningitidis , Serogroup , Serum Bactericidal Antibody Assay , Toxoids , VaccinationABSTRACT
The quadrivalent meningococcal conjugate vaccine (MenACWY-CRM) has been introduced for military recruits in Korea since 2012. This study was performed to evaluate the immunogenicity of MenACWY-CRM in Korean military recruits. In addition, the influence of tetanus-diphtheria toxoids (Td) vaccination on the vaccine response to MenACWY-CRM was analyzed. A total of 75 military recruits were enrolled. Among them, 18 received a dose of MenACWY-CRM only (group 1), and 57 received Td three days before MenACWY-CRM immunization (group 2). The immunogenicity of MenACWY-CRM was compared between the two groups. The serum bactericidal activity with baby rabbit complement was measured before and three weeks after immunization against serogroups A, C, W-135, and Y. The geometric mean titers (GMTs) against four serogroups were significantly increased in both groups after immunization. Compared to group 2, group 1 exhibited significantly higher vaccine responses in several aspects: post-immune GMTs against serogroup A and C, seroresponse rates against serogroup A, and a fold increases of titers against serogroup A, C, and Y. MenACWY-CRM was immunogenic against all vaccine-serogroups in Korean military recruits. Vaccine response to MenACWY-CRM was influenced by Td administered three days earlier.
Subject(s)
Humans , Complement System Proteins , Immunization , Korea , Meningococcal Vaccines , Military Personnel , Neisseria meningitidis , Serogroup , Serum Bactericidal Antibody Assay , Toxoids , VaccinationABSTRACT
Although it is well known that pneumococcal conjugate vaccines provide cross-protection against some vaccine-related serotypes, these mechanisms are still unclear. This study was performed to investigate the role of cross-protective IgM antibodies against vaccine-related serotypes 6A, 6C, and 19A induced in children aged 12-23 months after immunization with 7-valent pneumococcal conjugate vaccine (PCV7). We obtained serum samples from 18 Korean children aged 12-23 months after a PCV7 booster immunization. The serum IgG and IgM concentrations of serotypes 6B and 19F were measured by enzyme-linked immunosorbent assay (ELISA) in serum. The opsonic indices (OIs) against vaccine serotypes 6B and 19F and vaccine-related serotypes 6A, 6C, and 19A were determined by an opsonophagocytic killing assay (OPA) in IgM-depleted and control serum. Both IgG and IgM antibodies in ELISA and opsonic indices in OPA against serotypes 6B and 19F were demonstrated in the immune serum. IgM depletion decreased the OIs against vaccine serotypes 6B (geometric means of OIs (GMIs) of 3,009 vs. 1,396, 38% reduction) and 19F (1,117 vs. 750, 36% reduction). In addition, IgM depletion markedly decreased the OIs against vaccine-related serotypes 6A (GMIs of 961 vs. 329, 70% reduction), 6C (432 vs. 185, 72% reduction), and 19A (301 vs. 166, 58% reduction). The booster immunization PCV7 induced protective antibodies in the form of both IgG and IgM isotypes. IgM antibodies contributed to eliciting cross-protection against vaccine-related serotypes as well as against vaccine serotypes.
Subject(s)
Humans , Infant , Antibodies, Bacterial/blood , Antibodies, Neutralizing/blood , Enzyme-Linked Immunosorbent Assay , Heptavalent Pneumococcal Conjugate Vaccine/immunology , Immunoglobulin M/blood , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/immunology , Serogroup , Streptococcus pneumoniae/immunologyABSTRACT
PURPOSE: The long-term administration of antibiotics interferes with bacterial culture in the middle ear fluids (MEFs) of young children with otitis media with effusion (OME). The purpose of this study is to determine whether molecular diagnostics can be used for rapid and direct detection of the bacterial pathogen in culture-negative MEFs. METHODS: The specificity and sensitivity of both polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) to the lytA gene of Streptococcus pneumoniae were comparatively tested and then applied for pneumococcal detection in the clinical MEFs. RESULTS: The detection limit of the PCR assay was approximately 10(4) colony forming units (CFU), whereas that of LAMP was less than 10 CFU for the detection of S. pneumoniae. Both PCR and LAMP did not amplify nucleic acid at over 10(6) CFU of H. influenzae or M. catarrhalis, both of which were irrelevant bacterial species. Of 22 culture-negative MEFs from children with OME, LAMP positivity was found in twelve MEFs (54.5%, 12/22), only three of which were PCR-positive (25%, 3/12). Our results showed that the ability of LAMP to detect pneumococcal DNA is over four times higher than that of PCR (P<0.01). CONCLUSIONS: As a high-resolution tool able to detect nucleic acid levels equivalent to <10 CFU of S. pneumoniae in MEFs without any cross-reaction with other pathogens, lytA-specific LAMP may be applied for diagnosing pneumococcus infection in OME as well as evaluating the impact of a pneumococcal conjugate vaccine against OME.
Subject(s)
Child , Humans , Anti-Bacterial Agents , Diagnosis , DNA , Ear, Middle , Influenza, Human , Limit of Detection , Otitis Media with Effusion , Otitis Media , Otitis , Pathology, Molecular , Pneumonia , Polymerase Chain Reaction , Sensitivity and Specificity , Stem Cells , Streptococcus pneumoniae , StreptococcusABSTRACT
BACKGROUND: Acne vulgaris is a common dermatologic disease that can largely affect psychosocial aspects of the patient. OBJECTIVE: This study was performed to survey the perception of acne vulgaris, including the cause of acne vulgaris, and patient attitude towards the disease, as well as preference for treatment methods in Busan. METHODS: A total of 170 patients with acne vulgaris, seeking treatment at 1st-, 2nd-, and 3rd-grade hospitals in Busan, were surveyed by questionnaire. Patient informed consent was obtained. RESULTS: With regards to the cause of acne, increased sebum secretion was the most selected answer, followed by stress and eating habits. Most of the patients believed that all of the acne treatment modalities were effective; however, negative recognition about the safety and durability of each treatment was also reported by a majority of the patients. Acne extraction and laser therapy were the most preferred treatment methods, and the most important reason to choose the treatment method was effectiveness. CONCLUSION: In this study, we could recognize a patients' overall perception about acne vulgaris. It is suggested that dermatologists should try not only to help patients gain a better understanding about acne but also to cope with their demands.
Subject(s)
Humans , Acne Vulgaris , Eating , Informed Consent , Laser Therapy , Sebum , Surveys and QuestionnairesABSTRACT
BACKGROUND: Acne vulgaris is a common dermatologic disease that can largely affect psychosocial aspects of the patient. OBJECTIVE: This study was performed to survey the perception of acne vulgaris, including the cause of acne vulgaris, and patient attitude towards the disease, as well as preference for treatment methods in Busan. METHODS: A total of 170 patients with acne vulgaris, seeking treatment at 1st-, 2nd-, and 3rd-grade hospitals in Busan, were surveyed by questionnaire. Patient informed consent was obtained. RESULTS: With regards to the cause of acne, increased sebum secretion was the most selected answer, followed by stress and eating habits. Most of the patients believed that all of the acne treatment modalities were effective; however, negative recognition about the safety and durability of each treatment was also reported by a majority of the patients. Acne extraction and laser therapy were the most preferred treatment methods, and the most important reason to choose the treatment method was effectiveness. CONCLUSION: In this study, we could recognize a patients' overall perception about acne vulgaris. It is suggested that dermatologists should try not only to help patients gain a better understanding about acne but also to cope with their demands.
Subject(s)
Humans , Acne Vulgaris , Eating , Informed Consent , Laser Therapy , Sebum , Surveys and QuestionnairesABSTRACT
Here, we report a case of Cowden syndrome with an unusual clinical course of late-onset oral papillomatosis and a novel germline PTEN mutation. Cowden syndrome is the most common phosphatase and tensin homolog hamartomatous tumor syndrome. It is characterized by multiple hamartomas in the gastrointestinal tract and mucocutaneous lesions such as trichilemmomas, oral papillomatosis, facial papules, and acral keratoses. Patients with Cowden syndrome have a higher risk of malignancies, especially breast, colon, and thyroid cancers. A 53-year-old female presented with cobblestone-like papillomatous papules on the lower gums that developed 1 year earlier. She had no other mucocutaneous lesions besides oral papillomatosis. Gastrointestinal endoscopy and colonoscopy revealed multiple hamartomas in the stomach and colon. The patient had a history of breast cancer and multinodular goiter diagnosed 4 and 5 years ago, respectively. She was diagnosed with Cowden syndrome and a novel PTEN mutation was confirmed by direct sequencing.
Subject(s)
Female , Humans , Middle Aged , Breast , Breast Neoplasms , Colon , Colonoscopy , Endoscopy, Gastrointestinal , Gastrointestinal Tract , Gingiva , Goiter , Hamartoma , Hamartoma Syndrome, Multiple , Keratosis , Papilloma , Stomach , Thyroid GlandABSTRACT
PURPOSE: We evaluated serum procalcitonin (PCT) as a diagnostic marker of neonatal sepsis, and compared PCT levels with C-reactive protein (CRP) levels. METHODS: We retrospectively reviewed the medical records of 269 neonates with a suspected infection, admitted to Wonkwang University School of Medicine & Hospital between January 2011 and December 2012, for whom PCT and CRP values had been obtained. Neonates were categorized into 4 groups according to infection severity. CRP and PCT values were analyzed and compared, and their effectiveness as diagnostic markers was determined by using receiver operating characteristic (ROC) curve analysis. We also calculated the sensitivity, specificity, and positive, and negative predictive values. RESULTS: The mean PCT and CRP concentrations were respectively 56.27+/-81.89 and 71.14+/-37.17 mg/L in the "confirmed sepsis" group; 15.64+/-32.64 and 39.23+/-41.41 mg/L in the "suspected sepsis" group; 9.49+/-4.30 and 0.97+/-1.16 mg/L in the "mild infection" group; and 0.21+/-0.12 and 0.72+/-0.7 mg/L in the control group. High concentrations indicated greater severity of infection (P<0.001). Five of 18 patients with confirmed sepsis had low PCT levels (<1.0 mg/L) despite high CRP levels. In the ROC analysis, the area under the curve was 0.951 for CRP and 0.803 for PCT. The cutoff concentrations of 0.5 mg/L for PCT and 1.0 mg/L for CRP were optimal for diagnosing neonatal sepsis (sensitivity, 88.29% vs. 100%; specificity, 58.17% vs. 85.66%; positive predictive value, 13.2% vs. 33.3%; negative predictive value, 98.6% vs. 100%, respectively). CONCLUSION: PCT is a highly effective early diagnostic marker of neonatal infection. However, it may not be as reliable as CRP.
Subject(s)
Humans , Infant, Newborn , C-Reactive Protein , Medical Records , Retrospective Studies , ROC Curve , Sensitivity and Specificity , SepsisABSTRACT
Erythrokeratodermia variabilis is an autosomal-dominant inherited disease associated with a mutation in gap junction beta (GJB) 3 and 4. It shows two characteristic features: migratory and irregularly shaped erythematous lesions usually accompanied by a burning sensation and fixed, symmetrically located hyperkeratotic plaques. A 6-year-old boy had developed erythematous scaly patches with a geographic pattern on the entire body at age 1, and the lesions had migrated with an irregular pattern. Accompanying hyperkeratotic plaque developed on the trunk and both legs when he was 4 years old. As he grew older, the erythematous patches progressively disappeared and the hyperkeratotic plaque dominantly remained. His family history was unidentifiable because he was adopted at birth. Pathologic findings showed hyperkeratosis and superficial perivascular inflammation. Based on the clinical and pathologic features, we diagnosed erythrokeratodermia variabilis in this patient. Herein, we report a case of erythrokeratodermia variabilis showing gradual disappearance of erythema.