Ewha Medical Journal最新文献

{"title":"Clinical practice guidelines for the diagnosis and treatment of scabies in Korea: Part 1. Epidemiology, clinical manifestations, and diagnosis - a secondary publication.","authors":"Jin Park, Soon-Hyo Kwon, Young Bok Lee, Hei Sung Kim, Jie Hyun Jeon, Gwang Seong Choi","doi":"10.12771/emj.2024.e73","DOIUrl":"10.12771/emj.2024.e73","url":null,"abstract":"<p><p>Scabies is a skin disease caused by the parasite <i>Sarcoptes scabiei</i> var. <i>hominis</i>, which is primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 cases per year in 2010 to about 30,000 cases per year in 2021. However, outbreaks are consistently observed in residential facilities, such as nursing homes, especially among older adults. The clinical manifestations of scabies vary based on the patient's age, health status, the number of mites, and the route of transmission. Typical symptoms of classic scabies include intense nocturnal itching and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. In contrast, older adults with immunodeficiency or neurological disorders may exhibit hyperkeratotic scaly lesions or an atypical distribution with mild to no itching (crusted scabies). The diagnosis of scabies is based on clinical symptoms and the results of diagnostic tests aimed at identifying the presence of the parasite. While a history of close contact and characteristic clinical findings suggest scabies, confirmation of the diagnosis requires detecting scabies mites, eggs, or scybala. This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution <i>in vivo</i> imaging techniques.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e73"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How should medical students and young physicians prepare to be National Assembly members in Korea?","authors":"Hyun-Yung Shin","doi":"10.12771/emj.2024.e50","DOIUrl":"10.12771/emj.2024.e50","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e50"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The histopathological and molecular heterogeneity of hepatocellular carcinoma: a narrative review.","authors":"Wonju Chung, Haeryoung Kim","doi":"10.12771/emj.2024.e58","DOIUrl":"10.12771/emj.2024.e58","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related deaths worldwide, with poor clinical outcomes due to challenges in early detection and limited efficacy of current treatments such as receptor tyrosine kinase inhibitors and immunotherapy. HCC exhibits significant heterogeneity at both histopathological and molecular levels, complicating its management but offering potential for personalized therapeutic approaches. This review outlines the morpho-molecular heterogeneity of HCC and summarizes various histological subtypes, including steatohepatitic, clear cell, macrotrabecular-massive, scirrhous, lymphocyte-rich, and fibrolamellar HCCs. Each subtype possesses distinct clinical, histological, and molecular features; for instance, steatohepatitic HCC is associated with metabolic dysfunction and shows IL-6/JAK/STAT activation, while clear cell HCCs often have <i>IDH1</i> mutations and favorable prognosis. The macrotrabecular-massive subtype is linked to poor outcomes and <i>TP53</i> mutations, whereas scirrhous HCCs express stemness markers and have <i>TSC1/TSC2</i> mutations. Lymphocyte-rich HCCs are characterized by immune cell infiltration and better prognosis. <i>CTNNB1</i>-mutated HCCs show specific morphological features and may benefit from targeted therapies. Understanding these subtypes and associated molecular alterations is crucial for developing effective diagnostic and therapeutic strategies, including potential predictive biomarkers and personalized treatments. Additionally, the identification of patterns like vessels-encapsulating-tumor-clusters offers prognostic implications and may guide therapeutic decisions. Recent molecular studies have enhanced our comprehension of HCC heterogeneity, laying the groundwork for more personalized approaches. Pathologists play a vital role in recognizing these subtypes, aiding in prognosis prediction and treatment planning. Advances in digital pathology and artificial intelligence may further facilitate biomarker research, ultimately improving patient outcomes in HCC management.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e58"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for the conduct, reporting, editing and publication of scholarly work in medical journals (revised in January 2024): a Korean translation].","authors":"International Committee Of Medical Journal Editors","doi":"10.12771/emj.2024.e48","DOIUrl":"https://doi.org/10.12771/emj.2024.e48","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e48"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender and healthcare issues related to the Protected Birth Act in Korea.","authors":"Jiah Jeong","doi":"10.12771/emj.2024.e47","DOIUrl":"https://doi.org/10.12771/emj.2024.e47","url":null,"abstract":"<p><p>This paper discusses the implications of South Korea's birth notification system and Protected Birth Act, which is set to take effect on July 19, 2024. The legislation aims to prevent infanticide and child abandonment by mandating birth reporting and allowing anonymous births for women in crisis. However, concerns have been raised about the Act's effectiveness in protecting both women and children, particularly regarding issues of disability and migrant families. This paper focuses on gender and healthcare issues, highlighting how the Act perpetuates discrimination against out-of-wedlock pregnancies and upholds normal family ideologies. It notes the absence of critical discussions on women's autonomy, safe pregnancy termination, and paternal responsibility. The importance of healthcare providers understanding and preparing for the Act's implementation is emphasized. The paper calls for strengthening social safety nets to improve healthcare access for vulnerable populations and eliminate discrimination against non-traditional families. Additionally, it addresses the need for comprehensive support systems for crisis pregnancies, including financial assistance, psychological support, parenting education, housing solutions, and expanded healthcare services. This paper acknowledges the Act's significance in providing a systematic state-level approach to protecting pregnant women in crisis, replacing the previous reliance on private organizations. Nonetheless, it also emphasizes the importance of continually reviewing and supplementing the system to address potential rights infringements and ensure its effectiveness. In conclusion, this paper advocates for ongoing discussions on gender and healthcare issues, and for future amendments to the law that reflect real-world circumstances and provide genuine protection for crisis pregnancies and infants.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e47"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The leitmotifs we shared.","authors":"Minyoung Kim","doi":"10.12771/emj.2024.e62","DOIUrl":"https://doi.org/10.12771/emj.2024.e62","url":null,"abstract":"","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e62"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current perspectives on the pharmacological treatment of advanced hepatocellular carcinoma: a narrative review.","authors":"Hye-Jin Yoo, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim","doi":"10.12771/emj.2024.e53","DOIUrl":"10.12771/emj.2024.e53","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) remains a critical health concern in Korea, ranking as the second leading cause of cancer mortality and imposing substantial economic burdens, particularly among the working-age population. This review examines recent advancements in treating advanced HCC, referencing the updated 2022 HCC guidelines and the Barcelona Clinical Liver Cancer system. Historically, first-line systemic therapies included sorafenib and lenvatinib, with regorafenib, cabozantinib, or ramucirumab serving as second-line options. Since 2020, immune checkpoint inhibitors have shown superior overall survival than sorafenib, leading to the adoption of combination therapies such as atezolizumab with bevacizumab and durvalumab with tremelimumab as first-line treatments. The IMbrave150 study demonstrated that atezolizumab-bevacizumab significantly extended median overall survival and progression-free survival, with the longest survival reported in any phase 3 trial for advanced HCC. Similarly, the HIMALAYA study indicated that durvalumab combined with tremelimumab significantly improved survival rates. Second-line therapies now include regorafenib, cabozantinib, ramucirumab, nivolumab with ipilimumab, and pembrolizumab, each offering benefits for specific patient populations. Nonetheless, these therapies are associated with side effects that require careful management. Traditional targeted therapies can lead to hypertension, cardiovascular events, and hand-foot skin reactions, whereas immune checkpoint inhibitors may cause immune-related adverse events affecting the skin, gastrointestinal tract, and endocrine system. Clinicians must be well-versed in these treatments and their potential side effects to provide optimal patient care. The emergence of combination therapies targeting complex biological pathways signifies a new paradigm in HCC treatment, emphasizing the importance of continuous education and vigilant monitoring to optimize patient outcomes.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e53"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardization of the Denver Developmental Screening Test for children in Seoul: a validity study.","authors":"Keun Lee","doi":"10.12771/emj.2024.e61","DOIUrl":"10.12771/emj.2024.e61","url":null,"abstract":"<p><p><b>Objectives:</b> This study aimed to evaluate the applicability of the Denver Developmental Screening Test (DDST) for Korean children and to develop a Korean version reflecting the developmental characteristics of children in Seoul. <b>Methods:</b> The DDST was administered to 2,140 children, aged 2 weeks to 6 years and 4 months, in Seoul between July 1985 and September 1986. Participants were recruited from the pediatric departments and counseling centers of several hospitals, excluding those with conditions affecting development. Certain test items were aligned with the Korean context. Inter-examiner reliability was evaluated based on 32 children, while validity was assessed with 30 children using standard developmental scales. The Probit method was employed for statistical analysis. <b>Results:</b> Children from Seoul exhibited more rapid development than their counterparts in Denver and Tokyo across all four developmental domains: personal-social, fine motor-adaptive, language, and gross motor. Specifically, Korean children displayed earlier development for 10 items within the personal-social domain, eight within fine motor-adaptive, seven in language, and seven in the gross motor domain. This advanced development was consistent across age groups. Inter-examiner reliability averaged 97.3%, and validity tests demonstrated high concordance with established developmental scales. <b>Conclusion:</b> The rapid development of Korean children may be attributed to close attention paid by parents and early exposure to educational materials. However, the potential role of genetic differences cannot be denied. The occupational distribution of the fathers in the sample did not differ significantly from that of the Seoul population; thus, these findings were applied to establish a standardized Korean DDST.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e61"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced cardiovascular events through dynamic lifestyle modification in individuals with prediabetes or prehypertension in Korea: a nationwide cohort study.","authors":"Yeji Kim, Shinjeong Song, Chang Mo Moon, Hye Ah Lee, Junbeom Park","doi":"10.12771/emj.2024.e60","DOIUrl":"10.12771/emj.2024.e60","url":null,"abstract":"<p><p><b>Objectives:</b> There is limited knowledge regarding the impact of lifestyle changes on cardiovascular events and mortality among individuals with prehypertension or prediabetes. <b>Methods:</b> This was a serial retrospective cohort study utilizing data from the Korean National Health Insurance Service Health Screening Cohort. The primary outcome considered in the study was major adverse cardiovascular events (MACE). <b>Results:</b> A higher risk of MACE was found in men with prehypertension whose unhealthy lifestyle deteriorated (hazard ratio [HR], 1.13; 95% CI, 1.04-1.23; P=0.004), those who gained weight (HR, 1.15; 95% CI, 1.03-1.28; P=0.010), and those who began smoking (HR, 1.34; 95% CI, 1.17-1.55; P<0.001). Conversely, a reduced risk of MACE was observed in men with prehypertension who improved their unhealthy lifestyle, quit smoking, reduced alcohol consumption, or increased the frequency of physical activity. In men with prediabetes, the risk of MACE was higher in those whose unhealthy lifestyle worsened (HR, 1.23; 95% CI, 1.12-1.35; P<0.001), those who gained weight (HR, 1.19; 95% CI, 1.06-1.33; P=0.003), those who started smoking (HR, 1.41; 95% CI, 1.22-1.64; P<0.001), and those who decreased their physical activity frequency (HR, 1.21; 95% CI, 1.09-1.35; P<0.001). <b>Conclusion:</b> Preventive lifestyle changes reduce cardiovascular events and mortality, particularly in men at risk of developing hypertension or type 2 diabetes.</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e60"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the long-term outcomes of cast immobilization methods in distal radius fractures: a systematic review of randomized controlled trials.","authors":"Maria Florencia Deslivia, Claudia Santosa, Sherly Desnita Savio, Erica Kholinne, Made Bramantya Karna, Anak Agung Gde Yuda Asmara","doi":"10.12771/emj.2024.e51","DOIUrl":"10.12771/emj.2024.e51","url":null,"abstract":"<p><p><b>Objectives:</b> Conservative treatment for distal radius fractures typically involves closed reduction and immobilization with a plaster cast. However, no consensus exists regarding the best method and duration for immobilization. This study investigated the functional outcomes associated with different plaster cast application techniques in the treatment of stable distal radius fractures. <b>Methods:</b> A systematic search was performed in accordance with PRISMA guidelines for studies in the last 5 years. The inclusion criteria were randomized controlled trials that investigated non-operative treatments for distal radius fractures. We excluded studies with short-term follow-up (less than 3 months), ongoing trials, those that did not directly address fractures, and studies involving the use of sugar-tong splints or non-circular immobilization. The outcomes evaluated included subjective measures (Disabilities of the Arm, Shoulder and Hand score; Patient-Rated Wrist Evaluation score; Mayo Wrist Score; and visual analog scale) and objective outcomes (complication rate and radiological parameters). <b>Results:</b> We included seven articles from 2017 to 2022. These studies reported a total of 542 fractures, predominantly in women, with a mean age of over 50 years. Both short and long arm casts demonstrated similar functional and radiological outcomes. A longer immobilization period (>3 weeks) should be considered to prevent re-displacement. <b>Conclusion:</b> In stable fractures treated conservatively, the use of both short and long arm casts resulted in comparable functional outcomes in older patients. Immobilization for at least 3 weeks is recommended, as it provided similar clinical and radiological outcomes compared to longer periods of immobilization (level of evidence: 2A).</p>","PeriodicalId":41392,"journal":{"name":"Ewha Medical Journal","volume":"47 4","pages":"e51"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}