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Aim: This study aimed to analyze extramammary Paget's disease (EMPD)‐specific survival, overall survival, and recurrence rate (RR) in patients with EMPD in South Korea, with a focus on wide local excision. Methods: We retrospectively reviewed the medical records of patients with EMPD from 1993 to 2020 at Kyungpook National University Hospital. We determined the survival and RRs after wide local excision. Results: A total of 95 patients (66 males and 29 females; mean age 67.4 years) were included. The 5‐year disease‐specific survival and overall survival were 91.8% and 79.3%, respectively, whereas the 10‐year rates were 81.6% and 64.7%, respectively. No significant sex differences were observed. Seventy‐five patients (78.9%) underwent wide local excision. Mucosal involvement and lymphadenopathy were identified as the significant prognostic factors of disease‐specific survival in multivariate analysis. The RR was 14.7% in patients who underwent wide local excision: seven local, two regional, and two distant metastases, with a mean recurrence‐free interval of 42.3 months. Conclusion: Based on the survival and RRs obtained, surgical treatment of EMPD with wide local excision provides fair curative resection. Practitioner points: Wide local excision can be a feasible treatment option for extramammary Paget's disease. [ABSTRACT FROM AUTHOR]

Invasive species and climate change are primary factors influencing biodiversity, and examining the behavior of invasive species is essential for effective conservation management. Here, we report the global distribution of the sika deer (Cervus nippon) based on locations reported in published literature (Google Scholar), the Global Biodiversity Information Facility (GBIF) database, and the International Union for Conservation of Nature report. We used the maximum entropy (Maxent) model to examine the impact of climate change on sika deer habitats in South Korea based on GBIF occurrence data and WorldClim bioclimatic variables. Habitat suitability analysis was performed using the Maxent model under Representative Concentration Pathways (RCPs) 4.5 and 8.5 (for predicted climatic conditions in both 2050 and 2070) to project the effects of different climate change scenarios on South Korean sika deer habitats. We identified that the sika deer is distributed in 39 countries worldwide. Due to climate change effects, South Korean sika deer habitats will decline by approximately 24.98% and 20.63% (under RCP 4.5) and by 50.51% and 57.35% (under RCP 8.5) by 2050 and 2070, respectively. Our findings shed light on sika deer ecology and provide reference data for future conservation management strategies and policy design. [ABSTRACT FROM AUTHOR]

Background: The tumor, nodes and metastasis (TNM) classification and stage grouping have been updated in the 8th edition of the American Joint Committee on Cancer (AJCC) melanoma staging manual. However, restaging all the previous cases are not recommended.Aims: The aims of the study were to investigate the necessity of restaging Korean melanoma patients staged by the previous edition of the AJCC manual.Methods: Differences in the staging criteria of the 7th and 8th editions of the AJCC manual were identified. The staging of 276 primary melanomas from January 2011 to December 2018 was classified by both 7th and 8th editions of the manual and their differences were compared.Results: Staging by 7th and 8th edition of the AJCC manual differed in 64 cases (23.2%). The pathological prognostic staging changed in 35 (12.7%), and 29 (10.5%) had changes in only TNM classification but not the pathological staging. None of the patients needed additional sentinel lymph node biopsy or systemic treatment as a result of restaging. Additional counseling was needed for the patients, because melanoma-specific survival was increased in the 8th edition.Limitations: This is a retrospective study with relatively small number of patients at a single tertiary center in Korea.Conclusion: Assessment of the need for additional sentinel lymph node biopsy or systemic treatment is recommended because of the latest changes in the AJCC melanoma staging manual. Although the restaging of previously staged melanomas is not significantly needed in our patients, still the differences in TNM classification and/or pathological prognostic staging suggest the need to separately recognize the patients previously staged by 7th edition and recently staged by 8th edition. Careful counseling about melanoma-specific survival is needed for Asian patients. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy and safety of Banha-sasim-tang (BST) in patients with functional dyspepsia (FD). BST (Banxia-xiexin-tang in traditional Chinese medicine and Hange-shashin-to in Kampo medicine) is traditionally prescribed for the treatment of dyspepsia with epigastric stiffness and gastric fullness in China, Japan, and Korea. Patients with FD were randomly administered an oral dose (10 g) of BST syrup or placebo, twice a day for 4 weeks. The primary outcome was the symptom checklist part of the Nepean dyspepsia index (NDI). The secondary outcomes were the quality of life (QoL) part of the NDI, functional dyspepsia-related QoL (FD-QoL), and visual analog scale (VAS). A total of 60 patients with FD were screened, and 50 were randomized into BST group (n = 25) and placebo group (n = 25). Two patients in the placebo group withdrew before the start of the treatment. Administration of BST syrup resulted in improvement in the symptom-related NDI score in the BST group compared with that in the control group; however, the difference was not significant. BST syrup significantly improved "fullness after eating" index of NDI at follow-up time point (2.88 ± 2.65 vs 4.78 ± 2.69, p = 0.0081). In the total score of the QoL section of the NDI and FD-QoL scales, there was no significant improvement in the BST group compared to that in the placebo group. With regard to improvement in overall FD symptoms, the VAS scale showed improvement in both groups, but the difference was not significant. Interestingly, follow-up investigation showed a significantly beneficial effect of BST on FD symptoms, when compared to placebo. Significant improvement observed in VAS score (39.60 ± 22.29 vs 52.17 ± 20.55, p = 0.048). This indicated that the effect of BST lasted even after the completion of the medication regimen. Overall, our data suggest that while BST showed no significant improvement in the symptom-related NDI score and the QoL related scores in NDI and FD-QoL after 4 weeks of treatment, it effectively improved the VAS score and fullness after eating-related symptoms in the follow-up visit. Clinical Trial Registration: https://cris.nih.go.kr; Identifier KCT 0002013 [ABSTRACT FROM AUTHOR]

Background: Sentinel lymph node biopsy (SLNB) of primary cutaneous melanoma as an important staging method has not been popularly undertaken in Korea and only a few studies with small patient numbers have been published. Aim: We examined the clinical feasibility and overall outcomes of SLNB in acral melanoma (AM) of Korean in Kyungpook National University Hospital (KNUH) over the past 13 years. Methods: SLNB in AM patients during 2006–2018 were analyzed retrospectively for sentinel lymph node (SLN) harvesting rate, positivity rate, positivity‐relevant overall survival (OS) and disease‐free survival (DFS), and its side effects. Results: A total of 109 AM patients who underwent SLNB were enrolled. Harvested nodes were identified from 107 patients and SLN harvesting rate was 98.2%. The mean Breslow thickness (±standard deviation) was 3.38 ± 3.03 mm, and the proportion of ulcerated melanomas was 64%. Twenty‐two (20.6%) had a tumor‐positive SLN and, among them, 82% (18/22) underwent immediate complete lymph node dissection (CLND). The metastasis‐positive nodal basin after CLND was detected in 16.7% of cases (3/18). Tumor‐negative SLN cohorts showed significantly better OS and DFS than tumor‐positive ones (P = 0.006 and P < 0.001 for each). Two side effects, one seroma and one lymphocele, were observed without major sequelae. Conclusion: SLNB, crucial management of melanoma, proved its efficacy to predict patients' prognosis and could be performed successfully and safely in Korean AM patients by interdisciplinary cooperation between dermatology and other surgical departments. SLN(−) showed significantly better OS and DFS than SLN(+). Significant risk factors for DFS were Breslow thickness, the presence of ulceration and the presence of SLN metastasis. SLNB should be encouraged in order to stage melanoma accurately and direct the proper management in Korean AM. [ABSTRACT FROM AUTHOR]

Discrepant incidence has been reported regarding the incidence of herb-induced liver injury (HILI). To address the growing worldwide concern of HILI, we evaluated the risk of HILI in a nationwide prospective study. Between April 2013 and January 2016, 1001 inpatients (360 males and 641 females) from 10 tertiary hospitals throughout South Korea were treated with herbal drugs and had their liver enzymes periodically measured. A total of six patients met the criteria for HILI with RUCAM scores ranging from 4 to 7. All these participants were women and developed the hepatocellular type of HILI. One HILI participant met the criteria for Hy's law; however, none of six cases presented clinical symptoms related to liver injury. This is the first nationwide prospective study that estimated the extent of the incidence of HILI [total: 0.60%, 95% confidence interval (CI) 0.12-1.08; women: 0.95%, 95% CI 0.19-1.68] and described its features in hospitalized participants. [ABSTRACT FROM AUTHOR]

Background: Hair dye is one of the most common causes of allergic contact dermatitis. The main allergen has been identified as para-phenylenediamine. To prevent the recurrence of contact dermatitis to para-phenylenediamine, patients should discontinue the use of para-phenylenediamine-containing hair dye products. However, many patients are unable to discontinue their use for cosmetic or social reasons. Sometimes, they continue to have symptoms even after switching to so-called "less allergenic" hair dyes.Objectives: To evaluate the safety of 15 commercially available hair dye products in patients with allergic contact dermatitis due to para-phenylenediamine.Methods: We performed patch tests using 15 hair dyes that were advertised as "hypoallergenic," "no para-phenylenediamine" and "non-allergenic" products in the market.Results: Twenty three patients completed the study and 20 (87.0%) patients had a positive patch test reaction to at least one product. While four (26.7%) hair dye products contained para-phenylenediamine, 10 (66.7%) out of 15 contained m- aminophenol and 7 (46.7%) contained toluene-2,5-diamine sulfate. Only one product did not elicit a positive reaction in any patient.Limitations: Small sample size and possibility of false-positive reactions.Conclusions: Dermatologists should educate patients with allergic contact dermatitis to para-phenylenediamine about the importance of performing sensitivity testing prior to the actual use of any hair dye product, irrespective of how it is advertised or labelled. [ABSTRACT FROM AUTHOR]

Pesticides which are diluted and sprayed according to the pre-harvest interval (PHI) are generally decomposed and lost through various factors and pathways, and the leftover pesticides are known as residual pesticides. This study aims to determine the dissipation of residual amounts of dinotefuran, fluazinam, indoxacarb, and thiacloprid in persimmon and the changes in the concentration of various processing products. Pesticide spraying is performed in accordance with the GAP (good agricultue practice) of Korea, and the processed products are manufactured using a conventional method after removing the skin of persimmons. The modified QuEchERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) method and an optimized method using LC-MS/MS (liquid chromatography mass spectrometry) is implemented to analyze the residual pesticides. The linearity, recovery, and LOQ (limit of quantitation) are presented to verify the analysis method. The amount of residual pesticides tested decreases significantly in a time-dependent manner, regardless of the minimal dilution effect present due to growth. The residual concentration does not vary significantly during the processing stage despite the removal of the systemic pesticides, dinotefuran and thiacloprid. The residues of non-systemic pesticides, fluazinam and indoxacarb, are typically removed by the peeling removal and processing methods. The reduction factor of dinotefuran, whose residual concentration is increased, is less than 1, and the absolute amount of pesticides is decreased through processing. The results of this study can be used as the scientific basis data to ensure the safety of residual pesticides in processed products in the future. [ABSTRACT FROM AUTHOR]

Infectious bronchitis virus (IBV) was first identified in the 1930s and it imposes a major economic burden on the poultry industry. In particular, GI-19 lineage has spread globally and has evolved constantly since it was first detected in China. In this study, we analyzed S1 gene sequences from 60 IBVs isolated in South Korea. Two IBV lineages, GI-15 and GI-19, were identified in South Korea. Phylogenetic analysis suggested that there were six distinct subgroups (KM91-like, K40/09-like, and QX-like I to IV) of the South Korean GI-19 IBVs. Among them, QX-type III and IV subgroups, which are phylogenetically different from those reported in South Korea in the past, accounted for more than half of the total. Moreover, the phylogeographic analysis of the QX-like subgroups indicated at least four distinct introductions of GI-19 IBVs into South Korea during 2001–2020. The efficacy of commercialized vaccines against the recently introduced QX-like subgroups should be verified, and continuous international surveillance efforts and quarantine procedures should be enhanced to prevent the incursion of viruses. [ABSTRACT FROM AUTHOR]