Purpose: Drainage fluid may serve as a biologically informative indicator of immune and infectious status during postsurgical recovery after trauma. However, microbiome shifts in drainage fluid associated with clinical resilience have not yet been characterized. This study aimed to investigate microbial dynamics in drainage fluid across the intensive care unit (ICU) and ward recovery phases in Korean trauma patients. Methods: A total of 25 drainage and 10 stool samples were collected from 10 trauma patients who underwent abdominal surgery at a regional trauma center. Microbial composition was analyzed using 16S ribosomal RNA amplicon sequencing.Alpha and beta diversity were compared between sample types and recovery stages. Linear mixed-effects models were used to identify recovery-associated taxa while adjusting for clinical variables, and predicted metabolic pathways were assessed using PICRUSt2. Results: Drainage fluid harbored distinct microbial communities independent of the intestinal microbiota. Shared taxa between drainage and stool increased significantly in patients with bowel injury, suggesting microbial translocation.Seven genera and 5 species showed significantly decreased abundance during the ward stage, with Modestobacter and Blastococcus tunisiensis demonstrating the highest discriminative ability between recovery stages (area under the curve = 0.721). Predicted metabolic pathways related to fatty acid degradation, amino acid degradation, and pro-inflammatory processes were more active during the ICU stage. Conclusion These findings provide preliminary evidence that drainage fluid microbiome profiles may reflect recovery dynamics following trauma, supporting its potential utility for microbiome-based monitoring and biomarker discovery in trauma surgery.

Objectives: . This study aimed to evaluate the therapeutic efficacy of intranasal insulin in treating persistent and refractory olfactory dysfunction following viral infections. Methods: . A comprehensive literature search was performed across PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, covering all articles indexed up to July 2025. Studies were included if they evaluated changes in olfactory scores in patients receiving intranasal insulin, either compared with a control group (placebo or no treatment) or between pre- and post-treatment measurements. Secondary outcomes included serum glucose and insulin levels and the proportion of patients achieving significant olfactory recovery. Results: . Eight studies including 457 participants were reviewed. Intranasal insulin was generally associated with improvement in olfactory scores. Delivery via absorbable materials may enhance both threshold and discrimination outcomes, whereas self-administration demonstrated minimal benefit. Several studies also reported higher rates of substantial olfactory recovery with absorbable material-based delivery. Combination therapy with intranasal insulin and budesonide was suggested to further improve threshold scores. Overall, treatment was well tolerated, with no major changes in serum glucose levels, although one study documented a mild hypoglycemic event. Conclusion . Current evidence suggests that intranasal insulin, particularly when delivered using absorbable materials, may offer therapeutic benefit for persistent post-viral olfactory dysfunction. Corticosteroid coadministration may also provide additional improvements. These findings remain preliminary and require confirmation in larger, well-controlled studies.

Background and Objectives: A substantial proportion of patients presenting with sinus headaches are ultimately diagnosed with migraines. The ID-Migraine tool has been developed to aid in identifying migraine patients in primary care settings. Therefore, we conducted a meta-analysis of validation studies evaluating the diagnostic accuracy of the ID-Migraine tool. Methods: Data were extracted regarding true positives, false positives, true negatives, and false negatives, along with study characteristics. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results: In total, 30 studies involving 9,942 participants were included in the final analysis. The pooled diagnostic odds ratio for the ID-Migraine tool was 13.84. The area under the summary receiver operating characteristic curve was 0.846. The pooled sensitivity and specificity were 0.865 and 0.702, respectively, while the negative predictive value was 0.791 and the positive predictive value was 0.799. Conclusion The ID-Migraine screening tool is highly accurate and user-friendly for identifying migraines among patients presenting with sinus headaches. By employing this tool, unnecessary diagnostic tests or treatments can be minimized, and patients can be promptly referred to appropriate specialists.

Objectives: This study examined factors associated with health-related quality of life (HRQoL) in Korean adults. Methods: Using data from 5,620 participants in the 9th Korea National Health and Nutrition Examination Survey, obesity was defined as body mass index ≥25 kg/m2 and HRQoL assessed by the health-related quality of life instrument with 8 items (HINT-8). Complex survey weights were applied. Results: General linear and multiple regression analyses showed that among women, obesity was significantly associated with lower HINT-8 scores (B=-0.008, p=0.032), while no association was found in men. Age, household income, education, perceived stress, and smoking were also significantly related to HRQoL in both sexes. Conclusions HRQoL in Korean adults is influenced by obesity, socioeconomic status, and mental health indicators. The adverse effect of obesity observed only in women highlights the need for sex-specific public health strategies and the relevance of culturally adapted tools such as the HINT-8.

Objective: To characterize age-related motor, olfactory, and auditory changes in 5×FAD mice and assess associated AD pathologies and neuroinflammation in relevant brain regions. Methods: 5×FAD and control mice were tested at 3, 6, and 12 months. Locomotor activity and motor coordination were assessed using the open field and rotarod tests, respectively. Olfactory and auditory performance were evaluated using the buried food test and the acoustic startle response test, respectively. Amyloid-β pathology and glial activation were examined in relevant nervous system components using western blot and immunohistochemistry analyses. Results: 5×FAD mice showed no differences in open-field locomotion at any age, but exhibited a significantly greater passive clinging duration at 12 months compared to wild-type controls (p < 0.001). In the buried food test, olfactory latency was significantly prolonged in 5×FAD mice at 6 months (p = 0.035) and 12 months (p < 0.001). Acoustic startle amplitude was significantly reduced at 6 months (p = 0.030) and 12 months (p = 0.007). Amyloid-β and p-Tau accumulation and glial activation were elevated in the olfactory bulb and auditory cortex in an age-dependent manner. Conclusions and Relevance: This study provides an age-related behavioral and pathological characterization of olfactory and auditory impairments in the 5×FAD mouse model, with motor measures included as complementary assessments. Our findings broaden the spectrum of functional deficits associated with the AD pathology in this model.

Background: One-lung ventilation (OLV) during thoracic surgery frequently requires approximately 100% oxygen, imposing the risk of hyperoxemia. This study aimed to assess whether oxygen reserve index (ORI)-guided fraction of inspired oxygen (FiO2) adjustment can reduce the incidence of hyperoxemia in children undergoing lung resection. Methods: This prospective, randomized controlled trial enrolled children aged < 7 years scheduled for thoracoscopic lung resection. The participants were randomly assigned to either a conventional group (FiO2 adjusted based on arterial blood gas analysis [ABGA]) or an ORI group (FiO2 titrated to maintain an ORI target of 0.15). ABGA was performed 10 and 30 min after the start of OLV (T1 and T2). The primary outcome was the incidence of hyperoxemia 30 min after OLV (T2). Results: Data from 64 children (31 conventional, 33 ORI groups) were analyzed. The incidence rate of hyperoxemia at T2 was similar between the conventional and ORI groups (54.8% vs. 60.6%, P = 0.801). However, partial pressure of arterial oxygen at T1 was significantly lower in the ORI group than in the conventional group (214.6 ± 65.5 mmHg vs. 268.8 ± 92.7 mmHg, P = 0.014). The ORI group demonstrated a lower time-weighted average FiO2 during OLV (0.79 ± 0.12 vs. 0.87 ± 0.09, P = 0.004). The ORI group required more rescue interventions than the conventional group and experienced fewer episodes of hypoxia. Conclusions ORI-guided FiO2 adjustment does not significantly reduce the incidence of hyperoxemia in children undergoing OLV but reduces time-weighted FiO2 and hypoxic events.

Intradiscal electrothermal therapy (IDET) is a minimally invasive procedure used to treat discogenic back pain and offers an alternative to surgical intervention in selected patients. Although it is generally considered safe, rare but significant complications can occur and may be difficult to diagnose because their symptoms overlap with those of other spinal conditions. We describe the case of a 69-year-old woman who presented with severe lower back and left buttock pain that was unresponsive to conservative treatment. Magnetic resonance imaging revealed disc bulging with a high-intensity zone at the L4–5 and L5–S1 levels. IDET was performed at the L4–5 level, resulting in initial pain relief. However, the patient returned 7 days later with recurrent pain. Despite undergoing percutaneous epidural neuroplasty at the left L5–S1 level, a medial branch block, and a piriformis muscle block, her symptoms persisted. Further evaluation with spinal computed tomography revealed a retroperitoneal hematoma near the left psoas muscle. Referred pain from the hematoma mimicked discogenic pain, resulting in delayed diagnosis and unnecessary interventions. The patient remained hemodynamically stable and gradually improved with conservative management alone. This case highlights retroperitoneal hematoma as a rare complication of IDET and emphasizes the importance of accurate and timely diagnosis in patients with persistent or worsening symptoms after spinal procedures. Clinicians should consider non-discogenic sources of pain when treatment outcomes deviate from expected patterns.

Background: Left bundle branch block (LBBB) significantly increases the risk of left ventricular systolic dysfunction (LVSD) due to cardiac dyssynchrony. Although artificial intelligence–enabled electrocardiography (AI-ECG) mod‑ els show promise in detecting LVSD, their performance in LBBB patients remains underexplored. We hypothesized that an AI-ECG model clinically validated for detecting LVSD would accurately detect LVSD and predict future clinical outcomes in LBBB patients. Methods: In this retrospective multicenter study, 5,689 expert-validated LBBB ECGs collected from 2,813 patients between 2016 and 2024 were analyzed using a previously developed and validated AI-ECG model. LVSD was defined as an ejection fraction of ≤ 40%. Model performance was assessed using the area under the receiver operating char‑ acteristic curve (AUROC), the area under the precision-recall curve (AUPRC), sensitivity, and specificity. Patients were stratified into high- and low-risk groups based on a threshold that achieved 90% sensitivity. A Kaplan–Meier analysis was used to compare clinical outcomes. Results: Among the 2,813 LBBB patients (mean age, 70.7 years; male sex, 43.7%), hypertension and a history of heart failure were common. The AiTiALVSD model showed strong diagnostic performance for LVSD (AUROC, 0.930 [95% CI, 0.924–0.937]; AUPRC, 0.913 [95% CI, 0.902–0.923]; sensitivity, 0.979; specificity, 0.473). During the mean follow-up of 4.1 years, high-risk patients had significantly higher hazards than low-risk patients for all-cause mortality (adjusted hazard ratio [HR], 1.87; 95% CI, 1.53–2.28), implantable cardioverter defibrillator/cardiac resynchronization therapy implantation (adjusted HR, 15.2; 95% CI, 7.51–30.77), and cardiovascular hospitalization (adjusted HR, 1.11; 95% CI, 0.96–1.28). Conclusions AiTiALVSD effectively detects LVSD and stratifies long-term cardiovascular risk in LBBB patients, support‑ ing its clinical utility for early detection and patient management.

Background/Aims: We previously reported that patients with moderate-to-severe ulcerative colitis (UC) often experience common mental disorders (CMDs) such as anxiety and depression, necessitating immediate psychological interventions within the first 4 weeks of diagnosis. In this 3-year follow-up study of the MOSAIK cohort in Korea, we examined the effects of CMDs at initial diagnosis on clinical outcomes and health-related quality of life (HRQoL). Methods: We examined differences in clinical outcomes (evaluated based on clinical response, relapse, hospitalization, and medication use) and HRQoL (assessed using the Inflammatory Bowel Disease Questionnaire [IBDQ] and Short Form 12 [SF-12]) according to Hospital Anxiety and Depression Scale (HADS) scores at diagnosis. Results: In a study involving 199 UC patients, 47.7% exhibited significant psychological distress (anxiety and/or depression) at diagnosis. Clinical follow-up showed no major differences in outcomes, including remission rates, response rates, or hospitalization rates, between patients with anxiety or depression at diagnosis and patients without anxiety or depression at diagnosis. The HRQoL at the end of follow-up was notably lower in those with baseline CMDs, particularly anxiety, across all domains of the IBDQ and SF-12. Linear mixed-effect models revealed that higher HADS scores, as well as higher Mayo scores, were independently associated with lower IBDQ scores and both summary domains of the SF-12. Additionally, regular attendance at follow-up visits during the study period was also related to improvements in HRQoL (all p<0.05). Conclusions While CMDs present at the time of UC diagnosis did not influence long-term clinical outcomes, they persistently impaired HRQoL. Our findings support the routine incorporation of psychological interventions into the long-term management of moderate-to-severe UC.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.