Purpose: To propose improvements for promoting eyeball donation and managing donated corneas, this study analyzed the current system in Korea and reviewed relevant Korean laws, international standards, and foreign practices. Methods: To understand the current situation in Korea, annual reports published by the Korean Network for Organ Sharing and existing Korean laws were examined. For the international context, references were made to the National Organ Transplant Act, 21 CFR Part 1271 (Code of Federal Regulations Title 21 Part 1271), Current Good Tissue Practice guidelines of the Food and Drug Administration, and the Medical Standards of the Eye Bank Association of America in the United States. Opinions on promoting eyeball donation, improving the monitoring system for donated corneas and revising laws related to cornea management were gathered. The perspectives of 31 experts affiliated with the Korea Cornea Society were collected through a survey. Results: Currently, there are no laws or regulations that can be appropriately applied to the cornea which has properties of both organs and tissue. Additionally, there is no law regulating imported corneas. Therefore, there is a need to legislate or revise the current law; all experts who conducted the survey agreed on this. Furthermore, the current system faces limitations in the efficient procurement, stable supply, and management of donor corneas, as well as in donation promotion. To address these issues, the establishment of independent legislation for managing donated corneas and a National Central Eye Bank was proposed. This central body would oversee continuous personnel training, education, and monitoring, along with ensuring stable procurement, processing, and supply of corneas within a structured management system. Sixty-eight percent of the surveyed experts agreed with this proposal. Conclusions To establish a safe and efficient Korean corneal supply and demand system, it is imperative to enact cornea-specific laws, including the establishment of a National Central Eye Bank.

Purpose: Radical cystectomy (RC), which is the standard of care for muscle-invasive and high-grade noninvasive bladder cancer, is accompanied by postoperative renal function deterioration. We aimed to evaluate the effect of serum albumin level on postoperative renal function decline after RC. Materials and Methods: A total of 272 patients with estimated glomerular filtration rate (eGFR) ≥60 mL/minute/1.73 m 2 who underwent RC between October 2003 and December 2020 were included. Acute kidney injury (AKI) was defined according to the KDIGO (Kidney Disease Improving Global Outcomes) criteria, while postoperative chronic kidney disease (CKD) progression was defined as an eGFR <60 mL/minute/1.73 m 2 at ≥3 months after RC. Results: In our cohort, 20 (7.4%) and 99 (36.4%) patients experienced postoperative AKI and CKD progression, respectively, with a median follow-up period of 51.5 months. The median preoperative serum albumin level and eGFR were 4.1 g/dL and 82.0 mL/minute/1.73 m 2 , respectively. Preoperative serum albumin less than the median (4.1 g/dL) was associated with postoperative AKI (odds ratio [OR] 3.76, p=0.027) and CKD progression (OR 2.87, p<0.001) after adjusting for other factors. Conclusions Serum albumin level <4.1 g/dL was associated with short- and long-term renal function decline after RC, suggesting that close monitoring of renal function after RC might be considered in these patients.

Enterococcus faecium, particularly in its multidrug-resistant forms, causes invasive nosocomial infections. Given the limited data comparing the effectiveness of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the CLSI clinical breakpoints (CBPs) for quinupristin–dalfopristin (QD) resistance and the need to evaluate their practical application, we retrospectively investigated the susceptibility patterns of 287 E.faecium bloodstream isolates from Korean hospitals to QD using the updated EUCAST and CLSI CBPs and two antimicrobial susceptibility testing methods: disk diffusion (DD) and Sensititre broth microdilution (Sensititre). QD resistance rates were 5.9% (CLSI) and 18.8% (EUCAST) for DD and 22.6% (CLSI) and 28.2% (EUCAST) for Sensititre. The most prevalent QD resistance gene types among QD-resistant isolates were ermB+msrC+ or ermB– msrC+. Categorical agreement between DD and Sensititre ranged from 77.7% to 90.7%, depending on the testing method and CBPs applied. The EUCAST zone diameter CBPs more effectively help identify QD-resistant E. faecium isolates using the DD method than the CLSI zone diameter CBPs. In comparison, the CLSI minimum inhibitory concentration (MIC) CBPs provide more reliable results for resistance classification in the Sensititre method than EUCAST MIC CBPs. These findings would help improve clinical decision-making for treating multidrug-resistant E. faecium infections.

Purpose: This study aimed to evaluate the predictive value of apparent diffusion coefficient (ADC) values from magnetic resonance imaging (MRI) in assessing pathologic response to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC) and the optimal cutoff value of ADC for predicting NAC response. Materials and Methods: Among 582 patients who underwent radical cystectomy between December 2011 and December 2024, we included 146 patients who received preoperative NAC and pretreatment MRI. Pathologic response was determined based on the surgical pathology results: patients with pathologic stage >pT2 and/or presence of nodal involvement (N+) were classified as nonresponders, while those with ≤pT2 and no nodal involvement (N0) were classified as responders. MRI-derived ADC values were compared between the 2 groups. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value for predicting NAC response. Multivariate logistic regression analysis using preoperative parameter was performed and Kaplan-Meier survival analysis were utilized to assess overall survival (OS) and cancer-specific survival (CSS) according to NAC response. Results: Among the 146 patients, 90 (61.6%) were classified as responders, 56 (38.4%) were nonresponders. The mean ADC value was significantly higher in responders (1,100.35±249.12 mm2/sec) than in nonresponders (763.95±118.97 mm2/sec, p<0.001). ROC analysis demonstrated an area under the curve of 0.69, with an optimal cutoff value of 845.0 mm2/sec. Multivariate logistic regression identified ADC value as an independent predictor of NAC response (odds ratio, 1.025; 95% confidence interval, 1.006–1.043; p=0.008). During median follow-up 30.3 months, Kaplan-Meier analysis revealed that responders had significantly better 5-year OS (80.8% vs. 45.9%) and 5-year CSS (92.6% vs. 54.5%), with log-rank test p<0.001. Conclusion MRI-derived ADC values are a reliable imaging biomarker for predicting pathologic response to NAC in MIBC. Further validation in large-scale prospective studies is required to confirm these findings.

Purpose: This study aimed to assess the rate of germline variant detection following targeted cascade genetic testing among family members of prostate cancer (PCa) probands. Materials and Methods: Records of PCa patients with confirmed germline mutations and their family members recommended for cascade testing were retrospectively reviewed. Cascade testing for germline mutations identified in PCa probands was conducted among first-degree relatives (FDRs) and second-degree relatives. The rate of counseled family members who proceeded to actual testing, the proportion of mutation carriers detected, and the reasons for test refusal were analyzed. Clinical variables, including family history of malignancy and variant type, were also collected. Results: A total of 15 PCa patients and 44 eligible relatives were included in the final analysis. Eleven probands (73.3%) had a positive family history of cancer across 22 family members (18 FDRs). Among FDRs, breast/ovarian cancer (27.8%) and gastric cancer (22.2%) were the most common, followed by lymphoma, prostate, esophageal, and lung cancer (each 11.1%). Among probands, BRCA2 variants were predominant (80%, 12 of 15), followed by BRCA1 (n=2) and MLH1 (n=1) mutations. Of 41 eligible FDRs, 21 (51.2%) underwent genetic testing, and 61.9% (13 of 21) were found to carry identical germline mutations. Approximately half of the counseled family members declined testing due to concerns regarding privacy and disclosure, travel distance to the clinic, or loss to follow-up. Conclusion Over half of the FDRs who underwent cascade testing were confirmed to carry pathogenic germline variants. As the first study to evaluate cascade testing in family members of PCa probands in Korea, these findings underscore the strong heritable component of PCa and highlight the need to enhance participation in familial genetic screening.

Purpose: This study evaluated the nutrition and food intake status among adults in Jeju, Republic of Korea, based on their sociodemographic characteristics and obesity. Methods: Nine hundred and forty-nine adults aged 19 years or older were included based on the 2022 Jeju Nutrition and Physical Activity Survey data. A dietary assessment was conducted using a one-day, 24-hour recall method, and the nutrition status was evaluated using the 2020 Dietary Reference Intakes for Koreans. The sociodemographic status included sex, age, education, and household income, and obesity was defined as a body mass index (BMI) of ≥ 25 kg/m 2 . Results: The mean age of the subjects was 49.8 years, and the overall prevalence of obesity was 48.4% (59.5% for males and 37.2% for females). The top three insufficient nutrients consumed at less than the estimated average requirement were calcium (77.7%), vitamin A (77.3%), and vitamin C (61.3%), while 40.9% of the subjects consumed fat as more than 30% of their total energy intake. The sodium intake was approximately 1.5 times higher than the chronic disease risk reduction intake level. In terms of food groups, the participants consumed more meat (148.2 g/day), seafood (69.0 g/day), potatoes, and starches (41.6 g/day) but consumed fewer vegetables (214.3 g/day) and less dairy (62.0 g/day) than Korean adults. The nutritional status and food intake patterns differed by the sociodemographic status. In addition, the obese group consumed more poultry and beverages than the non-obese group (p < 0.05 for all). Conclusion Adults in Jeju under-consume essential nutrients while over-consuming certain nutrients, such as fat and sodium. The nutritional status also varied according to the sociodemographic characteristics. These findings suggest that sociodemographic factors should be considered carefully when developing nutritional policies and programs to improve the nutritional status and address obesity among adults in Jeju.

Purpose: This study evaluated the nutrition and food intake status among adults in Jeju, Republic of Korea, based on their sociodemographic characteristics and obesity. Methods: Nine hundred and forty-nine adults aged 19 years or older were included based on the 2022 Jeju Nutrition and Physical Activity Survey data. A dietary assessment was conducted using a one-day, 24-hour recall method, and the nutrition status was evaluated using the 2020 Dietary Reference Intakes for Koreans. The sociodemographic status included sex, age, education, and household income, and obesity was defined as a body mass index (BMI) of ≥ 25 kg/m 2 . Results: The mean age of the subjects was 49.8 years, and the overall prevalence of obesity was 48.4% (59.5% for males and 37.2% for females). The top three insufficient nutrients consumed at less than the estimated average requirement were calcium (77.7%), vitamin A (77.3%), and vitamin C (61.3%), while 40.9% of the subjects consumed fat as more than 30% of their total energy intake. The sodium intake was approximately 1.5 times higher than the chronic disease risk reduction intake level. In terms of food groups, the participants consumed more meat (148.2 g/day), seafood (69.0 g/day), potatoes, and starches (41.6 g/day) but consumed fewer vegetables (214.3 g/day) and less dairy (62.0 g/day) than Korean adults. The nutritional status and food intake patterns differed by the sociodemographic status. In addition, the obese group consumed more poultry and beverages than the non-obese group (p < 0.05 for all). Conclusion Adults in Jeju under-consume essential nutrients while over-consuming certain nutrients, such as fat and sodium. The nutritional status also varied according to the sociodemographic characteristics. These findings suggest that sociodemographic factors should be considered carefully when developing nutritional policies and programs to improve the nutritional status and address obesity among adults in Jeju.

Purpose: This study evaluated the nutrition and food intake status among adults in Jeju, Republic of Korea, based on their sociodemographic characteristics and obesity. Methods: Nine hundred and forty-nine adults aged 19 years or older were included based on the 2022 Jeju Nutrition and Physical Activity Survey data. A dietary assessment was conducted using a one-day, 24-hour recall method, and the nutrition status was evaluated using the 2020 Dietary Reference Intakes for Koreans. The sociodemographic status included sex, age, education, and household income, and obesity was defined as a body mass index (BMI) of ≥ 25 kg/m 2 . Results: The mean age of the subjects was 49.8 years, and the overall prevalence of obesity was 48.4% (59.5% for males and 37.2% for females). The top three insufficient nutrients consumed at less than the estimated average requirement were calcium (77.7%), vitamin A (77.3%), and vitamin C (61.3%), while 40.9% of the subjects consumed fat as more than 30% of their total energy intake. The sodium intake was approximately 1.5 times higher than the chronic disease risk reduction intake level. In terms of food groups, the participants consumed more meat (148.2 g/day), seafood (69.0 g/day), potatoes, and starches (41.6 g/day) but consumed fewer vegetables (214.3 g/day) and less dairy (62.0 g/day) than Korean adults. The nutritional status and food intake patterns differed by the sociodemographic status. In addition, the obese group consumed more poultry and beverages than the non-obese group (p < 0.05 for all). Conclusion Adults in Jeju under-consume essential nutrients while over-consuming certain nutrients, such as fat and sodium. The nutritional status also varied according to the sociodemographic characteristics. These findings suggest that sociodemographic factors should be considered carefully when developing nutritional policies and programs to improve the nutritional status and address obesity among adults in Jeju.

Vestibular schwannoma is a benign tumor that arises from the eighth cranial nerve and is the most common neoplasm in the internal auditory canal (IAC). It typically arises in the cerebellopontine angle or in IAC; however, in rare cases, they can arise within the labyrinth. These tumors arising in the labyrinth have been termed intra-labyrinthine schwannomas (ILS) and have different clinical features than the typical vestibular schwannomas. Clinical manifestations of an ILS typically include hearing loss, tinnitus, and vertigo, with unusual symptoms including a sense of fullness or imbalance. Temporal bone MRI is considered the most important test for diagnosing ILS. Tumors show nodular enhancement on T1-weighted images and filling defects on T2-weighted images. Treatment of ILS may include observation, microsurgical resection, and stereotactic radiosurgery depending on the location, size, and clinical presentation. In this paper, we present two cases diagnosed as ILS with different treatment options and provide a literature review for each case.

Background/Aims: Besifovir dipivoxil maleate (BSV) and tenofovir alafenamide fumarate (TAF) have been recently approved in Korea as the initial antiviral agents for chronic hepatitis B (CHB).However, the real-world outcome data for these drugs remain limited. Therefore, we conducted a noninferiority analysis using real-world data to compare the clinical outcomes of the two nucleotide analogs in treatment-naïve patients with CHB. Methods: We retrospectively investigated a cohort of patients with CHB who received BSV or TAF as first-line antiviral agents. The endpoints were virological response (VR) and liver-related clinical outcomes. Results: A total of 537 patients, consisting of 202 and 335 patients administered BSV and TAF, respectively, were followed up for 42 months. No significant difference was observed between the VRs of the patients from the two groups. The rates of biochemical response, virologic breakthrough, and incidence rates of hepatocellular carcinoma did not differ between the groups. However, the hepatitis B e antigen seroclearance rate was higher and the renal function declined less in the BSV group. Multivariable analysis indicated older age, alcohol abuse, cirrhosis and ascites, and lower serum HBV DNA level to be independently associated with increased hepatocellular carcinoma risk. The 1:1 propensity score-matched analysis with 400 patients showed VR rates of 85.0% and 88.7% in the BSV and TAF group patients, respectively, at 2 years. The absolute value of the 95% confidence interval for the difference (–0.04 to 0.12) satisfied the a priori limit of a noninferiority of 0.15. Conclusions BSV is noninferior to TAF in terms of VR, and their clinical outcomes are comparable to CHB.