Background: The prognosis of end-of-life patients is challenging, and clinicians have attempted to predict survival more accurately. High serum creatinine (sCr) levels are associated with lower survival rates in patients with various cancers; however, low sCr levels are commonly expected in patients with terminal cancer because of muscle wasting and malnutrition. Therefore, we investigated the prevalence of low and high sCr levels and their association with survival duration in patients with terminal cancer in a palliative care unit. Methods: We analyzed the medical records of 280 patients admitted to a palliative care unit. Patients were divided into low (<0.5 mg/dL), normal (0.5–1.2 mg/dL), and high (>1.2 mg/dL) sCr groups. Kaplan-Meier survival curves using sCr levels were plotted and compared using the log-rank test. Using stepwise selection, a multivariable Cox proportional hazards model was used to identify the significant prognostic factors. Results: The median survival durations in the high-, low-, and normal-sCr groups were 9.57 days, 22.26 days, and 27.51 days, respectively. Multivariable Cox proportional hazard model identified that males (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.16–2.85), poor performance status (HR, 3.43; 95% CI, 1.12–10.54), total parenteral nutrition use (HR, 1.84; 95% CI, 1.09–3.1), high sCr (HR, 2.74; 95% CI, 1.52–4.94), and low sCr (HR, 1.22; 95% CI, 1.07–1.43) were significantly associated with a shorter survival time. Conclusion Low and high serum creatinine levels were significantly associated with poor survival in patients with cancer at the end-of-life stage. Therefore, readily available and simple biomarkers may help plan advanced care in palliative care settings.

This study aimed to provide basic data for promoting healthy food choices by evaluating the energy and nutrient content of ready-to-cook or ready-to-heat home meal replacement snacks. Eight hundred and ninety-four flour-based home meal replacement (HMR) products were analyzed, including 367 noodle dishes, 230 tteokbokki products, and 297 dumpling items. The serving sizes were determined by the product labeling. If not indicated, the total weight was used as the serving size if it could be considered a single serving. A serving size of 150 g was applied to dumplings sold in large packages. The average serving size was 249.9 g for noodles and 210.0 g for tteokbokki. The energy content varied significantly: noodles, tteokbokki, and dumplings had 439.8 kcal, 433.0 kcal, and 292.7 kcal, respectively (P＜0.001). The carbohydrate content were higher in noodles (87.9 g) and tteokbokki (87.6 g) compared to dumplings (32.0 g) (P＜0.001), while the sugar content was highest in tteokbokki (13.5 g) (P＜0.001). The protein content was highest in noodles (11.7 g), followed by dumplings (10.9 g) and tteokbokki (9.9 g) (P＜0.001). The sodium content was highest in noodles (1,777.9 mg), followed by tteokbokki (1,152.3 mg) and dumplings (583.7 mg) (P＜0.001). The price per serving was highest for noodles (3,303.9 KRW) (P＜0.001). The nutrient content varied within the same product type depending on the flavor, temperature (hot vs. cold), and whether a broth was included.These findings highlight the considerable differences in nutritional profiles among HMR snack foods and underscore the importance of selecting products based on their intended dietary use.

Diagnosing amyotrophic lateral sclerosis (ALS) is challenging and requires distinguishing it from conditions like distal hereditary motor neuropathy type 5 (dHMN-V). A 21-year-old female initially diagnosed with ALS showed progressive upper limb weakness extending to the lower limbs. Trio exome sequencing revealed a de novo pathogenic Berardinelli-Seip congenital lipodystrophy 2 variant (c.263A>G, p.Asn88Ser), confirming dHMN-V. Minipolymyoclonus of small amplitudes in bilateral wrists and ankles was an atypical presentation. This case underscores the importance of considering dHMN-V as a differential diagnosis in ALS-like distal upper extremity weakness.

Purpose: We investigated the changes in ocular higher-order aberrations (HOAs) between sutured scleral fixation and modified Yamane sutureless scleral fixation. Methods: We retrospectively reviewed 20 patients (20 eyes) who underwent sutured scleral fixation and 22 patients (22 eyes) who underwent modified Yamane sutureless scleral fixation. The best corrected visual acuity (BCVA) and HOAs were measured preoperatively, and at 3 months postoperatively, and the two groups were compared. Results: BCVA was significantly improved in both sutured scleral fixation and modified Yamane sutureless scleral fixation (p = 0.038, 0.015, respectively). The internal optic HOAs decreased significantly after scleral fixation both in both groups (p = 0.012, 0.033, respectively). Postoperative internal optic HOAs were significantly higher in modified Yamane sutureless scleral fixation group than in sutured scleral fixation group. (p = 0.034) Postoperative third-order aberrations, coma-like aberrations were significantly higher in modified Yamane sutureless scleral fixation group than in sutured scleral fixation group. (p = 0.032, 0.038, respectively) Conclusions Sutured scleral fixation showed more effectively decreased internal optics HOAs. IOL tilt and decentrations correlated with internal HOAs and thus should be avoided particularly in modified Yamane sutureless scleral fixation.

Nephrogenic diabetes insipidus (NDI) is characterized by polyuria and polydipsia, high serum osmolality, and low urine osmolality because of resistance to antidiuretic hormone. Lithium is commonly used to treat psychiatric disorders, and NDI is one of the common renal side effects of lithium therapy. On the other hand, NDI induced by lithium medication in a patient after a coronavirus disease-19 (COVID-19) infection has not been reported. This paper presents a patient who developed new-onset NDI secondary to a COVID-19 infection despite being on a stable lithium dose for several years. This case highlights the importance of considering a COVID-19 infection as a possible cause of NDI in patients taking lithium medication.

Lecanemab and donanemab have received full U.S. Food and Drug Administration (FDA) approval, and subsequently, lecanemab has been approved by the Korean FDA and it has recently entered commercial use in Korea. This has increased interest in anti-amyloid immunotherapy for Alzheimer’s disease. Anti-amyloid immunotherapy has shown potential to modify the progression of the disease by specifically binding to amyloid β, a key pathological product in Alzheimer’s disease, and eliminating accumulated amyloid plaques in the brain. However, this treatment can be accompanied by a side-effect, amyloid-related imaging abnormalities (ARIA), which requires periodic monitoring by MRI. It is crucial to detect ARIA and accurately assess the severity by radiology. The role of the radiologist is important in this context, requiring proficiency in basic knowledge of ARIA, and in diagnosing/evaluating ARIA. This review aims to comprehensively cover aspects of ARIA, including its definition, pathophysiology, incidence, risk factors, assessment of severity by radiology, differential diagnosis, and management.

The introduction of anti-amyloid therapies for Alzheimer’s disease (AD), such as lecanemab (Lequembi®), which was recently approved in Korea, necessitates careful monitoring for amyloid-related imaging abnormalities (ARIA) using brain MRI. To optimize ARIA monitoring in Korean clinical settings, the Korean Society of Neuroradiology (KSNR) and the Age and Neurodegeneration Imaging (ANDI) Study Group proposed MRI protocol recommendations on essential MR sequences, MRI acquisition parameters, timing and condition of MRI examinations, and essential details to provide a scientific basis for maximizing the safety and efficacy of AD treatment. A customized, standardized MRI protocol focusing on Korea’s healthcare environment can improve ARIA management and ensure patient safety through early detection of potential anti-amyloid therapy side effects, thereby enhancing treatment quality.

Purpose: This study aimed to ascertain the influence of moral distress and ethical nursing competence on retention intention among nurses. Methods: Participants included 191 nurses working in general hospitals. Data were collected from July 11 to 18, 2023 and analyzed using SPSS/WIN 23.0. Results: Factors Influencing retention intention were clinical experience in the present department (β=.22, t=3.20, p=.002), moral distress (β=-.22, t=-3.15, p=.002) and ethical nursing competence (β=.26, t=3.82, p<.001). These variables accounted for 19.7% of nurses' retention intentions. Conclusion Based on our findings, it is necessary to identify interventions aimed at alleviating moral distress, and establish and implement systematic programs to improve ethical nursing competence in order to increase the retention intention of nurses.