This study aimed to establish an organoid culture model using small intestine tissues from male and female C57BL/6 mice and to compare it with rat organoid cultures derived from frozen tissues. Crypts were isolated from the small intestines of eight-week-old male and female mice and cultured in 3D extracellular matrix with Wnt, R-spondin, and Noggin. In addition, small intestine tissues from sixteen-week-old F344 rats were preserved in a storage solution immediately post-sacrifice and stored at –80°C before being transferred to a nitrogen tank. Upon thawing, crypts from frozen rat tissues failed to develop into organoids due to structural damage, suggesting the need for fresh tissues or optimized preservation methods. In contrast, mouse-derived organoids showed viability for 7 days, with distinct morphological changes and clear differentiation by Day 7. Quantitative real-time PCR analysis revealed that Lgr5, a stem cell marker, showed significantly higher expression in organoids than in tissues, confirming the successful establishment of the organoid culture. Among epithelial markers, the antimicrobial enzyme Lyz1 was more highly expressed in organoids, while Muc2, a key goblet cell marker, was more highly expressed in male tissues. The enterocyte marker Alp exhibited higher expression in male organoids compared to females, with no sex differences in tissues. These findings highlight sex-specific differences in gene expression related to small intestine differentiation and demonstrate the challenges in organoid culture from frozen rat tissues. The results suggest the importance of immediate tissue processing or improved preservation methods for successful organoid cultures.

Background: and Purpose To determine the clinical phenotypes, relapse timing, treatment responses, and outcomes of children with relapsing myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Methods: We collected the demographic, clinical, laboratory, and radiological data of patients aged <18 years who had been diagnosed with MOGAD at Seoul National University Children’s Hospital between January 2010 and January 2022; 100 were identified as positive for MOG antibodies, 43 of whom experienced relapse. Results: The median age at onset was 7 years (range 2–16 years). The median number of relapses was 2 (range 1–8), and patients were followed up for a median of 65 months (range 5–214 months). The first relapse was experienced before 3 months from onset by 15 patients (34.9%). The most-common initial phenotypes were acute disseminated encephalomyelitis (n=17, 39.5%) and optic neuritis (ON; n=11, 25.6%). The most-common relapse phenotypes were neuromyelitis optica spectrum disorder (n=9, 20.9%), relapsing ON (n=6, 14.0%), and multiphasic disseminated encephalomyelitis (n=6, 14.0%). Many of the patients (n=18, 41.9%) were not specifically categorized. A high proportion of these patients had non-acute disseminated encephalomyelitis encephalitis. Atypical phenotypes such as prolonged fever or hemiplegic migraine-like episodes were also noted. Mycophenolate mofetil and cyclic immunoglobulin treatment significantly reduced the annual relapse rates. Conclusions Our 43 pediatric patients with relapsing MOGAD showed a tendency toward early relapse and various relapse phenotypes. The overall prognoses of these patients were good regardless of phenotype or response to second-line immunosuppressant treatment.

The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.

Purpose: Physical activity (PA) is considered a potentially effective factor in the primary prevention of gastric cancer (GC). As body mass index (BMI) and waist circumference (WC) differ by sex, particularly with age, this study aimed to investigate the impact of PA on GC development, considering BMI and WC variations by sex. Materials and Methods: We analyzed the impact of PA on GC development using Cox proportional hazard regression in a cohort of 314,525 Korean individuals from the National Health Insurance Service–Health Screening database, using data from 2009–2019.Additionally, subgroup analyses were conducted based on BMI and WC. The models were adjusted for age, sex, smoking status, alcohol consumption, BMI, and comorbidities. Results: The effect of PA on the prevention of GC development was relatively evident in males. The high PA group (metabolic equivalents of task, METs/week of 500–999) showed a lower risk of GC compared to the group with METs/week of 0 (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79–0.98). Especially in males with WC <90 cm and BMI <23 kg/m2 , a lower risk of GC was observed in the group with METs/week of 1–499 compared to the group with METs/week of 0 (HR, 0.80; 95% CI, 0.67–0.96). In contrast, no consistent association was observed between PA levels and risk of GC in females. Conclusions Moderate PA had a preventive effect on GC development in males, particularly in those with low BMI and WC. However, this effect was not observed in females.

Purpose: This study aimed to establish a basis for minimizing readmission of patients with heart failure by comparing their demographic, clinical, psychosocial, and behavioral characteristics based on the presence or absence of readmission. Methods: This retrospective descriptive study included 160 elderly patients with heart failure aged 60 years and older, who regularly visited the cardiovascular outpatient clinic in K hospital in Daegu.Data were collected from April to December 2021 using self-report questionnaires including the Lubben Social Network Scale, the Scale of Positive and Negative Experience, and European Heart Failure Self-care Behaviour 9-Item Tools, which were translated in the Korean context. IBM SPSS Statistics 25 was used for analysis, and descriptive statistics, χ2 test, Fisher’s exact test, t-test, and logistic regression analysis were conducted. Results: The factors that significantly affected the readmission of elderly patients with heart failure were social network and the type of medications taken. The total explanatory power of the regression model was 22.7%. Social network (OR=0.93, p=.037) and the type of medication taken were 4~5 (OR=4.80, p=.014) and more than 6 medications (OR=7.84, p=.037) had a significant impact on readmission. Conclusion Social network was the most influential factor for readmission. Further studies are needed to minimize readmission by analyzing additional factors that show significant differences.

Purpose: : This study examined the effects of a multimodal intervention (earplugs, eye patches, and aromatherapy) on sleep quality and duration in intensive care unit(ICU)patients and the feasibility of the intervention to address sleep disturbances. Methods: : This experimental study comprised a nonequivalent control group and non-synchronized design. The participants included 50 adult patients admitted to the ICU with an internal medicine diagnosis who did not receive postoperative care. The intervention was conducted on a random day from 10 pm to 5 am the following morning. Subjective sleep quality was measured using the Korean version of the Richards–Campbell Sleep Questionnaire, and objective sleep duration was recorded using a smartwatch (Galaxy Watch 5; Samsung Electronics). Data were collected from September 2023 to March 2024 and analyzed using a t-test, χ2 test, Fisher’s exact test, and analysis of covariance. Results: : The multimodal intervention significantly improved the subjective andobjective measures of sleep quality. The experimental group had higher scores on sleep depth, falling asleep, sleeping without awakening, returning to sleep, and overall sleep quality. Objective measures revealed longer total sleep time, actual sleep time, light sleep, and deep sleep in the experimental group, with no differences in rapid eye movement sleep, sleep efficiency, or ratio of awakening. Conclusion : The multimodal sleep intervention effectively improved patients’ sleep quality and duration, demonstrating the feasibility of using multimodal interventions to improve sleep quality in clinical settings.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Diarrheal disease accounts for a large proportion of childhood deaths in North Korea, however, information regarding its management in North Korean clinical settings is limited. The absence of a reliable diarrheal disease database hinders efforts to determine priorities for support. Methods: Articles published in three major North Korean medical journals between 2012 and 2019 were analyzed to determine the clinical aspects of diagnosing and treating diarrhea. A total of 43 articles were identified during the screening process. Original articles and case reports focusing on the clinical features of diarrheal disease in the pediatric population were included. Results: The clinical features and markers of several types of diarrheal diseases, including infectious diarrhea (20.9%) and diarrhea due to indigestion or malabsorption (18.6%), were assessed. Healthcare providers used multiple treatment modalities, including rehydration solutions, antibiotics, probiotics, and vitamin supplementation. Therapeutic trials on North Korean Oriental medicine were also conducted in more than half of the studies (55.8%). Conclusion This review provides insights into understanding the types of diarrhea and unmet needs in clinical settings in North Korea. Follow-up studies are required to interpret the situation in detail.

Background: Severe fever with thrombocytopenia syndrome virus (SFTSV) is a lethal threat.Increasing Severe fever with thrombocytopenia syndrome (SFTS) risk in Asia and the United States stems from the spread of natural host, Haemaphysalis longicornis. Rapid and accurate SFTSV molecular diagnosis is crucial for treatment decisions, reducing fatality risk. Methods: Blood samples from 17 suspected SFTS patients at Chuncheon Sacred Heart Hospital (September-December 2022) were collected. SFTSV was diagnosed using two reverse transcription-quantitative polymerase chain reaction (RT-qPCR) assays from Gangwon Institute of Health and Environment (RT-qPCR/GIHE) and Asan Medical Center (RT-qPCR/AMC). To address RT-qPCR disparities, amplicon-based MinION sequencing traced SFTSV genomic sequences in clinical samples. Results: In two samples (N39 and N50), SFTSV was detected in both RT-qPCR/GIHE and RTqPCR/AMC. Among 11 samples, RT-qPCR/AMC exclusively detected SFTSV. In four samples, both assays yielded negative results. Amplicon-based MinION sequencing enabled nearly whole-genome sequencing of SFTSV in samples N39 and N50. Among 11 discordant samples, five contained significant SFTSV reads, aligning with the RT-qPCR/AMC findings. However, another six samples showed insufficient viral reads in accordance with the negativity observed in RT-qPCR/GIHE. The phylogenetic pattern of SFTSV demonstrated N39 formed a genetic lineage with genotype A in all segments. SFTSV N50 grouped with the B-1 sub-genotype for L segment and B-2 sub-genotype for the M and S segments, indicating genetic reassortment. Conclusion The study demonstrates the robust sensitivity of amplicon-based MinION sequencing for the direct detection of SFTSV in clinical samples containing ultralow copies of viral genomes. Next-generation sequencing holds potential in resolving SFTSV diagnosis discrepancies, enhancing understanding of diagnostic capacity, and risk assessment for emerging SFTSV.