Purpose: This study aimed to evaluate the association between triglyceride-glucose (TyG)–related parameters and the incidence of diabetes mellitus in Korean adults. Data were obtained from the Korean Genome and Epidemiology Study (KoGES). Methods: This secondary analysis examined data from 6,816 adults aged 40–69 years who participated in the KoGES from 2001 to 2020. TyG–related parameters, including the TyG index, TyG–body mass index (TyG–BMI), TyG–waist circumference (TyG–WC), and TyG–waist-to-height ratio (TyG–WHtR), were assessed. Cox proportional hazards models were employed to determine the association between these parameters and the incidence of diabetes mellitus, with adjustments made for demographic, lifestyle, and health-related characteristics. Results: Higher levels of all TyG–related parameters were significantly associated with an increased risk of developing diabetes mellitus. Specifically, participants in the highest quartile of the TyG index, TyG–BMI, TyG–WC, and TyG–WHtR exhibited significantly higher hazard ratios for diabetes mellitus incidence compared with those in the lowest quartile (p<.001 for all). Notably, the TyG index demonstrated a stronger predictive value for diabetes mellitus than traditional measures such as the homeostatic model assessment of insulin resistance. Conclusion TyG–related parameters are robust predictors of diabetes mellitus incidence in Korean adults. These findings support the incorporation of TyG–related measures into clinical settings for the early identification and intervention of high-risk populations. Utilizing these parameters for early diagnosis and preventive strategies may significantly enhance diabetes mellitus management.

Purpose: This study aimed to assess the impact of aerobic exercise at different intensities over an eight-week period on the expression and activation of cortical synaptic proteins, with the potential to reduce anxiety and improve memory in young mice. Methods: Seven-week-old C57BL/6 mice were subjected to treadmill exercises at low (n = 10), moderate (n = 10), and high intensity (n = 10) for eight weeks. Behavioral assessments were conducted to evaluate anxiety and cognitive function. To explore the underlying mechanisms, we measured the phosphorylated levels of extracellular signal-regulated kinase (ERK), cyclic adenosine monophosphate response-binding protein (CREB), protein kinase (AKT), adenosine monophosphate activated protein kinase (AMPK), synapsin (S9, S549, S609), and PSD-95 in the cortex, as these are associated with synaptic strength. Additionally, the expression of doublecortin (DCX), a neurogenic factor, was analyzed in the hippocampus. Results: Exercise led to reductions in depressive and anxiety-related behaviors and elevated the levels of phosphorylated ERK, CREB, AKT, AMPK, synapsin (S9, S549, S609), and PSD-95 in the cortex of young mice. Furthermore, exercise increased DCX expression in the hippocampus. Moderate-intensity exercise yielded more pronounced effects than other intensities. Conclusion The findings of this research indicate that consistent moderate-intensity exercise increases synaptic strength and reduces depression and anxiety in young mice by activating multiple factors.

Objective: This study aimed to identify factors associated with the recovery of mandibular nerve disturbance and to predict the possibility of recovery tailored to individual patients. Materials and Methods: Patients who visited the dental hospital with symptoms of mandibular nerve disturbance from April 2015 to September 2020 were studied. Patients were divided into two groups based on treatment outcomes: recovered or non-recovered. Variables related to recovery included age, sex, onset event of the nerve disturbance, affected area, imaging findings, and treatment methods. The correlation between recovery and these variables was analyzed using the Chi-square test and Fisher’s exact test. Results: A total of 328 patients were included in the study.Among the variables associated with recovery, the onset event of the symptom (P-value=0.02) and imaging findings (P-value=0.04) were statistically significant. Among the significant variables, the highest proportion of patients (77.78%) recovered without symptoms of onset event, while implant surgery showed the lowest recovery rate (34.25%). Regarding imaging findings, the recovery rate was highest in cases of suspected canal damage (58.82%), while no patients recovered from compression of the canal (0.00%). Conclusion This study highlights the importance of large-scale data analysis and a thorough evaluation of clinical variables to understand mandibular nerve disturbances. The findings provide a basis for improving treatment strategies and reducing the impact of nerve disturbances on patients’ quality of life.

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.

Objective: : Korea’s healthcare system and policy promotes early, actively stroke treatment to improve prognosis. This study represents stroke epidemiology and outcomes in Korea. Methods: : This study investigated data from the Acute Stroke Assessment Registry. The registry collects data from over 220 hospitals nationwide, focusing on quality stroke service management. Data analysis included patient demographics, stroke severity assessment, and discharge prognosis measurement using standardized scales. Results: : Eighty-six thousand five hundred sixty-eight acute stroke patients were collected with demographic and clinical characteristics during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute subarachnoid hemorrhage (SAH), acute intracerebral hemorrhage (ICH), and acute ischemic stroke. Of these 86568 patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over the years. 68.3% stroke patients had the clear onset time. 49.6% stroke patients arrived within 4.5 hours of symptom onset, with more patients treated at general hospitals. Good functional outcomes at discharge was obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. Conclusion : The results showed that ischemic stroke was the most common subtype, followed by ICH and SAH. Prognosis differed among subtypes, with favorable outcomes more common in ischemic stroke and SAH compared to ICH.

Objective: This study aims to objectively evaluate turning gait parameters in Parkinson’s disease (PD) patients using 2D-RGB video-based analysis and explore their relationships with imbalance. Methods: We prospectively enrolled PD patients for clinical assessment, balance analysis and gait with 180º turning. Spatiotemporal gait parameters during turning were derived using video-based analysis and correlated with modified Hoehn and Yahr (mHY) stages and center of pressure (COP) oscillations. Results: A total of 64 PD patients were enrolled. The PD patients with higher mHY stages (≥2.5) had significantly longer turning times, greater numbers of steps, wider step bases and less variability in step length during turns. COP oscillations were positively correlated with the mean turning time on both the anterior-posterior and right-left axes. Conclusion Spatiotemporal gait parameter during turning, derived from video-based gait analysis, may represent apromising biomarker for monitoring postural instability in PD patients.

The use of miniscrew-assisted rapid palatal expansion (MARPE) has yielded successful outcomes in late adolescence and early adulthood, particularly in correcting transverse maxillary discrepancies and enhancing airway expansion. This report presents three cases of children at different dentition stages treated with MARPE. In one patient with severe crowding, MARPE enabled dental alignment without the need for premolar extractions. Additionally, MARPE combined with facemask therapy improved the patient’s facial profile, resulting in high patient and guardian satisfaction. These cases highlight MARPE’s potential as an effective treatment for maxillary discrepancies and severe arch length discrepancies in children.

Purpose: Immunochemical fecal occult blood tests (iFOBT) have been utilized as the primary method for colorectal cancer screening within Korea's National Cancer Screening Program. This study aimed to evaluate the impact of the accreditation program for clinical laboratories and external quality assessment (EQA) programs on colorectal cancer screening. Methods: We analyzed the false-positive rates of iFOBT in colorectal cancer screening from 2016 to 2020 according to participation and performance in the Outstanding Laboratory Accreditation Program (OLAP) conducted by the Laboratory Medicine Foundation, and the External Quality Assessment programs run by the Korean Association of External Quality Assessment Service. Results: False-positive rates of iFOBT were lower among institutions accredited by OLAP (2.35%) compared with non-accredited (3.04%) and non-participating institutions (5.60%). Similarly, institutions participating in the EQA program exhibited lower false-positive rates (3.79%) compared to non-participants (7.04%). Within the iFOBT-specific EQA program, institutions that passed demonstrated the lowest false-positive rate (3.37%), while failing institutions showed the highest rate (9.07%), surpassing even non-participating institutions (6.44%). Conclusion Participation in quality management programs such as OLAP and EQA was associated with lower false-positive rates in iFOBT for colorectal cancer screening. These findings suggest that quality management initiatives can increase the accuracy of iFOBT, potentially improving the effectiveness of colorectal cancer screening programs, and reducing unnecessary follow-up procedures and associated healthcare costs.

Background: This study explores effective fixation methods for Pauwel type III femoral neck fractures by evaluating the biomechanical benefits of adding a screw to the Femoral Neck System (FNS). Methods: Computed tomography (CT) scans of an 82-year-old female patient with an intertrochanteric fracture were used to establish a finite element femur model with heterogeneous material properties. Finite element models of Pauwel type III fractures were created with and without an additional screw. The central and inferior trajectories of the FNS bolt were examined separately and combined with an additional screw for virtual fixation. Walking and stair-climbing loads were applied. Results: With the addition of a screw, both peak maximum and minimum principal strains consistently stayed comparable or decreased in models with both central and inferior bolt trajectories, while the volume of elements with principal strain exceeding 1% decreased by more than half. The peak von Mises stress observed in the implants ranged from 215.7 to 359.3 MPa, remaining below the titanium alloy's yield strength of 800 MPa. For normal walking, the addition of a screw to the central bolt trajectory model decreased the fracture gap by 50.6% and reduced sliding distance by 8.6%. For the inferior bolt trajectory, the gap was reduced by 57.9% and sliding distance by 25.0%.Under stair-climbing conditions, these improvements were also evident; the central trajectory model saw a halved fracture gap and a 7.9% decrease in sliding distance, while the inferior trajectory model experienced a 55.7% gap reduction and a 27.2% decrease in sliding distance. The additional screw increased the area ratio of the fracture site experiencing interfragmentary compression 34%–39%, while the additional screw alleviated peak interfragmentary compression by 12%–18% under both normal walking and stair-climbing conditions. Conclusions The addition of a screw reduced the fracture gap, sliding distance, and peak interfragmentary compression, while increasing the area ratio of interfragmentary compression under both walking and stair-climbing loads, regardless of the FNS bolt trajectory, suggesting a better mechanical environment for fracture healing.

Background: The removal of a well-fixed acetabular cup is a challenging, labor-intensive, and time-consuming step during revision hip arthroplasty. Although the advent of the manual osteotome, Explant, has simplified the procedure, it is still a stressful process as it dissipates the surgeon’s strength and time and risks an iatrogenic pelvic fracture. Recently, EZX, a powered tool for extraction of well-fixed acetabular cups with semicircular blade was invented. This study aimed to compare Explant and EZX in an experimental condition for their efficacy and safety. Methods: Cementless acetabular cups were press-fitted to 20 hemipelvic polyurethane models using foam adhesives. Ten cups were removed with each tool for comparison of the elapsed time, loads on the entire hemipelvis, periacetabular strain and temperature, volume of periacetabular bone removed, and diameter of the remaining acetabular rim. Strains and loads were quantitatively assessed using strain gauges and load cells for precise and reliable measurements. Results: The mean duration required to remove a well-fixed cup with EZX was 38.5 seconds (range, 25–55), whereas that with Explant was 543.7 seconds (range, 214–1,051) (p < 0.001). The load on the entire hemipelvis with EZX (mean, 9.1 kgf; range, 6.4–11.3) was 33% lower than that with Explant (mean, 13.6 kgf; range, 9.2–17.1) (p < 0.001). The periacetabular peak strains at the 3 positions with EZX were significantly lower than those with Explant (p < 0.001). The temperature during the removal did not differ significantly between the 2 tools. Although the mean volume of bone loss with Explant was 2.4 mL more than that with EZX (p < 0.001), the mean diameters of the remaining acetabular rim were not significantly different, measuring 54.1 mm with both tools. Conclusions The present experiment revealed that a well-fixed cup could be removed using a powered tool with less strength and time and less load on the entire pelvis. Although the powered tool removed a larger volume of bone, the diameters of the remaining acetabular rims were equivalent. This tool may help surgeons remove well-fixed cups in a short time and reduce the deforming load on the bone around the cup without increasing the size of the subsequent reconstruction cup.