Background: and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia. Methods: Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects. Conclusions This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.

Background: In this comprehensive retrospective nationwide cohort study, we examined the relationships between various asthma medications and bone health, utilizing data from the National Health Insurance Service database of South Korea. Methods: From 2015 to 2019, the relevant dataset included 168,611 individuals aged 66 years, among whom 8,747 were diagnosed with asthma. We focused on a subset of 6,173 patients, all 66-year-old women. Participants were categorized into four groups: nonusers of asthma medication (n=2,868), leukotriene antagonist users (n=2,281), inhaled corticosteroid (ICS) users (n=517), and those using a combination of ICS and long-acting beta-agonist (ICS+LABA) medication (n=507). The primary outcomes measured were the incidences of major osteoporotic fractures and hip fractures during the follow-up period. Results: Over 2.7 years of follow-up, 615 cases of major osteoporotic fractures and 96 cases of hip fractures were recorded. ICS users exhibited a heightened risk of both injuries, with hazard ratios of 1.38 (95% confidence interval [CI], 1.18 to 1.63; P<0.001) for major osteoporotic fractures and 1.56 (95% CI, 1.33 to 1.83; P<0.001) for hip fractures. Similarly elevated risks were observed in the ICS+LABA group. Notably, the risk associated with ICS was particularly pronounced among patients with osteopenia for both fracture types. Overall, the use of ICS, alone or in combination with LABA, in patients with asthma is associated with significantly increased risks of osteoporotic fractures, especially among those with osteopenia. Conclusion These findings underscore the importance of considering bone health when managing asthma, especially in older patients and those with existing bone density issues.

Background/Aims: The incidence of steatotic liver disease (SLD) is increasing across all age groups as the incidence of obesity increases worldwide. The existing noninvasive prediction models for SLD require laboratory tests or imaging and perform poorly in the early diagnosis of infrequently screened populations such as young adults and individuals with healthcare disparities. We developed a machine learning-based point-of-care prediction model for SLD that is readily available to the broader population with the aim of facilitating early detection and timely intervention and ultimately reducing the burden of SLD. Methods: We retrospectively analyzed the clinical data of 28,506 adults who had routine health check-ups in South Korea from January to December 2022. A total of 229,162 individuals were included in the external validation study. Data were analyzed and predictions were made using a logistic regression model with machine learning algorithms. Results: A total of 20,094 individuals were categorized into SLD and non-SLD groups on the basis of the presence of fatty liver disease. We developed three prediction models: SLD model 1, which included age and body mass index (BMI); SLD model 2, which included BMI and body fat per muscle mass; and SLD model 3, which included BMI and visceral fat per muscle mass. In the derivation cohort, the area under the receiver operating characteristic curve (AUROC) was 0.817 for model 1, 0.821 for model 2, and 0.820 for model 3. In the internal validation cohort, 86.9% of individuals were correctly classified by the SLD models. The external validation study revealed an AUROC above 0.84 for all the models. Conclusions As our three novel SLD prediction models are cost-effective, noninvasive, and accessible, they could serve as validated clinical tools for mass screening of SLD.

Basal cell adenocarcinoma, considered to be the malignant counterpart of basal cell adenoma, is a rare, low-grade malignant tumor of the salivary glands, accounting for 1-2% of salivary gland malignancies. It predominantly affects the parotid gland, while involvement of the minor salivary glands is exceptionally rare. This report presented a case of basal cell adenocarcinoma involving the left retromolar trigone in a 54-year-old woman. The initial provisional diagnosis suggested a benign or low-grade malignant salivary tumor. Advanced magnetic resonance imagingtechniques, including diffusion-weighted imaging and apparent diffusion coefficient analysis, aided in the preoperative prediction of malignancy, and an incisional biopsy confirmed the diagnosis of basal cell adenocarcinoma. This caseunderscored the challenge of distinguishing basal cell adenocarcinoma from benign salivary tumors, as clinical and imaging features often overlap. Surgical excision remains the primary treatment, yielding favorable outcomes;however, long-term follow-up is crucial due to the risk of recurrence.

Overactive bladder (OAB) and detrusor underactivity (DUA) are representative voiding dysfunctions with a chronic nature and limited treatment modalities, and are ideal targets for stem cell therapy. In the present study, we investigated the therapeutic efficacy of human mesenchymal stem cells (MSCs) with a high antioxidant capacity generated by the Primed Fresh OCT4 (PFO) procedure in chronic bladder ischemia (CBI)-induced OAB and DUA rat models. Sixteen-week-old male Sprague-Dawley rats were divided into three groups (sham, OAB or DUA, and stem cell groups; n=10, respectively).CBI was induced by bilateral iliac arterial injury (OAB, 10 times; DUA, 30 times) followed by a 1.25% cholesterol diet for 8 weeks. Seven weeks after injury, rats in the stem cell and other groups were injected with 1×10 6 PFO-MSCs and phosphate buffer, respectively. One week later, bladder function was analyzed by awake cystometry and bladders were harvested for histological analysis. CBI with a high-fat diet resulted in atrophy of smooth muscle and increased collagen deposits correlating with reduced detrusor contractility in both rat models. Arterial injury 10 and 30 times induced OAB (increased number of non-voiding contractions and shortened micturition interval) and DUA (prolonged micturition interval and increased residual volume), respectively. Injection of PFO-MSCs with the enhanced glutathione dynamics reversed both functional and histological changes; it restored the contractility, micturition interval, residual volume, and muscle layer, with reduced fibrosis. CBI followed by a high-fat diet with varying degrees of arterial injury induced OAB and DUA in rats. In addition, PFO-MSCs alleviated functional and histological changes in both rat models.

Background and Objectives: This study aimed to investigate the effects of hearing aids (HAs) on reducing symptoms of dizziness in patients with hearing loss (HL) and dizziness. Subjects and Methods: A pre- and post-intervention study was conducted between February 2022 and July 2022 at the outpatient clinic of a tertiary hospital in Seoul, South Korea. Ten participants (four males and six females) with HL and dizziness were recruited. Participants were screened using pure-tone audiometry and visual analog scale scores at baseline. Selected participants underwent the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) and Korean Dizziness Handicap Inventory (K-DHI) in the unaided state. Thereafter, participants were provided HAs and instructed to use them for at least 6 hours every day. At the 1-month follow-up, all participants were assessed in the aided state using the same tests as at baseline. All tests were performed bilaterally. Results: In the mCTSIB, a significant difference was observed in the foam surface-eyes closed score before (median=2.35) and after (median=2.2) HA use (p=0.049). No significant differences were observed in the K-DHI scores before and after HA use. Conclusions HA use may improve the static and subjective perception of balance in patients with HL and dizziness. Future research should explore the benefits of HAs under various balance conditions such as dynamic balance and gait.

Due to rapid westernization, Korean dietary habits have emerged as significant risk factors for chronic disease and cancer. Despite this transition, Korea’s cancer prevention guidelines have remained consistent since their establishment about 18 years ago. This study aimed to investigate the degree of awareness and practice to global dietary guidelines among Korean adults and identify demographic and lifestyle factors associated with low practice. A cross-sectional survey conducted in 2023 included 4,000 adults and assessed their awareness and practice of four global recommendations: “Eat a diet rich in whole grains,” “Limit consumption of processed meat,” “Limit consumption of sugar-sweetened beverages,” and “Limit consumption of fast and other processed foods.” While more than half of the participants recognized the guidelines’ importance for cancer prevention, implementation rates remained below 40%. Furthermore, over 80% of the respondents expressed a compelling requirement for updated and tailored dietary guidelines. Younger individuals, those who were physically inactive, individuals who had not received prior nutrition education, and participants with obesity were more likely to exhibit low practice, particularly to guidelines limiting processed foods and sugary beverages intake. These findings highlight the need to revise Korea’s cancer prevention recommendations by incorporating global dietary practices and addressing the westernized eating patterns prevalent within the population. Efforts should focus on promoting these updated guidelines through targeted education and public health interventions that improve practice, especially in high-risk groups, and effectively mitigate the burden of diet-related cancers in Korea.

Background: Intraoperative hemoglobin (Hb) monitoring is critical for ensuring patient safety during bimaxillary orthognathic surgery. Intraoperative Hb monitoring performed using portable devices with arterial blood samples is invasive, is time-consuming, and lacks the ability to provide real-time information. This retrospective study investigated the correlation between continuous and real-time total Hb (SpHb) using a Masimo Radical 7 device and Hb levels derived by portable devices during bimaxillary orthognathic surgery. Methods: Patients who underwent elective bimaxillary orthognathic surgery were enrolled. The correlation between SpHb and laboratory Hb (Lab-Hb) was evaluated immediately after the induction of anesthesia (T1) and at surgical closure (T2) and compared with postoperative Hb. Results: Eighty-eight patients were included. The correlation coefficients between SpHb and Lab-Hb were 0.795 and 0.859 at T1 and T2, respectively. The correlation coefficient between Lab-Hb at T2 and postoperative Hb was 0.918. A Bland-Altman analysis of the Lab-Hb at T2 and postoperative Hb showed a mean bias of 0.49. Conclusion In conclusion, here we demonstrated acceptable accuracy of the SpHb measured by the Masimo Radical 7 device during bimaxillary orthognathic surgery. However, SpHb is valuable as an adjunct value to Lab-Hb and a substitute for Hb monitoring due to its wide limits of agreement. These findings suggest that SpHb can help guide the timing of invasive blood sampling for Hb measurements, which may facilitate earlier intervention and treatment.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.