Purpose: To investigate indicators of dry eye disease that influence punctal plug loss. Methods: A retrospective review was conducted on patients who received SuperFlex® punctal plugs. To analyze the relationship between punctal plug loss and markers for dry eye, patients were categorized into a loss group, defined as those who experienced unintended loss within 3 months of insertion, and a retention group. In total, 11 indicators were compared between the two groups, including meibomian gland expressibility, cloudiness of meibomian gland secretions, telangiectasis of the eyelid margin, tear osmolarity, Schirmer’s test value, the expression levels of matrix metalloproteinase-9 in tears, NEI/Industry grading system score, Sjögren’s International Collaborative Clinical Alliance ocular staining score, tear lipid layer thickness (LLT), and meiboscore. Results: In all, 47 eyes of 30 patients were included in the study. Of these, 16 eyes (34%) were assigned to the loss group. Meibomian gland expressibility grade was significantly higher in the loss group (1.60 ± 0.58) compared to the retention group (1.04 ± 0.37, p = 0.0247). Additionally, LLT was significantly lower in the loss group (58.7 ± 17.0 nm vs. 88.4 ± 17.6 nm, p = 0.0303). However, no significant correlations were found between punctal plug loss and other indicators of dry eye. Conclusions Worse meibomian gland expressibility and thinner LLT are associated with a higher rate of punctal plug loss.

Objectives: Osteoporosis is a silent disease with low screening rates in many developing countries. This study aimed to evaluate the feasibility of using an artificial intelligence (AI)-based system to screen osteoporosis from pelvic and hip radiographs in Vietnam. Methods: We conducted a cross-sectional study at a tertiary medical center in Central Vietnam in 2023. A total of 2000 consecutive pelvic and hip radiographs from patients aged ≥ 40 years were collected. After excluding poorquality images, 1987 radiographs were analyzed using an AI-based software designed to estimate bone mineral density (BMD) from plain radiographs and derive T-scores. Osteoporosis was defined as a T-score ≤ − 2.5. Patient characteristics, radiographic findings, and risk factors for osteoporosis were analyzed. Results: Among 1987 patients (mean age 66.4 ± 15.1 years; 41.3% men), osteoporosis was identified in 872 patients (43.9%). The prevalence increased with age and was higher in women than in men (58.7% vs 22.8%, P < 0.001). Osteoporosis was associated with femoral neck (OR = 3.8, 95% CI: 2.7–5.2) and intertrochanteric fractures (OR = 7.0, 95% CI: 4.5–11.0). Patients with lower T-scores had a higher risk of hip fractures, especially those with T-scores ≤ − 3.0 (OR = 11.5, 95% CI: 5.5–24.5). Conclusions AI-based analysis of pelvic and hip radiographs is a feasible and effective tool for osteoporosis screening in Vietnam. The prevalence of osteoporosis in this hospital-based setting was high, particularly among elderly women.AI-assisted screening may offer an accessible strategy for early detection of osteoporosis in resource-limited settings.

Purpose: This study analyzed the characteristics of pediatric patients’ (≤ 18 years) intentional injury-related visits to the emergency department (ED) using National Emergency Department Information System data from January 1 through December 31, 2023, providing foundational evidence for prevention strategies and policy development. Methods: The injuries were categorized into unintentional and intentional, and relevant characteristics were compared between the 2 categories. The intentional injuries were further divided into self-harm and violence. Percentages were calculated for each variable and compared using the chi-square or Fisher exact tests. Results: Among 301,852 pediatric patients, those with intentional injuries showed higher proportions of girls, adolescents, visits in the wee hours, visits via firehouse ambulances, injuries by collision, by penetration, or by poisoning, hospitalization, Korean Triage and Acuity Scale levels 1-3, an ED length of stay of 2 hours or longer, and primary care by psychiatrists, than those with unintentional injuries. The pediatric patients with self-harm injuries showed higher proportions of girls, adolescents, visits in the wee or morning hours, visits via firehouse ambulances, injuries by collision, by penetration, or by poisoning, hospitalization or inter-facility transfer, Korean Triage and Acuity Scale levels 1-3, an ED length of stay of 2 hours or longer, and primary care by psychiatrists as well as by orthopedic surgeons or pediatricians, than those with violence injuries. Conclusion This study highlights the need to develop strategies per age and sex for preventing self-harm among pediatric patients, and to ensure safe and effective psychiatric care in EDs. In addition, the prevention of child abuse requires a multidisciplinary approach that includes preventive education programs, mandatory reporting in EDs, and the adoption of screening tools such as the Finding Instrument for Non-accidental Deeds.

Purpose: Preterm birth remains a leading cause of long-term neurodevelopmental impairment, yet early evaluations frequently underestimate subsequent deficits. This study examined longitudinal neurodevelopmental trajectories across gestational age groups and identified predictors of developmental delay. Methods: A retrospective cohort of 532 preterm children, stratified by gestational age, was followed from the neonatal period to early preschool age. Neurodevelopment was assessed using the Korean version of the Bayley Scales of Infant and Toddler Development, Third Edition at 8–12 months (n=481), 13–24 months (n=118), and 25–42 months (n=100). Longitudinal trajectories were analyzed using general linear models, and predictors of developmental delay were identified through multivariable logistic regression. Results: During the first year, motor scores differed significantly across gestational age groups, with extremely preterm infants showing the lowest values. By the third to fourth years of life, cognitive and language scores diverged markedly, with extremely preterm children exhibiting the steepest decline and additional deficits in motor and adaptive behavior domains. Lower gestational age remained an independent predictor of both cognitive and language delay at early preschool age, while no independent predictors were identified for motor, social-emotional, or adaptive behavior outcomes. Conclusion Neurodevelopmental outcomes in preterm children follow dynamic, domain-specific trajectories influenced by gestational age and developmental timing. Motor delays are most evident in infancy, whereas cognitive and language impairments emerge by early preschool age. Gestational age remains a consistent predictor of later delay, emphasizing the need for longitudinal, gestational age–stratified monitoring and early, targeted intervention.

Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Natural killer (NK) cells play critical roles in immune surveillance and homeostasis maintenance through cytotoxicity and cytokine release. The ability of NK cells to eliminate target cells without the need for prior antigen recognition or antibody involvement has drawn considerable attention for translational and clinical applications. As clinical applications continue to broaden, interest in NK cell assays has been growing markedly. This review provides an in-depth discussion of current clinical applications of NK cell assays, including NK cell phenotype, frequency, and functional activity assessments. This review further highlights the diagnostic potential of these assays in terms of hemophagocytic lymphohistiocytosis and potential NK cell biomarker candidates in diverse pathological contexts, such as cancer, infection, autoimmune diseases, and other diseases. By integrating clinical insights with technological advancements, NK cell assays can serve as valuable tools for disease diagnosis, prognosis, and therapeutic monitoring.

Objective: To explore whether ultrasonographic measurements of tongue thickness are associated with swallowing function and related clinical domains in patients with amyotrophic lateral sclerosis (ALS), this feasibility study was conducted. Few studies have examined the usefulness of ultrasonographic tongue thickness measurement in patients with ALS, but its association with physiological measures remains unclear. Methods: Ten patients with ALS underwent tongue thickness measurement using ultrasonography. Clinical assessments including the Korean version of the ALS Functional Rating Scale-Revised (K-ALSFRS-R), Functional Oral Intake Scale (FOIS), Eating Assessment Tool-10 (EAT-10), Dysphagia Handicap Index, Korean version of the Swallowing Quality of Life Questionnaire, Mini Nutritional Assessment–Short Form (MNA-SF), handgrip strength, and bioelectrical impedance analysis for skeletal muscle index (SMI) were performed. Swallowing physiology was evaluated using the Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale. Simple and partial Pearson’s correlation analyses as well as univariate regression were performed with adjustments for age, sex, and body mass index (BMI). Results: Tongue thickness showed significant associations with multiple functional and systemic measures in the unadjusted analyses, including FOIS, EAT-10, MNA-SF, BMI, SMI, K-ALSFRS-R. After adjustment, the most consistent associations were observed with the MBSImP oral, pharyngeal, and combined phase scores. Conclusion Tongue ultrasonography may serve as a radiation-free method to preliminarily assess bulbar involvement in ALS. Tongue thickness was most specifically associated with dysphagia outcomes, particularly MBSImP. Given the feasibility design and small sample size, larger longitudinal studies are warranted to confirm its clinical utility in monitoring the progression of dysphagia in patients with ALS.

Purpose: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Materials and Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes.Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Purpose: This study was conducted to revise the Nutrition Quotient for Preschool children (NQ-P), a tool for evaluating the overall dietary quality and eating behavior among Korean preschool-aged children. Methods: At the first stage, 20 items for assessing dietary behavior were selected based on the previous NQ-P checklist, incorporating the results of the Seventh Korea National Health and Nutrition Examination Survey, national nutrition policies, dietary guidelines, and recent literature reviews. A pilot study was conducted with 100 preschool children residing in Seoul and Gyeonggi Province, using an 18-item checklist. After exploratory factor analysis and expert consultation, 15 items were finalized for use in nationwide survey checklists. The nationwide survey was conducted with a stratified sample of 800 preschool children across six metropolitan cities. Confirmatory factor analysis was used to revise the NQ-P 2021 and make it suitable for the structural equation model. Results: The NQ-P 2021 was developed using 15 checklist items organized into three factors:balance (7 items), moderation (4 items), and practice (4 items). The standardized path coefficients were used as item weights to determine the nutrition quotients. The weights of balance, moderation, and practice were 0.40, 0.15, and 0.45, respectively. In the nationwide survey, the mean NQ-P 2021 score was 59.67. The average scores for balance, moderation, and practice were 51.00, 62.45, and 66.46, respectively. Conclusion The revised NQ-P 2021 provides a validated and practical tool for assessing the dietary quality and eating behaviors of preschool children in Korea.