Background: Despite the increase in daily alcohol intake in recent decades and the implementation of national health screenings, effective management strategies for alcohol consumption remain outdated. This review evaluates intervention studies on screening and behavioral counseling for unhealthy alcohol use, with the aim of enhancing the effectiveness of interventions and improving health outcomes. Methods: On the basis of the GRADE (Grading of Recommendations Assessment, Development, and Evaluation)- ADOLOPMENT framework, systematic reviews and randomized controlled trials were examined to investigate the effectiveness of screening and counseling interventions in reducing unhealthy alcohol use. Five key questions were generated, and an evaluation and quality assessment of existing systematic reviews and new evidence related to each key question were conducted. Results: Updating the U.S. Preventive Services Task Force and Cochrane 2018 reviews, we identified five new randomized trials that evaluated screening and counseling interventions for unhealthy alcohol use. For Key Question 2, the sensitivity and specificity of the new screening studies were consistent with those of prior research. Brief interventions were confirmed to reduce alcohol use (Key Question 4a), although additional research is required for a wider array of health outcomes. One study highlighted the benefits of counseling interventions for newborn health indicators in pregnant women (Key Question 4b). No new evidence was found regarding the harms of screening (Key Question 3) or alcohol use reduction interventions (Key Question 5). Conclusion This review supports the continued use of brief interventions to reduce alcohol consumption in highrisk groups and highlights the need for culturally tailored research in Korea.

Background: Since the World Health Organization’s pandemic declaration in March 2020, Korea has witnessed shifts in lifestyle behaviors, impacting habits tied to socioeconomic status and contributing to metabolic syndrome (MetS). To investigate this issue, the current study aimed to investigate changes in MetS prevalence, particularly based on income levels before and after the coronavirus disease 2019 (COVID-19) pandemic. Methods: This study used data from the 8th Korea National Health and Nutrition Examination Survey (2019–2020). A total of 6,840 individuals aged 30–65 years were included in this study. Household income was divided into high (≥75th percentile), middle (25–75th percentile), and low (≤25th percentile). A multivariable logistic regression analysis was performed to explore the interaction between this association before and after the COVID-19 pandemic. Results: A statistically significant difference was found in the prevalence of MetS before and after the COVID-19 pandemic (26.7% to 30.2%, P=0.001). These changes differed based on income levels. The increase in the prevalence of MetS was statistically significant in the low- and high-income groups but not in the middle-income group (low: 8.0%p increase [P=0.039], middle: 1.0%p increase [P=0.522], high: 6.4%p increase [P<0.001]). The interaction between household income and the COVID-19 pandemic on MetS was statistically significant (P for interaction=0.032). Conclusion This study revealed that P for interaction between household income, MetS, and the period before and after the COVID-19 pandemic was significant. Changes in physical activity and eating habits during the COVID-19 pandemic may have contributed to these differences.

Background: Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker. Methods: A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests. Results: Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036). Conclusion Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection contribute to platelet activation and thrombus formation. Severe coronavirus disease 2019 (COVID-19) is characterized by an increased risk of thromboembolic events that can lead to adverse outcomes in patients with severe disease manifestations. We present the case of a 41-year-old man who died from a pulmonary embolism and review the connection between SARS-CoV-2 infection, increased platelet counts, and the resulting fatal thrombosis. Total knee replacement surgery was performed and the patient was able to ambulate for a few days postoperatively. The platelet count exceeded the upper limit between postoperative days six and nine, reaching 708,000/μL on day 20. SARS-CoV-2 was confirmed 14 days after surgery, and the patient died 23 days after surgery while hospitalized. Autopsy revealed a fatal pulmonary embolism and deep vein thrombosis. If blood clots are caused by increased platelet counts due to COVID-19, it is essential to understand this relationship and prepare for complications that may arise after infection. Several recent studies have shown a link between COVID-19 and coagulation. We propose several considerations for autopsies of unexpected fatal pulmonary embolism during the SARS-CoV-2 endemic period.

HIV/AIDS control in Korea characterized with “AIDS Prevention Law”, enacted in 1987. It was one of the first separate legal enforcement around the world that governs control of the HIV/AIDS epidemic. Yet with significant limitations regarding human rights, as it criminalized HIV infection, and dictates penal action against ‘transmitters’. This papers looks into how HIV/AIDS epidemic started in Korea in 1980s, with specific focus on disease narrative that was constructed by the government. It was known to United States Forces Korea, that HIV was already spreading steady into Korean female sex workers around U.S. military bases in 1985. This information was concealed by Korean Ministry of health, in the face of upcoming international events such as 1988 Seoul Olympics. Instead, the Korean government turned public attention to ‘imported’ cases, constructing narrative that HIV/AIDS as a foreign disease. With direction of president, HIV/AIDS control focus on compulsory testing and isolation of identified risk group of sexual minorities and sex workers around U.S. military bases. This narrative of foreign disease had lasting impact even after democratization of Korea in 1987, as civil society, unaware that HIV/AIDS had already became endemic in Korea, argued to enforced compulsory testing against foreign nationals upon entry. This paper argues that disease narratives were carefully constructed by the government during early phase of HIV/AIDS epidemic in Korea, and used legal structure as ways to conceal the actual prevalence from both domestic and international attention.

Benign renal cysts are fluid-filled sacs that originate from the kidneys. Infected renal cysts are a rare manifestation of benign renal cysts, that can be managed with antibiotic therapy, drainage, and surgery. A 74-year-old man was admitted to our hospital with an infected renal cyst. Initial treatment managed with only broad-spectrum antibiotics, as percutaneous drainage was postponed due to apparent clinical improvement. However, his condition deteriorated, leading to cardiac arrest. Radiological intervention with cyst drainage resulted in rapid improvement. The patient recovered successfully and was discharged 16 days later. A follow-up computed tomography revealed a marked reduction in cyst size, with normal blood and urine tests, and the patient remained asymptomatic.

Cardiovascular-kidney-metabolic (CKM) syndrome is a progressive disorder resulting from the complex interaction between metabolic risk factors, chronic kidney disease, and cardiovascular disease (CVD), leading to multi-organ dysfunction. Given the increasing prevalence of metabolic syndrome, obesity, hypertension, dyslipidemia, and diabetes, a comprehensive approach to risk stratification and management is essential. The American Heart Association introduced the CKM staging system to classify disease progression and identify early intervention opportunities. Additionally, the predicting risk of cardiovascular disease EVENTs (PREVENT) equation was developed to enhance cardiovascular risk prediction by incorporating metabolic risk factors, estimated glomerular filtration rate, albuminuria, glycated hemoglobin (HbA1c), and social determinants of health. Unlike traditional risk models, PREVENT enables 10-year and 30-year risk prediction of both CVD and heart failure in individuals aged 30 to 79 years and integrates the social deprivation index for a more equitable and individualized risk assessment. However, as PREVENT is derived from United States population data, its applicability to Asian populations, including Koreans, remains uncertain. Developing a region-specific risk prediction model using local cohort data is crucial for optimizing CKM syndrome management. Furthermore, effective prevention and treatment require a multidisciplinary approach involving nephrologists, cardiologists, endocrinologists, dietitians, and social workers. Implementing CKM staging and PREVENT in clinical practice can facilitate early risk identification and personalized interventions, ultimately improving cardiovascular and renal health outcomes.

Long coronavirus disease (COVID) is a condition in which coronavirus disease 2019 (COVID-19) symptoms persist for over 3 months, and currently poses a global public health challenge. Due to varying manifestations and lack of standardized definitions, diagnostic methods, and treatments, comprehensive clinical guidelines are required. This review article, summarizing research and expert consensus up to June 2023, provides recommendations for diagnosis and long-term management of long COVID symptoms. It emphasizes thorough patient evaluation, including medical history, physical examinations, and tests, and advocates vaccination and antiviral treatments to reduce risk. Guidelines for long COVID will be updated as new knowledge emerges.

Colorectal cancer ranks second in incidence and third in cancer-related mortality in Korea, and screening colonoscopies are being used more frequently to facilitate early detection and treatment. Some cancers are diagnosed after colonoscopy but before the recommended surveillance interval: this is referred to as post-colonoscopy colorectal cancer (PCCRC). A recent meta-analysis revealed that interval cancers occur in 8.2% of cases, with proximal PCCRC accounting for 9.7% and distal PCCRC for 5.4%. The primary causes of PCCRC include inadequate bowel preparation, missed lesions, incomplete resection, and development of new lesions. Ensuring high-quality endoscopic procedures and achieving complete resection will be critical to addressing these causes and preventing PCCRC.

Objectives: This study presents a comprehensive review of the clinical applications, technical challenges, and ethical considerations associated with using large language models (LLMs) in medicine. Methods: A literature survey of peer-reviewed articles, technical reports, and expert commentary from relevant medical and artificial intelligence journals was conducted. Key clinical application areas, technical limitations (e.g., accuracy, validation, transparency), and ethical issues (e.g., bias, safety, accountability, privacy) were identified and analyzed. Results: LLMs have potential in clinical documentation assistance, decision support, patient communication, and workflow optimization. The level of supporting evidence varies; documentation support applications are relatively mature, whereas autonomous diagnostics continue to face notable limitations regarding accuracy and validation. Key technical challenges include model hallucination, lack of robust clinical validation, integration issues, and limited transparency. Ethical concerns involve algorithmic bias risking health inequities, threats to patient safety from inaccuracies, unclear accountability, data privacy, and impacts on clinician-patient interactions. Conclusions LLMs possess transformative potential for clinical medicine, particularly by augmenting clinician capabilities. However, substantial technical and ethical hurdles necessitate rigorous research, validation, clearly defined guidelines, and human oversight. Existing evidence supports an assistive rather than autonomous role, mandating careful, evidence-based integration that prioritizes patient safety and equity.