Purpose: Radiotherapy (RT) remains a cornerstone of curative treatment for localized and locally advanced prostate cancer. However, dose escalation to improve tumor control is often constrained by the proximity of the rectum, which increases the risk of gastrointestinal (GI) and genitourinary toxicities. Biodegradable rectal spacers inserted between the prostate and rectum have emerged as an effective approach to reduce rectal radiation exposure. This guideline provides evidence-based recommendations on indications, contraindications, procedural standards, and clinical management for biodegradable rectal spacer insertion during prostate cancer RT. Materials and Methods: This guideline was developed by a multidisciplinary expert panel through a systematic review of the literature, analysis of international guidelines (National Comprehensive Cancer Network, European Association of Urology, American Society for Radiation Oncology), and expert consensus among radiation oncologists, radiologists, and urologists with clinical experience in spacer insertion. The strength of each recommendation and the level of evidence were classified according to the modified GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. Results: Spacer insertion is conditionally recommended (Grade C, Level I) for patients receiving definitive external-beam RT without rectal invasion. It reduces the high-dose rectal irradiation volume (V70–75) by >50%, decreases acute GI toxicity, and helps maintain bowel-related quality of life. However, the benefit for late severe toxicity (grade 2 or higher) remains debated in recent meta-analyses. Contraindications include rectal invasion, anatomical inaccessibility, infection, and material hypersensitivity. Procedures should be performed under local anesthesia in a sterile environment by trained physicians. Short-course antibiotics and simulator-based training, including completion of multiple supervised cases, are advised. Conclusion Biodegradable rectal spacer insertion is clinically validated and effective in reducing acute rectal toxicity. Although pivotal trials demonstrated a favorable procedural safety profile, real-world postmarket data include reports of rare but severe procedural complications. This guideline provides standardized recommendations tailored to Korean clinical practice while remaining consistent with international standards, emphasizing the importance of operator training and careful patient selection.

Purpose: The study was undertaken to investigate the electromyographic activities of the gluteus maximus (GM), hamstring (HAM), and multifidus (MF) in three different sling locations during bridge exercise in the supine position. Methods: Twenty healthy male subjects participated. An electromyography device was used to measure the muscle activities of the GM, HAM, and MF muscles. Subjects were asked to perform bridge exercises with three different sling locations as follows: 1) Bridge exercise with an ankle sling; BEAS, 2) Bridge exercise with a calf sling; BECS, and 3) Bridge exercise with a knee sling; BEKS in random order. The analysis was conducted using one-way repeated ANOVA and the Bonferroni post hoc. Significance was set at α= 0.01. Results: HAM muscle activity was significantly different in the three conditions (BEAS, BECS, BEKS) (adjusted p-value [padj]< 0.01), and HAM muscle activity was significantly smaller during BEKS than during BEAS or BECS (padj < 0.01). Muscle activity ratio (GM/HAM) during BEKS was significantly greater than muscle activity ratios during BEAS or BECS (padj < 0.01). Conclusion BEKS is recommended to inhibit HAM muscle activity and improve the GM/HAM muscle activity ratio.

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Purpose: This study aumed to identify the effects of job satisfaction, nursing organizational culture and social support on intention retention among general hospital nurses. Methods: The subjects were 254 nurses working in one general hospital. Data were collected from January 1 to 30, 2023. Data were analyzed by t-test, ANOVA, Pearson correlation, and multiple regression analysis using the SPSS/WIN 25.0 program. Results: (a) In this study, the mean value of job satisfaction was 3.07±0.43, relation-oriented culture was 3.45±0.51, hierarchy-oriented culture was 3.39±0.49, task-oriented culture was 3.35±0.48, innovation-oriented culture was 3.00±0.46, social support was 3.75±0.49, and intention retention was 4.98±1.39. (b) Intention retention had a positive correlation with job satisfaction (r=.41, p<.001), social support (r=.29, p<.001), innovation-oriented culture (r=.29, p<.001), relation-oriented culture (r=.20, p=.001), and hierarchy-oriented culture (r=.18, p=.002). (c) Factors that affect intention retention include job satisfaction (β=.41, p<.001), Working type (Non-shift) (β=.18, p=.001), Nursing job selection (Recommendation, employment) (β=-.16, p=.003), and the explanation power was 23.1% (F=9.43, p<.001). Conclusion Our study shows that job satisfaction plays a significant role in the intention retention of nurses. It is important to strengthen job satisfaction to increase the retention of nurses. The results of this study may serve as basic data for the development of strategies to improve intention retention in nurses.

Viral load and the duration of viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important determinants of the transmission of coronavirus disease 2019.In this study, we examined the effects of viral doses on the lung and spleen of K18-hACE2 transgenic mice by temporal histological and transcriptional analyses. Approximately, 1×105 plaque-forming units (PFU) of SARS-CoV-2 induced strong host responses in the lungs from 2 days post inoculation (dpi) which did not recover until the mice died, whereas responses to the virus were obvious at 5 days, recovering to the basal state by 14 dpi at 1×102 PFU. Further, flow cytometry showed that number of CD8+ T cells continuously increased in 1×102 PFU-virusinfected lungs from 2 dpi, but not in 1×105 PFU-virus-infected lungs. In spleens, responses to the virus were prominent from 2 dpi, and number of B cells was significantly decreased at 1×105PFU; however, 1×102 PFU of virus induced very weak responses from 2 dpi which recovered by 10 dpi. Although the defense responses returned to normal and the mice survived, lung histology showed evidence of fibrosis, suggesting sequelae of SARS-CoV-2 infection. Our findings indicate that specific effectors of the immune response in the lung and spleen were either increased or depleted in response to doses of SARS-CoV-2. This study demonstrated that the response of local and systemic immune effectors to a viral infection varies with viral dose, which either exacerbates the severity of the infection or accelerates its elimination.

Background: Mpox is a viral illness with a characteristic skin rash caused by the monkeypox virus. In 2022, Mpox spread throughout the world, and an epidemic through domestic transmission started in South Korea in early 2023. This study aimed to summarize the clinical features of Mpox patients in South Korea. Methods: This is a multicenter retrospective study conducted at four hospitals in South Korea. All adult patients diagnosed with Mpox who were admitted to the study hospitals between June 1, 2022 and May 26, 2023 and were discharged by June 30, 2023 were reviewed. Results: Sixty patients were included, accounting for 65.9% of Mpox cases reported in South Korea during the study period. Median age was 32 years and 97% (58/60) of patients were male. In total, 85% (51/60) of patients reported their sexual orientation as homosexual or bisexual. The most common route of transmission was sexual or close contact (55/60). Every patient had a skin rash and 88% (53/60) had constitutional symptoms. In total, 42% (25/60) of patients had human immunodeficiency virus and 25% (15/60) had concomitant sexually transmitted infections. Severe manifestations of Mpox were identified in only two patients. Conclusion Mpox patients in South Korea were mainly young adult males and were infected through sexual contact. The clinical outcomes were favorable.

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Purpose: The study was undertaken to investigate the electromyographic activities of the gluteus maximus (GM), hamstring (HAM), and multifidus (MF) in three different sling locations during bridge exercise in the supine position. Methods: Twenty healthy male subjects participated. An electromyography device was used to measure the muscle activities of the GM, HAM, and MF muscles. Subjects were asked to perform bridge exercises with three different sling locations as follows: 1) Bridge exercise with an ankle sling; BEAS, 2) Bridge exercise with a calf sling; BECS, and 3) Bridge exercise with a knee sling; BEKS in random order. The analysis was conducted using one-way repeated ANOVA and the Bonferroni post hoc. Significance was set at α= 0.01. Results: HAM muscle activity was significantly different in the three conditions (BEAS, BECS, BEKS) (adjusted p-value [padj]< 0.01), and HAM muscle activity was significantly smaller during BEKS than during BEAS or BECS (padj < 0.01). Muscle activity ratio (GM/HAM) during BEKS was significantly greater than muscle activity ratios during BEAS or BECS (padj < 0.01). Conclusion BEKS is recommended to inhibit HAM muscle activity and improve the GM/HAM muscle activity ratio.

Purpose: The study was undertaken to investigate the electromyographic activities of the gluteus maximus (GM), hamstring (HAM), and multifidus (MF) in three different sling locations during bridge exercise in the supine position. Methods: Twenty healthy male subjects participated. An electromyography device was used to measure the muscle activities of the GM, HAM, and MF muscles. Subjects were asked to perform bridge exercises with three different sling locations as follows: 1) Bridge exercise with an ankle sling; BEAS, 2) Bridge exercise with a calf sling; BECS, and 3) Bridge exercise with a knee sling; BEKS in random order. The analysis was conducted using one-way repeated ANOVA and the Bonferroni post hoc. Significance was set at α= 0.01. Results: HAM muscle activity was significantly different in the three conditions (BEAS, BECS, BEKS) (adjusted p-value [padj]< 0.01), and HAM muscle activity was significantly smaller during BEKS than during BEAS or BECS (padj < 0.01). Muscle activity ratio (GM/HAM) during BEKS was significantly greater than muscle activity ratios during BEAS or BECS (padj < 0.01). Conclusion BEKS is recommended to inhibit HAM muscle activity and improve the GM/HAM muscle activity ratio.

Purpose: The study was undertaken to investigate the electromyographic activities of the gluteus maximus (GM), hamstring (HAM), and multifidus (MF) in three different sling locations during bridge exercise in the supine position. Methods: Twenty healthy male subjects participated. An electromyography device was used to measure the muscle activities of the GM, HAM, and MF muscles. Subjects were asked to perform bridge exercises with three different sling locations as follows: 1) Bridge exercise with an ankle sling; BEAS, 2) Bridge exercise with a calf sling; BECS, and 3) Bridge exercise with a knee sling; BEKS in random order. The analysis was conducted using one-way repeated ANOVA and the Bonferroni post hoc. Significance was set at α= 0.01. Results: HAM muscle activity was significantly different in the three conditions (BEAS, BECS, BEKS) (adjusted p-value [padj]< 0.01), and HAM muscle activity was significantly smaller during BEKS than during BEAS or BECS (padj < 0.01). Muscle activity ratio (GM/HAM) during BEKS was significantly greater than muscle activity ratios during BEAS or BECS (padj < 0.01). Conclusion BEKS is recommended to inhibit HAM muscle activity and improve the GM/HAM muscle activity ratio.