Purpose: This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes. Methods: We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test. Results: Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures. Conclusion Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.

Purpose: Congenital hypothyroidism (CH) is a major preventable cause of intellectual disability, particularly in very low birth weight (VLBW) infants, who are at increased risk due to hypothalamic-pituitary-thyroid axis immaturity. Early differentiation between transient CH (TCH) and permanent CH (PCH) is crucial to optimize L-thyroxine (LT4) treatment duration. This study aimed to determine the incidence of PCH among Korean VLBW infants and to identify clinical factors that may aid in distinguishing TCH from PCH. Methods: This retrospective cohort study included VLBW infants diagnosed with CH and treated with LT4 at a single tertiary neonatal intensive care unit between 2011 and 2020. Infants requiring LT4 beyond 3 years were classified as PCH, while those who discontinued earlier were considered TCH. Clinical characteristics, neonatal morbidities, and thyroid-related parameters were compared between the groups. Results: Among 1,292 VLBW infants, 122 (9.4%) were diagnosed with CH. After excluding deaths and those lost to follow-up, 73 infants were included in the final analysis (TCH, n=50; PCH, n=23). The PCH group had a significantly higher mean gestational age and greater LT4 requirements at both 12 and 36 months of age. Major anomalies were more frequently observed in PCH infants, including congenital heart defects. In multivariate analysis, higher gestational age, the presence of major anomalies, screening thyroid-stimulating hormone (TSH) >10 μIU/mL, and higher LT4 dose at 36 months were significantly associated with PCH. Conclusion The incidence of PCH in Korean VLBW infants was relatively higher than that reported in previous studies studies. Screening TSH level and LT4 dose requirements may support individualized follow-up and help distinguish PCH from TCH.

Foreign body ingestion is a common emergency that necessitates endoscopic intervention. Although many foreign bodies are easily removed, removal of magnets, blades, barbs, and unusually shaped objects, such as toothbrushes is challenging. Toothbrush ingestion may potentially cause complications such as pressure ulcers and perforations. We present a rare case of a 26-year-old woman with schizophrenia, who ingested multiple foreign bodies but was asymptomatic. Radiography showed multiple toothbrushes in the stomach. Emergency non-sedated endoscopy revealed eight toothbrushes in the stomach; five toothbrushes lodged in the great curvature of the stomach and three in the duodenal bulb were successfully removed using a snare and a technique that involved neck hyperextension to facilitate passage. This report describes a case of non-sedated endoscopic removal of multiple toothbrushes, which is rarely reported in the literature. This case highlights that even complex foreign bodies can be safely removed via endoscopy without surgical intervention. To our knowledge, this is the first report in the English literature that discusses endoscopic removal of more than five toothbrushes and underscores the role of customized approaches in the management of ingestion of unusual foreign bodies.

Objective: Temporary anchorage devices (TADs) have considerably reduced the need for anterior segmental osteotomy (ASO) in patients with Class I malocclusion. Most previous studies have been published before the widespread use of TADs, thus warranting new guidelines for determining the optimal approach for surgery and orthodontic treatment. This study aimed to establish guidelines on the choice between ASO and non-ASO (NASO) based on soft tissue considerations. Methods: Sixty-seven patients diagnosed with skeletal Class II malocclusion were divided into the ASO (n = 31) and NASO (n = 36) groups. Cephalometric analyses were used to compare the initial and final records to assess the effect of treatment on soft tissues. The interlabial gap, upper lip anterior to the E-line, lower lip anterior to the E-line, H-angle, upper lip to the nasion-perpendicular line, and nasolabial angle were evaluated. In particular, a proportional difference indicator between the upper and lower lips relative to the pogonion angle between the facial plane and CK line was presented, followed by statistics analyses. Statistical significance was set at P < 0.05. Results: Both groups demonstrated normal proportions of the upper and lower lips; however, significant differences favoring ASO over NASO in terms of soft tissue changes were observed for several variables. Conclusions ASO is advised if the required adjustment for the upper and lower lips is –4.0 mm and –5.0 mm, respectively. For modifications of –2.0 mm, NASO is preferred. This study provides clinical guidelines on the choice between ASO and NASO based on the required lip movement measurements.

Foreign body ingestion is a common emergency that necessitates endoscopic intervention. Although many foreign bodies are easily removed, removal of magnets, blades, barbs, and unusually shaped objects, such as toothbrushes is challenging. Toothbrush ingestion may potentially cause complications such as pressure ulcers and perforations. We present a rare case of a 26-year-old woman with schizophrenia, who ingested multiple foreign bodies but was asymptomatic. Radiography showed multiple toothbrushes in the stomach. Emergency non-sedated endoscopy revealed eight toothbrushes in the stomach; five toothbrushes lodged in the great curvature of the stomach and three in the duodenal bulb were successfully removed using a snare and a technique that involved neck hyperextension to facilitate passage. This report describes a case of non-sedated endoscopic removal of multiple toothbrushes, which is rarely reported in the literature. This case highlights that even complex foreign bodies can be safely removed via endoscopy without surgical intervention. To our knowledge, this is the first report in the English literature that discusses endoscopic removal of more than five toothbrushes and underscores the role of customized approaches in the management of ingestion of unusual foreign bodies.

Objective: Temporary anchorage devices (TADs) have considerably reduced the need for anterior segmental osteotomy (ASO) in patients with Class I malocclusion. Most previous studies have been published before the widespread use of TADs, thus warranting new guidelines for determining the optimal approach for surgery and orthodontic treatment. This study aimed to establish guidelines on the choice between ASO and non-ASO (NASO) based on soft tissue considerations. Methods: Sixty-seven patients diagnosed with skeletal Class II malocclusion were divided into the ASO (n = 31) and NASO (n = 36) groups. Cephalometric analyses were used to compare the initial and final records to assess the effect of treatment on soft tissues. The interlabial gap, upper lip anterior to the E-line, lower lip anterior to the E-line, H-angle, upper lip to the nasion-perpendicular line, and nasolabial angle were evaluated. In particular, a proportional difference indicator between the upper and lower lips relative to the pogonion angle between the facial plane and CK line was presented, followed by statistics analyses. Statistical significance was set at P < 0.05. Results: Both groups demonstrated normal proportions of the upper and lower lips; however, significant differences favoring ASO over NASO in terms of soft tissue changes were observed for several variables. Conclusions ASO is advised if the required adjustment for the upper and lower lips is –4.0 mm and –5.0 mm, respectively. For modifications of –2.0 mm, NASO is preferred. This study provides clinical guidelines on the choice between ASO and NASO based on the required lip movement measurements.

Purpose: This study aimed to characterize the clinical patterns and severity of brain injury in neonates who survived extracorporeal membrane oxygenation (ECMO) therapy for acute respiratory failure during the neonatal period, to evaluate their short-term neurodevelopmental outcomes, and to identify the factors associated with these outcomes. Methods: We retrospectively reviewed the medical records of neonates who survived ECMO between 2018 and 2024. Based on brain magnetic resonance imaging (MRI) findings, the patients were classified into two groups: no/mild and moderate/severe brain injury. Neurodevelopmental outcomes were assessed at 12–40 months of age using the Bayley Scale of Infant Development II/III and/or the Korean Developmental Screening Test. Results: Among the 19 neonates included in the study, 18 (94.7%) showed varying degrees of brain injury on MRI (mild: 12, moderate: 1, severe: 5). Neonates with moderate/severe brain injury had significantly longer durations of ECMO support and extended durations of mechanical ventilation and were more likely to receive continuous renal replacement therapy than those with no or mild injury. Developmental delay was identified in 36.8% of survivors and was significantly associated with prolonged mechanical ventilation, longer neonatal intensive care unit stays, and a higher incidence of seizures. Conclusion Brain injury is frequently observed on MRI in neonates treated with ECMO. However, its direct association with adverse neurodevelopmental outcomes is not definitive. Since MRI findings alone cannot predict developmental outcomes, clinical and environmental factors should be integrated into prognostic assessments.

Purpose: Congenital hypothyroidism (CH) is a major preventable cause of intellectual disability, particularly in very low birth weight (VLBW) infants, who are at increased risk due to hypothalamic-pituitary-thyroid axis immaturity. Early differentiation between transient CH (TCH) and permanent CH (PCH) is crucial to optimize L-thyroxine (LT4) treatment duration. This study aimed to determine the incidence of PCH among Korean VLBW infants and to identify clinical factors that may aid in distinguishing TCH from PCH. Methods: This retrospective cohort study included VLBW infants diagnosed with CH and treated with LT4 at a single tertiary neonatal intensive care unit between 2011 and 2020. Infants requiring LT4 beyond 3 years were classified as PCH, while those who discontinued earlier were considered TCH. Clinical characteristics, neonatal morbidities, and thyroid-related parameters were compared between the groups. Results: Among 1,292 VLBW infants, 122 (9.4%) were diagnosed with CH. After excluding deaths and those lost to follow-up, 73 infants were included in the final analysis (TCH, n=50; PCH, n=23). The PCH group had a significantly higher mean gestational age and greater LT4 requirements at both 12 and 36 months of age. Major anomalies were more frequently observed in PCH infants, including congenital heart defects. In multivariate analysis, higher gestational age, the presence of major anomalies, screening thyroid-stimulating hormone (TSH) >10 μIU/mL, and higher LT4 dose at 36 months were significantly associated with PCH. Conclusion The incidence of PCH in Korean VLBW infants was relatively higher than that reported in previous studies studies. Screening TSH level and LT4 dose requirements may support individualized follow-up and help distinguish PCH from TCH.

Breast magnetic resonance imaging (MRI) is the most sensitive method available for detecting breast cancer, and its use in clinical practice is on the rise. Preoperative breast MRI plays a vital role in assessing the full extent of disease and identifying additional lesions in the contralateral breast that conventional imaging may overlook. These unexpected findings can lead to significant changes in treatment approaches and may ultimately affect long-term outcomes for patients. Despite this, the value of preoperative breast MRI for early-stage breast cancer patients remains a contentious issue. This review evaluates the existing literature on the influence of preoperative breast MRI on clinical outcomes in this patient population.