Purpose: To investigate the long-term efficacy and safety of posterior chamber implantable collamer lens (ICL) implantation in high myopia, and the risk factors associated with endothelial cell loss (ECL) or cataract development. Methods: Medical records of 66 eyes of 37 patients who underwent ICL implantation for high myopia were retrospectively analyzed with a mean follow-up of 12 years. Changes in best-corrected visual acuity (logarithm of the minimum angle of resolution), intraocular pressure (IOP), refractive power, and endothelial cell density over time were analyzed with the incidence of cataract and IOP elevation. Risk factors were analyzed for their association with ECL or cataract development. Results: At 10 years after surgery, the mean uncorrected visual acuity was 0.06 and the spherical equivalent was –0.90 diopters. By year 10, cataract was present in 13 of 66 eyes (19.7%), whereas glaucoma was found in 1 of 66 eyes (1.5%). Although IOP continuously elevated over time (p < 0.05), it remained within normal limits. The cataract group had a lower vault of ICL and a higher mean age at surgery (p < 0.05). Endothelial cell density remained above 2,000/mm2 in 98.5% of cases, with an average annualized rate of decline of 1.13%. The high annualized rate group (>1.13% loss per year) had a lower mean age than in the low annualized rate group (<1.13% loss per year, p < 0.05). Conclusions This indicates that ICL implantation is effective for high myopia, and its main complication is cataract and ECL. It also suggests that ECL and cataract should be regularly monitored although ECL looks stable in long-term follow-up. Age may affect both ECL and cataract, while low-vault ICL may affect cataract.

Incidentally detected gallbladder polyps (GBPs) and gallbladder wall thickening (GBWT) are frequently encountered in clinical practice. However, characterizing GBPs and GBWT in asymptomatic patients can be challenging and may result in overtreatment, including unnecessary follow-ups or surgeries. The Korean Society of Abdominal Radiology (KSAR) Clinical Practice Guideline Committee has developed expert recommendations that focus on standardized imaging interpretation and follow-up strategies for both GBPs and GBWT, with support from the Korean Society of Radiology and KSAR. These guidelines, which address 24 key questions, aim to standardize the approach for the interpretation of imaging findings, reporting, imaging-based workups, and surveillance of incidentally detected GBPs and GBWT. This recommendation promotes evidence-based practice, facilitates communication between radiologists and referring physicians, and reduces unnecessary interventions.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

RESULTS: Resveratrol significantly reduced cardiac hypertrophy and remodeling in aging hearts. In addition, resveratrol significantly ameliorated aging-induced mitochondrial dysfunction (e.g., decreased oxygen respiration and increased hydrogen peroxide emission) and mitochondria-dependent apoptotic signaling (the Bax/Bcl-2 ratio, mitochondrial permeability transition pore opening sensitivity, and cleaved caspase-3 protein levels).Resveratrol also significantly attenuated aging-induced apoptosis (determined via cleaved caspase-3 staining and TUNEL-positive myonuclei) in cardiac muscles. CONCLUSION This study demonstrates that resveratrol treatment has a beneficial effect on aging-induced cardiac remodeling by ameliorating mitochondrial dysfunction and inhibiting mitochondria-mediated apoptosis in the heart.

Background/Aims: Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia. This research aimed to evaluate the clinical features and outcomes of PVT in patients with IBD at a leading hospital in South Korea. Methods: This retrospective analysis reviewed adult patients diagnosed with both IBD and PVT from 1989 to 2021 at a renowned South Korean medical center. The study focused on patient characteristics, specifics of PVT, administered treatments, and outcomes, all confirmed through enhanced CT scans. Results: A total of 78 patients met the study’s criteria. Notably, only 20.5% (16/78) were treated with oral anticoagulants; however, a vast majority (96.2%; 75/78) achieved complete radiographic resolution (CRR). When comparing patients receiving anticoagulants to those who did not, a significant preference for anticoagulant use was observed in cases where the main portal vein was affected, as opposed to just the left or right veins (p = 0.006). However, multivariable analysis indicated that neither anticoagulant use nor previous surgeries significantly impacted CRR. Conclusions Patients with IBD and PVT generally had favorable outcomes, regardless of anticoagulant use.

Purpose: This retrospective cohort study aimed to investigate the association between the use of pain medications with varying cyclooxygenase-2 (COX-2) selectivity and the incidence of endometriosis (EMS) in women. Materials and Methods: Medical records from January 1, 1994, to December 31, 2022, were retrospectively analyzed. The cohort included 33406 patients diagnosed with any pain-related condition who were prescribed either selective COX-2 inhibitors or nonsteroidal anti-inflammatory drugs (NSAIDs). Patients were followed for up to 5 years from the cohort entry date. The incidence of EMS was compared between the two medication groups using Cox proportional hazards models, adjusting for confounding factors such as age, past drug use, and prior diagnosis. Results: The incidence rates of EMS were 3.00 per 1000 person-years in the COX-2 inhibitor group and 3.97 per 1000 person-years in the NSAIDs group. After adjustment for confounders, the hazard ratio for EMS incidence in the COX-2 inhibitor group compared to the NSAIDs group was 0.77 [95% confidence interval (CI), 0.63 to 0.93; p<0.01], indicating a significantly lower risk in the COX-2 inhibitor group. Subgroup analysis revealed that this association was particularly significant in younger women aged 20– 44 years, with a hazard ratio of 0.71 (95% CI, 0.54 to 0.95; p<0.05) in this age group. Conclusion The findings suggest that COX-2 inhibitors may reduce the incidence of EMS compared to traditional NSAIDs, highlighting their potential as a strategic option for managing EMS, particularly among younger women. Further prospective studies are needed to confirm these findings.

Purpose: Adjuvant treatment for craniopharyngioma after surgery is controversial. Adjuvant external beam radiation therapy (EBRT) can increase the risk of long-term sequelae. Stereotactic radiosurgery (SRS) is used to reduce treatment-related toxicity.In this study, we compared the treatment outcomes and toxicities of adjuvant therapies for craniopharyngioma. Materials and Methods: We analyzed patients who underwent craniopharyngioma tumor removal between 2000 and 2017. Of the 153 patients, 27 and 20 received adjuvant fractionated EBRT and SRS, respectively. We compared the local control (LC), progression-free survival (PFS), and overall survival between groups that received adjuvant fractionated EBRT, SRS, and surveillance. Results: The median follow-up period was 77.7 months. For SRS and surveillance, the 10-year LC was 57.2% and 57.4%, respectively. No local progression was observed after adjuvant fractionated EBRT. One patient in the adjuvant fractionated EBRT group died owing to glioma 94 months after receiving radiotherapy (10-year PFS: 80%). The 10-year PFS was 43.6% and 50.7% in the SRS and surveillance groups, respectively. The treatment outcomes significantly differed according to adjuvant treatment in nongross total resection (GTR) patients. Additional treatment-related toxicity was comparable in the adjuvant fractionated EBRT and other groups. Conclusion Adjuvant fractionated EBRT could be effective in controlling local failure, especially in patients with non-GTR, while maintaining acceptable treatment-related toxicity.

Purpose: To develop a machine learning (ML) classifier for predicting post-induction hypotension (PIH) in non-cardiac surgeries. Materials and Methods: Preoperative data and early vital signs were obtained from 3669 cases in the VitalDB database, an opensource registry. PIH was defined as sustained mean arterial pressure (MAP) <65 mm Hg within 20 minutes since induction or from induction to incision. Six different ML algorithms were used to create binary classifiers to predict PIH. The primary outcome was the area under the receiver operating characteristic curve (AUROC) of ML classifiers. Results: A total of 2321 (63.3%) cases exhibited PIH. Among ML classifiers, the random forest regressor and extremely gradient boosting regressor showed the highest AUROC, both recording a value of 0.772. Excluding these models, the light gradient boosting machine regressor showed the second highest AUROC [0.769; 95% confidence interval (CI), 0.767–0.771], followed by the gradient boosting regressor (0.768; 95% CI, 0.763–0.772), AdaBoost regressor (0.752; 95% CI, 0.743–0.761), and automatic relevance determination regression (0.685; 95% CI, 0.669–0.701). The top three important features were mean diastolic blood pressure (DBP), minimum MAP, and minimum DBP from anesthetic induction to tracheal intubation, and these features were lower in cases with PIH (all p<0.001). Conclusion ML classifiers exhibited moderate performance in predicting PIH, and have the potential for real-time prediction.

Background/Aims: We aim to compare the remission of erosive esophagitis (EE) among individuals with different phenotypes based on their metabolic health and obesity status and investigate the impact of changes in metabolic health on the EE remission. Methods: Asymptomatic adults (n = 16 845) with EE at baseline, who underwent follow-up esophagogastroduodenoscopy (EGD) were categorized into 4 groups as follows: metabolically healthy (MH) nonobese, metabolically unhealthy (MU) nonobese, MH obese, and MU obese. EE was defined as grade A or higher mucosal breaks observed using esophagogastroduodenoscopy. Results: During a median follow-up of 2.2 years, the remission rates of EE were 286.4/10 3 , 260.1/10 3 , 201.5/10 3 , and 219.9/10 3 person-years in MH nonobese, MU nonobese, MH obese, and MU obese groups, respectively. Multivariate-adjusted hazard ratios (95% CI) for EE remission among the MH nonobese, MU nonobese, and MH obese groups versus that of the MU obese group were 1.30 (1.23-1.37), 1.17 (1.12-1.23), and 0.98 (0.90-1.06), respectively, whereas those of the persistent MH, progression of MH to MU, and remission of MU to MH compared with the persistent MU group were 1.37 (1.23-1.52), 1.15 (1.01-1.30), and 1.28 (1.12-1.46), respectively.Increased EE remission in the persistent MH group was consistently observed in individuals with and without obesity (or abdominal obesity). Conclusions Metabolic health and nonobesity independently and favorably impact EE remission. Maintaining normal weight and healthy metabolic status may contribute to EE remission.