Purpose: This study aimed to report the real-world outcomes of intravesical gemcitabine for bacillus Calmette–Guérin (BCG)–unresponsive, high-risk, non–muscle-invasive bladder cancer (HR-NMIBC) in Korean patients who were unable or unwilling to undergo radical cystectomy (RC). Materials and Methods: This retrospective study included 131 patients (median age, 69 years; 88.5% men) treated with intravesical gemcitabine for BCG-unresponsive HR-NMIBC at nine centers between May 2019 and April 2022. The primary endpoint was 1-year recurrence-free survival (RFS). The secondary endpoints included factors influencing RFS, progression-free survival (PFS), cystectomy- free survival, cancer-specific survival (CSS), overall survival (OS), and safety. Survival analysis was performed using the Kaplan-Meier method, and risk factors for recurrence were assessed using Cox regression models. Results: Patients were followed up for a median duration of 25 months, with carcinoma in situ (CIS) in 41.9% of the patients. The 1-year and 2-year RFS rates were 68% and 42%, while the 1-year and 2-year PFS rates were 87% and 77%, respectively. No significant factors influencing RFS were identified. Seventeen patients underwent RC during a median follow-up of 16 months, with the condition in three patients progressing to muscle-invasive disease on final pathological analysis. The 2-year CSS and OS rates were 98% and 97%, respectively. Intravesical gemcitabine was well-tolerated, with only seven patients (5.3%) unable to complete the full induction course. Conclusion Our research highlights the potential of intravesical gemcitabine as a viable bladder-sparing treatment option for BCG-unresponsive HR-NMIBC, providing real-world evidence on its safety, efficacy, and tolerability.

Purpose: This study aimed to develop pilot clinical skills assessment (CSA) modules for Korean medicine-specific procedures and to examine their preliminary appropriateness, perceived necessity, and feasibility as a foundation for future licensing-related assessment development. Methods: A participatory action research framework, supplemented by qualitative interviews, was used to develop 4 CSA modules—acupuncture, Chuna manual therapy, pulse diagnosis, and constitutional diagnosis—in collaboration with expert evaluators, students, and standardized patients. The modules were implemented as formative examinations for third-year Korean medicine students, after which semi-structured interviews were conducted to obtain feedback on module content, implementation processes, and scoring procedures. Each module was also reviewed using the RUMBA checklist (Realistic, Understandable, Measurable, Behavioral, and Achievable), together with ratings of perceived necessity and feasibility for possible future use in licensing-related assessment. Interview data were analyzed inductively at the level of individual responses and then compared across modules and participant groups. Results: Qualitative analysis yielded 3 themes: content and scoring criteria, physical environment or simulators, and education or training. Participants emphasized the need to make key aspects of performance more observable, improve authenticity through simulators or task trainers, and strengthen the capacity of scoring systems to distinguish between levels of student performance. Across all modules, mean RUMBA scores were high in the understandable, behavioral, and achievable domains, whereas measurability was more problematic, especially for pulse diagnosis. Conclusion These pilot findings clarify both the strengths and the limitations of Korean medicine-specific CSA modules. The modules received favorable ratings for understandability and achievability, whereas lower ratings for measurability and realism identified priorities for refinement before wider use. This study provides preliminary guidance for the continued development and broader evaluation of Korean medicine-specific performance assessments.

Background: The incidence of preterm birth in Korea increased from 6.5% in 2013 to 9.7% in 2020. Very low birth weight (VLBW) infants, defined as those weighing < 1,500 g, are particularly vulnerable to numerous health risks. Breast milk provision reduces the incidence of complications in this vulnerable population. The objective of this study was to examine the rate and factors associated with breast milk provision at neonatal intensive care unit (NICU) discharge and to investigate its potential effects on growth and developmental outcomes at 18–24 months corrected age (CA). Methods: We conducted this cohort study using data from over 70 NICUs participating in the Korean Neonatal Network. VLBW infants born between January 2019 and December 2020 at a gestational age of 23 +0 to 31 +6 weeks were included. Discharge feeding types were analyzed of 2,490 infants, while follow-up assessments of growth and neurodevelopmental outcomes at 18–24 months of CA were available for 1,426 infants. Propensity score matching was used for comparative analysis. Results: The rate of breast milk provision at discharge among VLBW infants was 55.9% in 2019 and 56.5% in 2020. Factors that were positively associated with breast milk feeding included higher maternal education level and antenatal steroid use. In contrast, maternal hypertensive disorders, cesarean section, and severe neonatal morbidities (e.g., necrotizing enterocolitis) were correlated with lower breast milk feeding rates at the time of discharge.The provision of breast milk at discharge was not associated with a higher risk of suboptimal growth (below two standard deviations) compared to control infants at 18–24 months of CA. Neurodevelopmental assessments indicated that breast milk was associated with a reduced risk of developmental delay (adjusted odds ratio, 0.72; 95% confidence interval, 0.56–0.94) at follow-up. Conclusion Breast milk provision to VLBW infants at NICU discharge in Korea was comparable to that in other countries. This nationwide study highlights the critical role of breast milk in promoting the neurodevelopment of VLBW infants. Future efforts should focus on identifying the barriers to breast milk provision to improve health outcomes in vulnerable populations.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Methods: A total of 90 patients underwent APCT within 48 hours of surgery. Medical records were reviewed to determine each patient’s age, sex, body mass index, medical and surgical histories, characteristics of LLIF procedures, and subjective symptoms and abnormal findings in the physical examination related to acute abdomen after surgery. Various parameters were compared between patients with and without pneumoperitoneum. Results: Bowel injuries were identified in the first two patients and five patients (5.5%) were diagnosed with pneumoperitoneum only on APCT. We found that the greater the number of fused segments, the higher the incidence of postoperative bowel injury and/or pneumoperitoneum. The incidence was significantly high when the L2–3 level was included in the LLIF surgery. Conclusions Pneumoperitoneum after LLIF indicates damage to the peritoneum and the presence of bowel injury that may lead to peritonitis. However, it is difficult to distinguish pneumoperitoneum and/or bowel injury from general abdominal pain after surgery because patients may present with a wide range of symptoms. We recommend that APCT be routinely performed after LLIF surgery in order to promptly identify pneumoperitoneum and bowel injury.

OBJECTIVES: This study aimed to investigate the correlation between oral health behaviors of workers by examining the oral health awareness and the need for oral health education. METHODS: After the institutional review board approval, we surveyed industrial workers in Seoul, Gwangju, Changwon, and Goksung, in Korea, from July 19 to August 29, 2016. The final questionnaires (287 in total) were assessed using the SPSS 24.0 software for Windows (SPSS Inc. Chicago, IL, USA). The data were analyzed using frequency analysis, average, standard deviation, t-test, and the Pearson's correlation coefficient. RESULTS: Through the response of “yes” for the question, “oral health education experience,” we can see the respondents have high level of interest (P<0.001). And through the response of “yes” for the question, “Periodic oral Examination” and “regular scaling” and “oral care product use” we can see the respondents have high level of interest (P<0.001) and high importance (P<0.001), there was a statistically significant difference. On analyzing the correlations between workers, there was positive correlation oral health ‘Interest’ and ‘Importance’ (r=0.598, P<0.001). Of the 287 participants, 80.1% indicated that they did not receive any previous oral health education, while 85.4% indicated a willingness to attend oral health education programs in the future. Of the 80.1% of participants with no prior oral health education, 60.0% indicated lack of oral health education because of few opportunities to participate in such programs. They most prefer “Oral Hygiene Management” 64.8% for education contents and choose “Direct-education by inviting Expert” as the best education method 75.6%. CONCLUSIONS: It is necessary to develop oral health education programs suitable for the industrial field characteristics for people in workplace, and to enhance and expand oral health education services in the workplace in order to maintain interest in oral health.
Education* ; Ethics Committees, Research ; Gwangju ; Gyeongsangnam-do ; Health Education ; Hygiene ; Korea ; Methods ; Oral Health* ; Seoul ; Surveys and Questionnaires

Interleukin-32 (IL-32), a recently identified pro-inflammatory cytokine, is involved in the pathogenesis and progression of infections, cancer, chronic inflammation, and autoimmune disease. IL-32γ is the most active isoform in cell death and cell activation among nine distinct isoforms of IL-32. IL-32γ potentiates both osteogenic and osteoclastogenic capacities, and is critical in the coupling of bone resorption and bone formation for maintenance of bone homeostasis. IL-32γ is strongly associated with inflammatory bone disorders such as rheumatoid arthritis, ankylosing spondylitis, and osteoporosis. In this review, we summarize current research on the role of IL-32γ in inflammatory bone disorders, highlighting this cytokine as a novel target for prognostic marker and control of these diseases.
Arthritis, Rheumatoid ; Autoimmune Diseases ; Bone Diseases* ; Bone Resorption ; Cell Death ; Homeostasis ; Inflammation ; Osteogenesis ; Osteoporosis ; Protein Isoforms ; Spondylitis, Ankylosing

PURPOSE: Triage tags help prioritize the treatment for disaster patients based on the severity of the illness and help distribute limited resources during a time of disaster. In this study, we developed a novel triage tag and evaluated its feasibility during a hospital-based disaster drill. METHODS: For the first stage, we developed a new triage tag. The most commonly used triage tags (Medical Emergency Triage-TAG and SMART tag) were analyzed. We reassembled their advantages and invented a novel triage tag (NT tag). The second stage involved an evaluation of the quality of NT tag. The NT tag was used in a hospital-based disaster drill held in a single center with 22 mock patients. After the drill, hospital staffs were asked to complete a questionnaire which included visibility, comprehensibility, and ease of use with respect to the new NT tag. A five-category Likert scale was used to quantify the answer. RESULTS: The NT tag was successfully developed considering 6 quality indexes: visibility, expandability, flexibility, solidity, space, and fixity. Forty-two out of ninety (46.7%) subjects answered the questionnaire. Approximately 21% of participants had previous disaster drill experience and 33% had previous education of the SMART triage system. The visibility scale of the severity category was on average 3.3 (standard deviation (SD): 1.0), the comprehensiveness of the severity category was 3.6 (SD:0.9), the ease to understand patient information was 2.2-4.2, the ease to follow up symptoms and vital signs was 2.3-4.1. Eighty and percent of participants preferred to use the NT tag in a future disaster situation or disaster drill. CONCLUSION: We successfully developed a novel triage tag. The NT tag showed moderate feasibility.
Disasters ; Education ; Emergencies ; Follow-Up Studies ; Humans ; Pliability ; Triage* ; Vital Signs

Interleukin 5 (IL-5) is a key cytokine involved in the induction of T-helper type 2 (Th2) responses in the asthmatic airway. We investigated IL-5 genetic polymorphisms associated with asthma phenotypes, including IgE responses to staphylococcal enterotoxins A and B (SEA and SEB, respectively), in asthmatics. Adult asthmatics (n=310) and normal controls (n=160) were enrolled in the present study. Serum total and specific IgE to SEA and SEB were measured. Two IL-5 polymorphisms, -746A>G and +4499T>G, were genotyped using the primer-extension method. There were no significant differences in genotype or haplotype frequencies of these polymorphisms between the two groups. Asthmatics carrying the AG/GG genotype at -746A>G had a significantly higher prevalence of serum specific IgE to SEA (P=0.008), higher total IgE levels (P=0.014), and lower PC20 methacholine levels (P=0.002) compared to those with the AA genotype. These findings suggest that the IL-5 promoter polymorphism at -746A>G enhances serum total and specific IgE responses to SEA, which may augment airway hyperresponsiveness in adult asthmatics.
Adult ; Asthma ; Enterotoxins ; Genotype ; Haplotypes ; Humans ; Immunoglobulin E ; Interleukin-5 ; Lifting ; Methacholine Chloride ; Phenotype ; Polymorphism, Genetic ; Prevalence ; Superantigens

In humans, skin barrier dysfunction is thought to be responsible for enhanced penetration of allergens. Similar to conditions seen in humans, canine atopic dermatitis (CAD) is characterized by derangement of corneocytes and disorganization of intercellular lipids in the stratum corenum (SC) with decreased ceramide levels. This study was designed to evaluate the effects of a moisturizer containing ceramide on dogs with CAD. Dogs (n = 20, 3~8 years old) with mild to moderate clinical signs were recruited and applied a moisturizer containing ceramide for 4 weeks. Transepidermal water loss (TEWL), skin hydration, pruritus index for canine atopic dermatitis (PICAD) scores, and canine atopic dermatitis extent and severity index (CADESI) scores of all dogs were evaluated. Skin samples from five dogs were also examined with transmission electron microscopy (TEM) using ruthenium tetroxide. TEWL, PICAD, and CADESI values decreased (p < 0.05) and skin hydration increased dramatically over time (p < 0.05). Electron micrographs showed that the skin barrier of all five dogs was partially restored (p < 0.05). In conclusion, these results demonstrated that moisturizer containing ceramide was effective for treating skin barrier dysfunction and CAD symptoms.
Animals ; Ceramides/*therapeutic use ; Cholesterol/*therapeutic use ; Dermatitis, Atopic/complications/drug therapy/physiopathology/*veterinary ; Dog Diseases/*drug therapy/etiology/physiopathology ; Dogs ; Emollients/*therapeutic use ; Epidermis/drug effects/physiopathology/ultrastructure ; Fatty Acids, Nonesterified/*therapeutic use ; Female ; Male ; Microscopy, Electron, Transmission/veterinary ; Pruritus/drug therapy/etiology/physiopathology/veterinary ; Republic of Korea ; Ruthenium Compounds/chemistry ; Water Loss, Insensible/drug effects