Background: To investigate Korean neurologists' perceptions of the non-standard term ‘jayulsingyeongsiljo’ and their actual evaluation and management of such patients. Methods: We performed an anonymous web-based cross-sectional survey of board-certified Korean neurologists by Korean Society of Pain and Autonomic Disorders between August 13 and September 10, 2025. A questionnaire sent by e-mail asked about demographics, experience with patients labeled with ‘jayulsingyeongsiljo,’ use and perceived usefulness of autonomic function tests, the impact of coronavirus disease 2019, and opinions on terminology and the role of neurologists. Results: In total, 109 neurologists responded. Most reported that patients presenting for ‘jayulsingyeongsiljo’ were young or middle-aged adults and that their numbers had increased over the preceding 2 years. Referrals frequently originated from Korean medicine clinics and other non-neurology departments, often after stand-alone heart rate variability testing. Fatigue, orthostatic intolerance, palpitations, sweating abnormalities, gastrointestinal symptoms, and anxiety or insomnia were common, and autonomic testing was generally regarded as helpful. Eighty percent felt that the risks associated with ‘jayulsingyeongsiljo’ are overstated, and 95% preferred replacing the term with standardized expressions such as autonomic dysfunction. Conclusions Korean neurologists view ‘jayulsingyeongsiljo’ as an unrecognized and potentially misleading label and support society-led standardization of terminology and guidance to improve autonomic dysfunction care and resource use.

Flow cytometric lymphocyte subset analysis (FCLSA) is essential for assessing immune status across various diseases and clinical settings. We surveyed current clinical laboratory practices related to FCLSA to establish a baseline reference for future standardization in Korea. Nine university hospitals actively performing FCLSA responded to the 22-question survey, which covered seven categories of laboratory practice. These hospitals used commercial reagent antibody kits from either Beckton Dickinson Biosciences (N = 4) or Beckman Coulter Diagnostics (N = 5). Most hospitals performed daily instrument setup and scheduled maintenance every 2–6 months. Two levels of commercial quality control materials were routinely used each day. Sample and reagent antibody volumes varied across hospitals, even when the same reagent kit was used. Acquired cell counts ranged from 5 × 10 3 to 5 × 10 4 cells, with two hospitals adjusting counts based on the cell type analyzed. Most laboratories reported percentages and general opinions; some additionally reported white blood cell and lymphocyte counts, along with lymphocyte percentages. This is the first comprehensive survey on the clinical laboratory practice of FCLSA in Korea.Standardization of FCLSA should be accelerated to ensure reliable and reproducible results.

Purpose: This study aimed to develop and evaluate the effectiveness of the Trauma-nursing Education and Skill Support (TESS) program based on the ADDIE model (Analysis, Design, Development, Implementation, Evaluation model). The program was designed to enhance trauma nurses’ clinical competencies, including trauma-related knowledge, self-efficacy, and problem-solving ability, through the integration of theoretical education and simulation-based practice. Methods: A quasi-experimental study using a non-equivalent control group pretest–posttest design was conducted. Participants included 108 trauma nurses from regional trauma centers, military trauma centers, and emergency care facilities, who were assigned to an experimental group (n=52) or a control group (n=56). The TESS program consisted of a 2-day, 14-hour blended-learning course that included eight lecture sessions and four simulation-based practice stations. Data were collected at baseline, immediately after the intervention, and at 6 months using validated instruments measuring trauma-related knowledge, self-efficacy, and problem-solving ability. Two-way repeated-measures analysis of variance was used for data analysis. Results: The experimental group demonstrated significant improvements in trauma-related knowledge, self-efficacy, and problem-solving ability compared with baseline (all p<.001). These improvements were sustained at 6 months, although trauma-related knowledge scores showed a slight decline compared with immediate posttest levels. Between-group analyses confirmed significant group-by-time interaction effects for all outcomes: trauma-related knowledge (η2=0.12, p<.001), self-efficacy (η2=0.09, p=.002), and problem-solving ability (η2=0.08, p=.003). Conclusion The TESS program effectively enhanced trauma nurses’ trauma-related knowledge, self-efficacy, and problem-solving ability, with effects sustained for up to 6 months. Incorporating blended learning and simulation-based training into standardized trauma nursing education may strengthen clinical competencies and ultimately contribute to improved patient outcomes.

Purpose: We investigated the antiadhesive effects of lidocaine, methylene blue, and atorvastatin, with a focus on preventing remote adhesions in a rat model of postoperative adhesions. Methods: Models were assigned to either the control group (saline infusion only) or treatment groups (group L, lidocaine;group M, methylene blue; or group S, atorvastatin). Adhesions were induced by intestinal or abdominal wall injuries. The rats were sacrificed 2 weeks after surgery. Results: The number of remote adhesions was markedly lower in groups L, M, and S than in the control group. The macroscopic adhesion score was substantially lower in groups L, M, and S than in the control group. Acute and chronic inflammation, as well as fibrosis scores, were also markedly lower in groups L, M, and S than in the control group. IL-1βlevels were considerably reduced in groups L, M, and S at 2 hours after surgery and remained substantially lower in group S at 48 hours. IL-6 levels were markedly reduced in groups M and S at 2 hours and in all treatment groups at 48 hours than in the control group. Conclusion Intraperitoneal administration of lidocaine, methylene blue, and atorvastatin effectively reduced remote adhesion formation, macroscopic and microscopic adhesion scores, and inflammatory cytokine levels in a rat adhesion model.

Although aspartate aminotransferase (AST) is a serum marker of hepatocellular damage in chronic hepatitis, it is difficult to interpret very high AST levels with concurrent low alanine aminotransferase (ALT) levels. Macro-AST is an immunoglobulin-AST complex that can present as aberrant high enzymatic activity without significant inflammation in the liver. Two patients with chronic hepatitis B presented with disproportionate AST elevations. Their plasma samples were precipitated with polyethylene glycol (PEG) and stored at 4°C for macro-AST determinations. In Case 1, PEG precipitation showed 100% removal of AST activity, and refrigerated storage resulted in a ~70% decline over seven days, confirming macro-AST. In Case 2, both tests showed minimal changes, suggesting that macro-AST was unlikely. The AST levels normalized after antiviral therapy, suggesting immune-active hepatitis as the probable cause, but the other contributing factors could not be completely excluded. The abrupt decrease in AST activity after PEG precipitation and during refrigeration storage suggests that relatively high AST values compared to ALT might be attributed to the presence of macro-AST.These non-invasive methods for detecting macroenzymes might help the patient avoid unnecessary further work-ups.

Purpose: Hereditary spastic paraplegia (HSP) refers to a group of genetic neurodegenerative diseases marked by gradually worsening spasticity and hyperreflexia in the lower extremities. This study aimed to describe the clinical and genetic characteristics of Korean patients with spastic paraplegia. Materials and Methods: We retrospectively reviewed medical records of 69 patients with spastic paraplegia from 54 unrelated families between 2002 and 2024. Genetic, clinical, electrophysiological, and radiological features were comprehensively analyzed. Results: Causative genes were identified in 34 (63%) of 54 unrelated families; SPAST, detected in 26 families, was the most prevalent. Seven novel pathogenic variants were identified. Clinically, the median age of symptom onset was 25 years [14.0–37.0]. Out of 69 patients with spastic paraplegia, 51 (74%) presented with the pure form of spastic paraplegia, which included all patients with SPG4. Spastic gait was a universal feature in all patients. Urinary dysfunction was present in 42 (61%) patients. Additional neurologic manifestations included peripheral neuropathy 9 (13%), cognitive impairment 5 (7%), upper limb weakness 4 (6%), dysarthria 4 (6%), dysphagia 3 (4%), ataxia 3 (4%), and scoliosis 1 (3%). Brain MRI findings demonstrated a thin corpus callosum in two patients with SPG11; all patients with SPG4 had normal findings. Spine MRI revealed spinal cord atrophy in 16 (27%) patients, including 6 (21%) patients with SPG4. Conclusion The study comprehensively reviewed genetic and clinical spectra of spastic paraplegia in Korean patients, emphasizing the predominance of SPAST as the causative gene and underscoring the genetic and phenotypic heterogeneity of spastic paraplegia.

Background: There are limited long-term clinical outcome data comparing first-generation (1G) versus second-generation (2G) drug-eluting stents (DES) in patients with single-vessel disease (SVD). We sought to compare the efficacy and safety of 1G- and 2G-DES in SVD patients who underwent successful percutaneous coronary intervention (PCI) over 10 years of clinical follow-up. Methods: A total of 2,312 consecutive patients with SVD who underwent PCI with 1G-DES (paclitaxel- or sirolimus-eluting stents, n = 811) or 2G-DES (zotarolimus [Endeavor, Endeavor Resolute]- or everolimus-eluting stents [Promus Element, Xience], n = 1,082) were enrolled.After propensity score matching, 2 matched groups (538 pairs) were generated. Study endpoints included individual and composite clinical outcomes through 10 years. Results: During the 10-year follow-up, the 2G-DES group had lower incidences of myocardial infarction (MI; hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.22–0.92; P = 0.028) and target lesion revascularization (TLR; HR, 0.54; 95% CI, 0.32–0.91; P = 0.021) than the 1G-DES group. Rates of total death, cardiac death, non-target vessel revascularization, stroke, major adverse cardiac events, and major adverse cardiac and cerebrovascular events were similar between groups. Conclusions In our single-center, all-comer registry, 2G-DES were associated with lower incidence rates of MI and TLR compared to 1G-DES in SVD patients over 10 years of followup, indicating a safer and more durable effect than 1G-DES.

Purpose: This study evaluated the clinical outcomes and prognostic factors in patients with borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) treated with upfront FOLFIRINOX followed by local-regional therapy (LRT), surgical resection (SR), and radiotherapy (RT). We aimed to identify specific patient subgroups for which RT may serve as a reasonable alternative to SR for local tumor control. Methods: We retrospectively analyzed 116 patients (SR group, n= 70; RT group, n= 46) at a single center between 2015 and 2020. Survival outcomes were compared based on LRT modalities, focusing on identifying subgroups in which RT provided an efficacy comparable to that of SR. Results: Among 116 patients, the SR group achieved a significantly higher 5-year overall survival (OS) than the RT group (27.1% vs. 8.7%, P< 0.0001), despite similar progression-free survival (P= 0.23). Significant prognostic factors for OS included carbohydrate antigen 19-9 (CA19-9) response in BRPC (P= 0.02) and radiologic partial response in LAPC (P= 0.05). Subgroup analysis revealed that, while SR provided a survival advantage in CA19-9 responders, no significant difference in OS was observed between SR and RT in CA19-9 non-responders (P= 0.37). Conclusion Although surgery remains the gold standard, RT may be considered a justifiable local alternative for CA19-9 non-responders and surgically ineligible patients with LAPC, yielding comparable outcomes in these specific, biologically unfavorable subgroups.

Objectives: Tegoprazan is an alternative to proton pump inhibitors (PPIs). This study evaluated the occurrence of upper gastrointestinal (GI) and cardiovascular (CV) complications in patients with ischemic heart disease undergoing antiplatelet therapy after percutaneous coronary intervention (PCI) who were treated with tegoprazan or PPIs. Methods: Data from 604 patients who received antiplatelet therapy with tegoprazan or PPIs for >6 months after PCI between March 2019 and November 2023 were retrospectively analyzed. The primary GI endpoints were symptomatic gastroduodenal ulcers and upper GI bleeding, while the primary CV endpoints comprised major adverse cardiac events (MACEs), nonfatal myocardial infarction (MI), target vessel revascularization, and death from CV-related causes. Results: Among the 604 patients, 265 received tegoprazan and 339 received PPIs. During a mean follow-up of 17 months, seven patients experienced a GI event (0.4% with tegoprazan vs. 1.8% with PPIs; p=0.112) and 12 experienced MACEs (1.1% with tegoprazan vs. 2.7% with PPIs; p=0.183). Subgroup analysis indicated that target vessel revascularization occurred in six patients, with event rates of 0.8% (n=2) for tegoprazan and 1.2% (n=4) for PPIs (p=0.598). Tegoprazan was associated with similar rates of nonfatal MI (0.8% vs. 2.4%; p=0.125) and death from CV-related causes (0.4% vs. 0%; p=0.258) as PPIs. Conclusions There were no significant differences in GI- or CV-related complications between patients treated with tegoprazan and those treated with PPIs.

Background: Cisplatin-based chemotherapy is a mainstay treatment for head and neck squamous cell carcinoma (HNSC); however, resistance to cisplatin contributes substantially to poor clinical outcomes. Identifying biomarkers associated with cisplatin response may improve prognostic assessment and treatment selection. Methods: We retrospectively analyzed The Cancer Genome Atlas (TCGA)-HNSC dataset to evaluate the association between microtubule associated scaffold protein 1 (MTUS1) expression and clinical outcomes, with particular emphasis on patients who were cisplatin-treated. Survival analysis was performed using the Kaplan-Meier curves, and differential expression analysis was conducted separately by comparing patients in disease-specific survival (DSS)-living and DSS-deceased groups. MTUS1 messenger RNA and protein levels were examined in cisplatin-sensitive oral cancer cell lines and their paired cisplatin-resistant counterparts using quantitative reverse transcription polymerase chain reaction and western blotting. Functional relevance was assessed by small interfering RNA-mediated MTUS1 knockdown in primary oral squamous cell carcinoma organoids. Results: MTUS1 protein expression was significantly lower in HNSC tumors than in non-tumor tissues. In the overall TCGA-HNSC cohort, MTUS1 expression was not significantly associated with survival. However, in patients who were cisplatin-treated, higher MTUS1 expression was significantly associated with more favorable DSS. MTUS1 expression was consistently lower in cisplatin-resistant oral cancer cell lines than in their paired cisplatin-sensitive counterparts. Functional experiments further suggested that reduced MTUS1 expression is associated with decreased cisplatin sensitivity and a resistant phenotype. Conclusion MTUS1 expression may be associated with clinical outcomes in patients with cisplatin-treated HNSC and is related to cisplatin responsiveness. These findings suggest a role for MTUS1 as a candidate treatment-relevant biomarker and highlight the value of integrating public omics data with experimental validation.