Background: The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction. Methods: We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected. Results: Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures. Conclusions Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.

Background: The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction. Methods: We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected. Results: Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures. Conclusions Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.

Background: The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction. Methods: We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected. Results: Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures. Conclusions Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.

Multiple myeloma (MM), a hematological malignancy, is characterized by malignant plasma cell proliferation in the bone marrow. Recent treatment advances have significantly improved patient outcomes associated with MM.In this study, we aimed to develop comprehensive, evidence-based guidelines for the diagnosis, prognosis, and treat‑ ment of MM. We identified 12 key clinical questions essential for MM management, guiding the extensive literature review and meta-analysis of the study. Our guidelines provide evidence-based recommendations by integrating patient preferences with survey data. These recommendations include current and emerging diagnostic tools, thera‑ peutic agents, and treatment strategies. By prioritizing a patient-centered approach and rigorous data analysis, these guidelines were developed to enhance MM management, both in Korea and globally.

Objective: We intended to investigate the relationships between visual sensory impairment (VSI) or auditory sensory impairment (ASI) and brain pathological changes associated with cognitive decline in older adults. Methods: We primarily tried to examine whether each sensory impairment is related to Alzheimer’s disease (AD) pathology, specifically beta-amyloid (Aβ) deposition, through both cross-sectional and longitudinal approaches in cognitively unimpaired older adults. Self-report questionnaires on vision and hearing status were administered at the baseline.Neuroimaging scans including brain [ 11 C] Pittsburgh Compound B PET and MRI, as well as clinical assessments, were performed at baseline and 2-year follow-up. Results: Cross-sectional analyses showed that the VSI-positive group had significantly higher Aβ deposition than the VSI-negative group, whereas there was no significant association between ASI positivity and Aβ deposition. Longitudinal analyses revealed that VSI positivity at baseline was significantly associated with increased Aβ deposition over 2 years (β = 0.153, p = 0.025), although ASI positivity was not (β = 0.045, p = 0.518). VSI positivity at baseline was also significantly associated with greater atrophic changes in AD-related brain regions over the 2-year follow-up period (β = −0.207, p = 0.005), whereas ASI positivity was not (β = 0.024, p = 0.753). Neither VSI nor ASI positivity was related to cerebrovascular injury, as measured based on the white matter hyperintensity volume. Conclusion The findings suggest that VSI is probably related to AD-specific pathological changes, which possibly mediate the reported relationship between VSI and cognitive decline. In contrast, ASI appears not associated with AD pathologies but may contribute to cognitive decline via other mechanisms.

Objective: Previous studies have reported that vitamin D deficiency increased the risk of Alzheimer’s disease (AD) dementia in older adults. However, little is known about how vitamin D is involved in the pathophysiology of AD. Thus, this study aimed to examine the association and interaction of serum vitamin D levels with in vivo AD pathologies including cerebral beta-amyloid (Aβ) deposition and neurodegeneration in nondemented older adults. Methods: 428 Nondemented older adults were recruited from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease, a prospective cohort that began in 2014. All participants underwent comprehensive clinical assessments, measurement of serum 25-hydroxyvitamin D (25[OH]D), and multimodal brain imaging including Pittsburgh compound B (PiB) positron emission tomography and magnetic resonance imaging. Global PiB deposition was measured for the Aβ biomarker. Intracranial volume-adjusted hippocampal volume (HVa) was used as a neurodegeneration biomarker. Results: Overall, serum 25(OH)D level was not associated with either Aβ deposition or HVa after controlling for age, sex, apolipoprotein E ε4 positivity, and vascular risk factors. However, serum 25(OH)D level had a significant moderating effect on the association between Aβ and neurodegeneration, with lower serum 25(OH)D level significantly exacerbating cerebral Aβ-associated hippocampal volume loss (B = 34.612, p = 0.008). Conclusion Our findings indicate that lower serum vitamin D levels may contribute to AD by exacerbating Aβ-associated neurodegeneration in nondemented older adults. Further studies to explore the potential therapeutic effect of vitamin D supplementation on the progression of AD pathology will be necessary.

Objective: We intended to investigate the relationships between visual sensory impairment (VSI) or auditory sensory impairment (ASI) and brain pathological changes associated with cognitive decline in older adults. Methods: We primarily tried to examine whether each sensory impairment is related to Alzheimer’s disease (AD) pathology, specifically beta-amyloid (Aβ) deposition, through both cross-sectional and longitudinal approaches in cognitively unimpaired older adults. Self-report questionnaires on vision and hearing status were administered at the baseline.Neuroimaging scans including brain [ 11 C] Pittsburgh Compound B PET and MRI, as well as clinical assessments, were performed at baseline and 2-year follow-up. Results: Cross-sectional analyses showed that the VSI-positive group had significantly higher Aβ deposition than the VSI-negative group, whereas there was no significant association between ASI positivity and Aβ deposition. Longitudinal analyses revealed that VSI positivity at baseline was significantly associated with increased Aβ deposition over 2 years (β = 0.153, p = 0.025), although ASI positivity was not (β = 0.045, p = 0.518). VSI positivity at baseline was also significantly associated with greater atrophic changes in AD-related brain regions over the 2-year follow-up period (β = −0.207, p = 0.005), whereas ASI positivity was not (β = 0.024, p = 0.753). Neither VSI nor ASI positivity was related to cerebrovascular injury, as measured based on the white matter hyperintensity volume. Conclusion The findings suggest that VSI is probably related to AD-specific pathological changes, which possibly mediate the reported relationship between VSI and cognitive decline. In contrast, ASI appears not associated with AD pathologies but may contribute to cognitive decline via other mechanisms.

Objective: Previous studies have reported that vitamin D deficiency increased the risk of Alzheimer’s disease (AD) dementia in older adults. However, little is known about how vitamin D is involved in the pathophysiology of AD. Thus, this study aimed to examine the association and interaction of serum vitamin D levels with in vivo AD pathologies including cerebral beta-amyloid (Aβ) deposition and neurodegeneration in nondemented older adults. Methods: 428 Nondemented older adults were recruited from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer’s Disease, a prospective cohort that began in 2014. All participants underwent comprehensive clinical assessments, measurement of serum 25-hydroxyvitamin D (25[OH]D), and multimodal brain imaging including Pittsburgh compound B (PiB) positron emission tomography and magnetic resonance imaging. Global PiB deposition was measured for the Aβ biomarker. Intracranial volume-adjusted hippocampal volume (HVa) was used as a neurodegeneration biomarker. Results: Overall, serum 25(OH)D level was not associated with either Aβ deposition or HVa after controlling for age, sex, apolipoprotein E ε4 positivity, and vascular risk factors. However, serum 25(OH)D level had a significant moderating effect on the association between Aβ and neurodegeneration, with lower serum 25(OH)D level significantly exacerbating cerebral Aβ-associated hippocampal volume loss (B = 34.612, p = 0.008). Conclusion Our findings indicate that lower serum vitamin D levels may contribute to AD by exacerbating Aβ-associated neurodegeneration in nondemented older adults. Further studies to explore the potential therapeutic effect of vitamin D supplementation on the progression of AD pathology will be necessary.

A new En score of the proficiency test (PT) is formulated; it is applicable when a correlation exists between the reference and participant’s values. Based on the uncertainty propagation rule given in ISO/IEC Guide 98-3 (GUM:1995), the En score covering the correlation case is newly developed for the PT. The new En score will be applied in a future PT organized by the Korea Research Institute of Standards and Science (KRISS) dosimetry team. The new En score will enhance measurement traceability and contribute to improving the quality management system of participants in the KRISS PT by avoiding performance underestimation.

A new En score of the proficiency test (PT) is formulated; it is applicable when a correlation exists between the reference and participant’s values. Based on the uncertainty propagation rule given in ISO/IEC Guide 98-3 (GUM:1995), the En score covering the correlation case is newly developed for the PT. The new En score will be applied in a future PT organized by the Korea Research Institute of Standards and Science (KRISS) dosimetry team. The new En score will enhance measurement traceability and contribute to improving the quality management system of participants in the KRISS PT by avoiding performance underestimation.