Purpose: This study aimed to evaluate age- and sex-specific dietary vitamin B12 intake among Koreans, assess adequacy relative to the 2025 Korean Dietary Reference Intakes, and identify major food groups using nationally representative data from the 2022–2024 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from 19,191 participants in the KNHANES 2022–2024 aged1 year and older were analyzed after excluding individuals with extreme energy intake values. Individual vitamin B12 intake was calculated based on 24-hour dietary recall data using the Korean National Standard Food Composition Database (version 10.3). Intake levels were evaluated against age- and sex-specific Estimated Average Requirement (EAR) and Recommended Nutrient Intake (RNI) values. Complex sample general linear models and cross-tabulation analyses were conducted to examine differences in intake and adequacy. Results: The mean vitamin B12 intake of the study population was 8.27 μg/day, exceeding the RNI in most age groups. The proportion of individuals meeting or exceeding the RNI was generally high; however, the prevalence of intake below the EAR increased with age, particularly among older women, approximately 35% of whom were at risk of inadequate intake. Animal-based foods, including fish and shellfish, meat, eggs, and dairy products, were the primary contributors to vitamin B12 intake. Adults and older adults with intake below the RNI consumed significantly lower amounts of these food groups compared with those meeting the RNI. Conclusion Although overall vitamin B12 intake among Koreans appears sufficient, older adults remain at increased risk of insufficient intake. Continuous monitoring of vitamin B12 nutritional status and targeted dietary strategies, with a focus on older populations, is warranted to prevent potential deficiencies.

Purpose: Radiotherapy (RT) remains a cornerstone of curative treatment for localized and locally advanced prostate cancer. However, dose escalation to improve tumor control is often constrained by the proximity of the rectum, which increases the risk of gastrointestinal (GI) and genitourinary toxicities. Biodegradable rectal spacers inserted between the prostate and rectum have emerged as an effective approach to reduce rectal radiation exposure. This guideline provides evidence-based recommendations on indications, contraindications, procedural standards, and clinical management for biodegradable rectal spacer insertion during prostate cancer RT. Materials and Methods: This guideline was developed by a multidisciplinary expert panel through a systematic review of the literature, analysis of international guidelines (National Comprehensive Cancer Network, European Association of Urology, American Society for Radiation Oncology), and expert consensus among radiation oncologists, radiologists, and urologists with clinical experience in spacer insertion. The strength of each recommendation and the level of evidence were classified according to the modified GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. Results: Spacer insertion is conditionally recommended (Grade C, Level I) for patients receiving definitive external-beam RT without rectal invasion. It reduces the high-dose rectal irradiation volume (V70–75) by >50%, decreases acute GI toxicity, and helps maintain bowel-related quality of life. However, the benefit for late severe toxicity (grade 2 or higher) remains debated in recent meta-analyses. Contraindications include rectal invasion, anatomical inaccessibility, infection, and material hypersensitivity. Procedures should be performed under local anesthesia in a sterile environment by trained physicians. Short-course antibiotics and simulator-based training, including completion of multiple supervised cases, are advised. Conclusion Biodegradable rectal spacer insertion is clinically validated and effective in reducing acute rectal toxicity. Although pivotal trials demonstrated a favorable procedural safety profile, real-world postmarket data include reports of rare but severe procedural complications. This guideline provides standardized recommendations tailored to Korean clinical practice while remaining consistent with international standards, emphasizing the importance of operator training and careful patient selection.

This paper examines the reactivation of the Oedipus complex during adolescence and its link to self-destructive behaviorthrough a psychoanalytic analysis of the film “The Son (2022)”, directed by Florian Zeller. Adolescence is a developmental stage characterized by the resurfacing of early conflicts, especially in response to traumatic events like parental divorce. The protagonist, Nicolas, exhibits depression, school refusal, and multiple suicide attempts following his parents’ divorce and his father’s remarriage, which serve as traumatic triggers. From a psychodynamic perspective, the disruption of an idealized paternal figure leads to the reactivation of Oedipal conflicts marked by rivalry, aggression, and ambivalence toward the father. These conflicts intersect with the narcissistic vulnerability and immature ego functioning typical of adolescence. Nicolas resorts to omnipotent fantasies as a defense mechanism to cope with feelings of helplessness, loss, and internal struggle. Nonetheless, repeated narcissistic injuries and the lack of stabilizing object relations cause aggression to turn inward, resulting in self-destructive behavior.The film further illustrates the intergenerational transmission of narcissistic dynamics in the father-son relationship, emphasizing how unresolved paternal narcissism contributes to the adolescent’s fragile sense of self. This analysis highlights the necessi-ty of understanding adolescent suicidal behavior through a developmental psychoanalytic lens that incorporates unconscious fanta-sies, object relations, and family dynamics. Such an approach has important implications for the clinical assessment and therapeutic intervention of adolescents at risk for self-destructive behavior.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

Pediatric nephrotic syndrome is a clinical condition characterized by severe proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema, most commonly affecting children aged 2 and 6 years. Although standard oral steroid therapy is effective in managing most cases, relapses are common during childhood. Nephrotic syndrome presents significant challenges due to frequent relapses and the potential side effects of long-term drug therapy. In Korea, the absence of a unified national clinical guideline has led physicians to manage pediatric nephrotic syndrome based on diverse clinical guidelines and individual clinical judgment. To address this, the Korean Society of Pediatric Nephrology has developed an evidence-based guideline specifically tailored to the Korean healthcare system. This guideline provides recommendations for the diagnosis and management of steroid-sensitive nephrotic syndrome in children under the age of 18 years.

Objectives: Food neophobia in children is often associated with limited exposure and familiarity to some foods. Cooking-based nutrition education (CBNE), which promotes acceptance through direct experience, may support the development of healthy eating habits. This study aimed to develop and implement a standardized CBNE program for school-aged children in Seoul, South Korea, and to evaluate its effectiveness by assessing changes in raw vegetable intake. Raw vegetable intake is an early indicator of the effectiveness of nutrition education on diverse topics in promoting healthy eating habits. Methods: A single-group pre–post study was conducted with 37 children aged 6–11 years who participated in a 2-day CBNE program in October 2023. The participants completed pre- and post-education questionnaires and raw vegetable intake assessments. Four low-preference vegetables (bell pepper, carrot, cucumber, and tomato) were selected and served raw (25 g each) before and after the program. Intake changes were analyzed using paired t-tests, and Pearson’s correlation and hierarchical regression analyses were performed to identify predictors. Results: Total raw vegetable intake significantly increased post-education (P = 0.008), particularly for carrots (P = 0.023). By subgroup, raw vegetable intake significantly increased in girls, upper-grade students, and those who consumed four or more vegetable side dishes per meal. Hierarchical regression analysis revealed that while vegetable preference was initially significant, vegetable-related experiences (β = 0.395, P = 0.026) and diversity of vegetable side dishes per meal (β = 0.403, P = 0.032) were stronger predictors in the final model (adj R2 = 0.333). Conclusion The CBNE program may enhance vegetable intake in children. Although preference remained the strongest individual factor, vegetable experience and the diversity of vegetable side dishes per meal had a greater combined effect. These findings underscore the importance of repeated and diverse exposure, not only by supporting previous studies that link such exposure to increased intake but also by suggesting that environmental support may be essential for sustaining healthy eating habits.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

During the coronavirus disease 2019 (COVID-19) pandemic, conclusively evaluating possible associations between COVID-19 vaccines and potential adverse events was of critical importance. The National Academy of Medicine of Korea established the COVID-19 Vaccine Safety Research Center (CoVaSC) with support from the Korea Disease Control and Prevention Agency to investigate the scientific relationship between COVID-19 vaccines and suspected adverse events. Although determining whether the COVID-19 vaccine was responsible for any suspected adverse event necessitated a systematic approach, traditional causal inference theories, such as Hill's criteria, encountered certain limitations and criticisms. To facilitate a systematic and evidence-based evaluation, the United States Institute of Medicine, at the request of the Centers for Disease Control and Prevention, offered a detailed causality assessment framework in 2012, which was updated in the recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM) in 2024.This framework, based on a weight-of-evidence approach, allows the independent evaluation of both epidemiological and mechanistic evidence, culminating in a comprehensive conclusion about causality. Epidemiological evidence derived from population studies is categorized into four levels—high, moderate, limited, or insufficient—while mechanistic evidence, primarily from biological and clinical studies in animals and individuals, is classified as strong, intermediate, weak, or lacking. The committee then synthesizes these two types of evidence to draw a conclusion about the causal relationship, which can be described as “convincingly supports” (“evidence established” in the 2024 NASEM report), “favors acceptance,” “favors rejection,” or “inadequate to accept or reject.” The CoVaSC has established an independent committee to conduct causality assessments using the weightof-evidence framework, specifically for evaluating the causality of adverse events associated with COVID-19 vaccines. The aim of this study is to provide an overview of the weight-ofevidence framework and to detail the considerations involved in its practical application in the CoVaSC.