Pediatric kidney disease has a relatively lower prevalence than do other pediatric conditions and has a notably different etiology from kidney diseases observed in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require more specialized and meticulous nutritional management than do adults. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to establish nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations covering energy, protein, calcium, phosphorus, and potassium consumption while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.

Background: This study investigated the association between thyroid function and the 10-year cardiovascular disease (CVD) risk in patients with diabetes. Methods: This retrospective cross-sectional study analyzed 246 patients with diabetes aged 30 to 79 years (weighted n=1,611,708) from the 2013 to 2014 Korea National Health and Nutrition Examination Survey. Individuals with a history of CVD, thyroid disease, or pregnancy were excluded. Thyroid function was categorized as euthyroid, hypothyroid, or hyperthyroid, based on serum thyroid-stimulating hormone (TSH) levels (reference in Koreans, 0.62–6.86 mIU/L). The 10-year CVD risk was estimated using the Predicting Risk of CVD EVENTs calculator. Results: The mean participant age was 54.3±10.1 years, with a male-to-female ratio of 1.41:1. Although patients with hypothyroid (14.1%) and hyperthyroid (15.7%) statuses showed a higher CVD risk than those with euthyroid status (12.3%), the difference was not statistically significant (p=0.337). However, in the hypothyroid group (n=11), TSH levels showed a moderate correlation with 10-year CVD risk (r=0.603, p<0.05), although this finding should be interpreted with caution owing to the small sample size. After adjusting for diabetes- and thyroid-related variables, TSH level was independently associated with higher estimated 10-year CVD risk, particularly in patients with a glycated hemoglobin level of <7% (adjusted coefficient, 0.17; 95% confidence interval, 0.05–0.29; p<0.05). Conclusion Monitoring TSH levels in patients with well-controlled diabetes may provide additional information regarding the risk of CVD; however, prospective studies are needed to confirm the long-term prognostic value.

Purpose: Processing methods for hematopoietic stem cells vary significantly across institutions, with no standardized guidelines currently in place. This lack of standardization presents challenges in ensuring consistent quality and out‑ comes of stem cell transplantation procedures. This study investigated current practices in peripheral blood stem cell (PBSC) processing and storage among transplant centers in Korea to establish a foundation for the development of standardized guidelines. Methods: A comprehensive questionnaire was distributed to 46 hematopoietic stem cell transplantation centers in Korea, examining five key areas: PBSC collection procedures, use of cryopreservatives, cryopreservation protocols, quality control measures, and thawing protocols. Results: Analysis of the 29 responses revealed significant variations across different stages of PBSC handling. All centers used controlled-rate freezers, and 92.9% stored cells at temperatures below -150 ◦ C . However, other prac‑ tices varied widely. Additional post-collection processing was performed by 53.8% of respondents. DMSO concen‑ trations ranged from 5 to 15%, with diverse combinations of supplementary media. Notably, 28.6% of patients did not undergo post-thaw quality assessment tests. Conclusion This study identified significant heterogeneity in PBSC processing practices across Korean transplant centers. These findings underscore the need for evidence-based standardized guidelines to ensure consistent product quality and improve transplantation outcomes.

Purpose: To evaluate patient‐reported experiences of 3 primary treatments for localized or locally advanced prostate cancer—radical prostatectomy (RP), radiation therapy (RT), and active surveillance (AS)—based on cross‐sectional data from a prospective registry, and to explore how these findings can inform a structured shared decision making (SDM) framework. Materials and Methods: Men with clinical stage cT3aN0M0 or lower were enrolled. Those who underwent RP or RT were surveyed 6–24 months posttreatment; men on AS had 6–60 months of follow‐up. All participants completed the EORTC QLQ‐PR25 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Prostate Cancer Module), capturing urinary, bowel, hormonal, and sexual function. The Kruskal‐Wallis test evaluated group differences, with significance set at p<0.05. Results: Among 542 patients, 435 underwent RP, 73 received RT (43% with androgen deprivation therapy), and 34 were on AS. RP patients reported higher rates of urinary incontinence and sexual dysfunction, whereas RT patients had more severe urinary irritative and bowel symptoms. AS generally preserved baseline sexual function but still involved some urinary complaints and anxiety regarding disease progression. These findings underscore the distinct trade‐offs among the 3 management strategies, emphasizing the importance of individualized SDM that accounts for functional priorities and patient values. Conclusion Each treatment modality poses unique impacts on quality of life. Incorporating these patient‐reported data into SDM discussions can improve alignment between clinical recommendations and patient preferences, potentially reducing decisional regret and enhancing long‐term outcomes.

Purpose: This study aimed to assess the rate of germline variant detection following targeted cascade genetic testing among family members of prostate cancer (PCa) probands. Materials and Methods: Records of PCa patients with confirmed germline mutations and their family members recommended for cascade testing were retrospectively reviewed. Cascade testing for germline mutations identified in PCa probands was conducted among first-degree relatives (FDRs) and second-degree relatives. The rate of counseled family members who proceeded to actual testing, the proportion of mutation carriers detected, and the reasons for test refusal were analyzed. Clinical variables, including family history of malignancy and variant type, were also collected. Results: A total of 15 PCa patients and 44 eligible relatives were included in the final analysis. Eleven probands (73.3%) had a positive family history of cancer across 22 family members (18 FDRs). Among FDRs, breast/ovarian cancer (27.8%) and gastric cancer (22.2%) were the most common, followed by lymphoma, prostate, esophageal, and lung cancer (each 11.1%). Among probands, BRCA2 variants were predominant (80%, 12 of 15), followed by BRCA1 (n=2) and MLH1 (n=1) mutations. Of 41 eligible FDRs, 21 (51.2%) underwent genetic testing, and 61.9% (13 of 21) were found to carry identical germline mutations. Approximately half of the counseled family members declined testing due to concerns regarding privacy and disclosure, travel distance to the clinic, or loss to follow-up. Conclusion Over half of the FDRs who underwent cascade testing were confirmed to carry pathogenic germline variants. As the first study to evaluate cascade testing in family members of PCa probands in Korea, these findings underscore the strong heritable component of PCa and highlight the need to enhance participation in familial genetic screening.

Pediatric kidney disease has a relatively lower prevalence than do other pediatric conditions and has a notably different etiology from kidney diseases observed in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require more specialized and meticulous nutritional management than do adults. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to establish nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations covering energy, protein, calcium, phosphorus, and potassium consumption while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.

Objective: This study aimed to develop a machine learning-based classification model to differentiate bipolar disorder from major depressive disorder using self-report scales, including the Mood Disorder Questionnaire (MDQ), Bipolar Spectrum Diagnostic Scale (BSDS), and Anger Coping Scale (ACS). Methods: A total of 122 bipolar and 67 depressive patients participated. Recursive feature elimination with 1,000 iterations was used to identify the most informative features. Machine learning classifiers assessed combinations of MDQ, BSDS, and ACS items for classification performance. Results: The AUC values for MDQ and BSDS were 0.8212 and 0.7934, respectively. Combining MDQ and BSDS increased the AUC to 0.8477, which improved further to 0.8548 when ACS was included. For MDQ, the best performance was achieved when all 13 items were included. In contrast, the combined model of MDQ, BSDS, and ACS showed optimal performance when BSDS items 18 (conflicts with colleagues or police), 19 (alcohol or substance use), and ACS item 15 (beating others) were excluded. Conclusion Integrating anger coping styles with mood symptoms enhanced diagnostic accuracy, particularly when items related to undesirable behaviors were excluded. This machine learning approach shows potential for effectively evaluating bipolarity and underscores the importance of refining self-report scales to optimize diagnostic tools. Future research should incorporate clinical and objective data to enhance classification models.

Background: This study investigated the relationship between intraoperative requirement for an inhalational anesthetic (sevoflurane) or an opioid (remifentanil) and postoperative analgesic consumption. Methods: The study included 200 adult patients undergoing elective laparoscopic colectomy. In the sevoflurane group, the effect-site concentration of remifentanil was fixed at 1.0 ng/ml, while the inspiratory sevoflurane concentration was adjusted to maintain an appropriate anesthetic depth. In the remifentanil group, the end-expiratory sevoflurane concentration was fixed at 1.0 volume%, and the remifentanil concentration was adjusted. Pain scores and cumulative postoperative analgesic consumptions were evaluated at 2, 6, 24, and 48 h after surgery. Results: Average end-tidal concentration of sevoflurane and effect-site concentration of remifentanil were 2.0 ± 0.4 volume% and 3.9 ± 1.4 ng/ml in the sevoflurane and remifentanil groups, respectively. Cumulative postoperative analgesic consumption at 48 h postoperatively was 55 ± 26 ml in the sevoflurane group and 57 ± 33 ml in the remifentanil group. In the remifentanil group, the postoperative cumulative analgesic consumptions at 2 and 6 h were positively correlated with intraoperative remifentanil requirements (2 h: r = 0.36, P < 0.01; 6 h: r = 0.38, P < 0.01). However, there was no significant correlation in the sevoflurane group (r = 0.04, P = 0.69). Conclusions The amount of intraoperative requirement of short acting opioid, remifentanil, is correlated with postoperative analgesic consumption within postoperative 6 h. It may be contributed by the development of acute opioid tolerance. However, intraoperative sevoflurane requirement had no effect on postoperative analgesic consumption.

Objective: To establish reference values for the computerized cognitive test and evaluate cognitive function improvements across different age groups, we introduce the computerized Cognitive Function Test program (eCFT), specifically designed for children. We aimed to establish eCFT reference values and assess cognitive function improvements across different age groups. Methods: We included children aged 3–6 years with confirmed normal cognition based on the Korean Developmental Screening Test for Infants and Children and Kaufman Assessment Battery for Children-II. The eCFT consists of 8 subtests for visual perception, attention, memory, and executive function. Results: A total of 66 participants (36 males and 30 females) with an average age of 4.4 years participated. The age 6 group consistently outperformed both age group 3 and 4 in terms of correct responses. With regard to the completed stage, the “selective auditory stimulus” test findings were 2.0 and 3.9 for the age 3 and age 6 groups, respectively (p<0.05). The “trail-making” test findings were 1.7, 2.1, 2.6, and 2.8, respectively (between ages 3 and 6, p<0.01; between ages 4 and 6, p<0.05); moreover, the age 5 group surpassed the age 3 group (2.6 and 1.7, respectively, p<0.05). Conclusion The eCFT is an easily accessible tool to evaluate cognitive function in young children. We introduce reference values with a cutoff range for preschool-aged children, enabling early intervention for those with cognitive impairment. Given its accessibility and relatively short evaluation time, the eCFT has potential for clinical use.

Objective: This retrospective study aimed to investigate the prevalence of chronic endometritis, diagnosed using CD138 immunohistochemistry, among infertile women and to assess the association between chronic endometritis and recurrent implantation failure (RIF). Methods: In total, 266 patients who underwent hysteroscopy due to infertility between 2019 and 2020 were included in the analysis. Of these, 136 patients with RIF and 130 non-RIF patients were included in the study. CD138 immunohistochemistry test results, blood biomarkers (including natural killer cells, white blood cells, and the lymphocyte-to-neutrophil ratio), and data on pregnancy outcomes were obtained. If the CD138 test yielded a positive result, the patients received antibiotic treatment. Results: The overall proportion of CD138-positive patients was 32.7% (87/266). The CD138 positivity rate was not related to the number of cycles with implantation failure. In the RIF patient group, no significant associations were found between CD138 positivity and peripheral blood markers. The clinical pregnancy rates were similar between infertile women treated with antibiotics for chronic endometritis and those without chronic endometritis. Conclusion To improve the pregnancy rate in infertile patients, it may be helpful to combine CD138 testing with other laboratory tests and administer antibiotic treatment if the result is positive.