Background: Mycoplasma pneumoniae is a major cause of community-acquired pneumonia (CAP) in children, with a rising incidence of macrolide resistance. Early diagnosis is crucial for reducing the disease burden; however, current diagnostic tools have limitations.We evaluated the diagnostic accuracy of serological assays and their performance based on symptom onset in children with CAP. Methods: From September 2023 to September 2024, we prospectively enrolled children with CAP, classified as M. pneumoniae pneumonia (MPP) or non-MPP, from 16 hospitals in Korea. Serological testing included chemiluminescence immunoassay (CLIA) and ELISA for detecting IgM and IgG, along with particle agglutination (PA) for total antibody measurements. Serological responses were analyzed at different times after symptom onset (0–4, 5–9, and 10–21 days). Results: Among 472 children with CAP (362 MPP, 110 non-MPP), 138 (29.2%) underwent PA testing, and 334 (70.8%) underwent IgM testing. PA at a 1:640 cutoff showed 48.0% sensitivity and 100% specificity. CLIA and ELISA showed comparable sensitivities (69.1% vs. 69.2%) and specificities (76.9% vs. 66.7%) for IgM testing. Seropositivity increased significantly with time since symptom onset (P for trend < 0.001), reaching 97.9% for IgM, 62.5% for IgG, and 94.7% for PA at 10–21 days. Conclusions The time post-symptom onset significantly influenced the diagnostic utility of serological tests for pediatric MPP, which showed limited value during the early stage of illness. These findings emphasize the importance of symptom onset-based interpretation of serological test results and their utility in complementing PCR when optimizing MPP diagnosis in children.

Background and Objectives: Studies investigating the correlation between papillary thyroid carcinoma (PTC) tumor size and the prevalence of the B-type Raf kinase (BRAF) mutation have yielded conflicting results. Therefore, we evaluated the prevalence of BRAF mutation according to tumor size in a large cohort of PTC patients to clarify this association. Materials and Methods: We retrospectively analyzed 6,438 patients with surgically diagnosed classic PTC between January 2009 and December 2017 at Samsung Medical Center, Seoul, Republic of Korea.During the study period, BRAF mutation testing was attempted on all fine-needle aspiration specimens, except for a small number of inadequate specimens. All other histologic subtypes were excluded. The prevalence of BRAF mutation was assessed based on tumor size, and further analyzed by age group and sex according to tumor size. Results: The overall prevalence of BRAF mutation was 79.2%. When PTCs ≤1 cm were excluded, the prevalence was 77.2%. The prevalence significantly decreased with increasing tumor size (p for trend ＜0.001). It was significantly higher in men than in women (p=0.013), but did not differ by age. The inverse correlation between tumor size and prevalence was prominent in patients aged 20-49 years but was less distinct in those aged 50 years and older. Conclusion In this large cohort of patients with PTC, the prevalence of BRAF mutation significantly decreased with increasing tumor size. These findings suggest that BRAF mutation is enriched in smaller surgically treated classic PTCs and may provide a hypothesis-generating clue regarding its role in early PTC development, although selection bias cannot be excluded.

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: In this study, we aimed to compare the genetic architecture of schizophrenia (SCZ) and bipolar disorder (BD) in a Korean population by analyzing polygenic risk scores (PRS) derived from large-scale psychiatric disorder genome-wide association study data, based on genetic information collected from SCZ, BD, and healthy control groups. Methods: The study included 713 Korean patients with SCZ, 1,317 with BD, 526 healthy controls. Genotyping was performed using the Korean Biobank Array. PRS-continuous shrinkage method was used to calculate the PRS. Analysis of covariance (ANCOVA) was conducted to determine the association between SCZ or BD disorder and PRS after adjusting for sex. Results: ANCOVA revealed significant differences in PRS values by diagnosis for PRS for SCZ (F=215.281, p<0.001), PRS for BD (F=13.811, p<0.001), and PRS for major depressive disorder (F=6.042, p=0.002). Post-hoc analysis showed that PRS for SCZ was highest in SCZ, followed by BD, and healthy controls. PRS for BD was elevated in both BD and SCZ compared to healthy controls. Conclusion Our study revealed quantitative differences in genetic architecture between SCZ and BD compared to healthy controls, while also suggesting a shared genetic background between the two disorders.

Purpose: This study aimed to identify the pathogens of bloodstream infection in children with underlying hemato-oncologic diseases, analyze susceptibility patterns, compare temporal trends with those of previous studies, and assess empirical antimicrobial therapy. Methods: Retrospective review study of children bacteremia in hemato-oncologic diseases was conducted at Seoul National University Bundang Hospital from January 2013 to July 2023. Results: Overall, 98 episodes of bacteremia were observed in 74 patients. Among pathogens isolated, 57.1% (n=56) were Gram-positive bacteria, 38.8% (n=38) were Gram-negative bacteria, and 4.1% (n=4) were Candida spp. The most common Gram-positive bacteria were coagulase-negative staphylococci (n=21, 21.4%) and Staphylococcus aureus, (n=14, 14.3%) whereas the most common Gram-negative bacteria were Klebsiella pneumoniae (n=16, 16.3%) and Escherichia coli (n=10, 10.2%). The susceptibility of Gram-positive bacteria to penicillin, oxacillin, and vancomycin was 11.5%, 32.7%, and 94.2%, respectively and the susceptibility of Gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin was 68.6%, 80%, 97.1%, 82.9%, and 91.4%, respectively. Methicillin-resistant S. aureus was detected in 1 strain and among Gram-negative strains, extended spectrum β-lactamase accounted for 28.9% (12/38). When analyzing the antibiotic susceptibility and empirical antibiotics, the mismatch rate was 25.5% (n=25). The mortality rate of children within 30 days of bacteremia was 7.1% (n=7). Conclusions Empirical antibiotic therapy for bacteremia in children with hemato-oncologic diseases should be based on the local antibiogram in each institution and continuous monitoring is necessary.

Background: Although exercising can be effective in alleviating mood symptoms, implementing an exercise regimen can be challenging. This study aims to evaluate the subjective experience and satisfaction with an exercise program that uses augmented reality (AR) developed to improve exercise adherence in patients with mood disorders. Methods: Thirty patients diagnosed with mood disorders participated in this study. Before and after the AR-based exercise program, psychological states were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). In addition, the satisfaction survey conducted after participating in the exercise program was analyzed. Results: The mean score of PHQ-9 decreased significantly following the exercise program. Moreover, the mean scores for GAD-7 and PSS significantly decreased when compared before and after the exercise program. Meanwhile, the mean score of WHOQOL-BREF for physical and social satisfaction increased significantly. Furthermore, this program received positive responses on the satisfaction survey. Conclusion In patients with mood disorders, the AR-based exercise program showed remarkable positive effects on psychological states and satisfaction levels. The exercise program using AR technology may effectively improve exercise program adherence in patients with mood disorders.

Background: Although exercising can be effective in alleviating mood symptoms, implementing an exercise regimen can be challenging. This study aims to evaluate the subjective experience and satisfaction with an exercise program that uses augmented reality (AR) developed to improve exercise adherence in patients with mood disorders. Methods: Thirty patients diagnosed with mood disorders participated in this study. Before and after the AR-based exercise program, psychological states were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). In addition, the satisfaction survey conducted after participating in the exercise program was analyzed. Results: The mean score of PHQ-9 decreased significantly following the exercise program. Moreover, the mean scores for GAD-7 and PSS significantly decreased when compared before and after the exercise program. Meanwhile, the mean score of WHOQOL-BREF for physical and social satisfaction increased significantly. Furthermore, this program received positive responses on the satisfaction survey. Conclusion In patients with mood disorders, the AR-based exercise program showed remarkable positive effects on psychological states and satisfaction levels. The exercise program using AR technology may effectively improve exercise program adherence in patients with mood disorders.

Histone deacetylase 4 (HDAC4), a class IIa HDAC, has gained attention as a potential therapeutic target in treating inflammatory and metabolic processes based on its essential role in various biological pathways by deacetylating non-histone proteins, including transcription factors. The activity of HDAC4 is regulated at the transcriptional, post-transcriptional, and post-translational levels. The functions of HDAC4 are tissue-dependent in response to endogenous and exogenous factors and their substrates. In particular, the association of HDAC4 with non-histone targets, including transcription factors, such as myocyte enhancer factor 2, hypoxia-inducible factor, signal transducer and activator of transcription 1, and forkhead box proteins, play a crucial role in regulating inflammatory and metabolic processes. This review summarizes the regulatory modes of HDAC4 activity and its functions in inflammation, insulin signaling and glucose metabolism, and cardiac muscle development.

Background: Although exercising can be effective in alleviating mood symptoms, implementing an exercise regimen can be challenging. This study aims to evaluate the subjective experience and satisfaction with an exercise program that uses augmented reality (AR) developed to improve exercise adherence in patients with mood disorders. Methods: Thirty patients diagnosed with mood disorders participated in this study. Before and after the AR-based exercise program, psychological states were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). In addition, the satisfaction survey conducted after participating in the exercise program was analyzed. Results: The mean score of PHQ-9 decreased significantly following the exercise program. Moreover, the mean scores for GAD-7 and PSS significantly decreased when compared before and after the exercise program. Meanwhile, the mean score of WHOQOL-BREF for physical and social satisfaction increased significantly. Furthermore, this program received positive responses on the satisfaction survey. Conclusion In patients with mood disorders, the AR-based exercise program showed remarkable positive effects on psychological states and satisfaction levels. The exercise program using AR technology may effectively improve exercise program adherence in patients with mood disorders.

Background: Although exercising can be effective in alleviating mood symptoms, implementing an exercise regimen can be challenging. This study aims to evaluate the subjective experience and satisfaction with an exercise program that uses augmented reality (AR) developed to improve exercise adherence in patients with mood disorders. Methods: Thirty patients diagnosed with mood disorders participated in this study. Before and after the AR-based exercise program, psychological states were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale (PSS), and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). In addition, the satisfaction survey conducted after participating in the exercise program was analyzed. Results: The mean score of PHQ-9 decreased significantly following the exercise program. Moreover, the mean scores for GAD-7 and PSS significantly decreased when compared before and after the exercise program. Meanwhile, the mean score of WHOQOL-BREF for physical and social satisfaction increased significantly. Furthermore, this program received positive responses on the satisfaction survey. Conclusion In patients with mood disorders, the AR-based exercise program showed remarkable positive effects on psychological states and satisfaction levels. The exercise program using AR technology may effectively improve exercise program adherence in patients with mood disorders.