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.

Background and Objectives: Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disorder that can adversely affect quality of life in patients with Graves’ disease (GD). The objective of this study was to characterize the clinical features of patients with GO and to identify risk factors associated with its development and the need for anti-inflammatory treatment. Materials and Methods: In this multicenter, retrospective observational study, 818 patients with GD were identified via electronic medical record review. Clinical characteristics were assessed, and logistic regression analyses were performed to identify risk factors for GO development and the need for anti-inflammatory treatment. Results: Among the 818 patients with GD, 135 (16.5%) developed GO, and 60 (7.3%) of these patients received anti-inflammatory treatment. GO was diagnosed at the time of GD diagnosis in 54.8% of cases, and proptosis and eyelid/orbital swelling were the common presenting features. In multivariable analysis, female sex (odds ratio [OR]: 1.75, confidence interval [CI]: 1.02-3.03), goiter (OR: 1.71, CI: 1.08-2.71), and smoking (ex-smokers: OR, 2.18; 95% CI: 1.02-4.65; current smokers: OR, 3.11; CI, 1.78-5.44) were independently associated with GO development, whereas diabetes (OR: 0.35, CI: 0.14-0.89) was inversely associated. Higher total cholesterol (OR: 1.31, CI: 1.01-1.04) and elevated thyrotropin-binding inhibitory immunoglobulin levels (OR: 1.07, CI: 1.02-1.11) were also significantly associated with the need for anti-inflammatory treatment. Conclusion This study delineated the clinical features of GO and identified risk factors for its development and the need for anti-inflammatory treatment in patients with GD, providing valuable information for the management of GO in Korean patients.

Background: and Objective: Maternal hypothyroidism increases the risk of adverse pregnancy outcomes, making appropriate levothyroxine (LT4) replacement essential. However, the optimal initial LT4 dose for women newly diagnosed with subclinical hypothyroidism (SCH) or overt hypothyroidism (OH) during pregnancy remains unclear.This study evaluated the appropriate starting LT4 dose based on baseline thyroid-stimulating hormone (TSH) and body mass index (BMI). Materials and Methods: This single-center retrospective cohort study included 126 pregnant women from June 2018 to April 2025. After pregnancy was confirmed, all participants started LT4.Patients were categorized by baseline TSH (2.5-4, 4-10, and ＞10 mIU/L) and BMI (＜23, 23-＜25, and ≥25 kg/m2 ) to determine the appropriate LT4 dose. The treatment goal was a TSH level ＜2.5 mIU/L. Results: Among the 126 patients, 101 (80.2%) were diagnosed with SCH or OH in the first trimester. The mean baseline TSH was 5.19 mIU/L, and 29.4% had autoimmune thyroiditis. Baseline TSH (r=0.315, p＜0.001) was positively associated with weight-based LT4 dose, whereas body weight (r=−0.304, p＜0.001) and BMI (r=−0.248, p=0.005) were inversely associated. The median weight-based LT4 dose was 0.45 μg/kg/day for TSH 2.5-4.0 mIU/L, 0.71 μg/kg/day for TSH 4.0-10 mIU/L, and 1.34 μg/kg/day for TSH ＞10 mIU/L (p for trend ＜0.001). Patients with TSH ＞10 mIU/L required more time to achieve TSH ＜2.5 mIU/L, and those with BMI ≥25 kg/m2 received lower weight-based LT4 doses. Conclusion Initial LT4 dosing should be tailored based on baseline TSH and BMI.

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.

Background: The aim of this study is to evaluate the prevalence and associated psychosocial factors of behavioral addictions among school adolescents living in the Gwangju and Jeonnam regions in Korea. Methods: A self-reported survey was conducted from December 4, 2023, to January 31, 2024, including 855 middle and high school students residing in the Gwangju-Jeonnam regions. Aside from the information on demographic characteristics, data on depression, anxiety, Internet gaming addiction, gambling problems, and resilience was obtained. Results: The prevalence of Internet gaming addiction among adolescents was 5.4%, while the prevalence of gambling problems was 3.3%. The male adolescents had a significantly higher risk of behavioral addiction compared with the female adolescents. The logistic regression analysis revealed that male and depression were significant risk factors for Internet gaming addiction. For gambling problems, male was identified as a significant risk factor. Conclusion The findings of this study suggested that the prevalence of behavioral addiction among school adolescents has been relatively higher than that of previous studies, emphasizing the need for community-based prevention and intervention strategies tailored to the sex difference and psychological factors associated with adolescent behavioral addictions.

Background: The aim of this study is to evaluate the prevalence and associated psychosocial factors of behavioral addictions among school adolescents living in the Gwangju and Jeonnam regions in Korea. Methods: A self-reported survey was conducted from December 4, 2023, to January 31, 2024, including 855 middle and high school students residing in the Gwangju-Jeonnam regions. Aside from the information on demographic characteristics, data on depression, anxiety, Internet gaming addiction, gambling problems, and resilience was obtained. Results: The prevalence of Internet gaming addiction among adolescents was 5.4%, while the prevalence of gambling problems was 3.3%. The male adolescents had a significantly higher risk of behavioral addiction compared with the female adolescents. The logistic regression analysis revealed that male and depression were significant risk factors for Internet gaming addiction. For gambling problems, male was identified as a significant risk factor. Conclusion The findings of this study suggested that the prevalence of behavioral addiction among school adolescents has been relatively higher than that of previous studies, emphasizing the need for community-based prevention and intervention strategies tailored to the sex difference and psychological factors associated with adolescent behavioral addictions.

Beginning in March 2026, South Korea will implement the Community Care Integration Act to establish a nationwide system linking healthcare, long-term care, and social services—particularly for the elderly, who face high risks from chronic diseases and polypharmacy. Although the Act formally acknowledges pharmacists’ roles in integrated care (Article 15, Clause 7), their participation remains limited and their clinical expertise underutilized. This study investigates strategies to enhance the integration of pharmacists into South Korea’s community care system by analyzing pharmacist-led medication management services in Australia. Australia has developed a robust healthcare and medication safety framework through national and state-level agencies (e.g., Home Medicines Review (HMR), and Residential Medication Management Review (RMMR)). These services improve medication safety and adherence through structured medication reviews and interdisciplinary collaboration. In contrast, pharmacist-led services in Korea remain fragmented and are not yet systematically embedded within the integrated care infrastructure, despite a series of pilot initiatives since2018 aimed at managing polypharmacy in both hospital and community settings. These pilots, however, offer a foundational plat-form for national-scale adoption. Based on the Australia’s experience, this paper recommends establishment standardized medicationreview protocols, expanding pharmacist roles services within interdisciplinary teams, and provision of financial and institutionalsupport to ensure sustainable implementation. Deploying clinically trained pharmacists in community settings will be critical to safeguarding medication use and advancing person-centered care for Korea’s aging population.

Objective: Suicide is a significant public health issue, particularly among older adults, where the risk is heightened.Early identification of individuals at risk for suicidal ideation is essential for timely interventions, greatly improving prevention efforts. This study aimed to develop a predictive model for suicidal ideation in community-dwelling older adults using psychiatric self-report scales and machine learning classifiers. Methods: A total of 238 older adults were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7, Perceived Stress Scale-10, and World Health Organization Quality of Life Scale – Abbreviated Version.A nested 5-fold cross-validation procedure repeated 100 times was used for feature selection and model evaluation.Various classifiers—including support vector machines, random forest, logistic regression, linear discriminant analysis, and gradient boosting—were employed. Results: As the number of PHQ-9 items increased from two to six, the area under the curve (AUC) rose from 0.835 to 0.892. When a set of nine features—selected based on feature stability across iterations—was used, the AUC further improved to 0.904. This progression indicates that inclusion of additional informative items enhances classification performance. Conclusion This study demonstrates that psychiatric self-report scales can effectively predict suicidal ideation risk in community-dwelling older adults. By utilizing efficient features, the predictive accuracy of the model can be enhanced, offering valuable insights for developing early identification systems for high-risk groups. These findings suggest that a community-based suicide prevention program could be promoted by implementing a screening system to identify individuals at high risk for suicidal ideation among the elderly.

Background: The liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed to overcome interference from thyroglobulin autoantibodies (TgAb); however, it has not yet been implemented in Korea. This study aimed to confirm the accuracy of LC-MS/MS compared to conventional methods and to identify its advantages in patients with thyroid carcinoma (TC). Methods: A total of 206 TC and 18 Hashimoto’s thyroiditis samples were collected. TgAb-positive (TgAb-P) was defined as TgAb >60 U/mL. Tg testing was performed using LC-MS/MS, immunoradiometric assay (Tg-IRMA), and chemiluminescence microparticle immunoassay (Tg-CMIA). The interference of TgAb in LC-MS/MS and CMIA methods was evaluated through an in vitro TgAb spiking experiment. Results: The frequency of TgAb-P in TC samples was 76.2%. Correlations between assays were as follows: Tg measurements made by LC-MS/MS (Tg-MS) and Tg-IRMA (R=0.93), Tg-MS and Tg-CMIA (R=0.96), and Tg-CMIA and Tg-IRMA (R=0.99), and it was lower in TgAb-P than TgAb-negative group. Clinical factors (total thyroidectomy, thyroid lobectomy, and Hashimoto’s thyroiditis) did not affect these correlations. In TgAb spiking experiments, Tg-CMIA showed false negatives in TgAb-P, whereas Tg-MS did not. Among 21 TC cases with highly suspicious disease recurrence but Tg-IRMA <1 ng/mL, Tg-MS detected Tg ≥0.5 ng/mL in six samples. However, there was no consistent pattern of recurrence or TgAb trends. Conclusion Correlations between assays were lower in TgAb-P cases. The spike test results show Tg-MS is less prone to false negatives in TgAb-P cases. Tg-MS may improve Tg detection in TgAb-P cases. However, we could not identify a distinct patient group with shared clinical features that would benefit from Tg-MS.