Neuropathic pain markedly impairs quality of life and imposes a substantial socioeconomic burden, while available treatments often provide only partial relief and are limited by safety concerns. The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG-IASP) first published pharmacologic recommendations in 2007, followed by a major update in 2015 and a new guideline in 2025. This narrative review specifically compares the 2015 and 2025 NeuPSIG-IASP guidelines, outlining key methodological changes and therapeutic shifts. The 2025 guideline is based on a larger, more rigorous meta-analysis, maintains α2δ-ligands (adds mirogabalin), serotonin-noradrenaline reuptake inhibitors, and tricyclic antidepressants as first-line drugs, downgrades tramadol into the opioid third-line group. It also introduces high-frequency motor-cortex repetitive transcranial magnetic stimulation as a weakly recommended third-line option and discusses implications for Korean clinical practice.

Background: Microfocused ultrasound (MFU) has emerged as a noninvasive treatment modality for facial aging, with proven efficacy in eyebrow lifting and wrinkle reduction. However, there are only limited split-face studies that quantitatively compare treatment protocols with different focal depths. This prospective, singlecenter, randomized, split-face, open-label study aimed to compare the clinical outcomes of two MFU protocols (2-depth vs. 3-depth) for eyebrow elevation and improvement of glabellar wrinkles. Methods: Twenty-two female participants were enrolled and randomly assigned to two groups (n = 11 per group). One group received the 3-depth protocol (2.0 mm, 2.5 mm, 3.0 mm) on the left forehead and the 2-depth protocol (2.0 mm, 3.0 mm) on the right, while in the other group the protocols were reversed. Clinical outcomes were assessed at baseline and at 4, 8, 12, and 16 weeks post-treatment. Evaluations included average eyebrow height (AEH), maximum eyebrow height (MEH), glabellar line scale (GLS), and participant satisfaction. Results: Both AEH and MEH showed consistently greater improvements with the 3-depth protocol compared to the 2-depth protocol. Although the differences did not reach statistical significance, a trend toward enhanced lifting effects with the 3-depth protocol was observed at all time points. GLS demonstrated the greatest reduction, with 90.9% of participants achieving a ≥1-point improvement by week 12. Conclusion Both MFU protocols were effective for eyebrow elevation and glabellar wrinkle reduction.However, the 3-depth protocol yielded greater improvements, suggesting a potential clinical benefit of multidepth treatment in this female cohort.

Background: Despite the increasing competition caused by the rapid growth in the number of pharmacies in the Republic of Korea,research on factors influencing pharmacy sales is limited. This study aimed to investigate the factors affecting the financial performance of chain-affiliated versus independent pharmacies, with a focus on average transaction values. Methods: Transaction data from January 1, 2023, to December 31, 2023, were analyzed, excluding prescription drug sales. The focus was on over-the-counter medications, health supplements, and quasi-drugs. Results: The average transaction value at chain pharmacies was significantly higher, with an average of 14,596 KRW compared to 5,523 KRW at independent pharmacies. Within chain pharmacies, a higher proportion of pharmacies where pharmacists had completed a three-year training program was observed in the group with higher average transaction values (60.34% vs. 41.38%, p = 0.0411). Pharmacies that underwent interior renovations in accordance with franchise guidelines experienced a 1.27-fold increase in transaction values within 3 to 6 months, which was sustained at 1.41 times for up to 48 months. Conclusion Chain-affiliated pharmacies demonstrated higher average transaction values compared to independent pharmacies. Additionally, pharmacist training and interior renovations significantly contribute to increased transaction values, suggesting that investing in these areas can enhance financial performance. Further research with broader data and additional metrics is recommended to deepen the understanding of factors influencing pharmacy sales.

Background and Objectives: Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease. Methods: This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. Results: A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS).At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. Conclusions The present registry shows that Ultimaster™ stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

The Oriental stork (Ciconia boyciana), an endangered species, faces significant threats despite extensive conservation efforts aimed at their reintroduction and long-term survival in South Korea. Understanding the primary causes of mortality and identifying predominant pathological lesions are crucial for enhancing these efforts. This study aimed to investigate the causes of unexplained mortality in Oriental storks between 2019 and 2023 through comprehensive postmortem examinations. Twelve storks, including both wild and captive birds, classified as “unknown“ deaths, were examined. The results revealed that parasitic infections, particularly in wild storks, were frequently observed (41.7%). Additionally, gastrointestinal obstruction due to the ingestion of foreign materials was identified in a wild stork, highlighting the impact of environmental pollution. Despite the prevalence of inflammatory lesions in liver (58.3%), no cases of hepatitis were confirmed, except for one case of liver rupture in a wild stork. Notably, three nestling death cases from a single litter of captive storks suggested potential parental infanticide or lack of parental care. The overall results highlight the importance of addressing parasitic infections and environmental risks to improve the survival of wild Oriental storks, and emphasize the need for effective management in breeding facilities. Continuous monitoring and pathological evaluations for mortality cases are essential for understanding disease trends and developing adaptive conservation strategies to ensure the long-term preservation of this endangered species.

Purpose: To investigate the incidence and clinical course of acute endophthalmitis after idiopathic epiretinal membrane (iERM) surgery employing microincision vitrectomy (MIVS). Methods: We retrospectively reviewed the medical records of eyes with acute endophthalmitis developing after iERM surgery via 23- or 25-gauge MIVS from 2011 to 2021. The incidence, culture-positive rate (and responsible bacteria), final visual acuity (VA), and factors affecting poor visual outcomes were assessed. Results: Acute endophthalmitis developed in 20 of the 12,921 eyes (0.15%) after MIVS. Of these, 14 of 3,180 eyes treated via iERM (0.44%, one per 227 procedures) developed endophthalmitis; the incidence ratio (iERM versus non-iERM) was 7.1 (p < 0.001, 95% confidence interval [CI] = 2.6-22.7). At least one sclerotomy remained unsutured in all eyes after iERM surgery. Thirteen eyes (92.9%) were given intravitreal antibiotic injections after emergency vitrectomy, and one eye was treated with intravitreal antibiotic injection alone. Staphylococcus epidermidis was cultured from four eyes (28.6%); three strains were methicillin-resistant. All final VAs were not better than the initial VAs; the average VA decreased from 20/42 to 20/259 (p < 0.001). Six eyes (42.9%) attained legal blindness status (final VA < 20/200); Macular invasion was a unique risk factor for such blindness (p = 0.020, odds ratio = 35.0, 95% CI = 1.7-703.0). Conclusions Acute endophthalmitis developing after iERM surgery with MIVS was more common than such endophthalmitis after other retinal surgery. Approximately 40% of the former patients became legally blind, and the risk was higher in eyes with macular involvement of endophthalmitis.

Alternative complement pathway dysregulation plays a key role in glomerulonephritis (GN) and is associated with C3 deposition. Herein, we examined pathological and clinical differences between cases of primary GN with C3-dominant (C3D-GN) and nondominant (C3ND-GN) deposition. Methods: We extracted primary GN data from the Korean GlomeruloNEphritis sTudy (KoGNET). C3D-GN was defined as C3 staining two grades greater than C1q, C4, and immunoglobulin via immunofluorescence analysis. To overcome a large difference in the number of patients between the C3D-GN and C3ND-GN groups (31 vs. 9,689), permutation testing was used for analysis. Results: The C3D-GN group exhibited higher serum creatinine (p ≤ 0.001), a greater prevalence of estimated glomerular filtration rate of <60 mL/min/1.72 m2 (p ≤ 0.001), higher (but not significantly so) C-reactive protein level, and lower serum C3 level (p ≤ 0.001). Serum albumin, urine protein/creatinine ratio, number of patients who progressed to end-stage renal disease, and all-cause mortality were comparable between groups. Interstitial fibrosis and mesangial cellularity were greater in the C3D-GN group (p = 0.04 and p = 0.01, respectively) than in the C3ND-GN group. C3 deposition was dominant in the former group (p < 0.001), in parallel with increased subendothelial deposition (p ≤ 0.001). Conclusion: Greater progression of renal injury and higher mortality occurred in patients with C3D-GN than with C3ND-GN, along with pathologic differences in interstitial and mesangial changes.

Methemoglobinemia (MetHb), which is characterized by an increased methemoglobin level, is a rare but potentially fatal disorder caused by congenital enzyme deficiencies or exposure to oxidizing agents, including dapsone. Elevation in the methemoglobin level impairs the oxygen-carrying capacity of hemoglobin, produces functional anemia, and induces tissue hypoxia. Such hypoxia results in microcirculation injury and hypoperfusion in the tissue and organs, including the kidney, and is a risk factor for acute kidney injury (AKI). This paper reports a case of AKI caused by dapsone-induced MetHb in a patient with chronic kidney disease, in which the patient ingested approximately 1,500 mg of dapsone in a suicide attempt, which was treated with aggressive management, including methylene blue, ascorbic acid, and transfusion.

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis.

Background/Aims: We aimed to analyze the efficacy of angiotensin receptor-neprilysin inhibitor (ARNI) by the disease course of heart failure (HF). Methods: We evaluated 227 patients with HF in a multi-center retrospective cohort that included those with left ventricular ejection fraction (LVEF) ≤ 40% undergoing ARNI treatment. The patients were divided into patients with newly diagnosed HF with ARNI treatment initiated within 6 months of diagnosis (de novo HF group) and those who were diagnosed or admitted for HF exacerbation for more than 6 months prior to initiation of ARNI treatment (prior HF group). The primary outcome was a composite of cardiovascular death and worsening HF, including hospitalization or an emergency visit for HF aggravation within 12 months. Results: No significant differences in baseline characteristics were reported between the de novo and prior HF groups. The prior HF group was significantly associated with a higher primary outcome (23.9 vs. 9.4%) than the de novo HF group (adjusted hazard ratio 2.52, 95% confidence interval 1.06–5.96, p = 0.036), although on a higher initial dose. The de novo HF group showed better LVEF improvement after 1 year (12.0% vs 7.4%, p = 0.010). Further, the discontinuation rate of diuretics after 1 year was numerically higher in the de novo group than the prior HF group (34.4 vs 18.5%, p = 0.064). Conclusions The de novo HF group had a lower risk of the primary composite outcome than the prior HF group in patients with reduced ejection fraction who were treated with ARNI.