1.Deep Learning–Based Bone Age Assessment for Predicting Final Adult Height in Girls With Central Precocious Puberty
Jeong Min SONG ; Pyeong Hwa KIM ; Young Ah CHO ; Ah Young JUNG ; Jin Seong LEE ; Ja Hye KIM ; Hee Mang YOON
Korean Journal of Radiology 2026;27(6):568-577
Objective:
This study aimed to evaluate the accuracy of predicting final adult height (FAH) in Korean girls with central precocious puberty (CPP) using artificial intelligence (AI)-derived bone age assessments integrated into the Bayley–Pinneau (BP) or Korean National Growth Chart (KGC) prediction models.
Materials and Methods:
This single-center, retrospective study included 122 Korean girls with CPP who received gonadotropinreleasing hormone agonist (GnRHa) treatment for at least two years between January 2000 and November 2022. We assessed bone age and predicted adult height at the initiation and completion of GnRHa treatment. We used three bone age assessment methods: human expert assessment based on the Greulich-Pyle (GP) atlas (Human-GP), AI-derived GP (AI-GP), and AI-weighted GP scoring (AI-GPw). We calculated predicted adult heights (PAHs) using both the BP and KGC models, generating 12 PAH estimates per patient (2 time points x 3 bone-age methods x 2 height-prediction models). We assessed prediction accuracy and agreement with FAH using linear regression analysis and Bland–Altman plots and performed multivariable analysis to identify significant predictors of FAH.
Results:
Human-GP, AI-GP, and AI-GPw demonstrated comparable overall performance in predicting FAH (R 2 : 0.470–0.646 and 0.691–0.822 for treatment initiation and completion, respectively). AI-GPw combined with BP yielded slightly better point estimates but showed no statistically significant differences. At both time points, the BP model demonstrated consistently narrower 95% limits of agreement (LoA) than the KGC model. Multivariable analysis identified AI-GPw-BP and height percentile score as significant predictors of FAH at both time points; mid-parental height was significant only at treatment initiation.
Conclusion
Human-GP, AI-GP, and AI-GPw demonstrated comparable accuracy in predicting FAH. The BP model demonstrated consistently narrower 95% LoA than did the KGC model. AI-GPw-BP was an independent predictor of FAH. These findings support the clinical utility of AI-derived bone age assessments for individualized FAH prediction in patients with CPP.
2.Bowel preparation for colonoscopy in special populations: a practical and risk-stratified approach
Myung-Hun LEE ; Won MOON ; Kyoungwon JUNG ; Jae Hyun KIM ; Sung Eun KIM ; Moo In PARK ; Seun Ja PARK
Kosin Medical Journal 2026;41(1):9-18
Bowel preparation is a key determinant of colonoscopy quality; however, inadequate cleansing remains common among patients with overlapping clinical and logistical barriers. In routine practice, preparation failure may prolong procedures, reduce diagnostic confidence, and necessitate early repeat colonoscopy. We review major society guidelines and selected studies addressing bowel preparation in inflammatory bowel disease (IBD), chronic kidney disease (CKD), older adults, chronic constipation, and hospitalized patients. Across these settings, the most consistently supported measures include split-dose administration, completion of the final dose close to the time of colonoscopy in accordance with local fasting and sedation policies, and structured patient instructions reinforced through follow-up communication. A standardized assessment of preparation quality is recommended to support quality improvement and appropriate follow-up. Risk stratification can help identify patients who may benefit from intensified preparation pathways, including those with prior inadequate preparation, severe constipation, frailty, or inpatient status. Safety considerations are particularly important in CKD, in which oral sodium phosphate should be avoided and magnesium-containing agents used cautiously; polyethylene glycol-based solutions are generally preferred. In IBD, regimen selection should also consider endoscopic interpretability because sodium phosphate preparations have been associated with preparation-related mucosal abnormalities that may confound the assessment of subtle inflammatory findings. Among hospitalized patients, system-level barriers often predominate, and protocolized pathways may improve workflow and patient comfort while maintaining cleansing effectiveness. We propose a practical, risk-stratified approach to regimen selection, timing, rescue strategies, and safety monitoring that can be implemented in high-volume clinical practice.
3.Are the long-term oncologic outcomes different between appendiceal cancer and right-sided colon cancer? An exact matching analysis of a 10-year institutional cohort
Gunwoo LEE ; Eun Jung PARK ; Soo Young OH ; Young Il KIM ; Min Hyun KIM ; Jong Lyul LEE ; Chan Wook KIM ; Yong Sik YOON ; In Ja PARK ; Seok-Byung LIM ; Chang Sik YU
Annals of Surgical Treatment and Research 2026;110(4):246-258
Purpose:
Due to its rarity, treatment guidelines for appendiceal cancer have traditionally followed those established for colorectal cancer, despite showing distinct histologic and clinical features. This study aimed to compare the clinicopathologic characteristics and long-term oncologic outcomes of appendiceal cancer with those of right-sided colon cancers.
Methods:
We retrospectively reviewed the records of patients with stage I–III appendiceal, cecal, or ascending colon cancer who underwent curative resection between 2010 and 2020 at our center. A 1:3:3 exact matching for age, sex, TNM stage, and adjuvant chemotherapy was performed. Survival outcomes were analyzed using the Kaplan-Meier and Cox regression methods.
Results:
Overall, 245 patients with appendiceal cancer (n = 35), ascending colon cancer (n = 105), and cecal cancer (n = 105) were analyzed. Appendiceal cancer exhibited a higher proportion of T4 tumors and fewer harvested lymph nodes compared with ascending or cecal cancers. The mean follow-up duration was 9.5 years. The 5- and 10-year overall survival rates were lower in appendiceal cancer (66.2% and 52.9%) than in ascending (91.2% and 78.4%) or cecal cancer (88.5% and 78.3%). Similarly, the 10-year disease-free survival rate was lower in appendiceal cancer (59.2%) compared with ascending (83.1%) and cecal cancers (78.4%). Cox regression analysis identified age (≥65 years), perforation, nodal metastasis, and lymphovascular invasion as independent predictors of poor prognosis.
Conclusion
Appendiceal cancer exhibited significantly worse long-term survival compared to cecal or ascending colon cancer. Tumor perforation, nodal metastasis, and lymphovascular invasion were adverse prognostic factors for overall and disease-free survival.
4.Primary Merkel cell carcinoma of the salivary gland: a clinicopathologic study of four cases with a review of literature
Gyuheon CHOI ; Joon Seon SONG ; Hee Jin LEE ; Gi Hwan KIM ; Young Ho JUNG ; Yoon Se LEE ; Kyung-Ja CHO
Journal of Pathology and Translational Medicine 2025;59(3):171-179
Background:
Primary Merkel cell carcinoma of the salivary gland is currently not listed in the World Health Organization classification. However, cases of Merkel cell type neuroendocrine carcinomas of the salivary gland with perinuclear cytokeratin 20 positivity have been intermittently reported. We here investigated the clinicopathologic features of additional cases.
Methods:
Data of four cases of Merkel cell type small cell neuroendocrine carcinoma of the salivary gland were retrieved. To confirm the tumors’ primary nature, clinical records and pathologic materials were reviewed. Optimal immunohistochemical staining was performed to support the diagnosis.
Results:
All tumors were located in the parotid gland. Possibilities of metastasis were excluded in all cases through a meticulous clinicopathological review. Tumor histology was consistent with the diagnosis of small cell neuroendocrine carcinoma. Tumors’ immunohistochemical phenotypes were consistent with Merkel cell carcinoma, including Merkel cell polyomavirus large T antigen positivity in two of the four cases.
Conclusions
Merkel cell carcinomas can originate in salivary glands and are partly associated with Merkel cell polyomavirus infection as in cutaneous Merkel cell carcinomas.
5.Erratum: Correction of Text in the Article “The Long-term Outcomes and Risk Factors of Complications After Fontan Surgery: From the Korean Fontan Registry (KFR)”
Sang-Yun LEE ; Soo-Jin KIM ; Chang-Ha LEE ; Chun Soo PARK ; Eun Seok CHOI ; Hoon KO ; Hyo Soon AN ; I Seok KANG ; Ja Kyoung YOON ; Jae Suk BAEK ; Jae Young LEE ; Jinyoung SONG ; Joowon LEE ; June HUH ; Kyung-Jin AHN ; Se Yong JUNG ; Seul Gi CHA ; Yeo Hyang KIM ; Youngseok LEE ; Sanghoon CHO
Korean Circulation Journal 2025;55(3):256-257
6.Primary Merkel cell carcinoma of the salivary gland: a clinicopathologic study of four cases with a review of literature
Gyuheon CHOI ; Joon Seon SONG ; Hee Jin LEE ; Gi Hwan KIM ; Young Ho JUNG ; Yoon Se LEE ; Kyung-Ja CHO
Journal of Pathology and Translational Medicine 2025;59(3):171-179
Background:
Primary Merkel cell carcinoma of the salivary gland is currently not listed in the World Health Organization classification. However, cases of Merkel cell type neuroendocrine carcinomas of the salivary gland with perinuclear cytokeratin 20 positivity have been intermittently reported. We here investigated the clinicopathologic features of additional cases.
Methods:
Data of four cases of Merkel cell type small cell neuroendocrine carcinoma of the salivary gland were retrieved. To confirm the tumors’ primary nature, clinical records and pathologic materials were reviewed. Optimal immunohistochemical staining was performed to support the diagnosis.
Results:
All tumors were located in the parotid gland. Possibilities of metastasis were excluded in all cases through a meticulous clinicopathological review. Tumor histology was consistent with the diagnosis of small cell neuroendocrine carcinoma. Tumors’ immunohistochemical phenotypes were consistent with Merkel cell carcinoma, including Merkel cell polyomavirus large T antigen positivity in two of the four cases.
Conclusions
Merkel cell carcinomas can originate in salivary glands and are partly associated with Merkel cell polyomavirus infection as in cutaneous Merkel cell carcinomas.
7.Erratum: Correction of Text in the Article “The Long-term Outcomes and Risk Factors of Complications After Fontan Surgery: From the Korean Fontan Registry (KFR)”
Sang-Yun LEE ; Soo-Jin KIM ; Chang-Ha LEE ; Chun Soo PARK ; Eun Seok CHOI ; Hoon KO ; Hyo Soon AN ; I Seok KANG ; Ja Kyoung YOON ; Jae Suk BAEK ; Jae Young LEE ; Jinyoung SONG ; Joowon LEE ; June HUH ; Kyung-Jin AHN ; Se Yong JUNG ; Seul Gi CHA ; Yeo Hyang KIM ; Youngseok LEE ; Sanghoon CHO
Korean Circulation Journal 2025;55(3):256-257
8.Erratum: Correction of Text in the Article “The Long-term Outcomes and Risk Factors of Complications After Fontan Surgery: From the Korean Fontan Registry (KFR)”
Sang-Yun LEE ; Soo-Jin KIM ; Chang-Ha LEE ; Chun Soo PARK ; Eun Seok CHOI ; Hoon KO ; Hyo Soon AN ; I Seok KANG ; Ja Kyoung YOON ; Jae Suk BAEK ; Jae Young LEE ; Jinyoung SONG ; Joowon LEE ; June HUH ; Kyung-Jin AHN ; Se Yong JUNG ; Seul Gi CHA ; Yeo Hyang KIM ; Youngseok LEE ; Sanghoon CHO
Korean Circulation Journal 2025;55(3):256-257
9.The Impact of Clinical Competence and Perception of Clinical Ladder System on Organizational Commitment among Nurses at a General Tertiary Hospital
Yeon Hee SHIN ; Mi Ra LEE ; Sung Nam KIM ; Min Jung KIM ; Ae Jin KIM ; Hyun Ja KIM ; Ji Yoon KANG
Journal of Korean Academy of Nursing Administration 2025;31(1):120-131
Purpose:
This study aimed to evaluate the performance of a clinical ladder system in a tertiary hospital by examining how nurses' clinical competence and perceptions of the system affect organizational commitment.
Methods:
The study involved 394 nurses working at a tertiary hospital. Data were collected from May 3 to July 10, 2023, using a self-reported questionnaire. Statistical analyses, including descriptive statistics, independent t-tests, one-way ANOVA, Kruskal-Wallis test, Scheffé post-hoc test, Pearson correlation, and hierarchical regression analysis, were performed using SPSS 27.0.
Results:
Nurses who applied for promotion to the CN III level and current CN III nurses reported higher clinical competence, perceptions of the clinical ladder system, and organizational commitment than those who did not and those at lower levels (p<.001). A positive correlation existed among all independent variables.Controlling for general characteristics, the effects of clinical competence and perceptions of the clinical ladder system explained 49% of organizational commitment variance (Adjusted R 2 =.49, F=33.43, p<.001).
Conclusion
Greater clinical competence and positive perceptions of the clinical ladder system are likely to enhance organizational commitment, emphasizing its effectiveness in fostering better organizational outcomes.
10.Permanent Congenital Hypothyroidism in Very Low Birth Weight Infants: A Single Center’s Experience
Joo Hyung ROH ; Tae-Gyeong KIM ; Keon Hee SEOL ; Chae Young KIM ; Soo Hyun KIM ; Ji Yoon JEONG ; Ja Hye KIM ; Euiseok JUNG ; Jin-Ho CHOI ; Byong Sop LEE
Neonatal Medicine 2025;32(1):30-38
Purpose:
Congenital hypothyroidism (CH) is a major preventable cause of intellectual disability, particularly in very low birth weight (VLBW) infants, who are at increased risk due to hypothalamic-pituitary-thyroid axis immaturity. Early differentiation between transient CH (TCH) and permanent CH (PCH) is crucial to optimize L-thyroxine (LT4) treatment duration. This study aimed to determine the incidence of PCH among Korean VLBW infants and to identify clinical factors that may aid in distinguishing TCH from PCH.
Methods:
This retrospective cohort study included VLBW infants diagnosed with CH and treated with LT4 at a single tertiary neonatal intensive care unit between 2011 and 2020. Infants requiring LT4 beyond 3 years were classified as PCH, while those who discontinued earlier were considered TCH. Clinical characteristics, neonatal morbidities, and thyroid-related parameters were compared between the groups.
Results:
Among 1,292 VLBW infants, 122 (9.4%) were diagnosed with CH. After excluding deaths and those lost to follow-up, 73 infants were included in the final analysis (TCH, n=50; PCH, n=23). The PCH group had a significantly higher mean gestational age and greater LT4 requirements at both 12 and 36 months of age. Major anomalies were more frequently observed in PCH infants, including congenital heart defects. In multivariate analysis, higher gestational age, the presence of major anomalies, screening thyroid-stimulating hormone (TSH) >10 μIU/mL, and higher LT4 dose at 36 months were significantly associated with PCH.
Conclusion
The incidence of PCH in Korean VLBW infants was relatively higher than that reported in previous studies studies. Screening TSH level and LT4 dose requirements may support individualized follow-up and help distinguish PCH from TCH.

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