Background: Cancer cell line-derived feeder cells enhance natural killer (NK) cell expansion; however, concerns regarding viable residual feeder cells in the final product limit their use. Evidence supporting the safety of NK-sensitive K562-based feeders, even when irradiated, is scarce. We optimized an NK cell expansion protocol using genetically engineered K562-mbIL-18/-21 (GE-K562) feeder cells and clinical-grade media and confirmed the absence of residual feeder cells. Methods: NK cell expansion efficiency was compared between feeder-free and feederbased systems using CTS NK-Xpander Medium. To achieve optimal NK expansion, various peripheral blood mononuclear cell (PBMC)-to-feeder ratios and re-stimulation frequencies were tested over 21 days. Flow cytometry and BCR::ABL1 quantitative reverse transcription PCR (RT-qPCR) were used to confirm the absence of feeder cells in the final NK cell product. Results: Feeder-based systems showed superior NK cell fold expansion compared with that of feeder-free systems. Among feeder-based conditions, NK cells expanded 5,224-fold at a 2:1 PBMC-to-feeder ratio after 3 weeks, relative to 1,450-fold at a 6:1 ratio (P < 0.05).Re-stimulation on days 7 and 14 further increased expansion up to 261,457-fold. Irradiated feeder cells showed no proliferation and were eliminated within 3–6 days. On day 21, flow cytometry and BCR::ABL1 RT-qPCR results confirmed the absence of residual feeder cells. Conclusions Our optimized NK cell expansion protocol using irradiated GE-K562 feeder cells and clinical-grade media offers a safe and scalable approach to generating large numbers of NK cells, supporting its potential use in clinical immunotherapy applications.

Objectives: Adolescent non-suicidal self-injury (NSSI) is a marker of severe emotional distress and a significant public health concern.This narrative review aimed to synthesize major theoretical models explaining the psychopathology of NSSI and critically evaluate the efficacy of evidence-based psychotherapies using the most recent high-level evidence. Methods: We searched articles in major academic databases published from January 2000 up to June 2025. We prioritized studies on adolescents, including efficacy studies (randomized controlled trials and meta-analyses) addressing NSSI as a primary outcome, and key theoretical papers. Results: NSSI was understood through integrated models, prominently featuring emotion dysregulation (biosocial theory), experiential avoidance (cognitive-behavioral models), impaired mentalization (attachment theory), and operant conditioning (functional model). The synthesis of high-level evidence, including a 2021 review from Cochrane, indicated that dialectical behavior therapy (DBT) had the strongest empirical support (high-certainty evidence) for reducing adolescent NSSI. However, while mentalization-based treatment, acceptance and commitment therapy, and attachment-based family therapy offered promising mechanism-specific approaches, evidence for their effectiveness for NSSI was preliminary or uncertain. Conclusion DBT is currently the first-line treatment for NSSIs in adolescents. However, the field must move toward personalized care.Future research should focus on validating alternative therapies through head-to-head randomized controlled trials, identifying the core change mechanisms across treatments, and implementing stepwise care models to improve accessibility.

Cemented and uncemented fixation are the two categories of fixation in hip arthroplasty (HA). While uncemented stems rely on biologic fixation, cemented HA uses PMMA (polymethylmethacrylate) to lend stability through an interlocking fit between the stem and the cancellous bone. The optimal choice of fixation in elderly patients is debatable. Although patients with poor bone quality have demonstrated good results with uncemented stems, recent improvements in cementing techniques have led to superior outcomes compared to those of older versions. We prefer fully cemented HA in elderly patients to achieve immediate stability that leads to early mobilization and minimal complications, such as intraoperative or postoperative periprosthetic femur fractures. This technical note describes cement fixation in HA.

suggest that some reproductive factors associated with BC differ across ethnicities and time trends, perhaps due to the prevalence of reproductive factors and the baseline hazard of BC.

This study examined the mediating effect of empowerment on the relationship between nursing professionalism and job satisfaction, with the goal of informing strategies to enhance job satisfaction among insurance review nurses. Methods: A total of 165 insurance review nurses with more than 1 year of work experience in 12 general hospitals (≥500 beds) participated in this study. Data were analyzed using descriptive statistics, t-tests, analysis of variance, Pearson correlation analysis, and multiple regression analysis. The mediating effect was tested using the PROCESS Macro (model 4) in SPSS version 26.0 with 10,000bootstrap samples. Results: The mean scores for nursing professionalism, empowerment, and job satisfaction were 100.37 (standard deviation [SD], 17.03), 86.24 (SD, 17.70), and 45.44 (SD, 9.17), respectively. Significant positive correlations were observed between nursing professionalism and job satisfaction (r=.64, p<.001), empowerment and job satisfaction (r=.77, p<.001), and nursing professionalism and empowerment. Empowerment was found to partially mediate the relationship between nursing professionalism and job satisfaction (95% CI, .20–.44). Conclusion: Enhancing empowerment and strengthening nursing professionalism are essential for improving job satisfaction among insurance review nurses. Institutional interventions that promote professional identity and provide structural empowerment may increase job satisfaction and support retention within this specialized nursing workforce.

Objective: This study aimed to validate the reliability and validity of the Diagnostic Interview for the Internet Addiction Scale (DIA) among Korean children and adolescents in the clinical setting. Methods: We collected the clinical data from university hospitals in South Korea and 194 children and adolescents (aged 7–18 years) completed the questionnaire. The content validity was conducted on 10 items of the DIA and an internal consistency test was performed for the verification of reliability. Results: Participants on average, aged 13.17 years (standard deviation=2.46), and 75.3% (n=146) were boys. The DIA was highly correlated with the scores of the Korean scale for Internet addiction for adolescents, Young’s Internet Addiction Test, Internet addiction proneness scale for children and adolescents. The overall sampling suitability of the 10-item scale was tested using the Kaiser–Meyer–Olkin, resulting in a high value of 0.861. The DIA revealed a two-factor structure and the Cronbach’s alpha correlation coefficient for the total scale was 0.806. Confirmatory factor analysis showed an acceptable model fit (root-mean square error of approximation=0.058, comparative fit index=0.950, and Tucker-Lewis Index=0.919). Conclusion The DIA may suggest in-depth-scale examinations of the factors that influence Internet addiction. We may expect that DIA would be used efficiently for the diagnosing of Internet addiction and further studies for the assessment.

Background: Primary cutaneous CD30+ lymphoproliferative disorders (pcCD30-LPDs) are a diseases with various clinical and prognostic characteristics. Objective: Increasing our knowledge of the clinical characteristics of pcCD30-LPDs and identifying potential prognostic variables in an Asian population. Methods: Clinicopathological features and survival data of pcCD30-LPD cases obtained from 22 hospitals in South Korea were examined. Results: A total of 413 cases of pcCD30-LPDs (lymphomatoid papulosis [LYP], n=237; primary cutaneous anaplastic large cell lymphoma [C-ALCL], n=176) were included. Ninety percent of LYP patients and roughly 50% of C-ALCL patients presented with multiple skin lesions. Both LYP and C-ALCL affected the lower limbs most frequently. Multiplicity and advanced T stage of LYP lesions were associated with a chronic course longer than 6 months. Clinical morphology with patch lesions and elevated serum lactate dehydrogenase were significantly associated with LPDs during follow-up in LYP patients. Extracutaneous involvement of C-ALCL occurred in 13.2% of patients. Lesions larger than 5 cm and increased serum lactate dehydrogenase were associated with a poor prognosis in C-ALCL. The survival of patients with C-ALCL was unaffected by the anatomical locations of skin lesions or other pathological factors. Conclusion The multiplicity or size of skin lesions was associated with a chronic course of LYP and survival among patients with C-ALCL.

Background: Primary cicatricial alopecia (PCA) is a group of disorders causing irreversible hair loss because of hair follicle destruction. Although bacterial colonization is suspected to contribute to PCA pathogenesis, its role remains unclear. Objective: To investigate bacterial colonization patterns and antibiotic susceptibility profiles in patients with PCA compared to those with non-inflammatory scalp conditions. Methods: This retrospective study analyzed bacterial cultures from scalp swabs of 161 subjects (68 patients with PCA and 93 controls) at a tertiary hospital between June 2011 and December 2023. Bacterial species and antibiotic resistance rates were evaluated using subgroup analyses of neutrophilic PCA (NCA). Results: PCA cultures showed a higher prevalence of Staphylococcus aureus (24.3%) and S. lugdunensis (8.1%) than controls, where S. capitis (54.5%) was predominant. Gram-negative bacteria were more frequent in the PCA group (13.5%) than in the control group (9.9%), with Klebsiella spp.(10.9%) being the most prevalent. Resistance rates were significantly higher in PCA for benzylpenicillin, fusidic acid, erythromycin, clindamycin, oxacillin, and telithromycin (p<0.05). Methicillin-resistant S. aureus was identified in 15% of S. aureus isolates from NCA cases. Gram-negative bacteria in PCA also exhibited increased resistance to ampicillin and ampicillin/sulbactam. Conclusion PCA exhibits distinct bacterial colonization and elevated antibiotic resistance, particularly in the neutrophilic subtypes. Bacterial culture and susceptibility testing are essential for targeted therapies in clinical practice. Further multicenter microbiome analyses with mechanistic studies are needed to elucidate bacterial contributions to PCA pathogenesis.

The LabGenius C-CT/NG-BMX assay (LabGenius CT/NG; BIOMEDUX, Gyeonggi, Republic of Korea) is a recently developed real-time PCR assay that can simultaneously detect the sexually transmitted pathogens Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in genitourinary specimens. We evaluated the analytical performance of this assay in comparison with BD MAX CT/GC/TV (Becton Dickinson, Franklin Lakes, NJ, USA). The results of both assays were in nearly perfect agreement for the detection of CT and NG. LabGenius CT/NG demonstrated acceptable analytical performance, comparable with that of another commercially available kit, and provides a cost-effective option for detecting sexually transmitted pathogens in routine and follow-up testing.