Objective: Revision surgery for recurrent cervical radiculopathy or myelopathy after posterior decompression is technically challenging because of epidural adhesions, altered anatomy, and the risk of postoperative instability. Although anterior cervical discectomy and fusion is commonly performed, it sacrifices segmental motion and is associated with fusion-related morbidity. This technical report describes the surgical technique and early clinical outcomes of unilateral biportal endoscopic (UBE) posterior cervical revision as a motion-preserving alternative. Methods: Five patients underwent UBE-assisted posterior cervical revision surgery for recurrent cervical disc herniation, foraminal stenosis, or central canal stenosis. Procedures included inclinatory foraminotomy or unilateral laminotomy with bilateral decompression, depending on pathology. Clinical outcomes were evaluated using visual analogue scale (VAS) scores for neck and arm pain, motor strength assessment, radiographic evaluation, and modified MacNab criteria. All patients were followed for at least 1 year. Results: All procedures were completed without conversion to open surgery or the need for fusion. Adequate neural decompression was achieved in all cases, with preservation of facet joint integrity and cervical alignment. Neck pain VAS scores improved from 4–8 preoperatively to 0–1 at 1 year postoperatively, while arm pain VAS scores improved from 7–9 to 0–2. Motor weakness improved in all patients who presented with preoperative deficits. No intraoperative or postoperative complications were observed during the follow-up period. Conclusion UBE-assisted posterior cervical revision surgery appears to be a feasible and effective minimally invasive option for selected patients. This technique allows sufficient decompression while preserving cervical motion and avoiding fusion-related morbidity.

To demonstrate the feasibility and highlight key technical nuances of a unilateral biportal endoscopic (UBE) transforaminal approach for resecting chronic, centrally calcified thoracic disc herniation (TDH). Central TDH is a rare and technically demanding condition due to the narrow thoracic canal, proximity to the spinal cord, and frequent calcification in chronic cases. Minimally invasive techniques that reduce spinal cord manipulation and preserve posterior stabilizing structures are therefore preferred. A 74-year-old woman presented with lower back and left leg pain, sensory disturbance, and gait impairment. Magnetic resonance imaging revealed a centrally calcified TDH at T10–11 with significant spinal cord compression. The lesion was approached via a transforaminal UBE route under continuous irrigation, providing a direct lateral working corridor for optimal visualization and controlled decompression. The calcified and adherent disc was progressively thinned and delicately dissected from the dura using an angled sharp hook and fine endoscopic instruments, minimizing cord manipulation. Postoperative imaging confirmed complete decompression, and the patient showed marked neurological recovery without complications. For centrally located, calcified TDH, the transforaminal UBE approach enables effective decompression while minimizing spinal cord retraction and preserving posterior elements. The accompanying video provides a detailed step-by-step demonstration of the procedure to enhance its safety and reproducibility.

Osteoid osteoma is a benign bone-forming tumor that rarely occurs in the cervical spine. Surgical removal is indicated when symptoms persist despite conservative management. Although open excision or radiofrequency ablation has traditionally been performed, these approaches may be associated with extensive tissue disruption or postoperative spinal instability. Recently, minimally invasive techniques, including unilateral biportal endoscopy (UBE), have been introduced for spinal tumor resection. We report the case of a 50-year-old man with persistent left-sided neck pain lasting 6 months. Imaging studies revealed a 15-mm nidus in the left lamina of C3, consistent with osteoid osteoma. The lesion was completely excised using the UBE technique, with preservation of the facet joint and surrounding structures. Histopathologic examination confirmed the diagnosis of osteoid osteoma. The patient’s symptoms improved immediately after surgery, and no perioperative complications occurred. Follow-up computed tomography and magnetic resonance imaging demonstrated complete lesion removal, with no evidence of recurrence at the 7-month follow-up. UBE-assisted resection represents an effective and minimally invasive surgical option for cervical osteoid osteoma. This approach enables adequate visualization, precise lesion excision, and preservation of spinal stability, resulting in favorable clinical and radiologic outcomes.

Objective: Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors combined with endocrine therapy (ET) constitute the standard systemic treatment for estrogen receptor-positive, human epidermal growth factor 2-negative (ER+/HER2-) metastatic breast cancer (MBC). However, treatment responses remain heterogeneous, highlighting the need for reliable prognostic markers. This study aimed to evaluate the prognostic significance of 18F-fluorodeoxyglucose (FDG) PET/CT findings in this setting. Materials and Methods: This retrospective single-center cohort study included patients with ER+/HER2- MBC who underwent18F-FDG PET/CT before initiating CDK4/6 inhibitors plus ET between 2018 and 2023. Maximum standardized uptake value(SUVmax), whole-body metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. Progression-free survival (PFS) and overall survival (OS) were evaluated as the primary and secondary outcomes, respectively, using multivariable Cox models. PET parameters (SUVmax, MTV, and TLG) were analyzed as both continuous and dichotomized variables based on median values, adjusting for relevant clinical covariates. Results: Among the 374 patients, 82 (21.9%) presented with de novo metastatic disease, and 357 (95.5%) received CDK4/6 inhibitors as first-line therapy. In multivariable Cox analysis, all continuous PET parameters were independently associated with PFS (adjusted hazard ratio for SUVmax 1.05 [95% confidence interval 1.02–1.08]; log-transformed MTV 1.16 [1.08–1.25]; and log-transformed TLG 1.14 [1.07–1.23]) and OS (SUVmax 1.08 [1.04–1.11]; log-transformed MTV 1.24 [1.12–1.38]; and log-transformed TLG 1.22 [1.11–1.34]) with all P < 0.001. Results based on dichotomized PET parameters were similar to those obtained with continuous values: PFS (adjusted hazard ratio for SUVmax ≥ 7.6, 1.41 [1.08–1.85]; MTV ≥ 21.2 cm 3 , 1.41 [1.08–1.86]; and TLG ≥ 78.9, 1.51 [1.14–1.99]) with P ≤ 0.013 and OS (1.43 [1.01–2.04]; 1.84 [1.28– 2.66]; and 1.73 [1.20–2.50], respectively) with P ≤ 0.046. Conclusion Pretreatment 18F-FDG PET/CT parameters are independent prognostic markers in patients with ER+/HER2- MBC receiving CDK4/6 inhibitors with ET, supporting their potential utility in risk stratification.

Objective: We investigated the distribution of AI viruses in fecal samples from wild bird habitats (and nearby poultry-farm areas) surveyed between September and March from 2019 to 2025 and identified associated epidemiological risk factors. Methods: Samples were screened for influenza A (M, H5, H7) genes using real-time reverse transcription polymerase chain reaction (PCR), subjected to virus isolation in embryonated chicken eggs, and subtyped by PCR and sequencing. Host species were identified through DNA barcoding. Relative risks (RRs) with 95% confidence intervals were estimated for province, month, and waterfowl density. Results: Overall prevalence of HPAI and low pathogenic AI (LPAI) virus was 0.10% and 3.21%, respectively. HPAI virus was continuously isolated since 2020–2021, except 2019– 2020, while LPAI prevalence steadily increased (3.01%–4.35%). Twelve hemagglutinin (H1–H12) subtypes were identified in 1,722 isolates, and H3 (16.5%) was the most prevalent, followed by H5 (11.1%) and H7 (5.2%). LPAI H5N3 (55.7%) and H7N7 (75.5%) were the predominant H5 and H7 subtypes, respectively. Detection was higher in western coastal provinces, and higher mallard/spot-billed duck density and sampling in September– December were associated with increased risk. Conclusions and Relevance: Continued surveillance of migratory-bird habitats can provide early warning of HPAIV incursions and support targeted biosecurity measures in high-risk regions and seasons.

Objective: Objective of this study is to evaluate the association between high risk of depression and metabolic diseases such as hypertension, diabetes, and dyslipidemia in Korean cervical cancer patients. Methods: A total of 330 women with cervical cancer were included in this study, using data from the Korea National Health and Nutrition Examination Survey from 2010 to 2021. Participants were categorized into two groups—high risk of depression and non-depression—based on their answers to survey items related to depression. A multivariate logistic regression analysis was used to evaluate the influence of metabolic diseases on high risk of depression in patients with cervical cancer. Results: A total of 78 (23.64%) and 252 (76.36%) women were classified into the high risk of depression and non-depression groups, respectively. In multivariate logistic regression analysis adjusting for age, menopausal status, and smoking status, diabetes was associated with an odds ratio of 2.47 (95% confidence interval: 1.205, 5.071) for high risk of depression in cervical cancer patients. However, among the metabolic diseases, hypertension, and dyslipidemia were not associated with high risk of depression in patients with cervical cancer. Conclusion This study suggests that diabetes may be associated with a increased risk of high risk of depression in cervical cancer patients. Therefore, appropriate treatment of diabetes in cervical cancer patients may contribute to lowering the risk of depression in the future.

Background: and Purpose The Treat Stroke to Target (TST) was a randomized clinical trial involving French and Korean patients demonstrating that a lower low-density lipoprotein cholesterol (LDL-C, <70 mg/dL) target group (LT) experienced fewer cerebro-cardiovascular events than a higher target (90–110 mg/dL) group (HT). However, whether these results can be applied to Asian patients with different ischemic stroke subtypes remains unclear. Methods: Patients from 14 South Korean centers were analyzed separately. Patients with ischemic stroke or transient ischemic attack with evidence of atherosclerosis were randomized into LT and HT groups. The primary endpoint was a composite of ischemic stroke, myocardial infarction, coronary or cerebral revascularization, and cardiovascular death. Results: Among 712 enrolled patients, the mean LDL-C level was 71.0 mg/dL in 357 LT patients and 86.1 mg/dL in 355 HT patients. The primary endpoint occurred in 24 (6.7%) of LT and in 31 (8.7%) of HT group patients (adjusted hazard ratio [HR]=0.78; 95% confidence interval [CI]=0.45–1.33, P=0.353). Cardiovascular events alone occurred significantly less frequently in the LT than in the HT group (HR 0.26, 95% CI 0.09–0.80, P=0.019), whereas there were no significant differences in ischemic stroke events (HR 1.12, 95% CI 0.60–2.10, P=0.712). The benefit of LT was less apparent in patients with small vessel disease and intracranial atherosclerosis than in those with extracranial atherosclerosis. Conclusion In contrast to the French TST, the outcomes in Korean patients were neutral. Although LT was more effective in preventing cardiovascular diseases, it was not so in stroke prevention, probably attributed to the differences in stroke subtypes. Further studies are needed to elucidate the efficacy of statins and appropriate LDL-C targets in Asian patients with stroke.

Objective: Objective of this study is to evaluate the association between high risk of depression and metabolic diseases such as hypertension, diabetes, and dyslipidemia in Korean cervical cancer patients. Methods: A total of 330 women with cervical cancer were included in this study, using data from the Korea National Health and Nutrition Examination Survey from 2010 to 2021. Participants were categorized into two groups—high risk of depression and non-depression—based on their answers to survey items related to depression. A multivariate logistic regression analysis was used to evaluate the influence of metabolic diseases on high risk of depression in patients with cervical cancer. Results: A total of 78 (23.64%) and 252 (76.36%) women were classified into the high risk of depression and non-depression groups, respectively. In multivariate logistic regression analysis adjusting for age, menopausal status, and smoking status, diabetes was associated with an odds ratio of 2.47 (95% confidence interval: 1.205, 5.071) for high risk of depression in cervical cancer patients. However, among the metabolic diseases, hypertension, and dyslipidemia were not associated with high risk of depression in patients with cervical cancer. Conclusion This study suggests that diabetes may be associated with a increased risk of high risk of depression in cervical cancer patients. Therefore, appropriate treatment of diabetes in cervical cancer patients may contribute to lowering the risk of depression in the future.