OBJECTIVES: This mixed-methods observational study aimed to examine the temporal relationship between trends in cigarette smoking prevalence and lung cancer mortality and incidence rates, and to estimate the latency period between smoking initiation and lung cancer diagnosis among smokers at the individual level. METHODS: Smoking prevalence data for 1960–2022 were reconstructed using data from the Korea National Health and Nutrition Examination Survey (1998–2022). Lung cancer mortality data (1983–2022) and incidence data (1999–2022) were obtained from Statistics Korea and the Korea Central Cancer Registry. The population latency period was estimated using peak comparison and distributed lag non-linear models. The individual latency period was estimated as the average time interval between age at smoking initiation and age at lung cancer diagnosis using individual-level data from the National Health Insurance Service cohort. RESULTS: In men, smoking prevalence peaked around 1985, whereas lung cancer mortality peaked around 2000 during 1960–2022, indicating a lag time of approximately 15 years. In women, lung cancer mortality peaked in 2002, while smoking prevalence peaked around the same time. The population-level latency period between smoking and lung cancer incidence was estimated to be 15 years after adjustment for age, gender, and year of outcome. The individual latency period was estimated to be 42.6 years (standard deviation [SD], 12.5) in men and 34.4 years (SD, 14.2) in women. Smoking intensity and age at initiation did not appear to shorten the individual latency period. CONCLUSIONS Estimates of the smoking-attributable lung cancer burden should account for historical smoking prevalence from approximately 15 years earlier.

In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.

Objective: The incidence of psychiatric illnesses might be higher in individuals people living with human immunodeficiency virus (PLWH) than in individuals without human immunodeficiency virus (HIV). We aimed to investigate whether PLWH had different risks of psychiatric morbidities in comparison to non-HIV-infected individuals. Methods: This study included all PLWH in South Korea between January 1, 2017 and December 31, 2017. The control group, which had never been diagnosed with HIV, was selected using a 1:10 stratified random sampling technique, considering age and sex. The endpoint of this study was new diagnosis of psychiatric morbidities which were diagnosed from January 1, 2018 to December 31, 2022. Results: After conducting a 1:5 propensity score (PS) matching process, the final analysis comprised a group of 17,815 PLWH and 78,021 control subjects. In the PS-matched cohort, the incidence rate of psychiatric morbidity in PLWH was 5,677.7 per 100,000 per year, whereas that in the controls was 4,926.3 per 100,000 per year. In Cox regression in the PS-matched cohort, PLWH showed 17% (hazard ratio, 1.17; 95% confidence interval, 1.14–1.21; p<0.001) higher risk of psychiatric morbidity than controls. Specifically, PLWH showed higher risk of depression, mania, bipolar disorder, insomnia disorder, substance use disorder, and schizophrenia compared to controls. Conclusion PLWH had a greater likelihood of experiencing psychiatric morbidities compared to those without HIV in South Korea. Our research findings indicate the importance of public health policy in addressing the declining mental health of individuals living with HIV.

Background: Rosacea is a chronic inflammatory skin disorder characterized by erythema, papules, ocular symptoms, and heightened sensitivity. Patients with neurogenic symptoms such as burning or stinging remain particularly difficult to manage. Current guidelines often underrepresent energy-based devices (EBDs), pigmentary sequelae, psychosocial burden, and ocular comorbidities. Objective: To examine Korean dermatologists’ expert perspectives on rosacea management, focusing on skin sensitivity, neurogenic symptoms, pigmentary changes, psychosocial impact, ocular involvement, and EBD use. Methods: A web-based, 29-item survey was administered to 25 board-certified Korean dermatologists (May–June 2025). Quantitative and qualitative responses were analyzed. Results: Erythematotelangiectatic and papulopustular phenotypes with sensitivity skin predominated. EBDs (pulsed dye laser, intense pulsed light) were frequently used but limited by cost and sensitivity issues. Neurogenic symptoms were recognized but rarely treated with neuromodulators. Post-inflammatory hyperpigmentation was infrequent, yet monitoring was inconsistent.Psychosocial and ocular aspects were acknowledged but seldomly systematically addressed.Respondents expressed interest in emerging adjunctive treatments such as cold plasma, skin boosters, and holistic care approaches. Conclusion Korean dermatologists adopt individualized strategies for rosacea, yet practice gaps remain regarding neurogenic symptoms, pigmentary complications, and psychosocial and ocular comorbidities. Findings support the need for updated multidisciplinary, phenotype-driven guidelines aligned with real-world practice.

Purpose: This study aimed to develop and evaluate the effectiveness of the Trauma-nursing Education and Skill Support (TESS) program based on the ADDIE model (Analysis, Design, Development, Implementation, Evaluation model). The program was designed to enhance trauma nurses’ clinical competencies, including trauma-related knowledge, self-efficacy, and problem-solving ability, through the integration of theoretical education and simulation-based practice. Methods: A quasi-experimental study using a non-equivalent control group pretest–posttest design was conducted. Participants included 108 trauma nurses from regional trauma centers, military trauma centers, and emergency care facilities, who were assigned to an experimental group (n=52) or a control group (n=56). The TESS program consisted of a 2-day, 14-hour blended-learning course that included eight lecture sessions and four simulation-based practice stations. Data were collected at baseline, immediately after the intervention, and at 6 months using validated instruments measuring trauma-related knowledge, self-efficacy, and problem-solving ability. Two-way repeated-measures analysis of variance was used for data analysis. Results: The experimental group demonstrated significant improvements in trauma-related knowledge, self-efficacy, and problem-solving ability compared with baseline (all p<.001). These improvements were sustained at 6 months, although trauma-related knowledge scores showed a slight decline compared with immediate posttest levels. Between-group analyses confirmed significant group-by-time interaction effects for all outcomes: trauma-related knowledge (η2=0.12, p<.001), self-efficacy (η2=0.09, p=.002), and problem-solving ability (η2=0.08, p=.003). Conclusion The TESS program effectively enhanced trauma nurses’ trauma-related knowledge, self-efficacy, and problem-solving ability, with effects sustained for up to 6 months. Incorporating blended learning and simulation-based training into standardized trauma nursing education may strengthen clinical competencies and ultimately contribute to improved patient outcomes.

Purpose: To characterize perioperative changes in posterior corneal curvature (PCC) following pterygium excision using anterior segment (AS) swept-source optical coherence tomography (SS-OCT), and to identify the critical threshold of horizontal invasion length (HIL) predicting significant PCC alterations. Methods: This retrospective cohort study included 85 eyes of 77 patients with primary nasal pterygium. PCC parameters, including posterior keratometry (K) average, posterior steep K, posterior flat K and posterior corneal astigmatism, were measured preoperatively and postoperatively using AS SS-OCT (Anterion). Perioperative PCC changes were analyzed in relation to HIL and postoperative duration. Subgroup analyses were performed to identify the HIL cutoff value associated with statistically significant changes in posterior K average. Results: Significant postoperative flattening was observed in both posterior K average (from –6.27 ± 0.24 to –6.23 ± 0.23 diopters [D], p < 0.001) and posterior flat K (from –6.14 ± 0.23 to –6.09 ± 0.23 D, p < 0.001), accompanied by a significant increase in posterior corneal astigmatism (from –0.25 ± 0.12 to –0.29 ± 0.17 D, p = 0.003). The magnitude of posterior flattening showed a significant positive correlation with HIL (r = 0.384, p < 0.001) but was not correlated with postoperative duration (p = 0.428). In subgroup analysis, eyes with HIL ≥3.5 mm exhibited a significant change in posterior K average (p < 0.001), whereas those with HIL <3.0 mm and HIL <3.5 mm showed no significant change (p = 0.065 and p = 0.443, respectively). Conclusions Pterygium excision leads to significant posterior corneal flattening proportional to HIL, with 3.5 mm identified as a clinically relevant cutoff. Although the refractive impact may be subtle, surgeons should be aware of these posterior corneal changes as a consistent morphological response, especially in eyes with HIL ≥3.5 mm.

Purpose: While MRI-based tumor regression grade (mrTRG) has shown promise in evaluating pathologic response to concurrent chemoradiotherapy (CCRT) in rectal cancer, its ability to predict pathologic complete response remains limited.This study aimed to enhance mrTRG’s diagnostic performance in predicting ypT0–1N0 status, a key factor in considering non-radical management after CCRT for locally advanced rectal cancer (LARC). Methods: This retrospective study included 430 patients with LARC who underwent radical resection following CCRT at a single referral hospital between April 2018 and September 2024. Multivariable logistic regression was used to identify predictive factors associated with achieving ypT0–1N0 status. The diagnostic performances of mrTRG1–2 alone and in combination with other factors were assessed by comparing sensitivity, specificity, positive-predictive value (PPV), negative-predictive value, and area under the curve (AUC). Results: Ninety-three patients (21.6%) achieved ypT0–1N0. In the multivariable analysis, fungating type, cT1–2, and mrTRG1–2 were independent predictors for ypT0–1N0. Integrating mrTRG with gross tumor type yielded the highest AUC of 0.689 among the combined models. For predicting ypT0–1N0, the combination of mrTRG and gross tumor type improved PPV (79.2% vs. 41.5% for mrTRG alone) while also demonstrating enhanced sensitivity compared with ycT0–1N0, the conventional MRI-based predictor (40.9% vs. 22.6%). Conclusion This study demonstrated that combining mrTRG and gross tumor type improved the PPV of mrTRG in predicting ypT0–1N0 after CCRT in LARC. Further studies are warranted to validate the role of gross tumor type in refining predictive systems for selecting candidates for non-radical treatment.

Immunosenescence, an age-associated decline in immune function, is increasingly recognized as a central determinant of health and disease in older adults. Characterized by thymic involution, loss of naïve T cells, contraction of T cell receptor diversity, accumulation of senescent and exhausted lymphocytes, and a chronic inflammatory state known as inflammaging, immunosenescence compromises both innate and adaptive immune responses. Immunosenescence contributes to the pathogenesis of diverse age-related diseases. In autoimmune and metabolic diseases, premature accumulation of senescent T cells and impaired regulatory T cell function drive chronic inflammation and tissue damage, while in neurodegenerative diseases, microglial aging and sustained neuroinflammation exacerbate neuronal loss. These findings highlight immunosenescence as a unifying mechanism linking aging to systemic and organ-specific pathologies. Advances in biomarker discovery, including phenotypic markers, telomere attrition, and epigenetic signatures, have enabled the quantitative assessment of immune aging, while emerging therapeutic strategies, such as cytokine modulation, mTOR inhibition, senolytics, and epigenetic reprogramming, show promise in restoring immune competence. Here, we summarize recent research on immunosenescence in various diseases, particularly chronic inflammatory, metabolic, and neurodegenerative diseases, and suggest novel strategies for the development of senolytic drugs.

Purpose: The aim of this study is to compare the detection ability of quality of life (QoL) changes and responsiveness of the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS)-40 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ). Materials and Methods: A multicenter prospective observational study was conducted to evaluate QoL changes after various gastrectomies between January 2021 and April 2022. Participants were instructed to complete the KOQUSS-40 and EORTC QLQ-C30/STO22 preoperatively and at 1, 3, 6, and 12 months postoperatively. QoL changes over time and QoL responsiveness were assessed for each questionnaire. Results: Data from 491 patients who underwent curative gastrectomy for gastric cancer at 22 institutions were analyzed. The summary scores of the KOQUSS-40 and EORTC QLQ-STO22 showed significant differences between the total and proximal gastrectomy groups (p=0.044 and p=0.038, respectively), but no difference was observed for the EORTC QLQ-C30. Dysphagia on the KOQUSS-40 was significantly different between the total and proximal gastrectomy groups (p=0.031); however, dysphagia on the EORTC QLQ-STO22 did not differ. The responsiveness of the KOQUSS-40 was similar to that of the EORTC QLQ in patients who experienced ≥ 10% body weight loss, but approximately 10% less in patients receiving adjuvant chemotherapy than the EORTC QLQ. Conclusion KOQUSS-40 has several advantages over EORTC QLQ-C30/STO22 when comparing QoL between the total and proximal gastrectomy groups. The findings provide information for researchers investigating the QoL of patients who have undergone curative gastrectomy for gastric cancer.

Purpose: The male predominance in the incidence of gastric cancer (GC) is established; however, sex differences in the prognosis of GC remain controversial. As such, this study analyzed the prognosis of patients with GC based on age and sex. Materials and Methods: Data from 14,739 patients diagnosed with GC at Seoul National University Bundang Hospital between 2003 and 2023 were analyzed. Baseline characteristics, histological types of GC, overall and GC-specific survival rates (age and stage stratification), and associated risk factors were analyzed. Results: Females were significantly younger (p < 0.001) and exhibited more gastric body cancers (p < 0.001) and tumors with diffuse-type or poorly differentiated histology (p < 0.001) than males. Females exhibited an advantage over males in terms of overall survival (p=0.004), but not in GC-specific survival. However, age stratification revealed significant sex differences, that females < 50 years of age exhibited survival disadvantages (p < 0.001); however, this trend was reversed with age, and females > 60 years exhibited survival advantages (p < 0.001) for both overall and GC-specific survival. This may be explained by the lower ratio of diffuse-type GC as females age. Furthermore, in the analysis according to stage, females with stage IV disease exhibited significant survival disadvantages, with significantly younger age and a higher proportion of diffuse-type GC which exhibits aggressive features, resulting in poorer survival than in males. Conclusion Age and stage stratification revealed significant differences in survival between the sexes, which can be helpful for public health strategies.