Objective: To evaluate the performance of supplemental automated breast ultrasound (ABUS) added to mammography-based breast cancer screening for women with nondense breasts. Materials and Methods: A retrospective search of radiology databases at two tertiary institutions identified asymptomatic women with nondense breasts who underwent breast cancer screening using both digital mammography (DM) and supplemental ABUS between January 2020 and December 2023. We excluded women without sufficient follow-up data or those without an established final diagnosis, including histopathologic results. The performance measures of DM alone and ABUS combined with DM (ABUS plus DM) were compared. The primary outcome was the cancer detection rate (CDR), and the secondary outcomes were sensitivity and specificity. Subgroup analyses were performed for women with scattered fibroglandular density and almost entirely fatty breasts. Results: A total of 2,904 pairs of screening examinations were performed in 1,683 women (59 ± 10 years), detecting 26 cancers. In comparison with DM alone, ABUS plus DM showed higher CDR (9.0 vs. 7.9 per 1,000 examinations, P < 0.001), higher sensitivity (100% [26/26] vs. 88.5% [23/26], P < 0.001), and lower specificity (95.0% [2,735/2,878] vs. 97.9% [2,817/2,878], P < 0.001). In women with scattered fibroglandular density, ABUS increased the CDR from 7.4 to 8.5 per 1,000 examinations and improved the sensitivity from 87.0% [20/23] to 100% [23/23] (P < 0.001). In women with almost entirely fatty breasts, ABUS plus DM showed the same CDR (16.4 per 1,000 examinations) and sensitivity (100% [3/3]) as DM alone. Three cancers (11.5% [3/26]), all of which were stage T1N0, were detected only by supplemental ABUS. Conclusion Supplemental ABUS improved cancer detection and sensitivity in women with nondense breasts, with the benefits primarily observed in those with scattered fibroglandular density.

Purpose: To report the clinical characteristics and treatment outcome of dematiaceous fungal keratitis initially misdiagnosed as a corneal foreign body.Case summary: A 51-year-old woman with a history of corneal opacity and recurrent ocular irritation presented with aggravated pain and a brown lesion in the right eye. A well-demarcated, elevated brown lesion located at the central cornea, corneal infiltration and epithelial defects were observed by slit-lamp examination. Anterior segment optical coherence tomography demonstrated posterior signal attenuation behind the brown lesion, with intact anterior chamber. Following removal of the lesion, fungal culture and potassium hydroxide (KOH) smear examination were performed. Yeast-like organisms exhibiting both hyphal and pseudohyphal forms were observed on KOH smear. For accurate identification of the fungus, molecular analysis using DNA sequencing was performed, confirming Cladophialophora boppii. After treatment with topical amphotericin B and oral itraconazole, corneal infiltration and clinical symptoms gradually improved. No recurrence was observed after discontinuation of antifungal therapy. Conclusions The patient presenting with a brown corneal lesion initially misdiagnosed as a corneal foreign body was diagnosed with dematiaceous fungal keratitis through microbiological culture and was successfully treated with antifungal agents.

Purpose: This study investigated the nursing competency of graduates of 4-year college nursing programs following curriculum reforms. Methods: Participants were nurses with clinical experience ranging from six months to three years at tertiary and general hospitals. Proportional quota sampling was performed based on region and hospital type. Nursing competency among college graduates was examined using university graduates as the reference group; nursing managers evaluated the competencies of both groups. Results: First, the overall nursing competencies of college graduates (4.03±0.49) and university graduates (3.97±0.49) did not differ significantly (t=1.43, p=.154). Second, nursing managers’ evaluations indicated comparable nursing competencies of graduates from colleges (3.68±0.72) and university (3.54±0.64) (t=1.87, p=.062). Conclusion These results suggest that the reform of the 4-year nursing program at colleges successfully achieved its educational goals, equivalent to university training programs. These findings reflect positive educational outcomes achieved through changes in the academic system.

Background: This study aimed to investigate the association between obesity and periodontitis among Korean adults and examinewhether the intensity of physical activity modifies this relationship. Methods: The analysis included 11,230 adults aged 19 years and older who participated in the 7th Korea National Health andNutrition Examination Survey between 2016 and 2018. Periodontal status was assessed using the community periodontal index, and obesity was defined as a body mass index of 23.0 kg/m2 or greater. Physical activity intensity was categorized as none, moderate, or high. Multivariable logistic regression analyses, including interaction terms, were conducted to assess the moderating effect of exercise intensity on the association between obesity and periodontitis. Results: Obesity was significantly associated with high-risk periodontitis, and this association varied according to exerciseintensity. The adjusted odds ratios for obesity were 1.23 (95% confidence interval [CI]: 1.09∼1.40) among non-exercisers, 1.43 (95% CI: 1.09∼1.87) among those engaging in moderate-intensity exercise only, and 2.21 (95% CI: 1.27∼3.85) among those engaging in high-intensity exercise only. Conclusion Obesity is a significant risk factor for periodontitis in Korean adults, and the intensity of physical activity modifies thisrelationship. Contrary to expectations, high-intensity exercise may increase the risk of periodontal disease in individuals with obesity. These findings underscore the importance of personalized exercise recommendations and the need to consider metabolic and behavioral factors in oral health promotion strategies.

The global shortage of healthcare personnel, especially in low- and middle-income countries, has raised concerns about the quality and availability of medical education across these economies. Therefore, standardization and accreditation of medical education are essential to ensure the competence of healthcare professionals. This study reports the first-ever application of the set of standards developed by the Korean Institute of Medical Education and Evaluation (KIMEE) to assess a Vietnamese medical school. Under this initiative, the Accreditation Standards of KIMEE 2019 (ASK 2019) was implemented under the auspices of a Korea International Cooperation Agency Development Project. This study compared the evaluation results of a Vietnamese medical school’s performance with that of accredited Korean medical schools. The findings revealed both strengths and areas requiring significant improvement and underscore the need for Vietnam to develop its own contextually appropriate accreditation system.

Purpose: This study evaluated the long-term clinical outcomes of silicone tube intubation using a Nunchaku® (FCI Ophthalmics Inc., Pembroke, MA, USA) tube in adult patients with epiphora. Methods: A prospective study was conducted on 42 eyes in 32 patients who underwent silicone tube intubation with a Nunchaku® tube between March 2023 and September 2023. Clinical manifestations, Munk scale scores, lacrimal syringing test results, and tear meniscus height were assessed before and after surgery. Surgical success was defined as a Munk score of ≤ 1. Results: The mean age of the participants was 56.2 years. Preoperative lacrimal irrigation testing revealed partial obstruction in 29 eyes (69.0%), patent passage in 11 eyes (26.2%), and punctal stenosis in 2 eyes (4.76%). The mean operative time was 6.4 minutes for monocular procedures and 9.7 minutes for binocular procedures. At three months postoperatively, 33 eyes (78.6%) in 28 patients achieved a Munk scale score of ≤ 1. No significant differences were observed between the surgical success and failure groups in terms of preoperative Munk scale scores, lacrimal syringing test results, or tear meniscus height. One patient who underwent binocular surgery experienced worsening symptoms in both eyes postoperatively with associated punctal inflammation and granuloma formation necessitating early silicone tube removal. Slit punctum was observed in 17 eyes across 11 patients, six of whom underwent a snip procedure during surgery. Conclusions Silicone tube intubation using the Nunchaku-style tube is a relatively simple and effective treatment for nasolacrimal duct obstruction. However, an increased incidence of lacrimal punctum-related complications was observed compared to previous studies, indicating the need for caution when performing the snip procedure concurrently.

Purpose: 11C-Methionine PET/CT is a promising method for detecting parathyroid lesions in patients with primary hyperparathyroidism (PHPT). We aimed to determine the diagnostic ability and correlation of digital 11C-Methionine PET/CT for parathyroid lesions in patients with PHPT, particularly in cases where standard imaging methods yielded inconclusive results. Methods: This retrospective analysis was conducted on patients diagnosed with PHPT who underwent digital 11C-Methionine PET/CT imaging because of ambiguous results on standard imaging work-up ( 99m Tc-MIBI parathyroid scan and/or neck ultrasonography). Quantitative 11C-Methionine PET/CT parameters, including maximum standardized uptake value (SUVmax), mean SUV (SUVmean), peak SUV (SUVpeak), parathyroid methionine volume (PMV), and whole methionine uptake(WMU: PMV multiplied by SUVmean) were calculated with various thresholds, and their correlations with biochemical andpathologic parameters were investigated. Results: This study included 22 consecutive patients (10 men and 12 women) with a median age of 64.0 years. The lesion detection rate and sensitivity of digital 11C-Methionine PET/CT were 81.8% (18/22) and 100.0% (18/18), respectively.Quantitative analysis revealed that serum PTH (r = 0.490, P = 0.039) and serum calcium (r = 0.583, P = 0.011) were signifi-cantly correlated with PMV50%. Conclusion Digital 11C-Methionine PET/CT offers good performance in the detection of parathyroid lesions in PHPT patients with inconclusive standard imaging work-up. The volume parameter of PMV50% significantly correlated biochemi-cal parameters and can serve as a complementary diagnostic tool.

This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.

Background and Objectives: Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR. Methods: All procedures were guided by fluoroscopy and transthoracic echocardiography.The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment. Results: A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period. Conclusions The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.

Purpose: To determine the current management pattern for hordeolum and chalazion among members of the Korean Society of Ophthalmic Plastic and Reconstructive Surgery (KSOPRS). Methods: An anonymous web-based survey was emailed to 260 current members of the KSOPRS. The survey comprised five sections: differential diagnosis, treatment strategies for hordeolum, treatment strategies for chalazion, postsurgical care, and pediatric-specific approaches. Results: Eighty KSOPRS members participated in this study (response rate, 30.8%). Redness, swelling, and pain were the most important factors for differentiating hordeolum from chalazion. For hordeolum, topical antibiotics are preferred by 59 respondents (73.8%), with 49 (83.7%) considering them effective. Most (62 respondents, 77.6%) pursue nonsurgical treatment for 5 to 14 days before considering incision and curettage. For chalazion, treatment practices are split between conservative management and invasive methods. Intralesional steroid injections are recommended by 55 respondents (68.8%), with a preference for diluted triamcinolone acetonide. Relative to hordeolum, chalazion treatment involves less frequent antibiotic use, with only 21 respondents (26.3%) always recommending antibiotic ointments. Tissue biopsy is considered for abnormal changes in the surrounding tissues (72 respondents, 90.0%) and frequent recurrence (46 respondents, 57.5%). The practices differ between pediatric and adult cases among 38 respondents (47.5%), with 31 (81.4%) extending conservative management and delaying surgical interventions in pediatric cases. Anesthesia preferences for pediatric cases varied, with 40 respondents (50.0%) favoring local anesthesia, 19 (23.8%) opting for monitored anesthesia care, and 13 (16.2%) choosing general anesthesia. Conclusions This survey of the management of hordeolum and chalazion by KSOPRS members has revealed several interesting common practices that are considered valuable by current practitioners.