Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Purpose: This study investigated the impact of online education during the pandemic on students’interpersonal relationships. Methods: In this systematic review, we analyzed2,238 articles fromdatabases such as DBpia, PubMed, EMBASE, and CINAHL, ultimately including12 articles in the final analysis. Results: The findings revealed that male students were negatively affected by an increasein online activities, while female students were more impactedby psychological factors. Forlower-grade students, parental involvement was crucial as parents soughtto compensate for their children'sdisconnection frompeers. Consequently, educational activitiesshould be designed to promote interaction with parentsthrough play. Forupper-grade students, attempts to mitigatedisconnection occurred through online activities, but they experienced significant stress when their studieswere disrupted. Therefore, an educational support system mustbe established to alleviate anxietyand stress related totheir academic responsibilities. During this period, the social inequality faced byvulnerable groupswas exacerbatedby various factors. Conclusion To prepare for future crises, it is essential to addresstechnical and institutional issues that can bridgethe care gap and enhance the quality of hybrid education.

This study aimed to derive insights into professional self-concept, teamwork, and job satisfaction among emergency department (ED) nurses and to prepare basic data for improving job satisfaction among ED nurses. Methods: The study was conducted between October 2023 and April 2024 at two certified tertiary hospitals and one general hospital in Gyeonggi-do, Korea, among 124 ED nurses. Data were analyzed using SPSS version 26.0, and the analysis included descriptive statistics, the t-test, Pearson correlation, and multiple regression. Results: The factors affecting job satisfaction in ED nurses were professional self-concept (β = .66, p < .001), teamwork (β = .17, p = .003), and ED work satisfaction (β = .17, p = .003), and the overall explanatory power of the model was 67.7%. Conclusion: This study makes a significant contribution by demonstrating that professional self-concept and teamwork can increase job satisfaction in ED nurses. Therefore, as a strategy to increase job satisfaction through improving ED nurses’ professional self-concept and teamwork, effort should be made to apply team simulation programs that provide education and self-improvement opportunities for frequent diseases and situations encountered in the ED, and to communicate effectively about patient treatment strategies.

Objective: To establish local diagnostic reference levels (DRLs) for pediatric neck CT based on age, weight, and water-equivalent diameter (WED) across multiple university hospitals in South Korea. Materials and Methods: This retrospective study analyzed pediatric neck CT examinations from nine university hospitals, involving patients aged 0–18 years. Data were categorized by age, weight, and WED, and radiation dose metrics, including volume CT dose index (CTDIvol) and dose length product, were recorded. Data retrieval and analysis were conducted using a commercially available dose-management system (Radimetrics, Bayer Healthcare). Local DRLs were established following the International Commission on Radiological Protection guidelines, using the 75th percentile as the reference value. Results: A total of 1159 CT examinations were analyzed, including 169 scans from Institution 1, 132 from Institution 2, 126 from Institution 3, 129 from Institution 4, 128 from Institution 5, 105 from Institution 6, 162 from Institution 7, 127 from Institution 8, and 81 from Institution 9. Radiation dose metrics increased with age, weight, and WED, showing significant variability both within and across institutions. For patients weighing less than 10 kg, the DRL for CTDIvol was 5.2 mGy. In the 10–19 kg group, the DRL was 5.8 mGy; in the 20–39 kg group, 7.6 mGy; in the 40–59 kg group, 11.0 mGy; and for patients weighing 60 kg or more, 16.2 mGy. DRLs for CTDIvol by age groups were as follows: 5.3 mGy for infants under 1 year, 5.7 mGy for children aged 1–4 years, 7.6 mGy for ages 5–9 years, 11.2 mGy for ages 10–14 years, and 15.6 mGy for patients 15 years or older. Conclusion Local DRLs for pediatric neck CT were established based on age, weight, and WED across nine university hospitals in South Korea.

BACKGROUND/OBJECTIVES: Dietary factors act on lower urinary tract symptoms (LUTS).This study examined the relationship between the overall diet quality and LUTS. SUBJECTS/METHODS: This study analyzed the data from examinees who visited a general hospital in Korea (October 13, 2014−March 12, 2020). The number of subjects in the study was 6,506 adult men. The recommended food score was used to evaluate the overall quality of the diet, and the International Prostate Symptom Score was used to quantify LUTS. Logistic regression analysis was used to derive the odds ratio (OR) and 95% confidence interval (CI) to evaluate the relationship between the dietary quality and LUTS. The influence of age, education, marital history, income, occupation, smoking, drinking, exercise, metabolic syndrome, body mass index (BMI), and prostate-specific antigen (PSA) level was analyzed to determine the net influence of the overall diet quality on LUTS. RESULTS: The group with high overall dietary quality showed a lower incidence of LUTS than the group with relatively lower dietary quality (OR, 0.88; 95% CI, 0.79–0.99). These results were also observed after correcting for other risk factors and associated variables: age, education, smoking, metabolic syndrome, BMI, and PSA level. CONCLUSION The overall diet quality and LUTS were correlated. Nevertheless, further research will be needed to find the relationship between diet quality and LUTS.

Placental Hofbauer cells (HBCs) are specialized macrophages present in the human placenta that play a crucial role in maintaining a healthy pregnancy. These cells are derived from the fetal mesoderm and are responsible for various functions, including immune regulation, angiogenesis, and nutrient transport. In normal pregnancies, HBCs primarily exhibit an M2 or immunomodulatory phenotype, which helps maintain a tolerant and antiinflammatory environment at the maternal-fetal interface. However, in pregnancies complicated by conditions such as immunological disorders, inflammation, or infection, the phenotype and function of HBCs may be altered. Although emerging evidence has highlighted the vital role of HBCs in both normal pregnancies and those with complications, such as chorioamnionitis, gestational diabetes, preeclampsia, and viral infections, their role remains unclear. Recent research also suggests a relationship between HBCs and the development of diseases in offspring. Understanding the role of HBCs in pregnancy could provide insights into the pathophysiology of various pregnancy-related disorders and offer potential therapeutic targets for improving maternal and fetal outcomes. This review explores the functions of HBCs in normal pregnancy and their involvement in complications, emphasizing their potential as biomarkers or targets for interventions aimed at reducing the incidence of adverse pregnancy outcomes. Additionally, we reviewed their potential for perinatal research in recent studies.

Objective: Deficits in social cognition (mentalization) and other cognitive deficits have been reported in patients with major depressive disorder (MDD) and may influence treatment response. This study examined the impact of cognitive function on treatment response of patients with MDD after 8 weeks of medication and whether the impact was mediated by mentalization. Methods: Cognitive function (memory, attention, executive function, processing speed) and mentalization were measured in 28 patients with MDD at baseline using neuropsychological tests and self-report scales. The treatment response was defined as the rate of improvement in symptom severity and global function. Results: Multiple regression analyses, controlling for mentalization and cognitive function, separately revealed that delayed recall was a negative predictor of functional improvement after 8 weeks of treatment, while mentalization was a positive predictor. A single mediation model using PROCESS macro showed that delayed recall and Digit Span backward indirectly affected functional improvement, mediated by mentalization. When age at onset was controlled for as a covariate, the mediating effect lost significance, and the direct effect of delayed recall on functional improvement was still significant. Conclusion Despite the small sample size, our results provide evidence that patients with MDD and low memory (delayed recall) at baseline may benefit more from short-term pharmacological treatments.

Purpose: To compare the perioperative and postoperative outcomes between traditional trans-vesical robot-assisted simple prostatectomy (TV-RASP) and the newly introduced urethral-sparing (US) RASP. Materials and Methods: We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation. Results: This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001). Conclusions US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP.

Purpose: This retrospective cohort study aimed to investigate the association between the use of pain medications with varying cyclooxygenase-2 (COX-2) selectivity and the incidence of endometriosis (EMS) in women. Materials and Methods: Medical records from January 1, 1994, to December 31, 2022, were retrospectively analyzed. The cohort included 33406 patients diagnosed with any pain-related condition who were prescribed either selective COX-2 inhibitors or nonsteroidal anti-inflammatory drugs (NSAIDs). Patients were followed for up to 5 years from the cohort entry date. The incidence of EMS was compared between the two medication groups using Cox proportional hazards models, adjusting for confounding factors such as age, past drug use, and prior diagnosis. Results: The incidence rates of EMS were 3.00 per 1000 person-years in the COX-2 inhibitor group and 3.97 per 1000 person-years in the NSAIDs group. After adjustment for confounders, the hazard ratio for EMS incidence in the COX-2 inhibitor group compared to the NSAIDs group was 0.77 [95% confidence interval (CI), 0.63 to 0.93; p<0.01], indicating a significantly lower risk in the COX-2 inhibitor group. Subgroup analysis revealed that this association was particularly significant in younger women aged 20– 44 years, with a hazard ratio of 0.71 (95% CI, 0.54 to 0.95; p<0.05) in this age group. Conclusion The findings suggest that COX-2 inhibitors may reduce the incidence of EMS compared to traditional NSAIDs, highlighting their potential as a strategic option for managing EMS, particularly among younger women. Further prospective studies are needed to confirm these findings.