The sixth edition of the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) was published in 2025. This review compared KMAP-DD 2025 with four major international clinical practice guidelines: Canadian Network for Mood and Anxiety Treatments Clinical Guidelines for the Management of Major Depressive Disorders, National Institute for Health and Care Excellence Depression Guideline, Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for Mood Disorders, and British Association for Psychopharmacology Guideline. While KMAP-DD is based on expert consensus, and others on evidence-based methods, overall treatment strategies for depressive episodes were fairly consistent. Especially, KMAP-DD 2025 offers more structured recommendations in areas lacking strong evidence, such as premenstrual dysphoric disorder, perinatal depression, and depression with medical comorbidities. KMAP-DD 2025 also reflected Korean clinical practice patterns emphasizing rapid symptom relief and early use of combination strategies. Despite limitations as a consensus-based guideline, KMAP-DD 2025 complements evidence-based approaches and provides practical, situation-specific guidance for real-world clinical decision-making in Korea.

Background: Despite the rising incidence of end-stage renal disease (ESRD) among individuals with type 2 diabetes mellitus (T2DM) in Korea, no predictive model or nomogram has been developed using a nationwide cohort. In this study, we developed a nomogram to predict the long-term risk of ESRD in patients with T2DM using a large-scale, population-based Korean database. Methods: Using the Korean National Health Insurance Database, patients with T2DM who underwent health examinations between 2015 and 2016 were assigned as development (n=1,744,277) and validation (n=747,407) cohorts. New ESRD cases were identified using codes for renal replacement therapy. A Cox proportional hazards regression model was used to derive a risk-scoring system, and 13 variables were selected. A risk score nomogram was then created to estimate the risk of ESRD. Results: In the development cohort, 8,631 patients with T2DM developed ESRD during a follow-up period of 4.8±0.9 years. After multivariable adjustment, significant predictors of ESRD included male sex, current smoking, physical inactivity, low income, low body mass index, hypertension, low-density lipoprotein cholesterol ≥160 mg/dL, chronic kidney disease, insulin use, and longer duration of T2DM. A final nomogram incorporating 13 variables was developed to estimate the individual probability of ESRD. The concordance index for ESRD prediction in the validation cohort was 0.906 (95% confidence interval, 0.9 to 0.912). Conclusion This 13-variable nomogram provides a simple tool for identifying patients with T2DM at high risk of ESRD and may aid in early intervention.

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.

Background and Objectives: Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disorder that can adversely affect quality of life in patients with Graves’ disease (GD). The objective of this study was to characterize the clinical features of patients with GO and to identify risk factors associated with its development and the need for anti-inflammatory treatment. Materials and Methods: In this multicenter, retrospective observational study, 818 patients with GD were identified via electronic medical record review. Clinical characteristics were assessed, and logistic regression analyses were performed to identify risk factors for GO development and the need for anti-inflammatory treatment. Results: Among the 818 patients with GD, 135 (16.5%) developed GO, and 60 (7.3%) of these patients received anti-inflammatory treatment. GO was diagnosed at the time of GD diagnosis in 54.8% of cases, and proptosis and eyelid/orbital swelling were the common presenting features. In multivariable analysis, female sex (odds ratio [OR]: 1.75, confidence interval [CI]: 1.02-3.03), goiter (OR: 1.71, CI: 1.08-2.71), and smoking (ex-smokers: OR, 2.18; 95% CI: 1.02-4.65; current smokers: OR, 3.11; CI, 1.78-5.44) were independently associated with GO development, whereas diabetes (OR: 0.35, CI: 0.14-0.89) was inversely associated. Higher total cholesterol (OR: 1.31, CI: 1.01-1.04) and elevated thyrotropin-binding inhibitory immunoglobulin levels (OR: 1.07, CI: 1.02-1.11) were also significantly associated with the need for anti-inflammatory treatment. Conclusion This study delineated the clinical features of GO and identified risk factors for its development and the need for anti-inflammatory treatment in patients with GD, providing valuable information for the management of GO in Korean patients.

Purpose: The accurate localization of bifurcation points in the brain near the circle of Willis is essential for labeling cerebral arteries and detecting potential aneurysms. Studies on the development of segmentation-based landmark localization methods for cerebral angiography are lacking. This study aimed to develop and validate a method for localizing anatomical landmarks using a three-dimensional (3D) encoder-decoder deep convolutional neural network architecture. Materials and Methods: Time-of-flight magnetic resonance angiography (MRA) images of 224 subjects obtained from publicly available datasets were used. Ten anatomical landmark points were annotated, and four different landmark subset configurations were trained and validated. For each configuration, 3D U-Net-based models were developed using the MRA images and their corresponding annotated landmarks. The deep learning prediction results were evaluated in terms of landmark localization errors. Results: Among the four configurations, the configuration with five landmark subsets produced the smallest landmark localization errors in the test dataset. Post-processing of the U-Net-predicted segmentation masks further reduced the mean localization errors across all landmark points for the configuration with five subsets. Conclusion The proposed landmark localization method effectively identified major anatomical landmarks around the circle of Willis and showed the potential to automate segmental analyses of intracranial arterial tortuosity.

Alcohol-associated liver disease (ALD) encompasses a progressive pathological spectrum, ranging from steatosis to cirrhosis and hepatocellular carcinoma. Its development is driven by complex interactions among ethanol metabolism, oxidative stress, inflammation, fibrogenesis, and gut-liver axis dysregulation. Emerging evidence indicates that microRNAs (miRNAs) function as key posttranscriptional regulators that integrate metabolic reprogramming, immune responses, and fibrogenic signaling during ALD progression. This review summarizes the current understanding of miRNA biology and highlights their roles in lipid metabolism, oxidative stress responses, innate immune activation, and hepatic stellate cell-mediated fibrosis. Particular attention is given to context-dependent miRNAs, including miR-122, miR-34a, miR-155, miR-21, and the miR-29 family, whose functional effects vary by cell type and disease stage. We further discuss extracellular vesicles and exosome-associated miRNAs as mediators of intercellular communication and as minimally invasive biomarkers that reflect liver-derived injury signals rather than disease-specific signatures. Circulating miR-122 and miR-192 exemplify this concept, emphasizing the need for multi-miRNA panels integrated with clinical parameters to improve diagnostic specificity. Furthermore, therapeutic strategies targeting miRNAs―such as miRNA mimics, antagomirs, and locked nucleic acid inhibitors―have demonstrated promising preclinical efficacy in modulating steatosis, inflammation, and fibrosis. However, challenges such as off-target effects, delivery efficiency, and cell-type specificity remain major barriers to clinical translation. Overall, miRNAs represent a central molecular layer linking metabolic stress, immune dysregulation, and fibrogenesis in ALD. Future integration of multiomics and cell-specific delivery technologies might enable precision medicine approaches that leverage miRNA networks for early diagnosis and targeted therapy in ALD.

This study was conducted to identify educational needs for infection prevention and control (IPC) among staff in long-term care hospitals and to determine education priorities using the Borich model, importance-performance analysis (IPA), and the Locus for Focus (LFF) model. Methods: A descriptive crosssectional survey was conducted with 162 staff members from two long-term care hospitals in Gyeongsangbuk-do, Republic of Korea (January 5 to 16, 2026). A 32-item instrument across eight IPC domains was developed and refined based on the fourth cycle long-term care hospital accreditation standards and the national healthcareassociated infection surveillance manual. Participants rated the importance and perceived performance of each item. Data were analyzed using descriptive statistics, paired t-tests, Borich need scores, IPA, and LFF, with crosshairs based on the overall mean values. Results: Across all eight IPC domains, importance scores exceeded performance scores in both healthcare professionals and allied health personnel. At the domain level, priorities varied by occupation: overall, standard precautions and transmission-based precautions were the highest priorities. Among healthcare professionals, transmission-based precautions ranked first, followed by standard precautions, whereas among allied health personnel, standard precautions and multidrug-resistant organisms (MDRO) and antibiotic stewardship were identified as top priorities. Conclusion: IPC education in long-term care hospitals should be delivered as an integrated, role- and competency-based training system that standardizes facility-wide core practices-particularly standard precautions and transmission-based precautions-while providing job-specific advanced modules aligned with occupational scope and work processes, and should be supported by organizational measures such as monitoring, feedback, and ensuring access to IPC resources.

Oroantral communication (OAC) is a common complication associated with implant failure and maxillary posterior teeth extraction, and while various flap techniques provide reliable soft-tissue closure, reconstruction of the underlying bony defect often requires extensive procedures or autogenous bone harvesting. This report presents a staged, minimally invasive approach that enabled successful OAC closure and implant restoration using allogenic bone alone. A large OAC in the maxillary posterior region was first closed using a palatal rotation flap, chosen for its robust vascularity and preservation of keratinized tissue and vestibular depth—factors advantageous for later implant placement. After adequate soft-tissue healing, bone augmentation was performed using a partial-thickness separation technique that allowed elevation of the inner sinus layer, creating a space analogous to a sinus lift. Freeze-dried bone allograft and a collagen membrane were used, resulting in satisfactory bone formation and enabling subsequent implant placement with stable primary fixation. This case demonstrates that a staged approach can achieve satisfactory clinical outcomes without autogenous grafting, general anesthesia, or extensive surgical morbidity. While further studies are needed, this method offers a practical and less invasive alternative for managing large OACs requiring implant-based rehabilitation.

Objectives: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes. Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5460 ESD cases from 5250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.