Although splenomegaly is typically uncommon in myelodysplastic syndromes (MDS), it is associated with reduced engraftment rates and poor survival outcomes. Despite its clinical significance, the incidence and genetic associations of splenomegaly in MDS remain understudied. To address this, we conducted a retrospective study of 27 patients with MDS at the Veterans Health Service Medical Center in South Korea. Based on computed tomography scan evaluation, splenomegaly was identified in 26% of patients with MDS, and significant associations with variants in ASXL1 (P = 0.0089 for null and missense/inframe variants) and RUNX1 (P = 0.042 for null variants) were observed, suggesting that these variants are linked to an increased risk of splenomegaly. Notably, one patient with ASXL1 and TET2 variants developed severe splenomegaly (spleen size, 29 cm) following granulocyte colony-stimulating factor (G-CSF) treatment, requiring splenectomy. This case suggests a potential interaction between specific genetic variants and G-CSF sensitivity, potentially exacerbating splenomegaly. Our findings suggest that the incidence of splenomegaly in patients with MDS, including mild cases, is likely underestimated and that ASXL1 and RUNX1 variants increase the risk of splenomegaly. Furthermore, careful monitoring for the development of severe splenomegaly during G-CSF treatment may be warranted in genetically susceptible individuals with MDS.

Background: Although the association between handgrip strength and glycemic control has been reported, studies conducted exclusively within specific occupational groups remain limited. To explore the association between handgrip strength and metabolic health in industrial settings, this study examined the relationship between relative handgrip strength and glycated hemoglobin (HbA1c) among male automobile manufacturing workers using vibration tools in South Korea. Methods: Using 66,212 occupational health examination records collected at Inha University Hospital between January 2024 and April 2025, a total of 3,365 workers with HbA1c and handgrip strength measurements were identified. After excluding duplicates (n = 1,536), female workers (n = 2), and records without Hb and estimated glomerular filtration rate, 1,823 male participants were included in the final analysis. Relative handgrip strength was calculated as the maximum value of bilateral grip strength divided by body mass index. Multiple linear regression analyses were conducted to assess the association between relative handgrip strength and HbA1c, adjusting for age, smoking status, alcohol consumption, current hypertension, current dyslipidemia, current hypoglycemic-agents use, family diabetes history, leisure-time physical activity, and resistance exercise. Results: Relative handgrip strength was inversely associated with HbA1c levels (B: –0.060; 95% confidence interval [CI]: −0.081 to −0.039; p < 0.001). The association was strongest among normoglycemic participants (B: −0.185; 95% CI: −0.305 to −0.065; p = 0.003). Effect size was reduced but significantly associated among individuals with prediabetes (B: −0.115; 95% CI: −0.180 to −0.050; p < 0.001) and further attenuated to a borderline significance in individuals with diabetes (B: −0.023; 95% CI: −0.050 to 0.003; p = 0.082). These findings indicate that greater muscle strength relative to body size is related to better glycemic control. Conclusions Handgrip strength was associated with HbA1c levels in industrial workers. This study suggests that handgrip strength may provide complementary information on metabolic health in occupational settings.

Purpose: Early differentiation between transient congenital hypothyroidism (TCH) and permanent congenital hypothyroidism (PCH) is crucial for optimizing the duration of treatment. This retrospective cohort study aimed to evaluate whether levothyroxine (LT4) dose requirements over time can predict TCH and guide earlier discontinuation of treatment. Methods: We retrospectively analyzed 105 infants with congenital hypothyroidism and normal thyroid glands confirmed by imaging at a single tertiary care center (Inha University Hospital) between January 2013 and December 2022. Patients were classified into TCH (n=70) or PCH (n=35) based on thyroid function after LT4 withdrawal at 3 years of age. LT4 dose/kg at 6, 12, and 24 months, along with clinical and biochemical parameters, were compared between the 2 groups. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of LT4 dose thresholds. Results: The LT4 dose was significantly lower in the TCH group at 6 (3.16±0.83 μg/kg vs. 3.75±0.99 μg/kg, P=0.005), 12 (2.51±0.82 μg/kg vs. 3.37±1.17 μg/kg, P<0.001), and 24 months (2.02±0.61 μg/kg vs. 3.09±1.19 μg/kg, P<0.001). ROC curve analysis showed an area under the curve (AUC) of 0.649, 0.746, and 0.794 at 6, 12, and 24 months, respectively. A logistic regression model incorporating LT4 dose, birth weight, and thyroid-stimulating hormone (TSH) levels improved prediction accuracy (AUC: 0.740, 0.782, 0.833 at 6, 12, and 24 months, respectively). Conclusion LT4 dose requirements at 6, 12, and 24 months serve as useful indicators for differentiating TCH from PCH. A combined predictive model incorporating LT4 dose, birth weight, and TSH levels may improve diagnostic accuracy, supporting earlier discontinuation of treatment.

Objectives: This study aimed to identify gender- and household type-specific nutritional vulnerability among older Koreans by comparing dietary behaviors, nutrient intake, and diet quality. Methods: We analyzed data from 2,412 adults aged ≥ 65 years (1,118 men; 1,294 women) from the 8th Korea National Health and Nutrition Examination Survey (2019–2021). Household type was classified as one-person, couple-only, or with-children. Outcome variables included dietary behavior, daily energy and nutrient intake, and diet quality, assessed using the Korean Healthy Eating Index (KHEI). Analyses were carried out accounting for the complex sampling design, adjusting for age, residential area, education level, household income level, economic activity status, self-rated health status, and survey year. Results: Elderly men in one-person households, compared with those in couple-only households, were more likely to skip breakfast and lunch and to consume less energy. The odds of intake below the estimated average requirement (EAR) were higher for iron (odds ratio [OR] = 1.731, P = 0.022) and zinc (OR = 2.460, P = 0.002) among men in one-person households. The KHEI score was the lowest among men in one-person households. Elderly women in with-children households, compared with those in couple-only households, were more likely to skip breakfast and to consume less energy. The risks of intake below the estimated energy requirement (EER) and EAR were higher among women in with-children households than those in couple-only households (EER: OR = 1.448; magnesium: OR = 2.090; iron: OR = 1.692; zinc: OR = 1.902; folate: OR = 2.282; all P < 0.05). The KHEI score was lower among women in with-children households. Conclusion Elderly men living alone and elderly women living with children showed significantly greater nutritional vulnerability. More attention should be given to understanding how gender-specific household types can affect nutritional vulnerability in later life.

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.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

Purpose: This study examined the diet quality and its relationship with risk factors for diabetes complications and the related markers in Korean adults with type 2 diabetes (T2D). Methods: This study analyzed 1,774 adults aged 31–79 years with T2D who participated in the 8th Korea National Health and Nutrition Examination Survey. The diet quality was examined by the Korean Healthy Eating Index (KHEI), and the dependent variables were the risk factors for diabetes complications (overweight/obesity, hyperglycemia, dyslipidemia, and hypertension) and related markers (HbA1c, fasting plasma glucose [FPG], triglycerides, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol [HDL-C], systolic blood pressure, and diastolic blood pressure). The data were analyzed using SPSS v. 29.0. Results: The total KHEI scores were Q1 45.80, Q2 58.98, Q3 67.91, and Q4 77.90 in men and Q1 48.96, Q2 60.79, Q3 69.62, and Q4 80.34 in women. The odds ratio [OR]s of the adverse level HDL-C were significant for men in KHEI Q1 (OR, 1.844; 95% confidence interval [CI], 1.115–3.052), Q2 (OR, 1.777; 95% CI, 1.085–2.911), and Q3 (OR, 1.982; 95% CI, 1.220–3.220) compared to those in Q4. The KHEI ‘have breakfast’ score was inversely and significantly associated with the adverse level FPG in men (OR, 0.942; 95% CI, 0.891–0.996) and women (OR, 0.935; 95% CI, 0.883–0.990). The ORs of dyslipidemia were significant for men in KHEI Q2 (OR,2.026; 95% CI, 1.179–3.483) and Q3 (OR, 1.817; 95% CI, 1.062–3.110) compared to those in Q4. Conclusion A good diet quality can help with the proper control of HDL-C in men with T2D, and having breakfast can help control the FPG level in people with T2D.

Cavernous lymphangiomas, characterized by the cystic enlargement of lymphatic vessels in the dermis and subcutaneous tissue, are rarely reported in the scalp. We present the case of a 6-month-old male infant with occipital scalp swelling, whose ultrasonographic examination identified a multiseptated hypoechoic mass in the subcutaneous layer. Histologically, the tumor exhibited irregular, dilated spaces lined with a single layer of endothelial cells, showing D2-40 positivity. This represents a rare case of pediatric cavernous lymphangioma of the scalp, accompanied by a literature review.