This study compared key health indicators of poor, older urban adults attending a free clinic with those of the general older population, using data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This cross-sectional comparative study included 60 adults aged ≥60 years who attended the Raphael Nanum Homeless Clinic in Seoul. Participants completed a questionnaire, underwent anthropometric assessment, and provided fasting blood samples for measurement of total cholesterol, low density lipoprotein (LDL)-cholesterol, and triglycerides (TG). Obesity, current smoking, monthly alcohol use, poor self-rated health, and strength exercise (≥ 2 days/week) were defined according to 2023 KNHANES criteria and compared with age-matched 2023 KNHANES estimates for adults aged ≥ 60 years using independent t-tests and two-proportion z-tests. Results: Participants were predominantly men (80.0%) with a mean age of 79.9 years; 70.0% reported no regular income, and 46.7% rated their health as poor. Compared with their 2023 KNHANES counterparts, the clinic group had a higher prevalence of obesity (50.0% vs. 35.0%), particularly among men, and a more atherogenic lipid profile characterized by higher LDL-cholesterol despite similar total cholesterol levels and lower TG. The prevalence of current smoking (3.3% vs. 10.6%) and monthly alcohol use (31.7% vs. 53.0%) was significantly lower, whereas participation in strength exercise was low in both groups, with no significant differences observed. Conclusion: Poor, older urban adults exhibited multidimensional health disparities, including obesity, adverse lipid profiles, and markedly poorer self-rated health, despite lower levels of smoking and alcohol consumption. Community-based interventions targeting nutrition, physical activity, and chronic disease management are needed to reduce health inequalities in this vulnerable population.

Background: s/Aims: Pancreaticoduodenectomy (PD) is the standard treatment for periampullary tumors, but it is technically challenging. Evidence directly comparing open, laparoscopic, robotic, and hybrid approaches is limited. This study conducts a network meta-analysis (NMA) to compare the perioperative and oncologic outcomes of open PD (OPD), laparoscopic PD (LPD), robotic PD (RPD), and hybrid PD. Methods: We searched PubMed, EMBASE, and the Cochrane Library for studies published between January 1994 and August 2024.We included randomized controlled trials and comparative observational studies that evaluated at least two PD approaches. Perioperative outcomes were the primary endpoints, while oncologic safety served as a secondary endpoint. A random-effects NMA was performed, establishing treatment hierarchies through ranking probabilities (PROSPERO ID: CRD420250365864). Results: A total of 78 studies were included (5 randomized and 73 retrospective). RPD was associated with lower blood loss compared to OPD (mean difference [MD], –163.85 mL) and LPD (MD, –84.14 mL). Hospital stays were also shorter for RPD compared to OPD (MD, –2.50 days) and LPD (MD, –1.88 days). In contrast, OPD was the most time-efficient approach compared to LPD (MD, –77.61 minutes) and RPD (MD, –73.30 minutes). Mortality rates, severe complications, clinically relevant postoperative pancreatic fistula rates, and reoperation rates were comparable across all surgical approaches. In terms of oncologic safety, lymph node yield and R0 resection rates were similar for all modalities. Conclusions While OPD is the most time-efficient approach, RPD provides significant advantages in reducing intraoperative blood loss and shortening hospital stays compared to both LPD and OPD.

Purpose: While progesterone receptor (PR) negativity in luminal-type breast cancer is generally associated with worse oncologic outcomes, its prognostic role in estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-positive breast cancer remains underexplored. This study aimed to evaluate the prognostic significance of PR expression in ER-positive, HER2-positive breast cancer. Methods: A retrospective analysis was conducted on patients diagnosed with ER-positive, HER2-positive breast cancer who underwent primary surgery at Korea University Guro Hospital between January 2009 and December 2019. Patients were grouped by PR expression as negative/low (Allred score, 0–6) or strongly positive (Allred score,7 or 8). Prognostic outcomes, including disease-free survival (DFS), distant recurrence-free survival (DRFS), and breast cancer-specific survival (BCSS) were analyzed. Results: A total of 223 patients were included. Patients in the negative/low PR group were older compared to the strongly positive PR group. The negative/low PR group showed significantly worse DFS (P = 0.005) and DRFS (P = 0.014) but showed no significant difference in BCSS (P = 0.153). On multivariate analysis, negative or low PR expressions were linked to inferior DFS (hazard ratio [HR], 3.10; 95% confidence interval [CI], 1.34–7.16; P = 0.008) and DRFS (HR, 9.55; 95% CI, 1.22– 74.77; P = 0.032). Conclusion In ER-positive, HER2-positive breast cancer, negative or weak PR expression was associated with inferior DFS and DRFS compared to strong PR expression. These findings highlight the potential prognostic value of PR status in this group, underscoring its relevance in guiding treatment and follow-up strategies for more individualized patient care.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.

Crossbite refers to a condition where there are remaining teeth, but none of the teeth are in occlusal contact, resulting in the loss of vertical support. When posterior vertical stop is lost, it is important to appropriately restore this support and create a harmonious occlusal plane. In this case, the patient had lost posterior support but declined surgical intervention due to a history of osteoporosis and the associated risk of medication-related osteonecrosis of the jaw (MRONJ). To restore the vertical space required for prosthetic rehabilitation, the vertical dimension was increased. The missing posterior teeth were replaced using removable partial dentures. Cross-mounting was performed, and the metal copings of the surveyed crowns and the framework of the final removable partial denture were 3D printed. After the treatment was completed, the patient expressed satisfaction with both functions and aesthetics. Regular follow-ups were conducted to monitor oral hygiene and occlusal stability.

Background: Primary cutaneous CD30+ lymphoproliferative disorders (pcCD30-LPDs) are a diseases with various clinical and prognostic characteristics. Objective: Increasing our knowledge of the clinical characteristics of pcCD30-LPDs and identifying potential prognostic variables in an Asian population. Methods: Clinicopathological features and survival data of pcCD30-LPD cases obtained from 22 hospitals in South Korea were examined. Results: A total of 413 cases of pcCD30-LPDs (lymphomatoid papulosis [LYP], n=237; primary cutaneous anaplastic large cell lymphoma [C-ALCL], n=176) were included. Ninety percent of LYP patients and roughly 50% of C-ALCL patients presented with multiple skin lesions. Both LYP and C-ALCL affected the lower limbs most frequently. Multiplicity and advanced T stage of LYP lesions were associated with a chronic course longer than 6 months. Clinical morphology with patch lesions and elevated serum lactate dehydrogenase were significantly associated with LPDs during follow-up in LYP patients. Extracutaneous involvement of C-ALCL occurred in 13.2% of patients. Lesions larger than 5 cm and increased serum lactate dehydrogenase were associated with a poor prognosis in C-ALCL. The survival of patients with C-ALCL was unaffected by the anatomical locations of skin lesions or other pathological factors. Conclusion The multiplicity or size of skin lesions was associated with a chronic course of LYP and survival among patients with C-ALCL.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.