Background and Objectives: The clinical significance of incidental pulmonary nodules detected during thyroid cancer evaluation remains unclear. This study aimed to investigate how such findings affect surgical decisionmaking and whether management differs by physician characteristics. Materials and Methods: A web-based survey was distributed to 722 active members of the Korean Thyroid Association in March 2025. Eligible participants included board-certified endocrinologists, endocrine surgeons, and otolaryngologists actively treating thyroid cancer. The questionnaire included clinical scenarios featuring incidental lung nodules found during thyroid cancer work-up, with respondents asked to choose preferred surgical extent (thyroid lobectomy vs. total thyroidectomy) and management approaches. Results: Out of 72 physicians who completed the survey, half (n=36, 50.0%) of the respondents answered that the presence of incidental lung nodules could influence their decision on thyroidectomy extent. Among those influenced by lung nodules, 86.1% recommended total thyroidectomy in patients with high- or intermediate-risk thyroid cancer, while 11.1% would do so for all thyroid cancer patients.Endocrinologists, compared to surgeons, were more likely to choose total thyroidectomy in patients with preoperative incidental lung nodules (78.3% vs. 36.7%, p=0.001). Conclusion Incidental lung nodules may influence surgical planning in clinicians due to the risk of micrometastasis from thyroid cancer. Endocrinologists tend to favor a more extensive surgical approach compared to surgeons, reflecting greater concern for potential metastatic disease. These findings underscore the need for multidisciplinary consensus guidelines for the management of incidental pulmonary nodules in thyroid cancer patients.

Background: There are limited long-term clinical outcome data comparing first-generation (1G) versus second-generation (2G) drug-eluting stents (DES) in patients with single-vessel disease (SVD). We sought to compare the efficacy and safety of 1G- and 2G-DES in SVD patients who underwent successful percutaneous coronary intervention (PCI) over 10 years of clinical follow-up. Methods: A total of 2,312 consecutive patients with SVD who underwent PCI with 1G-DES (paclitaxel- or sirolimus-eluting stents, n = 811) or 2G-DES (zotarolimus [Endeavor, Endeavor Resolute]- or everolimus-eluting stents [Promus Element, Xience], n = 1,082) were enrolled.After propensity score matching, 2 matched groups (538 pairs) were generated. Study endpoints included individual and composite clinical outcomes through 10 years. Results: During the 10-year follow-up, the 2G-DES group had lower incidences of myocardial infarction (MI; hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.22–0.92; P = 0.028) and target lesion revascularization (TLR; HR, 0.54; 95% CI, 0.32–0.91; P = 0.021) than the 1G-DES group. Rates of total death, cardiac death, non-target vessel revascularization, stroke, major adverse cardiac events, and major adverse cardiac and cerebrovascular events were similar between groups. Conclusions In our single-center, all-comer registry, 2G-DES were associated with lower incidence rates of MI and TLR compared to 1G-DES in SVD patients over 10 years of followup, indicating a safer and more durable effect than 1G-DES.

Hepatocellular carcinoma (HCC) is a highly invasive tumor with a strong tendency for metastasis. The most common sites of metastasis are the lungs, followed by lymph nodes, adrenal glands, and bones. However, metastasis of HCC to the small bowel is extremely rare. A 42-yearold female with HCC secondary to chronic hepatitis B and lung metastasis underwent a right hepatic lobectomy, followed by two wedge resections performed via video-assisted thoracic surgery, four sessions of transcatheter arterial chemoembolization, and stereotactic body radiation therapy. She was under regular follow-up for HCC, during which her alpha-fetoprotein level increased to 722.2 IU/ml. Abdominal computed tomography (CT) revealed segmental wall thickening and aneurysmal dilatation of the small bowel loops. An 18 F-fluorodeoxyglucose positron emission tomography/CT scan demonstrated a 3.3-cm hypermetabolic mass-like lesion (standardized uptake value: 11.3) in the small bowel. Surgical resection of the affected small bowel segment was performed. Histopathological examination of the specimen confirmed metastatic HCC, with immunohistochemical positivity for hepatocyte-specific antigen. The patient has remained cancer-free for 60 months post-operatively. Surgical intervention may offer favorable long-term outcomes in patients with small bowel metastasis from HCC.

Purpose: We compared short-term clinical outcomes after cataract surgery with implantation of a novel refractive extended depth-of-focus TECNIS PureSee intraocular lens (IOL) between patients with stage 1 epiretinal membrane (ERM)—characterized by a thin membrane over the macula with preserved foveal depression―and those with a normal retina. Methods: This retrospective study included 60 eyes of 60 patients who underwent cataract surgery with implantation of the TECNIS PureSee IOL between January 2024 and January 2025: 30 eyes with stage 1 ERM and 30 eyes with a normal retina. Preoperative characteristics, including age, sex distribution, cataract severity, corrected distance visual acuity (CDVA), and higher-order aberrations, were compared between groups, as were IOL power and target refraction. Postoperative outcomes at 1 month―including CDVA, uncorrected distance, intermediate, and near visual acuity, ocular aberrations, and contrast sensitivity―were evaluated. Results: There were no significant differences in preoperative characteristics, such as age, sex distribution, cataract grade, CDVA, higher-order aberrations, IOL power, or target refraction between the two groups. At 1 month postoperatively, CDVA, uncorrected distance, intermediate, and near visual acuity, higher-order aberrations, and contrast sensitivity exhibited no significant differences between groups. Conclusions In this short-term analysis, the PureSee IOL demonstrated comparable efficacy and safety in cataract patients with stage 1 ERM to those with a normal retina.

Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Background: Rosacea is a chronic inflammatory skin disorder characterized by erythema, papules, ocular symptoms, and heightened sensitivity. Patients with neurogenic symptoms such as burning or stinging remain particularly difficult to manage. Current guidelines often underrepresent energy-based devices (EBDs), pigmentary sequelae, psychosocial burden, and ocular comorbidities. Objective: To examine Korean dermatologists’ expert perspectives on rosacea management, focusing on skin sensitivity, neurogenic symptoms, pigmentary changes, psychosocial impact, ocular involvement, and EBD use. Methods: A web-based, 29-item survey was administered to 25 board-certified Korean dermatologists (May–June 2025). Quantitative and qualitative responses were analyzed. Results: Erythematotelangiectatic and papulopustular phenotypes with sensitivity skin predominated. EBDs (pulsed dye laser, intense pulsed light) were frequently used but limited by cost and sensitivity issues. Neurogenic symptoms were recognized but rarely treated with neuromodulators. Post-inflammatory hyperpigmentation was infrequent, yet monitoring was inconsistent.Psychosocial and ocular aspects were acknowledged but seldomly systematically addressed.Respondents expressed interest in emerging adjunctive treatments such as cold plasma, skin boosters, and holistic care approaches. Conclusion Korean dermatologists adopt individualized strategies for rosacea, yet practice gaps remain regarding neurogenic symptoms, pigmentary complications, and psychosocial and ocular comorbidities. Findings support the need for updated multidisciplinary, phenotype-driven guidelines aligned with real-world practice.

Gastroesophageal reflux disease (GERD) is a chronic and relapsing gastrointestinal disorder characterized by the reflux of gastric contents into the esophagus, leading to troublesome symptoms and/or complications. Since the publication of the 2020 Seoul Consensus on GERD, significant new evidence has emerged, particularly regarding acid-suppressive therapies and diagnostic approaches. This 2025 focused update aims to refine GERD management strategies by incorporating the latest evidence on acid suppressive therapies and regional considerations in Asian populations. This study builds on the 2020 Seoul Consensus by integrating systematic reviews, meta-analyses, and expert consensuses to offer updated recommendations for the definition and medical treatment of GERD. These guidelines incorporate recent advances in acid-suppressive therapies, particularly potassium-competitive acid blockers, and adopt updated diagnostic frameworks in accordance with the Lyon Consensus 2.0. Key clinical questions were identified and structured using the following format: Population, Intervention, Comparator, Outcome. The resulting recommendations address the initial treatment, long-term maintenance strategies, and role of personalized therapy based on disease severity, such as the grade of reflux esophagitis. Six key statements are presented: updated definition and classification of GERD (Statement 1); initial and long-term treatment strategies tailored to GERD phenotypes, such as non-erosive reflux disease, mild erosive esophagitis, and severe erosive esophagitis (Statements 2-5); and dose optimization strategies for long-term safety (Statement 6). These guidelines aim to support gastroenterologists and general healthcare providers in making individualized evidence-based decisions for GERD management.

Background: Handgrip strength (HGS) is an indicator of late-life health, associated with disability, cardiovascular and all-cause mortality. While exercise helps maintain HGS, diabetes may reduce its benefits. This study investigated the association between exercise and low HGS (LHGS) stratified by diabetes status and sex. Methods: Data from 16,443 participants in the 2017–2019 Korea National Health and Nutrition Examination Survey were analyzed. HGS was measured using a digital dynamometer. Exercise type and frequency were assessed by questionnaire. Three-way and twoway interaction terms were analyzed for exercise, sex and diabetes. Results: Aerobic exercise, resistance exercise, and diabetes were significantly associated with LHGS (P<0.05). A significant interaction between diabetes and aerobic exercise was observed in females (odds ratio [OR] of LHGS=1.704, 95% confidence interval= 1.073–2.707). Among males, both exercise types were associated with lower odds of LHGS regardless of diabetes status, except for aerobic exercise in non-diabetic males. Among males, the ORs of LHGS for aerobic and resistance exercise were 0.479 (0.278– 0.827) and 0.317 (0.165–0.611) with diabetes, 0.757 (0.554–1.035) and 0.536 (0.360–0.798) without diabetes. Among females, the ORs of LHGS for aerobic exercise and resistance exercise were 1.109 (0.716–1.719) and 0.529 (0.224–1.249) with diabetes, 0.676 (0.539–0.848) and 0.795 (0.564–1.121) without diabetes. Conclusions The modifying effect of diabetes on the relationship between exercise and grip strength was observed in females but not in males. Females with diabetes may require tailored exercise guideline to prevent LHGS.

The late complications of autologous fat grafting, including overcorrection and asymmetry, are difficult to treat non-invasively. This paper reports a novel approach using diamond particle acoustic patch-mediated laserinduced shockwave (LISW) therapy.A 38-year-old female with a 10-year history of bilateral malar overcorrection and asymmetry following an autologous fat graft was treated with a diamond particle acoustic patch (Belluti; Simple-Stick®) coupled with 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet laser. The procedure successfully softened the firm tissue and reduced volume asymmetry without thermal epidermal injury. Transient wheals and petechiae resolved within five to seven days. Visible volume reduction began at two weeks, with sustained improvement and lifting effects observed at the two-month follow-up.Diamond particle acoustic patch-mediated LISW therapy provides a safe, non-thermal, purely mechanical approach to reduce the subcutaneous fat volume and remodel deep fibrosis, offering a promising potential noninvasive option for refractory fat graft overcorrection.

Purpose: Timely surgical intervention is crucial in trauma care, particularly in patients with hypotensive abdominal injuries.In South Korea, the regional trauma center system has adopted a quality metric mandating initiation of emergency surgery within 1 hour of emergency department (ED) arrival for such patients. We evaluated the impact of ED-to-surgery time on clinical outcomes in hypotensive abdominal trauma and assessed the appropriateness of the 1-hour threshold. Methods: This multicenter retrospective study included 425 trauma patients who underwent emergency abdominal surgery at 2 regional trauma centers between 2019 and 2022. Patients with an initial or lowest recorded systolic blood pressure (SBP) <90 mmHg were included. The primary outcome was in-hospital mortality; secondary outcomes included complications, intensive care unit stay, and total hospital stay. Patients were categorized into early (≤1 hour) and delayed (>1 hour) surgery groups. Statistical analyses included logistic regression, propensity score matching (PSM), receiver operating characteristic curve, and complication analysis by 30-minute intervals. Results: We found that 243 patients (57.2%) underwent surgery within 1 hour. In-hospital mortality did not differ significantly between early and delayed groups. Age, Glasgow Coma Scale, lowest SBP, 4-hour RBC transfusion volume, and abdominal Abbreviated Injury Scale were independent mortality predictors. PSM confirmed no mortality difference by surgical timing. However, complication rates increased with surgical delays. Conclusion While surgical delay was not associated with mortality, it was linked to increased complications. Future trauma quality metrics should incorporate refined patient stratification and evaluate the entire process aimed at restoring physiological instability, rather than relying on a strict 1-hour threshold.