Background: Older patients aged ≥75 years are underrepresented in major statin trials, leaving the optimal statin intensity after acute ischemic stroke (AIS) undefined. We aimed to compare functional outcomes and short-term safety between high-intensity statin therapy (HIST) and moderate-intensity statin therapy (MIST) in patients aged ≥75 years with AIS or transient ischemic attack. Methods: Using a prospective stroke registry at a single tertiary center (2019–2022), we retrospectively analyzed 337 patients aged ≥75 years with AIS or transient ischemic attack who maintained statin therapy for 3 months (HIST n=117; MIST n=220). The primary outcome was a favorable 3-month functional outcome (modified Rankin Scale score 0–2). Secondary outcomes included stroke recurrence, adverse effects, and statin discontinuation. Multivariable logistic regression with pre-specified sensitivity analyses was performed. Results: Favorable outcomes at 3 months were more frequent with HIST (70.9% vs. 55.9%; p=0.010). After multivariable adjustment, HIST was independently associated with a favorable outcome (adjusted odds ratio [aOR]=2.03, 95% confidence interval [CI] 1.17–3.53), consistent across sensitivity analyses: per-protocol (aOR=3.48, 95% CI 1.97–6.17) and atrial fibrillation-adjusted (aOR=2.21, 95% CI 1.26–3.89). No significant differences were observed in statin discontinuation, stroke recurrence, or adverse effects. Conclusion In older patients with AIS, HIST was independently associated with better functional outcomes without evidence of increased harm, broadly consistent with current guideline recommendations for HIST when tolerated. Prospective studies are needed to confirm a causal relationship.

Flow cytometric lymphocyte subset analysis (FCLSA) is essential for assessing immune status across various diseases and clinical settings. We surveyed current clinical laboratory practices related to FCLSA to establish a baseline reference for future standardization in Korea. Nine university hospitals actively performing FCLSA responded to the 22-question survey, which covered seven categories of laboratory practice. These hospitals used commercial reagent antibody kits from either Beckton Dickinson Biosciences (N = 4) or Beckman Coulter Diagnostics (N = 5). Most hospitals performed daily instrument setup and scheduled maintenance every 2–6 months. Two levels of commercial quality control materials were routinely used each day. Sample and reagent antibody volumes varied across hospitals, even when the same reagent kit was used. Acquired cell counts ranged from 5 × 10 3 to 5 × 10 4 cells, with two hospitals adjusting counts based on the cell type analyzed. Most laboratories reported percentages and general opinions; some additionally reported white blood cell and lymphocyte counts, along with lymphocyte percentages. This is the first comprehensive survey on the clinical laboratory practice of FCLSA in Korea.Standardization of FCLSA should be accelerated to ensure reliable and reproducible results.

Objective: To identify the asymmetric spinal stabilizing exercise (ASSE) postures that selectively activate the multifidus (Mu) relative to the erector spinae (ES) in patients with adolescent idiopathic scoliosis (AIS), thereby supporting the development of curve-specific exercise programs for three-dimensional spinal deformities. Methods: Surface electromyography recordings were obtained bilaterally from the ES and Mu muscles during ASSE postures. Signals were normalized to the maximal voluntary isometric contraction. The asymmetry ratio, Mu/ES ratio, and additional asymmetric contraction of the Mu were analyzed. Results: The study included 40 patients with AIS. The Mu demonstrated greater ipsilateral activation in the side-lying posture, whereas greater contralateral activation was observed during unilateral lower extremity lifting and combined upper–lower extremity lifting in the prone posture, as well as during combined upper–lower extremity lifting in the bird-dog posture. In the prone and bird-dog postures, the Mu/ES ratio exceeded 1.0, indicating relatively stronger Mu recruitment under rotational loading. Additional asymmetric contraction of the Mu was greatest in the side-lying posture (47%), with differences<15% in all other postures. Conclusion ASSE induces posture-specific asymmetric activation of the paraspinal muscles in patients with AIS. Although the side-lying posture produced the largest asymmetry, this reflected increased ES activity for trunk elevation rather than true selective Mu contraction. In contrast, the prone and bird-dog postures demonstrated a greater Mu contribution relative to the ES under rotational loading. These findings suggest that ASSE can be adapted to target specific paraspinal muscle components: side lying for lateral bending and bird-dog variations to enhance rotational stability.

Purpose: 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. Materials and 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 5,460 ESD cases from 5,250 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.

Interest in embedding diversity, equity, and inclusion (DEI) across medical training has grown rapidly, yet the overall landscape of DEI-related medical education research remains fragmented. This scoping review mapped recent DEI-related curricula, programs, and training initiatives implemented in undergraduate medical education (UME) and graduate medical education (GME) settings. We conducted a PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews)–reported scoping review. PubMed was searched for studies published between 2020 and 2025 that examined DEI-focused educational activities in UME and GME involving medical students, residents or fellows, or faculty members. Data were extracted on publication year, country, target population, study design, and primary DEI domain, and results were summarized descriptively. Of 203 records identified, 164 met the inclusion criteria. Publications increased sharply after 2022 and were predominantly US-based. Most studies focused on residents, followed by medical students, faculty members, and analyses of program websites or institutional documents. Studies clustered into five domains: (1) learning environment and discrimination; (2) admissions and workforce diversity; (3) frameworks and measures; (4) curriculum development and implementation; and (5) outcomes and evaluation. Ten studies were purposively selected for narrative synthesis across key educational contexts. Most reported short-term learner outcomes, with limited evidence of behavior change, organizational impact, or patient-level outcomes. DEI-related medical education research is expanding; however, it remains geographically concentrated and methodologically constrained. Future studies should adopt context-sensitive, longitudinal, and multi-level designs to better inform curriculum planning, implementation, and evaluation.

Diversity, equity, and inclusion (DEI) are increasingly emphasized in medical education worldwide. However, it remains unclear how these values are reflected within the context of Korean medical education. This study explores how DEI is articulated through an analysis of the official websites of Korean medical schools. We conducted a content analysis of the official websites of 40 Korean medical schools. DEI-related synonyms and associated phrases were identified across mission and values statements, educational objectives, graduate outcomes, and student support sections. Identified phrases were coded according to the dimensions of diversity, equity, and inclusion. Quantitative frequencies were then summarized. For further analysis, qualitative thematic analysis and integrated analysis were performed to examine how each DEI element was conceptually represented. Among the 40 universities, 32 institutions (80%) demonstrated at least one component of DEI. Diversity (60%) was more frequently referenced than inclusion (50%) and equity (42.5%). DEI elements were most prominently observed in student support sections (62.5%) and were least frequently identified in mission and values statements (15%) and educational objectives (12.5%). In the qualitative analysis, diversity was primarily described in terms of respect for diversity within organizations and global citizenship. Equity was largely limited to scholarships and material support for disadvantaged students. Inclusion mainly emphasized the creation of respectful environments. Overall, in Korean medical schools, DEI was more commonly represented through student support mechanisms than through institutional philosophy or educational objectives. An integrated approach to the implementation of DEI is therefore needed to achieve meaningful change in Korean medical education.

Background: Farnesoid X receptor (FXR) is known to play important roles in glucose and lipid metabolism. We aimed to evaluate effects of FXR agonist on metabolic disorders in db/db mice. Seven week-old db/db mice were injected FXR agonist GW4064 (30 mg/kg/day) or carrier solution (dimethyl sulfoxide) intraperitoneally for 4 weeks. Body weight, food intake, and blood glucose levels were measured weekly. Glucose tolerance test and insulin tolerance test were performed at the end of study. Hepatic genes involed in lipogenesis and gluconeogenesis were analyzed by real time polymerase chain reaction. Endoplasmic reticulum stress markers were analyzed by western blot. Results: GW4064 treatment significantly attenuated weight gain, and improved glucose intolerance and insulin resistance in db/db mice. In addition, GW4064 treatment significantly repressed hepatic steatosis. GW4064 treatment significantly lowered hepatic gene expression of phosphoenolpyruvate carboxykinase 1, glucose 6-phosphatase, and sterol regulatory element binding protein 1c. GW4064 treatment significantly lowered the protein levels of ATF6, CHOP, Caspase3, and Cleaved Caspase3 in liver. FXR agonist GW4064 showed beneficial effects on weight gain, glucose intolerance, insulin resistance, hepatic steatosis, and hepatic ER stress. Conclusions These findings suggest that FXR agonists are promising therapeutic agents for treatment of various metabolic disorders.

BACKGROUND/OBJECTIVES: High-protein diets are increasingly used by young women for weight loss; however, concerns have been raised regarding their potential impact on bone health under insufficient calcium intake. This study investigated the associations between highprotein diet use for weight loss and bone status and diet quality among female college students. SUBJECTS/METHODS: In total, 260 female college students residing in Chungcheong, Korea, participated in this cross-sectional study. Data were collected using questionnaires, anthropometric measurements, 24-h dietary recall, and calcaneal ultrasound assessment.Participants were classified according to self-reported weight loss attempts during the past year into non-weight control (NWC; n = 108) and weight control (WC; n = 152) groups. The WC group was further subdivided into high-protein diet (HP-WC; n = 82) and non-high-protein diet (NHP-WC; n = 70) groups on the basis of high-protein diet practices. RESULTS: The mean body weight and body mass index (BMI) were significantly greater in the WC group than in the NWC group (P < 0.001 for both). Although calcium intake was significantly lower in the HP-WC group, protein intake exceeded the recommended level more frequently in this group (P < 0.05). A dietary diversity score less than 3 was more common in the HP-WC group (P < 0.05). Osteopenia prevalence was highest in the NWC group (64.8%), followed by the HP-WC group (50.0%) and the NHP-WC group (41.4%; P < 0.05). After adjustment for BMI and other confounding factors, the bone quality index and speed of sound values were significantly lower in the HP-WC group than in the NHP-WC group. CONCLUSION These findings suggest that high-protein weight-control practices may be associated with less favorable bone parameters among female college students during early adulthood, particularly in the context of lower calcium intake and reduced dietary diversity.

Background: Elevated active glucocorticoids (GCs) are implicated in skin barrier dysfunction, notably in aging and diabetes. The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive GCs to active forms, potentially exacerbating this dysfunction. Objective: We aimed to investigate the impact of a novel 11β-HSD1 inhibitor on skin inflammation using both in vitro and in vivo models. Methods: To elucidate the efficacy of a new 11β-HSD1 inhibitor in mitigating skin inflammation induced by various triggers, including dexamethasone treatment, ultraviolet B irradiation, and high glucose levels, in cultured human keratinocytes and the db/db mice as a type 2 diabetes murine model. In cultured keratinocytes, we assessed the effects of the 11β-HSD1 inhibitor on cortisol levels, 11β-HSD1 expression, and cytokine production under conditions simulating inflammation. In db/db mice, we evaluated the inhibitor’s impact on skin barrier function, hemoglobin A1c (HbA1c) levels, corticosterone levels, 11β-HSD1 expression, and cytokine profiles following a 2-week treatment regimen. Results: Our results demonstrated that both the novel 11β-HSD1 inhibitor and a known inhibitor reduced cortisol levels, 11β-HSD1 expression, and inflammatory cytokine production in cultured keratinocytes. In db/db mice, treatment with either inhibitor improved skin barrier function, lowered serum HbA1c levels, and decreased corticosterone, 11β-HSD1, and inflammatory cytokine expression. Conclusion A new 11β-HSD1 inhibitor, “11b-0048,” showed a significant inhibitory effect on the expression of 11β-HSD1 in keratinocytes activated by various conditions and diabetic skin.