Pediatric kidney disease has a relatively lower prevalence than do other pediatric conditions and has a notably different etiology from kidney diseases observed in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require more specialized and meticulous nutritional management than do adults. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to establish nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations covering energy, protein, calcium, phosphorus, and potassium consumption while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.

Objectives: In alignment with the World Health Organization’s goal of eliminating hepatitis C, this study assessed the current treatment status and reasons for non-treatment among patients with hepatitis C in Jeonbuk State, Republic of Korea, to inform strategies for improving care engagement. Methods: Among 311 individuals diagnosed with hepatitis C and reported through the NationalNotifiable Infectious Disease Surveillance system between January 2023 and June 2024, 208 patients were surveyed after excluding those who had died or could not be contacted.Statistical analyses included the chi-square test, the Cochran-Armitage test for trend, and logistic regression. Results: Overall, 116 participants (55.8%) reported having received antiviral therapy. Among the 92 untreated individuals, the most common reason for non-treatment was the absence of symptoms (n = 23; 25.0%), followed by the burden of drug costs (n = 21; 22.8%). Conclusion These findings highlight suboptimal treatment uptake and key barriers that may hinder progress toward hepatitis C elimination. Expanding screening and strengthening linkage-to-care strategies, while addressing financial barriers, will be essential to achievingnational elimination targets.

Purpose: Preterm birth remains a leading cause of long-term neurodevelopmental impairment, yet early evaluations frequently underestimate subsequent deficits. This study examined longitudinal neurodevelopmental trajectories across gestational age groups and identified predictors of developmental delay. Methods: A retrospective cohort of 532 preterm children, stratified by gestational age, was followed from the neonatal period to early preschool age. Neurodevelopment was assessed using the Korean version of the Bayley Scales of Infant and Toddler Development, Third Edition at 8–12 months (n=481), 13–24 months (n=118), and 25–42 months (n=100). Longitudinal trajectories were analyzed using general linear models, and predictors of developmental delay were identified through multivariable logistic regression. Results: During the first year, motor scores differed significantly across gestational age groups, with extremely preterm infants showing the lowest values. By the third to fourth years of life, cognitive and language scores diverged markedly, with extremely preterm children exhibiting the steepest decline and additional deficits in motor and adaptive behavior domains. Lower gestational age remained an independent predictor of both cognitive and language delay at early preschool age, while no independent predictors were identified for motor, social-emotional, or adaptive behavior outcomes. Conclusion Neurodevelopmental outcomes in preterm children follow dynamic, domain-specific trajectories influenced by gestational age and developmental timing. Motor delays are most evident in infancy, whereas cognitive and language impairments emerge by early preschool age. Gestational age remains a consistent predictor of later delay, emphasizing the need for longitudinal, gestational age–stratified monitoring and early, targeted intervention.

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.

The surgical options for arthritis of the first metatarsophalangeal (MTP) joint include cheilectomy, interpositional arthroplasty, and arthrodesis. Arthrodesis provides reliable pain relief but sacrifices joint motion. Therefore, motion-preserving interpositional arthroplasty is preferred for selected active patients. This paper reports a case and early outcomes of interpositional arthroplasty of the first MTP joint using a collagen patch allograft circumferentially wrapped around the metatarsal head, secured with symmetric 1.6-mm mini suture anchors, and protected by temporary transarticular K-wire fixation. At 6 weeks, the pain decreased (VAS 8→3), and the active dorsiflexion/ plantarflexion improved to approximately 45°/45°, without wound complications or radiographic loosening. The collagen patch allograft provided uniform coverage and mechanical stability while avoiding donor-site morbidity associated with autografts. This technique is a reproducible, motion-preserving alternative for patients seeking to maintain joint mobility. Nevertheless, longer-term studies will be required to evaluate the durability and comparative outcomes.

Objective: To evaluate the impact of adding CT to ultrasound (US) for nodal assessment in patients with papillary thyroid microcarcinoma (PTMC), particularly in those with US-node-negative disease. Materials and Methods: This single-center retrospective study included consecutive patients with PTMC (≤1 cm on US) who underwent both US and CT for PTMC staging between August 2016 and January 2020, and subsequently underwent surgery including neck dissection. The number of patients with clinical N1 and pathological N1 disease was assessed. The diagnostic performance of US, CT, and combined US + CT (positive if either was positive) for macroscopic lymph node metastasis (LNM) (i.e., metastatic tumor foci >2 mm) was evaluated. Cases with discordant nodal staging between US and CT were identified.The diagnostic utility of CT was also assessed in a subgroup of patients with node-negative findings on US. Results: Among 982 patients (mean age ± standard deviation, 47.3 ± 11.5 years; 774 female), pathological analysis confirmed cervical LNM in 377 patients, including macroscopic, microscopic, and size-unknown LNM in 187, 175, and 15 patients, respectively. The addition of CT to US improved sensitivity for detecting macroscopic LNM compared to US alone (68.4% [128/187] vs. 26.7% [50/187]; P < 0.001), while maintaining high specificity despite a significant decrease (90.9% [709/780] vs. 97.2% [758/780]; P < 0.001). Discordant nodal staging between US and CT regarding macroscopic LNM was observed in 149 cases (15.2% [149/982]), with 131 patients (87.9% [131/149]) being upstaged by CT. In patients with node-negative US findings, CT detected US-undetected macroscopic LNM in 78 patients (8.7% [78/895]) and exhibited a sensitivity of 56.9% (78/137) and specificity of 93.5% (709/758) for macroscopic LNM. Conclusion The integration of CT with US improved sensitivity for detecting macroscopic LNM in patients with PTMC, identifying those who would otherwise be inappropriately considered candidates for active surveillance based solely on US findings. This may assist in refining patient management.

Background: Despite advancements in laboratory animal facility management, pinworm infections remain a persistent issue in immunodeficient mouse colonies. Rapid diagnosis and treatment are crucial to mitigating potential scientific and economic consequences. Effective control requires both the administration of anthelmintic agents and rigorous environmental decontamination. However, the safety and efficacy of these treatments in genetically modified mouse models remains uncertain.Case presentation Aspiculuris tetraptera infestation was identified in multiple immunodeficient mouse models housed in a laboratory facility. Diagnosis was confirmed through fecal flotation for egg detection and necropsy for adult worm examination in the large intestines. Mice received three subcutaneous ivermectin injections at two-week intervals, coupled with environmental decontamination using ivermectin spray for four consecutive weeks. Following treatment, all colonies tested negative for A. tetraptera without any mortality. Conclusions A combination of subcutaneous ivermectin injection and environmental spray application effectively eradicated A. tetraptera infestation in immunodeficient mouse colonies. The treatment protocol led to the complete elimination of eggs and adult worms, offering a practical strategy for managing pinworm infections in genetically modified mouse models. Limitations include the small sample size, and the lack of a comprehensive evaluation of physiological and metabolic safety in immunodeficient mice. Further validation will be required to confirm the broader applicability of this approach.

Globally, postpartum hemorrhage is still among the most significant factors in preventable maternal morbidity and mortality. Although early recognition and intervention have improved with advances in obstetric care, transfusion practices are often based on fixed thresholds that may not accurately reflect the unique physiological changes that occur during pregnancy or in the clinical context of acute bleeding. In this narrative review, we propose a phase-specific, patient-centered transfusion strategy for the preoperative, intraoperative, and postpartum periods. Key components of this strategy include proactive anemia correction during pregnancy, timely administration of uterotonic agents, early implementation of antifibrinolytic therapy, such as tranexamic acid within 3 hours of bleeding onset, and appropriate activation of massive transfusion protocols when severe hemorrhage is ongoing. Clinical decision-making should be based on continuous assessment of maternal status, rather than on static hemoglobin values. Point-of-care coagulation monitoring, including thromboelastography and rotational thromboelastometry, can allow rapid identification of coagulopathy and support goal-directed transfusion. For high-risk populations, such as those with placenta accreta spectrum or those who decline allogeneic transfusion, strategies can include intraoperative cell salvage and non-blood interventions. Balanced transfusion approaches, using equal ratios of red blood cells, plasma, and platelets, at an early stage have demonstrated improved outcomes. Standardized protocols, multidisciplinary collaboration, and the integration of emerging technologies may further improve safety, minimize unnecessary transfusions, and promote consistency of care in the management of obstetric hemorrhage.

Background and Objectives: Circulating microRNAs (miRNAs) have been proposed as potential biomarkers in atrial fibrillation (AF) and heart failure (HF), but their role in patients with AF and heart failure with preserved ejection fraction (HFpEF) remains uncertain. Methods: We measured serum levels of 4 candidate miRNAs (miR-21, miR-146a, miR-146b, and miR-328) using quantitative polymerase chain reaction in 45 patients with persistent AF and HFpEF and five non-AF arrhythmia controls (Healthy). Expression levels were normalized to miR-16 and expressed as fold change (2−ΔCt ). Baseline (V1) and 3–6 months follow-up (V2) samples were analyzed, and comparisons were performed using non-parametric tests. Results: At baseline, none of the 4 miRNAs differed significantly between AF patients and Healthy controls; miR-21, 1.24 ± 0.55 vs. 1.15 ± 0.32 (P = 0.57); miR-146a, 0.66 ± 0.35 vs. 0.65 ± 0.06 (P = 0.71); miR-146b, 0.12 ± 0.07 vs. 0.11 ± 0.01 (P = 0.90); and miR-328, 0.08 ± 0.05 vs. 0.07 ± 0.03 (P = 0.95), all P > 0.5. Baseline comparisons were analyzed using relative expression values (2−ΔCt , normalized to miR-16), while longitudinal changes between V1 and V2 were assessed using fold change (2−ΔΔCt ). No significant longitudinal changes were observed across treatment groups. Conclusions In patients with persistent AF and HFpEF/HF with mildly reduced ejection fraction, circulating miR-21, miR-146a, miR-146b, and miR-328 showed no significant differences compared with the non-AF arrhythmia control group and did not change after 6 months of renin-angiotensin-aldosterone system-targeted therapy. These pilot data suggest that the short-term utility of biomarkers is limited and warrants validation in larger, randomized cohorts.