Purpose: To evaluate the differences in the level of concerns regarding exotropia surgery according to the perspectives regarding surgery and basic characteristics of parents of pediatric patients with intermittent exotropia in South Korea. Methods: This study included the parents of pediatric patients with intermittent exotropia who underwent surgery at five hospitals, between June 2022 and February 2023. Parental perspectives, basic characteristics, and levels of concern regarding surgery were assessed using a questionnaire. We investigated the differences in concern levels according to perspectives regarding surgery and basic characteristics among parents, such as sex, age, residential area, and the most influential factors in the decision-making for surgery. Results: A total of 266 parents were included (228 mothers; age, 40.0±4.7 years). Parents who chose surgery for subjective symptoms had higher levels of concern about hemorrhage, conjunctival redness, and persistent overcorrection than did those who chose surgery for cosmetic reasons (all p < 0.05). Fathers were more concerned about postoperative pain, compared to mothers (p = 0.039). Parents in their 40s and 50s had higher levels of concern about the hospital environment compared with those in their 20s and 30s (p = 0.003). Concern did not significantly differ by residential area. Conclusions The level of concern regarding surgery differed according to the perspectives and characteristics of the parents of pediatric patients with intermittent exotropia. Parents who chose surgery for subjective symptoms of exotropia had a higher level of concern than did those who chose surgery for cosmetic reasons. The concern level differed according to the parents’ sex and age but not their residential area.

Purpose: To evaluate the differences in the level of concerns regarding exotropia surgery according to the perspectives regarding surgery and basic characteristics of parents of pediatric patients with intermittent exotropia in South Korea. Methods: This study included the parents of pediatric patients with intermittent exotropia who underwent surgery at five hospitals, between June 2022 and February 2023. Parental perspectives, basic characteristics, and levels of concern regarding surgery were assessed using a questionnaire. We investigated the differences in concern levels according to perspectives regarding surgery and basic characteristics among parents, such as sex, age, residential area, and the most influential factors in the decision-making for surgery. Results: A total of 266 parents were included (228 mothers; age, 40.0±4.7 years). Parents who chose surgery for subjective symptoms had higher levels of concern about hemorrhage, conjunctival redness, and persistent overcorrection than did those who chose surgery for cosmetic reasons (all p < 0.05). Fathers were more concerned about postoperative pain, compared to mothers (p = 0.039). Parents in their 40s and 50s had higher levels of concern about the hospital environment compared with those in their 20s and 30s (p = 0.003). Concern did not significantly differ by residential area. Conclusions The level of concern regarding surgery differed according to the perspectives and characteristics of the parents of pediatric patients with intermittent exotropia. Parents who chose surgery for subjective symptoms of exotropia had a higher level of concern than did those who chose surgery for cosmetic reasons. The concern level differed according to the parents’ sex and age but not their residential area.

BACKGROUND/OBJECTIVES: This study examined the socio-demographic and dietary characteristics of the elderly in Seoul according to their food insecurity status and analyzed the characteristics associated with food insecurity. SUBJECTS/METHODS: The data from 513 elderly individuals aged 65 or older were analyzed using the raw data from the Seoul Food Survey 2023. The subjects were classified into food-secure or food-insecure groups. The socio-demographic and dietary characteristics of each group were analyzed. Logistic regression analysis was conducted to identify the characteristics associated with food insecurity among the elderly in Seoul. RESULTS: The proportion of the food-insecure group was 56.9% among the total elderly in Seoul. The main reasons for experiencing food insecurity were environmental (38.0%), followed by physical (37.5%) and financial (24.5%). The food-insecure group had a higher frequency of skipping breakfast and eating alone than the food-secure group while having lower dietary literacy and food environment satisfaction. Logistic regression analysis showed that the elderly living alone were approximately four times (odds ratio [OR], 3.59; 95% confidence interval [CI], 1.52–8.51) more likely to suffer food insecurity than those living with others. Higher digital food literacy (OR, 0.63; 95% CI, 0.41–0.97) and food environment satisfaction (OR, 0.38; 95% CI, 0.20–0.74) were associated with a lower likelihood of food insecurity. CONCLUSION These results suggest that policies aimed at improving food security for the elderly in Seoul should prioritize those living alone. Educational programs designed to enhance the ability to purchase online food, use self-service kiosks in restaurants, and use food delivery apps would effectively decrease food insecurity among the elderly in Seoul.Furthermore, policies aimed at improving the food environment may also help reduce food insecurity among this population.

Objective: Resilience is the ability to bounce back from stressful events using individual and environmental resources. The online intervention program, MoVemEnT, which includes mindfulness training and emotion regulation, was developed to enhance resilience among young adults. Methods: Persons without current medical or psychiatric diseases, aged 20–40 years, were recruited. Ninety-six participants were randomly assigned to either the intervention group or a waiting list control (WLC) group, with 45 participants per group completing the program. Results: Results demonstrated significant improvements in the intervention group in measures of emotion regulation (Difficulties in Emotion Regulation Scale, DERS) and clinical symptoms of depression (Center for Epidemiological Studies-Depression Scale, CES-D) and anxiety (Generalized Anxiety Disorder-7) compared to the WLC group (all p<0.05). Correlation analyses indicated that improvements in DERS scores were associated with enhanced resilience, as measured by the Korean Resilience Quotient-53 (KRQ-53) and reduced CES-D scores. Reduction in DERS scores can reduce depressive symptoms (CES-D) through direct and indirect pathways via an increase in KRQ-53, according to mediation analyses. Conclusion Our findings reported positive effects of the MoVemEnT program, which includes short videos and brief homework assignments, on resilience in young adults. This study suggests that online intervention programs could offer an opportunity to simultaneously improve general mental health among a large population and may help reduce the burden of face-to-face psychological interventions.

Background: Distal nerve block approaches have been explored to reduce hemidiaphragmatic paresis (HDP) more effectively than interscalene block (ISB). However, these approaches are associated with a high incidence of HDP. The costoclavicular block (CCB) provides effective analgesia while reducing HDP. Here, we hypothesized that CCB would decrease the incidence of HDP compared to ISB while still providing effective pain relief after surgery. Methods: Seventy patients who underwent arthroscopic rotator cuff repair were randomly allocated to receive either ultrasound-guided CCB (n = 35) or ISB (n = 35). Each group received 0.2% ropivacaine (20 ml CCB, 10 ml ISB). The primary outcome was the incidence of HDP, as measured using M-mode ultrasound. Diaphragmatic excursion, pulmonary function test results, opioid consumption, and pain scores were evaluated. Results: Sixty-six patients were included. CCB group had a significantly lower incidence of HDP than those in the ISB group (5.9% vs. 84.4%, P < 0.001). The diaphragmatic excursion reduction was significantly more in the ISB (3.87 cm) group than in the CCB (0.25 cm) group (P < 0.001). The decrease in forced vital capacity and forced expiratory volume in 1 s from baseline was significantly greater in the ISB. There was no significant difference in opioid consumption between the two groups during the entire postoperative period. Conclusions Compared with ISB, CCB significantly reduced the incidence of HDP while maintaining effective analgesia and causing less pulmonary function impairment. CCB may be a viable option for diaphragmatic-sparing analgesia after shoulder surgery.

Polyetheretherketone (PEEK) crowns offer a provisional option for esthetic restorations in pediatric patients. PEEK has mechanical properties similar to dentin but exhibits low bond strength with luting cements. This study aimed to evaluate the effect of different surface treatments on the bond strength between PEEK and four luting cements by measuring shear bond strength (SBS). Sixty specimens were divided into three surface treatment groups: control, sandblast, and 98% sulfuric acid, and further divided into four cement subgroups: methyl methacrylate (MMA)-based resin cement, composite-based resin cement, resin-modified glass ionomer cement (RMGI), and glass ionomer cement (GI). Failure modes and treated surfaces were examined using scanning electron microscopy (SEM), and wettability was assessed through water contact angle. Both surface treatment methods showed significantly higher SBS than the control. The combination of sulfuric acid treatment with MMA-based resin cement demonstrated the highest bond strength (11.25 ± 1.86 MPa), while the second highest value was observed with sandblasting combined with MMA-based resin cement. These values were significantly higher than other groups and exceeded the clinically acceptable SBS threshold of 10 MPa. SEM analysis revealed that sandblasting created irregular fissures with large grooves and cracks for improved micro-retention, while sulfuric acid treatment produced a complex fiber network with sponge-like porosities. Within the limits of this in vitro study, MMA- and composite-based resin cement application with sandblast or sulfuric acid surface treatment proved effective bonding methods.

Purpose: Claudin 18.2 (CLDN18.2) has emerged as a promising therapeutic target for CLDN18.2-expressing gastric cancer (GC). We sought to examine the heterogeneity of CLDN18.2 expression between primary GC (PGC) and metastatic GC (MGC) using various scoring methods. Materials and Methods: We retrospectively analyzed data from 102 patients with pathologically confirmed paired primary and metastatic gastric or gastroesophageal junction adenocarcinomas. CLDN18.2 expression was evaluated through immunohistochemistry on formalin-fixed paraffin-embedded tissue samples. We assessed CLDN18.2 positivity using multiple scoring approaches, including the immunoreactivity score, H-score, and the percentage of tumor cells showing moderate-to-strong staining intensity. We analyzed the concordance rates between PGC and MGC and the association of CLDN18.2 positivity with clinicopathological features. Results: CLDN18.2 positivity varied from 25% to 65% depending on the scoring method, with PGC consistently showing higher expression levels than MGC. Intratumoral heterogeneity was noted in 25.5% of PGCs and 19.6% of MGCs. Intertumoral heterogeneity, manifesting as discordance in CLDN18.2 positivity between PGC and MGC, was observed in about 20% of cases, with moderate agreement across scoring methods (κ=0.47 to 0.60).In PGC, higher CLDN18.2 positivity correlated with synchronous metastasis, presence of peritoneal metastasis, poorly differentiated grade, and biopsy specimens. In MGC, positivity was associated with synchronous metastasis, presence of peritoneal metastasis, and metastatic peritoneal tissues. Conclusions CLDN18.2 expression demonstrates significant heterogeneity between PGC and MGC, with a 20% discordance rate. Comprehensive tissue sampling and reassessment of CLDN18.2 status are crucial, especially before initiating CLDN18.2-targeted therapies.

Background: The impact of weight or weight changes on kidney function remains a matter of debate. This study aimed to investigate the association between weight fluctuation and the incidence of end-stage renal disease (ESRD) using data from the Korean National Health Insurance Corporation health checkups (2009–2015). Methods: The study included 2,310,667 participants (1,546,749 men and 763,918 women), aged ≥40 years. Weight fluctuation was assessed using the average real variability (ARV) of weight and categorized into quartiles (Q1–Q4). Hazard ratios (HRs) and 95% confidence intervals for ESRD incidence were calculated using multivariable Cox proportional hazards models. Results: After adjustment for comorbidities, increased body mass index was associated with a decreased HR for ESRD. The highest quartile of weight variability (ARV Q4) demonstrated a higher probability and HR for ESRD compared to the lower variability quartiles (Q1–Q3). Among men, individuals with sustained weight, and those with weight gain, the ARV Q4 group showed significantly increased HRs for ESRD (HR of 1.372, 1.222, and 1.49, respectively). Furthermore, irrespective of changes in creatinine levels, all ARV Q4 groups exhibited increased HRs for ESRD (HR of 1.342, 1.472, and 1.299, respectively). Conclusions High weight fluctuation (ARV Q4) was associated with an increased incidence of ESRD in the general Korean population, with notable significance in men and in groups with sustained or increased weight. Clinically, individuals in the ARV Q4 category should be considered at risk for ESRD, and early interventions should be pursued for this population.

BACKGROUND/OBJECTIVES: This study examined the socio-demographic and dietary characteristics of the elderly in Seoul according to their food insecurity status and analyzed the characteristics associated with food insecurity. SUBJECTS/METHODS: The data from 513 elderly individuals aged 65 or older were analyzed using the raw data from the Seoul Food Survey 2023. The subjects were classified into food-secure or food-insecure groups. The socio-demographic and dietary characteristics of each group were analyzed. Logistic regression analysis was conducted to identify the characteristics associated with food insecurity among the elderly in Seoul. RESULTS: The proportion of the food-insecure group was 56.9% among the total elderly in Seoul. The main reasons for experiencing food insecurity were environmental (38.0%), followed by physical (37.5%) and financial (24.5%). The food-insecure group had a higher frequency of skipping breakfast and eating alone than the food-secure group while having lower dietary literacy and food environment satisfaction. Logistic regression analysis showed that the elderly living alone were approximately four times (odds ratio [OR], 3.59; 95% confidence interval [CI], 1.52–8.51) more likely to suffer food insecurity than those living with others. Higher digital food literacy (OR, 0.63; 95% CI, 0.41–0.97) and food environment satisfaction (OR, 0.38; 95% CI, 0.20–0.74) were associated with a lower likelihood of food insecurity. CONCLUSION These results suggest that policies aimed at improving food security for the elderly in Seoul should prioritize those living alone. Educational programs designed to enhance the ability to purchase online food, use self-service kiosks in restaurants, and use food delivery apps would effectively decrease food insecurity among the elderly in Seoul.Furthermore, policies aimed at improving the food environment may also help reduce food insecurity among this population.

Objective: Resilience is the ability to bounce back from stressful events using individual and environmental resources. The online intervention program, MoVemEnT, which includes mindfulness training and emotion regulation, was developed to enhance resilience among young adults. Methods: Persons without current medical or psychiatric diseases, aged 20–40 years, were recruited. Ninety-six participants were randomly assigned to either the intervention group or a waiting list control (WLC) group, with 45 participants per group completing the program. Results: Results demonstrated significant improvements in the intervention group in measures of emotion regulation (Difficulties in Emotion Regulation Scale, DERS) and clinical symptoms of depression (Center for Epidemiological Studies-Depression Scale, CES-D) and anxiety (Generalized Anxiety Disorder-7) compared to the WLC group (all p<0.05). Correlation analyses indicated that improvements in DERS scores were associated with enhanced resilience, as measured by the Korean Resilience Quotient-53 (KRQ-53) and reduced CES-D scores. Reduction in DERS scores can reduce depressive symptoms (CES-D) through direct and indirect pathways via an increase in KRQ-53, according to mediation analyses. Conclusion Our findings reported positive effects of the MoVemEnT program, which includes short videos and brief homework assignments, on resilience in young adults. This study suggests that online intervention programs could offer an opportunity to simultaneously improve general mental health among a large population and may help reduce the burden of face-to-face psychological interventions.