Background: This study was performed to establish a rabbit model for esophageal surgery in the treatment of cervical esophageal diseases. The necessary steps for postoperative treatment and esophageal examination were detailed. Methods: This study aimed to confirm the feasibility of the surgical procedure in rabbits and develop a postoperative management protocol. Six New Zealand White rabbits underwent esophagectomy and end-to-end anastomosis of the cervical esophagus under general anesthesia. Postoperatively, the rabbits were fed a specially formulated therapeutic liquid diet for 3 to 7 days. Recovery was monitored for 8 weeks, after which the rabbits were euthanized. Esophagography and endoscopy were conducted during the first postoperative week to assess healing. Results: Of the six rabbits that underwent surgery, two died from nonsurgical complications within 7 days after the operation. Of the remaining rabbits, two were diagnosed with esophageal stricture via esophagography and underwent endoscopy after the first postoperative week. The final two rabbits completed the 8-week postoperative period without complications. Conclusions Esophageal surgery and postoperative treatment in rabbits require careful attention. We anticipate that this study will provide valuable and practical information for researchers conducting esophageal studies using rabbits.

Background and Objectives: Clinical characteristics and outcomes in acute heart failure (AHF) vary by phenotype. We assessed phenotype-specific features, treatment patterns, and outcomes in a nationwide Korean cohort. Methods: The Korean Heart Failure III registry prospectively enrolled 7,351 AHF admissions at 47 hospitals. Among 6,777 patients with available left ventricular ejection fraction (EF), phenotypes were defined as heart failure with reduced EF (HFrEF, ≤40%), mildly reduced EF (HFmrEF,41–49%), or preserved EF (HFpEF, ≥50%). The primary endpoint was a 12-month composite of all-cause death or heart transplantation, evaluated from index admission and, among hospital survivors, from discharge. We used inverse probability weighting (multinomial generalized boosted models with stabilized, trimmed weights) and weighted Cox proportional-hazards models to estimate hazard ratios (HRs). Results: Phenotype distribution was 58.9% HFrEF, 13.6% HFmrEF, and 27.5% HFpEF. Crude 12-month composite rates from index admission were 13.4% (HFrEF), 12.7% (HFmrEF), and 16.8% (HFpEF). After weighting, from index admission, HFmrEF (HR, 0.892; 95% confidence interval [CI], 0.731–1.088) and HFpEF (HR, 1.101; 95% CI, 0.939–1.291) did not differ from HFrEF; from discharge, HFpEF had modestly higher risk (HR, 1.207; 95% CI, 1.008–1.445) whereas HFmrEF did not (HR, 1.039; 95% CI, 0.844–1.279). Hyponatremia and chronic kidney disease were consistent adverse markers, while angiotensin-converting enzyme inhibitor/ angiotensin II receptor blocker use at discharge was protective. Conclusions Across the EF spectrum, phenotypes showed distinct profiles and risk. Postdischarge risk was modestly higher in HFpEF, supporting phenotype-tailored care and systematic discharge optimization in Korean patients with AHF.

Background and Objectives: Heart failure (HF) imposes a significant global burden, yet awareness and implementation of guideline-directed management remain suboptimal. This study evaluated HF awareness, diagnostic patterns, and therapeutic strategies among physicians in Korea. Methods: A nationwide online survey was conducted from July to August 2019, targeting primary care physicians (PCPs; n=8,000) and hospital-based cardiology specialists (n=1,339) across Korea. The questionnaire comprised 23 items covering baseline characteristics, perceptions of HF prognosis, diagnostic approaches, and treatment practices. Results: A total of 543 physicians responded (209 PCPs and 334 cardiology specialists). While the majority correctly defined HF, a substantial proportion underestimated the lifetime risk and poor prognosis. Cardiology specialists were more likely than PCPs to use objective diagnostic tools, including echocardiography (97% vs. 61%, p<0.001) and natriuretic peptide testing (90% vs. 57%, p<0.001). Among PCPs, 29% reported diagnosing HF based on symptoms and physical findings without objective testing, and 27% reported referring patients to general hospitals for diagnostic evaluation. Prescription rates for guideline-directed medical therapies, including renin-angiotensin system blockers and beta-blockers, were consistently higher among cardiology specialists.PCPs more frequently cited advanced age as a barrier to prescribing evidence-based medications. Conclusions Physicians’ awareness and clinical practices regarding HF in Korea remain suboptimal. Given the growing burden, high mortality, and substantial costs of HF, early detection, appropriate diagnostic evaluation, and timely referral are essential. Targeted education and system-level strategies to improve guideline implementation, particularly in primary care settings, are warranted.

Background and Objectives: Graves’ ophthalmopathy (GO) is an autoimmune inflammatory disorder that can adversely affect quality of life in patients with Graves’ disease (GD). The objective of this study was to characterize the clinical features of patients with GO and to identify risk factors associated with its development and the need for anti-inflammatory treatment. Materials and Methods: In this multicenter, retrospective observational study, 818 patients with GD were identified via electronic medical record review. Clinical characteristics were assessed, and logistic regression analyses were performed to identify risk factors for GO development and the need for anti-inflammatory treatment. Results: Among the 818 patients with GD, 135 (16.5%) developed GO, and 60 (7.3%) of these patients received anti-inflammatory treatment. GO was diagnosed at the time of GD diagnosis in 54.8% of cases, and proptosis and eyelid/orbital swelling were the common presenting features. In multivariable analysis, female sex (odds ratio [OR]: 1.75, confidence interval [CI]: 1.02-3.03), goiter (OR: 1.71, CI: 1.08-2.71), and smoking (ex-smokers: OR, 2.18; 95% CI: 1.02-4.65; current smokers: OR, 3.11; CI, 1.78-5.44) were independently associated with GO development, whereas diabetes (OR: 0.35, CI: 0.14-0.89) was inversely associated. Higher total cholesterol (OR: 1.31, CI: 1.01-1.04) and elevated thyrotropin-binding inhibitory immunoglobulin levels (OR: 1.07, CI: 1.02-1.11) were also significantly associated with the need for anti-inflammatory treatment. Conclusion This study delineated the clinical features of GO and identified risk factors for its development and the need for anti-inflammatory treatment in patients with GD, providing valuable information for the management of GO in Korean patients.

Background: Although various surface modifications enhance titanium (Ti) implant osseointegration, achieving rapid bone formation comparable to native healing remains challenging. Current strategies primarily focus on micro-scale topography, often overlooking the critical role of macroscopic three-dimensional (3D) architecture in osteoconduction. Methods: We hypothesized that mimicking native bone’s porous architecture is key to accelerating osseointegration. First, we verified the impact of structural continuity by comparing standard Ti implants with decellularized bone grafts in a mouse calvaria defect model. Subsequently, we developed a biomimetic polycaprolactone (PCL)-based 3D architectural cover (Cover-type) and evaluated its osseointegration efficacy in a rat femur model against conventional Ti implants. Results: The mouse study confirmed that decellularized bone integrated significantly faster than Ti, highlighting the necessity of 3D continuity. In the rat model, micro-computed tomography analysis indicated a clear trend of increased bone formation in the Cover-type group, though statistical significance was limited by sample size. However, histological analysis confirmed a statistically significant enhancement in bone-to-implant contact compared to controls (P<0.05). The PCL structure served as a scaffold for cell migration, effectively bridging the implant-bone gap. Conclusions These findings suggest that providing a bone-like 3D environment via a PCL cover may enhance histological osseointegration, rather than relying solely on surface chemistry.

Purpose: Based on the KEYNOTE-522 study, neoadjuvant pembrolizumab plus chemotherapy has become the standard treatment for early-stage triple-negative breast cancer (TNBC).This study evaluated the real-world efficacy, safety, and predictors of pathologic complete response (pCR) in Korean patients. Methods: We conducted a retrospective cohort study of 174 patients with early-stage TNBC who received the KEYNOTE-522 regimen (neoadjuvant pembrolizumab plus paclitaxel and carboplatin, followed by doxorubicin and cyclophosphamide) at a tertiary cancer center between August 2022 and July 2024. We assessed the primary endpoints, including pCR rate and event-free survival (EFS). We performed univariable and multivariable logistic regression analyses to identify independent predictors of pCR. Results: The median patient age was 50 years (range, 24–74 years). The clinical stages were II and III in 79.3% and 20.1% of patients, respectively, and 10.9% had clinical N3 disease. The overall pCR rate was 62.1%, and the N3 subgroup had a pCR rate of 47.4%. On multivariable analysis, high baseline Ki-67 expression (≥ median, 75%) was significantly associated with pCR (odds ratio, 2.84; 95% confidence interval, 1.45 to 5.66; p = 0.002). At a median followup of 18.4 months, the 12-month EFS rate was 97.4%, with significantly superior outcomes observed in patients who achieved pCR compared with those who did not achieve pCR (100% vs. 93.1%, p = 0.007). The treatment completion rate was 92.0%, and immune-related adverse events occurred in 13.8% of patients. Conclusion In this real-world analysis of one of the largest Asian cohorts of patients with earlystage TNBC treated with neoadjuvant pembrolizumab, the KEYNOTE-522 regimen demonstrated substantial efficacy and manageable toxicity, consistent with the original trial findings.

Reference management software (RMS) represents a cornerstone of modern academic writing and publishing. For decades, programs such as EndNote, Zotero, and Mendeley have played central roles in facilitating citation organization, bibliography formatting, and collaborative scholarship. Although each platform has introduced unique innovations, persistent limitations remain, particularly with respect to usability, accessibility, and accuracy. In parallel, the rise of generative artificial intelligence has introduced an unprecedented challenge: the inadvertent inclusion of fabricated or incorrect references mistakenly incorporated into manuscripts. This phenomenon has exposed a critical limitation of traditional RMS platforms, namely their inability to verify reference authenticity. Against this backdrop, new solutions have emerged. One such example is CiteWell (https://citewell.org/), an artificial intelligence (AI)-era RMS that introduces several notable innovations, including PubMed-integrated verification, an intuitive interface for new users, customizable journal-specific styles, and multilingual accessibility. This review provides a comprehensive historical overview of RMS, evaluates the strengths and weaknesses of major platforms, and positions emerging AI-based tools as a new paradigm that combines traditional reference management with essential safeguards for contemporary academic challenges.

Objective: To investigate the longitudinal association between sarcopenia and depressive symptoms in community-dwellingolder adults, focusing on sex-specific differences. Methods: This 2-year prospective study utilized data from the Korean Frailty and Aging Cohort Study. We included 1,366participants (700 men, 666 women) aged 70-84 years who were free of depressive symptoms (Short Geriatric Depression Scale-Korean [SGDS-K]<8) at baseline. Sarcopenia status (no sarcopenia, sarcopenia, severe sarcopenia) was defined by the AsianWorking Group for Sarcopenia 2019 criteria. Multivariate logistic regression analysis was performed to assess the association be-tween baseline sarcopenia and incident depressive symptoms (SGDS-K≥8) at follow-up, adjusting for covariates. Results: After adjustment, baseline severe sarcopenia was significantly associated with a higher risk of incident depression (adjusted odds ratio [aOR]=3.040, 95% confidence interval [CI]=1.494-6.188). In the sex-stratified analysis, this association remained robust only in men (aOR=3.344, 95% CI=1.332-8.395), but was not statistically significant in women (aOR=2.490, 95% CI=0.699-8.872, p=0.159). Conclusion Severe sarcopenia independently predicts for 2-year development of depressive symptoms, particularly amongolder Korean men. These findings highlight a significant sex difference in the temporal relationship between sarcopenia and de-pression for older men.

Objectives: 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. 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 5460 ESD cases from 5250 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.

Purpose: This study aimed to analyze changes in plantar pressure distribution at the fifth metatarsal (M5) during running with different foot strike patterns. Methods: Thirty-five healthy adults ran barefoot over a foot scan pressure plate installed in a 10-m shuttle walkway.Each participant completed 10 trials per strike pattern and mean peak pressures at M1–M5 heads and M5 base of the dominant foot was analyzed. Results: The mean peak pressures at M2– M5 heads increased progressively from heel to midfoot to forefoot strike (p＜ 0.05). Significant differences among strike patterns were found at M2–M5 heads (p＜ 0.05). Post hoc analysis showed that forefoot strike produced significantly higher pressures at M2–M5 heads than heel and midfoot strikes (p＜ 0.001). At M5, peak pressure at the head increased from heel (14.54±7.82) to midfoot (15.54±7.75) to forefoot strike (19.37±7.37), whereas peak pressure at the base decreased from heel (6.27±1.69) and midfoot strikes (5.85±1.94) to forefoot strike (4.35±1.79). At M5, both the head and base demonstrated significant differences according to strike pattern. Conclusion Plantar pressure patterns vary across foot strike types, with forefoot strike producing greater M5 head loading but lower base loading. These findings suggest that forefoot-based low-intensity running may be considered as an early loading option during rehabilitation after Jones fractures, although further clinical studies are needed to confirm its clinical benefits.