Objective: : This study investigated the relationship between arterial partial pressure of oxygen (PaO2) levels in the first 24 hours of intensive care unit (ICU) admission and clinical outcomes in neurocritically ill brain tumor patients. Methods: : In this single-center retrospective study of 2123 brain tumor patients, we analyzed PaO2 levels from arterial blood gas samples within 24 hours of ICU admission. The primary endpoint was 28-day mortality. Analysis utilized multivariable logistic regression and inverse probability of treatment weighting (IPTW). Results: : PaO2 exceeding 91.5 mmHg was defined as hyperoxia. The non-hyperoxia group showed higher 28-day mortality than the hyperoxia group (15.5% vs. 6.0%, p<0.002), a trend that persisted after IPTW adjustment (10.7% vs. 6.6%, p=0.019). In IPTW-adjusted regression, non-hyperoxia remained significant (adjusted odds ratio [OR], 3.24; 95% confidence interval [CI], 1.82–5.77). Survival analysis demonstrated significantly higher survival rates in the hyperoxia group (p<0.001). Subgroup analysis revealed significant heterogeneity across tumor types (p for interaction <0.001), with protective effects observed in malignant brain tumors (adjusted OR, 3.5; 95% CI, 1.88– 6.51) and brain metastases (adjusted OR, 3.86; 95% CI, 2.31–6.44), but not in benign tumors (adjusted OR, 1.14; 95% CI, 0.22–5.87). Conclusion : Elevated PaO2 levels within the first 24 hours of ICU admission were associated with decreased mortality rates, suggesting oxygenation as a potential therapeutic target in brain tumor patients. The protective effects were most pronounced in patients with malignant brain tumors and brain metastases, supporting a tumor type-specific approach to oxygenation management.

Background: The management of sexually transmitted infections (STIs) at the national level is necessary for the health and well-being of individuals in society. The purpose of this study was to propose a redesign of the STI surveillance system by collecting opinions from experts. Methods: After the major STIs were reviewed, 1) gonorrhea, 2) chancroid, 3) Mycoplasma genitalium infection, and 4) trichomoniasis were selected as diseases requiring a redesign of the surveillance system through the Delphi method, a technique for solving problems by collecting opinions from experts. The expert panel was selected from experts on STIs (n = 17) and included members of the Korean Association of Urogenital Tract Infection and Inflammation, the Korean Society of Infectious Diseases, and the 3rd advisory committee on STIs. Results: The experts agreed upon the exclusion of surveillance for chancroid on the basis of the low incidence, with an agreement rate of 83%. The experts agreed upon the inclusion of M. genitalium in the surveillance system, with a high agreement rate of 88%. However, there was disagreement among the experts on whether to include trichomoniasis in the surveillance system and whether to switch to a mandatory surveillance system for gonorrhea. Conclusion Although a consensus was not reached in some of the surveys in this study, it involved the collection of various expert opinions. Therefore, policies should be promoted with a prioritized focus on items with high agreement, but items for which no consensus was reached need to be reviewed in greater depth through additional research and investigation.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Objectives: Clinical nutrition treatment is the central part of diabetes management, such as prevention, treatment, and self-management of diabetes, and personalized clinical nutrition treatment, which enables improvement in patients with type 2 diabetes mellitus (T2DM). Our study aimed to contribute to the improvement of appropriate nutrition management in personalized treatment for obese and non-obese diabetes patients. Methods: T2DM patients were recruited as participants, and 36 final participants were assigned to the lean diabetes mellitus group (LDM; body mass index [BMI] < 25 kg/m2) and the obese diabetes mellitus group (ODM; BMI ≥ 25 kg/m2). We assessed the dietary intakes, body composition, dietary habits, the Korean version of obesity-related quality of life, and biochemical indices. Results: According to the phenotype’s comparison, the ODM group had a high prevalence of T2DM complications and hypertension, had a dietary habit of less than 10 minutes of mealtime duration and preferred fast food intake, and had a low obesity-related quality of life. However, the LDM group had a high choice of Korean dishes at the time of eating out and a high intake of vitamin C, and iodine because of the intake of vegetables and seaweeds. Conclusion We observed differences in diet, nutrient intake, and clinical characteristics according to the phenotype of T2DM patients. In particular, obese diabetes patients have an increased risk of cardiovascular diseases, bad dietary habits, and low obesity-related quality of life. Therefore, personalized nutrition treatment is needed in consideration of the risk of cardiovascular disease and dietary habits for patients in the ODM group, as well as determining the energy requirements of Korean patients with T2DM.

Early-life stress (ELS) is a major contributor to neurodevelopmental vulnerability, particularly within the dentate gyrus (DG), where oxidative burden and microglial activation disrupt adult neurogenesis. Here, we examined whether N-acetylcysteine (NAC), a cysteine prodrug and glutathione precursor, could counteract impaired neurogenesis induced by neonatal maternal separation (NMS). Adolescent NAC administration restored the number of Ki67 + proliferating progenitors and DCX + immature neurons in the DG of NMS rats, accompanied by reduced reactive oxygen species, suppressed iNOS induction, and attenuated microglial activation. NAC also normalized EAAC1 expression, indicating enhanced neuronal antioxidant capacity. Notably, NAC rescued diminished neurogenesis in EAAC1 knockout mice, demonstrating its efficacy under both stress-induced and transporter-deficient redox imbalance. These findings identify NAC as a potent modulator of hippocampal neuroplasticity, acting through the restoration of redox and inflammatory homeostasis, and support its potential as an early therapeutic strategy to mitigate long-lasting neurodevelopmental consequences of ELS.

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Smoking is a major health risk factor contributing to substantial morbidity and mortality worldwide. Although most smokers express a desire to quit— or they attempt to do so—, achieving smoking cessation solely through individual willpower is often challenging. Primary care plays a pivotal role in supporting smoking cessation efforts by increasing the likelihood of success. Even brief advice from a physician significantly increases the chance of quitting, and combining counseling with pharmacotherapy further improves cessation rates. Particular attention is required for smokers in special populations, such as those with cardiovascular diseases or mental health conditions, wherein tailored and proactive smoking cessation interventions are crucial. Digital health tools, including smartphone applications and text messaging interventions, have recently emerged as effective strategies to support personalized smoking cessation behaviors. Furthermore, institutional support, such as national programs, quitlines, and post-screening counseling for lung cancer, are critical resources that promote successful cessation. Primary care physicians are uniquely positioned to foster longterm smoking cessation success through sustained relationships with patients by leveraging these tools and resources to provide comprehensive and continuous care.

The spleen is occasionally referred to as the ‘forgotten organ’ because splenic lesions are less common and encountered rarely compared to pathologies of other abdominal solid organs. Therefore, although well-demonstrated using various abdominal imaging modalities, radiologists tend to be less familiar with splenic diseases, making interpretation challenging. This study aimed to review common and uncommon splenic diseases and illustrate the multimodal imaging (including ultrasonography, CT, MRI, and PET/CT) features of these lesions in correlation with their histopathology. Recognizing the radiological findings of various splenic lesions helps narrow down the differential diagnosis and guide appropriate clinical decision-making for radiologists.