In forensic medicine, age estimation commonly involves assessing age-related changes in teeth and skeletal structures. Vertebral morphological alterations, such as osteophyte formation, serve as age indicators. Recent studies using deep-learning techniques, such as neural networks, for age estimation from radiographic images have been conducted, reporting significantly higher accuracy than previous studies. This study aimed to estimate age using neural network-based deep-learning techniques applied to computed tomography (CT) cross-sectional images of the spine and evaluate its feasibility. Postmortem CT scans of 214 cadavers with varying decomposition levels were used. Coronal and sagittal cross-sectional images penetrating the center of each vertebral body were extracted for the 11th and 12th thoracic vertebrae and the first to fifth lumbar vertebrae. Using these images, along with the chronological ages of deceased individuals, an age estimation model was developed through regression analysis in PyTorch, employing a convolutional neural networks architecture with five-fold cross-validation. The model achieved a mean absolute error of 5.385 years, root mean squared error of 7.029 years, and coefficient of determination of 0.793. Although the sample size was relatively small, the results suggested the potential applicability of vertebral imagingbased age estimation in the Korean population. Further research using a larger dataset may improve the accuracy and reliability of the model.

Background/Aims: Cardiovascular disease remains a major cause of mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This study evaluated the association between subclinical carotid atherosclerosis (SCA) and MASLD or MASLD and increased alcohol intake (MetALD) in asymptomatic individuals. Methods: This cross-sectional study included 56,889 adults undergoing health check-ups in South Korea. Hepatic steatosis was diagnosed by ultrasound, and SCA was defined by carotid plaques or increased intima-media thickness. Liver fibrosis was evaluated using the fibrosis-4 index and elastography. Results: SCA was identified in 13.5%. MASLD and MetALD were significantly associated with SCA in models adjusted for demographic and lifestyle factors (adjusted odds ratio [aOR], 1.26;95% confidence interval [CI], 1.19 to 1.33; aOR, 1.43; 95% CI, 1.30 to 1.58; respectively, p<0.001for both). However, these associations attenuated and lost statistical significance when metabolic risk factors were further adjusted. The risk of SCA increased with greater hepatic steatosis and liver fibrosis severity. In patients with MASLD, aORs were 1.70 (hepatic steatosis index >36),1.23 (fibrosis-4 index ≥1.3), and 1.78 (liver stiffness measurement ≥5.6 kPa), compared to indi-viduals without MASLD. Similar trends were observed in the MetALD group. Additionally, hyper-tension and clustering of ≥3 cardiometabolic risk factors were significantly associated with SCA inthe MASLD group, supporting the role of metabolic burden in SCA development. Conclusions MASLD and MetALD were associated with increased SCA risk, particularly in individuals with hepatic steatosis and fibrosis. These findings suggest that metabolic burden and liver disease severity jointly contribute to subclinical atherosclerosis risk.

Heart failure (HF) prevalence and associated socio-economic costs have risen rapidly in Korea, creating urgent demand for a national, standardized prospective registry to support quality monitoring, outcome comparison, and real-world evidence. Standardized data definitions are essential for valid comparisons across studies and healthcare settings. We created a unified national HF cohort by integrating the two largest Korean registries, KorAHF (2011–2014;n=5,625) and KorHF III (2018–2023; n=7,351), yielding 12,976 hospitalized HF patients. Because heterogeneous variable definitions impeded direct comparisons, we implemented a harmonization pipeline across demographic, clinical, imaging, biomarker, therapeutic, and outcome domains, aligned with international standards and reinforced by systematic data quality checks.A multidisciplinary panel then conducted a structured decision process to produce the Korean HF Standard Dataset, a tiered and interoperable variable set spanning six domains: demographics, presentation at admission, in-hospital events and comorbidities, discharge status, outpatient follow-up, and readmission events. This integrated platform and standardized variables enable precise identification of HF patient phenotypes and prognostic factors, establishing an evidence-based foundation for disease management. This supports an analysis of temporal changes in treatment patterns and outcomes, generates data to inform future clinical practice guidelines, and provides a practical basis for planning large, continuous, prospective HF registries. Furthermore, it also facilitates pragmatic, registry-based randomized clinical trials and unmet-needs assessments that can guide national health policy. Establishing a foundation for future linkage with national health databases, this platform will allow for enhanced accuracy, comparability, and representativeness, powering quality improvement initiatives and population-level monitoring of Korea’s growing HF burden.

Purpose: This study aimed to develop and implement an antimicrobial stewardship education program for physician assistant nurses and to evaluate its effects on their knowledge and clinical performance. Methods: A quasi-experimental, single-group pre-post design was conducted with 50 physician assistant nurses at a university hospital in Seoul, Republic of Korea. The antimicrobial stewardship education program, developed using the ADDIE model, consisted of 12 sessions including lectures and case-based learning (CBL)-based discussions.Knowledge was measured before and immediately after the intervention, while performance was assessed pre-intervention and four weeks post-program. Data were analyzed using paired t-tests, Wilcoxon signed-rank tests, and analysis of covariance (ANCOVA). Results: Knowledge scores significantly improved from 44.65±7.45 to 58.50±10.11 (p<.001), and all subdomains showed significant increases (p<.001). Performance scores increased from 3.68±0.77 to 4.28±0.68 (p<.001). Knowledge gain did not differ significantly between the medical and surgical departments (p=.710). Likewise, after adjusting for pre-test scores, no significant difference in performance improvement was observed between the two departments (ANCOVA, p=.170). These results indicate that the program was effective across both departments regardless of their characteristics. Conclusion The antimicrobial stewardship education program improved both knowledge and performance among physician assistant nurses. This program may contribute to the standardization of antimicrobial stewardship education and to appropriate antimicrobial use and the reduction of antimicrobial resistance.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

BACKGROUND/OBJECTIVES: Green Citrus junos (yuja) peel extract has higher naringin and hesperidin contents and antioxidant activity than yellow yuja peel extract, but its anti-obesity effects are unclear. This study examined the anti-obesity properties of green yuja peel ethanol extract (GYE) in 3T3-L1 cells and high-fat diet (HFD)-induced obese mice.MATERIALS/METHODS: The effects of GYE on adipocyte differentiation were assessed by measuring Oil red O staining, mRNA and protein expression. The beneficial effects of GYE on HFD-induced obese mice were evaluated using the body weight, body composition, visceral fat size, and biochemical analysis. RESULTS: GYE inhibited adipocyte differentiation and lipid accumulation compared to the control cells, as evidenced by Oil red O staining and the triglyceride level, respectively.GYE down-regulated the adipogenic genes CCAAT/enhancer binding protein α (C/EBPα) and peroxisome proliferator-activated receptor γ (PPARγ), and lipogenic gene diacylglycerol O-acyltransferase 2 (DGAT2). GYE at 100 μg/mL downregulated the phosphorylation levels of phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt), and their downstream targets PPARγ and sterol regulatory element-binding protein-1 (SREBP-1c) compared to the control group. In obese mice, GYE (100 mg/kg/day) reduced the body weight, body weight gain, and serum lipid level compared to the control group. Analysis using dual-energy X-ray absorptiometry showed that GYE decreased the fat percentage, fat in tissue, and abdominal circumference, while it increased the lean percentage compared to control group.Furthermore, GYE significantly reduced the visceral fat weight and size compared to the control group. CONCLUSION GYE suppressed adipocyte differentiation by inhibiting the PI3K-Akt pathway in vitro and reduced the body fat mass and visceral adiposity in HFD-induced obese mice.These findings suggest that GYE is a viable natural option for combating obesity.

Objective: The purpose of this study is to identify the types of pain changes that affect older Koreans, as well as their effects on depressive symptom. Methods: We analyzed the Korean Longitudinal Study of Aging data collected from 2010 to 2018. A data of total of 1,359 participants, aged 65 or older were used to estimate the change in pain. A latent growth model and growth mixture modeling were performed to estimate the overall change in pain and to categorize the types of pain changes. Results: The pain changes of older adults were classified into two categories: low-stable and high increasing. The depressive symptom showed a stronger relationship among the high-increasing type of pain than the low-stable type. The high-increasing type had a higher percentage of females, lower income, relatively low educational attainment, and a higher percentage of rural residents than the low-stable type. Conclusion The significance of this study is that it reiterated the importance of early pain diagnosis and intervention by identifying the types of pain changes in older adults and analyzing their effects on depressive symptoms. Therefore, it is especially important to pay attention to interventions that are designed to help vulnerable groups with a high risk of pain obtain effective pain management.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women. Conclusion KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD. Conclusion KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.

Background: The utility of the QuantiFERON-Monitor (QFM, Qiagen), a tool developed to assess general immune function, remains insufficiently explored in critically ill patients with acute respiratory failure (ARF). Therefore, we used the QFM to evaluate the immune function of patients with ARF at intensive care unit (ICU) admission and monitored QFM changes based on disease severity and clinical outcome correlations. Methods: We evaluated the immune function of 99 patients with ARF in an ICU setting.The QFM was evaluated upon ICU admission, day 7 post-ICU admission, and discharge.Their results were compared with those of five healthy controls. Results: The QFM levels at ICU admission were significantly lower in patients with ARF than in healthy controls (median IUs/mL: 5.5 vs. 465.0, respectively). The QFM levels in patients with coronavirus disease 2019 or pneumonia (9.2 and 7.9 IUs/mL, respectively) were higher than those in patients with acute respiratory distress syndrome or septic shock (4.9 and 3.6 IUs/mL, respectively). On day 7, the QFM levels increased to 8.3 IUs/ mL and reached 16.7 IUs/mL at discharge. At ICU admission, patients requiring ventilator support had lower QFM levels than those requiring nasal prong or high-flow nasal cannula support. Those who died in the ICU had significantly lower QFM levels (4.0 IUs/mL) at ICU admission than those who survived (5.8 IUs/mL). Conclusions Reduced QFM levels among patients with severe ARF reflect impaired cellular immune responses and suggest that QFM may serve as a practical tool for early risk stratification and immune monitoring in ICU settings.