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.

Biliary tract cancer (BTC) is an uncommon, heterogeneous malignancy with increasing incidence and mortality. Most patients present with advanced disease, which limits curative treatment options and contributes to a poor prognosis. Recent advances in molecular profiling and immuno-oncology have substantially reshaped the therapeutic landscape of BTC by providing deeper insight into its molecular and immunological features. In particular, the incorporation of immune checkpoint inhibitors, such as durvalumab and pembrolizumab, into first-line gemcitabine-cisplatin therapy has demonstrated clinically meaningful survival benefits. Phase III trials, including TOPAZ-1 and KEYNOTE-966, reported significant improvements in overall survival and progression-free survival compared with gemcitabine-cisplatin alone, establishing chemoimmunotherapy as a new standard of care for advanced BTC. The advent of targeted therapies has further expanded treatment options. Agents directed against fibroblast growth factor receptor 2 (FGFR2) fusions, isocitrate dehydrogenase 1 (IDH1) mutations, and human epidermal growth factor receptor 2 (HER2) overexpression have enabled precision-based approaches for patients harboring actionable molecular alterations. These developments highlight the critical role of comprehensive molecular profiling in guiding individualized treatment strategies. Despite these advances, important challenges remain, largely because of the relative rarity of BTC and the inherent limitations of small, heterogeneous study populations. Future research should prioritize large-scale, multicenter, prospective trials to optimize therapeutic sequencing and combination strategies. Furthermore, the routine integration of next-generation sequencing into clinical practice is essential to fully realize the potential of molecularly tailored therapies. This review summarizes the latest evidence on immunotherapy and targeted therapy for BTC and discusses their clinical implications for improving patient outcomes.

Objectives: This study aims to investigate the challenges faced by individuals with schizophrenia in adhering to COVID-19 prevention guidelines and the difficulties they experienced due to social distancing measures. Methods: The study focused on 286 registered members with schizophrenia who were utilizing mental health welfare center services in the Busan area. The general control group consisted of individuals aged 19 and older in Busan. A survey was used to examine changes in daily life due to COVID-19 and perceptions of preventive measures. The survey also investigated the difficulties in daily life and the services needed by individuals with schizophrenia after the onset of COVID-19.To compare the two groups, independent sample t-tests were used for continuous variables, and chi-square tests were conducted for categorical variables. Results: Compared to the general population, individuals with schizophrenia reported lower levels of anxiety about contracting COVID-19 and experiencing fatal outcomes. They also indicated that they were less likely to engage in new activities or experience conflicts with those around them. Additionally, they rated the necessity of COVID-19 preventive guidelines lower and reported experiencing less stress from adhering to these guidelines. However, individuals with schizophrenia expressed significant discomfort due to the reduction in face-to-face counseling as a result of the suspension of mental health welfare center services. They also reported difficulties with attending outpatient appointments and maintaining regular meals, among other challenges. Conclusions In this study, it was observed that individuals with schizophrenia tended to underestimate the risk and severity of COVID-19 infection and found it challenging to recognize the necessity of preventive measures. Additionally, they appeared to experience greater difficulties in managing their daily lives independently.

Although aspartate aminotransferase (AST) is a serum marker of hepatocellular damage in chronic hepatitis, it is difficult to interpret very high AST levels with concurrent low alanine aminotransferase (ALT) levels. Macro-AST is an immunoglobulin-AST complex that can present as aberrant high enzymatic activity without significant inflammation in the liver. Two patients with chronic hepatitis B presented with disproportionate AST elevations. Their plasma samples were precipitated with polyethylene glycol (PEG) and stored at 4°C for macro-AST determinations. In Case 1, PEG precipitation showed 100% removal of AST activity, and refrigerated storage resulted in a ~70% decline over seven days, confirming macro-AST. In Case 2, both tests showed minimal changes, suggesting that macro-AST was unlikely. The AST levels normalized after antiviral therapy, suggesting immune-active hepatitis as the probable cause, but the other contributing factors could not be completely excluded. The abrupt decrease in AST activity after PEG precipitation and during refrigeration storage suggests that relatively high AST values compared to ALT might be attributed to the presence of macro-AST.These non-invasive methods for detecting macroenzymes might help the patient avoid unnecessary further work-ups.

Purpose: Our study identified prognostic factors affecting visual outcomes in patients with unilateral indirect traumatic optic neuropathy (TON), determined the risk of legal blindness, and assessed changes in visual acuity, visual fields, retinal structure, and the therapeutic effect of high-dose corticosteroid treatment. Methods: We retrospectively reviewed the medical records of 52 patients (52 eyes) diagnosed with TON between 2014 and 2023. Patients were categorized into two groups according to the final best-corrected visual acuity (BCVA): Group 1 (BCVA ≥0.1) and Group 2 (BCVA <0.1). Prognostic factors were analyzed using logistic regression, and receiver operating characteristic curve analysis was performed to determine optimal cutoff values. Longitudinal changes in visual acuity, visual field index (VFI), and retinal structural parameters were assessed using a generalized linear mixed model. Results: Factors significantly associated with Group 1 included the absence of intracranial hemorrhage, administration of high-dose steroids within 24 h, and better logMAR visual acuity and VFI within 4 weeks post-trauma. In multivariate analysis, VFI within 4 weeks remained significantly associated with favorable visual outcomes (p = 0.008). The optimal VFI cutoff value for predicting a good prognosis was 13%, yielding a sensitivity of 90% and specificity of 93.3%. Visual acuity outcomes over time differed significantly according to the timing of high-dose steroid administration. Conclusions VFI within 4 weeks after injury was the most reliable prognostic indicator, demonstrating high sensitivity and specificity for predicting legal blindness. Early administration of high-dose steroids within 24 h helped prevent visual deterioration. These findings emphasize the importance of early quantitative assessment of visual function and prompt therapeutic intervention to guide treatment strategies in patients with TON.

RESULTS: Resveratrol significantly reduced cardiac hypertrophy and remodeling in aging hearts. In addition, resveratrol significantly ameliorated aging-induced mitochondrial dysfunction (e.g., decreased oxygen respiration and increased hydrogen peroxide emission) and mitochondria-dependent apoptotic signaling (the Bax/Bcl-2 ratio, mitochondrial permeability transition pore opening sensitivity, and cleaved caspase-3 protein levels).Resveratrol also significantly attenuated aging-induced apoptosis (determined via cleaved caspase-3 staining and TUNEL-positive myonuclei) in cardiac muscles. CONCLUSION This study demonstrates that resveratrol treatment has a beneficial effect on aging-induced cardiac remodeling by ameliorating mitochondrial dysfunction and inhibiting mitochondria-mediated apoptosis in the heart.

Objectives: This study aimed to explore factors influencing satisfaction with medical services among medically underserved populations at the free medical clinic, providing data to improve free medical services for these populations. Methods: We employed a descriptive correlational study design involving 112 individuals (aged 19 years and older) from medically underserved populations who visited the clinic. Data were collected through face-to-face surveys from September to October 2023, and statistical analyses (t-tests, analysis of variance, Pearson correlation, and hierarchical multiple regression) were used to identify key predictors of satisfaction. Results: Perceived support from healthcare providers emerged as the strongest predictor ofsatisfaction with medical services, demonstrating a significant positive association. While socialsupport was positively correlated with perceived support from healthcare providers, it did not independently predict satisfaction. Conclusion These findings underscore the importance of healthcare provider and social supportin increasing satisfaction with medical services among medically underserved populations.Developing tailored healthcare programs and specialized healthcare provider training are essential strategies to improve healthcare access and outcomes for these vulnerable groups.