Purpose: The aim of this study is to compare the detection ability of quality of life (QoL) changes and responsiveness of the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS)-40 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ). Materials and Methods: A multicenter prospective observational study was conducted to evaluate QoL changes after various gastrectomies between January 2021 and April 2022. Participants were instructed to complete the KOQUSS-40 and EORTC QLQ-C30/STO22 preoperatively and at 1, 3, 6, and 12 months postoperatively. QoL changes over time and QoL responsiveness were assessed for each questionnaire. Results: Data from 491 patients who underwent curative gastrectomy for gastric cancer at 22 institutions were analyzed. The summary scores of the KOQUSS-40 and EORTC QLQ-STO22 showed significant differences between the total and proximal gastrectomy groups (p=0.044 and p=0.038, respectively), but no difference was observed for the EORTC QLQ-C30. Dysphagia on the KOQUSS-40 was significantly different between the total and proximal gastrectomy groups (p=0.031); however, dysphagia on the EORTC QLQ-STO22 did not differ. The responsiveness of the KOQUSS-40 was similar to that of the EORTC QLQ in patients who experienced ≥ 10% body weight loss, but approximately 10% less in patients receiving adjuvant chemotherapy than the EORTC QLQ. Conclusion KOQUSS-40 has several advantages over EORTC QLQ-C30/STO22 when comparing QoL between the total and proximal gastrectomy groups. The findings provide information for researchers investigating the QoL of patients who have undergone curative gastrectomy for gastric cancer.

Objective: To examine the risk of cardiovascular disease (CVD) associated with use of tumor necrosis factor inhibitors (TNFi) in patients with ankylosing spondylitis (AS). Methods: This study used data from the Korean National Health Insurance database. Patients aged ≥18 years who were newly diagnosed with AS between 2010 and 2018 and did not suffer prior CVD were included. The primary outcome was a composite endpoint of myocardial infarction (MI) or stroke. The secondary outcomes were specific endpoints of MI, stroke, or congestive heart failure. TNFi use was evaluated as a time-dependent variable. Cox proportional hazard regression was used to examine the association between TNFi use and risk of incident CVD. Results: Of 19,775 patients (mean age, 36.1 years; 75% male), 5,978 (30.2%) were exposed to TNFi treatment during the study period. During a follow-up of 4.8 (interquartile range, 2.9~7.2) years, 522 events of MI or stroke occurred. TNFi use was associated with a lower risk of MI or stroke than no TNFi use after adjusting for traditional CV risk factors and medications (adjusted hazard ratio [aHR], 0.72; 95% confidence interval [CI], 0.55~0.94). The lower risk of MI or stroke associated with TNFi use was consistently observed across subgroups. Risk of congestive heart failure did not differ between users and non-users of TNFi (aHR, 0.94; 95% CI, 0.75~1.18). Conclusion In a real-world AS cohort, TNFi treatment was associated with a reduced risk of atherosclerotic CVD. However, TNFi use was not associated with risk of congestive heart failure.

Objective: To explain process of developing basic veterinary clinical performance guidelines, based on frequently observable clinical manifestations, thereby supporting competencybased veterinary education in Korea. Methods: A structured review of learning outcomes established by Korean Association of Veterinary Medical Colleges (KAVMC) was conducted by a planning committee including veterinary educators, practitioners, and advisory members. Owner-oriented descriptions were used to frame each performance task, and each was mapped to corresponding learning outcomes. These tasks were aligned with learning outcomes recommended by the KAVMC to support the development of communication, clinical reasoning, and performance-related competencies among veterinary students, thereby enhancing day-one clinical readiness. Results: In total, 63 clinical manifestations for a guidebook format that can be used for clinical education were identified and categorized by organ systems that are described in language understandable to animal owners. Conclusions and Relevance: The basic veterinary clinical performance guidelines based on common clinical manifestations would serve as a vital component in veterinary education to reinforce core graduation competencies.

Janus kinase (JAK) inhibitors are an important treatment option for ulcerative colitis, providing rapid onset of action, oral administration, and efficacy even after biologic failure. The 3 approved agents—tofacitinib, filgotinib, and upadacitinib—differ in JAK isoform selectivity, leading to clinically meaningful differences in efficacy and safety. Evidence from network meta-analyses, clinical trials, and real-world studies consistently shows that upadacitinib provides the highest efficacy for induction and maintenance of remission, whereas filgotinib demonstrates the most favorable safety profile. The strong efficacy of upadacitinib and tofacitinib is particularly relevant in patients with severe disease, including acute severe ulcerative colitis, and upadacitinib maintains high efficacy regardless of prior advanced therapy exposure. JAK inhibitors also benefit extraintestinal manifestations. Although risks such as herpes zoster, serious infection, thromboembolism, and major cardiovascular events differ among agents, long-term data suggest generally acceptable safety when used appropriately. Intraclass JAK-to-JAK cycling is feasible, with about half of patients achieving steroid-free clinical remission in retrospective cohorts. Based on mechanistic, clinical, and real-world evidence, filgotinib may be a first-line option for patients with lower disease activity or when safety is a priority, whereas upadacitinib or tofacitinib may be preferred in higher disease activity. Strategically selecting agents may improve durability and outcomes.

Intradiscal electrothermal therapy (IDET) is a minimally invasive procedure used to treat discogenic back pain and offers an alternative to surgical intervention in selected patients. Although it is generally considered safe, rare but significant complications can occur and may be difficult to diagnose because their symptoms overlap with those of other spinal conditions. We describe the case of a 69-year-old woman who presented with severe lower back and left buttock pain that was unresponsive to conservative treatment. Magnetic resonance imaging revealed disc bulging with a high-intensity zone at the L4–5 and L5–S1 levels. IDET was performed at the L4–5 level, resulting in initial pain relief. However, the patient returned 7 days later with recurrent pain. Despite undergoing percutaneous epidural neuroplasty at the left L5–S1 level, a medial branch block, and a piriformis muscle block, her symptoms persisted. Further evaluation with spinal computed tomography revealed a retroperitoneal hematoma near the left psoas muscle. Referred pain from the hematoma mimicked discogenic pain, resulting in delayed diagnosis and unnecessary interventions. The patient remained hemodynamically stable and gradually improved with conservative management alone. This case highlights retroperitoneal hematoma as a rare complication of IDET and emphasizes the importance of accurate and timely diagnosis in patients with persistent or worsening symptoms after spinal procedures. Clinicians should consider non-discogenic sources of pain when treatment outcomes deviate from expected patterns.

Purpose: Overactive bladder (OAB) symptoms may improve following surgical correction of cystocele. This study aimed to evaluate changes in urgency, the primary symptom of OAB, and identify factors associated with improvement in urgency after surgical treatment for cystocele. Methods: We conducted a retrospective analysis of medical records for patients who underwent surgical treatment for cystocele and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Patients were categorized into 2 groups based on their urgency status 3 months postsurgery: those with improved urgency and those without improvement. Improvement was defined as a reduction of 2 or more points on the scale following surgery. We compared preoperative clinical and urodynamic factors between the 2 groups. Results: A total of 137 patients were included in the study, with 98 (71.5%) showing improvement in urgency symptoms after surgery. The improved group had a significantly higher prevalence of preoperative urgency urinary incontinence (UUI) (62.2% vs. 30.8%, P=0.001) and bladder outlet obstruction (43.9% vs. 20.5%, P=0.011) compared to the nonimproved group. Urodynamic evaluations indicated that the detrusor pressure at maximum flow rate (PdetQmax) was significantly higher in the improved group than in the nonimproved group (P=0.004). Multivariate logistic regression analysis identified preoperative UUI, higher PdetQmax, and lower vaginal parity as independent predictors of improvement in urgency postoperatively. Conclusions Preoperative UUI, higher PdetQmax, and lower vaginal parity were significant predictors of postoperative improvement in urgency. Both clinical and urodynamic factors may help identify patients with cystocele and preoperative urgency who are most likely to benefit from anatomical correction.

Ado-trastuzumab emtansine (T-DM1) is an effective adjuvant therapy for human epidermal growth factor receptor 2-positive breast cancer; however, its surgical safety profile remains unclear. We observed delayed bleeding with variable and often subtle clinical manifestations during implant-based breast reconstruction (IBBR). Two patients who received adjuvant T-DM1 therapy after IBBR were retrospectively reviewed. The patient in Case 1 developed a recurrent seroma and liquefied hematoma requiring repeated aspirations, with platelet counts decreasing from 218 × 109 /L to 33 × 109 /L before expander removal.The patient in Case 2 experienced an acute massive hematoma on postoperative day (POD) 2, prior to T-DM1 initiation, which resolved after re-exploration; a temporally distinct delayed hemorrhagic event occurred on POD 175 during T-DM1 therapy after radiotherapy, accompanied by a platelet nadir of 34 × 109 /L. Both patients required plateletpheresis and prolonged drainage. Delayed bleeding during T-DM1 therapy may reflect a combination of hematological suppression and vascular vulnerability. Therefore, vigilant surveillance and cautious postoperative rehabilitation are warranted.

Background: A nationwide Rehabilitation at Home Care Pilot Program for patients undergoing lower extremity orthopedic surgeries has been ongoing since 2020. The program was designed to improve clinical outcomes through early mobilization and rehabilitation after discharge. This study aimed to analyze the interim data to assess its effectiveness and suggest improvements, particularly for older patients who are more vulnerable compared to younger patients. Methods: We analyzed the data of 872 patients from seven hospitals. Patients were divided into an older-age group (OG; ≥60 years) and younger-age group (YG; <60 years). The Berg Balance Scale (BBS) and Numeric Rating Scale (NRS) scores for pain were the main outcomes. Results: Participants were categorized into OG (n=801) and YG (n=71). The most common surgeries were knee joint replacement (63.7%) in OG and hip joint replacement in YG (77.5%). It took more days to enroll in the pilot program in OG (4.4 days) than YG (3.2 days). OG showed less improvement in BBS than YG for all surgeries (23.3 vs. 31.9) and hip joint surgery (19.8 vs. 33.5). In patients with hip joint replacement in OG, those with a higher number of comorbidities (≥3) showed less BBS improvement than those with fewer comorbidities (<3). In the pain domain, NRS scores decreased in both groups. Conclusion The postoperative rehabilitation education program appeared to be effective in improving physical function and reducing pain severity, though the improvement was less obvious in older patients who may require a more comprehensive approach compared to younger patients.

Background and Objectives: Hearing loss significantly affects communication, psychosocial well-being, and quality of life. This study analyzes the National Health Insurance Service database to assess the trends and characteristics of hearing loss in South Korea from 2010 to 2020.Subjects and Method The database encompasses 97% of the Korean population, providing comprehensive data on medical history, prescriptions, and health examinations. The analysis used the World Health Organization’s ICD-10 definitions to categorize hearing loss types and examine their prevalence and incidence across various demographics over 11 years. Results: There was an overall annual increase of 4.62% in diagnosed cases of hearing loss, with the most significant rise among the elderly. The rate of increase accelerated from 3.32% between 2010 and 2014 to 6.49% between 2014 and 2020, corresponding with the improved hearing aid access facilitated by policy changes. Women showed a slightly higher increase than men. The data also indicated a consistent rise in abnormal hearing test results during health examinations, especially in older adults. Conclusion The study highlights an increasing trend in hearing loss diagnoses, driven by an aging population and enhanced detection facilitated by policy changes. These findings emphasize the need for continuous monitoring and targeted health policies to manage hearing loss effectively, offering valuable insights for global health management and policy development.

Background and Objectives: This study aims to analyze trends in hearing disability and the use of hearing rehabilitation devices (hearing aids and cochlear implants) in South Korea over the past 11 years (2010-2020) using data from the National Health Insurance Service (NHIS).Subjects and Method Data were extracted from the NHIS database, covering approximately 97% of the South Korean population. Patients diagnosed with hearing loss were classified using ICD-10 codes. The data were analyzed to determine trends in hearing disability, hearing aid prescriptions, and cochlear implant usage by age, gender, and types and causes of hearing loss. Results: The number of hearing disability patients increased from 170900 in 2010 to 362738 in 2020, with an annual growth rate of 7.95%. The highest increase was observed in the ≥60 age group, with an annual growth rate of 11.04%. Hearing aid prescriptions rose from 4966 in 2010 to 11974 in 2020, showing a 10.45% annual increase. Females showed a higher growth rate in both hearing disability and hearing aid prescriptions compared to males. Cochlear implant prescriptions also increased, particularly among older adults. Conclusion The study highlights a significant rise in hearing disability and the use of hearing aids and cochlear implants in South Korea, especially among the elderly. The findings underscore the importance of early diagnosis and intervention for hearing loss and the need for policy improvements to enhance accessibility and affordability of hearing rehabilitation services. Additional strategies are needed to ensure appropriate hearing rehabilitation for those not yet receiving adequate care.