Background: Skin rejuvenation has become an increasingly popular noninvasive approach to address age-related changes such as sagging, wrinkles, and skin laxity. Energy-based devices (EBDs) and injectables are widely used, but their application requires careful customization based on individual patient characteristics to optimize outcomes and minimize potential adverse effects. Objective: This study aimed to explore clinical practice patterns among board-certified dermatologists in South Korea, focusing on their strategies for tailoring skin rejuvenation treatments to individual patients, including the integration of EBDs, injectables, and senotherapeutics. Methods: A structured survey comprising 10 questions was administered to 13 experienced dermatologists specializing in skin rejuvenation. The survey covered treatment strategies for patients with varying facial fat volumes, pain management approaches, and the use of EBDs, injectables and senotherapeutics. Results: High-intensity focused ultrasound (HIFU) and radiofrequency (RF) were the most employed EBDs, often combined with injectables for enhanced outcomes. For patients with higher facial fat, HIFU and deoxycholic acid injections were preferred for contouring and tightening. For those with lower facial fat, biostimulatory agents such as poly-D, L-lactic acid and microneedle RF were favored to restore volume and elasticity. Pain management strategies included topical anesthetics and stepwise protocols. Although less commonly used, senotherapeutics were occasionally prescribed for specific conditions, such as melasma and extensive photoaging. Conclusion Dermatologists in South Korea employ a variety of patient-specific strategies for skin rejuvenation, combining various EBDs, injectables, and senotherapeutics. These findings highlight the importance of personalized treatment protocols and the need for further research to optimize treatment efficacy and safety.

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.

Background: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder characterized by tumors in multiple endocrine organs, caused by variants in the MEN1 gene. This study analyzed the clinical and genetic features of MEN1 in a Korean cohort, identifying prevalent manifestations and genetic variants, including novel variants. Methods: This multicenter retrospective study reviewed the medical records of 117 MEN1 patients treated at three tertiary centers in Korea between January 2012 and September 2022. Patient demographics, tumor manifestations, outcomes, and MEN1 genetic testing results were collected. Variants were classified using American College of Medical Genetics and Genomics (ACMG) and French Oncogenetics Network of Neuroendocrine Tumors propositions (TENGEN) guidelines. Results: A total of 117 patients were enrolled, including 55 familial cases, with a mean age at diagnosis of 37.4±15.3 years. Primary hyperparathyroidism was identified as the most common presentation (84.6%). The prevalence of gastroenteropancreatic neuroendocrine tumor and pituitary neuroendocrine tumor (PitNET) was 77.8% (n=91) and 56.4% (n=66), respectively. Genetic testing revealed 61 distinct MEN1 variants in 101 patients, with 18 being novel. Four variants were reclassified according to the TENGEN guidelines. Patients with truncating variants (n=72) exhibited a higher prevalence of PitNETs compared to those with non-truncating variants (n=25) (59.7% vs. 36.0%, P=0.040). Conclusion The association between truncating variants and an increased prevalence of PitNETs in MEN1 underscores the importance of genetic characterization in guiding the clinical management of this disease. Our study sheds light on the clinical and genetic characteristics of MEN1 among the Korean population.

Background: Patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) have reduced vascular com‑ pliance and are likely to develop heart failure (HF). In this study, we estimated the prevalence of HF pre- and post-HD in ESRD using the current guidelines. Methods: We prospectively investigated HF in ESRD patients on HD using echocardiography pre- and post-HD. We used the structural and functional abnormality criteria of the 2021 European Society of Cardiology guidelines. Results: A total of 54 patients were enrolled. The mean age was 62.6 years, and 40.1% were male. Forty-five patients (83.3%) had hypertension, 28 (51.9%) had diabetes, and 20 (37.0%) had ischemic heart disease. The mean N-terminalpro brain natriuretic peptide BNP (NT-proBNP) level was 12,388.8 ± 2,592.2 pg/dL. The mean ideal body weight was 59.3 kg, mean hemodialysis time was 237.4 min, and mean real filtration was 2.8 kg. The mean left ventricular ejection fraction (LVEF) was 62.4%, and mean left ventricular end-diastolic diameter was 52.0 mm in pre-HD. Post-HD echocardiography showed significantly lower left atrial volume index (33.3 ± 15.9 vs. 40.6 ± 17.1, p = 0.030), tricuspid regurgitation jet V (2.5 ± 0.4 vs. 2.8 ± 0.4 m/s, p < 0.001), and right ventricular systolic pressure (32.1 ± 10.3 vs. 38.4 ± 11.6, p = 0.005) compared with pre-HD. There were no differences in LVEF, E/E′ ratio, or left ventricular global longitudinal strain. A total of 88.9% of pre-HD patients and 66.7% of post-HD patients had either structural or functional abnor‑ malities in echocardiographic parameters according to recent HF guidelines (p = 0.007). Conclusions Our data showed that the majority of patients undergoing hemodialysis satisfy the diagnostic criteria for HF according to current HF guidelines. Pre-HD patients had a 22.2% higher incidence in the prevalence of func‑ tional or structural abnormalities as compared with post-HD patients.

Background: Infantile hemangioma is the most prevalent benign vascular tumor in children, with propranolol being the first line systemic treatment. However, the efficacy of low dose propranolol has not been studied yet. Objective: This study aims to explore the effectiveness of low dose propranolol in treating infantile hemangioma in Korea. Methods: This study is a single-arm, retrospective cohort study to evaluating the efficacy of low dose propranolol (1 mg/kg/d) in treating infantile hemangioma. We collected data of patient’s demographics, lesion characteristics, duration and dosage of propranolol use, residual scar, and other treatments used. We evaluate treatment response of infantile hemangioma based on changes in the size of the lesion. Initially, patients were prescribed propranolol at 1 mg/kg/d and monitored on a monthly basis. In cases where the dermatologist deemed the treatment response was clinically insufficient, the dosage was increased to 2 mg/kg/d. Results: We analyzed 68 patients diagnosed with infantile hemangioma. A total of 86.76% of the patients (59/68) were exclusively treated with propranolol at 1 mg/kg/d, resulting in complete regression in 38.98% and partial regression in 61.02%. A total of 13.24% of patients (9/68) had their dosage increased to 2 mg/kg/d due to insufficient effectiveness, which led to improved conditions in nearly 90% of these patients. Conclusion Low dose propranolol (1 mg/kg) is effective in treating infantile hemangioma. Low dose propranolol is recommended to be used in combination with other treatments or for patients at high risk of propranolol adverse effects.

Postmortem computed tomography (PMCT) is used in forensic medicine worldwide due to its ability to non-invasively visualize injuries, hemorrhage, and estimate volume. In the autopsy of infants, assessing nutritional conditions such as weight is crucial for identifying neglect. This study aims to evaluate the usefulness of retrospectively estimating the weight of Korean infants using PMCT-based volume and multiplication factors, even when the body has been cremated. A total of 44 cases of infant death (under 12 months) were analyzed. PMCT images were obtained before autopsy. Autopsy records and documentation provided by the police at the time of autopsy were reviewed to determine the weight (g) of the infant. PMCT-based infant volumes (mL) were estimated using a three-dimensional semi-automatic segmentation method. Multiplication factors (g/mL) were calculated by dividing the weight recorded at autopsy by the PMCT-based volume, yielding a mean of 1.047 g/mL, ranging from 1.014 g/mL to 1.085 g/mL. The mean absolute error compared to weights recorded at autopsy was 95 g. Significant discrepancies were observed between weights recorded at the scene or medical center and those measured at autopsy. This study demonstrates that PMCT-based weight estimation for Korean infants is a reliable method and has the potential for retrospectively validating incorrect weight measurements and addressing inconsistencies in recorded weight data.

Detecting sphenoid sinus fluid (SSF) is an additional finding in autopsies for diagnosing drowning. SSF can provide additional forensic evidence through laboratory tests such as diatom and electrolyte analyses. If drowning is suspected, accurately assessing the presence and volume of SSF during an autopsy is crucial. Utilizing postmortem computed tomography (PMCT) images could aid in accurately sampling SSF. Accurately segmenting the region of interest is essential for volume analysis using computed tomography images. However, manual segmentation techniques are labor-intensive and time-consuming, and their success depends on the experience of the observer. Therefore, this study aimed to develop a U-Net–based deep learning model for the automatic segmentation of SSF in drowning cases using PMCT images and to evaluate the performance of the model. We retrospectively reviewed 34 drowning cases in which both PMCT scans and forensic autopsies were performed at our institution. The U-Net architecture of deep learning was used for automatic segmentation. The proposed model achieved the Dice similarity coefficient (DSC) and Intersection over Union (IoU) of a maximum of 95.85% and 92.03%, a minimum of 0% and 0%, and an average of 77.15% and 67.18%, respectively. Although the average DSC and IoU did not show high similarity, this study showed that PMCT images can be used for automatic segmentation of SSF in drowning cases, which could improve the performance with sufficient dataset acquisition and further model training.

Benign vascular tumors are relatively common in the head and neck region, but are rarely found in the ear. Among vascular tumors, infantile hemangioma stands as the prevailing entity, characterized by a rapid initial proliferation of endothelial cells, succeeded by a gradual regression over the course of several years. In contrast, arteriovenous malformation (AVM) is a less common phenomenon, originating from peripheral vascular anomalies during embryogenesis, and it does not undergo spontaneous regression. Specifically, the occurrence of AVM within the external auditory canal are exceedingly uncommon. Here, we describe a case of a 49-year-old male patient who had a mass incidentally discovered in the external auditory canal, but refused initial treatment. He later returned as the mass enlarged. This case could have been clinically misdiagnosed as a hemangioma, but was ultimately diagnosed pathologically as an AVM.