Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

Background: Adiposity rebound (AR) refers to the period during growth when the body mass index reaches its lowest point before increasing again. The timing of AR is associated with the development of obesity and puberty onset. Although studies have evaluated AR timing in Korean children, none has focused on children born small for gestational age (SGA). Methods: This study analyzed data from a multicenter observational clinical trial (LG Growth Study) to determine AR timing in children born SGA without catch-up growth (CUG) who were treated with growth hormone (GH) therapy. The study also aimed to identify factors associated with AR timing, examine the influence of AR timing on puberty onset, and assess the effectiveness of GH therapy. Results: A total of 151 children born SGA without CUG were included. Of them, 15% experienced AR between 4 and 5 years of age, 42% between 5 and 6 years, 27% between 6 and 7 years, and 16% after 7 years of age. A significant positive correlation was noted between the height standard deviation score at the start of treatment and AR timing. However, no significant correlation was observed between AR timing and puberty onset or the effectiveness of GH therapy. Conclusion This study provides insights into AR timing in prepubertal children who meet the specific SGA criteria and its relationship with growth outcomes. The findings suggest that AR in children born SGA who do not experience CUG occurs later than in the general population, with no significant relationship between AR timing and puberty onset or growth outcomes.

Background: Adiposity rebound (AR) refers to the period during growth when the body mass index reaches its lowest point before increasing again. The timing of AR is associated with the development of obesity and puberty onset. Although studies have evaluated AR timing in Korean children, none has focused on children born small for gestational age (SGA). Methods: This study analyzed data from a multicenter observational clinical trial (LG Growth Study) to determine AR timing in children born SGA without catch-up growth (CUG) who were treated with growth hormone (GH) therapy. The study also aimed to identify factors associated with AR timing, examine the influence of AR timing on puberty onset, and assess the effectiveness of GH therapy. Results: A total of 151 children born SGA without CUG were included. Of them, 15% experienced AR between 4 and 5 years of age, 42% between 5 and 6 years, 27% between 6 and 7 years, and 16% after 7 years of age. A significant positive correlation was noted between the height standard deviation score at the start of treatment and AR timing. However, no significant correlation was observed between AR timing and puberty onset or the effectiveness of GH therapy. Conclusion This study provides insights into AR timing in prepubertal children who meet the specific SGA criteria and its relationship with growth outcomes. The findings suggest that AR in children born SGA who do not experience CUG occurs later than in the general population, with no significant relationship between AR timing and puberty onset or growth outcomes.

Background: Adiposity rebound (AR) refers to the period during growth when the body mass index reaches its lowest point before increasing again. The timing of AR is associated with the development of obesity and puberty onset. Although studies have evaluated AR timing in Korean children, none has focused on children born small for gestational age (SGA). Methods: This study analyzed data from a multicenter observational clinical trial (LG Growth Study) to determine AR timing in children born SGA without catch-up growth (CUG) who were treated with growth hormone (GH) therapy. The study also aimed to identify factors associated with AR timing, examine the influence of AR timing on puberty onset, and assess the effectiveness of GH therapy. Results: A total of 151 children born SGA without CUG were included. Of them, 15% experienced AR between 4 and 5 years of age, 42% between 5 and 6 years, 27% between 6 and 7 years, and 16% after 7 years of age. A significant positive correlation was noted between the height standard deviation score at the start of treatment and AR timing. However, no significant correlation was observed between AR timing and puberty onset or the effectiveness of GH therapy. Conclusion This study provides insights into AR timing in prepubertal children who meet the specific SGA criteria and its relationship with growth outcomes. The findings suggest that AR in children born SGA who do not experience CUG occurs later than in the general population, with no significant relationship between AR timing and puberty onset or growth outcomes.

Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

Background: Adiposity rebound (AR) refers to the period during growth when the body mass index reaches its lowest point before increasing again. The timing of AR is associated with the development of obesity and puberty onset. Although studies have evaluated AR timing in Korean children, none has focused on children born small for gestational age (SGA). Methods: This study analyzed data from a multicenter observational clinical trial (LG Growth Study) to determine AR timing in children born SGA without catch-up growth (CUG) who were treated with growth hormone (GH) therapy. The study also aimed to identify factors associated with AR timing, examine the influence of AR timing on puberty onset, and assess the effectiveness of GH therapy. Results: A total of 151 children born SGA without CUG were included. Of them, 15% experienced AR between 4 and 5 years of age, 42% between 5 and 6 years, 27% between 6 and 7 years, and 16% after 7 years of age. A significant positive correlation was noted between the height standard deviation score at the start of treatment and AR timing. However, no significant correlation was observed between AR timing and puberty onset or the effectiveness of GH therapy. Conclusion This study provides insights into AR timing in prepubertal children who meet the specific SGA criteria and its relationship with growth outcomes. The findings suggest that AR in children born SGA who do not experience CUG occurs later than in the general population, with no significant relationship between AR timing and puberty onset or growth outcomes.

Irritable bowel syndrome (IBS) is a chronic, disabling, and functional bowel disorder that significantly affects social functioning and reduces quality of life and increases social costs. The Korean Society of Neurogastroenterology and Motility published clinical practice guidelines on the management of IBS based on a systematic review of the literature in 2017, and planned to revise these guidelines in light of new evidence on the pathophysiology, diagnosis, and management of IBS. The current revised version of the guidelines is consistent with the previous version and targets adults diagnosed with or suspected of having IBS. These guidelines were developed using a combination of de novo and adaptation methods, with analyses of existing guidelines and discussions within the committee, leading to the identification of key clinical questions. Finally, the guidelines consisted of 22 recommendations, including 3 concerning the definition and risk factors of IBS, 4 regarding diagnostic modalities and strategies, 2 regarding general management, and 13 regarding medical treatment. For each statement, the advantages, disadvantages, and precautions were thoroughly detailed. The modified Delphi method was used to achieve expert consensus to adopt the core recommendations of the guidelines. These guidelines serve as a reference for clinicians (including primary care physicians, general healthcare providers, medical students, residents, and other healthcare professionals) and patients, helping them to make informed decisions regarding IBS management.

We report a patient with whole neuroaxis dissemination of a sporadic supratentorial hemangioblastoma (HB) for more than 15 years. A 68-year-old female patient presented with severe radiating pain in the right leg. Gadolinium-enhanced lumbar spine MRI showed an intradural mass (2.5 cm in diameter) at the L4 level. The patient had been severely disabled for 22 years after a previous intraventricular brain tumor resection. At that time, the diagnosis was angioblastic meningioma, which was thought to be incorrect. At 14 years after the brain surgery, gamma knife radiosurgery was performed three times for newly developed or recurred supratentorial and infratentorial tumors in the cerebrospinal fluid pathway. The patient underwent lumbar spinal surgery, and a gross total removal of the mass was performed, which confirmed the histopathological diagnosis of HB. We reexamined the old histopathological specimen of the intraventricular tumor from 20 years ago and changed the diagnosis from angioblastic meningioma to supratentorial HB. Six months after spinal surgery, the patient underwent a second spinal surgery and brain surgery, and the histopathological diagnosis was HB following both surgeries, which was the same following the first spinal surgery. Here, we report a sporadic supratentorial HB patient who showed cranial and spinal disseminations for more than two decades along with a literature review

Background: Delayed postoperative hyponatremia (DPH) is the most common cause of readmission after pituitary surgery. In this study, we aimed to evaluate the cutoff values of serum copeptin and determine the optimal timing for copeptin measurement for the prediction of the occurrence of DPH in patients who undergo endoscopic transsphenoidal approach (eTSA) surgery and tumor resection. Methods: This was a prospective observational study of 73 patients who underwent eTSA surgery for pituitary or stalk lesions. Copeptin levels were measured before surgery, 1 hour after extubation, and on postoperative days 1, 2, 7, and 90. Results: Among 73 patients, 23 patients (31.5%) developed DPH. The baseline ratio of copeptin to serum sodium level showed the highest predictive performance (area under the curve [AUROC], 0.699), and its optimal cutoff to maximize Youden’s index was 2.5×10–11, with a sensitivity of 91.3% and negative predictive value of 92.0%. No significant predictors were identified for patients with transient arginine vasopressin (AVP) deficiency. However, for patients without transient AVP deficiency, the copeptin-to-urine osmolarity ratio at baseline demonstrated the highest predictive performance (AUROC, 0.725). An optimal cutoff of 6.5×10–12 maximized Youden’s index, with a sensitivity of 92.9% and a negative predictive value of 94.1%. Conclusion The occurrence of DPH can be predicted using baseline copeptin and its ratio with serum sodium or urine osmolarity only in patients without transient AVP deficiency after pituitary surgery.

OBJECTIVES: Salmonellosis outbreaks occurred at 2 restaurants 2 days apart, and an epidemiological investigation was conducted to determine whether the outbreaks were connected. METHODS: Case studies were conducted for both outbreaks. Stool samples were collected from individuals, and food samples were collected from the restaurants. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing analyses were performed on outbreak-related Salmonella enterica serovar Enteritidis (Salmonella Enteritidis) isolates. Traceback investigations were also conducted for the ingredients from gimbap restaurants A and B. RESULTS: In total, 106 people from gimbap restaurant A and 5 from gimbap restaurant B met the case definition. Salmonella Enteritidis was detected in samples from 2 food handlers, 22 patients, and 1 food (iceberg lettuce) at gimbap restaurant A and from 1 patient at gimbap restaurant B. According to PFGE, all isolates were identified as SEGX01.089. The molecular typing of all isolates showed the same pattern, and the genetic distance was close according to phylogenetic analysis. Eggs were the only food ingredient that was supplied to both gimbap restaurants. CONCLUSIONS The outbreaks were caused by Salmonella Enteritidis, and the source of infections was suspected to be contaminated eggs. To prevent foodborne outbreaks of Salmonella, restaurants should heat eggs sufficiently, and egg farms need to establish management systems that prevent Salmonella infections.