Purpose: This study was conducted to revise the Nutrition Quotient for Preschool children (NQ-P), a tool for evaluating the overall dietary quality and eating behavior among Korean preschool-aged children. Methods: At the first stage, 20 items for assessing dietary behavior were selected based on the previous NQ-P checklist, incorporating the results of the Seventh Korea National Health and Nutrition Examination Survey, national nutrition policies, dietary guidelines, and recent literature reviews. A pilot study was conducted with 100 preschool children residing in Seoul and Gyeonggi Province, using an 18-item checklist. After exploratory factor analysis and expert consultation, 15 items were finalized for use in nationwide survey checklists. The nationwide survey was conducted with a stratified sample of 800 preschool children across six metropolitan cities. Confirmatory factor analysis was used to revise the NQ-P 2021 and make it suitable for the structural equation model. Results: The NQ-P 2021 was developed using 15 checklist items organized into three factors:balance (7 items), moderation (4 items), and practice (4 items). The standardized path coefficients were used as item weights to determine the nutrition quotients. The weights of balance, moderation, and practice were 0.40, 0.15, and 0.45, respectively. In the nationwide survey, the mean NQ-P 2021 score was 59.67. The average scores for balance, moderation, and practice were 51.00, 62.45, and 66.46, respectively. Conclusion The revised NQ-P 2021 provides a validated and practical tool for assessing the dietary quality and eating behaviors of preschool children in Korea.

With the growth of the population of older adults, cement-augmented pedicle screws (CAPS) have become more commonly employed. Although CAPS are considered safe, cement leakage can occur, leading to complications. Neurological symptoms resulting from bone cement leakage pose significant challenges in both diagnosis and treatment. Unilateral biportal endoscopy (UBE) offers a minimally invasive solution for these issues. UBE enables a thorough exploration of potential compression sites, allowing precise visualization of the entire nerve roots without necessitating removal of the instrument or compromising spinal stability. Additionally, it facilitates the removal of cement fragments under direct vision. Herein, we present the case of an 84-year-old female patient who underwent endoscopic interbody fusion of L4–5. After surgery, she presented with radiating pain in the right lower extremity. Postoperative magnetic resonance imaging indicated indirect evidence of cement leakage under the right L5 pedicle screw. The patient underwent UBE exploration under spinal anesthesia. During the procedure, the cement fragment was detected and removed without complication. UBE can also be performed under local or regional anesthesia, significantly reducing the anesthetic risk for medically fragile individuals. Using UBE, it is also possible to monitor neurological function while manipulating the neural tissue. UBE is a viable option for both the diagnosis and treatment of cement leakage following CAPS placement.

Objective: With advances in endoscopic surgery, L5–S1 foraminotomy has become a readily accessible surgical technique. However, symptom relief is often short-lived, and recurrence is common. As an alternative, biportal endoscopic fusion at L5–S1 can improve symptoms. However, it can be challenging and may lead to fusion-related complications. Therefore, we aimed to compare 2 procedures for L5–S1 foraminal stenosis. Methods: A total of 37 patients diagnosed with L5–S1 foraminal stenosis were divided into 2 groups for this study. Group 1, comprising 18 patients, underwent L5–S1 foraminotomy via a paraspinal approach from 2017 to 2019. Group 2, comprising 19 patients, underwent biportal endoscopic L5–S1 fusion with the facet-sacrificing approach from January 2021 to August 2023. A comprehensive evaluation of both groups was conducted using various metrics, including image findings, operation time, hospital stay, visual analogue score (VAS) back, VAS leg, Oswestry Disability Index (ODI), and the MacNab criteria. Postsurgical complications were meticulously recorded. The statistical analysis was performed using the Wilcoxon signed-rank test, and differences between the 2 surgical approaches were assessed using the Mann-Whitney U-test. Results: No statistically significant difference was found in VAS back or ODI improvement between the 2 groups. However, the foraminotomy group exhibited a statistically significant advantage in terms of operation time and hospital stay. Conversely, the fusion group demonstrated statistically significant improvements in VAS leg and McNab criteria in comparison to the foraminotomy group. The most prevalent complication observed in the foraminotomy group was early symptom recurrence, while the fusion group experienced complications related to screw-related issues and infections. Conclusion Leg symptoms recurred more frequently in the foraminotomy group. Biportal endoscopic facet-sacrificing transforaminal lumbar interbody fusion surgery has been demonstrated to be a valuable technique for L5–S1 fusion with lower recurrence of leg symptoms; however, it is associated with complications specific to fusion.

The usefulness of the living kidney donor profile index (LKDPI) has not been widely demonstrated; therefore, it requires verification before clinical application. We analyzed the LKDPI using data from the Korean Organ Transplantation Registry (KOTRY) to confirm whether the LKDPI can be used to predict the survival of allografts in living donor kidney transplantation (LDKT) patients in Korea. Methods: The study population was obtained from the KOTRY database. A total of 2,598 kidney recipients registered in the KOTRY database were enrolled between May 2014 and December 2020. Donor and recipient information was observed, and the LKDPI was measured. Results: Median LKDPI score was 15.5 with a follow-up duration of 33.7 ± 16.1 months. According to LKDPI scores (group 1, <0; group 2, 0–20; group 3, 20–40; and group 4, >40), LKDPI group 4 had significantly higher death-censored graft loss than LKDPI group 1 (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.06– 3.40; p = 0.03). When divided based on the cutoff value (LKDPI, 36.6), the high LKDPI group had higher graft loss than the low LKDPI group (HR, 2.14; 95% CI, 1.37–3.34; p < 0.001). When follow-up was repeated after transplantation, it was confirmed that the higher the LKDPI value was, the lower the average estimated glomerular filtration rate (p < 0.001). Conclusion: This study confirmed that LKDPI can serve as an independent predictor for assessing the risk of allograft failure and transplant outcomes in Korean LDKT patients.

Background: Calcineurin inhibitor (CNI) toxicity is a significant cause of graft dysfunction in kidney transplant recipients, yet distinguishing it from acute rejection (AR) and acute tubular necrosis (ATN) remains challenging. This study investigated the use of urinary mRNA biomarkers as a noninvasive tool for identifying CNI toxicity. Methods: We retrospectively enrolled 110 kidney transplant recipients and classified them into four groups based on pathological findings: stable graft function (n=35), CNI toxicity (n=25), AR (n=30), and ATN (n=20). Candidate biomarkers were selected using the GEO database. Urinary mRNA was extracted from cell pellets, reverse-transcribed, and quantified by real-time polymerase chain reaction. Results: Estimated glomerular filtration rates were comparable among the CNI toxicity, AR, and ATN groups. Four transcripts (LTF, NNMT, WFDC2, and HIF1A) were identified as candidate biomarkers. Urinary mRNA levels of LTF, NNMT, and HIF1A were significantly lower in the CNI toxicity group than the AR group. NNMT and HIF1A levels were also significantly lower than those observed in the ATN group. In contrast, WFDC2 levels did not differ significantly across groups. A three-gene signature (LTF, NNMT, and HIF1A) effectively differentiated CNI toxicity from AR and ATN (area under the curve [AUC], 0.867;95% confidence interval [CI], 0.787–0.947) and significantly enhanced the diagnostic performance of the clinical variable-based model (AUC increased from 0.776; 95% CI, 0.660–0.892, to 0.934; 95% CI, 0.881–0.986). Conclusions Urinary mRNA levels of LTF, NNMT, and HIF1A may serve as useful biomarkers for identifying CNI toxicity in kidney transplant recipients with graft dysfunction.

Fungal sinusitis is relatively rare, but it has become more common in recent years. When fungal sinusitis invades the orbit, it can cause proptosis, chemosis, ophthalmoplegia, retroorbital pain, and vision impairment. We present a case of an extensive orbital floor defect due to invasive fungal sinusitis. A 62-year-old man with hypertension and a history of lung adenocarcinoma, presented with right-side facial pain and swelling. On admission, the serum glucose level was 347 mg/dL, and hemoglobin A1c was 11.4%. A computed tomography scan and a Waters’ view X-ray showed right maxillary sinusitis with an orbital floor defect. On hospital day 3, functional endoscopic sinus surgery was performed by the otorhinolaryngology team, and an aspergilloma in necrotic inflammatory exudate obtained during exploration. On hospital day 7, orbital floor reconstruction with a Medpor Titan surgical implant was done. In principle, the management of invasive sino- orbital fungal infection often begins with surgical debridement and local irrigation with an antifungal agent. Exceptionally, in this case, debridement and immediate orbital floor reconstruction were performed to prevent enophthalmos caused by the extensive orbital floor defect. The patient underwent orbital floor reconstruction and received intravenous and oral voriconazole. Despite orbital invasion, there were no ophthalmic symptoms or sequelae.

Purpose: This study examined the impact of adolescents’ dietary behavior on their quality of life using the nutrition quotient for adolescents (NQ-A) for some high school students in Seoul. Methods: The subjects were 176 high school students living in Seoul. The NQ-A was used to assess the dietary quality, and the quality of life was assessed by categorizing it into life satisfaction, environment, health, participation and safety, leisure activities, and emotional factors using survey questions validated through previous studies. Results: The NQ score of the survey subjects was 49.30 points. Based on the NQ scores, 7.4%, 46.6%, and 46.0% of participants were categorized as the ‘high’, ‘medium’, and ‘low’ groups, respectively. The total NQ score and balance, diversity, and practice factor scores were positively correlated with life satisfaction, environment, health, participation and safety, and leisure activities among the quality of life subscales. Regression analysis showed that the total NQ score was positively associated with life satisfaction, health, leisure activities, and emotions; the moderation factor was negatively associated with life satisfaction and health. The balance factor was positively associated with the environmental factor. The practice factor was positively associated with health, leisure activities, and emotions, and the environment factor was negatively associated with emotions. Conclusion These results show that adolescents’ quality of life is closely related to their diet, so it is necessary to maintain a balanced and varied food intake and desirable eating behaviors to improve adolescents’ quality of life. Furthermore, adolescents’ quality of life is influenced by other factors. Therefore, further research is needed to assess the quality of life, including dietary factors, as well as physical, emotional, psychological, and social development.

BACKGROUND/OBJECTIVES: Zinc is an essential trace mineral which is important for the growth and development of the human body and immunological and neurological functions.Inadequate zinc intake may cause zinc deficiency with its adverse consequences. In this study, we aimed to estimate the dietary zinc intake levels and sources among Koreans. SUBJECTS/METHODS: For this secondary analysis, we obtained data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2019. Individuals aged ≥ 1 yr who had completed a 24-h recall were included. The dietary zinc intake of each individual was calculated by applying data from a newly developed zinc content database to the KNHANES raw data. We also compared the extracted data with the sex-, age-specific reference values suggested in the Korean Dietary Reference Intakes 2020. The prevalence of adequate zinc intake was then evaluated by the proportion of the individuals who met the estimated average requirement (EAR). RESULTS: The mean zinc intake of Koreans aged ≥ 1 yr and adults aged ≥ 19 yrs were 10.2 and 10.4 mg/day, equivalent to 147.4% and 140.8% of the EAR, respectively. Approximately 2 in 3 Koreans met the EAR for zinc, but the zinc intake differed slightly among the different age and sex groups. In children aged 1–2 yrs, 2 out of 5 exceeded the upper level of intake, and nearly half of the younger adults (19–29 yrs) and the elders (≥ 75 yrs) did not meet the EAR. The major contributing food groups were grains (38.9%), meats (20.4%), and vegetables (11.1%). The top 5 food contributors to zinc intake were rice, beef, pork, egg, and baechu kimchi, which accounted for half of the dietary intake. CONCLUSION The mean zinc intake among Koreans was above the recommended level, but 1 in 3 Koreans had inadequate zinc intake and some children were at risk of excessive zinc intake. Our study included zinc intake from diet only, thus to better understand zinc status, further research to include intake from dietary supplements is needed.

BACKGROUND/OBJECTIVES: The purpose of this study was to establish a database (DB) of foods containing vitamin D that were investigated in the Korea National Health and Nutrition Examination Survey (KNHANES), to estimate the dietary vitamin D intake, to evaluate the dietary adequacy of this intake, and to identify the major food sources of Koreans that contain vitamin D. SUBJECTS/METHODS: This study used data from the KNHANES 2016–2019. Individuals aged ≥ 1 year who participated in the nutrition survey (n = 28,418) were included. The dietary intake was assessed by the 24-h dietary recall method and individual dietary vitamin D intake was estimated using a newly established vitamin D DB. Dietary adequacy was evaluated by comparing the dietary intake of the participants with adequate intake (AI) as defined by Dietary Reference Intakes for Koreans (KDRIs) 2020. RESULTS: The average dietary vitamin D intake for all the subjects was 3.13 μg/d, which was 33.1% of AI. Dietary vitamin D intake was lower in rural residents, the elderly, and those with low income. The major food groups that contributed to the total dietary vitamin D intake were fish and shellfish (61.59%), eggs (17.75%), meat (8.03%), milk (4.25%), legumes (3.93%), and grains (3.84%). The top 10 individual food items that contributed to the total vitamin D intake were eggs (17.44%), squid (8.5%), eels (7.44%), salmon (5.35%), mackerel (5.27%), anchovies (4.65%), yellow croakers (4.58%), pork meat (4.47%), soymilk (4.46%), and skipjack tuna (3.80%). CONCLUSION These results show that the mean dietary vitamin D intake of Koreans is lower than the reference AI level. Nutritional policies need to be put in place to increase the vitamin D intake of Koreans in the future. In addition, comprehensive research on all the sources of vitamin D, including intake of supplements and biosynthesis in the skin, is required.

BACKGROUND/OBJECTIVES: Magnesium is an essential nutrient for human health.However, inadequate intake is commonly reported worldwide. Along with reduced consumption of vegetables and fruits and increased consumption of refined or processed foods, inadequate magnesium intake is increasingly reported as a serious problem.This study aimed to assess magnesium intake, its dietary sources, and the adequacy of magnesium intake in Korean populations. SUBJECTS/METHODS: Data was obtained from the Korea National Health and Nutrition Examination Survey 2016–2019 and included individuals aged ≥1 yr who had participated in a nutrition survey (n=28,418). Dietary intake was assessed by 24-h recall, and dietary magnesium intake was estimated using a newly established magnesium database. Diet adequacy was evaluated by comparing dietary intake with the estimated average requirement (EAR) suggested in the Korean Dietary Reference Intakes 2020. RESULTS: The mean dietary magnesium intake of Koreans aged ≥1 yr was 300.4 mg/d, which was equivalent to 119.8% of the EAR. The prevalence of individuals whose magnesium intake met the EAR was 56.8%. Inadequate intake was observed more in females, adolescents and young adults aged 12–29 yrs, elders aged ≥65 yrs, and individuals with low income. About four-fifths of the daily magnesium came from plant-based foods, and the major food groups contributing to magnesium intake were grains (28.3%), vegetables (17.6%), and meats (8.4%). The top 5 individual foods that contributed to magnesium intake were rice, Baechu (Korean cabbage) kimchi, tofu, pork, and milk. However, the contribution of plant foods and individual contributing food items differed slightly by sex and age groups. CONCLUSIONS This study found that the mean dietary magnesium intake among Koreans was above the recommended intake, whereas nearly one in 2 Koreans had inadequate magnesium intake. To better understand the status of magnesium intake, further research is required, which includes the intake of dietary supplements.