The sixth edition of the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) was published in 2025. This review compared KMAP-DD 2025 with four major international clinical practice guidelines: Canadian Network for Mood and Anxiety Treatments Clinical Guidelines for the Management of Major Depressive Disorders, National Institute for Health and Care Excellence Depression Guideline, Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines for Mood Disorders, and British Association for Psychopharmacology Guideline. While KMAP-DD is based on expert consensus, and others on evidence-based methods, overall treatment strategies for depressive episodes were fairly consistent. Especially, KMAP-DD 2025 offers more structured recommendations in areas lacking strong evidence, such as premenstrual dysphoric disorder, perinatal depression, and depression with medical comorbidities. KMAP-DD 2025 also reflected Korean clinical practice patterns emphasizing rapid symptom relief and early use of combination strategies. Despite limitations as a consensus-based guideline, KMAP-DD 2025 complements evidence-based approaches and provides practical, situation-specific guidance for real-world clinical decision-making in Korea.

OBJECTIVES: Kudoa septempunctata has been identified as the causative agent of food poisoning following the consumption of raw farmed Paralichthys olivaceus. However, cohort studies providing robust evidence for an association between K. septempunctata and gastrointestinal symptoms remain limited. This prospective cohort study investigated the association between the consumption of K. septempunctata–infected farmed P. olivaceus and the occurrence of gastrointestinal symptoms. METHODS: Individuals who purchased raw farmed P. olivaceus between 2020 and 2021 were selected as the study population. Study data included 2 rounds of questionnaire surveys administered before and after consumption, 2 muscle specimens obtained from each purchased fish, and human biological specimens collected from individuals who developed gastrointestinal symptoms within 24 hours after consumption. Data were analyzed using the chi-square test and t-test, and the association between consumption of K. septempunctata–infected farmed P. olivaceus and gastrointestinal symptoms was evaluated using relative risk estimates between exposure groups. RESULTS: The relative risk of gastrointestinal symptoms associated with exposure to K. septempunctata–infected P. olivaceus ranged from 71.2 (95% confidence interval [CI], 27.0 to 178.6) to 124.5 (95% CI, 43.5 to 355.0) across the 2 case definitions. A strong and statistically significant association was observed between exposure to K. septempunctata–infected P. olivaceus and the development of acute gastrointestinal symptoms. CONCLUSIONS These findings indicate both an association and a causal relationship between consumption of K. septempunctata–infected farmed P. olivaceus and the onset of gastrointestinal symptoms.

Pancreatic cancer is an aggressive malignancy in which early detection is critical but challenging. Because population-wide screening is not feasible, surveillance efforts have increasingly focused on individuals with hereditary susceptibility or a strong family history, who carry a substantially elevated lifetime risk. Evidence from recent prospective cohorts demonstrates that structured surveillance enables detection at earlier stages, improving resectability and survival in selected high-risk groups. Magnetic resonance imaging and endoscopic ultrasonography currently serve as complementary modalities. However, limitations remain, including reduced sensitivity for subtle lesions, variability in risk criteria and surveillance protocols, and uncertainties regarding the economic feasibility. Emerging approaches―including liquid biopsybased biomarkers, artificial intelligence-assisted imaging, and integrated risk stratification models―show promise for enhancing the precision and sustainability of future programs. This review summarizes the current recommendations for pancreatic cancer surveillance in highrisk individuals and highlights evidence from recent studies.

Vaccines are highly effective, but rare or delayed adverse events following immunization (AEFIs) require post-licensure surveillance beyond clinical trials. Korea lacks a comprehensive, active, database-based framework, yet key assets exist: nationwide claims databases (National Health Insurance Service/Health Insurance Review and Assessment Service), the national immunization registry (Korea Disease Control and Prevention Agency’s Immunization Registry Information System) for National Immunization Program (NIP) and non-NIP vaccines, and increasingly standardized hospital electronic health records.We propose a federated, code to data architecture with data linkages between these data.Implementation should adopt a common data model (CDM), standardized case definitions, latency accounting, and transparent public reporting under strong privacy governance. Major challenges include multi step administrative approvals for data linkage, incomplete capture of adult non-NIP vaccinations, heterogeneous hospital data structures, and strict data protection constraints. Strategic priorities are to streamline statutory and administrative processes for public health use, mandate or enable claims-based capture of adult vaccinations, enhance CDM based interoperability, and develop secure hubs for aggregated outputs. With these measures, Korea will be well positioned to establish a scalable active surveillance system capable of detecting rare AEFIs, supporting transparent and evidence-based communication, and ensuring equitable injury compensation grounded in domestic data.

Purpose: This study aimed to compare the acute effects of isometric handgrip (IHG) and wall squat (IWS) exercise on 24-hour ambulatory blood pressure (BP) and related indices in young men with prehypertension. Methods: Ten young men with prehypertension (aged 25.0±2.3 years) completed three randomized crossover conditions: IHG, IWS, and control. Twenty-four-hour ambulatory BP monitoring was used to assess 24-hour, daytime, and nighttime mean BP, BP variability (BPV; average real variability and standard deviation), morning BP, and nocturnal dipping pattern. Office BP was measured at baseline, 30 minutes, and 90 minutes after each condition. Results: Twenty-four hour, daytime, and nighttime systolic and diastolic BP did not differ significantly among conditions. BPV indices also showed no significant between-condition differences across 24-hour, daytime, or nighttime periods. Nocturnal systolic BP dipping averaged 5%–8% and did not differ among conditions, indicating a nondipper pattern in all trials. Morning systolic BP, sleep-trough surge, and prewaking surge were similar across conditions. Office BP showed no significant condition or interaction effects; however, both IHG and IWS tended to lower BP at 90 minutes compared with control session. Conclusion A single bout of IHG or IWS did not elicit significant changes in 24-hour ambulatory BP, BPV, morning BP, or dipping pattern in young men with prehypertension. Nonetheless, the small acute reductions in office and morning BP suggest that isometric exercise may have potential as a time-efficient adjunctive strategy for early BP management. Larger and longer-term studies are needed to confirm these findings.

Purpose: Inspiratory muscle strength training is a time-efficient strategy for lowering blood pressure, but the acute vascular effects and its hemodynamic characteristics remain unclear. This study aimed to determine the acute effects of inspiratory muscle strength exercise (IMSE) on vascular function and shear patterns. Methods: In a single-arm acute trial, 12 young adults (aged 26±2 years) performed a single bout of IMSE (about 8 minutes) consisting of 30 breaths (6 breaths×5 sets) at 60% of maximal inspiratory pressure. Vascular function indices were assessed as endothelial function and arterial stiffness. Measurements of endothelial function via flow-mediated dilation (FMD) in the brachial artery and arterial stiffness by carotid-femoral pulse wave velocity (cfPWV) were taken at baseline, 10 minutes, and 40 minutes post-IMSE. Shear rate (SR) responses were continuously obtained throughout the IMSE session at the brachial artery and were analyzed as mean SR, anterograde SR, and retrograde SR. Results: Compared to baseline, cfPWV significantly decreased (7.95±0.9 m/sec to 7.49±0.9 m/sec, p=0.033) and FMD increased (4.76%±1.0% to 6.26%±1.1%, p＜ 0.001) at post-10 min. Both cfPWV and FMD returned to baseline levels at post-40 min. During IMSE, mean SR and anterograde SR significantly increased (both, p＜ 0.05), whereas retrograde SR decreased (p=0.032) during inter-set rest periods. In addition, rhythmic fluctuations in SR were observed corresponding to inspiration and expiration phases. Conclusion These findings suggest that an acute bout of IMSE is associated with improved endothelial function and arterial stiffness. IMSE may elicit distinct hemodynamic responses during exercise, which may be linked to improvements in vascular function.

Purpose: We compared short-term clinical outcomes after cataract surgery with implantation of a novel refractive extended depth-of-focus TECNIS PureSee intraocular lens (IOL) between patients with stage 1 epiretinal membrane (ERM)—characterized by a thin membrane over the macula with preserved foveal depression―and those with a normal retina. Methods: This retrospective study included 60 eyes of 60 patients who underwent cataract surgery with implantation of the TECNIS PureSee IOL between January 2024 and January 2025: 30 eyes with stage 1 ERM and 30 eyes with a normal retina. Preoperative characteristics, including age, sex distribution, cataract severity, corrected distance visual acuity (CDVA), and higher-order aberrations, were compared between groups, as were IOL power and target refraction. Postoperative outcomes at 1 month―including CDVA, uncorrected distance, intermediate, and near visual acuity, ocular aberrations, and contrast sensitivity―were evaluated. Results: There were no significant differences in preoperative characteristics, such as age, sex distribution, cataract grade, CDVA, higher-order aberrations, IOL power, or target refraction between the two groups. At 1 month postoperatively, CDVA, uncorrected distance, intermediate, and near visual acuity, higher-order aberrations, and contrast sensitivity exhibited no significant differences between groups. Conclusions In this short-term analysis, the PureSee IOL demonstrated comparable efficacy and safety in cataract patients with stage 1 ERM to those with a normal retina.

Purpose: To evaluate the efficacy and safety of latanoprostene bunod 0.024% (LBN) in Korean patients with glaucoma or ocular hypertension in a real-world clinical setting. Methods: This retrospective study included patients who initiated LBN treatment between March 1, 2022, and December 31, 2024. Patients were categorized into monotherapy, switched therapy, and concomitant therapy groups. Changes in intraocular pressure (IOP) were assessed at baseline, month 1, and month 6 according to treatment group and diagnosis. The type and frequency of adverse events were also analyzed. Results: Among the 138 patients initially identified, 129 were included in the analysis. The mean IOP for all patients was 17.4 ± 4.9 mmHg at baseline, 16.0 ± 4.6 mmHg at month 1, and 14.6 ± 3.7 mmHg at month 6. The mean IOP reduction was -1.4 ± 2.8 mmHg at month 1 (p < 0.001) and -2.2 ± 3.3 mmHg at month 6 (p < 0.001). Subgroup analyses by treatment type (monotherapy, switched, and concomitant) and diagnosis revealed significant IOP reductions at both time points across all groups. Adverse events occurred in 22 patients (17.1%), with eye pain being the most frequent. No serious adverse events were observed, including systemic side effects, severe visual impairment, or significant ocular complications. Conclusions LBN significantly reduced IOP in Korean patients with glaucoma and ocular hypertension, irrespective of prior IOP-lowering medication use and was well tolerated with a favorable safety profile. These findings support the use of LBN as an effective treatment option for Korean patients with glaucoma or ocular hypertension in diverse clinical settings.

Background: s/Aims: Phase angle (PhA), as measured by bioelectrical impedance analysis, provides insights into hydration and nutritional status, making it a prognostic indicator of frailty. While low preoperative PhA has been linked to postoperative complications in cancer patients, its predictive value in individuals undergoing pancreaticoduodenectomy (PD) has not been thoroughly investigated.This study aims to evaluate the clinical utility of preoperative PhA in predicting postoperative complications for patients undergoing PD. Methods: Among 41 patients who underwent PD at Seoul National University Hospital between September and December 2024, 35 were included in the analysis after excluding 6 patients who had concomitant blood vessel or other organ resections. Patients were divided into low (Comprehensive Complication Index [CCI] ≤ 20) and high (CCI > 20) complication groups based on the CCI, derived from the Clavien–Dindo classification. The differences in PhA between the two groups were analyzed, and logistic regression was performed to assess the relationship between PhA and CCI. Results: The mean PhA was significantly lower in the high-CCI group compared to the low-CCI group (5.7° vs. 6.7°, p = 0.025). Multivariate logistic regression analysis indicated that PhA (odds ratio: 0.17; 95% confidence interval: 0.04–0.68; p = 0.012) was an independent predictor of high CCI. A low preoperative PhA was associated with an increased risk of postoperative complications following PD. Conclusions Preoperative PhA may serve as a valuable predictive indicator of postoperative complications after PD, enabling the identification of patients who could benefit from preoperative prehabilitation, including nutritional support.

Purpose: We aimed to compare the final adult height (FAH) of male patients with central precocious puberty (CPP) after treatment with a gonadotropin-releasing hormone agonist (GnRHa). Specifically, we compared FAH with the target height (TH) and the predicted adult height (PAH) before and after GnRHa treatment to quantify height gain and identify predictive factors. Methods: We retrospectively reviewed the medical records of 92 male patients with CPP and known FAH after GnRHa treatment at the Department of Pediatrics of Severance Children’s Hospital between January 2000 and June 2024. Results: The mean duration of GnRHa treatment was 2.7±1.3 years. A significant 1.1±0.9 years narrowing was observed in the difference between bone age (BA) and chronological age (CA) during treatment (P<0.001). TH was 172.4±3.4 cm. FAH was 173.6±6.4 cm. FAH was greater than TH by 1.2±5.9 cm (P=0.047). PAH before and after treatment was 179.9±8.1 and 181.2±7.4 cm, respectively. PAH was increased by 1.3±4.9 cm (P=0.012) after treatment. As the PAH standard deviation score (SDS) before GnRHa treatment increased, FAH tended to exceed TH. In contrast, higher testosterone levels before treatment are associated with FAH falling below TH. A longer duration of treatment and taller TH are associated with an FAH SDS greater than height SDS before treatment. Conversely, a greater weight SDS, BA–CA difference, and testis size before treatment are associated with FAH SDS being less than height SDS before GnRHa treatment. Conclusion GnRHa treatment improved FAH and inhibited bone maturation in male patients with CPP.