Venous leg ulcers (VLUs) represent the most advanced manifestation of chronic venous disease and arise from sustained ambulatory venous hypertension due to superficial reflux, deep venous obstruction, or both. Accurate etiologic assessment is essential, with duplex ultrasound serving as the primary tool to identify axial reflux, perforator incompetence, and signs of proximal outflow obstruction in accordance with contemporary ESVS and SVS/AVF guidelines. Compression therapy remains the foundation of treatment, with inelastic or adjustable compression systems providing the most effective pressure reduction and edema control. Optimal wound care—including moisturebalancing dressings, debridement, and judicious use of antimicrobials—supports timely epithelialization. Adjunctive pharmacologic agents such as micronized purified flavonoid fraction, pentoxifylline, and sulodexide may further enhance healing. Early correction of superficial reflux accelerates healing and reduces recurrence, as demonstrated in the Early Venous Reflux Ablation trial. Iliac venous obstruction should be considered in nonhealing or recurrent ulcers, with IVUS-guided stenting appropriate when significant stenosis is confirmed. Integrating guideline-directed venous intervention, optimized compression, and structured wound care is central to improving long-term outcomes in VLU management.

Purpose: Incidental prostate cancer (IPCa) is frequently discovered during radical cystectomy (RC) for bladder cancer. While small-scale Korean studies have reported IPCa in 36%–50% of cases and clinically significant prostate cancer (sPCa) in up to 20%, large-scale data assessing its oncologic impact remain scarce. Materials and Methods: We retrospectively analyzed 1,358 male patients who underwent RC between June 1996 and January 2024. IPCa was histologically confirmed and classified per the International Society of Urological Pathology (ISUP) system. sPCa was defined as ISUP grade group (GG) ≥2. Kaplan-Meier analyses were conducted to evaluate survival outcomes. Results: IPCa was identified in 240 patients (17.7%), among whom 7.51% had sPCa. The distribution of ISUP GG was: GG1, 53.8%; GG2, 27.9%; GG3, 9.6%; GG4, 2.5%; and GG5, 1.7%. The proportion of sPCa remained stable across 3 time periods (p=0.281). Mean preoperative prostate-specific antigen (PSA) levels significantly differed among GG1, GG2, and GG3+ groups (2.14±2.37, 4.31±6.69, and 5.86±7.66 ng/mL, respectively; p<0.001). Mean patient age also varied significantly (67.99±8.39, 71.54±8.60, and 72.97±5.53 years; p<0.001). After a median follow-up of 44 months, deaths were unrelated to IPCa. Biochemical recurrence (BCR), defined as PSA ≥0.2 ng/mL, occurred in 11 patients (4.58%), with rates of 3.10%, 4.48%, and 12.12% in GG1, GG2, and GG3+ groups, respectively. Overall mortality rates across GG groups were similar (33.3%, 34.3%, and 33.3%; p=0.99). Compared to GG1, hazard ratios for overall survival were 1.03 (GG2, p=0.92), 0.87 (GG3, p=0.76), and 1.05 (GG4–5, p=0.89). Conclusion In this large Korean cohort, IPCa and sPCa were frequently detected at rates similar to global reports. Bladder cancer remained the primary determinant of survival. For older patients with elevated PSA, radical cystoprostatectomy may offer added benefit by treating undiagnosed high-risk IPCa.

Background: Human adenovirus (HAdV) is a common cause of acute respiratory disease (ARD) and has raised significant concerns within the Korean military. Here, we conducted a comprehensive epidemiological analysis of HAdV-associated ARD by evaluating its prevalence, clinical outcomes, and prognosis. Methods: We reviewed data from multiple sources, including the New Defense Medical Information System, Defense Medical Statistical Information System, Ministry of National Defense, Army Headquarters, Navy Headquarters, Air Force Headquarters, and Armed Forces Medical Command. We analyzed data of patients who underwent polymerase chain reaction (PCR) testing for respiratory viruses between January 2013 and July 2022 in all 14 Korean military hospitals. The analysis included the PCR test results, demographic characteristics, health care utilization, and prognosis including types of treatments received, incidence of pneumonia, and mortality. Results: Among the 23,830 individuals who underwent PCR testing at Korean military hospitals, 44.78% (10,670 cases) tested positive for respiratory viruses. Across all military types and ranks, HAdV was the most prevalent virus, with a total of 8,580 patients diagnosed, among HAdV, influenza virus, human metapneumovirus, human parainfluenza virus, and human respiratory syncytial virus. HAdV-infected patients exhibited higher rates of healthcare use compared to non-HAdV-infected patients, including a greater number of emergency visits (1.04 vs. 1.02) and outpatient visits (1.31 vs. 1.27), longer hospitalizations (8.14 days vs. 6.84 days), and extended stays in the intensive care unit (5.21 days vs. 3.38 days).Furthermore, HAdV-infected patients had a higher proportion of pneumonia cases (65.79%vs. 48.33%) and greater likelihood of receiving advanced treatments such as high flow nasal cannula or continuous renal replacement therapy. Conclusion Our findings indicate that HAdV posed a significant public health concern within the Korean military prior to the coronavirus disease 2019 (COVID-19) pandemic. Given the potential for a resurgence of outbreaks in the post-COVID-19 era, proactive measures, such as education, environmental improvements, and the development of HAdV vaccines, are crucial for effectively preventing future outbreaks.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, patients with myasthenia gravis (MG) were more susceptible to poor outcomes owing to respiratory muscle weakness and immunotherapy. Several studies conducted in the early stages of the COVID-19 pandemic reported higher mortality in patients with MG compared to the general population. This study aimed to investigate the clinical course and prognosis of COVID-19 in patients with MG and to compare these parameters between vaccinated and unvaccinated patients in South Korea. Methods: This multicenter, retrospective study, which was conducted at 14 tertiary hospitals in South Korea, reviewed the medical records and identified MG patients who contracted COVID-19 between February 2022 and April 2022. The demographic and clinical characteristics associated with MG and vaccination status were collected. The clinical outcomes of COVID-19 infection and MG were investigated and compared between the vaccinated and unvaccinated patients. Results: Ninety-two patients with MG contracted COVID-19 during the study. Nine (9.8%) patients required hospitalization, 4 (4.3%) of whom were admitted to the intensive care unit. Seventy-five of 92 patients were vaccinated before contracting COVID-19 infection, and 17 were not. During the COVID-19 infection, 6 of 17 (35.3%) unvaccinated patients were hospitalized, whereas 3 of 75 (4.0%) vaccinated patients were hospitalized (P < 0.001). The frequencies of ICU admission and mechanical ventilation were significantly lower in the vaccinated patients than in the unvaccinated patients (P = 0.019 and P = 0.032, respectively). The rate of MG deterioration was significantly lower in the vaccinated patients than in the unvaccinated patients (P = 0.041). Logistic regression after weighting revealed that the risk of hospitalization and MG deterioration after COVID-19 infection was significantly lower in the vaccinated patients than in the unvaccinated patients. Conclusion This study suggests that the clinical course and prognosis of patients with MG who contracted COVID-19 during the dominance of the omicron variant of COVID-19 may be milder than those at the early phase of the COVID-19 pandemic when vaccination was unavailable. Vaccination may reduce the morbidity of COVID-19 in patients with MG and effectively prevent MG deterioration induced by COVID-19 infection.

BACKGROUND/OBJECTIVES: The prevalence of hypertension is increasing, and noodles have a high sodium content, so noodle consumption might be associated with a higher prevalence of hypertension. This study aimed to analyze the association between total and types of noodle intake and the risk of hypertension among Korean adults. Subjects aged 40–69 years were selected for this study. SUBJECTS/METHODS: This study included 56,580 participants (18,246 men and 38,334 women) aged 40–69 years old from the Health Examinees study. Noodle and nutrient intakes were assessed using the food frequency questionnaire. Hypertension was diagnosed as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or antihypertensive medication use. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for hypertension. RESULTS: Higher noodle consumption was associated with increased hypertension among men (HR, 1.273; 95% CI, 1.166–1.390) and women (HR, 1.116; 95% CI, 1.038–1.199). CONCLUSION We recommended reducing noodle intake and consuming vegetables and fruits to increase potassium intake, which can prevent vascular diseases.

BACKGROUND/OBJECTIVES: Poly-γ-glutamic acid (γ-PGA), a natural polymer found in fermented soybean products, has been reported to play a prebiotic role in the gut. This intervention study investigated the effects of γ-PGA-containing supplement consumption on urinary microbiota in healthy adults because of limited data on such investigation. SUBJECTS/METHODS: A 4-week parallel trial including 39 male and female Korean adults, who were free of chronic diseases and infection, was designed as a randomized, doubleblinded, placebo-controlled study. A total of 30 participants completed the study wherein the intervention group (n = 17) received a mixture supplement containing 600 mg/day of γ-PGA and 100 mg/day of vitamin B6, while the control group (n = 13) received a placebo.Paired datasets (baseline and endpoint data) of microbiota profiles, which were constructed via urinary assays of microbe-derived extracellular vesicles, were analyzed and compared between the two groups. RESULTS: Only the intervention group yielded significant results for the Bray-Curtis and Jaccard dissimilarity indices between baseline and endpoint data (P < 0.05). In the phylumlevel analysis of microbial composition, the Firmicutes to Bacteroidetes ratio (FB ratio) tended to decrease from baseline in the intervention group; however, it increased in the control group.Differences between the baseline and endpoint FB ratios were significant between the two groups (P < 0.05). CONCLUSION This study’s findings suggest that γ-PGA-vitamin B6 supplementation potentially alters the microbial community composition of a host. Further investigation into the biological consequences of commensal microbiota alteration by γ-PGA-containing supplement consumption is warranted.

Background/Aims: Epicardial adipose tissue (EAT) shares pathophysiological properties with other visceral fats and potentially triggers local inflammation. However, the association of EAT with cardiovascular disease (CVD) is still debatable. The study aimed to observe the changes and associations in EAT and risk factors over time, as well as to investigate whether EAT was associated with CVD. Methods: A total of 762 participants from Seoul National University Hospital (SNUH) and SNUH Gangnam Center were included in this study. EAT was measured using coronary computed tomography angiography. Results: Baseline EAT level was positively associated with body mass index (BMI), calcium score, atherosclerotic cardiovascular disease (ASCVD) 10-year risk score, glucose, triglycerides (TG)/high-density lipoprotein (HDL), but not with total cholesterol, low-density lipoprotein (LDL). At follow-up, EAT levels increased in all groups, with low EAT groups demonstrating a significant increase in EAT per year. Change in EAT was associated with a change in BMI, TG/HDL, and glucose, while changes in LDL, calcium score, and ASCVD 10-year risk score were not associated. Although calcium score and ASCVD 10-year risk score were associated with CVD events, baseline information of EAT, baseline EAT/body surface area, or EAT change was not available. Conclusions Metabolic risks, e.g., BMI, TG/HDL, and glucose, were associated with EAT change per year, whereas classical CVD risks, e.g., LDL, calcium score, and ASCVD 10-year risk score, were not. The actual CVD event was not associated with EAT volume, warranting future studies combining qualitative assessments with quantitative ones.