Osteopenia—defined by a bone mineral density T-score between −1.0 and −2.5—is more common than osteoporosis and accounts for most fragility fractures in postmenopausal women. Approximately 50% of Korean women aged ≥ 50 years have osteopenia. Despite this high prevalence, optimal therapeutic strategies remain unclear. This review summarizes the clinical significance and management of osteopenia. Clinical practice often categorizes osteopenia into mild, moderate, and severe based on specific T-score ranges. Studies indicate that women transitioning from normal or moderate osteopenia to lower bone density experience more fractures. One study reported that approximately 10% of women with normal BMD or osteopenia progressed to osteoporosis, mostly from moderate to severe osteopenia groups. Fracture risks, particularly for hip and vertebral fractures, are elevated mainly in moderate to severe osteopenia.The National Osteoporosis Foundation and the American Association of Clinical Endocrinologists incorporate FRAX® scores alongside T-scores and clinical history to guide pharmacological intervention. Accordingly, South Korean guidelines classify fracture-risk groups as low, moderate, high, or very high, allowing treatment of patients with osteopenia in the high-risk categories. Evidence supporting medications for fracture prevention remains limited. However, growing interest in preventing fractures has directed the ongoing studies to evaluate various drugs. Food and Drug Administration-approved treatments include menopausal hormone therapy, bisphosphonates, and selective estrogen receptor modulators. To reduce fractures in postmenopausal women, treatment should not be restricted to osteoporosis alone. Women with moderate to severe osteopenia may also benefit from medications used for osteoporosis. Clinicians should assess individual fracture risks and select preventive treatments based on risk level, fracture site, menopausal symptoms, patient preference, and cost-effectiveness.

Since its introduction, laparoscopic surgery has been often preferred over open surgery in obstetrics and gynecology due to its advantages, such as less bleeding, lower incidence of adhesions, reduced postoperative pain, short hospital stay, and quick return to daily life. However, in the case of complex surgeries, laparoscopy presented some limitations. Nonetheless, since the 1980s, medical robots have been introduced to overcome the technical limitations of laparoscopy and start a new age for minimally invasive surgery. In this review, we explore the indications and advantages and disadvantages of robotic surgery in the field of gynecology, and try to assess the recent trend of robotic surgery.

Background: Topical timolol is widely used for treatment of superficial infantile hemangioma (IH). However, little is known about factors that affect the response to topical timolol treatment. Objective: This study aimed to investigate the efficacy, safety, and predictive value for good response to topical timolol for IH. Methods: A retrospective review of medical records and clinical photos of 328 patients with IH treated with topical timolol 0.5% solution was conducted. Serial clinical photographs were compared with those at the initial visit using a 100-mm visual analogue scale (VAS). Treatment response was defined as an improvement of at least 75% from baseline in IH lesions within 12 months of treatment. Results: Overall, IH patients treated with topical timolol showed significant improvement from baseline, showing that the final VAS score within 12 months of treatment was 69.7±20.4. The multivariable logistic regression analysis showed age at initiation of treatment (p=0.007), length of gestation and fetal growth (p=0.03), depth (p=0.01), and flexural area (p=0.007) were significantly associated with treatment response. Only four patients (1.1%) reported local irritation. Conclusion This study demonstrated that topical timolol treatment was an effective and well-tolerated treatment for IHs. Physicians are encouraged to consider several patient- or lesional factors that might affect treatment response to achieve better clinical outcomes.

A schwannoma can develop anywhere along the course of nerves. However, a schwannoma presenting as a scalp nodule is rare. Here, we present a rare case of schwannoma on the scalp with a review of magnetic resonance imaging (MRI) findings, which was initially misdiagnosed as an epidermal cyst or vascular malformation despite various radiologic examinations. Recognition of characteristic MRI features of schwannomas, such as low signal margin, target, entering-and-exiting-nerve, and fascicular signs, may result in an accurate diagnosis and proper management of tumors. In this report, we summarized differential characteristics of a schwannoma with an epidermal cyst and a lipoma.

OBJECTIVE: To develop a simplified functional scale and classification system to evaluate the functional abilities of patients with Duchenne muscular dystrophy (DMD). METHODS: A Comprehensive Functional Scale for DMD (CFSD) was developed using the modified Delphi method. The accompanying Ambulatory Functional Classification System for DMD (AFCSD) was developed based on previously published classification systems. RESULTS: The CFSD consists of 21 items and 78 sub-items, assessing body structure and function, activities, and participation. Inter-rater intraclass correlation coefficient values were above 0.7 for 17 items. The overall limits of agreement between the two examiners ranged from -6.21 to 3.11. The Spearman correlation coefficient between the total score on the AFCSD and the Vignos Functional Scale was 0.833, and 0.714 between the total score of the AFCSD and the Brooke scale. Significant negative correlations existed between the total score for each functional level of the AFCSD and each functional grade of the Vignos and Brooke scales. The total scores of the CFSD varied significantly between the functional grades of the Vignos scale, and specific grades of the Brooke scale. For the AFCSD, total scores of the CFSD varied significantly between the functional levels. CONCLUSION: We have developed a new scale and the associated classification system, to assess the functional ability of children diagnosed with DMD. Preliminary evaluation of the psychometric properties of the functional scale and classification systems indicate sufficient reliability and concurrent validity.
Child ; Classification* ; Humans ; Methods ; Muscular Dystrophy, Duchenne* ; Psychometrics ; Reproducibility of Results* ; Weights and Measures

No abstract available.
Syphilis*

No abstract available.
Cell Lineage* ; Dendritic Cells*

Insomnia is a common sleep-related symptom which occurs in many populations, however, the neural mechanism underlying insomnia is not yet known. The hyperarousal model explains the neural mechanism of insomnia to some extent, and the frontal cortex dysfunction has been known to be related to primary insomnia. In this review, we discuss studies that applied resting state and/or task-related functional magnetic resonance imaging to demonstrate the deficits/dysfunctions of functional activation and network in primary insomnia. Empirical evidence of the hyperarousal model and proposed relation between the frontal cortex and other brain regions in primary insomnia are examined. Reviewing these studies could provide critical insights regarding the pathophysiology, brain network and cerebral activation in insomnia and the development of novel methodologies for the diagnosis and treatment of insomnia.
Brain ; Diagnosis ; Frontal Lobe* ; Magnetic Resonance Imaging* ; Sleep Initiation and Maintenance Disorders*

No abstract available.
Lymphoma, T-Cell* ; T-Lymphocytes*

Eccrine poroma is a benign solitary tumor with acrosyringeal differentiation that usually occurs on the sole or either side of the foot. Rapid growth of eccrine poroma during pregnancy has rarely been reported. We demonstrate a unique case of a 37-year-old pregnant woman who suffered from enlarged eccrine poroma on her left palm, which was tiny for 10 years but suddenly grew to a size of bean-sized reddish brown colored, pedunculated mass during pregnancy. The patient denied a previous history of trauma or infection to the lesion. Histopathologic findings with a shave biopsy were consistent with eccrine poroma. After the tumor was completely removed by the shave biopsy, no recurrence was noted for 5 months.
Adult ; Biopsy ; Eccrine Glands ; Female ; Foot ; Humans ; Poroma* ; Pregnancy* ; Pregnant Women ; Recurrence