Objective: Perinatal depression often remains undertreated due to concerns about antidepressant exposure during fertility treatment, pregnancy, or breastfeeding. Non-pharmacological, home-based interventions such as transcranial direct current stimulation (tDCS) present a promising alternative; however, real-world evidence in perinatal populations remains limited. Methods: This prospective observational study included 38 women who received infertility, pregnancy, or postpartum treatment at four hospitals in South Korea. Participants self-administered anodal tDCS targeting the left dorsolateral prefrontal cortex for 20–28 sessions over 4 weeks. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and weeks 2, 4, and 8. Subjective health perception was measured at baseline using a 5-point Likert scale. Results: Time had a significant effect on depressive symptoms (Wald χ2=90.75, p<0.001), with the largest reduction observed during the first 2 weeks. The CES-D scores remained significantly lower than baseline at week 8, 4 weeks after treatment ended. Subjective health perception was significantly associated with baseline depression severity (Wald χ2=26.41, p<0.001), and its interaction with time was also significant (Wald χ2=320.18, p<0.001). Participants with poorer perceived health (scores 4–5) experienced greater depressive symptom reductions than those with more favorable perceptions (scores 1–2). Conclusion Home-based tDCS was feasible and associated with clinically meaningful improvement in depressive symptoms among perinatal women. Those who initially perceived their health more negatively showed greater response, suggesting subjective health perception may serve as a useful moderator and potential marker to inform personalized treatment strategies.

Purpose: We evaluated the 3-year clinical outcomes of simultaneous Ahmed valve implantation and vitrectomy in patients with neovascular glaucoma. Methods: We retrospectively reviewed 38 eyes that underwent combined Ahmed valve implantation and vitrectomy. Best-corrected visual acuity, intraocular pressure (IOP), and the number of IOP-lowering medications were assessed preoperatively and up to 36 months postoperatively. Patients were categorized into two groups (anterior chamber and vitreous cavity) based on the site of Ahmed valve tube insertion. Clinical outcomes were compared between the two groups. Surgical success was defined as maintaining IOP between 6 and 21 mmHg, with or without topical IOP-lowering medications. Surgical failure was defined as IOP outside this range despite IOP-lowering therapy, loss of vision to no light perception, or the need for valve replacement or additional Ahmed valve implantation. Results: The overall surgical success rate was 68.4%; rates were 58.8% in the anterior chamber group and 76.2% in the vitreous cavity group. The mean durations of target IOP maintenance were 24.91 ± 3.45 months in the anterior chamber group and 29.00 ± 2.89 months in the vitreous cavity group, with no significant difference between groups (p > 0.05). Changes in visual acuity before and after surgery did not significantly differ between groups. However, at 36 months postoperatively, the vitreous cavity group required significantly more IOP-lowering medications (p = 0.044). The most common complication was encapsulation removal (39.5%), followed by tube obstruction (10.5%). Conclusions Surgical success rates and the duration of target IOP maintenance did not significantly differ between the anterior chamber and vitreous cavity groups. However, patients in the vitreous cavity group required more IOP-lowering medications postoperatively. These findings suggest that the tube insertion site should be considered when planning surgery for neovascular glaucoma.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Purpose: This retrospective study compared the maxillary sinus floor augmentation techniques (lateral and transcrestal approaches) to assess the impact of bone grafting, graft materials, and initial residual bone height (RBH). Materials and Methods: Fifty patients who underwent maxillary sinus floor augmentation for posterior maxillary implant placement were included. Panoramic radiographs were obtained before surgery (T0), immediately after surgery (T1), and 6-10 months post-surgery (T2). Length measurements on panoramic radiographs were performed using a digital caliper at T1 and T2. Statistical validation included one-way ANOVA, t-tests, Mann-Whitney U tests, and correlation analyses. Multivariate linear regression was used to assess associations after adjusting for confounding factors. Results: Of the 50 patients, 35 underwent a transcrestal approach and 15 underwent a lateral approach. The results showed significant endosinus bone gain (ESBG) differences between allogeneic and xenogeneic grafts and no grafts (p < .001). Osteotomy sinus floor elevation without grafting yielded 3.24 ± 1.42 of ESBG. When divided into three groups based on initial RBH, RBH 1 had 27 patients, RBH 2 had 12 patients, and RBH 3 had 11 patients. Within the RBH group 1 (RBH under 4), the lateral approach had significantly greater ESBG than the transcrestal approach (p < .001). Multivariate linear regression analysis confirmed statistically significant associations between the studied variables after adjusting for confounding factors. Conclusion When the RBH is < 4 mm, lateral-approach sinus augmentation and bone grafting should be performed to attain significant ESBG. The RBH, bone graft materials, and sinus elevation techniques vary considerably in ESBG.

Purpose: This study investigated the impact of the guide hole height on the accuracy of implant placement using CAD/ CAM-fabricated surgical guides in resin models. The hypothesis is that decreasing the height of the guide hole reduces placement accuracy. Materials and Methods: Ten identical partially edentulous maxillary models were each fitted with surgical guides featuring guide hole heights of 1 mm, 3 mm, and/or 5 mm. Using a surgical guide and drill kit, implants were placed in six predetermined sites per model. Placement accuracy was evaluated by comparing the actual implant positions with the planned positions using digital scanning and computer software analysis. Statistical analyses were performed using ANOVA and Kruskal-Wallis tests to determine the significance of deviations at both the coronal and apical positions. Results: The average deviations were 0.75±0.33 mm at the coronal position and 1.10±0.51 mm at the apical position. Placement accuracy didnot differ with different guide hole heights. Additionally, errors were consistent regardless of the guide hole height and were not influenced by the type of support or the implant placement site. Conclusion In this rotro study, varying the height of the guide hole did not significantly affect the accuracy of implant placement. The results suggest that guide hole height within the tested range does not have a substantial impact on placement errors. Our findings indicate that factors other than the guide holeheight may play a more critical role in implant placement accuracy.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Objective: Atrial fibrillation (AF) increases the risk of thromboembolic events, making oral anticoagulants (OACs) essential for high-risk patients. This fact sheet provides nationwide statistics on AF management for stroke prevention in Korea. We aimed to evaluate current anticoagulation treatment trends and strategies in Korea.MethodThe Korean national health claims database from the National Health Insurance Service was used. AF patients aged ≥ 18 years from 2013 to 2022 were included. OAC use, including warfarin and non-vitamin K antagonist OACs (NOACs), was tracked through prescription data. The rates of OAC use were calculated based on continued use, considering prescription dates and amounts. For patients with multiple encounters, the last encounter was used for analysis. Results: During the study, 20.4% of strokes were accompanied by AF, with AF diagnosed within 6 months before or after the stroke. The number of patients diagnosed with AF after a stroke increased from 4893 in 2013 to 6978 in 2022. Among newly diagnosed AF patients requiring OACs, 51% were not prescribed OACs within 6 months. OAC treatment rates for high-risk AF patients increased from 44.6% in 2013 to 77.5% in 2022, with NOAC prescriptions rising significantly after 2015. Regional variations in OAC prescription rates were observed, with lower rates in suburban/rural areas than in urban regions (76.0% vs. 79.6%, p < 0.001). Conclusions Considerable strokes could have been prevented with earlier AF detection and OAC treatment through more intensive electrocardiogram screening.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Purpose: This retrospective study compared the maxillary sinus floor augmentation techniques (lateral and transcrestal approaches) to assess the impact of bone grafting, graft materials, and initial residual bone height (RBH). Materials and Methods: Fifty patients who underwent maxillary sinus floor augmentation for posterior maxillary implant placement were included. Panoramic radiographs were obtained before surgery (T0), immediately after surgery (T1), and 6-10 months post-surgery (T2). Length measurements on panoramic radiographs were performed using a digital caliper at T1 and T2. Statistical validation included one-way ANOVA, t-tests, Mann-Whitney U tests, and correlation analyses. Multivariate linear regression was used to assess associations after adjusting for confounding factors. Results: Of the 50 patients, 35 underwent a transcrestal approach and 15 underwent a lateral approach. The results showed significant endosinus bone gain (ESBG) differences between allogeneic and xenogeneic grafts and no grafts (p < .001). Osteotomy sinus floor elevation without grafting yielded 3.24 ± 1.42 of ESBG. When divided into three groups based on initial RBH, RBH 1 had 27 patients, RBH 2 had 12 patients, and RBH 3 had 11 patients. Within the RBH group 1 (RBH under 4), the lateral approach had significantly greater ESBG than the transcrestal approach (p < .001). Multivariate linear regression analysis confirmed statistically significant associations between the studied variables after adjusting for confounding factors. Conclusion When the RBH is < 4 mm, lateral-approach sinus augmentation and bone grafting should be performed to attain significant ESBG. The RBH, bone graft materials, and sinus elevation techniques vary considerably in ESBG.