Background: Transthoracic echocardiography (TTE) requires time-intensive integration of quantitative measure‑ ments and qualitative visual assessment. Fully automated artificial intelligence (AI)-based analysis may reduce total analysis time while preserving accuracy, but systematic real-world validation remains limited. Methods: This prospective, single-center pilot study enrolled 40 TTE examinations. Identical deidentified DICOM datasets were independently provided to a trained cardiac sonographer and a fully automated AI system comprising quantitative and qualitative visual interpretation modules. All outputs were compared with a cardiologist-adjudicated reference standard. Primary endpoints were total analysis time and noninferiority of AI-derived left ventricular ejection fraction (LVEF) versus the reference standard, with a prespecified margin of 3 percentage points (one-sided α = 0.025). Results: Median analysis time was 94 s (interquartile range [IQR], 82–106 s) for the AI workflow versus 490 s (IQR, 438–626 s) for the human workflow (P < 0.001). AI-derived LVEF met the noninferiority criterion (mean difference, 0.00 percentage points; upper one-sided 95% confidence bound, 1.41 percentage points; P < 0.001), with an intraclass correlation coefficient (ICC) of 0.902 (95% confidence interval, 0.822–0.947). ICCs for secondary quantitative indi‑ ces ranged from 0.625 to 0.989. For aortic regurgitation severity grading, AI’s overall accuracy was 75.0% (quadratic weighted κ = 0.762), compared with 82.5% for human interpretation (κ = 0.812, McNemar P = 0.579). Conclusions Fully automated AI-assisted TTE analysis substantially reduced total analysis time while maintaining noninferior LVEF accuracy and acceptable performance across secondary quantitative and qualitative indices. These findings support the use of AI as a practical workflow accelerator in routine echocardiography.

Purpose: Children with tic disorders/Tourette syndrome (TD/TS) frequently present with co-occurring neuropsychiatric conditions, such as obsessive-compulsive disorder and a range of behavioral issues. However, these accompanying problems may be overlooked during diagnosis. This study aimed to investigate the neurocognitive and behavioral characteristics of children with TD/TS who visited a pediatric clinic. Methods: We retrospectively reviewed medical records of children diagnosed with TD/TS at a secondary referral center in Korea. A subset of these data was statistically compared with those from healthy controls. To minimize confounding factors, only children with cognitive development within the normal range were included. Results: Data from 36 children with TD/TS (27 males, nine females; ages 6 to 14 years, mean 9.5±2.1) were analyzed. The mean Full Scale Intelligence Quotient (FSIQ) on the Korean–Wechsler Intelligence Scales for Children (K-WISC) was 98.8±11.7 (n=24). Compared with healthy controls (n=38), the TD/TS group (n=13) scored significantly lower on the Perceptual Reasoning Index, despite no group difference in overall FSIQ (K-WISC-IV). On the Korean Child Behavior Checklist, the TD/TS group showed significantly higher rates of clinical-range scores in multiple domains, including anxiety, somatic complaints, attention problems, and obsessive-compulsive behaviors (P<0.05). The mean Korean-attention-deficit/hyperactivity disorder Rating Scale-IV (K-ARS-IV) score was 11.3±7.7, with 17.1% of participants exceeding the clinical threshold. Conclusion Children with TD/TS and normal cognitive development demonstrate specific neurocognitive weaknesses and elevated behavioral/emotional problems. Early behavioral and cognitive assessments should be incorporated into the initial evaluation.

New psychoactive substances (NPS) have rapidly emerged in illicit drug markets worldwide and are increasingly encountered in postmortem examinations. However, postmortem data on NPS-related deaths remain limited worldwide. This study describes postmortem findings from forensic autopsy cases in which NPS were detected and explores the characteristics of these deaths through a retrospective review. Six postmortem cases were identified between 2023 and 2024. The cases predominantly involved young adults. Toxicological analysis identified synthetic cannabinoids, dissociatives, and a stimulant, either alone or in combination with alcohol or conventional illicit drugs such as methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA). Drug paraphernalia or a documented history of drug use was identified in only some cases. The causes of death included acute intoxication and traumatic deaths in which drug intoxication may have contributed to abnormal behavior and fatal outcomes. These findings provide preliminary forensic evidence of the emergence of NPS in South Korea. They underscore the importance of postmortem examination with comprehensive toxicological screening and continued surveillance of emerging psychoactive substances in forensic practice. They also suggest the value of reviewing a history of prior substance use even in unexpected sudden deaths not initially suspected to be drugrelated.

Chronic kidney disease (CKD) patients are hospitalized for various conditions. Hospitalization increases the readmission rate and mortality rate, seriously deteriorating patients’ quality of life. Consequently, it is crucial to analyze the reasons for hospitalization in CKD patients from a broader perspective according to CKD grade. Methods: This is a prospective cohort study of CKD patients entitled the KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease (KNOW-CKD). A total of 2,238 patients were examined, and the reasons for hospitalization were classified into 16 disease categories. The incidence rate ratio (IRR) according to CKD stage was compared using negative bimodal regression analysis. Results: The all-cause hospitalization incidence was 184.96 per 1,000 person-years. The most common reason for hospitalization was circulatory system disease, followed by infection and digestive system disease. Among hospitalizations for acute kidney injury, endocrine-nutrition-metabolic–related illness, blood-related disease, and diseases of the nervous system and sensory organs, IRR increased as CKD grade advanced. The incidence of ophthalmologic surgery during hospitalization increased according to the CKD stage. The IRR of KNOW-CKD patients was 6.19 (95% confidence interval, 5.92–6.48; p < 0.001) compared with the general population. Conclusion: This in-depth analysis of hospitalizations among CKD patients confirmed that CKD patients were hospitalized for various reasons, such as metabolic, ophthalmic, and hematologic diseases. Early detection and intervention regarding causative diseases of CKD are important to reduce the hospitalization burden and improve patients’ quality of life.

This case report details a rare presentation of multifocal osteomyelitis with bilateral femoral pathologic fractures caused by Klebsiella pneumoniae sepsis in a 54-year-old female patient. In the initial evaluation, the patient presented with swelling and pain in the left lower limb. Imaging revealed multiple liver abscesses and deep vein thrombosis. Further bone scan assessments confirmed extensive osteolytic lesions in the femurs and left tibias, which is consistent with multifocal osteomyelitis. Initial management involved broad-spectrum antibiotics and debridement. On the other hand, temporary circular wiring and intramedullary nailing were required for stabilization as fractures developed in both femurs, including additional fixation for a fracture at the curettage site on the contralateral femur. Infected tibial lesions were treated with antibiotic-loaded cement beads after abscess drainage to control local infection. Despite the complexities, the patient ultimately achieved bone union after a year-long recovery, including dynamic conversion of femoral fixation. This paper reports a rare experience in treating multiple osteomyelitis and introduces the emergence of a highly pathogenic hypervirulent K. pneumoniae strain (hvKP), causing invasive infections, including metastatic and severe infections (e.g., osteomyelitis). Furthermore, the authors emphasize that early identification of hvKP and coordinated treatment strategies are crucial for improving the outcomes in severe hvKP-related infections.

This case report details a rare presentation of multifocal osteomyelitis with bilateral femoral pathologic fractures caused by Klebsiella pneumoniae sepsis in a 54-year-old female patient. In the initial evaluation, the patient presented with swelling and pain in the left lower limb. Imaging revealed multiple liver abscesses and deep vein thrombosis. Further bone scan assessments confirmed extensive osteolytic lesions in the femurs and left tibias, which is consistent with multifocal osteomyelitis. Initial management involved broad-spectrum antibiotics and debridement. On the other hand, temporary circular wiring and intramedullary nailing were required for stabilization as fractures developed in both femurs, including additional fixation for a fracture at the curettage site on the contralateral femur. Infected tibial lesions were treated with antibiotic-loaded cement beads after abscess drainage to control local infection. Despite the complexities, the patient ultimately achieved bone union after a year-long recovery, including dynamic conversion of femoral fixation. This paper reports a rare experience in treating multiple osteomyelitis and introduces the emergence of a highly pathogenic hypervirulent K. pneumoniae strain (hvKP), causing invasive infections, including metastatic and severe infections (e.g., osteomyelitis). Furthermore, the authors emphasize that early identification of hvKP and coordinated treatment strategies are crucial for improving the outcomes in severe hvKP-related infections.

Objectives: Pandemic diseases like COVID-19 could affect people even after they are cured. In this study, we asked COVID-19 survivors whether they showed post-traumatic stress disorder (PTSD) symptoms, and tried to figure out what factors can affect their symptoms. Methods: Approximately 3 months after their discharge, a psychological survey was conducted with 83 adults (38 men and 45 women, mean age 38.6±11.3 years) who had been hospitalized with COVID-19 in an isolation ward. The group was divided according to the presence or absence of PTSD symptoms, and differences in demographic, psychological, and hospitalizationrelated factors between the groups were analyzed using the independent t-test. We conducted hierarchical multiple regression analysis exploring variables affecting PTSD symptoms. Results: Fourteen of the survey respondents (15.8%) reported experiencing PTSD symptoms, including partial PTSD symptoms. The group with PTSD symptoms appeared to have more pain upon admission to hospital, compared to the group without PTSD symptoms. The group with PTSD symptoms showed higher anxiety and depression than the group without PTSD symptoms, and their physical quality of life was found to be low. The presence of PTSD symptoms seemed to be influenced by anxiety sensitivity. Conclusion Our findings suggest that hospitalization in an isolation ward due to COVID-19 may be associated with the development of PTSD symptoms. Anxiety sensitivity could influence the level of PTSD symptoms after discharge. The results of this study suggest the need to monitor and care for the mental health of patients admitted to and discharged from isolation wards due to infection.

We analyzed the manner and cause of death in 1,193 forensic autopsies from the Jungbu province (central part of South Korea) conducted by the National Forensic Service Daejeon Institute in 2022. Analysis of the manner of deaths revealed that 43.1% (514/1,193 cases) were natural deaths; 42.8% (511/1,193 cases) were unnatural deaths; and 14.1% (168/1,193 cases) were unknown. Among the unnatural deaths, the major manner of death was 44.6% (228/511 cases) by accidents, 34.1% (174/511 cases) by suicide, 13.5% (69/511 cases) undetermined, and 7.8% (40/511 cases) by homicide. Among the unnatural deaths, the major causes of death was 38.4% (196/511 cases) by trauma, 20.4% (104/511 cases) by poisoning, and 17.6% (90/511 cases) by asphyxia. Falling was the major cause of death by trauma (58.7%, 115/196 cases), and strangulation was the major cause of death by asphyxia (75.6%, 68/90 cases). Among the natural deaths, heart disease was the major cause (46.7%, 240/514 cases), followed by endocrine, nutritional and metabolic diseases (14.0%, 72/514 cases). A time-series statistical analysis and comparison of the manner and cause of deaths in this province may facilitate more advanced interpretations relating to both public safety and healthcare in the future.

This case report details a rare presentation of multifocal osteomyelitis with bilateral femoral pathologic fractures caused by Klebsiella pneumoniae sepsis in a 54-year-old female patient. In the initial evaluation, the patient presented with swelling and pain in the left lower limb. Imaging revealed multiple liver abscesses and deep vein thrombosis. Further bone scan assessments confirmed extensive osteolytic lesions in the femurs and left tibias, which is consistent with multifocal osteomyelitis. Initial management involved broad-spectrum antibiotics and debridement. On the other hand, temporary circular wiring and intramedullary nailing were required for stabilization as fractures developed in both femurs, including additional fixation for a fracture at the curettage site on the contralateral femur. Infected tibial lesions were treated with antibiotic-loaded cement beads after abscess drainage to control local infection. Despite the complexities, the patient ultimately achieved bone union after a year-long recovery, including dynamic conversion of femoral fixation. This paper reports a rare experience in treating multiple osteomyelitis and introduces the emergence of a highly pathogenic hypervirulent K. pneumoniae strain (hvKP), causing invasive infections, including metastatic and severe infections (e.g., osteomyelitis). Furthermore, the authors emphasize that early identification of hvKP and coordinated treatment strategies are crucial for improving the outcomes in severe hvKP-related infections.

This case report details a rare presentation of multifocal osteomyelitis with bilateral femoral pathologic fractures caused by Klebsiella pneumoniae sepsis in a 54-year-old female patient. In the initial evaluation, the patient presented with swelling and pain in the left lower limb. Imaging revealed multiple liver abscesses and deep vein thrombosis. Further bone scan assessments confirmed extensive osteolytic lesions in the femurs and left tibias, which is consistent with multifocal osteomyelitis. Initial management involved broad-spectrum antibiotics and debridement. On the other hand, temporary circular wiring and intramedullary nailing were required for stabilization as fractures developed in both femurs, including additional fixation for a fracture at the curettage site on the contralateral femur. Infected tibial lesions were treated with antibiotic-loaded cement beads after abscess drainage to control local infection. Despite the complexities, the patient ultimately achieved bone union after a year-long recovery, including dynamic conversion of femoral fixation. This paper reports a rare experience in treating multiple osteomyelitis and introduces the emergence of a highly pathogenic hypervirulent K. pneumoniae strain (hvKP), causing invasive infections, including metastatic and severe infections (e.g., osteomyelitis). Furthermore, the authors emphasize that early identification of hvKP and coordinated treatment strategies are crucial for improving the outcomes in severe hvKP-related infections.