Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Purpose: This study aimed to develop and evaluate the effectiveness of the Trauma-nursing Education and Skill Support (TESS) program based on the ADDIE model (Analysis, Design, Development, Implementation, Evaluation model). The program was designed to enhance trauma nurses’ clinical competencies, including trauma-related knowledge, self-efficacy, and problem-solving ability, through the integration of theoretical education and simulation-based practice. Methods: A quasi-experimental study using a non-equivalent control group pretest–posttest design was conducted. Participants included 108 trauma nurses from regional trauma centers, military trauma centers, and emergency care facilities, who were assigned to an experimental group (n=52) or a control group (n=56). The TESS program consisted of a 2-day, 14-hour blended-learning course that included eight lecture sessions and four simulation-based practice stations. Data were collected at baseline, immediately after the intervention, and at 6 months using validated instruments measuring trauma-related knowledge, self-efficacy, and problem-solving ability. Two-way repeated-measures analysis of variance was used for data analysis. Results: The experimental group demonstrated significant improvements in trauma-related knowledge, self-efficacy, and problem-solving ability compared with baseline (all p<.001). These improvements were sustained at 6 months, although trauma-related knowledge scores showed a slight decline compared with immediate posttest levels. Between-group analyses confirmed significant group-by-time interaction effects for all outcomes: trauma-related knowledge (η2=0.12, p<.001), self-efficacy (η2=0.09, p=.002), and problem-solving ability (η2=0.08, p=.003). Conclusion The TESS program effectively enhanced trauma nurses’ trauma-related knowledge, self-efficacy, and problem-solving ability, with effects sustained for up to 6 months. Incorporating blended learning and simulation-based training into standardized trauma nursing education may strengthen clinical competencies and ultimately contribute to improved patient outcomes.

Limited data exist regarding the real-world practices and clinical outcomes in patients with ischemic heart failure with reduced left ventricular ejection fractions (LVEFs).Using nationwide registry data from South Korea, we aimed to investigate long-term outcomes and clinical practices, especially implantable cardioverter defibrillators (ICDs) implantation, in patients with reduced LVEFs at least 40 days after acute myocardial infarction (AMI). Of 13,056 patients with AMI between 2011 and 2015, we analyzed 350 (median age, 66 years [interquartile range, 56-75]) who had LVEFs <40% on follow-up transthoracic echocardiogram 40 days after the index event. The primary outcome was cardiac-cause mortality at 3 years. Secondary outcomes comprised major cardiovascular events as well as outcomes defined by the use of ICDs, cardiac resynchronization therapy defibrillators (CRT-Ds), and electrophysiology studies. Among 350 patients, 39 (11.1%) died from cardiac causes during 3 years of follow-up. Eleven (3.1%) were hospitalized for ventricular tachycardia. The rate of ICD or CRT-D implantation up to 3 years was 5.7% (20/350). Cox time-to-event analysis revealed older age, LVEF <30%, diabetes mellitus, and previous MI or revascularization as positively associated with cardiac death, whereas the use of statins and body weight <67 kg were negatively associated. This nationwide Korean registry demonstrated that only 5.7% of patients who had reduced LVEFs after 40 days of AMI underwent ICD implantations over 3 years. Considering the high mortality, concerted efforts are needed to improve clinical outcomes for patients who may have been candidates for ICD implantation.

Bipolar disorder (BD) is a highly heritable psychiatric condition characterized by recurrent alternations between manic and depressive episodes. This review summarizes recent advances in understanding the genetic architecture of BD, spanning early heritability and candidate gene studies through genome-wide and sequencing-based discoveries, and discusses the potential clinical implications of these findings.Current concepts: Family and twin studies have established the substantial heritability of BD, whereas early candidate gene approaches focusing on neurotransmitter and circadian pathways demonstrated limited reproducibility. In contrast, large-scale genome-wide association studies have identified numerous common risk variants implicating synaptic signaling, calcium channel function, and neurodevelopmental processes. Complementary exome and whole-genome sequencing studies have further uncovered rare variants and structural alterations contributing to disease risk. Epigenome-wide association studies additionally reveal how genetic variants interact with DNA methylation and chromatin accessibility to regulate transcription. Emerging multi-ancestry research, including studies involving Korean cohorts, has expanded understanding of both shared and population-specific loci. Functionally, BD risk genes converge on biological networks involved in neurotransmission, ion channel regulation, neurodevelopment, circadian rhythm regulation, and immune-inflammatory pathways.Discussion and conclusion: Despite these genomic advances, translation into routine clinical practice remains limited. Integrating genetic findings with multi-omics data and detailed clinical phenotypes may improve diagnostic precision, enhance prediction of treatment response (e.g., lithium efficacy and adverse drug reactions), and support the development of personalized psychiatry. Future research should prioritize cross-ancestry analyses, functional validation, and causal inference frameworks to bridge the gap between genetic discovery and clinical application.

Background: Chromosomal alterations serve as diagnostic and prognostic markers in acute leukemia. Given the evolving landscape of chromosomal abnormalities in acute leukemia, we previously studied these over two periods. In this study, we investigated the frequency of these abnormalities and clinical trends in acute leukemia in Korea across three time periods. Methods: We retrospectively analyzed data from 1,787 patients with acute leukemia (319 children and 1,468 adults) diagnosed between 2006 and 2020. Conventional cytogenetics, FISH, and multiplex quantitative PCR were used for analysis. The patient groups were divided according to the following three study periods: 2006–2009 (I), 2010–2015 (II), and 2016–2020 (III). Results: Chromosomal aberrations were detected in 92% of patients. The PML::RARA translocation was the most frequent. Over the 15-yr period, chromosomal aberrations showed minimal changes, with specific fusion transcripts being common among patients.ALL was more prevalent in children than in adults and correlated significantly with the ETV6::RUNX1 and RUNX1::RUNX1T1 aberrations. The incidence of ALL increased during the three periods, with PML::RARA remaining common. Conclusions The frequency of chromosomal abnormalities in acute leukemia has changed subtly over time. Notably, the age of onset of adult AML has continuously increased. Our results may help in establishing diagnoses and clinical treatment strategies and developing various molecular diagnostic platforms.

Purpose: To evaluate the short-term efficacy and safety of latanoprostene bunod 0.024% in patients with primary open-angle glaucoma. Methods: A retrospective study was conducted from September 2022 to September 2023, involving 29 eyes from patients diagnosed with primary open-angle glaucoma. The study analyzed the intraocular pressure (IOP)-lowering effects of latanoprostene bunod 0.024% at 1 and 3 months after administration. Additionally, adverse events reported by patients at each visit were documented. Results: The mean age of patients at the start of treatment was 64.46 years. The baseline IOP was 17.46 ± 4.03 mmHg, which significantly decreased to 15.07 ± 4.23 mmHg (p = 0.002) at 1 month (29 eyes) and 14.93 ± 3.86 mmHg (p = 0.002) at 3 months (28 eyes) after latanoprostene bunod administration. After 1 month, 9 patients reported adverse events, including conjunctival hyperemia (1 eye, 3.5%), itching (2 eyes, 6.9%), foreign body sensation (2 eyes, 6.9%), stinging (2 eyes, 6.9%), ocular pain (2 eyes, 6.9%), and deepening of the upper eyelid sulcus (1 eye, 3.5%). The patient who experienced deepening of the upper eyelid sulcus discontinued treatment. After 3 months, 2 eyes with itching discontinued treatment due to conjunctival allergy. Conclusions Latanoprostene bunod 0.024% demonstrated short-term efficacy in reducing IOP and a manageable safety profile in patients with primary open-angle glaucoma.

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.

The loss of occlusal vertical dimension due to multiple tooth loss and wear can lead to a collapsed occlusion, resulting in both functional and aesthetic problems.This case report describes a patient exhibiting mandibular prognathism as a result of vertical dimension loss. A comprehensive oral rehabilitation involving an increase in vertical dimension was required. A minimal number of implants were placed, and implant-supported surveyed crowns were fabricated, allowing for the design of a stable and retentive implant-assisted removable partial denture. The treatment resulted in both functional and aesthetic improvements. The anterior rotational pattern of the mandible was alleviated, and the implant-assisted partial denture provided clinically high levels of patient satisfaction. This case report details the diagnostic and therapeutic processes involved in this treatment.

Crossbite refers to a condition where there are remaining teeth, but none of the teeth are in occlusal contact, resulting in the loss of vertical support. When posterior vertical stop is lost, it is important to appropriately restore this support and create a harmonious occlusal plane. In this case, the patient had lost posterior support but declined surgical intervention due to a history of osteoporosis and the associated risk of medication-related osteonecrosis of the jaw (MRONJ). To restore the vertical space required for prosthetic rehabilitation, the vertical dimension was increased. The missing posterior teeth were replaced using removable partial dentures. Cross-mounting was performed, and the metal copings of the surveyed crowns and the framework of the final removable partial denture were 3D printed. After the treatment was completed, the patient expressed satisfaction with both functions and aesthetics. Regular follow-ups were conducted to monitor oral hygiene and occlusal stability.

Objective: Recently, various mental health promotion programs using virtual reality (VR) technology have been tried in the psychiatric field. Considering the importance of mental health in pregnant women, VR-assisted mental health promotion programs for pregnant women are needed to be developed. This study aimed to prospectively investigate the efficacy of a VR-assisted mental health promotion program for pregnant women. Methods: Fifty-five pregnant women were participated in this study. Mental health states such as depression, anxiety, perceived stress, and quality of life were assessed by Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Stress Scale, and World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) before and after using VR program treatment. Based on the mental health types of pregnant women classified by cluster analysis, the effects of the VR program were analyzed by paired t test and Wilcoxon signed rank test. Results: The VR program significantly reduced PHQ-9 (p = 0.033) and GAD-7 (p = 0.046) scores, and significantly increased WHOQOL-BREF (p = 0.026) score of the participants. Additionally, when classifying the mental health types of pregnant women, the VR program was significantly effective to improve depression, anxiety, and quality of life in the most severe group based on the cluster analysis. Conclusion The results of this study suggest that VR program may be effective to improve the mental health of pregnant women. Particularly, VR programs for the high-risk group of depression might be the most effective. Therefore, VR-assisted mental health promotion programs could be useful for managing the mental health in pregnant women.