This study investigated the molecular mechanism of phenotypic switching of vascular smooth muscle cells (VSMCs), which play a crucial role in vascular remodeling using 9H-Carbazol-3-yl 4-aminobenzoate (CAB). CAB significantly attenuated platelet-derived growth factor (PDGF)-induced VSMC proliferation and migration. CAB suppressed PDGF-induced STAT3 activation by directly binding to the SH2 domain of STAT3. Downregulation of STAT3 phosphorylation by CAB attenuated CIAPIN1/JAK2/STAT3 axis through a decrease in CIAPIN1 transcription. Furthermore, abrogated CIAPIN1 decreased KLF4-mediated VSMC dedifferentiation and increased CDKN1B-induced cell cycle arrest and MMP9 suppression. CAB inhibited intimal hyperplasia in injury-induced neointima animal models by inhibition of the CIAPIN1/JAK2/STAT3 axis. However, CIAPIN1 overexpression attenuated CAB-mediated suppression of VSMC proliferation, migration, phenotypic switching, and intimal hyperplasia. Our study clarified the molecular mechanism underlying STAT3 inhibition of VSMC phenotypic switching and vascular remodeling and identified novel active CAB. These findings demonstrated that STAT3 can be a major regulator to control CIAPIN1/JAK2/STAT3 axis that may be a therapeutic target for treating vascular proliferative diseases.

Despite the widespread impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019, COVID-19) and vaccination in South Korea, our understanding of kidney diseases following these events remains limited. We aimed to address this gap by investigating the characteristics of glomerular diseases following the COVID-19 infection and vaccination in South Korea. Methods: Data from multiple centers were used to identify de novo glomerulonephritis (GN) cases with suspected onset following COVID-19 infection or vaccination. Retrospective surveys were used to determine the COVID-19–related histories of patients who were initially not implicated. Bayesian structural time series and autoregressive integrated moving average models were used to determine causality. Results: Glomerular diseases occurred shortly after the infection or vaccination. The most prevalent postinfection GN was podocytopathy (42.9%), comprising primary focal segmental glomerulosclerosis and minimal change disease, whereas postvaccination GN mainly included immunoglobulin A nephropathy (IgAN; 57.9%) and Henoch-Schönlein purpura nephritis (HSP; 15.8%). No patient progressed to end-stage kidney disease. Among the patients who were initially not implicated, nine patients with IgAN/HSP were recently vaccinated against COVID-19. The proportion of glomerular diseases changed during the pandemic in South Korea, with an increase in acute interstitial nephritis and a decrease in pauci-immune crescentic GN. Conclusion: This study showed the characteristics of GNs following COVID-19 infection or vaccination in South Korea. Understanding these associations is crucial for developing effective patient management and vaccination strategies. Further investigation is required to fully comprehend COVID-19’s impact on GN.

Meningiomas are common intracranial tumors; however, reports on extracranial cutaneous meningiomas are exceedingly rare. A 77-year-old woman visited our hospital with an asymptomatic child fist-sized mass on the scalp.Biopsy results indicated nuclear atypia and mitoses of sarcomatous cells. Brain magnetic resonance imaging revealed a subgaleal mass with strong enhancement. Suspecting sarcoma, wide excision was performed jointly by the departments of plastic surgery and neurosurgery, during which no evidence of cranial invasion was noted. In the surgical specimen, numerous mitoses of sarcomatous cells and poorly formed nests of epithelioid cells were observed. This led to the diagnosis of anaplastic meningioma without intracranial origin. Subsequently, the patient received adjuvant radiotherapy and is currently under close follow-up. Anaplastic meningioma is rare, but early diagnosis is important as it enables timely and appropriate treatment, thus, improving survival rates. Dermatologists should remain vigilant as meningiomas can manifest as cutaneous scalp nodules, and their accurate diagnosis can profoundly impact prognosis.

Objective: Oral frailty is associated with a decline in overall function in the elderly and increases the risk of dysphagia and aspiration pneumonia. Early diagnosis is essential to prevent these issues. This study aimed to determine the correlation between the Korean oral frailty diagnostic criteria and oral diadochokinesis (ODK) in community-dwelling elderly individuals. Methods: Six diagnostic criteria for oral frailty were examined and ODK was assessed in 100 elderly individuals aged 60 years and above residing in the Gangwon State. The correlation was analyzed using Pearson’s correlation, Spearman’s rank correlation, and multiple regression analysis. Results: The study found that elderly individuals in the later stages of life had significantly lower tongue pressure, occlusal force, chewing ability, and ODK compared to those in earlier stages. Additionally, increased age and decreased chewing ability and tongue pressure were significantly associated with a decline in ability to rapidly repeat monosyllables /pʌ/tʌ/kʌ/. Conclusion As age increases in the elderly population, the frequency of /pʌ/tʌ/kʌ/ in ODK assessments may serve as a simple screening tool for oral frailty in community-dwelling elderly individuals.

Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

OBJECTIVES: This study aimed to establish the validity—specifically, the sensitivity and specificity—of the screening questionnaire and diagnostic criteria for oral frailty proposed by the Korean Academy of Geriatric Dentistry (KAGD) among community-dwelling older adults. METHODS: This study enrolled 100 participants. Among various definitions of oral frailty, this study used the criteria proposed by Tanaka as the reference test. The screening questionnaire consisted of 11 items for screening physical frailty, chewing ability, swallowing difficulties, oral dryness, and tongue and lip motor function. Each question had a different scoring weight, and if the total score was 1 or higher, an oral frailty diagnostic examination proposed by the KAGD would be recommended. The diagnostic test was the oral frailty diagnostic criteria proposed by the KAGD including 6 measures: chewing ability, occlusal force, tongue pressure, oral dryness, swallowing difficulty, and oral hygiene. If a participant exhibited 2 or more positive measures, this participant was classified as “oral frail.” The screening questionnaire was analyzed using a cut-off value of 1 or higher, while the diagnostic criteria utilized a cut-off of 2 or more positive measures. Sensitivity and specificity were calculated. RESULTS: The screening questionnaire showed significant power for screening oral frailty (area under the receiver operating characteristic curve, 0.783; sensitivity, 87.8%; specificity, 52.5%). The diagnostic accuracy of the newly proposed diagnostic criteria was acceptable (sensitivity, 95.1%; specificity, 42.4%). CONCLUSIONS The newly proposed screening questionnaire and diagnostic criteria in Korea appear to be a useful tool to identify oral frailty in community-dwelling older adults.

Purpose: This study aims to develop a tool to systematically assess the risk of collapse in the delivery infrastructure and apply it to 42 districts in Gyeonggi Province. The ultimate goal is to provide data for preventive and improvement strategies tailored to regional needs. Methods: Hospitals performing over 50 deliveries annually were identified. Regions were categorized as 'none,' 'one,' or 'more than two' delivery hospitals, with further subdivision by annual delivery volume. Regions were then classified into 5 categories: 'relatively stable,' 'low-risk,' 'moderate-risk,' 'high-risk,' and 'collapsed.' Results: Of the 42 districts, 23 were classified as relatively stable, 3 as low-risk, 1 as moderate-risk, 4 as highrisk, and 11 as collapsed. Notably, areas where the delivery infrastructure has collapsed or is at high risk of collapse accounted for approximately 36% of the total. Conclusion Tailored strategies and urgent policy support are required for high-risk regions. While perinatal regionalization may be a future direction, stable infrastructure must be maintained until the maternal care delivery system is established.

Background: The benefits of transradial access (TRA) over transfemoral access (TFA) for bifurcation percutaneous coronary intervention (PCI) are uncertain because of the limited availability of device selection. This study aimed to compare the procedural differences and the in-hospital and long-term outcomes of TRA and TFA for bifurcation PCI using secondgeneration drug-eluting stents (DESs). Methods: Based on data from the Coronary Bifurcation Stenting Registry III, a retrospective registry of 2,648 patients undergoing bifurcation PCI with second-generation DES from 21 centers in South Korea, patients were categorized into the TRA group (n = 1,507) or the TFA group (n = 1,141). After propensity score matching (PSM), procedural differences, in-hospital outcomes, and device-oriented composite outcomes (DOCOs; a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization) were compared between the two groups (772 matched patients each group). Results: Despite well-balanced baseline clinical and lesion characteristics after PSM, the use of the two-stent strategy (14.2% vs. 23.7%, P = 0.001) and the incidence of in-hospital adverse outcomes, primarily driven by access site complications (2.2% vs. 4.4%, P = 0.015), were significantly lower in the TRA group than in the TFA group. At the 5-year follow-up, the incidence of DOCOs was similar between the groups (6.3% vs. 7.1%, P = 0.639). Conclusion The findings suggested that TRA may be safer than TFA for bifurcation PCI using second-generation DESs. Despite differences in treatment strategy, TRA was associated with similar long-term clinical outcomes as those of TFA. Therefore, TRA might be the preferred access for bifurcation PCI using second-generation DES.

Objective: Oral frailty is associated with a decline in overall function in the elderly and increases the risk of dysphagia and aspiration pneumonia. Early diagnosis is essential to prevent these issues. This study aimed to determine the correlation between the Korean oral frailty diagnostic criteria and oral diadochokinesis (ODK) in community-dwelling elderly individuals. Methods: Six diagnostic criteria for oral frailty were examined and ODK was assessed in 100 elderly individuals aged 60 years and above residing in the Gangwon State. The correlation was analyzed using Pearson’s correlation, Spearman’s rank correlation, and multiple regression analysis. Results: The study found that elderly individuals in the later stages of life had significantly lower tongue pressure, occlusal force, chewing ability, and ODK compared to those in earlier stages. Additionally, increased age and decreased chewing ability and tongue pressure were significantly associated with a decline in ability to rapidly repeat monosyllables /pʌ/tʌ/kʌ/. Conclusion As age increases in the elderly population, the frequency of /pʌ/tʌ/kʌ/ in ODK assessments may serve as a simple screening tool for oral frailty in community-dwelling elderly individuals.