Purpose: Preterm birth remains a leading cause of long-term neurodevelopmental impairment, yet early evaluations frequently underestimate subsequent deficits. This study examined longitudinal neurodevelopmental trajectories across gestational age groups and identified predictors of developmental delay. Methods: A retrospective cohort of 532 preterm children, stratified by gestational age, was followed from the neonatal period to early preschool age. Neurodevelopment was assessed using the Korean version of the Bayley Scales of Infant and Toddler Development, Third Edition at 8–12 months (n=481), 13–24 months (n=118), and 25–42 months (n=100). Longitudinal trajectories were analyzed using general linear models, and predictors of developmental delay were identified through multivariable logistic regression. Results: During the first year, motor scores differed significantly across gestational age groups, with extremely preterm infants showing the lowest values. By the third to fourth years of life, cognitive and language scores diverged markedly, with extremely preterm children exhibiting the steepest decline and additional deficits in motor and adaptive behavior domains. Lower gestational age remained an independent predictor of both cognitive and language delay at early preschool age, while no independent predictors were identified for motor, social-emotional, or adaptive behavior outcomes. Conclusion Neurodevelopmental outcomes in preterm children follow dynamic, domain-specific trajectories influenced by gestational age and developmental timing. Motor delays are most evident in infancy, whereas cognitive and language impairments emerge by early preschool age. Gestational age remains a consistent predictor of later delay, emphasizing the need for longitudinal, gestational age–stratified monitoring and early, targeted intervention.

Osteoid osteoma accounts for approximately 10% of all benign bone tumors, but only approximately 4% of cases occur in the foot and ankle area. Periarticular osteoid osteoma frequently manifests with nonspecific clinical symptoms that mimic other conditions, potentially leading clinicians down a diagnostic side path and resulting in delayed or missed diagnoses compared to extra-articular osteoid osteoma. Although plain radiographs may show nonspecific findings, magnetic resonance imaging can detect bone marrow edema and surrounding soft tissue changes. Computed tomography is the most accurate modality for diagnosis. This paper reports the case of a 26-year-old female diagnosed with periarticular osteoid osteoma of the calcaneus and was treated with arthroscopic localized curettage at the author’s institution.

Popliteal artery entrapment syndrome (PAES) can mimic ankle pathology in young athletes and may lead to irreversible ischemia if a diagnosis is delayed. A 13-year-old Taekwondo athlete had exertional ankle pain unresponsive to synovectomy. Computed tomography angiography revealed a 5-cm popliteal artery occlusion. The patient underwent decompression surgery, but the arterial occlusion persisted, and bypass surgery was planned. This case highlights the importance of considering PAES as part of a differential diagnosis in young athletes presenting with persistent ankle pain, particularly when symptoms persist despite appropriate orthopedic treatment.

Objective: This study aims to compare the incidence of active tuberculosis (TB) among Korean patients with rheumatoid arthritis (RA) initiating treatment with tumor necrosis factor inhibitors (TNFi) or tofacitinib. Methods: Using the Korean National Health Insurance database, we conducted a nationwide, retrospective cohort study of RA patients who started TNFi or tofacitinib therapy between 2015 and 2018. We calculated the incidence rates of active TB based on the treatment type and results from latent tuberculosis infection (LTBI) screening tests. A multivariable Cox proportional hazards model was employed to evaluate the risk of active TB in RA patients beginning TNFi or tofacitinib treatment. Results: Among 3,382 RA patients (596 on tofacitinib and 2,786 on TNFi), LTBI screening was predominantly conducted using the IGRA (interferon-gamma release assays) test. Of these patients, 624 (18.5%) with a positive LTBI test received prophylactic treatment. No cases of active TB occurred in tofacitinib users, while 32 cases were observed in TNFi users. The adjusted hazard ratio for active TB in LTBI-positive patients was 5.47 (95% confidence interval 2.74 to 10.92) compared to LTBI-negative patients.In subgroup analyses, TB incidence was significantly higher among individuals aged over 65 years. Conclusion Despite LTBI treatment, active TB remains prevalent among RA patients on TNFi therapy and in those with positive LTBI tests.

Purpose: We aimed to investigate how genetic predisposition to drinking and gastric cancer (GC) modifies the association between alcohol consumption and GC risk in the Korean population. Materials and Methods: Polygenic risk scores for GC (PRS-GC) and alcohol consumption (PRS-Alcohol) were formulated using genome-wide association results from BioBank Japan. Validation was performed using Korean cohorts (SNUBH-GENIE cohort), incorporating 8,846 controls and 531 patients with GC. Subsequently, these PRSs were applied to an independent Korean cohort of 67,771 participants, including 313 patients with GC during the follow-up for 14 years (KoGES cohort). Results: In KoGES cohort, the influence of alcohol consumption on GC risk was significantly altered by the PRS-GC and exhibited a synergistic interaction effect. PRS-Alcohol itself shows a negative correlation with GC risk. However, when actual alcohol consumption significantly exceeded genetically predicted levels, the risk of alcohol-related GC was notably increased (adjusted hazard ratio, 1.32; 95% confidence interval, 1.01 to 1.72). Heavy drinkers in the high–PRS-GC/low–PRS-Alcohol group had a 2.16 times higher risk of GC than non-to-light drinkers, which was prominent in males. Conclusion Korean drinkers with higher PRS-GC who consume alcohol more than genetically predicted levels are susceptible to GC. PRS-GC and PRS-Alcohol may be beneficial for assessing the impact of alcohol consumption on GC risk in Koreans.

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.

Objectives: This study investigated whether the coronavirus disease 2019 (COVID-19) pandemic affected quality of life (QOL) and whether its impact differed between individuals with and without suicidal ideation. Methods: A secondary analysis was performed using community-based cross-sectional survey data collected in Daegu, Republic of Korea, in 2018 (pre-pandemic phase), 2020 (pandemic phase), and 2022 (post-peak phase). Participants aged 18 years or older were recruited through stratified random sampling. Suicidal ideation over the past year was assessed using a single “yeso” question. QOL was measured using the Korean version of the abbreviated version of the World Health Organization Quality of Life Assessment, comprising physical, psychological, social, and environmental domains. A multivariate analysis of covariance was conducted to examine the main and interaction effects of suicidal ideation and the COVID-19 phase, adjusting for age, education, marital status, and income. Results: Suicidal ideation was significantly associated with lower QOL in all domains (p<0.001). QOL declined significantly during the pandemic compared with the pre-pandemic phase, especially in the physical, psychological, and social domains. A significant interaction between suicidal ideation and the COVID-19 phase was observed for physical health (p=0.03), driven by a decline in physical QOL among those without suicidal ideation during the pandemic. Conclusions The COVID-19 pandemic negatively impacted multiple domains of QOL, with differing patterns depending on suicidal ideation status. Continuous and adaptive mental health strategies developed according to individuals’ suicidality are needed during and beyond public health crises to mitigate pandemic-related declines in QOL.

Background: Hypertensive patients tend to have an increased risk of hypotension during anesthesia induction, which can result in adverse outcomes. This study aimed to compare hemodynamic stability with remimazolam versus propofol in hypertensive patients. Methods: This meta-analysis analyzed randomized controlled trials investigating the hemodynamic outcomes of remimazolam versus propofol during anesthesia induction in hypertensive adults. A systematic search of electronic databases was conducted in November 2024. Results: Six studies were included in the final analysis. The administration of remimazolam significantly lowered the risk of hypotension (risk ratio [RR] = 0.711, 95% CI [0.545–0.929], I2 = 67.54%) and bradycardia (RR = 0.256, 95% CI [0.101–0.649], I2 = 0.0%). It also resulted in a higher minimum mean arterial pressure (mean difference [MD] = 9.023 mmHg, 95% CI [0.243–17.802], I2 = 97.50%) and higher minimum heart rate (MD = 7.200 beats/min, 95% CI [1.960–12.441], I2 = 86.40%). Despite these findings, substantial heterogeneity was observed in continuous outcomes. The trial sequential analysis revealed that none of the outcomes reached the required information size. Conclusions The administration of remimazolam showed a trend toward superior hemodynamic stability compared with propofol during anesthesia induction in hypertensive patients, especially in minimizing the incidence of hypotension and bradycardia. However, the trial sequential analysis results remain inconclusive, the current evidence is limited by small sample sizes, and larger trials are needed to confirm our findings.

Objective: This study aimed to evaluate reproductive outcomes according to the timing of testicular sperm retrieval. Methods: The study included 282 infertile couples divided into three groups: group A (freeze-thawed testicular sperm extraction [TESE] sperm, n=233), group B (fresh TESE sperm collected 1 day before ovum pickup, n=22), and group C (fresh TESE sperm collected on the same day as ovum pickup, n=27). The indications for TESE were surgically uncorrectable azoospermia or ejaculation failure, often accompanied by medical comorbidities such as diabetes mellitus and spinal cord injury. The outcome parameters assessed were fertilization rates, embryo quality, and clinical pregnancy rates. Results: The mean paternal age was 36.8±5.7 years, and the mean maternal age was 32.6±3.5 years. The mean duration of infertility was 2.9±1.8 years. The fertilization rates were 70.7%, 78.9%, and 73.0% for groups A, B, and C, respectively (p=0.047). The percentages of good-quality embryos were 68.2%, 65.3%, and 48.4%, respectively (p=0.007); specifically, the percentage of good-quality embryos was significantly lower in group C compared with the other two groups. Clinical pregnancy rates per transfer were similar at 51.1%, 50.0%, and 48.1% (p=0.958), with no differences observed in miscarriage rates. Conclusion Testicular sperm retrieval can be safely performed 1 day before ovum pickup, resulting in favorable fertility outcomes.