Phyllodes tumors are rare biphasic fibroepithelial breast neoplasms classified as benign, borderline, or malignant. Despite their rarity, malignant variants carry higher risks of recurrence and metastasis. This review synthesizes current evidence on their clinical, histopathological, and molecular characteristics, including treatment strategies and prognostic factors, emphasizing tailored management. We performed a comprehensive literature review to summarize knowledge on clinical presentation, imaging, histopathological features, surgical treatment, adjuvant therapy, and outcomes. Recent genomic and molecular research was also evaluated to identify future directions. Persistent challenges include a lack of consensus on optimal surgical margins, adjuvant radiotherapy, and follow-up protocols, highlighting the need for larger, high-quality studies. Advances in molecular profiling suggest potential for targeted therapies, especially in aggressive or metastatic cases. Due to clinical heterogeneity and the limited accuracy of core biopsies, definitive grading based on surgical histopathology remains essential for treatment planning. This review offers an updated perspective on phyllodes tumor management, identifies critical gaps, and suggests priorities for future research.

Purpose: High-cost novel therapies for multiple myeloma (MM) require evaluation of efficacy and cost-effectiveness. Materials and Methods: This study developed a methodology to assess cost-effectiveness using nationwide data from 11,450 newly diagnosed MM patients. A novel algorithm was applied to identify lines of therapy (LoT). Results: The number of newly diagnosed MM patients increased significantly, from 873 in 2010 to 1,464 in 2019 (p < 0.001). Advancing LoT was associated with shorter time to next treatment (TTNT) and overall survival (OS) (p < 0.001), while all-cause medical costs increased with each LoT (p < 0.001). Bortezomib-melphalan-prednisolone was the most common frontline regimen for transplant-ineligible patients (29.2%), while bortezomib-thalidomide-dexamethasone was most used for transplant-eligible patients (11.3%). Daratumumab monotherapy demonstrated superior second TTNT (7.8 vs. 5.2 months) and OS (8.5 vs. 5.3 months) compared to standard care in heavily treated MM patients, with statistical significance maintained after cost adjustment. For subsequent therapies following daratumumab, a methodology was developed to estimate required medical costs using the incremental cost-effectiveness ratio (ICER): Expected cost ($)=ICER×(Expected life expectancy–0.567)+35,601. Conclusion This study provides a novel cost-effectiveness framework linking treatment efficacy and real-world costs, supporting predictions of societal costs for future MM therapies.

Background: Out-of-hospital cardiac arrest is a major public health concern in Korea.Identifying spatiotemporal patterns of out-of-hospital cardiac arrest incidence and survival outcomes is crucial for effective resource allocation and targeted interventions. Thus, this study aimed to investigate the spatiotemporal epidemiology of out-of-hospital cardiac arrest in Korea, with a focus on identifying high-risk areas and populations and examining factors associated with prehospital outcomes. Methods: We conducted this population-based observational study using data from the Korean out-of-hospital cardiac arrest registry from January 2009 to December 2021. Using a Bayesian spatiotemporal model based on the Integrated Nested Laplace Approximation, we calculated the standardized incidence ratio and assessed the relative risk to compare the spatial and temporal distributions over time. The primary outcome was out-ofhospital cardiac arrest incidence, and the secondary outcomes included prehospital return of spontaneous circulation, survival to hospital admission and discharge, and good neurological outcomes. Results: Although the number of cases increased over time, the spatiotemporal analysis exhibited a discernible temporal pattern in the standardized incidence ratio of out-ofhospital cardiac arrest with a gradual decline over time (1.07; 95% credible interval [CrI], 1.04–1.09 in 2009 vs. 1.00; 95% CrI, 0.98–1.03 in 2021). The district-specific risk ratios of survival outcomes were more favorable in the metropolitan and major metropolitan areas.In particular, the neurological outcomes were significantly improved from relative risk 0.35 (0.31–0.39) in 2009 to 1.75 (1.65–1.86) in 2021. Conclusion This study emphasized the significance of small-area analyses in identifying high-risk regions and populations using spatiotemporal analyses. These findings have implications for public health planning efforts to alleviate the burden of out-of-hospital cardiac arrest in Korea.

The demand for complementary and alternative medicine (CAM) is increasing worldwide. High-technology medicine is not always effective and is often accompanied by neglected self-care and high cost. Also, conventional medicine has become dependent on expensive technological solutions to health problems. Integrated medicine is not simply a synonym for complementary medicine. It involves the understanding of the interaction of the mind, body, and spirit and how to interpret this relationship in the dynamics of health and disease. Integrative medicine shifts the orientation of the medical practice from a disease-based approach to a healing-based approach. In South Korea, CAM education was first provided 20 years ago, and integrative medicine is becoming part of the current mainstream medicine. Increasing numbers of fellowships in integrative medicine are being offered in many academic health centers in the U.S. Also, it has emerged as a potential solution to the American healthcare crisis and chronic diseases, which are bankrupting the economy. It provides care that is patient-centered, healing-oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine.
Chronic Disease ; Complementary Therapies ; Delivery of Health Care ; Education ; Fellowships and Scholarships ; Holistic Health ; Integrative Medicine* ; Mind-Body Therapies ; Republic of Korea ; Self Care

The demand for complementary and alternative medicine (CAM) is increasing worldwide. High-technology medicine is not always effective and is often accompanied by neglected self-care and high cost. Also, conventional medicine has become dependent on expensive technological solutions to health problems. Integrated medicine is not simply a synonym for complementary medicine. It involves the understanding of the interaction of the mind, body, and spirit and how to interpret this relationship in the dynamics of health and disease. Integrative medicine shifts the orientation of the medical practice from a disease-based approach to a healing-based approach. In South Korea, CAM education was first provided 20 years ago, and integrative medicine is becoming part of the current mainstream medicine. Increasing numbers of fellowships in integrative medicine are being offered in many academic health centers in the U.S. Also, it has emerged as a potential solution to the American healthcare crisis and chronic diseases, which are bankrupting the economy. It provides care that is patient-centered, healing-oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine.
Chronic Disease ; Complementary Therapies ; Delivery of Health Care ; Education ; Fellowships and Scholarships ; Holistic Health ; Integrative Medicine* ; Mind-Body Therapies ; Republic of Korea ; Self Care

BACKGROUND: The reports that obesity could be associated with upper gastrointestinal disorders such as gastritis, gastric ulcer, duodenal ulcer, reflux esophagitis have not been consistent. Therefore, we studied the association between esophagogastroduodenoscopic (EGD) findings and the related risk factors of obesity. METHODS: The study subjects include 2,210 adults who visited the Health Promotion Center of one university hospital from January 2006 to December 2006. All subjects had standard physical measurements as well as resting blood pressure, fasting blood glucose, HbA1c, serum lipids, and gastroendoscopic examination. BMI was classified into two groups (BMI > or = 23 kg/m2, normal; BMI < 23 kg/m2, overweight or obese). The study subjects were classified into four groups according to the EGD findings; normal, gastritis, gastric or duodenal ulcer, reflux esophagitis. RESULTS: Mean BMI of gastritis, gastric or duodenal ulcer, and reflux esophagitis groups were higher than normal group after adjusting age, sex, alcohol and smoking (P < 0.001). Gastritis risk (OR, 2.098; 95% CI, 1.195 to 3.682; P = 0.01), gastric or duodenal ulcer risk (OR, 2.562; 95% CI, 1.282 to 5.117; P = 0.008), and reflux esophagitis risk (OR, 2.856; 95% CI, 1.522 to 5.360; P = 0.001) were significantly higher in overweight and obesity group compare with normal weight group after adjusting age, sex, alcohol and smoking. CONCLUSION: We suggest that overweight or obesity is the risk factor of gastritis, gastric or duodenal ulcer, and reflux esophagitis.
Adult ; Blood Glucose ; Blood Pressure ; Duodenal Ulcer ; Esophagitis, Peptic ; Fasting ; Gastritis ; Health Promotion ; Humans ; Obesity ; Overweight ; Risk Factors ; Smoke ; Smoking ; Stomach Ulcer

BACKGROUND: The reports that obesity could be associated with upper gastrointestinal disorders such as gastritis, gastric ulcer, duodenal ulcer, reflux esophagitis have not been consistent. Therefore, we studied the association between esophagogastroduodenoscopic (EGD) findings and the related risk factors of obesity. METHODS: The study subjects include 2,210 adults who visited the Health Promotion Center of one university hospital from January 2006 to December 2006. All subjects had standard physical measurements as well as resting blood pressure, fasting blood glucose, HbA1c, serum lipids, and gastroendoscopic examination. BMI was classified into two groups (BMI > or = 23 kg/m2, normal; BMI < 23 kg/m2, overweight or obese). The study subjects were classified into four groups according to the EGD findings; normal, gastritis, gastric or duodenal ulcer, reflux esophagitis. RESULTS: Mean BMI of gastritis, gastric or duodenal ulcer, and reflux esophagitis groups were higher than normal group after adjusting age, sex, alcohol and smoking (P < 0.001). Gastritis risk (OR, 2.098; 95% CI, 1.195 to 3.682; P = 0.01), gastric or duodenal ulcer risk (OR, 2.562; 95% CI, 1.282 to 5.117; P = 0.008), and reflux esophagitis risk (OR, 2.856; 95% CI, 1.522 to 5.360; P = 0.001) were significantly higher in overweight and obesity group compare with normal weight group after adjusting age, sex, alcohol and smoking. CONCLUSION: We suggest that overweight or obesity is the risk factor of gastritis, gastric or duodenal ulcer, and reflux esophagitis.
Adult ; Blood Glucose ; Blood Pressure ; Duodenal Ulcer ; Esophagitis, Peptic ; Fasting ; Gastritis ; Health Promotion ; Humans ; Obesity ; Overweight ; Risk Factors ; Smoke ; Smoking ; Stomach Ulcer

BACKGROUND: C-reactive protein (CRP) is one of the increasing plasma proteins in inflammatory diseases and tissue necrosis and recent evidence show that increased elevated levels of CRP are associated with an increased risk of coronary heart disease (CHD) and obesity. To investigate the relationship of obesity and CRP, we evaluated the correlation of CRP with obesity index in healthy adults. METHODS: The subjects included 1,926 healthy adults (1,168 men and 758 women) who visited the Health Promotion Center of a general hospital from May to December 2004. We excluded subjects who had inflammatory diseases, and investigated based on age, physical examination, blood pressure, fasting plasma glucose, serum lipid profile, percentage of body fat, and body mass index (BMI). CRP was analyzed by method of Turbid Immuno Assay (TIA) which has high sensitivity-CRP. We evaluated serum level of CRP in relation to %body fat, BMI, and clustering of metabolic risk factors. RESULTS: Comparing the median CRP with the percentage of body fat, BMI, clustering of metabolic risk factors the value of CRP significantly increased according to increase in %body fat BMI and metabolic risk fakfor (P<0.001). The proportion of elevated CRP levels (> or =0.22 mg/dL) was increased as %body fat, BMI, and clustering of metabolic risk factor increased. The Odds Ratios for elevated levels of CRP were 1.5 (95% CI 1.0~2.1) in men and 2.9 (95% CI 1.7~4.8) in women for subjects with obesity (BMI> or =25 kg/m2), 2.0 (95% CI 1.3~2.9) in men with more than 25% %body fat, and 2.5 (95% CI 1.4~4.1) in women with more than 30% %body fat. CONCLUSION: As %body fat increased, the proportion of elevated CRP (> or =0.22 mg/dL) level increased in men and women. We conclude that obesity is related with CRP.
Adipose Tissue ; Adult* ; Blood Glucose ; Blood Pressure ; Blood Proteins ; Body Mass Index ; C-Reactive Protein* ; Coronary Disease ; Fasting ; Female ; Health Promotion ; Hospitals, General ; Humans ; Male ; Necrosis ; Obesity* ; Odds Ratio ; Physical Examination ; Risk Factors*