Background and Objectives: Hearing loss significantly affects communication, psychosocial well-being, and quality of life. This study analyzes the National Health Insurance Service database to assess the trends and characteristics of hearing loss in South Korea from 2010 to 2020.Subjects and Method The database encompasses 97% of the Korean population, providing comprehensive data on medical history, prescriptions, and health examinations. The analysis used the World Health Organization’s ICD-10 definitions to categorize hearing loss types and examine their prevalence and incidence across various demographics over 11 years. Results: There was an overall annual increase of 4.62% in diagnosed cases of hearing loss, with the most significant rise among the elderly. The rate of increase accelerated from 3.32% between 2010 and 2014 to 6.49% between 2014 and 2020, corresponding with the improved hearing aid access facilitated by policy changes. Women showed a slightly higher increase than men. The data also indicated a consistent rise in abnormal hearing test results during health examinations, especially in older adults. Conclusion The study highlights an increasing trend in hearing loss diagnoses, driven by an aging population and enhanced detection facilitated by policy changes. These findings emphasize the need for continuous monitoring and targeted health policies to manage hearing loss effectively, offering valuable insights for global health management and policy development.

Background and Objectives: This study aims to analyze trends in hearing disability and the use of hearing rehabilitation devices (hearing aids and cochlear implants) in South Korea over the past 11 years (2010-2020) using data from the National Health Insurance Service (NHIS).Subjects and Method Data were extracted from the NHIS database, covering approximately 97% of the South Korean population. Patients diagnosed with hearing loss were classified using ICD-10 codes. The data were analyzed to determine trends in hearing disability, hearing aid prescriptions, and cochlear implant usage by age, gender, and types and causes of hearing loss. Results: The number of hearing disability patients increased from 170900 in 2010 to 362738 in 2020, with an annual growth rate of 7.95%. The highest increase was observed in the ≥60 age group, with an annual growth rate of 11.04%. Hearing aid prescriptions rose from 4966 in 2010 to 11974 in 2020, showing a 10.45% annual increase. Females showed a higher growth rate in both hearing disability and hearing aid prescriptions compared to males. Cochlear implant prescriptions also increased, particularly among older adults. Conclusion The study highlights a significant rise in hearing disability and the use of hearing aids and cochlear implants in South Korea, especially among the elderly. The findings underscore the importance of early diagnosis and intervention for hearing loss and the need for policy improvements to enhance accessibility and affordability of hearing rehabilitation services. Additional strategies are needed to ensure appropriate hearing rehabilitation for those not yet receiving adequate care.

Objectives: Although non-ampullary duodenal neuroendocrine tumors (NADNETs) are rare neoplasms, their incidence has been increasing. In this study, we aimed to analyze the long-term outcomes of patients with NADNETs who underwent endoscopic resection (ER) or surgery. Methods: This retrospective study included 55 adults (aged 26–78 years) diagnosed with NADNETs between 2009 and 2022 at Seoul National University Hospital. We categorized the patients into 3 groups: 21 underwent ER, 28 underwent surgical resection, and 6 had no detectable residual tumors after the initial biopsy during the follow-up period. Continuous data were examined using the Mann–Whitney U or Kruskal–Wallis tests, and categorical variables were analyzed using the χ2 or Fisher’s exact tests. Results: A total of 21 patients, with a mean tumor size of 9.2±5.3 mm, underwent successful ER. After ER, three patients experienced perforation (14% [3/21]); two underwent primary repair surgery, and one recovered with conservative treatment. The mean tumor size of 28 patients who underwent surgical resection was 13.9±6.7 mm. There were no cases of postoperative bleeding or perforation; however, four patients experienced ileus and required prolonged hospital stays. The median follow-up periods for patients who underwent ER, surgical resection, and removal after the initial biopsy were 42, 48, and 42.5 months, respectively. During the follow-up period, no recurrence was observed in any group. Conclusions Recurrence-free survival in patients undergoing ER for NADNETs, with an endoscopically measured size of approximately 10 mm, was comparable to that of patients undergoing surgical resection. However, ER carried a relatively high risk of perforation due to the challenging anatomical access and thin duodenal wall.

Purpose: Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery. Materials and Methods: Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support. Results: Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (p=0.082). There was no significant difference between the two groups in terms of operative time (p=0.698), estimated blood loss (p=0.210), and duration of mechanical ventilation (p=0.713). There was a significant difference in intensive care unit stay between the two groups (p=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (p>0.999). Conclusion ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.

Background and Objectives: Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily). Methods: Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events. Results: A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA 2 DS 2 -VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very lowdose edoxaban prescriptions increased. The main reasons for the prescription of very lowdose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3–16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding. Conclusions The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.

Background: Skipping breakfast is associated with an increased risk of chronic inflammatory diseases. This study aimed to examine the association between breakfast-eating habits and inflammation, using high-sensitivity C-reactive protein (hs-CRP) as a marker. Methods: A total of 4,000 Korean adult males with no history of myocardial infarction, angina, stroke, diabetes, rheumatoid arthritis, cancer, or current smoking were included. Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for analysis. The frequency of breakfast consumption was assessed through a questionnaire item in the dietary survey section asking participants about their weekly breakfast consumption routines over the past year. Participants were categorized into two groups, namely “0–2 breakfasts per week” and “3–7 breakfasts per week”; hs-CRP concentrations were measured through blood tests. Results: Comparing between the “infrequent breakfast consumption (0–2 breakfasts per week)” and “frequent breakfast consumption (3–7 breakfasts per week)” groups, the mean hs-CRP was found to be significantly higher in the “infrequent breakfast consumption” group, even after adjusting for age, body mass index, physical activity, alcohol consumption, systolic blood pressure, blood pressure medication, fasting blood glucose, and triglycerides (mean hs-CRP: frequent breakfast consumption, 1.36±0.09 mg/L; infrequent breakfast consumption, 1.17±0.05 mg/L; P-value=0.036). Conclusion Less frequent breakfast consumption was associated with elevated hs-CRP levels. Further large-scale studies incorporating adjusted measures of daily eating patterns as well as food quality and quantity are required for a deeper understanding of the role of breakfast in the primary prevention of chronic inflammatory diseases.

Background/Aims: Gastric neuroendocrine tumors (GNETs), once rare, have become more prevalent due to the increased use of endoscopy and increased physician awareness. The clinical characteristics and long-term outcomes of GNET management were explored in this study. Methods: The clinical data of 69 patients who treated at Seoul National University Hospital between January 2013 and October 2023 were retrospectively studied. Baseline characteristics, recurrence rates, associated factors, and overall survival rates were analyzed. Results: Of the tumors, 71.0% were grade 1, 24.6% were grade 2, 1.4% were grade 3, and 2.9% were poorly differentiated. In terms of tumor type, 69.6% were type I, 1.4% were type II, and 29.0% were type III. A significant proportion of patients with grade 1 tumors received more endoscopic treatment, whereas a significant proportion of patients with grade 2 tumors underwent surgery or chemotherapy (p=0.015). The overall 5-year survival and recurrence rates were 93.8% and 7.25% (5/69), respectively. Among five patients who experienced recurrence, three had metachronous recurrence, all of which were type I; the remaining two patients exhibited distant hepatic metastasis, encompassing types I and III. The time to recurrence was 1 to 9.8 years.Margin positivity (p=0.002) and invasion deeper than the submucosal layer (p=0.007) were associated with higher recurrence rates. However, there was no significant association between recurrence and intestinal metaplasia, atrophic gastritis, or Helicobacter pylori infection. Conclusions Most patients with GNETs in this study had grade I and type I tumors, and the overall prognosis was favorable. Patients with risk factors for recurrence warrant further investigation. Those presenting margin positivity or deep invasion after resection should be closely monitored and undergo follow-up examinations, as necessary.

Purpose: This study aimed to develop a comprehensive practical guide for enteral nutrition (EN) designed to enhance patient safety and reduce complications in Korea. Under the leadership of the Korean Society for Parenteral and Enteral Nutrition (KSPEN), the initiative sought to standardize EN procedures, improve decision-making, and promote effective multidisciplinary communication. Methods: The KSPEN EN committee identified key questions related to EN practices and organized them into seven sections such as prescribing, delivery route selection, formula preparation, administration, and quality management. Twenty-one experts, selected based on their expertise, conducted a thorough literature review to formulate evidence-based recommendations. Drafts underwent peer review both within and across disciplines, with final revisions completed by the KSPEN Guideline Committee. The guide, which will be published in three installments, addresses critical elements of EN therapy and safety protocols. Results: The practical guide recommends that EN orders include detailed elements and advocates the use of electronic medical records for communication. Standardized prescription forms and supplementary safety measures are outlined. Review frequency is adjusted according to patient condition—daily for critically ill or unstable patients and as dictated by institutional protocols for stable patients. Evidence indicates that adherence to these protocols reduces mortality, complications, and prescription errors. Conclusion The KSPEN practical guide offers a robust framework for the safe delivery of EN tailored to Korea’s healthcare context. It emphasizes standardized protocols and interdisciplinary collaboration to improve nutritional outcomes, patient safety, and operational efficiency. Rigorous implementation and monitoring of adherence are critical for its success.

Human rhinovirus (HRV) causes the common cold and exacerbates chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease. Despite its significant impact on public health, there are currently no approved vaccines or antiviral treatments for HRV infection. Apoptosis is the process through which cells eliminate themselves through the systematic activation of intrinsic death pathways in response to various stimuli. It plays an important role in viral infections and serves as a key immune defense mechanism in the interactions between viruses and the host. In the present study, we investigated the antiviral effects of quercetin-3-methyl ether, a flavonoid isolated from Serratula coronata, on human rhinovirus 1B (HRV1B). Quercetin-3-methyl ether significantly inhibited HRV1B replication in HeLa cells in a concentration-dependent manner, thereby reducing cytopathic effects and viral RNA levels. Time-course and time-of-addition analyses confirmed that quercetin-3-methyl ether exhibited antiviral activity during the early stages of viral infection, potentially targeting the replication and translation phases. Gene expression analysis using microarrays revealed that pro-apoptotic genes were upregulated in quercetin-3-methyl ether-treated cells, suggesting that quercetin-3-methyl ether enhances early apoptosis to counteract HRV1B-induced immune evasion. In vivo administration of quercetin-3-methyl ether to HRV1B-infected mice significantly reduced viral RNA levels and inflammatory cytokine production in the lung tissues. Our findings demonstrated the potential of quercetin-3-methyl ether as a novel antiviral agent against HRV1B, thereby providing a promising therapeutic strategy for the management of HRV1B infections and related complications.

Allogeneic stem cell transplantation (allo-SCT) is a salvage treatment option for patients with relapsed or refractory lymphoid malignancies. However, the clinical variables impacting outcomes in these patients remain unclear. We analyzed 58 patients who underwent allo-SCT for lymphoid malignancies, including B-cell lymphoma (BCL, n = 20), Hodgkin’s disease (n = 3), multiple myeloma (n = 9), natural killer/T-cell lymphoma (NK/TCL, n = 4), and TCL (n = 22).The median progression-free survival (PFS) was 27.4 months, while the median overall survival (OS) was 30.6 months.In univariate analysis, human leukocyte antigen (HLA) matching and complete remission status post-transplantation were associated with improved PFS and OS. However, only post-transplant response remained significant for both sur‑ vival outcomes in the multivariate analysis. Moreover, HLA matching was associated with a significantly improved PFS in patients with BCL and NK/TCL, but with better OS only in those with BCL. Complete remission after transplantation was associated with better PFS and OS in patients with BCL, NK/TCL, and TCL. Our results indicate that post-transplant response is an important prognostic indicator in allo-SCT for lymphoid malignancies and may guide clinical decisions and additional treatment.