Objective: In South Korea, there is a significant gap in systematic, evidence-based research on intensive case management (ICM) for individuals with severe mental illness (SMI). This study aims to evaluate the effectiveness of ICM through a randomized controlled trial (RCT) comparing ICM with standard case management (non-ICM). Methods: An RCT was conducted to assess the effectiveness of Seoul-intensive case management (S-ICM) vs. non-ICM in individuals with SMI in Seoul. A total of 78 participants were randomly assigned to either the S-ICM group (n=41) or the control group (n=37). Various clinical assessments, including the Brief Psychiatric Rating Scale (BPRS), Montgomery–Åsberg Depression Rating Scale, Health of the Nation Outcome Scale, and Clinical Global Impression-Improvement (CGI-I), along with quality-of-life measures such as the WHO Disability Assessment Schedule, WHO Quality of Life scale, and Multidimensional Scale of Perceived Social Support (MSPSS) were evaluated over a 3-month period. Statistical analyses, including analysis of covariance and logistic regression, were used to determine the effectiveness of S-ICM. Results: The S-ICM group had significantly lower odds of self-harm or suicidal attempts compared to the control group (adjusted odds ratio [aOR]=0.30, 95% confidence interval [CI]: 0.21–1.38). Psychiatric symptoms measured by the BPRS and perceived social support measured by the MSPSS significantly improved in the S-ICM group. The S-ICM group also had significantly higher odds of CGI-I compared to the control group (aOR=8.20, 95% CI: 2.66–25.32). Conclusion This study provides inaugural evidence on the effectiveness of S-ICM services, supporting their standardization and potential nationwide expansion.

Objectives: This study aimed to assess the health rights of inmates in correctional facilities from the perspective of unmet needs and to explore institutional improvement plans that could yield substantial qualitative and quantitative advancements.

Methods: Data on capacity and actual occupancy, external and internal medical services, the number of inmates with mental health conditions, and cell area were obtained from the Ministry of Justice. Overall, 1,057 inmates were surveyed, representing 1.84% of the total inmate population of 57,560 as of September 30, 2016. A structured questionnaire was distributed to these inmates, and upon collection, the responses were analyzed. Furthermore, a request was submitted to the Ministry of Justice to survey the status of healthcare personnel and medical services across 52 correctional facilities nationwide.

Results: Between 2014 and 2015, the Ministry of Justice in South Korea allocated approximately 14 to 22 billion Korean won for healthcare services in correctional facilities. The major facilities with the most inmates with mental health conditions had 160 such inmates in 2014 and 161 in 2015. Overcrowding and insufficient cooling pose ongoing health risks. Inmates face challenges accessing medical care, with unmet needs for dental and psychiatric services.

Conclusion: Strategies to improve inmates’ health rights include establishing a primary healthcare system, improving governance, alleviating overcrowding, and introducing mental health programs. Emphases are placed on managing severe illnesses such as cancer, strengthening emergency care, and ensuring oversight by the National Human Rights Commission. Regular education of prison staff is also recommended to improve inmate health management.

With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.

Background/Aims: The clinical outcomes and optimal treatment of esophageal squamous cell carcinoma (ESCC) in elderly patients are unclear. This study aimed to assess the clinical outcomes of ESCC in patients aged ≥ 80 years. Methods: Medical records of patients diagnosed with ESCC between December 2008 and February 2024 were retrospectively reviewed. In total, 479 patients with ESCC were included and divided into the elderly (n = 52) and younger (n = 427) groups based on age. The clinical outcomes and survival rates, according to treatment, were compared between the two groups. Results: The median ages of the two groups were 82 years (range, 80–95 yr) and 66 years (41–79 yr). The overall survival was slightly lower in the elderly group; however, no statistical significance (hazard ratio [HR] 1.27, 95% confidence interval [CI] 0.85−1.91; p = 0.238) was observed. No differences were observed in the outcomes or survival between the two groups according to the treatment method (surgery, chemoradiotherapy or radiotherapy alone, and endoscopic resection). The elderly group was more likely to receive no treatment for cancer (30.8% vs. 13.6%, p = 0.002) than the younger group. However, when there was no treatment for cancer in the elderly group, survival was significantly lower than when treatment was administered (HR 0.08, 95% CI 0.03−020; p < 0.001). Conclusions In patients with ESCC aged ≥ 80 years, active cancer treatment was beneficial, and the results did not differ from those of younger patients.

Background/Aims: Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia. This research aimed to evaluate the clinical features and outcomes of PVT in patients with IBD at a leading hospital in South Korea. Methods: This retrospective analysis reviewed adult patients diagnosed with both IBD and PVT from 1989 to 2021 at a renowned South Korean medical center. The study focused on patient characteristics, specifics of PVT, administered treatments, and outcomes, all confirmed through enhanced CT scans. Results: A total of 78 patients met the study’s criteria. Notably, only 20.5% (16/78) were treated with oral anticoagulants; however, a vast majority (96.2%; 75/78) achieved complete radiographic resolution (CRR). When comparing patients receiving anticoagulants to those who did not, a significant preference for anticoagulant use was observed in cases where the main portal vein was affected, as opposed to just the left or right veins (p = 0.006). However, multivariable analysis indicated that neither anticoagulant use nor previous surgeries significantly impacted CRR. Conclusions Patients with IBD and PVT generally had favorable outcomes, regardless of anticoagulant use.

Obesity is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and contributes through multiple pathophysiological pathways, including systemic inflammation, neurohormonal activation, and mechanical inhibition. The treatment of obesity has shown significant potential for improving HFpEF outcomes. Sodium-glucose cotransporter 2 inhibitors have emerged as effective treatments for improving symptoms and quality of life in patients with HFpEF while aiding in weight control. Furthermore, a recent demonstration of the clinical benefits of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in HFpEF showed promising results in reducing weight loss, and improving symptoms and clinical outcomes. In this review article, we discuss the association between HFpEF and obesity, the emerging role of GLP-1 RAs, and future directions for medical therapies targeting obesity-associated HFpEF.

Background/Aims: To analyze the characteristics of the sputum microbiota of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD) based on treatment status. Methods: Twenty-eight sputum samples from 14 patients with NTM-PD, including 14 samples from the microbiologically cured group (7 at baseline and 7 during follow-up) and 14 from the treatment-refractory group (7 at baseline and 7 during follow-up) were included in this study. Bacterial microbiota was analyzed by sequencing the V3–V4 region of the 16S rRNA gene. Results: Among the 14 patients, most had infections with Mycobacterium avium complex (n = 6), followed by Mycobacterium abscessus (n = 5); three patients exhibited mixed infection with both organisms. Alpha-diversity was higher in the cured group than in the treatment refractory group in both the baseline sputum (ACE, p = 0.005; Chao1, p = 0.010; Jackknife, p = 0.022, 0.043; Shannon, p = 0.048) and follow-up sputum (ACE, p = 0.018). Linear discriminant analysis effect size revealed that several taxa showed differential distributions based on treatment status. At the species level, Streptococcus pneumoniae, Prevotella melaninogenica, Haemophilus parahaemolyticus, Haemophilus haemolyticus, Fusobacterium nucleatum, Neisseria elongata, and Prevotella denticola were more abundant in sputum from the microbiologically cured group than in that from the refractory group (all p < 0.05). Conclusions In contrast to patients with treatment-refractory NTM-PD, those with stable disease without recurrence had higher microbial diversity in their sputum, including several predominant taxa.

Objective:   This study aimed to evaluate the changes in upper airway (UA) dimensions in growing patients with Pierre-Robin sequence (PRS). Methods: The subjects were 23 PRS patients who had not undergone growth modification therapy or surgical intervention. Their lateral cephalograms were obtained longitudinally at mean ages of 8.81 (T0) and 14.05 (T1). Patients were categorized based on their SNB value at T0 (Criteria: –2 SD): Group-1 (very retrusive mandible, n = 13) and Group-2 (moderately retrusive mandible, n = 10). Skeletal and UA variables at T0 and T1, as well as ∆T0-T1, were statistically analyzed. Results: At T0, Group-1 exhibited more retrusive maxilla and mandible (SNA, P < 0.01; SNB, P < 0.001), a more hyperdivergent pattern (facial height ratio, P < 0.05), and a more posteriorly positioned hyoid bone (H-PTV, P < 0.05), while Group-1 showed larger UA spaces (superior pharyngeal airway space [SPAS] and inferior pharyngeal airway space, all P < 0.05) than Group 2, which might indicate the existence of a compensatory response to maintain the UA patency.At T1, Group-1 maintained significantly retrusive maxilla and mandible (SNA and SNB, all P < 0.01), exhibited a less anteriorly positioned tongue (TT-PTV, P < 0.05), and displayed a more obtuse soft palate angle (SPA, P < 0.05) than Group-2.Between T0 and T1, Group-1 demonstrated significant increases in the hyoid symphysis distance (∆H-RGN, P < 0.001), tongue length (∆TGL, P < 0.01), and pharyngeal UA spaces (∆SPAS and ∆PNS-ad2, all P < 0.001). Conclusions Even in growing PRS patients with severe mandibular retrusion, the UA dimensions increased due to forward growth of the mandible, repositioning of tongue and hyoid bone, and existence of compensatory mechanism.

Schwann cells are the most abundant cells in the peripheral nervous system, maintaining the development, function and regeneration of peripheral nerves. Defects in these Schwann cells injury response potentially contribute to the pathogenesis of diabetic peripheral neuropathy (DPN), a common complication of diabetes mellitus. The protein p66shc is essential in regulating oxidative stress responses, autophagy induction and cell survival, and is also vital in the development of DPN. In this study, we hypothesized that p66shc mediates high glucose-induced oxidative stress and autophagic dysfunction. In Schwann cells treated with high glucose; p66shc expression, levels of reactive oxygen species, autophagy impairment, and early apoptosis were elevated. Inhibition of p66shc gene expression by siRNA reversed high glucose-induced oxidative stress, autophagy impairment, and early apoptosis. We also demonstrated that the levels of p66shc was increased, while autophagy-related proteins p62 and LC3 (LC3-II/I) were suppressed in the sciatic nerve of streptozotocin-induced diabetes mice. P66shc-deficient mice exhibited the improvement in autophagy impairment after diabetes onset. Our findings suggest that the p66 plays a crucial role in Schwann cell dysfunction, identifying its potential as a therapeutic target.