Background/Aims: Patients with atrial fibrillation (AF) and end-stage kidney disease (ESKD) require careful anticoagulation because thrombotic and bleeding risks are both elevated. We evaluated the efficacy and safety of warfarin, direct oral anticoagulants (DOACs), and no anticoagulation in Korean patients with ESKD and AF. Methods: In this multicenter retrospective study, we included 933 patients with ESKD and nonvalvular AF treated between 2010 and 2023. Patients were assigned to three groups by initial treatment: no anticoagulation (n = 604), warfarin (n = 197), or DOACs (n = 132). The primary efficacy outcome was ischemic stroke or systemic embolism (IS/SE); the primary safety outcome was major bleeding (MB). Secondary outcomes were intracranial hemorrhage (ICH), gastrointestinal bleeding (GIB), and all-cause mortality. Inverse probability of treatment weighting was used to adjust for confounding. Results: Both warfarin (adjusted hazard ratio [aHR], 0.55) and DOACs (aHR, 0.36) significantly reduced the risk of IS/SE compared with no anticoagulation. However, warfarin increased MB risk compared with no anticoagulation (aHR, 2.69), including ICH and GIB. DOACs also increased MB risk versus no anticoagulation (aHR, 1.37), driven primarily by ICH. Compared with warfarin, DOACs showed a lower MB risk (aHR, 0.51). Both warfarin and DOACs reduced all-cause mortality relative to no anticoagulation (aHR, 0.53 and 0.57, respectively). Conclusions Among Korean patients with ESKD and AF, both warfarin and DOACs reduced IS/SE but increased MB. Given their lower MB risk than warfarin, DOACs may be preferable for anticoagulation in this high-risk population.

Background: Various strategies are being explored to improve outcomes in advanced ovarian cancer. This study evaluated the survival outcomes of a sequential treatment strategy comprising dose-dense weekly chemotherapy, selective adjuvant radiotherapy, and poly(ADP-ribose) polymerase (PARP) inhibitor maintenance following primary debulking surgery. Methods: We retrospectively reviewed 12 patients with newly diagnosed advanced high-grade serous ovarian cancer (HGSOC) who underwent a sequential treatment strategy (debulking surgery followed by dose-dense chemotherapy, selective adjuvant radiotherapy, and PARP inhibitor maintenance) at Kosin University Gospel Hospital between December 2019 and March 2023. Survival outcomes were analyzed using the Kaplan-Meier method, and treatment-related adverse effects were evaluated. Results: All 12 patients achieved complete remission after the sequential treatment strategy. At the cutoff date (June 20, 2025), all patients were alive, with a median follow-up duration of 48.1 months (range, 28.7–66.5 months). The median progression-free survival (PFS) was 43.8 months. Acute toxicities, including bone marrow suppression and alopecia, were transient and manageable. Peripheral neuropathy and extremity edema were observed as persistent late toxicities. Conclusions This study highlights promising outcomes with a multimodal sequential treatment strategy in newly diagnosed advanced HGSOC. All patients remained alive at the time of analysis, and the median PFS reached 43.8 months, suggesting a potential benefit of this sequential approach compared with conventional treatment strategies. Prospective studies are warranted to validate these findings.

In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

In cases of partially edentulous patients with insufficient remaining teeth, rotational movement of the denture occurs and prognosis of the remaining teeth is uncertain when restoring with a removable partial denture. Recently, implant-assisted removable partial dentures, where a small number of implants are placed and surveyed crowns are fabricated on the implants to be used as abutments, have been suggested. In this case, the patient had only one remaining tooth in the mandible and implants were placed in both posterior regions to be used as surveyed crowns to restore the patient with an implant-assisted removable partial denture. This approach improved the support, retention, and stability of the denture, resulting in functionally and aesthetically satisfactory outcomes.

Background/Aims: Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis. Methods: We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality). Results: In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups. Conclusions Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.

Purpose: This study evaluated the educational impact of an artificial intelligence (AI)–based decision support system for breast ultrasonography (US) on medical professionals not specialized in breast imaging. Methods: In this multi-case, multi-reader study, educational materials, including American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors, were provided alongside corresponding AI results during training. The AI system presented results in the form of AIheatmaps, AI scores, and AI-provided BI-RADS assessment categories. Forty-two readers evaluated the test set in three sessions: the first session (S1) occurred before the educational intervention, the second session (S2) followed education without AI assistance, and the third session (S3) took place after education with AI assistance. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall performance, were compared between the sessions. Results: The mean sensitivity increased from 66.5% (95% confidence interval [CI], 59.2% to 73.7%) to 88.7% (95% CI, 84.1% to 93.3%), with a statistically significant difference (P<0.001), and the AUC non-significantly increased from 0.664 (95% CI, 0.606 to 0.723) to 0.684 (95% CI, 0.620 to 0.748) (P=0.300). Both measures were higher in S2 than in S1. The AI-achieved AUC was comparable to that of the expert reader (0.747 [95% CI, 0.640 to 0.855] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.217). Additionally, with AI assistance, the mean AUC for inexperienced readers was not significantly different from that of the expert reader (0.745 [95% CI, 0.660 to 0.830] vs. 0.803 [95% CI, 0.706 to 0.900], P=0.120). Conclusion The mean AUC and sensitivity improved after incorporating AI into breast US education and interpretation. AI systems with high-level performance for breast US can potentially be used as educational tools in the interpretation of breast US images.

Purpose: This study aimed to evaluate long-term treatment outcomes in patients with localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma treated with radiotherapy (RT). Materials and Methods: A total of 229 patients who received RT in 10 tertiary hospitals between 2010 and 2019 were included in this multicenter analysis. Response after RT was based on esophagogastroduodenoscopy after RT. Locoregional relapse-free survival (LRFS) and disease-free survival (DFS), and overall survival (OS) were evaluated. Results: After a median follow-up time of 93.2 months, 5-year LRFS, DFS, and OS rates were 92.8%, 90.4%, and 96.1%, respectively. LRFS, DFS, and OS rates at 10 years were 90.3%, 87.7%, and 92.8%, respectively. Of 229 patients, 228 patients (99.6%) achieved complete remission after RT. Five-year LRFS was significantly lower in patients with stage IIE than in those with stage IE (77.4% vs. 94.2%, p=0.047). Patients with age ≥ 60 had significantly lower LRFS than patients with age < 60 (89.3% vs. 95.1%, p=0.003). In the multivariate analysis, old age (≥ 60 years) was a poor prognostic factor for LRFS (hazard ratio, 3.72; confidence interval, 1.38 to 10.03; p=0.009). Grade 2 or higher gastritis was reported in 69 patients (30.1%). Secondary malignancies including gastric adenocarcinoma, malignant lymphoma, lung cancer, breast cancer, and prostate cancer were observed in 11 patients (4.8%) after RT. Conclusion Patients treated with RT for localized gastric MALT lymphoma showed favorable 10-year outcomes. Radiation therapy is an effective treatment without an increased risk of secondary cancer. The toxicity for RT to the stomach is not high.