Gastric leaks after laparoscopic sleeve gastrectomy are serious complications with mortality rates of up to 10%. Conventional self-expanding metal stents exhibit high migration rates (up to 58%), limiting their efficacy. Large, fully covered megastents that reduce migration rates are poorly tolerated and associated with traumatic ulcers and discomfort. We present two cases of successful endoscopic management of persistent gastric leaks following laparoscopic sleeve gastrectomy using long, fully covered Gastro-Seal stents (240 mm) after failed surgical re-exploration. These patients achieved complete fistula closure without stent migration or traumatic ulceration within 26 days and 45 days, respectively. The extended length and round-ended design of the Gastro-Seal stent effectively addressed the key limitations of both conventional and mega-stents. Long, fully covered gastroseal stents may thus be an effective treatment option for managing persistent post-bariatric leaks.

Neuropathic pain markedly impairs quality of life and imposes a substantial socioeconomic burden, while available treatments often provide only partial relief and are limited by safety concerns. The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain (NeuPSIG-IASP) first published pharmacologic recommendations in 2007, followed by a major update in 2015 and a new guideline in 2025. This narrative review specifically compares the 2015 and 2025 NeuPSIG-IASP guidelines, outlining key methodological changes and therapeutic shifts. The 2025 guideline is based on a larger, more rigorous meta-analysis, maintains α2δ-ligands (adds mirogabalin), serotonin-noradrenaline reuptake inhibitors, and tricyclic antidepressants as first-line drugs, downgrades tramadol into the opioid third-line group. It also introduces high-frequency motor-cortex repetitive transcranial magnetic stimulation as a weakly recommended third-line option and discusses implications for Korean clinical practice.

Background: Self-rated health (SRH) is crucial for predicting morbidity and mortality across age groups, including adolescents and adults. Body image dissatisfaction, measured by difference between current and ideal weight, surpasses body mass index (BMI) in predicting health outcomes. We evaluated the correlation between body image perception and SRH among middle and high school students in Korea. Methods: This study comprised of 51,850 students aged 12–18 years who participated in the 2022 Korea Youth Risk Behavior Survey. Subjective health status was categorized into ‘good’ or ‘poor’ groups. Body image was classified into ‘underweight,’ ‘normal,’ or ‘overweight.’ BMI was determined using age-specific percentiles: underweight (<5th percentiles), overweight (85th–95th percentiles), and obese (>95th percentiles). Data analysis was performed by multivariable logistic analysis and adjusted for depressive mood, stress, and socioeconomic status. Results: The total participants (N=50,455) included 59.4% with normal weight according to BMI, only 36.4% perceived themselves as normal. Students who perceived themselves as having a normal weight had higher rates of good SRH compared to others. Excluding females with BMI ≥25 kg/m2, both sex showed higher odds ratios [ORs] for poor SRH when perceiving themselves overweight (male: OR=2.57, 95% confidence interval [95% CI]=2.367–2.782; female: OR=1.36, 95% CI=1.270–1.452) or underweight (male: OR=1.64, 95% CI=1.507–1.791; female: OR=1.36, 95% CI=1.256–1.472). Conclusions More than half of the students responded negatively to their body image, associated with poor subjective health status. Therefore, promoting accurate body weight perceptions will play a positive role in overall health of adolescents.

Pharyngeal dysphagia can be caused by structural abnormalities or neurological disorders such as stroke, meningitis, and other conditions. Herpes zoster (HZ), caused by the varicella-zoster virus (VZV), is a rare cause of pharyngeal dysphagia. The symptoms of HZ usually involve a painful rash with vesicles along the dermatome area, but it can also affect the cranial nerves (CN), such as CN VII (Ramsay-Hunt syndrome), and less commonly, other CN. A 69-year-old man presented with a sore throat and dysphagia symptoms. A laryngoscopy revealed multiple ulcerative mucosal lesions on the right soft palate and lateral pharynx. The patient was treated with oral valacyclovir, and although the lesions disappeared, the dysphagia symptoms remained. While dysphagia associated with a VZV infection is rare, it can occur with the additional symptoms of vocal cord paralysis. This paper reports a rare case of pharyngeal dysphagia caused by a VZV infection, and the patient presented only with the initial symptoms of sore throat and dysphagia without skin lesions or signs of vocal cord paralysis.

Ramucirumab is a vascular endothelial growth factor (VEGF) receptor-2 inhibiting monoclonal antibody for the treatment of gastric cancer, non-small cell lung cancer, colorectal cancer, and hepatocellular carcinoma. Some VEGF inhibitors are known to increase the risk of ischemic stroke; however, their association with ramucirumab remains controversial. To the best of our knowledge, only two cases of ischemic stroke following ramucirumab treatment have been reported worldwide. We herein present the first case of acute cerebral infarction secondary to ramucirumab in Korea.

Background: Coronavirus Disease 2019 (COVID-19) is a novel coronavirus identified in 2019 that exhibited an exceptionally rapid spread. Although the development and administration of COVID-19 vaccines progressed quickly, concerns about side effects and safety persisted. This study utilized data from the 2021 Community Health Survey to analyze the relationship between COVID-19 vaccination and psychosocial factors, including depression and subjective health status. Methods: Analysis included 203,449 individuals, excluding those who had not received or were ineligible for the COVID-19 vaccine, based on the 2021 Community Health Survey. The chi-square tests assessed sociodemographic and health status differences related to vaccination status. Subjective health status was categorized based on survey responses as ‘good’ or ‘poor,’ and depression was assessed using the self-reported Patient Health Questionnaire-9. The association between depression, subjective health status, and vaccination status was examined using chi-square tests, followed by multiple logistic regression to determine independent effects. Results: Vaccination rates were higher among the elderly, those with lower education, higher income, healthcare workers, and individuals with lower depression, higher subjective health, and chronic conditions like hypertension or diabetes. Significantly lower vaccination rates were observed in those with lower subjective health and Patient Health Questionnaire-9 scores ≥5 or ≥10. Among individuals with chronic illnesses, those with good subjective health had the lowest odds for non-vaccination (odds ratio=0.42; 95% confidence interval, 0.39-0.45), while those without chronic illnesses and poor subjective health had the highest odds (odds ratio=1.89; 95% confidence interval, 1.76-2.02). Conclusions This study found significantly higher odds ratios for vaccine non-receipt among individuals with lower levels of depression and subjective health status. Incorporating psychosocial factors such as depression and subjective health status may be crucial in developing strategies to enhance vaccination rates during future outbreaks of novel infectious diseases.

Background: Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model. Methods: This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments. Results: Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878). Conclusion Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

Background: The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction. Methods: 2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic. Results: The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried. Conclusion The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.

Background: Lung cancer has a high incidence and mortality worldwide, and smoking, age, sex, and body mass index are known risk factors. Using a health examination cohort, we constructed a comprehensive lung cancer risk-prediction model. Methods: This study comprised 308,804 adults aged 20 years and older who underwent health examinations at one general hospital in Korea, from 2011 to 2018. We developed a lung cancer risk prediction model using a multivariate Cox proportional hazards regression analysis for lung cancer risk factors and estimated the hazard ratios and coefficients. The model evaluation included discrimination and calibration assessments. Results: Among the 308,804 adults in the study cohort, there were 338 (0.11%) patients lung cancer, with 215 males (0.07% of 169,420 males) and 123 females (0.04% of 139,384 females). The prevalence of lung cancer was higher in males and females aged over 60 years. Age, sex, body mass index, and smoking behavior were identified as risk factors for lung cancer prevalence in this model through multivariate Cox proportional hazards analysis. The C-statistic of the development cohort was 0.785 (0.749, 0.821) and that of the validation cohort was 0.823 (0.769, 0.878). Conclusion Our lung cancer risk prediction model showed statistical significance, similar to previous prediction models, among variables that included young age, female sex, and body mass index. Future improvements should focus on population-wide applicability and associated health examination policies.

Background: The study aim was to investigate the level of restrictions on daily life and concern about economic damage caused by the coronavirus disease 2019 (COVID-19) pandemic and analyze the effects on daily life satisfaction. Methods: 2021 Community Health Survey data of 229,242 individuals were analyzed. Such factors as restrictions on daily life, changes in physical activity and instant food consumption and concern about economic damage were selected as variables for analysis, as they were presumed to impact daily life satisfaction during the COVID-19 pandemic. Results: The odds ratio for poor daily life satisfaction was 1.88 (95% confidence interval [CI], 1.83–1.94) for those who experienced moderate restrictions and 3.48 (95% CI, 3.31–3.65) for those who experienced severe restrictions, compared to those who had no restrictions in daily life. The group with reduced physical activity had an odds ratio of 1.29 (95% CI, 1.26–1.33) for poor daily life satisfaction compared to the group with no change. The group with increased consumption of instant foods had an odds ratio of 1.23 (95% CI, 1.18–1.28) for poor daily life satisfaction compared to the group without such an increase. Regarding the economic damage caused by the COVID-19 pandemic, the odds ratio for experiencing negative daily life satisfaction was 1.17 (95% CI, 1.10–1.24) for those with moderate concern and 1.43 (95% CI, 1.37–1.50) for those with severe concern, compared to those who were not worried. Conclusion The results of this study could be helpful in planning public health and medical policies for population groups that are relatively vulnerable to decreased daily life satisfaction.