Purpose: This study aimed to evaluate the feasibility, safety, and immunological outcomes of low-dose cow’s milk oral immunotherapy (CM OIT) in school-aged children and adolescents with severe, persistent cow’s milk allergy (CMA), a group typically considered at a high risk for OIT. Methods: We conducted a retrospective study involving 12 patients (median age, 11.4 years) with immunoglobulin E (IgE)-mediated CMA, who underwent individualized low-dose CM OIT in the outpatient setting at a single tertiary hospital. Baseline and longitudinal clinical and immunological data, including casein-specific IgE and immunoglobulin G4 (IgG4) levels, were analyzed. Patients were classified as either desensitized or unsuccessful based on treatment outcomes. Results: Of the 12 patients with severe CMA, 6 achieved desensitization up to the target dose, while the remaining 6 discontinued treatment because of intolerance or poor adherence. The desensitized and unsuccessful groups showed no significant differences in baseline age, OIT starting dose, or serum casein-specific IgE level. Immunological evaluation revealed a significantly greater increase in serum casein-specific IgG4 (0.87 vs. -0.37 mg/L, P = 0.004) and a significantly lower natural log-transformed fold change in the IgE/IgG4 ratio (-1.38 vs. 0.44, P = 0.008) in the desensitized group. None of the patients required epinephrine during OIT, and adverse events were generally mild. Conclusion In selected high-risk pediatric populations with severe CMA, outpatient-based low-dose OIT using individualized flexible protocols may provide a relatively safe approach that improves tolerability and adherence. Increased casein-specific IgG4 levels and a reduced casein-specific IgE/IgG4 ratio may serve as valuable biomarkers for treatment response.

Background: Pathogenic Escherichia coli (PEC) is a leading cause of acute diarrhea worldwide. With increasing antibiotic use, antimicrobial resistance in PEC has become a significant public health concern. In this study, we investigated the distribution and antimicrobial susceptibility patterns of PEC isolated from patients with acute diarrhea in the Busan and Gyeongnam regions of South Korea. Methods: In this retrospective cross-sectional laboratory-based study, 272 PCR-positive residual stool or rectal swab specimens collected between October 2023 and June 2024 were screened; after exclusion of 80 specimens without recoverable or confirmable isolates, 192 pathogenic E. coli isolates were included for pathotype identification and antimicrobial susceptibility testing. Pathotypes were identified using multiplex real-time polymerase chain reaction, and antimicrobial susceptibility was tested against 18 agents using the VITEK II system. Results: Enteroaggregative E. coli (EAEC) was the most prevalent pathotype (44.8%), followed by enteropathogenic E. coli (34.9%). High resistance rates were observed for ampicillin (77.1%), cefazolin (55.2%), and amoxicillin/clavulanic acid (44.3%). EAEC demonstrated the highest multidrug resistance (MDR) rate (34.9%). Pediatric patients (< 18 years) exhibited significantly higher resistance rates and MDR frequencies compared with adults, particularly against β-lactam antibiotics. Conclusion EAEC was identified as the predominant and most resistant pathotype in this region. The elevated resistance levels in children and the prevalence of MDR EAEC underscore the need for continuous local surveillance and appropriate antibiotic stewardship.

Background: Postoperative liver regeneration is essential for maintaining hepatic function. This study evaluated the rate, determinants, and volumetric patterns of early liver regeneration after hemihepatectomy. Methods: A retrospective review was conducted of 50 patients who underwent right or left hemihepatectomy between April 2019 and March 2025. Liver and spleen volumes (SV) were assessed preoperatively, at postoperative day (POD) 1 week, and at POD 3 months. Early liver regeneration rate (LRR) was defined as the percentage increase in remnant liver volume at POD 1 week relative to the preoperative future liver remnant (FLR), and patients were categorized into low (<50%) and high (≥50%) LRR groups. Clinical, biochemical, and volumetric variables were compared, and predictors of regeneration were identified using multivariable analyses. Regeneration patterns were also examined according to whether the FLR/standard liver volume (SLV) ratio was <50% or ≥50%. Results: FLR/SLV was the strongest independent predictor of rapid early liver regeneration (p<0.001). Remnants with FLR/SLV <50% exhibited rapid and sustained regeneration, whereas those with FLR/SLV ≥50% showed slower regrowth that plateaued after reaching approximately 90% of SLV. SV increased at POD 1 week in all patients; however, only the FLR/SLV ≥50% group showed a reduction by POD 3 months, whereas the <50% group maintained elevated volumes. Conclusions FLR/SLV reliably predicts early postoperative liver regeneration. Smaller remnants regenerate more rapidly, whereas persistent splenic enlargement suggests a sustained portal hemodynamic burden. Combined evaluation of FLR/SLV and SV may enhance perioperative risk assessment and surgical planning.

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act to assess the health and nutritional status of the Korean population. Over the past 2 decades, the survey has continuously introduced timely survey components while strengthening its survey methodology and operational systems to enhance both the policy relevance and scientific utility of its findings. The 10th KNHANES (2025–2027) preserves the statistical representativeness of its sampling design while expanding the use of web-based self-administered questionnaires to improve participant convenience. In response to Korea’s transition into a super-aged society, the 10th KNHANES incorporates enhanced older-adult health surveys, including osteoporosis assessment and older adults’ life functioning, and newly introduces items addressing social support as part of the social determinants of health. In addition, a longitudinal follow-up survey system has been established to monitor long-term changes in population health. Collectively, these changes are expected to improve understanding of aging-related health issues, support evidence-based national health policy development, and expand the applicability of KNHANES data for academic research.

Purpose: Periprosthetic joint infections (PJIs) resulting from total hip arthroplasty (THA) pose significant challenges. Partial two-stage exchange arthroplasty (TSEA) retains either the femoral stem or acetabular cup by preserving bone stock and soft tissue and offers a potential alternative to total TSEA. Our meta-analysis evaluated the pooled success rate of partial TSEA in treating late chronic PJIs in THA. Our study also focused on the outcomes associated with retained prosthetic implant (stem or cup) and the type of prior surgery (primary vs. revision arthroplasty) performed. Materials and Methods: We analyzed data from 355 hips of patients with PJI following THA across 11 studies using a random-effects model to estimate the success rate of partial TSEA and spacer dislocation that occurs during the interval between the first and second stages of partial TSEA. The heterogeneity between the subgroups was also calculated. Results: The overall pooled success rate of partial TSEA in the study cohort was 87% (95% confidence interval [CI] 83-91).Lacking statistical significance (P=0.904), the success rates were 88% for stem-retained and 90% for cup-retained implant cases. The partial TSEA success rates were 88% for primary arthroplasty and 80% for revision arthroplasty, although this was not statistically significant (P=0.193). Spacer dislocation occurred in only 5% of the cases (95% CI 1-9). Conclusion Partial TSEA achieves high success rates comparable to those of total TSEA. Although revision arthroplasty cases carry a high risk of recurrence, partial TSEA remains a viable, tailored treatment option with a low complication rate.

Background: Rare cases of Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) have been reported following the coronavirus disease 2019 (COVID-19) vaccination; however, the association between COVID-19 vaccination and the risk of developing KD/MIS-C has not yet been established. Methods: We conducted a self-controlled case series analysis using a large-linked database that connects the COVID-19 immunization registry with nationwide claims data. We identified individuals aged < 18 years who received their initial COVID-19 vaccination and had a KD/MIS-C diagnosis with a prescription for intravenous immunoglobulin or corticosteroids between October 18, 2021, and April 15, 2023. The observation period was set as 240 days from the date of the COVID-19 vaccination. The risk window was 60 days after vaccination, with the remaining observation period serving as the control window. The incidence rate ratios (IRRs) and 95% confidence intervals (CIs) in the risk versus control windows were estimated using the conditional Poisson regression model. We further analyzed the vaccine doses and types for secondary analysis. We also performed subgroup analyses stratified by sex, age, comorbidities, and other conditions and sensitivity analyses by varying the length of the risk window and outcome definition. Results: Among 2,369,490 individuals who received the COVID-19 vaccination, 12 cases of KD/MIS-C were identified, which included five and seven patients in the risk and control windows, respectively. There was no increased risk of KD/MIS-C within the 60-day period of vaccination (IRR, 0.53; 95% CI, 0.17–1.60). Secondary subgroup and sensitivity analyses showed no significant increase in the risk of KD/MIS-C after COVID-19 vaccination, which is consistent with the results of the main analysis. Conclusion The results of this nationwide study suggest that the risk of developing KD/MIS-C did not increase after COVID-19 vaccination. However, owing to the lack of a sufficient number of cases, future studies utilizing multinational long-term follow-up databases should be conducted. Considering the increasing incidence of KD/MIS-C and the limited understanding of its precise biological mechanisms, additional research on KD/MIS-C is warranted.

Suicidal cases involving sodium nitrite have been reported worldwide. However, postmortem features, such as brownish or grayish livor mortis, remain difficult to interpret, especially as decomposition advances. Here, we present three fatal cases (2020-2023) presumably caused by sodium nitrite ingestion. In these cases, characteristic nitrite-induced changes were inconsistent or obscured by decomposition, but ingestion traces (cup or bottle near the decedents) were observed at each scene. Additionally, containers labeled “sodium nitrite” were found in two cases; however, since sodium nitrite is designated a suicide-hazardous material in South Korea, future scenes may rarely reveal such clear labeling. Although autopsy, including methemoglobin testing, can confirm the cause of death, any delay in the investigative process risks the loss of critical evidence about the ingestion process and other factors. This underscores the importance of focusing on early scene evidence, particularly ingestion traces, and conducting thorough chemical and forensic examinations. Our findings illustrate that timely detection of ingestion-related evidence and subsequent forensic analysis, in conjunction with autopsy results, can elucidate a decedent’s cause and manner of death and clarify any criminal implications.

Purpose: Accurate prediction of blood glucose variability is crucial for effective diabetes management, as both hypoglycemia and hyperglycemia are associated with increased morbidity and mortality. However, conventional predictive models rely primarily on patient-specific biometric data, often neglecting the influence of patient–provider interactions, which can significantly impact outcomes. This study introduces Cyclic Dual Latent Discovery (CDLD), a deep learning framework that explicitly models patient–provider interactions to improve prediction of blood glucose levels. By leveraging a real-world intensive care unit (ICU) dataset, the model captures latent attributes of both patients and providers, thus improving forecasting accuracy. Methods: ICU patient records were obtained from the MIMIC-IV v3.0 critical care database, including approximately 5,014 instances of patient–provider interaction. The CDLD model uses a cyclic training mechanism that alternately updates patient and provider latent representations to optimize predictive performance. During preprocessing, all numeric features were normalized, and extreme glucose values were capped at 500 mg/dL to mitigate the effect of outliers. Results: CDLD outperformed conventional models, achieving a root mean square error of 0.0852 on the validation set and 0.0899 on the test set, which indicates improved generalization. The model effectively captured latent patient–provider interaction patterns, yielding more accurate glucose variability predictions than baseline approaches. Conclusion Integrating patient–provider interaction modeling into predictive frameworks can increase blood glucose prediction accuracy. The CDLD model offers a novel approach to diabetes management, potentially paving the way for artificial intelligence-driven personalized treatment strategies.

BACKGROUND: Osteoporosis, characterized by decreased bone mineral density due to an imbalance between osteoblast and osteoclast activity, poses significant challenges in bone healing, particularly in postmenopausal women. Current treatments, such as bisphosphonates, are effective but associated with adverse effects like medication-related osteonecrosis of the jaw, necessitating safer alternatives. METHODS: This study investigated the use of L-serine-incorporated gelatin sponges for bone regeneration in calvarial defects in an ovariectomized rat model of osteoporosis. Thirty rats were divided into three groups: a control group, a group treated with a gelatin sponge containing an amino acid mixture, and a group treated with a gelatin sponge containing L-serine. Bone regeneration was assessed using micro-computed tomography (micro-CT) and histological analyses. RESULTS: The L-serine group showed a significant increase in bone volume (BV) and bone area compared to the control and amino acid groups. The bone volume to total volume (BV/TV) ratio was also significantly higher in the L-serine group.Immunohistochemical analysis demonstrated that L-serine treatment suppressed the expression of cathepsin K, a marker of osteoclast activity, while increasing serine racemase activity. CONCLUSION These findings suggest that L-serine-incorporated gelatin sponges not only enhance bone formation but also inhibit osteoclast-mediated bone resorption, providing a promising and safer alternative to current therapies for osteoporosis-related bone defects. Further research is needed to explore its clinical applications in human patients.