This study aimed to analyze the 3D morphology of the condylar part of the occiput in a Korean population and evaluate its applicability for sex estimation. A total of 87 individuals (44 males and 43 females) were included, and measurements of the occipital condyle and foramen magnum were obtained using computed tomography–based 3D reconstructions. Intra-observer reliability was assessed, and univariate and multivariate discriminant analyses were performed to evaluate the discriminative power of each variable. Most measurements showed significant sexual dimorphism, with males generally exhibiting higher values than females. Particularly, variables related to the occipital condyle, including length, width, and area, demonstrated relatively high discriminative performance, whereas those related to the foramen magnum showed comparatively lower discriminative ability. Multivariate analysis further improved the classification accuracy, indicating that the combined use of multiple variables enhanced the ability to distinguish between sexes. These findings suggest that this approach may be particularly valuable in forensic contexts where skeletal remains are incomplete and offer a reliable alternative when more commonly used elements are unavailable.

Background: Seborrheic dermatitis (SD) is a chronic inflammatory scalp disorder associated with Malassezia dysbiosis and increased sebum production. AMPamide has been suggested to have anti-inflammatory and sebum-regulating effects, but its clinical efficacy and microbiome-modulating effects in SD remain unclear. Objective: To evaluate the clinical efficacy and scalp microbiome changes following 4 weeks of use of an AMPamide-containing shampoo in patients with SD. Methods: In this observational study, 30 patients with SD applied an AMPamide-containing shampoo for 4 consecutive weeks. Clinical outcomes, including sebum levels and overall severity scores, were assessed. Scalp bacterial and fungal communities were analyzed to evaluate α- and β-diversity and changes in Malassezia composition. Results: Treatment resulted in significant reductions in sebum levels and clinical severity scores, particularly in erythema, dandruff, and pruritus. Bacterial community composition remained largely stable, while fungal α-diversity increased, and β-diversity analysis revealed a decrease in the ratio of Malassezia restricta to Malassezia globosa. Conclusion AMPamide-containing shampoo was associated with improved clinical symptoms and a shift toward a more balanced fungal community composition in patients with SD, supporting its potential as a non-steroidal therapeutic option for SD.

Objectives: To investigate the causal factors of proximal contact loss (PCL) between an implant prosthesis and the adjacent natural teeth using cast model analysis. Materials and Methods: Patients who underwent restoration using dental implants in the posterior region were analyzed. To identify factors associated with PCL incidence, cast model analyses were conducted based on sex, implant site, jaw position, Angle’s classification, anterior overbite, preexisting interproximal gap between consecutive (mesial side) natural teeth adjacent to the implant, generalized gap of the full arch, and mandibular anterior crowding. Chi-square, multivariate logistic regression, and multivariate generalized estimating equation (GEE) analyses were used to evaluate the impact of each factor. The incidence of PCL over time was analyzed using Kaplan–Meier analysis. Results: Of 653 implants, 293 implants were selected from 240 patients. Ninety implant sites (30.7%) showed PCL between the implant prostheses and the adjacent teeth. The analysis of PCL incidence revealed a gradual increase over time, with half of PCL cases occurring by 19.2 months. The chisquare test revealed significant associations between a pre-existing interproximal gap between adjacent natural teeth and a generalized overall gap in the corresponding arch and PCL (P=0.002 and P=0.027). The logistic regression (P=0.007, odds ratio [OR]: 2.684) and GEE (P=0.003, OR: 3.255) showed significant correlations between PCL and a pre-existing interproximal gap between adjacent natural teeth. Conclusion The occurrence of PCL between implant prostheses and adjacent teeth is influenced by the pre-existing interproximal gap between consecutive natural teeth adjacent to the implant. This factor should be carefully monitored.

Objectives: To evaluate the factors that influence the survival of dental implants and marginal bone loss (MBL) in patients taking osteoporosis or osteopenia medication. Materials and Methods: This study included patients who underwent dental implant treatment after taking medication for osteoporosis or osteopenia. Electronic medical records were used to collect data of patient age, sex, age at osteoporosis or osteopenia diagnosis, types of medications, age at medication initiation, duration of medication before implant surgery, whether the medication was paused before surgery, paused duration of medication, implant survival status, and MBL before and after prosthetic treatment. Firth’s logistic regression was used to analyze the relationships between each variable and implant survival as well as between MBL before and after prosthetic treatment. Results: Of the 267 patients, 111 with 209 implants were included in the study. The mean observation period was 57.9 months. The survival rate was 92.8% at the patient level and 96.2% at the implant level. No significant associations were found between implant survival and any of the variablesexamined. MBL before prosthetic treatment was significantly associated with use of receptor activator of nuclear factor-κB ligand (RANKL) inhibitors(P=0.032) and bone formation stimulators (P=0.022). Comparing the concurrent and single use of bisphosphonates and RANKL inhibitors, only the use of RANKL inhibitors alone was significantly associated with MBL before prosthetic treatment (P=0.039). MBL after prosthetic treatment was significantly associated with injection method among the routes of drug administration (P=0.011). Conclusion The implant survival rate in patients undergoing medical treatment for osteoporosis or osteopenia was comparable to the general implant survival rate. MBL before prosthetic treatment was associated with type of anti-osteoporotic medication, whereas MBL after prosthetic treatment was correlated with drug administration route. Further studies with larger sample sizes are required.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.

Objective: : Hemifacial spasm (HFS) is treated by a surgical procedure called microvascular decompression (MVD). However, HFS re-appearing phenomenon after surgery, presenting as early recurrence, is experienced by some patients after MVD. Dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI) and two analytical methods : receiver operating characteristic (ROC) curve and machine learning, were used to predict early recurrence in this study. Methods: : This study enrolled 60 patients who underwent MVD for HFS. They were divided into two groups : group A consisted of 32 patients who had early recurrence and group B consisted of 28 patients who had no early recurrence of HFS. DSC perfusion MRI was undergone by all patients before the surgery to obtain the several parameters. ROC curve and machine learning methods were used to predict early recurrence using these parameters. Results: : Group A had significantly lower relative cerebral blood flow than group B in most of the selected brain regions, as shown by the region-of-interest-based analysis. By combining three extraction fraction (EF) values at middle temporal gyrus, posterior cingulate, and brainstem, with age, using naive Bayes machine learning method, the best prediction model for early recurrence was obtained. This model had an area under the curve value of 0.845. Conclusion : By combining EF values with age or sex using machine learning methods, DSC perfusion MRI can be used to predict early recurrence before MVD surgery. This may help neurosurgeons to identify patients who are at risk of HFS recurrence and provide appropriate postoperative care.

Background: With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey. Methods: For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke. Results: In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high. Conclusion Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.

Background: There are few long-term large-scale epidemiologic studies on hypertrophic cardiomyopathy (HCM; 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes: I42.1, I42.2). This analysis used the Korean National Health Insurance Service (KNHIS) data between 2006 and 2017 to evaluate the natural history of HCM over a decade. Methods: KNHIS data and death statistics were evaluated according to age, sex, socioeconomic position, and comorbidities. Survival rates (SRs) and adjusted hazard ratio (HR) were compared with death data of the Korean population from 2006 through 2018. Results: The mean age was 47.3 ± 14.9 years in males and 57.5 ± 15.4 years in females (P < 0.001).The male proportion was 58.9%. The most common cause of death was diseases of the circulatory system. The 10-year SR of HCM was higher in males (75.9% vs. 62.5%, P < 0.001).The adjusted HR for different age groups was significantly high in most age group: 3.67 (95% confidence interval [CI], 2.65–5.10) for 0–9 years, and it gradually increased from the 30s to the 80s group (1.39 [95% CI, 1.05–1.83] for 30–39 years and 48.2 [95% CI, 37.0–62.7] for those older than 80 years). The adjusted HR was 1.12 (95% CI, 1.07–1.17) for males, 1.40 (95% CI, 1.33–1.48) for the lower income level, and 1.18 (95% CI, 1.12–1.25) for the medium income level. In patients with comorbidities, the adjusted HRs were 1.23 (95% CI, 1.16–1.30) for diabetes, 1.45 (95% CI, 1.30–1.62) for myocardial infarction, 1.63 (95% CI, 1.52–1.76) for atrial fibrillation, 1.83 (95% CI, 1.68–1.99) for ischemic stroke, 1.66 (95% CI, 1.31–2.10) for hemorrhagic stroke, 2.42 (95% CI, 2.16–2.70) for chronic kidney disease, and 3.18 (95% CI, 2.87–3.52) for malignant neoplasm. Conclusion HCM in Korea showed a higher prevalence and incidence in males. The 10-year SR of HCM was approximately 70% and lower in females than that in males. The risk of death from HCM increased with age and was significantly higher in males, individuals with low income levels, and patients with various comorbidities. These findings should be considered for the long-term management and allocation of healthcare resources for patients with HCM.