Objective: The aims of this study were to assess embryonic development using a time-lapse monitoring system based on cleavage timing and the use of vitrification and to investigate the correlation between miRNA-429 expression and embryonic development in both fresh and vitrified-thawed embryos. Methods: Mouse embryos at the 1-cell stage were collected and randomly divided into fresh and vitrified-thawed groups. The embryos were monitored and further subdivided into early and delayed cleavage based on the timing of the third cleavage event at 55 hours after human chorionic gonadotropin injection. miRNA-429 extracted from spent media or embryos cultured in vitro was analyzed by quantitative reverse transcription-polymerase chain reaction. Results: Early cleavage was associated with a significantly higher blastulation rate, regardless of cryopreservation status. Notably, among vitrified-thawed embryos, outgrowth was greater in those exhibiting early cleavage compared to those with delayed cleavage. Furthermore, miRNA-429 expression was elevated in embryos exhibiting delayed cleavage, but only within the cryopreserved group. Conclusion Based on these findings, we suggest that the timing of the third cleavage event may be more critical than the vitrification process itself, and evaluating miRNA-429 expression could serve as an alternative non-invasive selection tool for vitrified surplus embryos.

Gastroesophageal reflux disease (GERD) is a chronic and relapsing gastrointestinal disorder characterized by the reflux of gastric contents into the esophagus, leading to troublesome symptoms and/or complications. Since the publication of the 2020 Seoul Consensus on GERD, significant new evidence has emerged, particularly regarding acid-suppressive therapies and diagnostic approaches. This 2025 focused update aims to refine GERD management strategies by incorporating the latest evidence on acid suppressive therapies and regional considerations in Asian populations. This study builds on the 2020 Seoul Consensus by integrating systematic reviews, meta-analyses, and expert consensuses to offer updated recommendations for the definition and medical treatment of GERD. These guidelines incorporate recent advances in acid-suppressive therapies, particularly potassium-competitive acid blockers, and adopt updated diagnostic frameworks in accordance with the Lyon Consensus 2.0. Key clinical questions were identified and structured using the following format: Population, Intervention, Comparator, Outcome. The resulting recommendations address the initial treatment, long-term maintenance strategies, and role of personalized therapy based on disease severity, such as the grade of reflux esophagitis. Six key statements are presented: updated definition and classification of GERD (Statement 1); initial and long-term treatment strategies tailored to GERD phenotypes, such as non-erosive reflux disease, mild erosive esophagitis, and severe erosive esophagitis (Statements 2-5); and dose optimization strategies for long-term safety (Statement 6). These guidelines aim to support gastroenterologists and general healthcare providers in making individualized evidence-based decisions for GERD management.

Postmortem inspection is a specialized medical practice that determines the cause and manner of death via external examination of a corpse. It is performed as part of the medico-legal death investigation and a crucial step in determining whether an autopsy is necessary. In South Korea, training for doctors performing postmortem inspection and quality control for postmortem inspection results remain lacking. Therefore, the Korean Society for Legal Medicine established a task force and proposed a standard operating procedure (SOP) of postmortem inspection. This article includes the background for proposing this SOP, an introduction to the postmortem inspection process, and the principles for performing the procedure and writing the report. This SOP may serve as a basic guideline for postmortem inspection.

and Relevance: This case supports the value of imaging, clinicopathologic assessment, and histopathology in diagnosis, and suggests that supportive husbandry modification may provide temporary welfare benefit in affected snakes.

An 8-year-old patient presented with mild headaches and was diagnosed with a suprasellar arachnoid cyst (SAC). Patency of the cerebral aqueduct was confirmed using cine magnetic resonance imaging (MRI), and the patient was initially managed with outpatient observation without surgical intervention. However, with worsening headaches and the new onset of bitemporal hemianopsia, a sudden increase in aqueductal peak flow was detected on follow-up cine MRI. Notably, no change in cyst volume or evidence of hydrocephalus was observed on the second MRI. Endoscopic surgery was subsequently performed via the right Kocher’s point, and both the rostral and caudal membranes of the SAC were fenestrated. Following the procedure, the patient’s symptoms improved, and normalization of aqueductal peak flow was confirmed on postoperative cine MRI.

Purpose: We investigated the results of endoscopic fenestration for deeply located intracranial cysts (DLICs), risk factors for reoperation, and symptom improvement. Materials and Methods: We included 51 patients with DLICs who underwent endoscopic fenestration between November 2006 and October 2022. The median age was 5±20 years (6 days–67 years), and 36 (70.6%) patients were aged <20 years. The male-tofemale ratio was 1.3:1. The ventriculoscope was used to fenestrate the cysts, which had diameters under 4.5 mm. The volume of DLICs was measured separately on serial magnetic resonance imaging, and the patients were followed up for 32±40 months. Results: The mean preoperative volume of DLICs was 63.5±87.4 cm, 3 , which decreased to 23.7±56.2 cm 3postoperatively, with a 45.4%±32.1% decrease rate in 32 months. All DLICs were approached appropriately, avoiding the eloquent areas. Overall, 39 (76.5%) patients showed symptom improvement after a single operation, which was preserved without recurrence, whereas 12 (23.5%) underwent a second operation [shunting (17.6%) or repeating the endoscopic fenestration (5.9%)] owing to symptom aggravation and recurrent cysts. Patients aged <12 months showed 7.4 times more re-operation rate (p>0.046) and 7.4 times less symptom improvement (p=0.038) compared to those with older age. Females showed 6.5 times more re-operation rate (p=0.037) and 7.1 times less symptom improvement (p=0.027) than males. No patients experienced complications such as cerebrospinal fluid leakage, postoperative hemorrhage, or infection. Conclusion Endoscopic surgery is feasible for the treatment of DLICs. Female sex and age <12 months are risk factors for re-operation and less symptom improvement.

Mammography is the standard screening method for breast cancer, proven to reduce mortality. However, its diagnostic performance varies depending on patient characteristics and radiologist expertise. Dense breast tissue, present in approximately 70% of Korean women aged 40 to 59, limits detection by obscuring malignancies. Additionally, optimal interpretation requires extensive training, which is not always achievable. Artificial intelligence-based computer-aided diagnosis (AI-CAD) has emerged as a promising tool for enhancing mammographic accuracy and efficiency.Current Concepts: AI-CAD has shown diagnostic performance comparable to that of experienced radiologists while addressing the limitations of traditional CAD systems, particularly excessive false positives. Studies suggest AI-CAD improves radiologists' accuracy, particularly among those with limited breast imaging experience. In Europe, AI-assisted reading is increasingly recognized as a viable alternative to traditional double reading. In Korea, adoption of AI-CAD is expanding, with systems approved by the Korean Food and Drug Administration currently in clinical use. Recently, one AI-CAD system received conditional non-reimbursement designation, allowing hospitals to use it for up to 5 years while collecting clinical evidence to support future insurance coverage decisions.Discussion and Conclusion: AI-CAD has significant potential to enhance early breast cancer detection while maintaining acceptable false-positive rates, making it a valuable adjunct in screening programs. Beyond improved detection, AI-CAD may optimize workflow efficiency by triaging cases and prioritizing high-risk examinations. However, its integration into clinical practice necessitates standardized guidelines, regulatory oversight, and further validation through large-scale prospective studies. As AI technology continues to advance, ongoing investigation into its role in personalized breast cancer screening is essential.

Plexiform neurofibromas (PNFs), a critical clinical feature of neurofibromatosis type 1, mainly involve several peripheral nerve branches and extend widely, including the skin and bones and the internal organs. Determining the appropriate treatment is difficult. Additionally, they possess the potential to develop into malignant peripheral nerve sheath tumors (MPNSTs), which are linked to an extremely poor prognosis. Active treatment is critical in patients with symptoms or progressive tumor growth, especially in pediatric cases. Surgery remains the standard treatment for managing PNFs and MPNSTs; however, it has often demonstrated insufficient results because of its wide distribution and the frequent involvement of major organs. Selumetinib, a recently approved mitogen-activated protein kinase kinase inhibitor, is gaining traction in treating inoperable PNFs in children.

Plexiform neurofibromas (PNFs), a critical clinical feature of neurofibromatosis type 1, mainly involve several peripheral nerve branches and extend widely, including the skin and bones and the internal organs. Determining the appropriate treatment is difficult. Additionally, they possess the potential to develop into malignant peripheral nerve sheath tumors (MPNSTs), which are linked to an extremely poor prognosis. Active treatment is critical in patients with symptoms or progressive tumor growth, especially in pediatric cases. Surgery remains the standard treatment for managing PNFs and MPNSTs; however, it has often demonstrated insufficient results because of its wide distribution and the frequent involvement of major organs. Selumetinib, a recently approved mitogen-activated protein kinase kinase inhibitor, is gaining traction in treating inoperable PNFs in children.