Background: This study was performed to establish a rabbit model for esophageal surgery in the treatment of cervical esophageal diseases. The necessary steps for postoperative treatment and esophageal examination were detailed. Methods: This study aimed to confirm the feasibility of the surgical procedure in rabbits and develop a postoperative management protocol. Six New Zealand White rabbits underwent esophagectomy and end-to-end anastomosis of the cervical esophagus under general anesthesia. Postoperatively, the rabbits were fed a specially formulated therapeutic liquid diet for 3 to 7 days. Recovery was monitored for 8 weeks, after which the rabbits were euthanized. Esophagography and endoscopy were conducted during the first postoperative week to assess healing. Results: Of the six rabbits that underwent surgery, two died from nonsurgical complications within 7 days after the operation. Of the remaining rabbits, two were diagnosed with esophageal stricture via esophagography and underwent endoscopy after the first postoperative week. The final two rabbits completed the 8-week postoperative period without complications. Conclusions Esophageal surgery and postoperative treatment in rabbits require careful attention. We anticipate that this study will provide valuable and practical information for researchers conducting esophageal studies using rabbits.

Optimal vascular access and effective closure are fundamental for ensuring the safety and success of percutaneous cardiovascular interventions. As procedural complexity has increased, various access and closure devices have been developed to enhance efficacy and minimize complications. Radial artery access is favored for coronary interventions because it is associated with a lower risk of bleeding and fewer access site complications. However, femoral access remains indispensable for large-bore procedures. Large-bore sheaths are required for endovascular treatments of peripheral artery disease and structural heart interventions. Ultrasound-guided arterial and venous access has become essential for minimizing complications, especially with femoral access. Despite significant advances in closure techniques, complications such as retroperitoneal hemorrhage, pseudoaneurysm, and arteriovenous fistula remain challenging and can adversely affect patient outcomes. This review presents state-of-the-art strategies for the prevention and management of vascular access complications in cardiovascular intervention.

Objective: Although most gallbladder polyps are benign, some neoplastic polyps may be malignant or may serve as precursors to malignancy. Distinguishing neoplastic and non-neoplastic polyps using imaging examinations remains a major challenge.This meta-analysis aimed to identify the ultrasound (US) features that are significantly associated with neoplastic polyps. Materials and Methods: The MEDLINE, EMBASE, Cochrane, and KoreaMed databases were searched for articles published up to August 31, 2025. Bivariate random-effects models were used to calculate the meta-analytic pooled diagnostic odds ratios (DORs), sensitivities, and specificities, along with their 95% confidence intervals (CIs), for each US imaging feature in the diagnosis of neoplastic polyps. Results: Thirty studies evaluating 8,953 patients, including 1,216 (13.6%) patients with neoplastic polyps, were included.Among the nine evaluated US imaging features, namely, size ≥10 mm, sessile morphology, single polyp, coexisting gallstones, hypoechogenicity, heterogeneous echogenicity, gallbladder wall thickening (GBWT), absence of hyperechoic spot, and vascularity, eight were significantly associated with neoplastic polyps: size ≥10 mm (DOR: 6.23 [95% CI: 1.86– 20.90]), sessile morphology (DOR: 3.54 [1.93–5.97]), single polyp (DOR: 2.21 [1.76–2.74]), coexisting gallstones (DOR:1.86 [1.29–2.60]), hypoechogenicity (DOR: 3.55 [1.47–7.30]), GBWT (DOR: 9.38 [1.47–32.20]), absence of hyperechoic spots (DOR: 4.23 [2.46–6.83]), and vascularity (DOR: 9.72 [5.81–15.30]). Of these, size ≥10 mm demonstrated the highest pooled sensitivity (0.79 [95% CI: 0.68–0.87]), whereas hypoechogenicity showed the highest pooled specificity (0.93 [95% CI: 0.82–0.98]). Conclusion Eight US imaging features (size ≥10 mm, sessile morphology, single polyp, coexisting gallstones, hypoechogenicity, GBWT, absence of hyperechoic spots, and vascularity) were significantly associated with the presence of neoplastic polyps.These features may facilitate the management of gallbladder polyps.

Obesity is a chronic, progressive neuroendocrine disease that warrants a shift toward an “onco-bariatric” treatment paradigm. This study introduces the tri-phasic metabolic obesity (TPMO) framework, which integrates glucagon-like peptide-1 receptor agonists (GLP-1 RAs) with metabolic bariatric surgery (MBS). Recent clinical and economic evidence—including findings from the Indiana multicenter study and the Highmark Health analysis—was reviewed to evaluate the effectiveness of the TPMO model in improving surgical and metabolic outcomes. The TPMO framework streamlines the patient journey through three synergistic phases. In the neoadjuvant phase, a 4–8-week course of GLP-1 RAs reduces liver volume and visceral fat, thereby improving surgical access, provided that treatment is discontinued 1 week before surgery to mitigate aspiration risk. During the core surgery phase, MBS provides a definitive metabolic reset and remains the most cost-effective treatment, yielding an average savings of $11,689 per patient over 2 years compared with medication alone. In the adjuvant phase, pharmacotherapy—used by 17.2% of post-bariatric patients—counteracts metabolic adaptation and supports sustained weight loss, while a high-protein intake (≥1.2 g/kg/day) is essential for preserving lean body mass. The TPMO framework represents a precision-based, synergistic standard of care designed to promote durable, cost-effective long-term metabolic health within the onco-bariatric paradigm.

Endocrine-disrupting chemicals (EDCs) and persistent organic pollutants (POPs) cross the placenta and accumulate during gestation and early postnatal life, periods of heightened hormonal and neurodevelopmental plasticity. Exposure to contaminants such as bisphenol A (BPA), phthalates, polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) during these critical windows can reprogram endocrine and neural circuits, resulting in persistent behavioral alterations. This review synthesizes mechanistic evidence from animal models and epidemiological studies linking developmental EDC/POP exposure to attention deficits, impulsivity, anxiety and altered reward sensitivity—phenotypes defined here as addiction vulnerability (addiction-relevant endophenotypes) rather than clinically diagnosed substance-use disorder (SUD). We propose a two-hit, adverse outcome pathway (AOP)-informed model in which prenatal EDC/POP exposure induces endocrine-related perturbations that prime reward and stress circuitry. Subsequent exposure to psychoactive drugs and/or chronic stress then acts on these sensitized systems to increase the probability of maladaptive reinforcement learning and impaired behavioral control. Mechanistically, early-life exposures disrupt thyroid and sex-steroid signaling, dysregulate the hypothalamic–pituitary–adrenal axis, and alter dopaminergic, serotonergic, and glutamatergic neurotransmission with additional modulation by epigenetic reprogramming, oxidative stress, and neuroinflammation. Human cohort studies consistently associate prenatal BPA and phthalate exposures with adverse neurobehavioral and externalizing symptoms in children, supporting this framework while underscoring the limited availability of longitudinal data linking early exposure to SUD outcomes. Integrating these findings within an AOP perspective highlights the importance of developmental timing, sex, dose, genetic background, and co-exposures, and supports risk-assessment strategies that account for sequential environmental and drug exposures.

Subglottic stenosis (SGS) and tracheal stenosis (TS) are rare conditions that can cause significant breathing difficulties and, if not properly managed, may lead to life-threatening complications. Despite their clinical importance, debate continues regarding the optimal management of adult SGS and TS, and no comprehensive guidelines have been established to date. The Korean Bronchoesophagological Society appointed a task force to develop clinical practice guidelines with the goal of providing evidence-based recommendations for managing SGS and TS in adults. The task force conducted a systematic review of the relevant literature by searching PubMed, Embase, and the Cochrane Library using predefined search terms aligned with key clinical questions. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach, which also informed the formulation and reporting of the recommendations. The strength of each recommendation reflects the guideline panel’s confidence that the benefits of an intervention outweigh its risks for eligible patients. After drafting the guidelines, feedback was obtained through Delphi questionnaires completed by members of the Korean Bronchoesophagological Society. Ultimately, the committee developed 17 evidence-based recommendations across four categories: initial evaluation, medical management, surgical treatment, and postoperative management and rehabilitation. These guidelines aim to support clinicians in delivering optimal care to adult patients with SGS and TS.

Purpose: Radiotherapy (RT) remains a cornerstone of curative treatment for localized and locally advanced prostate cancer. However, dose escalation to improve tumor control is often constrained by the proximity of the rectum, which increases the risk of gastrointestinal (GI) and genitourinary toxicities. Biodegradable rectal spacers inserted between the prostate and rectum have emerged as an effective approach to reduce rectal radiation exposure. This guideline provides evidence-based recommendations on indications, contraindications, procedural standards, and clinical management for biodegradable rectal spacer insertion during prostate cancer RT. Materials and Methods: This guideline was developed by a multidisciplinary expert panel through a systematic review of the literature, analysis of international guidelines (National Comprehensive Cancer Network, European Association of Urology, American Society for Radiation Oncology), and expert consensus among radiation oncologists, radiologists, and urologists with clinical experience in spacer insertion. The strength of each recommendation and the level of evidence were classified according to the modified GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. Results: Spacer insertion is conditionally recommended (Grade C, Level I) for patients receiving definitive external-beam RT without rectal invasion. It reduces the high-dose rectal irradiation volume (V70–75) by >50%, decreases acute GI toxicity, and helps maintain bowel-related quality of life. However, the benefit for late severe toxicity (grade 2 or higher) remains debated in recent meta-analyses. Contraindications include rectal invasion, anatomical inaccessibility, infection, and material hypersensitivity. Procedures should be performed under local anesthesia in a sterile environment by trained physicians. Short-course antibiotics and simulator-based training, including completion of multiple supervised cases, are advised. Conclusion Biodegradable rectal spacer insertion is clinically validated and effective in reducing acute rectal toxicity. Although pivotal trials demonstrated a favorable procedural safety profile, real-world postmarket data include reports of rare but severe procedural complications. This guideline provides standardized recommendations tailored to Korean clinical practice while remaining consistent with international standards, emphasizing the importance of operator training and careful patient selection.

Background: The World Health Organization has declared the end of the coronavirus disease 2019 (COVID-19) public health emergency. However, this did not indicate the end of COVID-19. Several months after the infection, numerous patients complain of respiratory or nonspecific symptoms; this condition is called long COVID. Even patients with mild COVID-19 can experience long COVID, thus the burden of long COVID remains considerable. Therefore, we conducted this study to comprehensively analyze the effects of long COVID using multi-faceted assessments. Materials and Methods: We conducted a prospective cohort study involving patients diagnosed with COVID-19 between February 2020 and September 2021 in six tertiary hospitals in Korea. Patients were followed up at 1, 3, 6, 12, 18, and 24 months after discharge. Long COVID was defined as the persistence of three or more COVID-19-related symptoms. The primary outcome of this study was the prevalence of long COVID after the period of COVID-19. Results: During the study period, 290 patients were enrolled. Among them, 54.5 and 34.6% experienced long COVID within 6 months and after more than 18 months, respectively. Several patients showed abnormal results when tested for post-traumatic stress disorder (17.4%) and anxiety (31.9%) after 18 months. In patients who underwent follow-up chest computed tomography 18 months after COVID-19, abnormal findings remained at 51.9%. Males (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05–0.53; P=0.004) and elderly (OR, 1.04; 95% CI, 1.00–1.09; P=0.04) showed a significant association with long COVID after 12–18 months in a multivariable logistic regression analysis. Conclusion Many patients still showed long COVID after 18 months post SARS-CoV-2 infection. When managing these patients, the assessment of multiple aspects is necessary.

Objective: : Korea’s healthcare system and policy promotes early, actively stroke treatment to improve prognosis. This study represents stroke epidemiology and outcomes in Korea. Methods: : This study investigated data from the Acute Stroke Assessment Registry. The registry collects data from over 220 hospitals nationwide, focusing on quality stroke service management. Data analysis included patient demographics, stroke severity assessment, and discharge prognosis measurement using standardized scales. Results: : Eighty-six thousand five hundred sixty-eight acute stroke patients were collected with demographic and clinical characteristics during 18 months from 2016, 2018, and between 2020 to 2021, focusing on acute subarachnoid hemorrhage (SAH), acute intracerebral hemorrhage (ICH), and acute ischemic stroke. Of these 86568 patients, 8.3% was SAH, 16.3% ICH, and 74.9% ischemic stroke. Trends showed decreasing SAH and increasing ICH cases over the years. 68.3% stroke patients had the clear onset time. 49.6% stroke patients arrived within 4.5 hours of symptom onset, with more patients treated at general hospitals. Good functional outcomes at discharge was obtained with 58.3% of acute stroke patients, 55.9% of SAH patients, 34.6% of ICH patients, and 63.8% of ischemic stroke patients. Conclusion : The results showed that ischemic stroke was the most common subtype, followed by ICH and SAH. Prognosis differed among subtypes, with favorable outcomes more common in ischemic stroke and SAH compared to ICH.

The use of miniscrew-assisted rapid palatal expansion (MARPE) has yielded successful outcomes in late adolescence and early adulthood, particularly in correcting transverse maxillary discrepancies and enhancing airway expansion. This report presents three cases of children at different dentition stages treated with MARPE. In one patient with severe crowding, MARPE enabled dental alignment without the need for premolar extractions. Additionally, MARPE combined with facemask therapy improved the patient’s facial profile, resulting in high patient and guardian satisfaction. These cases highlight MARPE’s potential as an effective treatment for maxillary discrepancies and severe arch length discrepancies in children.