The medical metaverse can be defined as a virtual spatiotemporal framework wherein higher-dimensional medical information is generated, exchanged, and utilized through communication among medical personnel or patients. This occurs through the integration of cutting-edge technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI), big data, cloud computing, and others. We can envision a future neurosurgical operating room that utilizes such medical metaverse concept such as shared extended reality (AR/VR) of surgical field, AI-powered intraoperative neurophysiological monitoring, and real-time intraoperative tissue diagnosis. The future neurosurgical operation room will evolve into a true medical metaverse where participants of surgery can communicate in overlapping virtual layers of surgery, monitoring, and diagnosis.

The medical metaverse can be defined as a virtual spatiotemporal framework wherein higher-dimensional medical information is generated, exchanged, and utilized through communication among medical personnel or patients. This occurs through the integration of cutting-edge technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI), big data, cloud computing, and others. We can envision a future neurosurgical operating room that utilizes such medical metaverse concept such as shared extended reality (AR/VR) of surgical field, AI-powered intraoperative neurophysiological monitoring, and real-time intraoperative tissue diagnosis. The future neurosurgical operation room will evolve into a true medical metaverse where participants of surgery can communicate in overlapping virtual layers of surgery, monitoring, and diagnosis.

Purpose: This study aimed to analyze whether the occurrence of complications increases if radiotherapy (RT) is administered after breast reconstructive surgery using implants. Methods: This retrospective study included 80 patients who underwent breast reconstruction using implants, of which 16 (20.0%) underwent RT. Most patients underwent conventional fractionated RT (n = 13), and hypofractionated RT was performed in 3 patients. Most patients (n = 51, 63.8%) underwent delayed reconstruction, which involved implant replacement after tissue expander insertion. Only 29 patients (36.3%) underwent immediate reconstruction simultaneously with breast cancer surgery. Results: The median postoperative follow-up was 39.9 months (range, 8.7–120.3 months). Complications occurred in 18 (22.5%); infectionecrosis (n = 8), leakage/rupture (n = 8), and capsular contracture (n = 2). Infectionecrosis is common in patients undergoing RT. Complications occurred in 4 patients (25.0%) who received RT and 14 (21.9%) who did not receive RT, and complications did not significantly increase with RT (P = 0.511). There was no overall difference in complications between the immediate (4 of 29) and delayed (14 of 51) reconstruction groups (P = 0.129). Nine patients underwent reoperation because of complications; 3 (18.8%) received RT and 6 (9.4%) did not receive RT. The reoperation rate did not increase significantly with RT (P = 0.254). There were 3 cases of recurrence, and patients who received RT had no recurrence. Conclusion RT did not significantly increase the complication or reoperation rates if reconstructive surgery was performed using implants. Therefore, RT should be performed in patients at a high risk of recurrence.

The medical metaverse can be defined as a virtual spatiotemporal framework wherein higher-dimensional medical information is generated, exchanged, and utilized through communication among medical personnel or patients. This occurs through the integration of cutting-edge technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI), big data, cloud computing, and others. We can envision a future neurosurgical operating room that utilizes such medical metaverse concept such as shared extended reality (AR/VR) of surgical field, AI-powered intraoperative neurophysiological monitoring, and real-time intraoperative tissue diagnosis. The future neurosurgical operation room will evolve into a true medical metaverse where participants of surgery can communicate in overlapping virtual layers of surgery, monitoring, and diagnosis.

The medical metaverse can be defined as a virtual spatiotemporal framework wherein higher-dimensional medical information is generated, exchanged, and utilized through communication among medical personnel or patients. This occurs through the integration of cutting-edge technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI), big data, cloud computing, and others. We can envision a future neurosurgical operating room that utilizes such medical metaverse concept such as shared extended reality (AR/VR) of surgical field, AI-powered intraoperative neurophysiological monitoring, and real-time intraoperative tissue diagnosis. The future neurosurgical operation room will evolve into a true medical metaverse where participants of surgery can communicate in overlapping virtual layers of surgery, monitoring, and diagnosis.

Purpose: This study aimed to analyze whether the occurrence of complications increases if radiotherapy (RT) is administered after breast reconstructive surgery using implants. Methods: This retrospective study included 80 patients who underwent breast reconstruction using implants, of which 16 (20.0%) underwent RT. Most patients underwent conventional fractionated RT (n = 13), and hypofractionated RT was performed in 3 patients. Most patients (n = 51, 63.8%) underwent delayed reconstruction, which involved implant replacement after tissue expander insertion. Only 29 patients (36.3%) underwent immediate reconstruction simultaneously with breast cancer surgery. Results: The median postoperative follow-up was 39.9 months (range, 8.7–120.3 months). Complications occurred in 18 (22.5%); infectionecrosis (n = 8), leakage/rupture (n = 8), and capsular contracture (n = 2). Infectionecrosis is common in patients undergoing RT. Complications occurred in 4 patients (25.0%) who received RT and 14 (21.9%) who did not receive RT, and complications did not significantly increase with RT (P = 0.511). There was no overall difference in complications between the immediate (4 of 29) and delayed (14 of 51) reconstruction groups (P = 0.129). Nine patients underwent reoperation because of complications; 3 (18.8%) received RT and 6 (9.4%) did not receive RT. The reoperation rate did not increase significantly with RT (P = 0.254). There were 3 cases of recurrence, and patients who received RT had no recurrence. Conclusion RT did not significantly increase the complication or reoperation rates if reconstructive surgery was performed using implants. Therefore, RT should be performed in patients at a high risk of recurrence.

Purpose: This study aimed to analyze whether the occurrence of complications increases if radiotherapy (RT) is administered after breast reconstructive surgery using implants. Methods: This retrospective study included 80 patients who underwent breast reconstruction using implants, of which 16 (20.0%) underwent RT. Most patients underwent conventional fractionated RT (n = 13), and hypofractionated RT was performed in 3 patients. Most patients (n = 51, 63.8%) underwent delayed reconstruction, which involved implant replacement after tissue expander insertion. Only 29 patients (36.3%) underwent immediate reconstruction simultaneously with breast cancer surgery. Results: The median postoperative follow-up was 39.9 months (range, 8.7–120.3 months). Complications occurred in 18 (22.5%); infectionecrosis (n = 8), leakage/rupture (n = 8), and capsular contracture (n = 2). Infectionecrosis is common in patients undergoing RT. Complications occurred in 4 patients (25.0%) who received RT and 14 (21.9%) who did not receive RT, and complications did not significantly increase with RT (P = 0.511). There was no overall difference in complications between the immediate (4 of 29) and delayed (14 of 51) reconstruction groups (P = 0.129). Nine patients underwent reoperation because of complications; 3 (18.8%) received RT and 6 (9.4%) did not receive RT. The reoperation rate did not increase significantly with RT (P = 0.254). There were 3 cases of recurrence, and patients who received RT had no recurrence. Conclusion RT did not significantly increase the complication or reoperation rates if reconstructive surgery was performed using implants. Therefore, RT should be performed in patients at a high risk of recurrence.

Migrant workers face challenging working conditions, resulting in physical and mental vulnerability. The objective is to identify their health vulnerabilities and ensure their right to health. Health records of 163 migrant workers (113 males and 50 females) (Group A) and 163 Korean citizens (Group B) visiting our institution were analyzed from August 2021 to July 2022. Both groups underwent urine analysis, chest radiography, and various blood tests. Statistical analysis using independent t-tests and χ2 tests was performed. Group A had a significantly higher rate of hepatitis B virus surface antigen-positive patients, lower vaccination rates for hepatitis B, and poorer nutritional status compared to Group B. Group B generally exhibited higher levels of albumin, glucose, total cholesterol, and thyroidstimulating hormone. There were significant quantitative differences in multiple blood cell and hemoglobin measurements between the two groups. These findings emphasize the need for policy support and public awareness to protect the health rights of migrant workers.

Purpose: The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in earlystage. Materials and Methods: Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected. Results: Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence. Conclusion Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.

Background: Prognosis of patients with diverse chronic diseases is reportedly associated with 25-hydroxyvitamin D levels. In this study, we investigated the potential role of 25-hydroxyvitamin D3 (25[OH]D3) levels in improving the predictive power of conventional prognostic models for patients with liver cirrhosis. Methods: We investigated clinical findings, including serum 25(OH)D3 levels at admission, of 155 patients with cirrhosis who were followed up for a median of 16.9 months. Results: Median 25(OH)D3 levels were significantly different among patients exhibiting Child-Pugh grades A, B, and C. Mortality, including urgent transplantation, was significantly associated with 25(OH)D3 levels in univariate analysis. Severe vitamin-D deficiency (serum 25[OH]D3 level < 5.0 ng/mL) was significantly related to increased mortality, even after adjusting for Child-Pugh and Model for End-stage Liver Disease (MELD) scores. In particular, the presence of severe vitamin D deficiency clearly defined a subgroup with significantly poorer survival among patients with Child-Pugh scores of 5–10 or MELD scores ≤ 20. A new combination model of MELD score and severe vitamin D deficiency showed significantly more accurate predictive power for short- and long-term mortality than MELD scores alone. Additionally, serum 25(OH)D3 levels and new model scores were significantly associated with the development of spontaneous bacterial peritonitis, overt encephalopathy, and acute kidney injury. Conclusion Serum 25(OH)D3 level is an independent prognostic factor for patients with liver cirrhosis and has a differential impact on disease outcomes according to MELD and Child-Pugh scores.