Dilated cardiomyopathy is the most common form of cardiomyopathy in children and often leads to irreversible myocardial dysfunction. To improve the prognosis, it is critical to identify rare but reversible causes. We report a 12-year-old girl referred to the emergency department for dyspnea on exertion and generalized edema that lasted for 1 month. She gained 20 kg over the past 3 years, which had gone uninvestigated. Transthoracic echocardiography demonstrated left ventricular dysfunction with pericardial effusion. Thyroid function tests revealed concentrations of free T4 and thyroid-stimulating hormone of 0.12 ng/dL (reference value, 0.93-1.7) and 86.9 µIU/mL (0.3-4.2), respectively, with anti-thyroid peroxidase and anti-thyroglobulin antibodies elevated, confirming the presence of autoimmune hypothyroidism. We initiated heart failure management alongside levothyroxine replacement therapy. After 5 months of treatment, a follow-up echocardiography showed improved left ventricular and thyroid function.

We evaluated the content fidelity of written discharge instructions (WDIs) for pediatric patients with mild traumatic brain injury (mTBI). In May 2023, copies of WDIs were collected from 55 academic hospitals across South Korea. Each document was scored for the fidelity of medical advice based on the “Counsel” section of the Pediatric mTBI Guideline Checklist of the Centers for Disease Control and Prevention (maximum 10 points). Among respondent 46 emergency departments, 21 (45.7%) provided WDIs to patients with mTBI. The median score was 6.0 (interquartile range, 4.0-7.0), indicating that the fidelity of the WDIs needs improving.

Purpose: Autism spectrum disorder (ASD) exhibits heterogeneous developmental trajectories; however, longitudinal studies using the Korean Childhood Autism Rating Scale (K-CARS) are scarce. This study examined diagnostic changes and related developmental characteristics through repeated K-CARS assessments. Methods: We retrospectively reviewed the medical records of children who underwent repeated K-CARS assessments between May 2021 and December 2024 at Gyeongsang National University Hospital. Based on diagnostic status at the initial (T1) and follow-up (T2) evaluations, participants were classified as having persistent ASD (ASD at T1 and T2), emerging ASD (non-ASD at T1 but ASD at T2), or desisting ASD (ASD at T1 but non-ASD at T2). Developmental profiles were evaluated using the social quotient (SQ), visual-motor integration (VMI), and language quotients. Results: Forty-three children (32 boys; median age, 2.9 years at T1 and 4.3 years at T2) were included. Twenty-two met ASD criteria at T1, and 15 (68%) retained the diagnosis at T2. Across the cohort, 15 (35%) had persistent ASD, 21 (49%) had emerging ASD, and seven (16%) had desisting ASD. The desisting group showed higher baseline VMI and better outcomes at follow-up. The emerging group initially had higher SQ and VMI than the persistent group, but these differences disappeared over time. Higher baseline VMI was associated with desisting status and higher baseline SQ with emerging ASD (odds ratios, 3.14 and 2.59 per standard deviation increase, respectively; P=0.06 and P=0.07). Conclusion Early ASD diagnoses were generally stable yet variable, supporting repeated assessment. Baseline VMI and SQ may relate to later diagnostic changes.

Sarcopenia is a major geriatric syndrome characterized by progressive loss of muscle mass and strength, resulting in disability and mortality. This narrative review synthesizes international consensus recommendations and Korean evidence to guide context-specific sarcopenia management strategies. PubMed, Embase, Cochrane Library, and KoreaMed (January 2000–November 2025) were searched, focusing on randomized trials, meta-analyses, systematic reviews, clinical practice guidelines, and large observational studies. Global diagnostic frameworks have evolved from muscle mass-based definitions toward multidimensional models that incorporate muscle strength and physical performance. Exercise and nutrition remain the mainstay treatments, with resistance-based training and adequate protein intake. Currently, pharmacologic options with proven clinical benefit are limited. In Korea, growing evidence supports the effectiveness of community-based sarcopenia interventions, underscoring the need for standardized, integrated delivery models that bridge the fragmented healthcare system and enable sustainable implementation.

Background: Mycoplasma pneumoniae is a major cause of community-acquired pneumonia (CAP) in children, with a rising incidence of macrolide resistance. Early diagnosis is crucial for reducing the disease burden; however, current diagnostic tools have limitations.We evaluated the diagnostic accuracy of serological assays and their performance based on symptom onset in children with CAP. Methods: From September 2023 to September 2024, we prospectively enrolled children with CAP, classified as M. pneumoniae pneumonia (MPP) or non-MPP, from 16 hospitals in Korea. Serological testing included chemiluminescence immunoassay (CLIA) and ELISA for detecting IgM and IgG, along with particle agglutination (PA) for total antibody measurements. Serological responses were analyzed at different times after symptom onset (0–4, 5–9, and 10–21 days). Results: Among 472 children with CAP (362 MPP, 110 non-MPP), 138 (29.2%) underwent PA testing, and 334 (70.8%) underwent IgM testing. PA at a 1:640 cutoff showed 48.0% sensitivity and 100% specificity. CLIA and ELISA showed comparable sensitivities (69.1% vs. 69.2%) and specificities (76.9% vs. 66.7%) for IgM testing. Seropositivity increased significantly with time since symptom onset (P for trend < 0.001), reaching 97.9% for IgM, 62.5% for IgG, and 94.7% for PA at 10–21 days. Conclusions The time post-symptom onset significantly influenced the diagnostic utility of serological tests for pediatric MPP, which showed limited value during the early stage of illness. These findings emphasize the importance of symptom onset-based interpretation of serological test results and their utility in complementing PCR when optimizing MPP diagnosis in children.

Purpose: This study explored the lived experiences of correctional officers working with individuals convicted of drug offenses. Methods: Data were collected through individual in-depth interviews and observations with 10 correctional officers who had experience working with individuals convicted of drug offenses. Data were collected from September 15 to November 2, 2025, and analyzed using van Manen’s hermeneutic phenomenological approach to identify essential themes. Results: The themes were interpreted within four existential grounds: body, space, other, and time. The lived body was experienced as a body of blurred judgment and growing powerlessness, a body of heightened alertness and preparedness, and a body that closes itself off for self-preservation. The lived space was experienced as a space in which recovery stagnation and potential coexist, a space in which drug proliferation and interdiction collide, and a space in which correctional responsibility and avoidance conflict. The lived other was experienced as a relationship oscillating between hope and resignation and as a relationship characterized by withheld trust and sustained vigilance. The lived time was experienced as a transition from fulfillment to vigilance, a time of recognizing the power of addiction and issuing warnings, a transition from punishment to recovery, and a time of cycles and growth. Conclusion This study shows that working with individuals convicted of drug offenses is not merely the execution of regulation and control, but an existential practice of care in which correctional officers continually attune themselves to sensing risk, negotiating relationships, and sustaining the possibility of recovery.

This study aimed to investigate the factors influencing end-of-life care competency by examining awareness of person-centered care, knowledge of life-sustaining treatment decisions, and attitudes toward advance directives among nurses in long-term care hospitals. Methods: Through convenience sampling, nurses with more than 6 months of clinical experience and who were responsible for inpatient care in long-term care hospitals in Jennam-do and Gwangju-metropolitan city were selected to participate in this study. Data were collected using a structured self-administered questionnaire between December 1 and 23, 2023. Data were analyzed through descriptive statistics, independent t-test, one-way ANOVA, Scheffé’s test, Pearson’s correlation coefficient, and multiple regression analysis. Results: End-of-life care competency had an average of 3.72 out of 5 points. “Collaboration with team members” had the highest average score and “professional development” the lowest. Multiple regression analysis identified that awareness of person-centered care (β=.31, p<.001), attitudes toward advance directives (β=.31, p<.001), and providing end-of-life care 11 times or more in the past year (β=.17, p=.014) significantly influenced end-of-life care competency. Conclusion: Various educational strategies that promote awareness of person-centered care and foster positive attitudes toward advance directives are needed to enhance nurses’ end-of-life care competency in long-term care hospitals. Additionally, educational programs that provide opportunities for both direct and indirect experience in end-of-life care are needed, as such programs can help establish a system to ensure the delivery of high-quality end-of-life care.

Burning mouth syndrome remains a frequent source of diagnostic delay, repeated consultations, and fragmented care because it has long been treated as a “diagnosis of exclusion.” Recent updates in orofacial pain classification and research diagnostic frameworks support a practical shift: from an exclusionary label toward a structured diagnostic algorithm and staged, phenotype-guided management. This narrative, algorithm-focused clinical review aims to summarize clinically actionable evidence and to propose a “minimum sufficient workup” that prioritizes safety, efficiency, and patient-centered communication.We first outline pragmatic diagnostic criteria and key symptom patterns, then integrate current concepts of mixed mechanisms—peripheral neuropathic features, centralociplastic amplification, and psychosocial modulators—that account for symptom fluctuation and discordance between symptom severity and objective findings. The core of this review is a one-page stepwise algorithm: (1) confirm chronicity and absence of visible mucosal disease, (2) screen for red flags requiring urgent evaluation, (3) address common local contributors (e.g., candidiasis, irritants, contact allergy, xerostomia), (4) perform a targeted systemic/medication/deficiency panel, and (5) phenotype patients to guide staged treatment choices and follow-up. Finally, we provide a practical management framework emphasizing education, trigger control, and individualized combinations of topical, systemic, and behavioral interventions with predefined reassessment intervals. Future priorities include phenotype-stratified randomized trials and implementation outcomes that quantify reductions in diagnostic delay, misdiagnosis, and unnecessary testing.

BACKGROUND/OBJECTIVES: Obesity is a complex metabolic disorder characterized by excessive adipose tissue accumulation, dysregulated lipid metabolism, and insulin resistance, leading to an increased risk of metabolic disease. While Withania somnifera (AS) and Chrysanthemum zawadskii Herbich var. latilobum (Maxim.) Kitamura (C) have traditionally been used for their metabolic regulatory properties, their combined effects on adipogenesis, lipogenesis, lipolysis, and insulin signaling remain unexplored. Therefore, this study aimed to evaluate the anti-obesity effects of AS, C, and their optimal combination (ASC) in 3T3-L1 adipocytes by investigating their impact on lipid metabolism and glucose homeostasis.MATERIALS/METHODS: Following adipogenic differentiation, 3T3-L1 adipocytes were treated with AS, C, and ASC at different concentrations. RESULTS: AS, C, and ASC significantly inhibited adipogenesis by downregulating cyclic adenosine monophosphate (cAMP) response element-binding protein, peroxisome proliferator-activated receptor gamma, CCAAT/enhancer-binding proteins alpha and beta phosphorylation, thereby reducing lipid accumulation in adipocytes. They also suppressed lipogenesis by downregulating the expression of dephosphorylated acetyl-CoA carboxylase, fatty acid synthase, and lipoprotein lipase. In contrast, they markedly enhanced lipolysis, as evidenced by increased hormone-sensitive lipase and protein kinase A expression, along with elevated glycerol release and cAMP levels. Furthermore, AS, C, and ASC activated energy metabolism pathways, as indicated by the upregulation of AMP-activated protein kinase, uncoupling protein 1, and carnitine palmitoyltransferase 1A, suggesting a transition toward enhanced mitochondrial fatty acid oxidation. Notably, AS, C, and ASC significantly improved insulin signaling by restoring insulin receptor substrate 1, phosphoinositide 3-kinase, and Akt phosphorylation, while upregulating glucose transporter type 4 expression, indicating enhanced glucose uptake. Among all treatments, ASC showed relatively greater efficacy compared to AS or C alone, suggesting a potential additive effect. CONCLUSION These findings demonstrate that ASC effectively modulates multiple metabolic pathways in adipocytes, including adipogenesis, lipogenesis, lipolysis, energy metabolism, and insulin signaling, to exert its anti-obesity effects.