Purpose: To investigate the clinical characteristics of South Korean patients with pericentral retinitis pigmentosa (RP) and to identify clinical biomarkers associated with rapid visual acuity decline based on baseline factors. Methods: This retrospective study included 59 eyes of 31 patients diagnosed with pericentral RP. Comprehensive ophthalmological examinations and genetic sequencing were conducted to assess the baseline characteristics. For biomarker analysis, eyes were categorized into two groups based on the annual rate of change in visual acuity. The clinical findings of the two groups were evaluated to identify the biomarkers associated with rapid loss of visual acuity. Results: Patients with pericentral RP in this study exhibited a mean best-corrected visual acuity of 0.17 ± 0.23 in logarithm of the minimum angle of resolution. The visual field test showed annular or semicircular scotoma with relatively preserved periphery and 27 eyes (45.8%) exhibited no macular complications in optical coherence tomography. Genetic analysis identified genes associated with previous typical and pericentral RP studies but also highlighted that many genetic causes of pericentral RP remain unidentified. Of the 55 eyes for which the rate of visual acuity change could be estimated, 18 exhibited an annual decline of ≥10%, whereas 37 showed an annual decline of <10%. Male sex and prolonged b-wave latency on dark-adapted 0.01 electroretinogram correlated with rapid visual acuity decline in the multivariate analysis. Conclusions South Korean patients with pericentral RP exhibited a milder phenotype compared to typical RP patients reported in previous studies. Genetic analysis revealed heterogeneity, with mutations in some genes commonly associated with milder forms of RP. Male sex and prolonged b-wave latency on dark-adapted 0.01 electroretinogram were significant biomarkers for predicting rapid visual acuity decline. Monitoring initial b-wave latency is important for predicting visual decline, particularly in male patients with pericentral RP.

BACKGROUND/OBJECTIVES: Particulate matter 2.5 (PM2.5) exposure can promote epithelialmesenchymal transition (EMT) in human retinal pigment epithelial (RPE) cells. The flowers of Tagetes erecta Linn, commonly known as marigold, are rich in diverse flavonoids and carotenoids and play a significant role in preventing cellular damage induced by oxidative stress, but the role of their extracts in RPE cells has not been reported. This study aimed to evaluate the influence of an ethanol extract of T. erecta Linn flower (TE) on PM2.5-induced EMT processes in RPE ARPE-19 cells.MATERIALS/METHODS: To investigate the protective effect of TE against ARPE-19 cell damage following PM2.5 treatment, cells were exposed to TE for 1 h before exposure to PM2.5 for 24 h. We investigated whether the efficacy of TE on suppressing PM2.5-induced EMT was related to antioxidant activity and the effect on the expression changes of factors involved in EMT regulation. Additionally, we further explored the role of intracellular signaling pathways associated with EMT inhibition. RESULTS: TE significantly blocked PM2.5-induced cytotoxicity while effectively preventing mitochondrial dysfunction, increased reactive oxygen species (ROS) generation, and mitochondrial membrane potential disruption. TE inhibited PM2.5-induced EMT and inflammatory response by suppressing the ROS-mediated transforming growth factor-β/ suppressor of mothers against decapentaplegic/mitogen-activated protein kinases signaling pathway. CONCLUSION Our results suggest that marigold extract is a highly effective in protection against PM2.5-induced eye damage.

Objective: In South Korea, there is a significant gap in systematic, evidence-based research on intensive case management (ICM) for individuals with severe mental illness (SMI). This study aims to evaluate the effectiveness of ICM through a randomized controlled trial (RCT) comparing ICM with standard case management (non-ICM). Methods: An RCT was conducted to assess the effectiveness of Seoul-intensive case management (S-ICM) vs. non-ICM in individuals with SMI in Seoul. A total of 78 participants were randomly assigned to either the S-ICM group (n=41) or the control group (n=37). Various clinical assessments, including the Brief Psychiatric Rating Scale (BPRS), Montgomery–Åsberg Depression Rating Scale, Health of the Nation Outcome Scale, and Clinical Global Impression-Improvement (CGI-I), along with quality-of-life measures such as the WHO Disability Assessment Schedule, WHO Quality of Life scale, and Multidimensional Scale of Perceived Social Support (MSPSS) were evaluated over a 3-month period. Statistical analyses, including analysis of covariance and logistic regression, were used to determine the effectiveness of S-ICM. Results: The S-ICM group had significantly lower odds of self-harm or suicidal attempts compared to the control group (adjusted odds ratio [aOR]=0.30, 95% confidence interval [CI]: 0.21–1.38). Psychiatric symptoms measured by the BPRS and perceived social support measured by the MSPSS significantly improved in the S-ICM group. The S-ICM group also had significantly higher odds of CGI-I compared to the control group (aOR=8.20, 95% CI: 2.66–25.32). Conclusion This study provides inaugural evidence on the effectiveness of S-ICM services, supporting their standardization and potential nationwide expansion.

With the increasing emphasis on diversity, equity, and inclusion (DEI) in organizations and institutions, academic societies in gastroenterology and hepatology are beginning to take actionable steps toward achieving DEI. The successful implementation of DEI initiatives leads to excellence in the field, improved patient outcomes, particularly in areas where health disparities are prevalent, and advances in the gastrointestinal discipline. Such implementation also results in a workforce that better reflects the growing diversity of the population. This review defines DEI and introduces the DEI policies and strategies adopted by the academic societies of gastroenterology in other countries. This paper proposes strategies to integrate DEI better into the Korean Society of Gastroenterology, emphasizing the importance of embedding DEI into the culture and strategic framework. The key strategies include establishing a DEI committee, setting clear targets, and conducting formal assessments to measure DEI progress. This study focused on enhancing workforce diversity, particularly among women and young doctors, and advocates for the need to support their academic development through male allyship and the promotion of equitable and inclusive academic cultures.

Background/Aims: The clinical outcomes and optimal treatment of esophageal squamous cell carcinoma (ESCC) in elderly patients are unclear. This study aimed to assess the clinical outcomes of ESCC in patients aged ≥ 80 years. Methods: Medical records of patients diagnosed with ESCC between December 2008 and February 2024 were retrospectively reviewed. In total, 479 patients with ESCC were included and divided into the elderly (n = 52) and younger (n = 427) groups based on age. The clinical outcomes and survival rates, according to treatment, were compared between the two groups. Results: The median ages of the two groups were 82 years (range, 80–95 yr) and 66 years (41–79 yr). The overall survival was slightly lower in the elderly group; however, no statistical significance (hazard ratio [HR] 1.27, 95% confidence interval [CI] 0.85−1.91; p = 0.238) was observed. No differences were observed in the outcomes or survival between the two groups according to the treatment method (surgery, chemoradiotherapy or radiotherapy alone, and endoscopic resection). The elderly group was more likely to receive no treatment for cancer (30.8% vs. 13.6%, p = 0.002) than the younger group. However, when there was no treatment for cancer in the elderly group, survival was significantly lower than when treatment was administered (HR 0.08, 95% CI 0.03−020; p < 0.001). Conclusions In patients with ESCC aged ≥ 80 years, active cancer treatment was beneficial, and the results did not differ from those of younger patients.

Schwann cells are the most abundant cells in the peripheral nervous system, maintaining the development, function and regeneration of peripheral nerves. Defects in these Schwann cells injury response potentially contribute to the pathogenesis of diabetic peripheral neuropathy (DPN), a common complication of diabetes mellitus. The protein p66shc is essential in regulating oxidative stress responses, autophagy induction and cell survival, and is also vital in the development of DPN. In this study, we hypothesized that p66shc mediates high glucose-induced oxidative stress and autophagic dysfunction. In Schwann cells treated with high glucose; p66shc expression, levels of reactive oxygen species, autophagy impairment, and early apoptosis were elevated. Inhibition of p66shc gene expression by siRNA reversed high glucose-induced oxidative stress, autophagy impairment, and early apoptosis. We also demonstrated that the levels of p66shc was increased, while autophagy-related proteins p62 and LC3 (LC3-II/I) were suppressed in the sciatic nerve of streptozotocin-induced diabetes mice. P66shc-deficient mice exhibited the improvement in autophagy impairment after diabetes onset. Our findings suggest that the p66 plays a crucial role in Schwann cell dysfunction, identifying its potential as a therapeutic target.

Purpose: The immunological response and adverse effects of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) in patients receiving coronavirus disease-2019 (COVID-19) vaccines remain unclear. We aimed to evaluate the effects of these vaccines on AAV disease activity. Materials and Methods: We reviewed the medical records of 52 patients with AAV who had received at least second doses of the COVID-19 vaccine and evaluated their immunogenicity by measuring the anti-spike (S) antibody (Ab) titer levels using the Roche Elecsys® immunoassay. Responses to the Birmingham Vasculitis Activity Score (BVAS) tool and 36-Item Short Form Survey before and after vaccination were obtained to assess AAV disease activity. Vaccine reactivity was measured using a standardized questionnaire. Results: We enrolled 52 patients with AAV. No differences were found between those who received second and third doses of vaccination in terms of AAV type, disease activity, vaccine type, or the use of immunosuppressive agents, including steroids. The median anti-S Ab titer was 3967.0 after third doses compared to 419.0 after second doses (p=0.001). Except for mycophenolate mofetil (MMF), when immunosuppressants were administered in conjunction with steroids, the Ab titer was higher after the third vaccination than that after the second dose. The BVAS remained unchanged before and after second and third doses. No life-threatening adverse events were reported. Conclusion Although COVID-19 vaccine may not produce sufficient antibodies in patients taking MMF, the vaccine did not exacerbate disease activity or cause severe side effects. Therefore, COVID-19 vaccines should be considered in patients with AAV.

Objectives: This study was performed to evaluate the utilization patterns of acid suppressants following the withdrawal of ranitidine in Korea. Methods: Health Insurance Review & Assessment Service (HIRA) data from January 2016 to May 2023 were utilized to assess the usage of histamine H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) for acid-related diseases. Drug utilization was calculated for each agent based on the defined daily dose (DDD). To evaluate changes in utilization following the ranitidine recall, an interrupted time series analysis was conducted using segmented linear regression and an autoregressive integrated moving average model. Results: Before the withdrawal of ranitidine, the DDD per 100 000 inhabitants per day was increasing by 6.9 (95% confidence interval [CI], 4.7 to 9.0) for H2RAs and by 19.3 (95% CI, 16.9 to 21.8) for PPIs each month. After the recall, H2RA utilization immediately declined by -1041.7 (95% CI, -1115.8 to -967.7), followed by a monthly increase of 6.6 (95% CI, 3.7 to 9.6) above the previous trend. PPI utilization temporarily surged by 235.2 (95% CI, 149.1 to 321.3), then displayed a monthly increase of 4.1 (95% CI, 0.7 to 7.6) on top of the pre-recall trend. Among PPIs, esomeprazole and rabeprazole demonstrated notable increases, representing the most commonly used acid suppressants in 2023. Conclusions PPI usage rose prominently following the withdrawal of ranitidine from the market. Considering the potential adverse effects of PPIs, further research is necessary to evaluate the public health implications of shifts in the utilization of acid suppressants.

Background: The prognosis of end-of-life patients is challenging, and clinicians have attempted to predict survival more accurately. High serum creatinine (sCr) levels are associated with lower survival rates in patients with various cancers; however, low sCr levels are commonly expected in patients with terminal cancer because of muscle wasting and malnutrition. Therefore, we investigated the prevalence of low and high sCr levels and their association with survival duration in patients with terminal cancer in a palliative care unit. Methods: We analyzed the medical records of 280 patients admitted to a palliative care unit. Patients were divided into low (<0.5 mg/dL), normal (0.5–1.2 mg/dL), and high (>1.2 mg/dL) sCr groups. Kaplan-Meier survival curves using sCr levels were plotted and compared using the log-rank test. Using stepwise selection, a multivariable Cox proportional hazards model was used to identify the significant prognostic factors. Results: The median survival durations in the high-, low-, and normal-sCr groups were 9.57 days, 22.26 days, and 27.51 days, respectively. Multivariable Cox proportional hazard model identified that males (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.16–2.85), poor performance status (HR, 3.43; 95% CI, 1.12–10.54), total parenteral nutrition use (HR, 1.84; 95% CI, 1.09–3.1), high sCr (HR, 2.74; 95% CI, 1.52–4.94), and low sCr (HR, 1.22; 95% CI, 1.07–1.43) were significantly associated with a shorter survival time. Conclusion Low and high serum creatinine levels were significantly associated with poor survival in patients with cancer at the end-of-life stage. Therefore, readily available and simple biomarkers may help plan advanced care in palliative care settings.