Background: The ionic mechanism underlying Brugada syndrome (BrS) arises from an imbalance in transient outward current flow between the epicardium and endocardium.Previous studies report that artemisinin, originally derived from a Chinese herb for antimalarial use, inhibits the Ito current in canines. In a prior study, we showed the antiarrhythmic effects of artemisinin in BrS wedge preparation models. However, quinidine remains a well-established antiarrhythmic agent for treating BrS. Therefore, this study aims to investigate the efficacy of combining artemisinin with low-dose quinidine in suppressing ventricular tachyarrhythmia (VTA) in experimental canine BrS models. Methods: Transmural pseudo-electrocardiogram and epicardial/endocardial action potential (AP) were recorded from coronary-perfused canine right ventricular wedge preparation. To mimic the BrS model, acetylcholine (3 μM), calcium channel blocker verapamil (1 μM), and Ito agonist NS5806 (6–10 μM) were administered until VTA was induced. Subsequently, lowdose quinidine (1–2 μM) combined with artemisinin (100 μM) was perfused to mitigate VTA.Key parameters, including AP duration, J wave area, notch index, and T wave dispersion, were measured. Results: After administering the provocation agents, all sample models exhibited prominent J waves and VTA. Artemisinin alone (100–150 μM) suppressed VTA and restored the AP dome in all three preparations. Its infusion resulted in reductions in the J wave area and epicardial notch index. Consequently, low-dose quinidine (1–2 μM) did not fully restore the AP dome in all six sample models. However, when combined with additional artemisinin (100 μM), lowdose quinidine effectively suppressed VTA in all six models and restored the AP dome while also decreasing the J wave area and epicardial notch index. Conclusion Low-dose quinidine alone fails to fully alleviate VTA in the BrS wedge model.However, its combination with artemisinin effectively suppresses VTA. Artemisinin may reduce the therapeutic dose of quinidine, potentially minimizing its associated adverse effects.

Background: Researchers have proposed that there is a potential link between folliclestimulating hormone (FSH) and cognitive function, yet the evidence remains inconclusive.The current study aims to identify the association between serum FSH levels and cognitive performance, and to examine whether this association varies by cognitive diagnosis, serum estradiol (E2) levels, or cognitive domain. Methods: This multicenter cross-sectional study used a clinical database comprising female visitors to memory clinics at three referral hospitals in Korea. Venous blood samples were collected to determine serum FSH and E2 concentrations via immunoradiometric assay.Cognitive performance was evaluated using either the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease or the Seoul Neuropsychological Screening Battery, while cognitive diagnoses were made via clinical diagnostic interviews. Results: Among the 159 participants (normal cognition [NC], n = 70; mild cognitive impairment [MCI], n = 52; Alzheimer’s disease [AD] dementia, n = 37), there were no significant differences in serum FSH levels associated with cognitive diagnosis. In women with NC, serum FSH levels were found to be positively correlated with cognitive performance in global cognition, nonverbal memory, and executive function, even after adjusting for serum E2 level and its interaction with serum FSH level. However, no significant correlations were observed in women with MCI and AD dementia. Conclusion The association between circulating FSH and cognition may be independent from circulating E2, but it may depend on disease progression or cognitive domains. This suggests a potential role of gonadotropin in cognitive decline in elderly women.

Background: Immunocompromised (IC) pediatric patients are at increased risk of severe acute respiratory syndrome coronavirus 2 infection, but the viral kinetics and seroimmunologic response in pediatric IC patients are not fully understood. Methods: From April to June 2022, a prospective cohort study was conducted. IC pediatric patients hospitalized for coronavirus disease 2019 (COVID-19) were enrolled. Serial saliva swab and serum specimens were subjected to reverse transcription polymerase chain reaction assays with mutation sequencing, viral culture, anti-spike-protein, anti-nucleocapsid antibody assays, plaque reduction neutralization test (PRNT) and multiplex cytokine assays. Results: Eleven IC children were evaluated. Their COVID-19 symptoms resolved promptly (median, 2.5 days; interquartile range, 2.0–4.3). Saliva swab specimens contained lower viral loads than nasopharyngeal swabs (P = 0.008). All cases were BA.2 infection, and 45.5% tested negative within 14 days by saliva swab from symptom onset. Eight (72.7%) showed a time-dependent increase in BA.2 PRNT titers, followed by rapid waning. Multiplex cytokine assays revealed that monocyte/macrophage activation and Th 1 responses were comparable to those of non-IC adults. Activation of interleukin (IL)-1Ra and IL-6 was brief, and IL-17A was suppressed. Activated interferon (IFN)-γ and IL-18/IL-1F4 signals were observed. Conclusion IC pediatric patients rapidly recovered from COVID-19 with low viral loads.Antibody response was limited, but cytokine analysis suggested an enhanced IFN-γ- and IL-18-mediated immune response without excessive activation of inflammatory cascades. To validate our observation, immune cell-based functional studies need to be conducted among IC and non-IC children.

This study aimed to assess the utilization trends of pulmonary rehabilitation (PR) among lung cancer patients in Korea using the National Health Insurance Service (NHIS) database (2017 to 2021). PR was introduced and covered under the NHIS in 2016, primarily for chronic obstructive pulmonary disease, but recent evidence suggests its benefits for lung cancer patients. Data extraction was based on Korea Informative Classification of Diseases 8th revision codes C33 and C34, with PR prescriptions identified by codes MM440 and MM290.Descriptive statistical analysis was performed, and propensity score matching was used for comparison between PR and non-PR groups. Results showed a significant increase in PR utilization, with the number of patients receiving PR (MM440) rising from 1,002 in 2017 to 3,723 in 2021, indicating a 3.7-fold increase. However, the proportion of patients receiving PR remained low at 2.9% in 2021. Enhanced access to PR services and improved evaluation strategies are essential for optimizing patient outcomes.

Purpose: This study aimed to investigate the relationship between body composition and glaucoma by analyzing the associations between anthropometric and ocular parameters. Methods: A total of 494 eyes from 247 patients were reviewed from a general health examination database at a tertiary hospital. Anthropometric parameters were assessed using a multifrequency bioelectrical impedance device. Mean ocular perfusion pressure (MOPP) was calculated based on systolic and diastolic blood pressures and intraocular pressure (IOP). Retinal thickness and other ocular parameters were analyzed for their association with body composition. Results: A total of 221 eyes from 221 patients, including 104 with glaucoma, were enrolled in the final analysis. The prevalence of sarcopenia was significantly higher in patients with glaucomatous damage than in those without (p = 0.025). Higher IOP showed significant associations with lower MOPP (p < 0.001), higher body mass index (BMI; p = 0.001), and higher waist to hip ratio (p = 0.001). Retinal thickness was not significantly associated with body composition parameters, including BMI and appendicular lean mass adjusted with squared height. Higher MOPP was significantly correlated with lower IOP (p < 0.001), higher BMI (p < 0.001), higher waist to hip ratio (p < 0.001), and higher appendicular lean mass divided by squared height (p = 0.009). Conclusions Skeletal muscle mass and BMI were significantly associated with MOPP. Since low MOPP is a known risk factor for glaucoma, its association with skeletal muscle mass may indicate a relationship between systemic muscle health, ocular blood perfusion, and glaucomatous damage. Further large-scale studies are needed to validate these associations between skeletal muscle mass and glaucoma and explore their clinical implications.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Objective: A humanities-based approach to understanding the brain can yield valuable insights, advancing neuroscience and enhancing mental, emotional, and social well-being. This study was aimed at exploring how engagement in literature-related activities stimulates brain activity in the prefrontal cortex. Methods: We recruited 24 healthy male participants aged 20 to 29 years. They completed clinical scales assessing depression, anxiety, attention, and humanistic knowledge. They also performed six tasks comprising various literature-related cognitive challenges while hemodynamic changes in their frontal cortices were measured using functional near-infrared spectroscopy. Results: Task 1 (word memory and recognition) increased activation in the ventrolateral prefrontal cortex (VLPFC), as did Task 2 (emotional words classification), which also elevated activity in the left orbitofrontal cortex (OFC). Task 3 (understanding context) increased activation in the dorsolateral PFC (DLPFC). Tasks 4 (interpersonal relationship) and 5 (listening, memory, understanding, and expression) drove similar increases in the frontopolar and DLPFC regions. Task 6 (creative activities using characters and items) significantly activated multiple regions, including the right and left VLPFC and OFC. Humanistic knowledge scores were positively correlated with left and right DLPFC activation in Tasks 3 and 5, respectively. Conversely, Task 6 showed negative correlations between attention-deficit/hyperactivity disorder scores and both right DLPFC and right OFC activation. Conclusion This study identified key brain regions involved in literature activities. Complex activities (semantic processing, understanding and creative expression, decision-making and emotional regulation, etc.) stimulated various regions of prefrontal cortices, including the VLPFC, DLPFC, and OFC.

This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.

For patients with edentulous maxillae, creating a prosthetic treatment plan involves considering anatomical factors, aesthetics, the patient’s financial situation, and oral hygiene capabilities. In this case, CAD-CAM technology was used to accurately plan implant placements for a full arch fixed restoration based on the design of the final prosthesis. A customized surgical guide ensured precise implant placement and a provisional restoration was created using CAD-CAM. The definitive prosthesis was then created based on the second provisional restoration that has been previously used and adjusted by the patient. This approach achieved an excellent functional and aesthetic outcome, highlighting the benefits of digital approach and its potential for further clinical applications.

Background/Aims: Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia. This research aimed to evaluate the clinical features and outcomes of PVT in patients with IBD at a leading hospital in South Korea. Methods: This retrospective analysis reviewed adult patients diagnosed with both IBD and PVT from 1989 to 2021 at a renowned South Korean medical center. The study focused on patient characteristics, specifics of PVT, administered treatments, and outcomes, all confirmed through enhanced CT scans. Results: A total of 78 patients met the study’s criteria. Notably, only 20.5% (16/78) were treated with oral anticoagulants; however, a vast majority (96.2%; 75/78) achieved complete radiographic resolution (CRR). When comparing patients receiving anticoagulants to those who did not, a significant preference for anticoagulant use was observed in cases where the main portal vein was affected, as opposed to just the left or right veins (p = 0.006). However, multivariable analysis indicated that neither anticoagulant use nor previous surgeries significantly impacted CRR. Conclusions Patients with IBD and PVT generally had favorable outcomes, regardless of anticoagulant use.