Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Objectives: This qualitative study explores the perspectives of dental hygienists and examines factors influencing payment structures in a community home-based oral health care intervention program. Methods: Focus group interviews were conducted on October 26, 2023, in a quiet study room over 120 minutes. Intervention providers who participated in the older adults medical care integration support program were included in this study. Their ages ranged from 25 to 57 years, with experience in home-based oral healthcare spanning from 1.5 to 5 years. Voice recordings of the interviews were transcribed using Clova Note and Naver’s AI transcription tool. Subsequently, the ‘Word Cloud Generator 3.7’ program was employed to extract, visualize, and analyze frequently mentioned words and key concepts from the responses. Results Semantic analysis identified 61 significant keywords and 10 subcategories, categorized into four main themes: ‘oral health challenges in the elderly,’ ‘work system of home-based dental hygienists,’ ‘needs and realities of home-based oral care,’ and ‘payment and compensation frameworks.’ Conclusions: To address the demands of a super-aging society, it is imperative to establish a standardized oral healthcare cost system for home-based interventions, supported by clear laws and regulations.

Purpose: Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT). Materials and Methods: In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1). Results: Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified. Conclusion Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.

Objective: Giant cell arteritis (GCA) is a large-vessel vasculitis that primarily affects elderly individuals. However, data regarding Korean patients with GCA are scarce owing to its extremely low prevalence in East Asia. This study aimed to investigate the clinical characteristics of Korean patients with GCA and their outcomes, focusing on relapse. Methods: The medical records of 27 patients with GCA treated at three tertiary hospitals between 2007 and 2022 were retrospectively reviewed. Results: Seventeen (63.0%) patients were females, and the median age at diagnosis was 75 years. Large vessel involvement (LVI) was detected in 12 (44.4%) patients, and polymyalgia rheumatica (PMR) was present in 14 (51.9%) patients. Twelve (44.4%) patients had fever at onset. The presence of LVI or concurrent PMR at diagnosis was associated with a longer time to normalization of the C-reactive protein level (p=0.039) or erythrocyte sedimentation rate (p=0.034). During follow-up (median: 33.8 months), four (14.8%) patients experienced relapse. Kaplan-Meier analyses showed that relapse was associated with visual loss (p=0.008) and the absence of fever (p=0.004) at onset, but not with LVI or concurrent PMR. Conclusion Concurrent PMR and LVI were observed in approximately half of Korean patients with GCA, and the elapsed time to normalization of inflammatory markers in these patients was longer. The relapse rate in Korean GCA is lower than that in Western countries, and afebrile patients or patients with vision loss at onset have a higher risk of relapse, suggesting that physicians should carefully monitor patients with these characteristics.

Background: The purpose of this study was to evaluate the effect of vanishing twin (VT) on maternal serum marker concentrations and nuchal translucency (NT). Methods: This is a secondary analysis of a multicenter prospective cohort study in 12 institutions. Serum concentrations of pregnancy-associated plasma protein-A in the first trimester and alpha-fetoprotein (AFP), total human chorionic gonadotrophin, unconjugated estriol, and inhibin A in the second trimester were measured, and NT was measured between 10 and 14 weeks of gestation. Results: Among 6,793 pregnant women, 5,381 women were measured for serum markers in the first or second trimester, including 65 cases in the VT group and 5,316 cases in the normal singleton group. The cases in the VT group had a higher median multiple of the median value of AFP and inhibin A than the normal singleton group. The values of other serum markers and NT were not different between the two groups. After the permutation test with adjustment,AFP and inhibin A remained significant differences. The frequency of abnormally increased AFP was also higher in the VT group than in the normal singleton group. Conclusion VT can be considered as an adjustment factor for risk assessment in the secondtrimester serum screening test.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Background: Various treatments exist for addressing volume loss in atrophic scars. Although laser therapy has gained traction in treating atrophic scars, it is associated with side effects, such as post-inflammatory hyperpigmentation or erythema. Additionally, not all types of atrophic scars respond optimally to laser therapy, even after multiple sessions. Objective: This study aimed to evaluate the efficacy and safety of punch elevation for atrophic scars that yielded unsatisfactory outcomes after repeated laser treatment sessions. Methods: Seven patients with atrophic scars on their facial area underwent punch elevation, concurrently supplemented by fractional CO2 laser application to the scar margins. Improvement in volume restoration of atrophic scars was assessed via investigator evaluation and 3-dimensional (3D) image analysis. Results: After 1 month, median volume (interquartile range) of depression improved from 4.39 mm3 (2.23∼9.90 mm3 ) to 1.97 mm3 (1.46∼7.50 mm3 ), indicating a statistically significant difference post-punch elevation (p=0.018). No serious adverse events were reported during follow-up. Conclusion The efficacy of the punch elevation was objectively evaluated. Punch elevation is a safe and effective therapeutic avenue for atrophic scars that exhibit resistance to laser or alternative interventions.