National Health Insurance Corporation Ilsan Hospital

Background Blood pressure (BP) control is important in the management of chronic kidney disease (CKD). However, in patients with advanced CKD, the benefits of BP control in delaying the progression of CKD remain uncertain. Methods We analyzed 2,939 participants with CKD G3b to G5 (estimated glomerular filtration rate [eGFR] <45 ml/min/1.73m ² ) without kidney replacement therapy from the Chronic Renal Insufficiency Cohort (CRIC) study and the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) (Phase I). The main predictors were baseline and time-updated systolic BP (SBP) and diastolic BP (DBP). The primary outcome was a composite kidney outcome of ≥50% decline in eGFR from baseline measurement or the initiation of kidney replacement therapy. In the analyses, multivariate cause-specific hazards models and marginal structural models were fitted for baseline and time-updated BPs, respectively. Results During 17,755 person-years of follow-up (median, 4.7 years), the composite outcome occurred 1,627 (55%) participants. Compared with baseline SBP <120 mmHg, the HRs (95% CIs) for 120–129, 130–139, and ≥140 mmHg were 1.33 (1.15–1.54), 1.48 (1.27–1.72), and 1.82 (1.58–2.10), respectively. This association was more evident in analysis with time-updated SBP, where the corresponding HRs (95% CIs) were 1.29 (1.09–1.54), 1.75 (1.46–2.10), and 2.79 (2.36–3.29), respectively. Furthermore, the slopes of eGFR decline were -1.20 (-1.36 to -1.04), -1.77 (-1.97 to -1.57), -2.11 (-2.35 to -1.88), and -2.48 (-2.70 to -2.27) mL/min/1.73m ² per year for respective baseline SBP categories. Additional analyses with DBP also showed similar results. Conclusion In patients with advanced CKD, higher BP levels were associated with a higher risk of CKD progression.

Background: This study evaluated the risk of human papillomavirus (HPV)-associated gynecologic cancers in women with rheumatic diseases (RD) during their childbearing years. Methods: Using the Korean National Health Insurance Service-National Health Information Database (2011-2021), we conducted a cohort study of 40,514 women with RD and 199,366 women without RD aged 20-49 years. The RD cohort included 9,932 women with systemic lupus erythematosus (SLE), 23,731 with seropositive rheumatoid arthritis (SPRA), and 6,851 with ankylosing spondylitis (AS). Incidence rates and hazard ratios (HRs) for HPV-associated gynecologic cancers, including cervical intraepithelial neoplasia grade 3, and cervical, vaginal, and vulva cancers, were estimated using Cox regression. Results: Over the mean (standard deviation) follow-up period of 67.5 (37.7) months, the incidence rate of HPV-associated gynecologic cancers was 111.5/100,000 person-years in the RD cohort and 73.2/100,000 person-years in the non-RD cohort. The incidence rate/100,000 person-years of HPV-associated gynecologic cancers in the RD subcohorts was higher in SLE (223.6) and SPRA (83.1) and lower in AS (69.1) than in the non-RD cohort. The fully adjusted HR for HPV-associated gynecologic cancers was higher in the RD cohort (HR, 2.95; 95% confidence interval [CI], 2.44-3.57) and all the RD subcohorts (SLE: HR, 1.85; 95% CI, 1.33-2.57, SPRA: HR, 4.10; 95% CI, 3.03-5.55, and AS: HR, 1.91; 95% CI, 1.06-3.43). After adjusting for comorbidities and medication use, hazard ratios increased in SPRA and AS but decreased in SLE. Conclusion: Korean women of childbearing age with RD have a threefold increased risk for HPV-associated gynecologic cancers compared with those without RD. Comorbidities and medication use in SLE may influence the risk. Improved screening strategies are needed for these women.

The Hemodialysis Reliable Outflow (HeRO) graft (Merit Medical Systems, Inc.), first approved by the U.S. Food and Drug Administration in 2008, provides an alternative vascular access option for patients with end-stage kidney disease who have exhausted upper extremity arteriovenous (AV) access. The first HeRO graft procedure was performed in South Korea in December 2023. Herein, we describe HeRO graft application in 2 complex vascular access scenarios: (1) establishing a new access pathway for a catheter-dependent patient with bilateral central venous occlusions and (2) bypassing recurrent central venous stenotic lesions to restore the function of a mature AV fistula. Given the potential risks, including thrombosis or infection, careful preoperative planning and meticulous patient selection are essential for optimizing HeRO graft outcomes. Further research is necessary to evaluate the long-term efficacy and complication profile of this technique.

Objectives: Some following up patients have poor clinical outcomes when they experience anterior cruciate ligament reconstruction. The patient will undergo progression of knee joint osteoarthritis or several secondary knee procedures such as high tibial osteotomy, total knee arthroplasty, menisectomy, meniscus repair, or meniscus transplantation on their knees after anterior cruciate ligament reconstruction. This may be related to the remaining instability of the knee joint, changes in the knee joint biomechanics, and progression of osteoarthritis. This study aims to determine which secondary knee procedures are performed over time after anterior cruciate ligament reconstruction. Methods: The National Health Insurance Service-Health Screening database analyzed 146,122 patients who underwent ACL reconstruction surgery between 1 January 2002 and 31 December 2021. Secondary knee procedures were investigated by categorizing them into revisional reconstruction, high tibial osteotomy, total knee arthroplasty, menisectomy, meniscus repair, and meniscus transplantation, respectively. Multivariable Cox Proportional Hazard model analysis was used. The significant predictors for complications (p < 0.05) were as follows. Results: Among a total of 146,122 patients with anterior cruciate ligament reconstruction, 1073 (0.7%) patients underwent HTO, 908 (0.6%) patients underwent TKA, 15,218 (10.4%) patients underwent meniscectomy, 7169 (4.9%) patients underwent meniscus repair, and 938 (0.6%) patients underwent meniscus transplantation. The hazard ratio differed according to graft type, gender, and age group. Conclusions: Patients who undergo ACL reconstruction may experience poor clinical outcomes, such as progression of osteoarthritis and undergoing secondary knee procedures several years after ACL reconstruction. It is important for decision-making, ongoing monitoring, and follow-up care for patients undergoing ACL reconstruction.

Aim Although it has been reported that poor oral health is associated with worsening general health, oral health has been given less importance than general health in Long‐Term Care (LTC) insurance beneficiaries. The aim of this study was to evaluate the association between dental care and improvement in dependency levels of LTC insurance beneficiaries. Methods This study collected data from 53 130 beneficiaries who were newly approved for LTC in Korea in 2015. They were assigned to five LTC levels according to their dependency on daily life and reassessed after 2–3 years. The change in LTC level was evaluated. The LTC level improvement percentage was compared according to socioeconomic factors, and medical and dental history using the χ ² ‐test. Factors related to the occurrence of LTC level improvement were evaluated using multivariate logistic regression analysis. Results LTC levels improved in 12.4% of the beneficiaries. Dental treatment experience showed significant differences between the worse or the same group and the better group ( P < 0.05), and the odds ratio of dental treatment experience for LTC level improvement was 1.18. In addition, multivariate logistic regression analysis showed that sex, age, hypertension and dental care were statistically significant factors related to the occurrence of LTC level improvement. Conclusions Dental care was associated with improvement of LTC levels. Therefore, professional dental care programs are helpful in reducing dependency and ultimately improving the quality of life of LTC beneficiaries. Geriatr Gerontol Int 2025; ••: ••–•• .

Fatigue negatively impacts health, safety, and productivity, yet current monitoring methods are often subjective, labor‐intensive, and inaccurate. To address these challenges, this study presents a capacitive sensor‐based eye tracker (ET) leveraging cylindrical carbon nanotube‐paper composite (CCPC) sensors for chronic fatigue (CF) assessment. Fabricated by novel wet‐fracture and paper‐rolling methods, CCPC sensors demonstrate superior proximity sensitivity with a small form factor. These 1D sensors are seamlessly integrated into an eyeglass frame for noncontact monitoring of blink rates and eye closures. Fifteen‐minute testing protocol, combining cognitive tasks and noise exposure, is designed to induce acute fatigue and identify CF. By analyzing changes in the digital markers against established fatigue indicators, CF is assessed with the aid of machine learning models for the evaluation of accuracy, sensitivity, and specificity. This real‐time, wearable monitoring platform provides an objective, effortless, and noncontact approach to fatigue assessment. With further testing and optimization, it holds the potential for user‐friendly evaluation of acute fatigue or fatigue‐associated diseases, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Purpose: This study aimed to evaluate and compare the responses of an artificial intelligence (AI)-powered chatbot and professional periodontists to patient queries in periodontology and implantology, using the Korean Academy of Periodontology's (KAP) online question and answer (Q&A) section. Methods: In this comparative cross-sectional study, we analysed 219 patient-submitted periodontal and implant knowledge questions from the KAP online Q&A section. A panel of 10 evaluators-5 periodontists and 5 laypersons-rated both the periodontist's and the AI chatbot's responses using standardised scales. We applied the t-test and Spearman correlation coefficients to compare response quality, empathy, consistency, and evaluator preferences. Results: Ten evaluators judged the AI chatbot's responses to be significantly superior in quality and empathy compared to periodontist replies. A higher proportion of periodontist responses fell below acceptable quality ("very poor" or "poor") than chatbot responses (28.7% vs. 15.0%; P<0.001), and more chatbot replies were rated "empathetic" or "very empathetic" (62.5% vs. 42.8%; P<0.001). Overall response consistency was deemed satisfactory at 64.2%, with no significant difference in consistency or preference between periodontist and lay evaluators. Conclusions: AI-powered chatbots can deliver more accurate and empathetic answers than human periodontists, suggesting their potential role as consultation assistants merits further investigation. The high intraclass correlation coefficient values (0.79-0.93) indicate a high

Acute kidney injury is a prevalent and severe complication in hospitalized patients, contributing to increased morbidity and mortality. While numerous predictive models exist, they primarily focus on identifying AKI after its onset rather than forecasting it in advance. We developed a labeling algorithm to capture the earliest onset time of in-hospital AKI based on KDIGO 2012 criteria to address this limitation. We retrospectively analyzed 143,512 in-hospital cases from National Health Insurance Service Ilsan Hospital between 2015 and 2021, applying the algorithm to capture the earliest AKI onset time based on serum creatinine and urine output measurements. Our results showed that 31.97% (45,882) of the cases were identified as AKI, with urine output criteria detecting 87.29% of these cases as the earliest onset indicator.

Importance Amiloride has been proposed as an alternative to spironolactone for treating resistant hypertension. However, no randomized clinical trials have compared the efficacy of spironolactone and amiloride in patients with resistant hypertension. Objective To determine whether amiloride is noninferior to spironolactone in reducing home-measured systolic blood pressure (SBP) in patients with resistant hypertension. Design, Setting, and Participants Prospective, open-label, blinded end-point randomized clinical trial conducted at 14 sites in South Korea. From November 16, 2020, to February 29, 2024, 118 patients with home SBP of 130 mm Hg or greater after a 4-week run-in period with a fixed-dose triple medication combination (angiotensin receptor blocker, calcium channel blocker, and thiazide) were enrolled. Intervention Patients were randomized in a 1:1 ratio to receive 12.5 mg/d of spironolactone (n = 60) or 5 mg/d of amiloride (n = 58). If home SBP remained 130 mm Hg or greater and serum potassium was less than 5.0 mmol/L after 4 weeks, dosages were increased to 25 mg/d and 10 mg/d, respectively. Main Outcomes and Measures The primary end point was the between-group difference in home SBP change at week 12, with a noninferiority margin of −4.4 mm Hg for the lower bound of the confidence interval. Secondary end points included achievement rates of home- and office-measured SBP of less than 130 mm Hg. Results The median age of the study population was 55 years, with 70% male. There were no differences between groups in demographic characteristics other than use of α-blockers (8.6% in the amiloride group and 0% in the spironolactone group). The mean baseline home SBPs were 141.5 (SD, 7.9) mm Hg and 142.3 (SD, 8.5) mm Hg in the amiloride and spironolactone groups, respectively. At week 12, mean home SBP measurements were changed from baseline by −13.6 (SD, 8.6) mm Hg and −14.7 (SD, 11.0) mm Hg in the amiloride and spironolactone groups, respectively (between-group difference in change, −0.68 mm Hg; 90% CI, −3.50 to 2.14 mm Hg), with amiloride demonstrating noninferiority to spironolactone. Home-measured achievement rates of SBP less than 130 mm Hg in the amiloride and spironolactone groups were 66.1% and 55.2%, respectively, and office-measured achievement rates of SBP less than 130 mm Hg were 57.1% and 60.3%, respectively, with no difference between the 2 groups. One case of hyperkalemia-related discontinuation occurred in the amiloride group, with no cases of gynecomastia in either group. Conclusions and Relevance Amiloride was noninferior to spironolactone in lowering home SBP, suggesting that it could be an effective alternative for treatment of resistant hypertension. Trial Registration ClinicalTrials.gov Identifier: NCT04331691

Objective This study aimed to compare the lipid‐lowering effect and safety of low‐intensity atorvastatin (5 mg) plus ezetimibe (10 mg) combination therapy (A5E10) with monotherapy regimens–atorvastatin 5 mg [A5], ezetimibe 10 mg [E10], and atorvastatin 10 mg [A10])–in dyslipidemia patients. Methods A randomized, double‐blind, placebo‐controlled trial involving 252 dyslipidemia patients was conducted at 25 centers in South Korea (NCT05970679). Participants aged ≥ 19 years were randomized into four groups: A5E10, A5, E10, and A10. The primary endpoint was the percentage change in low‐density lipoprotein cholesterol (LDL‐C) levels from baseline to 8 weeks. Secondary endpoints included changes in other lipid parameters, lipid ratios, LDL‐C goal achievement rates and safety assessments. Results The mean age of the patients was 63 years, and 51.2% were male. The A5E10 group showed significantly greater LDL‐C reduction (47.6%) compared with A5 (33.4%), E10 (19.4%), and A10 (40.1%) at 8 weeks (p < 0.0001). A5E10 also significantly reduced triglyceride, non‐high‐density lipoprotein cholesterol, and apolipoprotein B levels. In addition, a significant reduction in LDL‐C levels was observed over the 4 weeks, with a 46.7% reduction in LDL‐C levels after 4 weeks of A5E10 administration. No severe adverse events were observed in the A5E10 group. Conclusion The combination of low‐intensity atorvastatin and ezetimibe was more effective than moderate‐intensity atorvastatin monotherapy in lowering LDL‐C levels and improving other lipid parameters. It was well‐tolerated and demonstrated rapid benefits within a month, offering a promising alternative for patients with low to moderate cardiovascular risk who do not achieve adequate control with statin monotherapy.

There is growing recognition of the importance of rehabilitation through immediate and long-term follow-up, and neonatal intensive care unit (NICU) aftercare is emerging as an important field to consider rehabilitation services. An increasing number of children born are admitted to the NICU with complications commonly related to low birth weight, premature birth, and development of underlying diseases. Early initiation of rehabilitation services in the NICU has become more common and includes therapies relating to feeding tube removal and pulmonary breathing. We investigated the patterns of rehabilitation utilization (rehabilitation frequency, moving to an area for rehabilitation treatment) and medical expenses based on NICU hospitalization history. Data from the Korean National Health Insurance Service Database over a span of ten years were reviewed, with an observation period of 3 years after the first rehabilitation session. The newborns were divided into two groups: 16,626 in the NICU group and the non-NICU group, matched 1:1 based on NICU hospitalization history. The number of rehabilitation treatments in the non-NICU group was significantly higher over the two years following the initial rehabilitation session (p < 0.05). In contrast, the total medical expenses during the 6 months following the initial rehabilitation session were more than six times higher in the NICU group (KRW 1,868,516 vs. 11,348,940, p < 0.0001). The NICU group showed significantly more discrepancies between their residence and the first rehabilitation treatment area (9.5% vs. 13.4%, p < 0.001). Results indicate that the amount of rehabilitation sessions and access to rehabilitation for individuals with a NICU history is lower compared to those without a NICU history. Therefore, national support is needed to revitalize rehabilitation procedures and reduce medical expenses in the NICU group, and further studies should focus on novel methods to revitalize NICU rehabilitation.

Studies comparing efficacy and safety of moderate-intensity statin plus ezetimibe versus high-intensity statin in patients with atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (T2DM) are scarce. In this multicenter non-inferiority randomized trial, 223 ASCVD patients with T2DM were randomly assigned to receive either rosuvastatin 20 mg once daily or single-pill combination of rosuvastatin 10 mg plus ezetimibe 10 mg once daily for 24 weeks. Laboratory parameters and clinical events were evaluated at 12 and 24 weeks. Primary efficacy endpoint was the least square mean percent (LSM %) change of low-density lipoprotein cholesterol (LDL-C) level at 24 weeks from baseline. At 24 weeks, the LDL-C LSM % change from baseline was − 13.5 in the high-intensity rosuvastatin group and − 20.5 in the combination group, with the between-group difference remaining within the predefined non-inferiority margin (p = 0.06). Decrease in apolipoprotein B level at 24 weeks from baseline was significantly greater in the combination group than in the high-intensity rosuvastatin group (−15.6% vs. −9.9%, p-value = 0.008). Rates of achieving LDL-C < 55 mg/dL were higher in the combination group than in the high-intensity rosuvastatin group, with a significant difference at 12 weeks (p = 0.01), though the difference at 24 weeks was not statistically significant (p = 0.09). Incidence of total adverse events was lower in the combination groups than in the high-intensity rosuvastatin group (p = 0.048). Single-pill combination of moderate-intensity rosuvastatin plus ezetimibe was non-inferior to high-intensity rosuvastatin in LDL-C lowering efficacy with good safety profile in ASCVD patients with T2DM.

Background Cardiac rehabilitation (CR) is a well‐established program for improving exercise capacity, quality of life, and long‐term outcomes in patients with cardiovascular disease (CVD). Despite its proven benefits, CR participation rates remain low in many countries. Identifying the barriers to CR participation is crucial for developing effective strategies to enhance patient engagement in these programs. Objective To analyze the barriers to CR participation among patients with CVD. To analyze the barriers to cardiac rehabilitation (CR) participation among patients with cardiovascular disease (CVD). Design A nationwide cohort study using data from the Korean National Health Insurance Database. Setting South Korea. Patients In 2019, patients who received coronary revascularization at hospitals operating CR program. Interventions Comparison of the demographic, socioeconomic, and medical status between patients who actively participated in CR and those who did not. Main Outcome Measures The analysis considered potential influencing factors such as gender, age, residence area, income level, disability status, medical comorbidities, accompanying disease, cigarette smoking, alcohol consumption, physical activity levels, and obesity. Results The CR participation rate was low among women, older adults, rural residents, and low‐income families. In addition, the participation rate was low when there was a disability or medical comorbidity, such as hypertension, diabetes, and musculoskeletal disorders. CR participation rate was also low in patients who experienced CVD recurrence within 10 years. Conclusion CR participation is affected by medical comorbidities, in addition to gender, age, income level, and residence. In particular, participation rate is lower in patients with a high risk of CVD recurrence due to medical comorbidities.

Introduction While the efficacy of endovascular thrombectomy (EVT) in large core infarcts has been established, the influence of blood pressure (BP) management on functional outcomes based on infarct volume remains unclear. Patients and methods We conducted a secondary analysis of the Outcome in Patients Treated With Intra-Arterial Thrombectomy–Optimal Blood Pressure Control (OPTIMAL-BP) trial, which compared intensive (systolic BP < 140 mmHg) versus conventional (systolic BP 140–180 mmHg) BP management within the first 24 h following successful recanalization. Patients were grouped based on an infarct volume cut-off of 50 ml, assessed 24 h post-EVT. The primary efficacy outcome was functional independence (modified Rankin Scale of 0–2) at 3 months. Change of predicted probability for functional independence between BP managements, as infarct volume varied, was assessed. Results Of the 300 patients, 222 (74.0%) were in the infarct volume ⩽50 ml group and 78 (26.0%) were in the infarct volume >50 ml group. The conventional management was significantly associated with a higher rate of functional independence in the infarct volume ⩽50 ml group (adjusted odds ratio [AOR], 2.06 [95% CI, 1.12–3.86]). In the infarct volume >50 ml group, the proportion of patients with functional independence was not significantly different between BP managements (AOR, 1.52 [95% CI, 0.46–5.04]). The interaction effect between the infarct volume groups and BP managements was not significant. As infarct volume increased, the difference in predicted probability of functional independence between BP managements decreased. Discussion and conclusions Conventional BP management showed greater benefits for achieving functional independence at 3 months when infarct volumes were smaller. As infarct volume increased, the impact of BP management strategies on functional outcomes decreased. Registration ClinicalTrials.gov (NCT04205305)

Background Cyclin-dependent kinase (CDK) 4/6 inhibitors have remarkably improved the survival outcome in hormone-receptor-positive (HR+)/human epidermal growth factor-2-negative (HER2-) metastatic breast cancer (mBC). Although PALOMA-2 has met its primary outcome, overall survival (OS) was relatively shorter compared to ribociclib and abemaciclib. In Korea, use of palbociclib + aromatase inhibitor (AI) + gonadotropin-releasing hormone agonist (GnRHa) in premenopausal women is limited, and bilateral salpingo-oophorectomy (BSO) is necessary before treatment. We analyzed the real-world clinical outcome and patient characteristics of letrozole + palbociclib in Korea. Methods Between August 2016 and December 2022, 1017 HR+/HER2-postmenopausal women treated with first-line letrozole + palbociclib were enrolled. Primary endpoints were real-world progression-free survival (rwPFS) in total population and survival differences according to menopausal status (natural or induced menopause via BSO). Results Patients’ median age was 56 (range 27–92) years. Median rwPFS, real-world OS (rwOS) were 28.0 months (95 % confidence interval [CI] 25.5–32.1) and 61.8 months (95 % CI 57.7–70.5), with a median follow-up of 45.1 (IQR, 31.0–56.6) months. BSO group demonstrated similar median rwPFS compared to natural menopause group. Adjuvant tamoxifen ± GnRHa was most frequently prescribed (73.3 %). Primary endocrine resistant mBC patients showed inferior median rwPFS compared to secondary resistant mBC (14.6 vs. 27.1 months, p = 0.0063). Overall response rate was 47.5 %, with a disease control rate of 89.6 %. Conclusion This is the largest country-based real-world study on palbociclib + letrozole in Asia. Palbociclib demonstrated median rwOS over 60 months, comparable to other pivotal trials.

Enterococcus faecium, particularly in its multidrug-resistant forms, causes invasive nosocomial infections. Given the limited data comparing the effectiveness of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the CLSI clinical breakpoints (CBPs) for quinupristin-dalfopristin (QD) resistance and the need to evaluate their practical application, we retrospectively investigated the susceptibility patterns of 287 E. faecium bloodstream isolates from Korean hospitals to QD using the updated EUCAST and CLSI CBPs and two antimicrobial susceptibility testing methods: disk diffusion (DD) and Sensititre broth microdilution (Sensititre). QD resistance rates were 5.9% (CLSI) and 18.8% (EUCAST) for DD and 22.6% (CLSI) and 28.2% (EUCAST) for Sensititre. The most prevalent QD resistance gene types among QD-resistant isolates were ermB+msrC+ or ermB-msrC+. Categorical agreement between DD and Sensititre ranged from 77.7% to 90.7%, depending on the testing method and CBPs applied. The EUCAST zone diameter CBPs more effectively help identify QD-resistant E. faecium isolates using the DD method than the CLSI zone diameter CBPs. In comparison, the CLSI minimum inhibitory concentration (MIC) CBPs provide more reliable results for resistance classification in the Sensititre method than EUCAST MIC CBPs. These findings would help improve clinical decision-making for treating multidrug-resistant E. faecium infections.

Novel antimicrobial agents are continually developed to address the global threat of multidrug-resistant Neisseria gonorrhoeae. Promising candidates include zoliflodacin and, possibly, solithromycin. We evaluated their in-vitro activities against gonococcal isolates collected in Korea. In total, 250 N. gonorrhoeae isolates obtained across Korea between 2016 and 2018 were used to determine the minimum inhibitory concentrations (MICs) of 10 therapeutic agents using the CLSI agar dilution method. Most isolates (94.8%, 237/250) demonstrated non-susceptibility to penicillin G, tetracycline, and ciprofloxacin, and susceptibility to ceftriaxone and spectinomycin was substantially high. The half-maximal IC (MIC50) and 90% IC (MIC90) values for zoliflodacin were 0.03 and 0.06 μg/mL, respectively; 0.06 and 0.12 μg/mL, respectively, for solithromycin; and 0.03 and 0.12 μg/mL, respectively, for ceftriaxone. Notably, no cross-resistance was observed between zoliflodacin and ciprofloxacin, despite both targeting DNA topoisomerase II enzymes. Zoliflodacin and solithromycin demonstrated significant in-vitro activity against multidrug-resistant N. gonorrhoeae isolates, and zoliflodacin has shown non-inferiority to ceftriaxone/azithromycin dual therapy in a clinical phase 3 trial. Collectively, our findings highlight the potential of zoliflodacin as a novel therapeutic agent for gonococcal infections, particularly in the context of rising multidrug resistance, and highlight the need for continued surveillance and development of alternative antimicrobial strategies.

Purpose Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival. Methods A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death. Results Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreas-kidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045). Conclusion PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.

This study aimed to compare the push-out bond strength (POBS) of TotalFill (TFB) and AH Plus bioceramic (APB) sealers with different irrigation protocols. Sixty maxillary central incisors were prepared and randomly divided into three groups (n = 10) based on the final irrigation protocol. Group NC: 5.25% sodium hypochlorite (NaOCl); Group NE: 5.25% NaOCl and 17% EDTA; Group NH: 5.25% NaOCl and dual rinse HEDP (1-hydroxyethylidene-1,1-diphosphonic acid). Samples were obturated using either TFB or APB sealer only. In groups NC and NE, NaOCl was used during canal preparation, while in Group NH, NaOCl/HEDP was utilized. The teeth were then horizontally sectioned into three 3-mm thick sections at the apical, middle, and coronal levels. The POBS was performed on the root sections at a 1 mm/min speed. The failure mode was assessed using an optical microscope and a scanning electron microscope. Two-way ANOVA (analysis of variance) was used for statistical analysis to test the interaction between sealer type and irrigation solution, while an independent t-test was conducted to compare the means of the two sealer types at a significance level of 0.05. Specimens obturated with TFB showed significantly higher POBS than APB (p < 0.001). The highest bond strength was observed in the HEDP/TFB group and the lowest in the HEDP/APB group. Irrigation did not significantly influence the POBS (p > 0.05). Mixed failure was most commonly observed in all groups (>65%). TFB sealer had improved bond strength over APB sealer, regardless of the final irrigation protocol used, which did not significantly affect the bond strength.

Allergic diseases occur frequently and reduce the quality of life in patients with allergies. Many studies have investigated the pattern of various allergic antigens; however, studies on general patients are insufficient. Sensitization of allergens varies greatly depending on race or region. This study aims to investigate the sensitization of common allergens present in Korea and co-sensitization patterns among these allergens. We used data obtained from the Korea National Health and Nutrition Examination Survey conducted in 2019. Serum-specific immunoglobulin E levels were measured using the ImmunoCAP assay for Dermatophagoides farinae (Df), dog, cat, birch, oak, Japanese hop (J-hop), and ragweed. In addition, demographic data and responses to a questionnaire about rhinitis symptoms were obtained. The ImmunoCAP assay was performed on 2,397 out of 8,110 participants. The sensitization rate to at least one antigen was 45.2%. Df was the most common sensitized allergen (39.9%), followed by oak (11.2%), birch (10.2%), ragweed (8.7%), and cat (8.5%). Among the sensitized participants, 41.3% were sensitized to multiple antigens. In participants sensitized to a single allergen, 91.8% were sensitized to Df. In individuals sensitized to seasonal allergens, approximately 75% showed sensitization to Df too (birch: 74.6%, oak: 74.3%, J-hop: 74.3%, and ragweed: 76.3%). Around 90% exhibited co-sensitization with Df among individuals sensitized to perennial antigens (dog: 91.6% and cat: 88.7%). The allergen sensitization rate in the general population was about 41.3%. In addition, Df was co-sensitized to 75% of participants sensitized to seasonal allergens and 90% of participants sensitized to perennial allergens. Most allergens showed a tendency for sensitization to decrease with age, while some allergens exhibited peak sensitization at different age ranges. Further research is needed to explore these differences and their associations with co-sensitization. Moreover, studies are required to investigate how these cross-reactivity patterns are associated with patients’ symptoms.