A Prospective, Single-Cohort, Open, Multi-Center, Observational Study of Sublingual Fentanyl for Breakthrough Cancer Pain: Effectiveness, Safety, and Tolerability in Korean Cancer Patients.

Purpose: Fentanyl, a highly lipophilic opioid, was developed as a sublingual fentanyl tablet (SFT) for the management of breakthrough cancer pain (BTcP), and its efficacy and safety were confirmed in a randomized, controlled study. We investigated the effectiveness and safety of SFT administered to alleviate BTcP in a real-world setting.

Materials And Methods: In this prospective, open, single-cohort study, conducted in 13 referral hospitals in South Korea, opioid-tolerant cancer patients receiving around-the-clock opioids for persistent cancer pain were enrolled if the individual had BTcP ≥ 1 episode/day during the preceding week.

Staged versus immediate complete revascularization for non-culprit arteries in acute myocardial infarction: a post-hoc analysis of FRAME-AMI.

Background And Objectives: The optimal timing for complete revascularization (CR) in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) remain uncertain.

Methods: This post-hoc analysis of the FRAME-AMI trial included AMI patients with MVD ( = 549). They were classified into immediate ( = 329) and staged CR ( = 220) groups.

Effect of individualized versus conventional perioperative blood pressure management on postoperative major complications in high-risk patients undergoing noncardiac surgery: study protocol for the SPROUT-4 multicenter randomized controlled trial.

Background: Intraoperative hypotension is very common during surgery and is linked to major organ dysfunction and mortality. Current perioperative blood pressure management is largely based on universal blood pressure thresholds ranging from a mean arterial pressure of 60-70 mmHg. However, the effectiveness of this conventional management remains unproven in prospective randomized trials.

A multifunctional hyaluronic acid-engineered mesoporous nanoreactor with HO/O self-sufficiency for pH-triggered endo-lysosomal escape and synergetic cancer therapy.

Monotherapy has poor accuracy and is easily restricted by tumor microenvironment (TME). Remodeling components of the TME to activate multimodal cancer therapy with high precision and efficiency is worth exploring. A multifunctional nanoreactor was fabricated by decorating chlorin e6-modified and PEGylated hyaluronic acid bearing diethylenetriamine-conjugated dihydrolipoic acid on the surface of glucose oxidase (GOx)-loaded hollow mesoporous CuS nanoparticles (labeled as GOx@HCuS@HA).

SymScore: Machine learning accuracy meets transparency in a symbolic regression-based clinical score generator.

Self-report questionnaires play a crucial role in healthcare for assessing disease risks, yet their extensive length can be burdensome for respondents, potentially compromising data quality. To address this, machine learning-based shortened questionnaires have been developed. While these questionnaires possess high levels of accuracy, their practical use in clinical settings is hindered by a lack of transparency and the need for specialized machine learning expertise.

Obstructive sleep apnea subtyping based on apnea and hypopnea specific hypoxic burden is associated with brain aging and cardiometabolic syndrome.

Background: Conventional metrics such as the apnea-hypopnea index (AHI) may not fully capture the diverse clinical manifestations of obstructive sleep apnea (OSA). This study aims to establish a novel OSA subtype classification based on the patterns of apneic and hypopneic hypoxic burden (HB), a potential biomarker that more accurately reflects the severity and duration of respiratory events. We further examined the associations of these HB-based subtypes with cardiometabolic risk and brain health outcomes.

Distinct genomic, transcriptomic, and immune profiles for tumor and non-tumor mucosal regions in early gastric cancer.

In early gastric cancer, local recurrence develops after endoscopic resection by field cancerization. Understanding the nature of cancer-prone environments is important to establish effective strategies to prevent recurrence. We hypothesized that the molecular/immune profiles in non-tumor (cancer-prone) tissue differ according to the relative distance from the gastric tumor.

Breast cancers with neuroendocrine differentiation: Retrospective case studies series from a single institution based on the 2019 WHO classification.

Background: The World Health Organization's fifth edition of tumor series classification was published in 2019 and adopted the term 'Neuroendocrine neoplasm (NEN)' to encompass all tumor classes with predominant neuroendocrine differentiation (NED). Based on the updated classification of the NEN, we conducted a case series using the Clinical Data Warehouse platform of SMC.

Methods: In this retrospective study, breast NENs and invasive breast carcinomas no special type (IBCNST) with NED, were defined as 'NENS'.

Impact of CYP2C19 Phenotype on Escitalopram Response in Geriatrics: Based on Physiologically-Based Pharmacokinetic Modeling and Clinical Observation.

Escitalopram is commonly prescribed for depressive and anxiety disorders in elderly patients, who often show variable drug responses and face higher risks of side effects due to age-related changes in organ function. The CYP2C19 polymorphism may further affect escitalopram pharmacokinetics in elderly patients, complicating dose optimization for this group. Previous pharmacogenetic studies examining the impact of CYP2C19 phenotype on escitalopram treatment outcomes have primarily focused on younger adults, leaving a gap in understanding its effects on the elderly.

Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea.

Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included.

Complete or incomplete revascularization in patients with left main culprit lesion acute myocardial infarction with multivessel disease: a retrospective observational study.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better.

Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention.

Association of Weight-Bearing Activity and Prognosis of Plantar Melanoma: An Unanticipated Perspective.

Background: In the development of plantar melanoma, it is suspected that mechanical stress caused by weight-bearing activities, such as walking, rather than ultraviolet exposure, may play a significant role, showing a concentrated prevalence in areas of the foot where weight-bearing actions are prevalent. However, research investigating whether such mechanical stress influences disease prognosis has been limited. This study was designed to investigate the association between weight-bearing activity and the oncologic outcomes of patients with plantar melanoma.

Clinically-Driven Rapidly Developed Nanoparticle Corona for Label-Free Cerebrospinal Fluid Leakage Detection.

Rapid diagnosis of cerebrospinal fluid (CSF) leaks is critical as endoscopic endonasal skull base surgery gains global prominence. Current clinical methods such as endoscopic examination with and without intrathecal injection of fluorescent dye are invasive and rely on subjective judgment by physicians, highlighting the clinical need for label-free point-of-care (POC). However, a viable solution remains undeveloped due to the molecular complexity of CSF rhinorrhea mixed with nasal discharge and the scarcity of specific biomarkers, delaying sensor development.

Clinical Implications of the Obstructive Pattern on Chest Radiography in Children Aged 3-59 Months With Severe Lower Respiratory Tract Infections.

Objectives: To investigate the clinical implications of the obstructive pattern on plain chest radiography, defined as peribronchial cuffing or hyperinflation, in young children with severe lower respiratory tract infections (LRTIs).

Methods: We reviewed all children aged 3‒59 months with LRTIs who underwent radiography and polymerase chain reaction in a Korean emergency department from 2016 through 2020. The radiographs were read as consolidation, peribronchial cuffing, or hyperinflation, with each interrater reliability computed.

Phase II randomized study of dostarlimab alone or with bevacizumab versus non-platinum chemotherapy in recurrent gynecological clear cell carcinoma (DOVE/APGOT-OV7/ENGOT-ov80).

Background: Recurrent gynecological clear cell carcinoma (rGCCC) has a low objective response rate (ORR) to chemotherapy. Previous preclinical and clinical data suggest a potential synergy between immune checkpoint inhibitors and bevacizumab in rGCCC. Dostarlimab, a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1), combined with the anti-angiogenic bevacizumab, presents a novel therapeutic approach.

Current Trends in the Epidemiology and Treatment of Esophageal Cancer in South Korea.

According to 2021 statistics, esophageal cancer ranked as the 18th most common cancer and the 10th leading cause of cancer-related deaths in Korea, predominantly manifesting as squamous cell carcinoma. The incidence of esophageal cancer in Korea has been on a gradual decline, while the proportion of early-stage diagnoses has increased, leading to an improvement in the 5-year relative survival rate. The Health Insurance Review & Assessment Service, reports that around 800 esophagectomy procedures are performed each year.

AI model using CT-based imaging biomarkers to predict hepatocellular carcinoma in patients with chronic hepatitis B.

Background & Aims: Various hepatocellular carcinoma (HCC) prediction models have been proposed for patients with chronic hepatitis B (CHB) using clinical variables. We aimed to develop an artificial intelligence (AI)-based HCC prediction model by incorporating imaging biomarkers derived from abdominal computed tomography (CT) images along with clinical variables.

Methods: An AI prediction model employing a gradient-boosting machine algorithm was developed utilizing imaging biomarkers extracted by DeepFore, a deep learning-based CT auto-segmentation software.

Effects of Smoking Behavior Change on Diabetes Incidence after Cancer Development: A Nationwide Cohort Study.

Aim: Cigarette smoking and diabetes mellitus (DM) increase risks of cardiovascular diseases and all-cause mortality in cancer survivors. An increased risk of DM incidence in cancer survivors has been observed and smoking is an important modifiable risk factor for DM development in the general population. Thus, we investigated the association between smoking behavior change after cancer diagnosis and DM incidence in cancer survivors.

Brain Metabolic Resilience in Alzheimer's Disease: A Predictor of Cognitive Decline and Conversion to Dementia.

Objective: Brain atrophy measured by structural imaging has been used to quantify resilience against neurodegeneration in Alzheimer's disease. Considering glucose hypometabolism is another marker of neurodegeneration, we quantified metabolic resilience (MR) based on Fluorodeoxyglucose positron emission tomography (FDG PET) and investigated its clinical implications.

Methods: We quantified the MR and other resilience metrics, including brain resilience (BR) and cognitive resilience (CR), using partial least squares path modeling from the ADNI database.

Postsurgical outcomes differ according to baseline sagittal alignment status even in patients achieving adequate correction relative to age-adjusted alignment target for adult spinal deformity.

Background Context: Baseline severities of sagittal malalignment and degrees of pelvic compensation may affect postsurgical outcomes differently after adult spinal deformity (ASD) surgery, even if the patients achieved optimal correction of sagittal malalignment.

Purpose: To investigate whether postsurgical outcomes vary according to baseline sagittal alignment and pelvic compensation status in patients achieving adequate correction relative to age-adjusted alignment target in ASD surgery.

Study Design/setting: Retrospective study PATIENT SAMPLE: Patients who underwent ≥ 5-level fusion to the pelvis for ASD; achieved matched correction relative to age-adjusted pelvic incidence (PI)-lumbar lordosis (LL); and completed ≥ 2-year follow-up.

Reduction of postoperative pain and opioid consumption by VVZ-149, first-in-class analgesic molecule: A confirmatory phase 3 trial of laparoscopic colectomy.

Study Objective: VVZ-149 is a small molecule that inhibits the glycine transporter type 2 and the serotonin receptor 5-hydroxytryptamine 2 A. In this Phase 3 study, we investigated the efficacy and safety of VVZ-149 as a single-use injectable analgesic for treating moderate to severe postoperative pain after laparoscopic colectomy.

Design: Randomized, parallel group, double-blind, Phase 3 clinical trial (Trial no.

Graves' Disease and the Risk of Type 2 Diabetes: A Korean Population-Based Study.

Several meta-analyses have found no association between Graves' disease (GD) and an increased risk of incident diabetes; however, the intricate relationship between thyroid dysfunction and diabetes remains underexplored. In this study, we aimed to evaluate the risk of incident type 2 diabetes (T2DM) in a population newly diagnosed with GD, focusing on different treatment methods and treatment duration. This was a retrospective population-based study utilizing data from the Korean National Health Insurance database.