Bucheon University

BackgroundThe clinical and prognostic implications of asymptomatic tuberculosis remain poorly understood.MethodsWe conducted a multicentre prospective cohort study to evaluate the association between asymptomatic tuberculosis (TB) and treatment outcomes. Individuals with rifampicin-susceptible pulmonary TB were enrolled from the Cohort Study of Pulmonary Tuberculosis. Asymptomatic TB was defined as the absence of any TB-related symptoms at diagnosis. The primary outcome was a favourable outcome, defined as treatment success without recurrence. Multivariable logistic regression models were used to assess associations between asymptomatic TB and favourable outcomes. The Cox proportional hazards model was applied to evaluate effect of asymptomatic TB on failure to complete treatment within 1 year. Stratified analyses by symptom status and mode of detection were performed to examine stratum-specific effects.ResultsOf 1071 individuals with pulmonary TB, 32.7% were asymptomatic. Compared to symptomatic patients, asymptomatic individuals were younger, less likely to be underweight and more often diagnosed through population health screening rather than clinical presentation or opportunistic testing. Asymptomatic TB was associated with higher likelihood of favourable outcome in multivariable models (adjusted odds ratio (aOR) 1.50, 95% CI 1.04–2.20) and a reduced risk of failing to complete treatment within one year in survival analyses (adjusted hazard ratio 0.66, 95% CI 0.45–0.95). Asymptomatic TB detected through health screening had the most favourable outcomes (aOR 2.41, 95% CI 1.34–4.66).ConclusionAsymptomatic TB was significantly associated with treatment success without recurrence and particularly in patients identified through health screening. Our results support symptom-agnostic screening in TB control programmes.

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that leads to various systemic complications. This study aims to assess the association between RA and chronic dizziness, recurrent falls, and chronic imbalance in the Korean adult population. Data from 4,754 (weighted n = 17,694,932) individuals aged 40 years or older in the 2019–2020 Korean National Health and Nutrition Examination Survey were analyzed. A questionnaire including information on chronic dizziness, recurrent falls, demographic variables, and laboratory test data was evaluated. RA was defined based on patient-reported physician diagnoses. Factors potentially associated with chronic dizziness, recurrent falls, and chronic imbalance were examined. The mean age was 56.7 years. The weighted prevalence of RA was 1.9%. In patients with RA, the rates of chronic dizziness (10.1% vs. 3.4%, p = 0.005), recurrent falls (3.9% vs. 0.4%, p < 0.001), and chronic imbalance (5.1% vs. 1.0%, p < 0.001) were significantly higher than in those without RA. In multivariable analysis, RA (OR 2.65, 95% CI 1.10–6.34, p = 0.030) was associated with an increased risk of chronic dizziness, alongside females, a body mass index under 25, hearing impairment, stroke, and stress. Additionally, females, hearing impairment, and RA (OR 8.29, 95% CI 2.79–24.67, p < 0.001) were associated with an increased risk of recurrent falls. For chronic imbalance, RA (OR 3.73, 95% CI 1.22–9.6, p = 0.020) was significantly associated with chronic imbalance, alongside being female, smoking, and hearing impairment. RA was found to be independently associated with an increased risk of chronic dizziness, recurrent falls, and chronic imbalance.

Atopic dermatitis (AD), allergic rhinitis (AR), and asthma are typical allergic diseases, with a common pathogenesis involving increased type 2 immunity. Despite numerous studies, the association between these diseases and metabolic syndrome (MetS) remains controversial. This study aimed to explore relationships between AD, AR, and asthma both to MetS and to each of its components. Population-based, cross-sectional data were obtained from the Korean National Health and Nutrition Examination Survey from 2019 to 2020. Multiple logistic regression analyses were conducted to evaluate the association between allergic diseases and MetS. The results were compared with those of previous studies of the association between MetS and allergic diseases, identified in a literature review following a search of PubMed and the Cochrane Library. Based on assessments of 1,329, 4,824, and 1,172 patients with AD, AR, and asthma, respectively, negative associations between both AD and AR and MetS were determined, after adjusting for confounding factors. By contrast, asthma was positively associated with MetS (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.50-0.67; OR 0.73, 95% CI 0.67-0.78; OR 1.70, 95% CI 1.51-1.92, respectively). The heterogeneous findings highlight the need for further investigation of associations between the studied allergic diseases and MetS as well as each of its components.

Introduction: Efficient patient flow in emergency departments (EDs) is vital for improving outcomes, particularly for critically ill patients. Despite expanding critical care capacity, inefficiencies in processing times, bed allocation, and patient transfers were observed in the Regional Emergency Medical Center (REMC). This study aimed to evaluate the impact of quality improvement (QI) interventions on optimizing decision-to-discharge and discharge-to-exit times while enhancing critical care utilization. Methods: A multi-faceted QI initiative was conducted to streamline patient flow and optimize resource utilization from January to August 2024. The study period was divided into two phases: pre-intervention (January to April) and post-intervention (May to August). Key strategies included educational sessions to enhance staff competencies, the introduction of a “Zone Movement Assessment Tool” to improve patient transfers, and bed allocation based on the Korean Triage and Acuity Scale (KTAS), as well as collaboration with administrative units and local fire departments to expedite admissions. Data on decision-to-discharge and discharge-to-exit times were collected before and after these interventions, alongside metrics on bed utilization rates and financial impact. Results: The interventions reduced the median decision-to-discharge time from 147 to 130.5 minutes and discharge-to-exit time from 80.25 to 55 minutes. Although not statistically significant (p &gt; 0.05), boxplot analysis showed decreased variability, improving consistency. A strong correlation (r = 0.91) between the two metrics suggested that improvements in one area positively impacted the other. KTAS Level 3 patient allocation increased from 55% to 82%, and bed turnover nearly doubled from 2.9 to 4.8 times per month. Critical care revenue increased by KRW 302,826,630. Conclusion: The QI initiative improved ED efficiency, enhancing patient flow and resource utilization. While not statistically significant, the gains in consistency, bed use, and revenue highlight practical benefits. Ongoing monitoring, staff training, and iterative improvements are recommended to sustain these outcomes. Further studies with larger samples are needed to validate these results.

Yoon E Shin, M.D., Hyun Ju Lee, M.D., Yoon Young Cho, M.D., Bo-Yeon Kim, M.D., Chan-Hee Jung, M.D., Ji-Oh Mok, M.D., Ph.D., Chul-Hee Kim, M.D., Yong-Wha Lee, M.D., Ph.D., and Dughyun Choi, M.D., Ph.D.. Ann Lab Med -0001;0:. https://doi.org/10.3343/alm.2025.0305

Background/Objectives: This study analyzed ten years of domestic research on medical artificial intelligence (AI) from 2015 to 2024 using topic modeling and keyword network analysis. Chronological comparison showed that the research emphasis evolved through three stages-Introduction (2015-2018), Expansion (2019-2022), and Post-ChatGPT (2023-2024)-reflecting the growing incorporation of AI into clinical and service domains. Methods: We collected a curated set of 686 papers from the Korea Citation Index (KCI). After preprocessing-stopword removal, synonym unification, and lemmatization-7489 unique terms were extracted for the analysis. Results: Topic modeling identified three dominant themes: Diagnostic Imaging and Algorithm Validation, Healthcare Service and System Integration, and Patient-Centered Prediction and Disease Modeling. Keyword network analysis further revealed a structural shift from algorithm-oriented studies to system-level and patient-focused applications. Conclusions: These findings indicate that Korean medical AI research is maturing toward a more interpretable, integrated, and human-centered paradigm, underscoring the need for explainable AI (XAI), multidisciplinary collaboration, and governance frameworks for safe and ethical deployment.

Gastric intestinal metaplasia (IM) is a key precursor lesion in gastric cancer progression, as described by the Correa model. Image-enhanced endoscopy (IEE) with magnifying endoscopy has significantly improved the visualization of the mucosal surfaces and microvascular structures, aiding in the accurate diagnosis of IM. While histological evaluation remains the gold standard, IEE might provide a practical and cost-effective alternative for the risk stratification of gastric IM.

The superficial circumflex iliac artery perforator (SCIP) flap has gained popularity in microsurgical reconstruction, yet anatomical variations of the pedicle poses challenges in flap elevation. The primary aim of this study is to clarify whether the superficial branch of the SCIA exhibits a consistent axial course with reproducible, optimal setting of real-time ultrasonographic mapping. By focusing on this pedicle axiality with ultrasound, the study aims to improve the safety and precision of SCIP flap harvest. A stepwise ultrasound mapping protocol was performed in a prospective series of patients undergoing SCIP flap reconstruction. High-frequency linear ultrasound probes were used to identify the SCIA origin, its course, and cutaneous perforators relative to the anterior superior iliac spine (ASIS) and inguinal ligament. Ultrasound successfully identified the SCIA origin and mapped its course in all cases. Most branches followed a consistent intra-adiposal, longitudinal path between the deep and superficial fascia. The majority of SCIP pedicles (91.9%) demonstrated an axial pattern extending cephalically beyond the ASIS, and the most distal part could be mapped with ultrasound. Preoperative mapping closely correlated with intraoperative anatomy, facilitating safe flap elevation with minimal dissection time and improved flap design. This article presents concise guidelines for ultrasonographic mapping of the SCIP flap. Our findings demonstrate that the superficial branch of the SCIA shows a consistent axial flap pattern. These insights redefine the anatomical understanding of the SCIP flap and offer comprehensive guidance for its safe and reliable application in reconstructive surgery.LEVEL OF EVIDENCE: IV.

Structurally Adaptive Microneedle Bioelectrode The cover illustrates a structurally adaptive microneedle bioelectrode that transforms from a bulky state into an ultrathin, compliant interface after insertion. This transition extends epidermal electronics into dermal electronics, enabling stress-free, stable, and long-term signal acquisition. More details can be found in the Research Article by Geunbae Lim and co-workers (DOI: 10.1002/adma.202509719).