CHA Gangnam Medical Center

Survival outcomes for infants born at 22–23 weeks’ gestation vary widely across neonatal units. This national, prospective cohort study evaluated 919 infants born at 22–23 weeks’ gestation in South Korea between 2013 and 2022, using Korean Neonatal Network data. Infants were categorized based on the level of neonatal care: 785 in lower-level centers (Group A) and 134 in higher-level centers (Group B). Survival was significantly higher in Group B (64.9%) compared to Group A (29.3%) (P < 0.0001). Early deaths occurred more frequently and earlier in Group A. Proactive care—including antenatal corticosteroids, antenatal antibiotics, and immediate surfactant administration—was more common in Group B. Antenatal corticosteroid was significantly associated with reduced risk of death (hazard ratio 0.58; 95% confidence interval, 0.49–0.69; P < 0.0001). The timing of rapid decline in survival was delayed in higher-level centers. In addition, classifying institutions into higher- and lower-level groups according to the survival of infants born at 22–23 weeks’ gestation (≥50% vs. <50%) provides a good reflection of the quality of neonatal care. These findings highlight the importance of proactive care and timely in utero transfer to higher-level units in improving survival for peri-viable infants.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-28428-1.

Although implants have been linked to malignancies in other medical contexts, such as the relationship between anaplastic large cell lymphoma and breast implants, the potential association between orthopaedic implants and cancer remains unclear. Several studies have investigated this question, but findings have been inconsistent. A comprehensive meta-analysis is needed to clarify whether total joint arthroplasty increases the risk of malignancy. (1) Is receiving a THA or TKA associated with an increased risk of cancer? (2) Are certain implant types (such as metal-on-metal or cemented) associated with increased cancer risk? (3) Is follow-up duration associated with changes in observed cancer risk estimates? A systematic review and meta-analysis were conducted using PubMed, Embase, and SCOPUS to identify studies assessing cancer incidence rates in patients who received hip or knee arthroplasty compared to patients in control groups who did not receive arthroplasty. Databases were queried from inception through the final search date (November 23, 2024). Eligible studies reported or allowed derivation of an effect estimate comparing overall cancer incidence rates in recipients of THA or TKA with an external reference population. From 1838 screened articles, 16 studies were included, all of which provided extractable effect estimates that were entered into one or more of our meta-analyses. Included studies consisted primarily of record-linkage studies connecting national, longitudinally maintained arthroplasty registers to similarly longitudinal national mortality and cancer registers. Study quality was assessed using the Newcastle-Ottawa Scale, which awards up to nine points across three categories, with higher scores indicating lower risk of bias. The 16 included studies scored between 6 and 8 (mean ± SD 7.1 ± 0.8), reflecting generally high methodological quality. The primary analysis included data from 977,465 patients of both sexes and all age groups who underwent hip or knee arthroplasty and were followed up for over 7,415,134 person-years. Effect estimates were pooled with a random-effects model because heterogeneity was present (between-study σ 2 = 0.016 versus within-study σ 2 = 0.002; Q = 1195, p < 0.001), and a funnel plot showed no evidence of publication bias. To explore associations between implant type and cancer risk for patients undergoing THA, we conducted separate meta-analyses for studies reporting on metal-on-metal bearing surfaces and those reporting on cemented fixation. To assess latency effects, we compared cancer incidence rates in patients with more or less than 10 years of follow-up and conducted a meta-regression to evaluate the association between follow-up duration and cancer risk. We did not perform an a priori power analysis. Patients who underwent THA or TKA did not have an increased risk of cancer compared with the general population (pooled random-effects estimate [REE] = 0.99 [95% confidence interval (CI) 0.92 to 1.07]; p = 0.88). Subgroup analyses showed no increased cancer risk after TKA (pooled REE = 1.02 [95% CI 0.85 to 1.21]; p = 0.83) or THA (pooled REE = 0.99 [95% CI 0.91 to 1.07]; p = 0.73). Cancer risk did not increase among patients undergoing THA who received cemented implants (pooled REE = 1.00 [95% CI 0.87 to 1.15]; p = 0.93) or metal-on-metal implants (pooled REE = 1.02 [95% CI 0.85 to 1.21]; p = 0.86) compared with the general population. Among patients with ≥ 10 years of follow-up, cancer incidence did not differ from the general population (pooled REE = 1.05 [95% CI 0.97 to 1.14]; p = 0.21); similarly, among patients with < 10 years of follow-up, no increased cancer risk was observed (pooled REE = 0.93 [95% CI 0.81 to 1.06]; p = 0.27). Meta-regression showed no association between follow-up duration and cancer risk (β = -0.004 [95% CI -0.024 to 0.015]; p = 0.66). Based on these findings, clinicians can continue to recommend arthroplasty without additional cancer-related concern based on current evidence. However, future studies should ensure longer follow-up, improved global representation in large linkage studies, and detailed patient- and implant-specific data to better characterize potential rare or long-latency malignancies. Level III, therapeutic study.

In 2006, the IARC reported that inorganic lead is carcinogenic in animals but with limited evidence in humans. In addition, some studies have reported that exposure to lead increases the risk of lung cancer, but this remains controversial. Therefore, we aimed to assess the risk of developing lung cancer according to blood lead levels in workers with occupational lead exposure. A retrospective cohort study of male workers with 2009 blood lead (PbB) concentrations was conducted using nationwide special health examination data (SHED) from 2009 to 2021 and cancer registry data from 1999 to 2020 from the Republic of Korea. Standardized incidence ratios (SIRs) for lung cancer risk at each PbB level were calculated with a five-year wash-out period, adjusting for age, smoking status, duration of exposure, and the number of co-exposures to lung carcinogens. The study included 26,092 workers with an average follow-up period of 9.98 years. Compared with workers with PbB levels <3.130 µg/dL, the adjusted SIRs for lung cancer risk were 2.95 (95% confidence interval [CI]: 1.47-5.27) and 3.13 (95% CI: 1.82-5.00) for workers with PbB levels of 3.130-4.899 and ≥4.900 µg/dL, respectively, indicating a significant dose-response trend. This study demonstrates a significant association between lead exposure and an increased risk of lung cancer, highlighting the need for stronger occupational health policies and ongoing monitoring of workers exposed to lead. The observed dose-response relationship underscores the importance of reassessing current occupational safety standards and strengthening measures to reduce lead exposure in the workplace.

Background/AimsGastroesophageal reflux disease (GERD) requires symptom relief and treatment of associated conditions. In this study, we aimed to compare anti-reflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) for treating patients with GERD who are unresponsive to proton pump inhibitors (PPIs) and to identify the indications for each procedure.MethodsData of patients who underwent ARMS or SRF between March 2021 and April 2023 were analyzed. Changes in GERD questionnaire (GERDQ) scores, endoscopic Los Angeles (LA) grade, flap valve grade (FVG) based on Hill’s type, EndoFLIP distensibility index (DI), endoscopic Barrett’s epithelium (BE) resolution rate, and PPI withdrawal rate were compared between the two groups.ResultsImprovements in the GERDQ scores and PPI withdrawal rates were similar between the groups. The ARMS group showed significantly better changes in endoscopic LA grade, FVG, and EndoFLIP DI than the SRF group. The complications were more prevalent in the ARMS group than in the SRF group.ConclusionsThe change in endoscopic LA grade before and after the procedure was significantly higher in the ARMS group than in the SRF group. Significant improvements in endoscopic FVG, BE resolution, and EndoFLIP DI were observed only with the ARMS group.

Phytochemicals, naturally occurring compounds in plants, offer significant potential for drug development due to their diverse structures and biological activities. They exhibit antioxidant, anti-inflammatory, antimicrobial, anticancer, cardiovascular, and neuroprotective properties, making them beneficial for treating various health conditions. Advantages of phytochemicals include their natural origin, better safety profiles, multi-targeted actions, synergistic effects with other compounds, and sustainability. However, the traditional knowledge-based approach to analizing phytochemicals is limited by its reliance on well-known, locally available plants, resulting in a narrow scope and frequent redundancy. This approach often depends on anecdotal and subjective evidence, faces the risk of knowledge loss, and encounters ethical and legal issues. To address this issue, I propose a convolutional neural network-based systematic approach to predict potential biological activities from molecular structure inputs. The proposed system converts molecular structures into one-hot vector representations using SMILES notation and molecular fingerprint algorithms. These vectors are then fed into a biological activity prediction network to estimate possible biological activities. Through comprehensive experiments, I have demonstrated that applying a convolutional neural network-based machine learning approach yields promising results by achieving an accuracy of 87.8%.

To investigate prenatal ultrasound findings and the chromosomal outcomes of mosaic embryo transfer. This retrospective study was conducted on pregnant women who underwent mosaic embryo transfer following blastocyst-stage preimplantation genetic testing for aneuploidy (PGT-A) at CHA Gangnam Medical Center from January 2021 to July 2024. Trophectoderm biopsy specimens were collected using standard protocols, and next-generation sequencing profiles were defined as mosaics when displaying copy number counts in the 20-80% range. The results of the PGT-A, the amniocentesis results, the findings of prenatal ultrasounds, and the pregnancy outcomes were analyzed. A total of 88 mosaic embryos were transferred, of which 77 embryos were successfully implanted. Sixty-seven embryo-maintained pregnancies went beyond 11 weeks (87.0%), all among 58 patients with singleton pregnancies. The chaotic subtype showed the lowest ongoing pregnancy rate, and high-level mosaicism was less frequent in the ongoing group, compared to the total study group and the successful implantation group. Amniocentesis was performed on 33 mothers (56.9%), revealing two cases with abnormal findings that did not correlate with the PGT-A results. Two cases showed abnormalities in the second trimester detailed ultrasound, and both subsequently demonstrated normal findings in the third trimester and after birth. The average gestational age at birth was 38.4 weeks, and the average birth weight was 3313 g. No congenital anomalies were detected in 16 postnatal cases. Our study indicated that mosaic embryos can develop into euploid healthy infants with various levels or types of mosaicism, although the postnatal follow-up data are limited. This study is invaluable for counseling clinical results after mosaic embryo transfer, reassuring that, if patients do not have euploid embryos available, mosaic embryos can also be a viable option for transfer.

The development of intestinal anastomosis techniques, including hand suturing, stapling, and compression anastomoses, has been a significant advancement in surgical practice. These methods aim to prevent leakage and minimize tissue fibrosis, which can lead to stricture formation. The healing process involves various phases: hemostasis and inflammation, proliferation, and remodeling. Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines. Compression anastomosis devices, including those made of nickel-titanium alloy, offer a minimally invasive option for various surgical challenges and have shown safety and efficacy. However, despite advancements, anastomotic techniques are evaluated based on leakage risk, with complications being a primary concern. Newer devices like Magnamosis use magnetic rings for compression anastomosis, demonstrating greater strength and patency compared to stapling. Magnetic technology is also being explored for other medical treatments. While there are promising results, particularly in animal models, the real-world application in humans is limited, and further research is needed to assess their safety and practicality.