Probiotics have gained increasing clinical attention as adjunctive treatment for lower gastrointestinal disorders. However, evidence supporting their therapeutic efficacy remains limited, particularly with regard to sex-related differences. This expert review provides evidence-based insights and practical recommendations for the use of probiotics in patients with irritable bowel syndrome (IBS), functional constipation (FC), and Clostridioides difficile infection (CDI), considering possible sex-related differences. Evidence from randomized controlled trials and meta-analyses indicates that probiotics can modestly improve global symptoms, abdominal pain, and bloating in IBS and enhance bowel movement frequency and stool consistency in FC. However, these effects are strain-specific and heterogeneous. Although clinical studies on probiotics in IBS have not confirmed significant sex-related differences, experimental animal studies using stress-induced IBS models have demonstrated sex-dependent responses to specific probiotic strains, supporting the biological plausibility of such differences. For CDI, the efficacy of probiotics in preventing primary or recurrent infections remains inconsistent across large trials, and current guidelines usually do not recommend their routine use. However, sex- and age-related immunologic differences support the clinical differences of CDI. Probiotics are generally considered safe for healthy individuals, although caution is advised in patients who are immunocompromised or critically ill. Clinicians should select probiotic products based on strain-specific clinical evidence, adequate viable doses, patient characteristics and sex. In conclusion, probiotics might play a role as adjunctive therapy for IBS and FC, with variability in responses influenced by microbial, host, and potential sex-related factors. Further research is needed to establish optimized personalized probiotic strategies.

Cardiovascular disease, particularly ischemic heart disease, remains a leading cause of death worldwide. Although advances in pharmacological and device-based therapies have improved clinical outcomes, effective strategies for myocardial repair and regeneration remain limited. T-cadherin, a glycosylphosphatidylinositol-anchored atypical cadherin, has recently been identified as a functional receptor for both low-density lipoprotein cholesterol and adiponectin, a cardioprotective adipokine. Notably, the interaction between T-cadherin and adiponectin has emerged as a key regulator of exosome biogenesis and paracrine signaling within cardiovascular tissues. Exosomes are nanosized extracellular vesicles that carry protective molecular cargo, including microRNAs and proteins, and contribute to anti-inflammatory, antifibrotic, and angiogenic effects in the ischemic myocardium. However, their clinical translation is challenged by factors such as variability in yield, heterogeneity of exosome populations, and inefficient tissue targeting. Enhancing endogenous exosome production through the T-cadherin–adiponectin pathway may therefore offer a novel cell-free therapeutic strategy. This review explores the biological roles of T-cadherin and adiponectin in cardiovascular diseases, their regulatory influence on exosome formation, and the future potential of leveraging this axis for myocardial repair and regeneration.

Globally, rapid population aging—particularly in Korea—has extended life expectancy but not proportionally extended healthy life expectancy, resulting in longer periods of illness or disability and a higher demand for complex medical and social care. Therefore, prolonging healthy life and improving health-related quality of life have become primary objectives in geriatric medicine and rehabilitation. Geriatric rehabilitation is a critical intervention aimed at optimizing the functioning of older adults and pre-morbidly frail individuals who have lost independence due to acute illness or injury. For many older patients, the goal shifts from complete recovery to achieving a new equilibrium, maximizing autonomy despite greater dependency. Geriatric rehabilitation also targets key geriatric syndromes such as frailty, recognizing it as a dynamic and potentially reversible state that provides a crucial “time window” for intervention. This review summarizes the core principles and structural elements essential for geriatric rehabilitation, emphasizing the implementation challenges within the Korean healthcare system. Unlike the European consensus, which supports structured inpatient and outpatient services with seamless transitions of care guided by Comprehensive Geriatric Assessment, the Korean healthcare system remains fragmented and heavily centered on acute hospitals. This highlights the urgent need for a systematic model to integrate care facilities and strengthen interprofessional collaboration to support community-based “aging in place.” Effective geriatric rehabilitation requires multidisciplinary teams and multifaceted approaches to optimize quality of life, social participation, and independent living. Despite its importance, substantial awareness gaps and policy barriers persist, underscoring an urgent call to action.

This study aimed to provide a comprehensive understanding of aging with disability among polio survivors who continue to live with long-term sequelae. Although poliomyelitis has been eradicated in most regions, survivors entering older age face a dual challenge, as age-related decline overlaps with pre-existing impairments, creating a need for integrated management strategies. This narrative review examined the epidemiology, clinical manifestations, and late effects of polio, with particular attention to post-polio syndrome, secondary musculoskeletal disorders, and other systemic conditions. International and Korean studies were compared to highlight similarities and contextual differences. Polio survivors frequently experience accelerated functional decline due to post-polio syndrome, fatigue, pain, musculoskeletal disorders (e.g., arthritis, osteoporosis, fractures), and cardiopulmonary dysfunction. Approximately 64% report major falls, with 35% sustaining fractures, often at vulnerable sites such as the hip or distal femur. Psychological distress, sleep disturbances, metabolic syndrome, and cardiovascular disease are also prevalent, further compounding frailty. In Korea, where most survivors are now over 60 years of age, epidemiological patterns differ from those of Western cohorts; however, systematic investigations remain limited. Polio survivors exemplify the dual burden of aging and long-term disability, underscoring the need to move beyond fragmented, symptom-focused care toward integrated, life course–oriented approaches. Anticipating and managing late effects, strengthening preventive strategies, and ensuring equitable healthcare access are essential for maintaining function, independence, and quality of life. Lessons drawn from polio survivors offer valuable insights for understanding aging with disability more broadly.

Fragility fractures, particularly hip fractures, represent a major public health concern among older adults and are associated with high morbidity, mortality, functional decline, and socioeconomic burden. Cognitive impairment is common in older adults with hip fractures and contributes to increased fracture risk, poor postoperative outcomes, delayed recovery, and higher rates of institutionalization. This review aimed to examine rehabilitation strategies for older adults with hip fractures, with a specific focus on considerations for those with cognitive impairment. Evidence suggests that individuals with mild-to-moderate cognitive impairment can achieve meaningful functional gains through structured, intensive, multidisciplinary rehabilitation programs incorporating progressive resistance training, balance and mobility exercises, and individualized approaches tailored to cognitive and physical abilities. However, the implementation of such programs is often hindered by insufficient staff training and awareness in dementia-specific rehabilitation, limited resources, and the lack of standardized protocols defining eligibility, intensity, and adaptation. Optimizing outcomes requires structured, tailored rehabilitation protocols, enhanced staff education, interprofessional collaboration, and proactive management of delirium and secondary fracture prevention through fracture liaison services, while concurrently addressing systemic barriers such as resource constraints. Integrated, coordinated care across the continuum is essential to maximize recovery, independence, and quality of life in older adults with hip fractures and cognitive impairment.

Citations

• Encouraging recovery or avoiding risk? A proposed clinical framework for rehabilitation decision-making after fragility fractures
  Mariam A. Ibrahim, Hager Abdelzaher, Ahmed Abdullah Alghamdi, Abdulaziz Khalid Bakhaider, Osama Farouk, Mohammad Kamal Abdelnasser
  Injury.2026; 57(6): 113195.     CrossRef
• Management of hip fracture in older adults with cognitive impairment: a narrative review
  Hao Rao, Li Luo, Jialing Cheng, Gang Wu, Hongmei Zhang, Xuxing Zhang, Jian Qin, Zidong Wang
  Frontiers in Public Health.2026;[Epub]     CrossRef
• Does an Innovative PT Program Targeting Mobility Benefit Veterans With Executive Function Deficit?
  Elisa F. Ogawa, Rebekah Harris, Ildiko Halasz, William Milberg, Jonathan F. Bean
  Journal of the American Geriatrics Society.2026;[Epub]     CrossRef

Recent advancements in tuberculosis treatment research emphasize innovative strategies that enhance treatment efficacy, reduce adverse effects, and adhere to patient-centered care principles. As tuberculosis remains a significant global health challenge, integrating new and repurposed drugs presents promising avenues for more effective management, particularly against drug-resistant strains. Recently, the spectrum concept in tuberculosis infection and disease has emerged, underscoring the need for research aimed at developing treatment plans specific to each stage of the disease. The application of precision medicine to tailor treatments to individual patient profiles is crucial for addressing the diverse and complex nature of tuberculosis infections. Such personalized approaches are essential for optimizing therapeutic outcomes and improving patient adherence—both of which are vital for global tuberculosis eradication efforts. The role of tuberculosis cohort studies is also emphasized, as they provide critical data to support the development of these tailored treatment plans and deepen our understanding of disease progression and treatment response. To advance these innovations, a robust tuberculosis policy framework is required to foster the integration of research findings into practice, ensuring that treatment innovations are effectively translated into improved health outcomes worldwide.

Citations

• Protocol of a Nationwide Observational Cohort Study for Long-Term Impacts on Lung Health and Life after Tuberculosis in Korea (LIFE-TB)
  Chiwook Chung, Jinsoo Min, Doosoo Jeon, Yong-Soo Kwon, Jeongha Mok, Hyung Woo Kim, Youngmok Park, Young Ae Kang
  Tuberculosis and Respiratory Diseases.2026; 89(1): 86.     CrossRef
• Research hotspots, intellectual structures, and emerging themes in national tuberculosis program studies: a multi-dimensional analysis of global trends and directions
  Siddig Ibrahim Abdelwahab, Manal Mohamed Elhassan Taha, Hazem Mathkour, Edrous Alamer, Saleh Mohammad Abdullah, Saeed Alshahrani, Nizar A. Khamjan, Abdullah Farasani, Ahmed S. Alamer, Jobran M. Moshi, Khaled A. Sahli, Mohammed Jeraiby, Marwa Qadri, Abdulw
  Journal of Public Health.2026;[Epub]     CrossRef
• Post-tuberculosis Health: A Holistic Perspective on Multisystem Sequelae and Long-Term Wellbeing
  Jinsoo Min, Yoolwon Jeong, Hyung Woo Kim, Hongjo Choi, Hojoon Sohn, Marc Lipman, Ju Sang Kim
  Tuberculosis and Respiratory Diseases.2026; 89(2): 202.     CrossRef
• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Purpose
The standardized uptake value (SUV) is a key quantitative index in nuclear medicine imaging; however, variations in region‐of‐interest (ROI) determination exist across institutions. This study aims to standardize SUV evaluation by introducing a deep learning‐based quantitative analysis method that enhances diagnostic and prognostic accuracy.
Methods
We used the Swin UNETR model to automatically segment key organs (breast, liver, spleen, and bone marrow) critical for breast cancer prognosis. Tumor segmentation was performed iteratively based on predefined SUV thresholds, and prognostic information was extracted from the liver, spleen, and bone marrow (reticuloendothelial system). The artificial intelligence training process employed 3 datasets: a test dataset (40 patients), a validation dataset (10 patients), and an independent test dataset (10 patients). To validate our approach, we compared the SUV values obtained using our method with those produced by commercial software.
Results
In a dataset of 10 patients, our method achieved an auto‐segmentation accuracy of 0.9311 for all target organs. Comparison of maximum SUV and mean SUV values from our automated segmentation with those from traditional single‐ROI methods revealed differences of 0.19 and 0.16, respectively, demonstrating improved reliability and accuracy in whole‐organ SUV analysis.
Conclusion
This study successfully standardized SUV calculation in nuclear medicine imaging through deep learning‐based automated organ segmentation and SUV analysis, significantly enhancing accuracy in predicting breast cancer prognosis.

Purpose
This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements.
Methods
A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression.
Results
The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being.
Conclusion
An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.

Citations

• Recent advances in pulmonary tuberculosis, the application of deep learning to medical topics, and highlights from this issue of Ewha Medical Journal
  Hae-Sun Chung
  Ewha Medical Journal.2025; 48(2): e16.     CrossRef

Citations

• The One-and-a-Half Syndrome of Korean Clinical Training: 1.5 Years of Fracturing
  Jong Seok Bae, Jeeyoung Oh
  Journal of Clinical Neurology.2026; 22(2): 143.     CrossRef
• Impact of mass resident physician resignation on inpatient mortality and admissions in Korea
  Joon Young Choi, Hyonsoo Joo, Ju Sang Kim, Eung Gu Lee, Hyeong Jun Cho, Yeonhee Park, Chang Dong Yeo, Soon Kyu Lee, Donghoon Kang, Sang Hun Eum, Kwan Yong Lee, Tai Joon An
  Public Health.2026; 254: 106225.     CrossRef
• Current challenges in Korean medical research and highlights from this issue of Annals of Clinical Microbiology
  Hae-Sun Chung
  Annals of Clinical Microbiology.2025; 28(2): 11.     CrossRef