Most-cited are based on citations from 2023 ~ 2025.
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Artificial intelligence (AI) is rapidly transforming various medical fields, including radiation oncology. This review explores the integration of AI into radiation oncology, highlighting both challenges and opportunities. AI can improve the precision, efficiency, and outcomes of radiation therapy by optimizing treatment planning, enhancing image analysis, facilitating adaptive radiation therapy, and enabling predictive analytics. Through the analysis of large datasets to identify optimal treatment parameters, AI can automate complex tasks, reduce planning time, and improve accuracy. In image analysis, AI-driven techniques enhance tumor detection and segmentation by processing data from CT, MRI, and PET scans to enable precise tumor delineation. In adaptive radiation therapy, AI is beneficial because it allows real-time adjustments to treatment plans based on changes in patient anatomy and tumor size, thereby improving treatment accuracy and effectiveness. Predictive analytics using historical patient data can predict treatment outcomes and potential complications, guiding clinical decision-making and enabling more personalized treatment strategies. Challenges to AI adoption in radiation oncology include ensuring data quality and quantity, achieving interoperability and standardization, addressing regulatory and ethical considerations, and overcoming resistance to clinical implementation. Collaboration among researchers, clinicians, data scientists, and industry stakeholders is crucial to overcoming these obstacles. By addressing these challenges, AI can drive advancements in radiation therapy, improving patient care and operational efficiencies. This review presents an overview of the current state of AI integration in radiation oncology and insights into future directions for research and clinical practice.
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Although sciatica is commonly associated with lumbar spinal issues, it is important to acknowledge that non-spinal factors can also play a significant role in this condition. This is particularly relevant for female patients, in whom gynecologic conditions can lead to secondary sciatic neuropathy. Herein, we report the case of a 66-year-old woman who experienced posterolateral right lower extremity radiating pain. We initially performed a lumbar transforaminal epidural steroid injection, but the pain persisted. Subsequently, hip MRI revealed sciatic neuropathy adjacent to the pedunculated portions of a uterine myoma. We then performed a sub-gluteal sciatic nerve block under ultrasound guidance, resulting in significant relief of her pain. In conclusion, hip MRI can be helpful for the differential diagnosis of sciatica, and ultrasound-guided sciatic nerve block can be considered an appropriate and effective treatment option.
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This study analyzed drug-induced death statistics in Korea between 2011 and 2021.
Cause-of-death statistics data from Statistics Korea were examined based on the Korean Standard Classification of Diseases and Causes of Death and the International Statistical Classification of Diseases and Related Health Problems, 10th revision.
In 2021, there were 559 drug-induced deaths, marking a 172.7% increase compared to 2011, which recorded 205 deaths. The rate of drug-induced deaths per 100,000 people was 1.1 in 2021, up 153.6% from 0.4 in 2011. The mortality rate for men aged 25−34 years and women aged 35−44 years each increased fourfold from 2011 to 2021: from 0.3 to 1.2 for the former and 0.3 to 1.3 for the latter. Of the drug-induced deaths in 2021, 75.0% (419/559) were due to intentional self-harm, and 10.4% (58/559) were accidental. The number of deaths attributed to medical narcotics in 2021 was 169, a 5.5-fold increase from 2011. The most commonly implicated drugs in these deaths were sedative-hypnotic drugs, benzodiazepines, and opioids. Sedative-hypnotic drugs and benzodiazepines were frequently involved in cases of intentional self-harm, while opioids and psychostimulants were more often associated with accidental deaths.
The death rate from drug-induced causes is considerably lower in Korea than in the United States (1.1 vs. 29.2). However, the number of such deaths has increased recently. Since these deaths occur predominantly among younger age groups and are often the result of intentional self-harm, there is a clear need for systematic management and the implementation of targeted policies.
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During the COVID-19 pandemic, the first seasonal influenza epidemic was declared in the 37th week of 2022 in Korea and has continued through the winter of 2023–2024. However, this finding has not been observed in the United States and Europe. The present study aimed to determine whether the prolonged influenza epidemic in Korea from 2022 to 2023 was caused by using a different influenza epidemic threshold compared to the thresholds used in the United States and Europe.
Korea, the United States, and Europe use different methods to set seasonal influenza epidemic thresholds. First, we calculated the influenza epidemic thresholds for influenza seasons using the different methods of those three regions. Using these epidemic thresholds, we then compared the duration of influenza epidemics for the most recent three influenza seasons.
The epidemic thresholds estimated by the Korean method were lower than those by the other methods, and the epidemic periods defined using the Korean threshold were estimated to be longer than those defined by the other regions’ thresholds.
A low influenza epidemic threshold may have contributed to the prolonged influenza epidemic in Korea, which was declared in 2022 and has continued until late 2023. A more reliable epidemic threshold for seasonal influenza surveillance needs to be established in Korea.
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The worldwide incidence of precocious puberty, which is associated with negative health outcomes, is increasing. Several studies have suggested that environmental factors contribute to the development of precocious puberty alongside genetic factors. Some epidemiological studies have provided limited evidence suggesting an association between exposure to air pollution and changes in pubertal development. This systematic review aimed to summarize existing evidence on the association between air pollution exposure and precocious puberty. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science) until August 2023. The included studies assessed the association between air pollutant exposure and the risk of precocious puberty, early menarche, or pubertal development. Two authors independently performed study selection and data extraction. A meta-analysis and analysis of the risk of bias were infeasible due to the limited number of studies and the heterogeneity among them. The literature search resulted in 184 studies, from which we included six studies with sample sizes ranging from 437 to 4,074 participants. The studies reported heterogeneous outcomes. Four studies found that increased exposure to air pollution was related to earlier pubertal onset. One study was inconclusive, and another suggested that air pollutant exposure may delay the onset of thelarche. Most studies suggest that exposure to air pollutants accelerates pubertal development; however, the results from the available studies are inconsistent. More extensive and well-designed longitudinal studies are required for a comprehensive understanding of the association between air pollution and precocious puberty.
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Understanding the effects of sex and sex differences on liver health and disease is crucial for individualized healthcare and informed decision-making for patients with liver disease. The impact of sex on liver disease varies according to its etiology. Women have a lower prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) than men. However, postmenopausal women face a higher risk of advanced liver fibrosis due to hormonal influences. Sex differences affect the pathogenesis of MASLD, which involves a complex process involving several factors such as hormones, obesity, and the gut microbiome. Furthermore, sex-related differences in the development of MASLDrelated hepatocellular carcinoma have been observed. The sex-specific characteristics of MASLD necessitate an individualized management approach based on scientific evidence. However, research in this area has been lacking. This article reviews the current understanding of sex differences in MASLD.
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Coronary artery disease (CAD) remains the leading cause of mortality worldwide, driven primarily by atherogenesis. Recent efforts to understand sex differences in CAD have revealed distinct patterns in disease burden, risk factors, and clinical presentations. This review examines these sex differences in CAD, underscoring the importance of customized diagnostic and management strategies. Although men typically have higher rates of CAD prevalence and incidence, women face unique challenges, such as delayed diagnosis, atypical symptoms, and lower rates of medication prescription. Hormonal, genetic, and lifestyle factors all play a role in these disparities, with estrogen notably reducing CAD risk in women. Nontraditional risk factors, including chronic inflammation, psychological stress, socioeconomic status, and reproductive history, also contribute to CAD development and are often neglected in clinical settings. Addressing these differences requires increased awareness, more accurate diagnosis, and equitable healthcare access for both sexes. Furthermore, greater inclusion of women in CAD research is essential to better understand sex-specific mechanisms and optimize treatment outcomes. Personalizing CAD management based on sex-specific knowledge has the potential to improve prognosis and decrease disease incidence for both men and women.
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Enhanced recovery after surgery (ERAS) aims to promote postoperative recovery in patients by minimizing the surgical stress response through evidence-based multimodal interventions. In 2023, updated clinical practice guidelines were published in North America, potentially superseding the most recent guidelines previously announced at the ERAS Society in 2019. This review compares and reviews these two guidelines to examine the principle of ERAS and items related to colorectal surgery and to introduce the latest relevant study results published within the last 5 years. In the pre-hospitalization stage, the concept of pre-hospitalization is emphasized; this involves checking and reinforcing the patient’s nutritional status and physical functional status before surgery. In the preoperative stage, large-scale studies have prompted a change in the recommendation of mechanical bowel preparation combined with oral antibiotics in elective colorectal surgery. In the intraoperative stage, laparoscopic surgery has become a widespread and important component of ERAS, and more technologically advanced single-incision laparoscopic surgery and robotic surgery are the focus of active research. Ileus-prevention items, such as opioid-sparing multimodal pain management and euvolemic fluid therapy, are recommended in the postoperative stage. The adoption of ERAS protocols is expanding to encompass a wide range of surgical procedures, clinical scenarios, healthcare institutions, and professional medical societies. In order to maximize the effect by increasing adherence to ERAS, medical staff must fully understand the clinical basis and meaning of each item, and the protocol must be maintained and developed steadily through a team approach and audit system.
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This review describes a psychological support service designed to address post-traumatic stress disorder in workers impacted by workplace injuries, assisting in their recovery and facilitating their return to work. It explores the rationale and context behind establishing trauma counseling centers for these individuals, along with the status, roles, future directions, and recommendations for these centers. The review details the operational framework and functions of the workplace injury trauma management program, the scope of the impacts of such injury, the groups targeted for crisis intervention, and the psychological interventions tailored to each stage of recovery. Initiated as a pilot project in 2018, trauma counseling centers for workers have gradually become more common, with 23 centers in operation across Korea as of 2024.
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Enhanced recovery after surgery (ERAS) protocols are designed to minimize surgical stress, preserve physiological function, and expedite recovery through standardized perioperative care for primary colorectal surgery patients. This narrative review explores the benefits of current ERAS protocols in improving outcomes for these patients and provides insights into future advancements. Numerous studies have shown that ERAS protocols significantly reduce the length of hospital stays by several days compared to conventional care. Additionally, the implementation of ERAS is linked to a reduction in postoperative complications, including lower incidences of surgical site infections, anastomotic leaks, and postoperative ileus. Patients adhering to ERAS protocols also benefit from quicker gastrointestinal recovery, marked by an earlier return of bowel function. Some research indicates that colorectal cancer patients undergoing surgery with ERAS protocols may experience improved overall survival rates. High compliance with ERAS protocols leads to better outcomes, yet achieving full adherence continues to be a challenge. Despite these advantages, implementation challenges persist, with compliance rates affected by varying clinical practices and resource availability. However, the future of ERAS looks promising with the incorporation of prehabilitation strategies and technologies such as wearable devices and telemedicine. These innovations provide real-time monitoring, enhance patient engagement, and improve postoperative follow-up, potentially transforming perioperative care in colorectal surgery and offering new avenues for enhanced patient outcomes.
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FLASH radiotherapy (FLASH-RT) is an innovative approach that delivers ultra-high dose rates exceeding 40 Gy in less than a second, aiming to widen the therapeutic window by minimizing damage to normal tissue while maintaining tumor control. This review explores the advancements, mechanisms, and clinical applications of FLASH-RT across various radiation sources. Electrons have been predominantly used due to technical feasibility, but their limited penetration depth restricts clinical application. Protons, offering deeper tissue penetration, are considered promising for treating deep-seated tumors despite challenges in beam delivery. Preclinical studies demonstrate that FLASH-RT reduces normal tissue toxicity in the lung, brain, skin, intestine, and heart without compromising antitumor efficacy. The mechanisms underlying the FLASH effect may involve oxygen depletion leading to transient hypoxia, reduced DNA damage in normal tissues, and modulation of immune and inflammatory responses. However, these mechanisms are incompletely understood, and inconsistent results across studies highlight the need for further research. Initial clinical studies, including treatment of cutaneous lymphoma and bone metastases, indicate the feasibility and potential benefits of FLASH-RT in patients. Challenges for clinical implementation include technical issues in dosimetry accuracy at ultra-high dose rates, adaptations in treatment planning systems, beam delivery methods, and economic considerations due to specialized equipment requirements. Future directions will involve comprehensive preclinical studies to optimize irradiation parameters, large-scale clinical trials to establish standardized protocols, and technological advancements to overcome limitations. FLASH-RT holds the potential to revolutionize radiotherapy by reducing normal tissue toxicity and improving therapeutic outcomes, but significant research is required for real-world clinical applications.
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Sexually transmitted infections (STIs) continue to pose significant public health
challenges in Korea, with syphilis, gonorrhea, chlamydia,
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This paper discusses the implications of South Korea's birth notification system and Protected Birth Act, which is set to take effect on July 19, 2024. The legislation aims to prevent infanticide and child abandonment by mandating birth reporting and allowing anonymous births for women in crisis. However, concerns have been raised about the Act's effectiveness in protecting both women and children, particularly regarding issues of disability and migrant families. This paper focuses on gender and healthcare issues, highlighting how the Act perpetuates discrimination against out-of-wedlock pregnancies and upholds normal family ideologies. It notes the absence of critical discussions on women's autonomy, safe pregnancy termination, and paternal responsibility. The importance of healthcare providers understanding and preparing for the Act's implementation is emphasized. The paper calls for strengthening social safety nets to improve healthcare access for vulnerable populations and eliminate discrimination against non-traditional families. Additionally, it addresses the need for comprehensive support systems for crisis pregnancies, including financial assistance, psychological support, parenting education, housing solutions, and expanded healthcare services. This paper acknowledges the Act's significance in providing a systematic state-level approach to protecting pregnant women in crisis, replacing the previous reliance on private organizations. Nonetheless, it also emphasizes the importance of continually reviewing and supplementing the system to address potential rights infringements and ensure its effectiveness. In conclusion, this paper advocates for ongoing discussions on gender and healthcare issues, and for future amendments to the law that reflect real-world circumstances and provide genuine protection for crisis pregnancies and infants.
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