Patients with ectodermal dysplasia often have atrophied alveolar bone and an inadequate maxillomandibular relationship owing to congenital edentulism.Accurate implant placement that can overcomes anatomical limitations and orthognathic surgery to improve the maxillomandibular relationship is necessary for creating implant-supported prosthesis for these patients. Implant placement and provisional prosthesis fabrication before orthognathic surgery can provide critical fixed reference points and ensure accuracy during orthognathic surgery.In our patient, a digital system was used to design a surgical guide that considered the predictable position of the definitive prosthesis, allowing the placement of implants to overcome anatomical limitations and the creation of fixed reference points via the delivery of a provisional prosthesis for effective orthognathic surgery. The lack of compensation during orthognathic surgery was considered in the definitive prosthesis. As a result, a prosthesis with a minimal anterior cantilever was fabricated. This study aimed to determine the appropriate sequence of multidisciplinary collaborations that would, result in the best functional and aesthetic outcomes.

Background/Aims: Cardiovascular disease is the leading cause of death worldwide. This study aimed to investigate the recent nationwide trends in major dietary risk factors for dyslipidemia and atherosclerosis. Methods: We estimated age-standardized mean intakes of fresh fruits, fresh vegetables, whole grains, dietary fiber, and sugar-sweetened beverages (SSBs); and mean percentage of energy intake from protein, total fat, saturated fat, and polyunsaturated fat using nationally representative samples from the Korean National Health Examination and Nutrition Survey 2013–2022. To assess overall diet quality, we calculated mean Korean Healthy Eating Index (KHEI) (range 0–100, higher scores indicating greater diet quality). Results: In 2013–2022, there were overall decreasing trends in age-standardized mean KHEI score and intakes of fresh fruits and vegetables, whole grains, and dietary fiber; and overall increasing trends in mean intakes of SSBs, protein, and dietary fat among both male and female. The KHEI score increased in older adults aged ≥ 60 years, whereas it decreased among younger adults. Throughout the study period, younger adults tended to have lower intakes of fresh fruits, fresh vegetables, and whole grains; higher intakes of SSBs, protein, and dietary fat; and lower KHEI score. The mean KHEI score was lower in male (vs. female) and lower (vs. higher) income groups. Conclusions Our data suggest that, from 2013 to 2022, there was a trend toward an unhealthy diet in Korean adults. Our findings also suggest dietary inequalities among age, sex, and income groups, suggesting the need for more intense interventions targeting the vulnerable populations.

Purpose: To compare the perioperative and postoperative outcomes between traditional trans-vesical robot-assisted simple prostatectomy (TV-RASP) and the newly introduced urethral-sparing (US) RASP. Materials and Methods: We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation. Results: This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001). Conclusions US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP.

Purpose: Cognitive behavioral therapy (CBT) has long been recognized as an effective treatment for depression and suicidality.Virtual reality (VR) technology is widely used for cognitive training for conditions such as anxiety disorder and post-traumatic stress disorder, but little research has considered VR-based CBT for depressive symptoms and suicidality. We tested the effectiveness and safety of a VR-based CBT program for depressive disorders. Materials and Methods: We recruited 57 participants from May 2022 through February 2023 using online advertisements. This multi-center, assessor-blinded, randomized, controlled exploratory trial used two groups: VR treatment group and treat as usual (TAU) group. VR treatment group received a VR mental health training/education program. TAU group received standard pharmacotherapy. Assessments were conducted at baseline, immediately after the 6-week treatment period, and 4 weeks after the end of the treatment period in each group. Results: Depression scores decreased significantly over time in both VR treatment and TAU groups, with no differences between the two groups. The suicidality score decreased significantly only in VR group. No group differences were found in the remission or response rate for depression, perceived stress, or clinical severity. No adverse events or motion sickness occurred during the VR treatment program. Conclusion VR CBT treatment for major depressive disorder has the potential to be equivalent to the gold-standard pharmacotherapy in reducing depressive symptoms, suicidality, and related clinical symptoms, with no difference in improvement found in this study. Thus, VR-based CBT might be an effective alternative to pharmacotherapy for depressive disorders.

Purpose: To investigate whether using a continuous glucose monitoring (CGM) for the second time (2nd_CGM) would be effective after using it for the first time (1st_CGM), depending on age. Materials and Methods: This study included patients aged ≥40 years who were diagnosed with type 2 diabetes and had used a CGM at least twice between 2017 and 2021. Participants were divided into two groups based on their age: those aged <60 years and those aged ≥60 years. We assessed the glycemic control status of the 1st_CGM and 2nd_CGM, along with the glycemic variability. Results: Overall, 15 patients were included in the study. The mean glucose level in users aged <60 years significantly decreased (p<0.001) owing to the CGM use, while it did not increase in those aged ≥60 years. In users aged ≥60 years, the 1st_CGM group showed a significant decrease in blood glucose levels over time (p<0.05), whereas the 2nd_CGM group only showed a non-significant decreasing trend. The time in range tended to increase in those aged <60 years but decreased in those aged ≥60 years. In those aged <60 years, the mean amplitude of glycemic excursions (p<0.001), standard deviation (p<0.05), and coefficient of variation (p<0.001) significantly decreased. In those aged ≥60 years, these parameters exhibited a non-significant decreasing trend. Conclusion Glycemic effect and variability improved as expected with 1st_CGM use. However, 2nd_CGM did not significantly improve glycemic effect or variability in users aged ≥60 years, contrary to expectations. To address this issue, further investigation is needed to understand why, compared to 1st_CGM, 2nd_CGM fails to achieve better glycemic control in individuals aged ≥60 years.

Purpose: Cancer poses a significant global health challenge, demanding precise genomic testing for individualized treatment strategies. Targeted-panel sequencing (TPS) has improved personalized oncology but often lacks comprehensive coverage of crucial cancer alterations. Whole-genome sequencing (WGS) addresses this gap, offering extensive genomic testing. This study demonstrates the medical potential of WGS. Materials and Methods: This study evaluates target-enhanced WGS (TE-WGS), a clinical-grade WGS method sequencing both cancer and matched normal tissues. Forty-nine patients with various solid cancer types underwent both TE-WGS and TruSight Oncology 500 (TSO500), one of the mainstream TPS approaches. Results: TE-WGS detected all variants reported by TSO500 (100%, 498/498). A high correlation in variant allele fractions was observed between TE-WGS and TSO500 (r=0.978). Notably, 223 variants (44.8%) within the common set were discerned exclusively by TE-WGS in peripheral blood, suggesting their germline origin. Conversely, the remaining subset of 275 variants (55.2%) were not detected in peripheral blood using the TE-WGS, signifying them as bona fide somatic variants. Further, TE-WGS provided accurate copy number profiles, fusion genes, microsatellite instability, and homologous recombination deficiency scores, which were essential for clinical decision-making. Conclusion TE-WGS is a comprehensive approach in personalized oncology, matching TSO500’s key biomarker detection capabilities. It uniquely identifies germline variants and genomic instability markers, offering additional clinical actions. Its adaptability and cost-effectiveness underscore its clinical utility, making TE-WGS a valuable tool in personalized cancer treatment.

Purpose: There is few evidence regarding the optimal salvage treatment options for loco-reginal recurrence of esophageal cancer. This study aimed to evaluate the clinical outcomes of salvage radiotherapy (RT) in patients with loco-regional recurrence (LRR) after surgery for esophageal cancer. Materials and Methods: We retrospectively reviewed 147 esophageal cancer patients who received salvage RT for loco-regional recurrence between 1996 and December 2019. A total dose of 60 Gy in 20 fractions was used for RT alone and 60-70 Gy in 30-35 fractions for concurrent chemoradiotherapy (CCRT). Results: The patients’ median age was 65 years (range, 41 to 86 years). The median disease-free interval was 13.5 months (1.0 to 97.4 months). After a median 18.8 months follow-up, the 2-year overall survival (OS) and progression-free survival (PFS) rates were 38.1% and 25.9%, respectively. The median OS and PFS were 18.8 and 8.4 months, respectively. The CCRT could not improve OS compared to RT (p=0.336), but there was a trend of better PFS in the CCRT group. Regarding toxicities, the rate of grade 3 or higher toxicity was 10.9% occurring in 16 patients, and it was higher in patients who received CCRT than in the RT alone group (19.6% vs. 6.3%, p=0.023). Conclusion Salvage RT alone as well as CCRT could be effective in patients with locoregionally recurrent esophageal cancer.

Background: Studies comparing the minimally invasive proximal chevron and Akin osteotomies (MIPCA) technique with conventional techniques, such as the open proximal chevron metatarsal osteotomy with the Akin procedure (open PCMO-Akin procedure), are limited. This study aimed to compare and evaluate operative MIPCA and open PCMO-Akin procedure outcomes in the surgical correction of moderate-to-severe hallux valgus deformities. Methods: We conducted a retrospective comparison of clinical and radiographic outcomes between the MIPCA and open PCMOAkin procedure in patients with a hallux valgus deformity, defined as a preoperative hallux valgus angle (HVA) of ≥ 30° and/or a first to second intermetatarsal angle of ≥ 13°. The postoperative complication rate was monitored in both groups for a minimum of 12 months. An unsatisfactory correction was defined as an HVA > 15° at final follow-up. Results: We assigned 58 and 99 patients to the MIPCA or open PCMO-Akin procedure group, respectively. At final follow-up, no significant differences were observed between the groups in terms of clinical and radiographic parameters (p > 0.05), with the exception of the distal metatarsal articular angle (DMAA) (p = 0.012). No statistically significant postoperative changes in the DMAA were observed in the MIPCA group (p = 0.875). Five patients (5.1%) experienced postoperative hallux varus in the open PCMO-Akin procedure group, whereas no such cases were observed in the MIPCA group. No statistically significant difference in the rate of unsatisfactory correction was observed between the groups at the final follow-up (MIPCA group, 15.5%; open PCMO-Akin procedure group, 10.1%; p = 0.315). Conclusions The MIPCA technique is a viable alternative to the open PCMO-Akin procedure for correcting moderate-to-severe hallux valgus deformities. Given the potential lack of postoperative changes in the DMAA following the MIPCA technique, careful consideration is advised when applying this technique to patients with a large DMAA.

Background: and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia. Methods: Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects. Conclusions This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.