Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Background: The time-consuming process of drug development contributes to unmet healthcare needs for rheumatoid arthritis (RA). Studies of Western populations suggest the potential use of antidiabetic drugs as an alternative to lower RA risk. We aimed to examine the possibility of repurposing antidiabetic drugs for RA by evaluating their causal associations with genetic antidiabetic drug target genes using Mendelian randomization (MR) of samples from an East Asian biobank. Methods: We conducted drug-targeting two-sample MR to estimate the association between the antidiabetic drug and RA risk using summary statistics of genome-wide association studies (GWAS). Six single-nucleotide polymorphisms (SNPs) were selected as independent genetic variants that encode the target proteins of the selected antidiabetic drugs (insulin/insulin analogues, thiazolidinediones, and sulfonylureas). Instrumental associations with fasting blood glucose and RA were extracted from the KoGES (Korean Genome and Epidemiology Study) and BBJ (BioBank Japan), respectively. Results: A decrease in fasting blood sugar level of 1 mmol (1.8 mg/dL) by the rs1801282 SNP in the PPARG gene reduced the incidence of RA by about 20%. Moreover, another SNP within the PPARG gene, rs35240997, reduced the incidence of RA about 16%. Conclusion SNPs within the anti-diabetic drug target genes lowered fasting blood sugar levels and the risk of RA. However, the results from this study require cautious interpretations due to weak instrument bias.

Purpose: The Korean Society of Coloproctology has been conducting Colorectal Cancer Awareness Campaign, also known as the Gold Ribbon Campaign, every September since 2007. The 2022 campaign was held through a metaverse platform targeting the younger age group under the slogan of raising awareness of early-onset colorectal cancer (CRC). This study aimed to analyze the impact of the 2022 campaign on a metaverse platform. Methods: Anonymized survey data were collected from participants in the metaverse campaign from September 1 to 15, 2022. The satisfaction score of the participants was evaluated by sex, age group, and previous campaign participation status. Results: During the campaign, 2,770 people visited the metaverse. Among them, 455 people participated in the survey (response rate, 16.4%). Approximately 95% of the participants reported being satisfied with the information provided by the campaign, understood the necessity of undergoing screening for and prevention of early-onset CRC, and were familiar with the structure of the metaverse. The satisfaction score for campaign information tended to decrease as the participants’ age increased. When the participants’ overall level of satisfaction with the metaverse platform was assessed, teenagers scored particularly lower than the other age groups. The satisfaction scores for CRC information provided in the metaverse, as well as the scores for recognizing the seriousness and necessity of screening for early-onset CRC, indicated a high positive tendency (P<0.001). Conclusion Most of the 2022 Gold Ribbon Campaign participants were satisfied with the metaverse platform. Medical society should pay attention to increasing participation in and satisfaction with future public campaigns.

Background: We aimed to evaluate the utility of repeat biopsy of thyroid nodules classified as atypia of undetermined significance with architectural atypia (IIIB) on core-needle biopsy (CNB). Methods: This retrospective study evaluated patients with thyroid nodules categorized as IIIB on CNB between 2013 and 2015. Demographic characteristics, subsequent biopsy results, and ultrasound (US) images were evaluated. The malignancy rates of nodules according to number of CNBs and the number of IIIB diagnoses was compared. Demographic and US features were evaluated to determine factors predictive of malignancy. Results: Of 1,003 IIIB nodules on CNB, the final diagnosis was determined for 328 (32.7%) nodules, with 121 of them confirmed as malignant, resulting in a malignancy rate of 36.9% (95% confidence interval, 31.7% to 42.1%). Repeat CNB was performed in 248 nodules (24.7%), with 75 (30.2%), 131 (52.8%), 13 (5.2%), 26 (10.5%), one (0.4%), and two (0.8%) reclassified into categories II, IIIB, IIIA, IV, V, and VI, respectively. Malignancy rates were not significantly affected by the number of CNBs (P=0.291) or the number of IIIB diagnoses (P=0.473). None of the nodules confirmed as category II on repeat CNB was malignant. US features significantly associated with malignancy (P<0.003) included solid composition, irregular margins, microcalcifications, and high suspicion on the US risk stratification system. Conclusion Repeat biopsy of nodules diagnosed with IIIB on CNB did not increase the detection of malignancy but can potentially reduce unnecessary surgery. Repeat biopsy should be performed selectively, with US features guiding the choice between repeat biopsy and diagnostic surgery.

Objectives: Limited information is available concerning the epidemiology of stroke and acute myocardial infarction (AMI) in the Republic of Korea. This study aimed to develop a national surveillance system to monitor the incidence of stroke and AMI using national claims data. Methods: We developed and validated identification algorithms for stroke and AMI using claims data. This validation involved a 2-stage stratified sampling method with a review of medical records for sampled cases. The weighted positive predictive value (PPV) and negative predictive value (NPV) were calculated based on the sampling structure and the correspondingsampling rates. Incident cases and the incidence rates of stroke and AMI in the Republic ofKorea were estimated by applying the algorithms and weighted PPV and NPV to the 2018National Health Insurance Service claims data. Results: In total, 2,200 cases (1,086 stroke cases and 1,114 AMI cases) were sampled from the 2018 claims database. The sensitivity and specificity of the algorithms were 94.3% and 88.6% for stroke and 97.9% and 90.1% for AMI, respectively. The estimated number of cases, including recurrent events, was 150,837 for stroke and 40,529 for AMI in 2018. The age- and sex-standardized incidence rate for stroke and AMI was 180.2 and 46.1 cases per 100,000 person-years, respectively, in 2018. Conclusion This study demonstrates the feasibility of developing a national surveillance system based on claims data and identification algorithms for stroke and AMI to monitor their incidence rates.

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.