Background/Aims: Biliary tract cancer (BTC) is a rare malignancy with poor prognosis. We investigated genomic determinants of clinical benefit from gemcitabine, cisplatin, and nab-paclitaxel (GAP) versus gemcitabine and cisplatin (GC) in advanced BTC. Methods: Clinical and genomic data using TruSight Oncology 500 were analyzed from patients treated with GAP (N=198) or GC (N=89) as first-line therapy. Results: With a median follow-up of 33.0 months, GAP modestly improved progression-free survival (PFS) (hazard ratio [HR] 0.764; 95% confidence interval [CI] 0.591–0.989) without significant overall survival (OS) difference compared to GC. Genomic profiling revealed frequent alterations in TP53 (35.2%), KRAS (16.4%), SMAD4 (10.5%), and TNFRSF14 (10.5%), involving RTK/RAS (44.3%), TP53 (41.8%), and PI3K (20.2%) pathways. Single-gene mutations did not predict treatment benefit. However, pathway-level analysis identified PI3K pathway activation as significantly associated with inferior PFS (HR 2.148; 95% CI 1.478–3.124) and OS (HR 2.096; 95% CI 1.413–3.109) in patients receiving GAP, an effect not observed with GC. Importantly, GAP conferred clinical benefit only in patients without PI3K pathway activation, while no survival advantage was seen in those with such alterations (Pinteraction=0.023 for PFS, Pinteraction=0.003 for OS). Similar results were obtained in the independent validation cohort treated with GAP (N=103) or GC (N=64) for BTC. Conclusions Genomic profiling using next-generation sequencing identified PI3K pathway activation as key molecular determinant that differentiates patient outcomes between GAP and GC treatments in advanced BTC.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Objectives: To evaluate the effects of commercially available non-alcoholic beers on the enamel surface of bovine teeth. Methods: The test beverages included regular beer (Cass), non-alcoholic beer (Cass 0.0), lemonflavored non-alcoholic beer (Cass lemon squeeze 0.0), Coca-cola, and bottled water. The pH of all beverages was measured, followed by titratable acidity calculations to pH 5.5 and pH 7.0. Bovine enamel samples were immersed in each beverage and changes in surface microhardness were assessed. Surface alterations were observed using scanning electron microscopy. Results: Lemon-flavored non-alcoholic beer had the lowest pH and highest titratable acidity, causing enamel microhardness reduction and surface demineralization comparable to those of Cocacola. Regular and non-alcoholic beers caused relatively mild erosion; however, a gradual reduction in microhardness was observed over time. Enamel microhardness and surface demineralization of samples immersed in non-alcoholic beer were significantly different compared with those immersed in bottled water. Conclusions Non-alcoholic beer, particularly lemon-flavored products with a lower pH, erode enamel, indicating the necessity for dietary guidance to minimize the risk. Beverage manufacturers should consider acidity and buffering capacity to assist in reducing the erosive potential of their products.

Objectives: This study investigated the factors influencing patient satisfaction at healthcare-accredited dental hospital, thereby providing foundational data to enhance the quality of dental healthcare services. Methods: Data were collected through a structured self-administered survey of 200 patients who visited a healthcare-accredited dental hospital in Gwangju metropolitan city from August 1 to August 31, 2023. After excluding seven responses with insincere answers, 193 responses were used for analysis. The survey consisted of 36 questions: 9 on sociodemographic characteristics, 20 on quality of medical services, 4 on awareness of healthcare accreditation, and 3 on overall satisfaction with dental services. Analysis methods included t-tests, one-way ANOVA, Pearson’s correlation analysis, and multiple regression analysis. Results: According to SERVQUAL, factors influencing healthcare service satisfaction were “tangibles” (β=0.318, P<0.05), “reliability” (β=0.236, P<0.001), and “empathy” (β=0.235, P<0.05), in that order. It was observed that satisfaction increased as these three factors improved. Conclusions To enhance satisfaction with healthcare services at accredited dental hospital, a focus on accurate understanding of visible and tangible factors as well as patient demands is necessary. In addition, increasing the importance of hospital promotional materials is necessary to increase awareness of healthcare accreditation among patients visiting hospitals and create positive perceptions among them.

Objectives: This study was aimed to investigate the association between chronic kidney disease and tooth loss in elderly Koreans. Methods: Data of 2,419 elderly people aged 65 years or older who participated in the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were obtained. Those with no missing values were analyzed. Complex samples multiple logistic regression analysis was performed to determine the effect of chronic kidney disease on tooth loss. Results: After adjusting for all covariates, chronic kidney disease was significantly associated with fewer than 20 present teeth (OR 1.53, 95% CI 1.01-2.30). Conclusions In elderly Korean people, chronic kidney disease was significantly associated with having less than 20 teeth, suggesting that chronic kidney disease is a risk factor for tooth loss in the elderly.

Objectives: This study aim to evaluate the effect of Greek yogurt on the tooth surface by comparing it with liquid fermented milk. Methods: After purchasing Greek yogurt available on the domestic market and measuring pH and titratable acidity, Greek yogurt was selected as the Greek yogurt group, Jeju Samdasoo as the mineral water group, and liquid fermented milk as the liquid fermented milk group. The specimens were treated with the experimental drinks for 30 minutes. Afterwards, the change in surface microhardness of the tooth surface was measured and the surface change was observed. Results: The pH of the experimental beverage was slightly higher in the Greek yogurt group than the liquid fermented milk group. In the effect of Greek yogurt on tooth surface hardness, there was a statistically significant difference in surface microhardness before and after immersion in the liquid fermented milk group, but there was no significant difference between the mineral water group and the Greek yogurt group. When comparing the surface microhardness change values among groups, the difference in surface microhardness (△VHN) between before and after 30 minutes of immersion showed a statistically significant difference between the liquid fermented milk group and the mineral water group and the Greek yogurt group, but there was no significant difference between the mineral water group and the Greek yogurt group. As a result of scanning electron microscopy, the surfaces of the mineral water and Greek yogurt groups were smooth without damage, but the surfaces of the liquid fermented milk group were rough and uneven. Conclusions Considering the results of this experiment, it is considered that Greek yogurt has a lower risk of causing dental erosion compared to liquid fermented milk, and these characteristics of Greek yogurt can be considered when providing dietary counseling regarding fermented milk products.

Purpose: We aimed to assess the humoral response to and reactogenicity of coronavirus disease 2019 (COVID-19) vaccination according to the vaccine type and to analyze factors associated with immunogenicity in actively treated solid cancer patients (CPs). Materials and Methods: Prospective cohorts of CPs, undergoing anticancer treatment, and healthcare workers (HCWs) were established. The participants had no history of previous COVID-19 and received either mRNA-based or adenovirus vector–based (AdV) vaccines as the primary series. Blood samples were collected before the first vaccination and after 2 weeks for each dose vaccination. Spike-specific binding antibodies (bAbs) in all participants and neutralizing antibodies (nAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wild-type, Delta, and Omicron variants in CPs were analyzed and presented as the geometric mean titer. Results: Age-matched 20 HCWs and 118 CPs were included in the analysis. The bAb seroconversion rate and antibody concentrations after the first vaccination were significantly lower in CPs than in HCWs. After the third vaccination, antibody levels in CPs with a primary series of AdV were comparable to those in HCWs, but nAb titers against the Omicron variant did not quantitatively increase in CPs with AdV vaccine as the primary series. The incidence and severity of adverse reactions post-vaccination were similar between CPs and HCWs. Conclusion CPs displayed delayed humoral immune response after SARS-CoV-2 vaccination. The booster dose elicited comparable bAb concentrations between CPs and HCWs, regardless of the primary vaccine type. Neutralization against the Omicron variant was not robustly elicited following the booster dose in some CPs, implying the need for additional interventions to protect them from COVID-19.

Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.