Background/Aims: Hepatocellular carcinoma (HCC) exhibits high de novo recurrence rates post-resection. Current post-surgery recurrence prediction methods are limited, emphasizing the need for reliable biomarkers to assess recurrence risk. We aimed to develop methylation-based markers for classifying HCC patients and predicting their risk of de novo recurrence post-surgery. Methods: In this retrospective cohort study, we analyzed data from HCC patients who underwent surgical resection in Korea, excluding those with recurrence within one year post-surgery. Using the Infinium Methylation EPIC array on 140 samples in the discovery cohort, we classified patients into low- and high-risk groups based on methylation profiles. Distinctive markers were identified through random forest analysis. These markers were validated in the cancer genome atlas (n=217), Validation cohort 1 (n=63) and experimental Validation using a methylation-sensitive high-resolution melting (MS-HRM) assay in Validation cohort 1 and Validation cohort 2 (n=63). Results: The low-risk recurrence group (methylation group 1; MG1) showed a methylation average of 0.73 (95% confidence interval [CI] 0.69–0.77) with a 23.5% recurrence rate, while the high-risk group (MG2) had an average of 0.17 (95% CI 0.14–0.20) with a 44.1% recurrence rate (P<0.03). Validation confirmed the applicability of methylation markers across diverse populations, showing high accuracy in predicting the probability of HCC recurrence risk (area under the curve 96.8%). The MS-HRM assay confirmed its effectiveness in predicting de novo recurrence with 95.5% sensitivity, 89.7% specificity, and 92.2% accuracy. Conclusions Methylation markers effectively classified HCC patients by de novo recurrence risk, enhancing prediction accuracy and potentially offering personalized management strategies.

Background/Aims: Hepatocellular carcinoma (HCC) exhibits high de novo recurrence rates post-resection. Current post-surgery recurrence prediction methods are limited, emphasizing the need for reliable biomarkers to assess recurrence risk. We aimed to develop methylation-based markers for classifying HCC patients and predicting their risk of de novo recurrence post-surgery. Methods: In this retrospective cohort study, we analyzed data from HCC patients who underwent surgical resection in Korea, excluding those with recurrence within one year post-surgery. Using the Infinium Methylation EPIC array on 140 samples in the discovery cohort, we classified patients into low- and high-risk groups based on methylation profiles. Distinctive markers were identified through random forest analysis. These markers were validated in the cancer genome atlas (n=217), Validation cohort 1 (n=63) and experimental Validation using a methylation-sensitive high-resolution melting (MS-HRM) assay in Validation cohort 1 and Validation cohort 2 (n=63). Results: The low-risk recurrence group (methylation group 1; MG1) showed a methylation average of 0.73 (95% confidence interval [CI] 0.69–0.77) with a 23.5% recurrence rate, while the high-risk group (MG2) had an average of 0.17 (95% CI 0.14–0.20) with a 44.1% recurrence rate (P<0.03). Validation confirmed the applicability of methylation markers across diverse populations, showing high accuracy in predicting the probability of HCC recurrence risk (area under the curve 96.8%). The MS-HRM assay confirmed its effectiveness in predicting de novo recurrence with 95.5% sensitivity, 89.7% specificity, and 92.2% accuracy. Conclusions Methylation markers effectively classified HCC patients by de novo recurrence risk, enhancing prediction accuracy and potentially offering personalized management strategies.

Background/Aims: Hepatocellular carcinoma (HCC) exhibits high de novo recurrence rates post-resection. Current post-surgery recurrence prediction methods are limited, emphasizing the need for reliable biomarkers to assess recurrence risk. We aimed to develop methylation-based markers for classifying HCC patients and predicting their risk of de novo recurrence post-surgery. Methods: In this retrospective cohort study, we analyzed data from HCC patients who underwent surgical resection in Korea, excluding those with recurrence within one year post-surgery. Using the Infinium Methylation EPIC array on 140 samples in the discovery cohort, we classified patients into low- and high-risk groups based on methylation profiles. Distinctive markers were identified through random forest analysis. These markers were validated in the cancer genome atlas (n=217), Validation cohort 1 (n=63) and experimental Validation using a methylation-sensitive high-resolution melting (MS-HRM) assay in Validation cohort 1 and Validation cohort 2 (n=63). Results: The low-risk recurrence group (methylation group 1; MG1) showed a methylation average of 0.73 (95% confidence interval [CI] 0.69–0.77) with a 23.5% recurrence rate, while the high-risk group (MG2) had an average of 0.17 (95% CI 0.14–0.20) with a 44.1% recurrence rate (P<0.03). Validation confirmed the applicability of methylation markers across diverse populations, showing high accuracy in predicting the probability of HCC recurrence risk (area under the curve 96.8%). The MS-HRM assay confirmed its effectiveness in predicting de novo recurrence with 95.5% sensitivity, 89.7% specificity, and 92.2% accuracy. Conclusions Methylation markers effectively classified HCC patients by de novo recurrence risk, enhancing prediction accuracy and potentially offering personalized management strategies.

Background: Living-donor liver transplantation (LDLT) is a viable alternative to deceased-donor liver transplantation. Enhanced recovery after surgery protocols that include early extubation offer short-term benefits; however, the effect of immediate extubation in the operating room (OR) on long-term outcomes in patients undergoing LDLT remains unknown. We hypothesized that immediate OR extubation is associated with improved long-term outcomes in patients undergoing LDLT. Methods: This retrospective cohort study included 205 patients who underwent LDLT. The patients were classified based on the extubation location as OREX (those extubated in the OR) or NOREX (those extubated in the intensive care unit [ICU]). The primary outcome was overall survival (OS), while secondary outcomes included ICU stay, hospital stay duration, and various postoperative outcomes. Results: Among the 205 patients, 98 (47.8%) underwent extubation in the OR after LDLT. Univariate analysis revealed that OR extubation did not significantly affect OS (hazard ratio [HR]: 0.50, 95% confidence interval [CI]: 0.24–1.05; P = 0.066). Furthermore, multivariate analysis revealed no statistically significant association between OR extubation and OS (HR: 0.79, 95% CI: 0.35–1.80; P = 0.580). However, OR extubation was significantly associated with a lower incidence of 30-day composite complications and shorter ICU and hospital stays. Multivariate analysis indicated that higher preoperative platelet counts, increased serum creatinine levels, and a longer surgery duration were associated with poorer OS. Conclusions Immediate OR extubation following LDLT surgery was associated with fewer 30-day composite complications and shorter ICU and hospital stays; however, it did not significantly improve OS compared with ICU extubation.

Purpose: This study analyzed raw data from the 2022 Korean Community Health Survey (KCHS) to explore the relationship between physical activities and the mental health of middle-aged individuals, and examined factors influencing chewing discomfort. Materials and Methods: Data pertaining to 104,500 middle-aged people aged between 40 and 64 were analyzed. The variables analyzed included general characteristics, perceived level of health, level of oral health, physical activities, mental health (PHQ-9), and statusof chewing discomfort. Cross-analysis was conducted to explore the differences in general characteristics, physical activities, mental health factors, and chewing discomfort status. Meanwhile, logistic regression analysis was performed on factors influencing chewing discomfort. Results: It was observed that chewing discomfort was more severe for middle-aged individuals who reported that theiroral health level was neither good nor poor compared with those who reported that their oral health was good (OR: 8.443, P < 0.001), those who reported that their perceived level of health was poor (OR: 49.173, P < 0.001), those who reported not performing the walking exercise (OR: 1.354, P < 0.001), those who reported that they had suicidal ideation compared with those who did not (OR:2.543, P < 0.001), those who reported that they had made a suicidal attempt compared with those who had not (OR: 4.456, P < 0.001), and those who reported that their level of depression was severe or more serious (OR: 4.624, P < 0.001). Conclusion In middleaged individuals, physical activities and mental health needs to be considered as a risk factor in the improvement of oral health.

Purpose: The purpose of this study is to analyze the factors affecting oral function by general characteristics and mental health level. Materials and Methods: Raw data from the 1st year of the 9th National Health and Nutrition Examination Survey (2022 - 2024) were used to analyze 3,518 individuals aged 20 to 80 years. The difference in oral function problems according to mental health level was assessed using the Chi-squared test. Logistic regression was performed to determine the risk factors affecting mental health level and oral function problems. Results: Chewing difficulty, phonation difficulty, and tooth pain were found to be higher in the high stress group than in the low stress group, showing a significant difference. When adjusting for general characteristics, it was confirmed that more severe levels of depression and anxiety had a significant impact on chewing difficulty, phonation difficulty, and tooth pain. Conclusion Recognizing the close relationship between oral function and mental health, it is important to develop integrated programs that not only provide regular oral checkups for individuals suffering from oral function problems but also manage mental health systematically and periodically.

Purpose: This study analyzed raw data from the 2022 Korean Community Health Survey (KCHS) to explore the relationship between physical activities and the mental health of middle-aged individuals, and examined factors influencing chewing discomfort. Materials and Methods: Data pertaining to 104,500 middle-aged people aged between 40 and 64 were analyzed. The variables analyzed included general characteristics, perceived level of health, level of oral health, physical activities, mental health (PHQ-9), and statusof chewing discomfort. Cross-analysis was conducted to explore the differences in general characteristics, physical activities, mental health factors, and chewing discomfort status. Meanwhile, logistic regression analysis was performed on factors influencing chewing discomfort. Results: It was observed that chewing discomfort was more severe for middle-aged individuals who reported that theiroral health level was neither good nor poor compared with those who reported that their oral health was good (OR: 8.443, P < 0.001), those who reported that their perceived level of health was poor (OR: 49.173, P < 0.001), those who reported not performing the walking exercise (OR: 1.354, P < 0.001), those who reported that they had suicidal ideation compared with those who did not (OR:2.543, P < 0.001), those who reported that they had made a suicidal attempt compared with those who had not (OR: 4.456, P < 0.001), and those who reported that their level of depression was severe or more serious (OR: 4.624, P < 0.001). Conclusion In middleaged individuals, physical activities and mental health needs to be considered as a risk factor in the improvement of oral health.

Purpose: The purpose of this study is to analyze the factors affecting oral function by general characteristics and mental health level. Materials and Methods: Raw data from the 1st year of the 9th National Health and Nutrition Examination Survey (2022 - 2024) were used to analyze 3,518 individuals aged 20 to 80 years. The difference in oral function problems according to mental health level was assessed using the Chi-squared test. Logistic regression was performed to determine the risk factors affecting mental health level and oral function problems. Results: Chewing difficulty, phonation difficulty, and tooth pain were found to be higher in the high stress group than in the low stress group, showing a significant difference. When adjusting for general characteristics, it was confirmed that more severe levels of depression and anxiety had a significant impact on chewing difficulty, phonation difficulty, and tooth pain. Conclusion Recognizing the close relationship between oral function and mental health, it is important to develop integrated programs that not only provide regular oral checkups for individuals suffering from oral function problems but also manage mental health systematically and periodically.

Purpose: This study analyzed raw data from the 2022 Korean Community Health Survey (KCHS) to explore the relationship between physical activities and the mental health of middle-aged individuals, and examined factors influencing chewing discomfort. Materials and Methods: Data pertaining to 104,500 middle-aged people aged between 40 and 64 were analyzed. The variables analyzed included general characteristics, perceived level of health, level of oral health, physical activities, mental health (PHQ-9), and statusof chewing discomfort. Cross-analysis was conducted to explore the differences in general characteristics, physical activities, mental health factors, and chewing discomfort status. Meanwhile, logistic regression analysis was performed on factors influencing chewing discomfort. Results: It was observed that chewing discomfort was more severe for middle-aged individuals who reported that theiroral health level was neither good nor poor compared with those who reported that their oral health was good (OR: 8.443, P < 0.001), those who reported that their perceived level of health was poor (OR: 49.173, P < 0.001), those who reported not performing the walking exercise (OR: 1.354, P < 0.001), those who reported that they had suicidal ideation compared with those who did not (OR:2.543, P < 0.001), those who reported that they had made a suicidal attempt compared with those who had not (OR: 4.456, P < 0.001), and those who reported that their level of depression was severe or more serious (OR: 4.624, P < 0.001). Conclusion In middleaged individuals, physical activities and mental health needs to be considered as a risk factor in the improvement of oral health.

Purpose: The purpose of this study is to analyze the factors affecting oral function by general characteristics and mental health level. Materials and Methods: Raw data from the 1st year of the 9th National Health and Nutrition Examination Survey (2022 - 2024) were used to analyze 3,518 individuals aged 20 to 80 years. The difference in oral function problems according to mental health level was assessed using the Chi-squared test. Logistic regression was performed to determine the risk factors affecting mental health level and oral function problems. Results: Chewing difficulty, phonation difficulty, and tooth pain were found to be higher in the high stress group than in the low stress group, showing a significant difference. When adjusting for general characteristics, it was confirmed that more severe levels of depression and anxiety had a significant impact on chewing difficulty, phonation difficulty, and tooth pain. Conclusion Recognizing the close relationship between oral function and mental health, it is important to develop integrated programs that not only provide regular oral checkups for individuals suffering from oral function problems but also manage mental health systematically and periodically.