Background/Aims: Early detection and removal of colon polyps are critical for preventing colorectal cancer. Computer-aided detection (CADe) systems have been introduced to increase the polyp detection rate (PDR) during colonoscopy, potentially enhancing its effectiveness. This study aimed to evaluate the efficacy of a CADe system in colorectal neoplasm detection. Methods: This prospective, randomized controlled trial was conducted at two tertiary centers (May 2023 to April 2025). Patients were randomly assigned to CADe or conventional colonoscopy and underwent screening, surveillance, or diagnostic colonoscopy. The primary endpoint was the adenoma detection rate (ADR), while the secondary endpoints were the PDR, relative risk (RR) of polyp detection, adenomas per colonoscopy (APC), and factors influencing adenoma detection. Results: Of 1,004 enrolled patients, 998 were randomly allocated into CADe and conventional colonoscopy groups (497 CADe system and 501 conventional colonoscopy). The CADe group had greater polyp counts (2.2 per colonoscopy vs 1.4 per colonoscopy; p<0.001) and APC values (1.2 vs 0.8; p<0.001). The CADe group showed significantly higher PDRs (72.2% vs 54.5%;p<0.001; RR, 2.173; 95% confidence interval [CI], 1.669 to 2.828) and ADRs (52.3% vs 36.1%;p<0.001; RR, 1.940; 95% CI, 1.505 to 2.499). CADe also significantly increased the detection rate of hyperplastic polyps (p=0.007; RR, 1.474; 95% CI, 1.113 to 1.952) and increased the detection rates across all sizes and locations. In multivariable analysis, CADe use was the strongest independent predictor of adenoma detection (odds ratio, 1.914; 95% CI, 1.467 to 2.496), outweighing male sex, older age, diagnostic indication, and withdrawal time. Conclusions Real-time CADe-assisted colonoscopy significantly increased PDR and ADR and proved to be a strong independent predictor of adenoma detection (cris.nih.go.kr, KCT0009664).

In addition to well-known side effects such as rash, redness, and bone resorption, unexpected facial complications may occasionally occur several years after certain medical procedures. This report presents rare cases of orofacialsymptoms that developed as delayed responses to cosmetic filler injections. Three separate patients presented to theauthors’ institution with varying severities of orofacial symptoms. These symptoms, initially diagnosed clinically asinflammation or neoplasms of the parotid gland, were later identified through magnetic resonance imaging as diseases potentially associated with filler materials injected approximately 4-8 years earlier. The primary goal of this report was to inform specialists in the oral and maxillofacial field about the possibility of such complications, enabling them tomanage patient symptoms effectively and develop appropriate treatment strategies.

Helicobacter pylori (H. pylori) is a bacterium that colonizes the human stomach, leading to various gastrointestinal diseases including gastritis, peptic ulcers, and gastric cancer. There is no gold standard test that relies entirely on one method in H. pylori diagnosis. We must be aware of the pros and cons of various testing methods to perform an appropriate test according to the situation. Accurate diagnosis and eradication therapy are essential for disease management. Diagnostic methods include invasive techniques like tissue biopsy and rapid urease test, as well as non-invasive tests such as urea breath test, serology test, and stool antigen test. Each method has its advantages and limitations, requiring careful consideration in clinical practice. Understanding these diagnostic tools is crucial for effective H. pylori management and prevention of associated complications.

Objective: Previous studies have investigated obesity and appetite changes in patients with depression, which consisted of a small age range of adults and used body mass index rather than abdominal obesity. The objective of this study is to examine the relationship between abdominal obesity and the risk of depression by sex and age groups. Methods: This study utilized the National Health Insurance Sharing Service (NHISS) database of South Korea, which includes those over 20 years old and who had undergone a health examination in 2009 and their claims data between 2009 and 2018. The diagnosis of depressive episodes was based on the International Statistical Classification of Disease and Related Health Problems 10th revision. Abdominal obesity was measured by waist circumference (WC) and was divided into six levels (cm). Cox proportional-hazard regression analyses were conducted to examine the relationship between abdominal obesity and the risk of depression by sex and age groups. Results: Among 9,041,751 participants, 1,376,279 were diagnosed with depression. Those with higher WC (90 cm or higher for males, 85 cm or higher for females) showed an increased risk for depression in both sexes (hazard ratio [HR]=1.09, 95% confidence interval [CI]: 1.07–1.11 for males, HR=1.03, 95% CI: 1.02–1.05 for females). Underweight males (WC<80 cm) also showed an increased risk for depression (HR=1.05, 95% CI: 1.04–1.05). Conclusion It has been found that higher WC was associated with increased risks of depression in both sexes. Although underweight males showed an elevated risk of depression, a healthy weight is associated with fewer depression symptoms.

Objectives: Poor oral hygiene is known to be associated with gastric cancer, but this remains controversial. In this study, we investigated the association between oral health and gastric cancer in Korean adults using data from the Korea National Health and Nutrition Examination Survey. Methods: We analyzed data of 79501 patients with gastric cancer and 41856805 individuals without gastric cancer (control group) using the 7th and 8th Korea National Health and Nutrition Examination Survey (2016–2019) records. Layer and colony variables and weights were used for the complex sample design. We performed logistic regression analysis of complex samples to analyze factors that affect gastric cancer development. Results: Patients with gastric cancer were older and had a higher prevalence of hypertension, hyperlipidemia, and diabetes and a higher rate of current smoking and alcohol consumption than individuals without gastric cancer (p<0.001). Regarding oral health-related factors, the prevalence of very uncomfortable chewing difficulty was significantly higher in patients with gastric cancer (14.4% vs. 3.6%, p<0.001). On multivariate analysis of factors associated with gastric cancer, chewing difficulty showed the highest odds ratio (5.351, 95% confidence interval 2.128–8.982). Patients with very uncomfortable chewing difficulty had high rates of previous dental nerve treatment, gum disease treatment, tooth extraction or intraoral surgery, and prosthetic repair (p<0.001). Conclusions Oral health-related chewing difficulties were associated with gastric cancer, which may be attributable to poor oral hygiene and degradation of oral microbiota. Patients at risk of gastric cancer warrant timely medical interventions to address their oral health and chewing difficulties.

Background/Aims: Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). In this study, we developed a retractable robot-assisted traction device and evaluated its performance in colorectal ESD. Methods: An experienced endoscopist performed ESD 18 times on an ex vivo porcine colon using the robot and 18 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate. Results: Thirty-six colonic lesions were resected from ex vivo porcine colon samples. The total procedure time was significantly shorter in robot-assisted ESD (RESD) than in conventional ESD (CESD) (20.1±4.1 minutes vs 34.3±8.3 minutes, p<0.05). The submucosal dissection speed was significantly faster in the RESD group than in the CESD group (36.8±9.2 mm 2 /min vs 18.1±4.7 mm 2 /min, p<0.05). The blind dissection rate was also significantly lower in the RESD group (12.8%±3.4% vs 35.1%±3.9%, p<0.05). In an in vivo porcine feasibility study, the robotic device was attached to a colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed. Conclusions The dissection speed and safety profile improved significantly with the retractable RESD. Thus, our robotic device has the potential to provide simple, effective, and safe multidirectional traction during colonic ESD.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

Helicobacter pylori (H. pylori) is a bacterium that colonizes the human stomach, leading to various gastrointestinal diseases including gastritis, peptic ulcers, and gastric cancer. There is no gold standard test that relies entirely on one method in H. pylori diagnosis. We must be aware of the pros and cons of various testing methods to perform an appropriate test according to the situation. Accurate diagnosis and eradication therapy are essential for disease management. Diagnostic methods include invasive techniques like tissue biopsy and rapid urease test, as well as non-invasive tests such as urea breath test, serology test, and stool antigen test. Each method has its advantages and limitations, requiring careful consideration in clinical practice. Understanding these diagnostic tools is crucial for effective H. pylori management and prevention of associated complications.