1.Burning Mouth Syndrome 2026: From “Diagnosis of Exclusion” to a Structured Diagnostic Algorithm (Narrative Review)
Chang-Kyu OH ; Hye-Min JU ; Sung-Hee JEONG ; Yong-Woo AHN ; Hye-Mi JEON ; Soo-Min OK
Journal of Oral Medicine and Pain 2026;51(1):20-28
Burning mouth syndrome remains a frequent source of diagnostic delay, repeated consultations, and fragmented care because it has long been treated as a “diagnosis of exclusion.” Recent updates in orofacial pain classification and research diagnostic frameworks support a practical shift: from an exclusionary label toward a structured diagnostic algorithm and staged, phenotype-guided management. This narrative, algorithm-focused clinical review aims to summarize clinically actionable evidence and to propose a “minimum sufficient workup” that prioritizes safety, efficiency, and patient-centered communication.We first outline pragmatic diagnostic criteria and key symptom patterns, then integrate current concepts of mixed mechanisms—peripheral neuropathic features, centralociplastic amplification, and psychosocial modulators—that account for symptom fluctuation and discordance between symptom severity and objective findings. The core of this review is a one-page stepwise algorithm: (1) confirm chronicity and absence of visible mucosal disease, (2) screen for red flags requiring urgent evaluation, (3) address common local contributors (e.g., candidiasis, irritants, contact allergy, xerostomia), (4) perform a targeted systemic/medication/deficiency panel, and (5) phenotype patients to guide staged treatment choices and follow-up. Finally, we provide a practical management framework emphasizing education, trigger control, and individualized combinations of topical, systemic, and behavioral interventions with predefined reassessment intervals. Future priorities include phenotype-stratified randomized trials and implementation outcomes that quantify reductions in diagnostic delay, misdiagnosis, and unnecessary testing.
2.Ultrasound Imaging Features Associated With Neoplastic Gallbladder Polyps: A Systematic Review and Meta-Analysis
Sunyoung LEE ; Won CHANG ; Yeun-Yoon KIM ; Jin Young PARK ; Sun Kyung JEON ; Jeong Eun LEE ; Jeongin YOO ; Seungchul HAN ; So Hyun PARK ; Jae Hyun KIM ; Hyo Jung PARK ; Hyun-Soo ZHANG ; Jeong Hee YOON
Korean Journal of Radiology 2026;27(4):332-343
Objective:
Although most gallbladder polyps are benign, some neoplastic polyps may be malignant or may serve as precursors to malignancy. Distinguishing neoplastic and non-neoplastic polyps using imaging examinations remains a major challenge.This meta-analysis aimed to identify the ultrasound (US) features that are significantly associated with neoplastic polyps.
Materials and Methods:
The MEDLINE, EMBASE, Cochrane, and KoreaMed databases were searched for articles published up to August 31, 2025. Bivariate random-effects models were used to calculate the meta-analytic pooled diagnostic odds ratios (DORs), sensitivities, and specificities, along with their 95% confidence intervals (CIs), for each US imaging feature in the diagnosis of neoplastic polyps.
Results:
Thirty studies evaluating 8,953 patients, including 1,216 (13.6%) patients with neoplastic polyps, were included.Among the nine evaluated US imaging features, namely, size ≥10 mm, sessile morphology, single polyp, coexisting gallstones, hypoechogenicity, heterogeneous echogenicity, gallbladder wall thickening (GBWT), absence of hyperechoic spot, and vascularity, eight were significantly associated with neoplastic polyps: size ≥10 mm (DOR: 6.23 [95% CI: 1.86– 20.90]), sessile morphology (DOR: 3.54 [1.93–5.97]), single polyp (DOR: 2.21 [1.76–2.74]), coexisting gallstones (DOR:1.86 [1.29–2.60]), hypoechogenicity (DOR: 3.55 [1.47–7.30]), GBWT (DOR: 9.38 [1.47–32.20]), absence of hyperechoic spots (DOR: 4.23 [2.46–6.83]), and vascularity (DOR: 9.72 [5.81–15.30]). Of these, size ≥10 mm demonstrated the highest pooled sensitivity (0.79 [95% CI: 0.68–0.87]), whereas hypoechogenicity showed the highest pooled specificity (0.93 [95% CI: 0.82–0.98]).
Conclusion
Eight US imaging features (size ≥10 mm, sessile morphology, single polyp, coexisting gallstones, hypoechogenicity, GBWT, absence of hyperechoic spots, and vascularity) were significantly associated with the presence of neoplastic polyps.These features may facilitate the management of gallbladder polyps.
3.Establishing Epidemiological Cutoff Values for Helicobacter pylori Strains in Korea: A Model-Based Analysis of Antibiotic Resistance Patterns
Jin Hee NOH ; Jung Mogg KIM ; Hwoon-Yong JUNG ; Ji Yong AHN ; Sun Mi LEE ; Seong Woo JEON ; Yong Hwan KWON ; Jeong Hoon LEE ; Kee Don CHOI ; Eun Jeong GONG
Gut and Liver 2026;20(1):47-58
Background/Aims:
The absence of standardized clinical minimum inhibitory concentration (MIC) breakpoints for Helicobacter pylori infection has resulted in inconsistent resistance definitions, even within the same research group in Korea. Therefore, establishing epidemiological cutoff values (ECOFFs) is essential for standardization.
Methods:
The MIC distributions for antibiotics commonly used against H. pylori infection in South Korea were analyzed from 2015 to 2023. A total of 5,925 primary H. pylori isolates were collected from five data sources, and MIC values were determined using the serial 2-fold agar dilution method. The ECOFFinder program was used to establish ECOFFs for six antibiotics.
Results:
The tentative ECOFFs for amoxicillin and clarithromycin were 0.125 μg/mL. The ECOFFs for levofloxacin, metronidazole, and tetracycline were 0.5, 8.0, and 0.25 μg/mL, respec-tively. The ECOFF for rifabutin could not be determined due to insufficient data. On the basis of these ECOFFs, the resistance rate was 17.9% for amoxicillin, 31.9% for clarithromycin, 40.9% for levofloxacin, 24.7% for metronidazole, and 11.5% for tetracycline.
Conclusions
This comprehensive analysis defined regional antibiotic resistance patterns and established Korea-specific ECOFFs, providing a foundation for determining clinical breakpoints and optimizing H. pylori eradication strategies.
4.A customized guide device for single needle arthrocentesis on temporomandibular joint
Jun-Hyung JEON ; Sang-Hee PARK ; Pil-Young YUN ; Jeong-Kui KU
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2025;51(2):95-101
Objectives:
This study aims to evaluate the accuracy and effectiveness of temporomandibular joint (TMJ) arthrocentesis using the three-dimensional (3D)-printed TMJ injection guide in cases of hemarthrosis caused by condyle fractures.
Materials and Methods:
A retrospective chart review was conducted for patients treated with the customized TMJ arthrocentesis guide to address hemarthrosis. Inclusion criteria included adults older than 18 years with condylar fractures not indicated for open reduction and internal fixation. The guide was fabricated using computed tomography or cone-beam computed tomography scans and 3D printing to control the degree and depth of the needle through the guide to aspirate hemarthrosis.
Results:
Six joints from five patients (average age 52.4 years) were treated using the guide. Post-procedural magnetic resonance imaging confirmed complete resolution of hemarthrosis in all cases. A representative case demonstrated successful outcomes with normal healing and no complications at 8 months post-procedure.
Conclusion
The customized TMJ injection guide, using ear-based reference points, significantly enhances the accuracy and safety of TMJ arthrocentesis. This innovation is expected to increase the accessibility and effectiveness of TMJ-related treatments for clinicians without specialized TMJ expertise.
5.The impact of the laboratory quality management program on colorectal cancer screening using immunochemical fecal occult blood tests in Korea
Hye Ryun LEE ; Sollip KIM ; Hyeongsu KIM ; Yeo-Min YUN ; Ho Jin JEONG ; Minje HAN ; Myeong Hee KIM ; Tae-Hyun UM ; You Kyoung LEE ; Byung Ryul JEON ; Kunsei LEE ; Sail CHUN
Journal of the Korean Medical Association 2025;68(5):338-347
Purpose:
Immunochemical fecal occult blood tests (iFOBT) have been utilized as the primary method for colorectal cancer screening within Korea's National Cancer Screening Program. This study aimed to evaluate the impact of the accreditation program for clinical laboratories and external quality assessment (EQA) programs on colorectal cancer screening.
Methods:
We analyzed the false-positive rates of iFOBT in colorectal cancer screening from 2016 to 2020 according to participation and performance in the Outstanding Laboratory Accreditation Program (OLAP) conducted by the Laboratory Medicine Foundation, and the External Quality Assessment programs run by the Korean Association of External Quality Assessment Service.
Results:
False-positive rates of iFOBT were lower among institutions accredited by OLAP (2.35%) compared with non-accredited (3.04%) and non-participating institutions (5.60%). Similarly, institutions participating in the EQA program exhibited lower false-positive rates (3.79%) compared to non-participants (7.04%). Within the iFOBT-specific EQA program, institutions that passed demonstrated the lowest false-positive rate (3.37%), while failing institutions showed the highest rate (9.07%), surpassing even non-participating institutions (6.44%).
Conclusion
Participation in quality management programs such as OLAP and EQA was associated with lower false-positive rates in iFOBT for colorectal cancer screening. These findings suggest that quality management initiatives can increase the accuracy of iFOBT, potentially improving the effectiveness of colorectal cancer screening programs, and reducing unnecessary follow-up procedures and associated healthcare costs.
6.Age Estimation Using Attrition and Pulp Cavity Size of the Mandibular First Molar in Korean Population
Hee-Won KIM ; Hye-Mi JEON ; Kyung-Hee KIM ; Hye-Min JU ; Soo-Min OK ; Sung-Hee JEONG ; Yong-Woo AHN
Korean Journal of Legal Medicine 2025;49(1):1-6
In forensic science, age estimation is essential for identifying both living and deceased individuals. Teeth and jawbones serve as reliable indicators due to their gradual age-related changes and resistance to environmental factors. Among the various methods, attrition and pulp cavity size are commonly used to estimate adult age. This study aimed to enhance the accuracy of age estimation in Korean adults by combining measurements of tooth attrition and pulp cavity size obtained from panoramic radiographs of mandibular first molars. We evaluated 118 patients (62 male, 56 female) who visited Pusan National University Dental Hospital between 2010 and 2024. Radiographs and clinical photographs were analyzed for grade C teeth with exposed dentin using Takei’s method, and the pulp chamber height ratio (PCHR) and width ratio (PCWR) were measured using Jeon’s method. Intraobserver reliability was high (intraclass correlation coefficient>0.6), with no significant sex-based differences in PCHR and PCWR. Both ratios negatively correlated with age, with PCWR showing a stronger correlation, particularly in females (r=–0.606). This study derived an improved age estimation formula with R² values ranging from 0.540 to 0.546 when both PCHR and PCWR were combined. Despite the limitations of this study, such as its small sample size and reliance on panoramic radiographs, the findings suggest that combining tooth wear and pulp cavity size offers a more robust tool for age estimation in clinical and forensic settings.
7.Interpretation, Reporting, Imaging-Based Workups, and Surveillance of Incidentally Detected Gallbladder Polyps and Gallbladder Wall Thickening: 2025 Recommendations From the Korean Society of Abdominal Radiology
Won CHANG ; Sunyoung LEE ; Yeun-Yoon KIM ; Jin Young PARK ; Sun Kyung JEON ; Jeong Eun LEE ; Jeongin YOO ; Seungchul HAN ; So Hyun PARK ; Jae Hyun KIM ; Hyo Jung PARK ; Jeong Hee YOON
Korean Journal of Radiology 2025;26(2):102-134
Incidentally detected gallbladder polyps (GBPs) and gallbladder wall thickening (GBWT) are frequently encountered in clinical practice. However, characterizing GBPs and GBWT in asymptomatic patients can be challenging and may result in overtreatment, including unnecessary follow-ups or surgeries. The Korean Society of Abdominal Radiology (KSAR) Clinical Practice Guideline Committee has developed expert recommendations that focus on standardized imaging interpretation and follow-up strategies for both GBPs and GBWT, with support from the Korean Society of Radiology and KSAR. These guidelines, which address 24 key questions, aim to standardize the approach for the interpretation of imaging findings, reporting, imaging-based workups, and surveillance of incidentally detected GBPs and GBWT. This recommendation promotes evidence-based practice, facilitates communication between radiologists and referring physicians, and reduces unnecessary interventions.
10.Comparison of Patients Who Were Not Evaluated and Lost to Follow-Up with Multidrug/Rifampin-Resistant Tuberculosis in South Korea
Hongjo CHOI ; Jeongha MOK ; Young Ae KANG ; Dawoon JEONG ; Hee-Yeon KANG ; Hee Jin KIM ; Hee-Sun KIM ; Doosoo JEON
Yonsei Medical Journal 2025;66(1):16-24
Purpose:
This study aimed to evaluate the prognosis of the not evaluated (NE) group by comparing it with the lost to follow-up (LTFU) group among patients with multidrug/rifampin-resistant tuberculosis (MDR/RR-TB).
Materials and Methods:
This was a retrospective longitudinal follow-up study using an integrated database constructed by data linkage of the three national databases. This database included 7226 cases of MDR/RR-TB notified between 2011 and 2017 in South Korea.
Results:
Among the 7226 MDR/RR-TB cases, 730 (10.1%) were classified as LTFU group, and 353 (4.9%) as NE group. When comparing NE group with LTFU group, there were no significant differences in the all-cause mortality rate (18.1% vs. 13.8%, p=0.065), median time to death [404 days (interquartile range, IQR 46–850) vs. 443 days (IQR 185–1157), p=0.140], and retreatment rate (26.9% vs.22.2%, p=0.090). After adjusting for potential confounders, the adjusted hazard ratio (aHR) for all-cause mortality (aHR 1.11; 95% confidence interval 0.80-1.53; p=0.531) in NE group was not significantly different than that in LTFU group. Among retreated cases, NE group had a higher treatment success rate (57.9% vs 43.8%, p=0.029) and a lower LTFU rate (11.6% vs 38.3%, p<0.001) compared to LTFU group.
Conclusion
NE group had an unfavorable outcome comparable to LTFU group, suggesting undetected cases of LTFU or deaths during the referral process. Establishing an efficient patient referral system would contribute to reducing the incidence of NE cases.

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