Purpose: This study evaluated the long-term clinical outcomes of silicone tube intubation using a Nunchaku® (FCI Ophthalmics Inc., Pembroke, MA, USA) tube in adult patients with epiphora. Methods: A prospective study was conducted on 42 eyes in 32 patients who underwent silicone tube intubation with a Nunchaku® tube between March 2023 and September 2023. Clinical manifestations, Munk scale scores, lacrimal syringing test results, and tear meniscus height were assessed before and after surgery. Surgical success was defined as a Munk score of ≤ 1. Results: The mean age of the participants was 56.2 years. Preoperative lacrimal irrigation testing revealed partial obstruction in 29 eyes (69.0%), patent passage in 11 eyes (26.2%), and punctal stenosis in 2 eyes (4.76%). The mean operative time was 6.4 minutes for monocular procedures and 9.7 minutes for binocular procedures. At three months postoperatively, 33 eyes (78.6%) in 28 patients achieved a Munk scale score of ≤ 1. No significant differences were observed between the surgical success and failure groups in terms of preoperative Munk scale scores, lacrimal syringing test results, or tear meniscus height. One patient who underwent binocular surgery experienced worsening symptoms in both eyes postoperatively with associated punctal inflammation and granuloma formation necessitating early silicone tube removal. Slit punctum was observed in 17 eyes across 11 patients, six of whom underwent a snip procedure during surgery. Conclusions Silicone tube intubation using the Nunchaku-style tube is a relatively simple and effective treatment for nasolacrimal duct obstruction. However, an increased incidence of lacrimal punctum-related complications was observed compared to previous studies, indicating the need for caution when performing the snip procedure concurrently.

Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

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.

Objective: This study aimed to compare the therapeutic outcomes of no-touch (NT) radiofrequency ablation (RFA) vs. tumorpuncture microwave ablation (MWA) in the treatment of single hepatocellular carcinomas (HCCs) measuring ≤3 cm. Materials and Methods: This multicenter retrospective study included 304 patients who underwent either NT-RFA (n = 144) or MWA (n = 160) for a single HCC measuring ≤3 cm. Comparative analyses were conducted for the overall cohort, while 81 patients per group were matched using propensity score matching (PSM). The analyzed outcomes included technical success, primary technique efficacy, local tumor progression (LTP), and major complications. Cumulative LTP was estimated using Kaplan–Meier analysis and compared using the log-rank text, while the rate of ablative margin ≥5 mm and ablation time were compared using Chi-squared and Mann–Whitney U tests, respectively. Results: Technical success was achieved in 98.6% (142/144) and 100% (160/160) of in the NT-RFA and MWA patients, respectively before PSM (P = 0.224), and 98.8% (80/81) and 100% (81/81) after PSM (P = 1.000). The primary technique efficacies were 98.6% (142/144) and 100% (160/160) before PSM (P = 0.224), and 97.5 % (79/81) and 100% (81/81) after PSM (P = 0.497), respectively. The 1-, 2-, and 3-year cumulative LTP rates were 1.4%, 1.4%, and 2.3%, respectively, for NTRFA and 5.1%, 8.6%, and 8.6%, respectively, for MWA before PSM (P = 0.013). After PSM, the corresponding rates were 0%, 0%, and 0% for NT-RFA, and 7.6%, 10.4%, and 10.4% for MWA (P = 0.006). Major complications were not observed. NT-RFA achieved a higher proportion, with an ablative margin ≥5 mm (88.7% [126/142] vs. 71.9% [115/160]; P < 0.001), but required longer ablation times (median, 10.0 vs. 6.0 min; P < 0.001). Conclusion NT-RFA showed superior local tumor control compared to MWA, despite greater procedural complexity and longer ablation times.

Interest in embedding diversity, equity, and inclusion (DEI) across medical training has grown rapidly, yet the overall landscape of DEI-related medical education research remains fragmented. This scoping review mapped recent DEI-related curricula, programs, and training initiatives implemented in undergraduate medical education (UME) and graduate medical education (GME) settings. We conducted a PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews)–reported scoping review. PubMed was searched for studies published between 2020 and 2025 that examined DEI-focused educational activities in UME and GME involving medical students, residents or fellows, or faculty members. Data were extracted on publication year, country, target population, study design, and primary DEI domain, and results were summarized descriptively. Of 203 records identified, 164 met the inclusion criteria. Publications increased sharply after 2022 and were predominantly US-based. Most studies focused on residents, followed by medical students, faculty members, and analyses of program websites or institutional documents. Studies clustered into five domains: (1) learning environment and discrimination; (2) admissions and workforce diversity; (3) frameworks and measures; (4) curriculum development and implementation; and (5) outcomes and evaluation. Ten studies were purposively selected for narrative synthesis across key educational contexts. Most reported short-term learner outcomes, with limited evidence of behavior change, organizational impact, or patient-level outcomes. DEI-related medical education research is expanding; however, it remains geographically concentrated and methodologically constrained. Future studies should adopt context-sensitive, longitudinal, and multi-level designs to better inform curriculum planning, implementation, and evaluation.

Diversity, equity, and inclusion (DEI) are increasingly emphasized in medical education worldwide. However, it remains unclear how these values are reflected within the context of Korean medical education. This study explores how DEI is articulated through an analysis of the official websites of Korean medical schools. We conducted a content analysis of the official websites of 40 Korean medical schools. DEI-related synonyms and associated phrases were identified across mission and values statements, educational objectives, graduate outcomes, and student support sections. Identified phrases were coded according to the dimensions of diversity, equity, and inclusion. Quantitative frequencies were then summarized. For further analysis, qualitative thematic analysis and integrated analysis were performed to examine how each DEI element was conceptually represented. Among the 40 universities, 32 institutions (80%) demonstrated at least one component of DEI. Diversity (60%) was more frequently referenced than inclusion (50%) and equity (42.5%). DEI elements were most prominently observed in student support sections (62.5%) and were least frequently identified in mission and values statements (15%) and educational objectives (12.5%). In the qualitative analysis, diversity was primarily described in terms of respect for diversity within organizations and global citizenship. Equity was largely limited to scholarships and material support for disadvantaged students. Inclusion mainly emphasized the creation of respectful environments. Overall, in Korean medical schools, DEI was more commonly represented through student support mechanisms than through institutional philosophy or educational objectives. An integrated approach to the implementation of DEI is therefore needed to achieve meaningful change in Korean medical education.

Purpose: Technological advancements have enabled reduced-port robotic systems, enhancing the benefits of robotic surgery. This study compared the surgical outcomes of conventional multiport (5 ports), single-site (2 ports), and singleport (2 ports) robotic gastrectomy for gastric cancer. Methods: A prospectively collected database was retrospectively reviewed for patients who underwent robotic distal subtotal gastrectomy between January 2010 and August 2022 at Severance Hospital, Yonsei University Health System. The initial 20 cases from each group (multiport, single-site, and SP) were analyzed, focusing on demographics, surgical procedures, pathological results, and postoperative outcomes. The “textbook outcome” metric was employed to assess surgical quality. Results: The SP group showed lower visual analog pain scale compared to the multiport and single-site groups (3.5, 4.4, and 4.3, respectively, P = 0.017), faster time to first flatus (2.0, 2.7, and 2.8 days, respectively; P < 0.001), and shorter hospital stays (3.5, 6.2, and 5.5 days, respectively; P < 0.001). No significant differences were observed in major complications, unplanned intensive care unit care, readmission, or mortality between the groups. The rate of patients achieving textbook outcomes were 85.0% for the multiport group, 100% for the single-site group, and 95.0% for the SP group (P = 0.310). Conclusion Reduced-port robotic gastrectomy, including single-site and SP, has shown surgical safety with a high proportion of patients meeting textbook outcomes. The SP system demonstrated less pain and faster recovery, aligning with minimally invasive surgical goals. Therefore, the SP system could be a reliable and safe option for robotic gastrectomy, offering enhanced recovery without compromising surgical quality.

Purpose: Neoadjuvant treatment (NAT) is now the standard for borderline resectable pancreatic cancer (RPC) and is being considered for RPC. Early recurrence after curative surgery in RPC is often seen as a treatment failure, prompting considerations for NAT. Our goal was to develop an artificial intelligence (AI)-based predictive model utilizing preoperatively available factors to forecast early recurrences of resected RPC. Methods: This study included 469 patients who underwent surgery for RPC between 2011 and 2019. Clinicopathologic and oncologic data were retrospectively reviewed. Preoperative variables, including laboratory data and imaging findings, were collected. Early recurrence was defined as recurrence occurring within a year after surgery. Deep neural networks were then used to select variables by assessing their importance. A new model predicting early recurrence of RPC was subsequently developed. Results: Of the patients evaluated, 199 (42.4%) experienced early recurrence. The predictive model included 14 preoperative variables: CA 19-9, preoperative pancreatitis, serum albumin, platelet count, lymphocyte count, the American Society of Anesthesiologists physical status classification, tumor size, monocyte count, age, body mass index, CRP, hemoglobin, WBC count, and CEA. The area under the curve for the model was 0.786 in the training set and 0.734 in the test set. Conclusion We developed an AI-based model to predict the early recurrence of RPC using preoperative parameters. By identifying patients at risk of early recurrence, optimal individualized treatments such as NAT can be considered. Future prospective studies are crucial to establish clear indications for NAT in RPC.

Purpose: The aim of this study is to compare the detection ability of quality of life (QoL) changes and responsiveness of the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS)-40 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ). Materials and Methods: A multicenter prospective observational study was conducted to evaluate QoL changes after various gastrectomies between January 2021 and April 2022. Participants were instructed to complete the KOQUSS-40 and EORTC QLQ-C30/STO22 preoperatively and at 1, 3, 6, and 12 months postoperatively. QoL changes over time and QoL responsiveness were assessed for each questionnaire. Results: Data from 491 patients who underwent curative gastrectomy for gastric cancer at 22 institutions were analyzed. The summary scores of the KOQUSS-40 and EORTC QLQ-STO22 showed significant differences between the total and proximal gastrectomy groups (p=0.044 and p=0.038, respectively), but no difference was observed for the EORTC QLQ-C30. Dysphagia on the KOQUSS-40 was significantly different between the total and proximal gastrectomy groups (p=0.031); however, dysphagia on the EORTC QLQ-STO22 did not differ. The responsiveness of the KOQUSS-40 was similar to that of the EORTC QLQ in patients who experienced ≥ 10% body weight loss, but approximately 10% less in patients receiving adjuvant chemotherapy than the EORTC QLQ. Conclusion KOQUSS-40 has several advantages over EORTC QLQ-C30/STO22 when comparing QoL between the total and proximal gastrectomy groups. The findings provide information for researchers investigating the QoL of patients who have undergone curative gastrectomy for gastric cancer.

Purpose: Triple-negative breast cancer (TNBC) is a particularly aggressive subtype of breast cancer, with approximately 30% of patients eventually developing brain metastases (BM), which result in poor outcomes. An understanding of the tumor microenvironment (TME) at both primary and metastatic sites offers insights into the mechanisms underlying BM and potential therapeutic targets. Materials and Methods: Spatial RNA sequencing (spRNA-seq) was performed on primary TNBC and paired BM tissues from three patients, one of whom had previously received immune checkpoint inhibitors before BM diagnosis. Specimen regions were categorized into tumor, proximal, and distal TME based on their spatial locations. Gene expression differences across these zones were analyzed, and immune cell infiltration was estimated using TIMER. A gene module analysis was conducted to identify key gene clusters associated with BM. Results: Distinct gene expression profiles were noted in the proximal and distal TMEs. In BM, the proximal TME exhibited neuronal gene expression, suggesting neuron-tumor interactions compared to tumor, and upregulation of epithelial genes compared to the distal TME. Immune cell analysis revealed dynamic changes in CD8+ T cells and macrophages across the tumor and TME zones. Gene module analysis identified five key modules, including one related to glycolysis, which correlated with patient survival. Drug repurposing analysis identified potential therapeutic targets, including VEGFA, RAC1, EGLN3, and CAMK1D. Conclusion This study provides novel insights into the transcriptional landscapes in TNBC BM using spRNA-seq, emphasizing the role of neuron-tumor interactions and immune dynamics. These findings suggest new therapeutic strategies and underscore the importance of further research.