Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Background: Urinalysis, an essential diagnostic tool, faces challenges in terms of standardization and accuracy. The use of artificial intelligence (AI) with mobile technology can potentially solve these challenges. Therefore, we investigated the effectiveness and accuracy of an AI-based program in automatically interpreting urine test strips using mobile phone cameras, an approach that may revolutionize point-of-care testing. Methods: We developed novel urine test strips and an AI algorithm for image capture.Sample images from the Chungnam National University Sejong Hospital were collected to train a k-nearest neighbor classification algorithm to read the strips. A mobile application was developed for image capturing and processing. We assessed the accuracy, sensitivity, specificity, and ROC area under the curve for 10 parameters. Results: In total, 2,612 urine test strip images were collected. The AI algorithm demonstrated 98.7% accuracy in detecting urinary nitrite and 97.3% accuracy in detecting urinary glucose. The sensitivity and specificity were high for most parameters. However, this system could not reliably determine the specific gravity. The optimal time for capturing the test strip results was 75 secs after dipping. Conclusions The AI-based program accurately interpreted urine test strips using smartphone cameras, offering an accessible and efficient method for urinalysis. This system can be used for immediate analysis and remote testing. Further research is warranted to refine test parameters such as specific gravity to enhance accuracy and reliability.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Background: s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018. Results: The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%). Conclusions Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.

Purpose: Root coverage (RC) procedures require long-term evaluation. This study assessed the clinical validity and long-term stability of a modified tunneling technique for lower anterior gingival recession (GR) using a subepithelial connective tissue graft (SCTG) and a volume-stable collagen matrix. Methods: Across 39 patients, 66 mandibular incisors with ≥1.0 mm of GR were examined before and after RC surgery. Clinical photographs documenting the results of RC were taken at baseline (T0 ) and the most recent follow-up visit (T l ). Impressions were obtained either at baseline (T0 ) or 3 weeks later (T 3 ). The recession depth, Miller classification, and rates of RC and complete root coverage (CRC) were assessed. Results: This study analyzed 66 GR sites across 39 patients, with an average follow-up period of 41.3 months. Overall, the mean RC achieved was 86.2%±15.7%. Among single recessions, the RC was 85.2%±25.6% for Miller class I, 91.5%±10.4% for class II, and 79.2%±18.3% for class III. Regarding multiple recessions, the RC was 85.1%±16.2% for Miller class I, 87.0%±12.5% for class II, and 89.8%±16.0% for class III. By Miller classification, the RC was 85.1%±16.8% for class I, 88.7%±11.6% for class II, and 85.8%±17.3% for class III.Furthermore, the RC varied by follow-up duration: 72.5%±15.1% at 12 months, 90.1%±12.6% at 25–36 months, 89.0%±16.7% at 37–48 months, 91.10%±9.88% at 49–60 months, and 97.6±4.79% for longer than 61 months, with 77.8% of the last group achieving CRC. RC also differed based on the initial recession depth, at 88.0%±16.8% for 1–3 mm, 83.1%±14.1% for 3–6 mm, and 80.2%±5.04% for depths exceeding 6 mm. Conclusions A modified tunneling technique, utilizing SCTG and a volume-stable collagen matrix, appears to represent a reliable option for the long-term management of GR in the lower anterior region, even in cases involving multiple Miller class III GRs.

Purpose: A small magnetic peg, named “BracketPeg,” has been developed as an attachment magnet for implant prostheses. This study aimed to determine the feasibility of measuring implant stability at the prosthesis level, evaluate the reliability and accuracy of BracketPeg, and examine the consistency of measurements obtained using other devices for damping capacity assessment (DCA) and resonance frequency analysis (RFA). Methods: Forty implants were installed into artificial bone blocks, with each block representing 1 of 4 different diameters (3.5, 4.0, 4.5, and 5.5 mm; 10 implants per diameter).Each implant was paired with a customized zirconia prosthesis that matched the implant diameter. Implant stability was measured at both the fixture and prosthesis levels using Anycheck™ (Neobiotech) for DCA and Osstell™ Beacon (W&H) and ChecQ™ (Dentis) for RFA. To obtain prosthesis-level measurements using RFA devices, BracketPeg was attached to the coronal, middle, and apical thirds of the prosthesis to evaluate implant stability. Results: The implant stability quotient (ISQ) was significantly lower at the prosthesis level than at the fixture level (P<0.001), reflecting the impact of the increased mass and size of the prosthesis. RFA values varied depending on the position of BracketPeg, with lower stability values observed at the coronal position than at the apical position. The 2 RFA devices demonstrated reasonable agreement between ISQ measurements, with a mean difference of −0.58 (95% confidence interval: ±0.31). Conclusions BracketPeg provides reliable and consistent implant stability measurements at the prosthesis level compared to other devices, making it a practical and feasible tool for the clinical evaluation of implants.

Purpose: This retrospective study aimed to evaluate the long-term survival rate and marginal bone loss (MBL) of tapered-straight-tapered dental implants, considering various associated factors, over an observational period of ≥5 years. Methods: This study included 186 patients who underwent tapered-straight-tapered dental implant placement at Seoul National University Dental Hospital from 2014 to 2019. Digital panoramic radiographic images and dental records were examined. We evaluated multiple variables, such as sex, age, diabetes mellitus (DM), smoking status, placement region, jaw type (maxilla and mandible), implant diameter, implant length, staged surgery, immediate placement, splinted prosthesis, and implant placement depth (IPD). We first determined the implant survival rate using Kaplan–Meier analysis and analyzed potential risk factors for implant survival using mixed-effects Cox proportional hazards regression. Next, the Mann– Whitney and Kruskal–Wallis tests were used to examine differences in MBL across variables.Linear mixed-effects models with backward stepwise selection were used to identify associations between risk factors and MBL. Results: This study included 316 implants in 186 patients, monitored over a follow-up period of 7.0±1.36 years. The cumulative survival rate of the implants was 98.1%. The average mesial and distal MBLs were 0.59±1.36 mm and 0.68±1.36 mm, respectively. Linear mixed-effects models indicated that MBL exhibited statistically significant positive correlations with DM (Coeff.=0.614, P=0.026) and staged surgery (Coeff.=0.410, P=0.002). Additionally, greater mesial IPD was associated with reduced MBL (Coeff.=−0.143, P=0.046), and a similar trend was observed for distal IPD (Coeff.=−0.316, P=0.068). Conclusions This study demonstrated a high cumulative survival rate for tapered-straighttapered dental implants over a 5-year period. DM, staged surgery, and IPD showed strong associations with increased MBL. The results suggest that tapered-straight-tapered implants offer advantages in terms of peri-implant MBL and consistent clinical outcomes. These findings underscore the importance of considering these variables in clinical decisionmaking to optimize implant outcomes.

Purpose: Immediate implant placement (IIP) offers several advantages, including minimizing hard and soft tissue deformation, reducing implant time and cost, and rapidly restoring tooth function. However, IIP is technically challenging due to the need to secure initial stability and limit functional loading during healing. Therefore, this study aimed to evaluate the clinical outcomes of a bone-level implant featuring a dual thread design—an upper U-shaped thread and a lower V-shaped thread—with an 11° internal hexagonal connection in IIP within the maxillary esthetic zone. Methods: This study included 20 patients. Implants were inserted immediately after tooth extraction. Soft tissue changes were evaluated before tooth extraction (V0), after IIP (V1), at prosthesis delivery (V5), at a 3-month follow-up after prosthesis delivery (V6), and at a 1-year follow-up (V8). Bone dimensional changes were assessed at V1 and V8 using cone beam computed tomography, and the marginal bone level (MBL) was evaluated at V6 and V8 using 2-dimensional. Results: Of the 20 patients, 3 dropped out due to osseointegration failure during the followup period. Although the horizontal dimensions of the soft and hard tissues decreased slightly, the gingival margin and MBL remained well maintained throughout the follow-up. Conclusions Within this limited dataset, the lower V-shaped thread enabled favorable initial stability in IIP, and the esthetic outcomes were positive—with minimal gingival recession and marginal bone loss. Long-term follow-up is required to fully assess the impact of thread design and connection on esthetics.

Informed consent for whole-genome sequencing (WGS)-based newborn screening presents distinctive ethical and legal challenges, particularly in balancing parental consent given on behalf of the child with the progressive realization of children’s rights. This study examines the issues discussed in the literature and proposes consent frameworks that are responsive to evolving clinical and societal contexts. A systematic literature review was conducted in accordance with PRISMA 2020 guidelines, analyzing 19 empirical, normative, and legal studies. The synthesis identified persistent tensions between safeguarding parental autonomy and ensuring the child’s future selfdetermination, alongside challenges in determining the scope, timing, and format of genomic information disclosure. International models increasingly adopt dynamic consent processes, such as staged consent or re-consent upon reaching legal capacity. These approaches illustrate the feasibility of aligning clinical utility, public health objectives, and rights-based ethics within largescale genomic programs. Based on its findings, this study recommends the implementation of staged consent mechanisms, transparent disclosure protocols, and procedural safeguards tailored to domestic legal and political frameworks. Such evolving consent practices are expected to support the development of ethically robust and socially sustainable governance for WGS-based newborn screening.

Objective: This study aims to systematically review the ethical and legal discussions regarding the utilization of artificial intelligence (AI) for patient triage and resource allocation in emergency medicine, and to identify the current state of discussions, their limitations, and future research directions. Methods: A comprehensive literature search was conducted following scoping review methodology. Relevant literature published after January 2020 was searched in the Web of Science, Scopus, CINAHL, PubMed, and Cochrane Library databases. Based on a PCC (population, concept, and context) framework (emergency patients/medical staff; triage, resource allocation; and emergency medicine with AI application), a final selection of 27 articles was analyzed. Results: The selected literature raised various ethical and legal issues related to the introduction of AI triage systems and AI utilization in emergency medicine, including data privacy, algorithmic bias, automation dependency, accountability, and explainability. In response to these issues, human-centered design, implementation of explainable AI, establishment of regulatory frameworks, continuous verification and evaluation, and ensuring human-in-the-loop were discussed as major solutions. However, discussions on the risks of “persuasive AI” that could mislead users, ethical issues of generative AI, and social validation and patient and public involvement were found to be insufficient. Conclusion Ethical and legal discussions regarding AI in emergency medicine are evolving toward seeking concrete solutions at technical, institutional, and relational dimensions. However, in-depth research on ethical challenges, such as reflecting the specificity of rapidly developing AI and the values of emergency medicine, is urgently required.