Background: s/Aims: Pancreaticoduodenectomy (PD) is the standard treatment for periampullary tumors, but it is technically challenging. Evidence directly comparing open, laparoscopic, robotic, and hybrid approaches is limited. This study conducts a network meta-analysis (NMA) to compare the perioperative and oncologic outcomes of open PD (OPD), laparoscopic PD (LPD), robotic PD (RPD), and hybrid PD. Methods: We searched PubMed, EMBASE, and the Cochrane Library for studies published between January 1994 and August 2024.We included randomized controlled trials and comparative observational studies that evaluated at least two PD approaches. Perioperative outcomes were the primary endpoints, while oncologic safety served as a secondary endpoint. A random-effects NMA was performed, establishing treatment hierarchies through ranking probabilities (PROSPERO ID: CRD420250365864). Results: A total of 78 studies were included (5 randomized and 73 retrospective). RPD was associated with lower blood loss compared to OPD (mean difference [MD], –163.85 mL) and LPD (MD, –84.14 mL). Hospital stays were also shorter for RPD compared to OPD (MD, –2.50 days) and LPD (MD, –1.88 days). In contrast, OPD was the most time-efficient approach compared to LPD (MD, –77.61 minutes) and RPD (MD, –73.30 minutes). Mortality rates, severe complications, clinically relevant postoperative pancreatic fistula rates, and reoperation rates were comparable across all surgical approaches. In terms of oncologic safety, lymph node yield and R0 resection rates were similar for all modalities. Conclusions While OPD is the most time-efficient approach, RPD provides significant advantages in reducing intraoperative blood loss and shortening hospital stays compared to both LPD and OPD.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.

PURPOSE: The purpose of this study was to compare the surface characteristics and healing patterns after implantation of implants treated with SLA and those treated with both SLA and femtosecond laser. MATERIALS AND METHODS: A total of 10 male New Zealand white rabbits were used to compare recovery levels between implants treated with SLA (SLA group) and those treated with both SLA and femtosecond laser (SF group). The implants’ surface characteristics were determined through topographic evaluation, element analysis, surface roughness, and wettability evaluation. In total, 4 implants were placed in each rabbit (2 in each tibia), with 20 implants per treatment group. Using the implant stability quotient (ISQ), marginal bone volume, and histological analysis (bone-to-implant contact (BIC), bone volume/tissue volume (BV/TV)), and post implantation outcomes were assessed. Outcome data were analyzed using independent t-tests, Mann-Whitney U tests, Wilcoxon signed-rank tests, and one-way ANOVA (α = 0.05). RESULTS: No significant differences were noted between SLA and SF groups in terms of ISQ, marginal bone volume, BIC, and BV/TV (P > .05). However, significant differences in ISQ were observed within each group over time (P < .05). Furthermore, significant differences were noted in the marginal bone volume of the SF group (P < .05) and the BV/TV of the SLA group between weeks 4 and 6 (P < .05). CONCLUSION Surface treatment via SLA and femtosecond laser is feasible compared with SLA treatment alone in terms of ISQ, marginal bone volume, BIC, and BV/TV. However, further clinical research is warranted.

BACKGROUND/OBJECTIVES: Regulating the postprandial glucose levels is crucial for preventing the progression of prediabetes to diabetes. This study examined the effects of a diabetes-specific nutrition formula (DSNF) on the postprandial plasma glucose, serum insulin, and serum c-peptide levels in individuals with prediabetes. SUBJECTS/METHODS: An open-label, crossover clinical trial was conducted to compare the effects of the DSNF versus standard oral nutritional supplement (ONS) on glycemic control.Fifteen subjects with prediabetes were enrolled and received the DSNF on the first visit and standard ONS on the second. The postprandial plasma glucose, serum insulin, and serum c-peptide incremental area under the curve (iAUC), as well as the incremental maximal concentration (iCmax ) and the maximum concentration (Cmax ), were measured after each intervention. Statistical comparisons between DSNF and standard ONS were conducted using a Wilcoxon’s signed-rank test. RESULTS: After consuming the DSNF, the iAUC of the postprandial glucose level was significantly low compared to the standard ONS (1,683.49 ± 911.65 vs. 4,455.92 ± 1,658.77, P < 0.0001). Similarly, the serum insulin iAUC (2,017.33 ± 987.64 vs. 2,570.59 ± 1,201.09, P = 0.0181) and c-peptide iAUC (274.17 ± 116.12 vs. 491.18 ± 123.90, P < 0.0001) decreased significantly after DSNF administration compared to the standard ONS. CONCLUSIONS The consumption of DSNF significantly improved the postprandial glucose, insulin, and c-peptide responses compared to the standard ONS.

Background: Despite the increasing use of continuous glucose monitoring (CGM) systems, limited data exist on their perceived benefits and challenges among patients and healthcare providers. This study explored CGM-related experiences in South Korea. Methods: An anonymous online survey was conducted between January and December 2021 at four university hospitals. Respondents included patients with diabetes mellitus (DM), physicians, and DM education nurses. The survey assessed the use of CGM, its benefits, and barriers. Most devices were first-generation CGMs: FreeStyle Libre 1 (Abbott Diabetes Care), Dexcom G6 (Dexcom Inc.), and Medtronic Guardian 3 (Medtronic MiniMed). Results: Among 1,010 patients (33.4% with type 1 DM [T1DM], 63.6% with type 2 DM [T2DM], and 3.1% others; mean age, 51.4±14.6 years), 92.7% found CGM helpful. Although 59.6% reported discomfort, 81.9% intended to continue using CGM, indicating that perceived benefits outweighed barriers. The key advantages were glucose monitoring without finger pricks (T1DM, 57.9%; T2DM, 56.2%) and maintenance of target glucose levels. Discomfort was related to discomfort during activities (53.8%), skin problems (45.0%), and pain (43.0%). Healthcare provider recommendations were associated with reduced discomfort (adjusted odds ratio, 0.36; 95% confidence interval, 0.21–0.60). Physicians (n=29) cited high costs as the main barrier (T1DM, 58.9%; T2DM, 64.8%); only 51.9% and 14.5% prescribed CGM for T1DM and T2DM, respectively. Insulin adjustment and glucose control were the main reasons for prescription, while cost (89.3%) and limited consultation time (67.9%) were barriers. DM educators (n=9) reported heavy workloads, with training and follow-up times averaging 31.7±7.5 minutes and 21.7±9.7 minutes, respectively; 77.8% of DM educators identified frequent patient inquiries as their greatest burden. Conclusion CGM provides significant clinical benefits but is limited by discomfort, costs, and educational burden. Sustained adoption requires device improvements, insurance support, and workforce expansion.

Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Background: Alopecia, a benign dermatologic condition affecting both genders, particularly harms female patients due to psychosocial effects. Female pattern hair loss (FPHL), the primary cause of hair loss in women, lacks sufficient Korean epidemiological studies examining its psychosocial aspects. Objective: This study aimed to explore FPHL’s psychosocial impacts, including quality of life (QoL), depression, anxiety, medical consumption, and hair loss factors in Korean women. Methods: A total of 202 patients with FPHL were interviewed using a validated questionnaire to assess the QoL, psychological impact, and pattern of medical consumption. The severity of hair loss was evaluated using the “basic and specific (BASP) classification” by dermatologists. The Hair-Specific Skindex-29 (HSS29) was used to assess the QoL and Beck depression inventory (BDI), Beck anxiety inventory (BAI) to evaluate psychological aspects, and medical expenses and the number of clinic visits to determine medical consumption. Results: The global HSS29 score of FPHL was 40.97±18.92, indicating a notable impact on QoL. The mean BDI and BAI scores were 14.47 and 10.06, respectively. In multivariable regression analysis, HSS29, BDI, and BAI scores were most affected by the severity of hair loss (p<0.001). Conclusion FPHL damages the psychosocial aspects of patients, such as QoL, depression, and medical consumption, according to the severity of hair loss.