Purpose: To develop the 2025 update to the Korean colorectal cancer (CRC) screening guidelines by systematically evaluating recent evidence, integrating domestic data, and addressing changes since the 2015 guideline revision, thereby providing an evidence-based standard for clinicians and policymakers. Methods: A multidisciplinary committee developed the guidelines using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The process included formulation of three key questions addressing screening efficacy, diagnostic accuracy, and optimal screening age and interval. A systematic review of international guidelines and primary literature was conducted, yielding 327 eligible studies. In addition, a utility-based analysis using a Markov model was performed to determine optimal screening ages and intervals. Results: The evidence synthesis identified high-certainty evidence supporting the use of the fecal immunochemical test (FIT) for reducing CRC mortality and moderate-certainty evidence for colonoscopy. Evidence for computed tomographic colonography (CTC) and stool DNA testing was rated as very low certainty. Based on the evidence review and cost-utility analysis, the committee conditionally recommends CRC screening for asymptomatic, average-risk adults aged 45–74 years using either colonoscopy every 10 years or FIT every 1–2 years. CTC and stool DNA testing were not recommended owing to insufficient evidence. Conclusion The 2025 Korean Guidelines for Colorectal Cancer Screening present updated, evidence-based recommendations tailored to the domestic healthcare context. By conditionally endorsing both colonoscopy and FIT for individuals aged 45–74 years, these guidelines aim to improve population-level screening effectiveness and reduce the burden of CRC in South Korea.

Objective: We investigated the distribution of AI viruses in fecal samples from wild bird habitats (and nearby poultry-farm areas) surveyed between September and March from 2019 to 2025 and identified associated epidemiological risk factors. Methods: Samples were screened for influenza A (M, H5, H7) genes using real-time reverse transcription polymerase chain reaction (PCR), subjected to virus isolation in embryonated chicken eggs, and subtyped by PCR and sequencing. Host species were identified through DNA barcoding. Relative risks (RRs) with 95% confidence intervals were estimated for province, month, and waterfowl density. Results: Overall prevalence of HPAI and low pathogenic AI (LPAI) virus was 0.10% and 3.21%, respectively. HPAI virus was continuously isolated since 2020–2021, except 2019– 2020, while LPAI prevalence steadily increased (3.01%–4.35%). Twelve hemagglutinin (H1–H12) subtypes were identified in 1,722 isolates, and H3 (16.5%) was the most prevalent, followed by H5 (11.1%) and H7 (5.2%). LPAI H5N3 (55.7%) and H7N7 (75.5%) were the predominant H5 and H7 subtypes, respectively. Detection was higher in western coastal provinces, and higher mallard/spot-billed duck density and sampling in September– December were associated with increased risk. Conclusions and Relevance: Continued surveillance of migratory-bird habitats can provide early warning of HPAIV incursions and support targeted biosecurity measures in high-risk regions and seasons.

Background/Aims: Chronic kidney disease (CKD) is a significant health problem worldwide, and identifying risk factors for CKD is crucial. We investigated the association between steatotic liver disease (SLD) and the incidence of CKD. Methods: This longitudinal cohort study involved 70,361 adults who did not have CKD at baseline and who underwent at least two health checkups. SLD status was assessed via ultrasonography. The severity of SLD was determined using the Fibrosis-4 score. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m 2 . Results: Over 475,835 person-years (mean 6.8 years), 2,723 participants developed CKD.The adjusted hazard ratio (aHR) for development of CKD in participants with SLD compared to those without SLD was 1.17 (95% confidence interval [CI], 1.08 to 1.27), with the risk increasing with SLD severity. The aHR (95% CI) for incident CKD was 0.84 (0.51 to 1.37) for cryptogenic SLD, 1.25 (1.16 to 1.36) for metabolic dysfunction-associated SLD (MASLD), and 1.32 (1.01 to 1.73) for metabolic dysfunction-associated alcoholic liver disease (MetALD) compared with participants without SLD. Within these SLD subclassifications, the risk of CKD development was increased as disease severity advanced. Conclusions SLD was linked to a higher incidence of CKD, with the CKD risk increasing sequentially from cryptogenic SLD to MASLD and MetALD. Advanced fibrosis in each SLD subclassification further increases the risk of CKD. Stratifying SLD according to metabolic dysfunction, significant alcohol intake, and fibrosis severity may help identify and monitor individuals at high risk of developing CKD.

With a solitary remaining tooth in the mandible, restoration with a conventional removable partial denture is often associated with insufficient retention, support, and stability, as well as excessive stress concentration on the remaining tooth, leading to an unfavorable prognosis. Recently, treatment plans involving the placement of a small number of strategically positioned implants to fabricate removable partial dentures have been adopted to overcome these limitations.The use of implant surveyed crowns is considered to offer superior long-term outcomes compared with implant attachments. This report describes the restoration of a partially edentulous mandible with a single remaining tooth using an implant-assisted removable partial denture assisted by a surveyed fixed partial denture following bilateral posterior implant placement, achieving favorable clinical results.

Background: Asthma remission has recently emerged as an aspirational treatment goal, yet its definition remains inconsistent across studies and expert groups. The absence of a standardized framework hampers its application in clinical practice and research, particularly in Korea where biologics use is rapidly increasing. This study aimed to establish a consensus definition of clinical remission in severe asthma among Korean experts. Methods: A two-round modified Delphi survey, followed by a focused third round, was conducted among 28 board-certified pulmonologists from the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD). The questionnaire consisted of six domains and 27 items. Responses were analyzed using agreement rates, interquartile ranges, and content validity ratios to determine consensus levels. Results: Consensus was reached on defining clinical remission as a composite of no exacerbations, no systemic corticosteroid use, sustained symptom control (Asthma Control Test ≥20 on at least three occasions over 12 months), and stabilization and optimization of pulmonary function while on maintenance treatment. Experts agreed that pulmonary function should be assessed based on clinical judgment rather than absolute thresholds. Complete remission was additionally defined as fulfilling all clinical remission criteria with normalization of type 2 inflammation (blood eosinophils <300/μL and fractional exhaled nitric oxide <25 ppb). Conclusion This Delphi consensus provides a regionally relevant and pragmatic framework for defining remission in severe asthma. These statements may help guide clinical practice, inform guideline development, and support future research on remission as a treatment goal.

Chrysanthemum zawadskii flower ethanol extract (CZ-F) was evaluated for its neuroprotective potential against inflammation-associated cognitive impairment. To assess its anti-inflammatory properties, we first conducted in vitro studies using LPS-stimulated BV2 microglial cells. CZ-F demonstrated strong antioxidant activity with IC₅₀ values of 186.04 µg/ml (DPPH) and 94.56 µg/ml (ABTS), suppressed the production of reactive oxygen species and nitric oxide, and downregulated the expression of iNOS and IL-1β, likely via inhibiting the NF-κB signaling pathway. CZ-F also decreased inflammation-induced acetylcholinesterase (AChE) expression and directly inhibited AChE activity. Among the constituents of CZF, quercetin and luteolin exhibited the strongest anti-inflammatory and antioxidant effects, while linarin most potently inhibited AChE activity. In an in vivo zebrafish model, CZ-F treatment ameliorated learning and memory impairments induced by sleep deprivation. These findings suggest that CZ-F can attenuate neuroinflammation and modulate cholinergic dysfunction, providing a potential therapeutic approach for inflammationrelated cognitive deficits.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease that can progress from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH), advanced fibrosis or cirrhosis, and hepatocellular carcinoma. MicroRNAs (miRNAs) are increasingly recognized as central post-transcriptional regulators of lipid metabolism, insulin resistance, inflammatory signaling, fibrogenesis, and exosome-mediated intercellular communication. This review critically reassesses key miRNA axes implicated in MASLD progression, focusing on mechanistically supported examples (miR-34a, miR-21, miR-122, the miR-29 family, miR-20b, and miR-93), tissue miRNA isoforms (isomiRs), circulating miRNA biomarkers, and therapeutic translation. Recent studies support the diagnostic relevance of selected circulating miRNA panels and hepatic isomiR landscapes; however, current evidence remains insufficient to position miRNAs as standalone replacements for established noninvasive tests or liver biopsy. Liver-directed oligonucleotide delivery platforms continue to advance; however, MASLD-specific miRNA drug development remains largely preclinical, with only limited exploratory early clinical activity. Importantly, the rapidly evolving therapeutic landscape, which currently includes Food and Drug Administration-approved therapies, some of which have been granted accelerated approval, for adults with noncirrhotic steatohepatitis/ MASH and F2–F3 fibrosis, reshapes how miRNA therapeutics should be positioned: not as broad substitutes, but as mechanism-informed, patient-stratified, and potentially combinationbased approaches. Overall, miRNA and isomiR biology provide a compelling framework for precision diagnostics and next-generation therapeutic design in MASLD, provided that mechanistic rigor, preanalytical standardization, and clinically meaningful endpoints are maintained.

Olanzapine is a second-generation antipsychotic drug associated with the development of type 2 diabetes. However, the development and remission of diabetes with glutamic acid decarboxylase (GAD) antibody (Ab) positivity related to olanzapine treatment have not been reported. Here, we present the case of a 33-year-old man taking olanzapine who was diagnosed with diabetes with GAD Ab positivity complicated by diabetic ketoacidosis (DKA). After discontinuation of the drug and tight glycemic control, his diabetes remitted, and the GAD Ab became negative spontaneously after 18 months. The classification of diabetes is challenging because of overlapping autoimmune and metabolic features. Olanzapine may have contributed to pancreatic β-cell apoptosis, which could potentially trigger autoimmunity and the development of type 1 diabetes-like features (DKA as the initial presentation, a low C-peptide level, and GAD Ab positivity). The rapid amelioration of hyperglycemia and weight reduction may be responsible for the remission of diabetes after the discontinuation of olanzapine.

Composite gangliocytomaeuroma and neuroendocrine tumors (CoGNETs) are extremely rare periampullary neoplasms composed of neuroendocrine epithelial, Schwannian spindle, and ganglion cells. Although endoscopic papillectomy or surgery have been used to treat ampullary CoGNETs, underwater endoscopic mucosal resection (UEMR) for periampullary lesions has not been previously described. In this study, we present a case of a 53-year-old man referred to our hospital with an incidentally detected subepithelial tumor in the second portion of the duodenum. Endoscopic ultrasound revealed a 13×10-mm homogeneous, hypoechoic, and well-demarcated submucosal mass. UEMR was performed under conscious sedation without submucosal injection, achieving safe en bloc resection within 12 min. Histopathology revealed a 2.0×1.5×1.2-cm lesion composed of mixed neuroendocrine epithelial, Schwannian spindle, and ganglion cells. Immunohistochemical staining was positive for chromogranin A, synaptophysin, CD56, neuron-specific enolase, and S-100, confirming CoGNET with a Ki-67 index of <1% and no lymphovascular or perineural invasion. Follow-up endoscopy 3 months later revealed only a post-resection scar without residual or recurrent tumors. This appears to be the first reported case of periampullary CoGNET successfully treated with UEMR. Therefore, UEMR might represent a safe and effective therapeutic option for selected periampullary subepithelial tumors.