Purpose: Due to its rarity, treatment guidelines for appendiceal cancer have traditionally followed those established for colorectal cancer, despite showing distinct histologic and clinical features. This study aimed to compare the clinicopathologic characteristics and long-term oncologic outcomes of appendiceal cancer with those of right-sided colon cancers. Methods: We retrospectively reviewed the records of patients with stage I–III appendiceal, cecal, or ascending colon cancer who underwent curative resection between 2010 and 2020 at our center. A 1:3:3 exact matching for age, sex, TNM stage, and adjuvant chemotherapy was performed. Survival outcomes were analyzed using the Kaplan-Meier and Cox regression methods. Results: Overall, 245 patients with appendiceal cancer (n = 35), ascending colon cancer (n = 105), and cecal cancer (n = 105) were analyzed. Appendiceal cancer exhibited a higher proportion of T4 tumors and fewer harvested lymph nodes compared with ascending or cecal cancers. The mean follow-up duration was 9.5 years. The 5- and 10-year overall survival rates were lower in appendiceal cancer (66.2% and 52.9%) than in ascending (91.2% and 78.4%) or cecal cancer (88.5% and 78.3%). Similarly, the 10-year disease-free survival rate was lower in appendiceal cancer (59.2%) compared with ascending (83.1%) and cecal cancers (78.4%). Cox regression analysis identified age (≥65 years), perforation, nodal metastasis, and lymphovascular invasion as independent predictors of poor prognosis. Conclusion Appendiceal cancer exhibited significantly worse long-term survival compared to cecal or ascending colon cancer. Tumor perforation, nodal metastasis, and lymphovascular invasion were adverse prognostic factors for overall and disease-free survival.

Purpose: This study aimed to report the real-world outcomes of intravesical gemcitabine for bacillus Calmette–Guérin (BCG)–unresponsive, high-risk, non–muscle-invasive bladder cancer (HR-NMIBC) in Korean patients who were unable or unwilling to undergo radical cystectomy (RC). Materials and Methods: This retrospective study included 131 patients (median age, 69 years; 88.5% men) treated with intravesical gemcitabine for BCG-unresponsive HR-NMIBC at nine centers between May 2019 and April 2022. The primary endpoint was 1-year recurrence-free survival (RFS). The secondary endpoints included factors influencing RFS, progression-free survival (PFS), cystectomy- free survival, cancer-specific survival (CSS), overall survival (OS), and safety. Survival analysis was performed using the Kaplan-Meier method, and risk factors for recurrence were assessed using Cox regression models. Results: Patients were followed up for a median duration of 25 months, with carcinoma in situ (CIS) in 41.9% of the patients. The 1-year and 2-year RFS rates were 68% and 42%, while the 1-year and 2-year PFS rates were 87% and 77%, respectively. No significant factors influencing RFS were identified. Seventeen patients underwent RC during a median follow-up of 16 months, with the condition in three patients progressing to muscle-invasive disease on final pathological analysis. The 2-year CSS and OS rates were 98% and 97%, respectively. Intravesical gemcitabine was well-tolerated, with only seven patients (5.3%) unable to complete the full induction course. Conclusion Our research highlights the potential of intravesical gemcitabine as a viable bladder-sparing treatment option for BCG-unresponsive HR-NMIBC, providing real-world evidence on its safety, efficacy, and tolerability.

Limited data exist regarding the real-world practices and clinical outcomes in patients with ischemic heart failure with reduced left ventricular ejection fractions (LVEFs).Using nationwide registry data from South Korea, we aimed to investigate long-term outcomes and clinical practices, especially implantable cardioverter defibrillators (ICDs) implantation, in patients with reduced LVEFs at least 40 days after acute myocardial infarction (AMI). Of 13,056 patients with AMI between 2011 and 2015, we analyzed 350 (median age, 66 years [interquartile range, 56-75]) who had LVEFs <40% on follow-up transthoracic echocardiogram 40 days after the index event. The primary outcome was cardiac-cause mortality at 3 years. Secondary outcomes comprised major cardiovascular events as well as outcomes defined by the use of ICDs, cardiac resynchronization therapy defibrillators (CRT-Ds), and electrophysiology studies. Among 350 patients, 39 (11.1%) died from cardiac causes during 3 years of follow-up. Eleven (3.1%) were hospitalized for ventricular tachycardia. The rate of ICD or CRT-D implantation up to 3 years was 5.7% (20/350). Cox time-to-event analysis revealed older age, LVEF <30%, diabetes mellitus, and previous MI or revascularization as positively associated with cardiac death, whereas the use of statins and body weight <67 kg were negatively associated. This nationwide Korean registry demonstrated that only 5.7% of patients who had reduced LVEFs after 40 days of AMI underwent ICD implantations over 3 years. Considering the high mortality, concerted efforts are needed to improve clinical outcomes for patients who may have been candidates for ICD implantation.

Bipolar disorder (BD) is a highly heritable psychiatric condition characterized by recurrent alternations between manic and depressive episodes. This review summarizes recent advances in understanding the genetic architecture of BD, spanning early heritability and candidate gene studies through genome-wide and sequencing-based discoveries, and discusses the potential clinical implications of these findings.Current concepts: Family and twin studies have established the substantial heritability of BD, whereas early candidate gene approaches focusing on neurotransmitter and circadian pathways demonstrated limited reproducibility. In contrast, large-scale genome-wide association studies have identified numerous common risk variants implicating synaptic signaling, calcium channel function, and neurodevelopmental processes. Complementary exome and whole-genome sequencing studies have further uncovered rare variants and structural alterations contributing to disease risk. Epigenome-wide association studies additionally reveal how genetic variants interact with DNA methylation and chromatin accessibility to regulate transcription. Emerging multi-ancestry research, including studies involving Korean cohorts, has expanded understanding of both shared and population-specific loci. Functionally, BD risk genes converge on biological networks involved in neurotransmission, ion channel regulation, neurodevelopment, circadian rhythm regulation, and immune-inflammatory pathways.Discussion and conclusion: Despite these genomic advances, translation into routine clinical practice remains limited. Integrating genetic findings with multi-omics data and detailed clinical phenotypes may improve diagnostic precision, enhance prediction of treatment response (e.g., lithium efficacy and adverse drug reactions), and support the development of personalized psychiatry. Future research should prioritize cross-ancestry analyses, functional validation, and causal inference frameworks to bridge the gap between genetic discovery and clinical application.

Purpose: Radical cystectomy (RC) is associated with substantial postoperative morbidity, and unplanned readmission remains common despite advances in perioperative management. However, the association between postoperative readmission due to complications and oncologic outcomes after RC for bladder cancer has not been clearly defined. We evaluated the impact of postoperative readmission on overall survival (OS) and cancer-specific survival (CSS) after RC for bladder cancer. Materials and Methods: We retrospectively analyzed 3,972 patients who underwent RC for bladder cancer in a multicenter cohort. Postoperative readmission was defined as unplanned hospitalization within 90 days postsurgery due to surgery-related complications. Survival outcomes were assessed using the Kaplan-Meier method and compared using the log-rank test. Univariable and multivariable Cox proportional hazards regression analyses were performed to identify independent predictors of OS and CSS. Results: Among the study population, 916 patients (23.1%) experienced postoperative readmission. Baseline and perioperative characteristics were generally comparable between patients with and without readmission. Kaplan-Meier analyses demonstrated significantly worse OS and CSS among patients who experienced postoperative readmission (both log-rank p<0.001). In multivariable analyses adjusting for clinicopathological factors, postoperative readmission remained independently associated with worse OS (hazard ratio [HR], 1.654; 95% confidence interval [CI], 1.464–1.868; p<0.001) and CSS (HR, 1.761; 95% CI, 1.509–2.055; p<0.001). Conclusion Postoperative readmission within 90 days after RC was independently associated with inferior long-term oncologic outcomes. These findings suggest the importance of strategies aimed at preventing postoperative complications and subsequent readmission.

Background/Aims: This study aimed to investigate the influence of metabolic dysfunction-associated steatotic liver disease (MASLD) and body mass index (BMI) on the incidence of Alzheimer disease (AD) in the general South Korean population. Methods: The National Screening Program for Transitional Ages collected data from 66-year-old dementia-free Koreans in 2010 and 2011. MASLD was diagnosed based on the fatty liver index(≥30) and the presence of metabolic components, and overweight/obese status was defined as a BMI ≥23 kg/m 2 . The primary outcome was the development of AD up to December 2021.Multivariable Cox analyses were performed to evaluate whether the presence of MASLD or overweight/obese status influenced the risk of developing AD. Results: A total of 376,902 dementia-free individuals aged 66 years were included in this cohort. The participants were categorized into four groups: overweight/obese non-MASLD (30.4%, n=114,528), overweight/obese MASLD (37.0%, n=139,551), lean non-MASLD (29.9%, n=126,692), and lean MASLD (2.7%, n=10,131). During a mean follow-up period of 10.38±1.90 years, 23,874 individuals (6.3%) were newly diagnosed with AD. Compared to the overweight/ obese non-MASLD group, the adjusted hazard ratios (95% confidence interval) for AD in the lean MASLD, lean non-MASLD, and overweight/obese MASLD groups were 1.34 (1.24 to 1.45), 1.08 (1.04 to 1.13), and 1.13 (1.09 to 1.17), respectively. Conclusions A normal/underweight BMI and the presence of MASLD synergistically increased the risk of AD. The lean MASLD group had a higher risk of developing AD than the overweight/ obese MASLD group, suggesting that the clinical relevance of MASLD for incident AD differs based on the BMI.

BACKGROUND: Alveolar bone loss following trauma, periodontal disease, congenital anomalies, or tooth extraction poses a major challenge for oral rehabilitation, especially in implant dentistry. Traditional grafting techniques using autografts, allografts, or xenografts provide limited predictability due to issues of resorption, donor morbidity, and immune incompatibility. Advances in three-dimensional (3D) printing now enable preparation of patient-specific biodegradable scaffolds designed using 3D imaging, like cone beam computed tomography (CBCT) and computer-aided design (CAD), allowing precise replication of defect geometry and tailored biological performance. METHODS: This review article summarizes the most recent preclinical and clinical studies investigating biodegradable 3D printed scaffolds for alveolar bone regeneration. Studies were searched in the PubMed database, Scopus, and Google Scholar with the most relevant keywords related to 3D printed scaffolds focusing on alveolar bone regeneration. RESULTS: Polymers such as PLA, PCL, and PLGA offer mechanical stability and printability but require bioactive modification. Ceramics, including hydroxyapatite and tricalcium phosphate, provide osteoconductivity yet are brittle.Hydrogels such as gelatin and alginate support cellular viability but lack structural strength. Composite scaffolds integrating polymers with ceramics or bioactive agents demonstrated superior osteogenic potential. Clinical applications included alveolar ridge preservation, guided bone regeneration, cleft repair, and implant site reconstruction. Emerging strategies utilizing bioinks with stem cells and growth factors further enhanced the biological properties of patient-specific 3D printed scaffolds for clinical purposes. CONCLUSION 3D printed patient-specific biodegradable scaffolds represent a promising alternative to conventional grafting, offering precise defect reconstruction, improved biological integration, and translational potential in maxillofacial surgery. Continued optimization of material printing combinations and vascularization strategies will be critical to achieving long-term clinical success.

In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.

Abrupt vessel closure (AVC) is a complication of percutaneous coronary intervention (PCI) and is defined as the sudden cessation of forward coronary blood flow due to a variety of mechanisms. The incidence of AVC has markedly decreased from approximately 3.0% in the early era to about 0.3% today. Nevertheless, cardiovascular interventionists must remain prepared to manage AVC effectively, given its significant impact on clinical outcomes.AVC can arise from several mechanisms, including dissection, intramural hematoma, intracoronary thrombosis, air embolism, vasospasm, and no-reflow. The clinical impact of AVC varies depending on the extent of myocardium affected, ranging from asymptomatic events or transient ischemic chest pain to cardiogenic shock or cardiac arrest. Both a general approach for stabilizing hemodynamic consequences and an etiology-specific management strategy are essential. Hasty decision-making may worsen the situation, whereas a structured approach—focused on hemodynamic stabilization, logical diagnostic processes, and targeted interventions—can improve outcomes. In this narrative review, we describe the mechanisms underlying each etiology, outline mechanism-specific management strategies, and discuss general approaches to managing patients with AVC through logical diagnostic and treatment processes. We hope this review offers valuable insights into this uncommon but significant complication and enhances readers’ skills in managing AVC more effectively during PCI.

Background: Pregnant women are particularly vulnerable to oral diseases due to hormonal and behavioral changes, yet disparitiesin healthcare resources and limited access to structured oral health education persist. Plaque visualization technologies may improve self-awareness and encourage behavioral changes. Although digital education media are increasingly utilized, comparative evidence on their effectiveness and acceptability across modalities remains limited. This study aimed to compare the perceived effectiveness and preferences for plaque visualization-based digital oral health education media among pregnant women in Vietnam. Methods: In total, 497 pregnant women were recruited from obstetric and maternal health facilities in Vietnam. Participants useda mobile application with artificial intelligence-based dental plaque visualization and feedback once and viewed pregnancytailored infographics and video educational materials once. After exposure, they completed a structured post-intervention questionnaire assessing sociodemographic characteristics, self-reported periodontal symptoms, oral health behaviors, perceived effectiveness, satisfaction with each medium, and media preferences. Descriptive statistics were calculated, and t-tests were used to compare evaluation scores across media and preferences according to participant characteristics. Results: Overall, 85.1% of participants reported gingival problems during pregnancy. Media preference was highest for video-basededucation, followed by mobile applications and infographics. However, mobile applications received the highest scores for educational effectiveness. Internal consistency was acceptable to high across media (video α=0.81, infographic α=0.84, mobile application α=0.91), with the mobile application demonstrating the highest reliability. Preference for mobile applications was significantly higher among women aged 28∼34 years and those employed in the service and tourism sectors. Conclusion Perceived educational values and preferences varied by digital oral health education medium. Although video-basededucation was preferred for accessibility and initial understanding, plaque visualization-based mobile application education received higher ratings for supporting self-management and feedback. These findings suggest that a multimedia strategy integrating visual feedback technology with educational content may be effective for oral health promotion among pregnant women.