1.Association between relative handgrip strength and glycemic control among male automobile manufacturing workers using vibration tools in South Korea
Dong-Jae SEO ; Hyun Joong KIM ; Yongjin KIM ; Jaewon MUN ; Jong-Han LEEM ; Shin-Goo PARK ; Dong-Wook LEE ; Hwan-Cheol KIM
Annals of Occupational and Environmental Medicine 2026;38(1):e14-
Background:
Although the association between handgrip strength and glycemic control has been reported, studies conducted exclusively within specific occupational groups remain limited. To explore the association between handgrip strength and metabolic health in industrial settings, this study examined the relationship between relative handgrip strength and glycated hemoglobin (HbA1c) among male automobile manufacturing workers using vibration tools in South Korea.
Methods:
Using 66,212 occupational health examination records collected at Inha University Hospital between January 2024 and April 2025, a total of 3,365 workers with HbA1c and handgrip strength measurements were identified. After excluding duplicates (n = 1,536), female workers (n = 2), and records without Hb and estimated glomerular filtration rate, 1,823 male participants were included in the final analysis. Relative handgrip strength was calculated as the maximum value of bilateral grip strength divided by body mass index. Multiple linear regression analyses were conducted to assess the association between relative handgrip strength and HbA1c, adjusting for age, smoking status, alcohol consumption, current hypertension, current dyslipidemia, current hypoglycemic-agents use, family diabetes history, leisure-time physical activity, and resistance exercise.
Results:
Relative handgrip strength was inversely associated with HbA1c levels (B: –0.060; 95% confidence interval [CI]: −0.081 to −0.039; p < 0.001). The association was strongest among normoglycemic participants (B: −0.185; 95% CI: −0.305 to −0.065; p = 0.003). Effect size was reduced but significantly associated among individuals with prediabetes (B: −0.115; 95% CI: −0.180 to −0.050; p < 0.001) and further attenuated to a borderline significance in individuals with diabetes (B: −0.023; 95% CI: −0.050 to 0.003; p = 0.082). These findings indicate that greater muscle strength relative to body size is related to better glycemic control.
Conclusions
Handgrip strength was associated with HbA1c levels in industrial workers. This study suggests that handgrip strength may provide complementary information on metabolic health in occupational settings.
2.Predictive Value of Insertion/Deletion Rate in Patients With Gastric Cancer Treated With Nivolumab Plus Chemotherapy
Hyung-Don KIM ; Hyungeun LEE ; Sun Young LEE ; Yuna LEE ; Jaewon HYUNG ; Meesun MOON ; Jinho SHIN ; Young Soo PARK ; Min-Hee RYU
Journal of Gastric Cancer 2026;26(2):219-231
Purpose:
Immune checkpoint inhibitor plus chemotherapy is the standard first-line treatment for advanced gastric cancer; however, predictive biomarkers for optimal patient selection remain unsatisfactory. This study was aimed at evaluating the predictive value of tumor mutational burden (TMB) and insertion/deletion (Indel) rate in patients with gastric cancer treated with nivolumab plus chemotherapy.
Materials and Methods:
This retrospective study included 132 patients with gastric cancer treated with first-line nivolumab plus chemotherapy and 185 patients treated with chemotherapy alone, all of whom had next-generation sequencing data available. The TMB and Indel cut-offs were set at 15.63 mutations per megabase and 18.19%, respectively, as determined based on their ability to best distinguish progression-free survival (PFS) among the patients who received nivolumab plus chemotherapy.
Results:
PFS was favorable for nivolumab and chemotherapy than for chemotherapy alone in both the high and low TMB groups; nevertheless, survival benefits were observed only in the high Indel group. Among the subgroups defined based on both TMB and Indel rates, the high TMB and high Indel rate subgroup showed the greatest benefit from nivolumab plus chemotherapy compared with that from chemotherapy alone. The benefit of this subgroup remained significant in patients with proficient mismatch repair (MMR) tumors, whose survival outcomes were comparable to those of patients with deficient MMR tumors.Among patients treated with nivolumab plus chemotherapy, high TMB and Indel rate were independently associated with favorable survival outcomes.
Conclusions
Thus, Indel rate, particularly in combination with TMB, may be a promising predictive biomarker for gastric cancer. However, further validation of their predictive value is warranted.
3.Association of Physical Activity with Dementia Risk in Cancer Survivors: A Korean Nationwide Cohort Study
Su Kyoung LEE ; Minji HAN ; Sangwoo PARK ; Sun Jae PARK ; Jihun SONG ; Hye Jun KIM ; Jaewon KIM ; Hyeokjong LEE ; Hyun-Young SHIN ; Kyae Hyung KIM ; Sang Min PARK
Cancer Research and Treatment 2026;58(1):48-60
Purpose:
This study aimed to investigate the impact of physical activity on dementia risk among cancer survivors in South Korea.
Materials and Methods:
This retrospective, population-based cohort study included 344,152 cancer survivors identified from the National Health Insurance Service database in South Korea. The mean follow-up time was 5.81 years. Different levels of physical activity post-cancer diagnosis, ranging from inactive to highly active, were assessed. The primary outcome was the incidence of overall dementia, Alzheimer’s disease, and vascular dementia. Secondary outcomes included dementia risk stratified by cancer type and treatment (chemotherapy and radiation).
Results:
Of the total participants, 24,363 (7.08%) developed dementia. The risk of overall dementia decreased sequentially across the exercise groups compared to the inactive group: insufficiently active (adjusted hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.86 to 0.92), active (adjusted HR, 0.85; 95% CI, 0.83 to 0.88), and highly active (adjusted HR, 0.79; 95% CI, 0.76 to 0.82). This inverse relationship between exercise and dementia risk was statistically significant across various cancer types and was consistent regardless of age, comorbidities, and whether or not excluding the first 1, 2 years.
Conclusion
Among cancer survivors in South Korea, increased physical activity post-diagnosis was associated with a significantly lower risk of dementia. These findings underscore the importance of promoting physical activity in cancer survivors for cognitive health.
4.Three Decades of Research Trends in Rhinology: A Bibliometric Analysis of the Journal of Rhinology
Jaewon KIM ; Subeen LEEM ; Yoonjae CHO ; Jieun SHIN ; Jong-Yeup KIM ; Sung Ryul SHIM
Journal of Rhinology 2026;33(1):29-36
Background and Objectives:
This study conducted a comprehensive bibliometric analysis of articles published in the Journal of Rhinology (JR), the official journal of the Korean Rhinologic Society, to examine research trends, thematic evolution, and emerging hotspots in rhinology.
Methods:
A total of 836 JR articles (1994–2025) were retrieved from PubMed and Research Information Sharing Service (RISS) after duplicate removal. The R bibliometrix package was used to perform keyword trend and thematic evolution analyses. VOSviewer was used to visualize keyword co-occurrence networks and temporal relationships between keywords. Gephi was used to calculate centrality measures, providing insight into the structural characteristics of the research network.
Results:
From 1994 to 2025, JR published an average of 26.6 articles per year, with publication activity increasing in recent years. Keyword and thematic analyses demonstrated that the research focus gradually shifted from basic disease- and anatomy-related topics and traditional clinical themes in the 2010s to functional conditions, infectious diseases, and increasingly surgical, procedural, and methodological research after 2020, while “rhinitis” and “sleep apnea syndromes” were consistently addressed. Co-occurrence analysis further identified “endoscopy” as a central keyword, highlighting its continued importance in JR research.
Conclusion
The articles published in JR encompass a broad spectrum of rhinology research, integrating disease pathophysiology, clinical applications, surgical techniques, and evidence-based approaches. These findings highlight evolving research trends and provide guidance for future domestic and international studies in rhinology.
5.Association of weight and dietary habits with high blood mercury levels in Korean adolescents: data from the KoNEHS cycle 4, 2018-2020
Ji Hoon KIM ; Minju JUNG ; Jaewon MUN ; Dong-Jae SEO ; Jong-Han LEEM ; Shin-Goo PARK ; Dong-Wook LEE ; Hyung Doo KIM ; Hwan-Cheol KIM
Annals of Occupational and Environmental Medicine 2025;37(1):e5-
Background:
Humans are exposed to mercury primarily in its highly toxic form, methyl mercury, which is known to have adverse effects on various organs and systems. The negative impact of mercury exposure on the growth, development, and mental health of children, from infancy to adolescence, is well-documented. However, there are no internationally standardized safe limits for mercury exposure. This study investigated the impact of dietary habits and higher body mass index (BMI) on blood mercury levels in adolescents.
Methods:
This study analyzed the data from the 4th Korean National Environmental Health Survey (KoNEHS) 2018–2020. The focus was on 825 middle and high school students aged 13–18 years, whose blood mercury levels were measured. A survey on dietary and lifestyle habits was also conducted. Blood mercury levels were categorized by geometric median values, and associations with overweight status and seafood consumption were examined using a generalized linear model.
Results:
The geometric mean blood mercury level for the entire sample was 1.37 μg/L, with levels of 1.31 μg/L in normal-weight individuals and 1.43 μg/L in overweight individuals, showing a statistically significant difference between the two groups. After adjusting for other variables, blood mercury levels were significantly associated with overweight status (estimate: 0.084; p = 0.018; 95% confidence interval [CI]: 0.015–0.153), consumption of large fish and tuna more than once a week (estimate: 0.18; p = 0.001; 95% CI: 0.077–0.284), and consumption of fish once a week or more (estimate: 0.147; p = 0.004; 95% CI: 0.043–0.250).
Conclusions
In adolescents, a higher BMI and an increased consumption of large fish, tuna, and fish were associated with higher blood mercury levels. Notably, a stronger association was found between large fish consumption and blood mercury levels in the overweight group. These findings suggest the need to moderate seafood consumption and establish more proactive mercury exposure standards for adolescents.
6.Treatment of a Large Gastric Phytobezoar With Coca-Cola, Cellulase, and Endoscopic Fragmentation in a Community Hospital
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):73-77
Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.
7.Treatment of a Large Gastric Phytobezoar With Coca-Cola, Cellulase, and Endoscopic Fragmentation in a Community Hospital
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):73-77
Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.
8.Treatment of a Large Gastric Phytobezoar With Coca-Cola, Cellulase, and Endoscopic Fragmentation in a Community Hospital
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):73-77
Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.
9.Treatment of a Large Gastric Phytobezoar With Coca-Cola, Cellulase, and Endoscopic Fragmentation in a Community Hospital
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):73-77
Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.
10.Treatment of a Large Gastric Phytobezoar With Coca-Cola, Cellulase, and Endoscopic Fragmentation in a Community Hospital
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):73-77
Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.

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