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: This study assessed the behavioral and cardiorespiratory effects of medetomidine (M) administered with and without tramadol (T) in horses. Methods: Eight horses were sedated intravenously with M (5 µg/kg) alone or with T (2 mg/ kg) in a arandomized, blind, two-way crossover trial. Behavioral responses, including head height above the ground (HHAG), postural instability (PI), and response to pressure stimulus (RPS), and cardiorespiratory responses, including vital variables and blood analyses, were assessed following administration. Results: There were no clinically meaningful differences in cardiorespiratory values, HHAG, or PI between the groups. The RPS score over the scapula was significantly higher in the medetomidine and tramadol (MT) group (p < 0.05) and a trend towards a higher RPS score over the femur was observed (p = 0.08) in the MT group. Heart rate decreased significantly below baseline from 10 to 40 min in both treatments. Conclusions and Relevance: These results suggest that the MT combination may provide sufficient sedation and analgesia with minimal cardiorespiratory changes in horses.

This case report documents the first standing laparoscopic cryptorchidectomy performed on a Jeju horse. A 3-year-old Jeju horse underwent the procedure after pre-operative fasting and sedation. Three portals were created:one for the laparoscope and two for instruments. The first undescended testis was located, double ligated for blood flow control, and then transected. Hemostasis was confirmed. The procedure was repeated for the other undescended testis. The time required for this procedure was approximately 2 hours. The horse was hospitalized overnight for monitoring before being discharged the following day. No complications were observed during or after surgery.

A 4-year-old thoroughbred mare was referred to the Jeju National University Equine Hospital as it exhibited stallion-like behavior and was unmanageable during training. A transrectal ultrasound revealed an enlarged left ovary. We decided on a standing laparoscopic ovariectomy through the left flank. Three portals were positioned to permit triangulation for optimal visualization with minimal incisions. The enlarged ovary was resected successfully. Histological examination confirmed the presence of a fibroma. The mare recovered without complications and returned to racing within 3 months post-surgery. The successful outcome seen in this mare indicates that laparoscopic surgery has multiple advantages, including faster recovery times and minimal scarring. This approach is recommended for mares presenting with ovarian fibromas, particularly those intended for a future career in athletics.

Purpose: Axillary surgery is increasingly omitted in patients with early-stage breast cancer undergoing upfront surgery, as supported by trials such as SOUND and INSEMA. However, in the neoadjuvant setting, the omission of axillary surgery has only been explored in small single-arm studies involving highly selected patients with confirmed breast pathologic complete response (pCR). The NeoNAUTILUS trial aimed to evaluate the oncologic safety of omitting sentinel lymph node biopsy (SLNB) in patients with a high probability of achieving an axillary pCR (ypN0) following neoadjuvant systemic therapy (NST), regardless of breast pCR status. Methods NeoNAUTILUS is a prospective, multicenter, randomized, controlled, noninferiority trial conducted at 12 tertiary centers in Korea. Eligible participants were women with clinical T1–T3, N0, or selected N1 invasive breast cancer, who completed NST and were candidates for breast-conserving surgery (BCS). Prior to enrollment, all patients underwent axillary ultrasound after NST completion to exclude suspicious lymph nodes. Patients with clinical N0 disease of any subtype were eligible for inclusion. Patients with clinical N1 disease with human epidermal growth factor receptor 2-positive or triple-negative tumors may be included if their primary tumor demonstrates a > 30% reduction on magnetic resonance imaging after NST. Participants were randomized 1:1 to undergo BCS with or without SLNB, stratified by clinical nodal status and tumor subtype. Patients were randomized and remained blinded until surgery. The primary endpoint is the 5-year invasive disease-free survival. A total of 464 patients are expected to be enrolled over 3 years, with a 5-year follow-up period.Discussion: NeoNAUTILUS is the first randomized trial to assess the omission of axillary surgery after NST based on the predicted nodal response, independent of breast pCR. This study may redefine axillary management in the neoadjuvant setting by identifying patients who can safely avoid SLNB, thereby reducing surgical morbidity without compromising oncologic outcomes.

Background: and Purpose The accurate prediction of functional outcomes in patients with acute ischemic stroke (AIS) is crucial for informed clinical decision-making and optimal resource utilization. As such, this study aimed to construct an ensemble deep learning model that integrates multimodal imaging and clinical data to predict the 90-day functional outcomes after AIS. Methods: We used data from the Korean Stroke Neuroimaging Initiative database, a prospective multicenter stroke registry to construct an ensemble model integrated individual 3D convolutional neural networks for diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR), along with a deep neural network for clinical data, to predict 90-day functional independence after AIS using a modified Rankin Scale (mRS) of 3–6. To evaluate the performance of the ensemble model, we compared the area under the curve (AUC) of the proposed method with that of individual models trained on each modality to identify patients with AIS with an mRS score of 3–6. Results: Of the 2,606 patients with AIS, 993 (38.1%) achieved an mRS score of 3–6 at 90 days post-stroke. Our model achieved AUC values of 0.830 (standard cross-validation [CV]) and 0.779 (time-based CV), which significantly outperformed the other models relying on single modalities: b-value of 1,000 s/mm2 (P<0.001), apparent diffusion coefficient map (P<0.001), FLAIR (P<0.001), and clinical data (P=0.004). Conclusion The integration of multimodal imaging and clinical data resulted in superior prediction of the 90-day functional outcomes in AIS patients compared to the use of a single data modality.

A seven-month pregnant 15-year-old Thoroughbred mare presented with acute abdominal pain to Jeju National University Equine Hospital. At presentation, a nasogastric intubation revealed 10 L of gastric reflux; rectal palpation and ultrasound revealed dilated loops and thickening of the walls of the small intestine. An exploratory laparotomy revealed strangulation of the small intestine due to a large abdominal mass. The mass was double-ligated and resected blindly due to the short pedicle. An enterectomy was not performed as intestinal motility was detected following the mass removal. Histopathological examination confirmed that the mass was a lipoma, measuring 24 cm × 16 cm × 16 cm in size. On day 8 post-surgery, the mare was discharged without complications. This case report describes the diagnosis and treatment of strangulation of the small intestine by a pedunculated lipoma, thus providing useful information on lipoma in horses.