Objectives: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes. Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5460 ESD cases from 5250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

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.

Purpose: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Materials and Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes.Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Background: Ensuring reference material (RM) commutability is crucial for evaluating measurement traceability in order to standardize laboratory tests. However, commutability assessment is not routinely performed. We assessed whether RMs prepared following CLSI C37-A guidelines could be used without assessing commutability by evaluating their commutability for four lipid measurements using the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and CLSI EP14 protocols. Methods: We analyzed total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in frozen sera from 20 individuals and 11 RMs, prepared by the Korea Disease Control and Prevention AgencyLaboratory Standardization Project (per CLSI C37-A), using six routine measurement procedures (MPs). Regression equations and 95% prediction intervals derived from single-donor sera were analyzed following CLSI EP14. The IFCC protocol was used to assess differences in inter-MP biases between RM and clinical samples. The effect of the TG concentration on commutability was evaluated by analyzing biases between MP results and reference procedure-assigned values. Results: RMs were commutable for most MP pairs for TC and TG. Commutability for HDL-C and LDL-C varied across RMs, with RM10 and RM11 showing higher TG levels (2.38 and 2.95 mmol/L, respectively) and lower commutability. Increased bias percentages from assigned values were observed for RMs with higher TG levels. Conclusions RMs prepared per CLSI C37-A were commutable with most MP pairs for TC and TG. Elevated TG levels affected HDL-C and LDL-C commutability, highlighting the need to consider TG concentrations during RM preparation and assess commutability to standardize laboratory tests.

Background: PM2.5 (particulate matter less than 2.5 μm) causes various health problems. Recent studies suggest that long-term exposure to PM2.5 may have a negative impact on vision. This study examined the effects of long-term exposure to concentrations of PM2.5 exceeding Korean standards on myopia prevalence. Methods: This study was conducted on adults aged 40–69 years. The PM2.5 concentrations were calculated as the 1–5-year moving averages based on the participants' residential areas. The relationships between the PM2.5 levels, categorized by the annual average concentration standard in Korea, and the prevalence of myopia were analyzed using binary logistic regression. The results were evaluated using the 95% confidence interval. Results: PM2.5 concentrations averaged over 1–3 years were not significantly associated with the prevalence of myopia. On the other hand, the prevalence of myopia was significantly higher in areas where the 4–5-year moving average PM2.5 levels exceeded the Korean standards. These findings suggest that long-term exposure to PM2.5 may have a detrimental effect on vision. Conclusions This study revealed the impact of long-term PM2.5 exposure on the prevalence of myopia, highlighting the importance of managing PM2.5 levels. Nevertheless, further cohort studies focusing on adults and in-depth research into the effects of long-term exposure will be necessary.

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.

Purpose: Several types of dermal fillers have been recently introduced and used for penile augmentation (PA). However, few studies have compared outcomes after the injection of different fillers. This study aimed to compare the clinical outcomes of hyaluronic acid (HLA), polylactic acid (PLA), and polymethyl methacrylate (PMA) filler injections, which are the most commonly used for aesthetic purposes. Materials and Methods: This prospective study was conducted for 24 weeks after a filler injection by a surgeon between March 2017 and December 2021. Healthy adult men complaining of small penis were enrolled. Penile girth, satisfaction, and injection-associated adverse events (AEs) were assessed at baseline and 4, 12, and 24 weeks after injection. Results: Of the 301 men who received filler injections, 125, 134, and 42 received HLA, PLA, and PMA fillers, respectively. The augmentation effect was in the order of PMA, HLA, and PLA, respectively, at 24 weeks (PMA vs. HLA, p<0.001; HLA vs. PLA, p=0.006). Satisfaction levels increased significantly at 24 weeks in all groups (each with p<0.001). However, the increase in satisfaction levels was smaller in the PMA group (PMA vs. HLA or PLA, p<0.05, for both penile appearance and sexual life). No serious or systemic AEs were recorded. Filler injection-associated local AEs in the HLA, PLA, and PMA groups occurred in 9 (7.2%), 16 (11.9%), and 6 (14.3%) men, respectively. There was no significant difference in AEs among the groups (p=0.299). Conclusions The augmentative effect was greater in the PMA group than in the HLA and PLA groups, whereas the increase in satisfaction levels was smaller in the PMA group. Our study demonstrated the clinical course of different types of fillers and suggests that the filler type should be selected after detailed counseling considering individual characteristics and preferences.

Background: We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation. Methods: This study analyzed data from the 2014 and 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes, using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS. Results: Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients=0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS. Conclusion Nutritional intake was found to not be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.

Purpose: Since 1995, the Korean Gastric Cancer Association (KGCA) has been periodically conducting nationwide surveys on patients with surgically treated gastric cancer. This study details the results of the survey conducted in 2023. Materials and Methods: The survey was conducted from March to December 2024 using a standardized case report form. Data were collected on 86 items, including patient demographics, tumor characteristics, surgical procedures, and surgical outcomes. The results of the 2023 survey were compared with those of previous surveys. Results: Data from 12,751 cases were collected from 66 institutions. The mean patient age was 64.6 years, and the proportion of patients aged ≥71 years increased from 9.1% in 1995 to 31.7% in 2023. The proportion of upper-third tumors slightly decreased to 16.8% compared to 20.9% in 2019. Early gastric cancer accounted for 63.1% of cases in 2023.Regarding operative procedures, a totally laparoscopic approach was most frequently applied (63.2%) in 2023, while robotic gastrectomy steadily increased to 9.5% from 2.1% in 2014.The most common anastomotic method was the Billroth II procedure (48.8%) after distal gastrectomy and double-tract reconstruction (51.9%) after proximal gastrectomy in 2023.However, the proportion of esophago-gastrostomy with anti-reflux procedures increased to 30.9%. The rates of post-operative mortality and overall complications were 1.0% and 15.3%, respectively. Conclusions The results of the 2023 nationwide survey demonstrate the current status of gastric cancer treatment in Korea. This information will provide a basis for future gastric cancer research.