Purpose: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality, necessitating the identification of novel therapeutic targets. The E3 ubiquitin ligase WW domain-containing E3 ubiquitin protein ligase 2 (WWP2) has been implicated in various cancers, yet its specific role and underlying molecular mechanisms in CRC are poorly understood. This study aimed to investigate the functional role of WWP2 in CRC progression and to elucidate its regulatory mechanisms. Methods: WWP2 expression was evaluated in CRC patient tissues and cell lines using immunohistochemistry, quantitative real-time polymerase chain reaction, and western blotting. The biological functions of WWP2 were assessed using in vitro assays for cell proliferation, migration, and invasion following adenovirus-mediated overexpression. The molecular mechanism was investigated by analyzing the protein expression levels of p53 and its downstream target, p21, via western blot. An in vivo xenograft mouse model was used to confirm the oncogenic role of WWP2. Results: WWP2 expression was significantly upregulated in CRC tissues. Overexpression of WWP2 promoted CRC cell proliferation, migration, and invasion. Mechanistically, increased WWP2 expression led to a marked reduction in the protein levels of the tumor suppressor p53. Consequently, the expression of the p53 downstream target, the cell cycle inhibitor p21, was also suppressed. In the xenograft model, WWP2 overexpression significantly enhanced tumor growth. Conclusion Our findings demonstrate that WWP2 functions as an oncogene in CRC. It promotes cancer progression by destabilizing the tumor suppressor p53 and downregulating p21. This study highlights the WWP2-p53-p21 axis as a potential novel therapeutic target for CRC.

Purpose: Molecular characteristics of synchronous colorectal cancers (SCRCs) remain incompletely elucidated, despite their importance in targeted therapy selection. We compared the molecular characteristics and somatic mutations between SCRCs. Materials and Methods: This retrospective study (2012-2014) included 98 consecutive patients with surgically resected SCRCs. Molecular characteristics, including microsatellite instability (MSI) and tumor-infiltrating lymphocytes (TILs), were analyzed for all cancer lesions. The intertumoral heterogeneity of SCRCs was evaluated using whole-exome sequencing (WES) for 18 cancers from nine patients with at least one MSI-high (MSI-H) tumor. Results: Twelve patients had at least one MSI-H tumor; five showed discordant MSI status. Mucinous adenocarcinoma frequency and TIL density were higher in patients with at least one MSI-H tumor than in those with only microsatellite-stable tumors. WES revealed that, except one patient (6.5%), most synchronous cancers shared few variants in each patient (0.09%-0.36%). The concordance rates for BRAF, KRAS, NRAS, and PIK3CA, in synchronous cancers from each patient were 66.7%, 66.7%, 66.7%, and 55.6%, respectively. Conclusion Although synchronous cancers shared a mutated gene, the mutation subtypes differed. SCRCs exhibited 5.1% MSI status discordance rate and a high discordance rate in somatic mutational variants. As intertumoral heterogeneity may affect the targeted therapy response, molecular analysis of all tumors is recommended for patients with SCRCs.

Purpose: This study aimed to evaluate the role of hepatic resection in patients with objective responses after combined transarterial chemoembolization (TACE) and radiotherapy (RT) for hepatocellular carcinoma (HCC) with macroscopic vascular invasion (MVI). Materials and Methods: We retrospectively reviewed the patients treated with combined TACE and RT for HCC with MVI between 2010 and 2015. Some of the patients with objective responses underwent hepatic resection or liver transplantation; to investigate the impact of surgery, patients with objective responses who did not undergo surgery were selected as the control group. Survival outcomes were compared using a propensity score–based stabilized inverse probability of treatment weighting method. Results: Out of the 170 patients with objective responses after combined TACE and RT, 41 patients underwent surgery, including eight liver transplantations. The unweighted surgery group was younger and had a higher proportion of solitary tumors and unilateral vascular involvement. After adjustment, the 3-year overall survival (OS) rates were 61.0% and 28.6% in the surgery and non-surgery groups, respectively. The most important prognostic factor for OS was surgery (adjusted Cox hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.17 to 0.46; p < 0.001). Complete response after TACE and RT (vs. partial response) was also a significant prognostic factor for OS (adjusted HR, 0.41; 95% CI, 0.27 to 0.61; p < 0.001). There was no surgical mortality. Four patients (9.8%) required additional surgery due to bleeding or graft failure. Conclusion Hepatic resection was significantly associated with improved OS in patients who showed objective responses after receiving combined TACE and RT for HCC with MVI.

The COVID-19 pandemic has adversely affected the mental health of the global population. This study aimed to assess the acute and persistent symptoms of depression, as well as factors related to their manifestation, through a longitudinal study design. A total of 1,492 community-dwelling adults from an online public panel across three regions were evaluated at baseline, with 908 adults (60.9%) followed up after six months. Depression symptoms were evaluated using Patient Health Questionnaire-9 (PHQ-9). Participants also completed self-administered questionnaires on sociodemographic information, psychosocial experiences related to COVID-19, the UCLA Loneliness Scale, and the Korean version of the Gratitude Questionnaire (K-GQ-6).The prevalence of acute and persistent depression symptoms was 8.4% and 12.0%, respectively. Multivariate logistic regression analysis identified changes in predictors of depression over time, with younger age and self-isolation experience found to be associated with acute depression. Factors such as underlying mental illness, eating and sleeping disturbances, loneliness, and COVID-19-related stress emerged as significant risk factors for persistent depression. A disposition toward gratitude was identified as a protective factor for persistent depressive symptoms. These findings suggest that during any long-term pandemic crisis such as COVID-19, timely support and attention are essential for vulnerable populations, including young people and individuals with mental health conditions, to prevent depression. Specifically, promoting daily routines such as regular eating and sleeping patterns, and managing COVID-19-related stress may be critical in preventing persistent depression. Additionally, psychological support that reduces loneliness and fosters gratitude may help mitigate depression risk.

Objectives: This study aimed to investigate the impact of behavioral and psychological symptoms (BPS), assessed by the neuropsychiatric inventory (NPI) total score, on instrumental activities of daily living (IADL) performance in patients with mild cognitive impairment. Methods: Ninety-two patients diagnosed with mild cognitive impairment who visited a university hospital dementia clinic were recruited. Assessments included the Korean version-Mini Mental State Examination, NPI, Korean-IADL (KIADL), and Short Form of Geriatric Depression Scale-Korean version. Correlation and hierarchical multiple regression analyses were performed to analyze the relationship between BPS and IADL. Results: The mean age of participants was 74.61±5.86 years. K-IADL scores significantly correlated with age (r=0.347, p<0.001) and NPI total score (r=0.265, p<0.05). Hierarchical regression analysis showed that the addition of the NPI total score significantly increased the explained variance of functional decline (R 2 =0.197, F=5.332, p<0.001), with age (β=0.354, p<0.001) and NPI total score (β=0.248, p<0.05) identified as independent predictors in patients with mild cognitive impairment. Conclusions The overall severity of BPS exerts a detrimental effect on IADL function in mild cognitive impairment patients, independent of age and cognitive status. These results underscore the clinical importance of evaluating the cumulative burden of BPS to predict functional prognosis and implement early interventions.

Background: Rosacea is a chronic inflammatory skin disorder characterized by erythema, papules, ocular symptoms, and heightened sensitivity. Patients with neurogenic symptoms such as burning or stinging remain particularly difficult to manage. Current guidelines often underrepresent energy-based devices (EBDs), pigmentary sequelae, psychosocial burden, and ocular comorbidities. Objective: To examine Korean dermatologists’ expert perspectives on rosacea management, focusing on skin sensitivity, neurogenic symptoms, pigmentary changes, psychosocial impact, ocular involvement, and EBD use. Methods: A web-based, 29-item survey was administered to 25 board-certified Korean dermatologists (May–June 2025). Quantitative and qualitative responses were analyzed. Results: Erythematotelangiectatic and papulopustular phenotypes with sensitivity skin predominated. EBDs (pulsed dye laser, intense pulsed light) were frequently used but limited by cost and sensitivity issues. Neurogenic symptoms were recognized but rarely treated with neuromodulators. Post-inflammatory hyperpigmentation was infrequent, yet monitoring was inconsistent.Psychosocial and ocular aspects were acknowledged but seldomly systematically addressed.Respondents expressed interest in emerging adjunctive treatments such as cold plasma, skin boosters, and holistic care approaches. Conclusion Korean dermatologists adopt individualized strategies for rosacea, yet practice gaps remain regarding neurogenic symptoms, pigmentary complications, and psychosocial and ocular comorbidities. Findings support the need for updated multidisciplinary, phenotype-driven guidelines aligned with real-world practice.

Older adults living alone face challenges in managing diabetes, yet research on glycemic control in this group is limited. This study analyzed data from the Korean National Health and Nutrition Examination Survey (2016~2021) to identify factors associated with glycemic control in 453 older adults with diabetes living alone. Methods: Glycemic control was categorized as good (glycated hemoglobin [HbA1c]<7.0%) or poor (HbA1c≥7.0%). Complex sample logistic regression examined demographic, disease and health-related, behavioral, and psychological factors associated with glycemic control. Results: Older adults aged ≥80 years had better glycemic control than those aged 65~69 years, while a diabetes duration of ≥15 years and higher body mass index were linked to poorer control. Strength training 5~7 days per week was associated with better control, whereas non-adherence to a healthy diet was unexpectedly linked to better outcomes. Conclusion: These findings highlight the need for tailored interventions to improve diabetes self-management and support healthy aging among older adults living alone. They also offer practical insights into shaping community-based health programs and social support systems for this population.

Purpose: This study aimed to evaluate age- and sex-specific dietary vitamin B12 intake among Koreans, assess adequacy relative to the 2025 Korean Dietary Reference Intakes, and identify major food groups using nationally representative data from the 2022–2024 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Data from 19,191 participants in the KNHANES 2022–2024 aged1 year and older were analyzed after excluding individuals with extreme energy intake values. Individual vitamin B12 intake was calculated based on 24-hour dietary recall data using the Korean National Standard Food Composition Database (version 10.3). Intake levels were evaluated against age- and sex-specific Estimated Average Requirement (EAR) and Recommended Nutrient Intake (RNI) values. Complex sample general linear models and cross-tabulation analyses were conducted to examine differences in intake and adequacy. Results: The mean vitamin B12 intake of the study population was 8.27 μg/day, exceeding the RNI in most age groups. The proportion of individuals meeting or exceeding the RNI was generally high; however, the prevalence of intake below the EAR increased with age, particularly among older women, approximately 35% of whom were at risk of inadequate intake. Animal-based foods, including fish and shellfish, meat, eggs, and dairy products, were the primary contributors to vitamin B12 intake. Adults and older adults with intake below the RNI consumed significantly lower amounts of these food groups compared with those meeting the RNI. Conclusion Although overall vitamin B12 intake among Koreans appears sufficient, older adults remain at increased risk of insufficient intake. Continuous monitoring of vitamin B12 nutritional status and targeted dietary strategies, with a focus on older populations, is warranted to prevent potential deficiencies.

Although venous invasion (VI) is associated with distant metastasis and observed in >50% of pT2–4 colorectal cancers (CRCs), the role of VI in pT1 CRCs is not well-defined. Methods: Thirty-four surgically resected pT1 CRCs were reevaluated for 2-dimensional (2D) VI using hematoxylin and eosin (H&E)–stained slides with additional elastic and desmin immunohistochemical staining (cohort A). Additionally, 27 pT1 CRCs without knowing VI status were selected for 3-dimensional (3D) VI evaluation only (cohort B). All 61 cases (cohorts A and B) were studied in 3D using tissue clearing. Results: VI was detected more commonly in 3D (17/34, 50.0%) than in 2D H&E slide evaluation (9/34, 26.5%, p = .047). When VI was identified in 3D (27/61, 44.3%), the most common phase was that of intraluminal growth (22/27, 81.5%), followed by intravasation (7/27, 25.9%) and extravasation (5/27, 18.5%). E-cadherin expression was characterized in 3D in foci of VI and varied in each phase of invasion. Conclusions: All three phases were observed in VI of pT1 CRCs. The extravasation of neoplastic cells from foci of VI in pT1 CRC suggests that VI could be a route of intratumoral spreading in a subset of pT1 CRCs.