The da Vinci Single-Port (SP) robotic system (Intuitive Surgical) was developed to enable true single-incision surgery while preserving the dexterity and precision of advanced robotic platforms. Since its clinical introduction, the SP system has generated growing interest in colorectal surgery, particularly for procedures performed in anatomically confined spaces.However, clinical evidence remains limited and heterogeneous. This narrative review summarizes the current clinical applications, technical considerations, and perioperative outcomes of the da Vinci SP system in the treatment of colorectal cancer. Available literature—predominantly from South Korea and selected centers in the United States—suggests that SP surgery is technically feasible for both colon and rectal cancer. In colon cancer, outcomes appear comparable to conventional laparoscopic and multiport robotic approaches, albeit with longer operative times during early experience. In rectal cancer, SP surgery demonstrates distinct technical advantages, including single docking, reduced incision burden, and favorable short-term outcomes, particularly for low anterior resection and intersphincteric resection. Pathologic outcomes, including lymph node yield and resection margins, are oncologically acceptable across reported series.While early results support the safety and feasibility of SP colorectal surgery, long-term oncologic outcomes and highlevel comparative evidence remain lacking. Further prospective studies are warranted to define optimal indications and establish the long-term value of this emerging platform.

Genetic variation in the leptin receptor (LEPR) gene has been implicated in metabolic regulation, while the gut microbiome and circulating metabolites are increasingly recognized as mediators of host metabolic phenotype. However, the systems-level interactions among LEPR genotypes, gut microbial composition, and serum metabolomic profiles remain poorly understood, particularly in healthy individuals. We conducted a cross-sectional study involving 37 healthy Korean adults. Three LEPR single nucleotide polymorphisms (rs1137101, rs1173100, rs790419) were genotyped. Untargeted metabolomics of fasting serum was performed using gas chromatography–time-of-flight mass spectrometry, and gut microbiome composition was profiled by 16S rRNA gene sequencing. Statistical analysis included principal component analysis, Mann–Whitney U tests, and Spearman correlations. Network analysis integrating microbiome, metabolomic, and clinical phenotype data was conducted using Cytoscape. A total of 54 serum metabolites were identified. LEPR genotypes, particularly rs1137101 and rs1173100, were associated with differences in metabolites such as pimelic acid, malonic acid, and 2,4-dihydroxybutyric acid. Firmicutes negatively correlated with saturated fatty acids and organic acids, whereas Actinobacteria positively correlated with cholesterol and amino acids. Network analysis revealed indole-3-acetate and cholesterol as central nodes linking microbial taxa with body mass index and leptin levels. However, no direct molecular pathways connecting leptin or its receptor were identified. LEPR genetic variation is associated with distinct serum metabolomic patterns and microbiome–host networks in healthy adults. Although no direct leptin signaling links were found, network-level associations suggest indirect genetic influences on metabolic states through microbiome–metabolome interactions.These findings advance understanding of personalized metabolic regulation and gene–microbiome interplay.

Objective: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest, but its prognostic determinants in emergency department (ED) settings remain unclear. This study investigated the predictors of survival and the prognostic value of lactate and bilirubin in ECPR patients treated at a single university hospital. Methods: Adult ECPR patients treated in a single university hospital ED from 2018 to 2023 were reviewed retrospectively. The clinical variables, laboratory markers, and procedural factors were collected from medical records. Univariate and multivariate logistic regression analyses were performed, and lactate/bilirubin were assessed by quartiles to examine the dose-response trends. Results: Fifty-eight patients were included, of whom 25 (43.1%) survived to discharge. Older age, higher lactate, and elevated bilirubin were associated with mortality, and all three remained independent predictors in multivariate analysis (age odds ratio [OR], 0.93; lactate OR, 0.97; bilirubin OR, 0.41). Survival declined markedly across the lactate (68.8%→0%) and bilirubin quartiles (60.0%→13.3%; P for trend <0.01). The cardiopulmonary resuscitation (CPR) to extracorporeal membrane oxygenation (ECMO) time was shorter in the survivors than the non-survivors (39.9±18.9 min vs. 51.8±23.2 min; P=0.069), whereas the door to ECMO time did not differ. Conclusion Higher lactate and bilirubin concentrations, advanced age, and prolonged CPR to ECMO time were independently associated with poor outcomes after ECPR. Early ECMO initiation and prompt metabolic correction may improve survival in cardiac arrest patients receiving ECPR in the ED.

This study examines the impact of medical artificial intelligence (AI) on physician workload and the quality of patient care. A meta-analysis of empirical studies found that AI significantly reduces physician workload and diagnostic time by automating repetitive interpretation and documentation processes, freeing clinicians to focus solely on patients. Automated generative AI-based electronic medical record systems reduce documentation time by approximately 40%, while voice recognition and AI scribing technologies reduce patient charting time by 28.8%. This reduces administrative burden, a major cause of physician burnout, by more than 30%. In radiology, AI-based interpretation reduced the interpretation time for abnormal contrast-enhanced brain CT lesions by 11.23%, the interpretation time for lung lesions by 52.82%, and the analysis time for peripheral blood smears by 61%. Importantly, these time savings occur naturally and, in some cases, improve diagnostic accuracy for major diseases (e.g., lung nodules, brain lesions, and breast cancer). Furthermore, AI minimizes the workload of interpretation through its automatic filtering function. This includes a 77.4%–86.7% reduction in review time for pulmonary nodules, a 51.3%–72.9% reduction in endometrial slide screening time, and an 86% saving in manual review time for epilepsy electroencephalography evaluation. These findings confirm that AI is establishing itself as a reliable tool that simultaneously improves physician efficiency, diagnostic efficiency, and clinical accuracy. Therefore, future healthcare policies regarding AI should not simply focus on expanding the workforce, but should adopt a strategic approach, optimizing resource efficiency and building a more resilient healthcare system.

Background and Objectives: Cardiac arrhythmia is highly prevalent in hypertrophic cardiomyopathy (HCM), but its relation to genotype has not been well established.We investigated the arrhythmia manifestations according to genotype in HCM patients. Methods: This single-center, retrospective study included 119 patients with HCM who underwent genetic testing using a next-generation sequencing panel. Incidence of cardiac arrhythmias and long-term outcomes were analyzed according to the presence of pathogenic variants (PVs). Results: PVs related to HCM were identified in 45 (37.8%) patients. Presentation of sustained ventricular tachycardia (VT) prior to HCM diagnosis was more prevalent in the PV-positive group. During a median follow-up of 45.9 months, the incidence of sustained VT was significantly higher in the PV-positive group (11.1% vs. 1.4%, hazard ratio, 8.71; 95% confidence interval, 1.02–74.61). A new implantable cardioverter defibrillator insertion rate was comparable in the 2 groups, but appropriate shocks were delivered in only 4 patients in the PV-positive group (8.9% vs. 0%, P = 0.037). Incidence of bradyarrhythmias requiring pacemaker and new-onset atrial fibrillation (AF) was not significantly different between the 2 groups. Among 56 patients with AF, there was no significant difference in treatment strategies in the 2 groups. However, sinus rhythm was maintained over the last 6 months of follow-up in 4/17 (23.5%) patients in the PV-positive group and 24/39 (61.5%) patients in the PV-negative group (P = 0.031). Conclusions Patients with PVs related to HCM exhibited higher incidence of life-threatening VTs. While overall AF incidence was similar between the groups, the presence of PVs was significantly associated with poorer rhythm outcomes of AF.

suggest that some reproductive factors associated with BC differ across ethnicities and time trends, perhaps due to the prevalence of reproductive factors and the baseline hazard of BC.

Piezo2, a mechanosensitive ion channel, serves as a crucial mechanotransducer in dental primary afferent (DPA) neurons and is potentially involved in hypersensitivity to mild mechanical irritations observed in dental patients. Given Piezo2's widespread expression across diverse subpopulations of DPA neurons, this study aimed to characterize the mechanosensory properties of Piezo2-expressing DPA neurons with a focus on distinct features of voltage-gated sodium channels (VGSCs) and neuropeptide profiles. Using whole-cell patch-clamp recordings, we observed mechanically activated action potentials (APs) and classified AP waveforms based on the presence or absence of a hump during the repolarization phase. Single-cell reverse transcription polymerase chain reaction combined with patch-clamp recordings revealed specific associations between AP waveforms and molecular properties, including tetrodotoxin-resistant VGSCs (Na_V1.8 and Na_V1.9) and TRPV1 expression. Reanalysis of the transcriptomic dataset of DPA neurons identified correlations between neuropeptides-including two CGRP isoforms (α-CGRP and β-CGRP), Substance P, and Galanin-and the expression of Na_V1.8 and Na_V1.9, which were linked to defined AP subtypes. These molecular associations were further validated in Piezo2⁺ DPA neurons using fluorescence in situ hybridization. Together, these findings highlight the electrophysiological and neurochemical heterogeneity of Piezo2-expressing DPA neurons and their specialized roles in distinct mechanosensory signal transmission.
Ion Channels/physiology* ; Mechanotransduction, Cellular/physiology* ; Animals ; Neurons, Afferent/metabolism* ; Patch-Clamp Techniques ; Mice ; TRPV Cation Channels/metabolism* ; Action Potentials ; Rats

We explored the utility of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) sequencing as a noninvasive diagnostic tool for detecting central nervous system (CNS) involvement in patients with diffuse large B-cell lymphoma (DLBCL). Secondary CNS involvement in DLBCL, although rare (~5% of cases), presents diagnostic and prognostic challenges during systemic disease progression or relapse. Effective treatment is impeded by the blood–brain barrier. This was a prospective cohort study (Samsung Lymphoma Cohort Study III) involving 17 patients with confirmed CNS involvement. High-throughput sequencing was conducted using targeted gene panels designed to detect low-frequency variants and copy number alterations pertinent to lymphomas in ctDNA extracted from archived CSF samples. Despite challenges such as low DNA concentrations affecting library construction, the overall variant detection rate was 76%. Detected variants included those in genes commonly implicated in CNS lymphoma, such as MYD88. The study highlights the potential of CSF ctDNA sequencing to identify CNS involvement in DLBCL, providing a promising alternative to more invasive diagnostic methods such as brain biopsy, which are not always feasible. Further validation is necessary to establish the clinical utility of this method, which could significantly enhance the management and outcomes of DLBCL patients with suspected CNS involvement.

Background: Circulating tumor DNA (ctDNA) profiling from peripheral blood allows relatively noninvasive monitoring of solid tumors; however, its utility post-surgery or chemotherapy in colorectal cancer remains underexplored. We evaluated the clinical implications of a ctDNA next-generation sequencing (NGS) panel post-surgery or chemotherapy in patients with colorectal cancer. Methods: We collected samples from 23 patients with colorectal cancer (17 men, median age 65 yrs) at baseline and post-surgery or chemotherapy at the National Cancer Center, Korea, between January 2021 and September 2023. ctDNA was analyzed using an NGS panel including 46 genes, and variant allele frequencies (VAFs) were determined. Followup samples were analyzed using the NGS panel or droplet digital PCR (ddPCR) when probes were available. Clinical status was compared with ctDNA results, and survival was analyzed using a time-dependent Cox model. Results: Mutations were identified in 13 out of 14 patients (92.8%) with stage II/III cancer and in all nine patients (100%) with stage IV cancer. Mutations were detected in KRAS (N = 15, 65%), APC (N = 8, 35%), TP53 (N = 7, 30%), PIK3CA (N = 5, 22%), and RET (N = 4, 17%). A 1% increase in KRAS and TP53 VAFs was associated with 48% and 32% increased mortality risk, respectively. Changes in VAF correlated well with clinical findings. Conclusions The detection of and an increase in KRAS and TP53 VAFs were associated with poor prognosis. ddPCR-based ctDNA monitoring results were comparable to those obtained with the NGS panel. ctDNA monitoring during treatment is clinically informative in managing colorectal cancer.