Objectives: To evaluate changes in probing depth, bleeding on probing, and three-dimensional plaque distribution after using an interdental brush for three months. Methods: This was a split-mouth design, examiner-blinded, randomized controlled trial. Fifteen patients were randomly assigned to use an interdental brush between their maxillary left or right 1st and 2nd premolar. They were instructed not to use an interdental brush on the opposite side for three months. Probing depth, bleeding on probing, bleeding on using an interdental brush, gingival recession, and plaque distribution were assessed at baseline and after three months. Results: After using an interdental brush for three months, 4.26±15.16% of plaque on interdental surfaces decreased. Bleeding on probing and bleeding on using an interdental brush also decreased by 16.67% and 40%, respectively. The size of interdental areas increased by 0.16 mm when using an interdental brush. There were no statistically significant changes in probing depth or gingival recession. Conclusions An interdental brush is an effective interdental cleaning aid that reduces interdental plaque and decreases inflammation of interdental soft tissues.

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: This study evaluated the use of brainstem score (BSS) on pre-procedural diffusion-weighted imaging (DWI) to predict outcomes after mechanical thrombectomy (MT) in acute basilar artery occlusion (ABAO) patients and compared its predictive effectiveness to the critical area perfusion score (CAPS) on perfusion magnetic resonance imaging (MRI) using RAPID. Methods: This study focused on ABAO patients who underwent MT after MRI at Dong-A University Hospital from 2013 to 2023. Ischemic lesion volume and DWI BSS were measured for all. For the group that underwent perfusion MRI using RAPID, CAPS were measured. The primary end point was a poor outcome at 90 days (modified Rankin scale [mRS], >2). Results: 71 patients had ABAO and underwent MT after MRI. The poor outcome group (66.2%) had significantly larger ischemic lesion volume and higher DWI BSS compared with the good outcome group. In the multiple logistic regression analysis, DWI BSS (odds ratio, 8.27; 95% confidence interval, 1.93-35.50; p<0.01) was an independent predictor of poor outcomes. In 26 patients, CAPS was measured on perfusion MRI. In this subgroup, poor outcome group (50.0%) had higher DWI BSS and CAPS than the good outcome group. In the multiple logistic regression analysis, DWI BSS remained a valid independent predictor for predicting outcomes, but CAPS did not function as an independent predictor. Conclusion In this study, the DWI BSS before MT in ABAO patients emerged as a useful imaging marker for predicting post-procedural outcomes. Its predictive ability is not only comparable to but even superior to CAPS on perfusion MRI.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H.pylori infection in Korea. Methods: This interim report describes the adherence to the revised guidelines and their impact on firstline eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form. Results: A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed.The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001). Conclusions The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.

Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.

Objectives: To evaluate changes in probing depth, bleeding on probing, and three-dimensional plaque distribution after using an interdental brush for three months. Methods: This was a split-mouth design, examiner-blinded, randomized controlled trial. Fifteen patients were randomly assigned to use an interdental brush between their maxillary left or right 1st and 2nd premolar. They were instructed not to use an interdental brush on the opposite side for three months. Probing depth, bleeding on probing, bleeding on using an interdental brush, gingival recession, and plaque distribution were assessed at baseline and after three months. Results: After using an interdental brush for three months, 4.26±15.16% of plaque on interdental surfaces decreased. Bleeding on probing and bleeding on using an interdental brush also decreased by 16.67% and 40%, respectively. The size of interdental areas increased by 0.16 mm when using an interdental brush. There were no statistically significant changes in probing depth or gingival recession. Conclusions An interdental brush is an effective interdental cleaning aid that reduces interdental plaque and decreases inflammation of interdental soft tissues.

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: This study evaluated the use of brainstem score (BSS) on pre-procedural diffusion-weighted imaging (DWI) to predict outcomes after mechanical thrombectomy (MT) in acute basilar artery occlusion (ABAO) patients and compared its predictive effectiveness to the critical area perfusion score (CAPS) on perfusion magnetic resonance imaging (MRI) using RAPID. Methods: This study focused on ABAO patients who underwent MT after MRI at Dong-A University Hospital from 2013 to 2023. Ischemic lesion volume and DWI BSS were measured for all. For the group that underwent perfusion MRI using RAPID, CAPS were measured. The primary end point was a poor outcome at 90 days (modified Rankin scale [mRS], >2). Results: 71 patients had ABAO and underwent MT after MRI. The poor outcome group (66.2%) had significantly larger ischemic lesion volume and higher DWI BSS compared with the good outcome group. In the multiple logistic regression analysis, DWI BSS (odds ratio, 8.27; 95% confidence interval, 1.93-35.50; p<0.01) was an independent predictor of poor outcomes. In 26 patients, CAPS was measured on perfusion MRI. In this subgroup, poor outcome group (50.0%) had higher DWI BSS and CAPS than the good outcome group. In the multiple logistic regression analysis, DWI BSS remained a valid independent predictor for predicting outcomes, but CAPS did not function as an independent predictor. Conclusion In this study, the DWI BSS before MT in ABAO patients emerged as a useful imaging marker for predicting post-procedural outcomes. Its predictive ability is not only comparable to but even superior to CAPS on perfusion MRI.