Background/Aims: Early detection and removal of colon polyps are critical for preventing colorectal cancer. Computer-aided detection (CADe) systems have been introduced to increase the polyp detection rate (PDR) during colonoscopy, potentially enhancing its effectiveness. This study aimed to evaluate the efficacy of a CADe system in colorectal neoplasm detection. Methods: This prospective, randomized controlled trial was conducted at two tertiary centers (May 2023 to April 2025). Patients were randomly assigned to CADe or conventional colonoscopy and underwent screening, surveillance, or diagnostic colonoscopy. The primary endpoint was the adenoma detection rate (ADR), while the secondary endpoints were the PDR, relative risk (RR) of polyp detection, adenomas per colonoscopy (APC), and factors influencing adenoma detection. Results: Of 1,004 enrolled patients, 998 were randomly allocated into CADe and conventional colonoscopy groups (497 CADe system and 501 conventional colonoscopy). The CADe group had greater polyp counts (2.2 per colonoscopy vs 1.4 per colonoscopy; p<0.001) and APC values (1.2 vs 0.8; p<0.001). The CADe group showed significantly higher PDRs (72.2% vs 54.5%;p<0.001; RR, 2.173; 95% confidence interval [CI], 1.669 to 2.828) and ADRs (52.3% vs 36.1%;p<0.001; RR, 1.940; 95% CI, 1.505 to 2.499). CADe also significantly increased the detection rate of hyperplastic polyps (p=0.007; RR, 1.474; 95% CI, 1.113 to 1.952) and increased the detection rates across all sizes and locations. In multivariable analysis, CADe use was the strongest independent predictor of adenoma detection (odds ratio, 1.914; 95% CI, 1.467 to 2.496), outweighing male sex, older age, diagnostic indication, and withdrawal time. Conclusions Real-time CADe-assisted colonoscopy significantly increased PDR and ADR and proved to be a strong independent predictor of adenoma detection (cris.nih.go.kr, KCT0009664).

Background: Previous studies have shown various positive associations between the usual source of care (USC) and medication adherence in chronic diseases. However, no studies specifically on patients with diabetes have been conducted in Korea. This study examined the association between the USC type and medication adherence in patients with diabetes. Methods: Data from the 2021 Korea Health Panel Survey were used. The final sample comprised 1,493 participants aged ≥20 years. The types of USC were categorized into three groups: no USC, place only (without a regular doctor [RD]), and RD. Medication adherence was assessed using detailed items (dose, frequency, time, and discontinuation) and a four-point Likert scale. Logistic regression analysis was conducted with adjustment for control variables. Results: The odds ratios (ORs) for overall medication adherence were significantly higher in the RD group at 1.66 (95% confidence interval [CI], 1.15– 2.40) than in the no-USC group. No significant difference was observed in the place-only group at 0.73 (95% CI, 0.49–1.09). The ORs for medication adherence for each item (dosage, frequency, and timing) were also significantly higher in the RD group (2.21, 1.95, and 1.67, respectively). No statistically significant differences in these parameters were observed in the place-only group. Conclusion The presence of an RD positively affected medication adherence in patients with diabetes, but the presence of place-only did not. These findings emphasize the importance of an RD for medication adherence.

Purpose: Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones. Methods: This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded. Results: Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes vs. 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL vs. 49.1 mL, P = 0.661), open conversion rate (2.9% vs. 0%, P = 0.461), postoperative complication (15.3% vs. 22.2%, P = 0.430), and postoperative hospital stay (6.5 days vs. 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% vs. 13.6%, P = 0.477), hospital stay (6.4 days vs.7.3 days, P = 0.607), and recurrence (50.0% vs. 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% vs. 81.8%, P = 0.057). Conclusion Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.

Purpose: Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones. Methods: This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded. Results: Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes vs. 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL vs. 49.1 mL, P = 0.661), open conversion rate (2.9% vs. 0%, P = 0.461), postoperative complication (15.3% vs. 22.2%, P = 0.430), and postoperative hospital stay (6.5 days vs. 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% vs. 13.6%, P = 0.477), hospital stay (6.4 days vs.7.3 days, P = 0.607), and recurrence (50.0% vs. 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% vs. 81.8%, P = 0.057). Conclusion Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.

Background: Previous studies have shown various positive associations between the usual source of care (USC) and medication adherence in chronic diseases. However, no studies specifically on patients with diabetes have been conducted in Korea. This study examined the association between the USC type and medication adherence in patients with diabetes. Methods: Data from the 2021 Korea Health Panel Survey were used. The final sample comprised 1,493 participants aged ≥20 years. The types of USC were categorized into three groups: no USC, place only (without a regular doctor [RD]), and RD. Medication adherence was assessed using detailed items (dose, frequency, time, and discontinuation) and a four-point Likert scale. Logistic regression analysis was conducted with adjustment for control variables. Results: The odds ratios (ORs) for overall medication adherence were significantly higher in the RD group at 1.66 (95% confidence interval [CI], 1.15– 2.40) than in the no-USC group. No significant difference was observed in the place-only group at 0.73 (95% CI, 0.49–1.09). The ORs for medication adherence for each item (dosage, frequency, and timing) were also significantly higher in the RD group (2.21, 1.95, and 1.67, respectively). No statistically significant differences in these parameters were observed in the place-only group. Conclusion The presence of an RD positively affected medication adherence in patients with diabetes, but the presence of place-only did not. These findings emphasize the importance of an RD for medication adherence.

Background: Previous studies have shown various positive associations between the usual source of care (USC) and medication adherence in chronic diseases. However, no studies specifically on patients with diabetes have been conducted in Korea. This study examined the association between the USC type and medication adherence in patients with diabetes. Methods: Data from the 2021 Korea Health Panel Survey were used. The final sample comprised 1,493 participants aged ≥20 years. The types of USC were categorized into three groups: no USC, place only (without a regular doctor [RD]), and RD. Medication adherence was assessed using detailed items (dose, frequency, time, and discontinuation) and a four-point Likert scale. Logistic regression analysis was conducted with adjustment for control variables. Results: The odds ratios (ORs) for overall medication adherence were significantly higher in the RD group at 1.66 (95% confidence interval [CI], 1.15– 2.40) than in the no-USC group. No significant difference was observed in the place-only group at 0.73 (95% CI, 0.49–1.09). The ORs for medication adherence for each item (dosage, frequency, and timing) were also significantly higher in the RD group (2.21, 1.95, and 1.67, respectively). No statistically significant differences in these parameters were observed in the place-only group. Conclusion The presence of an RD positively affected medication adherence in patients with diabetes, but the presence of place-only did not. These findings emphasize the importance of an RD for medication adherence.

Purpose: Common bile duct (CBD) stone recurrence after laparoscopic CBD exploration (LCBDE) is relatively common. No studies have been conducted evaluating the safety and feasibility of re-do LCBDE in the treatment of recurrent CBD stones. Methods: This single-center retrospective study reviewed 340 consecutive patients who underwent LCBDE for CBD stones between January 2004 and December 2020. Patients with pancreatobiliary malignancies and those who underwent other surgical procedures were excluded. Results: Of the 340 included patients, 45 experienced a recurrence after a mean follow-up period of 24.2 months. Of them, 18 underwent re-do LCBDE, 20 underwent endoscopic intervention, 2 underwent radiologic intervention, and 5 underwent observation. Re-do LCBDE and initial LCBDE showed similar surgical outcomes in terms of operative time (113.1 minutes vs. 107.5 minutes, P = 0.515), estimated blood loss (42.5 mL vs. 49.1 mL, P = 0.661), open conversion rate (2.9% vs. 0%, P = 0.461), postoperative complication (15.3% vs. 22.2%, P = 0.430), and postoperative hospital stay (6.5 days vs. 6.4 days, P = 0.921). Comparing re-do LCBDE and nonsurgical treatment (endoscopic or radiologic), no statistically significant differences were noted in posttreatment complication (22.2% vs. 13.6%, P = 0.477), hospital stay (6.4 days vs.7.3 days, P = 0.607), and recurrence (50.0% vs. 36.4%, P = 0.385). The clearance rate was higher in the re-do LCBDE group than in the nonsurgical group (100% vs. 81.8%, P = 0.057). Conclusion Compared to initial LCBDE and endoscopic or radiological treatments, re-do LCBDE for recurrent CBD stones is a treatment option worth considering in selected patients.

Background: Liver transplantation (LT) is the standard treatment for end-stage liver disease; however, it can lead to biliary strictures in 25%–30% of cases. We aimed to develop a biodegradable stent loaded with paclitaxel that could be inserted during surgery without requiring removal. We evaluated the safety and efficacy of this stent using a porcine model. Methods: Fourteen pigs underwent simulated ischemic injury during LT, and a biodegradable paclitaxel-eluting stent was inserted after duct-to-duct anastomosis.Pigs were divided into four groups: no stent (n=3), bare stent (n=3), 300 µg paclitaxel stent (n=4), and 900 µg paclitaxel stent (n=4). After 3 months of follow-up, autopsies were conducted to obtain common bile duct tissue samples, and inflammation and fibrosis thicknesses were assessed under a microscope. Results: Most tissues had resolved the inflammatory reactions by the 3-month mark. The thinnest fibrosis thickness was observed in the 900 µg group (359.08±167.23 µm); however, no statistical significance was observed. Conclusion This study demonstrated the safety of paclitaxel-eluting biodegradable biliary stents and their positive effects on fibrosis in an ischemic bile duct porcine model. This biodegradable stent represents a potential approach for overcoming the complications associated with biliary strictures after LT.

Background: Previous studies have shown various positive associations between the usual source of care (USC) and medication adherence in chronic diseases. However, no studies specifically on patients with diabetes have been conducted in Korea. This study examined the association between the USC type and medication adherence in patients with diabetes. Methods: Data from the 2021 Korea Health Panel Survey were used. The final sample comprised 1,493 participants aged ≥20 years. The types of USC were categorized into three groups: no USC, place only (without a regular doctor [RD]), and RD. Medication adherence was assessed using detailed items (dose, frequency, time, and discontinuation) and a four-point Likert scale. Logistic regression analysis was conducted with adjustment for control variables. Results: The odds ratios (ORs) for overall medication adherence were significantly higher in the RD group at 1.66 (95% confidence interval [CI], 1.15– 2.40) than in the no-USC group. No significant difference was observed in the place-only group at 0.73 (95% CI, 0.49–1.09). The ORs for medication adherence for each item (dosage, frequency, and timing) were also significantly higher in the RD group (2.21, 1.95, and 1.67, respectively). No statistically significant differences in these parameters were observed in the place-only group. Conclusion The presence of an RD positively affected medication adherence in patients with diabetes, but the presence of place-only did not. These findings emphasize the importance of an RD for medication adherence.

Little is known about the transgenerational effects of maternal exposure to fine particulate matter (PM2.5) on offspring kidney health. This study investigated the effect of maternal administration of PM2.5 or PM2.5 with vitamin D during pregnancy and lactation on renal injury in rat dams and their offspring. Methods: Nine pregnant Sprague-Dawley rats received oral administration of normal saline, airborne PM2.5, or PM2.5 with vitamin D from gestational day 11 to postpartum day 21. Kidneys of rat dams (n = 3 for each group) and their male offspring (n = 5 for each group) were taken for analysis on postpartum or postnatal day 21. Results: Maternal PM2.5 exposure increased glomerular damage, tubulointerstitial injury, and cortical macrophage infiltration in both dams and pups; all increases were attenuated by vitamin D administration. In dam kidneys, PM2.5 increased the protein expression of vitamin D receptor (VDR), klotho, and tumor necrosis factor-α; vitamin D lessened these changes. The expressions of renin, nuclear factor erythroid 2-related factor 2 (Nrf2), and nuclear factor-kappa B (NF-κB) p50 decreased in rat dams exposed to PM2.5. In offspring kidneys, exposure to maternal PM2.5 reduced the expression of VDR, renin, angiotensin-converting enzyme (ACE), Nrf2, and NF-κB p50, but increased cytochrome P450 24A1 expression. Maternal vitamin D administration with PM2.5 enhanced VDR, ACE, and NF-κB p50 activities in pup kidneys. Conclusion: PM2.5 exposure during nephrogenesis may exert transgenerational renal impairment, and maternal vitamin D intake could attenuate PM2.5-induced kidney damage in mothers and their offspring.