The bond strength to the silicate-based CAD/CAM blocks may be affected by the composition and microstructure of the silicatebased blocks, surface treatment, and the properties of the applied adhesive. In this study, the shear bond strength to the silicate blocks with various universal adhesives after sandblasting or HF-treatment was measured, and the effects of the additional silane application after surface treatments are evaluated. Six silica-containing blocks and five universal adhesives currently used in dental clinics were selected. After polishing the silicate block surface, the specimens were divided into two groups. The first groups were HF-treated and the second groups were sandblasted with alumina, and the surface roughness, contact angle, and microstructure were analyzed by CLSM (Confocal Laser Scanning Microscope), contact angle analyzer, and FE-SEM (Field Emission Scanning Electron Microscope).Composite resin (2 mm diameter) was bonded with universal adhesive to silicate blocks and stored in a 37 ℃ water bath for 24 hours, and the shear bond strength was measured using a universal testing machine. The measured values were statistically analyzed using the Tukey-multiple comparison test (α=0.05). For hybrid composite ceramics, there was no significant difference in bond strength between sandblasting or HF-treatment, and additional silane application may not be necessary when bonding with a universal adhesive, whereas for leucite-reinforced and lithium disilicate glass-ceramics, HF-treatment may be more favorable for adhesion than sandblasting, and additional silane application appears to be necessary even when applying a universal adhesive.

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

With an aging population, the number of patients with difficulty swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. Long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach, aided endoscopically, which may be an alternative to a nasogastric tube when enteral nutritional is required for 4 weeks or more. This paper is the first Korean clinical guideline for PEG. It was developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tubes removal for PEG based on the currently available clinical evidence.

Background/Aims: Tegoprazan is a novel potassium-competitive acid blocker that has beneficial effects on acid-related disorders such as gastroesophageal reflux and peptic ulcer diseases.This study aimed to validate the effect of tegoprazan on endoscopic submucosal dissection (ESD)-induced artificial ulcers. Methods: Patients from 16 centers in Korea who underwent ESD for gastric neoplasia were enrolled. After ESD, pantoprazole was administered intravenously for 48 hours. The patients were randomly allocated to either the tegoprazan or esomeprazole group. Tegoprazan 50 mg or esomeprazole 40 mg were administered for 4 weeks, after which gastroscopic evaluation was performed. If the artificial ulcer had not healed, the same dose of tegoprazan or esomeprazole was administered for an additional 4 weeks, and a gastroscopic evaluation was performed. Results: One hundred sixty patients were enrolled in this study. The healing rates of artificial ulcers at 4 weeks were 30.3% (23/76) and 22.1% (15/68) in the tegoprazan and esomeprazole groups, respectively (p=0.006). At 8 weeks after ESD, the cumulative ulcer healing rates were 73.7% (56/76) and 77.9% (53/68) in the tegoprazan and esomeprazole groups, respectively (p=0.210). Delayed bleeding occurred in two patients in the tegoprazan group (2.6%) and in one patient in the esomeprazole group (1.5%). Other adverse events were negligible in both groups. Conclusions Tegoprazan showed similar effects on post-ESD artificial ulcer healing in comparison with esomeprazole.

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

Airway management is a fundamental and complex process that involves a sequence of integrated tasks. Situations requiring emergency airway management may occur in the emergency department, intensive care units, and various other clinical spaces. A variety of challenges can arise during emergency airway preparation, intubation, and postintubation, which may result in significant complications for patients. Therefore, many countries are establishing step-by-step systemization and detailed guidelines and/or updating their content based on the latest research. This clinical review introduces the current trends in emergency airway management, such as emergency airway management algorithms, comparison of video and direct laryngoscopy, rapid sequence intubation, pediatric airway management, prehospital airway management, surgical airway management, and airway management education.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Background/Objectives: Pediatric parotid malignancies are rare but represent a critical subset of head and neck cancers. This study integrates nationwide incidence trends in Korea with detailed surgical outcomes from a single tertiary institution to better understand the characteristics and management of these tumors.Materials & Methods: Nationwide data from the Korea Central Cancer Registry (1999-2019) were analyzed to assess trends in pediatric parotid malignancy incidence. A retrospective review was conducted on 31 pediatric parotidectomy cases at a tertiary hospital from 2011 to 2024. Clinical data, surgical methods, pathology results, and follow-up outcomes were examined. Results: Nationwide analysis revealed an annual mean of 9.0 ± 4.0 cases of pediatric parotid malignancies, with a significant rise in incidence among patients aged 10-19 years (APC 5.4%, 95% CI 1.1-9.8, p=0.016). Institutional data showed that the median age of patients underwent parotidectomy was 15.0 years, with males comprising 67.7%. Among 31 cases, 19 (61.3%) were benign, primarily pleomorphic adenomas (68.4%), and 12 (38.7%) were malignant, predominantly mucoepidermoid carcinoma (87.5%). Superficial or partial parotidectomy was the most common surgical approach (71.0%), and no unexpected complications or recurrences were observed. Conclusion Pediatric parotid malignancies in Korea exhibit rising incidence rates, particularly among teenagers. Surgical outcomes confirm the predominance of pleomorphic adenomas and mucoepidermoid carcinomas. Pediatric parotid surgery is a procedure with minimized complications and a promising prognosis. Tailored treatment strategies adapted to the unique characteristics of pediatric patients are essential to optimize outcomes.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.