Background/Aims: Early colorectal cancer (ECC) is commonly resected endoscopically. Perforation is a devastating complication of endoscopic resection. We aimed to identify the characteristics and predictive risk factors for perforation related to endoscopic resection of ECC. Methods: This nationwide retrospective multicenter study included patients with ECC who underwent endoscopic resection. We investigated the demographics, endoscopic findings at the time of treatment, and histopathological characteristics of the resected specimens. Logistic regression analysis was used to investigate the clinical factors associated with procedure-related perforations. Survival analysis was conducted to assess the impact of perforation on the overall survival of patients with ECC. Results: This study included 965 participants with a mean age of 63.4 years. The most common endoscopic treatment was conventional endoscopic mucosal resection (n=573, 59.4%), followed by conventional endoscopic submucosal dissection (n=259, 26.8%). Thirty-three patients (3.4%) experienced perforations, most of which were managed endoscopically (n=23/33, 69.7%). Patients who undergo endoscopic submucosal dissection-hybrid and precut endoscopic mucosal resection have a higher risk of perforation than those who undergo conventional endoscopic mucosal resection (odds ratio, 78.65 and 39.72, p<0.05). Procedure-related perforations were not associated with patient survival. Conclusions Perforation after endoscopic resection had no significant impact on the prognosis of ECC. The type of endoscopic resection was a crucial predictor of perforation. Large-scale prospective studies are needed to further investigate endoscopic resection of ECC.

Background/Aims: Early colorectal cancer (ECC) is commonly resected endoscopically. Perforation is a devastating complication of endoscopic resection. We aimed to identify the characteristics and predictive risk factors for perforation related to endoscopic resection of ECC. Methods: This nationwide retrospective multicenter study included patients with ECC who underwent endoscopic resection. We investigated the demographics, endoscopic findings at the time of treatment, and histopathological characteristics of the resected specimens. Logistic regression analysis was used to investigate the clinical factors associated with procedure-related perforations. Survival analysis was conducted to assess the impact of perforation on the overall survival of patients with ECC. Results: This study included 965 participants with a mean age of 63.4 years. The most common endoscopic treatment was conventional endoscopic mucosal resection (n=573, 59.4%), followed by conventional endoscopic submucosal dissection (n=259, 26.8%). Thirty-three patients (3.4%) experienced perforations, most of which were managed endoscopically (n=23/33, 69.7%). Patients who undergo endoscopic submucosal dissection-hybrid and precut endoscopic mucosal resection have a higher risk of perforation than those who undergo conventional endoscopic mucosal resection (odds ratio, 78.65 and 39.72, p<0.05). Procedure-related perforations were not associated with patient survival. Conclusions Perforation after endoscopic resection had no significant impact on the prognosis of ECC. The type of endoscopic resection was a crucial predictor of perforation. Large-scale prospective studies are needed to further investigate endoscopic resection of ECC.

Background/Aims: Early colorectal cancer (ECC) is commonly resected endoscopically. Perforation is a devastating complication of endoscopic resection. We aimed to identify the characteristics and predictive risk factors for perforation related to endoscopic resection of ECC. Methods: This nationwide retrospective multicenter study included patients with ECC who underwent endoscopic resection. We investigated the demographics, endoscopic findings at the time of treatment, and histopathological characteristics of the resected specimens. Logistic regression analysis was used to investigate the clinical factors associated with procedure-related perforations. Survival analysis was conducted to assess the impact of perforation on the overall survival of patients with ECC. Results: This study included 965 participants with a mean age of 63.4 years. The most common endoscopic treatment was conventional endoscopic mucosal resection (n=573, 59.4%), followed by conventional endoscopic submucosal dissection (n=259, 26.8%). Thirty-three patients (3.4%) experienced perforations, most of which were managed endoscopically (n=23/33, 69.7%). Patients who undergo endoscopic submucosal dissection-hybrid and precut endoscopic mucosal resection have a higher risk of perforation than those who undergo conventional endoscopic mucosal resection (odds ratio, 78.65 and 39.72, p<0.05). Procedure-related perforations were not associated with patient survival. Conclusions Perforation after endoscopic resection had no significant impact on the prognosis of ECC. The type of endoscopic resection was a crucial predictor of perforation. Large-scale prospective studies are needed to further investigate endoscopic resection of ECC.

Background/Aims: Early colorectal cancer (ECC) is commonly resected endoscopically. Perforation is a devastating complication of endoscopic resection. We aimed to identify the characteristics and predictive risk factors for perforation related to endoscopic resection of ECC. Methods: This nationwide retrospective multicenter study included patients with ECC who underwent endoscopic resection. We investigated the demographics, endoscopic findings at the time of treatment, and histopathological characteristics of the resected specimens. Logistic regression analysis was used to investigate the clinical factors associated with procedure-related perforations. Survival analysis was conducted to assess the impact of perforation on the overall survival of patients with ECC. Results: This study included 965 participants with a mean age of 63.4 years. The most common endoscopic treatment was conventional endoscopic mucosal resection (n=573, 59.4%), followed by conventional endoscopic submucosal dissection (n=259, 26.8%). Thirty-three patients (3.4%) experienced perforations, most of which were managed endoscopically (n=23/33, 69.7%). Patients who undergo endoscopic submucosal dissection-hybrid and precut endoscopic mucosal resection have a higher risk of perforation than those who undergo conventional endoscopic mucosal resection (odds ratio, 78.65 and 39.72, p<0.05). Procedure-related perforations were not associated with patient survival. Conclusions Perforation after endoscopic resection had no significant impact on the prognosis of ECC. The type of endoscopic resection was a crucial predictor of perforation. Large-scale prospective studies are needed to further investigate endoscopic resection of ECC.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.

Background: Angelica gigas Nakai Root (AGN) is a medicinal plant with various therapeutic effects. The purpose of this study was to determine the effect of a 70% ethanol extract of AGN (EAGN) on biofilm formation and metabolic activities of Streptococcus mutans according to exposure to xylitol and sucrose, and to confirm the possibility of using EAGN as an effective medicinal plant-derived anti-cariogenic substance. Methods: Bacterial growth and disk diffusion test were performed to confirm the antibacterial effects of EAGN against S. mutans in a brain-heart infusion (BHI) medium containing 1% xylitol and 1% sucrose, measurement of. Biofilm formation was confirmed using a biofilm formation assay and glycosyltransferase (GTF) activity. Metabolic activity was evaluated using a calcium assay, acid production assay and buffering capacity measurements. Results: EAGN showed antibacterial activity against S. mutans in a BHI medium containing 1% xylitol and sucrose. At 3.75 and 5.0 mg/ml EAGN in S. mutans-inoculated medium containing 1% sucrose, the antibacterial effect was greater than those of BHI only and 1% xylitol BHI media. In S. mutans-inoculated medium containing 1% sucrose, cariogenic biofilm formation, GTF activity, released Ca2+ levels, and acidogenicity were significantly increased, but the buffering capacity was significantly decreased.According to EAGN treatment, cariogenic biofilm formation, GTF activity, measured released Ca2+ levels, and acidogenicity were significantly decreased and buffering capacity was significantly increased. An EAGN over 3.75 mg/ml significantly reduced biofilm formation and Ca2+ . Regardless of the concentration of EAGN, acidogenicity was reduced, and the buffering capacity was increased. Conclusion EAGN is a safe natural anti-cariogenic substance that inhibits biofilm formation by directly inhibiting GTF activity andadjusts the microenvironment for tooth remineralization by reducing Ca2+ and acidogenicity and increasing the buffering capacity according to exposure to sucrose in S. mutans.

Background: Angelica gigas Nakai Root (AGN) is a medicinal plant with various therapeutic effects. The purpose of this study was to determine the effect of a 70% ethanol extract of AGN (EAGN) on biofilm formation and metabolic activities of Streptococcus mutans according to exposure to xylitol and sucrose, and to confirm the possibility of using EAGN as an effective medicinal plant-derived anti-cariogenic substance. Methods: Bacterial growth and disk diffusion test were performed to confirm the antibacterial effects of EAGN against S. mutans in a brain-heart infusion (BHI) medium containing 1% xylitol and 1% sucrose, measurement of. Biofilm formation was confirmed using a biofilm formation assay and glycosyltransferase (GTF) activity. Metabolic activity was evaluated using a calcium assay, acid production assay and buffering capacity measurements. Results: EAGN showed antibacterial activity against S. mutans in a BHI medium containing 1% xylitol and sucrose. At 3.75 and 5.0 mg/ml EAGN in S. mutans-inoculated medium containing 1% sucrose, the antibacterial effect was greater than those of BHI only and 1% xylitol BHI media. In S. mutans-inoculated medium containing 1% sucrose, cariogenic biofilm formation, GTF activity, released Ca2+ levels, and acidogenicity were significantly increased, but the buffering capacity was significantly decreased.According to EAGN treatment, cariogenic biofilm formation, GTF activity, measured released Ca2+ levels, and acidogenicity were significantly decreased and buffering capacity was significantly increased. An EAGN over 3.75 mg/ml significantly reduced biofilm formation and Ca2+ . Regardless of the concentration of EAGN, acidogenicity was reduced, and the buffering capacity was increased. Conclusion EAGN is a safe natural anti-cariogenic substance that inhibits biofilm formation by directly inhibiting GTF activity andadjusts the microenvironment for tooth remineralization by reducing Ca2+ and acidogenicity and increasing the buffering capacity according to exposure to sucrose in S. mutans.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.

Background: Angelica gigas Nakai Root (AGN) is a medicinal plant with various therapeutic effects. The purpose of this study was to determine the effect of a 70% ethanol extract of AGN (EAGN) on biofilm formation and metabolic activities of Streptococcus mutans according to exposure to xylitol and sucrose, and to confirm the possibility of using EAGN as an effective medicinal plant-derived anti-cariogenic substance. Methods: Bacterial growth and disk diffusion test were performed to confirm the antibacterial effects of EAGN against S. mutans in a brain-heart infusion (BHI) medium containing 1% xylitol and 1% sucrose, measurement of. Biofilm formation was confirmed using a biofilm formation assay and glycosyltransferase (GTF) activity. Metabolic activity was evaluated using a calcium assay, acid production assay and buffering capacity measurements. Results: EAGN showed antibacterial activity against S. mutans in a BHI medium containing 1% xylitol and sucrose. At 3.75 and 5.0 mg/ml EAGN in S. mutans-inoculated medium containing 1% sucrose, the antibacterial effect was greater than those of BHI only and 1% xylitol BHI media. In S. mutans-inoculated medium containing 1% sucrose, cariogenic biofilm formation, GTF activity, released Ca2+ levels, and acidogenicity were significantly increased, but the buffering capacity was significantly decreased.According to EAGN treatment, cariogenic biofilm formation, GTF activity, measured released Ca2+ levels, and acidogenicity were significantly decreased and buffering capacity was significantly increased. An EAGN over 3.75 mg/ml significantly reduced biofilm formation and Ca2+ . Regardless of the concentration of EAGN, acidogenicity was reduced, and the buffering capacity was increased. Conclusion EAGN is a safe natural anti-cariogenic substance that inhibits biofilm formation by directly inhibiting GTF activity andadjusts the microenvironment for tooth remineralization by reducing Ca2+ and acidogenicity and increasing the buffering capacity according to exposure to sucrose in S. mutans.