This study was performed to evaluate the antibacterial activity of water-soluble mangostin derivatives (WsMD) of the ethanol extract of the peel of Garcinia mangostana L. (mangosteen) and the ethanol extracts of the fruit of Psoralea corylifolia L. and the root of Glycyrrhiza uralensis (licorice) against oral bacteria associated with endodontic infections. Cytotoxicity of the three natural products was tested on human embryonic kidney 293 cells (HEK 293) using the methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay or the cell counting method. Antimicrobial activity was evaluated based on the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). The highest concentrations of the WsMD of the ethanol extract of the peel of mangosteen and ethanol extracts of P. corylifolia L. fruit and licorice root without cytotoxic effects on HEK 293 cells were 20, 400, and 320 µg/ml, respectively. The MIC and MBC values of the WsMD of the ethanol extract of the peel of mangosteen and ethanol extracts of P. corylifolia L. fruit against 35 isolates (23 species) of pulpitis- and periapical disease-causative bacteria were 1.25–20 µg/ml and 25–200 µg/ml, respectively, except for Dialister invisus KCOM 1973. The ethanol extract of licorice root had MBC values of 40–320 µg/ml against 27 of 35 bacterial strains. These results showed that the WsMD of the ethanol extract of mangosteen peel had the highest antibacterial activity among the three natural extracts and suggested it as a potential root canal irrigation agent.

The American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging classification of thyroid cancer can predict death but cannot determine the type and frequency of follow-up testing. Risk stratification is a concept proposed by the American Thyroid Association that uses additional prognostic factors that are not included in the AJCC/UICC classification, such as number or size of metastatic lymph nodes, genetic mutations, and vascular invasion in follicular cancer, to further refine the prognosis of thyroid cancer. The risk of recurrence was categorized as low, intermediate, and high risk, and the need for total thyroidectomy, radioiodine therapy, or thyroid-stimulating hormone suppression was determined depending on each risk level. This approach has been accepted worldwide, and the previous recommendations of the Korean Thyroid Association followed a similar line of thinking but these have been modified in the revised 2024 guidelines.For the revised initial risk stratification, after careful review of the results of the recent meta-analyses and large observational studies and after a multidisciplinary meeting, four major changes were made: 1) thyroid cancer was reclassified according to the World Health Organization (WHO) 2022 tumor classification system; 2) recurrence risk was stratified by combining encapsulated follicular variant papillary thyroid cancer, follicular thyroid cancer, and oncocytic thyroid cancer, which have similar recurrence risk and associated factors, into follicular-patterned tumor; 3) low-risk groups were defined as those with a known recurrence rate of ≤5%, high-risk groups were upgraded to those with a known recurrence rate of ≥30%, and intermediate-risk groups were those with a recurrence risk of 5–30%; and 4) the intermediate risk group had the recurrence rate presented according to various clinicopathological factors, mainly based on reports from Korea. Thus, it is recommended to evaluate the initial risk group by predicting the recurrence rate by combining each clinical factor in individual patients, rather than applying the recurrence rate caused by single risk factor.

Only a small percentage of patients (2-5%) with differentiated thyroid cancer (DTC) exhibit distant metastasis at the initial diagnosis or during the disease course. The most common metastatic sites of DTC are the lungs, followed by the bones. Radioactive iodine (RAI) therapy is considered the primary treatment for RAI-avid distant metastatic DTC. Depending on the characteristics of metastatic lesions, local treatment such as surgical resection, radiofrequency ablation, and external beam radiation therapy may be considered for some patients with metastatic DTC. Slowly growing and asymptomatic metastases can be monitored with follow-up while receiving thyroid-stimulating hormone (TSH) suppression therapy. In patients with a limited number of lung metastases and good performance status, surgical removal of the metastatic lesions may be considered. Systemic therapy should be considered for patients with progressive RAI refractory DTC. In this clinical guideline, we aim to outline the treatment principles for patients with lung, bone, and brain metastases of DTC.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

This study was conducted to evaluate the cytotoxic and anti-inflammatory effects of the ethanol extract of Syzygium aromaticum L. (clove) buds. The cytotoxicity test was performed by cell counting method using hTERT-hNOF cells, a human immortalized gingival fibroblast cell line. To test the anti-inflammatory effects, the hTERT-hNOF cells were treated with lipopolysaccharide (LPS) extracted from Porphyromonas gingivalis KCOM 2804 (PgLPS) and ethanol extract of clove buds. The expression levels of PGE2, IL-6, and IL-8 were measured by enzyme-linked immunosorbent assay. The cytotoxicity test data showed a cell viability of ≧ 82% in hTERT-hNOF cells treated with 10 to 80 µg/mL of the ethanol extract of clove buds. The anti-inflammatory test data showed that the expression of PGE2 by PgLPS treatment was reduced to the level of the negative control group by treatment with 10 µg/mL or more of the ethanol extract of clove buds. In group treated with PgLPS and 40 µg/mL of clove bud ethanol extract, the expression levels of IL-6 and IL-8 in were inhibited by 75% and 77%, respectively (p<0.05), compared to the positive control (PgLPS treatment) group. These results suggest that the ethanol extract of clove buds can be used in developing oral hygine products for preventing periodontal disease.

Purpose: Fusobacterium species can cause infections, and associations with cancer are being increasingly reported. As their clinical significance differs, accurate identification of individual species is important. However, matrix-assisted laser desorption/ionization-time of flight mass spectrometry has not been found to be effective in identifying Fusobacterium species in previous studies. In this study, we aimed to improve the accuracy and efficacy of identifying Fusobacterium species in clinical laboratories. Materials and Methods: In total, 229 Fusobacterium isolates were included in this study. All isolates were identified at the species level based on nucleotide sequences of the 16S ribosomal RNA gene and/or DNA-dependent RNA polymerase β-subunit gene (rpoB). Where necessary, isolates were identified based on whole genome sequences. Among them, 47 isolates were used for updating the ASTA database, and 182 isolates were used for the validation of Fusobacterium spp. identification. Results: Fusobacterium isolates used for validation (182/182) were correctly identified at the genus level, and most (180/182) were correctly identified at the species level using the ASTA MicroIDSys system. Most of the F. nucleatum isolates (74/75) were correctly identified at the subspecies level. Conclusion The updated ASTA MicroIDSys system can identify nine species of Fusobacterium and four subspecies of F. nucleatum in good agreement. This tool can be routinely used in clinical microbiology laboratories to identify Fusobacterium species and serve as a springboard for future research.

Purpose: Coronavirus disease 2019 (COVID-19) has affected many parts of daily life and healthcare, including cancer screening and diagnosis. The purpose of this study was to determine whether there was an upshift in the colorectal cancer stage at diagnosis due to delays related to the COVID-19 outbreak. Methods: From January to June of each year from 2017 to 2020, a total of 3,229 patients who were first diagnosed with colorectal cancer were retrospectively reviewed. Those enrolled from 2017 to 2019 were classified as the ‘pre-COVID’ group, and those enrolled in 2020 were classified as the ‘COVID’ group. The primary outcome was the rate of stage IV disease at the time of diagnosis. Results: There was no statistically significant difference in the proportion of stage IV patients between the pre-COVID and COVID groups (P=0.19). The median preoperative carcinoembryonic antigen level in the COVID group was higher than in the pre-COVID group in all stages (all P<0.05). In stage I, II patients who underwent radical surgery, the lymphatic invasion was more presented in COVID patients (P=0.009). Conclusion We did not find significant stage upshifting in colorectal cancer during the COVID-19 outbreak. However, there were more initially unresectable stage IV colorectal cancer patients with a low conversion rate to resectable status, and more patients had factors related to poor prognosis. These results may become more apparent over time, so it is vital not to neglect cancer screening to not delay the diagnosis during the COVID-19 epidemic.

The purpose of this study was to introduce a new in vitro method for evaluating the antimicrobial activity of toothpaste, reflecting the actual toothbrushing time and the dilution of toothpaste by salivation. We designed three experimental groups and one negative control group. The experimental groups were (1) 90 μL of toothpaste + 10 μL 1X phosphate-buffered saline (PBS, 9/10 dilution group), (2) 50 μL of toothpaste + 40 μL 1X PBS (1/2 dilution group), and (3) 25 μL of toothpaste + 65 μL 1X PBS (1/4 dilution group). During toothbrushing, saliva is continuously secreted into the oral cavity and the toothpaste concentration is diluted over time during toothbrushing. Therefore, the 1/2 and 1/4 dilution experimental groups were added. The negative control group was toothpaste diluted 20,000-fold with 1X PBS. Miracle Fresh Doctor toothpaste and Streptococcus mitis KCOM 1350, Prevotella intermedia KCOM 1107, Fusobacterium nucleatum subsp. polymorphum KCOM 1322, and Aggregatibacter actinomycetemcomitans KCOM 1306 were used as the toothpaste and target bacterial strains, respectively. The number of bacterial cells plated on agar plates in the negative control group was 1,000 CFU. If the number of colonies on the experimental group plate was less than one, the treatment was considered to have > 99.9% bactericidal activity. These results suggest that this new in vitro method for antimicrobial evaluation could be used as the standard method for testing the antimicrobial activity of toothpaste.

This study evaluated the antimicrobial activity of Endoseal TCS, an mineral trioxide aggregate-based root canal sealer, mixed with water-soluble mangostin derivatives (WsMD) of Garcinia mangostana L. (mangosteen) ethanol extract against Enterococcus faecalis and Staphylococcus aureus. The antibacterial activity of Endoseal TCS mixed with WsMD against three strains of E. faecalis and three strains of S. aureus was performed using agar diffusion test. The data showed that Endoseal TCS mixed with 0.115% WsMD had a zone of inhibition of 0.7 ± 0.2–2.4 ± 0.1 mm. The results suggest that Endoseal TCS mixed with WsMD of Garcinia mangostana L. ethanol extract is useful as a root canal sealer with antibacterial activity against E. faecalis and S. aureus.