Purpose: Since 1995, the Korean Gastric Cancer Association (KGCA) has been periodically conducting nationwide surveys on patients with surgically treated gastric cancer. This study details the results of the survey conducted in 2023. Materials and Methods: The survey was conducted from March to December 2024 using a standardized case report form. Data were collected on 86 items, including patient demographics, tumor characteristics, surgical procedures, and surgical outcomes. The results of the 2023 survey were compared with those of previous surveys. Results: Data from 12,751 cases were collected from 66 institutions. The mean patient age was 64.6 years, and the proportion of patients aged ≥71 years increased from 9.1% in 1995 to 31.7% in 2023. The proportion of upper-third tumors slightly decreased to 16.8% compared to 20.9% in 2019. Early gastric cancer accounted for 63.1% of cases in 2023.Regarding operative procedures, a totally laparoscopic approach was most frequently applied (63.2%) in 2023, while robotic gastrectomy steadily increased to 9.5% from 2.1% in 2014.The most common anastomotic method was the Billroth II procedure (48.8%) after distal gastrectomy and double-tract reconstruction (51.9%) after proximal gastrectomy in 2023.However, the proportion of esophago-gastrostomy with anti-reflux procedures increased to 30.9%. The rates of post-operative mortality and overall complications were 1.0% and 15.3%, respectively. Conclusions The results of the 2023 nationwide survey demonstrate the current status of gastric cancer treatment in Korea. This information will provide a basis for future gastric cancer research.

Objective: To evaluate the safety and efficacy of coil embolization of venous segments in patients with Type IIa pelvic arteriovenous malformations (AVMs). Materials and Methods: A retrospective study was performed on 13 patients (median age, 43 years, range 20–62 years, 7 males) who underwent transvenous coil embolization for Type IIa pelvic AVM (characterized by multiple arterioles shunting to focal venous segments of a single draining vein) without the use of additional liquid embolic agents from March 2017 to February 2023. Treatment outcomes were analyzed based on clinical evaluations, post angiography findings, and follow-up CT. Results: Fourteen procedures were performed on 13 patients. Except in one patient, all treatments were completed in a single session. Transvenous access was employed in 10 procedures, whereas direct puncture was used in four sessions. The embolization procedures used an average of 55.7 ± 58.5 coils (range, 7–238) and lasted an average of 127.3 ± 39.5 minutes.The technical success rate was 92.9% (of 13/14). All patients reported symptom improvement. Follow-up CT scans showed complete occlusion of the AVM without recurrence in ten of the 13 patients. There was one minor adverse event: a small retroperitoneal hemorrhage, likely related to direct puncture, which resolved spontaneously. No other adverse events were observed. Conclusion Coil embolization of the draining vein segment, without the use of additional liquid embolic agents is a safe and effective method for managing Type IIa pelvic AVM.

BACKGROUND/OBJECTIVES: Isoflavones are estrogen-like compounds found in plants and their health effects remain equivocal. We investigated dietary isoflavone intake and its associated factors in Korean breast cancer survivors, with a comparison to cancer-free women. SUBJECTS/METHODS: The usual dietary intake of breast cancer survivors (n = 981, mean age 52 yrs) in 9 hospitals between 2012 and 2019 was assessed using 3-day food records or food frequency questionnaires (FFQs). They were age-matched to 2,943 cancer-free women who completed FFQs as part of a nationwide study conducted between 2012 and 2016. We used the flavonoid database of common Korean foods and the Phenol-Explorer database to estimate isoflavone intake. The contribution of each food or food group to the total isoflavone intake was calculated. The adjusted least-squares means of dietary isoflavone intake according to lifestyle and clinical factors were calculated using generalized linear models. RESULTS: Breast cancer survivors had a higher mean dietary isoflavone intake (23.59 mg/day) than cancer-free women (17.81 mg/day). Major food sources, including tofu, soybeans, and doenjang, contributed to over 70% of the isoflavone intake in both groups. When we estimated dietary isoflavone intake according to lifestyle characteristics, isoflavone intake increased with higher scores of adherence to the American Cancer Society dietary guidelines but decreased with increasing body mass index in both groups. Among cancer-free women, dietary isoflavone intake was higher among those who had never smoked and among dietary supplement users. Among breast cancer survivors, dietary isoflavone intakes did not vary with clinical characteristics, including time since surgery and estrogen receptor status. CONCLUSION Breast cancer survivors were more likely to consume isoflavones than agematched cancer-free women. Dietary isoflavone intake was associated with healthy lifestyle characteristics in women both with and without breast cancer. Further research is needed to understand the role of the higher isoflavone intake among breast cancer survivors compared to cancer-free women on their prognosis.

BACKGROUND/OBJECTIVES: Orostachys japonicus A. Berger (O. japonicus) is a perennial herb belonging to the Crassulaceae family that has been traditionally used to treat inflammation, fever, and poisoning. Although studies on the anticancer activity of O. japonicus have been conducted, its effect on virus-induced cancers has yet to be elucidated.MATERIALS/METHODS: In the present study, we investigated the effects and mechanisms of action of the ethyl acetate fraction of O. japonicus extract (E-OJ) on the viability and apoptosis of HeLa cervical cancer cells. RESULTS: The effect of E-OJ on HeLa cells was compared to that of kaempferol, quercetin, and gallic acid, which are components of O. japonicus. Treatment with E-OJ induced a concentration-dependent decrease in cell viability, as confirmed by MTS assay. Pretreatment with a broad-spectrum caspase inhibitor resulted in the recovery of cell viability. Western blot analysis was conducted to determine whether the induction of apoptosis was caspasedependent. E-OJ induced apoptosis by increasing Bax/Bcl-2 ratio. Furthermore, it modulated the levels of cleaved caspase-3, -8, and -9, indicative of an impact on both the intrinsic and extrinsic pathways of apoptosis. Pretreatment with caspase inhibitors reduced caspase activity. CONCLUSION These results suggest that the anticancer activity of O. japonicus is mediated by caspases, resulting in a decrease in the viability of HeLa cells.

Primary cholangiocarcinoma is a rare bile duct epithelial neoplasm that can present with atypical clinical manifestations, complicating its diagnosis. A 62-year-old male showed symptoms suggestive of a complicated hepatic cyst that was later identified as intrahepatic cholangiocarcinoma. The patient presented with abdominal discomfort without fever. Imaging revealed a large cystic lesion in the liver. Despite the initial treatment for a presumed abscess, a biopsy confirmed cholangiocarcinoma. This case highlights the diagnostic challenge of distinguishing between benign complicated hepatic cysts and malignancies, particularly when typical markers of infection are absent. Early biopsy and vigilant assessments are crucial in such presentations to avoid a delayed diagnosis and initiate appropriate treatment.

Hepatic tuberculosis, typically associated with miliary tuberculosis, can occasionally present as localized liver lesions. This case report describes a 77-year-old male presenting with persistent abdominal pain and fever, following an endoscopic retrograde cholangiopancreatography for bile duct sludge removal. Subsequent computed tomography revealed focal liver lesions. Despite initial treatment with antibiotics for a suspected inflammatory liver abscess, his condition did not improve. A liver biopsy was performed, revealing caseous granulomas, and the tuberculosis polymerase chain reaction result was positive. The patient was diagnosed with primary hepatic tuberculosis, which later disseminated. Oral anti-tuberculosis therapy was initiated and is currently being closely monitored. This case emphasizes the importance of considering hepatic tuberculosis in the differential diagnosis of liver lesions, particularly in cases involving cholestatic liver function tests, and persistent symptoms unresponsive to conventional antibiotics.

Objectives: The success of Helicobacter pylori eradication using clarithromycin-based triple therapy relies on the bacteria being sensitive to clarithromycin. This study evaluated the diagnostic performance of two frequently used polymerase chain reaction (PCR) methods (AllplexTM H. pylori & ClariR Assay [Seegene] and Ezplex® HP-CLA Real-time PCR [SML Genetree]) to detect H. pylori infection and identify point mutations associated with clarithromycin resistance. Methods: Patients who underwent esophagogastroduodenoscopy between August 2023 and April 2024 at Incheon St. Mary’s Hospital were enrolled in this study. The diagnostic performance of the Allplex method was evaluated against the rapid urease test (RUT), culture, and Ezplex HP-CLA methods. Point mutation detection using the Allplex and Ezplex methods was compared with the results of gene sequencing. The rates of H. pylori eradication following Ezplex-based tailored therapy were also analyzed. Results: Eighty-seven gastric biopsy specimens were analyzed. For diagnosing H. pylori infections, Allplex demonstrated kappa values of 0.670 compared with RUT, 0.468 compared with culture, and 0.880 compared with Ezplex. Among the 87 bacterial isolates subjected to gene sequencing to detect clarithromycin resistance-associated point mutations, the Allplex and Ezplex methods demonstrated 74 and 76 concordant results, respectively. The H. pylori eradication rate using Ezplex-based tailored therapy was 90.7%. Conclusions This study demonstrated that both the Allplex and Ezplex methods are helpful for diagnosing H. pylori infections and detecting clarithromycin resistance. Furthermore, the Ezplex method was clinically effective for guiding tailored therapy to yield successful H. pylori eradication.