Objective: : To analyze the outcomes of coil embolization (CE) for unruptured intracranial aneurysm (UIA) according to region and hospital size based on National Health Insurance Service data in South Korea. Methods: : The incidence of complications, including intracranial hemorrhage (ICRH) and cerebral infarction (CI), occurring within 3 months and the 1-year mortality rates in UIA patients who underwent CE in 2018 were analyzed. Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs) or semigeneral hospitals (sGHs) according to their size, and the administrative districts of South Korea were divided into 15 regions. Results: : In 2018, 8425 (TRGHs, 4438; GHs, 3617; sGHs, 370) CEs were performed for UIAs. Complications occurred in 5.69% of patients seen at TRGHs, 13.48% at GHs, and 20.45% at sGHs. The complication rate in TRGHs was significantly lower than that in GHs (p=0.039) or sGHs (p=0.005), and that in GHs was significantly lower than that in sGHs (p=0.030). The mortality rates in TRGHs, GHs, and sGHs were 0.81%, 2.16%, and 3.92%, respectively, with no significant difference. Despite no significant difference in the mortality rates, the complication rate significantly increased as the number of CE procedures per hospital decreased (p=0.001; rho=-0.635). Among the hospitals where more than 30 CEs were performed for UIAs, the incidence of CIs (p=0.096, rho=-0.205) and the mortality rates (3 months, p=0.048, rho=-0.243; 1 year, p=0.009, rho=-0.315) significantly decreased as the number of CEs that were performed increased and no significant difference in the incidence of post-CE ICRH was observed. Conclusion : The complication rate in patients who underwent CE for UIA increased as the hospital size and physicians’ experience in conducting CEs decreased. We recommend nationwide quality control policies CEs for UIAs.

Background: Mohs micrographic surgery (MMS) is a surgical technique for skin cancer that has the advantage of increasing the cure rate while having a tissue-sparing property. Objective: To investigate the benefits of MMS and the characteristics of various skin cancers that are increasing in incidence in Korea. Methods: We retrospectively analyzed 1,013 cases treated with MMS, including slow MMS, from 2010 to 2020. Patient and tumor characteristics, reconstruction, recurrence, metastasis, and operation time were reviewed. Results: Female (61.4%) outnumbered male (38.6%), and the mean patient age was 72.7 years. The most diagnosed skin cancer was basal cell carcinoma (BCC), followed by squamous cell carcinoma (SCC) and cutaneous melanoma. BCC and SCC showed significant differences in various variables, including age, tumor location and size, and MMS stages for clearance. Although BCC was smaller than SCC, it required more MMS stages for a clear margin (p ＜0.05). The recurrence rate was 2.2% (0.7%, 3.0%, and 7.7% for BCC, SCC, and cutaneous melanoma, respectively). There have been no reported recurrences of extramammary Paget’s disease and dermatofibrosarcoma protuberans. The mean number of MMS stages for a clear margin was 1.41±1.05, and clearance was achieved in the first stage in 72.6% of cases. The mean operation time was 123.7 minutes. Conclusion MMS is an efficient surgical method that can lower the recurrence rate in the treatment of various skin cancers, and there were statistically significant differences between BCC and SCC in various parameters.

Background/Aims: Adjuvant chemotherapy is the standard of care for resected stage II-IIIA non-small cell lung cancer (NCSLC). The efficacy of adjuvant chemotherapy in stage IB (< 4 cm) NSCLC with high-risk factors is controversial. Methods: This retrospective multicenter study included 285 stage IB NSCLC patients with high-risk factors according to the 8th edition tumor, node, metastasis (TNM) classification from four academic hospitals. High-risk factors included visceral pleural invasion, vascular invasion, lymphatic invasion, lung neuroendocrine tumors, and micropapillary histology patterns. Results: Of the 285 patients, 127 (44.6%) were included in the adjuvant chemotherapy group and 158 (55.4%) were included in the non-adjuvant chemotherapy group. The median follow-up was 41.5 months. Patients in the adjuvant chemotherapy group had a significantly reduced recurrence rate and risk of mortality than those in the non-adjuvant chemotherapy group (hazards ratio, 0.408; 95% confidence interval, 0.221 to 0.754; p = 0.004 and hazards ratio, 0.176; 95% confidence interval, 0.057 to 0.546; p = 0.003, respectively). Adjuvant chemotherapy should be particularly considered for the high-risk factors such as visceral pleural involvement or vascular invasion. Based on the subgroup analysis, adjuvant chemotherapy should be considered when visceral pleural involvement is present, even if the tumor size is < 3 cm. Conclusions Adjuvant chemotherapy may be useful for patients with stage IB NSCLC with high-risk factors and is more relevant for patients with visceral pleural involvement or vascular invasion.

Background: Syphilis is an infectious and sexually transmitted disease caused by Treponema pallidum. The diagnosis and treatment of syphilis may be delayed because of the various clinical features. Objective: The purpose of this study was to investigate the epidemiological changes and clinical features of syphilis in Korea. Methods: We conducted a retrospective analysis of 303 subjects with positive venereal disease research laboratories results, including 208 syphilis patients who visited the Dermatology Department of Chosun University Hospital between 2008 and 2019. The analysis was performed based on variables, such as age, sex, serological results, and clinical stages. Results: During the study period, the mean reactive rate of the serum venereal disease research laboratories test was 0.14%, and the annual incidence rate tended to decrease. Of the 208 syphilis patients, the male:female ratio was 1:2.7 among those aged 0 to 19 years and 2.3:1 among those aged 50 to 59 years. Eighty-six patients (41.3%) were diagnosed with symptomatic syphilis, which accounted for the highest proportion (63.6%) among those aged 0 to 19 years. The incidence tended to decrease with increasing age (p＜0.001). Maculopapular syphilis was the most commonly observed form of secondary syphilis (44.6%). One hundred and twenty-two patients (58.7%) were diagnosed with latent syphilis, and the rate tended to increase with age (p＜0.001). Conclusion Although the number of patients with syphilis is declining, the number of young and female patients is increasing compared to the past. Therefore, education and caution against syphilis by dermatologists may be necessary, especially for younger people.

Background: Syphilis is an infectious and sexually transmitted disease caused by Treponema pallidum. The diagnosis and treatment of syphilis may be delayed because of the various clinical features. Objective: The purpose of this study was to investigate the epidemiological changes and clinical features of syphilis in Korea. Methods: We conducted a retrospective analysis of 303 subjects with positive venereal disease research laboratories results, including 208 syphilis patients who visited the Dermatology Department of Chosun University Hospital between 2008 and 2019. The analysis was performed based on variables, such as age, sex, serological results, and clinical stages. Results: During the study period, the mean reactive rate of the serum venereal disease research laboratories test was 0.14%, and the annual incidence rate tended to decrease. Of the 208 syphilis patients, the male:female ratio was 1:2.7 among those aged 0 to 19 years and 2.3:1 among those aged 50 to 59 years. Eighty-six patients (41.3%) were diagnosed with symptomatic syphilis, which accounted for the highest proportion (63.6%) among those aged 0 to 19 years. The incidence tended to decrease with increasing age (p＜0.001). Maculopapular syphilis was the most commonly observed form of secondary syphilis (44.6%). One hundred and twenty-two patients (58.7%) were diagnosed with latent syphilis, and the rate tended to increase with age (p＜0.001). Conclusion Although the number of patients with syphilis is declining, the number of young and female patients is increasing compared to the past. Therefore, education and caution against syphilis by dermatologists may be necessary, especially for younger people.

The dramatic spread of Coronavirus Disease 2019 (COVID-19) has profound impacts on every continent and life. Due to humanto-human transmission of COVID-19, nuclear medicine staffs also cannot escape the risk of infection from workplaces. Everystaff in the nuclear medicine department must prepare for and respond to COVID-19 pandemic which tailored to the characteristicsof our profession. This article provided the guidance prepared by the Korean Society of Nuclear Medicine (KSNM) incooperation with the Korean Society of Infectious Disease (KSID) and Korean Society for Healthcare-Associated InfectionControl and Prevention (KOSHIC) in managing the COVID-19 pandemic for the nuclear medicine department.We hope that thisguidance will support every practice in nuclear medicine during this chaotic period.

Purpose: Single-photon emission computed tomography/computed tomography (SPECT/CT) is an advanced hybrid nuclear medicine technology that generates both functional and anatomical images in a single study. As utilization of SPECT/CT in Korea has been increasing, the purpose of this study was to survey its application of cardiac and skeletal SPECT/CT imaging for protocol optimization. Methods: We surveyed CT protocols established for cardiac and skeletal SPECT/CT. We searched the guidelines for the CT protocols for SPECT/CT and reviewed the literature recently published. Results: Among 36 hybrid SPECT scanners equipped with four or more multi-channel detector CTs (MDCTs), 18 scanners were used to perform cardiac studies at both very low current CT (30–80 mA; 11.1%) and ultra-low current CT (13–30 mA; 88.9%). Among the 33 canners, very low current (≤ 80 mA) CT or low current CT (80–130 mA) was used in 23.5%, and 41.8% for spine disorders, and in 36.4% or 30.3% for foot/ankle disorders, respectively. In the CT reconstructions, slice thickness of 5 mm for cardiac studies was most commonly used (94.4%); thinner slices (0.6–1.0 mm) for spine and foot/ankle studies were used in 24.2% and 45.5%, respectively. We also reviewed the international guidelines. Conclusions The results and current recommendations will be helpful for optimizing CT protocols for SPECT/CT. Optimization of SPECT/CT protocols will be required for generating the proper strategy for the specific lesions and clinical purpose.

BACKGROUND/AIMS: Colorectal cancer is associated with different anatomical, biological, and clinical characteristics. We determined the impact of the primary tumor location in patients with metastatic colorectal cancer (mCRC). METHODS: Demographic data and clinical information were collected from 1,115 patients from the Republic of Korea, who presented with mCRC between January 2009 and December 2011, using web-based electronic case report forms. Associations between the primary tumor location and the patient's clinical characteristics were assessed, and factors inf luencing overall survival were analyzed using Cox proportional hazards regression models. RESULTS: Of the 1,115 patients recruited to the study, 244 (21.9%) had right colon cancer, 483 (43.3%) had left colon cancer, and 388 (34.8%) had rectal cancer. Liver and lung metastases occurred more frequently in patients with left colon and rectal cancer (p = 0.005 and p = 0.006, respectively), while peritoneal and ovarian metastases occurred more frequently in patients with right and left colon cancer (p < 0.001 and p = 0.031, respectively). The median overall survival of patients with tumors originating in the right colon was significantly shorter than that of patients whose tumors had originated in the left colon or rectum (13.7 months [95% confidence interval (CI), 12.0 to 15.5] vs. 18.0 months [95% CI, 16.3 to 19.7] or 19.9 months [95% CI, 18.5 to 21.3], respectively; p = 0.003). Tumor resection, the number of metastatic sites, and primary tumor location correlated with overall survival in the univariate and multivariate analyses. CONCLUSIONS: Primary tumor location influences the metastatic sites and prognosis of patients with mCRC.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Liver ; Lung ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Rectal Neoplasms ; Rectum ; Republic of Korea