Purpose: The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients. Materials and Methods: We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided. Results: From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient. Conclusion Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs.

Purpose: The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients. Materials and Methods: We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided. Results: From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient. Conclusion Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs.

Purpose: The Korean Cancer Study Group (KCSG) is a nationwide cancer clinical trial group dedicated to advancing investigator-initiated trials (IITs) by conducting and supporting clinical trials. This study aims to review IITs conducted by KCSG and quantitatively evaluate the survival and financial benefits of IITs for patients. Materials and Methods: We reviewed IITs conducted by KCSG from 1998 to 2023, analyzing progression-free survival (PFS) and overall survival (OS) gains for participants. PFS and OS benefits were calculated as the difference in median survival times between the intervention and control groups, multiplied by the number of patients in the intervention group. Financial benefits were assessed based on the cost of investigational products provided. Results: From 1998 to 2023, KCSG conducted 310 IITs, with 133 completed and published. Of these, 21 were included in the survival analysis. The analysis revealed that 1,951 patients in the intervention groups gained a total of 2,558.4 months (213.2 years) of PFS and 2,501.6 months (208.5 years) of OS, with median gains of 1.31 months in PFS and 1.58 months in OS per patient. When analyzing only statistically significant results, PFS and OS gain per patients was 1.69 months and 3.02 months, respectively. Investigational drug cost analysis from six available IITs indicated that investigational products provided to 252 patients were valued at 10,400,077,294 won (approximately 8,046,481 US dollars), averaging about 41,270,148 won (approximately 31,930 US dollars) per patient. Conclusion Our findings, based on analysis of published research, suggest that IITs conducted by KCSG led to survival benefits for participants and, in some studies, may have provided financial benefits by providing investment drugs.

Background: Biologics effectively improve psoriatic skin lesions, but their impact on itch relief remains unclear. Objective: To evaluate itch improvement in severe psoriasis patients treated with ustekinumab or guselkumab. Methods: This retrospective study analyzed patients with severe psoriasis who completed initial efficacy evaluations after treatment with either biologic. Itch severity was assessed using numerical rating scale (NRS), visual analog scale, and verbal rating scale. NRS improvement was evaluated after three injections. Results: Among 108 patients (74 on ustekinumab, 34 on guselkumab), 77 (71.3%) had moderate-to-severe itch (NRS ≥4) at baseline. Of these, 63 (81.8%) achieved an NRS improvement of ≥4 points. Ustekinumab showed greater itch relief compared to guselkumab in NRS (p=0.033). On the other hand, guselkumab showed more reduction for psoriatic skin lesions than ustekinumab in the Psoriasis Area and Severity Index (p=0.040). In the moderate-to-severe itch group, patients with large plaques experienced significantly greater improvement in NRS than those with small plaques (p=0.012). Conclusion While guselkumab is generally preferred for psoriatic skin lesions, ustekinumab may provide superior itch relief.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Background: Although the prevalence of diabetic kidney disease (DKD) is increasing, reliable biomarkers for its early detection are scarce. This study aimed to evaluate the association of adenosine and succinate levels and their related pathways, including hyaluronic acid (HA) synthesis, with DKD. Methods: We examined 235 participants and categorized them into three groups: healthy controls; those with diabetes but without DKD; and those with DKD, which was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. We compared the concentrations of urinary adenosine, succinate, and HA and the serum levels of cluster of differentiation 39 (CD39) and CD73, which are involved in adenosine generation, among the groups with DKD or albuminuria. In addition, we performed multiple logistic regression analysis to evaluate the independent association of DKD or albuminuria with the metabolites after adjusting for risk factors. We also showed the association of these metabolites with eGFR measured several years before enrollment. This study was registered with the Clinical Research Information Service (https://cris.nih.go.kr; Registration number: KCT0003573). Results: Urinary succinate and serum CD39 levels were higher in the DKD group than in the control and non-DKD groups. Correlation analysis consistently linked urinary succinate and serum CD39 concentrations with eGFR, albuminuria, and ΔeGFR, which was calculated retrospectively. However, among the various metabolites studied, only urinary succinate was identified as an independent indicator of DKD and albuminuria. Conclusion Among several potential metabolites, only urinary succinate was independently associated with DKD. These findings hold promise for clinical application in the management of DKD.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Purpose: To investigate the epidemiological trends and socioeconomic disparities associated with ankylosing spondylitis (AS) in South Korea over a decade (2010–2021) using National Health Insurance Service (NHIS) claims data. Materials and Methods: Employing data from the NHIS database, this study identified 31753 incident AS patients in 2010–2021.We calculated the annual age-standardized prevalence and incidence rates and analyzed crude incidence rates and diagnostic patterns across age groups. Additionally, we compared the mean annual proportions of medical aid recipients between AS patients and the general population, utilizing p for trend analysis to assess the differences between the two groups across increasing age groups. Results: The study period saw a steady increase in age-standardized prevalence (from 34.6 to 91.0 per 100000) and incidence rates (from 4.41 to 8.33 per 100000 person-years), with the most substantial rise of incidence found in younger demographics. Diagnostic trends revealed a shift from internal medicine (IM) to other specialties including orthopedics with increasing patient age groups (p for trend=0.008), indicating old-age diagnosis in non-IM departments. A 1.4-fold higher proportion of medical aid recipients in AS patients (p<0.001) and the widening gap of dependency on medical aid in older age groups (p for trend=0.012) compared to the general population highlight socioeconomic disparities. Conclusion This comprehensive analysis reveals the growing epidemiological burden of AS, especially in younger populations, and the socioeconomic disparities regarding the disease in South Korea. It underscores the need for early diagnosis and effective treatment strategies, paving the way for health interventions and policies aimed at improving patient outcomes and addressing socioeconomic disparities.

Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.

Background: Although the prevalence of diabetic kidney disease (DKD) is increasing, reliable biomarkers for its early detection are scarce. This study aimed to evaluate the association of adenosine and succinate levels and their related pathways, including hyaluronic acid (HA) synthesis, with DKD. Methods: We examined 235 participants and categorized them into three groups: healthy controls; those with diabetes but without DKD; and those with DKD, which was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. We compared the concentrations of urinary adenosine, succinate, and HA and the serum levels of cluster of differentiation 39 (CD39) and CD73, which are involved in adenosine generation, among the groups with DKD or albuminuria. In addition, we performed multiple logistic regression analysis to evaluate the independent association of DKD or albuminuria with the metabolites after adjusting for risk factors. We also showed the association of these metabolites with eGFR measured several years before enrollment. This study was registered with the Clinical Research Information Service (https://cris.nih.go.kr; Registration number: KCT0003573). Results: Urinary succinate and serum CD39 levels were higher in the DKD group than in the control and non-DKD groups. Correlation analysis consistently linked urinary succinate and serum CD39 concentrations with eGFR, albuminuria, and ΔeGFR, which was calculated retrospectively. However, among the various metabolites studied, only urinary succinate was identified as an independent indicator of DKD and albuminuria. Conclusion Among several potential metabolites, only urinary succinate was independently associated with DKD. These findings hold promise for clinical application in the management of DKD.