Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background/Aims: We investigated the clinical practice patterns of Korean endoscopists for the endoscopic resection of colorectal polyps. Methods: From September to November 2021, an online survey was conducted regarding the preferred resection methods for colorectal polyps, and responses were compared with the international guidelines. Results: Among 246 respondents, those with <4 years, 4–9 years, and ≥10 years of experiencein colonoscopy practices accounted for 25.6%, 34.1%, and 40.2% of endoscopists, respectively. The most preferred resection methods for non-pedunculated lesions were cold forceps polypectomy for ≤3 mm lesions (81.7%), cold snare polypectomy for 4–5 mm (61.0%) and 6–9 mm (43.5%) lesions, hot endoscopic mucosal resection (EMR) for 10–19 mm lesions (72.0%), precut EMR for 20–25 mm lesions (22.0%), and endoscopic submucosal dissection (ESD) for ≥26 mm lesions (29.3%). Hot EMR was favored for pedunculated lesions with a head size <20 mm and stalk size <10 mm (75.6%) and for those with a head size ≥20 mm or stalk size ≥10 mm (58.5%). For suspected superficial and deep submucosal lesions measuring 10–19 mm and ≥20 mm, ESD (26.0% and 38.6%) and surgery (36.6% and 46.3%) were preferred, respectively. The adherence rate to the guidelines ranged from 11.2% to 96.9%, depending on the size, shape, and histology of the lesions. Conclusions Adherence to the guidelines for endoscopic resection techniques varied depend-ing on the characteristics of colorectal polyps. Thus, an individualized approach is required to increase adherence to the guidelines.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Background: Transfusion reactions have been under-reported, and the laboratory tests to evaluate the causes of the reactions are unfamiliar to physicians other than transfusion specialists. The paper-based transfusion reaction reporting system previously used in our hospital was one-way, with physicians submitting it to the Department of Transfusion Management. To address this, we developed an electronic reporting system that improves communication with physicians to identify the cause of transfusion reactions and recommend appropriate blood components. Methods: To assess the status of transfusion reaction reporting, transfusion reaction reports and transfusion nursing records of 5 years from 2019 to 2023 were analyzed. The transfusion reaction reporting system comprises two parts: the physician's report and the response from the Department of Transfusion Management. If physicians order blood products for patients with a history of prior transfusion reactions, a pop-up alert appears, warning them to check the details of the previous report. Results: From 2019 to 2023, 2.5% cases of transfusion-related symptoms occurred annually and only 2.6% of transfusion reactions were reported. In 21 out of the 31 cases, the cause was difficult to determine due to inadequate laboratory tests.The attending physicians of 12 cases were given a recommendation to use blood products or to conduct further laboratory tests by the Department of Transfusion Management to reduce recurrence, but the advice was followed only in 4 cases. Conclusion The electronic transfusion reaction reporting system could help physicians conduct appropriate investigations for transfusion reactions and inform physicians regarding the laboratory tests required to be undertaken. It is expected to enhance blood transfusion safety and management by improving communication with physicians.

Purpose: Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT). Materials and Methods: In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1). Results: Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified. Conclusion Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.

Viral load and the duration of viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important determinants of the transmission of coronavirus disease 2019.In this study, we examined the effects of viral doses on the lung and spleen of K18-hACE2 transgenic mice by temporal histological and transcriptional analyses. Approximately, 1×105 plaque-forming units (PFU) of SARS-CoV-2 induced strong host responses in the lungs from 2 days post inoculation (dpi) which did not recover until the mice died, whereas responses to the virus were obvious at 5 days, recovering to the basal state by 14 dpi at 1×102 PFU. Further, flow cytometry showed that number of CD8+ T cells continuously increased in 1×102 PFU-virusinfected lungs from 2 dpi, but not in 1×105 PFU-virus-infected lungs. In spleens, responses to the virus were prominent from 2 dpi, and number of B cells was significantly decreased at 1×105PFU; however, 1×102 PFU of virus induced very weak responses from 2 dpi which recovered by 10 dpi. Although the defense responses returned to normal and the mice survived, lung histology showed evidence of fibrosis, suggesting sequelae of SARS-CoV-2 infection. Our findings indicate that specific effectors of the immune response in the lung and spleen were either increased or depleted in response to doses of SARS-CoV-2. This study demonstrated that the response of local and systemic immune effectors to a viral infection varies with viral dose, which either exacerbates the severity of the infection or accelerates its elimination.