Objective: The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. Methods: We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed. Results: A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001). Conclusion The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

Objective: The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. Methods: We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed. Results: A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001). Conclusion The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

Objective: The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. Methods: We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed. Results: A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001). Conclusion The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

Objective: The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. Methods: We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed. Results: A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001). Conclusion The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

Objective: The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. Methods: We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed. Results: A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001). Conclusion The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Objectives: ：This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation. Methods: ：The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation. Results: ：Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased. Conclusions ：Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Objective: We aimed to identify the expectations and preferences for medication and medical decision-making in patients with major psychiatric disorders. Methods: A survey was conducted among patients with major psychiatric disorders who visited psychiatric outpatient clinics at 15 hospitals between 2016 and 2018 in Korea. The survey consisted of 12 questions about demographic variables and opinions on their expectations for medication, important medical decision-makers, and preferred drug type. The most preferred value in each category in the total population was identified, and differences in the preference ratio of each item among the disease groups were compared. Results: A total of 707 participants were surveyed. In the total population, patients reported high efficacy (44.01%±21.44%) as the main wish for medication, themselves (37.39%±22.57%) and a doctor (35.27%±22.88%) as the main decision makers, and tablet/capsule (36.16%±30.69%) as the preferred type of drug. In the depressive disorders group, the preference ratio of high efficacy was significantly lower, and the preference ratio of a small amount was significantly higher than that of the psychotic disorder and bipolar disorder groups. The preference ratio of a doctor as an important decision maker in the bipolar disorder group was higher compared to the other groups. Conclusion This study revealed the preference for medications and showed differences among patients with psychiatric disorders. Providing personalized medicine that considers a patient’s preference for the drug may contribute to the improvement of drug compliance and outcomes.