The global increase in obesity highlights the need for accurate tools to assess body composition and monitor treatment efficacy.Traditional metrics, including body mass index and waist circumference, offer limited precision for fat quantification. Imagingbased techniques capable of visualizing internal structures are increasingly being recognized for their ability to provide comprehensive fat assessment. This review outlines the principles, strengths, and limitations of key modalities, including dualenergy X-ray absorptiometry (DXA), CT, MRI, and bioelectrical impedance analysis (BIA). DXA is cost-effective and accessible for population-level screening, whereas CT and MRI offer higher precision, particularly for visceral fat assessment. BIA is a practical, low-cost alternative, but it is limited by variability and lack of standardization. Regulatory agencies, including the US Food and Drug Administration and the Korean Ministry of Food and Drug Safety, are increasingly supporting imaging-based endpoints in clinical trials of anti-obesity drugs because these methods capture fat mass reduction beyond total weight loss. Recent phase III trials of semaglutide and tirzepatide have underscored the utility of DXA and CT in quantifying fat loss and preserving lean mass. Selecting appropriate imaging modalities based on technical capabilities and regulatory considerations can improve the evaluation of obesity treatments and strengthen the design of anti-obesity drug trials.

Purpose: The male predominance in the incidence of gastric cancer (GC) is established; however, sex differences in the prognosis of GC remain controversial. As such, this study analyzed the prognosis of patients with GC based on age and sex. Materials and Methods: Data from 14,739 patients diagnosed with GC at Seoul National University Bundang Hospital between 2003 and 2023 were analyzed. Baseline characteristics, histological types of GC, overall and GC-specific survival rates (age and stage stratification), and associated risk factors were analyzed. Results: Females were significantly younger (p < 0.001) and exhibited more gastric body cancers (p < 0.001) and tumors with diffuse-type or poorly differentiated histology (p < 0.001) than males. Females exhibited an advantage over males in terms of overall survival (p=0.004), but not in GC-specific survival. However, age stratification revealed significant sex differences, that females < 50 years of age exhibited survival disadvantages (p < 0.001); however, this trend was reversed with age, and females > 60 years exhibited survival advantages (p < 0.001) for both overall and GC-specific survival. This may be explained by the lower ratio of diffuse-type GC as females age. Furthermore, in the analysis according to stage, females with stage IV disease exhibited significant survival disadvantages, with significantly younger age and a higher proportion of diffuse-type GC which exhibits aggressive features, resulting in poorer survival than in males. Conclusion Age and stage stratification revealed significant differences in survival between the sexes, which can be helpful for public health strategies.

A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. A coronary computed tomography showed moderate stenosis with soft plaque at the distal segment of right coronary artery. His pain was improved with antianginal and reflux medications. Twenty days later, he ran to the emergency room complaining of squeezing chest pain. ECG showed mild ST segment elevation in inferior territories. Invasive coronary angiography via right radial artery revealed severe thrombotic occlusion at the same lesion. A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.

This fifth revised version of the Korean Society of Gynecologic Oncology practice guidelines for the management of cervical cancer incorporates recent research findings and changes in treatment strategies based on version 4.0 released in 2020. Each key question was developed by focusing on recent notable insights and crucial contemporary issues in the field of cervical cancer. These questions were evaluated for their significance and impact on the current treatment and were finalized through voting by the development committee. The selected key questions were as follows: the efficacy and safety of immune checkpoint inhibitors as firstor second-line treatment for recurrent or metastatic cervical cancer; the oncologic safety of minimally invasive radical hysterectomy in early stage cervical cancer; the efficacy and safety of adjuvant systemic treatment after concurrent chemoradiotherapy in locally advanced cervical cancer; and the oncologic safety of sentinel lymph node mapping compared to pelvic lymph node dissection. The recommendations, directions, and strengths of this guideline were based on systematic reviews and meta-analyses, and were finally confirmed through public hearings and external reviews. In this study, we describe the revised practice guidelines for the management of cervical cancer.

Background: Although symptomatic local recurrence (SLR) of spinal metastasis is relatively common after aggressive surgery, there have been few studies on SLR according to the extent of tumor removal. This study aimed to evaluate the incidence of SLR after surgery in spinal metastasis and analyze the risk factors of SLR. Methods: This study included patients with spinal metastasis to all 3 vertebral columns. SLR was defined as the occurrence of new symptoms, confirmed by radiologic regrowth of tumor. The extent of tumor removal was classified into 3 types (corpectomy, separation surgery, and only posterior column removal). The Kaplan-Meier method was used to analyze the SLR rate after surgery.The presumed risk factors of SLR were evaluated using log-rank test and Cox regression analysis. Results: This study included 102 patients with a mean follow-up period of 17.7 months (range, 3–84 months). After surgical treatment, SLR was confirmed in 35 patients (34.3%). Kaplan-Meier analysis predicted that the incidence of SLR was 4.4% at 6 months, 21.5% at 12 months, 34.0% at 18 months, and 42.7% at 24 months. In the univariate analysis, the primary malignancy site, number of vertebral metastases, and surgery for progressed tumor after previous radiation therapy were significant (p = 0.042, p = 0.048, and p = 0.008, respectively). No significant differences were observed in the extent of tumor removal (p = 0.536). In the multivariate analysis, the significant risk factors of SLR included only previous radiation therapy (p = 0.012). The risk of SLR was 2.8 times higher in patients who received surgery for progressed tumor after previous radiation therapy than in those without it. Conclusions The SLR of spinal metastasis was predicted in 21.5% of patients at 1 year after surgical treatment. The extent of tumor removal did not seem to affect SLR. Surgery for progressed tumor after previous radiation therapy was confirmed as the only substantial risk factor. Therefore, the tumor's response to preoperative radiation therapy is the most important factor in determining SLR.

Background: Although symptomatic local recurrence (SLR) of spinal metastasis is relatively common after aggressive surgery, there have been few studies on SLR according to the extent of tumor removal. This study aimed to evaluate the incidence of SLR after surgery in spinal metastasis and analyze the risk factors of SLR. Methods: This study included patients with spinal metastasis to all 3 vertebral columns. SLR was defined as the occurrence of new symptoms, confirmed by radiologic regrowth of tumor. The extent of tumor removal was classified into 3 types (corpectomy, separation surgery, and only posterior column removal). The Kaplan-Meier method was used to analyze the SLR rate after surgery.The presumed risk factors of SLR were evaluated using log-rank test and Cox regression analysis. Results: This study included 102 patients with a mean follow-up period of 17.7 months (range, 3–84 months). After surgical treatment, SLR was confirmed in 35 patients (34.3%). Kaplan-Meier analysis predicted that the incidence of SLR was 4.4% at 6 months, 21.5% at 12 months, 34.0% at 18 months, and 42.7% at 24 months. In the univariate analysis, the primary malignancy site, number of vertebral metastases, and surgery for progressed tumor after previous radiation therapy were significant (p = 0.042, p = 0.048, and p = 0.008, respectively). No significant differences were observed in the extent of tumor removal (p = 0.536). In the multivariate analysis, the significant risk factors of SLR included only previous radiation therapy (p = 0.012). The risk of SLR was 2.8 times higher in patients who received surgery for progressed tumor after previous radiation therapy than in those without it. Conclusions The SLR of spinal metastasis was predicted in 21.5% of patients at 1 year after surgical treatment. The extent of tumor removal did not seem to affect SLR. Surgery for progressed tumor after previous radiation therapy was confirmed as the only substantial risk factor. Therefore, the tumor's response to preoperative radiation therapy is the most important factor in determining SLR.

A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. A coronary computed tomography showed moderate stenosis with soft plaque at the distal segment of right coronary artery. His pain was improved with antianginal and reflux medications. Twenty days later, he ran to the emergency room complaining of squeezing chest pain. ECG showed mild ST segment elevation in inferior territories. Invasive coronary angiography via right radial artery revealed severe thrombotic occlusion at the same lesion. A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.

Background: Although symptomatic local recurrence (SLR) of spinal metastasis is relatively common after aggressive surgery, there have been few studies on SLR according to the extent of tumor removal. This study aimed to evaluate the incidence of SLR after surgery in spinal metastasis and analyze the risk factors of SLR. Methods: This study included patients with spinal metastasis to all 3 vertebral columns. SLR was defined as the occurrence of new symptoms, confirmed by radiologic regrowth of tumor. The extent of tumor removal was classified into 3 types (corpectomy, separation surgery, and only posterior column removal). The Kaplan-Meier method was used to analyze the SLR rate after surgery.The presumed risk factors of SLR were evaluated using log-rank test and Cox regression analysis. Results: This study included 102 patients with a mean follow-up period of 17.7 months (range, 3–84 months). After surgical treatment, SLR was confirmed in 35 patients (34.3%). Kaplan-Meier analysis predicted that the incidence of SLR was 4.4% at 6 months, 21.5% at 12 months, 34.0% at 18 months, and 42.7% at 24 months. In the univariate analysis, the primary malignancy site, number of vertebral metastases, and surgery for progressed tumor after previous radiation therapy were significant (p = 0.042, p = 0.048, and p = 0.008, respectively). No significant differences were observed in the extent of tumor removal (p = 0.536). In the multivariate analysis, the significant risk factors of SLR included only previous radiation therapy (p = 0.012). The risk of SLR was 2.8 times higher in patients who received surgery for progressed tumor after previous radiation therapy than in those without it. Conclusions The SLR of spinal metastasis was predicted in 21.5% of patients at 1 year after surgical treatment. The extent of tumor removal did not seem to affect SLR. Surgery for progressed tumor after previous radiation therapy was confirmed as the only substantial risk factor. Therefore, the tumor's response to preoperative radiation therapy is the most important factor in determining SLR.

Background: Although symptomatic local recurrence (SLR) of spinal metastasis is relatively common after aggressive surgery, there have been few studies on SLR according to the extent of tumor removal. This study aimed to evaluate the incidence of SLR after surgery in spinal metastasis and analyze the risk factors of SLR. Methods: This study included patients with spinal metastasis to all 3 vertebral columns. SLR was defined as the occurrence of new symptoms, confirmed by radiologic regrowth of tumor. The extent of tumor removal was classified into 3 types (corpectomy, separation surgery, and only posterior column removal). The Kaplan-Meier method was used to analyze the SLR rate after surgery.The presumed risk factors of SLR were evaluated using log-rank test and Cox regression analysis. Results: This study included 102 patients with a mean follow-up period of 17.7 months (range, 3–84 months). After surgical treatment, SLR was confirmed in 35 patients (34.3%). Kaplan-Meier analysis predicted that the incidence of SLR was 4.4% at 6 months, 21.5% at 12 months, 34.0% at 18 months, and 42.7% at 24 months. In the univariate analysis, the primary malignancy site, number of vertebral metastases, and surgery for progressed tumor after previous radiation therapy were significant (p = 0.042, p = 0.048, and p = 0.008, respectively). No significant differences were observed in the extent of tumor removal (p = 0.536). In the multivariate analysis, the significant risk factors of SLR included only previous radiation therapy (p = 0.012). The risk of SLR was 2.8 times higher in patients who received surgery for progressed tumor after previous radiation therapy than in those without it. Conclusions The SLR of spinal metastasis was predicted in 21.5% of patients at 1 year after surgical treatment. The extent of tumor removal did not seem to affect SLR. Surgery for progressed tumor after previous radiation therapy was confirmed as the only substantial risk factor. Therefore, the tumor's response to preoperative radiation therapy is the most important factor in determining SLR.

This fifth revised version of the Korean Society of Gynecologic Oncology practice guidelines for the management of cervical cancer incorporates recent research findings and changes in treatment strategies based on version 4.0 released in 2020. Each key question was developed by focusing on recent notable insights and crucial contemporary issues in the field of cervical cancer. These questions were evaluated for their significance and impact on the current treatment and were finalized through voting by the development committee. The selected key questions were as follows: the efficacy and safety of immune checkpoint inhibitors as firstor second-line treatment for recurrent or metastatic cervical cancer; the oncologic safety of minimally invasive radical hysterectomy in early stage cervical cancer; the efficacy and safety of adjuvant systemic treatment after concurrent chemoradiotherapy in locally advanced cervical cancer; and the oncologic safety of sentinel lymph node mapping compared to pelvic lymph node dissection. The recommendations, directions, and strengths of this guideline were based on systematic reviews and meta-analyses, and were finally confirmed through public hearings and external reviews. In this study, we describe the revised practice guidelines for the management of cervical cancer.