Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Background: Although patients with malignant melanoma in situ (MIS) have a high survival rate, a risk of recurrence or upstaging remains. Thus, a comprehensive understanding of its prognosis is essential for optimal patient management. Objective: To investigate the clinical characteristics and survival outcomes of Korean patients with MIS. Methods: We retrospectively analyzed the medical records and photographs of patients with MIS treated at a single tertiary center between 2008 and 2021. Clinical features, including diagnosis, treatment, recurrence, and mortality, were examined. Results: A total of 156 patients with MIS were included, with a mean age of 59.3 years. The most common subtype was acral lentiginous melanoma (80.8%). Delayed diagnosis was associated with subungual MIS (SUMis; p ＜0.05). Among the subtypes other than SUMis, 77.3% met three or more of the ABCD criteria for melanoma.Hutchinson’s sign was observed in 67.3% of cases of SUMis. Ulceration was present in only two cases (1.3%).Recurrence occurred in nine patients (5.8%), with four (2.6%) experiencing relapse after 5 years. Upstaging was observed in two patients (1.3%) due to intralymphatic or regional nodal metastasis occurring at 19 and 10 months post-treatment. The 5-year and 10-year melanoma-specific/overall survival rates were 100.0/96.9% and 100.0/89.0%, respectively. Conclusion Although the survival rates of patients with MIS are high, long-term and close follow-up after treatment is essential because of the possibility of late recurrence and rare instances of intralymphatic or regional nodal metastasis. Additionally, the presence of clinical ulceration is highly suggestive of invasive melanoma.

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.

Background: Dynapenia is one of several important factors determining the prognosis of patients with diabetes mellitus. The present study aimed to identify factors associated with dynapenia in older Korean adults with diabetes. Methods: Based on information from the 2014–2019 Korea National Health and Nutrition Examination Survey, data from 1,769 patients with diabetes ≥65 years of age were analyzed. Dynapenia was defined grip strength <28 kg in males and <18 kg in females. Subjects were divided into a dynapenia group and a normal group according to sex, and logistic regression analysis was performed to analyze factors associated with dynapenia. Results: The prevalence of dynapenia in the entire cohort was 29.8% (n=499), with 21.6% (n=183) of 860 males and 37.2% (n=316) of 909 females. The odds ratio of dynapenia increased with advancing age in both males and females. After multivariable analysis, the factors significantly associated with dynapenia were lack of regular strength exercise (adjusted odds ratio [aOR], 3.188; 95% confidence interval [CI], 1.751–5.806) and body mass index (aOR, 0.908 per 1 kg/m 2 ; 95% CI, 0.845–0.975) among male, and lack of regular aerobic exercise (aOR, 1.511; 95% CI, 1.033–2.209) among females. Conclusion Advancing age in Korean adult males and females with diabetes exhibited a statistically significant association with dynapenia. In addition, significant associations with dynapenia were observed in males with lower body mass index and males who did not engage in regular strength exercise. A lack of regular aerobic exercise was statistically associated with dynapenia among females.

Background: Dynapenia is one of several important factors determining the prognosis of patients with diabetes mellitus. The present study aimed to identify factors associated with dynapenia in older Korean adults with diabetes. Methods: Based on information from the 2014–2019 Korea National Health and Nutrition Examination Survey, data from 1,769 patients with diabetes ≥65 years of age were analyzed. Dynapenia was defined grip strength <28 kg in males and <18 kg in females. Subjects were divided into a dynapenia group and a normal group according to sex, and logistic regression analysis was performed to analyze factors associated with dynapenia. Results: The prevalence of dynapenia in the entire cohort was 29.8% (n=499), with 21.6% (n=183) of 860 males and 37.2% (n=316) of 909 females. The odds ratio of dynapenia increased with advancing age in both males and females. After multivariable analysis, the factors significantly associated with dynapenia were lack of regular strength exercise (adjusted odds ratio [aOR], 3.188; 95% confidence interval [CI], 1.751–5.806) and body mass index (aOR, 0.908 per 1 kg/m 2 ; 95% CI, 0.845–0.975) among male, and lack of regular aerobic exercise (aOR, 1.511; 95% CI, 1.033–2.209) among females. Conclusion Advancing age in Korean adult males and females with diabetes exhibited a statistically significant association with dynapenia. In addition, significant associations with dynapenia were observed in males with lower body mass index and males who did not engage in regular strength exercise. A lack of regular aerobic exercise was statistically associated with dynapenia among females.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Background: Dynapenia is one of several important factors determining the prognosis of patients with diabetes mellitus. The present study aimed to identify factors associated with dynapenia in older Korean adults with diabetes. Methods: Based on information from the 2014–2019 Korea National Health and Nutrition Examination Survey, data from 1,769 patients with diabetes ≥65 years of age were analyzed. Dynapenia was defined grip strength <28 kg in males and <18 kg in females. Subjects were divided into a dynapenia group and a normal group according to sex, and logistic regression analysis was performed to analyze factors associated with dynapenia. Results: The prevalence of dynapenia in the entire cohort was 29.8% (n=499), with 21.6% (n=183) of 860 males and 37.2% (n=316) of 909 females. The odds ratio of dynapenia increased with advancing age in both males and females. After multivariable analysis, the factors significantly associated with dynapenia were lack of regular strength exercise (adjusted odds ratio [aOR], 3.188; 95% confidence interval [CI], 1.751–5.806) and body mass index (aOR, 0.908 per 1 kg/m 2 ; 95% CI, 0.845–0.975) among male, and lack of regular aerobic exercise (aOR, 1.511; 95% CI, 1.033–2.209) among females. Conclusion Advancing age in Korean adult males and females with diabetes exhibited a statistically significant association with dynapenia. In addition, significant associations with dynapenia were observed in males with lower body mass index and males who did not engage in regular strength exercise. A lack of regular aerobic exercise was statistically associated with dynapenia among females.

Owing to advances in diagnostics and the increase in invasive procedures, and immunocompromised patients, cutaneous nontuberculous mycobacteria (NTM) infection is rising. NTM should be suspected in patients with persistent skin lesions refractory to treatment with a history of immunosuppression or skin injury. A 59-year-old woman presented with a 4-week history of multiple erythematous tender nodules on left arm. A year prior, multiple nodules appeared on left hand dorsum, followed by recurrent suppurative nodules in left arm. She has been taking methotrexate and leflunomide for 7 years due to rheumatoid arthritis (RA). Skin biopsy revealed granulomatous inflammation, and NTM polymerase chain reaction test was positive. Furthermore, she had cut her left finger with a knife 14 months ago. Based on these findings, cutaneous NTM infection was diagnosed. Herein, we report a case of cutaneous NTM infection in an immunosuppressed patient with RA, emphasizing differentiating subcutaneous nodules from rheumatoid nodules in RA.

Background: Dynapenia is one of several important factors determining the prognosis of patients with diabetes mellitus. The present study aimed to identify factors associated with dynapenia in older Korean adults with diabetes. Methods: Based on information from the 2014–2019 Korea National Health and Nutrition Examination Survey, data from 1,769 patients with diabetes ≥65 years of age were analyzed. Dynapenia was defined grip strength <28 kg in males and <18 kg in females. Subjects were divided into a dynapenia group and a normal group according to sex, and logistic regression analysis was performed to analyze factors associated with dynapenia. Results: The prevalence of dynapenia in the entire cohort was 29.8% (n=499), with 21.6% (n=183) of 860 males and 37.2% (n=316) of 909 females. The odds ratio of dynapenia increased with advancing age in both males and females. After multivariable analysis, the factors significantly associated with dynapenia were lack of regular strength exercise (adjusted odds ratio [aOR], 3.188; 95% confidence interval [CI], 1.751–5.806) and body mass index (aOR, 0.908 per 1 kg/m 2 ; 95% CI, 0.845–0.975) among male, and lack of regular aerobic exercise (aOR, 1.511; 95% CI, 1.033–2.209) among females. Conclusion Advancing age in Korean adult males and females with diabetes exhibited a statistically significant association with dynapenia. In addition, significant associations with dynapenia were observed in males with lower body mass index and males who did not engage in regular strength exercise. A lack of regular aerobic exercise was statistically associated with dynapenia among females.