Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Objectives: This study was designed to investigate whether there was a relationship between smoking and generalized anxiety disorder (GAD) in a Korean adult group. Methods: This study was based on the data from eighth Korean National Health and Nutrition Examination Survey (KNHANES). The subjects were 5,273 adults aged 19 years or older. Smoking group was classified into non-smoker, exsmoker, and current smoker. GAD was defined as above 10 points of GAD-7. The correlation between smoking and GAD was examined using complex sample design after adjusting confounders. Results: For male, smoking did not have a significant effect on GAD, but for female, current smokers were significantly more likely to have GAD than non-smokers (odds ratio=2.33, p=0.012). Conclusions The association between smoking and GAD was found only in female. The result means that a differentiated approach is needed for female and male in the management of smokers and patients with GAD.

Objectives: This study was designed to investigate whether there was a relationship between smoking and generalized anxiety disorder (GAD) in a Korean adult group. Methods: This study was based on the data from eighth Korean National Health and Nutrition Examination Survey (KNHANES). The subjects were 5,273 adults aged 19 years or older. Smoking group was classified into non-smoker, exsmoker, and current smoker. GAD was defined as above 10 points of GAD-7. The correlation between smoking and GAD was examined using complex sample design after adjusting confounders. Results: For male, smoking did not have a significant effect on GAD, but for female, current smokers were significantly more likely to have GAD than non-smokers (odds ratio=2.33, p=0.012). Conclusions The association between smoking and GAD was found only in female. The result means that a differentiated approach is needed for female and male in the management of smokers and patients with GAD.

Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disease characterized by spiking fever, arthralgia, skin rashes, and hyperferritinemia. The rash is usually salmon-colored, non-itchy, accompanied by fever, and disappears with an improvement of fever. However, in some cases, the rash persisted regardless of fever. Here, we present a case of AOSD with an atypical persistent rash that showed histological findings resembling those of neutrophilic urticarial dermatosis. The patient was a 60-year-old woman with high fever, arthralgia, and a persistent flagellated skin rash. Despite systemic steroid treatment, the patient developed a serious complication: macrophage activation syndrome. Since this case presented with an atypical persistent rash with histological resemblance to neutrophilic urticarial dermatosis, we report its contribution to the further study of AOSD.

Polychlorinated biphenyls (PCBs) were once used throughout various industries; however, because of their persistence in the environment, exposure remains a global threat to the environment and human health. The Kv1.3 and Kv1.5 channels have been implicated in the immunotoxicity and cardiotoxicity of PCBs, respectively. We determined whether 3,3′,4,4′-tetrachlorobiphenyl (PCB77), a dioxin-like PCB, alters human Kv1.3 and Kv1.5 currents using the Xenopus oocyte expression system. Exposure to 10 nM PCB77 for 15 min enhanced the Kv1.3 current by approximately 30.6%, whereas PCB77 did not affect the Kv1.5 current at concentrations up to 10 nM. This increase in the Kv1.3 current was associated with slower activation and inactivation kinetics as well as right-shifting of the steady-state activation curve. Pretreatment with PCB77 significantly suppressed tumor necrosis factor-α and interleukin-10 production in lipopolysaccharide-stimulated Raw264.7 macrophages. Overall, these data suggest that acute exposure to trace concentrations of PCB77 impairs immune function, possibly by enhancing Kv1.3 currents.

Objectives: This study was designed to investigate whether there was a relationship between smoking and generalized anxiety disorder (GAD) in a Korean adult group. Methods: This study was based on the data from eighth Korean National Health and Nutrition Examination Survey (KNHANES). The subjects were 5,273 adults aged 19 years or older. Smoking group was classified into non-smoker, exsmoker, and current smoker. GAD was defined as above 10 points of GAD-7. The correlation between smoking and GAD was examined using complex sample design after adjusting confounders. Results: For male, smoking did not have a significant effect on GAD, but for female, current smokers were significantly more likely to have GAD than non-smokers (odds ratio=2.33, p=0.012). Conclusions The association between smoking and GAD was found only in female. The result means that a differentiated approach is needed for female and male in the management of smokers and patients with GAD.

Background: Various treatment modalities are used to treat keloids. However, a comprehensive assessment comparing the effectiveness of these modalities in terms of patient-reported outcomes is warranted. Objective: To assess and compare the effectiveness of various treatment modalities for keloids. Methods: We assessed treatment outcomes in a cohort of 250 patients diagnosed with keloids.The patients were categorized into four treatment groups: triamcinolone acetonide (TA), TA + cryotherapy, TA + pulsed dye laser (PDL), and TA + cryotherapy + PDL. The Vancouver Scar Scale was used to evaluate the keloid severity before and after treatment. Results: Significant differences were noted in the Vancouver Scale scores among the treatment groups (p=0.023). Notably, the TA + cryotherapy + PDL group exhibited the most substantial improvement in the Vancouver Scale scores, whereas the TA + PDL group showed the least difference. Pliability was the most significantly improved in the TA + cryotherapy + PDL group (p=0.039). Male patients experienced a greater reduction in pigmentation scores than female patients (p=0.037). Conclusion Our findings highlight the effectiveness of combined therapies, particularly TA + cryotherapy + PDL, in improving keloid-related parameters. These results offer valuable insights for clinicians in tailoring keloid treatment strategies and support the implementation of combination therapies for enhanced outcomes. This study underscores the importance of comprehensively assessing treatment modalities for keloid management. Combination therapies such as TA + cryotherapy + PDL irradiation have demonstrated significant promise in improving keloid characteristics.

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.