Echinococcosis, caused by the tapeworm Echinococcus, is rare in Korea and is primarily imported from endemic areas. We report a case of a 37-year-old Korean man with multiple large hepatic cysts, initially diagnosed as simple cysts at a local clinic in 2018. The patient had lived in Oman, an endemic area, for several months in 2016. Upon referral to a tertiary hospital in 2023, due to progressive cyst enlargement, liver magnetic resonance imaging revealed three large cysts with a water lily sign. Serum IgG against Echinococcus was positive by enzyme-linked immunosorbent assay. After diagnosis of echinococcosis, treatment with albendazole and puncture-aspiration-injection-reaspiration (PAIR) was performed.Microscopic and molecular analysis of cyst aspirates confirmed Echinococcus granulosus infection. Follow-up computed tomography demonstrated a reduction in cyst size, yet the emergence of a new right pleural effusion and consolidation in the left lower lobe of the lung necessitated the continuation of albendazole therapy. This case highlights the importance of thorough travel history, imaging findings, and the effectiveness of PAIR combined with albendazole in treating imported echinococcosis.

Echinococcosis, caused by the tapeworm Echinococcus, is rare in Korea and is primarily imported from endemic areas. We report a case of a 37-year-old Korean man with multiple large hepatic cysts, initially diagnosed as simple cysts at a local clinic in 2018. The patient had lived in Oman, an endemic area, for several months in 2016. Upon referral to a tertiary hospital in 2023, due to progressive cyst enlargement, liver magnetic resonance imaging revealed three large cysts with a water lily sign. Serum IgG against Echinococcus was positive by enzyme-linked immunosorbent assay. After diagnosis of echinococcosis, treatment with albendazole and puncture-aspiration-injection-reaspiration (PAIR) was performed.Microscopic and molecular analysis of cyst aspirates confirmed Echinococcus granulosus infection. Follow-up computed tomography demonstrated a reduction in cyst size, yet the emergence of a new right pleural effusion and consolidation in the left lower lobe of the lung necessitated the continuation of albendazole therapy. This case highlights the importance of thorough travel history, imaging findings, and the effectiveness of PAIR combined with albendazole in treating imported echinococcosis.

Purpose: Since 1995, the Korean Gastric Cancer Association (KGCA) has been periodically conducting nationwide surveys on patients with surgically treated gastric cancer. This study details the results of the survey conducted in 2023. Materials and Methods: The survey was conducted from March to December 2024 using a standardized case report form. Data were collected on 86 items, including patient demographics, tumor characteristics, surgical procedures, and surgical outcomes. The results of the 2023 survey were compared with those of previous surveys. Results: Data from 12,751 cases were collected from 66 institutions. The mean patient age was 64.6 years, and the proportion of patients aged ≥71 years increased from 9.1% in 1995 to 31.7% in 2023. The proportion of upper-third tumors slightly decreased to 16.8% compared to 20.9% in 2019. Early gastric cancer accounted for 63.1% of cases in 2023.Regarding operative procedures, a totally laparoscopic approach was most frequently applied (63.2%) in 2023, while robotic gastrectomy steadily increased to 9.5% from 2.1% in 2014.The most common anastomotic method was the Billroth II procedure (48.8%) after distal gastrectomy and double-tract reconstruction (51.9%) after proximal gastrectomy in 2023.However, the proportion of esophago-gastrostomy with anti-reflux procedures increased to 30.9%. The rates of post-operative mortality and overall complications were 1.0% and 15.3%, respectively. Conclusions The results of the 2023 nationwide survey demonstrate the current status of gastric cancer treatment in Korea. This information will provide a basis for future gastric cancer research.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Purpose: This study aimed to report the results of Korean Antimicrobial Resistance Monitoring System (KARMS) for uncomplicated cystitis (UC) in 2023. Materials and Methods: KARMS was established for the surveillance of antimicrobial resistance in urinary tract infections with the cooperation of Korean nationwide medical centers. Data from patients with UC have been collected in the web-based KARMS database. Demographic data, uropathogen distribution, and antimicrobial susceptibility of representative pathogens were analyzed. Results: A total of 885 patients’ data were collected in KARMS database. The mean patient age was 56.39±18.26 years. The number of postmenopausal and recurrent cystitis were 530 (61.1%) and 102 (11.5%), respectively. Escherichia coli was the most frequently identified uropathogen (654/871, 75.1%). Regarding antimicrobial susceptibility, 94.9% were susceptible to fosfomycin, 90.5% to nitrofurantoin, 58.4% to ciprofloxacin, 83.6% to cefotaxime, and 100.0% to ertapenem. ESBL positivity was 13.7% (96/702), and significantly higher in tertiary hospital (23.1%, p<0.001), postmenopausal (15.9%, p=0.044), and recurrent cystitis (24.7%, p=0.001).Fluoroquinolone resistance was significantly higher in tertiary hospital (47.4%, p=0.001), postmenopausal (44.9%, p<0.001), and recurrent cystitis (59.8%, p<0.001). In addition, postmenopausal (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.38–2.77, p<0.001) and recurrent cystitis (OR 2.37, 95% CI 1.44–3.92, p=0.001) were associated with increased fluoroquinolone resistance. Conclusions These data provide information on the distribution of uropathogen and the status of antimicrobial resistance in UC of South Korea. In addition, KARMS will be a useful reference in the future through the continuous surveillance system construction over the years.

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.