1.The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0
Hyo Seon RYU ; Hyun Jung KIM ; Dong Hyun KANG ; Yoo-Kang KWAK ; Han Deok KWAK ; Yoon-Hye KWON ; Dalyon KIM ; Baek-Hui KIM ; Jae Hyun KIM ; Ji Hun KIM ; Jin Won KIM ; Tae Hyung KIM ; Hae Young KIM ; Soo Min NAM ; Gyoung Tae NOH ; Jun Woo BONG ; Nak Song SUNG ; Seon Hui SHIN ; Kil-Yong LEE ; Sung Chul LEE ; Sea-Won LEE ; Jung Won LEE ; Jong Min LEE ; Myung Hoon IHN ; Joo Han LIM ; Woong Bae JI ; Dae Hee PYO ; Young Ki HONG ; Jung-Myun KWAK ;
Annals of Coloproctology 2026;42(1):4-33
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.
2.Vitrectomy as a Treatment for Vitreous Floaters: A Review
Jiwon BAEK ; Seung Min LEE ; Yong-Sok JI ; Un Chul PARK ; Kyu Hyung PARK ;
Journal of Retina 2025;10(2):127-134
Vitreous floaters are a common ophthalmic symptom caused by age-related vitreous degeneration, trauma, or other ocular conditions.Patients typically describe floaters as moving shadows or thread-like opacities in their visual field, which can cause significant visual and psychological discomfort. While most cases improve over time through natural neuroadaptation, some patients experience persistent symptoms that impact quality of life and seek active treatment. Despite various therapeutic attempts—including Nd:YAG vitreolysis, pharmacologic vitreolysis, and pars plana vitrectomy (PPV)—no standardized treatment guideline has been established. Among those proposed, PPV is the most direct method to remove floaters, but it poses considerable risks, including cataract formation, retinal tears, retinal detachment, and endophthalmitis. Additionally, its subjective efficacy raises concerns about inconsistent outcomes. This review explores the pathophysiology of vitreous changes leading to floaters and critically evaluates the efficacy and safety of PPV for floater treatment based on current literature and the results of a survey conducted by the Korean Retina Society. The survey indicates that most specialists prefer observation and patient counseling over surgery, citing high complication risks, limited benefits, and ethical concerns.Floater management should prioritize conservative approaches, and PPV should be considered only in highly selected cases following thorough evaluation and counseling. Continued research into safer and more effective treatments is essential for addressing this common yet complex clinical issue.
3.Conventional machine learning-based prediction models did not outperform the International IgA Nephropathy Prediction Tool
Sehoon PARK ; Yisak KIM ; Chung Hee BAEK ; Hyunjeong CHO ; Ji In PARK ; Eun Sil KOH ; Jung Pyo LEE ; Sun-Hee PARK ; Hyung Woo KIM ; Seung Hyeok HAN ; Ho Jun CHIN ; Dong Ki KIM ; Kyung Chul MOON ; Young-Gon KIM ; Hajeong LEE
Kidney Research and Clinical Practice 2025;44(5):802-813
Immunoglobulin A nephropathy (IgAN) is a major cause of end-stage kidney disease (ESKD). The International IgA Nephropathy Prediction Tool (IIgAN-PT) predicts IgAN prognosis, but improvement in the prediction performance using machine learning (ML)-based methods is needed. Methods: We analyzed 4,425 biopsy-confirmed patients with IgAN and ≥6 months of follow-up from nine tertiary university hospitals in Korea. The study population was divided into development and validation cohorts. Using the collected 87 clinicodemographic and pathological variables, ML-based prediction models for ESKD or estimated glomerular filtration rate decline (50% reduction or <15 mL/min/1.73 m2 ) were constructed: 1) the conventional CatBoost model, 2) the optimized CatBoost model with Cox proportional hazards, 3) the deep Cox proportional hazards model, and 4) the deep Cox mixture model. The area under the curve (AUC) and calibration plots were used to investigate the discriminative and calibration performance of the models, which were then compared with those of the IIgAN-PT full model. Results: The full model showed excellent performance (AUC [95% confidence interval] for 5-year outcome, 0.896 [0.853–0.940]), with acceptable calibration results. The ML-based models showed good performance in predicting adverse kidney outcomes and revealed acceptable discrimination performance in the external validation (AUC [95% confidence interval] for the 5-year outcome: 1) 0.829 [0.791–0.866]; 2) 0.847 [0.804–0.890]; 3) 0.823 [0.784–0.862]; and 4) 0.832 [0.794–0.870]), although the models showed underestimation in calibration analysis of the external validation cohort. With the validation data, the overall performance of the IIgAN-PT was non-inferior to that of the ML-based model. Conclusions: Our ML-based models showed good performance in predicting adverse kidney outcomes in patients with IgAN but they did not outperform the IIgAN-PT.
4.Impact of the COVID-19 pandemic on emergency department utilization trends: a three-year analysis
Ho Chul JUNG ; Ji Eun KIM ; Yuri CHOI ; Jin Woo JEONG ; Hyung Jun MOON
Journal of the Korean Society of Emergency Medicine 2024;35(6):403-412
Objective:
This study was conducted to examine the trends in patient visits to the emergency departments (EDs) during the coronavirus disease 2019 (COVID-19) pandemic and analyze the changes in the pattern of ED utilization over time.
Methods:
We analyzed the National Emergency Department Information System data on ED visits for 3 years, from January 1, 2018 to December 31, 2020.
Results:
A total of 25,260,790 patients visited the ED during the study period. There was a notable 23.3% decrease in visits in 2020 during the pandemic compared to the preceding year. The number of patients visiting the ED appeared to decrease in response to the increase in confirmed COVID-19 cases. In 2020, a total of 13,801 patients were diagnosed with COVID-19 in the ED, accounting for 22.7% of the confirmed COVID-19 cases in the country. In 2018, 2019, and 2020, ED visitors presenting with respiratory symptoms as their chief complaint numbered 1,438,137 (15.5%), 1,605,551 (17.7%), and 1,019,314 (14.7%), respectively. The length of stay of these patients increased at the regional and local emergency centers. However, a reverse trend was observed at local emergency medical agencies.
Conclusion
During the COVID-19 pandemic in 2020, patient visits to the ED decreased, irrespective of patient’s health status. The concentration of emergency and isolation-requiring patients at regional emergency medical centers and local emergency medical centers led to an increase in the length of stay. Further analysis and research are needed to assess the role of the local emergency medical agencies in the response to infectious diseases in the future.
5.Hazards of Tattoo Procedures Performed by Non-Medical Personnel:1st Policy Forum of the Korean Dermatological Research Foundation
Dong Hyun KIM ; Gwang June LEE ; Sungjoo HWANG ; Si-Hyung LEE ; Hyun Chul SUNG ; Sang Ju LEE ; Ji Hwan HWANG ; Young-wook RYOO ; Dong Hun LEE ; Sung Eun CHANG ; Hoon KANG
Korean Journal of Dermatology 2024;62(10):541-549
Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.
7.Hazards of Tattoo Procedures Performed by Non-Medical Personnel:1st Policy Forum of the Korean Dermatological Research Foundation
Dong Hyun KIM ; Gwang June LEE ; Sungjoo HWANG ; Si-Hyung LEE ; Hyun Chul SUNG ; Sang Ju LEE ; Ji Hwan HWANG ; Young-wook RYOO ; Dong Hun LEE ; Sung Eun CHANG ; Hoon KANG
Korean Journal of Dermatology 2024;62(10):541-549
Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.
8.Impact of the COVID-19 pandemic on emergency department utilization trends: a three-year analysis
Ho Chul JUNG ; Ji Eun KIM ; Yuri CHOI ; Jin Woo JEONG ; Hyung Jun MOON
Journal of the Korean Society of Emergency Medicine 2024;35(6):403-412
Objective:
This study was conducted to examine the trends in patient visits to the emergency departments (EDs) during the coronavirus disease 2019 (COVID-19) pandemic and analyze the changes in the pattern of ED utilization over time.
Methods:
We analyzed the National Emergency Department Information System data on ED visits for 3 years, from January 1, 2018 to December 31, 2020.
Results:
A total of 25,260,790 patients visited the ED during the study period. There was a notable 23.3% decrease in visits in 2020 during the pandemic compared to the preceding year. The number of patients visiting the ED appeared to decrease in response to the increase in confirmed COVID-19 cases. In 2020, a total of 13,801 patients were diagnosed with COVID-19 in the ED, accounting for 22.7% of the confirmed COVID-19 cases in the country. In 2018, 2019, and 2020, ED visitors presenting with respiratory symptoms as their chief complaint numbered 1,438,137 (15.5%), 1,605,551 (17.7%), and 1,019,314 (14.7%), respectively. The length of stay of these patients increased at the regional and local emergency centers. However, a reverse trend was observed at local emergency medical agencies.
Conclusion
During the COVID-19 pandemic in 2020, patient visits to the ED decreased, irrespective of patient’s health status. The concentration of emergency and isolation-requiring patients at regional emergency medical centers and local emergency medical centers led to an increase in the length of stay. Further analysis and research are needed to assess the role of the local emergency medical agencies in the response to infectious diseases in the future.
9.Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment
Hyo Seon RYU ; Hyun Jung KIM ; Woong Bae JI ; Byung Chang KIM ; Ji Hun KIM ; Sung Kyung MOON ; Sung Il KANG ; Han Deok KWAK ; Eun Sun KIM ; Chang Hyun KIM ; Tae Hyung KIM ; Gyoung Tae NOH ; Byung-Soo PARK ; Hyeung-Min PARK ; Jeong Mo BAE ; Jung Hoon BAE ; Ni Eun SEO ; Chang Hoon SONG ; Mi Sun AHN ; Jae Seon EO ; Young Chul YOON ; Joon-Kee YOON ; Kyung Ha LEE ; Kyung Hee LEE ; Kil-Yong LEE ; Myung Su LEE ; Sung Hak LEE ; Jong Min LEE ; Ji Eun LEE ; Han Hee LEE ; Myong Hoon IHN ; Je-Ho JANG ; Sun Kyung JEON ; Kum Ju CHAE ; Jin-Ho CHOI ; Dae Hee PYO ; Gi Won HA ; Kyung Su HAN ; Young Ki HONG ; Chang Won HONG ; Jung-Myun KWAK ;
Annals of Coloproctology 2024;40(2):89-113
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.
10.Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry
Do Yeon KIM ; Tai Hwan PARK ; Yong-Jin CHO ; Jong-Moo PARK ; Kyungbok LEE ; Minwoo LEE ; Juneyoung LEE ; Sang Yoon BAE ; Da Young HONG ; Hannah JUNG ; Eunvin KO ; Hyung Seok GUK ; Beom Joon KIM ; Jun Yup KIM ; Jihoon KANG ; Moon-Ku HAN ; Sang-Soon PARK ; Keun-Sik HONG ; Hong-Kyun PARK ; Jeong-Yoon LEE ; Byung-Chul LEE ; Kyung-Ho YU ; Mi Sun OH ; Dong-Eog KIM ; Dong-Seok GWAK ; Soo Joo LEE ; Jae Guk KIM ; Jun LEE ; Doo Hyuk KWON ; Jae-Kwan CHA ; Dae-Hyun KIM ; Joon-Tae KIM ; Kang-Ho CHOI ; Hyunsoo KIM ; Jay Chol CHOI ; Joong-Goo KIM ; Chul-Hoo KANG ; Sung-il SOHN ; Jeong-Ho HONG ; Hyungjong PARK ; Sang-Hwa LEE ; Chulho KIM ; Dong-Ick SHIN ; Kyu Sun YUM ; Kyusik KANG ; Kwang-Yeol PARK ; Hae-Bong JEONG ; Chan-Young PARK ; Keon-Joo LEE ; Jee Hyun KWON ; Wook-Joo KIM ; Ji Sung LEE ; Hee-Joon BAE ;
Journal of Korean Medical Science 2024;39(34):e278-
This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

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