Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

The peer review process ensures the integrity of scientific research. This is particularly important in the medical field, where research findings directly impact patient care. However, the rapid growth of publications has strained reviewers, causing delays and potential declines in quality. Generative artificial intelligence, especially large language models (LLMs) such as ChatGPT, may assist researchers with efficient, high-quality reviews. This review explores the integration of LLMs into peer review, highlighting their strengths in linguistic tasks and challenges in assessing scientific validity, particularly in clinical medicine. Key points for integration include initial screening, reviewer matching, feedback support, and language review. However, implementing LLMs for these purposes will necessitate addressing biases, privacy concerns, and data confidentiality. We recommend using LLMs as complementary tools under clear guidelines to support, not replace, human expertise in maintaining rigorous peer review standards.

Purpose: The present study investigated the impact of lifestyle behaviors and body mass index (BMI) on late recurrence, gastric remnant cancer (GRC), and long-term survival after curative gastrectomy. Materials and Methods: This retrospective study utilized data from the Korean National Health Insurance claims database. Among 71,014 patients with gastric cancer who underwent curative gastrectomy between January 2009 and December 2012, 23,359 remained cancerfree for five years. Of these, 7,735 patients with health examination data within 2 years before surgery and 5 years after surgery were analyzed for lifestyle behaviors, including smoking, alcohol consumption, and physical activity. Multivariable analysis was used to evaluate the independent effects of these factors and changes in BMI on late recurrence, GRC, and longterm survival. Results: Late recurrence or GRC occurred among 628 patients (8.1%). Older age (≥60 years) and total gastrectomy were identified as risk factors. Although lifestyle behaviors and BMI changes did not directly affect recurrence, they significantly affected mortality. In the total gastrectomy group, current underweight status (hazard ratio [HR], 1.586) was associated with increased mortality. Among the partial gastrectomy group, continued smoking (HR, 1.366) and current underweight status (HR, 1.915) increased mortality risk. Conversely, regular physical activity (starting: HR, 0.674; continuing: HR, 0.699) and postoperative overweight or obesity (BMI >25 kg/m 2 ) (HR, 0.713) were associated with reduced mortality.Changes in alcohol consumption showed inconsistent effects between the partial and total gastrectomy groups. Conclusions The long-term survival of post-gastrectomy patients improved with smoking cessation, regular physical activity, and maintenance of body weight.

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.

The Korean Society of Gynecologic Oncology has updated its clinical practice guidelines for endometrial cancer to incorporate advancements in recent high-quality randomized controlled trials. These guidelines address evolving treatment paradigms, and are tailored to the Korean medical context. Key updates include a strong recommendation for doxorubicin/trabectedin combination therapy in metastatic or recurrent unresectable leiomyosarcoma based on the significant survival benefits demonstrated in a randomized controlled trial. For advanced or recurrent endometrial cancer, immune checkpoint inhibitors combined with chemotherapy have received strong recommendations, owing to their proven efficacy and increased accessibility in Korea. Conditional recommendations were made for combination therapies involving durvalumab and olaparib, reflecting their potential benefits, but acknowledging regulatory and accessibility constraints. These guidelines aim to provide evidence-based, practical strategies to optimize care for patients with endometrial cancer while addressing unmet clinical needs and adapting global advancements to Korea’s healthcare environment.

Background: Recurrent gynecological clear cell carcinoma (rGCCC) has a low objective response rate (ORR) to chemotherapy. Previous preclinical and clinical data suggest a potential synergy between immune checkpoint inhibitors and bevacizumab in rGCCC.Dostarlimab, a humanized monoclonal antibody targeting programmed cell death protein 1 (PD-1), combined with the anti-angiogenic bevacizumab, presents a novel therapeutic approach. This study will investigate the efficacy of dostarlimab +/− bevacizumab in rGCCC. Methods DOVE is a global, multicenter, international, open-label, randomized phase 2 study of dostarlimab +/− bevacizumab with standard chemotherapy in rGCCC. We will enroll 198 patients with rGCCC and assign them to one of three groups in a 1:1:1 ratio: arm A (dostarlimab monotherapy), B (dostarlimab + bevacizumab), and C (investigator’s choice of chemotherapy [weekly paclitaxel, pegylated liposomal doxorubicin, doxorubicin, or gemcitabine]). Patients with disease progression in arm A or C will be allowed to cross over to arm B. Stratification factors include prior bevacizumab use, prior lines of therapy (1 vs. >1), and primary site (ovarian vs. non-ovarian). Key inclusion criteria are histologically proven recurrent or persistent clear cell carcinoma of the ovary, endometrium, cervix, vagina, or vulva; up to five prior lines of therapy; disease progression within 12 months after platinumbased chemotherapy; and measurable disease. Key exclusion criteria are prior treatment with an anti–PD-1, anti–programmed death-ligand 1, or anti–programmed death-ligand 2 agent.The primary endpoint is progression-free survival determined by investigators. Secondary endpoints are ORR, disease control rate, clinical benefit rate, progression-free survival 2, overall survival, and toxicity. Exploratory objectives include immune biomarkers.

Purpose: The career ladder system is a pivotal strategy for securing excellent nurses. The aim of this study is to understand hospital nurses’ experiences of participating in the career ladder system and to explore the essence of this system. Methods: In February 22 to March 3, 2022, nurses employed at a general hospital in South Korea were selected for this study using snowball and purposive sampling. Data were collected from interviews with three focus groups, the compositions of which are as follows: group 1, 6 participants; group 2, 5 participants; and group 3, 6 participants. All interviews were recorded, transcribed verbatim, and subsequently analyzed using qualitative research methods. Results: The following six categories were derived under the overall theme of “the arduous journey to discovering a nurse’s true name”: (1) rites of passage to becoming the ideal nurse; (2) unexpected challenges in the promotion preparation process; (3) biased criteria for evaluating nursing competencies; (4) unclear changes in roles and perceptions after promotion; (5) self-discovered pride and fulfillment as a nurse; and (6) the unspoken struggles of evaluators. Conclusion The findings suggest that the career ladder system fosters nurses’ professional growth and self-actualization. However, for effective implementation, nurses’ deep understanding and systematic management of the career ladder system are essential. This study offers valuable insights and benchmarks for healthcare institutions aiming to adopt the system.

Purpose: This study aimed to describe and understand the meaning and nature of the process of forming a therapeutic relationship among nursing students working with older patients with dementia in long-term care hospitals. Methods: In-depth interviews were conducted with 10 nursing students from September to October 2024. We examined and described the collected data based on Colaizzi's phenomenological method. Results: Seventeen theme clusters and five categories were derived from the nursing students' experiences. The five categories were as follows: preparing for scheduled encounters with unfamiliar people, embarking upon exploration to build a relationship, making various efforts to maintain a therapeutic relationship, facing obstacles in maintaining a relationship, and witnessing myself growing in a therapeutic relationship. Conclusion Efforts should be made to develop and implement training programs that would reinforce nursing students' competencies to care for older patients with dementia through consistent interactions and exchanges with field practitioners.

Purpose: This study aimed to develop a Korean version of the frailty model that reflects a holistic perspective. There were three phases of the study: a literature review, a two-round Delphi study, and a public hearing. Methods: The model was developed based on the middle-range theory generation approach proposed by Roy. A literature search was conducted, and a review of 36 studies on frailty involving Koreans led to the development of an initial frailty model. A two-round Delphi study was then conducted with nine experts to evaluate the appropriateness of the model. The revised model was presented at a public hearing to achieve consensus. Based on feedback indicating the need for improved visualization, a finalized diagrammatic model was developed. Results: The final frailty model comprised four domains, seven subdomains, and 30 items. It included specific items reflecting the distinctive characteristics of Korean culture, such as relationships with adult children (filial piety), nutritional status (consumption of red meat), and type of residential building. Conclusion The final frailty model provides a comprehensive perspective on the factors contributing to frailty, their interactions, and the potential interventions that healthcare providers can implement to prevent frailty.