It is extensively documented that tumor hypoxia contributes to the failure of chemotherapy and radiotherapy. Recent evidence suggests that hypoxia is also closely involved in the resistance to immunotherapy. In this review, we highlight how immune cells that are essential for the maximized immunotherapy efficacy, including cytotoxic T cells, dendritic cells, and natural killer cells, can adapt to tumor hypoxia. We then outline previous attempts targeting tumor hypoxia (for example, modulators of tumor cell oxygen consumption, perfusion modulators, hypoxia-activated prodrugs, hypoxia-inducible factor inhibitors, and hypoxia-responsive chimeric antigen receptor T cells) discussing how these approaches have resulted in an improvement of the antitumor response to immunotherapy in preclinical or clinical settings. Lastly, we review various non-invasive techniques to detect the tumor hypoxia and immune responses. We believe that an integration of the biological knowledge of immune cell adaptation to tumor hypoxia with the cutting edge non-invasive imaging technologies may ultimately allow us not only to select for patients who would benefit the most from the immunotherapy but also to monitor their responses in a real-time manner so that we can offer them an optimal personalized medicine in the clinic.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women. Conclusion KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.

Background: Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed. Objective: This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices. Methods: The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved. Results: The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD. Conclusion KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.

Sensitive skin (SS) is increasingly recognized as a complex syndrome characterized by discomfort and heightened sensitivity to otherwise harmless stimuli, such as environmental changes, physical contact, and cosmetic products. This condition poses challenges in both diagnosis and treatment due to its variable presentation and subjective nature. The pathophysiological features of SS include neurogenic inflammation and small fiber neuropathy, largely driven by the hyperactivation of sensory nerves. This hyperactivation is closely associated with transient receptor potential (TRP) channels, particularly TRPV1, which contribute to the exaggerated sensory responses seen in SS. Furthermore, psychological factors like stress and anxiety, along with environmental stressors such as pollution and ultraviolet exposure, play significant roles in exacerbating symptoms. The diverse and individualized responses to stimuli make it difficult to establish standardized diagnostic criteria for SS, necessitating a combination of subjective diagnostic tools (e.g., the Sensitive Scale-10) and objective assessments (e.g., transepidermal water loss and lactic acid sting test) to accurately identify and assess SS. This paper provides a comprehensive review of SS, covering its definition, prevalence, pathogenesis, diagnostic challenges, and management strategies, and highlights the importance of personalized care in effectively managing SS and improving patient quality of life.

Background: In 2006, the Korean Atopic Dermatitis Association (KADA) working group released the diagnostic criteria for Korean atopic dermatitis (AD). Recently, more simplified, and practical AD diagnostic criteria have been proposed. Objective: Based on updated criteria and experience, we studied to develop and share a consensus on diagnostic criteria for AD in Koreans. Materials and Methods: For the diagnostic criteria, a questionnaire was constructed by searching the English-language literature in MEDLINE and the Cochrane Database of Systematic Reviews. A modified Delphi method composed of 3 rounds of email questionnaires was adopted for the consensus process. Fifty-four KADA council members participated in the 3 rounds of votes and expert consensus recommendations were established. Results: Diagnostic criteria for AD include pruritus, eczema with age-specific pattern, and chronic or relapsing history. Diagnostic aids for AD encompass xerosis, immunoglobulin E reactivity, hand–foot eczema, periorbital changes, periauricular changes, perioral changes, nipple eczema, perifollicular accentuation, and personal or family history of atopy. Conclusion This study streamlined and updated the diagnostic criteria for AD in Korea, making them more practicable for use in real-world clinical field.

Background/Aims: Hepatocellular carcinoma (HCC) exhibits high de novo recurrence rates post-resection. Current post-surgery recurrence prediction methods are limited, emphasizing the need for reliable biomarkers to assess recurrence risk. We aimed to develop methylation-based markers for classifying HCC patients and predicting their risk of de novo recurrence post-surgery. Methods: In this retrospective cohort study, we analyzed data from HCC patients who underwent surgical resection in Korea, excluding those with recurrence within one year post-surgery. Using the Infinium Methylation EPIC array on 140 samples in the discovery cohort, we classified patients into low- and high-risk groups based on methylation profiles. Distinctive markers were identified through random forest analysis. These markers were validated in the cancer genome atlas (n=217), Validation cohort 1 (n=63) and experimental Validation using a methylation-sensitive high-resolution melting (MS-HRM) assay in Validation cohort 1 and Validation cohort 2 (n=63). Results: The low-risk recurrence group (methylation group 1; MG1) showed a methylation average of 0.73 (95% confidence interval [CI] 0.69–0.77) with a 23.5% recurrence rate, while the high-risk group (MG2) had an average of 0.17 (95% CI 0.14–0.20) with a 44.1% recurrence rate (P<0.03). Validation confirmed the applicability of methylation markers across diverse populations, showing high accuracy in predicting the probability of HCC recurrence risk (area under the curve 96.8%). The MS-HRM assay confirmed its effectiveness in predicting de novo recurrence with 95.5% sensitivity, 89.7% specificity, and 92.2% accuracy. Conclusions Methylation markers effectively classified HCC patients by de novo recurrence risk, enhancing prediction accuracy and potentially offering personalized management strategies.

Colorectal cancer accounts for 10% of global cancer cases in each year, making accurate evaluation and resection crucial. Imaging-enhanced endoscopy helps differentiate between hyperplastic polyps and adenomas, guiding treatment decisions. Colon tumors are classified into benign (e.g., serrated and adenomatous polyps) and malignant (e.g., adenocarcinomas). The Paris classification categorizes superficial neoplastic lesions by morphology, while laterally spreading tumors are classified by size and growth pattern. Effective classification aids in determining resectability and appropriate interventions for colon tumors, ultimately improving patient outcomes. Image-enhanced endoscopy improves colon tumor diagnosis using various techniques like dye, optical, and electronic methods. Kudo’s pit pattern categorizes lesions based on surface morphology using dye, while Sano, Jikei, and Hiroshima classifications focus on vascular patterns using narrow-band imaging (NBI). The NBI International Colorectal Endoscopic (NICE) classification integrates these methods to identify lesions, especially deep submucosal invasive cancers. The Workgroup Serrated Polyps and Polyposis (WASP) classification targets sessile serrated lesions, and the Japan NBI Expert Team (JNET) classification further refines adenoma categorization with low- and high-grade adenoma. The Colorectal Neoplasia Endoscopic Classification to Choose the Treatment (CONECCT) classification consolidates multiple systems for comprehensive assessment, aiding in treatment decisions and potentially applicable to artificial intelligence for diagnostic validation across imaging modalities like linked color imaging, blue light imaging, or i-scan.

Background/Aims: Hepatocellular carcinoma (HCC) exhibits high de novo recurrence rates post-resection. Current post-surgery recurrence prediction methods are limited, emphasizing the need for reliable biomarkers to assess recurrence risk. We aimed to develop methylation-based markers for classifying HCC patients and predicting their risk of de novo recurrence post-surgery. Methods: In this retrospective cohort study, we analyzed data from HCC patients who underwent surgical resection in Korea, excluding those with recurrence within one year post-surgery. Using the Infinium Methylation EPIC array on 140 samples in the discovery cohort, we classified patients into low- and high-risk groups based on methylation profiles. Distinctive markers were identified through random forest analysis. These markers were validated in the cancer genome atlas (n=217), Validation cohort 1 (n=63) and experimental Validation using a methylation-sensitive high-resolution melting (MS-HRM) assay in Validation cohort 1 and Validation cohort 2 (n=63). Results: The low-risk recurrence group (methylation group 1; MG1) showed a methylation average of 0.73 (95% confidence interval [CI] 0.69–0.77) with a 23.5% recurrence rate, while the high-risk group (MG2) had an average of 0.17 (95% CI 0.14–0.20) with a 44.1% recurrence rate (P<0.03). Validation confirmed the applicability of methylation markers across diverse populations, showing high accuracy in predicting the probability of HCC recurrence risk (area under the curve 96.8%). The MS-HRM assay confirmed its effectiveness in predicting de novo recurrence with 95.5% sensitivity, 89.7% specificity, and 92.2% accuracy. Conclusions Methylation markers effectively classified HCC patients by de novo recurrence risk, enhancing prediction accuracy and potentially offering personalized management strategies.

Colorectal cancer accounts for 10% of global cancer cases in each year, making accurate evaluation and resection crucial. Imaging-enhanced endoscopy helps differentiate between hyperplastic polyps and adenomas, guiding treatment decisions. Colon tumors are classified into benign (e.g., serrated and adenomatous polyps) and malignant (e.g., adenocarcinomas). The Paris classification categorizes superficial neoplastic lesions by morphology, while laterally spreading tumors are classified by size and growth pattern. Effective classification aids in determining resectability and appropriate interventions for colon tumors, ultimately improving patient outcomes. Image-enhanced endoscopy improves colon tumor diagnosis using various techniques like dye, optical, and electronic methods. Kudo’s pit pattern categorizes lesions based on surface morphology using dye, while Sano, Jikei, and Hiroshima classifications focus on vascular patterns using narrow-band imaging (NBI). The NBI International Colorectal Endoscopic (NICE) classification integrates these methods to identify lesions, especially deep submucosal invasive cancers. The Workgroup Serrated Polyps and Polyposis (WASP) classification targets sessile serrated lesions, and the Japan NBI Expert Team (JNET) classification further refines adenoma categorization with low- and high-grade adenoma. The Colorectal Neoplasia Endoscopic Classification to Choose the Treatment (CONECCT) classification consolidates multiple systems for comprehensive assessment, aiding in treatment decisions and potentially applicable to artificial intelligence for diagnostic validation across imaging modalities like linked color imaging, blue light imaging, or i-scan.

Background/Aims: Hepatocellular carcinoma (HCC) exhibits high de novo recurrence rates post-resection. Current post-surgery recurrence prediction methods are limited, emphasizing the need for reliable biomarkers to assess recurrence risk. We aimed to develop methylation-based markers for classifying HCC patients and predicting their risk of de novo recurrence post-surgery. Methods: In this retrospective cohort study, we analyzed data from HCC patients who underwent surgical resection in Korea, excluding those with recurrence within one year post-surgery. Using the Infinium Methylation EPIC array on 140 samples in the discovery cohort, we classified patients into low- and high-risk groups based on methylation profiles. Distinctive markers were identified through random forest analysis. These markers were validated in the cancer genome atlas (n=217), Validation cohort 1 (n=63) and experimental Validation using a methylation-sensitive high-resolution melting (MS-HRM) assay in Validation cohort 1 and Validation cohort 2 (n=63). Results: The low-risk recurrence group (methylation group 1; MG1) showed a methylation average of 0.73 (95% confidence interval [CI] 0.69–0.77) with a 23.5% recurrence rate, while the high-risk group (MG2) had an average of 0.17 (95% CI 0.14–0.20) with a 44.1% recurrence rate (P<0.03). Validation confirmed the applicability of methylation markers across diverse populations, showing high accuracy in predicting the probability of HCC recurrence risk (area under the curve 96.8%). The MS-HRM assay confirmed its effectiveness in predicting de novo recurrence with 95.5% sensitivity, 89.7% specificity, and 92.2% accuracy. Conclusions Methylation markers effectively classified HCC patients by de novo recurrence risk, enhancing prediction accuracy and potentially offering personalized management strategies.