Objectives: To assess the trends and disparities in the utilization of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) in Korea between 2018 and 2022, with a focus on disease classification, patient demographics, and regional distribution. Methods: This national surveillance retrospective study uses data from the Health Insurance Review and Assessment Service (HIRA) database, which includes all FDG PET/CT examinations conducted in Korea from 2018 to 2022. Disease classifications, cancer types, age groups, gender, and geographic regions were analyzed using descriptive statistics. Utilization rates per 100,000 population were calculated for regional comparisons. Results: FDG PET/CT utilization increased by 25.4%, from 174,885 examinations in 2018 to 219,377 in 2022. Older age groups (60 years and above) accounted for the majority of examinations, with males undergoing more examinations than females. Oncology remained the primary indication, with lung, colorectal, and non-Hodgkin lymphoma leading in examination numbers. The number of examinations performed on patients aged 60 and above increased at a higher rate compared to those under 60. Significant geographic disparities were found, with Seoul reporting the highest utilization rate (1,114.3 examinations per 100,000 population), while Gyeongbuk exhibited much lower rate (26.2 examinations per 100,000 population). Conclusions This study highlights the growing utilization of FDG PET/CT in Korea, particularly among older adults, with significant gender differences in cancer types. The findings also reveal disparities in FDG PET/CT utilization across regions, indicating varying access to advanced imaging technology.

Thyroid cancer, one of the most common endocrine tumors, generally has a favorable prognosis but remains a significant medical and societal concern due to its high incidence. Early diagnosis and treatment of differentiated thyroid cancer (DTC) significantly affect long-term outcomes, requiring the selection and application of appropriate initial treatments to improve prognosis and quality of life. Recent advances in technology and health information systems have enhanced our understanding of the molecular genetics of thyroid cancer, facilitating the identification of aggressive subgroups and enabling the accumulation of research on risk factors through big data. The Korean Thyroid Association (KTA) has revised the “KTA Guidelines on the Management of Differentiated Thyroid Cancers 2024” to incorporate these advances, which were developed by a multidisciplinary team and underwent extensive review and approval processes by various academic societies. This article summarizes the 2024 KTA guidelines for nuclear medicine imaging in patients with DTC, written by the Nuclear Medicine members of the KTA Guideline Committee, and covers 18 F-FDG PET/CT and radioiodine imaging with SPECT/CT in the management of DTC. 

Thyroid cancer, one of the most common endocrine tumors, generally has a favorable prognosis but remains a significant medical and societal concern due to its high incidence. Early diagnosis and treatment of differentiated thyroid cancer (DTC) significantly affect long-term outcomes, requiring the selection and application of appropriate initial treatments to improve prognosis and quality of life. Recent advances in technology and health information systems have enhanced our understanding of the molecular genetics of thyroid cancer, facilitating the identification of aggressive subgroups and enabling the accumulation of research on risk factors through big data. The Korean Thyroid Association (KTA) has revised the “KTA Guidelines on the Management of Differentiated Thyroid Cancers 2024” to incorporate these advances, which were developed by a multidisciplinary team and underwent extensive review and approval processes by various academic societies.This article summarizes the 2024 KTA guidelines for radioactive iodine (RAI) therapy in patients with DTC, written by the Nuclear Medicine members of the KTA Guideline Committee, and covers RAI therapy as initial management of DTC and RAI therapy in advanced thyroid cancer.

Objective: To analyze the microbiological and clinical characteristics of vulvovaginitis in girls, distinguishing between the premenarcheal and postmenarcheal groups in a tertiary center in South Korea. Methods: This retrospective cohort study included 195 patients under 20 years of age diagnosed with vulvovaginitis at a tertiary hospital between 2014 and 2023. The patients were categorized into premenarcheal (n=95) and postmenarcheal (n=100) groups. Data on initial symptoms, microbial cultures, and treatment methods were analyzed. Results: The most common initial symptom was vaginal discharge, reported in 63.1% of cases. Culture results showed a 51.3% positivity rate for any microorganism, with a prevalence of gram-negative rods (32.8%) and gram-positive cocci (14.4%). The most frequently isolated microorganisms were Escherichia coli (17.9%), Candida albicans (7.7%), and Enterococcus faecalis (6.7%). Gram-negative rods were more common in the premenarcheal group (37.1% vs. 25.0%; p=0.01). No significant differences were observed in the prevalence of gram-positive cocci and Candida species between the two groups (16.8% vs. 12.0%, p=0.22; 6.3% vs. 13.0%, p=0.09; respectively). The susceptibilities of grampositive microorganisms to penicillin, oxacillin, clindamycin, vancomycin, and tetracycline were 58.8%, 58.3%, 94.7%, 100.0%, and 73.7%, respectively. The susceptibilities of gram-negative microorganisms to amoxicillin/clavulanic acid, ciprofloxacin, ceftriaxone, and nitrofurantoin were 89.3%, 85.3%, 76.0%, and 100.0%, respectively. Conclusion This study identified differences in the microbial profiles associated with vulvovaginitis between premenarcheal and postmenarcheal girls. Age-specific and history-based clinical approaches tailored to menarcheal status are warranted to improve the management and outcomes of pediatric and adolescent vulvovaginitis.

Background and Objectives: Metoclopramide is an antagonist of dopamine D2 receptor and is capable of alleviating chemotherapy-induced nausea and vomiting. However, its underlying mechanisms and function in improving the efficiency of chemotherapy are not fully understood. In this study, we investigated the sensitizing effect of metoclopramide on the platinum-based drugs-mediated apoptosis in human head and neck cancer cells.Subjects and Method Apoptosis was analyzed using a cell-based cytometer. The protein expression and messenger ribonucleic acid (mRNA) levels were assessed by Western blotting and real-time polymerase chain reaction, respectively. Results: Metoclopramide sensitized the platinum-based drug (cisplatin and oxaliplatin)-mediated apoptosis in AMC-HN4 cells, but not in normal cells. Mechanistically, we found that metoclopramide decreased Mcl-1 protein expression through post-translational regulation. Moreover, the overexpression of Mcl-1 prevented apoptosis by combined treatment of metoclopramide and platinum-based drugs. Conclusion Metoclopramide induced proteasome-mediated Mcl-1 downregulation, resulting in increased sensitivity to platinum-based drugs.

It is difficult to determine a cause of bile duct stricture and dilatation. Eosinophilic cholangitis, a rare benign condition, may be one cause of bile duct stricture and dilatation. It can be evaluated using various methods of histopathology, radiographs, endoscopy, and hematologic findings. Treatment generally involves steroid therapy which can lead to improvement. This case report will discuss eosinophilic cholangitis, emphasizing that while it can easily be overlooked but should be considered in differential diagnoses.

Objective: To evaluate the adherence of large language model (LLM)-based healthcare research to the Minimum Reporting Items for Clear Evaluation of Accuracy Reports of Large Language Models in Healthcare (MI-CLEAR-LLM) checklist, a framework designed to enhance the transparency and reproducibility of studies on the accuracy of LLMs for medical applications. Materials and Methods: A systematic PubMed search was conducted to identify articles on LLM performance published in high-ranking clinical medicine journals (the top 10% in each of the 59 specialties according to the 2023 Journal Impact Factor) from November 30, 2022, through June 25, 2024. Data on the six MI-CLEAR-LLM checklist items: 1) identification and specification of the LLM used, 2) stochasticity handling, 3) prompt wording and syntax, 4) prompt structuring, 5) prompt testing and optimization, and 6) independence of the test data—were independently extracted by two reviewers, and adherence was calculated for each item. Results: Of 159 studies, 100% (159/159) reported the name of the LLM, 96.9% (154/159) reported the version, and 91.8% (146/159) reported the manufacturer. However, only 54.1% (86/159) reported the training data cutoff date, 6.3% (10/159) documented access to web-based information, and 50.9% (81/159) provided the date of the query attempts. Clear documentation regarding stochasticity management was provided in 15.1% (24/159) of the studies. Regarding prompt details, 49.1% (78/159) provided exact prompt wording and syntax but only 34.0% (54/159) documented prompt-structuring practices. While 46.5% (74/159) of the studies detailed prompt testing, only 15.7% (25/159) explained the rationale for specific word choices. Test data independence was reported for only 13.2% (21/159) of the studies, and 56.6% (43/76) provided URLs for internet-sourced test data. Conclusion Although basic LLM identification details were relatively well reported, other key aspects, including stochasticity, prompts, and test data, were frequently underreported. Enhancing adherence to the MI-CLEAR-LLM checklist will allow LLM research to achieve greater transparency and will foster more credible and reliable future studies.

Objectives: To assess the trends and disparities in the utilization of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) in Korea between 2018 and 2022, with a focus on disease classification, patient demographics, and regional distribution. Methods: This national surveillance retrospective study uses data from the Health Insurance Review and Assessment Service (HIRA) database, which includes all FDG PET/CT examinations conducted in Korea from 2018 to 2022. Disease classifications, cancer types, age groups, gender, and geographic regions were analyzed using descriptive statistics. Utilization rates per 100,000 population were calculated for regional comparisons. Results: FDG PET/CT utilization increased by 25.4%, from 174,885 examinations in 2018 to 219,377 in 2022. Older age groups (60 years and above) accounted for the majority of examinations, with males undergoing more examinations than females. Oncology remained the primary indication, with lung, colorectal, and non-Hodgkin lymphoma leading in examination numbers. The number of examinations performed on patients aged 60 and above increased at a higher rate compared to those under 60. Significant geographic disparities were found, with Seoul reporting the highest utilization rate (1,114.3 examinations per 100,000 population), while Gyeongbuk exhibited much lower rate (26.2 examinations per 100,000 population). Conclusions This study highlights the growing utilization of FDG PET/CT in Korea, particularly among older adults, with significant gender differences in cancer types. The findings also reveal disparities in FDG PET/CT utilization across regions, indicating varying access to advanced imaging technology.

Thyroid cancer, one of the most common endocrine tumors, generally has a favorable prognosis but remains a significant medical and societal concern due to its high incidence. Early diagnosis and treatment of differentiated thyroid cancer (DTC) significantly affect long-term outcomes, requiring the selection and application of appropriate initial treatments to improve prognosis and quality of life. Recent advances in technology and health information systems have enhanced our understanding of the molecular genetics of thyroid cancer, facilitating the identification of aggressive subgroups and enabling the accumulation of research on risk factors through big data. The Korean Thyroid Association (KTA) has revised the “KTA Guidelines on the Management of Differentiated Thyroid Cancers 2024” to incorporate these advances, which were developed by a multidisciplinary team and underwent extensive review and approval processes by various academic societies. This article summarizes the 2024 KTA guidelines for nuclear medicine imaging in patients with DTC, written by the Nuclear Medicine members of the KTA Guideline Committee, and covers 18 F-FDG PET/CT and radioiodine imaging with SPECT/CT in the management of DTC.