1.Serum Krebs von den Lungen-6 Level as a Reflecting Biomarker in Patients with Interstitial Lung Abnormalities
Hyung Koo KANG ; Sung Jun CHUNG ; Jiyeon KANG ; Hyeon-Kyoung KOO ; Sung-Soon LEE ; Jae-Woo JUNG ; Jae-Chol CHOI ; Jae Yeol KIM ; Jong Wook SHIN
Tuberculosis and Respiratory Diseases 2026;89(2):266-274
Background:
Research on the relationship between the progression of interstitial lung abnormalities (ILA) and serum biomarkers, including white blood cell differential counts and Krebs von den Lungen-6 (KL-6), is limited. This study aimed to examine the clinical characteristics of patients with ILA and evaluate the association between disease progression and serum biomarkers.
Methods:
This retrospective cohort study analyzed data from 159 patients (63 with ILA and 74 with interstitial lung diseases) between October 2021 and September 2022. Data collected included clinical characteristics, pulmonary function tests, chest computed tomography (CT), complete blood cell counts, and KL-6 levels. In 52 of these patients who had previously undergone chest CT, the utility of serum biomarkers in reflecting radiologic progression was assessed using receiver operating characteristic curve analysis.
Results:
Patients with ILA exhibited clinical characteristics similar to those with idiopathic pulmonary fibrosis. Serum KL-6 levels did not correlate with forced vital capacity or diffusing capacity of the lung for carbon monoxide in patients with ILA. Among the 52 patients with ILA, 13 demonstrated radiologic progression. Serum KL-6 displayed moderate predictive performance, with area under the curves ranging from 0.57 to 0.89 (p=0.014) for radiologic progression. Levels of KL-6 greater than 400 U/mL were more frequently observed in patients with radiologic progression (61.5% vs. 20.5%, p=0.006). In multivariate analysis, age and KL-6 were independently associated with radiologic progression in patients with ILA.
Conclusion
Serum KL-6 levels may serve as a potential indicator of ILA progression in asymptomatic patients. Those with KL-6 levels exceeding 400 U/mL should be closely monitored for radiologic progression.
2.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part II. Follow-up Surveillance after Initial Treatment 2026
Eun Kyung LEE ; Seung Heon KANG ; Bon Seok KOO ; Mijin KIM ; Min Joo KIM ; Bo Hyun KIM ; Ji Won KIM ; Dong Gyu NA ; Sohyun PARK ; Ji-In BANG ; Kyorim BACK ; Youngduk SEO ; Young-Ik SON ; Young Shin SONG ; Dong Yeob SHIN ; Jong-Hyuk AHN ; Hwa Young AHN ; So Won OH ; Ho-Ryun WON ; Won Sang YOO ; Min Kyoung LEE ; Sang-Woo LEE ; Jeongmin LEE ; Ji Ye LEE ; Dong-Jun LIM ; Ki-Wook CHUNG ; Ari CHONG ; Jin Hyang JUNG ; Sun Wook CHO ; Yoon Young CHO ; Chae Moon HONG ; Young Joo PARK ;
International Journal of Thyroidology 2026;19(1):1-40
In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.
3.Real-World Efficacy of Intravesical Gemcitabine for BCG-Unresponsive Non–muscle-Invasive Bladder Cancer
Hye Won LEE ; Eui Hyun JUNG ; Kyung Hwan KIM ; Hong Koo HA ; Jong Jin OH ; Seok Ho KANG ; Seung-hwan JEONG ; Hyeong Dong YUK ; Ji Eun HEO ; Won Sik HAM ; Eu Chang HWANG ; Seung Il JUNG ; Wan SONG ; Bumjin LIM ; Bumsik HONG ; Byung Chang JEONG ; Ho Kyung SEO
Cancer Research and Treatment 2026;58(2):591-602
Purpose:
This study aimed to report the real-world outcomes of intravesical gemcitabine for bacillus Calmette–Guérin (BCG)–unresponsive, high-risk, non–muscle-invasive bladder cancer (HR-NMIBC) in Korean patients who were unable or unwilling to undergo radical cystectomy (RC).
Materials and Methods:
This retrospective study included 131 patients (median age, 69 years; 88.5% men) treated with intravesical gemcitabine for BCG-unresponsive HR-NMIBC at nine centers between May 2019 and April 2022. The primary endpoint was 1-year recurrence-free survival (RFS). The secondary endpoints included factors influencing RFS, progression-free survival (PFS), cystectomy- free survival, cancer-specific survival (CSS), overall survival (OS), and safety. Survival analysis was performed using the Kaplan-Meier method, and risk factors for recurrence were assessed using Cox regression models.
Results:
Patients were followed up for a median duration of 25 months, with carcinoma in situ (CIS) in 41.9% of the patients. The 1-year and 2-year RFS rates were 68% and 42%, while the 1-year and 2-year PFS rates were 87% and 77%, respectively. No significant factors influencing RFS were identified. Seventeen patients underwent RC during a median follow-up of 16 months, with the condition in three patients progressing to muscle-invasive disease on final pathological analysis. The 2-year CSS and OS rates were 98% and 97%, respectively. Intravesical gemcitabine was well-tolerated, with only seven patients (5.3%) unable to complete the full induction course.
Conclusion
Our research highlights the potential of intravesical gemcitabine as a viable bladder-sparing treatment option for BCG-unresponsive HR-NMIBC, providing real-world evidence on its safety, efficacy, and tolerability.
4.2025 Korean Thyroid Association Clinical Management Guideline on Active Surveillance for Low-Risk Papillary Thyroid Carcinoma
Eun Kyung LEE ; Min Joo KIM ; Seung Heon KANG ; Bon Seok KOO ; Kyungsik KIM ; Mijin KIM ; Bo Hyun KIM ; Ji-hoon KIM ; Shin Je MOON ; Kyorim BACK ; Young Shin SONG ; Jong-hyuk AHN ; Hwa Young AHN ; Ho-Ryun WON ; Won Sang YOO ; Min Kyoung LEE ; Jeongmin LEE ; Ji Ye LEE ; Kyong Yeun JUNG ; Chan Kwon JUNG ; Yoon Young CHO ; Dong-Jun LIM ; Sun Wook KIM ; Young Joo PARK ; Dong Gyu NA ; Jee Soo KIM
International Journal of Thyroidology 2025;18(1):30-64
The increasing detection of papillary thyroid microcarcinoma (PTMC) has raised concerns about overtreatment.For low-risk PTMC, either immediate surgery or active surveillance (AS) can be considered. To support AS implementation, the Korean Thyroid Association convened a multidisciplinary panel and developed the first Korean guideline. AS is recommended to adults with pathologically proven Bethesda V-VI PTMC without clinical evidence of lymph node or distant metastasis, gross extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, or aggressive histology. Baseline assessment requires high‑resolution cervical ultrasound by experienced operators to rule out extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, and lymph node metastasis;contrast‑enhanced neck computed tomography is optional. Patient characteristics such as age, comorbidities, and capacity for long-term follow-up should be assessed. Shared decision-making should weigh the benefits and risks of surgery and AS, expected oncologic outcomes, complications, quality of life, anxiety, medical cost, and patient preference. Follow-up includes cervical ultrasound and thyroid function test every six months for two years, then annually. Disease progression, defined as significant tumor growth or newly detected nodal or distant metastasis, warrants surgery. Despite remaining uncertainties, this guideline offers a framework to ensure oncologic safety and support patient-centered active surveillance.
5.Comparison and consideration of vaccine injury compensation programs in the Republic of Korea, Japan, and Taiwan
Cho Ryok KANG ; Young June CHOE ; Jihyun MOON ; Dooyoung KIM ; Taemi KIM ; Jong-Koo LEE
Osong Public Health and Research Perspectives 2024;15(6):479-488
This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.
6.Evaluation of Aortic Diseases Using Four-Dimensional Flow Magnetic Resonance Imaging
Hyun Jung KOO ; Hojin HA ; Gyu-Han LEE ; Jong En LEE ; Sang-hyub PARK ; Kyoung-jin PARK ; Joon-Won KANG ; Dong Hyun YANG
Vascular Specialist International 2024;40(4):41-
The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases.
7.Evaluation of Aortic Diseases Using Four-Dimensional Flow Magnetic Resonance Imaging
Hyun Jung KOO ; Hojin HA ; Gyu-Han LEE ; Jong En LEE ; Sang-hyub PARK ; Kyoung-jin PARK ; Joon-Won KANG ; Dong Hyun YANG
Vascular Specialist International 2024;40(4):41-
The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases.
8.Impact of body mass index and waist-to-hip ratio on mortality in middle-aged Koreans: a prospective cohort study based on a Health Examinees study
Sooyoung CHO ; Aesun SHIN ; Ji-Yeob CHOI ; Jong-Koo LEE ; Daehee KANG
Epidemiology and Health 2024;46(1):e2024073-
OBJECTIVES:
We aimed to assess the impact of obesity on mortality in middle-aged Koreans using data from a Health Examinees study.
METHODS:
We used data from the participants who had complete information on body size and gave informed consent for the linkage of their data with the national death certificate data. Cox proportional hazard model was used to estimate the hazard ratios and 95% confidence intervals (CIs) of body mass index (BMI) and waist-to-hip ratio (WHR) for all-cause, cardiovascular, and cancer mortality.
RESULTS:
A total of 115,961 participants were included in the study. The results showed a U-shaped association between BMI and mortality, indicating that both males and females with BMIs of less than 21.0 kg/m2 and greater than or equal to 30.0 kg/m2 are at increased risk. The results showed that males with a BMI of less than 18.5 kg/m² had a significantly higher risk of all-cause mortality (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.73 to 2.91) and cardiovascular mortality (aHR, 2.27; 95% CI, 1.23 to 4.20). Similarly, males with a WHR of less than 0.80 (aHR, 1.38; 95% CI, 1.08 to 1.77), 0.90 to less than 0.95 (aHR, 1.15; 95% CI, 1.02 to 1.29), and greater than or equal to 0.95 (aHR, 1.28; 95% CI, 1.11 to 1.47) showed an increased risk of all-cause mortality. In females, a BMI of less than 18.0 kg/m2 was linked to a higher risk of cardiovascular mortality (aHR, 2.67; 95% CI, 1.13 to 6.33).
CONCLUSIONS
Being underweight was associated with an increased risk of mortality in both sexes, and the lowest risk of death was found in males who were slightly overweight with a BMI of 23.0-25.0 kg/m2.
9.Comparison and consideration of vaccine injury compensation programs in the Republic of Korea, Japan, and Taiwan
Cho Ryok KANG ; Young June CHOE ; Jihyun MOON ; Dooyoung KIM ; Taemi KIM ; Jong-Koo LEE
Osong Public Health and Research Perspectives 2024;15(6):479-488
This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.
10.Comparison and consideration of vaccine injury compensation programs in the Republic of Korea, Japan, and Taiwan
Cho Ryok KANG ; Young June CHOE ; Jihyun MOON ; Dooyoung KIM ; Taemi KIM ; Jong-Koo LEE
Osong Public Health and Research Perspectives 2024;15(6):479-488
This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

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