Objective: We aimed to describe the [ 18 F]fluorodeoxyglucose (FDG) and prostate-specific membrane antigen (PSMA) PET/CT findings in Korean men with advanced metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: The results of paired FDG and PSMA PET/CT examinations performed in 42 consecutive men with prostate cancer for treatment planning after failure of anti-androgen therapy and chemotherapy were studied. Tumor lesions with FDG or PSMA uptake intensity higher than that of the liver on visual review were considered positive and noted per patient and tumor site (prostate bed, lymph node, bone, and visceral organ). The presence of unequivocally discordant FDG and PSMA uptake patterns in tumor lesions was assessed. Patients were grouped according to the total tumor volume as seen on each PET/CT scan, and the clinical findings between the patient groups were compared using the Mann-Whitney U test. Results: On patient-based analysis, the image findings were PSMA+/FDG- in 2 patients, PSMA-/FDG+ in one, and PSMA+/FDG+ in 39 patients. On site-based analysis, the discordance (PSMA+/FDG- or PSMA-/FDG+) rate was 9.5% (4/42) for prostate/bed, 11.9% (5/42) for lymph nodes, 9.5% (4/42) for bones, and 11.9% (5/42) for visceral organs. FDG uptake was higher than PSMA uptake in at least one tumor site in 54.8% (23/42) of patients. Patients with greater total tumor volume on FDG PET/CT than that on PSMA PET/CT (“FDG-dominant pattern”) accounted for 28.6% (12/42), and they had significantly shorter time from diagnosis (median 25 months vs. 62 months, P = 0.049), and higher aspartate aminotransferase (median 28.5 vs. 22.5, P = 0.027) and lactate dehydrogenase (median 341.5 vs. 224.5, P = 0.010) levels. Conclusion Most patients with advanced mCRPC had tumors with positive findings on both FDG and PSMA PET/CT. However, the uptake patterns varied; 54.8% of the patients had tumor(s) with FDG uptake greater than PSMA uptake, and FDGdominant pattern was noted in 28.6% of the patients.

Objective: We aimed to describe the [ 18 F]fluorodeoxyglucose (FDG) and prostate-specific membrane antigen (PSMA) PET/CT findings in Korean men with advanced metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: The results of paired FDG and PSMA PET/CT examinations performed in 42 consecutive men with prostate cancer for treatment planning after failure of anti-androgen therapy and chemotherapy were studied. Tumor lesions with FDG or PSMA uptake intensity higher than that of the liver on visual review were considered positive and noted per patient and tumor site (prostate bed, lymph node, bone, and visceral organ). The presence of unequivocally discordant FDG and PSMA uptake patterns in tumor lesions was assessed. Patients were grouped according to the total tumor volume as seen on each PET/CT scan, and the clinical findings between the patient groups were compared using the Mann-Whitney U test. Results: On patient-based analysis, the image findings were PSMA+/FDG- in 2 patients, PSMA-/FDG+ in one, and PSMA+/FDG+ in 39 patients. On site-based analysis, the discordance (PSMA+/FDG- or PSMA-/FDG+) rate was 9.5% (4/42) for prostate/bed, 11.9% (5/42) for lymph nodes, 9.5% (4/42) for bones, and 11.9% (5/42) for visceral organs. FDG uptake was higher than PSMA uptake in at least one tumor site in 54.8% (23/42) of patients. Patients with greater total tumor volume on FDG PET/CT than that on PSMA PET/CT (“FDG-dominant pattern”) accounted for 28.6% (12/42), and they had significantly shorter time from diagnosis (median 25 months vs. 62 months, P = 0.049), and higher aspartate aminotransferase (median 28.5 vs. 22.5, P = 0.027) and lactate dehydrogenase (median 341.5 vs. 224.5, P = 0.010) levels. Conclusion Most patients with advanced mCRPC had tumors with positive findings on both FDG and PSMA PET/CT. However, the uptake patterns varied; 54.8% of the patients had tumor(s) with FDG uptake greater than PSMA uptake, and FDGdominant pattern was noted in 28.6% of the patients.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Objective: We aimed to describe the [ 18 F]fluorodeoxyglucose (FDG) and prostate-specific membrane antigen (PSMA) PET/CT findings in Korean men with advanced metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: The results of paired FDG and PSMA PET/CT examinations performed in 42 consecutive men with prostate cancer for treatment planning after failure of anti-androgen therapy and chemotherapy were studied. Tumor lesions with FDG or PSMA uptake intensity higher than that of the liver on visual review were considered positive and noted per patient and tumor site (prostate bed, lymph node, bone, and visceral organ). The presence of unequivocally discordant FDG and PSMA uptake patterns in tumor lesions was assessed. Patients were grouped according to the total tumor volume as seen on each PET/CT scan, and the clinical findings between the patient groups were compared using the Mann-Whitney U test. Results: On patient-based analysis, the image findings were PSMA+/FDG- in 2 patients, PSMA-/FDG+ in one, and PSMA+/FDG+ in 39 patients. On site-based analysis, the discordance (PSMA+/FDG- or PSMA-/FDG+) rate was 9.5% (4/42) for prostate/bed, 11.9% (5/42) for lymph nodes, 9.5% (4/42) for bones, and 11.9% (5/42) for visceral organs. FDG uptake was higher than PSMA uptake in at least one tumor site in 54.8% (23/42) of patients. Patients with greater total tumor volume on FDG PET/CT than that on PSMA PET/CT (“FDG-dominant pattern”) accounted for 28.6% (12/42), and they had significantly shorter time from diagnosis (median 25 months vs. 62 months, P = 0.049), and higher aspartate aminotransferase (median 28.5 vs. 22.5, P = 0.027) and lactate dehydrogenase (median 341.5 vs. 224.5, P = 0.010) levels. Conclusion Most patients with advanced mCRPC had tumors with positive findings on both FDG and PSMA PET/CT. However, the uptake patterns varied; 54.8% of the patients had tumor(s) with FDG uptake greater than PSMA uptake, and FDGdominant pattern was noted in 28.6% of the patients.

Objective: 177 Lutetium [Lu] Ludotadipep is a novel prostate-specific membrane antigen targeting therapeutic agent with an albumin motif added to increase uptake in the tumors. We assessed the biodistribution and dosimetry of [ 177 Lu]Ludotadipep in patients with metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: Data from 25 patients (median age, 73 years; range, 60–90) with mCRPC from a phase I study with activity escalation design of single administration of [ 177 Lu]Ludotadipep (1.85, 2.78, 3.70, 4.63, and 5.55 GBq) were assessed. Activity in the salivary glands, lungs, liver, kidneys, and spleen was estimated from whole-body scan and abdominal SPECT/CT images acquired at 2, 24, 48, 72, and 168 h after administration of [ 177 Lu]Ludotadipep. Red marrow activity was calculated from blood samples obtained at 3, 10, 30, 60, and 180 min, and at 24, 48, and 72 h after administration. Organand tumor-based absorbed dose calculations were performed using IDAC-Dose 2.1. Results: Absorbed dose coefficient (mean ± standard deviation) of normal organs was 1.17 ± 0.81 Gy/GBq for salivary glands, 0.05 ± 0.02 Gy/GBq for lungs, 0.14 ± 0.06 Gy/GBq for liver, 0.77 ± 0.28 Gy/GBq for kidneys, 0.12 ± 0.06 Gy/GBq for spleen, and 0.07 ± 0.02 Gy/GBq for red marrow. The absorbed dose coefficient of the tumors was 10.43 ± 7.77 Gy/GBq. Conclusion [ 177 Lu]Ludotadipep is expected to be safe at the dose of 3.7 GBq times 6 cycles planned for a phase II clinical trial with kidneys and bone marrow being the critical organs, and shows a high tumor absorbed dose.

Objective: We aimed to describe the [ 18 F]fluorodeoxyglucose (FDG) and prostate-specific membrane antigen (PSMA) PET/CT findings in Korean men with advanced metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: The results of paired FDG and PSMA PET/CT examinations performed in 42 consecutive men with prostate cancer for treatment planning after failure of anti-androgen therapy and chemotherapy were studied. Tumor lesions with FDG or PSMA uptake intensity higher than that of the liver on visual review were considered positive and noted per patient and tumor site (prostate bed, lymph node, bone, and visceral organ). The presence of unequivocally discordant FDG and PSMA uptake patterns in tumor lesions was assessed. Patients were grouped according to the total tumor volume as seen on each PET/CT scan, and the clinical findings between the patient groups were compared using the Mann-Whitney U test. Results: On patient-based analysis, the image findings were PSMA+/FDG- in 2 patients, PSMA-/FDG+ in one, and PSMA+/FDG+ in 39 patients. On site-based analysis, the discordance (PSMA+/FDG- or PSMA-/FDG+) rate was 9.5% (4/42) for prostate/bed, 11.9% (5/42) for lymph nodes, 9.5% (4/42) for bones, and 11.9% (5/42) for visceral organs. FDG uptake was higher than PSMA uptake in at least one tumor site in 54.8% (23/42) of patients. Patients with greater total tumor volume on FDG PET/CT than that on PSMA PET/CT (“FDG-dominant pattern”) accounted for 28.6% (12/42), and they had significantly shorter time from diagnosis (median 25 months vs. 62 months, P = 0.049), and higher aspartate aminotransferase (median 28.5 vs. 22.5, P = 0.027) and lactate dehydrogenase (median 341.5 vs. 224.5, P = 0.010) levels. Conclusion Most patients with advanced mCRPC had tumors with positive findings on both FDG and PSMA PET/CT. However, the uptake patterns varied; 54.8% of the patients had tumor(s) with FDG uptake greater than PSMA uptake, and FDGdominant pattern was noted in 28.6% of the patients.

Objective: We aimed to describe the [ 18 F]fluorodeoxyglucose (FDG) and prostate-specific membrane antigen (PSMA) PET/CT findings in Korean men with advanced metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods: The results of paired FDG and PSMA PET/CT examinations performed in 42 consecutive men with prostate cancer for treatment planning after failure of anti-androgen therapy and chemotherapy were studied. Tumor lesions with FDG or PSMA uptake intensity higher than that of the liver on visual review were considered positive and noted per patient and tumor site (prostate bed, lymph node, bone, and visceral organ). The presence of unequivocally discordant FDG and PSMA uptake patterns in tumor lesions was assessed. Patients were grouped according to the total tumor volume as seen on each PET/CT scan, and the clinical findings between the patient groups were compared using the Mann-Whitney U test. Results: On patient-based analysis, the image findings were PSMA+/FDG- in 2 patients, PSMA-/FDG+ in one, and PSMA+/FDG+ in 39 patients. On site-based analysis, the discordance (PSMA+/FDG- or PSMA-/FDG+) rate was 9.5% (4/42) for prostate/bed, 11.9% (5/42) for lymph nodes, 9.5% (4/42) for bones, and 11.9% (5/42) for visceral organs. FDG uptake was higher than PSMA uptake in at least one tumor site in 54.8% (23/42) of patients. Patients with greater total tumor volume on FDG PET/CT than that on PSMA PET/CT (“FDG-dominant pattern”) accounted for 28.6% (12/42), and they had significantly shorter time from diagnosis (median 25 months vs. 62 months, P = 0.049), and higher aspartate aminotransferase (median 28.5 vs. 22.5, P = 0.027) and lactate dehydrogenase (median 341.5 vs. 224.5, P = 0.010) levels. Conclusion Most patients with advanced mCRPC had tumors with positive findings on both FDG and PSMA PET/CT. However, the uptake patterns varied; 54.8% of the patients had tumor(s) with FDG uptake greater than PSMA uptake, and FDGdominant pattern was noted in 28.6% of the patients.

Background: Suture ligation has been used widely for the treatment of rudimentary type extra digits, but several complications related to this treatment have been reported. The purpose of this study was to describe a new technique for excision of rudimentary preaxial polydactyly of the hand using electrocautery and assess its clinical outcomes. Methods: The authors performed a retrospective study of 34 thumbs (32 patients) that had undergone excision of rudimentary preaxial polydactyly using electrocautery under local anesthesia. The mean follow-up period was 16.5 months. Results: All children had full range of thumb motion without angular deformity at the most recent follow-up. There were no postoperative complications such as bleeding or infection. In 33 thumbs (97.1% of 34 thumbs), there were no signs of residual digit prominence. One thumb had a residual digit prominence at the extra digit removal site. In two thumbs, scar hypertrophy was evident at the operation site. All parents of the patients except two were very satisfied with this technique and the mean visual analog scale score for satisfaction was 9.5 ± 2.0 (range, 0–10). Conclusions Excision of rudimentary preaxial polydactyly of the hand with the use of electrocautery could remove an extra digit completely in 97.1% of the cases. This technique would be a useful alternative to suture ligation, surgical clip application, or surgical excision for the treatment of rudimentary preaxial polydactyly of the hand.

Background/Aims: The long-term course of Crohn’s disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the longterm prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort. Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015. Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68). Conclusions The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades.

Background/Aims: We aimed to evaluate the clinical characteristics and long-term prognosis of elderly-onset ulcerative colitis (EOUC) in Korean patients over a 30-year period using a wellestablished population-based cohort in the Songpa-Kangdong district of Seoul, Korea. Methods: Clinical characteristics and prognosis were compared between two groups: EOUC,defined as UC diagnosed in individuals aged ≥60 years and non-EOUC (N-EOUC), defined asUC diagnosed in individuals aged 18 to 59 years. Results: We identified 99 patients with EOUC (10.3%) and 866 patients with N-EOUC (89.7%) between 1986 and 2015. During the median follow-up of 104.5 months, the overall exposure tomedications was comparable between patients with EOUC and N-EOUC (p=0.091 for corticosteroids, p=0.794 for thiopurines, and p=0.095 for anti-tumor necrosis factor agents). The cumula-tive risks of disease outcomes were also comparable between patients with EOUC and N-EOUC (22.4% vs 30.4% for proximal disease extension [p=0.351], 11.9% vs 18.1% for hospitalization [p=0.240], and 2.3% vs 1.8% for colectomy [p=0.977]) at 10 years after diagnosis. Multivariate Cox regression analysis revealed that corticosteroid use at diagnosis was an independent predic-tor of proximal disease extension (hazard ratio [HR], 6.216; 95% confidence interval [CI], 1.314 to 28.826) and hospitalization (HR, 11.241; 95% CI, 3.027 to 41.742) in patients with EOUC. Conclusions In this population-based study from Korea, the pattern of medication use seemed comparable between the EOUC and N-EOUC groups. Moreover, patients with EOUC and those with N-EOUC have a similar disease course in terms of proximal disease extension, hospitaliza-tion, and colectomy.