Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Purpose: Adjuvant chemotherapy (AC) is recommended for muscle-invasive or lymph node-positive upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). However, disease recurrences are frequently observed in pT1 disease, and AC may increase the risk of overtreatment in pT2 UTUC patients. This study aimed to validate a risk-adapted scoring model for selecting UTUC patients with ≤pT2 disease who would benefit from AC. Materials and Methods: We retrospectively analyzed 443 ≤pT2 UTUC patients who underwent RNU. A risk-adapted scoring model was applied, categorizing patients into low- or high-risk groups. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed according to risk group. Results: Overall, 355 patients (80.1%) and 88 patients (19.9%) were categorized into the low- and high-risk groups, respectively, with the latter having higher pathological stages, concurrent carcinoma in situ, and synchronous bladder tumors. Disease recurrence occurred in 45 patients (10.2%), among whom 19 (5.4%) and 26 (29.5%) belonged to the low- and high-risk groups, respectively (p<0.001). High-risk patients had significantly shorter RFS (64.3% vs. 93.6% at 60 months; hazard ratio [HR] 13.66; p<0.001) and worse CSS (80.7% vs. 91.5% at 60 months; HR 4.25; p=0.002). Multivariate analysis confirmed that pT2 stage and the high-risk group were independent predictors of recurrence and cancer-specific death (p<0.001). Decision curve analysis for RFS showed larger net benefits with our model than with the T stage model. Conclusions The risk-adapted scoring model effectively predicts recurrence and identifies optimal candidates for AC post RNU in non-metastatic UTUC.

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.

Thymic diseases such as thymic hyperplasia, thymic cysts, thymoma, and thymic carcinoma are common causes of mediastinal masses that present with diverse clinical and radiological features. Magnetic resonance imaging (MRI) is a pivotal tool for evaluating thymic pathologies as it offers superior soft-tissue contrast and has the ability to distinguish between benign and malignant lesions. Thymic MRI protocols include T1- and T2-weighted imaging, diffusion-weighted MRI (DW-MRI) with apparent diffusion coefficient mapping, and contrast-enhanced MRI (CE-MRI), each offering unique diagnostic insights into the composition and behavior of thymic lesions. However, interpreting MRI findings in thymic diseases may present challenges. Thymic cysts containing hemorrhage or proteinaceous material may mimic solid lesions owing to altered signal intensities, necessitating DW-MRI and CE-MRI for accurate differentiation. Small thymic lesions, particularly those <1 cm in diameter, are susceptible to signal distortion and partial volume effects, complicating their detection and characterization. Furthermore, respiratory and cardiac motion artifacts can degrade the image quality and obscure important diagnostic details, especially in lesions near the heart and lungs. Despite these challenges, MRI remains a critical imaging modality for assessing and managing thymic diseases, offering detailed tissue characterization. Interpretive pitfalls and technical limitations underscore the importance of employing optimized imaging protocols and expert analyses to ensure diagnostic accuracy and guide appropriate clinical decision-making.

Background and Objectives: Cardiac resynchronization therapy (CRT) is a treatment option for patients with heart failure and left ventricular (LV) dyssynchrony. However, one-third of CRT patients are non-responders. The objective of this study is to evaluate the feasibility of an in silico electromechanical heart model to predict CRT outcomes. Methods: The three-dimensional heart geometries of 11 patients (age, 64.0 ± 10.7 years, 4 men) with CRT were constructed from cardiac computed tomography images. The finite element method was used to simulate the electrical wave propagation and mechanics in the heart. We coupled cardiac electrical excitation and mechanical contraction with vascular hemodynamics using a lumped parameter model. We predicted the LV end-diastolic and end-systolic volumes and LV ejection fraction (LVEF) after CRT implantation using the in silico CRT simulation model. A CRT responder was defined as a patient with an absolute LVEF increase ≥ 5%. We compared the in silico CRT outcomes with the real CRT outcomes. Results: Two patients were in silico CRT responders, and those 2 patients were also real CRT responders. Nine patients were in silico CRT non-responders, 8 who were real CRT non-responders, and 1 who was a real CRT responder. The in silico CRT outcomes agreed with the real CRT outcomes in 10 of 11 patients. The positive and negative predictive values, accuracy, sensitivity, and specificity of the in silico CRT model were 100%, 88.9%, 90.9%, 66.7%, and 100%, respectively. Conclusion The in silico CRT simulation model is feasible for predicting real CRT outcomes.

Purpose: The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards. Methods: Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt. Results: Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: ‘Wishing for precise operating systems based on patient severity,’ ‘Anticipating active caregiver participation in treatment process,’ ‘Requiring a countermeasure for safety accidents,’ 2) Professional nursing service which provides relief: ‘Patient-centered professional nursing service,’ ‘Inpatient service that provides relief for patients and caregivers,’ 3) Anticipating continuous use of the service: ‘Inpatient service which users are willing to reuse,’ ‘Wishing for expansion and reinforcement of the service.’ Conclusion Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers.

Purpose: The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards. Methods: Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt. Results: Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: ‘Wishing for precise operating systems based on patient severity,’ ‘Anticipating active caregiver participation in treatment process,’ ‘Requiring a countermeasure for safety accidents,’ 2) Professional nursing service which provides relief: ‘Patient-centered professional nursing service,’ ‘Inpatient service that provides relief for patients and caregivers,’ 3) Anticipating continuous use of the service: ‘Inpatient service which users are willing to reuse,’ ‘Wishing for expansion and reinforcement of the service.’ Conclusion Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers.

Purpose: The purpose of this study was to explore and assess the experiences of cancer patients and their caregivers who had been admitted to comprehensive nursing care service wards. Methods: Data were collected from 10 patients and 10 caregivers by in-depth interviews. The data were analyzed using content analysis of Downe-Wamboldt. Results: Three categories and seven subcategories were extracted. 1) Realizing institutional limitations of comprehensive nursing care service: ‘Wishing for precise operating systems based on patient severity,’ ‘Anticipating active caregiver participation in treatment process,’ ‘Requiring a countermeasure for safety accidents,’ 2) Professional nursing service which provides relief: ‘Patient-centered professional nursing service,’ ‘Inpatient service that provides relief for patients and caregivers,’ 3) Anticipating continuous use of the service: ‘Inpatient service which users are willing to reuse,’ ‘Wishing for expansion and reinforcement of the service.’ Conclusion Cancer patients and their caregivers experienced institutional limitations while satisfied with professional nursing service and willing to reuse the service. To improve this situation, institutional support such as separate wards for severe patients, measures for active caregiver participation and prevention of safety accidents, and adequate staffing would be helpful for relatively severe level cancer patients and their caregivers.

Objective: Parkinson’s disease (PD) patients often find it difficult to visit hospitals because of motor symptoms, distance to the hospital, or the absence of caregivers. Telemedicine is one way to solve this problem. Methods: We surveyed 554 PD patients from eight university hospitals in Korea. The questionnaire consisted of the clinical characteristics of the participants, possible teleconferencing methods, and preferences for telemedicine. Results: A total of 385 patients (70%) expressed interest in receiving telemedicine. Among them, 174 preferred telemedicine whereas 211 preferred in-person visits. The longer the duration of disease, and the longer the time required to visit the hospital, the more patients were interested in receiving telemedicine. Conclusion This is the first study on PD patients’ preferences regarding telemedicine in Korea. Although the majority of patients with PD have a positive view of telemedicine, their interest in receiving telemedicine depends on their different circumstances.