Purpose: This study aimed to explore the practices, perceptions, and barriers related to specialty palliative care (SPC) referrals among oncologists in Korea, highlighting the clinical implications of early integration. Materials and Methods: A cross-sectional online survey targeting board-certified hemato-oncology specialists was conducted between August 1-25, 2024. The survey assessed referral practices, attitudes toward early SPC integration, referral criteria, barriers, and institutional characteristics. Results: A total of 227 oncologists participated (response rate, 36.7%). Among them, 68.7% reported frequent SPC referrals, with higher referral rates observed among younger physicians, those in tertiary hospitals, and institutions with in-house SPC teams (p < 0.001). Although 74.9% supported early SPC integration, referrals were often inconsistently timed, frequently occurring after disease progression or at the discontinuation of chemotherapy. For time-based referrals, the most commonly endorsed triggers were disease progression despite palliative second-line treatment and a prognosis of expected mortality within 6-12 months. Need-based referral triggers such as patient or family requests (96.5%), psychological distress (89.9%), or uncontrolled symptoms (83.3%), were also widely endorsed. The major barriers to early SPC integration included patient and family resistance (70.0%) and limited availability of SPC teams (34.4%). Conclusion This study emphasizes the importance of systematic efforts to promote timely SPC integration in Korea, including education to raise patient awareness, improved referral systems, and enhanced infrastructure. The positive attitudes toward early SPC among oncologists reflect a growing recognition of its value, highlighting the need for strategies that align with international standards.

This report presents radiologic changes after clinical improvement in a patient with acute interstitial nephritis (AIN). A 45-year-old female patient was referred for decreased renal function. Eight months prior, she had undergone hysterectomy and received chemotherapy. At the start of chemotherapy, her baseline creatinine level was 0.55 mg/dL, which rose to 1.46 mg/dL. Multiple imaging modalities performed when decreased renal function was observed revealed bilateral renal enlargement with increased cortical attenuation on computed tomography (CT), cortical hyperechogenicity on ultrasonography, and diffusion restriction in the renal cortices on magnetic resonance imaging. A renal biopsy was performed, and AIN was diagnosed. Follow-up laboratory tests showed that kidney function had improved to normal levels, and CT at that time showed a reduction in the size of both kidneys. Radiologic changes can serve as clues for the diagnosis of AIN. This is the first report to confirm radiological changes after the clinical improvement of AIN, thereby providing novel information about the course of AIN.

Background/Aims: Chronic obstructive pulmonary disease (COPD) management guidelines have increasingly emphasised the importance of exacerbation prevention, and the role of blood eosinophil count (BEC) as a biomarker for inhaled corticosteroids (ICS) response. This study aimed to describe the distribution and stability of BEC and understand real-world treatment patterns among COPD patients in South Korea. Methods: This was a retrospective database analysis using data obtained from the KOrea COPD Subgroup Study (KOCOSS) registry between January 2012 and August 2018. KOCOSS is an ongoing, longitudinal, prospective, multi-centre, non-interventional study investigating early COPD amongst South Korean patients. BEC stability was assessed by calculating the intra-class correlation (ICC) coefficient. “Exacerbators” were patients who had a record of ≥ 1 exacerbation in the 12 months prior to the visit. Results: The study included 2,661 patients with a mean age of 68.6 years. Most patients were male (92.0%). Mean BEC was significantly higher in exacerbators compared to non-exacerbators. Patients with ≥ 2 exacerbations at baseline had a less stable BEC over time (ICC = 0.44) compared to non-exacerbators (ICC = 0.57). Patients with BEC ≥ 300 cells/μL at baseline predominantly received triple therapy (43.8%). Conclusions This study may further develop current understanding on BEC profiles amongst COPD patients in South Korea. BEC measurements are stable and reproducible among COPD patients, which supports its use as a potential biomarker.

Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Background/Aims: Chronic obstructive pulmonary disease (COPD) management guidelines have increasingly emphasised the importance of exacerbation prevention, and the role of blood eosinophil count (BEC) as a biomarker for inhaled corticosteroids (ICS) response. This study aimed to describe the distribution and stability of BEC and understand real-world treatment patterns among COPD patients in South Korea. Methods: This was a retrospective database analysis using data obtained from the KOrea COPD Subgroup Study (KOCOSS) registry between January 2012 and August 2018. KOCOSS is an ongoing, longitudinal, prospective, multi-centre, non-interventional study investigating early COPD amongst South Korean patients. BEC stability was assessed by calculating the intra-class correlation (ICC) coefficient. “Exacerbators” were patients who had a record of ≥ 1 exacerbation in the 12 months prior to the visit. Results: The study included 2,661 patients with a mean age of 68.6 years. Most patients were male (92.0%). Mean BEC was significantly higher in exacerbators compared to non-exacerbators. Patients with ≥ 2 exacerbations at baseline had a less stable BEC over time (ICC = 0.44) compared to non-exacerbators (ICC = 0.57). Patients with BEC ≥ 300 cells/μL at baseline predominantly received triple therapy (43.8%). Conclusions This study may further develop current understanding on BEC profiles amongst COPD patients in South Korea. BEC measurements are stable and reproducible among COPD patients, which supports its use as a potential biomarker.

This report presents radiologic changes after clinical improvement in a patient with acute interstitial nephritis (AIN). A 45-year-old female patient was referred for decreased renal function. Eight months prior, she had undergone hysterectomy and received chemotherapy. At the start of chemotherapy, her baseline creatinine level was 0.55 mg/dL, which rose to 1.46 mg/dL. Multiple imaging modalities performed when decreased renal function was observed revealed bilateral renal enlargement with increased cortical attenuation on computed tomography (CT), cortical hyperechogenicity on ultrasonography, and diffusion restriction in the renal cortices on magnetic resonance imaging. A renal biopsy was performed, and AIN was diagnosed. Follow-up laboratory tests showed that kidney function had improved to normal levels, and CT at that time showed a reduction in the size of both kidneys. Radiologic changes can serve as clues for the diagnosis of AIN. This is the first report to confirm radiological changes after the clinical improvement of AIN, thereby providing novel information about the course of AIN.

This report presents radiologic changes after clinical improvement in a patient with acute interstitial nephritis (AIN). A 45-year-old female patient was referred for decreased renal function. Eight months prior, she had undergone hysterectomy and received chemotherapy. At the start of chemotherapy, her baseline creatinine level was 0.55 mg/dL, which rose to 1.46 mg/dL. Multiple imaging modalities performed when decreased renal function was observed revealed bilateral renal enlargement with increased cortical attenuation on computed tomography (CT), cortical hyperechogenicity on ultrasonography, and diffusion restriction in the renal cortices on magnetic resonance imaging. A renal biopsy was performed, and AIN was diagnosed. Follow-up laboratory tests showed that kidney function had improved to normal levels, and CT at that time showed a reduction in the size of both kidneys. Radiologic changes can serve as clues for the diagnosis of AIN. This is the first report to confirm radiological changes after the clinical improvement of AIN, thereby providing novel information about the course of AIN.

Background/Aims: Chronic obstructive pulmonary disease (COPD) management guidelines have increasingly emphasised the importance of exacerbation prevention, and the role of blood eosinophil count (BEC) as a biomarker for inhaled corticosteroids (ICS) response. This study aimed to describe the distribution and stability of BEC and understand real-world treatment patterns among COPD patients in South Korea. Methods: This was a retrospective database analysis using data obtained from the KOrea COPD Subgroup Study (KOCOSS) registry between January 2012 and August 2018. KOCOSS is an ongoing, longitudinal, prospective, multi-centre, non-interventional study investigating early COPD amongst South Korean patients. BEC stability was assessed by calculating the intra-class correlation (ICC) coefficient. “Exacerbators” were patients who had a record of ≥ 1 exacerbation in the 12 months prior to the visit. Results: The study included 2,661 patients with a mean age of 68.6 years. Most patients were male (92.0%). Mean BEC was significantly higher in exacerbators compared to non-exacerbators. Patients with ≥ 2 exacerbations at baseline had a less stable BEC over time (ICC = 0.44) compared to non-exacerbators (ICC = 0.57). Patients with BEC ≥ 300 cells/μL at baseline predominantly received triple therapy (43.8%). Conclusions This study may further develop current understanding on BEC profiles amongst COPD patients in South Korea. BEC measurements are stable and reproducible among COPD patients, which supports its use as a potential biomarker.

Background/Aims: Chronic obstructive pulmonary disease (COPD) management guidelines have increasingly emphasised the importance of exacerbation prevention, and the role of blood eosinophil count (BEC) as a biomarker for inhaled corticosteroids (ICS) response. This study aimed to describe the distribution and stability of BEC and understand real-world treatment patterns among COPD patients in South Korea. Methods: This was a retrospective database analysis using data obtained from the KOrea COPD Subgroup Study (KOCOSS) registry between January 2012 and August 2018. KOCOSS is an ongoing, longitudinal, prospective, multi-centre, non-interventional study investigating early COPD amongst South Korean patients. BEC stability was assessed by calculating the intra-class correlation (ICC) coefficient. “Exacerbators” were patients who had a record of ≥ 1 exacerbation in the 12 months prior to the visit. Results: The study included 2,661 patients with a mean age of 68.6 years. Most patients were male (92.0%). Mean BEC was significantly higher in exacerbators compared to non-exacerbators. Patients with ≥ 2 exacerbations at baseline had a less stable BEC over time (ICC = 0.44) compared to non-exacerbators (ICC = 0.57). Patients with BEC ≥ 300 cells/μL at baseline predominantly received triple therapy (43.8%). Conclusions This study may further develop current understanding on BEC profiles amongst COPD patients in South Korea. BEC measurements are stable and reproducible among COPD patients, which supports its use as a potential biomarker.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.