Purpose: Non-operative management (NOM) has emerged as a promising organ-preserving strategy for patients with rectal cancer who achieve a clinical complete response (cCR) after neoadjuvant chemoradiotherapy (CRT). However, no standardized treatment protocol has been established for watch-and-wait strategies. Materials and Methods: This prospective study evaluated oncological outcomes of NOM combined with 4 months of adjuvant capecitabine. Patients with resectable rectal cancer (≤ 8 cm from the anal verge, cT2-4 or N+) underwent CRT (50-54 Gy in 25-27 fractions with capecitabine). Eight weeks post-CRT, a multidisciplinary team assessed cCR. Patients achieving cCR received six cycles of capecitabine (2 weeks on/1 week off) and were actively monitored. Results: Among 89 patients receiving CRT (2018-2023), 17 (19.1%) achieved cCR and were included. The median age was 65 years, and 64.7% were male. Eleven (64.7%) completed all six cycles of adjuvant therapy. After a median follow-up of 31.4 months, 11 patients (64.7%) remained disease-free. Local regrowth occurred in six patients (35.3%) with 2- and 4-year rates of 34.5% and 47.6%, respectively. Five underwent radical surgery, and one received transanal excision with systemic chemotherapy. At the time of assessment, 15 patients (88.2%) showed no evidence of disease, while two (11.8%) received palliative chemotherapy. All patients were alive. Conclusion NOM with adjuvant capecitabine showed promising oncological outcomes, offering an alternative to passive watch-and-wait approaches. Further refinement through multidisciplinary strategies is warranted.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

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.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

This review examines the challenges associated with occupational disease surveillance in Korea, particularly emphasizing the limitations of current data sources such as the Industrial Accident Compensation Insurance (IACI) statistics and special health examinations. The IACI system undercounts cases due to its emphasis on severe diseases and restrictions on approvals. Special health examinations, although they cover a broad workforce, are constrained by their annual scheduling, which leads to missed acute illnesses and subclinical conditions. The paper also explores the history of occupational disease surveillance in Korea, highlighting the fragmented and disease-specific approach of earlier systems. The authors introduce the newly established Korea Occupational Disease Surveillance Center (KODSC), a comprehensive nationwide system designed to gather, analyze, and interpret data on occupational diseases through a network of regional centers. By incorporating hospital-based surveillance and focusing on acute poisonings and other sentinel events, the KODSC aims to overcome the limitations of previous systems and promote collaboration with various agencies. Although it is still in the early stages of implementation, the KODSC demonstrates potential for improving data accuracy and contributing valuable insights for public health policy.

Objective: Because of the possible therapeutic benefit of removing occult tumor cells, a source of recurrence and chemoresistance, total parietal peritonectomy (TPP) is an alternative treatment for advanced epithelial ovarian/fallopian tube/primary peritoneal cancer. Interventional studies comparing TPP with selective parietal peritonectomy (SPP) are in progress. Since surgeons skilled in TPP are essential for such trials to be conducted, this nationwide survey aimed to examine current peritonectomy practice among gynecologic oncologists in Korea. Methods: A 17-item questionnaire, developed by a surgery committee and reviewed by the scientific review board of the Korean Gynecology Oncology Group (KGOG), was distributed to 144 KGOG members. The questionnaire was divided into 3 categories: respondent demographics, peritonectomy practice during primary debulking surgery (PDS), and peritonectomy practice during interval debulking surgery (IDS). Results: We received 88 (61.1%) valid responses. Of the valid respondents, 98.9% and 93.8% performed SPP during PDS and IDS, respectively. Only 4.9% of the respondents performed TPP during IDS. Most respondents performed peritonectomy in cases where optimal postoperative outcomes were expected. Approximately 50.6% of the respondents had performed peritonectomy independently, while the others did so in cooperation with non-gynecologic surgeons. The primary reasons for not performing TPP were concerns about morbidity and uncertainty about the clinical benefits of the procedure. Conclusion SPP is the predominant technique used in both PDS and IDS in Korea. A small percentage (4.9%) of gynecologic oncologists have performed TPP during IDS. Accordingly, a study regarding the feasibility of TPP should be conducted before proceeding with a prospective clinical trial.

Background: The question of whether large language models (LLMs) possess consciousness has been increasingly debated. Integrated information theory (IIT) offers a quantitative framework for assessing consciousness through a measure of integrated information. Methods: This study applied IIT principles to the architecture of transformer-based LLMs, focusing on causal integration, temporal persistence, and system irreducibility. Ablation experiments on Generative Pretrained Transformer 2 (GPT-2) were performed, selectively removing individual attention heads and measuring changes in perplexity as a behavioral proxy for integrated information to empirically approximate the measure of integrated information. Results: The ablation study of a single attention head produced minimal or negative changes in perplexity in four out of five representative sentences, indicating redundancy or noise. Only one sentence revealed a significant increase in perplexity change (ΔPPL +11.29), reflecting a localized but nonessential contribution. A comparison with biological systems demonstrated that LLMs meet the IIT criterion of differentiation, but fail to meet the criteria of integration, causal closure, and temporal persistence. These findings confirm that LLMs are architecturally decomposable, lack persistent internal states, and do not sustain global causal irreducibility. Philosophical considerations, including Searle’s Chinese Room argument, further support the idea that the linguistic fluency of LLMs arises from syntactic manipulation rather than semantic understanding. Conclusion Current LLMs do not satisfy the structural and informational requirements of consciousness under IIT. Although capable of simulating intelligent language, LLMs remain unconscious systems with a negligible amount of integrated information, underscoring the distinction between linguistic competence and conscious experience.

The natural course of chronic kidney disease (CKD) progression in children varies according to their underlying conditions. This study aims to identify different patterns of subsequent decline in kidney function and investigate factors associated with different patterns of estimated glomerular filtration rate (eGFR) trajectories. Methods: We analyzed data from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease), which is a longitudinal, prospective cohort study. A latent class linear mixed model was applied to identify the trajectory groups. Results: In a total of 287 patients, the median baseline eGFR (mL/min/1.73 m2) was 63.3, and the median age was 11.5 years. The eGFR decline rate was –1.54 during a 6.0-year follow-up. The eGFR trajectory over time was classified into four groups. Classes 1 (n = 103) and 2 (n = 11) had a slightly reduced eGFR at enrollment with a stable trend (ΔeGFR, –0.2/year) and a rapid decline eGFR over time (ΔeGFR, –10.5/year), respectively. Class 3 had a normal eGFR (n = 16), and class 4 had a moderately reduced eGFR (n = 157); both these chasses showed a linear decline in eGFR over time (ΔeGFR, –4.1 and –2.4/year). In comparison with classes 1 and 2, after adjusting for age, causes of primary renal disease, and baseline eGFR, nephrotic-range proteinuria was associated with a rapid decline in eGFR (odds ratio, 8.13). Conclusion: We identified four clinically relevant subgroups of kidney function trajectories in children with CKD. Most children showed a linear decline in eGFR; however, there are different patterns of eGFR trajectories.