Background: The clinical manifestations of metastatic brachial plexopathy include pain, sensory loss, paresthesia, weakness, and reduced range of motion. These symptoms closely resemble those of shoulder disorders and peripheral nerve entrapment, which are commonly diagnosed in pain clinics, increasing the risk of misdiagnosis or delayed diagnosis, particularly in patients with a history of malignancy.Case: A 51-year-old woman with a history of breast cancer in complete remission for 19 years presented with shoulder pain, arm weakness, and tingling in the fingers. Initial treatments for suspected cervical radiculopathy, shoulder disorders, and nerve entrapment were ineffective. Electromyography and nerve conduction studies revealed electrophysiological abnormalities consistent with left brachial plexopathy. Magnetic resonance imaging of the brachial plexus confirmed metastatic involvement. The patient is currently undergoing chemotherapy. Conclusions Clinicians must be vigilant of the possibility of malignancy in patients with a history of cancer and should pursue comprehensive diagnostic evaluations to exclude cancer recurrence.

Background: Liver transplantation (LT) is the standard treatment for end-stage liver disease; however, it can lead to biliary strictures in 25%–30% of cases. We aimed to develop a biodegradable stent loaded with paclitaxel that could be inserted during surgery without requiring removal. We evaluated the safety and efficacy of this stent using a porcine model. Methods: Fourteen pigs underwent simulated ischemic injury during LT, and a biodegradable paclitaxel-eluting stent was inserted after duct-to-duct anastomosis.Pigs were divided into four groups: no stent (n=3), bare stent (n=3), 300 µg paclitaxel stent (n=4), and 900 µg paclitaxel stent (n=4). After 3 months of follow-up, autopsies were conducted to obtain common bile duct tissue samples, and inflammation and fibrosis thicknesses were assessed under a microscope. Results: Most tissues had resolved the inflammatory reactions by the 3-month mark. The thinnest fibrosis thickness was observed in the 900 µg group (359.08±167.23 µm); however, no statistical significance was observed. Conclusion This study demonstrated the safety of paclitaxel-eluting biodegradable biliary stents and their positive effects on fibrosis in an ischemic bile duct porcine model. This biodegradable stent represents a potential approach for overcoming the complications associated with biliary strictures after LT.

Background: The number of organ transplants in South Korea has increased, with a notable rise in living donor transplants. Ensuring their long-term health and well-being is critical to address potential complications and maintain the success of the transplant programs. Methods: A diverse advisory panel, including transplant experts and coordinators, was established to evaluate the follow-up care for living donors. The panel reviewed the results of a brief survey of donors regarding their donation experience, follow-up programs, guidelines, and policies from South Korea and other countries, aiming to identify best practices and recommend improvements. Results: The study found that follow-up care for living donors in South Korea is inconsistent and lacks standardization. Significant variability exists in follow-up practices across different institutions, and comprehensive data on donor health pre- and post-donation are scarce. The need for continuous, systematic follow-up, encompassing both medical and psychological support, is emphasized to ensure donor well-being. Conclusion Improving follow-up care for living donors is essential. Establishing a national registry and increasing donor advocacy teams are meaningful steps to enhance donor care, ensure long-term health, and maintain ethical standards in organ donation.

Background: The number of organ transplants in South Korea has increased, with a notable rise in living donor transplants. Ensuring their long-term health and well-being is critical to address potential complications and maintain the success of the transplant programs. Methods: A diverse advisory panel, including transplant experts and coordinators, was established to evaluate the follow-up care for living donors. The panel reviewed the results of a brief survey of donors regarding their donation experience, follow-up programs, guidelines, and policies from South Korea and other countries, aiming to identify best practices and recommend improvements. Results: The study found that follow-up care for living donors in South Korea is inconsistent and lacks standardization. Significant variability exists in follow-up practices across different institutions, and comprehensive data on donor health pre- and post-donation are scarce. The need for continuous, systematic follow-up, encompassing both medical and psychological support, is emphasized to ensure donor well-being. Conclusion Improving follow-up care for living donors is essential. Establishing a national registry and increasing donor advocacy teams are meaningful steps to enhance donor care, ensure long-term health, and maintain ethical standards in organ donation.

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.

Background: Dental caries is a prevalent public health problem among adolescents that significantly affects their quality of life. The Caries Management by Risk Assessment (CAMBRA) model provides a structured, risk-based approach for caries prevention and management. This study evaluated the effectiveness of the CAMBRA-students mobile application, integrated with an information and communication technology (ICT) based intervention, in modifying caries risk factors in middle school students. Methods: A non-equivalent control group pretest-posttest design was used. A total of 131 middle school students aged 13∼14 years participated. The experimental group (n=68) received a risk-based intervention using the CAMBRA-student mobile application for 1 year, while the control group (n=63) received only standard oral health education and underwent pre- and post-tests. Data on caries risk factors; protective factors; disease indicators; and decayed, missing, and filled teeth rates were collected. Paired and independent t-tests were conducted to analyze changes within and between groups. Results: The rate of change in the caries risk classification before and after the intervention differed between the groups. In the control group, 50% of the low-risk participants were at a high-risk after 12 months. In the intervention group, 90% of the low-risk participants shifted to the high-risk category, and those classified as extremely high-risk moved to the high-risk category. When comparing changes in the caries risk assessment before and after the intervention, both groups demonstrated a significant increase in protective factors (p＜0.001). However, disease indicators increased significantly in the control, whereas no significant change was noted in the intervention group. Conclusion This study evaluated the effectiveness of an ICT-based caries management program for middle school students and confirmed changes in protective factors and specific oral health behaviors through personalized interventions. Future studies should investigate the long-term sustainability of such interventions across diverse populations to further establish their effectiveness.

Purpose: Since 1995, the Korean Gastric Cancer Association (KGCA) has been periodically conducting nationwide surveys on patients with surgically treated gastric cancer. This study details the results of the survey conducted in 2023. Materials and Methods: The survey was conducted from March to December 2024 using a standardized case report form. Data were collected on 86 items, including patient demographics, tumor characteristics, surgical procedures, and surgical outcomes. The results of the 2023 survey were compared with those of previous surveys. Results: Data from 12,751 cases were collected from 66 institutions. The mean patient age was 64.6 years, and the proportion of patients aged ≥71 years increased from 9.1% in 1995 to 31.7% in 2023. The proportion of upper-third tumors slightly decreased to 16.8% compared to 20.9% in 2019. Early gastric cancer accounted for 63.1% of cases in 2023.Regarding operative procedures, a totally laparoscopic approach was most frequently applied (63.2%) in 2023, while robotic gastrectomy steadily increased to 9.5% from 2.1% in 2014.The most common anastomotic method was the Billroth II procedure (48.8%) after distal gastrectomy and double-tract reconstruction (51.9%) after proximal gastrectomy in 2023.However, the proportion of esophago-gastrostomy with anti-reflux procedures increased to 30.9%. The rates of post-operative mortality and overall complications were 1.0% and 15.3%, respectively. Conclusions The results of the 2023 nationwide survey demonstrate the current status of gastric cancer treatment in Korea. This information will provide a basis for future gastric cancer research.

We updated the Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of ovarian cancer as version 5.1. The ovarian cancer guideline team of the KSGO published announced the fifth version (version 5.0) of its clinical practice guidelines for the management of ovarian cancer in December 2023. In version 5.0, the selection of the key questions and the systematic reviews were based on the data available up to December 2022.Therefore, we updated the guidelines version 5.0 with newly accumulated clinical data and added 5 new key questions reflecting the latest insights in the field of ovarian cancer between 2023 and 2024. For each question, recommendation was provided together with corresponding level of evidence and grade of recommendation, all established through expert consensus.

Purpose: The purpose of this study was to explore and deeply understand the essential meaning of international students' healthcare management experiences in Korea. Methods: This study applied Colaizzi‘s phenomenological research method to identify the meanings and needs related to health care management experienced by international students during their academic stay in Korea. Data were collected through unstructured interviews, in which open-ended questions were asked to 12 international students. The interviews were conducted from May 10, 2024, to the end of July 2024, followed by an analysis based on Colaizzi’s six-step approach. The criteria set by Lincoln and Guba were used to enhance the reliability and validity of qualitative research. Results: Regarding the meaning of international students' healthcare management experiences in Korea, this study identified four categories, 11 themes, 27 sub-themes, and 108 significant statements. The four categories of international students' health care management experiences were: “neglecting health care management due to unresolved economic difficulties,” “choosing better healthcare management options than those in their home country,” “acquiring a new perspective on healthcare management during their stay in Korea,” and “suggesting directions for improvement and expectations based on their healthcare management experiences in Korea.” This study enabled an understanding of health management practices, with implications for ensuring the successful academic lives of international students. Conclusion This study implies that a deep understanding of international students' healthcare management experiences would contribute to the development of effective health promotion policies and programs for them in the future.