Prostate cancer (PCa) typically occurs in older adults and generally has a relatively long survival period, making it challenging to demonstrate the effectiveness of treatment. In 2012, medical guidelines recommending against PCa screening using prostate-specific antigen (PSA) became widespread, as randomized controlled trials had not consistently shown survival benefits.Current concepts: In South Korea, awareness of PCa has historically been very low, and the rate of PSA test screening has consequently been lower than that in other major developed countries. Additionally, PSA screening has tended to occur within a limited framework accessible only to individuals already aware of the test. Given that PCa is a high-risk cancer predominantly affecting older men in South Korea, unconditionally following medical guidelines from the 2010s that took a negative stance toward PSA screening may exacerbate health inequalities, increase metastatic cancer incidence, and elevate cancer-specific mortality, particularly in light of Korea’s rapidly aging population. Thus, recent shifts in clinical guidelines in the early 2020s, advocating the proactive implementation of PSA-based screening tests as announced by various countries, are significant. These shifts provide additional support for policy responses aligned with Korea’s epidemiological context. Discussion and conclusion: We advocate for increased public discourse on national PCa screening policies. Such policies should be rationally designed to reduce the incidence of high-risk PCa while minimizing the potential harms associated with overdiagnosis and overtreatment.

Intravesical therapy is crucial in treating non-muscle invasive bladder cancer (NMIBC), aiming to prevent recurrence and progression following transurethral resection of bladder tumor. This review provides an overview of intravesical therapies, including Bacillus Calmette-Guérin (BCG), intravesical chemotherapy, and emerging treatment modalities.Current Concepts: BCG therapy remains the gold standard for high-risk NMIBC, significantly reducing recurrence and progression rates. However, managing BCG-unresponsive disease remains challenging and necessitates alternative treatment approaches. Intravesical chemotherapy, such as mitomycin C and gemcitabine, is frequently employed for intermediate-to-high-risk NMIBC and as a second-line therapy after BCG failure. Recent advancements have introduced novel intravesical approaches aiming to overcome BCG resistance and enhance treatment efficacy. Innovative methods, including viral gene therapy and nogapendekin alfa-inbakicept, are being studied for their potential to improve tumor eradication while minimizing toxicity. These strategies aim to increase immune activation, increase drug penetration, and reduce recurrence rates in NMIBC.Discussion and Conclusion: Despite advances, optimizing intravesical treatment selection remains challenging. While BCG therapy is effective, resistance and side effects limit its utility, necessitating alternative therapies. Intravesical chemotherapy is beneficial but suboptimal for high-risk NMIBC. Emerging therapies offer promising solutions for BCG-unresponsive NMIBC. Future research should focus on biomarker-driven treatment and combination strategies to enhance clinical outcomes. As new treatments emerge, intravesical therapy will continue to play a pivotal role in managing NMIBC.

Lecanemab and donanemab have received full U.S. Food and Drug Administration (FDA) approval, and subsequently, lecanemab has been approved by the Korean FDA and it has recently entered commercial use in Korea. This has increased interest in anti-amyloid immunotherapy for Alzheimer’s disease. Anti-amyloid immunotherapy has shown potential to modify the progression of the disease by specifically binding to amyloid β, a key pathological product in Alzheimer’s disease, and eliminating accumulated amyloid plaques in the brain. However, this treatment can be accompanied by a side-effect, amyloid-related imaging abnormalities (ARIA), which requires periodic monitoring by MRI. It is crucial to detect ARIA and accurately assess the severity by radiology. The role of the radiologist is important in this context, requiring proficiency in basic knowledge of ARIA, and in diagnosing/evaluating ARIA. This review aims to comprehensively cover aspects of ARIA, including its definition, pathophysiology, incidence, risk factors, assessment of severity by radiology, differential diagnosis, and management.

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare Müllerian duct anomaly, commonly characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. While these are the three most common genitourinary anomalies in OHVIRA syndrome, a spectrum of urogenital anomalies can be present. Knowledge of this spectrum is crucial for proper patient management and treatment planning. In this case series, we report on five patients with OHVIRA syndrome, each presenting with a urogenital anomaly other than the typical renal agenesis or uterus didelphys. We highlight the gynecological complications encountered, which clinicians and radiologists should be aware of.

Purpose: This study aimed to examine the effects of a self-management education program on dietary self-care behaviors, patient role performance, self-efficacy, and physiological indicators in hemodialysis patients. Methods: A quasi-experimental study was conducted from February to May 2024 with 43 hemodialysis patients(22 experimental, 21 control at the artificial kidney units of Hospital A and Hospital Y in K region. Data were analyzed using descriptive statistics, independent t-test, achi-square test, and ANCOVA with SPSS/WIN 26.0. The reliability of the measurement tools was assessed using Cronbach’s ⍺. Results: The experimental group that participated in the self-management education program showed significant improvements in dietary self-care behavior (t=81.87, p=.011), patient role performance (t=27.86, p=.035), and self-efficacy (t=17.88, p=.003) compared to the control group. However, no significant differences were observed in serum potassium (F=0.06, p=.813) and phosphorus (F=0.02, p=.903) levels. In contrast, serum protein (F=6.94, p=.012) and albumin (F=8.05, p=.007) levels significantly increased in the experimental group. Conclusion The self-management education program was effective in improving dietary self-care behaviors, patient role performance, and self-efficacy among hemodialysis patients. However, its impact on physiological indicators was limited to specific parameters. Therefore, this program may be effectively implemented in clinical settings to enhance self-care adherence, improve patient role performance, and ultimately reduce complications in hemodialysis patients.

Background: Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. Methods: We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. Results: Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). Conclusion Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization.

Clonorchiasis is a parasitic disease caused by Clonorchis sinensis, a trematode that inhabits the intrahepatic bile ducts of humans and mammals. C. sinensis is one of common foodborne trematodes, prevalent in East Asia including Korea. The International Agency for Research on Cancer reclassified C. sinensis as the Group 1 biological carcinogen of human cholangiocarcinoma (CCA). Evidence supporting the carcinogenicity of C. sinensis includes epidemiological studies showing increased prevalence and odds ratio (OR) of CCA in clonorchiasis patients, the development of CCA in experimental animals, and molecular studies. Approximately 10% of CCA in Korea are believed to be solely caused by clonorchiasis, with an OR of 4.7 for CCA risk among clonorchiasis patients. All hamsters exposed to both of C. sinensis and N-nitrosodimethylamine (NDMA) developed CCA while those exposed to either C. sinensis or NDMA alone did not. In vitro studies using cell models investigated carcinogenetic changes of the intracellular molecules and genes following stimulation with a soluble extract of C. sinensis. The in vitro stimulated cells showed a significant shift to G2/M phage, produced oncogenic molecules, changed expression of oncogenes, increased cell proliferation and suppressed apoptosis. Additionally, the gap-junction proteins between cells, such as connexin (Cx) 43, Cx 26, and Cx 32, were changed significantly, disrupting intercellular homeostasis. These findings suggest that C. sinensis and nitrogen compounds synergistically stimulate the cholangiocytes to become neoplastic. C. sinensis is a biological carcinogen of human CCA, and the World Health Organization guidelines enlist food-borne trematodes as one of target neglected tropical diseases to be eliminated by 2030. The present article reviews and updates perspectives on clonorchiasis, focusing on carcinogenesis.