Purpose: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Materials and Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes.Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5,460 ESD cases from 5,250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Purpose: Ovarian cancer presents significant treatment challenges due to its aggressive nature and poor response to immune checkpoint inhibitors (ICIs). The lack of standardized programmed cell death-ligand 1 (PD-L1) assays and cut-off values complicates clinical decision-making. We evaluated the concordance among commonly used PD-L1 assays and assessed changes in the expression of PD-L1 following chemotherapy. Materials and Methods: Tissue samples from 29 patients with ovarian cancer were analyzed using five validated PD-L1 immunohistochemistry assays: Dako 22C3, Ventana SP263, Ventana SP142, Dako 28-8, and Ventana 22C3. PD-L1 positivity was assessed using a combined positive score (CPS), immune cell, or tumor proportion score at 1%, 5%, and 10% cut-offs. Concordance rates, including overall percent agreement and Cohen’s kappa coefficient, were analyzed. In addition, changes in the expression of PD-L1 pre- and postchemotherapy were evaluated. Results: Positivity rates ranged from 15.8% (SP142) to 29.8% (Dako 22C3 and SP263) at the 1% CPS cut-off. SP142 consistently exhibited the lowest concordance, whereas Dako 22C3 displayed high agreement with SP263, 28-8, and Ventana 22C3. Chemotherapy increased PD-L1 positivity, with 28% of patients converting from negative to positive. Conclusion The expression of PD-L1 in ovarian cancer varies across assays and scoring methods, emphasizing the need for standardized testing protocols. Increased PD-L1 expression post-chemotherapy underscores the importance of assessing its status at appropriate times to guide ICI therapy. Larger studies are required to validate these findings and refine clinical applications.

Purpose: Radical cystectomy (RC) is associated with substantial postoperative morbidity, and unplanned readmission remains common despite advances in perioperative management. However, the association between postoperative readmission due to complications and oncologic outcomes after RC for bladder cancer has not been clearly defined. We evaluated the impact of postoperative readmission on overall survival (OS) and cancer-specific survival (CSS) after RC for bladder cancer. Materials and Methods: We retrospectively analyzed 3,972 patients who underwent RC for bladder cancer in a multicenter cohort. Postoperative readmission was defined as unplanned hospitalization within 90 days postsurgery due to surgery-related complications. Survival outcomes were assessed using the Kaplan-Meier method and compared using the log-rank test. Univariable and multivariable Cox proportional hazards regression analyses were performed to identify independent predictors of OS and CSS. Results: Among the study population, 916 patients (23.1%) experienced postoperative readmission. Baseline and perioperative characteristics were generally comparable between patients with and without readmission. Kaplan-Meier analyses demonstrated significantly worse OS and CSS among patients who experienced postoperative readmission (both log-rank p<0.001). In multivariable analyses adjusting for clinicopathological factors, postoperative readmission remained independently associated with worse OS (hazard ratio [HR], 1.654; 95% confidence interval [CI], 1.464–1.868; p<0.001) and CSS (HR, 1.761; 95% CI, 1.509–2.055; p<0.001). Conclusion Postoperative readmission within 90 days after RC was independently associated with inferior long-term oncologic outcomes. These findings suggest the importance of strategies aimed at preventing postoperative complications and subsequent readmission.

Background: This study assessed 10-year changes in the proportion and epidemiology of work-related burns among inpatients at a single institution; as an institutional proportion, results reflect within-center surveillance. Methods: Burn inpatients admitted in 2016–2025 (n=5,074), including work-related burns (n=535), were retrospectively reviewed. Annual proportions were calculated. Because proportions dropped during COVID-19 (2020–2022), these years were excluded from the primary trend analysis. Period differences were tested with two-proportion tests and an overall 2×3 chi-square test; trends excluding 2020–2022 were evaluated with linear regression. Results: Work-related burns accounted for 10.5% (535/5,074). The proportion decreased in 2020–2022 versus 2016–2019 (7.7% vs. 10.9%; P=0.002) and increased in 2023–2025 versus 2020–2022 (13.1% vs. 7.7%; P<0.001); overall period differences were significant (chi-square P<0.001). Excluding 2020–2022, the proportion increased by +0.34 percentage points/year (95% confidence interval, 0.05–0.63; P=0.029). Scalds (53.6%) and electrical burns (18.5%) predominated. Mean burn total body surface area (TBSA) was 5.9%±9.2%, with 83.7% <10% TBSA; 78.9% were second-degree burns. Surgery was performed in 292 (54.6%), most commonly split-thickness skin grafting (STSG; n=150) or STSG with acellular dermal matrix (n=92). The highest incidence occurred in summer (33.3%). Conclusion After excluding 2020–2022, the institutional proportion of work-related burns increased over time despite declining total burn admissions. This reflects a relative shift in case-mix, not population-level incidence; explanations such as changing exposures or improved reporting/compensation are hypothesis-generating.

Objectives: Endoscopic submucosal dissection (ESD) has become a standard minimally invasive treatment for selected patients with early gastric cancer (EGC). This study presents the first nationwide survey of patients with EGC treated with ESD in 2023, conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research. Methods: Data were retrospectively collected from participating referral centers across Korea using a standardized case report form covering patient characteristics, tumor features, procedural details, histopathological findings, and clinical outcomes. Descriptive and comparative analyses were conducted to summarize nationwide ESD practice patterns and outcomes. Results: Data from 5460 ESD cases from 5250 patients across 27 institutions were analyzed. The mean age was 67.4 years, with 74.1% males. Multiple synchronous lesions were identified in 3.7%. Most lesions were located in the lower third of the stomach (64.0%), and differentiated-type adenocarcinomas accounted for 87.8%. The en bloc and complete resection rates were 99.2% and 91.4%, respectively. Curative resection was achieved in 80.5%, whereas local non-curative resection (L-NCR) and surgical non-curative resection (S-NCR) were identified in 2.8% and 16.7%, respectively. Additional surgery was performed more frequently in patients with S-NCR than in those with L-NCR (59.3% vs. 24.7%). The bleeding and perforation rates were 3.6% and 0.9%, respectively, and were mostly managed conservatively or endoscopically. The median length of hospitalization was 4.0 days. Conclusions This first nationwide survey provides a comprehensive overview of the current practice of EGC treatment using ESD in Korea, demonstrating high technical success and safety, and establishing a baseline dataset for future longitudinal research.

Objective: Acute coronary syndrome often requires urgent intervention. The 2023 European Society of Cardiology guidelines recommend invasive procedures within 24 hours for high-risk cases. Nevertheless, there have been limited studies on non-ST-segment elevation myocardial infarction (NSTEMI) in South Korea. This study compared the risk of complications based on the timing of intervention. Methods: A retrospective observational study was conducted on patients with chest pain and elevated high-sensitivity troponin T from January to December 2021 in the emergency department. Patients were categorized into early (≤24 hr) and late (>24 hr) intervention groups. Primary outcomes (death, restenosis, or stroke) at 12 months were compared. Survival and subgroup analyses were performed to examine the factors affecting the outcomes in the two groups. Results: Three hundred seventy six patients were enrolled in the study, and 115 patients were excluded. Among 261 patients, 106 and 155 patients were in the early intervention group (≤24 hr), and late intervention group (>24 hr), respectively. The primary outcome (death or restenosis) showed no significant difference (hazard ratio [HR] in the early intervention group at 12 mo; 1.03; 95% confidence interval [CI], 0.63-1.70; P=0.905). However, risk of stroke was lower in the early intervention group (HR in the early, 0.08; 95% CI, 0.00-0.66; P=0.013). Subgroup analysis showed no significant advantage for early intervention. Conclusion In NSTEMI patients, early intervention does not reduce death or restenosis but lowers stroke incidence. No specific risk factors favored early intervention.

Digital therapeutics (DTx) are emerging as a transformative innovation in healthcare offering evidence-based digital interventions for the treatment, management, and prevention of various diseases and disorders. In Korea, DTx have gained significant attention as potential solutions to the increasing burden of chronic diseases and mental health conditions. However, the Korean DTx market faces several challenges that hinder its widespread adoption and integration into the national healthcare system. This study provides a comprehensive analysis of the current state of the DTx market in Korea, identifies the key challenges impeding its growth, and proposes strategies for overcoming these obstacles. This study utilized a literature review and market analysis approach to examine the latest research, industry reports, and regulatory documents related to DTx. The analysis focused on three primary areas: (1) the current regulatory landscape, (2) technological advancements and challenges, and (3) economic and commercial factors influencing DTx adoption in Korea. A comparative analysis of global regulatory practices was also conducted to identify best practices. The findings revealed that while Korea has made significant strides in supporting DTx development, the market remains in its early stages. The key challenges include underdeveloped regulatory frameworks, issues with data quality and security, and a lack of established reimbursement pathways. We recommend developing tailored regulatory frameworks for DTx, enhancing policy support for small and medium-sized enterprises involved in DTx development, and increasing investments in technological infrastructure. By addressing these challenges, Korea could position itself as a leader in the global DTx market, delivering innovative and effective treatments to enhance patient care and outcomes.

Background and Objectives: Hearing loss significantly affects communication, psychosocial well-being, and quality of life. This study analyzes the National Health Insurance Service database to assess the trends and characteristics of hearing loss in South Korea from 2010 to 2020.Subjects and Method The database encompasses 97% of the Korean population, providing comprehensive data on medical history, prescriptions, and health examinations. The analysis used the World Health Organization’s ICD-10 definitions to categorize hearing loss types and examine their prevalence and incidence across various demographics over 11 years. Results: There was an overall annual increase of 4.62% in diagnosed cases of hearing loss, with the most significant rise among the elderly. The rate of increase accelerated from 3.32% between 2010 and 2014 to 6.49% between 2014 and 2020, corresponding with the improved hearing aid access facilitated by policy changes. Women showed a slightly higher increase than men. The data also indicated a consistent rise in abnormal hearing test results during health examinations, especially in older adults. Conclusion The study highlights an increasing trend in hearing loss diagnoses, driven by an aging population and enhanced detection facilitated by policy changes. These findings emphasize the need for continuous monitoring and targeted health policies to manage hearing loss effectively, offering valuable insights for global health management and policy development.

Background and Objectives: This study aims to analyze trends in hearing disability and the use of hearing rehabilitation devices (hearing aids and cochlear implants) in South Korea over the past 11 years (2010-2020) using data from the National Health Insurance Service (NHIS).Subjects and Method Data were extracted from the NHIS database, covering approximately 97% of the South Korean population. Patients diagnosed with hearing loss were classified using ICD-10 codes. The data were analyzed to determine trends in hearing disability, hearing aid prescriptions, and cochlear implant usage by age, gender, and types and causes of hearing loss. Results: The number of hearing disability patients increased from 170900 in 2010 to 362738 in 2020, with an annual growth rate of 7.95%. The highest increase was observed in the ≥60 age group, with an annual growth rate of 11.04%. Hearing aid prescriptions rose from 4966 in 2010 to 11974 in 2020, showing a 10.45% annual increase. Females showed a higher growth rate in both hearing disability and hearing aid prescriptions compared to males. Cochlear implant prescriptions also increased, particularly among older adults. Conclusion The study highlights a significant rise in hearing disability and the use of hearing aids and cochlear implants in South Korea, especially among the elderly. The findings underscore the importance of early diagnosis and intervention for hearing loss and the need for policy improvements to enhance accessibility and affordability of hearing rehabilitation services. Additional strategies are needed to ensure appropriate hearing rehabilitation for those not yet receiving adequate care.