We describe the updated Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of cervical cancer, version 5.1. The KSGO announced the fifth version of its clinical practice guidelines for the management of cervical cancer in March 2024. The selection of the key questions and the systematic reviews were based on data available up to December 2022. Between 2023 and 2024, substantial findings from large-scale clinical trials and new advancements in cervical cancer research remarkably emerged. Therefore, based on the existing version 5.0, we updated the guidelines with newly accumulated clinical data and added 4 new key questions reflecting the latest insights in the field of cervical cancer. For each question, recommendation was formulated with corresponding level of evidence and grade of recommendation, all established through expert consensus.

We describe the updated Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of cervical cancer, version 5.1. The KSGO announced the fifth version of its clinical practice guidelines for the management of cervical cancer in March 2024. The selection of the key questions and the systematic reviews were based on data available up to December 2022. Between 2023 and 2024, substantial findings from large-scale clinical trials and new advancements in cervical cancer research remarkably emerged. Therefore, based on the existing version 5.0, we updated the guidelines with newly accumulated clinical data and added 4 new key questions reflecting the latest insights in the field of cervical cancer. For each question, recommendation was formulated with corresponding level of evidence and grade of recommendation, all established through expert consensus.

We describe the updated Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of cervical cancer, version 5.1. The KSGO announced the fifth version of its clinical practice guidelines for the management of cervical cancer in March 2024. The selection of the key questions and the systematic reviews were based on data available up to December 2022. Between 2023 and 2024, substantial findings from large-scale clinical trials and new advancements in cervical cancer research remarkably emerged. Therefore, based on the existing version 5.0, we updated the guidelines with newly accumulated clinical data and added 4 new key questions reflecting the latest insights in the field of cervical cancer. For each question, recommendation was formulated with corresponding level of evidence and grade of recommendation, all established through expert consensus.

Metabolic abnormalities in the liver are closely associated with diverse metabolic diseases such as non-alcoholic fatty liver disease, type 2 diabetes, and obesity. The aim of this study was to evaluate the ameliorating effect of robinetin (RBN) on the significant pathogenic features of metabolic failure in the liver and to identify the underlying molecular mechanism. RBN significantly decreased triglyceride (TG) accumulation by downregulating lipogenesis-related transcription factors in AML-12 murine hepatocyte cell line. In addition, mice fed with Western diet (WD) containing 0.025% or 0.05% RBN showed reduced liver mass and lipid droplet size, as well as improved plasma insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values.CD38 was identified as a target of RBN using the BioAssay database, and its expression was increased in OPA-treated AML-12 cells and liver tissues of WD-fed mice. Furthermore, RBN elicited these effects through its anti-histone acetyltransferase (HAT) activity. Computational simulation revealed that RBN can dock into the HAT domain pocket of p300, a histone acetyltransferase, which leads to the abrogation of its catalytic activity. Additionally, knock-down of p300 using siRNA reduced CD38 expression.The chromatin immunoprecipitation (ChIP) assay showed that p300 occupancy on the promoter region of CD38 was significantly decreased, and H3K9 acetylation levels were diminished in lipid-accumulated AML-12 cells treated with RBN. RBN improves the pathogenic features of metabolic failure by suppressing the p300–CD38 axis through its anti-HAT activity, which suggests that RBN can be used as a new phytoceutical candidate for preventing or improving this condition.

Leucine-rich repeat kinase 2 (LRRK2), a large GTP-regulated serine/threonine kinase, is well-known for its mutations causing late-onset Parkinson’s disease. However, the role of LRRK2 in glioblastoma (GBM) carcinogenesis has not yet been fully elucidated. Here, we discovered that LRRK2 was overexpressed in 40% of GBM patients, according to tissue microarray analysis, and high LRRK2 expression correlated with poor prognosis in GBM patients. LRRK2 and stemness factors were highly expressed in various patient-derived GBM stem cells, which are responsible for GBM initiation. Canonical serum-induced differentiation decreased the expression of both LRRK2 and stemness factors.Given that LRRK2 is a key regulator of glioma stem cell (GSC) stemness, we developed DNK72, a novel LRRK2 kinase inhibitor that penetrates the blood-brain barrier. DNK72 binds to the phosphorylation sites of active LRRK2 and dramatically reduced cell proliferation and stemness factors expression in in vitro studies. Orthotopic patient-derived xenograft mouse models demonstrated that LRRK2 inhibition with DNK72 effectively reduced tumor growth and increased survival time. We propose that LRRK2 plays a significant role in regulating the stemness of GSCs and that suppression of LRRK2 kinase activity leads to reduced GBM malignancy and proliferation. In the near future, targeting LRRK2 in patients with high LRRK2-expressing GBM could offer a superior therapeutic strategy and potentially replace current clinical treatment methods.

Background: A healthcare system’s collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs. Methods: A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed. Results: A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety. Conclusion In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.

Background and Objectives: Surgical decision-making for papillary thyroid cancer (PTC) relies on accurate preoperative staging, where ultrasonography plays a crucial role in predicting outcomes. We aimed to analyze the predictive effects of preoperative sonographic findings on pathological characteristics. Materials and Methods: Retrospective study was performed using ultrasonographic images and clinico-pathologic data of papillary thyroid cancer patients who underwent total thyroidectomy or lobectomy between March 2016 and May 2020. Finally, 152 patients and 169 tumors were analyzed. Results: Mean age of patients was 54.2±14.2 years and the proportion of female was 75.7%. Tumor size was 13.6±10.3 mm and the proportions of extrathyroidal extension (ETE) and lymph node (LN) involvement were 52.2% and 23.0%, respectively. Preoperative sonographic findings, including ETE, tumor margin, echogenicity, and K-TIRDAS, were significantly associated with pathological ETE.Other pathological characteristics, including LN involvement, lymphovascular invasion, and resection margin positivity, were more observed in patients with more aggressive findings on preoperative sonography; however, we could not find statistical significances. Conclusion This study showed that preoperative sonographic characteristics, such as sonographic ETE, tumor margin, echogenicity, and K-TIRADS, can provide valuable insights into predicting pathological ETE in PTC patients.

Background and Objectives: Surgical decision-making for papillary thyroid cancer (PTC) relies on accurate preoperative staging, where ultrasonography plays a crucial role in predicting outcomes. We aimed to analyze the predictive effects of preoperative sonographic findings on pathological characteristics. Materials and Methods: Retrospective study was performed using ultrasonographic images and clinico-pathologic data of papillary thyroid cancer patients who underwent total thyroidectomy or lobectomy between March 2016 and May 2020. Finally, 152 patients and 169 tumors were analyzed. Results: Mean age of patients was 54.2±14.2 years and the proportion of female was 75.7%. Tumor size was 13.6±10.3 mm and the proportions of extrathyroidal extension (ETE) and lymph node (LN) involvement were 52.2% and 23.0%, respectively. Preoperative sonographic findings, including ETE, tumor margin, echogenicity, and K-TIRDAS, were significantly associated with pathological ETE.Other pathological characteristics, including LN involvement, lymphovascular invasion, and resection margin positivity, were more observed in patients with more aggressive findings on preoperative sonography; however, we could not find statistical significances. Conclusion This study showed that preoperative sonographic characteristics, such as sonographic ETE, tumor margin, echogenicity, and K-TIRADS, can provide valuable insights into predicting pathological ETE in PTC patients.

This fifth revised version of the Korean Society of Gynecologic Oncology practice guidelines for the management of cervical cancer incorporates recent research findings and changes in treatment strategies based on version 4.0 released in 2020. Each key question was developed by focusing on recent notable insights and crucial contemporary issues in the field of cervical cancer. These questions were evaluated for their significance and impact on the current treatment and were finalized through voting by the development committee. The selected key questions were as follows: the efficacy and safety of immune checkpoint inhibitors as firstor second-line treatment for recurrent or metastatic cervical cancer; the oncologic safety of minimally invasive radical hysterectomy in early stage cervical cancer; the efficacy and safety of adjuvant systemic treatment after concurrent chemoradiotherapy in locally advanced cervical cancer; and the oncologic safety of sentinel lymph node mapping compared to pelvic lymph node dissection. The recommendations, directions, and strengths of this guideline were based on systematic reviews and meta-analyses, and were finally confirmed through public hearings and external reviews. In this study, we describe the revised practice guidelines for the management of cervical cancer.

Background and Objectives: Surgical decision-making for papillary thyroid cancer (PTC) relies on accurate preoperative staging, where ultrasonography plays a crucial role in predicting outcomes. We aimed to analyze the predictive effects of preoperative sonographic findings on pathological characteristics. Materials and Methods: Retrospective study was performed using ultrasonographic images and clinico-pathologic data of papillary thyroid cancer patients who underwent total thyroidectomy or lobectomy between March 2016 and May 2020. Finally, 152 patients and 169 tumors were analyzed. Results: Mean age of patients was 54.2±14.2 years and the proportion of female was 75.7%. Tumor size was 13.6±10.3 mm and the proportions of extrathyroidal extension (ETE) and lymph node (LN) involvement were 52.2% and 23.0%, respectively. Preoperative sonographic findings, including ETE, tumor margin, echogenicity, and K-TIRDAS, were significantly associated with pathological ETE.Other pathological characteristics, including LN involvement, lymphovascular invasion, and resection margin positivity, were more observed in patients with more aggressive findings on preoperative sonography; however, we could not find statistical significances. Conclusion This study showed that preoperative sonographic characteristics, such as sonographic ETE, tumor margin, echogenicity, and K-TIRADS, can provide valuable insights into predicting pathological ETE in PTC patients.