Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.

Background: Laser procedures are integral to dermatologic practice, yet safety measures- particularly regarding ocular protection and plume control- are poorly studied in real-world settings. Objective: To evaluate current practices in eye protection, infection control, and occupational risk awareness among Korean dermatologists performing laser treatments. Methods: A cross-sectional survey was conducted among board-certified dermatologists at the 2024 Korean Society for Dermatologic Laser Surgery meeting. The questionnaire covered demographics, laser frequency, use of goggles and masks, infection control strategies, ophthalmologic monitoring, and history of warts or cancer. Results: Seventy-nine respondents completed the survey. All reported using protective goggles, but only 26.6% and 22.8% did so for CO 2 and erbium-doped yttrium aluminium garnet lasers, respectively. Only 24.1% underwent regular eye exams, and 13.9% reported eye conditions after starting laser practice. While 89.9% used masks, 40.8% used dental masks, which are inadequate for plume protection. Suction devices were used by 94.9%, though performance specifications were unclear. Warts were reported by 46.8% of respondents; two reported cancer diagnoses after initiating laser work. Conclusion Despite high overall adherence to basic safety practices, critical gaps remain. Our findings highlight the need for standardized guidelines and long-term occupational health monitoring to ensure safe laser practice.

Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare and highly aggressive hybrid malignancy characterized by a poor prognosis and high recurrence rates due to its dual histological nature. In the absence of established standard-of-care protocols, clinical management strategies are frequently extrapolated from the guidelines for its components, hepatocellular carcinoma and intrahepatic cholangiocarcinoma (iCCA). This review evaluates the evolving role of radiotherapy (RT) as an integral part of the multidisciplinary care for cHCC-CCA. Adjuvant RT may be considered for patients exhibiting high-risk pathological features, such as positive or close resection margins, lymphovascular invasion, and perineural invasion. For unresectable disease unfeasible for surgery or transarterial therapies, definitive RT using intensified doses, analogous to iCCA protocols, is employed to improve local control. High-precision modalities, particularly particle therapies such as proton or carbon ion RT, are emphasized as preferred options for delivering ablative doses while minimizing toxicity and preserving functional liver reserve. Furthermore, preliminary clinical evidence suggests a potential synergy between RT and immune checkpoint inhibitors, with reported cases demonstrating complete responses or successful conversion to curative-intent resection. While current evidence remains limited to retrospective cohorts and case series, the strategic integration of precision RT offers a rational pathway for optimizing outcomes in cHCC-CCA, necessitating further prospective validation.

Purpose: Declines in masticatory function have been reported to be closely associated with cognitive impairment and reduced brain activity in older adults. This study aimed to investigate the effects of intraoral vibratory stimulation on masticatory function, cognitive performance, and brain activity in elderly individuals and to evaluate its potential efficacy. Materials and Methods: Participants were divided into a vibration-stimulation group (n=9) and a non-vibration control group (n=7). Baseline assessments were conducted at the first visit. Participants then received either vibratory stimulation or a wash-out (control) condition for two weeks, followed by the same assessments at the final visit. Evaluation measures were dental assessments (maximum bite force, masticatory performance, and salivary flow rate), cognitive tests (CANTAB, paper-based and computerized tests), quantitative electroencephalography (qEEG), and functional magnetic resonance imaging (fMRI) during a short-term memory task. Results: No significant long-term effects or statistically meaningful differences were observed between the two groups in cognitive performance or brain activity. Similarly, no pre- to post-intervention differences were found between groups in dental measures related to masticatory function (maximum bite force, masticatory performance, and salivary flow rate). Due to the limited sample size, this study functioned as a pilot study focusing on descriptive rather than inferential statistical analysis. Conclusion Intraoral vibratory stimulation did not demonstrate immediate or clear effects on cognitive function or brain activity in older adults, suggesting the need for optimization of stimulation parameters such as location and intensity. Future studies with larger sample sizes and improved stimulation methods replicating masticatory function are warranted to further explore the potential cognitive benefits.

Purpose: This study evaluated the clinical outcomes and prognostic factors in patients with borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) treated with upfront FOLFIRINOX followed by local-regional therapy (LRT), surgical resection (SR), and radiotherapy (RT). We aimed to identify specific patient subgroups for which RT may serve as a reasonable alternative to SR for local tumor control. Methods: We retrospectively analyzed 116 patients (SR group, n= 70; RT group, n= 46) at a single center between 2015 and 2020. Survival outcomes were compared based on LRT modalities, focusing on identifying subgroups in which RT provided an efficacy comparable to that of SR. Results: Among 116 patients, the SR group achieved a significantly higher 5-year overall survival (OS) than the RT group (27.1% vs. 8.7%, P< 0.0001), despite similar progression-free survival (P= 0.23). Significant prognostic factors for OS included carbohydrate antigen 19-9 (CA19-9) response in BRPC (P= 0.02) and radiologic partial response in LAPC (P= 0.05). Subgroup analysis revealed that, while SR provided a survival advantage in CA19-9 responders, no significant difference in OS was observed between SR and RT in CA19-9 non-responders (P= 0.37). Conclusion Although surgery remains the gold standard, RT may be considered a justifiable local alternative for CA19-9 non-responders and surgically ineligible patients with LAPC, yielding comparable outcomes in these specific, biologically unfavorable subgroups.

Purpose: This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements. Methods: A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression. Results: The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being. Conclusion An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.

Background: Spinal cord stimulators (SCSs) are used to reduce pain and improve quality of life in patients with complex regional pain syndrome (CRPS). However, many patients opt for device removal after SCS implantation due to diminished effect or complications. There is limited research on the actual duration of SCS use in CRPS patients, and no nationwide population-based studies exist. This study aimed to estimate the real-world duration of SCS use in CRPS patients and examine the influencing factors on the duration of SCS use by analyzing the National Healthcare Insurance Database. Methods: Adult patients (age ≥ 18) with CRPS who underwent permanent SCS implantation between 2014 and2021 were included. The authors analyzed the median duration of SCS implantation and evaluated the impacts of age, sex, hospital type, and insurance type. Results: Of 408 potential patients, 373 patients were included. The median duration of SCS use was 4.4 (95%confidence interval [CI]: 4.0–4.8) years. Male patients retained SCSs longer than female patients (4.7 vs. 4.0 years, P = 0.014), and veterans’ healthcare beneficiaries showed the longest duration of SCS use (median 6.9 [95% CI: 4.6–7.8] years). Age and hospital type did not affect the duration of SCS use (P = 0.381 and P = 0.122, respectively). Conclusions The median SCS use duration in CRPS patients was 4.4 years. Considering the high cost and invasiveness of SCS, patients should be informed about the expected duration of SCS use, alongside potential risks and benefits.

Purpose: This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements. Methods: A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression. Results: The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being. Conclusion An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.

Background: Spinal cord stimulators (SCSs) are used to reduce pain and improve quality of life in patients with complex regional pain syndrome (CRPS). However, many patients opt for device removal after SCS implantation due to diminished effect or complications. There is limited research on the actual duration of SCS use in CRPS patients, and no nationwide population-based studies exist. This study aimed to estimate the real-world duration of SCS use in CRPS patients and examine the influencing factors on the duration of SCS use by analyzing the National Healthcare Insurance Database. Methods: Adult patients (age ≥ 18) with CRPS who underwent permanent SCS implantation between 2014 and2021 were included. The authors analyzed the median duration of SCS implantation and evaluated the impacts of age, sex, hospital type, and insurance type. Results: Of 408 potential patients, 373 patients were included. The median duration of SCS use was 4.4 (95%confidence interval [CI]: 4.0–4.8) years. Male patients retained SCSs longer than female patients (4.7 vs. 4.0 years, P = 0.014), and veterans’ healthcare beneficiaries showed the longest duration of SCS use (median 6.9 [95% CI: 4.6–7.8] years). Age and hospital type did not affect the duration of SCS use (P = 0.381 and P = 0.122, respectively). Conclusions The median SCS use duration in CRPS patients was 4.4 years. Considering the high cost and invasiveness of SCS, patients should be informed about the expected duration of SCS use, alongside potential risks and benefits.

Purpose: This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors’ interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements. Methods: A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression. Results: The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being. Conclusion An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.