1.Understanding Prolotherapy for Patients with Foot and Ankle Diseases
Hee-Chul GWAK ; Han Eol SEO ; Dae-Yoo KIM
Journal of Korean Foot and Ankle Society 2024;28(4):132-138
Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.
2.Understanding Prolotherapy for Patients with Foot and Ankle Diseases
Hee-Chul GWAK ; Han Eol SEO ; Dae-Yoo KIM
Journal of Korean Foot and Ankle Society 2024;28(4):132-138
Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.
3.Understanding Prolotherapy for Patients with Foot and Ankle Diseases
Hee-Chul GWAK ; Han Eol SEO ; Dae-Yoo KIM
Journal of Korean Foot and Ankle Society 2024;28(4):132-138
Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.
4.Understanding Prolotherapy for Patients with Foot and Ankle Diseases
Hee-Chul GWAK ; Han Eol SEO ; Dae-Yoo KIM
Journal of Korean Foot and Ankle Society 2024;28(4):132-138
Prolotherapy is a non-surgical treatment that involves injecting an irritant solution into ligament and tendon attachments to induce a localized inflammatory response and promote the regeneration of connective tissue. This study reviewed the effects and mechanisms of prolotherapy in the foot and ankle region. Prolotherapy contributes to pain reduction and functional improvement in conditions such as Achilles tendinopathy, plantar fasciitis, ankle sprain, and osteochondral lesions of the talus. On the other hand, the limited number of studies and lack of standardized protocols remain challenges. Further research and the establishment of standardized protocols will be needed to maximize the efficacy of prolotherapy and expand its indications.
5.Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry
Do Yeon KIM ; Tai Hwan PARK ; Yong-Jin CHO ; Jong-Moo PARK ; Kyungbok LEE ; Minwoo LEE ; Juneyoung LEE ; Sang Yoon BAE ; Da Young HONG ; Hannah JUNG ; Eunvin KO ; Hyung Seok GUK ; Beom Joon KIM ; Jun Yup KIM ; Jihoon KANG ; Moon-Ku HAN ; Sang-Soon PARK ; Keun-Sik HONG ; Hong-Kyun PARK ; Jeong-Yoon LEE ; Byung-Chul LEE ; Kyung-Ho YU ; Mi Sun OH ; Dong-Eog KIM ; Dong-Seok GWAK ; Soo Joo LEE ; Jae Guk KIM ; Jun LEE ; Doo Hyuk KWON ; Jae-Kwan CHA ; Dae-Hyun KIM ; Joon-Tae KIM ; Kang-Ho CHOI ; Hyunsoo KIM ; Jay Chol CHOI ; Joong-Goo KIM ; Chul-Hoo KANG ; Sung-il SOHN ; Jeong-Ho HONG ; Hyungjong PARK ; Sang-Hwa LEE ; Chulho KIM ; Dong-Ick SHIN ; Kyu Sun YUM ; Kyusik KANG ; Kwang-Yeol PARK ; Hae-Bong JEONG ; Chan-Young PARK ; Keon-Joo LEE ; Jee Hyun KWON ; Wook-Joo KIM ; Ji Sung LEE ; Hee-Joon BAE ;
Journal of Korean Medical Science 2024;39(34):e278-
This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.
6.Understanding Atelocollagen Injections for Patients with Foot and Ankle Diseases
Hee-Chul GWAK ; Jun-Min YOON ; Dae-Yoo KIM
Journal of Korean Foot and Ankle Society 2023;27(4):117-122
Collagen is the most common structural protein in the connective tissues of vertebrates, playing a crucial role in maintaining the tissue structure and wound healing. Atelocollagen retains the original properties of collagen but does not induce inflammatory cytokines. Atelocollagen is extracted from various animals and humans, with bovine-derived collagen being the most commonly used. The safety and efficacy of atelocollagen have been demonstrated through multiple studies, but further research will be needed in the field of orthopedics regarding its range of use and effects. Foot and ankle diseases have attracted little research attention, highlighting the need for further studies.
7.The Korean Society for Neuro-Oncology (KSNO) Guideline for Antiepileptic Drug Usage of Brain Tumor: Version 2021.1
Jangsup MOON ; Min-Sung KIM ; Young Zoon KIM ; Kihwan HWANG ; Ji Eun PARK ; Kyung Hwan KIM ; Jin Mo CHO ; Wan-Soo YOON ; Se Hoon KIM ; Young Il KIM ; Ho Sung KIM ; Yun-Sik DHO ; Jae-Sung PARK ; Hong In YOON ; Youngbeom SEO ; Kyoung Su SUNG ; Jin Ho SONG ; Chan Woo WEE ; Min Ho LEE ; Myung-Hoon HAN ; Je Beom HONG ; Jung Ho IM ; Se-Hoon LEE ; Jong Hee CHANG ; Do Hoon LIM ; Chul-Kee PARK ; Youn Soo LEE ; Ho-Shin GWAK ;
Brain Tumor Research and Treatment 2021;9(1):9-15
Background:
To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019.
Methods:
The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords.
Results:
The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naïve patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naïve patients with one early postoperative seizure (<1 week after surgery), it is advisable to maintain AED for at least 3 months before tapering. In seizure-naïve patients with ≥2 postoperative seizures or in patients with preoperative seizure history, it is recommended to maintain AEDs for more than 1 year. The possibility of drug interactions should be considered when selecting AEDs in brain tumor patients. Driving can be allowed in brain tumor patients when proven to be seizure-free for more than 1 year.
Conclusion
The KSNO suggests prescribing AEDs in patients with brain tumor based on the current guideline. This guideline will contribute to spreading evidence-based prescription of AEDs in brain tumor patients in Korea.
8.The Korean Society for Neuro-Oncology (KSNO) Guideline for Adult Diffuse Midline Glioma: Version 2021.1
Hong In YOON ; Chan Woo WEE ; Young Zoon KIM ; Youngbeom SEO ; Jung Ho IM ; Yun-Sik DHO ; Kyung Hwan KIM ; Je Beom HONG ; Jae-Sung PARK ; Seo Hee CHOI ; Min-Sung KIM ; Jangsup MOON ; Kihwan HWANG ; Ji Eun PARK ; Jin Mo CHO ; Wan-Soo YOON ; Se Hoon KIM ; Young Il KIM ; Ho Sung KIM ; Kyoung Su SUNG ; Jin Ho SONG ; Min Ho LEE ; Myung-Hoon HAN ; Se-Hoon LEE ; Jong Hee CHANG ; Do Hoon LIM ; Chul-Kee PARK ; Youn Soo LEE ; Ho-Shin GWAK ;
Brain Tumor Research and Treatment 2021;9(1):1-8
Background:
There have been no guidelines for the management of adult patients with diffuse midline glioma (DMG), H3K27M-mutant in Korea since the 2016 revised WHO classification newly defined this disease entity. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for DMG since 2019.
Methods:
The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. As ‘diffuse midline glioma’ was recently defined, and there was no international guideline, trials and guidelines of ‘diffuse intrinsic pontine glioma’ or ‘brain stem glioma’ were thoroughly reviewed first.
Results:
The core contents are as follows. The DMG can be diagnosed when all of the following three criteria are satisfied: the presence of the H3K27M mutation, midline location, and infiltrating feature. Without identification of H3K27M mutation by diagnostic biopsy, DMG cannot be diagnosed. For the primary treatment, maximal safe resection should be considered for tumors when feasible. Radiotherapy is the primary option for tumors in case the total resection is not possible. A total dose of 54 Gy to 60 Gy with conventional fractionation prescribed at 1-2 cm plus gross tumor volume is recommended. Although no chemotherapy has proven to be effective in DMG, concurrent chemoradiotherapy (± maintenance chemotherapy) with temozolomide following WHO grade IV glioblastoma’s protocol is recommended.
Conclusion
The detection of H3K27M mutation is the most important diagnostic criteria for DMG. Combination of surgery (if amenable to surgery), radiotherapy, and chemotherapy based on comprehensive multidisciplinary discussion can be considered as the treatment options for DMG.
9.The Korean Society for Neuro-Oncology (KSNO) Guideline for Antiepileptic Drug Usage of Brain Tumor: Version 2021.1
Jangsup MOON ; Min-Sung KIM ; Young Zoon KIM ; Kihwan HWANG ; Ji Eun PARK ; Kyung Hwan KIM ; Jin Mo CHO ; Wan-Soo YOON ; Se Hoon KIM ; Young Il KIM ; Ho Sung KIM ; Yun-Sik DHO ; Jae-Sung PARK ; Hong In YOON ; Youngbeom SEO ; Kyoung Su SUNG ; Jin Ho SONG ; Chan Woo WEE ; Min Ho LEE ; Myung-Hoon HAN ; Je Beom HONG ; Jung Ho IM ; Se-Hoon LEE ; Jong Hee CHANG ; Do Hoon LIM ; Chul-Kee PARK ; Youn Soo LEE ; Ho-Shin GWAK ;
Brain Tumor Research and Treatment 2021;9(1):9-15
Background:
To date, there has been no practical guidelines for the prescription of antiepileptic drugs (AEDs) in brain tumor patients in Korea. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for AED usage in brain tumors since 2019.
Methods:
The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of the keywords.
Results:
The core contents are as follows. Prophylactic AED administration is not recommended in newly diagnosed brain tumor patients without previous seizure history. When AEDs are administered during peri/postoperative period, it may be tapered off according to the following recommendations. In seizure-naïve patients with no postoperative seizure, it is recommended to stop or reduce AED 1 week after surgery. In seizure-naïve patients with one early postoperative seizure (<1 week after surgery), it is advisable to maintain AED for at least 3 months before tapering. In seizure-naïve patients with ≥2 postoperative seizures or in patients with preoperative seizure history, it is recommended to maintain AEDs for more than 1 year. The possibility of drug interactions should be considered when selecting AEDs in brain tumor patients. Driving can be allowed in brain tumor patients when proven to be seizure-free for more than 1 year.
Conclusion
The KSNO suggests prescribing AEDs in patients with brain tumor based on the current guideline. This guideline will contribute to spreading evidence-based prescription of AEDs in brain tumor patients in Korea.
10.The Korean Society for Neuro-Oncology (KSNO) Guideline for Adult Diffuse Midline Glioma: Version 2021.1
Hong In YOON ; Chan Woo WEE ; Young Zoon KIM ; Youngbeom SEO ; Jung Ho IM ; Yun-Sik DHO ; Kyung Hwan KIM ; Je Beom HONG ; Jae-Sung PARK ; Seo Hee CHOI ; Min-Sung KIM ; Jangsup MOON ; Kihwan HWANG ; Ji Eun PARK ; Jin Mo CHO ; Wan-Soo YOON ; Se Hoon KIM ; Young Il KIM ; Ho Sung KIM ; Kyoung Su SUNG ; Jin Ho SONG ; Min Ho LEE ; Myung-Hoon HAN ; Se-Hoon LEE ; Jong Hee CHANG ; Do Hoon LIM ; Chul-Kee PARK ; Youn Soo LEE ; Ho-Shin GWAK ;
Brain Tumor Research and Treatment 2021;9(1):1-8
Background:
There have been no guidelines for the management of adult patients with diffuse midline glioma (DMG), H3K27M-mutant in Korea since the 2016 revised WHO classification newly defined this disease entity. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, had begun preparing guidelines for DMG since 2019.
Methods:
The Working Group was composed of 27 multidisciplinary medical experts in Korea.References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. As ‘diffuse midline glioma’ was recently defined, and there was no international guideline, trials and guidelines of ‘diffuse intrinsic pontine glioma’ or ‘brain stem glioma’ were thoroughly reviewed first.
Results:
The core contents are as follows. The DMG can be diagnosed when all of the following three criteria are satisfied: the presence of the H3K27M mutation, midline location, and infiltrating feature. Without identification of H3K27M mutation by diagnostic biopsy, DMG cannot be diagnosed. For the primary treatment, maximal safe resection should be considered for tumors when feasible. Radiotherapy is the primary option for tumors in case the total resection is not possible. A total dose of 54 Gy to 60 Gy with conventional fractionation prescribed at 1-2 cm plus gross tumor volume is recommended. Although no chemotherapy has proven to be effective in DMG, concurrent chemoradiotherapy (± maintenance chemotherapy) with temozolomide following WHO grade IV glioblastoma’s protocol is recommended.
Conclusion
The detection of H3K27M mutation is the most important diagnostic criteria for DMG. Combination of surgery (if amenable to surgery), radiotherapy, and chemotherapy based on comprehensive multidisciplinary discussion can be considered as the treatment options for DMG.

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