Purpose: This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices. Methods: I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations. Results: For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines. Conclusions These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.

Purpose: This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices. Methods: I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations. Results: For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines. Conclusions These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.

Purpose: This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices. Methods: I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations. Results: For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines. Conclusions These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.

Purpose: This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices. Methods: I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations. Results: For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines. Conclusions These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.

Purpose: This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices. Methods: I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations. Results: For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines. Conclusions These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.

Purpose: Venous thromboembolism (VTE) is a major complication for hip fracture patients, and may exist preoperatively. This study aimed to examine the prevalence of VTE after immediate screening in hip fracture patients. Materials and Methods: Hip fracture patients with an elevated level of D-dimer underwent screening for VTE using computed tomography (CT) angiography. Anticoagulation treatments were administered preoperatively to patients diagnosed with VTE, followed by administration of additional anticoagulation postoperatively. Medical records were reviewed to identify risk factors for preoperative VTE and determine the prognosis of the patients. Results: Among 524 hip fracture patients, 66 patients (12.6%) were diagnosed with VTE, including 42 patients with deep vein thrombosis (DVT), 17 patients with pulmonary thromboembolism (PTE), and 7 patients with both DVT and PTE. Of the patients with VTE, 68.2% were diagnosed within 24 hours of injury, and 33.3% of these patients had PTE. VTE patients showed a tendency toward being overweight (P<0.01) and not on anticoagulant medication (P=0.02) compared to patients without VTE. The risk of VTE was higher for femur shaft fractures (odds ratio [OR] 4.83, 95% confidence interval [CI] 2.18-10.69) and overweight patients (OR 2.12, 95% CI 1.17-3.85), and lower for patients who were previously on anticoagulants (OR 0.36, 95% CI 0.18-0.74). Patients with preoperatively diagnosed VTE were asymptomatic before and after surgery. Conclusion Clinicians should be aware that VTE may be present within 24 hours of injury, and screening for VTE or prophylactic measures should be considered for high-risk patients.

Background/Aims: The efficacy of propofol in gastrointestinal endoscopy for patients with midazolam-induced paradoxical reactions remains unclarified. This study aimed to compare the efficacy and safety of propofol-based sedation in patients who previously experienced paradoxical reactions. Methods: This was a prospective, single-blinded, randomized controlled pilot study. Participants with a history of paradoxical reactions to midazolam during a previous esophagogastroduodenoscopy were recruited and randomly assigned to group I (propofol monosedation) or group II (combination of propofol and midazolam). The primary endpoint was the occurrence of a paradoxical reaction. Results: A total of 30 participants (mean age, 54.7±12.6 years; male, 19/30) were randomly assigned to group I (n=16) or group II (n=14). There were no paradoxical reactions in group I, but there were two in group II, without a significant difference (p=0.209). The mean dose of propofol was higher in group I than in group II (p=0.002). Meanwhile, the procedure and recovery times did not differ between groups. Conclusions Propofol-based sedation was safe and effective for patients who experienced paradoxical reactions to midazolam. However, caution is needed because few cases of paradoxical reaction again can happen in group II in which midazolam was readministered.

Objective: To investigate the clinical features and associated underlying conditions of isolated tuberculous myositis (ITBM), a rare extrapulmonary tuberculosis (TB). Methods: A systematic literature search and a multicenter survey were performed using a triangulation strategy. Data from the identified ITBM cases were extracted and analyzed to determine the underlying conditions, clinical presentations, treatments, and outcomes. Results: Based on the systematic review, we identified 58 ITBM, including 9 pediatric, cases in the literature published from 1981 to 2021: 25 (43.1%) immunocompromised and 33 (56.9%) non-immunocompromised patients. Immunocompromised cases had a significant shorter symptom duration (median 30.0 vs. 75.0 days) and a higher prevalence of multilocular involvement (20.8% vs. 0%). Among 24 immunocompromised adult patients, dermatomyositis/polymyositis (DM/PM; n=10, 41.7%) were the most common underlying diseases in adults with ITBM identified in the systematic review. Over the past 20 years, 11 Korean adults with ITBM were identified in the multicenter survey. Of 7 immunocompromised cases, two (28.6%) were DM/PM patients. TB death rate of immunocompromised patients was 0.0% and 5/23 (21.7%) in the pediatric and adult ITBM cases identified in the systematic review, respectively, and 3/7 (42.9%) in survey-identified ITBM cases. Conclusion ITBM has a unique clinical presentation including fever, tenderness, local swelling, overlying erythema, abscess formation and was associated with a grave outcome, especially in immunocompromised hosts. DM/PM was a highly prevalent underlying disease in both systematic review-identified and survey-identified immunocompromised ITBM patients.

The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.

The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.