1.F‑18 FDG PET/CT Clinical Service Trends in Korea from 2018 to 2022:A National Surveillance Study
Jaesun YOON ; Heejin KIM ; Do Hyun WOO ; Seung Yeop CHAE ; Ji Heui LEE ; Inki LEE ; Ilhan LIM ; Byung Il KIM ; Chang Woon CHOI ; Byung Hyung BYUN
Nuclear Medicine and Molecular Imaging 2025;59(2):117-124
		                        		
		                        			 Objectives:
		                        			To assess the trends and disparities in the utilization of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) in Korea between 2018 and 2022, with a focus on disease classification, patient demographics, and regional distribution. 
		                        		
		                        			Methods:
		                        			This national surveillance retrospective study uses data from the Health Insurance Review and Assessment Service (HIRA) database, which includes all FDG PET/CT examinations conducted in Korea from 2018 to 2022. Disease classifications, cancer types, age groups, gender, and geographic regions were analyzed using descriptive statistics. Utilization rates per 100,000 population were calculated for regional comparisons. 
		                        		
		                        			Results:
		                        			FDG PET/CT utilization increased by 25.4%, from 174,885 examinations in 2018 to 219,377 in 2022. Older age groups (60 years and above) accounted for the majority of examinations, with males undergoing more examinations than females. Oncology remained the primary indication, with lung, colorectal, and non-Hodgkin lymphoma leading in examination numbers. The number of examinations performed on patients aged 60 and above increased at a higher rate compared to those under 60. Significant geographic disparities were found, with Seoul reporting the highest utilization rate (1,114.3 examinations per 100,000 population), while Gyeongbuk exhibited much lower rate (26.2 examinations per 100,000 population). 
		                        		
		                        			Conclusions
		                        			This study highlights the growing utilization of FDG PET/CT in Korea, particularly among older adults, with significant gender differences in cancer types. The findings also reveal disparities in FDG PET/CT utilization across regions, indicating varying access to advanced imaging technology. 
		                        		
		                        		
		                        		
		                        	
2.F‑18 FDG PET/CT Clinical Service Trends in Korea from 2018 to 2022:A National Surveillance Study
Jaesun YOON ; Heejin KIM ; Do Hyun WOO ; Seung Yeop CHAE ; Ji Heui LEE ; Inki LEE ; Ilhan LIM ; Byung Il KIM ; Chang Woon CHOI ; Byung Hyung BYUN
Nuclear Medicine and Molecular Imaging 2025;59(2):117-124
		                        		
		                        			 Objectives:
		                        			To assess the trends and disparities in the utilization of F-18 fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT) in Korea between 2018 and 2022, with a focus on disease classification, patient demographics, and regional distribution. 
		                        		
		                        			Methods:
		                        			This national surveillance retrospective study uses data from the Health Insurance Review and Assessment Service (HIRA) database, which includes all FDG PET/CT examinations conducted in Korea from 2018 to 2022. Disease classifications, cancer types, age groups, gender, and geographic regions were analyzed using descriptive statistics. Utilization rates per 100,000 population were calculated for regional comparisons. 
		                        		
		                        			Results:
		                        			FDG PET/CT utilization increased by 25.4%, from 174,885 examinations in 2018 to 219,377 in 2022. Older age groups (60 years and above) accounted for the majority of examinations, with males undergoing more examinations than females. Oncology remained the primary indication, with lung, colorectal, and non-Hodgkin lymphoma leading in examination numbers. The number of examinations performed on patients aged 60 and above increased at a higher rate compared to those under 60. Significant geographic disparities were found, with Seoul reporting the highest utilization rate (1,114.3 examinations per 100,000 population), while Gyeongbuk exhibited much lower rate (26.2 examinations per 100,000 population). 
		                        		
		                        			Conclusions
		                        			This study highlights the growing utilization of FDG PET/CT in Korea, particularly among older adults, with significant gender differences in cancer types. The findings also reveal disparities in FDG PET/CT utilization across regions, indicating varying access to advanced imaging technology. 
		                        		
		                        		
		                        		
		                        	
3.Association of Age, Sex and Education With Access to the Intravenous Thrombolysis for Acute Ischemic Stroke
Yoona KO ; Beom Joon KIM ; Youngran KIM ; Jong-Moo PARK ; Kyusik KANG ; Jae Guk KIM ; Jae-Kwan CHA ; Tai Hwan PARK ; Kyungbok LEE ; Jun LEE ; Keun-Sik HONG ; Byung-Chul LEE ; Kyung-Ho YU ; Dong-Eog KIM ; Joon-Tae KIM ; Jay Chol CHOI ; Jee Hyun KWON ; Wook-Joo KIM ; Kyu Sun YUM ; Sung-Il SOHN ; Hyungjong PARK ; Sang-Hwa LEE ; Kwang-Yeol PARK ; Chi Kyung KIM ; Sung Hyuk HEO ; Moon-Ku HAN ; Anjail Z. SHARRIEF ; Sunil A. SHETH ; Hee-Joon BAE ;
Journal of Korean Medical Science 2025;40(13):e49-
		                        		
		                        			 Background:
		                        			Barriers to treatment with intravenous thrombolysis (IVT) for patients with acute ischemic stroke (AIS) in South Korea remain incompletely characterized. We analyze a nationwide prospective cohort to determine patient-level features associated with delayed presentation and non-treatment of potential IVT-eligible patients. 
		                        		
		                        			Methods:
		                        			We identified consecutive patients with AIS from 01/2011 to 08/2023 from a multicenter and prospective acute stroke registry in Korea. Patients were defined as IVT candidates if they presented within 4.5 hours from the last known well, had no lab evidence of coagulopathy, and had National Institute of Health Stroke Scale (NIHSS) ≥ 4. Multivariable generalized linear mixed regression models were used to investigate the associations between their characteristics and the IVT candidates or the use of IVT among the candidates. 
		                        		
		                        			Results:
		                        			Among 84,103 AIS patients, 41.0% were female, with a mean age of 69 ± 13 years and presentation NIHSS of 4 [interquartile range, 1–8]. Out of these patients, 13,757 (16.4%) were eligible for IVT, of whom 8,179 (59.5%) received IVT. Female sex (adjusted risk ratio [RR], 0.90; 95% confidence interval [CI], 0.86–0.94) and lower years of education (adjusted RR, 0.90; 95% CI, 0.84–0.97 for 0–3 years, compared to ≥ 13 years) were associated with a decreased likelihood of presenting as eligible for IVT after AIS; meanwhile, young age (adjusted RR, 1.12; 95% CI, 1.01–1.24 for ≤ 44 years, compared to 75–84 years) was associated with an increased likelihood of being an IVT candidate. Among those who were eligible for IVT, only age was significantly associated with the use of IVT (adjusted RR, 1.09; 95% CI, 1.03–1.16 for age 65–74 and adjusted RR, 0.83; 95% CI, 0.76–0.90 for ≥ 85 years, respectively). 
		                        		
		                        			Conclusion
		                        			Most patients with AIS present outside IVT eligibility in South Korea, and only 60% of eligible patients were ultimately treated. We identified increased age, female sex and lower education as key features on which to focus interventions for improving IVT utilization. 
		                        		
		                        		
		                        		
		                        	
4.Physician–Scientist Training System and Development Strategies in Korea
Gwang Hyeon EOM ; Jungmin KIM ; Jong-Il KIM ; Hyo Yi CHOI ; Dong Hyeon LEE
Journal of Korean Medical Science 2025;40(15):e140-
		                        		
		                        			
		                        			 Physician–scientists play a pivotal role in bridging clinical practice and biomedical research, advancing medical science, and tackling complex healthcare challenges. In South Korea, the declining number of medical doctors engaging in basic medical sciences has prompted the implementation of various training initiatives since the 2000s. Notable initiatives, such as the Integrated Physician–Scientist Training Program (2019) and the Global Physician–Scientist Training Program (2024), aim to cultivate multidisciplinary physician–scientists capable of addressing unmet medical needs. This study offers a comprehensive overview of the current training systems, funding mechanisms, and strategic approaches for physician–scientists in South Korea, compares them with international best practices, and proposes actionable policy recommendations to enhance their effectiveness and long-term sustainability. 
		                        		
		                        		
		                        		
		                        	
5.Cost Utility Analysis of National Cancer Screening Program for Gastric Cancer in Korea: A Markov Model Analysis
Seowoo BAE ; Hyewon LEE ; Eun Young HER ; Kyeongmin LEE ; Joon Sung KIM ; Jeonghoon AHN ; Il Ju CHOI ; Jae Kwan JUN ; Kui Son CHOI ; Mina SUH
Journal of Korean Medical Science 2025;40(6):e43-
		                        		
		                        			 Background:
		                        			The Korean National Cancer Screening Program (NCSP) for gastric cancer requires economic evaluation due to the low sensitivity of upper gastrointestinal series (UGIs) and the associated low cancer survival rate. This study aimed to ascertain the most cost-effective strategy for the NCSP. 
		                        		
		                        			Methods:
		                        			The hypothetical target population of this study was aged 40 years or older, and no actual participants were involved. Markov simulation models were constructed for 25 strategies, combinations of 1) screening methods (UGIs or endoscopy vs. endoscopy-only), 2) screening intervals (one, two, or three-year), and 3) upper age limit of screening (69, 74, 79 years old, or “no limit”). Costs, utility, and other input parameters were extracted from various databases and previous studies. Cost-utility, sensitivity, and scenario analyses were conducted. 
		                        		
		                        			Results:
		                        			The endoscopy-only strategy with a three-year interval with an upper age limit of 69 was the most cost-effective strategy with an incremental cost-utility ratio of KRW 13,354,106 per quality-adjusted life years. According to the probabilistic sensitivity analysis, the uncertainty of the result was significantly small. Scenario analysis is showed that as the screening rate increased, the endoscopy-only strategy saved more costs compared to the current NCSP. Therefore, it is important to maintain a high screening rate when altering the NCSP strategy. 
		                        		
		                        			Conclusion
		                        			Endoscopy-only screening was more cost-effective method than UGIs for the NCSP. Furthermore, a three-year interval with an upper-age limit of 69 years was the most cost-effective strategy. Efforts to improve cost-effective screening guidelines will support the efficient use of medical resources. Additionally, maintaining a higher screening rate may maximize the impact of the modification in strategy on cost-effectiveness. 
		                        		
		                        		
		                        		
		                        	
6.Prediction of 5-Year Survival Rate After Hip Fracture Surgery Using a Comprehensive Geriatric Assessment-Based Frailty Score Model
Jung-Yeon CHOI ; Jung-Wee PARK ; Kwang-il KIM ; Young-Kyun LEE ; Cheol-Ho KIM
Journal of Korean Medical Science 2025;40(12):e40-
		                        		
		                        			 Background:
		                        			Hip fractures (HFs) are major osteoporotic injuries associated with morbidity, loss of independence, increased mortality, and an increased socioeconomic burden.The total number of HFs is increasing owing to an aging population. While studies have focused on 30-day or 1-year mortality after HF surgery, studies reporting long-term mortality are lacking. Our study bridges this knowledge gap by exploring the relationship between frailty, postoperative complications, and the 5-year mortality after HF surgery.This study aimed to identify the risk factors associated with 5-year mortality after HF surgery. The impact of the Hip-Multidimensional Frailty Score (Hip-MFS) and postoperative complications on 5-year mortality was compared. 
		                        		
		                        			Methods:
		                        			This retrospective study included 536 individuals aged 65 years and older with HFs who underwent surgery between 2009 and 2014. The Hip-MFS was calculated using the comprehensive geriatric assessment. Patients whose Hip-MFS score above 8 considered as frail. Postoperative complications included pneumonia, urinary tract infection, delirium, pulmonary thromboembolism, and unplanned intensive care unit admission after surgery.The primary outcome was 5-year mortality. Univariate and multivariate cox-regression, Kaplan–Meier analysis and log-rank tests were used to assess predictive value of frailty and postoperative complications on 5-year mortality. 
		                        		
		                        			Results:
		                        			The mean age was 80.5 ± 7.0 years and 71.3% (n = 382) were women. Overall, 48.3% (n = 259) were diagnosed with femoral neck fractures, and 51.7% (n = 277) were diagnosed with intertrochanteric fractures. A total of 223 (41.6%) patients experienced postoperative complications. The overall mortality rate was 60.4% (n = 324), with 1-year and 5-year mortality rates after HF surgery being 13.8% (n = 74) and 43.8% (n = 235), respectively. In the multivariate regression analysis, after adjusting for clinical and demographic factors, the high-risk Hip-MFS group and the group with postoperative complications had hazard ratios for 5-year survival of 1.513 (95% confidence interval [CI], 1.105–2.017; P = 0.010) and 1.470 (95% CI, 1.117–1.936;P = 0.006), respectively. Patients who had postoperative complications with a low Hip-MFS showed better 5-year survival than those without postoperative complications with a high Hip-MFS in the Kaplan–Meier curve (P = 0.013). 
		                        		
		                        			Conclusion
		                        			A high Hip-MFS risk and postoperative complications were associated with an increased 5-year mortality rate. In comparison to the occurrence of postoperative complications, the frailty status evaluated using the Hip-MFS had a more significant impact on long-term mortality after HF surgery. 
		                        		
		                        		
		                        		
		                        	
7.Reinjection in Patients with Intraocular Inflammation Development after Intravitreal Brolucizumab Injection
Myung Ae KIM ; Soon Il CHOI ; Jong Min KIM ; Hyun Sub OH ; Yong Sung YOU ; Won Ki LEE ; Soon Hyun KIM ; Oh Woong KWON ; Ju Young KIM
Korean Journal of Ophthalmology 2025;39(3):213-221
		                        		
		                        			 Purpose:
		                        			To investigate the outcomes of brolucizumab reinjection after intraocular inflammation (IOI) development. 
		                        		
		                        			Methods:
		                        			This retrospective study analyzed patients with brolucizumab injections from April 2021 to January 2024. Patients who developed IOI after brolucizumab were included and categorized into subgroups depending on reinjection, discontinuation, and further IOI development. 
		                        		
		                        			Results:
		                        			A total of 472 eyes of 432 patients received brolucizumab injections. Thirty-eight cases developed IOI at least once, and 25 continued brolucizumab. Sixteen cases had no more IOI events, and nine experienced a second or more IOI events. Among the nine cases, three maintained brolucizumab injections despite IOI recurrence. The incidence of IOI was 8.1% based on the number of eyes (38 of 472 eyes) and 2.0% based on the number of brolucizumab injections (50 of 2,468 injections). The incidence of occlusive retinal vasculitis was 0.2% (1 of 472 eyes). The recurrence rate was 23.7% (9 of 38 eyes). The average number of injections between the first brolucizumab injection and the injection date on which IOI first developed was 2.15 times in the no-reinjection group, 3.44 times in the no-IOI-recurrence group, and 2.0 times in the second-IOI-episode group. Time to IOI occurrence in cases with first IOI episode was 18.60 ± 16.73 days, with 15 cases developing IOI within 1 week. 
		                        		
		                        			Conclusions
		                        			This study elucidates the real-world incidence of brolucizumab associated IOIs, with a description of information related to reinjections after the IOI episodes. A comprehensive understanding of brolucizumab reinjection is essential for its optimal utilization. 
		                        		
		                        		
		                        		
		                        	
8.Clinical Efficacy of Ultrafast Dynamic Contrast-Enhanced MRI Using Compressed Sensing in Distinguishing Benign and Malignant Soft-Tissue Tumors
You Seon SONG ; In Sook LEE ; Young Jin CHOI ; Jeung Il KIM ; Kyung-Un CHOI ; Kangsoo KIM ; Kyungeun JANG
Korean Journal of Radiology 2025;26(1):43-53
		                        		
		                        			 Objective:
		                        			To evaluate the clinical efficacy of ultrafast dynamic contrast-enhanced (DCE)-MRI using a compressed sensing (CS) technique for differentiating benign and malignant soft-tissue tumors (STTs) and to evaluate the factors related to the grading of malignant STTs. 
		                        		
		                        			Materials and Methods:
		                        			A total of 165 patients (96 male; mean age, 61 years), comprising 111 with malignant STTs and 54 with benign STTs according to the 2020 WHO classification, underwent DCE-MRI with CS between June 2018 and June 2023. The clinical, qualitative, and quantitative parameters associated with conventional MRI were also obtained. During post-processing of the early arterial phase of DCE-MRI, the time-to-enhance (TTE), time-to-peak (TTP), initial area under the curve at 60 s (iAUC60), and maximum slope were calculated. Furthermore, the delayed arterial phase parameters of DCEMRI, including Ktrans , Kep, Ve, and iAUC values and time-concentration curve (TCC) types, were determined. Clinical and MRI parameters were statistically analyzed to differentiate between benign and malignant tumors and their correlation with tumor grading. 
		                        		
		                        			Results:
		                        			According to logistic regression analysis, the TTE value (P < 0.001) of the early arterial phase and Ve (P = 0.039) and iAUC (P = 0.006) values of the delayed arterial phase, as well as age, location, peritumoral edema, and contrast heterogeneity on conventional MRI, were significant (P = 0.001–0.015) in differentiating benign and malignant tumors. Among all the quantitative parameters, the TTE value had the highest accuracy, with an area under the receiver operating characteristic curve of 0.902. The grading of malignant tumors was significantly correlated with peritumoral edema; CE heterogeneity; visual diffusion restriction; minimum and mean ADC; TTP, Kep, and Ve values; and the TCC graph (all P < 0.05). 
		                        		
		                        			Conclusion
		                        			Among the quantitative parameters obtained using ultrafast DCE-MRI, early arterial phase TTE was the most accurate for distinguishing between benign and malignant tumors. 
		                        		
		                        		
		                        		
		                        	
10.Prevalence and characteristics of impacted teeth in Korean orthodontic patients at ten university dental hospitals
Youn-Kyung CHOI ; Sung-Hun KIM ; Yong-Il KIM ; Seong-Sik KIM ; Soo-Byung PARK ; Dong-Soon CHOI ; Ho-Jin KIM ; Kyung-A KIM ; Mo-Hyeon LEE ; Sung-Hwan CHOI ; Sung-Kwon CHOI ; Kyungmin Clara LEE ; Young-Mi JEON ; Sewoong OH ; Seorin JEONG
The Korean Journal of Orthodontics 2025;55(3):234-241
		                        		
		                        			 Objective:
		                        			This study aimed to investigate the prevalence and characteristics of impacted teeth (ITs) in orthodontic patients at university dental hospitals in Korea.  
		                        		
		                        			Methods:
		                        			This study included 14,774 patients who visited the Department of Orthodontics at 10 university dental hospitals in Korea between 2020 and 2022 and underwent orthodontic diagnosis. The prevalence and characteristics of ITs were investigated using orthodontic diagnostic records, radiographs, and diagnostic casts.  
		                        		
		                        			Results:
		                        			The prevalence of ITs, excluding third molar impaction, in Korean orthodontic patients was 13.6% (n = 2,014).The prevalence of ITs in pediatric orthodontic patients was 24.5% (n = 1,614).Of these patients, 68.2% had one IT, 27.5% had two ITs, 24.3% had bilateral IT, and 75.7% had unilateral IT. The most frequent IT was the maxillary canine (50.1%), followed by the mandibular second molar (11.7%), and maxillary second premolar (9.6%). An abnormal eruption path (46.5%) was the most frequent etiology. Orthodontic traction after surgical exposure (70.6%) was the most frequent treatment option. Among the patients with ITs, 29.8% had other dental anomalies, such as tooth agenesis (8.7%), microdontia (8.0%), and supernumerary teeth (5.1%). Furthermore, 50.8% had complications such as cystic lesions (18.3%), transposition (17.7%), and root resorption (14.8%).Among the patients with maxillary canine impaction, 62.2% had labial maxillary canine impaction and 21.1% had palatal maxillary canine impaction. 
		                        		
		                        			Conclusions
		                        			The prevalence of ITs in Korean orthodontic patients at university dental hospitals was high, particularly in pediatric orthodontic patients. 
		                        		
		                        		
		                        		
		                        	
            
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