Purpose: Recent development in perioperative treatment of resectable non–small cell lung cancer (NSCLC) have changed the landscape of early lung cancer management. The ADAURA trial has demonstrated the efficacy of adjuvant osimertinib treatment in resectable NSCLC patients; however, studies are required to show which subgroup of patients are at a high risk of relapse and require adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor treatment. This study evaluated risk factors for postoperative relapse among patients who underwent complete resection. Materials and Methods: Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee. Results: A total of 3,176 patients who underwent curative resection was evaluated. The mean observation time was approximately 35.4 months. Among stage I to IIIA NSCLC patients, the EGFR-mutant subgroup included 867 patients, and 75.2%, 11.2%, and 11.8% were classified as stage I, stage II, and stage III, respectively. Within the EGFR-mutant subgroup, 44 (5.1%) and 121 (14.0%) patients showed early and late recurrence, respectively. Multivariate analysis on association with postoperative relapse among the EGFR-mutant subgroup showed that age, pathologic N and TNM stages, pleural invasion status, and surgery type were independent significant factors. Conclusion Among the population that underwent complete resection for early NSCLC with EGFR mutation, patients with advanced stage, pleural invasion, or limited resection are more likely to show postoperative relapse.

Purpose: Recent development in perioperative treatment of resectable non–small cell lung cancer (NSCLC) have changed the landscape of early lung cancer management. The ADAURA trial has demonstrated the efficacy of adjuvant osimertinib treatment in resectable NSCLC patients; however, studies are required to show which subgroup of patients are at a high risk of relapse and require adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor treatment. This study evaluated risk factors for postoperative relapse among patients who underwent complete resection. Materials and Methods: Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee. Results: A total of 3,176 patients who underwent curative resection was evaluated. The mean observation time was approximately 35.4 months. Among stage I to IIIA NSCLC patients, the EGFR-mutant subgroup included 867 patients, and 75.2%, 11.2%, and 11.8% were classified as stage I, stage II, and stage III, respectively. Within the EGFR-mutant subgroup, 44 (5.1%) and 121 (14.0%) patients showed early and late recurrence, respectively. Multivariate analysis on association with postoperative relapse among the EGFR-mutant subgroup showed that age, pathologic N and TNM stages, pleural invasion status, and surgery type were independent significant factors. Conclusion Among the population that underwent complete resection for early NSCLC with EGFR mutation, patients with advanced stage, pleural invasion, or limited resection are more likely to show postoperative relapse.

Purpose: Recent development in perioperative treatment of resectable non–small cell lung cancer (NSCLC) have changed the landscape of early lung cancer management. The ADAURA trial has demonstrated the efficacy of adjuvant osimertinib treatment in resectable NSCLC patients; however, studies are required to show which subgroup of patients are at a high risk of relapse and require adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor treatment. This study evaluated risk factors for postoperative relapse among patients who underwent complete resection. Materials and Methods: Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee. Results: A total of 3,176 patients who underwent curative resection was evaluated. The mean observation time was approximately 35.4 months. Among stage I to IIIA NSCLC patients, the EGFR-mutant subgroup included 867 patients, and 75.2%, 11.2%, and 11.8% were classified as stage I, stage II, and stage III, respectively. Within the EGFR-mutant subgroup, 44 (5.1%) and 121 (14.0%) patients showed early and late recurrence, respectively. Multivariate analysis on association with postoperative relapse among the EGFR-mutant subgroup showed that age, pathologic N and TNM stages, pleural invasion status, and surgery type were independent significant factors. Conclusion Among the population that underwent complete resection for early NSCLC with EGFR mutation, patients with advanced stage, pleural invasion, or limited resection are more likely to show postoperative relapse.

Background: Distal radius fractures with complete intra-articular involvement and diaphyseal extension pose significant challenges for stable fixation. Treatment options vary, with no single method demonstrating superiority. This study analyzed the outcomes of fixing these type of fractures with volar locking plates, which are widely used worldwide, and the fracture length according to plate type to determine when an extra-long plate should be used. Methods: This retrospective review analyzed 89 consecutive patients surgically treated for Association of Osteosynthesis (AO) classification type C distal radius fractures with diaphyseal extension, excluding open fractures. The plate length was determined to be long enough accordingly to avoid placing screws in the fracture site. Radiographic evaluation and clinical outcomes were analyzed. Results: According to the AO system, C3 type fractures comprised 50%, C1 type 28%, and C2 type 22%. The average distance from the radiocarpal joint to the most proximal fracture line was 41.1 mm, with articular step off and gap of 1.7 mm and 3.7 mm, respectively. Concomitant distal ulna fractures were present in 81%. At final follow-up, the mean radial height was 10.9 mm, radial inclination was 22.8°, volar tilt was 5.7°, and ulnar variance was 0.6 mm. Fracture union occurred on average at 2.6 months. The average Disabilities of the Arm, Shoulder, and Hand score was 12.0 and the average Modified Mayo Wrist Score was 83.6. Regarding the average wrist range of motion, extension was 63.8°, flexion was 53.7°, ulnar deviation was 25.1°, and radial deviation was 16.7°. Complications included delayed wound healing in 3% and delayed union in 1 patient, who eventually achieved union at 10 months after surgery. APTUS Wrist Distal Radius Plates XL 2.5 and 2.4-mm Variable Angle LCP Two-Column Volar Distal Radius Plates showed a statistically significant difference in fracture length, with the former being longer than the latter (62 mm vs. 35 mm, p < 0.001). Conclusions If the fracture length from the articular surface to the diaphysis exceeds 60 mm, we recommend preparing an extralong distal radius plate. Volar plate fixation with appropriate length selection has yielded favorable functional outcomes and few minor complications in distal radius fractures with complete intra-articular involvement and diaphyseal extension.

Background: Distal radius fractures with complete intra-articular involvement and diaphyseal extension pose significant challenges for stable fixation. Treatment options vary, with no single method demonstrating superiority. This study analyzed the outcomes of fixing these type of fractures with volar locking plates, which are widely used worldwide, and the fracture length according to plate type to determine when an extra-long plate should be used. Methods: This retrospective review analyzed 89 consecutive patients surgically treated for Association of Osteosynthesis (AO) classification type C distal radius fractures with diaphyseal extension, excluding open fractures. The plate length was determined to be long enough accordingly to avoid placing screws in the fracture site. Radiographic evaluation and clinical outcomes were analyzed. Results: According to the AO system, C3 type fractures comprised 50%, C1 type 28%, and C2 type 22%. The average distance from the radiocarpal joint to the most proximal fracture line was 41.1 mm, with articular step off and gap of 1.7 mm and 3.7 mm, respectively. Concomitant distal ulna fractures were present in 81%. At final follow-up, the mean radial height was 10.9 mm, radial inclination was 22.8°, volar tilt was 5.7°, and ulnar variance was 0.6 mm. Fracture union occurred on average at 2.6 months. The average Disabilities of the Arm, Shoulder, and Hand score was 12.0 and the average Modified Mayo Wrist Score was 83.6. Regarding the average wrist range of motion, extension was 63.8°, flexion was 53.7°, ulnar deviation was 25.1°, and radial deviation was 16.7°. Complications included delayed wound healing in 3% and delayed union in 1 patient, who eventually achieved union at 10 months after surgery. APTUS Wrist Distal Radius Plates XL 2.5 and 2.4-mm Variable Angle LCP Two-Column Volar Distal Radius Plates showed a statistically significant difference in fracture length, with the former being longer than the latter (62 mm vs. 35 mm, p < 0.001). Conclusions If the fracture length from the articular surface to the diaphysis exceeds 60 mm, we recommend preparing an extralong distal radius plate. Volar plate fixation with appropriate length selection has yielded favorable functional outcomes and few minor complications in distal radius fractures with complete intra-articular involvement and diaphyseal extension.

Background: Distal radius fractures with complete intra-articular involvement and diaphyseal extension pose significant challenges for stable fixation. Treatment options vary, with no single method demonstrating superiority. This study analyzed the outcomes of fixing these type of fractures with volar locking plates, which are widely used worldwide, and the fracture length according to plate type to determine when an extra-long plate should be used. Methods: This retrospective review analyzed 89 consecutive patients surgically treated for Association of Osteosynthesis (AO) classification type C distal radius fractures with diaphyseal extension, excluding open fractures. The plate length was determined to be long enough accordingly to avoid placing screws in the fracture site. Radiographic evaluation and clinical outcomes were analyzed. Results: According to the AO system, C3 type fractures comprised 50%, C1 type 28%, and C2 type 22%. The average distance from the radiocarpal joint to the most proximal fracture line was 41.1 mm, with articular step off and gap of 1.7 mm and 3.7 mm, respectively. Concomitant distal ulna fractures were present in 81%. At final follow-up, the mean radial height was 10.9 mm, radial inclination was 22.8°, volar tilt was 5.7°, and ulnar variance was 0.6 mm. Fracture union occurred on average at 2.6 months. The average Disabilities of the Arm, Shoulder, and Hand score was 12.0 and the average Modified Mayo Wrist Score was 83.6. Regarding the average wrist range of motion, extension was 63.8°, flexion was 53.7°, ulnar deviation was 25.1°, and radial deviation was 16.7°. Complications included delayed wound healing in 3% and delayed union in 1 patient, who eventually achieved union at 10 months after surgery. APTUS Wrist Distal Radius Plates XL 2.5 and 2.4-mm Variable Angle LCP Two-Column Volar Distal Radius Plates showed a statistically significant difference in fracture length, with the former being longer than the latter (62 mm vs. 35 mm, p < 0.001). Conclusions If the fracture length from the articular surface to the diaphysis exceeds 60 mm, we recommend preparing an extralong distal radius plate. Volar plate fixation with appropriate length selection has yielded favorable functional outcomes and few minor complications in distal radius fractures with complete intra-articular involvement and diaphyseal extension.

Background: Distal radius fractures with complete intra-articular involvement and diaphyseal extension pose significant challenges for stable fixation. Treatment options vary, with no single method demonstrating superiority. This study analyzed the outcomes of fixing these type of fractures with volar locking plates, which are widely used worldwide, and the fracture length according to plate type to determine when an extra-long plate should be used. Methods: This retrospective review analyzed 89 consecutive patients surgically treated for Association of Osteosynthesis (AO) classification type C distal radius fractures with diaphyseal extension, excluding open fractures. The plate length was determined to be long enough accordingly to avoid placing screws in the fracture site. Radiographic evaluation and clinical outcomes were analyzed. Results: According to the AO system, C3 type fractures comprised 50%, C1 type 28%, and C2 type 22%. The average distance from the radiocarpal joint to the most proximal fracture line was 41.1 mm, with articular step off and gap of 1.7 mm and 3.7 mm, respectively. Concomitant distal ulna fractures were present in 81%. At final follow-up, the mean radial height was 10.9 mm, radial inclination was 22.8°, volar tilt was 5.7°, and ulnar variance was 0.6 mm. Fracture union occurred on average at 2.6 months. The average Disabilities of the Arm, Shoulder, and Hand score was 12.0 and the average Modified Mayo Wrist Score was 83.6. Regarding the average wrist range of motion, extension was 63.8°, flexion was 53.7°, ulnar deviation was 25.1°, and radial deviation was 16.7°. Complications included delayed wound healing in 3% and delayed union in 1 patient, who eventually achieved union at 10 months after surgery. APTUS Wrist Distal Radius Plates XL 2.5 and 2.4-mm Variable Angle LCP Two-Column Volar Distal Radius Plates showed a statistically significant difference in fracture length, with the former being longer than the latter (62 mm vs. 35 mm, p < 0.001). Conclusions If the fracture length from the articular surface to the diaphysis exceeds 60 mm, we recommend preparing an extralong distal radius plate. Volar plate fixation with appropriate length selection has yielded favorable functional outcomes and few minor complications in distal radius fractures with complete intra-articular involvement and diaphyseal extension.

Advances in medical technology and health insurance coverage policies have significantly promoted radiological examinations in Korea. In 2019, the number of computed tomography examinations performed in Korea was approximately 1.5-times higher than the Organisation for Economic Co-operation and Development average. This surge in radiological examinations has raised concerns regarding inappropriate imaging practices that may lead to unnecessary radiation exposure and increased healthcare cost.Current Concepts: Two fundamental principles guide the radiation safety practices in medicine: Optimization and justification. Optimization, represented by the “As Low As Reasonably Achievable” principle, minimizes the radiation dose while maintaining the diagnostic quality. Justification ensures that the benefits of radiological procedures outweigh their potential risks. Evidence-based clinical imaging guidelines, such as the UK iRefer guidelines and USA American College of Radiology Appropriateness Criteria, have been internationally proposed to implement these principles. In Korea, collaborative efforts between the National Evidence-based Healthcare Collaborating Agency and Korean Society of Radiology have led to the development of Korean evidence-based clinical imaging guidelines.Discussion and Conclusion: Implementation of evidence-based imaging guidelines is crucial to reduce unnecessary radiation exposure and optimize resource utilization. However, various challenges, including the adaptation of the guidelines to individual patient needs and successful integration of rapidly advancing medical technologies, remain. Continuous updates, professional education, and system-wide support are essential to ensure the effective implementation of these guidelines. Future studies should focus on enhancing the precision and applicability of these guidelines in clinical practice to improve the patient safety and healthcare efficiency.

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.

Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b–3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b–3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0–2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninetynine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0–35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0–2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0–2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13;95% confidence interval, 1.59–10.8; p = 0.004). Conclusion Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0–2, even in patients with successful recanalization.