The anticancer drugs have evolved significantly, spanning molecular targeted therapeutics (MTTs), immune checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell (CAR-T) therapy, and antibody-drug conjugates (ADCs). Complications associated with these drugs vary widely based on their mechanisms of action. MTTs that target angiogenesis can often lead to complications related to ischemia or endothelial damage across various organs, whereas non-anti-angiogenic MTTs present unique complications derived from their specific pharmacological actions. ICIs are predominantly associated with immunerelated adverse events, such as pneumonitis, colitis, hepatitis, thyroid disorders, hypophysitis, and sarcoid-like reactions. CAR-T therapy causes unique and severe complications including cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome. ADCs tend to cause complications associated with cytotoxic payloads. A comprehensive understanding of these drug-specific toxicities, particularly using medical imaging, is essential for providing optimal patient care. Based on this knowledge, radiologists can play a pivotal role in multidisciplinary teams. Therefore, radiologists must stay up-to-date on the imaging characteristics of these complications and the mechanisms underlying novel anticancer drugs.

Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Background: Remimazolam is a novel short-acting benzodiazepine. This study compared the effects of remimazolam and propofol on cognitive function in adult patients after surgery or other procedures. Methods: We searched electronic databases, including PubMed, Embase, CENTRAL, Web of Science, and Scopus, for relevant studies. The primary outcome was the proportion of participants who experienced delirium or impaired cognitive function postoperatively. Secondary outcomes included the incidence of hypotension, bradycardia, and postoperative nausea and vomiting. We estimated the odds ratios (OR) and mean differences (MD) with 95% CIs using a random-effects model. Results: In total, 1295 patients from 11 randomized controlled trials were included. The incidence of postoperative delirium was 8.0% in the remimazolam group and 10.4% in the propofol group that was not significantly different (OR: 0.74, 95% CI [0.39–1.42], P = 0.369, I2 = 32%). More favorable cognitive function, as assessed using the Mini-Mental State Examination, was observed in the remimazolam group compared to the propofol group (MD: 1.06, 95% CI [0.32–1.80], P = 0.005, I2 = 89%). Remimazolam lowered the incidence of hypotension (OR: 0.28, 95% CI [0.21–0.37], P = 0.000, I2 = 0%) compared to propofol. Conclusions Remimazolam did not increase the risk of postoperative delirium and maintained cognitive function well, providing hemodynamic stability during surgery compared to propofol.

Background: We hypothesized that intranasal combination of dexmedetomidine (2 μg/kg) and ketamine (3 mg/kg) (IN DEXKET) improves the success rate of sedation in pediatric patients compared with chloral hydrate (CH; 50 mg/kg). Methods: This prospective, two-center, single-blinded, randomized controlled trial involved 136 pediatric patients (aged < 7 years) requiring procedural sedation. The participants were randomized to receive CH or IN DEXKET via a mucosal atomizer device. The primary outcome was the success rate of sedation (Pediatric Sedation State Scale, scores 1–3) within 15 min. The secondary outcomes included sedation failure at 30 min and overall complications of first-attempt sedation. Results: After excluding eight patients, 128 were included (CH = 66, IN DEXKET = 62). IN DEXKET showed a similar sedation success rate (75.8% [47/62] vs. 66.7% [44/66]; P = 0.330) but a lower complication rate (3.2% [2/62] vs. 16.7% [11/66]; P = 0.017) than CH. In the subgroup analysis for patients aged < 1 year, IN DEXKET showed a reduced complication rate than CH (2.6% [1/38] vs. 22.9% [8/35]; P = 0.012). In the subgroup analysis of children aged 1–7 years, IN DEXKET showed a higher sedation success rate within 15 min (79.2% [19/24] vs. 51.6% [16/31]; P = 0.049) and a lower sedation failure after 30 min (0% vs. 29.0% [9/31]; P = 0.003) than CH. Conclusions The intranasal combination of dexmedetomidine (2 μg/kg) and ketamine (3 mg/kg) is a safe and effective alternative to CH (50 mg/kg) for sedation in pediatric patients aged < 7 years.

Background: The development of frailty at hospital discharge affects the clinical outcomes in severe coronavirus disease 2019 (COVID-19) survivors who had no frailty before hospitalization. We aimed to describe the prevalence of new frailty using the clinical frailty scale (CFS) and evaluate its associated factors in patients with severe COVID-19 without pre-existing frailty before hospitalization. Methods: We performed a secondary analysis of clinical data from a nationwide retrospective cohort collected from 22 hospitals between January 1, 2020 and August 31, 2021. The patients were at least 19 years old and survived until discharge after admission to the intensive care unit (ICU) because of severe COVID-19. Development of new frailty was defined as a CFS score ≥5 at hospital discharge. Results: Among 669 severe COVID-19 survivors without pre-existing frailty admitted to the ICU, the mean age was 65.2±12.8 years, 62.5% were male, and 50.2% received mechanical ventilation (MV). The mean CFS score at admission was 2.4±0.9, and new frailty developed in 27.8% (186/483). In multivariate analysis, older age, cardiovascular disease, CFS score of 3–4 before hospitalization, increased C-reactive protein level, longer duration of corticosteroid treatment, and use of MV and extracorporeal membrane oxygenation were identified as factors associated with new-onset frailty. Conclusion Our study suggests that new frailty is not uncommon and is associated with diverse factors in survivors of severe COVID-19 without pre-existing frailty.

Contrast-enhanced ultrasound (CEUS) offers a distinctive approach to liver mass diagnosis by utilizing intravenous contrast agents for enhanced visualization of vascular structures and tissue characterization. This review highlights the unique advantages of CEUS compared to computed tomography (CT) and magnetic resonance imaging (MRI), particularly focusing on the Liver Imaging Reporting and Data System framework. Key differences include CEUS’s realtime imaging capability, which minimizes arterial phase mistiming and improves detection of hyperenhancing lesions, and its ability to provide detailed washout patterns. Also, CEUS's intravascular nature and lower risk of adverse reactions make it a safer alternative for patients with renal impairment or those contraindicated for CT/MRI.

Purpose: To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint. Materials and Methods: Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed. Results: Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement. Conclusion Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.

Objective: Previous studies have reported an association between cancer-related symptoms and perceived social support (PSS). The objective of this study was to analyze whether Chemotherapy-Induced Peripheral Neuropathy (CIPN), a prevalent side effect of chemotherapy, varies according to PSS level using a validated tool for CIPN at prospective follow-up. Methods: A total of 39 breast cancer patients were evaluated for PSS using the Multidimensional Scale of Perceived Social Support (MSPSS) prior to chemotherapy and were subsequently grouped into one of two categories for each subscale: low-to-moderate PSS and high PSS. CIPN was prospectively evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20) at five time points. A linear mixed-effects model with square root transformation was employed to investigate whether the CIPN20 scales varied by PSS level and time point. Results: Statistical analysis of the MSPSS total scale and subscales revealed a significant effect of the friends subscale group and time point on the CIPN20 sensory scale. The sensory scale score of CIPN20 was found to be lower in participants with high PSS from friends in comparison to those with low-to-moderate PSS at 1 month post-chemotherapy (p=0.010). Conclusion This is the first study to prospectively follow the long-term effect of pre-treatment PSS from friends on CIPN. Further studies based on larger samples are required to analyze the effects of PSS on the pathophysiology of CIPN.

Objective: This study aimed to investigate characteristics of suicide attempters who visited the emergency department to identify physical risk factors and rescue factors, and to assess the impact of social distancing during coronavirus disease-2019 (COVID-19) on suicide attempters. Methods: The study utilized data from the medical records of suicide attempters who visited the Bucheon Regional Emergency Medical Center of Soonchunhyang University Bucheon Hospital for 3 years from 2019 and the consultation records of the Life Love Crisis Response Team. This cross-sectional study analyzed changes in risk and rescue characteristics of suicide attempters before, during, and after the implementation of social distancing policies. The Risk-Rescue Rating Scale (RRRS) was used to assess the risk and rescue of suicide attempters. Results: During the implementation of social distancing, the RRRS for physical risk demonstrated a 1.67-fold increase in low-risk cases, which further escalated to a 2.39-fold increase post-implementation compared to the period prior to social distancing. Additionally, the RRRS indicated that behaviors became 1.44 times less rescued amid social distancing, with increased tendencies to conceal the act to evade detection and a reluctance to seek help (p<0.001). Conclusion Our findings indicate that it is important to develop suicide prevention programs for low-risk suicide attempts and to identify the characteristics of suicide attempts that occur during large-scale social isolation, such as infectious diseases, in order to develop strategies for suicide prevention in the future.

Background: The development of frailty at hospital discharge affects the clinical outcomes in severe coronavirus disease 2019 (COVID-19) survivors who had no frailty before hospitalization. We aimed to describe the prevalence of new frailty using the clinical frailty scale (CFS) and evaluate its associated factors in patients with severe COVID-19 without pre-existing frailty before hospitalization. Methods: We performed a secondary analysis of clinical data from a nationwide retrospective cohort collected from 22 hospitals between January 1, 2020 and August 31, 2021. The patients were at least 19 years old and survived until discharge after admission to the intensive care unit (ICU) because of severe COVID-19. Development of new frailty was defined as a CFS score ≥5 at hospital discharge. Results: Among 669 severe COVID-19 survivors without pre-existing frailty admitted to the ICU, the mean age was 65.2±12.8 years, 62.5% were male, and 50.2% received mechanical ventilation (MV). The mean CFS score at admission was 2.4±0.9, and new frailty developed in 27.8% (186/483). In multivariate analysis, older age, cardiovascular disease, CFS score of 3–4 before hospitalization, increased C-reactive protein level, longer duration of corticosteroid treatment, and use of MV and extracorporeal membrane oxygenation were identified as factors associated with new-onset frailty. Conclusion Our study suggests that new frailty is not uncommon and is associated with diverse factors in survivors of severe COVID-19 without pre-existing frailty.