1.Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety
Joohyung SON ; Bong Soo SON ; Jong Myung PARK ; Jeong Su CHO ; Yeongdae KIM ; Hoseok I ; Do Hyung KIM
Yonsei Medical Journal 2025;66(5):289-294
Purpose:
Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery.
Materials and Methods:
Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support.
Results:
Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (p=0.082). There was no significant difference between the two groups in terms of operative time (p=0.698), estimated blood loss (p=0.210), and duration of mechanical ventilation (p=0.713). There was a significant difference in intensive care unit stay between the two groups (p=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (p>0.999).
Conclusion
ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.
2.Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety
Joohyung SON ; Bong Soo SON ; Jong Myung PARK ; Jeong Su CHO ; Yeongdae KIM ; Hoseok I ; Do Hyung KIM
Yonsei Medical Journal 2025;66(5):289-294
Purpose:
Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery.
Materials and Methods:
Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support.
Results:
Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (p=0.082). There was no significant difference between the two groups in terms of operative time (p=0.698), estimated blood loss (p=0.210), and duration of mechanical ventilation (p=0.713). There was a significant difference in intensive care unit stay between the two groups (p=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (p>0.999).
Conclusion
ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.
3.Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety
Joohyung SON ; Bong Soo SON ; Jong Myung PARK ; Jeong Su CHO ; Yeongdae KIM ; Hoseok I ; Do Hyung KIM
Yonsei Medical Journal 2025;66(5):289-294
Purpose:
Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery.
Materials and Methods:
Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support.
Results:
Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (p=0.082). There was no significant difference between the two groups in terms of operative time (p=0.698), estimated blood loss (p=0.210), and duration of mechanical ventilation (p=0.713). There was a significant difference in intensive care unit stay between the two groups (p=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (p>0.999).
Conclusion
ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.
4.Evaluating Rituximab Failure Rates in Neuromyelitis Optica Spectrum Disorder: A Nationwide Real-World Study From South Korea
Su-Hyun KIM ; Ju-Hong MIN ; Sung-Min KIM ; Eun-Jae LEE ; Young-Min LIM ; Ha Young SHIN ; Young Nam KWON ; Eunhee SOHN ; Sooyoung KIM ; Min Su PARK ; Tai-Seung NAM ; Byeol-A YOON ; Jong Kuk KIM ; Kyong Jin SHIN ; Yoo Hwan KIM ; Jin Myoung SEOK ; Jeong Bin BONG ; Sohyeon KIM ; Hung Youl SEOK ; Sun-Young OH ; Ohyun KWON ; Sunyoung KIM ; Sukyoon LEE ; Nam-Hee KIM ; Eun Bin CHO ; Sa-Yoon KANG ; Seong-il OH ; Jong Seok BAE ; Suk-Won AHN ; Ki Hoon KIM ; You-Ri KANG ; Woohee JU ; Seung Ho CHOO ; Yeon Hak CHUNG ; Jae-Won HYUN ; Ho Jin KIM
Journal of Clinical Neurology 2025;21(2):131-136
Background:
and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation.
Methods:
We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months.
Results:
The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections.
Conclusions
This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.
5.Evaluating Rituximab Failure Rates in Neuromyelitis Optica Spectrum Disorder: A Nationwide Real-World Study From South Korea
Su-Hyun KIM ; Ju-Hong MIN ; Sung-Min KIM ; Eun-Jae LEE ; Young-Min LIM ; Ha Young SHIN ; Young Nam KWON ; Eunhee SOHN ; Sooyoung KIM ; Min Su PARK ; Tai-Seung NAM ; Byeol-A YOON ; Jong Kuk KIM ; Kyong Jin SHIN ; Yoo Hwan KIM ; Jin Myoung SEOK ; Jeong Bin BONG ; Sohyeon KIM ; Hung Youl SEOK ; Sun-Young OH ; Ohyun KWON ; Sunyoung KIM ; Sukyoon LEE ; Nam-Hee KIM ; Eun Bin CHO ; Sa-Yoon KANG ; Seong-il OH ; Jong Seok BAE ; Suk-Won AHN ; Ki Hoon KIM ; You-Ri KANG ; Woohee JU ; Seung Ho CHOO ; Yeon Hak CHUNG ; Jae-Won HYUN ; Ho Jin KIM
Journal of Clinical Neurology 2025;21(2):131-136
Background:
and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation.
Methods:
We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months.
Results:
The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections.
Conclusions
This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.
6.Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety
Joohyung SON ; Bong Soo SON ; Jong Myung PARK ; Jeong Su CHO ; Yeongdae KIM ; Hoseok I ; Do Hyung KIM
Yonsei Medical Journal 2025;66(5):289-294
Purpose:
Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery.
Materials and Methods:
Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support.
Results:
Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (p=0.082). There was no significant difference between the two groups in terms of operative time (p=0.698), estimated blood loss (p=0.210), and duration of mechanical ventilation (p=0.713). There was a significant difference in intensive care unit stay between the two groups (p=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (p>0.999).
Conclusion
ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.
7.Evaluating Rituximab Failure Rates in Neuromyelitis Optica Spectrum Disorder: A Nationwide Real-World Study From South Korea
Su-Hyun KIM ; Ju-Hong MIN ; Sung-Min KIM ; Eun-Jae LEE ; Young-Min LIM ; Ha Young SHIN ; Young Nam KWON ; Eunhee SOHN ; Sooyoung KIM ; Min Su PARK ; Tai-Seung NAM ; Byeol-A YOON ; Jong Kuk KIM ; Kyong Jin SHIN ; Yoo Hwan KIM ; Jin Myoung SEOK ; Jeong Bin BONG ; Sohyeon KIM ; Hung Youl SEOK ; Sun-Young OH ; Ohyun KWON ; Sunyoung KIM ; Sukyoon LEE ; Nam-Hee KIM ; Eun Bin CHO ; Sa-Yoon KANG ; Seong-il OH ; Jong Seok BAE ; Suk-Won AHN ; Ki Hoon KIM ; You-Ri KANG ; Woohee JU ; Seung Ho CHOO ; Yeon Hak CHUNG ; Jae-Won HYUN ; Ho Jin KIM
Journal of Clinical Neurology 2025;21(2):131-136
Background:
and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation.
Methods:
We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months.
Results:
The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections.
Conclusions
This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.
8.Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety
Joohyung SON ; Bong Soo SON ; Jong Myung PARK ; Jeong Su CHO ; Yeongdae KIM ; Hoseok I ; Do Hyung KIM
Yonsei Medical Journal 2025;66(5):289-294
Purpose:
Tracheal resection with end-to-end anastomosis (TREE) has many advantages over conservative treatment in terms of long-term results; however, this method requires improved safety and accessibility. We aimed to combine expanded venovenous extracorporeal membrane oxygenation (ECMO) during TREE surgery.
Materials and Methods:
Between May 2006 and December 2022, 41 patients diagnosed with tracheal stenosis or tracheal tumors underwent TREE. The non-ECMO and ECMO groups were classified based on the presence or absence of intraoperative ECMO support.
Results:
Reconstruction length was slightly longer in the ECMO group than in the non-ECMO group, but there was no statistical significance (p=0.082). There was no significant difference between the two groups in terms of operative time (p=0.698), estimated blood loss (p=0.210), and duration of mechanical ventilation (p=0.713). There was a significant difference in intensive care unit stay between the two groups (p=0.013) due to the postoperative maintenance of ECMO. There were no cases of early mortality in either group during hospitalization (p>0.999).
Conclusion
ECMO support could assist in more challenging cases as it makes surgery easier in difficult patient scenarios.
9.Difference of Spatiotemporal Patterns of Suicide Between Genders in Korea Over a Decade Using Geographic Information Systems
Soyoung PARK ; Jong-Ho PARK ; Bong-Jo KIM ; Boseok CHA ; So-Jin LEE ; Jae-Won CHOI ; Eun Ji LIM ; Nuree KANG ; Dongyun LEE
Korean Journal of Psychosomatic Medicine 2024;32(2):70-76
Objectives:
:Among the various risk factors for suicide, geographic factors have different effects on males and females. This study aimed to identify differences between genders in spatiotemporal dependence and spatiotemporal patterns of suicide mortality over the preceding decade.
Methods:
:This research analyzed the age-adjusted suicide mortality rate per 100,000 population, spanning from 2012 to 2021, for intentional suicides across each administrative district (229 Si, Gun, Gu) in Korea. Data were sourced from the National Statistical Office of the Korean Statistical Information Service. The Moran’s I in-dex for spatial autocorrelation of the suicide mortality rates was computed. An emerging hot spot analysis was conducted to examine the community-level spatiotemporal distribution patterns, thus providing insight into the re-gional clustering characteristics that reflect the temporal-spatial clusters of suicide mortality rates.
Results:
:TIn males, the Moran’s I indices were almost above 0 (p-value<0.05) for most years, indicating sig-nificant spatial autocorrelation. Conversely, no significant regional clustering was observed among females dur-ing the same period. The emerging hot spot analysis, focusing on the temporal trends in the spatial distributionof male suicide mortality rates from 2012 to 2021, identified two distinct time series patterns and a total of 12 hot spot areas: seven new spots and five sporadic spots.
Conclusions
:This study is the first to intuitively demonstrate the disparities in spatiotemporal dependencies and patterns of suicide mortality rates in Korea between genders. The findings highlight the necessity for tailoredsuicide prevention strategies that are sensitive to gender differences.
10.Difference of Spatiotemporal Patterns of Suicide Between Genders in Korea Over a Decade Using Geographic Information Systems
Soyoung PARK ; Jong-Ho PARK ; Bong-Jo KIM ; Boseok CHA ; So-Jin LEE ; Jae-Won CHOI ; Eun Ji LIM ; Nuree KANG ; Dongyun LEE
Korean Journal of Psychosomatic Medicine 2024;32(2):70-76
Objectives:
:Among the various risk factors for suicide, geographic factors have different effects on males and females. This study aimed to identify differences between genders in spatiotemporal dependence and spatiotemporal patterns of suicide mortality over the preceding decade.
Methods:
:This research analyzed the age-adjusted suicide mortality rate per 100,000 population, spanning from 2012 to 2021, for intentional suicides across each administrative district (229 Si, Gun, Gu) in Korea. Data were sourced from the National Statistical Office of the Korean Statistical Information Service. The Moran’s I in-dex for spatial autocorrelation of the suicide mortality rates was computed. An emerging hot spot analysis was conducted to examine the community-level spatiotemporal distribution patterns, thus providing insight into the re-gional clustering characteristics that reflect the temporal-spatial clusters of suicide mortality rates.
Results:
:TIn males, the Moran’s I indices were almost above 0 (p-value<0.05) for most years, indicating sig-nificant spatial autocorrelation. Conversely, no significant regional clustering was observed among females dur-ing the same period. The emerging hot spot analysis, focusing on the temporal trends in the spatial distributionof male suicide mortality rates from 2012 to 2021, identified two distinct time series patterns and a total of 12 hot spot areas: seven new spots and five sporadic spots.
Conclusions
:This study is the first to intuitively demonstrate the disparities in spatiotemporal dependencies and patterns of suicide mortality rates in Korea between genders. The findings highlight the necessity for tailoredsuicide prevention strategies that are sensitive to gender differences.

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