1.Pulmonary Tumor Thrombotic Microangiopathy Associated With Gastric Cancer: Clinical Characteristics and Outcomes
Tae-Se KIM ; Soomin AHN ; Sung-A CHANG ; Sung Hee LIM ; Byung-Hoon MIN ; Yang Won MIN ; Hyuk LEE ; Poong-Lyul RHEE ; Jae J. KIM ; Jun Haeng LEE
Journal of Gastric Cancer 2025;25(2):276-284
Purpose:
Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal complication of gastric cancer (GC). This study aimed to evaluate the clinical characteristics, outcomes, and immunohistochemical profiles of patients with GC-induced PTTM.
Materials and Methods:
From 2011 to 2023, 8 patients were clinically diagnosed with PTTM associated with GC antemortem. Clinical features and outcomes were reviewed, and immunohistochemical staining for c-erbB-2, MutL protein homolog 1, and programmed cell death ligand-1 was performed.
Results:
The median patient age was 56 years (range, 34–66 years). In all the patients, the tumors exhibited either ulceroinfiltrative or diffusely infiltrative gross morphology.The median tumor size was 5.8 cm (range, 2.0 cm–15.0 cm). Poorly differentiated adenocarcinoma was the most common histological type (6/8, 75%), followed by signet ring cell carcinoma (1/8, 12.5%) and moderately differentiated adenocarcinoma (1/8, 12.5%).Chest computed tomography revealed ground-glass opacities (7/8, 87.5%) or tree-in-bud signs (2/8, 25.0%) without definite evidence of pulmonary thromboembolism. Disseminated intravascular coagulation was present in 62.5% (5/8) of the patients diagnosed with PTTM.C-erbB-2 was positive in one patient (1/8, 12.5%). One patient who received palliative chemotherapy after developing PTTM survived for 35 days, whereas the other 7 patients who did not receive chemotherapy after developing PTTM survived for 7 days or less after PTTM diagnosis.
Conclusions
Most patients with GC-induced PTTM had an undifferentiated-type histology, infiltrative morphology, and extremely poor survival. Palliative chemotherapy may benefit patients with GC-induced PTTM; however, further studies are needed to explore the potential of targeted therapy in these patients.
2.Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline)
In-Ho KIM ; Seung Joo KANG ; Wonyoung CHOI ; An Na SEO ; Bang Wool EOM ; Beodeul KANG ; Bum Jun KIM ; Byung-Hoon MIN ; Chung Hyun TAE ; Chang In CHOI ; Choong-kun LEE ; Ho Jung AN ; Hwa Kyung BYUN ; Hyeon-Su IM ; Hyung-Don KIM ; Jang Ho CHO ; Kyoungjune PAK ; Jae-Joon KIM ; Jae Seok BAE ; Jeong Il YU ; Jeong Won LEE ; Jungyoon CHOI ; Jwa Hoon KIM ; Miyoung CHOI ; Mi Ran JUNG ; Nieun SEO ; Sang Soo EOM ; Soomin AHN ; Soo Jin KIM ; Sung Hak LEE ; Sung Hee LIM ; Tae-Han KIM ; Hye Sook HAN ; On behalf of The Development Working Group for the Korean Practice Guideline for Gastric Cancer 2024
Journal of Gastric Cancer 2025;25(1):5-114
Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.
3.Pulmonary Tumor Thrombotic Microangiopathy Associated With Gastric Cancer: Clinical Characteristics and Outcomes
Tae-Se KIM ; Soomin AHN ; Sung-A CHANG ; Sung Hee LIM ; Byung-Hoon MIN ; Yang Won MIN ; Hyuk LEE ; Poong-Lyul RHEE ; Jae J. KIM ; Jun Haeng LEE
Journal of Gastric Cancer 2025;25(2):276-284
Purpose:
Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal complication of gastric cancer (GC). This study aimed to evaluate the clinical characteristics, outcomes, and immunohistochemical profiles of patients with GC-induced PTTM.
Materials and Methods:
From 2011 to 2023, 8 patients were clinically diagnosed with PTTM associated with GC antemortem. Clinical features and outcomes were reviewed, and immunohistochemical staining for c-erbB-2, MutL protein homolog 1, and programmed cell death ligand-1 was performed.
Results:
The median patient age was 56 years (range, 34–66 years). In all the patients, the tumors exhibited either ulceroinfiltrative or diffusely infiltrative gross morphology.The median tumor size was 5.8 cm (range, 2.0 cm–15.0 cm). Poorly differentiated adenocarcinoma was the most common histological type (6/8, 75%), followed by signet ring cell carcinoma (1/8, 12.5%) and moderately differentiated adenocarcinoma (1/8, 12.5%).Chest computed tomography revealed ground-glass opacities (7/8, 87.5%) or tree-in-bud signs (2/8, 25.0%) without definite evidence of pulmonary thromboembolism. Disseminated intravascular coagulation was present in 62.5% (5/8) of the patients diagnosed with PTTM.C-erbB-2 was positive in one patient (1/8, 12.5%). One patient who received palliative chemotherapy after developing PTTM survived for 35 days, whereas the other 7 patients who did not receive chemotherapy after developing PTTM survived for 7 days or less after PTTM diagnosis.
Conclusions
Most patients with GC-induced PTTM had an undifferentiated-type histology, infiltrative morphology, and extremely poor survival. Palliative chemotherapy may benefit patients with GC-induced PTTM; however, further studies are needed to explore the potential of targeted therapy in these patients.
4.Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline)
In-Ho KIM ; Seung Joo KANG ; Wonyoung CHOI ; An Na SEO ; Bang Wool EOM ; Beodeul KANG ; Bum Jun KIM ; Byung-Hoon MIN ; Chung Hyun TAE ; Chang In CHOI ; Choong-kun LEE ; Ho Jung AN ; Hwa Kyung BYUN ; Hyeon-Su IM ; Hyung-Don KIM ; Jang Ho CHO ; Kyoungjune PAK ; Jae-Joon KIM ; Jae Seok BAE ; Jeong Il YU ; Jeong Won LEE ; Jungyoon CHOI ; Jwa Hoon KIM ; Miyoung CHOI ; Mi Ran JUNG ; Nieun SEO ; Sang Soo EOM ; Soomin AHN ; Soo Jin KIM ; Sung Hak LEE ; Sung Hee LIM ; Tae-Han KIM ; Hye Sook HAN ; On behalf of The Development Working Group for the Korean Practice Guideline for Gastric Cancer 2024
Journal of Gastric Cancer 2025;25(1):5-114
Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.
5.Pulmonary Tumor Thrombotic Microangiopathy Associated With Gastric Cancer: Clinical Characteristics and Outcomes
Tae-Se KIM ; Soomin AHN ; Sung-A CHANG ; Sung Hee LIM ; Byung-Hoon MIN ; Yang Won MIN ; Hyuk LEE ; Poong-Lyul RHEE ; Jae J. KIM ; Jun Haeng LEE
Journal of Gastric Cancer 2025;25(2):276-284
Purpose:
Pulmonary tumor thrombotic microangiopathy (PTTM) is a fatal complication of gastric cancer (GC). This study aimed to evaluate the clinical characteristics, outcomes, and immunohistochemical profiles of patients with GC-induced PTTM.
Materials and Methods:
From 2011 to 2023, 8 patients were clinically diagnosed with PTTM associated with GC antemortem. Clinical features and outcomes were reviewed, and immunohistochemical staining for c-erbB-2, MutL protein homolog 1, and programmed cell death ligand-1 was performed.
Results:
The median patient age was 56 years (range, 34–66 years). In all the patients, the tumors exhibited either ulceroinfiltrative or diffusely infiltrative gross morphology.The median tumor size was 5.8 cm (range, 2.0 cm–15.0 cm). Poorly differentiated adenocarcinoma was the most common histological type (6/8, 75%), followed by signet ring cell carcinoma (1/8, 12.5%) and moderately differentiated adenocarcinoma (1/8, 12.5%).Chest computed tomography revealed ground-glass opacities (7/8, 87.5%) or tree-in-bud signs (2/8, 25.0%) without definite evidence of pulmonary thromboembolism. Disseminated intravascular coagulation was present in 62.5% (5/8) of the patients diagnosed with PTTM.C-erbB-2 was positive in one patient (1/8, 12.5%). One patient who received palliative chemotherapy after developing PTTM survived for 35 days, whereas the other 7 patients who did not receive chemotherapy after developing PTTM survived for 7 days or less after PTTM diagnosis.
Conclusions
Most patients with GC-induced PTTM had an undifferentiated-type histology, infiltrative morphology, and extremely poor survival. Palliative chemotherapy may benefit patients with GC-induced PTTM; however, further studies are needed to explore the potential of targeted therapy in these patients.
6.Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline)
In-Ho KIM ; Seung Joo KANG ; Wonyoung CHOI ; An Na SEO ; Bang Wool EOM ; Beodeul KANG ; Bum Jun KIM ; Byung-Hoon MIN ; Chung Hyun TAE ; Chang In CHOI ; Choong-kun LEE ; Ho Jung AN ; Hwa Kyung BYUN ; Hyeon-Su IM ; Hyung-Don KIM ; Jang Ho CHO ; Kyoungjune PAK ; Jae-Joon KIM ; Jae Seok BAE ; Jeong Il YU ; Jeong Won LEE ; Jungyoon CHOI ; Jwa Hoon KIM ; Miyoung CHOI ; Mi Ran JUNG ; Nieun SEO ; Sang Soo EOM ; Soomin AHN ; Soo Jin KIM ; Sung Hak LEE ; Sung Hee LIM ; Tae-Han KIM ; Hye Sook HAN ; On behalf of The Development Working Group for the Korean Practice Guideline for Gastric Cancer 2024
Journal of Gastric Cancer 2025;25(1):5-114
Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.
7.Analysis and Consideration of Factors for Predicting Cooperation Levels in Pediatric Dentistry
Soomin LIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):229-244
This study aimed to evaluate various factors related to cooperation levels in pediatric dentistry and determine their correlation with children’s cooperation during dental treatments. This study included one hundred children and their guardians who visited the dental hospital at the Chonnam National University. Children and their guardians completed surveys regarding dental fear, dental caries experience, dental treatment experience, temperament, and guardians’ dental anxiety, as well as the background characteristics of the children. Based on these data, factors associated with children’s cooperation during dental treatment were investigated. Dental fear, caries experience during the primary and mixed dentition stages, and temperament traits such as shyness and negative emotionality significantly impacted children’s cooperation during dental visits, with higher levels of these factors corresponding to lower cooperation. The extent of dental experience also modestly influenced children’ s cooperation, with higher levels of cooperation observed in children with greater dental experience. Additionally, children’s dental fear was strongly correlated with guardians’ dental anxiety, increasing as guardians’ anxiety levels increased. Twelve-year-old children exhibited significantly lower levels of dental fear compared to other age groups, and regardless of cooperation levels, injections (shots) were identified as the primary factor inducing dental fear among the children. To improve children’ s cooperation in pediatric dentistry, strategies should focus on alleviating their fears and adopting an individualized approach that consider their oral health status and temperamental traits.
8.Perception of Parents Regarding Specialized Pediatric Dentistry
Soomin LIM ; Kyunghi KIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(4):344-358
This study analyzed parents’ perceptions of pediatric dentistry and pediatric dental specialists, identified factors influencing their choice of dental practice for children, and compared perceptions between those with and without pediatric dentistry experience. A nationwide online survey (February 15 - 19, 2024) was conducted among 500 parents of children aged 15 years or younger: 170 from Seoul/Gyeonggi/ Incheon, 100 each from Chungcheong, Gyeongsang, Jeolla, and 30 from Gangwon. Data covered demographics, factors influencing dentist selection for children, awareness of pediatric dentists, and insights on whether parents had visited a pediatric dentist. 75.6% had visited a pediatric dental clinic, and 49.6% recognized pediatric dental specialists. Among visitors, 59.5% were aware of pediatric dental specialists, compared to 18.9% of non-visitors. Furthermore, 90.7% of parents aware of pediatric dental specialists had visited a clinic, versus 60.7% of those unaware. The highest visit rates were among parents with three children, especially aged 7 - 9. Awareness of pediatric dental specialists was highest among parents in their 20s, living in Gangwon, Seoul, Gyeonggi, and Incheon regions, with professional occupations and household monthly incomes of 7.5 - 8.5 million won. Parents with experience visiting pediatric dental clinics prioritized dentists’ expertise; those without experience prioritized short waiting times. Prior experience with pediatric dental clinics significantly increased the intention to revisit and reduced hesitation. Improving parents’ perceptions of pediatric dentists enhances decision-making and accessibility for children’s specialized dental care. Professional associations must raise awareness of pediatric dentistry. Pediatric dentists should prioritize expertise and advance their specializations in pediatric orthodontics.
9.Analysis and Consideration of Factors for Predicting Cooperation Levels in Pediatric Dentistry
Soomin LIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(3):229-244
This study aimed to evaluate various factors related to cooperation levels in pediatric dentistry and determine their correlation with children’s cooperation during dental treatments. This study included one hundred children and their guardians who visited the dental hospital at the Chonnam National University. Children and their guardians completed surveys regarding dental fear, dental caries experience, dental treatment experience, temperament, and guardians’ dental anxiety, as well as the background characteristics of the children. Based on these data, factors associated with children’s cooperation during dental treatment were investigated. Dental fear, caries experience during the primary and mixed dentition stages, and temperament traits such as shyness and negative emotionality significantly impacted children’s cooperation during dental visits, with higher levels of these factors corresponding to lower cooperation. The extent of dental experience also modestly influenced children’ s cooperation, with higher levels of cooperation observed in children with greater dental experience. Additionally, children’s dental fear was strongly correlated with guardians’ dental anxiety, increasing as guardians’ anxiety levels increased. Twelve-year-old children exhibited significantly lower levels of dental fear compared to other age groups, and regardless of cooperation levels, injections (shots) were identified as the primary factor inducing dental fear among the children. To improve children’ s cooperation in pediatric dentistry, strategies should focus on alleviating their fears and adopting an individualized approach that consider their oral health status and temperamental traits.
10.Perception of Parents Regarding Specialized Pediatric Dentistry
Soomin LIM ; Kyunghi KIM ; Namki CHOI ; Seonmi KIM
Journal of Korean Academy of Pediatric Dentistry 2024;51(4):344-358
This study analyzed parents’ perceptions of pediatric dentistry and pediatric dental specialists, identified factors influencing their choice of dental practice for children, and compared perceptions between those with and without pediatric dentistry experience. A nationwide online survey (February 15 - 19, 2024) was conducted among 500 parents of children aged 15 years or younger: 170 from Seoul/Gyeonggi/ Incheon, 100 each from Chungcheong, Gyeongsang, Jeolla, and 30 from Gangwon. Data covered demographics, factors influencing dentist selection for children, awareness of pediatric dentists, and insights on whether parents had visited a pediatric dentist. 75.6% had visited a pediatric dental clinic, and 49.6% recognized pediatric dental specialists. Among visitors, 59.5% were aware of pediatric dental specialists, compared to 18.9% of non-visitors. Furthermore, 90.7% of parents aware of pediatric dental specialists had visited a clinic, versus 60.7% of those unaware. The highest visit rates were among parents with three children, especially aged 7 - 9. Awareness of pediatric dental specialists was highest among parents in their 20s, living in Gangwon, Seoul, Gyeonggi, and Incheon regions, with professional occupations and household monthly incomes of 7.5 - 8.5 million won. Parents with experience visiting pediatric dental clinics prioritized dentists’ expertise; those without experience prioritized short waiting times. Prior experience with pediatric dental clinics significantly increased the intention to revisit and reduced hesitation. Improving parents’ perceptions of pediatric dentists enhances decision-making and accessibility for children’s specialized dental care. Professional associations must raise awareness of pediatric dentistry. Pediatric dentists should prioritize expertise and advance their specializations in pediatric orthodontics.

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