Hepatocellular carcinoma (HCC) is the fifth most common cancer globally and the fourth most common cancer in men in Korea, where the prevalence of chronic hepatitis B infection is high in middle-aged and elderly patients. These practice guidelines will provide useful and constructive advice for the clinical management of patients with HCC. A total of 44 experts in hepatology, oncology, surgery, radiology and radiation oncology in the Korean Liver Cancer Association-National Cancer Center Korea Practice Guideline Revision Committee revised the 2014 Korean guidelines and developed new recommendations that integrate the most up-to-date research findings and expert opinions.

The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions. The primary targets of this guideline are patients with suspicious or newly diagnosed HCC. This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC.

Large quantities of microplastics are thought to be emitted to freshwater environments via wastewater treatment plants (WWTPs). To evaluate the occurrence of microplastics in Korean WWTPs, a nationwide study was conducted for the first time in 50 representative WWTPs with large treatment capacities. Grab sampling and laboratory filtration were used for influents, whereas in situ filtration using a custom-made sampling device was used for effluents. The filtrates were pretreated using wet peroxidation and density separation prior to the identification of microplastics with a dissection microscope and Fourier-transform infrared spectroscopy. Pooled analyses of the microplastics revealed that they were predominantly fragment-shaped, and thermoplastics and synthetic fibers were the dominant microplastic materials in WWTPs. The concentration ranged from 10 to 470 L–1 in influents and 0.004 to 0.51 L–1 in effluents. The removal efficiency of microplastics during wastewater treatment was calculated to be 98.7–99.99% in 31 WWTPs. Additionally, WWTPs using advanced phosphorus removal processes exhibited higher removal efficiency than those not implementing such processes. Power-law distribution was successful in describing microplastic particle sizes down to 100 μm, although it was not applicable for smaller particles. This comprehensive monitoring study provides information on the current level and characteristics of microplastics in WWTPs in Korea.

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Primary spinal cord melanoma is a rare central nervous system malignant tumor. Usually it resembles an intradural extramedullary (IDEM) nerve sheath tumor or melanoma. We experienced a patient with upper thoracic primary IDEM spinal cord melanoma who was diagnosed to be with hydrocephalus and without intracranial lesions. Initial symptoms of the patient were related to the hydrocephalus and the primary spinal cord melanoma was diagnosed eight months later. At the first operation, complete resection was impossible and the patient refused additional radiotherapy or chemotherapy. At 22 months after surgery, the patient revisited our institution with recurrent both leg weakness. Leptomeningeal dissemination was present in the whole spinal cord and only partial resection of tumor was performed. The symptoms slightly improved after surgery. Primary spinal cord melanoma is extremely rare but complete resection and additional radiotherapy or chemotherapy can prolong the disease free interval. Hydrocephalus or signs of increased intracranial pressure may be the diagnostic clue of spinal cord malignancy and progression.