Purpose: Due to its rarity, treatment guidelines for appendiceal cancer have traditionally followed those established for colorectal cancer, despite showing distinct histologic and clinical features. This study aimed to compare the clinicopathologic characteristics and long-term oncologic outcomes of appendiceal cancer with those of right-sided colon cancers. Methods: We retrospectively reviewed the records of patients with stage I–III appendiceal, cecal, or ascending colon cancer who underwent curative resection between 2010 and 2020 at our center. A 1:3:3 exact matching for age, sex, TNM stage, and adjuvant chemotherapy was performed. Survival outcomes were analyzed using the Kaplan-Meier and Cox regression methods. Results: Overall, 245 patients with appendiceal cancer (n = 35), ascending colon cancer (n = 105), and cecal cancer (n = 105) were analyzed. Appendiceal cancer exhibited a higher proportion of T4 tumors and fewer harvested lymph nodes compared with ascending or cecal cancers. The mean follow-up duration was 9.5 years. The 5- and 10-year overall survival rates were lower in appendiceal cancer (66.2% and 52.9%) than in ascending (91.2% and 78.4%) or cecal cancer (88.5% and 78.3%). Similarly, the 10-year disease-free survival rate was lower in appendiceal cancer (59.2%) compared with ascending (83.1%) and cecal cancers (78.4%). Cox regression analysis identified age (≥65 years), perforation, nodal metastasis, and lymphovascular invasion as independent predictors of poor prognosis. Conclusion Appendiceal cancer exhibited significantly worse long-term survival compared to cecal or ascending colon cancer. Tumor perforation, nodal metastasis, and lymphovascular invasion were adverse prognostic factors for overall and disease-free survival.

Purpose: Esophagojejunostomy leakage (EJL) continues to be a serious and potentially fatal complication following total gastrectomy for gastric cancer. This study aimed to evaluate the clinical outcomes of endoscopic Histoacryl (B. Braun) injection in comparison to alternative treatment strategies for EJL. Methods: Out of 885 patients who underwent total gastrectomy at a single institution between January 2003 and August 2023, 26 (2.9%) developed EJL. Patients were categorized into four groups according to the management received:conservative treatment (n = 5), endoscopic Histoacryl injection (n = 10), reoperation (n = 8), and combined therapy (n = 3).Outcomes assessed included postoperative hospital stay, duration to oral intake, treatment success rate, and mortality. Results: Of the 26 patients with EJL, 3 (11.5%) succumbed to sepsis: two in the reoperation group and 1 in the Histoacryl group. In the 23 successfully managed cases, the Histoacryl group achieved the shortest median postoperative hospital stay, the shortest time to resuming of oral intake, and a 90% success rate without any procedure-related complications.The reoperation group experienced increased morbidity and mortality. Stent migration was reported in one patient from the combined treatment group. Differences in recovery between the four groups reached statistical significance (P < 0.05). Conclusion Endoscopic Histoacryl injection represents a safe, effective, and minimally invasive modality for managing EJL, providing improved recovery times and reduced complication rates. It is beneficial both as a primary intervention and as part of combination therapy.

Purpose: Neoadjuvant chemotherapy (NAC) significantly revolutionized the management of locally advanced breast cancer, especially in human epidermal growth factor receptor 2 (HER2)-positive and triple-negative subtypes. However, its effectiveness is limited in estrogen receptor (ER)-positive, HER2-negative breast cancer. This study investigates the clinical response and prognosis of ER-positive, HER2-negative breast cancer after NAC. Methods: The clinicopathological characteristics and treatment responses of 149 patients with ER-positive, HER2-negative breast cancer treated with NAC and surgery at The Catholic University of Korea, Seoul St. Mary’s Hospital between 2018 and 2023 were retrospectively analyzed. Pathologic complete response (pCR) was defined as the absence of invasive tumors (ypT0/is, ypN0). Disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier methods, stratified by age (≤50 years vs. >50 years). Results: Among 149 patients, 13 (8.7%) achieved pCR, 87 (58.4%) attained partial responses, 40 (26.8%) had stable disease, and 9 (6.0%) experienced progressive disease. RECIST responses differed significantly by age (P = 0.003). DFS (P = 0.011) and OS (P = 0.005) were significantly associated with clinical response in patients aged ≤50 years. Post-NAC Ki-67 was associated with DFS (P = 0.013) but not OS (P = 0.083) in patients aged ≤50 years. Clinical responses and post-NAC Ki-67 were not associated with DFS (P = 0.544) or OS (P = 0.569) in patients aged >50 years. Conclusion In ER-positive, HER2-negative breast cancer, clinical responses and post-NAC Ki-67 were significant prognostic factors in patients aged ≤50 years but not in older patients. These findings highlight the need for tailored therapeutic approaches that consider age-specific prognostic differences.

Hypersensitivity reactions (HSRs) to iodinated contrast media (ICM) can range from mild cutaneous symptoms to life-threatening anaphylaxis. In patients with a history of ICM hypersensitivity, avoidance of the culprit agent is generally recommended. This case report describes a successful desensitization in a 56-year-old man with recurrent HSRs to multiple agents including ioversol, iohexol, iobitridol, and iopamidol. Intradermal testing was performed to identify potentially safe alternatives; however, all tested agents, including iohexol, ioversol, iobitridol, iopamidol, iodixanol, iomeprol, and iopromide, yielded positive results. Given the clinical necessity of transcatheter arterial chemoembolization, a 13-step rapid desensitization protocol with iodixanol was implemented. The procedure was completed without any breakthrough reactions. This case highlights desensitization as a feasible and effective strategy for patients with hypersensitivity to multiple ICM agents.

Vertebral artery (VA) occlusion is often managed conservatively, but anterior spinal artery (ASA) involvement may cause rapid neurological deterioration. We report two contrasting cases of VA occlusion with ASA compromise. One patient achieved complete recovery after timely endovascular treatment (EVT) restoring ASA flow, whereas the other developed severe bilateral medial medullary infarctions following unsuccessful EVT. These cases highlight the prognostic importance of ASA involvement and suggest that EVT should be considered when ASA perfusion is threatened.

Purpose: To evaluate the efficacy and safety of latanoprostene bunod 0.024% (LBN) in Korean patients with glaucoma or ocular hypertension in a real-world clinical setting. Methods: This retrospective study included patients who initiated LBN treatment between March 1, 2022, and December 31, 2024. Patients were categorized into monotherapy, switched therapy, and concomitant therapy groups. Changes in intraocular pressure (IOP) were assessed at baseline, month 1, and month 6 according to treatment group and diagnosis. The type and frequency of adverse events were also analyzed. Results: Among the 138 patients initially identified, 129 were included in the analysis. The mean IOP for all patients was 17.4 ± 4.9 mmHg at baseline, 16.0 ± 4.6 mmHg at month 1, and 14.6 ± 3.7 mmHg at month 6. The mean IOP reduction was -1.4 ± 2.8 mmHg at month 1 (p < 0.001) and -2.2 ± 3.3 mmHg at month 6 (p < 0.001). Subgroup analyses by treatment type (monotherapy, switched, and concomitant) and diagnosis revealed significant IOP reductions at both time points across all groups. Adverse events occurred in 22 patients (17.1%), with eye pain being the most frequent. No serious adverse events were observed, including systemic side effects, severe visual impairment, or significant ocular complications. Conclusions LBN significantly reduced IOP in Korean patients with glaucoma and ocular hypertension, irrespective of prior IOP-lowering medication use and was well tolerated with a favorable safety profile. These findings support the use of LBN as an effective treatment option for Korean patients with glaucoma or ocular hypertension in diverse clinical settings.

A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the devel opment of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.

Purpose: Cannabidiol (CBD) is a promising treatment option for pediatric drug-resistant epilepsy (DRE). The aim of this study was to assess the tolerability and safety of CBD in a single-center retrospective cohort based on real-world clinical experience. Methods: This study included 71 pediatric patients (median age, 8.9 years; interquartile range [IQR], 6.2 to 14.0) with Lennox–Gastaut syndrome who received purified CBD (Epidiolex, GW Pharmaceuticals) between March 2019 and July 2024. All patients had previously failed treatment with more than five anti-seizure medications (ASMs). Responder rate (≥50% seizure frequency reduction), retention rate, adverse effects (AEs), and predictors of favorable treatment response were analyzed over a median follow-up of 21.3 months (IQR, 2.8 to 38.5). Results: The initial responder rate during the first 3 months was 45.1%, which increased to 70.8% at 18 months and 63.0% at 24 months. The retention rate at 24 months was 52.4% (33/71). Seven patients (9.9%) achieved seizure freedom beyond 24 months of CBD therapy, and five of these patients were able to reduce their concomitant ASM burden. AEs were observed in 39.4% (28/71) of patients, with the most frequent being somnolence (20 cases) and increased seizure frequency (six cases); 92.9% of AEs occurred within the first 3 months of treatment. No serious AEs requiring treatment discontinuation were identified. Conclusion In this real-world study, CBD demonstrated potential as an adjunctive therapy with manageable AEs. These findings highlight that CBD can reduce seizure frequency while maintaining tolerability in pediatric patients with DRE.

Background: This study investigated the relationship between work-life balance (WLB), effort-reward imbalance (ERI), and presenteeism among Korean wageworkers through two models used simultaneously. Methods: Data from the 6th Korean Working Conditions Survey for 28,669 Korean workers, including 13,513 men and 15,156 women, were analyzed. All analyses were performed with pre-designed weight. Multiple logistic regression analysis was used to analyze the association between WLB, ERI, and presenteeism among Korean workers. The participants were classified into the following four groups: group 1, status of both WLB and ERI is “balanced”; group 2, WLB and ERI status are “imbalanced” and “balanced”, respectively; group 3, WLB and ERI status are “balanced” and “imbalanced”, respectively; group 4: status of both WLB and ERI is “imbalanced.” Results: We found that WLB and ERI were associated with presenteeism in both men and women. Depending on their WLB and ERI status, women generally had a higher tendency of presenteeism than men. Multiple logistic regression shows that, in most models and groups, there is an increased odds ratio (OR) for presenteeism in both men and women compared to the reference value. Moreover, the OR in both men and women gradually increased in groups 2, 3, and 4 compared with group 1. When considering both WLB and ERI status simultaneously, ERI had a greater impact on presenteeism than WLB. Furthermore, it was found that a synergistic effect of presenteeism manifests when both WLB and ERI are in a state of imbalance simultaneously. Conclusions Using the two models simultaneously, we found an association between WLB, ERI, and presenteeism according to sex with a synergistic effect among Korean workers. Our research suggests that active interventions targeting WLB and ERI are necessary to reduce presenteeism, which ultimately leads to decreased productivity.