Background: Circulating tumor DNA (ctDNA) is a potential biomarker in pancreatic ductal adenocarcinoma (PDAC). However, studies on residual ctDNA in patients post-chemotherapy are limited. We assessed the prognostic value of residual ctDNA in metastatic PDAC relative to that of carbohydrate antigen 19-9 (CA19-9). Methods: ctDNA analysis using a targeted next-generation sequencing panel was performed at baseline and during chemotherapy response evaluation in 53 patients. Progression-free survival (PFS) and overall survival (OS) were first evaluated based on ctDNA positivity at baseline. For further comparison, patients testing ctDNA-positive at baseline were subdivided based on residual ctDNA into ctDNA responders (no residual ctDNA post-chemotherapy) and ctDNA non-responders (residual ctDNA post-chemotherapy). Additional survival analysis was performed based on CA19-9 levels. Results: The baseline ctDNA detection rate was 56.6%. Although clinical outcomes tended to be poorer in patients with baseline ctDNA positivity than in those without, the differences were not significant. Residual ctDNA post-chemotherapy was associated with reduced PFS and OS. The prognosis of ctDNA responders was better than that of non-responders but did not significantly differ from that of ctDNA-negative individuals (no ctDNA both at baseline and during post-chemotherapy). Compared with ctDNA responses to che-motherapy, a ≥ 50% decrease in the CA19-9 level had less effect on both PFS and OSbased on hazard ratios and significance levels. ctDNA could be monitored in half of the patients whose baseline CA19-9 levels were within the reference range. Conclusions Residual ctDNA analysis post-chemotherapy is a promising approach for predicting the clinical outcomes of patients with metastatic PDAC.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Recently, reports of noise-induced hearing loss (NIHL) have sharply risen among workers in South Korea, almost 20-fold in 2022, compared to 2012. This is presumably because NIHL is combined with age-related hearing loss. For the correct diagnosis of NIHL, therefore, the effect of aging that contributes to threshold shifts is should be excluded, and that would require scrutinizing of various established methods. Additionally, international and domestic data from large cross-sectional studies may provide new insights in excluding the effect of age-related hearing loss in individuals in which threshold shifts occurred. This paper comprises the recommendations for the diagnosis and quantification of NIHL in a medico-legal context.

Background and Objectives: Cognitive behavioral therapy (CBT) is a treatment option for subjective tinnitus. There are many reports on its clinical efficacy, but the protocol has not been well established. The purpose of this study was to set an outpatient-based CBT protocol and evaluate its clinical efficacy for tinnitus.Subjects and Method A total of 85 chronic tinnitus patients was assessed in this prospective study. After evaluating for eligibility, 30 patients completed CBT based on a protocol of 5 weekly sessions in an outpatient setting. Therapeutic efficacy was assessed by Tinnitus Handicap Inventory (THI) questionnaires and visual analogue scale (VAS) for tinnitus. The initial scores were compared with the final scores, which were assessed a month after the fifth CBT session. Results: The results showed that CBT reduced THI and VAS scores significantly (p<0.05). Conclusion The results of the study suggest that an outpatient-based CBT protocol can be clinically beneficial for patients with tinnitus.

In rare cases, antiresoprtive medications for osteoporosis cause osteonecrosis. Necrotic bone lesions localized at the jaw after the use of antiresorptive medications is named medicationrelated osteonecrosis of the jaw (MRONJ). Although some cases with MRONJ affect the paranasal sinus, inferior turbinate necrosis have not been reported in South Korea yet. Here, we report a case of inferior turbinate osteonecrosis that developed after denosumab had been used.