Purpose: This network meta-analysis aimed to evaluate the relative efficacy of systemic treatments in patients with relapsed/refractory chronic lymphocytic leukemia (R/R CLL), focusing on key genetic mutations, specifically the 17p deletion and TP53 mutations. Methods: We conducted a systematic literature review to identify all publicly available randomized controlled trials (RCTs) using PubMed, EMBASE, the Cochrane database, and meeting abstracts published through December 2023.A Bayesian network meta-analysis was performed to estimate the hazard ratios (HRs) for progression-free survival (PFS) with 95% confidence intervals (CIs) and to determine the ranking of the included regimens. Results: Twelve trials involving 4,437 patients and 13 treatment options were included in the meta-analysis. Venetoclax plus rituximab and zanubrutinib emerged as the most effective treatments for the overall R/R CLL population, showing the lowest PFS HR (HR 0.62, 95% CI 0.32–1.20 and HR 0.65, 95% CI 0.49–0.86, respectively) versus ibrutinib, and were ranked as the best agent (surface under the cumulative ranking curve [SUCRA] value of both 90%, respectively) among the included drugs. In the 17p deletion/TP53 mutation subgroup, zanubrutinib demonstrated the most favorable efficacy (HR 0.52, 95% CI 0.31–0.88 versus ibrutinib) with the highest SUCRA value (97%). In patients without these mutations, venetoclax plus rituximab was the most effective (HR 0.49, 95% CI 0.26–0.94 versus ibrutinib) with a SUCRA value of 94%. Conclusion Our findings highlight the superior efficacy of venetoclax plus rituximab and zanubrutinib for treating R/R CLL and confirm that the role of each regimen may vary depending on the clinically significant mutations.

Correspondence to editorial on “Optimal cutoffs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis”

HIV/AIDS control in Korea characterized with “AIDS Prevention Law”, enacted in 1987. It was one of the first separate legal enforcement around the world that governs control of the HIV/AIDS epidemic. Yet with significant limitations regarding human rights, as it criminalized HIV infection, and dictates penal action against ‘transmitters’. This papers looks into how HIV/AIDS epidemic started in Korea in 1980s, with specific focus on disease narrative that was constructed by the government. It was known to United States Forces Korea, that HIV was already spreading steady into Korean female sex workers around U.S. military bases in 1985. This information was concealed by Korean Ministry of health, in the face of upcoming international events such as 1988 Seoul Olympics. Instead, the Korean government turned public attention to ‘imported’ cases, constructing narrative that HIV/AIDS as a foreign disease. With direction of president, HIV/AIDS control focus on compulsory testing and isolation of identified risk group of sexual minorities and sex workers around U.S. military bases. This narrative of foreign disease had lasting impact even after democratization of Korea in 1987, as civil society, unaware that HIV/AIDS had already became endemic in Korea, argued to enforced compulsory testing against foreign nationals upon entry. This paper argues that disease narratives were carefully constructed by the government during early phase of HIV/AIDS epidemic in Korea, and used legal structure as ways to conceal the actual prevalence from both domestic and international attention.

Cardiovascular-kidney-metabolic (CKM) syndrome is a progressive disorder resulting from the complex interaction between metabolic risk factors, chronic kidney disease, and cardiovascular disease (CVD), leading to multi-organ dysfunction. Given the increasing prevalence of metabolic syndrome, obesity, hypertension, dyslipidemia, and diabetes, a comprehensive approach to risk stratification and management is essential. The American Heart Association introduced the CKM staging system to classify disease progression and identify early intervention opportunities. Additionally, the predicting risk of cardiovascular disease EVENTs (PREVENT) equation was developed to enhance cardiovascular risk prediction by incorporating metabolic risk factors, estimated glomerular filtration rate, albuminuria, glycated hemoglobin (HbA1c), and social determinants of health. Unlike traditional risk models, PREVENT enables 10-year and 30-year risk prediction of both CVD and heart failure in individuals aged 30 to 79 years and integrates the social deprivation index for a more equitable and individualized risk assessment. However, as PREVENT is derived from United States population data, its applicability to Asian populations, including Koreans, remains uncertain. Developing a region-specific risk prediction model using local cohort data is crucial for optimizing CKM syndrome management. Furthermore, effective prevention and treatment require a multidisciplinary approach involving nephrologists, cardiologists, endocrinologists, dietitians, and social workers. Implementing CKM staging and PREVENT in clinical practice can facilitate early risk identification and personalized interventions, ultimately improving cardiovascular and renal health outcomes.

Fournier gangrene (FG) is a rare life-threatening infection j that can occasionally extend beyond the perineum into the retroperitoneal space. Preperitoneal involvement in female patients is extremely rare. We report a unique case of a 59-year-old female with FG, characterized by atypical preperitoneal extension. Despite initial treatment failure, the patient recovered following emergency debridement, and targeted antibiotic therapy. This case underscores the importance of early diagnosis, timely surgical intervention, and multidisciplinary care in managing atypical FG presentations in female patients. It emphasizes the need for prompt and aggressive management to improve survival in these rare instances.

Purpose: This network meta-analysis aimed to evaluate the relative efficacy of systemic treatments in patients with relapsed/refractory chronic lymphocytic leukemia (R/R CLL), focusing on key genetic mutations, specifically the 17p deletion and TP53 mutations. Methods: We conducted a systematic literature review to identify all publicly available randomized controlled trials (RCTs) using PubMed, EMBASE, the Cochrane database, and meeting abstracts published through December 2023.A Bayesian network meta-analysis was performed to estimate the hazard ratios (HRs) for progression-free survival (PFS) with 95% confidence intervals (CIs) and to determine the ranking of the included regimens. Results: Twelve trials involving 4,437 patients and 13 treatment options were included in the meta-analysis. Venetoclax plus rituximab and zanubrutinib emerged as the most effective treatments for the overall R/R CLL population, showing the lowest PFS HR (HR 0.62, 95% CI 0.32–1.20 and HR 0.65, 95% CI 0.49–0.86, respectively) versus ibrutinib, and were ranked as the best agent (surface under the cumulative ranking curve [SUCRA] value of both 90%, respectively) among the included drugs. In the 17p deletion/TP53 mutation subgroup, zanubrutinib demonstrated the most favorable efficacy (HR 0.52, 95% CI 0.31–0.88 versus ibrutinib) with the highest SUCRA value (97%). In patients without these mutations, venetoclax plus rituximab was the most effective (HR 0.49, 95% CI 0.26–0.94 versus ibrutinib) with a SUCRA value of 94%. Conclusion Our findings highlight the superior efficacy of venetoclax plus rituximab and zanubrutinib for treating R/R CLL and confirm that the role of each regimen may vary depending on the clinically significant mutations.

Correspondence to editorial on “Optimal cutoffs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis”

HIV/AIDS control in Korea characterized with “AIDS Prevention Law”, enacted in 1987. It was one of the first separate legal enforcement around the world that governs control of the HIV/AIDS epidemic. Yet with significant limitations regarding human rights, as it criminalized HIV infection, and dictates penal action against ‘transmitters’. This papers looks into how HIV/AIDS epidemic started in Korea in 1980s, with specific focus on disease narrative that was constructed by the government. It was known to United States Forces Korea, that HIV was already spreading steady into Korean female sex workers around U.S. military bases in 1985. This information was concealed by Korean Ministry of health, in the face of upcoming international events such as 1988 Seoul Olympics. Instead, the Korean government turned public attention to ‘imported’ cases, constructing narrative that HIV/AIDS as a foreign disease. With direction of president, HIV/AIDS control focus on compulsory testing and isolation of identified risk group of sexual minorities and sex workers around U.S. military bases. This narrative of foreign disease had lasting impact even after democratization of Korea in 1987, as civil society, unaware that HIV/AIDS had already became endemic in Korea, argued to enforced compulsory testing against foreign nationals upon entry. This paper argues that disease narratives were carefully constructed by the government during early phase of HIV/AIDS epidemic in Korea, and used legal structure as ways to conceal the actual prevalence from both domestic and international attention.

Cardiovascular-kidney-metabolic (CKM) syndrome is a progressive disorder resulting from the complex interaction between metabolic risk factors, chronic kidney disease, and cardiovascular disease (CVD), leading to multi-organ dysfunction. Given the increasing prevalence of metabolic syndrome, obesity, hypertension, dyslipidemia, and diabetes, a comprehensive approach to risk stratification and management is essential. The American Heart Association introduced the CKM staging system to classify disease progression and identify early intervention opportunities. Additionally, the predicting risk of cardiovascular disease EVENTs (PREVENT) equation was developed to enhance cardiovascular risk prediction by incorporating metabolic risk factors, estimated glomerular filtration rate, albuminuria, glycated hemoglobin (HbA1c), and social determinants of health. Unlike traditional risk models, PREVENT enables 10-year and 30-year risk prediction of both CVD and heart failure in individuals aged 30 to 79 years and integrates the social deprivation index for a more equitable and individualized risk assessment. However, as PREVENT is derived from United States population data, its applicability to Asian populations, including Koreans, remains uncertain. Developing a region-specific risk prediction model using local cohort data is crucial for optimizing CKM syndrome management. Furthermore, effective prevention and treatment require a multidisciplinary approach involving nephrologists, cardiologists, endocrinologists, dietitians, and social workers. Implementing CKM staging and PREVENT in clinical practice can facilitate early risk identification and personalized interventions, ultimately improving cardiovascular and renal health outcomes.

Purpose: To examine the factors impacting cone contrast sensitivity in Koreans aged > 60 years who are scheduled for cataract surgery and do not have congenital color vision deficiencies. Methods: The ColorDx Cone contrast test HD® (CCT-HD; Konan Medical, Inc., CA, USA) was administered to 33 Korean individuals (33 eyes) to evaluate CCT scores before and after cataract surgery, as well as changes in CCT scores according to the degree of progression by cataract type. Correlations between CCT scores and age, best corrected visual acuity (BCVA), regional retinal thickness, and length of the photoreceptor outer segment (PROS) at the fovea were analyzed in pseudophakic eyes. Results: Average scores for short-, medium-, and long-wavelength cone contrast sensitivity tests (S-CCT, M-CCT, and L-CCT, respectively) improved after surgery (p = 0.010, p = 0.001, and p = 0.028, respectively). Comparing CCT score changes before and after surgery by cataract progression, higher cataract grades were associated with greater CCT score changes, though the differences were not statistically significant (p > 0.05). In pseudophakic eyes, S-CCT scores negatively correlated with age (p = 0.017). No significant correlations were found between S-CCT, M-CCT, and L-CCT scores and BCVA, whereas S-CCT, M-CCT, and L-CCT scores positively correlated with PROS at the fovea (p < 0.001). Conclusions Cone contrast sensitivity in individuals aged > 60 years is influenced by age and cataract status and may serve as a valuable indicator of visual function in clinical research.