Long coronavirus disease (COVID) is a condition in which coronavirus disease 2019 (COVID-19) symptoms persist for over 3 months, and currently poses a global public health challenge. Due to varying manifestations and lack of standardized definitions, diagnostic methods, and treatments, comprehensive clinical guidelines are required. This review article, summarizing research and expert consensus up to June 2023, provides recommendations for diagnosis and long-term management of long COVID symptoms. It emphasizes thorough patient evaluation, including medical history, physical examinations, and tests, and advocates vaccination and antiviral treatments to reduce risk. Guidelines for long COVID will be updated as new knowledge emerges.

This review examines the therapeutic potential of neuromodulation methods, including neurofeedback, transcranial direct current stimulation (tDCS), and transcranial magnetic stimulation (TMS), as non-pharmacological interventions for children with attentiondeficit/hyperactivity disorder (ADHD). A comprehensive review of current studies was conducted, focusing on each technique’s mechanism, application, and efficacy in managing ADHD symptoms and cognitive deficits. Studies included human participants with ADHD, evaluating changes in symptom severity and cognitive outcomes. Neurofeedback demonstrated efficacy in symptom reduction, particularly when combined with pharmacotherapy, yielding sustained improvements. tDCS showed moderate efficacy, especially in attention and impulsivity control; however, variability in protocols and pediatric response highlights the need for standardization. TMS exhibited mixed outcomes, with high-frequency TMS targeting the dorsolateral prefrontal cortex indicating potential cognitive benefits, though results were inconsistent across studies. Neuromodulation presents a promising complementary approach for ADHD treatment in children, potentially addressing limitations of pharmacotherapy. Future research should focus on optimizing stimulation parameters, increasing sample sizes, and refining methodologies to establish neuromodulation as part of standard ADHD treatment protocols.

Growth differentiation factor 15 (GDF-15), a cytokine within the transforming growth factor-β superfamily, is involved in various malignancies, withimplications in oral squamous cell carcinoma (OSCC). Elevated GDF-15 levels are correlated with unfavorable prognosis, tumor progression, and chemotherapy resistance, and the protein has been identified as a potential diagnostic and prognostic biomarker for OSCC. Personalized treatment strategies based on GDF-15 expression could improve treatment outcomes.

Chronic recurrent sialadenitis is characterized by repeated inflammation of the salivary glands, leading to ductal structural abnormalities and salivary stasis, often resulting in megaducts. This study evaluates the efficacy of ultrasonography as a diagnostic and follow-up tool for the management of chronic recurrent sialadenitis. Three patients underwent sialendoscopy, which involved ductal dilation, removal of mucous plugs, and steroid administration. Ultrasonography was used postoperatively to monitor changes in ductal structure, including megaduct size, and to assess clinical outcomes.All three cases showed marked improvement in clinical symptoms after treatment. Ultrasonography demonstrated a reduction in megaduct size and provided real-time visualization of ductal and glandular changes. Compared to traditional imaging methods such as magnetic resonance imaging or sialography, ultrasonography offered a practical and safe option for follow-up assessment. This study highlights the utility of ultrasonography as an accessible, non-invasive, and effective tool for evaluating treatment outcomes in chronic recurrent sialadenitis. By offering detailed visualization of ductal changes and facilitating longitudinal follow-up, ultrasonography can optimize the management of this condition.

In this paper, we systematically review the literature on papillary thyroid carcinoma (PTC) metastasis to the mandible. This is a rare oc-currence, especially in young, asymptomatic patients. We propose appropriate surgical and adjuvant therapy guidelines based on our findings. A systematic PubMed search (up to July 2023) identified 10 eligible cases of papillary or follicular thyroid carcinoma with metastasis to the mandible. Studies of patients with different histologic types or without confirmed distant metastasis were excluded. A rare case of PTC metastasizing to the mandible in a young male highlights an unusual presentation. Surgical treatment of both primary and metastatic sites, along with aggressive adjuvant therapy after surgery, had a positive impact on survival.

Background: Despite the critical importance of sleep medicine within neurology, notable gaps in education and clinical practice persist among neurologists. This study aims to explore the extent of involvement and the challenges faced by Korean neurologists in sleep medicine, focusing on awareness of polysomnography training program, the operation of sleep study facilities, and educational exposure. Methods: An online survey collected responses from 233 neurologists, focusing on their demographics, knowledge of and involvement in sleep medicine, operation of sleep study facilities, and participation in residency training. Results: The findings indicated that 84.9% of neurologists were aware of polysomnography training program, primarily through professional societies. Nonetheless, 15.1% reported unfamiliarity with these initiatives, with 72.7% of this subgroup expressing interest in sleep medicine yet lacking access to information. In terms of clinical practice, 74 neurologists operated sleep study facilities, with 63% intending to expand. Key operational challenges included staff management, maintaining patient volumes, and inadequate institutional support. Among respondents from teaching hospitals, only 36 out of 114 reported active resident involvement in sleep study interpretations, predominantly hindered by excessive workloads and insufficient staffing. Conclusions A significant number of neurologists have an interest in sleep medicine; however, substantial challenges impede effective education and clinical practice. These results underscore the need for improved educational resources and institutional support to enhance the growth and effectiveness of sleep medicine practices among neurologists.

Neuronal intranuclear inclusion disease (NIID) is a rare neurodegenerative disorder characterized by the presence of eosinophilic nuclear inclusions in neurons and somatic cells. It clinically manifests as cognitive decline, seizures, and autonomic dysfunction. A 44-year-old man presented with a transient visual field defect and hemiparesis. Based on characteristic imaging findings and pathological findings, NIID was suspected and diagnosed through genetic testing. This case emphasizes the importance of comprehensive clinical phenotype analysis and accurate genetic diagnosis.

Purpose: Conjunctival incisional surgery is a known risk factor for trabeculectomy failure. The occurrence of avascular bleb following failed ab interno XEN stent implantation has been documented in patients undergoing trabeculectomy with mitomycin C (MMC). However, reports on same quadrant trabeculectomy with MMC after failed ab externo open conjunctiva XEN stent implantation are scarce. This study sought to document the 1-year clinical outcomes and bleb morphology following this procedure.Case summary: This retrospective study reviewed the medical records of 4 eyes from 4 patients who received trabeculectomy with MMC in the same quadrant following ab externo open conjunctiva XEN stent implantation failure. At 1 year after trabeculectomy, the intraocular pressure was successfully controlled without glaucoma medication, and no visual field progression was observed. Anterior segment tomography indicated that the blebs were elevated and broad, with a suprascleral fluid-filled space evident in all eyes. There were no instances of prolonged hypotony or bleb leakage one year after the trabeculectomy, although an avascular bleb was observed in one eye. Conclusions Performing trabeculectomy with MMC in the same quadrant appears to be an effective method for reducing IOP after the failure of ab externo open conjunctiva XEN stent implantation.

Purpose: To investigate the impact of nasal septal deviation and septoplasty on dacryocystorhinostomy progression. Methods: From March 2015 to January 2022, we reviewed the medical records of primary acquired nasolacrimal duct obstruction (PANDO) patients who underwent dacryocystorhinostomy at Konyang University Hospital. Patients were categorized into groups: those without septal deviation (group 1), those with septal deviation on the same side as the surgical site (group 2), and those with septal deviation on the opposite side (group 3). Septoplasty was performed in cases of symptomatic septal deviation on the same side. We assessed whether the presence, type, and correction of septal deviation influenced the postoperative outcome of dacryocystorhinostomy. Results: The study included 204 patients: 94 in group 1, 60 in group 2, and 50 in group 3. No significant differences were observed in the type, degree of nasal septum deviation, surgery duration, success rate, and symptom improvement period across the groups. When group 2 was subdivided into those who did not undergo septoplasty (group 2A) and those who did (group 2B), no differences were noted. Conclusions Nasal septum deviation and septoplasty did not influence the outcomes of dacryocystorhinostomy. Septoplasty may be unnecessary for PANDO patients without symptomatic nasal septum deviation.

Objective: Acute coronary syndrome often requires urgent intervention. The 2023 European Society of Cardiology guidelines recommend invasive procedures within 24 hours for high-risk cases. Nevertheless, there have been limited studies on non-ST-segment elevation myocardial infarction (NSTEMI) in South Korea. This study compared the risk of complications based on the timing of intervention. Methods: A retrospective observational study was conducted on patients with chest pain and elevated high-sensitivity troponin T from January to December 2021 in the emergency department. Patients were categorized into early (≤24 hr) and late (>24 hr) intervention groups. Primary outcomes (death, restenosis, or stroke) at 12 months were compared. Survival and subgroup analyses were performed to examine the factors affecting the outcomes in the two groups. Results: Three hundred seventy six patients were enrolled in the study, and 115 patients were excluded. Among 261 patients, 106 and 155 patients were in the early intervention group (≤24 hr), and late intervention group (>24 hr), respectively. The primary outcome (death or restenosis) showed no significant difference (hazard ratio [HR] in the early intervention group at 12 mo; 1.03; 95% confidence interval [CI], 0.63-1.70; P=0.905). However, risk of stroke was lower in the early intervention group (HR in the early, 0.08; 95% CI, 0.00-0.66; P=0.013). Subgroup analysis showed no significant advantage for early intervention. Conclusion In NSTEMI patients, early intervention does not reduce death or restenosis but lowers stroke incidence. No specific risk factors favored early intervention.