Background and Objectives: The sense of taste has a crucial role in maintaining good health, and this is why taste disturbance can negatively impact one’s quality of life. The purpose of this study was to investigate the etiologies, clinical characteristics, and effects of treatment in patients with taste disturbances.Subjects and Method A total of 160 patients with taste disorders, who visited our Smell and Taste Clinic from January 2021 to December 2022, were enrolled. All patients underwent chemical and electrical taste threshold tests, olfactory function tests, questionnaires including medical and dental history, and blood tests. The etiologies and clinical features of taste disorders were assessed and treatment was directed toward causative abnormalities. Factors affecting the improvement rates after treatment were evaluated. Results: Taste disorder due to olfactory disorder was the most frequent etiology, followed by laryngopharyngeal reflux, head trauma, and drug-induced. In many cases, there was a discrepancy in the severity of taste between the complaints reported by patients and the results of taste threshold tests. After treatment, 115 patients showed improvement in their taste function, and the improvement rates were significantly correlated with the age and etiologies of the taste disorders. Conclusion Careful history taking and accurate chemosensory testing were essential to establish the etiologies, nature, degree, and veracity of a patient’s complaint of taste disturbance. Appropriate treatments according to the etiologies allowed recovery of taste function in 71.9% of patients.

Objective: The objective of this study is to evaluate the feasibility and safety of renal artery embolization (RAE) via transradial access (TRA) in patients with renal angiomyolipoma (AML) or renal hemorrhage. Materials and Methods: Data were collected for this prospective single-center study from 50 patients (51 ± 12 years; male:female, 11:39) who underwent RAE for renal AML (n = 46) or renal hemorrhage (n = 4) between November 2020 and January 2024. Patients with a Barbeau D waveform or a radial artery diameter of <1.5 mm were excluded. Technical success in patients with renal AML and renal hemorrhage was defined as achieving selective catheterization of the culprit artery with embolization, leading to flow stasis and the absence of bleeding evidence, respectively. Clinical success was indicated by a reduction in AML size on follow-up CT scans and the absence of bleeding signs without necessitating additional RAE. The EuroQol 5-Dimension 5-level (EQ-5D-5L) questionnaire was utilized to assess health-related quality of life (HRQoL). Results: In one patient with AML, embolization could not be performed following selective catheterization and angiography due to the lack of visible tumor vascularity, resulting in a technical success rate of 98% (49/50). The clinical success rate was 96% (48/50 patients). No instances of TRA failure, conversion to transfemoral access (TFA), or hemostasis failure were noted.During the follow-up period, no major adverse events associated with the RAE occurred. Two patients exhibited asymptomatic radial artery occlusion, and one patient displayed asymptomatic partial thrombosis of the renal artery at the first follow-up visit. The EQ-5D-5L scores were 0.90 (95% confidence interval [CI]: 0.86–0.95) within 24 hours post-procedure and 0.89 (95% CI: 0.85–0.92) at the first follow-up (P = 0.332). Conclusion TRA is a feasible and safe approach for performing RAE in patients with renal AML or hemorrhage. RAE performed using TRA demonstrated high HRQoL outcomes and may serve as a viable alternative to TFA for performing RAE.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Background: Epidermal growth factor receptor (EGFR) gene mutation testing is crucial for the administration of tyrosine kinase inhibitors to treat non–small cell lung cancer. In addition to traditional tissue-based tests, liquid biopsies using plasma are increasingly utilized, particularly for detecting T790M mutations. This study compared tissue- and plasma-based EGFR testing methods. Methods: A total of 248 patients were tested for EGFR mutations using tissue and plasma samples from 2018 to 2023 at Pusan National University Yangsan Hospital. Tissue tests were performed using PANAmutyper, and plasma tests were performed using the Cobas EGFR Mutation Test v2. Results: All 248 patients underwent tissue-based EGFR testing, and 245 (98.8%) showed positive results. Of the 408 plasma tests, 237 (58.1%) were positive. For the T790M mutation, tissue biopsies were performed 87 times in 69 patients, and 30 positive cases (38.6%) were detected. Plasma testing for the T790M mutation was conducted 333 times in 207 patients, yielding 62 positive results (18.6%). Of these, 57 (27.5%) were confirmed to have the mutation via plasma testing. Combined tissue and plasma tests for the T790M mutation were positive in nine patients (13.4%), while 17 (25.4%) were positive in tissue only and 12 (17.9%) in plasma only. This mutation was not detected in 28 patients (43.3%). Conclusions Although the tissue- and plasma-based tests showed a sensitivity of 37.3% and 32.8%, respectively, combined testing increased the detection rate to 56.7%. Thus, neither test demonstrated superiority, rather, they were complementary.

Background: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Background/Aims: We previously reported that patients with moderate-to-severe ulcerative colitis (UC) often experience common mental disorders (CMDs) such as anxiety and depression, necessitating immediate psychological interventions within the first 4 weeks of diagnosis. In this 3-year follow-up study of the MOSAIK cohort in Korea, we examined the effects of CMDs at initial diagnosis on clinical outcomes and health-related quality of life (HRQoL). Methods: We examined differences in clinical outcomes (evaluated based on clinical response, relapse, hospitalization, and medication use) and HRQoL (assessed using the Inflammatory Bowel Disease Questionnaire [IBDQ] and Short Form 12 [SF-12]) according to Hospital Anxiety and Depression Scale (HADS) scores at diagnosis. Results: In a study involving 199 UC patients, 47.7% exhibited significant psychological distress (anxiety and/or depression) at diagnosis. Clinical follow-up showed no major differences in outcomes, including remission rates, response rates, or hospitalization rates, between patients with anxiety or depression at diagnosis and patients without anxiety or depression at diagnosis. The HRQoL at the end of follow-up was notably lower in those with baseline CMDs, particularly anxiety, across all domains of the IBDQ and SF-12. Linear mixed-effect models revealed that higher HADS scores, as well as higher Mayo scores, were independently associated with lower IBDQ scores and both summary domains of the SF-12. Additionally, regular attendance at follow-up visits during the study period was also related to improvements in HRQoL (all p<0.05). Conclusions While CMDs present at the time of UC diagnosis did not influence long-term clinical outcomes, they persistently impaired HRQoL. Our findings support the routine incorporation of psychological interventions into the long-term management of moderate-to-severe UC.

Background/Aims: The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H.pylori infection in Korea. Methods: This interim report describes the adherence to the revised guidelines and their impact on firstline eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form. Results: A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed.The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001). Conclusions The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.

Ancient DNA (aDNA) analysis has developed rapidly since it first emerged in the 1980s, becoming an almost indispensable tool in anthropological and archaeological sciences. Earlier aDNA study was based on the polymerase chain reaction (PCR) technique, with which, unfortunately, modern DNA contamination and other authenticity issues were often incurred. These technical hurdles were soon overcome by application of advancements in the forms of the next generation sequencing (NGS) technique and others. However, since NGS requires money, time, and, in the case of large projects, manpower as well, genetic analysis of some ancient samples considered to be insignificant is commonly delayed or, in the worst cases, neglected entirely. We acknowledge that as a diagnostic tool in aDNA analysis, PCR is less accurate than NGS and more easily affected by modern DNA contamination; but it also has advantages, such as simplicity, time-saving, and greater ease of interpretation, among others. The role of PCR in aDNA analysis, then, should be reconsidered.

Purpose: This study aims to evaluate the treatment approaches and locoregional patterns for adenoid cystic carcinoma (ACC) in the breast, which is an uncommon malignant tumor with limited clinical data. Materials and Methods: A total of 93 patients diagnosed with primary ACC in the breast between 1992 and 2022 were collected from multi-institutions. All patients underwent surgical resection, including breast-conserving surgery (BCS) or total mastectomy (TM). Recurrence patterns and locoregional recurrence-free survival (LRFS) were assessed. Results: Seventy-five patients (80.7%) underwent BCS, and 71 of them (94.7%) received post-operative radiation therapy (PORT). Eighteen patients (19.3%) underwent TM, with five of them (27.8%) also receiving PORT. With a median follow-up of 50 months, the LRFS rate was 84.2% at 5 years. Local recurrence (LR) was observed in five patients (5.4%) and four cases (80%) of the LR occurred in the tumor bed. Three of LR (3/75, 4.0%) had a history of BCS and PORT, meanwhile, two of LR (2/18, 11.1%) had a history of mastectomy. Regional recurrence occurred in two patients (2.2%), and both cases had a history of PORT with (n=1) and without (n=1) irradiation of the regional lymph nodes. Partial breast irradiation (p=0.35), BCS (p=0.96) and PORT in BCS group (p=0.33) had no significant association with LRFS. Conclusion BCS followed by PORT was the predominant treatment approach for ACC of the breast and LR mostly occurred in the tumor bed. The findings of this study suggest that partial breast irradiation might be considered for PORT in primary breast ACC.

Background and Objectives: The sense of taste has a crucial role in maintaining good health, and this is why taste disturbance can negatively impact one’s quality of life. The purpose of this study was to investigate the etiologies, clinical characteristics, and effects of treatment in patients with taste disturbances.Subjects and Method A total of 160 patients with taste disorders, who visited our Smell and Taste Clinic from January 2021 to December 2022, were enrolled. All patients underwent chemical and electrical taste threshold tests, olfactory function tests, questionnaires including medical and dental history, and blood tests. The etiologies and clinical features of taste disorders were assessed and treatment was directed toward causative abnormalities. Factors affecting the improvement rates after treatment were evaluated. Results: Taste disorder due to olfactory disorder was the most frequent etiology, followed by laryngopharyngeal reflux, head trauma, and drug-induced. In many cases, there was a discrepancy in the severity of taste between the complaints reported by patients and the results of taste threshold tests. After treatment, 115 patients showed improvement in their taste function, and the improvement rates were significantly correlated with the age and etiologies of the taste disorders. Conclusion Careful history taking and accurate chemosensory testing were essential to establish the etiologies, nature, degree, and veracity of a patient’s complaint of taste disturbance. Appropriate treatments according to the etiologies allowed recovery of taste function in 71.9% of patients.