Biliary tract cancer (BTC) is a rare but highly aggressive malignancy that includes intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma, and gallbladder cancer (GBC). While BTC has a low global incidence, its regional variations are notable. Among nations, Korea has the second-highest incidence of BTC globally, with the highest mortality rate worldwide, underscoring the need for a deeper understanding of this cancer. Liver fluke infection and hepatitis B virus infection are key risk factors unique to Korea, contributing to regional differences in BTC incidence. Additionally, genomic alterations in Korean patients with BTC differ from those in other populations, including lower frequencies of IDH1 mutations and FGFR2 fusions in ICC and a higher prevalence of ERBB2 amplification in GBC. Recognizing the clinical significance of these alterations, ivosidenib and pemigatinib have been approved in Korea for BTC patients with IDH1 mutations and FGFR2 fusions, respectively. This review explores the epidemiology, risk factors, and molecular features of BTC, along with corresponding targeted therapies. Furthermore, we compare the unique characteristics of BTC in Korea with global data to inform future research and clinical practice.

Biliary tract cancer (BTC) is a rare but highly aggressive malignancy that includes intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma, and gallbladder cancer (GBC). While BTC has a low global incidence, its regional variations are notable. Among nations, Korea has the second-highest incidence of BTC globally, with the highest mortality rate worldwide, underscoring the need for a deeper understanding of this cancer. Liver fluke infection and hepatitis B virus infection are key risk factors unique to Korea, contributing to regional differences in BTC incidence. Additionally, genomic alterations in Korean patients with BTC differ from those in other populations, including lower frequencies of IDH1 mutations and FGFR2 fusions in ICC and a higher prevalence of ERBB2 amplification in GBC. Recognizing the clinical significance of these alterations, ivosidenib and pemigatinib have been approved in Korea for BTC patients with IDH1 mutations and FGFR2 fusions, respectively. This review explores the epidemiology, risk factors, and molecular features of BTC, along with corresponding targeted therapies. Furthermore, we compare the unique characteristics of BTC in Korea with global data to inform future research and clinical practice.

Biliary tract cancer (BTC) is a rare but highly aggressive malignancy that includes intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma, and gallbladder cancer (GBC). While BTC has a low global incidence, its regional variations are notable. Among nations, Korea has the second-highest incidence of BTC globally, with the highest mortality rate worldwide, underscoring the need for a deeper understanding of this cancer. Liver fluke infection and hepatitis B virus infection are key risk factors unique to Korea, contributing to regional differences in BTC incidence. Additionally, genomic alterations in Korean patients with BTC differ from those in other populations, including lower frequencies of IDH1 mutations and FGFR2 fusions in ICC and a higher prevalence of ERBB2 amplification in GBC. Recognizing the clinical significance of these alterations, ivosidenib and pemigatinib have been approved in Korea for BTC patients with IDH1 mutations and FGFR2 fusions, respectively. This review explores the epidemiology, risk factors, and molecular features of BTC, along with corresponding targeted therapies. Furthermore, we compare the unique characteristics of BTC in Korea with global data to inform future research and clinical practice.

Objectives: This study aimed to investigate the association between self-reported sleep and cognitive function in individuals with mild cognitive impairment (MCI) to understand potential implications for Alzheimer’s disease prevention. Methods: This retrospective cohort study included 80 patients with MCI and 70 controls. Participants completed standardized questionnaires to assess self-reported sleep quality (Korean version of the Pittsburgh Sleep Quality Index [PSQI-K]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and insomnia severity (Insomnia Severity Index [ISI]). Cognitive function was evaluated using the Seoul Neuropsychological Test and the Korean version of the Mini-Mental State Examination. The Korea Instrumental Activities of Daily Living Scale was used to assess instrumental activities of daily living. Correlation analyses examined the relationship between sleep-related parameters and cognitive function. Results: The results indicated no significant differences in PSQI-K and ESS scores between patients with MCI and the control group. Correlation analyses revealed that poorer sleep quality was associated with reduced frontal and executive functions in patients with MCI, particularly in tests such as Controlled Oral Word Association Test (supermarket, -0.311, p<0.001) and Trail Making Test (TMT) B (0.232, p<0.001). Additionally, daytime dysfunction was associated with poorer cognitive performance across language and executive domains (e.g., Korean Boston Naming Test: -0.290, p<0.001; TMTA: 0.248, p<0.001). In both groups, ISI scores were linked to cognitive functions, particularly in attention, phonemic fluency, and executive function (e.g., digit span, backward: -0.225, p<0.01; TMTA: 0.327, p<0.01). Conclusions These findings suggest that sleep disturbances significantly impact cognitive function and daily living abilities in patients with MCI.

Objectives: This study aimed to investigate the association between self-reported sleep and cognitive function in individuals with mild cognitive impairment (MCI) to understand potential implications for Alzheimer’s disease prevention. Methods: This retrospective cohort study included 80 patients with MCI and 70 controls. Participants completed standardized questionnaires to assess self-reported sleep quality (Korean version of the Pittsburgh Sleep Quality Index [PSQI-K]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and insomnia severity (Insomnia Severity Index [ISI]). Cognitive function was evaluated using the Seoul Neuropsychological Test and the Korean version of the Mini-Mental State Examination. The Korea Instrumental Activities of Daily Living Scale was used to assess instrumental activities of daily living. Correlation analyses examined the relationship between sleep-related parameters and cognitive function. Results: The results indicated no significant differences in PSQI-K and ESS scores between patients with MCI and the control group. Correlation analyses revealed that poorer sleep quality was associated with reduced frontal and executive functions in patients with MCI, particularly in tests such as Controlled Oral Word Association Test (supermarket, -0.311, p<0.001) and Trail Making Test (TMT) B (0.232, p<0.001). Additionally, daytime dysfunction was associated with poorer cognitive performance across language and executive domains (e.g., Korean Boston Naming Test: -0.290, p<0.001; TMTA: 0.248, p<0.001). In both groups, ISI scores were linked to cognitive functions, particularly in attention, phonemic fluency, and executive function (e.g., digit span, backward: -0.225, p<0.01; TMTA: 0.327, p<0.01). Conclusions These findings suggest that sleep disturbances significantly impact cognitive function and daily living abilities in patients with MCI.

Objectives: This study aimed to investigate the association between self-reported sleep and cognitive function in individuals with mild cognitive impairment (MCI) to understand potential implications for Alzheimer’s disease prevention. Methods: This retrospective cohort study included 80 patients with MCI and 70 controls. Participants completed standardized questionnaires to assess self-reported sleep quality (Korean version of the Pittsburgh Sleep Quality Index [PSQI-K]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and insomnia severity (Insomnia Severity Index [ISI]). Cognitive function was evaluated using the Seoul Neuropsychological Test and the Korean version of the Mini-Mental State Examination. The Korea Instrumental Activities of Daily Living Scale was used to assess instrumental activities of daily living. Correlation analyses examined the relationship between sleep-related parameters and cognitive function. Results: The results indicated no significant differences in PSQI-K and ESS scores between patients with MCI and the control group. Correlation analyses revealed that poorer sleep quality was associated with reduced frontal and executive functions in patients with MCI, particularly in tests such as Controlled Oral Word Association Test (supermarket, -0.311, p<0.001) and Trail Making Test (TMT) B (0.232, p<0.001). Additionally, daytime dysfunction was associated with poorer cognitive performance across language and executive domains (e.g., Korean Boston Naming Test: -0.290, p<0.001; TMTA: 0.248, p<0.001). In both groups, ISI scores were linked to cognitive functions, particularly in attention, phonemic fluency, and executive function (e.g., digit span, backward: -0.225, p<0.01; TMTA: 0.327, p<0.01). Conclusions These findings suggest that sleep disturbances significantly impact cognitive function and daily living abilities in patients with MCI.

OBJECTIVE: Due to limited efficacy of medications, non-pharmacological interventions (NPI) are frequently co-administered to people with moderate to severe dementia (PWMSD). This systematic review and meta-analysis investigated the effects of NPI on activities of daily living (ADL), behavioral and psychological symptoms of dementia (BPSD), and cognition and quality of life (QoL) of PWMSD. METHODS: A literature search was conducted in the following databases: Cochrane CENTRAL, EMBASE, Medline, CIHNAL, PsycINFO, KoreaMED, KMbase, and KISS. We conducted a meta-analysis on randomized controlled trials and used the generic inverse variance method with a fixed-effects model to calculate the standardized mean difference (SMD). The protocol had been registered (CRD42017058020).
Activities of Daily Living ; Anxiety ; Cognition ; Dementia ; Depression ; Dihydroergotamine ; Methods ; Music Therapy ; Quality of Life

OBJECTIVES: This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. METHODS: We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. RESULTS: Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. CONCLUSIONS: Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.
Anti-Anxiety Agents ; Antipsychotic Agents ; Anxiety Disorders ; Bipolar Disorder ; Delirium ; Dementia ; Depressive Disorder ; Diagnosis ; Female ; Gyeonggi-do* ; Humans ; Hypnotics and Sedatives ; Length of Stay ; Lithium ; Male ; Medical Records ; Polypharmacy ; Prescriptions*

Splenosis refers to autotransplantation of splenic tissue into intraabdominal, intrathoracic or even any other parts of body and occurs after splenic trauma or splenectomy. Hepatic splenosis is usually incidental found during imaging workup. It can mimic other hypervascular mass because it presents vivid and heterogeneous enhancement representing that of splenic tissue. So far, about 20 cases of intrahepatic splenosis have been described in the literature. Herein we report a case of intrahepatic splenosis mimicking hepatocellular carcinoma in a patient with liver cirrhosis. The patient was finally diagnosed on the basis of specific radionuclide imaging.

Background: and Purpose Both hypertension and hypotension increase cerebral white matter hyperintensities. However, the effects of hypotension in individuals with treated hypertension are unknown. We analyzed the association of low blood pressure with the location and amount of white matter hyperintensities between elderly individuals with controlled hypertension and those without hypertension. Methods: We enrolled 505 community-dwelling, cognitively normal elderly individuals from the participants of the Korean Longitudinal Study on Cognitive Aging and Dementia. We measured blood pressure three times in a sitting position using a mercury sphygmomanometer and defined low systolic and diastolic blood pressure as ≤110 and ≤60 mm Hg, respectively. We segmented and quantified the periventricular and deep white matter hyperintensities from 3.0 Tesla fluid-attenuated inversion recovery magnetic resonance images. Results: Low systolic blood pressure was independently associated with larger volume of periventricular white matter hyperintensity (P=0.049). The interaction between low systolic blood pressure and hypertension was observed on the volume of periventricular white matter hyperintensity (P=0.005). Low systolic blood pressure was associated with the volume of periventricular white matter hyperintensity in individuals with controlled hypertension (F1,248=6.750, P=0.010), but not in those without hypertension (P=0.380). Low diastolic blood pressure was not associated with the volumes of white matter hyperintensities regardless of presence of controlled hypertension. Conclusions Low systolic blood pressure seems to be associated with larger volume of periventricular white matter hyperintensity in the individuals with a historyof hypertension but not in those without hypertension.