Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Background: Colorectal carcinomas (CRCs) with caudal-type homeobox 2 (CDX2) loss are recognized to pursue an aggressive behavior but tend to be accompanied by a high density of tumor-infiltrating lymphocytes (TILs). However, little is known about whether there is an interplay between CDX2 loss and TIL density in the survival of patients with CRC. Methods: Stage III CRC tissues were assessed for CDX2 loss using immunohistochemistry and analyzed for their densities of CD8 TILs in both intraepithelial (iTILs) and stromal areas using a machine learning-based analytic method. Results: CDX2 loss was significantly associated with a higher density of CD8 TILs in both intraepithelial and stromal areas. Both CDX2 loss and a high CD8 iTIL density were found to be prognostic parameters and showed hazard ratios of 2.314 (1.050–5.100) and 0.378 (0.175–0.817), respectively, for cancer-specific survival. A subset of CRCs with retained CDX2 expression and a high density of CD8 iTILs showed the best clinical outcome (hazard ratio of 0.138 [0.023–0.826]), whereas a subset with CDX2 loss and a high density of CD8 iTILs exhibited the worst clinical outcome (15.781 [3.939–63.230]). Conclusions Altogether, a high density of CD8 iTILs did not make a difference in the survival of patients with CRC with CDX2 loss. The combination of CDX2 expression and intraepithelial CD8 TIL density was an independent prognostic marker in adjuvant chemotherapy-treated patients with stage III CRC.

Purpose: Patient handovers are critical for patient safety. Studies have shown that nurses are often interrupted during handovers, and standardized guidelines are lacking. This study aimed to develop and evaluate the effectiveness of a new handover method for emergency nurses. Methods: This quasi-experimental study implemented a new handover method from August 1, 2022, at the emergency department of a university hospital. Pre- (34 responses) and post-(16 responses, six months later) surveys and post-interviews (six participants) were conducted. In the pre-survey, data were collected regarding handover-related characteristics, cause of handover error, handover perception and handover error experience. Data regarding handover perception and handover error experience were obtained again at the post-survey. Wilcoxon’s signed rank test was used to compare handover perception and handover error experience. The interview results were analyzed using inductive content analysis. Results: There were no significant differences in information quality or interaction and support, but the new handover method was more efficient, and handover errors decreased. Four themes were identified from interview responses. Conclusion By providing a quiet place and allowing emergency nurses to independently review patient records during handovers, we expect to maintain nursing continuity, increase efficiency, and ultimately ensure patient safety and nurses’ job satisfaction.

Purpose: Patient handovers are critical for patient safety. Studies have shown that nurses are often interrupted during handovers, and standardized guidelines are lacking. This study aimed to develop and evaluate the effectiveness of a new handover method for emergency nurses. Methods: This quasi-experimental study implemented a new handover method from August 1, 2022, at the emergency department of a university hospital. Pre- (34 responses) and post-(16 responses, six months later) surveys and post-interviews (six participants) were conducted. In the pre-survey, data were collected regarding handover-related characteristics, cause of handover error, handover perception and handover error experience. Data regarding handover perception and handover error experience were obtained again at the post-survey. Wilcoxon’s signed rank test was used to compare handover perception and handover error experience. The interview results were analyzed using inductive content analysis. Results: There were no significant differences in information quality or interaction and support, but the new handover method was more efficient, and handover errors decreased. Four themes were identified from interview responses. Conclusion By providing a quiet place and allowing emergency nurses to independently review patient records during handovers, we expect to maintain nursing continuity, increase efficiency, and ultimately ensure patient safety and nurses’ job satisfaction.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive or anticancer agents.Surgical intervention is generally recommended for advanced stages, but some patients may be ineligible for surgery due to systemic conditions or anatomical limitations. We present two patients who had been treated for osteoporosis with bisphosphonates and were diagnosed with stage 2 MRONJ. Their chief complaints included refractory pain, purulent discharge, and exposed bone following tooth extraction. Despite conservative treatment, the MRONJ worsened, prompting the initiation of teriparatide therapy. After teriparatide administration, the patients experienced symptom improvement, spontaneous sequestrum removal, and significant bone regeneration of vertical osteolysis. Teriparatide, a bone anabolic agent, is typically recommended as adjuvant therapy alongside surgical treatment for MRONJ. This case report illustrates the effectiveness of teriparatide monotherapy in the absence of surgical intervention, particularly for patients who cannot discontinue antiresorptive agents due to low bone mineral density.

Purpose: Patient handovers are critical for patient safety. Studies have shown that nurses are often interrupted during handovers, and standardized guidelines are lacking. This study aimed to develop and evaluate the effectiveness of a new handover method for emergency nurses. Methods: This quasi-experimental study implemented a new handover method from August 1, 2022, at the emergency department of a university hospital. Pre- (34 responses) and post-(16 responses, six months later) surveys and post-interviews (six participants) were conducted. In the pre-survey, data were collected regarding handover-related characteristics, cause of handover error, handover perception and handover error experience. Data regarding handover perception and handover error experience were obtained again at the post-survey. Wilcoxon’s signed rank test was used to compare handover perception and handover error experience. The interview results were analyzed using inductive content analysis. Results: There were no significant differences in information quality or interaction and support, but the new handover method was more efficient, and handover errors decreased. Four themes were identified from interview responses. Conclusion By providing a quiet place and allowing emergency nurses to independently review patient records during handovers, we expect to maintain nursing continuity, increase efficiency, and ultimately ensure patient safety and nurses’ job satisfaction.

Purpose: Patient handovers are critical for patient safety. Studies have shown that nurses are often interrupted during handovers, and standardized guidelines are lacking. This study aimed to develop and evaluate the effectiveness of a new handover method for emergency nurses. Methods: This quasi-experimental study implemented a new handover method from August 1, 2022, at the emergency department of a university hospital. Pre- (34 responses) and post-(16 responses, six months later) surveys and post-interviews (six participants) were conducted. In the pre-survey, data were collected regarding handover-related characteristics, cause of handover error, handover perception and handover error experience. Data regarding handover perception and handover error experience were obtained again at the post-survey. Wilcoxon’s signed rank test was used to compare handover perception and handover error experience. The interview results were analyzed using inductive content analysis. Results: There were no significant differences in information quality or interaction and support, but the new handover method was more efficient, and handover errors decreased. Four themes were identified from interview responses. Conclusion By providing a quiet place and allowing emergency nurses to independently review patient records during handovers, we expect to maintain nursing continuity, increase efficiency, and ultimately ensure patient safety and nurses’ job satisfaction.

Purpose: This subgroup analysis of the Korean subset of patients in the phase 3 LASER301 trial evaluated the efficacy and safety of lazertinib versus gefitinib as first-line therapy for epidermal growth factor receptor mutated (EGFRm) non–small cell lung cancer (NSCLC). Materials and Methods: Patients with locally advanced or metastatic EGFRm NSCLC were randomized 1:1 to lazertinib (240 mg/day) or gefitinib (250 mg/day). The primary endpoint was investigator-assessed progression-free survival (PFS). Results: In total, 172 Korean patients were enrolled (lazertinib, n=87; gefitinib, n=85). Baseline characteristics were balanced between the treatment groups. One-third of patients had brain metastases (BM) at baseline. Median PFS was 20.8 months (95% confidence interval [CI], 16.7 to 26.1) for lazertinib and 9.6 months (95% CI, 8.2 to 12.3) for gefitinib (hazard ratio [HR], 0.41; 95% CI, 0.28 to 0.60). This was supported by PFS analysis based on blinded independent central review. Significant PFS benefit with lazertinib was consistently observed across predefined subgroups, including patients with BM (HR, 0.28; 95% CI, 0.15 to 0.53) and those with L858R mutations (HR, 0.36; 95% CI, 0.20 to 0.63). Lazertinib safety data were consistent with its previously reported safety profile. Common adverse events (AEs) in both groups included rash, pruritus, and diarrhoea. Numerically fewer severe AEs and severe treatment–related AEs occurred with lazertinib than gefitinib. Conclusion Consistent with results for the overall LASER301 population, this analysis showed significant PFS benefit with lazertinib versus gefitinib with comparable safety in Korean patients with untreated EGFRm NSCLC, supporting lazertinib as a new potential treatment option for this patient population.

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal. Materials and Methods: We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation. Results: Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529). Conclusion In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.