Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies. Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed. Results: The median follow-up durations in the HRD and UCB groups were 7.0 and 10.9 years, respectively. The cumu‑ lative incidence of acute graft-versus-host disease (GVHD) grades II–IV and moderate-to-severe chronic GVHD did not differ significantly between the groups. However, the HRD group demonstrated significantly lower rates of acute GVHD grades III–IV (4.9% vs. 29.2%, p = 0.009) and non-relapse mortality (2.6% vs. 34.2%, p < 0.001) but a higher relapse incidence (32.1% vs. 8.8%, p = 0.004) than the UCB group. The 5-year event-free and overall survival rates were 65.8% and 54.2% (p = 0.204) and 78.0% and 65.7% (p = 0.142) for the HRD and UCB groups, respectively. Multivariate analysis identified disease status as a significant risk factor for overall survival (hazard ratio, 3.24; p = 0.016). Additionally, UCB HSCT exhibited a trend toward worse event-free survival compared to HRD HSCT (hazard ratio, 2.63; p = 0.05). Conclusions These findings indicate that HRD HSCT with post-transplant cyclophosphamide provides promising outcomes compared to UCB HSCT in pediatric patients, with a trend toward improved survival over a long-term follow-up period exceeding a median of 7 years. Thus, HRD HSCT may be a valuable option for pediatric patients with‑ out human leukocyte antigen-matched donors.

Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies. Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed. Results: The median follow-up durations in the HRD and UCB groups were 7.0 and 10.9 years, respectively. The cumu‑ lative incidence of acute graft-versus-host disease (GVHD) grades II–IV and moderate-to-severe chronic GVHD did not differ significantly between the groups. However, the HRD group demonstrated significantly lower rates of acute GVHD grades III–IV (4.9% vs. 29.2%, p = 0.009) and non-relapse mortality (2.6% vs. 34.2%, p < 0.001) but a higher relapse incidence (32.1% vs. 8.8%, p = 0.004) than the UCB group. The 5-year event-free and overall survival rates were 65.8% and 54.2% (p = 0.204) and 78.0% and 65.7% (p = 0.142) for the HRD and UCB groups, respectively. Multivariate analysis identified disease status as a significant risk factor for overall survival (hazard ratio, 3.24; p = 0.016). Additionally, UCB HSCT exhibited a trend toward worse event-free survival compared to HRD HSCT (hazard ratio, 2.63; p = 0.05). Conclusions These findings indicate that HRD HSCT with post-transplant cyclophosphamide provides promising outcomes compared to UCB HSCT in pediatric patients, with a trend toward improved survival over a long-term follow-up period exceeding a median of 7 years. Thus, HRD HSCT may be a valuable option for pediatric patients with‑ out human leukocyte antigen-matched donors.

Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies. Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed. Results: The median follow-up durations in the HRD and UCB groups were 7.0 and 10.9 years, respectively. The cumu‑ lative incidence of acute graft-versus-host disease (GVHD) grades II–IV and moderate-to-severe chronic GVHD did not differ significantly between the groups. However, the HRD group demonstrated significantly lower rates of acute GVHD grades III–IV (4.9% vs. 29.2%, p = 0.009) and non-relapse mortality (2.6% vs. 34.2%, p < 0.001) but a higher relapse incidence (32.1% vs. 8.8%, p = 0.004) than the UCB group. The 5-year event-free and overall survival rates were 65.8% and 54.2% (p = 0.204) and 78.0% and 65.7% (p = 0.142) for the HRD and UCB groups, respectively. Multivariate analysis identified disease status as a significant risk factor for overall survival (hazard ratio, 3.24; p = 0.016). Additionally, UCB HSCT exhibited a trend toward worse event-free survival compared to HRD HSCT (hazard ratio, 2.63; p = 0.05). Conclusions These findings indicate that HRD HSCT with post-transplant cyclophosphamide provides promising outcomes compared to UCB HSCT in pediatric patients, with a trend toward improved survival over a long-term follow-up period exceeding a median of 7 years. Thus, HRD HSCT may be a valuable option for pediatric patients with‑ out human leukocyte antigen-matched donors.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Background/Aims: Secondary infection with influenza virus occurs in critically ill patients and is associated with substantial morbidity and mortality; however, there is limited information about it in patients with severe coronavirus disease 2019 (COVID-19). Thus, we investigated the clinical outcomes of and risk factors for secondary infections in patients with severe COVID-19. Methods: This study included patients with severe COVID-19 who were admitted to seven hospitals in South Korea between February 2020 to February 2021. Multivariate logistic regression analyses were performed to assess factors associated with the risk of secondary infections. Results: Of the 348 included patients, 104 (29.9%) had at least one infection. There was no statistically significant difference in the 28-day mortality (17.3% vs. 12.3%, p = 0.214), but in-hospital mortality was higher (29.8% vs. 15.2%, p = 0.002) in the infected group than in the non-infected group. The risk factors for secondary infection were a high frailty scale (odds ratio [OR], 1.314; 95% confidence interval [CI], 1.123 to 1.538; p = 0.001), steroid use (OR, 3.110; 95% CI, 1.164 to 8.309; p = 0.024), and the application of mechanical ventilation (OR, 4.653; 95% CI, 2.533 to 8.547; p < 0.001). Conclusions In-hospital mortality was more than doubled in patients with severe COVID-19 and secondary infections. A high frailty scale, the use of steroids and application of mechanical ventilation were risk factors for secondary infection.

Autoimmune hemolytic anemia (AIHA) is a common complication after hematopoietic stem cell transplantation (HSCT). Although post-HSCT AIHA is associated with poor prognosis and is more resistant to treatment than primary AIHA, the standard treatment has not yet been determined. We report a case of post-HSCT AIHA, which occurred 9 years after unrelated donor bone marrow transplantation for acute biphenotypic leukemia. Steroid treatment was initially effective but prolonged steroid usage, due to recurrent relapses, caused avascular necrosis. Although rituximab was unsuccessful in preventing relapses, sirolimus was effective in allowing the discontinuation of steroid treatment and sustaining transfusion-free status. Sirolimus, previously reported to be effective in pediatric post-HSCT AIHA and AIHA after solid organ transplantation, may be effective in adult post-HSCT AIHA as well.