Multiple myeloma (MM), a hematological malignancy, is characterized by malignant plasma cell proliferation in the bone marrow. Recent treatment advances have significantly improved patient outcomes associated with MM.In this study, we aimed to develop comprehensive, evidence-based guidelines for the diagnosis, prognosis, and treat‑ ment of MM. We identified 12 key clinical questions essential for MM management, guiding the extensive literature review and meta-analysis of the study. Our guidelines provide evidence-based recommendations by integrating patient preferences with survey data. These recommendations include current and emerging diagnostic tools, thera‑ peutic agents, and treatment strategies. By prioritizing a patient-centered approach and rigorous data analysis, these guidelines were developed to enhance MM management, both in Korea and globally.

Background: The risk of device thrombosis and device-oriented clinical outcomes with bioresorbable vascular scaffold (BVS) was reported to be significantly higher than with contemporary drug-eluting stents (DESs). However, optimal device implantation may improve clinical outcomes in patients receiving BVS. The current study evaluated mid-term safety and efficacy of Absorb BVS with meticulous device optimization under intravascular imaging guidance. Methods: The SMART-REWARD and PERSPECTIVE-PCI registries in Korea prospectively enrolled 390 patients with BVS and 675 patients with DES, respectively. The primary endpoint was target vessel failure (TVF) at 2 years and the secondary major endpoint was patientoriented composite outcome (POCO) at 2 years. Results: Patient-level pooled analysis evaluated 1,003 patients (377 patients with BVS and 626 patients with DES). Mean scaffold diameter per lesion was 3.24 ± 0.30 mm in BVS group.Most BVSs were implanted with pre-dilatation (90.9%), intravascular imaging guidance (74.9%), and post-dilatation (73.1%) at proximal to mid segment (81.9%) in target vessel.Patients treated with BVS showed comparable risks of 2-year TVF (2.9% vs. 3.7%, adjusted hazard ratio [HR], 1.283, 95% confidence interval [CI], 0.487–3.378, P = 0.615) and 2-year POCO (4.5% vs. 5.9%, adjusted HR, 1.413, 95% CI, 0.663–3.012,P = 0.370) than those with DES. The rate of 2-year definite or probable device thrombosis (0.3% vs. 0.5%, P = 0.424) was also similar. The sensitivity analyses consistently showed comparable risk of TVF and POCO between the 2 groups. Conclusion With meticulous device optimization under imaging guidance and avoidance of implantation in small vessels, BVS showed comparable risks of 2-year TVF and device thrombosis with DES.

Background: Dental caries in preschool children can cause early loss of teeth, reduced masticatory function, malocclusion, and speech disorders, making oral care for preschool children essential. However, because children have a poor ability to perform oral hygiene by themselves, educational tools that help establish correct oral health behaviors are required. This study evaluated the effect of toothbrushing application for kids on dental plaque removal and toothbrushing interest in preschool children. Methods: Seven 5-year-old children enrolled in a daycare center participated in the evaluation, and the same children participated in the experiment twice a week. The Pokémon Smile application (App) was used as an auxiliary application for tooth brushing, and the degree of dental plaque removal on the tooth surface was evaluated by quantitative light-induced fluorescence-digital imaging. After the experiment, children’s toothbrushing preferences were investigated through interviews. Results: The levels of AREA R30 and AREA R70 measured after the children’s toothbrushing as usual decreased compared to those before toothbrushing; however, the change was not significant. The levels of AREA R30 and AREA R70 measured after using the Pokémon Smile App were significantly reduced compared to those before toothbrushing. Children’s interest in brushing their teeth increased by 28.59% after using the Pokémon Smile App. Conclusion The toothbrushing application for kids effectively removes dental plaque by helping preschool children brush their teeth. It also increased preschool children’s interest in tooth brushing. Therefore, an oral health education application would be useful for children who need to develop correct oral care methods and habits.

Background: The problem with current dental hygienist education is that it operates as an education system based on the national examination rather than on a practical basis; thus, graduates have difficulties in practice after obtaining their license. This study aimed to propose a job-oriented curriculum by analyzing the links between the task analysis of Korean dental hygienists and dental hygiene learning goals. Methods: This study performed a relationship analysis based on a second job analysis study of dental hygienists conducted by the Korea Health Personnel Licensing Examination Institute and the learning goals of the Korean Dental Hygiene Faculty Association. Results: Based on the links between the task and learning goals of the dental hygienist, they were classified into six types: 1) tasks listed in the license exam and learning goal, 2) tasks not listed in the license exam but listed in learning goals, 3) tasks not listed in learning goals, 4) learning goals not related to tasks, 5) learning goals listed in a few tasks, and 6) tasks related to several learning goals. The results showed that most of them correspond to the 5th classification, followed by the 3rd and 4th categories, which are mostly basic science learning goals. Tasks without learning goals are not included in the curriculum; thus, the curriculum needs to be supplemented. The overlapping learning goals of several subjects for one job skill must be reduced in job-oriented education. Conclusion We suggest that the dental hygiene curriculum be developed based on task analysis and reflected in the national dental hygienist exam. The clinical practice performance of dental hygienists will take further leap forward through task-oriented education.

PURPOSE: The purpose of this study was to investigate the effect of common sources of infection on outcome in patients with severe sepsis and septic shock in the emergency department (ED). METHODS: We conducted a retrospective observational study involving adult patients who were diagnosed with severe sepsis or septic shock in the ED of a tertiary care hospital during the period between August 2008 and March 2012. We categorized patients according to four groups based on source of infection (respiratory infection, intra-abdominal infection [IAI], urinary tract infection [UTI], and other sources [OS] group). The primary outcome was inhospital mortality. Multivariable logistic regression analysis was performed for adjustment of potential confounders, including age, gender, serum lactate concentrations, the Sequential Organ Failure Assessment score, timely antibiotic use, and achievements of early resuscitation targets. RESULTS: A total of 758 patients were included and overall in-hospital mortality was 16.6%. Significant differences in mortality were observed between four groups (27.5% for respiratory infection, 12.1% for IAI, 2.6% for UTI, and 20.0% for other sources, p<0.01). In patients with IAI, adjusted odds ratios (ORs) for mortality were 0.49 (95% confidence interval [CI], 0.27-0.92) compared with the OS group and 0.57 (95% CI, 0.35-0.93) compared with non-IAI. For UTI, adjusted ORs were 0.08 (95% CI, 0.02-0.32) compared with the OS group and 0.09 (95% CI, 0.03-0.35) compared with non-UTI. For respiratory infection, adjusted ORs were 1.33 (95% CI, 0.74-2.39) compared with the OS group and 2.56 (95% CI, 1.60-4.10) compared with non-respiratory infection. CONCLUSION: Results of our study showed that source of infection was independently associated with in-hospital mortality in patients with severe sepsis and septic shock in the ED. In particular, UTI and IAI showed significant association with in-hospital survival. Patients with respiratory infection showed significantly higher mortality, compared with non-respiratory infection patients.
Adult ; Emergency Service, Hospital* ; Hospital Mortality ; Humans ; Intraabdominal Infections ; Lactic Acid ; Logistic Models ; Mortality ; Observational Study ; Odds Ratio ; Resuscitation ; Retrospective Studies ; Sepsis* ; Shock, Septic* ; Tertiary Healthcare ; Urinary Tract Infections

Purpose: Development of malignancy is one of the key issues in the renal transplant recipients after long term follow up. Methods: We reviewed our renal transplant registry for the incidence of de novo malignancy after renal transplantation. Results: Among the 1006 renal transplant recipients from July 1969 until January 2006, 47 cases of de novo malignancy developed in 43 patients: stomach cancer (7 cases), Kaposi's sarcoma (6), post-transplantation lymphoproliferative disorder (PTLD, 7), primary liver cancer (4), thyroid cancer (3), skin cancer (4), colon cancer (3),), renal cell carcinoma (2), bladder cancer (2), anal cancer (2), sarcoma (3) and one malignancy case from conjunctiva, pancreas, uterine cervix, and tongue, respectively. Mean age at the time of diagnosis of cancer was 45.8+/-12.0 years (mean+/-standard deviation). The cancer diagnosis was made at 97.1+/-73.6 months after the renal transplantation. We have high prevalence of cancers with suspected viral etiology - i.e., Kaposi's sarcoma, PTLD, primary liver cancer and uterine cervix cancer. Conclusion: Careful surveillance of malignancy in renal allograft recipients is highly recommended.
Allografts ; Anus Neoplasms ; Carcinoma, Renal Cell ; Cervix Uteri ; Colonic Neoplasms ; Conjunctiva ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Kidney Transplantation* ; Kidney* ; Liver Neoplasms ; Lymphoproliferative Disorders ; Pancreas ; Prevalence ; Sarcoma ; Sarcoma, Kaposi ; Skin Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms ; Tongue ; Transplantation ; Urinary Bladder Neoplasms

The definition and management of microinvasive cervical cancer varies from time to time depending on the organization involved and is a persistent focus of controversy. The purpose of defining microinvasion is to identify a group of patients who are not at risk of lymph node metastases or recurrence and who therefore may be treated with less than radical therapy. Microinvasive cervical cancer with Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Recurrence ; Uterine Cervical Neoplasms

To assay the cytogenetic toxicity of NiCl, K2Cr2O7CdC12, and HgC12, the frequencies of sister chromatid exchanges(SCEs) and chromosomal aberrations were observed in the metaphase chromosomes of the human lymphocytes which were cultured with above materials. The frequencies of SCEs are dose-dependently increased by all materials in this experiment. Chromosomal aberrations, especially gap and break, are increased by the nickel and chromic compounds, while not significantly increased by the cadmium and mercurial compounds. This results indicate the dose dependent relationship between the frequencies of SCEs and the concentrations of the heavy metals, but the increasing rates of the SCEs induced by the heavy metals are less sensitive than other mutagens or carcinogens which were confirmed.
Cadmium ; Carcinogens ; Chromatids ; Chromosome Aberrations* ; Cytogenetics ; Humans ; Humans* ; Lymphocytes* ; Metals, Heavy* ; Metaphase ; Mutagens ; Nickel ; Siblings* ; Sister Chromatid Exchange*