Purpose: This study aimed to explore the practices, perceptions, and barriers related to specialty palliative care (SPC) referrals among oncologists in Korea, highlighting the clinical implications of early integration. Materials and Methods: A cross-sectional online survey targeting board-certified hemato-oncology specialists was conducted between August 1-25, 2024. The survey assessed referral practices, attitudes toward early SPC integration, referral criteria, barriers, and institutional characteristics. Results: A total of 227 oncologists participated (response rate, 36.7%). Among them, 68.7% reported frequent SPC referrals, with higher referral rates observed among younger physicians, those in tertiary hospitals, and institutions with in-house SPC teams (p < 0.001). Although 74.9% supported early SPC integration, referrals were often inconsistently timed, frequently occurring after disease progression or at the discontinuation of chemotherapy. For time-based referrals, the most commonly endorsed triggers were disease progression despite palliative second-line treatment and a prognosis of expected mortality within 6-12 months. Need-based referral triggers such as patient or family requests (96.5%), psychological distress (89.9%), or uncontrolled symptoms (83.3%), were also widely endorsed. The major barriers to early SPC integration included patient and family resistance (70.0%) and limited availability of SPC teams (34.4%). Conclusion This study emphasizes the importance of systematic efforts to promote timely SPC integration in Korea, including education to raise patient awareness, improved referral systems, and enhanced infrastructure. The positive attitudes toward early SPC among oncologists reflect a growing recognition of its value, highlighting the need for strategies that align with international standards.

Junctional epidermolysis bullosa (JEB) is a subtype of epidermolysis bullosa characterized by the formation of blisters within the basement membrane, particularly in the lamina lucida. Clinical manifestations of JEB include fragile skin with blisters and erosion. This case report presents a 35-year-old male with JEB caused by ITGA3mutations (p.Arg875Ter, p.Cys162Tyr) without pulmonary or renal complications. The patient exhibited various cutaneous signs such as persistent exfoliative patches, nail hypoplasia, and diffuse alopecia, with additional ophthalmic complications such as symblepharon and limbal stem cell deficiency. ITGA3 mutations are typically linked to interstitial lung disease and nephrotic syndrome, a characteristic group of symptoms known as ILNEB (‘Interstitial Lung disease, Nephrotic syndrome and Epidermolysis Bullosa’). However, the patient showed no evidence of renal or pulmonary involvement, with normal urinalysis and chest X-ray results, making the diagnosis more difficult until next generation sequencing confirmed the ITGA3 mutation.

Few cases of asthma caused by the two-spotted spider mite (TSM) have been reported among nonfarmer apple-packing workers. This study investigated whether allergic sensitization due to the TSM occurs in workers at the Agricultural Products Processing Center. The polymerase chain reaction was used to analyze apples and leaves provided to the Agricultural Products Processing Center for the presence of TSM. Skin prick tests using TSM antigen were administered to 10 workers, and serum levels of total immunoglobulin E (IgE) and specific IgE for TSM antigens were quantified. Of the 10 workers, four tested positive for TSM in the skin prick test, three had elevated total IgE levels, and one had also elevated specific IgE levels to TSM. This confirms that apple-packing workers risk allergic sensitization due to TSM exposure. Preventive measures are recommended not only for apple farmers but also for nonfarmer apple-packing workers.

Purpose: Although partial mesorectal excision (PME) and total mesorectal excision (TME) is primarily indicated for the upper and lower rectal cancer, respectively, few studies have evaluated whether PME or TME is more optimal for middle rectal cancer. Methods: This study included 671 patients with middle and upper rectal cancer who underwent robot-assisted PME or TME. The 2 groups were optimized by propensity score matching of sex, age, clinical stage, tumor location, and neoadjuvant treatment. Results: Complete mesorectal excision was achieved in 617 of 671 patients (92.0%), without showing a difference between the PME and TME groups. Local recurrence rate (5.3% vs. 4.3%, P>0.999) and systemic recurrence rate (8.5% vs. 16.0%, P=0.181) also did not differ between the 2 groups, in patients with middle and upper rectal cancer. The 5-year disease-free survival (81.4% vs. 74.0%, P=0.537) and overall survival (88.0% vs. 81.1%, P=0.847) also did not differ between the PME and TME groups, confined to middle rectal cancer. Moreover, 5-year recurrence and survival rates were not affected by distal resection margins of 2 cm (P=0.112) to 4 cm (P>0.999), regardless of pathological stages. Postoperative complication rate was higher in the TME than in the PME group (21.4% vs. 14.5%, P=0.027). Incontinence was independently associated with TME (odds ratio [OR], 2.009; 95% confidence interval, 1.015–3.975; P=0.045), along with older age (OR, 4.366, P<0.001) and prolonged operation time (OR, 2.196; P=0.500). Conclusion PME can be primarily recommended for patients with middle rectal cancer with lower margin of >5 cm from the anal verge.

Purpose: This study sought to investigate the perceptions and service needs of tele-physical therapy among people in their 50s and older in Korea. Methods: Subjects were inducted during a 14-day survey of 104 people over the age of 50 in Korea and were administered a questionnaire consisting of 14 questions about their general characteristics and another 14 questions about tele-physical therapy. Results: The general characteristics of the participants (participants’ gender, whether they were single or married, number of cohabiting families, final education, major, job, physical therapy experience, tele-physical therapy experience, presence of a physical therapy worker among relatives, subjective health awareness, chronic disease conditions if any, frequency of drinking, and smoking) were investigated.Among the perceptions of the subjects about tele-physical therapy, the score of ‘awareness’ was the lowest, and that of ‘resolving restrictions on hospital visits’ was the highest. In an analysis of the correlation between perceptions and needs, there was a significant correlation with factors other than ‘awareness’ and ‘information protection’ factors. The regression analysis of necessity and factors revealed that the awareness of necessity increased as the intention to use, health improvement, and time efficiency improved. Conclusion These findings presented the perception and necessity of tele-physical therapy for adults in their 50s or older in Korea. These results will help confirm the demand for tele-physical therapy in this age group in Korea and the need to improve the available physical therapy services.

Schaaf-Yang syndrome (SYS) is a rare genomic imprinting disorder caused by truncating mutations in the paternally derived MAGE family member L2 (MAGEL2) allele. It is also responsible for Prader-Willi syndrome, characterized by neonatal hypotonia, developmental delay, intellectual disability, respiratory distress in early infancy, and arthrogryposis. More than 250 individuals with approximately 57 different molecular variants have been reported since 2013, but the phenotype-genotype association in SYS is not yet fully understood. Here, we describe the case of a Korean patient diagnosed with SYS harboring a mutation in the paternal allele of MAGEL2: c.2895G>A, resulting in a protein change of p.Trp965*. The patient’s phenotype included respiratory distress, arthrogryposis, hypotonia, and feeding difficulty in the early neonatal period. Mild renal dysfunction and hearing impairment were observed during infancy.

Background: Cyst enucleation, which extracts only the tumor with the application of Carnoy’s solution (CS), has been suggested as a conservative treatment with a low recurrence rate and morbidity. However, there has been a concern that CS’s contact with inferior alveolar nerve (IAN) can cause neurons to degenerate and cause sensory dysfunction. The purpose of this retrospective cohort study aimed to investigate the neurosensory function after surgical treatment with or without the application of CS. Methods: While controlling the effects of sex, age, follow-up period, and invasion size of the tumor, we performed the binary logistic regression analysis to examine whether or not the sensory function of the patients who were treated with CS (n = 19) for the cyst enucleation procedure was significantly different from those who were not treated with CS (n = 58) at the end of the follow-up period. Results: The logistic regression result showed that the use of CS was not significantly related to the normalness of sensory function at the end of the follow-up period. Rather, the invasion size of the cyst was significantly associated with sensory dysfunction. Conclusions CS may be used for patients who are diagnosed with OKC and UAM without much fear of its impact on sensory dysfunction. However, a small number of patients who were treated with CS experienced severe sensory damage and did not recover at the end of the follow-up period, suggesting the need for further analysis of these patients.

Objective: Recent innovations in biology are boosting gene and cell therapy, but monitoring the response to these treatments is difficult. The purpose of this study was to find an MRI-reporter gene that can be used to monitor gene or cell therapy and that can be delivered without a viral vector, as viral vector delivery methods can result in long-term complications. Materials and Methods: CMV promoter-human organic anion transporting polypeptide 1B3 (CMV-hOATP1B3) cDNA or CMV-blank DNA (control) was transfected into HEK293 cells using Lipofectamine. OATP1B3 expression was confirmed by western blotting and confocal microscopy. In vitro cell phantoms were made using transfected HEK293 cells cultured in various concentrations of gadoxetic acid for 24 hours, and images of the phantoms were made with a 9.4T micro-MRI. In vivo xenograft tumors were made by implanting HEK293 cells transfected with CMV-hOATP1B3 (n = 4) or CMV-blank (n = 4) in 8-week-old male nude mice, and MRI was performed before and after intravenous injection of gadoxetic acid (1.2 μL/g). Results: Western blot and confocal microscopy after immunofluorescence staining revealed that only CMV-hOATP1B3-transfected HEK293 cells produced abundant OATP1B3, which localized at the cell membrane. OATP1B3 expression levels remained high through the 25th subculture cycle, but decreased substantially by the 50th subculture cycle. MRI of cell phantoms showed that only the CMV-hOATP1B3-transfected cells produced a significant contrast enhancement effect. In vivo MRI of xenograft tumors revealed that only CMV-hOATP1B3-transfected HEK293 tumors demonstrated a T1 contrast effect, which lasted for at least 5 hours. Conclusion The human endogenous OATP1B3 gene can be non-virally delivered into cells to induce transient OATP1B3 expression, leading to gadoxetic acid-mediated enhancement on MRI. These results indicate that hOATP1B3 can serve as an MRI-reporter gene while minimizing the risk of long-term complications.

Background/Aims: The Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and modified RECIST (mRECIST) criteria have been used to assess treatment responses for hepatocellular carcinoma (HCC) patients. We investigated which criteria provides better survival predictions in HCC patients treated with transarterial radioembolization (TARE). Methods: In total, 102 patients with unresectable intrahe-patic HCC, who were treated with TARE between 2012 and 2017, were reviewed retrospectively. The treatment response after TARE was evaluated at 1, 3, and 6 months by the mRE-CIST and RECIST 1.1. Responders were defined as patients with complete or partial responses by each criterion. Results: The median age of 83 men and 19 women was 64.3 years.The median alpha-fetoprotein and des-gamma-carboxy pro-thrombin levels were 37.1 ng/mL and 1,780.0 mAU/mL, re-spectively. The median maximal tumor size was 8.3 cm, and multiple tumors were observed in 36 patients (35.3%). Dur-ing the follow-up period (median, 20.7 months), 21 patients (20.6%) died, with a mean survival time of 55.5 months. The cumulative survival rate was 96.1% at 6 months and 89.3% at 12 months. Responders, defined by the mRECIST at 1, 3, and 6 months after TARE, showed better survival outcomes than nonresponders (hazard ratio [HR]=5.736, p=0.008 at 1 month; HR=3.145, p=0.022 at 3 months, and HR=2.887, p=0.061 at 6 months). The survival rates of responders and nonresponders defined by the RECIST 1.1 were similar (all p>0.05). Conclusions Response evaluations that use the mRECIST provide more accurate prognoses than those that use the RECIST 1.1 in HCC patients treated with TARE.