Carpal tunnel syndrome (CTS) is a common form of hand mononeuropathy that is typi-cally caused by median nerve compression. Although it is often idiopathic, CTS can also result from various conditions, including space-occupying lesions. Tumoral calcinosis, a rare condition characterized by periarticular deposition of calcified masses, is an un-common cause of secondary CTS. We present a case of a 78-year-old woman with idio-pathic tumoral calcinosis that caused secondary CTS. Despite conservative treatments, her symptoms persisted, and diagnostic imaging, including radiographs, computed to-mography, and magnetic resonance imaging, revealed a calcified mass in the carpal tun-nel. A surgical intervention involving carpal tunnel release and excisional biopsy con-firmed the diagnosis of tumoral calcinosis. Postoperatively, the patient showed complete resolution of symptoms, with no recurrence on follow-up radiographs. This case high-lights the importance of considering space-occupying lesions, such as tumoral calcinosis, as a rare but treatable cause of secondary CTS.

Objective: To evaluate the effects of Capsosiphon fulvescens (C. fulvescens) ethanolic extract on inflammation in lipopolysaccharide (LPS)-induced RAW296.7 macrophages. Methods: The protective effects of C. fulvescens ethanolic extract on LPS-induced inflammation in RAW264.7 macrophages were assessed using biochemical analysis, including enzyme-linked immunosorbent assay, quantitative reverse transcription-polymerase chain reaction, and Western blot analysis. To examine reactive oxygen species (ROS) production, flow cytometry analysis, and immunofluorescence staining were used. Furthermore, the modulatory effect of C. fulvescens ethanolic extract on NF-κB activation was investigated. Results: C. fulvescens ethanolic extract significantly attenuated LPS-induced levels of pro-inflammatory cytokines and notably reduced the secretion and mRNA levels of LPS-mediated matrix metalloproteinases. In addition, C. fulvescens ethanolic extract decreased ROS production and suppressed the TLR4/NF-κB signaling pathway. Conclusions: C. fulvescens ethanolic extract alleviates inflammation as well as oxidative stress by modulating the TLR4/NF-κB signaling in LPS-induced RAW264.7 macrophages. C. fulvescens can be used as a potential therapeutic agent to suppress inflammation and oxidative stress-associated diseases.

PURPOSE: This study aimed to compare the accuracy of an alternative scan path with that of traditional scan paths to obtain a more accurate method for complete arch scans. MATERIALS AND METHODS: A mandibular stone cast, including tooth preparations for the inlay, crown, and fixed prosthesis, was scanned 10 times using four different scan paths (A, B, C, and D). The scans were converted into stereolithography files, resized, and superimposed onto a control file obtained from a desktop scanner. The scan time, total surface deviation, and local deviation of the mandibular teeth were measured. One-way analysis of variance (ANOVA) and Welch ANOVA were used for statistical analyses (α = .05). The relative standard deviation and standard error of the mean were calculated to evaluate accuracy. RESULTS: The total surface deviation differed significantly according to the scanning path despite a similar scan time. Path D had the highest accuracy and the most uniform color maps, showing minimal deformation of the digital model. Meanwhile, no significant differences were found in the local deviations in the individual tooth assessments, likely owing to issues with the superimposition method. CONCLUSION Among all scan paths, the scan path with the shortest distance from the starting point to the end point showed the smallest total surface deviation and the highest accuracy. No differences were observed in the deviations of specific teeth based on the scan path.

Background and Objectives: It is unknown whether the presence of low body mass index (BMI) influences the incidence of laryngeal cancer. In a national population-based study, we investigated their relationship retrospectively.Subjects and Method Using the data of Korean Health Insurance claims database, we selected adults aged 20 years or older who underwent a national health examination from January 1, 2007 to December 31, 2008 and were followed up until 2015 for the occurrence of laryngeal cancer. The hazard ratio of laryngeal cancer according to BMI and smoking status in the subjects was analyzed and adjusted for factors such as age, sex, alcohol consumption, and exercise status. Results: Finally, a total of 13675470 subjects were included in the study, and we found that laryngeal cancer occurred in 3731 of those subjects. The risk of developing laryngeal cancer was significantly associated with underweight (BMI <18.5 kg/m2) even after adjustment (hazard ratio of 1.27; 95% confidence interval of 1.11-1.46). There was also a difference according to smoking status. Underweight was not associated with laryngeal cancer in never-smokers, but in ex-smokers and current smokers. Conclusion Being underweight can increase the risk of laryngeal cancer. In particular, this risk can increase if you drink and smoke at the same time.

PURPOSE: This study aimed to compare the accuracy of an alternative scan path with that of traditional scan paths to obtain a more accurate method for complete arch scans. MATERIALS AND METHODS: A mandibular stone cast, including tooth preparations for the inlay, crown, and fixed prosthesis, was scanned 10 times using four different scan paths (A, B, C, and D). The scans were converted into stereolithography files, resized, and superimposed onto a control file obtained from a desktop scanner. The scan time, total surface deviation, and local deviation of the mandibular teeth were measured. One-way analysis of variance (ANOVA) and Welch ANOVA were used for statistical analyses (α = .05). The relative standard deviation and standard error of the mean were calculated to evaluate accuracy. RESULTS: The total surface deviation differed significantly according to the scanning path despite a similar scan time. Path D had the highest accuracy and the most uniform color maps, showing minimal deformation of the digital model. Meanwhile, no significant differences were found in the local deviations in the individual tooth assessments, likely owing to issues with the superimposition method. CONCLUSION Among all scan paths, the scan path with the shortest distance from the starting point to the end point showed the smallest total surface deviation and the highest accuracy. No differences were observed in the deviations of specific teeth based on the scan path.

PURPOSE: This study aimed to compare the accuracy of an alternative scan path with that of traditional scan paths to obtain a more accurate method for complete arch scans. MATERIALS AND METHODS: A mandibular stone cast, including tooth preparations for the inlay, crown, and fixed prosthesis, was scanned 10 times using four different scan paths (A, B, C, and D). The scans were converted into stereolithography files, resized, and superimposed onto a control file obtained from a desktop scanner. The scan time, total surface deviation, and local deviation of the mandibular teeth were measured. One-way analysis of variance (ANOVA) and Welch ANOVA were used for statistical analyses (α = .05). The relative standard deviation and standard error of the mean were calculated to evaluate accuracy. RESULTS: The total surface deviation differed significantly according to the scanning path despite a similar scan time. Path D had the highest accuracy and the most uniform color maps, showing minimal deformation of the digital model. Meanwhile, no significant differences were found in the local deviations in the individual tooth assessments, likely owing to issues with the superimposition method. CONCLUSION Among all scan paths, the scan path with the shortest distance from the starting point to the end point showed the smallest total surface deviation and the highest accuracy. No differences were observed in the deviations of specific teeth based on the scan path.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Purpose: Optimal treatment for stage IIIA/N2 non–small cell lung cancer (NSCLC) is controversial. We aimed to assess the efficacy and safety of adjuvant pembrolizumab for stage IIIA/N2 NSCLC completely resected after neoadjuvant concurrent chemoradiation therapy (CCRT). Materials and Methods: In this open-label, single-center, single-arm phase 2 trial, patients with stage IIIA/N2 NSCLC received adjuvant pembrolizumab for up to 2 years after complete resection following neoadjuvant CCRT. The primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS) and safety. As an exploratory biomarker analysis, we evaluated the proliferative response of blood CD39+PD-1+CD8+ T cells using fold changes in the percentage of proliferating Ki-67+ cells from days 1 to 7 of cycle 1 (Ki-67D7/D1). Results: Between October 2017 and October 2018, 37 patients were enrolled. Twelve (32%) and three (8%) patients harbored EGFR and ALK alterations, respectively. Of 34 patients with programmed cell death ligand 1 assessment, 21 (62%), nine (26%), and four (12%) had a tumor proportion score of < 1%, 1%-50%, and ≥ 50%, respectively. The median follow-up was 71 months. The median DFS was 22.4 months in the overall population, with a 5-year DFS rate of 29%. The OS rate was 86% at 2 years and 76% at 5 years. Patients with tumor recurrence within 6 months had a significantly lower Ki-67D7/D1 among CD39+PD-1+CD8+ T cells than those without (p=0.036). No new safety signals were identified. Conclusion Adjuvant pembrolizumab may offer durable disease control in a subset of stage IIIA/N2 NSCLC patients after neoadjuvant CCRT and surgery.

Background: The US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved empagliflozin for reducing cardiovascular mortality and heart failure (HF) hospitalization in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). However, limited data are available on the generalizability of empagliflozin to clinical practice. Therefore, we evaluated real-world eligibility and potential cost-effectiveness based on a nationwide prospective HF registry. Methods: A total of 3,108 HFrEF and 2,070 HFpEF patients from the Korean Acute Heart Failure (KorAHF) registry were analyzed. Eligibility was estimated by inclusion and exclusion criteria of EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction (EMPEROR-Reduced) and EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction (EMPEROR-Preserved) trials and by FDA & EMA label criteria. The cost-utility analysis was done using a Markov model to project the lifetime medical cost and quality-adjusted life year (QALY). Results: Among the KorAHF patients, 91.4% met FDA & EMA label criteria, while 44.7% met the clinical trial criteria. The incremental cost-effectiveness ratio of empagliflozin was calculated at US$6,764 per QALY in the overall population, which is far below a threshold of US$18,182 per QALY. The cost-effectiveness benefit was more evident in patients with HFrEF (US$5,012 per QALY) than HFpEF (US$8,971 per QALY). Conclusion There is a large discrepancy in real-world eligibility for empagliflozin between FDA & EMA labels and clinical trial criteria. Empagliflozin is cost-effective in HF patients regardless of ejection fraction in South Korea health care setting. The efficacy and safety of empagliflozin in real-world HF patients should be further investigated for a broader range of clinical applications.

Background and Objectives: It is unknown whether the presence of low body mass index (BMI) influences the incidence of laryngeal cancer. In a national population-based study, we investigated their relationship retrospectively.Subjects and Method Using the data of Korean Health Insurance claims database, we selected adults aged 20 years or older who underwent a national health examination from January 1, 2007 to December 31, 2008 and were followed up until 2015 for the occurrence of laryngeal cancer. The hazard ratio of laryngeal cancer according to BMI and smoking status in the subjects was analyzed and adjusted for factors such as age, sex, alcohol consumption, and exercise status. Results: Finally, a total of 13675470 subjects were included in the study, and we found that laryngeal cancer occurred in 3731 of those subjects. The risk of developing laryngeal cancer was significantly associated with underweight (BMI <18.5 kg/m2) even after adjustment (hazard ratio of 1.27; 95% confidence interval of 1.11-1.46). There was also a difference according to smoking status. Underweight was not associated with laryngeal cancer in never-smokers, but in ex-smokers and current smokers. Conclusion Being underweight can increase the risk of laryngeal cancer. In particular, this risk can increase if you drink and smoke at the same time.