Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: The human gut mycobiome comprises diverse fungal species and plays a crucial role in health and disease, despite its relatively low abundance compared to bacterial populations. This review provides an overview of the mycobiome’s composition, developmental patterns, and dysbiosis in various pathological conditions. As well, the complex interactions of fungal communities within the gut microbiome are discussed.Current content: The development of the gut mycobiome follows patterns similar to those of the bacterial microbiome, with birth mode, diet, and age being key determinants. In contrast to the bacterial trends, mycobiome diversity increases during childhood and old age. Recent studies have revealed variations in the mycobiome composition across different ethnic groups. Mycobiome dysbiosis is associated with autoimmune, gastrointestinal, and cardiovascular diseases. Certain fungi, notably Candida albicans, are relatively more abundant in pathological states. Fungal metabolic activity, particularly secondary metabolite production, can significantly affect disease progression. Bacterial–fungal interactions in the gut microbiome are complex and modulated by environmental factors, such as diet and antibiotic use. Moreover, the gut mycobiome modulates therapeutic efficacy. Gut fungi enhance the bioactivity of compounds derived from natural products through biotransformation, including their anticancer and anti-inflammatory effects. This suggests the potential of the gut mycobiome to optimize the therapeutic efficacy of natural products. Conclusion This review highlights the relevance of the gut mycobiome as both a diagnostic biomarker and a therapeutic target. Future research should focus on elucidating the causal relationships between mycobiome alterations and disease states, and further explore bacterial–fungal interactions within the gut ecosystem.

Purpose: The human gut mycobiome comprises diverse fungal species and plays a crucial role in health and disease, despite its relatively low abundance compared to bacterial populations. This review provides an overview of the mycobiome’s composition, developmental patterns, and dysbiosis in various pathological conditions. As well, the complex interactions of fungal communities within the gut microbiome are discussed.Current content: The development of the gut mycobiome follows patterns similar to those of the bacterial microbiome, with birth mode, diet, and age being key determinants. In contrast to the bacterial trends, mycobiome diversity increases during childhood and old age. Recent studies have revealed variations in the mycobiome composition across different ethnic groups. Mycobiome dysbiosis is associated with autoimmune, gastrointestinal, and cardiovascular diseases. Certain fungi, notably Candida albicans, are relatively more abundant in pathological states. Fungal metabolic activity, particularly secondary metabolite production, can significantly affect disease progression. Bacterial–fungal interactions in the gut microbiome are complex and modulated by environmental factors, such as diet and antibiotic use. Moreover, the gut mycobiome modulates therapeutic efficacy. Gut fungi enhance the bioactivity of compounds derived from natural products through biotransformation, including their anticancer and anti-inflammatory effects. This suggests the potential of the gut mycobiome to optimize the therapeutic efficacy of natural products. Conclusion This review highlights the relevance of the gut mycobiome as both a diagnostic biomarker and a therapeutic target. Future research should focus on elucidating the causal relationships between mycobiome alterations and disease states, and further explore bacterial–fungal interactions within the gut ecosystem.

Purpose: Regenerative medicine is expected to offer an alternative to liver transplantation for treating liver diseases in the future, with one significant challenge being the establishment of an effective stem cell administration route. This study assessed the antifibrogenic effects of adipose-derived stem cells (ASCs) in a liver fibrosis mouse model, focusing on 2 methods of delivery: intravenous injection and scaffold implantation. Methods: An extracellular matrix mimic scaffold was utilized for culturing peroxisome proliferator-activated receptor gamma coactivator 1-alpha–overexpressing ASCs (tASCs). These scaffolds, laden with tASCs, were then implanted subcutaneously in mice exhibiting liver fibrosis. In contrast, the Cell groups received biweekly intravenous injections of tASCs for 4 weeks. After 4 weeks, tissue samples were harvested from the euthanized mice for subsequent analysis. Results: Real-time PCR and Western blot analyses on liver tissues, focusing on markers like alpha-smooth muscle actin (α-SMA), matrix metalloproteinase-2, and transforming growth factor-beta 1 (TGF-β1), showed that both delivery routes substantially lowered fibrotic and inflammatory markers compared to controls (P < 0.05), with no significant differences between the routes. Histological examinations, along with immunohistochemical analysis of α-SMA, collagen type I alpha, and TGF-β1, revealed that the scaffold implantation approach resulted in a greater reduction in fibrosis and lower immunoreactivity for fibrotic markers than intravenous delivery (P < 0.05). Conclusion These findings indicate that delivering tASCs via a scaffold could be more effective, or at least similarly effective, in treating liver fibrosis compared to intravenous delivery. Scaffold implantation could offer a beneficial alternative to frequent intravenous treatments, suggesting its potential utility in clinical applications for liver disease treatment.

Purpose: The human gut mycobiome comprises diverse fungal species and plays a crucial role in health and disease, despite its relatively low abundance compared to bacterial populations. This review provides an overview of the mycobiome’s composition, developmental patterns, and dysbiosis in various pathological conditions. As well, the complex interactions of fungal communities within the gut microbiome are discussed.Current content: The development of the gut mycobiome follows patterns similar to those of the bacterial microbiome, with birth mode, diet, and age being key determinants. In contrast to the bacterial trends, mycobiome diversity increases during childhood and old age. Recent studies have revealed variations in the mycobiome composition across different ethnic groups. Mycobiome dysbiosis is associated with autoimmune, gastrointestinal, and cardiovascular diseases. Certain fungi, notably Candida albicans, are relatively more abundant in pathological states. Fungal metabolic activity, particularly secondary metabolite production, can significantly affect disease progression. Bacterial–fungal interactions in the gut microbiome are complex and modulated by environmental factors, such as diet and antibiotic use. Moreover, the gut mycobiome modulates therapeutic efficacy. Gut fungi enhance the bioactivity of compounds derived from natural products through biotransformation, including their anticancer and anti-inflammatory effects. This suggests the potential of the gut mycobiome to optimize the therapeutic efficacy of natural products. Conclusion This review highlights the relevance of the gut mycobiome as both a diagnostic biomarker and a therapeutic target. Future research should focus on elucidating the causal relationships between mycobiome alterations and disease states, and further explore bacterial–fungal interactions within the gut ecosystem.

Purpose: Regenerative medicine is expected to offer an alternative to liver transplantation for treating liver diseases in the future, with one significant challenge being the establishment of an effective stem cell administration route. This study assessed the antifibrogenic effects of adipose-derived stem cells (ASCs) in a liver fibrosis mouse model, focusing on 2 methods of delivery: intravenous injection and scaffold implantation. Methods: An extracellular matrix mimic scaffold was utilized for culturing peroxisome proliferator-activated receptor gamma coactivator 1-alpha–overexpressing ASCs (tASCs). These scaffolds, laden with tASCs, were then implanted subcutaneously in mice exhibiting liver fibrosis. In contrast, the Cell groups received biweekly intravenous injections of tASCs for 4 weeks. After 4 weeks, tissue samples were harvested from the euthanized mice for subsequent analysis. Results: Real-time PCR and Western blot analyses on liver tissues, focusing on markers like alpha-smooth muscle actin (α-SMA), matrix metalloproteinase-2, and transforming growth factor-beta 1 (TGF-β1), showed that both delivery routes substantially lowered fibrotic and inflammatory markers compared to controls (P < 0.05), with no significant differences between the routes. Histological examinations, along with immunohistochemical analysis of α-SMA, collagen type I alpha, and TGF-β1, revealed that the scaffold implantation approach resulted in a greater reduction in fibrosis and lower immunoreactivity for fibrotic markers than intravenous delivery (P < 0.05). Conclusion These findings indicate that delivering tASCs via a scaffold could be more effective, or at least similarly effective, in treating liver fibrosis compared to intravenous delivery. Scaffold implantation could offer a beneficial alternative to frequent intravenous treatments, suggesting its potential utility in clinical applications for liver disease treatment.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.