Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.

Extramedullary relapse of acute promyelocytic leukemia is rare and has been reported in 3%- 5% of patients. Relapse in the external auditory canal and the temporal bone is even more uncommon and scarcely reported. We encountered a 69-year-old male who complained about right ear pain and hearing loss. The patient had extramedullary relapse of acute promyelocytic leukemia in the right external auditory canal and in the temporal bone.

Background and Objectives: Cognitive behavioral therapy (CBT) is a treatment option for subjective tinnitus. There are many reports on its clinical efficacy, but the protocol has not been well established. The purpose of this study was to set an outpatient-based CBT protocol and evaluate its clinical efficacy for tinnitus.Subjects and Method A total of 85 chronic tinnitus patients was assessed in this prospective study. After evaluating for eligibility, 30 patients completed CBT based on a protocol of 5 weekly sessions in an outpatient setting. Therapeutic efficacy was assessed by Tinnitus Handicap Inventory (THI) questionnaires and visual analogue scale (VAS) for tinnitus. The initial scores were compared with the final scores, which were assessed a month after the fifth CBT session. Results: The results showed that CBT reduced THI and VAS scores significantly (p<0.05). Conclusion The results of the study suggest that an outpatient-based CBT protocol can be clinically beneficial for patients with tinnitus.

Purpose: There are no reliable biomarkers to guide treatment for patients with borderline resectable pancreatic cancer (BRPC) in the neoadjuvant setting. We used plasma circulating tumor DNA (ctDNA) sequencing to search biomarkers for patients with BRPC receiving neoadjuvant mFOLFIRINOX in our phase 2 clinical trial (NCT02749136). Materials and Methods: Among the 44 patients enrolled in the trial, patients with plasma ctDNA sequencing at baseline or post-operation were included in this analysis. Plasma cell-free DNA isolation and sequencing were performed using the Guardant 360 assay. Detection of genomic alterations, including DNA damage repair (DDR) genes, were examined for correlations with survival. Results: Among the 44 patients, 28 patients had ctDNA sequencing data qualified for the analysis and were included in this study. Among the 25 patients with baseline plasma ctDNA data, 10 patients (40%) had alterations of DDR genes detected at baseline, inclu-ding ATM, BRCA1, BRCA2 and MLH1, and showed significantly better progression-free survival than those without such DDR gene alterations detected (median, 26.6 vs. 13.5 months; log-rank p=0.004). Patients with somatic KRAS mutations detected at baseline (n=6) had significantly worse overall survival (median, 8.5 months vs. not applicable; log-rank p=0.003) than those without. Among 13 patients with post-operative plasma ctDNA data, eight patients (61.5%) had detectable somatic alterations. Conclusion Detection of DDR gene mutations from plasma ctDNA at baseline was associated with better survival outcomes of pati-ents with borderline resectable pancreatic ductal adenocarcinoma treated with neoadjuvant mFOLFIRINOX and may be a prognostic biomarker.

Abnormal inflammatory responses are closely associated with intestinal microbial dysbiosis. Oral administration of Qmatrix-diabetes-mellitus complex (QDMC), an Aloe gel-based formula, has been reported to improve inflammation in type 2 diabetic mice; however, the role of the gut microbiota in ameliorating efficacy of QDMC remains unclear. We investigated the effect of QDMC on the gut microbiota in a type 2 diabetic aged mouse model that was administered a high-fat diet. Proinflammatory (TNF-α and IL-6) and anti-inflammatory (IL-4 and IL-10) cytokine levels in the fat were normalized via oral administration of QDMC, and relative abundances of Bacteroides, Butyricimonas, Ruminococcus, and Mucispirillum were simultaneously significantly increased. The abundance of these bacteria was correlated to the expression levels of cytokines. Our findings suggest that the immunomodulatory activity of QDMC is partly mediated by the altered gut microbiota composition.

Cognitive behavioral therapy, first introduced by Beck in the 1950s to treat depression by integrating cognitive and behavioral therapies, is now an established psychotherapy technique used to treat insomnia, chronic pain, and anxiety. Currently, cognitive behavioral therapy is widely used to treat tinnitus in European countries, and the efficacy and safety of the treatment have been proven through randomized clinical trials and meta-analyses. Although interest in cognitive behavioral therapy for tinnitus is increasing in Korea, there are limited reports. Because many studies so far have targeted patients in Western countries, it is difficult to apply the same to domestic patients due to cultural and linguistic differences, the absence of standardized guidelines, and limitations in clinic hours. We experienced various cases in which tinnitus was effectively treated simultaneously with pharmacotherapy and cognitive behavioral therapy, so here we report an introduction to the program along with a literature review. Cognitive behavioral therapy was performed as a 4-week program in our hospital, and progress was evaluated through Visual Analogue Scales (VAS) and tinnitus handicap inventory (THI). After each weekly 20-minute individual counseling session, a take-home writing task was given to the patient. The main goal was to guide the patient to discover and correct automatic thoughts related to their tinnitus symptoms. This paper aimed to introduce a specific scheme on how to perform cognitive behavioral therapy for domestic tinnitus patients.