Rhino-orbito-cerebral mucormycosis (ROCM) is a rare fungal infection that may be fatal in immunocompromised patients. Acupuncture is commonly used in Eastern Asia in addition to steroid medication for the treatment of Bell’s palsy. For such patients with comorbid medical conditions, potential risks might arise after the acupuncture procedure; however, ROCM following acupuncture therapy has not been reported to date. Here we present a rare case of invasive mucormycosis that began from the facial skin after acupuncture procedure. In this case, the patient was suspected of ROCM infection and emergently treated with surgical debridement and antifungal therapy. Despite early surgical debridement and medical treatment, the patient died due to brain infarction and invasion of mucormycosis into the internal carotid artery and cavernous sinus. Although acupuncture therapy is considered relatively safe in general, care should be taken when performing acupuncture in patients with underlying diseases that cause immunosuppression.

Background and Objectives: Hearing loss significantly affects communication, psychosocial well-being, and quality of life. This study analyzes the National Health Insurance Service database to assess the trends and characteristics of hearing loss in South Korea from 2010 to 2020.Subjects and Method The database encompasses 97% of the Korean population, providing comprehensive data on medical history, prescriptions, and health examinations. The analysis used the World Health Organization’s ICD-10 definitions to categorize hearing loss types and examine their prevalence and incidence across various demographics over 11 years. Results: There was an overall annual increase of 4.62% in diagnosed cases of hearing loss, with the most significant rise among the elderly. The rate of increase accelerated from 3.32% between 2010 and 2014 to 6.49% between 2014 and 2020, corresponding with the improved hearing aid access facilitated by policy changes. Women showed a slightly higher increase than men. The data also indicated a consistent rise in abnormal hearing test results during health examinations, especially in older adults. Conclusion The study highlights an increasing trend in hearing loss diagnoses, driven by an aging population and enhanced detection facilitated by policy changes. These findings emphasize the need for continuous monitoring and targeted health policies to manage hearing loss effectively, offering valuable insights for global health management and policy development.

Background and Objectives: Metoclopramide is an antagonist of dopamine D2 receptor and is capable of alleviating chemotherapy-induced nausea and vomiting. However, its underlying mechanisms and function in improving the efficiency of chemotherapy are not fully understood. In this study, we investigated the sensitizing effect of metoclopramide on the platinum-based drugs-mediated apoptosis in human head and neck cancer cells.Subjects and Method Apoptosis was analyzed using a cell-based cytometer. The protein expression and messenger ribonucleic acid (mRNA) levels were assessed by Western blotting and real-time polymerase chain reaction, respectively. Results: Metoclopramide sensitized the platinum-based drug (cisplatin and oxaliplatin)-mediated apoptosis in AMC-HN4 cells, but not in normal cells. Mechanistically, we found that metoclopramide decreased Mcl-1 protein expression through post-translational regulation. Moreover, the overexpression of Mcl-1 prevented apoptosis by combined treatment of metoclopramide and platinum-based drugs. Conclusion Metoclopramide induced proteasome-mediated Mcl-1 downregulation, resulting in increased sensitivity to platinum-based drugs.

Background and Objectives: This study aims to analyze trends in hearing disability and the use of hearing rehabilitation devices (hearing aids and cochlear implants) in South Korea over the past 11 years (2010-2020) using data from the National Health Insurance Service (NHIS).Subjects and Method Data were extracted from the NHIS database, covering approximately 97% of the South Korean population. Patients diagnosed with hearing loss were classified using ICD-10 codes. The data were analyzed to determine trends in hearing disability, hearing aid prescriptions, and cochlear implant usage by age, gender, and types and causes of hearing loss. Results: The number of hearing disability patients increased from 170900 in 2010 to 362738 in 2020, with an annual growth rate of 7.95%. The highest increase was observed in the ≥60 age group, with an annual growth rate of 11.04%. Hearing aid prescriptions rose from 4966 in 2010 to 11974 in 2020, showing a 10.45% annual increase. Females showed a higher growth rate in both hearing disability and hearing aid prescriptions compared to males. Cochlear implant prescriptions also increased, particularly among older adults. Conclusion The study highlights a significant rise in hearing disability and the use of hearing aids and cochlear implants in South Korea, especially among the elderly. The findings underscore the importance of early diagnosis and intervention for hearing loss and the need for policy improvements to enhance accessibility and affordability of hearing rehabilitation services. Additional strategies are needed to ensure appropriate hearing rehabilitation for those not yet receiving adequate care.

Administering sedation for endoscopic retrograde cholangiopancreatography (ERCP) involves using medications to reduce the patient's level of consciousness during a procedure, which can alleviate patient anxiety and discomfort, and improve clinical outcomes. Due to the complexity of the procedure and physiological changes induced by the prone position, meticulous sedation management is essential during ERCP. Before the procedure, a detailed history taking and physical examination are important. If the Mallampati or American Society of Anesthesiologists classification scores are high, anesthesia provider assistance should be considered. Both standard sedation with a combination of midazolam and opioids and balanced propofol sedation can be used safely. During the procedure, monitoring of vital signs, oxygen saturation, and electrocardiogram is important. For high-risk patients, capnography should also be considered. In particular, personalized approaches, including dosage adjustments and more vigilant monitoring during the procedure, are critical for high-risk patients. To ensure safe ERCP, endoscopists must be familiar with the characteristics of sedatives, as well as the types and dosages of antagonists. To prevent hypoxia during the procedure, preoxygenation and the use of high-flow nasal cannula can be considered, and a laryngeal mask can be useful if intubation is difficult in emergency situations. Above all, care must be taken to avoid excessive doses of sedatives, and it is crucial to continually assess the necessity of ERCP for each patient.

Incidentally detected gallbladder polyps (GBPs) and gallbladder wall thickening (GBWT) are frequently encountered in clinical practice. However, characterizing GBPs and GBWT in asymptomatic patients can be challenging and may result in overtreatment, including unnecessary follow-ups or surgeries. The Korean Society of Abdominal Radiology (KSAR) Clinical Practice Guideline Committee has developed expert recommendations that focus on standardized imaging interpretation and follow-up strategies for both GBPs and GBWT, with support from the Korean Society of Radiology and KSAR. These guidelines, which address 24 key questions, aim to standardize the approach for the interpretation of imaging findings, reporting, imaging-based workups, and surveillance of incidentally detected GBPs and GBWT. This recommendation promotes evidence-based practice, facilitates communication between radiologists and referring physicians, and reduces unnecessary interventions.

Objective: This study evaluated the effect of an accelerated three-dimensional (3D) T1-weighted pediatric brain MRI protocol using a deep learning (DL)-based reconstruction algorithm on scan time and image quality. Materials and Methods: This retrospective study included 46 pediatric patients who underwent conventional and accelerated, pre- and post-contrast, 3D T1-weighted brain MRI using a 3T scanner (SIGNA Premier; GE HealthCare) at a single tertiary referral center between March 1, 2023, and April 30, 2023. Conventional scans were reconstructed using intensity Filter A (Conv), whereas accelerated scans were reconstructed using intensity Filter A (Fast_A) and a DL-based algorithm (Fast_DL).Image quality was assessed quantitatively based on the coefficient of variation, relative contrast, apparent signal-to-noise ratio (aSNR), and apparent contrast-to-noise ratio (aCNR) and qualitatively according to radiologists’ ratings of overall image quality, artifacts, noisiness, gray-white matter differentiation, and lesion conspicuity. Results: The acquisition times for the pre- and post-contrast scans were 191 and 135 seconds, respectively, for the conventional scan. With the accelerated protocol, these were reduced to 135 and 80 seconds, achieving time reductions of 29.3% and 40.7%, respectively. DL-based reconstruction significantly reduced the coefficient of variation, improved the aSNR, aCNR, and overall image quality, and reduced the number of artifacts compared with the conventional acquisition method (all P < 0.05). However, the lesion conspicuity remained similar between the two protocols. Conclusion Utilizing a DL-based reconstruction algorithm in accelerated 3D T1-weighted pediatric brain MRI can significantly shorten the acquisition time, enhance image quality, and reduce artifacts, making it a viable option for pediatric imaging.

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.