Purpose: It is well known that the majority of the extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues (MALT lymphomas) are associated with microbiota, e.g., gastric MALT lymphoma with Helicobacter pylori. In general, they are very sensitive to low-dose radiotherapy and chemotherapeutic agents. The microbiota profile is not clearly elucidated in bronchus-associated lymphoid tissue (BALT) lymphoma, a rare type of MALT lymphoma in the lung. Thus, this study aimed to clarify the intratumor microbiome in BALT lymphoma using the third-generation next-generation sequencing (NGS) method. Materials and Methods: DNAs were extracted from 12 formalin-fixed paraffin-embedded (FFPE) tumor tissues obtained from BALT lymphoma patients diagnosed between 1990 and 2016. 16S rRNA gene was amplified by polymerase chain reaction. Amplicons were sequenced using a Nanopore platform. Next-generation sequencing analysis was performed to assess microbial profiles. For comparison, FFPE specimens from nine non-cancerous lung tissues were also analyzed. Results: Specific bacterial families including Burkholderiaceae, Bacillaceae, and Microbacteriaceae were associated with BALT lymphoma by a linear discriminant analysis effect size approach. Although the number of specimens was limited, BALT lymphomas exhibited significantly higher microbial abundance and diversity with distinct microbial composition patterns and correlation networks than non-cancerous lung tissues. Conclusion This study provides the first insight into intratumor microbiome in BALT lymphoma using the third-generation NGS method. A distinct microbial composition suggests the presence of a unique tumor microenvironment of BALT lymphoma.

Purpose: It is well known that the majority of the extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues (MALT lymphomas) are associated with microbiota, e.g., gastric MALT lymphoma with Helicobacter pylori. In general, they are very sensitive to low-dose radiotherapy and chemotherapeutic agents. The microbiota profile is not clearly elucidated in bronchus-associated lymphoid tissue (BALT) lymphoma, a rare type of MALT lymphoma in the lung. Thus, this study aimed to clarify the intratumor microbiome in BALT lymphoma using the third-generation next-generation sequencing (NGS) method. Materials and Methods: DNAs were extracted from 12 formalin-fixed paraffin-embedded (FFPE) tumor tissues obtained from BALT lymphoma patients diagnosed between 1990 and 2016. 16S rRNA gene was amplified by polymerase chain reaction. Amplicons were sequenced using a Nanopore platform. Next-generation sequencing analysis was performed to assess microbial profiles. For comparison, FFPE specimens from nine non-cancerous lung tissues were also analyzed. Results: Specific bacterial families including Burkholderiaceae, Bacillaceae, and Microbacteriaceae were associated with BALT lymphoma by a linear discriminant analysis effect size approach. Although the number of specimens was limited, BALT lymphomas exhibited significantly higher microbial abundance and diversity with distinct microbial composition patterns and correlation networks than non-cancerous lung tissues. Conclusion This study provides the first insight into intratumor microbiome in BALT lymphoma using the third-generation NGS method. A distinct microbial composition suggests the presence of a unique tumor microenvironment of BALT lymphoma.

Objective: The frequency and severity of dog bite injuries were reported to increase during the coronavirus disease-19 (COVID-19) pandemic. This study examined the status of dog bite injuries in Korea and the changes during the COVID-19 pandemic. Methods: Patient information was obtained from in-depth research data on patients from January 1, 2019, to December 31, 2020, conducted by the Korea Centers for Disease Control and Prevention. The general characteristics, the situation and location at the time of the dog bite injury, severity, and the means of transport to the emergency department (ED) were evaluated, and the excess mortality ratio-adjusted injury severity score was determined to evaluate the severity. The differences between the pre-COVID pandemic (2019) and post-COVID pandemic (2020) were compared, and subgroups by age were also analyzed. Results: Under the COVID-19 pandemic, the number of patients decreased in all age groups. In contrast, the severity, especially in the under-19-year-old group, showed a slight but significant increase. In addition, dog bite injuries occurred most frequently in the home, particularly during the COVID-19 pandemic. Conclusion The severity of dog bites in those under the age of 19 was highest, which should be considered when setting more appropriate guidelines for the classification and treatment of dog-bite patients in an ED. Dog bite injuries occur most frequently during daily activity in the house. This tendency was further strengthened in the context of the COVID-19 pandemic.

Purpose: It is well known that the majority of the extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues (MALT lymphomas) are associated with microbiota, e.g., gastric MALT lymphoma with Helicobacter pylori. In general, they are very sensitive to low-dose radiotherapy and chemotherapeutic agents. The microbiota profile is not clearly elucidated in bronchus-associated lymphoid tissue (BALT) lymphoma, a rare type of MALT lymphoma in the lung. Thus, this study aimed to clarify the intratumor microbiome in BALT lymphoma using the third-generation next-generation sequencing (NGS) method. Materials and Methods: DNAs were extracted from 12 formalin-fixed paraffin-embedded (FFPE) tumor tissues obtained from BALT lymphoma patients diagnosed between 1990 and 2016. 16S rRNA gene was amplified by polymerase chain reaction. Amplicons were sequenced using a Nanopore platform. Next-generation sequencing analysis was performed to assess microbial profiles. For comparison, FFPE specimens from nine non-cancerous lung tissues were also analyzed. Results: Specific bacterial families including Burkholderiaceae, Bacillaceae, and Microbacteriaceae were associated with BALT lymphoma by a linear discriminant analysis effect size approach. Although the number of specimens was limited, BALT lymphomas exhibited significantly higher microbial abundance and diversity with distinct microbial composition patterns and correlation networks than non-cancerous lung tissues. Conclusion This study provides the first insight into intratumor microbiome in BALT lymphoma using the third-generation NGS method. A distinct microbial composition suggests the presence of a unique tumor microenvironment of BALT lymphoma.

Objective: The frequency and severity of dog bite injuries were reported to increase during the coronavirus disease-19 (COVID-19) pandemic. This study examined the status of dog bite injuries in Korea and the changes during the COVID-19 pandemic. Methods: Patient information was obtained from in-depth research data on patients from January 1, 2019, to December 31, 2020, conducted by the Korea Centers for Disease Control and Prevention. The general characteristics, the situation and location at the time of the dog bite injury, severity, and the means of transport to the emergency department (ED) were evaluated, and the excess mortality ratio-adjusted injury severity score was determined to evaluate the severity. The differences between the pre-COVID pandemic (2019) and post-COVID pandemic (2020) were compared, and subgroups by age were also analyzed. Results: Under the COVID-19 pandemic, the number of patients decreased in all age groups. In contrast, the severity, especially in the under-19-year-old group, showed a slight but significant increase. In addition, dog bite injuries occurred most frequently in the home, particularly during the COVID-19 pandemic. Conclusion The severity of dog bites in those under the age of 19 was highest, which should be considered when setting more appropriate guidelines for the classification and treatment of dog-bite patients in an ED. Dog bite injuries occur most frequently during daily activity in the house. This tendency was further strengthened in the context of the COVID-19 pandemic.

Objective: The frequency and severity of dog bite injuries were reported to increase during the coronavirus disease-19 (COVID-19) pandemic. This study examined the status of dog bite injuries in Korea and the changes during the COVID-19 pandemic. Methods: Patient information was obtained from in-depth research data on patients from January 1, 2019, to December 31, 2020, conducted by the Korea Centers for Disease Control and Prevention. The general characteristics, the situation and location at the time of the dog bite injury, severity, and the means of transport to the emergency department (ED) were evaluated, and the excess mortality ratio-adjusted injury severity score was determined to evaluate the severity. The differences between the pre-COVID pandemic (2019) and post-COVID pandemic (2020) were compared, and subgroups by age were also analyzed. Results: Under the COVID-19 pandemic, the number of patients decreased in all age groups. In contrast, the severity, especially in the under-19-year-old group, showed a slight but significant increase. In addition, dog bite injuries occurred most frequently in the home, particularly during the COVID-19 pandemic. Conclusion The severity of dog bites in those under the age of 19 was highest, which should be considered when setting more appropriate guidelines for the classification and treatment of dog-bite patients in an ED. Dog bite injuries occur most frequently during daily activity in the house. This tendency was further strengthened in the context of the COVID-19 pandemic.

The circadian rhythm for mood (CRM) is a digital therapeutic, which aims to prevent mood episode and improve clinical course in patients with major mood disorders. Developed on the circadian rhythm hypothesis of mood disorder, CRM predicts the impending risk of mood episode with its built-in algorithm, utilizing wearable devices data and daily self-reports, and provides personalized feedback. In a pilot study of the CRM, the users experienced less frequent and shorter duration of mood episodes than the non-users. To investigate the efficacy of the upgraded CRM, a double-blind, randomized, sham-controlled, parallel-group trial is designed. Patients aged between 19 and 70, diagnosed with bipolar I disorder, bipolar II disorder, or major depressive disorder, in a euthymic state for more than two months, can participate. During this 12-month trial, participants are assessed for episode recurrence every three months, and the efficacy of the CRM as a potential digital therapeutic is evaluated. Trial registration: ClinicalTrials.gov Identifier: NCT05400785.

Background/Aims: Despite short-acting β2-agonist (SABA) overuse being associated with poor asthma outcomes, data on SABA use in South Korea is scarce. Herein, we describe prescription patterns of SABA and other asthma medications in patients from the South Korean cohort of the SABA use IN Asthma (SABINA) III study. Methods: This study included patients with asthma aged ≥ 12 years, who had ≥ 3 consultations with the same healthcare provider, and medical records containing data for ≥ 12 months prior to the study visit. Patients were classified by investigator-defined asthma severity (per 2017 Global Initiative for Asthma recommendations) and practice type (primary or specialist care). Data on disease characteristics, asthma treatments, and clinical outcomes in the 12 months before the study visit were collected using electronic case report forms. Results: Data from 476 patients (mean age, 55.4 years; female, 63.0%) were analyzed. Most patients were treated by specialists (83.7%) and had moderate-to-severe asthma (91.0%). Overall, 7.6% of patients were prescribed ≥ 3 SABA canisters (defined as over-prescription). In patients prescribed SABA in addition to maintenance therapy, 47.4% were over-prescribed SABA. Most patients (95.4%) were prescribed a fixed-dose combination of an inhaled corticosteroid and a long-acting β2-agonist as maintenance therapy. Although asthma was well-controlled/partly-controlled in 91.6% of patients, 29.6% experienced ≥ 1 severe asthma exacerbation. Conclusions SABA over-prescription was reported in nearly 50% of patients prescribed SABA in addition to maintenance therapy, underscoring the need to align clinical practices with the latest evidence-based recommendations and educate physicians and patients on appropriate SABA use.

Background/Aims: Epidermal growth factor receptor (EGFR) mutation is important in determining the treatment strategy for advanced lung cancer patients with malignant pleural effusion (MPE). Contrary to serum carcinoembryonic antigen (S-CEA) levels, the associations between pleural fluid CEA (PF-CEA) levels and EGFR mutation status as well as between PF-CEA levels and treatment efficacy have rarely been investigated in lung adenocarcinoma patients with MPE. Methods: This retrospective study enrolled lung adenocarcinoma patients with MPE and available PF-CEA levels and EGFR mutation results. The patients were categorized based on PF-CEA levels: < 10 ng/mL, 10–100 ng/mL, 100–500 ng/mL, and ≥ 500 ng/mL. The association between PF-CEA levels and EGFR mutation status as well as their therapeutic impact on overall survival was compared among the four groups. Results: This study included 188 patients. PF-CEA level was found to be an independent predictor of EGFR mutation but not S-CEA level. The EGFR mutation rates were higher as the PF-CEA levels increased, regardless of cytology results or sample types. Among EGFR-mutant lung adenocarcinoma patients receiving EGFR-tyrosine kinase inhibitor (TKI) treatment, those with high PF-CEA levels had significantly better survival outcomes than those with low PF-CEA levels. Conclusion High PF-CEA levels were associated with high EGFR mutation rate and may lead to a favorable clinical outcome of EGFR-TKI treatment in EGFR-mutant lung adenocarcinoma patients with MPE. These findings highlight the importance of actively investigating EGFR mutation detection in patients with suspected MPE and elevated PF-CEA levels despite negative cytology results.

Nocturnal stridor, a high-pitched breathing sound during sleep, is one of the respiratory signs indicating airway narrowing. A 70-year-old man experienced life-threatening nocturnal stridor following tracheostomy decannulation after medullary infarction and vocal cord paralysis. This rare case highlights the importance of evaluating risk of sleep apnea and vocal cord function pre-decannulation to prevent serious complications.