Background/Aims: Biliary tract cancer (BTC) is a rare malignancy with poor prognosis. We investigated genomic determinants of clinical benefit from gemcitabine, cisplatin, and nab-paclitaxel (GAP) versus gemcitabine and cisplatin (GC) in advanced BTC. Methods: Clinical and genomic data using TruSight Oncology 500 were analyzed from patients treated with GAP (N=198) or GC (N=89) as first-line therapy. Results: With a median follow-up of 33.0 months, GAP modestly improved progression-free survival (PFS) (hazard ratio [HR] 0.764; 95% confidence interval [CI] 0.591–0.989) without significant overall survival (OS) difference compared to GC. Genomic profiling revealed frequent alterations in TP53 (35.2%), KRAS (16.4%), SMAD4 (10.5%), and TNFRSF14 (10.5%), involving RTK/RAS (44.3%), TP53 (41.8%), and PI3K (20.2%) pathways. Single-gene mutations did not predict treatment benefit. However, pathway-level analysis identified PI3K pathway activation as significantly associated with inferior PFS (HR 2.148; 95% CI 1.478–3.124) and OS (HR 2.096; 95% CI 1.413–3.109) in patients receiving GAP, an effect not observed with GC. Importantly, GAP conferred clinical benefit only in patients without PI3K pathway activation, while no survival advantage was seen in those with such alterations (Pinteraction=0.023 for PFS, Pinteraction=0.003 for OS). Similar results were obtained in the independent validation cohort treated with GAP (N=103) or GC (N=64) for BTC. Conclusions Genomic profiling using next-generation sequencing identified PI3K pathway activation as key molecular determinant that differentiates patient outcomes between GAP and GC treatments in advanced BTC.

Although lipoma is a well-known non-malignant tumor, oral cavity lipoma is a rather uncommon disease. Intraoral lipoma originating from the buccal fat pad is an exceptionally rare disorder. Buccal fat pad lipomas typically impair the face's appearance and functionality. The treatment is surgical excision using an intraoral technique, and close identifying of the surrounding anatomical systems, including the parotid duct, vessels, and buccinator branch of the facial nerve. A fifty-year-old patient reported consistently growing swelling of the left cheek. Clinical examination revealed a unilateral mass in the soft tissue. An MRI scan showed a typical picture of a lipoma attached to the buccal fat pad. Surgery was performed to remove the tumor, and the histology report confirmed the clinical diagnosis of lipoma.

Although lipoma is a well-known non-malignant tumor, oral cavity lipoma is a rather uncommon disease. Intraoral lipoma originating from the buccal fat pad is an exceptionally rare disorder. Buccal fat pad lipomas typically impair the face's appearance and functionality. The treatment is surgical excision using an intraoral technique, and close identifying of the surrounding anatomical systems, including the parotid duct, vessels, and buccinator branch of the facial nerve. A fifty-year-old patient reported consistently growing swelling of the left cheek. Clinical examination revealed a unilateral mass in the soft tissue. An MRI scan showed a typical picture of a lipoma attached to the buccal fat pad. Surgery was performed to remove the tumor, and the histology report confirmed the clinical diagnosis of lipoma.

Although lipoma is a well-known non-malignant tumor, oral cavity lipoma is a rather uncommon disease. Intraoral lipoma originating from the buccal fat pad is an exceptionally rare disorder. Buccal fat pad lipomas typically impair the face's appearance and functionality. The treatment is surgical excision using an intraoral technique, and close identifying of the surrounding anatomical systems, including the parotid duct, vessels, and buccinator branch of the facial nerve. A fifty-year-old patient reported consistently growing swelling of the left cheek. Clinical examination revealed a unilateral mass in the soft tissue. An MRI scan showed a typical picture of a lipoma attached to the buccal fat pad. Surgery was performed to remove the tumor, and the histology report confirmed the clinical diagnosis of lipoma.

Although lipoma is a well-known non-malignant tumor, oral cavity lipoma is a rather uncommon disease. Intraoral lipoma originating from the buccal fat pad is an exceptionally rare disorder. Buccal fat pad lipomas typically impair the face's appearance and functionality. The treatment is surgical excision using an intraoral technique, and close identifying of the surrounding anatomical systems, including the parotid duct, vessels, and buccinator branch of the facial nerve. A fifty-year-old patient reported consistently growing swelling of the left cheek. Clinical examination revealed a unilateral mass in the soft tissue. An MRI scan showed a typical picture of a lipoma attached to the buccal fat pad. Surgery was performed to remove the tumor, and the histology report confirmed the clinical diagnosis of lipoma.

Background: Sarcopenia can be associated with the disease etiologies other than degenerative processes, such as neurologic disease including cerebral palsy, myelomeningocele, or Duchenne muscular dystrophy, even in children. Although the relationship between neurologic disease and scoliosis or ambulatory function is known, the mediators affecting scoliosis or gait function in these patients are unclear, an example might be sarcopenia. This study aimed to assess the degree of sarcopenia in young patients with neurologic diseases using computed tomography (CT), and analyze the correlation between sarcopenia and scoliosis or ambulatory function. Methods: Pediatric and young adult patients (≤ 25 years old) who underwent whole-spine or lower-extremity CT were retrospectively included. From bilateral psoas muscle areas (PMAs) at the L3 level, the psoas muscle z-score (PMz) and psoas muscle index [PMI = PMA/(L3 height) 2 ] were calculated. The t-test, Fisher’s exact test, and logistic regression analyses were performed. Results: A total of 121 patients (56 men, mean age 12.2 ± 3.7 years) were included with 79 neurologic and 42 non-neurologic diseases. Patients with neurologic diseases had lower PMz (P = 0.013) and PMI (P = 0.026) than patients without. In neurologic disease patients, severe scoliosis patients showed lower PMz (P < 0.001) and PMI (P = 0.001). Non-ambulatory patients (n = 42) showed lower BMI (β = 0.727, P < 0.001) and PMz (β = 0.547, P = 0.025). In non-ambulatory patients, patients with severe scoliosis also showed lower PMz (P < 0.001) and PMI (P = 0.004). Conclusion Patients with neurologic diseases could have sarcopenia even in young age.Psoas muscle volume was also associated with ambulatory function in these patients.Sarcopenia was more severe in severe scoliosis patients in the non-ambulatory subgroup.

Congenital isolated hydronephrosis encompasses a spectrum of physiologic states that spontaneously resolve and pathologic obstruction that necessitates surgical intervention. Distinguishing patients whose condition will resolve, those who will require stringent follow-up, and those who will eventually need surgical intervention present a challenge to clinicians, particularly because no unified guidelines for assessment and follow-up have been established. The recognition of the natural course and prognosis of hydronephrosis and a comprehensive understanding of the currently proposed consensus guidelines may aid in multidisciplinary treatment and in providing proper counseling to caregivers. In this review, we aimed to summarize the literature on the grading systems and management strategies for congenital isolated hydronephrosis.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.