Purpose: Radiotherapy (RT) remains a cornerstone of curative treatment for localized and locally advanced prostate cancer. However, dose escalation to improve tumor control is often constrained by the proximity of the rectum, which increases the risk of gastrointestinal (GI) and genitourinary toxicities. Biodegradable rectal spacers inserted between the prostate and rectum have emerged as an effective approach to reduce rectal radiation exposure. This guideline provides evidence-based recommendations on indications, contraindications, procedural standards, and clinical management for biodegradable rectal spacer insertion during prostate cancer RT. Materials and Methods: This guideline was developed by a multidisciplinary expert panel through a systematic review of the literature, analysis of international guidelines (National Comprehensive Cancer Network, European Association of Urology, American Society for Radiation Oncology), and expert consensus among radiation oncologists, radiologists, and urologists with clinical experience in spacer insertion. The strength of each recommendation and the level of evidence were classified according to the modified GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system. Results: Spacer insertion is conditionally recommended (Grade C, Level I) for patients receiving definitive external-beam RT without rectal invasion. It reduces the high-dose rectal irradiation volume (V70–75) by >50%, decreases acute GI toxicity, and helps maintain bowel-related quality of life. However, the benefit for late severe toxicity (grade 2 or higher) remains debated in recent meta-analyses. Contraindications include rectal invasion, anatomical inaccessibility, infection, and material hypersensitivity. Procedures should be performed under local anesthesia in a sterile environment by trained physicians. Short-course antibiotics and simulator-based training, including completion of multiple supervised cases, are advised. Conclusion Biodegradable rectal spacer insertion is clinically validated and effective in reducing acute rectal toxicity. Although pivotal trials demonstrated a favorable procedural safety profile, real-world postmarket data include reports of rare but severe procedural complications. This guideline provides standardized recommendations tailored to Korean clinical practice while remaining consistent with international standards, emphasizing the importance of operator training and careful patient selection.

Background and Objectives: Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results: A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.

Background and Objectives: Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results: A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.

Background and Objectives: Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results: A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.

Background and Objectives: Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results: A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.

Background and Objectives: Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.Subjects and Method The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed. Results: A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment. Conclusion We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.

Isolated myeloid sarcoma is a rare extramedullary manifestation, characterized by the presence of myeloid blasts in the body and occurring without bone marrow involvement. While the isolated myeloid sarcoma involvement in the nasal cavity of adults has been reported sparsely, there have been no documented cases involving children in South Korea. Given its rarity, diagnosing isolated myeloid sarcoma is challenging without resorting to a biopsy accompanied by a comprehensive panel of immunohistochemistry. In this context, we present a case of a 5-yearold child diagnosed with isolated myeloid sarcoma situated within the right nasal cavity. Notably, this case is unique as there is no evidence of bone marrow invasion or underlying hematological disorders.

Background: Pretransfusion testing is vital for safe transfusion. However, in situations without time to perform sufficient testing, all or part of the pretransfusion testing may be skipped to issue blood quickly. This study evaluated the safety of red blood cell (RBC) transfusion released by an emergency blood transfusion protocol through retrospective analysis at a tertiary hospital for eight years. Methods: All RBC transfusions following the emergency blood transfusion protocol from 2011 to 2018 at Seoul National University Hospital were included in the study. Crossmatching and unexpected antibody screening test results conducted after RBC release and the occurrence of hemolytic transfusion reactions were analyzed. Results: A total of 1,541 cases (5,299 RBCs issued) of emergency blood transfusion were identified. RBCs were issued after performing the immediate spin crossmatch without an unexpected antibody screening test in most cases (1,443; 93.64%), while RBCs were issued with no pretransfusion testing in 98 cases (6.36%). Antibody screening tests performed after the issue of RBCs showed that 17 (1.1%) cases were positive. Two units of RBCs from two different cases showed positive antiglobulin crossmatch test results. However, none of them were suspected to be associated with a hemolytic transfusion reaction. Conclusion The incidence of incompatible RBC release was very low in patients receiving RBC transfusion through the emergency blood transfusion protocol suggesting it can be used safely with minimal risk of hemolytic transfusion reactions caused by incompatible blood transfusions.

PURPOSE: Allergic rhinitis is the most common atopic disease and the most common chronic disease of children. Eosinophil count and percentage in nasal smear are useful for differential diagnosis of allergic rhinitis. The aim of this study is to investigate the correlation between nasal eosinophil count and percentage.METHODS: Between January 2017 and August 2018, 221 children patients with a clinical history of rhinitis were tested at the outpatient respiratory and allergy unit of the Department of Pediatrics, School of Medicine, The Catholic University of Korea. Nasal secretion was collected by swabbing a children's nasal inferior turbinate 3–4 times with a cotton swab and then placed on to a glass slide. Later, the smear was stained by Giemsa stain.RESULTS: This is the first study to assess the comparison of nasal eosinophil count and percent. There is a positive correlation between nasal eosinophil count and percent Y=1.02 X+2.82 (Y=Eosinophil count, X=Eosinophil percentage). To determine the usefulness of nasal eosinophil count and percentage in the diagnosis of allergic rhinitis, we analyzed receiver operating characteristic curves. The cutoff value of the nasal eosinophil count was 6.5/high-power field, and that of the nasal eosinophil ratio was 3% for the diagnosis of allergic rhinitis.CONCLUSION: In patients with suspected rhinitis, one of the values of nasal eosinophil count or percentage can be used in clinical practice.
Azure Stains ; Child ; Chronic Disease ; Diagnosis ; Diagnosis, Differential ; Eosinophils ; Glass ; Humans ; Hypersensitivity ; Korea ; Outpatients ; Pediatrics ; Rhinitis ; Rhinitis, Allergic ; ROC Curve ; Turbinates

PURPOSE: To prevent surgical site complications, many plastic surgeons use the so-called “conventional protocol,” which immobilizes the shoulder and upper arm for 1 month after reconstruction. In an effort to improve the shoulder mobility of patients who received immediate breast reconstruction with tissue expander insertion (TEI), we introduced an early rehabilitation protocol with a short-term immobilization period of 2 weeks. This study aims to compare this early rehabilitation exercise program with the conventional protocol and to determine factors affecting shoulder mobility and quality of life of patients after immediate breast reconstruction. METHODS: A total of 115 patients with breast cancer who underwent reconstructive surgery were retrospectively reviewed. For patients who underwent reconstruction before January 2017, the conventional protocol was followed with immobilization of their shoulder for over 4 weeks. Patients who underwent reconstruction after January 2017 were educated to undergo a self-exercise program after a short-term immobilization period of 2 weeks. We compared shoulder mobility, pain, quality of life, and complications at postoperative 1 and 2 months between the groups. RESULTS: Patients who received early rehabilitation showed greater shoulder flexion and abduction range at postoperative 1 month than those who received the conventional protocol. This increased shoulder abduction range continued until postoperative 2 months. There were no significant surgical site problems in both groups during the 2 months of follow-up. CONCLUSION: To enhance the recovery of shoulder mobility, early rehabilitation with a shorter immobilization period should be recommended to patients with breast cancer undergoing reconstruction surgery with TEI. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03541161
Arm ; Breast Neoplasms ; Breast ; Case-Control Studies ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Mammaplasty ; Mastectomy, Simple ; Plastics ; Quality of Life ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; Rehabilitation ; Retrospective Studies ; Shoulder ; Surgeons ; Tissue Expansion Devices