Background and Objectives: Anti-adhesion agents based on hyaluronate-carboxymethyl cellulose (HA-CMC) are widely used in thyroid surgery to reduce postoperative adhesions. However, concerns persist that higher application volumes may increase postoperative drainage and prolong hospitalization. This study aimed to evaluate the impact of different doses of an HA-CMC solution (Guardix-SGⓇ ) on postoperative drainage and clinical outcomes after hemithyroidectomy. Materials and Methods: This prospective study included 107 patients who underwent hemithyroidectomy with central neck lymph node dissection for thyroid cancer between January and October 2024. Patients were randomly assigned to receive either 3 g (n=57) or 6 g (n=50) of Guardix-SGⓇ intraoperatively.Postoperative drainage volume, drain duration, and length of hospital stay were compared between groups.Analysis of covariance and quantile regression were performed to assess the effects of HA-CMC dose and clinical covariates on drainage outcomes. Results: Baseline demographic and pathological characteristics were comparable between the two groups. Total postoperative drainage volume did not differ significantly between the 3 g and 6 g groups, even after adjustment for hospital stay (p=0.283), nor did drain duration. Quantile regression analysis revealed that hypertension was independently associated with increased drainage volume in higher quantiles (0.25– 0.75), whereas the dose of HA-CMC solution had no significant effect across any quantile. Conclusion Application of a higher dose (6 g) of HA-CMC solution did not increase postoperative drainage or prolong drain duration after hemithyroidectomy. These findings support the safe and effective use of higher-dose Guardix-SGⓇ in thyroid surgery.

Purpose: This study was conducted to establish and verify a hypothetical structural model and for identifying factors that affect the resilience of patients undergoing lung cancer surgery. Methods: A survey was conducted with 223 patients through face-to-face interviews at the outpatient clinics of two university hospitals from January 26 to April 27, 2023. Ultimately, data from 206 participants were included in the analysis, after the exclusion of data from 17 participants who chose not to complete the survey. Data analysis was conducted using SPSS 27.0 and Mplus 8. Results: The suitability of the hypothetical model was shown to be good (CFI=.97, RMSEA=.06, SRMR=.05). Hope was the only factor that directly affected resilience, and symptom distress had a double mediating effect on resilience through perceived social support and hope. Spirituality had a simple mediating effect on resilience through hope, while it had a double mediating effect on resilience through perceived social support and hope. Conclusion These findings suggest that it is necessary to strengthen spirituality and properly manage symptom distress in order to increase resilience in patients undergoing lung cancer surgery. It is also necessary to increase the degree of perceived social support and to develop and apply nursing interventions that can enhance hope.

Purpose: This study was conducted to establish and verify a hypothetical structural model and for identifying factors that affect the resilience of patients undergoing lung cancer surgery. Methods: A survey was conducted with 223 patients through face-to-face interviews at the outpatient clinics of two university hospitals from January 26 to April 27, 2023. Ultimately, data from 206 participants were included in the analysis, after the exclusion of data from 17 participants who chose not to complete the survey. Data analysis was conducted using SPSS 27.0 and Mplus 8. Results: The suitability of the hypothetical model was shown to be good (CFI=.97, RMSEA=.06, SRMR=.05). Hope was the only factor that directly affected resilience, and symptom distress had a double mediating effect on resilience through perceived social support and hope. Spirituality had a simple mediating effect on resilience through hope, while it had a double mediating effect on resilience through perceived social support and hope. Conclusion These findings suggest that it is necessary to strengthen spirituality and properly manage symptom distress in order to increase resilience in patients undergoing lung cancer surgery. It is also necessary to increase the degree of perceived social support and to develop and apply nursing interventions that can enhance hope.

Purpose: This study was conducted to establish and verify a hypothetical structural model and for identifying factors that affect the resilience of patients undergoing lung cancer surgery. Methods: A survey was conducted with 223 patients through face-to-face interviews at the outpatient clinics of two university hospitals from January 26 to April 27, 2023. Ultimately, data from 206 participants were included in the analysis, after the exclusion of data from 17 participants who chose not to complete the survey. Data analysis was conducted using SPSS 27.0 and Mplus 8. Results: The suitability of the hypothetical model was shown to be good (CFI=.97, RMSEA=.06, SRMR=.05). Hope was the only factor that directly affected resilience, and symptom distress had a double mediating effect on resilience through perceived social support and hope. Spirituality had a simple mediating effect on resilience through hope, while it had a double mediating effect on resilience through perceived social support and hope. Conclusion These findings suggest that it is necessary to strengthen spirituality and properly manage symptom distress in order to increase resilience in patients undergoing lung cancer surgery. It is also necessary to increase the degree of perceived social support and to develop and apply nursing interventions that can enhance hope.

Junctional epidermolysis bullosa (JEB) is a subtype of epidermolysis bullosa characterized by the formation of blisters within the basement membrane, particularly in the lamina lucida. Clinical manifestations of JEB include fragile skin with blisters and erosion. This case report presents a 35-year-old male with JEB caused by ITGA3mutations (p.Arg875Ter, p.Cys162Tyr) without pulmonary or renal complications. The patient exhibited various cutaneous signs such as persistent exfoliative patches, nail hypoplasia, and diffuse alopecia, with additional ophthalmic complications such as symblepharon and limbal stem cell deficiency. ITGA3 mutations are typically linked to interstitial lung disease and nephrotic syndrome, a characteristic group of symptoms known as ILNEB (‘Interstitial Lung disease, Nephrotic syndrome and Epidermolysis Bullosa’). However, the patient showed no evidence of renal or pulmonary involvement, with normal urinalysis and chest X-ray results, making the diagnosis more difficult until next generation sequencing confirmed the ITGA3 mutation.

Purpose: Triple-negative breast cancer (TNBC) is a heterogeneous and aggressive subtype of breast cancer associated with poor clinical outcomes. Although programmed death ligand 1 (PD-L1) expression has emerged as both a prognostic and predictive biomarker, its utility remains limited, especially in PD-L1-negative tumors. The identification of additional molecular markers is crucial for improving prognostic stratification and guiding treatment strategies. Methods: Formalin-fixed, paraffin-embedded tumor tissues from 38 patients with TNBC were analyzed. PD-L1 expression was assessed using immunohistochemistry and categorized as positive or negative. Whole-exome sequencing was performed, and somatic variants were analyzed using Maftools. Mutational signatures were compared with the Catalogue Of Somatic Mutations In Cancer reference profiles. Survival analyses were performed to evaluate the prognostic significance of the identified variants. Results: Mutational landscape analysis revealed that C>T and G>A transitions were the most frequent base substitutions. PD-L1-negative tumors exhibited a predominance of single-base substitution (SBS) 5, whereas PD-L1-positive tumors resembled SBS6, reflecting potential differences in the underlying mutational processes. Comparative analysis identified 12 PD-L1-negative-specific and seven PD-L1-positive-specific variants. Among PD-L1-negative tumors, mutations in ANGPTL5 and KIAA1549L were significantly associated with worse overall survival. Conclusion Our findings highlight distinct mutational profiles and prognostic variants according to PD-L1 status in TNBC. ANGPTL5 and KIAA1549L variants may serve as potential prognostic markers for PD-L1-negative tumors. These results underscore the value of incorporating genomic information to refine the prognostic stratification of TNBC.

Hemodialysis (HD) patients have a higher mortality rate compared to the general population. However, no study has investigated life expectancy in Korean HD patients so far. Therefore, this study aimed to calculate the remaining life expectancy among Korean maintenance HD patients and compare it to those of the general population as well as HD patients from other countries. Methods: Baseline data were retrieved from HD quality assessment data from 2015. Among the patients over 30 years old who were alive at the beginning of 2016 (20,304 males and 14,264 females), a total of 22,078 (12,621 males and 9,457 females) were still alive at the end of 2021 while 12,490 (7,683 males and 4,807 females) were deceased during 6 years of follow-up. We used the life table method to calculate the expected remaining years of life in 2-year increments. Results: The remaining life expectancies for 60-year-old patients were 11.64 years for males and 14.64 years for females. The average remaining life expectancies of the HD population were only about half of the general population. Diabetic patients demonstrated shorter life expectancy compared to patients with hypertension or glomerulonephritis. The remaining life expectancy of Korean HD patients was similar to that of Japanese and was almost double that of HD patients in Western countries such as Europe and the United States. Conclusion: The HD population shows a shorter life expectancy compared to the general population. Longitudinal analysis should be warranted to analyze the effect of advanced dialysis technology on improved survival rates among the HD population.

Background: Respiratory syncytial virus (RSV), a highly transmissible virus, is the leading cause of lower respiratory tract infections. We examined molecular changes in the RSV genome before and after the coronavirus disease 2019 (COVID-19) pandemic in Korea, and investigated whether drug-resistant mutations were present. Methods: In this prospective, single-center study, RSV-positive respiratory samples were collected between September 2019 and December 2022. Long-read whole-genome sequencing (WGS) was performed, and the presence of known drug-resistant substitutions for palivizumab, nirsevimab, and suptavumab was investigated. Results: Overall, 288 respiratory samples were collected from 276 children. WGS data were available for 133 samples (71 and 62 samples from the pre- and post-pandemic periods, respectively). All RSV-A strains (n = 56) belonged to the GA2.3.5 (ON1) genotype, whereas all RSV-B strains (n = 77) belonged to the GB5.0.5a (BA) genotype. No significant differences in genotypes were observed between the pre- and post-pandemic periods. In addition, no notable mutations related to nirsevimab or palivizumab resistance were detected in the F gene. However, the L172Q and S173L substitutions, which are known to confer resistance to suptavumab, were present in all RSV-B samples. Conclusion Despite the unprecedented interruption of RSV seasonality, there were no significant molecular changes in circulating RSV strains in Korea related to nirsevimab or palivizumab resistance before and after the COVID-19 pandemic. However, RSV-specific drug-resistance substitutions for suptavumab were identified.

Objective: This study investigates NOX4, an enzyme producing hydrogen peroxide, in endochondral ossification and bone remodeling. NOX4’s role in osteoblast formation and osteogenic signaling pathways is explored. Methods: Using NOX4-deficient (NOX4−/− ) and ovariectomized (OVX) mice, we identify NOX4’s potential mediators in bone maturation. Results: NOX4−/− mice displayed significant differences in bone mass and structure.Compared to the normal Control and OVX groups. Hematoxylin and eosin staining showed NOX4−/− mice had the highest trabecular bone volume, while OVX had the lowest. Proteomic analysis revealed significantly elevated MPO and OPN levels in bone marrow-derived cells in NOX4−/− mice. Immunohistochemistry confirmed increased MPO, OPN, and collagen II (COLII) near the epiphyseal plate. Collagen and chondrogenesis analysis supported enhanced bone development in NOX4−/− mice. Conclusions and Relevance: Our results emphasize NOX4’s significance in bone morphology, mesenchymal stem cell proteomics, immunohistochemistry, collagen levels, and chondrogenesis. NOX4 deficiency enhances bone development and endochondral ossification, potentially through increased MPO, OPN, and COLII expression. These findings suggest therapeutic implications for skeletal disorders.

During the long-term COVID-19 pandemic, wearing a mask is inevitable for protecting individuals from airborne infection. In this case, we found out that mask may exacerbate atopic dermatitis and it can be treated simply and effectively using silicone tape. We suggest that throughout the COVID-19 pandemic, silicone tape can be beneficial in both preventing and treating eczema caused by mask-wearing, especially in patients with atopic dermatitis.