Multiple myeloma (MM), a hematological malignancy, is characterized by malignant plasma cell proliferation in the bone marrow. Recent treatment advances have significantly improved patient outcomes associated with MM.In this study, we aimed to develop comprehensive, evidence-based guidelines for the diagnosis, prognosis, and treat‑ ment of MM. We identified 12 key clinical questions essential for MM management, guiding the extensive literature review and meta-analysis of the study. Our guidelines provide evidence-based recommendations by integrating patient preferences with survey data. These recommendations include current and emerging diagnostic tools, thera‑ peutic agents, and treatment strategies. By prioritizing a patient-centered approach and rigorous data analysis, these guidelines were developed to enhance MM management, both in Korea and globally.

Objective: This study aimed to develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify gentamicin residues in milk and to establish a withdrawal period for an intramuscular gentamicin product in dairy cows. Methods: Nine Holstein cows received a gentamicin product (50 mg gentamicin sulfate/ mL) at 0.1 mL/kg twice daily at 12 h intervals via intramuscular injection. Milk samples were collected before dosing and at 12 h intervals up to 168 h after the final administration and analysed with a validated LC-MS/MS method using heptafluorobutyric acid as an ion-pairing reagent. Results: The method showed recovery rates of 86%–104%, coefficients of variation of 3%–11%, and limits of detection and quantitation of 23 and 70 ng/mL, respectively. Mean gentamicin concentrations exceeded the maximum residue limit (MRL; 0.2 mg/kg) at 12 h during treatment and 12 h after the final administration, and were < MRL in all cows from 36 h after the last dose. Based on residue depletion data and a national non-statistical guideline, a withdrawal period of 40–48 h was derived, and the regulatory withdrawal period for this product was established as 3 days. Conclusions and Relevance: The validated LC-MS/MS method enables rapid quantitation of gentamicin residues in bovine milk. A 3-day regulatory withdrawal period for this product supports milk safety, regulatory compliance, and practical use in dairy herds.

Objectives: The objective of this study was to evaluate the long-term clinical outcomes of one-piece narrow-diameter implants (NDIs), with diameters of 2.5 mm and 3.0 mm, and to investigate the factors that affect marginal bone loss (MBL) around these implants. Materials and Methods: This study analyzed patients who were treated with 2.5 mm and 3.0 mm MS SA narrow ridge implants (Osstem Implant) at the Section of Dentistry in Seoul National University Bundang Hospital from 2007 to 2022 and had more than 6 years of follow-up data. MBL was measured using periapical radiographs. Age, sex, implant location, timing of implant placement and loading, placement depth, guided bone regeneration (GBR), fixture diameter, type of implant prosthesis, and opposing dentition type were investigated in relation to MBL. The implant survival rate was analyzed using Kaplan–Meier survival curves, and univariate and multivariate logistic regression models were used to identify factors associated with MBL. All analyses were conducted using R software (version 4.1.0 for Microsoft Windows; R Foundation). Results: Twenty-five patients with 40 NDIs were included in this study. The mean observation period after implant function was 10.5 years (range, 6.1 to 14.0 years), and the survival rate of the NDIs was 95.1% at the implant level and 96.0% at the patient level. The average amount of MBL was 0.44±0.57 mm. The only factor that showed a significant association with MBL was the presence of GBR (P=0.046). Conclusion Within the limitations of a retrospective evaluation, NDIs have demonstrated optimal clinical outcomes over a long period in areas in which anatomical structures are limited. MBL around the NDI also showed clinically acceptable results, and a correlation with MBL was observed in cases in which a bone graft was performed. Further studies with a larger number of implants over extended periods are needed in the future.

Objectives: The objective of this study was to evaluate the long-term clinical outcomes of one-piece narrow-diameter implants (NDIs), with diameters of 2.5 mm and 3.0 mm, and to investigate the factors that affect marginal bone loss (MBL) around these implants. Materials and Methods: This study analyzed patients who were treated with 2.5 mm and 3.0 mm MS SA narrow ridge implants (Osstem Implant) at the Section of Dentistry in Seoul National University Bundang Hospital from 2007 to 2022 and had more than 6 years of follow-up data. MBL was measured using periapical radiographs. Age, sex, implant location, timing of implant placement and loading, placement depth, guided bone regeneration (GBR), fixture diameter, type of implant prosthesis, and opposing dentition type were investigated in relation to MBL. The implant survival rate was analyzed using Kaplan–Meier survival curves, and univariate and multivariate logistic regression models were used to identify factors associated with MBL. All analyses were conducted using R software (version 4.1.0 for Microsoft Windows; R Foundation). Results: Twenty-five patients with 40 NDIs were included in this study. The mean observation period after implant function was 10.5 years (range, 6.1 to 14.0 years), and the survival rate of the NDIs was 95.1% at the implant level and 96.0% at the patient level. The average amount of MBL was 0.44±0.57 mm. The only factor that showed a significant association with MBL was the presence of GBR (P=0.046). Conclusion Within the limitations of a retrospective evaluation, NDIs have demonstrated optimal clinical outcomes over a long period in areas in which anatomical structures are limited. MBL around the NDI also showed clinically acceptable results, and a correlation with MBL was observed in cases in which a bone graft was performed. Further studies with a larger number of implants over extended periods are needed in the future.

Drug-induced liver injury (DILI) is considered to be a significant cause of drug wastage. Tomitigate clinical DILI risks, assessing drugs using human liver models is crucial since animal studies may fall short due to species-specific liver pathway variations. Cell-based preclinical hepatotoxicity testing is often pertinent. In the present study, cells from a human liver cancer line (HepG2 and HepaRG) were cultured in both formats of 2D and 3D spheroids to explore their responses to drugs. Liver-specific marker expressions across cell lines and culture formats were also examined to assess disparities in DILI marker expressions. After treating each cell with the drugs, cytotoxicity and liver injury markers aspartate aminotransferase and alanine aminotransferase were increased. In addition, liver specific markers albumin and urea decreased in a drug concentration-dependent manner. These findings were consistent with drug sensitivity. Additionally, mRNA expression levels of cytochrome P450 enzymes (CYPs) involved in hepatocellular drug metabolism were compared following treatment with enzyme inducers. CYP1A2 and CYP2C9 were not epxressed in HepG2 cells. HepaRG cells exhibited significantly increased expression of CYP1A2, 2C9, and 3A4 post-treatment. No-tably, enzyme expression was notably higher in 3D cultures than in 2D cultures. Collectively, these findings suggest that HepaRG cells and 3D cultures hold promise for evaluating DILI during early-stage drug development.

Objectives: The objective of this study was to evaluate the long-term clinical outcomes of one-piece narrow-diameter implants (NDIs), with diameters of 2.5 mm and 3.0 mm, and to investigate the factors that affect marginal bone loss (MBL) around these implants. Materials and Methods: This study analyzed patients who were treated with 2.5 mm and 3.0 mm MS SA narrow ridge implants (Osstem Implant) at the Section of Dentistry in Seoul National University Bundang Hospital from 2007 to 2022 and had more than 6 years of follow-up data. MBL was measured using periapical radiographs. Age, sex, implant location, timing of implant placement and loading, placement depth, guided bone regeneration (GBR), fixture diameter, type of implant prosthesis, and opposing dentition type were investigated in relation to MBL. The implant survival rate was analyzed using Kaplan–Meier survival curves, and univariate and multivariate logistic regression models were used to identify factors associated with MBL. All analyses were conducted using R software (version 4.1.0 for Microsoft Windows; R Foundation). Results: Twenty-five patients with 40 NDIs were included in this study. The mean observation period after implant function was 10.5 years (range, 6.1 to 14.0 years), and the survival rate of the NDIs was 95.1% at the implant level and 96.0% at the patient level. The average amount of MBL was 0.44±0.57 mm. The only factor that showed a significant association with MBL was the presence of GBR (P=0.046). Conclusion Within the limitations of a retrospective evaluation, NDIs have demonstrated optimal clinical outcomes over a long period in areas in which anatomical structures are limited. MBL around the NDI also showed clinically acceptable results, and a correlation with MBL was observed in cases in which a bone graft was performed. Further studies with a larger number of implants over extended periods are needed in the future.

The bite collapses due to posterior teeth loss or wear results in inadequate space for restoration and esthetic concerns. Increasing the occlusal vertical dimension to improve space deficiency rotates the mandible posteriorly, creating a gap between the maxillary and mandibular anterior teeth, leading to loss of anterior guidance. To solve this problem, the prosthodontics or orthodontics treatments are the commonly used methods for proper anterior guidance. However, it is reasonable to assume that the anterior teeth can naturally relapse to their original position when the occlusal force is eliminated. Therefore, this case report aimed to test whether natural relapse could recover the lost anterior guidance to develop a less invasive and more convenient treatment method.Digital superimposition was used to evaluate the changes in anterior teeth alignment to confirm the change of the recovered anterior guidance. The appropriate indications for this new treatment method were defined and applied clinically.

Purpose: Intrahepatic cholangiocarcinoma (ICC) has various characteristics according to anatomical, histologic classifications, and its prognoses are different. This study aimed to compare oncologic outcomes according to tumor location (second bile duct confluence) and evaluate the effect of adjuvant chemotherapy. Methods: Clinical data of 318 patients who underwent curative resection for ICC was reviewed. Central type ICC (C-ICC) and peripheral type ICC (P-ICC) were defined when the tumor invades the intrahepatic secondary biliary confluence and when located more peripherally, respectively. Results: A larger tumor size, higher rate of elevated CA 19-9 level, vascular invasion, R1 resection, advanced T stage, and lymph node metastasis were found in C-ICC. C-ICC had poorer overall survival (median, 33 months vs. 58 months; P = 0.001), and the difference was more prominent in the early stage. C-ICC had a higher recurrence rate (68.7% vs. 55.1%, P = 0.014); otherwise, there was no difference in the recurrence patterns. There were no survival benefits of adjuvant chemotherapy in the entire cohort, but there were benefits in advanced stages (T3–4, N1 stage), especially in C-ICC. Conclusion C-ICC has more aggressive tumor characteristics and poor survival compared to P-ICC. Adjuvant chemotherapy seems to have survival benefits in the advanced stages, especially in the central type.

Purpose: It is crucial to identify the causative allergen of respiratory allergic disease. Air pollution and climate change affect the allergen concentration as well as the sensitization rate. This study aims to analyze the inhalant allergen sensitization in patients with respiratory allergic disease in Busan and Gyeongsangnam-do province. Methods: We retrospectively analyzed skin prick test results from patients who visited an allergy clinic at a university hospital in Busan and Gyeongsangnam-do in 2011 and 2016. Sensitivity to inhalant allergens was identified and analyzed by year and region. The pollen allergen concentration in Busan was also analyzed. Results: The total numbers of participants were 697 in 2011 and 1,644 in 2016. The mite sensitization rate was the highest at approximately 36%, and tree pollen sensitization rate showed 10%–15%. However, the sensitization of most tree pollen and Japanese hop significantly decreased in 2016. In 2011, the mite sensitization rate of patients in the Western Gyeongsangnam-do region was remarkably low at 26%–28%, but this difference disappeared in 2016. The concentration of pollen allergens in Busan showed a tendency to decrease. Conclusion This study confirmed the longitudinal change in the sensitization rate of major inhalant allergens in patients with respiratory allergy in Busan and Gyeongsangnam-do province, as well as a significant decrease in tree pollen antigen. Based on our results, this information can be used as a basis for future patient management, and further research will be made possible by establishing a research network.

Background: There has been no comparison of the determinants of admission route between acute ischemic stroke (AIS) and acute myocardial infarction (AMI). We examined whether factors associated with direct versus transferred-in admission to regional cardiocerebrovascular centers (RCVCs) differed between AIS and AMI. Methods: Using a nationwide RCVC registry, we identified consecutive patients presenting with AMI and AIS between July 2016 and December 2018. We explored factors associated with direct admission to RCVCs in patients with AIS and AMI and examined whether those associations differed between AIS and AMI, including interaction terms between each factor and disease type in multivariable models. To explore the influence of emergency medical service (EMS) paramedics on hospital selection, stratified analyses according to use of EMS were also performed. Results: Among the 17,897 and 8,927 AIS and AMI patients, 66.6% and 48.2% were directly admitted to RCVCs, respectively. Multivariable analysis showed that previous coronary heart disease, prehospital awareness, higher education level, and EMS use increased the odds of direct admission to RCVCs, but the odds ratio (OR) was different between AIS and AMI (for the first 3 factors, AMI > AIS; for EMS use, AMI < AIS). EMS use was the single most important factor for both AIS and AMI (OR, 4.72 vs. 3.90). Hypertension and hyperlipidemia increased, while living alone decreased the odds of direct admission only in AMI;additionally, age (65–74 years), previous stroke, and presentation during non-working hours increased the odds only in AIS. EMS use weakened the associations between direct admission and most factors in both AIS and AMI. Conclusions Various patient factors were differentially associated with direct admission to RCVCs between AIS and AMI. Public education for symptom awareness and use of EMS is essential in optimizing the transportation and hospitalization of patients with AMI and AIS.