Purpose: While the benefit of neoadjuvant chemotherapy (NAC) has been established in human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancers, its effectiveness in achieving pathological complete response (pCR) and optimal patient selection in estrogen receptor (ER)-positive, HER2-negative breast cancers remain less clearly defined. This study aimed to identify immunohistochemistry (IHC)-based predictors of pCR and to develop a scoring model for ER-strong positive/HER2-negative breast cancer. Methods: Data from a prospective cohort were retrospectively analyzed. We included 522 patients with ER-strong positive/HER2-negative tumors who received NAC and surgery between 2008 and 2021. IHC markers including progesterone receptor (PR), Ki-67, epidermal growth factor receptor (EGFR), cytokeratin 5/6 (CK5/6), and p53 were evaluated to identify predictors of pCR. Independent predictors of pCR from multivariate logistic regression were used to develop a weighted 4-point model. Model performance was assessed using receiver operating characteristic analysis. The prognostic impact of pCR was evaluated using KaplanMeier and Cox regression analyses. Results: Independent predictors of pCR included PR-negative status, positivity for basallike markers (EGFR or CK5/6), and Ki-67 ≥ 50%. The scoring model demonstrated good discrimination for pCR (area under the curve = 0.754). pCR rates increased stepwise, with scores of 4.9% (low), 10.7% (intermediate), and 36.2% (high). In the high-score group, pCR was significantly associated with improved disease-free survival (hazard ratio [HR], 0.09; p = 0.023) and distant metastasis-free survival (HR, 0.11; p = 0.035), whereas no significant survival differences according to pCR status were observed in the low and intermediate score groups. Conclusion This IHC-based model predicts pCR and helps identify subgroups in which pCR is associated with meaningful survival benefit following NAC in ER-positive/HER2-negative breast cancers. High-scoring patients may benefit from NAC, while patients with low- or intermediatescores may be better managed with surgery and endocrine therapy. This model may support personalized treatment decisions regarding NAC.

Purpose: Lobular carcinoma In Situ (LCIS) is a noninvasive lesion associated with an increased risk of invasive cancer. Since its removal from the tumor, node, metastasis classification in the 8th edition of the American Joint Committee on Cancer (AJCC) guidelines, the clinical management of LCIS has shifted from surgery to surveillance. However, studies focusing on the risk and associated factors for invasive cancer development in pure LCIS without ductal carcinoma In Situ (DCIS) or invasive cancer remain limited. Methods: We retrospectively analyzed 106 patients diagnosed with pure LCIS between 2008 and 2018. This study evaluated the effect of tamoxifen use and histologic type on the development of invasive cancer. Results: All 106 patients underwent surgery, and nine (8.5%) developed invasive cancer over a median follow-up of 67.5 months. The incidence of invasive cancer was lower in the tamoxifen group (6.3%, n = 4) than in the non-tamoxifen group (11.9%, n = 5), although this difference was not statistically significant (p = 0.266). Pleomorphic LCIS had a significantly higher incidence of invasive cancer (30.0%, n = 3) than classic LCIS (6.3%, n = 6) (p = 0.045).Multivariable Cox regression analysis showed no significant difference in the risk of invasive cancer according to tamoxifen use (hazard ratio [HR], 2.031; 95% confidence interval [CI], 0.544–7.579; p = 0.292). However, pleomorphic LCIS showed a trend toward an increased risk of invasive cancer compared to classic LCIS (HR, 3.856; 95% CI, 0.922–16.126; p = 0.064). Conclusion Postoperative tamoxifen did not significantly lower invasive cancer development in patients with pure LCIS. Pleomorphic LCIS may carry a higher risk than classic LCIS. These findings require tailored follow-up and treatment strategies based on the histologic subtype of LCIS.

The active component in cannabis, cannabidiol (CBD), was first isolated from the hemp plant in 1940. Chronic pain, inflammation, migraines, depression, and anxiety have long been treated with CBD. The fundamental mechanisms of CBD’s effects on periodontal inflammation have yet to be fully understood. The amino sulfonic acid taurine is a substance that naturally exists in the body and is an inhibitory modulator of inflammation. This study examined the effects of CBD, taurine, and their combination on inflammatory cytokines and periodontitis in vivo. To assess the expression of inflammatory markers of iNOS, COX-2, TNF-α, and IL-1β, as well as TRAP count and resorbed pit areas, CBD and taurine were applied to RAW264.7 cells. The following groups of 45 Sprague-Dawley rats each were created: control (healthy), vehicle (induced periodontitis), low- and high-dose-CBD with taurine which were each treated for an additional 21 days. Rat teeth were obtained and subjected to histomorphometric studies.The combination of the two significantly decreased the expression of inflammatory markers TNF-α and IL-1β and the amount of TRAP+ cells and resorbed pit areas. Among rats with P. gingivalis-induced periodontitis, the alveolar bone resorption levels, periodontal pocket depth, and distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) were significantly reduced after treatment with CBD and taurine, suggesting that combining CBD with taurine could be a novel therapeutic agent against periodontal disease.

The active component in cannabis, cannabidiol (CBD), was first isolated from the hemp plant in 1940. Chronic pain, inflammation, migraines, depression, and anxiety have long been treated with CBD. The fundamental mechanisms of CBD’s effects on periodontal inflammation have yet to be fully understood. The amino sulfonic acid taurine is a substance that naturally exists in the body and is an inhibitory modulator of inflammation. This study examined the effects of CBD, taurine, and their combination on inflammatory cytokines and periodontitis in vivo. To assess the expression of inflammatory markers of iNOS, COX-2, TNF-α, and IL-1β, as well as TRAP count and resorbed pit areas, CBD and taurine were applied to RAW264.7 cells. The following groups of 45 Sprague-Dawley rats each were created: control (healthy), vehicle (induced periodontitis), low- and high-dose-CBD with taurine which were each treated for an additional 21 days. Rat teeth were obtained and subjected to histomorphometric studies.The combination of the two significantly decreased the expression of inflammatory markers TNF-α and IL-1β and the amount of TRAP+ cells and resorbed pit areas. Among rats with P. gingivalis-induced periodontitis, the alveolar bone resorption levels, periodontal pocket depth, and distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) were significantly reduced after treatment with CBD and taurine, suggesting that combining CBD with taurine could be a novel therapeutic agent against periodontal disease.

The active component in cannabis, cannabidiol (CBD), was first isolated from the hemp plant in 1940. Chronic pain, inflammation, migraines, depression, and anxiety have long been treated with CBD. The fundamental mechanisms of CBD’s effects on periodontal inflammation have yet to be fully understood. The amino sulfonic acid taurine is a substance that naturally exists in the body and is an inhibitory modulator of inflammation. This study examined the effects of CBD, taurine, and their combination on inflammatory cytokines and periodontitis in vivo. To assess the expression of inflammatory markers of iNOS, COX-2, TNF-α, and IL-1β, as well as TRAP count and resorbed pit areas, CBD and taurine were applied to RAW264.7 cells. The following groups of 45 Sprague-Dawley rats each were created: control (healthy), vehicle (induced periodontitis), low- and high-dose-CBD with taurine which were each treated for an additional 21 days. Rat teeth were obtained and subjected to histomorphometric studies.The combination of the two significantly decreased the expression of inflammatory markers TNF-α and IL-1β and the amount of TRAP+ cells and resorbed pit areas. Among rats with P. gingivalis-induced periodontitis, the alveolar bone resorption levels, periodontal pocket depth, and distance between cementoenamel junction (CEJ) and alveolar bone crest (ABC) were significantly reduced after treatment with CBD and taurine, suggesting that combining CBD with taurine could be a novel therapeutic agent against periodontal disease.

Background: A healthcare system’s collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs. Methods: A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed. Results: A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety. Conclusion In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.

Vitiligo is a type of chronic autoimmune skin disorder that is highly unpredictable. Houttuynia cordata Thunb. (HC) is a natural compound with several pharmacological properties; however, the fundamental mechanisms of HC effects on Vitiligo have yet to be fully understood. This study aimed to evaluate the effects of HC on the oxidative injury of melanocytes in vivo and in vitro. This study demonstrated that compounds significantly prevented the hydrogen peroxide (H2O2 )-induced B16F10 cell loss of viability and melanin synthesis; in addition, cell apoptosis-regulating of melanocytes significantly decreased, and the expression level of TRP-1 and MITF increased dose-dependently. In animal experiments, C57BL/6 mice received 5% hydroquinone (HQ) for 5 weeks and were treated with HC for 2 weeks. HQ-stimulated vitiligo in mice also produced melanocyte and melanosome degradation. The melanin content and tyrosinase activity of the mice (skin) that received the HC group significantly increased compared to the untreated and 8-methoxyprosalen (8-MOP) groups. These experiments suggest that the HC has potential protective and therapeutic effects for vitiligo.

In the 2023 series, we summarized the major clinical research advances in gynecologic oncology based on communications at the conference of Asian Society of Gynecologic Oncology Review Course. The review consisted of 1) Endometrial cancer: immune checkpoint inhibitor, antibody drug conjugates (ADCs), selective inhibitor of nuclear export, CDK4/6 inhibitors WEE1 inhibitor, poly (ADP-ribose) polymerase (PARP) inhibitors. 2) Cervical cancer: surgery in low-risk early-stage cervical cancer, therapy for locally advanced stage and advanced, metastatic, or recurrent setting; and 3) Ovarian cancer: immunotherapy, triplet therapies using immune checkpoint inhibitors along with antiangiogenic agents and PARP inhibitors, and ADCs. In 2023, the field of endometrial cancer treatment witnessed a landmark year, marked by several practice-changing outcomes with immune checkpoint inhibitors and the reliable efficacy of PARP inhibitors and ADCs.

Objective: We aimed to revalidate the chemotherapy response score (CRS) system as a prognostic factor for ovarian cancer patients with breast cancer gene (BRCA) mutations or those receiving frontline poly-ADP ribose polymerase (PARP) inhibitors or bevacizumab as maintenance therapy. Methods: A retrospective analysis was performed using medical records of patients with high-grade serous carcinoma who received neoadjuvant chemotherapy followed by interval debulking surgery between January 2007 and December 2021 at 5 tertiary medical institutions in South Korea. At each hospital, pathologists independently assessed each slide of omental tissues obtained from surgery using the CRS system. Progression-free survival (PFS) and overall survival (OS) values were obtained using Kaplan-Meier analysis to evaluate the effect of BRCA mutation, maintenance therapy, and CRS on survival time. Results: Of 466 patients, BRCA mutations were detected in 156 (33.5%) and 131 (28.1%) were treated with maintenance therapy; 98 (21.0%) and 42 (9.0%) were treated with PARP inhibitors or bevacizumab, respectively. Patients with CRS3 had significantly longer PFS than those with CRS1 or 2 (24.7 vs. 16.8 months, p<0.001). However, there was no significant difference in PFS improvement between CRS3 patients and those with CRS1 or 2 with BRCA mutation (22.0 vs. 19.3 months, p=0.193). Moreover, no significant PFS prolongation was observed in CRS3 patients compared to CRS1 or 2 patients treated with PARP inhibitors or bevacizumab (24.3 vs. 22.4 months, p=0.851; 27.5 vs. 15.7 months, p=0.347, respectively). Conclusion CRS may not be a prognostic factor in patients with BRCA mutations and those receiving frontline maintenance therapy.

In the 2023 series, we summarized the major clinical research advances in gynecologic oncology based on communications at the conference of Asian Society of Gynecologic Oncology Review Course. The review consisted of 1) Endometrial cancer: immune checkpoint inhibitor, antibody drug conjugates (ADCs), selective inhibitor of nuclear export, CDK4/6 inhibitors WEE1 inhibitor, poly (ADP-ribose) polymerase (PARP) inhibitors. 2) Cervical cancer: surgery in low-risk early-stage cervical cancer, therapy for locally advanced stage and advanced, metastatic, or recurrent setting; and 3) Ovarian cancer: immunotherapy, triplet therapies using immune checkpoint inhibitors along with antiangiogenic agents and PARP inhibitors, and ADCs. In 2023, the field of endometrial cancer treatment witnessed a landmark year, marked by several practice-changing outcomes with immune checkpoint inhibitors and the reliable efficacy of PARP inhibitors and ADCs.