Background: Post-transplantation cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG) are common pro‑ phylactic strategies for graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Interleukin (IL)-6 is a surrogate marker for cytokine release syndrome (CRS) and acute GVHD.Method The clinical outcomes and complications of haplo-HSCT with PTCy plus ATG versus PTCy monotherapy were compared according to serum IL-6 levels at Chungnam National University Hospital (Daejeon, South Korea) from Jan‑ uary 2019 to February 2023. Results: Forty patients who underwent haplo-HSCT were analyzed. A significant difference in IL-6 levels was observed between the PTCy plus ATG and PTCy alone groups (7.47 ± 10.55 vs. 117.65 ± 127.67; p = 0.003). More patients in the PTCy plus ATG group had a CRS grade of 0 than in the PTCy alone group (p < 0.001). Serum IL-6 levels were associated with grades II–IV acute GVHD (r = 0.547, p < 0.001). The cumulative incidence (CI) of grades II–IV acute GVHD was significantly higher in the PTCy alone group (67.9% vs. 4.8%; p < 0.001). No significant difference in the CI for chronic GVHD was detected between the PTCy plus ATG and PTCy alone groups (72.1% vs. 82.0%; p = 0.730). The CI of 1-year non-relapse mortality was significantly higher in the PTCy alone group than in the PTCy plus ATG group (42.2% vs. 15.9%; p = 0.022). The 1-year overall survival (OS) was significantly better in the PTCy plus ATG group (75.9% vs. 35.3%; p = 0.011). The 1-year GVHD-free, relapse-free survival rate was 29.4% in the PTCy alone group and 54.0% in the PTCy plus ATG group (p = 0.038). Conclusion Serum IL-6 levels were higher in the PTCy alone group than in the PTCy plus ATG group. The addition of ATG before stem cell infusion affected IL-6 levels and reduced the incidences of CRS and grade II–IV acute GVHD in haplo-HSCT patients. This study suggests that PTCy plus ATG as GVHD prophylaxis in haplo-HSCT is beneficial in terms of clinical outcomes and complications of HSCT.

Background: Strain elastography (SE) and shear wave elastography (SWE) are emerging techniques for evaluating the elasticity of soft tissue. This study aimed to determine interobserver and intraobserver reliability for elasticity measurements of different tissues and anatomic locations using SE and SWE. Methods: Ten healthy adult male individuals with 20 upper extremities participated in this study. The elasticities of the wrist extensor muscle, the common extensor tendon, and supraspinatus tendon were measured. Strain ratio and shear wave velocity were measured twice by 2 different examiners (examiner 1 with over 20 years of experience in musculoskeletal sonography and examiner 2 with 1 year of experience). Interobserver and intraobserver reliability was assessed using the intraclass correlation coefficient (ICC). Results: The 10 individuals’ age ranged from 28 to 35 years. In SE, interobserver reliabilities at the 3 anatomic locations (wrist extensor muscle, common extensor tendon, and supraspinatus tendon) showed fair to moderate agreement (ICC = 0.489, p = 0.076;ICC = 0.408, p = 0.131; and ICC = 0.296, p = 0.711, respectively). The intraobserver reliabilities of examiner 1 were moderate to substantial only at the wrist extensor muscle and the common extensor tendon (ICC = 0.563, p = 0.039 and ICC = 0.702, p = 0.006, respectively). In SWE, interobserver reliabilities for the wrist extensor muscle and the supraspinatus tendon were moderate to substantial (ICC = 0.756, p = 0.002 and ICC = 0.565, p = 0.039, respectively). The intraobserver reliabilities of examiner 1 at the 3 anatomic locations were almost perfect (ICC = 0.843, p = 0.001; ICC = 0.800, p = 0.001; and ICC = 0.825, p = 0.001, respectively).The results of examiner 2 showed almost perfect agreement at the wrist extensor muscle (ICC = 0.886, p = 0.001) and moderate to substantial agreement at the tendons of the common extensor and supraspinatus (ICC = 0.592, p = 0.029 and ICC = 0.682, p = 0.008, respectively). Conclusions SWE is a reliable method for assessing the flexibility of soft tissue, but it is affected by expertise and the specific anatomical site.

Background: Elementary school is a critical period for oral health because the incidence of dental caries is high, and early symptoms of gingivitis manifest. While existing oral health education improves knowledge, it has limitations in sustaining oral health behaviors. This study evaluated the effectiveness of an oral health education program based on motivational interviewing (MI), which enhances intrinsic motivation and promotes behavioral change. Methods: Thirty-five elementary school students (Grades 4∼6) were recruited and assigned to an intervention group or a control group. The intervention group (n=16) received an MI-based oral health education program, whereas the control group (n=16) received standard education. The program was conducted once per week for five weeks (1 hour/session) and covered: Session 1: Understanding tooth structure, causes of caries, and setting oral health goals; Session 2: Learning how to perform rotational brushing and exploring ambivalence; Session 3: Learning how to use dental floss and tongue cleaners while reinforcing motivation; Session 4: Identifying cariogenic and protective foods; and Session 5: Developing a change plan and assessing self-confidence. Oral health behaviors, diet-related oral health behaviors, and oral hygiene skills were assessed pre- and post-intervention, and at follow-up. Results: Both groups showed significant post-intervention improvements. However, the intervention group demonstrated statistically significant group-time interactions and sustained improvements in all areas except diet-related behaviors. The control group showed a temporary increase followed by a decline. Conclusion The MI-based oral health education program effectively improved and maintained oral health behaviors and oral hygiene skills. It can be applied to elementary school students to promote long-term changes in oral health behaviors.

Background: Gingivitis and periodontal disease are common conditions requiring early management. Regular scaling prevents periodontal disease but is often avoided due to pain and discomfort, leading to worsened conditions. Dental fear, particularly related to scaling, is a significant barrier; however, few studies have explored it. This study aimed to identify the factors that influence scaling fear in adults. Understanding these factors will enable dental professionals to mitigate these fears and promote regular scaling. Methods: An online survey was conducted, targeting adults aged 19 years and older with prior scaling experience. Using convenience sampling, 270 responses were analyzed. The survey included 30 items measuring general characteristics, periodontal disease knowledge, scaling awareness, and scaling fear. Data were analyzed using IBM SPSS version 23.0 (IBM Corp., Armonk, NY, USA) with multiple regression to identify factors affecting scaling fear. Results: The mean scores were 4.76±1.35 for periodontal disease knowledge, 3.82±0.55 for scaling awareness, and 2.87±0.63 for scaling fear. Scaling awareness (β=–0.236, p＜0.001), periodontal disease knowledge (β=–0.157, p=0.01), and the number of scaling sessions in the past two years (β=–0.147, p＜0.05) significantly influenced scaling fear. Conclusion Scaling awareness and periodontal disease knowledge are key to reducing fear of scaling. Dental professionals should educate patients and provide clear explanations to build trust and create positive experiences. Oral health education programs should be expanded to improve awareness, reduce fear, and foster regular scaling attendance.

Purpose: This study investigated the factors influencing posttraumatic growth (PTG) among nurses who worked in COVID-19 isolation wards in tertiary hospitals in South Korea. Method: A cross-sectional descriptive correlation research design was used. In total, 190 nurses who had worked with COVID-19-infected patients participated in the study. Their demographic characteristics, self-disclosure, resilience, social support, and PTG were examined using a structured online questionnaire administered from March 16 to 25, 2022. Data were analyzed using SPSS/WIN 27.0. Results: The mean scores for self-disclosure, resilience, social support, and PTG were 42.79 (range: 12~60), 60.92 (range: 0~100), 46.98 (range: 12~60), and 45.66 (range: 0~80), respectively. Self-disclosure (β=.18, p=.003) and resilience (β=.65, p<.001) significantly influenced PTG, explaining 55% of the total variance in this variable. Conclusion This study highlights the need to systematically develop and implement effective intervention programs to strengthen nurses' self-disclosure and resilience.

Peritoneal leiomyomas are extremely rare. Most reported cases are that of disseminated peritoneal leiomyomatosis, making isolated leiomyoma an uncommon occurrence. Given that isolated leiomyoma is rare, the preoperative diagnosis of isolated leiomyoma is challenging. To date, very few reports have described the radiological findings of isolated peritoneal leiomyoma. This study aimed to present a rare case of isolated peritoneal leiomyoma in the perihepatic region of a 54-year-old female, and present the US, CT, and MRI based radiological findings of the case.

Splenic duplication, also known as polysplenia syndrome, is a condition occasionally observed in which the spleen is divided into segments of similar size. However, gastric fundic varices arising from a duplicated spleen are exceedingly rare, and this medical anomaly has been infrequently reported in the literature. This case report presents a 40-year-old male with a rare instance of gastric fundic varices secondary to splenic duplication. Comprehensive imaging studies, including endoscopy, CT, Doppler US, and radioisotope splenic scans, were performed to confirm the diagnosis. This case contributes to valuable information in the medical literature, shedding light on a seldom-discussed condition.

Purpose: This study aimed to define an optimal age cutoff for early-onset gastric cancer (EOGC) and compare its characteristics with those of late-onset gastric cancer (LOGC) using nationwide survey data. Methods: Using data from a nationwide survey, this comprehensive population-based study analyzed data spanning 3 years (2009, 2014, and 2019). The joinpoint analysis and interrupted time series (ITS) methodology were employed to identify age cutoffs for EOGC based on the sex ratio and tumor histology. Clinicopathologic characteristics and surgical outcomes were compared between the EOGC and LOGC groups. Results: The age cutoff for defining EOGC was suggested to be 50 years, supported by joinpoint and ITS analyses. Early gastric cancer was predominantly present in the EOGC and LOGC groups. Patients with EOGC comprised 20.3% of the total study cohort and demonstrated a more advanced disease stage compared to patients with LOGC. However, patients with EOGC underwent more minimally invasive surgeries, experienced shorter hospital stays, and had lower postoperative morbidity and mortality rates. Conclusion This study proposes an age of ≤50 years as a criterion for defining EOGC and highlights its features compared to LOGC. Further research using this criterion should guide tailored treatment strategies and improve outcomes for young patients with gastric cancer.