Respiratory syncytial virus (RSV) poses a significant threat to infants and young children in Korea and globally.Current preventive measures, such as palivizumab, have limitations, necessitating the exploration of new strategies.Nirsevimab, a long-acting monoclonal antibody, has emerged as a promising option for protecting all infants from RSV. Clinical trials and real-world evidence support its effectiveness in reducing RSV-related hospitalizations.The economic burden of RSV infection in Korea underscores the need for cost-effective interventions. While several RSV vaccines are under development, none are currently available in Korea. Maternal immunization programs and vaccines for older infants offer potential avenues for expanding protection. This review highlights the evolving landscape of RSV prevention, with a shift towards nirsevimab and future vaccines. Further research is crucial to understand the long-term consequences of RSV infection and develop comprehensive prevention strategies tailored to the Korean population.

Respiratory syncytial virus (RSV) poses a significant threat to infants and young children in Korea and globally.Current preventive measures, such as palivizumab, have limitations, necessitating the exploration of new strategies.Nirsevimab, a long-acting monoclonal antibody, has emerged as a promising option for protecting all infants from RSV. Clinical trials and real-world evidence support its effectiveness in reducing RSV-related hospitalizations.The economic burden of RSV infection in Korea underscores the need for cost-effective interventions. While several RSV vaccines are under development, none are currently available in Korea. Maternal immunization programs and vaccines for older infants offer potential avenues for expanding protection. This review highlights the evolving landscape of RSV prevention, with a shift towards nirsevimab and future vaccines. Further research is crucial to understand the long-term consequences of RSV infection and develop comprehensive prevention strategies tailored to the Korean population.

Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients. Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT. Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA. Conclusion The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients. Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT. Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA. Conclusion The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

Respiratory syncytial virus (RSV) poses a significant threat to infants and young children in Korea and globally.Current preventive measures, such as palivizumab, have limitations, necessitating the exploration of new strategies.Nirsevimab, a long-acting monoclonal antibody, has emerged as a promising option for protecting all infants from RSV. Clinical trials and real-world evidence support its effectiveness in reducing RSV-related hospitalizations.The economic burden of RSV infection in Korea underscores the need for cost-effective interventions. While several RSV vaccines are under development, none are currently available in Korea. Maternal immunization programs and vaccines for older infants offer potential avenues for expanding protection. This review highlights the evolving landscape of RSV prevention, with a shift towards nirsevimab and future vaccines. Further research is crucial to understand the long-term consequences of RSV infection and develop comprehensive prevention strategies tailored to the Korean population.

Purpose: The purpose of this study was to determine the characteristics of patients with failed initial Kasai portoenterostomy (KP) and to compare the long-term prognosis of redo-KP with that of liver transplantation (LT) in these patients. Methods: The medical records of patients with biliary atresia (BA) who failed initial KP from 2010 to 2021 at a single center were retrospectively analyzed. KP failure was defined as persistent jaundice (total bilirubin concentration, ≥2.0 mg/dL) after KP or the performance of LT. Results: During the study period, 32 patients experienced initial KP failure, with 10 undergoing redo-KP and 22 undergoing LT. Redo-KP was successful in a minority of patients with failed initial KP, but the complications, particularly cholangitis, were more frequent in the redo-KP group. The long-term prognosis of redo-KP compared to LT showed that while some patients benefited from native liver survival after redo-KP, LT remains the more definitive solution for sustained liver function and survival in patients with BA. Conclusion The only factor differing significantly between patients who underwent redo-KP and LT after failed initial KP was complications of cholangitis. Redo-KP was successful in 4 of 10 patients with failed initial KP, suggesting that redo-KP may be a treatment option in patients with BA and failed initial KP.

Background: Genetic alterations play a pivotal role in multiple myeloma (MM) development and therapeutic resistance. Traditionally, the genetic profiling of MM requires invasive bone marrow (BM) procedures; however, these procedures are associated with patient discomfort and cannot fully capture the spatial and temporal heterogeneity of the disease.Therefore, we investigated the clinical implications of liquid biopsy using targeted deep sequencing. Methods: We analyzed the genetic profiles of circulating tumor DNA (ctDNA) by targeted deep sequencing from 102 patients, including those with monoclonal gammopathy of undetermined significance (MGUS, N = 7), smoldering MM (N = 6), and symptomatic MM (N = 89). Results: The number of ctDNA mutations increased with disease progression from MGUS to MM, with averages of 1.0 mutations in MGUS, 1.8 mutations in smoldering MM, and 1.9 mutations in MM, respectively. Shared mutations between BM and ctDNA were more prevalent in MM (68.9%) than in MGUS (25.0%). RAS/RAF and TP53 mutations were significantly enriched in MM ctDNA. Specific mutations were associated with clinical features in patients with MM: hypercalcemia and TET2 (P = 0.006), renal insufficiency and NRAS (P = 0.012), paramedullary myeloma and TP53(P = 0.02), and extramedullary myeloma and NRAS (P = 0.007). TET2 mutations significantly affected 2-yr progression-free survival (hazard ratio = 7.11, P = 0.003). Serial ctDNA profiling accurately predicted treatment response in patients with MM. Conclusions Our findings highlight the potential of liquid biopsy for understanding MM progression and prognosis utilizing a minimally invasive approach, paving the way for its integration into personalized treatment strategies and real-time disease monitoring.

Replacement of the retrohepatic inferior vena cava (IVC) after concurrent resection of IVC and tumor-bearing liver is regarded as a feasible living donor liver transplantation (LDLT) technique to cope with tumors around the IVC. This method can make the resection extent of LDLT comparable to that of deceased-donor liver transplantation. We present one pediatric LDLT case with IVC replacement using an enlarged iliac vein conduit to treat advanced hepatoblastoma. The patient was a 33-monthold and 12 kg-weighing girl suffering from large multiple hepatoblastomas invading the retrohepatic IVC. At 2-month waiting after deciding LDLT, we obtained a coldstored iliac vein graft and LDLT was performed with the father’s left lateral section graft. A 1.3 cm-wide and 10 cm-long iliac vein was transformed to be a 2 cm-wide and 5 cm-long vein graft through a double-barrel unification venoplasty. The left lateral section graft was implanted along the standard procedure of LDLT. The patient recovered uneventfully and is undergoing scheduled adjuvant chemotherapy. IVC replacement with vein homograft is a feasible option for LDLT in pediatric patients with advanced liver malignancy.

Background: Thyroid-stimulating hormone (TSH)-secreting pituitary neuroendocrine tumor (TSH PitNET) is a rare subtype of PitNET. We investigated the comprehensive characteristics and outcomes of TSH PitNET cases from a single medical center. Also, we compared diagnostic methods to determine which showed superior sensitivity. Methods: A total of 17 patients diagnosed with TSH PitNET after surgery between 2002 and 2022 in Samsung Medical Center was retrospectively reviewed. Data on comprehensive characteristics and treatment outcomes were collected. The sensitivities of diagnostic methods were compared. Results: Seven were male (41%), and the median age at diagnosis was 42 years (range, 21 to 65); the median follow-up duration was 37.4 months. The most common (59%) initial presentation was hyperthyroidism-related symptoms. Hormonal co-secretion was present in four (23%) patients. Elevated serum alpha-subunit (α-SU) showed the greatest diagnostic sensitivity (91%), followed by blunted response at thyrotropin-releasing hormone (TRH) stimulation (80%) and elevated sex hormone binding globulin (63%). Fourteen (82%) patients had macroadenoma, and a specimen of one patient with heavy calcification was negative for TSH. Among 15 patients who were followed up for more than 6 months, 10 (67%) achieved hormonal and structural remission within 6 months postoperatively. A case of growth hormone (GH)/TSH/prolactin (PRL) co-secreting mixed gangliocytoma-pituitary adenoma (MGPA) was discovered. Conclusion The majority of the TSH PitNET cases was macroadenoma, and 23% showed hormone co-secretion. A rare case of GH/TSH/PRL co-secreting MGPA was discovered. Serum α-SU and TRH stimulation tests showed great diagnostic sensitivity. Careful consideration is needed in diagnosing TSH PitNET. Achieving remission requires complete tumor resection. In case of nonremission, radiotherapy or medical therapy can improve the long-term remission rate.

Background: and Purpose The Karolinska Sleepiness Scale (KSS) is widely used for assessing current level of sleepiness, but it has not been validated in South Korea. This study aimed to validate the KSS using the Stanford Sleepiness Scale (SSS), polysomnography (PSG), and electroencephalography (EEG). Methods: The sample consisted of 27 adult participants in this study aged 40.5±7.7 years (mean±standard deviation) and included 22 males. They completed questionnaires and underwent EEG recording and overnight PSG. The KSS was completed from 18:00 to 24:00 every 2 hours and following PSG (at 07:00). KSS scores changed over time and in particular increased with the time since waking, with the score peaking at 24:00. Results: Convergent validity of the KSS was verified by performing a Spearman correlation analysis between the KSS and SSS (r=0.742, p<0.01). Concurrent validity of the KSS was verified by performing a Spearman correlation analysis between the KSS administered before sleep and the sleep onset latency measured using PSG (r=-0.456, p<0.05). Alpha waves were measured 5 minutes before administering the KSS, and the KSS scores were compared with these alpha waves. There were no significant correlations observed between the KSS scores and alpha waves measured in the left occipital area (O1), left frontal area (F3), or left central area (C3). In addition, Spearman correlation analyses of the difference between KSS scores and alpha waves measured at O1, F3, and C3 produced no significant results. Conclusions This study verified the convergent validity and concurrent validity of the KSS, and confirmed the capabilities of this scale in assessing sleepiness changes over time.