The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.

Objective: This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations. Materials and Methods: This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs.lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using t-tests. The T2 values were also compared between the medial and lateral sides within each group. Results: Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; P < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; P < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group (P ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides (P= 0.037 and 0.011, respectively). Conclusion MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations.

Objective: This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations. Materials and Methods: This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs.lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using t-tests. The T2 values were also compared between the medial and lateral sides within each group. Results: Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; P < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; P < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group (P ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides (P= 0.037 and 0.011, respectively). Conclusion MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations.

Objective: This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations. Materials and Methods: This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs.lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using t-tests. The T2 values were also compared between the medial and lateral sides within each group. Results: Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; P < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; P < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group (P ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides (P= 0.037 and 0.011, respectively). Conclusion MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations.

Purpose: To investigate the clinical efficacy of rebamipide eyedrops in patients with meibomian gland dysfunction (MGD) associated with Sjögren’s syndrome. Methods: The study included 50 patients with Sjögren’s syndrome accompanied by MGD treated with 0.05% (w/v) cyclosporine and 0.15% (w/v) sodium hyaluronate eyedrops. They were divided into two groups: 25 who added rebamipide eyedrops to their existing treatments and a control group of 25 whose treatments did not change. We evaluated the tear breakup time, the Schirmer test and conjunctival staining scores, meibomian gland quality and function, and eyelid margin irregularity before prescribing rebamipide eyedrops and 1 and 3 months after prescription. Additionally, before eyedrops use and 3 months later, meibographic scores were assessed via imaging of the meibomian gland and ocular surface disease index values also were assessed. Results: The rebamipide group exhibited significant improvements in the tear breakup time, conjunctival staining score, and ocular surface disease index compared to before treatment (all p < 0.05). However, the Schirmer test result, meibomian gland quality and function, and eyelid margin irregularity did not differ between either groups before or after treatment. After 3 months of eyedrop use, the rebamipide group exhibited a significantly higher tear breakup time (p < 0.01) and Schirmer test score (p < 0.01) than the control group (p = 0.01), and significantly lower ocular surface disease index and conjunctival staining scores (p < 0.01). Conclusions Addition of rebamipide eyedrops to the conventional treatment of patients with Sjögren’s syndrome accompanied by MGD effectively improves dry eye symptoms and the ocular surface parameters.

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM). Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy. Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, −6.98 ± 2.49, P < 0.001) and the least impact on the sex life (−0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy. Conclusion Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control.Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM). Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy. Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, −6.98 ± 2.49, P < 0.001) and the least impact on the sex life (−0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy. Conclusion Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control.Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Objective: This study aimed to quantitatively assess abnormalities in the talar dome cartilage using MRI T2 mapping, with additional analyses based on the Lauge-Hansen (LH) classification and anatomical locations. Materials and Methods: This retrospective study analyzed 78 patients who underwent ankle MRI with T2 mapping for acute ankle trauma between January 2021 and October 2022. Patients were classified into the supination (S) and pronation (P) groups based on the LH classification, and then divided into subgroups based on posterior malleolus (PM) involvement. The T2 values for the talar cartilage were quantitatively measured in six anatomical regions defined by the combination of medial vs.lateral and anterior vs. central vs. posterior. The T2 mapping values in each region of the talus were compared between the S and P groups and between the PM and non-PM injury groups using t-tests. The T2 values were also compared between the medial and lateral sides within each group. Results: Among the 78 patients (mean age, 38.62 ± 14.82 years; 47 male), 53 and 25 were in the S and P groups, respectively, and 53 patients showed PM involvement. In comparison with the P group, the S group exhibited higher T2 values in the medial portion (61.27 ± 8.30 vs. 54.03 ± 6.96; P < 0.001) and lower T2 values in the lateral talus (54.95 ± 8.47 vs. 64.15 ± 7.31; P < 0.001). The PM injury group showed higher T2 values in the posterior region than the non-PM injury group (P ≤ 0.011). Within the PM injury group, T2 values were higher in the anteromedial and posterolateral regions than on the opposite sides (P= 0.037 and 0.011, respectively). Conclusion MRI T2 values demonstrated significant regional variations in the talar dome cartilage in acute ankle trauma, and the T2 values may reflect different ankle trauma mechanisms and PM involvement. Thus, T2 mapping can facilitate evaluation of talar cartilage alterations.

The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.