Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies. Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed. Results: The median follow-up durations in the HRD and UCB groups were 7.0 and 10.9 years, respectively. The cumu‑ lative incidence of acute graft-versus-host disease (GVHD) grades II–IV and moderate-to-severe chronic GVHD did not differ significantly between the groups. However, the HRD group demonstrated significantly lower rates of acute GVHD grades III–IV (4.9% vs. 29.2%, p = 0.009) and non-relapse mortality (2.6% vs. 34.2%, p < 0.001) but a higher relapse incidence (32.1% vs. 8.8%, p = 0.004) than the UCB group. The 5-year event-free and overall survival rates were 65.8% and 54.2% (p = 0.204) and 78.0% and 65.7% (p = 0.142) for the HRD and UCB groups, respectively. Multivariate analysis identified disease status as a significant risk factor for overall survival (hazard ratio, 3.24; p = 0.016). Additionally, UCB HSCT exhibited a trend toward worse event-free survival compared to HRD HSCT (hazard ratio, 2.63; p = 0.05). Conclusions These findings indicate that HRD HSCT with post-transplant cyclophosphamide provides promising outcomes compared to UCB HSCT in pediatric patients, with a trend toward improved survival over a long-term follow-up period exceeding a median of 7 years. Thus, HRD HSCT may be a valuable option for pediatric patients with‑ out human leukocyte antigen-matched donors.

Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies. Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed. Results: The median follow-up durations in the HRD and UCB groups were 7.0 and 10.9 years, respectively. The cumu‑ lative incidence of acute graft-versus-host disease (GVHD) grades II–IV and moderate-to-severe chronic GVHD did not differ significantly between the groups. However, the HRD group demonstrated significantly lower rates of acute GVHD grades III–IV (4.9% vs. 29.2%, p = 0.009) and non-relapse mortality (2.6% vs. 34.2%, p < 0.001) but a higher relapse incidence (32.1% vs. 8.8%, p = 0.004) than the UCB group. The 5-year event-free and overall survival rates were 65.8% and 54.2% (p = 0.204) and 78.0% and 65.7% (p = 0.142) for the HRD and UCB groups, respectively. Multivariate analysis identified disease status as a significant risk factor for overall survival (hazard ratio, 3.24; p = 0.016). Additionally, UCB HSCT exhibited a trend toward worse event-free survival compared to HRD HSCT (hazard ratio, 2.63; p = 0.05). Conclusions These findings indicate that HRD HSCT with post-transplant cyclophosphamide provides promising outcomes compared to UCB HSCT in pediatric patients, with a trend toward improved survival over a long-term follow-up period exceeding a median of 7 years. Thus, HRD HSCT may be a valuable option for pediatric patients with‑ out human leukocyte antigen-matched donors.

Purpose: This study compared the outcomes of haploidentical-related donor (HRD) and umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematologic malignancies. Methods: Data on patients who underwent HRD HSCT with post-transplant cyclophosphamide (n = 41) and UCB HSCT (n = 24) after targeted busulfan-based myeloablative conditioning with intensive pharmacokinetic monitoring between 2009 and 2018 were retrospectively analyzed. Results: The median follow-up durations in the HRD and UCB groups were 7.0 and 10.9 years, respectively. The cumu‑ lative incidence of acute graft-versus-host disease (GVHD) grades II–IV and moderate-to-severe chronic GVHD did not differ significantly between the groups. However, the HRD group demonstrated significantly lower rates of acute GVHD grades III–IV (4.9% vs. 29.2%, p = 0.009) and non-relapse mortality (2.6% vs. 34.2%, p < 0.001) but a higher relapse incidence (32.1% vs. 8.8%, p = 0.004) than the UCB group. The 5-year event-free and overall survival rates were 65.8% and 54.2% (p = 0.204) and 78.0% and 65.7% (p = 0.142) for the HRD and UCB groups, respectively. Multivariate analysis identified disease status as a significant risk factor for overall survival (hazard ratio, 3.24; p = 0.016). Additionally, UCB HSCT exhibited a trend toward worse event-free survival compared to HRD HSCT (hazard ratio, 2.63; p = 0.05). Conclusions These findings indicate that HRD HSCT with post-transplant cyclophosphamide provides promising outcomes compared to UCB HSCT in pediatric patients, with a trend toward improved survival over a long-term follow-up period exceeding a median of 7 years. Thus, HRD HSCT may be a valuable option for pediatric patients with‑ out human leukocyte antigen-matched donors.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

Objectives: This study aims to evaluate the efficacy of single-tuft toothbrushes in removing dental plaque, particularly in areas that are difficult to reach using conventional toothbrushes. The study also explores the current level of awareness and usage of these brushes, and it identifies gaps in research and education regarding their application. Methods: A scoping review was conducted using the framework proposed by Arksey and O’Malley and guidelines by Peters et al. Databases including PubMed, Scopus, and Korean academic repositories were searched using keywords like “single-tuft toothbrush” and “end-tuft toothbrush.” A total of 403 articles were initially identified, with 9 studies meeting the inclusion criteria. These studies included 8 randomized controlled trials and 1 in-vitro experiment, focusing on the effectiveness of single-tuft toothbrushes in various contexts. Results: Single-tuft toothbrushes demonstrated superior plaque removal in challenging areas, such as interproximal surfaces of molars, lingual surfaces, and around orthodontic appliances. In combination with conventional toothbrushes, they showed significantly better results compared to conventional tools alone. However, they did not consistently outperform other interdental cleaning devices like floss or interdental brushes across all metrics. User satisfaction with single-tuft toothbrushes was high, especially among orthodontic patients, although their usage rate was significantly lower due to limited awareness and accessibility. Conclusions Single-tuft toothbrushes are highly effective as adjuncts to conventional oral hygiene tools, particularly in managing hard-to-reach areas. However, their overall efficacy in replacing other oral hygiene tools is limited. To maximize their potential, increased public awareness, improved accessibility, and targeted education programs are needed. Further research should explore their role in specific patient populations, such as those with orthodontic appliances or implant restorations.

The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.

Background/Aims: For patients hospitalized with coronavirus disease 2019 (COVID-19) who require supplemental oxygen, the evidence of the optimal duration of corticosteroid is limited. This study aims to identify whether long-term use of corticosteroids is associated with decreased mortality. Methods: Between February 10, 2020 and October 31, 2021, we analyzed consecutive hospitalized patients with COVID-19 with severe hypoxemia. The patients were divided into short-term (≤ 14 days) and long-term (> 14 days) corticosteroid users. The primary outcome was 60-day mortality. We performed propensity score (PS) analysis to mitigate the effect of confounders and conducted Kaplan-Meier curve analysis. Results: There were 141 (52%) short-term users and 130 (48%) long-term corticosteroid users. The median age was 68 years and the median PaO2/FiO2 at admission was 158. Of the patients, 40.6% required high-flow nasal cannula, 48.3% required mechanical ventilation, and 11.1% required extracorporeal membrane oxygenation. The overall 60-day mortality rate was 23.2%, and that of patients with hospital-acquired pneumonia (HAP) was 22.9%. The Kaplan-Meier curve for 60- day survival in the PS-matched cohort showed that corticosteroid for > 14 days was associated with decreased mortality (p = 0.0033). There were no significant differences in bacteremia and HAP between the groups. An adjusted odds ratio for the risk of 60-day mortality in short-term users was 5.53 (95% confidence interval, 1.90–18.26; p = 0.003). Conclusions For patients with severe COVID-19, long-term use of corticosteroids was associated with decreased mortality, with no increase in nosocomial complications. Corticosteroid use for > 14 days can benefit patients with severe COVID-19.