Purpose: This study aimed to assess the real-world clinical outcomes of consolidative durvalumab in patients with unresectable locally advanced non–small cell lung cancer (LA-NSCLC) and to explore the role of radiotherapy in the era of immunotherapy. Materials and Methods: This retrospective study assessed 171 patients with unresectable LA-NSCLC who underwent concurrent chemoradiotherapy (CCRT) with or without consolidative durvalumab at Asan Medical Center between May 2018 and May 2021. Primary outcomes included freedom from locoregional failure (FFLRF), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS). Results: Durvalumab following CCRT demonstrated a prolonged median PFS of 20.9 months (p=0.048) and a 3-year FFLRF rate of 57.3% (p=0.008), compared to 13.7 months and 38.8%, respectively, with CCRT alone. Furthermore, the incidence of in-field recurrence was significantly greater in the CCRT-alone group compared to the durvalumab group (26.8% vs. 12.4%, p=0.027). While median OS was not reached with durvalumab, it was 35.4 months in patients receiving CCRT alone (p=0.010). Patients positive for programmed cell death ligand 1 (PD-L1) expression showed notably better outcomes, including FFLRF, DMFS, PFS, and OS. Adherence to PACIFIC trial eligibility criteria identified 100 patients (58.5%) as ineligible. The use of durvalumab demonstrated better survival regardless of eligibility criteria. Conclusion The use of durvalumab consolidation following CCRT significantly enhanced locoregional control and OS in patients with unresectable LA-NSCLC, especially in those with PD-L1–positive tumors, thereby validating the role of durvalumab in standard care.

Purpose: To compare early changes in the macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (mGCIPL) thicknesses according to the severity of initial optic disc edema in optic neuritis patients using swept-source optical coherence tomography (SS-OCT). Methods: We retrospectively reviewed 18 eyes of patients diagnosed with naïve optic neuritis along with optic disc edema who underwent SS-OCT. The central thickness of the optic nerve head and the peripapillary retinal thickness were measured at the initial visit. To quantitate the degree of initial optic disc edema, we calculated the difference of each measurement between the affected eye and the normal fellow eye. The mRNFL and mGCIPL thicknesses were measured at the initial visit and at the 1 month follow-up. The association between changes in mRNFL and mGCIPL thicknesses at the 1 month follow-up and the severity of initial optic disc edema were evaluated. Results: In the affected eye, the mGCIPL thickness was reduced at 1 month. The central thickness of the optic nerve head at the initial visit correlated with the reduction in the temporal mGCIPL at 1 month (R = 0.648, p = 0.045). Furthermore, thicker nasal peripapillary retinal thickness at the initial visit correlated with a reduction in nasal (R = 0.659, p = 0.038) and temporal (R = 0.774, p = 0.009) mGCIPL at 1 month. Thicker temporal peripapillary retinal thickness at the initial visit correlated with reduction in the nasal (R = 0.646, p = 0.044) and temporal (R = 0.760, p = 0.011) mGCIPL at 1 month. Conclusions In optic neuritis patients with optic disc edema, severe optic disc edema, evaluated by peripapillary retinal thickness and central thickness of the optic nerve at the initial visit was associated with a reduced temporal mGCIPL thickness at 1 month. This study suggested that initially severe optic disc edema in optic neuritis patients can predict a rapid decline in the mGCIPL.

Superficial siderosis is attributed to hemosiderin deposition in the subpial layers of the nervous system. The clinical features of infratentorial superficial siderosis (ISS) are hearing loss, cerebellar ataxia, and corticospinal tract signs and the most common cause of idiopathic ISS is a dural defect. As magnetic resonance imaging (MRI) has advanced, the diagnosis of infratentorial superficial siderosis can be confirmed by unique radiological findings in MRI. Here, we report on a female patient diagnosed with idiopathic ISS by means of clinical symptoms and radiological findings.

PURPOSE: To report a case of recurrent endophthalmitis due to methicillin resistant Staphylococcus hemolyticus after phacoemulsification and posterior chamber intraocular lens (IOL) implantation. CASE SUMMARY: A 76-year-old female visited our outpatient clinic with decreased vision 40 days after uncomplicated cataract surgery in her right eye. At the visit, anterior chamber inflammation and cloudy fluid between the posterior capsule and IOL were observed. Uveitis due to residual cortex of lens or capsular block syndrome was suspected, so YAG laser capsulotomy and subconjunctival injection of dexamethasone were performed. Two days later, hypopyon and vitreous opacity were seen. The patient underwent an emergency vitrectomy and intravitreal antibiotic injection with suspicion of bacterial endophthalmitis. The culture was negative. Twenty days after the vitrectomy, anterior chamber inflammation and vitreous opacity developed. The recurrence of endophthalmitis was suspected due to infection by bacteria in the surrounding tissue of the IOL, so the patient underwent an IOL and lens capsule removal with intravitreal antibiotic injection. At this time, the culture revealed methicillin resistant staphylococcus hemolyticus. Systemic and topical vancomycin was then administered, resulting in decreased inflammation. Twenty days after the IOL removal, decreased vision, anterior chamber inflammation, and vitreous opacity developed. Endophthalmitis was decreased by intravitreal antibiotic injection and topical antibiotic treatment. CONCLUSIONS: Methicillin resistant staphylococcus hemolyticus should be considered in the differential diagnosis of chronic recurrent endophthalmitis after cataract surgery.
Aged ; Ambulatory Care Facilities ; Anterior Chamber ; Bacteria ; Cataract ; Dexamethasone ; Diagnosis, Differential ; Emergencies ; Endophthalmitis ; Female ; Humans ; Inflammation ; Lasers, Solid-State ; Lenses, Intraocular ; Methicillin Resistance ; Methicillin ; Phacoemulsification ; Recurrence ; Staphylococcus ; Uveitis ; Vancomycin ; Vitrectomy

BACKGROUND: Phlebotomy performed for laboratory testing has the potential to cause anemia in newborns and infants. This study investigated the minimum specimen volume required for an automated immunohematology analyzer DAYmate S. METHODS: Three combinations of tubes were evaluated: I. 6 mL EDTA tube, II. 0.5 mL microtainer (on top of 3 mL EDTA tube), and III. 1 mL sample cup (on top of 6 mL EDTA tube). ABO/RhD cell typing was done using centrifuged red cells; unexpected antibody screening was carried out using plasma, and Type & Screening was conducted using whole blood samples. The lowest specimen volume capable of performing 10 repetitive tests without errors was investigated. RESULTS: ABO/RhD cell typing could be performed from I. 30 μL, II. 25 μL, and III. 25 μL. Unexpected antibody screening could be performed from I. 170 μL, II. 150 μL, and III. 140 μL. According to the hematocrit levels, Type & Screening could be performed from 30%, I&III 650 μL, II. 800 μL; 40%, I&III 650 μL, II. 900 μL; and 50%, I&III 1,000 μL, II. Testing using specimen volumes below 1,000 μL was difficult. CONCLUSION: By separating red cells and plasma, pre-transfusion testing of ABO/RhD cell typing and unexpected antibody screening could be conducted with very small specimen volumes using DAYmate S compared to Type & Screening using whole blood. The application of small-sized sample tubes was more competitive and this is expected to be very useful for preventing iatrogenic anemia in neonates and infants less than 4 months old.
Anemia ; Edetic Acid ; Hematocrit ; Humans ; Infant ; Infant, Newborn ; Mass Screening* ; Phlebotomy ; Plasma

Approximately 15% of patients with frontotemporal dementia (FTD) have co-occurring motor neuron disease (MND). FTD-MND cases have frontotemporal lobar degeneration (FTLD)-transactive response DNA-binding protein (TDP) pathology, which is divided into four subtypes (types A, B, C, and D) based on the morphological appearance, cellular location, and distribution of the abnormal TDP inclusions and dystrophic neurites. We report a patient with FTD-MND whose pathological diagnosis was FTLD-TDP type B. This is the first documented autopsy-confirmed case of FTD-MND in Korea.
Autopsy* ; Diagnosis ; Frontotemporal Dementia* ; Frontotemporal Lobar Degeneration ; Humans ; Korea ; Motor Neuron Disease* ; Motor Neurons* ; Neurites ; Pathology

Approximately 15% of patients with frontotemporal dementia (FTD) have co-occurring motor neuron disease (MND). FTD-MND cases have frontotemporal lobar degeneration (FTLD)-transactive response DNA-binding protein (TDP) pathology, which is divided into four subtypes (types A, B, C, and D) based on the morphological appearance, cellular location, and distribution of the abnormal TDP inclusions and dystrophic neurites. We report a patient with FTD-MND whose pathological diagnosis was FTLD-TDP type B. This is the first documented autopsy-confirmed case of FTD-MND in Korea.
Autopsy* ; Diagnosis ; Frontotemporal Dementia* ; Frontotemporal Lobar Degeneration ; Humans ; Korea ; Motor Neuron Disease* ; Motor Neurons* ; Neurites ; Pathology

Coronary artery anomalies are rare presentations in primary percutaneous coronary interventions of acute myocardial infarction. Herein, we report the case of a 59-year-old man with acute anterior myocardial infarction who had anomalous separate origin of left anterior descending artery (LAD) and left circumflex artery (LCX) from the left coronary aortic sinus. Coronary angiography showed a normal right coronary artery and LCX, but no visualization of the LAD. After several unsuccessful attempts to cannulate the LAD, we found the LAD ostium located by the side of the LCX ostium. There was total occlusion at proxymal LAD. Coronary computed tomography angiography demonstrated the precise, separate origin of LAD and LCX from the left coronary aortic sinus.
Angiography ; Anterior Wall Myocardial Infarction ; Arteries ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Sinus of Valsalva

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder with a strong genetic component. Brain-derived neurotrophic factor (BDNF), which participates in the differentiation and survival of dopaminergic and noradrenergic neurons, could play a role in ADHD development. We aimed to explore the relationships between ADHD and BDNF gene polymorphism. METHODS: We conducted a case-control analysis of 202 ADHD subjects and 159 controls, performed a transmission disequilibrium test on 151 trios, and compared the results of a continuous performance test (CPT) according to the genotype of the three single nucleotide polymorphisms (rs11030101, rs6265, rs16917204) in the BDNF gene. RESULTS: In the case-control analysis, the AA genotype of the BDNF rs11030101 polymorphism was significantly associated with ADHD only in girls (p=0.024, odds ratio=3.00). The T-G-G haplotype was significantly less frequent (p=0.005) and A-G-G was more frequent (p=0.048) in girls with ADHD than in control girls (global p=0.027). A multivariate analysis of variance for commission errors on the CPT showed a significant main effect for the rs11030101 genotype (p=0.026) and an interaction effect of the rs11030101 genotype and gender (p=0.032) in ADHD probands. CONCLUSION: These results provide preliminary evidence for a gender-specific association between BDNF and ADHD in the Korean population.
Adrenergic Neurons ; Brain-Derived Neurotrophic Factor ; Case-Control Studies ; Genotype ; Haplotypes ; Multivariate Analysis ; Polymorphism, Single Nucleotide

BACKGROUND: Several studies have been conducted on the role of the p63 gene family in non-small cell lung carcinoma (NSCLC). Nevertheless, the role of these genes in the development and progression of NSCLC remains controversial. This study was designed to examine the expression and clinicopathologic significance of the p63 family in NSCLC. METHODS: Immunohistochemical staining was performed on 92 cases of NSCLC (47 squamous cell carcinomas [SqCCs] and 45 adenocarcinomas [ACs]) using tissue microarray blocks. The results were analyzed and correlated with clinicopathologic data. RESULTS: The expression of delta Np63 (Delta Np63) was elevated in SqCC (39/47), but not in AC (2/45; p<0.01). Both p63 and Delta Np63 had high expression in 39 SqCCs; p63 and Delta Np63 also had a similar geomorphologic distribution in most positive tumors. The expression of Delta Np63 was correlated with histologic type, gender, pT stage, p53 expression, and p63 expression. pT and pN stages were independent factors in survival (p<0.05, respectively). CONCLUSIONS: The major p63 isoform in NSCLC, Delta Np63, had a strong correlation with p53 and p63, and was exclusively expressed in SqCC. However, our findings suggest that Delta Np63 was not an independent prognostic factor for NSCLC.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Humans ; Immunohistochemistry ; Lung