1.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
		                        		
		                        			
		                        			 Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy. 
		                        		
		                        		
		                        		
		                        	
2.Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung-Ann LEE ; Hyeji JEON ; Hyun-Sook KIM ; Kyomin CHOI ; Gi Hyeon SEO
The Korean Journal of Internal Medicine 2025;40(2):330-338
		                        		
		                        			 Background/Aims:
		                        			This nationwide cohort study aimed to evaluate (1) whether primary Sjogren’s syndrome (pSS) can contribute to the development of dementia and (2) whether the use of hydroxychloroquine (HCQ) can decrease the incidence of dementia in patients with pSS using the Health Insurance Review and Assessment database. 
		                        		
		                        			Methods:
		                        			We established a cohort between 2008 and 2020 of 20,160 patients with pSS without a history of dementia. The control group comprised sex- and age-matched individuals with no history of autoimmune disease or dementia. Cox proportional hazard analyses were performed to identify the association between pSS and dementia development. We also assessed the hazard ratio (HR) of dementia in early users of HCQ (within 180 days of the diagnosis of pSS) compared to non-users, adjusted for age, sex, and comorbidities. 
		                        		
		                        			Results:
		                        			The incidence of dementia was 0.68 (95% CI 0.64–0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56–0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09–1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94–1.21]), but HCQ non-users had a 1.22 (1.12–1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71–0.94]). 
		                        		
		                        			Conclusions
		                        			Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS. 
		                        		
		                        		
		                        		
		                        	
3.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
		                        		
		                        			
		                        			 Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy. 
		                        		
		                        		
		                        		
		                        	
4.Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung-Ann LEE ; Hyeji JEON ; Hyun-Sook KIM ; Kyomin CHOI ; Gi Hyeon SEO
The Korean Journal of Internal Medicine 2025;40(2):330-338
		                        		
		                        			 Background/Aims:
		                        			This nationwide cohort study aimed to evaluate (1) whether primary Sjogren’s syndrome (pSS) can contribute to the development of dementia and (2) whether the use of hydroxychloroquine (HCQ) can decrease the incidence of dementia in patients with pSS using the Health Insurance Review and Assessment database. 
		                        		
		                        			Methods:
		                        			We established a cohort between 2008 and 2020 of 20,160 patients with pSS without a history of dementia. The control group comprised sex- and age-matched individuals with no history of autoimmune disease or dementia. Cox proportional hazard analyses were performed to identify the association between pSS and dementia development. We also assessed the hazard ratio (HR) of dementia in early users of HCQ (within 180 days of the diagnosis of pSS) compared to non-users, adjusted for age, sex, and comorbidities. 
		                        		
		                        			Results:
		                        			The incidence of dementia was 0.68 (95% CI 0.64–0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56–0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09–1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94–1.21]), but HCQ non-users had a 1.22 (1.12–1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71–0.94]). 
		                        		
		                        			Conclusions
		                        			Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS. 
		                        		
		                        		
		                        		
		                        	
5.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
		                        		
		                        			
		                        			 Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy. 
		                        		
		                        		
		                        		
		                        	
6.Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung-Ann LEE ; Hyeji JEON ; Hyun-Sook KIM ; Kyomin CHOI ; Gi Hyeon SEO
The Korean Journal of Internal Medicine 2025;40(2):330-338
		                        		
		                        			 Background/Aims:
		                        			This nationwide cohort study aimed to evaluate (1) whether primary Sjogren’s syndrome (pSS) can contribute to the development of dementia and (2) whether the use of hydroxychloroquine (HCQ) can decrease the incidence of dementia in patients with pSS using the Health Insurance Review and Assessment database. 
		                        		
		                        			Methods:
		                        			We established a cohort between 2008 and 2020 of 20,160 patients with pSS without a history of dementia. The control group comprised sex- and age-matched individuals with no history of autoimmune disease or dementia. Cox proportional hazard analyses were performed to identify the association between pSS and dementia development. We also assessed the hazard ratio (HR) of dementia in early users of HCQ (within 180 days of the diagnosis of pSS) compared to non-users, adjusted for age, sex, and comorbidities. 
		                        		
		                        			Results:
		                        			The incidence of dementia was 0.68 (95% CI 0.64–0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56–0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09–1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94–1.21]), but HCQ non-users had a 1.22 (1.12–1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71–0.94]). 
		                        		
		                        			Conclusions
		                        			Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS. 
		                        		
		                        		
		                        		
		                        	
7.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
		                        		
		                        			
		                        			 Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy. 
		                        		
		                        		
		                        		
		                        	
8.Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung-Ann LEE ; Hyeji JEON ; Hyun-Sook KIM ; Kyomin CHOI ; Gi Hyeon SEO
The Korean Journal of Internal Medicine 2025;40(2):330-338
		                        		
		                        			 Background/Aims:
		                        			This nationwide cohort study aimed to evaluate (1) whether primary Sjogren’s syndrome (pSS) can contribute to the development of dementia and (2) whether the use of hydroxychloroquine (HCQ) can decrease the incidence of dementia in patients with pSS using the Health Insurance Review and Assessment database. 
		                        		
		                        			Methods:
		                        			We established a cohort between 2008 and 2020 of 20,160 patients with pSS without a history of dementia. The control group comprised sex- and age-matched individuals with no history of autoimmune disease or dementia. Cox proportional hazard analyses were performed to identify the association between pSS and dementia development. We also assessed the hazard ratio (HR) of dementia in early users of HCQ (within 180 days of the diagnosis of pSS) compared to non-users, adjusted for age, sex, and comorbidities. 
		                        		
		                        			Results:
		                        			The incidence of dementia was 0.68 (95% CI 0.64–0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56–0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09–1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94–1.21]), but HCQ non-users had a 1.22 (1.12–1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71–0.94]). 
		                        		
		                        			Conclusions
		                        			Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS. 
		                        		
		                        		
		                        		
		                        	
9.Small Cell Transformation in Pancreatic Metastasis from EGFR-Mutated Lung Adenocarcinoma Following TKI
Wootaek SEO, ; Hyeon-Gi KIM ; Hee-Eon LIM ; Kwangrok JUNG ; Jong-Chan LEE ; Jin-Hyeok HWANG ; Jaihwan KIM
Korean Journal of Pancreas and Biliary Tract 2025;30(2):76-80
		                        		
		                        			
		                        			 Lazertinib is an oral, third-generation, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for the treatment of non-small cell lung cancer (NSCLC). This case report presents a rare instance of small cell carcinoma transformation in pancreatic metastasis in a patient with EGFR-mutated NSCLC undergoing treatment with lazertinib. Small cell carcinoma transformation indicates a mechanism of treatment resistance, and tissue biopsy is essential to confirm this. When isolated progression of a lesion is suspected during TKI therapy in EGFR-mutated NSCLC, histological evaluation is necessary to confirm the transformation for the treatment strategy. 
		                        		
		                        		
		                        		
		                        	
10.Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung-Ann LEE ; Hyeji JEON ; Hyun-Sook KIM ; Kyomin CHOI ; Gi Hyeon SEO
The Korean Journal of Internal Medicine 2025;40(2):330-338
		                        		
		                        			 Background/Aims:
		                        			This nationwide cohort study aimed to evaluate (1) whether primary Sjogren’s syndrome (pSS) can contribute to the development of dementia and (2) whether the use of hydroxychloroquine (HCQ) can decrease the incidence of dementia in patients with pSS using the Health Insurance Review and Assessment database. 
		                        		
		                        			Methods:
		                        			We established a cohort between 2008 and 2020 of 20,160 patients with pSS without a history of dementia. The control group comprised sex- and age-matched individuals with no history of autoimmune disease or dementia. Cox proportional hazard analyses were performed to identify the association between pSS and dementia development. We also assessed the hazard ratio (HR) of dementia in early users of HCQ (within 180 days of the diagnosis of pSS) compared to non-users, adjusted for age, sex, and comorbidities. 
		                        		
		                        			Results:
		                        			The incidence of dementia was 0.68 (95% CI 0.64–0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56–0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09–1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94–1.21]), but HCQ non-users had a 1.22 (1.12–1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71–0.94]). 
		                        		
		                        			Conclusions
		                        			Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS. 
		                        		
		                        		
		                        		
		                        	
            
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