Interleukin-1 receptor-associated kinase 4 (IRAK4) is a pivotal enzyme in the Toll-like receptor (TLR)/MYD88 dependent signaling pathway, which is highly activated in rheumatoid arthritis tissues and activated B cell-like diffuse large B-cell lymphoma (ABC-DLBCL). Inflammatory responses followed by IRAK4 activation promote B-cell proliferation and aggressiveness of lymphoma. Moreover, proviral integration site for Moloney murine leukemia virus 1 (PIM1) functions as an anti-apoptotic kinase in propagation of ABC-DLBCL with ibrutinib resistance. We developed a dual IRAK4/PIM1 inhibitor KIC-0101 that potently suppresses the NF-κB pathway and proinflammatory cytokine induction in vitro and in vivo. In rheumatoid arthritis mouse models, treatment with KIC-0101 significantly ameliorated cartilage damage and inflammation. KIC-0101 inhibited the nuclear translocation of NF-κB and activation of JAK/STAT pathway in ABC-DLBCLs. In addition, KIC-0101 exhibited an anti-tumor effect on ibrutinib-resistant cells by synergistic dual suppression of TLR/MYD88-mediated NF-κB pathway and PIM1 kinase. Our results suggest that KIC-0101 is a promising drug candidate for autoimmune diseases and ibrutinib-resistant B-cell lymphomas.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Purpose: To evaluate long-term clinical outcomes in patients with neovascular age-related macular degeneration (AMD) who were treated with an as-needed regimen but were switched to a proactive regimen during the course of treatment. Methods: This retrospective study included 23 eyes with neovascular AMD which were initially treated with an as-needed regimen, but switched to a proactive regimen during the course of treatment. The duration of the as-needed phase was compared to that of the proactive phase. In addition, the number of injections per year and the degree of visual deterioration per year were compared between the two phases. Results: The duration of the as-needed and proactive phases were 17.9 ± 8.3 months and 31.3 ± 13.2 months, respectively. The duration of the proactive phase was significantly longer (p < 0.001). The number of injections per year during the proactive phase (4.4 ± 1.0) was significantly more than that during the as-needed phase (2.8 ± 1.0) (p < 0.001). The degree of visual deterioration per year during the as-needed phase (0.08 ± 0.14) was slightly greater than that during the proactive phase (0.04 ± 0.08). However, the difference was not statistically significant (p = 0.229). Conclusions The number of injections was higher after switching to the proactive regimen. However, the degree of visual deterioration was slightly lower than that noted during the as-needed phase. Further studies with a more controlled design are needed to determine more clearly the impact of switching treatment regimens on long-term clinical outcomes.

Background and Objectives: Treatment choice for fungal ball is endoscopic endonasal removal. However, it is not easy to remove fungal elements from the maxilla using only an endonasal approach. To overcome this difficulty, we introduced a cotton pledget technique and evaluated its efficacy through a cadaveric study and clinical research.Materials and Method: A cadaveric study was performed using 10 half heads of seven cadavers. The ease and safety of the cotton pledget technique were compared to those of a previously reported technique. In clinical research, we enrolled 52 patients who underwent surgery with the cotton pledget technique and 36 patients who underwent surgery using the conventional endoscopic approach. Demographic factors, preoperative Lund-Mackay (LM) score, sinonasal outcome test (SNOT) score, surgical morbidity, and incomplete removal rate were analyzed. Results: The cadaveric study showed that the cotton pledget technique was easier (p=0.011) than the conventional technique. In addition, clinical evaluation showed that the cotton pledget group had significantly lower incomplete removal rate than that of the control group (p=0.010). Conclusion The cotton pledget technique is an easy and safe method that enables fungal ball removal more effectively than the conventional technique without need for inferior meatal antrostomy (IMA) or the Caldwell-Luc (CL) approach.

Myeloid-derived suppressor cells (MDSCs) are immature myeloid cells that exert suppressive function on the immune response. MDSCs expand in tumor-bearing hosts or in the tumor microenvironment and suppress T cell responses via various mechanisms, whereas a reduction in their activities has been observed in autoimmune diseases or infections. It has been reported that the symptoms of various diseases, including malignant tumors, can be alleviated by targeting MDSCs. Moreover, MDSCs can contribute to patient resistance to therapy using immune checkpoint inhibitors. In line with these therapeutic approaches, diverse oligonucleotide-based molecules and small molecules have been evaluated for their therapeutic efficacy in several disease models via the modulation of MDSC activity. In the current review, MDSC-targeting oligonucleotides and small molecules are briefly summarized, and we highlight the immunomodulatory effects on MDSCs in a variety of disease models and the application of MDSC-targeting molecules for immuno-oncologic therapy.

BACKGROUND AND OBJECTIVES: The purpose of this study was to review the clinical characteristics and treatment outcomes of benign and malignant nasal septal tumors. SUBJECTS AND METHODS: A total of 34 patients who underwent the treatment for nasal septal tumor between 2004 and 2015 were included in this study. Demographic characteristics, sinonasal chief complaints, size and localization of nasal septal tumor, imaging findings, surgical method, histopathologic results, treatment outcomes, and postoperative complications were reviewed. RESULTS: Of the 34 patients with nasal septal tumor used in this study, 22 (64.7%) had benign tumors and 12 (35.3%) had malignant tumors. The most common sinonasal complaint of both benign and malignant nasal septal tumors was nasal obstruction. The most common benign tumor was inverted papilloma (n=7), whereas the most common malignant tumors were malignant melanoma (n=2), plasmacytoma (n=2), and metastatic carcinoma (n=2). All patients except two cases underwent endoscopic tumor removal. There were 4 recurrences in malignant nasal septal tumors. There was no recurrence in benign tumors. No major complications resulting from surgical intervention were found. CONCLUSION Endoscopic surgery with complete excision is a safe and effective procedure for benign nasal septal tumors. Recurrence is more common in malignant nasal septal tumor. Therefore, long term follow-ups with regular radiologic and endoscopic examinations are necessary for patients with malignant nasal septal tumor.

During the 2014 survey of the mushroom flora of Gwangneung forest in South Korea, we collected two specimens of boletoid mushroom growing on a felled tree of Pinus koraiensis. These specimens were characterized by a light brown to reddish-brown pileus with appressed tomentum, pore surface bluing instantly when bruised, golden-yellow mycelium at the base of stipe, and lignicolous habitat. Both specimens were identified as Buchwaldoboletus lignicola, a rare basidiomycete, based on morphological characteristics and sequences of internal transcribed spacer (ITS; fungal barcode). Here, we describe these specimens and provide the first report of this genus in South Korea.

BACKGROUND: There has been no practical guidelines for the management of patients with central nervous system (CNS) tumors in Korea for many years. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, started to prepare guidelines for CNS tumors from February 2018. METHODS: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified through searches of PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL using specific and sensitive keywords as well as combinations of keywords. RESULTS: First, the maximal safe resection if feasible is recommended. After the diagnosis of a glioblastoma with neurosurgical intervention, patients aged ≤70 years with good performance should be treated by concurrent chemoradiotherapy with temozolomide followed by adjuvant temozolomide chemotherapy (Stupp's protocol) or standard brain radiotherapy alone. However, those with poor performance should be treated by hypofractionated brain radiotherapy (preferred)±concurrent or adjuvant temozolomide, temozolomide alone (Level III), or supportive treatment. Alternatively, patients aged >70 years with good performance should be treated by hypofractionated brain radiotherapy+concurrent and adjuvant temozolomide or Stupp's protocol or hypofractionated brain radiotherapy alone, while those with poor performance should be treated by hypofractionated brain radiotherapy alone or temozolomide chemotherapy if the patient has methylated MGMT gene promoter (Level III), or supportive treatment. CONCLUSION: The KSNO's guideline recommends that glioblastomas should be treated by maximal safe resection, if feasible, followed by radiotherapy and/or chemotherapy according to the individual comprehensive condition of the patient.
Brain ; Central Nervous System ; Chemoradiotherapy ; Diagnosis ; Drug Therapy ; Glioblastoma ; Humans ; Korea ; Radiotherapy

BACKGROUND: We aim to discuss the overall effect of customer service manual (CSM) on service industry workers using Korean Working Condition Survey. METHODS: Out of 50,007 total survey participants, 11,946 customer service workers were included in the current study (5613 men, 6333 women). Answers to survey questions were used to define the use of CSM, emotional burden, emotional dissonance, engaging angry customers and other covariates. Emotional burden included either depressive event or stress level. Odds ratio (OR) with 95% confidence interval (95% CI) of experiencing emotional burden was calculated by logistic regression model. Interaction effect between CSM and engaging angry customer on emotional burden was also estimated. RESULTS: Out of 11,946 subjects, total of 3279 (27.4%) have experienced emotional burden. OR (95% CI) of experiencing emotional burden was 1.40 (1.19–1.64) in men and 1.25 (1.09–1.44) in women. There was gender difference in interaction effect between the use of CSM and engaging angry customers. In men, OR (95% CI) was 3.16 (1.38–7.23) with additive effect when always engaging angry customers with CSM compared to rarely engaging without CSM, while in women OR (95% CI) was 8.85 (3.96–19.75) with synergistic effect. Moreover, the risk of depressive event increased only in women with OR (95% CI) 2.22 (1.42–3.48). CONCLUSIONS: Our current study highlighted association between emotional burden and CSM in both men and women service workers. Furthermore, women were affected more severely by CSM. The results from current study suggest that CSM should be changed appropriately to benefit workers.
Female ; Humans ; Logistic Models ; Male ; Mental Health ; Odds Ratio

BACKGROUND: There was no practical guideline for the management of patients with central nervous system tumor in Korea for many years. Thus, the Korean Society for Neuro-Oncology (KSNO), a multidisciplinary academic society, has developed the guideline for glioblastoma. Subsequently, the KSNO guideline for World Health Organization (WHO) grade II cerebral glioma in adults is established. METHODS: The Working Group was composed of 35 multidisciplinary medical experts in Korea. References were identified by searching PubMed, MEDLINE, EMBASE, and Cochrane CENTRAL databases using specific and sensitive keywords as well as combinations of keywords regarding diffuse astrocytoma and oligodendroglioma of brain in adults. RESULTS: Whenever radiological feature suggests lower grade glioma, the maximal safe resection if feasible is recommended globally. After molecular and histological examinations, patients with diffuse astrocytoma, isocitrate dehydrogenase (IDH)-wildtype without molecular feature of glioblastoma should be primarily treated by standard brain radiotherapy and adjuvant temozolomide chemotherapy (Level III) while those with molecular feature of glioblastoma should be treated following the protocol for glioblastomas. In terms of patients with diffuse astrocytoma, IDH-mutant and oligodendroglioma (IDH-mutant and 1p19q codeletion), standard brain radiotherapy and adjuvant PCV (procarbazine+lomustine+vincristine) combination chemotherapy should be considered primarily for the high-risk group while observation with regular follow up should be considered for the low-risk group. CONCLUSION: The KSNO's guideline recommends that WHO grade II gliomas should be treated by maximal safe resection, if feasible, followed by radiotherapy and/or chemotherapy according to molecular and histological features of tumors and clinical characteristics of patients.
Adult ; Astrocytoma ; Brain ; Central Nervous System ; Drug Therapy ; Drug Therapy, Combination ; Follow-Up Studies ; Glioblastoma ; Glioma ; Humans ; Isocitrate Dehydrogenase ; Korea ; Oligodendroglioma ; Radiotherapy ; World Health Organization