Background: Post-transplantation cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG) are common pro‑ phylactic strategies for graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Interleukin (IL)-6 is a surrogate marker for cytokine release syndrome (CRS) and acute GVHD.Method The clinical outcomes and complications of haplo-HSCT with PTCy plus ATG versus PTCy monotherapy were compared according to serum IL-6 levels at Chungnam National University Hospital (Daejeon, South Korea) from Jan‑ uary 2019 to February 2023. Results: Forty patients who underwent haplo-HSCT were analyzed. A significant difference in IL-6 levels was observed between the PTCy plus ATG and PTCy alone groups (7.47 ± 10.55 vs. 117.65 ± 127.67; p = 0.003). More patients in the PTCy plus ATG group had a CRS grade of 0 than in the PTCy alone group (p < 0.001). Serum IL-6 levels were associated with grades II–IV acute GVHD (r = 0.547, p < 0.001). The cumulative incidence (CI) of grades II–IV acute GVHD was significantly higher in the PTCy alone group (67.9% vs. 4.8%; p < 0.001). No significant difference in the CI for chronic GVHD was detected between the PTCy plus ATG and PTCy alone groups (72.1% vs. 82.0%; p = 0.730). The CI of 1-year non-relapse mortality was significantly higher in the PTCy alone group than in the PTCy plus ATG group (42.2% vs. 15.9%; p = 0.022). The 1-year overall survival (OS) was significantly better in the PTCy plus ATG group (75.9% vs. 35.3%; p = 0.011). The 1-year GVHD-free, relapse-free survival rate was 29.4% in the PTCy alone group and 54.0% in the PTCy plus ATG group (p = 0.038). Conclusion Serum IL-6 levels were higher in the PTCy alone group than in the PTCy plus ATG group. The addition of ATG before stem cell infusion affected IL-6 levels and reduced the incidences of CRS and grade II–IV acute GVHD in haplo-HSCT patients. This study suggests that PTCy plus ATG as GVHD prophylaxis in haplo-HSCT is beneficial in terms of clinical outcomes and complications of HSCT.

Background: Post-transplantation cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG) are common pro‑ phylactic strategies for graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Interleukin (IL)-6 is a surrogate marker for cytokine release syndrome (CRS) and acute GVHD.Method The clinical outcomes and complications of haplo-HSCT with PTCy plus ATG versus PTCy monotherapy were compared according to serum IL-6 levels at Chungnam National University Hospital (Daejeon, South Korea) from Jan‑ uary 2019 to February 2023. Results: Forty patients who underwent haplo-HSCT were analyzed. A significant difference in IL-6 levels was observed between the PTCy plus ATG and PTCy alone groups (7.47 ± 10.55 vs. 117.65 ± 127.67; p = 0.003). More patients in the PTCy plus ATG group had a CRS grade of 0 than in the PTCy alone group (p < 0.001). Serum IL-6 levels were associated with grades II–IV acute GVHD (r = 0.547, p < 0.001). The cumulative incidence (CI) of grades II–IV acute GVHD was significantly higher in the PTCy alone group (67.9% vs. 4.8%; p < 0.001). No significant difference in the CI for chronic GVHD was detected between the PTCy plus ATG and PTCy alone groups (72.1% vs. 82.0%; p = 0.730). The CI of 1-year non-relapse mortality was significantly higher in the PTCy alone group than in the PTCy plus ATG group (42.2% vs. 15.9%; p = 0.022). The 1-year overall survival (OS) was significantly better in the PTCy plus ATG group (75.9% vs. 35.3%; p = 0.011). The 1-year GVHD-free, relapse-free survival rate was 29.4% in the PTCy alone group and 54.0% in the PTCy plus ATG group (p = 0.038). Conclusion Serum IL-6 levels were higher in the PTCy alone group than in the PTCy plus ATG group. The addition of ATG before stem cell infusion affected IL-6 levels and reduced the incidences of CRS and grade II–IV acute GVHD in haplo-HSCT patients. This study suggests that PTCy plus ATG as GVHD prophylaxis in haplo-HSCT is beneficial in terms of clinical outcomes and complications of HSCT.

Background: Post-transplantation cyclophosphamide (PTCy) and anti-thymocyte globulin (ATG) are common pro‑ phylactic strategies for graft-versus-host disease (GVHD) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Interleukin (IL)-6 is a surrogate marker for cytokine release syndrome (CRS) and acute GVHD.Method The clinical outcomes and complications of haplo-HSCT with PTCy plus ATG versus PTCy monotherapy were compared according to serum IL-6 levels at Chungnam National University Hospital (Daejeon, South Korea) from Jan‑ uary 2019 to February 2023. Results: Forty patients who underwent haplo-HSCT were analyzed. A significant difference in IL-6 levels was observed between the PTCy plus ATG and PTCy alone groups (7.47 ± 10.55 vs. 117.65 ± 127.67; p = 0.003). More patients in the PTCy plus ATG group had a CRS grade of 0 than in the PTCy alone group (p < 0.001). Serum IL-6 levels were associated with grades II–IV acute GVHD (r = 0.547, p < 0.001). The cumulative incidence (CI) of grades II–IV acute GVHD was significantly higher in the PTCy alone group (67.9% vs. 4.8%; p < 0.001). No significant difference in the CI for chronic GVHD was detected between the PTCy plus ATG and PTCy alone groups (72.1% vs. 82.0%; p = 0.730). The CI of 1-year non-relapse mortality was significantly higher in the PTCy alone group than in the PTCy plus ATG group (42.2% vs. 15.9%; p = 0.022). The 1-year overall survival (OS) was significantly better in the PTCy plus ATG group (75.9% vs. 35.3%; p = 0.011). The 1-year GVHD-free, relapse-free survival rate was 29.4% in the PTCy alone group and 54.0% in the PTCy plus ATG group (p = 0.038). Conclusion Serum IL-6 levels were higher in the PTCy alone group than in the PTCy plus ATG group. The addition of ATG before stem cell infusion affected IL-6 levels and reduced the incidences of CRS and grade II–IV acute GVHD in haplo-HSCT patients. This study suggests that PTCy plus ATG as GVHD prophylaxis in haplo-HSCT is beneficial in terms of clinical outcomes and complications of HSCT.

Background/Aims: Urgent endoscopic removal is required for gallstones impacted at the duodenal papilla. This study compared the clinical features of impacted papillary stones (IPS) with those of common bile duct stones without impaction. Methods: This study analyzed a common bile duct stone database from 2017 to 2023, identifying patients with IPS. The clinical features of IPS were compared with those of common bile duct stones without IPS (NIPS). Results: One hundred and eighty patients were analyzed; 45 had IPS. The mean age was 63.9 years, with a male predominance in the IPS group. The success rates of selective biliary cannulation were comparable between the IPS and NIPS groups. Multivariate analysis showed that IPS was associated with pancreatitis (odds ratio [OR] 3.78, 95% confidence interval [CI]: 1.17–12.17, p=0.026), bile duct penetrating duodenal wall sign (BPDS, OR 12.09, 95% CI: 3.92–37.33, p<0.001), and the presence of pus (OR 27.05, 95% CI: 4.92–148.85, p<0.001). The periampullary diverticulum (OR 0.28, 95% CI: 0.10–0.82, p=0.021) and the largest stone ≥10 mm (OR 0.31, 95% CI: 0.10–0.96, p=0.043) were inversely correlated with IPS. Conclusions IPS are associated with pancreatitis, BPDS, and acute suppurative cholangitis, whereas periampullary diverticulum and the stone size are inversely correlated with IPS.

Background/Aims: Urgent endoscopic removal is required for gallstones impacted at the duodenal papilla. This study compared the clinical features of impacted papillary stones (IPS) with those of common bile duct stones without impaction. Methods: This study analyzed a common bile duct stone database from 2017 to 2023, identifying patients with IPS. The clinical features of IPS were compared with those of common bile duct stones without IPS (NIPS). Results: One hundred and eighty patients were analyzed; 45 had IPS. The mean age was 63.9 years, with a male predominance in the IPS group. The success rates of selective biliary cannulation were comparable between the IPS and NIPS groups. Multivariate analysis showed that IPS was associated with pancreatitis (odds ratio [OR] 3.78, 95% confidence interval [CI]: 1.17–12.17, p=0.026), bile duct penetrating duodenal wall sign (BPDS, OR 12.09, 95% CI: 3.92–37.33, p<0.001), and the presence of pus (OR 27.05, 95% CI: 4.92–148.85, p<0.001). The periampullary diverticulum (OR 0.28, 95% CI: 0.10–0.82, p=0.021) and the largest stone ≥10 mm (OR 0.31, 95% CI: 0.10–0.96, p=0.043) were inversely correlated with IPS. Conclusions IPS are associated with pancreatitis, BPDS, and acute suppurative cholangitis, whereas periampullary diverticulum and the stone size are inversely correlated with IPS.

Background/Aims: Urgent endoscopic removal is required for gallstones impacted at the duodenal papilla. This study compared the clinical features of impacted papillary stones (IPS) with those of common bile duct stones without impaction. Methods: This study analyzed a common bile duct stone database from 2017 to 2023, identifying patients with IPS. The clinical features of IPS were compared with those of common bile duct stones without IPS (NIPS). Results: One hundred and eighty patients were analyzed; 45 had IPS. The mean age was 63.9 years, with a male predominance in the IPS group. The success rates of selective biliary cannulation were comparable between the IPS and NIPS groups. Multivariate analysis showed that IPS was associated with pancreatitis (odds ratio [OR] 3.78, 95% confidence interval [CI]: 1.17–12.17, p=0.026), bile duct penetrating duodenal wall sign (BPDS, OR 12.09, 95% CI: 3.92–37.33, p<0.001), and the presence of pus (OR 27.05, 95% CI: 4.92–148.85, p<0.001). The periampullary diverticulum (OR 0.28, 95% CI: 0.10–0.82, p=0.021) and the largest stone ≥10 mm (OR 0.31, 95% CI: 0.10–0.96, p=0.043) were inversely correlated with IPS. Conclusions IPS are associated with pancreatitis, BPDS, and acute suppurative cholangitis, whereas periampullary diverticulum and the stone size are inversely correlated with IPS.

Kimura’s disease (KD) is a rare, chronic inflammatory disorder characterized by angiolymphoid hyperplasia, peripheral eosinophilia, and elevated serum immunoglobulin E levels. It primarily affects young Asian males and typically involves the head and neck region, especially near the mandible and postauricular regions. Orbital involvement is unusual and extraocular muscle (EOM) involvement is exceedingly rare, with only a few cases reported in the literature. The present report describes a case of surgically confirmed KD in a 16-yearold male, involving the bilateral EOM, lacrimal gland, and left parotid gland.