Background: This study examines integrating physical and mental healthcare for disadvantaged persons with type 2 diabetes mellitus and mild-to-moderate depression in the community, using a mobile application within a public-private-academic partnership. Methods: The Korean Diabetes Association has developed a mobile application combining behavioral activation for psychological well-being and diabetes self-management, with conventional medical therapy. Participants were randomly assigned to receive the application with usual care or only usual care. Primary outcomes measured changes in psychological status and diabetes selfmanagement through questionnaires at week 12 from the baseline. Secondary outcomes assessed glycemic and lipid control, with psychological assessments at week 16. Results: Thirty-nine of 73 participants completed the study (20 and 19 in the intervention and control groups, respectively) and were included in the analysis. At week 12, the intervention group showed significant reductions in depression severity and perceived stress compared to the control group. Additionally, they reported increased perceived social support and demonstrated improved diabetes self-care behavior. These positive effects persisted through week 16, with the added benefit of reduced anxiety. While fasting glucose levels in the intervention group tended to improve, no other significant differences were observed in laboratory assessments between the groups. Conclusion This study provides compelling evidence for the potential efficacy of a mobile application that integrates physical and mental health components to address depressive symptoms and enhance diabetes self-management in disadvantaged individuals with type 2 diabetes mellitus and depression. Further research involving larger and more diverse populations is warranted to validate these findings and solidify their implications.

Purpose: To document changes in the optical coherence biometry data over 1 year of Korean children aged 6 to 9 years with myopia and hyperopia. Methods: We used fluorescein angiography to retrospectively study changes in refractive errors over 1 year in 60 children who visited our hospital between December 2019 and June 2022. The IOL master 700 platform was used to derive axial length, corneal curvature (the K value), central corneal thickness, anterior chamber depth, lens thickness, and the white-to-white size at 1-year intervals. The Mann-Whitney and Wilcoxon signed-ranked tests were used to compare the values. A p-value < 0.05 was taken to indicate a significant difference. Results: The mean ages of hyperopic and myopic children were 6.27 ± 0.87 and 6.93 ± 0.87 years at initial presentation. Significant 1-year changes in axial length, anterior depth, and lens thickness were apparent. The mean corneal curvature, and central corneal and lens thicknesses were significantly higher in hyperopic than myopic children but the axial length and anterior chamber depth were significantly greater in myopic children. However, after 1 year, the lens thicknesses did not significantly differ between the two groups. Conclusions Over 1 year of early life, changes in the mean corneal curvature and lens thickness were significant in hyperopic children and changes in the axial length and anterior depth were significant in myopic children. Thus, the eye growth pattern may differ between hyperopic and myopic children.

Background: and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS.
Materials and Methods: This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed.
Results: The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure.
Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

PURPOSE: Papillary thyroid carcinomas (PTCs) frequently involve genetic alterations. The objective of this study was to investigate genetic alterations and further explore the relationships between these genetic alterations and clinicopathological characteristics in a high-recurrence risk (node positive, N1) PTC group. MATERIALS AND METHODS: Tumor tissue blocks were obtained from 240 surgically resected patients with histologically confirmed stage III/IV (pT3/4 or N1) PTCs. We screened gene fusions using NanoString’s nCounter technology and mutational analysis was performed by direct DNA sequencing. Data describing the clinicopathological characteristics and clinical courses were retrospectively collected. RESULTS: Of the 240 PTC patients, 207 (86.3%) had at least one genetic alteration, including BRAF mutation in 190 patients (79.2%), PIK3CA mutation in 25 patients (10.4%), NTRK1/3 fusion in six patients (2.5%), and RET fusion in 24 patients (10.0%). Concomitant presence of more than two genetic alterations was seen in 36 patients (15%). PTCs harboring BRAF mutation were associated with RET wild-type expression (p=0.001). RET fusion genes have been found to occur with significantly higher frequency in N1b stage patients (p=0.003) or groups of patients aged 45 years or older (p=0.031); however, no significant correlation was found between other genetic alterations. There was no trend toward favorable recurrence-free survival or overall survival among patients lacking genetic alterations. CONCLUSION: In the selected high-recurrence risk PTC group, most patients had more than one genetic alteration. However, these known alterations could not entirely account for clinicopathological features of high-recurrence risk PTC.
Gene Fusion ; Humans ; Retrospective Studies ; Sequence Analysis, DNA ; Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: Oropharyngeal squamous cell carcinoma (OSCC) has been recognized as an immunosuppressive disease. Various mechanisms have been proposed for immune escape, including dysregulation of immune checkpoints such as the PD-1:PD-L1 pathway. We investigated the expression of programmed cell death-ligand 1 (PD-L1) in HPV-negative and HPV-positive OSCC to determine its prevalence and prognostic relevance. MATERIALS AND METHODS: Using immunohistochemistry, 133 cases of OSCC were evaluated for expression of PD-L1. Formalin-fixed paraffin-embedded tumor samples were stained with monoclonal antibody (clone 5H1) to PD-L1. PD-L1 positivity was defined as membrane staining in ≥20% of tumor cells. Correlations between PD-L1 expression and HPV status and survival parameters were analyzed. RESULTS: Of the 133 patients, 68% showed PD-L1 expression, and 67% of patients were positive for p16 expression by immunohistochemistry. No significant difference in PD-L1 expression was observed between HPV(-) and HPV(+) tumors (61% vs. 71%, p=0.274). No significant difference in age, gender, smoking history, location of tumor origin, or stage was observed according to PD-L1 status. With a median follow-up period of 44 months, older age (≥65) (p=0.017) and T3-4 stage (p<0.001) were associated with poor overall survival (OS), whereas PD-L1 expression did not affect OS in univariate and multivariate analysis. CONCLUSION: PD-L1 expression was observed in the majority of OSCC patients regardless of HPV status. Further large prospective studies are required to determine the role of PD-L1 expression as a prognostic or predictive biomarker, and clinical studies of immune checkpoint inhibitors in OCSS are warranted regardless of HPV status.
Carcinoma, Squamous Cell* ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Membranes ; Multivariate Analysis ; Oropharyngeal Neoplasms ; Prevalence ; Prospective Studies ; Smoke ; Smoking ; United Nations

OBJECTIVE: The purpose of the current study was to evaluate survival outcome according to the expression status of CD73 in patients with epithelial ovarian cancer. METHODS: A total of 167 patients with epithelial ovarian cancer were enrolled in the current study. For each patient, a retrospective review of medical records was conducted. Immunohistochemical staining for CD73, CD8, FoxP3, and CD68 was performed using tissue microarray made with paraffin embedded tissue block. RESULTS: Among the enrolled patients, 29.9% of patients (n=50) showed negative expression for CD73, whereas 70.1% of patients (n=117) showed positive expression for CD73. The CD73 positive group showed better prognosis compared to the CD73 negative group (5-year overall survival of CD73 positive group, 73.0%; that of CD73 negative group, 50.1%; p=0.023). CD73 was more frequently expressed in mucinous adenocarcinoma and clear cell carcinoma compared to serous or endometrioid adenocarcinoma. In addition, CD73 overexpressions were more frequently detected in patients with known good prognostic factors, i.e., low stage, well/moderate differentiation, negative peritoneal cytology, no lymphovascular involvement, and no macroscopic residual tumor after debulking surgery. There was significantly more infiltration of regulatory T cells in the CD73 negative group compared to the CD73 positive group. CONCLUSION: Good prognosis in patients with overexpression of CD73 may be due to that overexpression of CD73 was more frequently observed in epithelial ovarian cancer patients with known good prognostic factors. Therefore, this result means that favorable differentiation and stage have more influence on survival outcome than adverse effect of CD73 per se.
5'-Nucleotidase ; Adenocarcinoma, Mucinous ; Carcinoma, Endometrioid ; Humans ; Medical Records ; Neoplasm, Residual ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Paraffin ; Prognosis ; Retrospective Studies ; T-Lymphocytes, Regulatory

OBJECTIVE: The purpose of the current study was to evaluate survival outcome according to the expression status of CD73 in patients with epithelial ovarian cancer. METHODS: A total of 167 patients with epithelial ovarian cancer were enrolled in the current study. For each patient, a retrospective review of medical records was conducted. Immunohistochemical staining for CD73, CD8, FoxP3, and CD68 was performed using tissue microarray made with paraffin embedded tissue block. RESULTS: Among the enrolled patients, 29.9% of patients (n=50) showed negative expression for CD73, whereas 70.1% of patients (n=117) showed positive expression for CD73. The CD73 positive group showed better prognosis compared to the CD73 negative group (5-year overall survival of CD73 positive group, 73.0%; that of CD73 negative group, 50.1%; p=0.023). CD73 was more frequently expressed in mucinous adenocarcinoma and clear cell carcinoma compared to serous or endometrioid adenocarcinoma. In addition, CD73 overexpressions were more frequently detected in patients with known good prognostic factors, i.e., low stage, well/moderate differentiation, negative peritoneal cytology, no lymphovascular involvement, and no macroscopic residual tumor after debulking surgery. There was significantly more infiltration of regulatory T cells in the CD73 negative group compared to the CD73 positive group. CONCLUSION: Good prognosis in patients with overexpression of CD73 may be due to that overexpression of CD73 was more frequently observed in epithelial ovarian cancer patients with known good prognostic factors. Therefore, this result means that favorable differentiation and stage have more influence on survival outcome than adverse effect of CD73 per se.
5'-Nucleotidase ; Adenocarcinoma, Mucinous ; Carcinoma, Endometrioid ; Humans ; Medical Records ; Neoplasm, Residual ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms ; Paraffin ; Prognosis ; Retrospective Studies ; T-Lymphocytes, Regulatory

BACKGROUND: Norovirus is one of the most prevalent pathogens causing acute gastroenteritis in children. We compared the clinical features of noroviral gastroenteritis to those of rotaviral gastroenteritis and analyzed the noroviruses' genotype frequencies. MATERIALS AND METHODS: Stool samples were obtained form 433 children hospitalized with acute gastroenteritis from May 2008 through February 2009 at Soonchunhyang University Cheonan Hospital and examined for the presence of norovirus or rotavirus. We then analyzed the clinical features of noroviral gastroenteritis in comparison with rotaviral gastroenteritis and observed the capsid protein gene sequences from the isolated norovirus for genotyping. RESULTS: Norovirus was isolated from 69 patients (16.4%) and rotavirus from 49 patients (11.6%). The noroviral gastroenteritis patients experienced vomiting (77.4%), diarrhea (73.2%), and respiratory symptoms (53.6%); the rotaviral gastroenteritis patients experienced diarrhea (71.4%), dehydration (69.3%), and vomiting (65.3%). Dehydration in patients with noroviral gastroenteritis (43.4%) was rare compared with rotavirus (69.3%) (P=0.008). The isolated norovirus belonged primarily to the GII.4 genogroup (85.5%). Our phylogenetic analysis of the GII.4 isolates revealed 3 clusters, including novel cluster C. CONCLUSIONS: Vomiting was the most common symptom in noroviral gastroenteritis patients. Dehydration in noroviral gastroenteritis patients was less common compared with rotavirus gastroenteritis patients. The majority of the norovirus strains isolated from children with acute gastroenteritis belonged to the GII.4 genogroup.
Capsid Proteins ; Child ; Child, Hospitalized ; Dehydration ; Diarrhea ; Gastroenteritis ; Genotype ; Humans ; Norovirus ; Rotavirus ; Vomiting

Nasal cavity foreign bodies are common accidents in children, especially between the newly born and four years of age, and sometimes lead to complications such as epistaxis, vestibulitis, sinusitis bronchoaspiration and nasal septal damage etc. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. If the diagnosis is confirmed, prompt foreign body removal should be done to avoid complications. We have recently experienced a case of nasal septal perforation secondary to magnetic nasal foreign bodies attracting each other across the nasal septum. After the removal of foreign bodies, the nasal septal perforation was repaired with acellular human dermal allograft.
Child ; Collagen ; Epistaxis ; Foreign Bodies ; Humans ; Magnetics ; Magnets ; Nasal Cavity ; Nasal Septal Perforation ; Nasal Septum ; Sinusitis ; Transplantation, Homologous ; Transplants