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Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim;Kwangho Yang;Gi Hong Choi;Hye Yeon Yang;Dong-Sik Kim;Hye-Sung Jo;Gyu-Seong Choi;Kwan Woo Kim;Young Chul Yoon;Jaryung Han;Doo Jin Kim;Shin Hwang;Koo Jeong Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.134-143
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    • 2024
  • Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Evaluation of the quality characteristics of nitrogen gas-stunned chicken meat and small intestine

  • Muhammad Shahbubul Alam;Dong-Heon Song;Sun-Moon Kang;Inho Hwang;Kuk-Hwan Seol;Soo-Hyun Cho;Jung-Hwan Jeon;Hyoun Wook Kim
    • Journal of Animal Science and Technology
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    • v.66 no.4
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    • pp.792-806
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    • 2024
  • This study aimed to confirm the applicability of the new nitrogen (N2) gas stunning method in the broiler slaughtering process by comparing the meat and small intestine quality following different stunning methods (electrical, carbon dioxide (CO2), N2, and halal). Four treatments were compared: (i) electrical stunning (Elec), (ii) 80% CO2 gas stunning (CO2-gas), (iii) 98% N2 gas stunning (N2-gas), and (iv) the non-stunning method (halal). N2 gas stunning (98%) and the halal method were conducted at the pilot plant abattoir of the national institute of animal science, Korea, and electrical and 80% CO2 stunning were performed on the nearest commercial slaughter house. Meat pH24h, color (lightness, redness and yellowness), proximate composition, water holding capacity (WHC), cooking loss, and Warner-Bratzler shear force (WBSF) were measured, and in the small intestine, pH24h, color, thickness, and WBSF were measured. The Elec treatment showed high lightness, yellowness, and low redness in both meat and the small intestine, indicated by a pale color; the CO2-gas treatment showed high redness, low lightness, and low yellowness, and the coloration of meat from the N2-gas treatment was intermediate between Elec and CO2-gas. For other quality traits, the N2-gas showed good results and was between Elec and CO2-gas. Additionally, severe stress (low pH in both meats), low WHC in meat, and cracked small intestine with numerous apertures were observed in the CO2-gas, and pale colored hemorrhagic breast meat was found in the Elec. Therefore, in view of animal welfare and quality traits of meat and the small intestine, 98% N2 gas can be considered in broiler stunning.

Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition

  • Su Young Kim;Min Seob Kwak;Soon Man Yoon;Yunho Jung;Jong Wook Kim;Sun-Jin Boo;Eun Hye Oh;Seong Ran Jeon;Seung-Joo Nam;Seon-Young Park;Soo-Kyung Park;Jaeyoung Chun;Dong Hoon Baek;Mi-Young Choi;Suyeon Park;Jeong-Sik Byeon;Hyung Kil Kim;Joo Young Cho;Moon Sung Lee;Oh Young Lee;Korean Society of Gastrointestinal Endoscopy;Korean Society of Gastroenterology;Korean Association for the Study of Intestinal Diseases
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.703-725
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    • 2022
  • Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Fresh and hardened properties of expansive concrete utilizing waste aluminum lathe

  • Yasin Onuralp Ozkilic;Ozer Zeybek;Ali Ihsan Celik;Essam Althaqafi;Md Azree Othuman Mydin;Anmar Dulaimi;Memduh Karalar;P. Jagadesh
    • Steel and Composite Structures
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    • v.50 no.5
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    • pp.595-608
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    • 2024
  • In this study, aluminum lathe waste was used by replacing aggregates in certain proportions in order to obtain expansive concrete using recycled materials. For this reason, five different aluminum wastes of 1%, 2%, 3%, 4% and 5% were selected and also reference without aluminum waste was produced. Based on the mechanical tests conducted, which included slump, compression, splitting tensile, and flexural tests, it was evident that the workability of the material declined dramatically once the volume ratio of aluminum exceeded 2%. As determined by the compressive strength test (CST), the CS of concrete (1% aluminum lathe wastes replaced with aggregate) was 11% reducer than that of reference concrete. It was noted that the reference concrete's CS values, which did not include aluminum waste, were greater than those of the concrete that contained 5% aluminum. When comparing for splitting tensile strength (STS), it was observed that the results of STS generally follow the parallel inclination as the CS. The reduction in these strengths when 1% aluminum is utilized is less than 10%. These ratios modified 18% when flexural strength (FS) is considered. Therefore, 1% of aluminum waste is recommended to obtain expansive concrete with recycled materials considering minimum loss of strength. Moreover, Scanning Electron Microscope (SEM) analysis was performed and the results also confirm that there was expansion in the aluminum added concrete. The presence of pores throughout the concrete leads to the formation of gaps, resulting in its expansion. Additionally, for practical applications, basic equations were developed to forecast the CS, STS, and FS of the concrete with aluminum lathe waste using the data already available in the literature and the findings of the current study. In conclusion, this study establishes that aluminum lathe wastes are suitable, readily available in significant quantities, locally sourced eco-materials, cost-effective, and might be selected for construction using concrete, striking a balance among financially and ecological considerations.

Attention and Memory Bias to threatened stimuli in Individuals with High Social Anxiety (고 사회 불안 성인의 위협 자극에 대한 주의 및 기억 편향)

  • Jin-Ah Park;So-Yeon Kim
    • Science of Emotion and Sensibility
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    • v.27 no.2
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    • pp.113-126
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    • 2024
  • Individuals with social anxiety disorders tend to hold attentional bias toward threatening stimuli in social contexts regardless of task relevance. Although attentional bias is relatively consistent, findings on memory performance are mixed. This study examined attentional and memory biases toward threat stimuli in individuals with high levels of social anxiety. Participants included 19 individuals with high social anxiety (HSA) and another 20 individuals with low social anxiety (LSA). They performed a continuous attention task to measure attentional bias to threat. Afterward, they performed an unexpected memory task using distracting stimuli from the previous attention task to measure memory bias to task-irrelevant threatening stimuli. The results indicated that the HSA and LSA groups exhibited an initial attentional bias toward emotional faces. However, only the HSA group displayed prolonged attentional bias and demonstrated memory bias toward angry faces. Conversely, the LSA group exhibited attentional bias toward happy faces after 4 s. The findings imply that the absence of bias toward positive stimuli and the presence of bias toward negative stimuli may contribute to the maintenance and severity of social anxiety pathology.

Risk assessment of water scarcity considering socio-economic characteristics in Gwangju and Jeonnam (광주·전남지역의 사회경제적 특성을 고려한 물부족 위험도 평가)

  • Hwang, Se Won;Park, Ju Young;Lee, Moon Hwan
    • Journal of Korea Water Resources Association
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    • v.57 no.9
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    • pp.599-613
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    • 2024
  • Unlike other disasters, the water shortage problem caused by drought is characterized by the long-lasting ripple effect of the social and economic sectors in all regions of Korea, and the types and purposes of water mainly used are different depending on the type of region, so the factors and scale of water shortage damage are different. In this study, a methodology to evaluate the risk of water shortage based on socioeconomic characteristics was developed and applied to Gwangju and Jeollanam-do to analyze the results. To this end, 20 impact indicators for risk, exposure, and vulnerability items were selected according to the climate risk concept of IPCC AR6. The results of the water shortage risk evaluation reflecting socioeconomic characteristics were different from the risk results considering only the existing meteorological and hydrological factors. The areas with the greatest risk of water shortage were calculated as Yeonggwang-eup in Yeonggwang-gun, Yeonsan-dong and Haean-dong 4-ga in Mokpo-si, Jeokryang-dong in Yeosu-si and Geumsan-myeon in Goheung-si. Through the evaluation results, risk factors and countermeasures for water shortage were derived in consideration of detailed characteristics of the region, which can be used as data contributing to the establishment of measures to reduce drought damage tailored to the region in the future.

Case Report on Three Patients with Cervical Myofascial Pain Syndrome Showing Improvement with Ultrasound-Guided Pharmacopuncture: Proposal of the 'SLS Triangle' Treatment Protocol (경추근막통증증후군에 대한 초음파 유도하 약침 치료 3례 증례보고)

  • Hongmin Chu;Seongjun Park;Taegwang Nam;Kwangho Kim;Junhui Kwon;Hyeon Joon Hong;Juhwan Song;Sanghyuk Kwon;Jaehyo Kim;Hyein Jeong;Kyeong Han Kim;Robin Kwon
    • Korean Journal of Acupuncture
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    • v.41 no.3
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    • pp.101-109
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    • 2024
  • Objectives : Cervical myofascial pain syndrome (C-MPS), a key aspect of Visual Display Terminals (VDT) Syndrome, leads to acute and chronic pain due to muscle shortening, potentially causing headaches and movement disorders. This study examines the effectiveness of Pharmacoacupuncture at the intersection of the Splenius Capitis (SC), Levator Scapulae (LS), and Serratus Posterior Superior(SPS) muscles under ultrasound guidance, known as the "SLS triangle" in treating C-MPS. Methods : Three patients (aged 30 to 37) with acute C-MPS presented at two Korean medicine clinics with severe neck pain and restricted cervical rotation. The evaluation of symptoms before treatment, immediately after treatment, and one day after treatment was conducted using the cervical rotation Range of motion (ROM) and the Numeric Rating Scale (NRS) for cervical pain. Treatments included Acupuncture, Cupping therapy, Chuna manipulation, Physical Therapy, and Pharmacopuncture (Jaha-geo extract, 2cc at the SLS triangle). Results : All three patients showed significant improvement post-treatment. Immediately after treatment, Patient 1's NRS improved from 7 to 2, Patient 2's NRS improved from 4 to 1, and Patient 3's NRS improved from 6 to 2. Directly after the procedure, there were no significant adverse reactions except for one patient experiencing temporary dizziness. When the patients were followed up by phone 24 hours later, no adverse reactions were reported. Conclusions : This study demonstrates that ultrasound-guided pharmacopuncture can significantly reduce pain and improve cervical rotation in patients with cervical myofascial pain syndrome. The findings suggest this non-invasive treatment is both safe and effective, warranting further research through larger-scale clinical trials to validate its efficacy and establish standardized protocols.

Late Outcomes of Pediatric and Congenital Heart Disease Patients Following Cardiac Resynchronization Therapy

  • Jeong Eun Ahn;Susan Taejung Kim;Hye Won Kwon;Sang Yun Lee;Gi Beom Kim;Jae Gun Kwak;Woong Han Kim;Mi Kyoung Song;Eun Jung Bae
    • Korean Circulation Journal
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    • v.52 no.12
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    • pp.865-875
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    • 2022
  • Background and Objectives: Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure. However, in pediatric and congenital heart disease (CHD) patients, current adult indications cannot be directly applied because of heterogeneity in anatomy and diagnosis. Therefore, CRT responses and clinical outcomes in these patients were investigated to derive possible candidates for CRT. Methods: This study retrospectively analyzed 16 pediatric and CHD patients who underwent CRT implantation at a single center in early (0.7±0.2 year) and late (4.7±0.3 years) follow-up period after CRT. Results: The median age at CRT implantation was 2.5 (0.3-37.2) years, and median follow-up duration was 6.3 (0.1-13.6) years. Thirteen had non-transvenous CRT. Two had congenital complete atrioventricular (AV) block with previous right ventricular pacing, 5 had dilated cardiomyopathy (DCM) with left bundle branch block, and 9 had CHD. The mean ejection fraction of the systemic ventricle increased from 28.1±10.0% to 44.3±21.0% (p=0.003) in early and 51.8±16.3% (p=0.012) in late outcome. The mean functional class improved from 3.1±0.9 to 1.8±1.1 after CRT (p=0.003). Twelve patients (75%) showed improvement in ventricular function or functional class after CRT. Proportion of responders differed between patients without CHD (2/2 patients with complete AV block and 5/5 with DCM, 100%) and those with CHD (5/9, 56%), although statistical significance was not reached (p=0.088). Conclusions: CRT improved ventricular function and functional status according to the underlying condition in pediatric and CHD patients. However, further large and longer-term studies are needed to establish the guideline for the patient selection of CRT in these patients.

Ischemic Burden Assessment Using Single Photon Emission Computed Tomography in Single Vessel Chronic Total Occlusion of Coronary Artery

  • Yong-Hoon Yoon;Sangwon Han;Osung Kwon;Kyusup Lee;Ju Hyeon Kim;Junghoon Lee;Tae oh Kim;Jae-Hyung Roh;Pil Hyung Lee;Soo-Jin Kang;Jae-Hwan Lee;Young-Hak Kim;Cheol Whan Lee;Dae Hyuk Moon;Seung-Whan Lee
    • Korean Circulation Journal
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    • v.52 no.2
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    • pp.150-161
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    • 2022
  • Background and Objectives: Studies evaluating the nature of ischemic burden of chronic total occlusion (CTO) vessels are still lacking. Methods: A total of 165 patients with single vessel CTO >2.5 mm in an epicardial coronary artery who underwent single photon emission computed tomography (SPECT) were enrolled in the study. Ischemic burden was calculated with the use of semi-quantitative SPECT analysis, and was defined as the summed difference score (SDS) divided by the maximal limit of the score (=SDS/68). Results: The mean age of the participants was 59.5 years and the CTO of the left anterior descending coronary artery (LAD), left circumplex coronary artery (LCX), and right coronary artery (RCA) accounted for 93 (56.4%), 18 (10.9%), and 54 (32.7%) patients, respectively. The median ischemic burden of the total population was 8.8%, and it was highest in the LAD CTO (10.3%) compared with the LCX (5.9%) and RCA CTO (5.9%, p<0.001). High-ischemic burden (ischemic burden >10%) was observed in 66 patients (40.0%), and in 47 patients (50.5%) of the LAD CTO. Ischemic burden was different according to the CTO location only in LAD CTO. The statistically significant predictors for high-ischemic burden were hypertension, baseline ejection fraction >45%, LAD CTO, proximal CTO location, and de novo CTO. Japanese-CTO score and Rentrop scale collateral grade were not associated with high-ischemic burden. Conclusions: Only 40% of patients with single vessel CTO had ischemic burden >10%. For CTO vessels, measurement of ischemic burden using SPECT prior to revascularization may be helpful in identifying beneficial subjects.

Mechanical ventilation in patients with idiopathic pulmonary fibrosis in Korea: a nationwide cohort study

  • Jae Kyeom Sim;Seok Joo Moon;Juwhan Choi;Jee Youn Oh;Young Seok Lee;Kyung Hoon Min;Gyu Young Hur;Sung Yong Lee;Jae Jeong Shim
    • The Korean journal of internal medicine
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    • v.39 no.2
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    • pp.295-305
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    • 2024
  • Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time. Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran-Armitage trend test. Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (p = 0.028). Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.