• Korean Journal of Radiology
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• v.24 no.7
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• pp.606-625
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• 2023

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1024-1037
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• 2020

The resource-based relative value scale (RBRVS) compares the value of a medical practice to the consumption of resources, which consist of the work of the physician, practice expenses, and professional liability insurance. At the time of the 2nd revision of RBRVS, the fee for radiological examinations had been reduced due to the high preservation rate. In RBRVS, practice expenses account for most of the compensation of radiological examinations, and physicians' work is relatively undervalued. A new healthcare policy (Moon Jae-In care) consists of the expansion of the National Health Insurance (NHI) coverage, reduction of patient charges for the vulnerable class, and support for catastrophic medical expenses. However, Moon Jae-In care is expected to negatively affect the NHI in Korea financially. The expansion of the insurance coverage for ultrasonography and MRI examinations is a significant part of the Moon Jae-In care, and radiological societies should establish fair compensations for physicians' work within the field of radiology while implementing the Moon Jae-In care.

• Safety and Health at Work
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• v.15 no.1
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• pp.87-95
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• 2024

Background: This study focuses on assessing occupational risk for the health hazards encountered during maintenance works (MW) in semiconductor fabrication (FAB) facilities. Objectives: The objectives of this study include: 1) identifying the primary health hazards during MW in semiconductor FAB facilities; 2) reviewing the methods used in evaluating the likelihood and severity of health hazards through occupational health risk assessment (OHRA); and 3) suggesting variables for the categorization of likelihood of exposures to health hazards and the severity of health effects associated with MW in FAB facilities. Methods: A literature review was undertaken on OHRA methodology and health hazards resulting from MW in FAB facilities. Based on this review, approaches for categorizing the exposure to health hazards and the severity of health effects related to MW were recommended. Results: Maintenance workers in FAB facilities face exposure to hazards such as debris, machinery entanglement, and airborne particles laden with various chemical components. The level of engineering and administrative control measures is suggested to assess the likelihood of simultaneous chemical and dust exposure. Qualitative key factors for mixed exposure estimation during MW include the presence of safe operational protocols, the use of air-jet machines, the presence and effectiveness of local exhaust ventilation system, chamber post-purge and cooling, and proper respirator use. Using the risk (R) and hazard (H) codes of the Globally Harmonized System alongside carcinogenic, mutagenic, or reprotoxic classifications aid in categorizing health effect severity for OHRA. Conclusion: Further research is needed to apply our proposed variables in OHRA for MW in FAB facilities and subsequently validate the findings.

• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.78-85
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• 2024

Objective: This Study aimed to examine the changes in muscle activity of trunk muscles by performing three squat exercises on normal adults. Design: cross-sectional study Methods: Thirty-two adult subjects participated in this study. General squat, overhead squat, and overhead squat combined with abdominal stabilization were randomly performed for 5 seconds, 3 times, to calculate the average muscle activation. Muscle activation was normalized using electrodes on the rectus abdominis, external oblique, internal oblique, and erector spinae muscles to measure maximum voluntary isometric contraction (MVIC) for 5 seconds, repeated 3 times each. Results: There was a significant difference in the mean and maximal muscle activity of the bilateral erector spinae (ES) when comparing the squat to the overhead squat (p<0.05). There was a significant difference (p<0.05) in the mean and maximal muscle activity of the bilateral external oblique (EO) when comparing the overhead squat to the overhead squat combined with the abdominal stabilization technique. When comparing the squat to the overhead squat with abdominal stabilization, there was a significant difference in the mean and maximum muscle activity of the bilateral RA, EO, and left Internal oblique (IO) (p<0.05), and there was a significant difference in the maximum muscle activity of the bilateral erector spinae (ES) (p<0.05). Post hoc tests showed significant differences between squatting methods for the RA, EO, IO, and ES (p<0.017). Conclusion: The results of this study showed that squats combined with abdominal stabilization were more effective at activating core muscles than squats or overhead squats alone.

• Tuberculosis and Respiratory Diseases
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• v.87 no.1
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• pp.52-64
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• 2024

Chronic respiratory diseases such as idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, and respiratory infections injure the alveoli; the damage evoked is mostly irreversible and occasionally leads to death. Achieving a detailed understanding of the pathogenesis of these fatal respiratory diseases has been hampered by limited access to human alveolar tissue and the differences between mice and humans. Thus, the development of human alveolar organoid (AO) models that mimic in vivo physiology and pathophysiology has gained tremendous attention over the last decade. In recent years, human pluripotent stem cells (hPSCs) have been successfully employed to generate several types of organoids representing different respiratory compartments, including alveolar regions. However, despite continued advances in three-dimensional culture techniques and single-cell genomics, there is still a profound need to improve the cellular heterogeneity and maturity of AOs to recapitulate the key histological and functional features of in vivo alveolar tissue. In particular, the incorporation of immune cells such as macrophages into hPSC-AO systems is crucial for disease modeling and subsequent drug screening. In this review, we summarize current methods for differentiating alveolar epithelial cells from hPSCs followed by AO generation and their applications in disease modeling, drug testing, and toxicity evaluation. In addition, we review how current hPSC-AOs closely resemble in vivo alveoli in terms of phenotype, cellular heterogeneity, and maturity.

• IMMUNE NETWORK
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• v.19 no.1
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• pp.7.1-7.11
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• 2019

Sjögren's syndrome (SS) is a chronic inflammatory autoimmune disorder that affects mainly salivary and lacrimal glands, but its cause remains largely unknown. Clinical data indicating that SS occurs in a substantial proportion of patients with lupus points to common pathogenic mechanisms underlying the two diseases. To address this idea, we asked whether SS develops in the lupus-prone mouse strain sanroque (SAN). Owing to hyper-activation of follicular helper T (Tfh) cells, female SAN mice developed lupus-like symptoms at approximately 20 wk of age but there were no signs of SS at that time. However, symptoms typical of SS were evident at approximately 40 wk of age, as judged by reduced saliva flow rate, sialadenitis, and IgG deposits in the salivary glands. Increases in serum titers of SS-related autoantibodies and numbers of autoantibody-secreting cells in cervical lymph nodes (LNs) preceded the pathologic manifestations of SS and were accompanied by expansion of Tfh cells and their downstream effector cells. Thus, our results suggest that chronic dysregulation of Tfh cells in salivary gland-draining LNs is sufficient to drive the development of SS in lupus-prone mice.

• Clinical Endoscopy
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• v.56 no.3
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• pp.283-289
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• 2023

Gastrointestinal (GI) bleeding is one of the most common conditions among patients visiting emergency departments in Korea. GI bleeding is divided into upper and lower GI bleeding, according to the bleeding site. GI bleeding is also divided into overt and occult GI bleeding based on bleeding characteristics. In addition, obscure GI bleeding refers to recurrent or persistent GI bleeding from a source that cannot be identified after esophagogastroduodenoscopy or colonoscopy. The small intestine is the largest part of the alimentary tract. It extends from the pylorus to the cecum. The small intestine is difficult to access owing to its long length. Moreover, it is not fixed to the abdominal cavity. When hemorrhage occurs in the small intestine, the source cannot be found in many cases because of the characteristics of the small intestine. In practice, small-intestinal bleeding accounts for most of the obscure GI bleeding. Therefore, in this review, we introduce and describe systemic approaches and examination methods, including video capsule endoscopy and balloon enteroscopy, that can be performed in patients with suspected small bowel bleeding in clinical practice.

• Clinical Endoscopy
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• v.56 no.3
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• pp.333-339
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• 2023

Background/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea. Methods: We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed. Results: In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m². Body mass index reduction was 3.72±2.63 kg/m² at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain. Conclusions: IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

• Clinical Endoscopy
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• v.56 no.4
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• pp.391-408
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• 2023

With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

• Clinical Endoscopy
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• v.56 no.4
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• pp.470-478
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• 2023

Background/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated. Methods: Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary's Hospital. Results: A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan-Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53-11.40) The histological types of MGN were not related to the primary histology types. Conclusions: MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.