MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology.Recommendations are as follows. Chest MRI can be considered in the following circumstances:for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology.Recommendations are as follows. Chest MRI can be considered in the following circumstances:for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

PURPOSE: The purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT). METHODS: Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation). RESULTS: The median follow-up period was 54.2 months (range, 0.5–192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group. CONCLUSION: Unlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.
Adult ; Budd-Chiari Syndrome ; Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Hepatic Veins* ; Humans ; Liver Transplantation* ; Liver* ; Living Donors* ; Phlebography ; Spleen ; Stents*

The General Rules for the Study of Primary Liver Cancer was published in June 2001 as the first edition. Since then, the 5th edition of the General Rules for the Study of Primary Liver Cancer was published by the 17th Committee of the Korean Liver Cancer Association based on the most recent data. The 5th edition of the General Rules for the Study of Primary Liver Cancer ranged over numerous topics such as anatomy, medical assessment of the patients, staging of hepatocellular carcinoma, description of the image findings, summary of hepatic resection, description of the surgical specimens, liver transplantation, reporting the pathological findings, pathological examinations of liver specimen, non-surgical treatment, radiotherapy, and assessment of tumor response after non-surgical treatment of hepatocellular carcinoma. The 5th General Rules for the Study of Primary Liver Cancer will not only become the basis of academic development for liver cancer studies in Korea, but also serve as the primary form of national liver cancer data accumulation based on standardized rules.
Carcinoma, Hepatocellular ; Humans ; Korea ; Liver Neoplasms* ; Liver Transplantation ; Liver* ; Radiotherapy

PURPOSE: There is no consensus regarding the difference in outcomes of HCV in patients who receive living donor liver transplantation (LDLT) or compared to deceased donor liver transplantation (DDLT). The aims of this study were to compare characteristics between LDLT and DDLT groups and to identify risk factors affecting patient survival. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent liver transplantation. RESULTS: Thirty-five patients underwent DDLT, and 146 underwent LDLT. The 1-, 3-, and 5-year patient survival rates were 66.7%, 63.0%, and 63.0% in the DDLT group and 86.1%, 82.3%, and 79.5% in the LDLT group (P = 0.024), respectively. After propensity matching, the patient survival curve of the LDLT group was higher than that of the DDLT group. However, there was no statistically significant difference in patient survival between the 2 groups (P = 0.061). Recipient age ≥ 60 years, LDLT, and use of tacrolimus were positively associated with patient survival in multivariate analyses. CONCLUSION: LDLT appears to be suitable for HCV-infected patients if appropriate living donor is available.
Case-Control Studies* ; Consensus ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Immunosuppression ; Liver Transplantation ; Liver* ; Living Donors* ; Multivariate Analysis ; Propensity Score* ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tacrolimus ; Tissue Donors

PURPOSE: There is no consensus regarding the difference in outcomes of HCV in patients who receive living donor liver transplantation (LDLT) or compared to deceased donor liver transplantation (DDLT). The aims of this study were to compare characteristics between LDLT and DDLT groups and to identify risk factors affecting patient survival. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent liver transplantation. RESULTS: Thirty-five patients underwent DDLT, and 146 underwent LDLT. The 1-, 3-, and 5-year patient survival rates were 66.7%, 63.0%, and 63.0% in the DDLT group and 86.1%, 82.3%, and 79.5% in the LDLT group (P = 0.024), respectively. After propensity matching, the patient survival curve of the LDLT group was higher than that of the DDLT group. However, there was no statistically significant difference in patient survival between the 2 groups (P = 0.061). Recipient age ≥ 60 years, LDLT, and use of tacrolimus were positively associated with patient survival in multivariate analyses. CONCLUSION: LDLT appears to be suitable for HCV-infected patients if appropriate living donor is available.
Case-Control Studies* ; Consensus ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Immunosuppression ; Liver Transplantation ; Liver* ; Living Donors* ; Multivariate Analysis ; Propensity Score* ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tacrolimus ; Tissue Donors

PURPOSE: HCV-related liver disease is the most common indication for liver transplantation (LT) in Western countries, whereas HCV LT is rare in Korea. We conducted a survey of HCV RNA-positive patients who underwent LT and investigated the prognostic factors for patient survival and the effects of immunosuppression. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent LT. RESULTS: The 1-, 3-, and 5-year overall survival rates were 78.8%, 75.3%, and 73.1%, respectively. Excluding the cases of hospital mortality (n = 23), 169 patients were evaluated for patient survival. Most patients were genotype 1 (n = 111, 65.7%) or genotype 2 (n = 42, 24.9%). The proportion of living donors for LT (n = 135, 79.9%) was higher than that of deceased donors (deceased donor liver transplantation [DDLT], n = 34, 20.1%). The median donor and recipient ages were 32 years and 56 years, respectively. Twenty-eight patients (16.6%) died during the observation period. Seventy-five patients underwent universal prophylaxis and 15 received preemptive therapy. HCV recurrence was detected in 97 patients. Recipients who were older than 60, received DDLT, used cyclosporine, or suffered acute rejection had lower rates of survival. CONCLUSION: Patent survival rates of HCV patients after LT in Korea were comparable with other countries.
Cyclosporine ; Genotype ; Hepacivirus ; Hospital Mortality ; Humans ; Immunosuppression ; Korea* ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Recurrence ; Retrospective Studies ; Survival Rate ; Tacrolimus ; Tissue Donors

PURPOSE: We report a case of a full-thickness macular hole which occurred many years after a blunt eye trauma leading to choroidal rupture. CASE SUMMARY: A 50-year-old male visited our clinic with a complaint of decreased vision in his left eye 2 years in duration. He experienced a blunt trauma to his left eye with a baseball when he was 6 years old, although he did not complain of any visual disturbance in the left eye at that time. Fundus examination revealed a full-thickness macular hole with vertical fibrotic scar at the temporal side of the macula, which was thought to be a choroidal rupture induced by the previous blunt eye trauma. We performed vitrectomy and intravitreal tamponade injection. Two months later, the full-thickness macular hole completely closed and visual acuity of the left eye improved.
Baseball ; Choroid* ; Cicatrix ; Humans ; Male ; Middle Aged ; Retinal Perforations* ; Rupture* ; Visual Acuity ; Vitrectomy

PURPOSE: To investigate which factors primarily influence refractory errors between various formulas used to calculate intraocular lens (IOL) power. METHODS: Records of 266 eyes of 191 patients who underwent uneventful cataract surgery were reviewed retrospectively. IOL power was determined using SRK/T, HofferQ (H/Q), Master SRK/T (M/T), Master HofferQ (M/Q), Master Holladay (M/Hol), and Master Haigis (M/Hai). The mean absolute error (MAE) of each formula was compared; MAE was defined as the difference between the postoperative spherical equivalence (SE) determined 1 month after surgery and the predicted SE. Factors that could have influenced interformula refractive errors were analyzed. Patients were divided into 3 groups based on average keratometric value (Kavg) and the inter-group differences of the AE of each formula were analyzed. Effects of corneal curvature on changes in AE of each formula were evaluated by linear regression. RESULTS: The MAE was minimized in the M/T formula, followed by the M/Hol, M/Hai, SRK/T, H/Q, and M/Q formulas. Interformula MAE differences were not statistically significant. Kavg and AXL were significantly influenced by the different predictive values between formulas in univariate analysis, but only AXL was significant in multivariate analysis. The AE in each formula among the 3 groups according to keratometry was significantly different in SRK, M/Hol, and M/Hai. Linear regression analysis showed a significant negative correlation between Kavg, AE of SRK/T and the MHai formula. In particular, this effect was more pronounced in those with short AXL (<22.5 mm). CONCLUSIONS: There were no significant MAE differences between formulas. AXL was a significant factor that influenced the differences between formulas. SRK/T and M/Hai may be affected by outside the normal range of corneal curvatures.
Cataract ; Humans ; Lenses, Intraocular* ; Linear Models ; Multivariate Analysis ; Reference Values ; Refractive Errors ; Retrospective Studies

PURPOSE: The purpose of this study was to examine the research characteristics and the trend of the Journal of the Korean Society of Clinical Toxicology by bibliometric analysis. METHODS: This study was a retrospective quantitative literature review of the publications. We collected data from the internet homepage of the Korean Society of Clinical Toxicology. Among 228 publications, a total of 225 articles were included in this analysis. The data were analyzed from different perspectives, including article types, study design, number of authors, type of toxic material, and the top five ranking prolific authors and the affiliated organization were identified. RESULTS: A total of 225 articles were analyzed; 98(43.6%) were original articles, 115(51.1%) were case reports, and 12(5.3%) were reviews. Among the original articles, nine were prospective studies and 89 were retrospective studies, which were assorted according to study design; there were two(2.0%) cross sectional studies, 93(94.9%) cohort studies, and three(3.1%) etc. The median number of authors per article was five and the top five ranking authors and affiliated organizations published 31.1% and 32.8% of total articles, respectively. The most abundant topic was pesticides, followed by natural poisons and poisons encountered in the work place. CONCLUSION: Since its foundation, the Journal of the Korean Society of Clinical Toxicology has published 19 issues and 228 articles and has played a key role in development of toxicology research in Korea. However, low ratio of original articles and a decrease in the number of recent articles indicates that greater effort is needed in clinical research. In addition, further interest of many experts and various institutions is necessary.
Bibliometrics* ; Cohort Studies ; Cross-Sectional Studies ; Internet ; Korea ; Pesticides ; Poisons ; Toxicology* ; Workplace