Cardio-oncology is a critical field due to the escalating significance of cardiovascular toxicity as a side effect of anti‑ cancer treatments. Cancer therapy-related cardiac dysfunction (CTRCD) is a prevalent condition associated with car‑ diovascular toxicity, necessitating effective strategies for prediction, monitoring, management, and tracking. This comprehensive review examines the definition and risk stratification of CTRCD, explores monitoring approaches during anticancer therapy, and highlights specific cardiovascular toxicities linked to various cancer treatments. These include anthracyclines, HER2-targeted agents, vascular endothelial growth factor inhibitors, immune checkpoint inhibitors, chimeric antigen receptor T-cell therapies, and tumor-infiltrating lymphocytes therapies. Incorporating the Korean data, this review offers insights into the regional nuances in managing CTRCD. Using systematic follow-up incorporating cardiovascular imaging and biomarkers, a better understanding and management of CTRCD can be achieved, optimizing the cardiovascular health of both cancer patients and survivors.

Purpose: Deceased donor liver transplantation (DDLT) recipients in Korea are generally sicker due to an increasing organ shortage. In the present study, the risk factors for early 30-day liver graft failure after DDLT were identified. Methods: From August 2017 to February 2021, 265 adult DDLTs were performed. The characteristics of patients with and without 30-day graft failure were compared. Results: Liver graft failure occurred in 11 patients (17.7%) after DDLT. Baseline and perioperative characteristics of donors and recipients were not statistically significantly different between the 2 groups. The cumulative graft and overall survival rates at 6 months were 83.9% and 88.7%, respectively. Multivariate analysis showed ventilator support in the pretransplant period was a predisposing factor for 30-day graft failure after DDLT. Conclusion Present study indicates that cautious decision is required when allocating DDLT in critically ill patients on mechanical ventilatory support.

Background and Objectives: Atrial tachycardias (ATs) from noncoronary aortic cusp (NCC) uncovered after radiofrequency ablation for atrial fibrillation (AF) are rarely reported. This study was conducted to investigate the prevalence and clinical characteristics of NCC ATs detected during AF ablation and compare their characteristics with de novo NCC ATs without AF. Methods: Consecutive patients who underwent radiofrequency catheter ablation for AF were reviewed from the multicenter AF ablation registry of 11 tertiary hospitals. The clinical and electrophysiological characteristics of NCC AT newly detected during AF ablation were compared with its comparators (de novo NCC AT ablation cases without AF). Results: Among 10,178 AF cases, including 1,301 redo ablation cases, 8 (0.08%) NCC AT cases were discovered after pulmonary vein isolation (PVI; 0.07% in first ablation and 0.15% in redo ablation cases). All ATs were reproducibly inducible spontaneously or with programmed atrial stimulation without isoproterenol infusion. The P-wave morphological features of tachycardia were variable depending on the case, and most cases exhibited 1:1 atrioventricular conduction. AF recurrence rate after PVI and NCC AT successful ablation was 12.5% (1 of 8). Tachycardia cycle length was shorter than that of 17 de novo ATs from NCC (303 versus 378, p=0.012). No AV block occurred during and after successful AT ablation. Conclusions Uncommon NCC ATs (0.08% in AF ablation cases) uncovered after PVI, showing different characteristics compared to de-novo NCC ATs, should be suspected irrespective of P-wave morphologies when AT shows broad propagation from the anterior interatrial septum.

Objective: To evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs. Materials and Methods: Nine patients (8 females and 1 male; age range, 23–65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics. Results: Feeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions).TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers. Conclusion Single-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.

Background: Chronic kidney disease is associated with chronic inflammation and progressive loss of peripheral muscle strength and the ability to exercise, and these changes are highly pronounced in patients receiving hemodialysis (HD). We evaluated hand grip strength (HGS) and leg muscle strength (LMS) in patients receiving HD and attempted to identify factors associated with muscle strength. Methods: We screened HGS (opposite the fistula side) and LMS (both sides) in HD patients at a single center (n = 112) by using digital hand and leg dynamometers (T.K.K. 5401 and 5710e/5715, Takei Scientific Instruments Co. Ltd., Niigata, Japan). Results: The mean age of patients was 62.6 years, and 73.2% of the patients were male.Diabetes was the cause of kidney failure in 50% of the patients, and the median HD vintage was 34 months. A total of 77.7% of patients reported that they participated in regular home-based exercise, and 29.5% of patients regularly participated in hospital-based resistance exercise.HGS and LMS showed good correlation (r = 0.715, P < 0.001). HGS (25.1 vs. 17.0 kg) and LMS (30.1 vs. 20.4 kg) were greater in males (P < 0.001 and P < 0.001, respectively) than in females.Older patients (≥ 60 years) showed less LMS than younger patients in both males and females (P = 0.012 and P = 0.037, respectively), but HGS did not differ according to age. Patients performing regular home- or hospital-based exercise showed higher HGS than those who did not exercise (24.2 vs. 18.6 kg, P = 0.011), but LMS was not significantly different (29.3 vs. 23.6 kg, P = 0.185). Multiple linear regression analysis proved that male sex, younger age, and any type of exercise were factors associated with improved HGS and LMS. Groups of older age (≥ 60 years), male sex, and shorter duration of HD (< median) benefitted more from exercise. Conclusion Sex, age, and exercise were the most important determinants of muscle strength in HD patients. We need to encourage patients to engage in regular home or group exercise from the beginning of dialysis and introduce new feasible forms of exercise for HD patients.

Background: Vulvar pruritus is a common complaint among women presenting to dermatologists. However, few studies have analyzed the dermatologic conditions that cause it. Objective: This retrospective study aims to evaluate the clinical features and causes of pruritic skin lesions of the female external genitalia. Methods: This study included 161 female patients with vulvar pruritus between 2008 and 2018 at CHA Bundang Medical Center. Data were collected by reviewing the electronic medical records retrospectively. The age, diagnosis, and histopathologic findings of the patients were reviewed. Results: The patients’ mean age was 49 years. On physical examination, 71.4% of patients (n=115) had definite skin lesions, and 28.6% (n=46) had ‘vulvar pruritus without skin rash’. The most common diagnostic category, confirmed by skin biopsy, was inflammatory dermatoses (53.4%, n=86), including lichen sclerosus et atrophicus, lichen simplex chronicus, nonatopic eczema, atopic eczema, and psoriasis. Moreover, 7.5% of patients (n=12) were diagnosed with infectious diseases, including candidiasis, herpes simplex virus, syphilis, and scabies; 5.6% (n=9) were diagnosed with neoplastic diseases, including vulvar intraepithelial neoplasia, squamous cell carcinoma, extramammary Paget’s disease, and Bowen’s disease. Conclusion The causes of vulvar itch are vast, and often, multiple causes coexist simultaneously. Therefore, it requires a systemic approach to establish the correct diagnosis. Dermatologists should actively participate in the diagnosis and treatment.

Background: Psoriasis is a chronic T17 cell-driven immune-mediated inflammatory disease. However, patients with psoriasis may have elevated total serum immunoglobulin E (IgE) levels, which is a hallmark of Th2 inflammation.In previous case reports, psoriasis patients with elevated total serum IgE levels did not respond well to treatment or had exacerbated eczema lesions. Objective: We sought to investigate the clinical characteristics of psoriasis patients with elevated total serum IgE levels. Methods: This is a retrospective chart review of 130 patients with psoriasis who were tested for total serum IgE levels from November 1, 2009, to October 31, 2019. We compared the demographics, clinical characteristics, disease severity, and treatment regimen for each elevated IgE group (＞214 U/mL) and normal IgE group (≤214 U/mL). Results: Among 130 patients with psoriasis, 41 (31.5%) had elevated total serum IgE levels. Elevated total serum IgE levels were positively associated with the severity of disease; psoriasis lesions including those on the scalp, hands, feet, and flexures, which are difficult to treat, were observed to be significantly higher in patients with elevated total serum IgE levels. There was no correlation between age, sex, disease duration, or presence of pruritus and total serum IgE levels. Conclusion This study identified the clinical characteristics of psoriasis patients with elevated total serum IgE levels in Korea.

Sarcoidosis is a chronic multi-organ disorder of unknown etiology, characterized by the development of non-caseating granulomas. Scar sarcoidosis is a cutaneous manifestation of sarcoidosis that originates in old cutaneous scars. Sarcoidosis may develop in scars that occur after surgery, vaccination, cosmetic tattoos, and herpes zoster infection. Upper eyelid blepharoplasty is the most popular aesthetic facial surgery performed in the Asian population. Despite the large number of blepharoplasty procedures performed over the last century, relatively few reports have described scar sarcoidosis involving a blepharoplasty scar. We report a rare case of sarcoidosis that originated in a post-blepharoplasty scar, together with a literature review. Scar sarcoidosis should be considered in the differential diagnosis in patients who present with post-blepharoplasty changes in an old scar.

Background: Chronic kidney disease is associated with chronic inflammation and progressive loss of peripheral muscle strength and the ability to exercise, and these changes are highly pronounced in patients receiving hemodialysis (HD). We evaluated hand grip strength (HGS) and leg muscle strength (LMS) in patients receiving HD and attempted to identify factors associated with muscle strength. Methods: We screened HGS (opposite the fistula side) and LMS (both sides) in HD patients at a single center (n = 112) by using digital hand and leg dynamometers (T.K.K. 5401 and 5710e/5715, Takei Scientific Instruments Co. Ltd., Niigata, Japan). Results: The mean age of patients was 62.6 years, and 73.2% of the patients were male.Diabetes was the cause of kidney failure in 50% of the patients, and the median HD vintage was 34 months. A total of 77.7% of patients reported that they participated in regular home-based exercise, and 29.5% of patients regularly participated in hospital-based resistance exercise.HGS and LMS showed good correlation (r = 0.715, P < 0.001). HGS (25.1 vs. 17.0 kg) and LMS (30.1 vs. 20.4 kg) were greater in males (P < 0.001 and P < 0.001, respectively) than in females.Older patients (≥ 60 years) showed less LMS than younger patients in both males and females (P = 0.012 and P = 0.037, respectively), but HGS did not differ according to age. Patients performing regular home- or hospital-based exercise showed higher HGS than those who did not exercise (24.2 vs. 18.6 kg, P = 0.011), but LMS was not significantly different (29.3 vs. 23.6 kg, P = 0.185). Multiple linear regression analysis proved that male sex, younger age, and any type of exercise were factors associated with improved HGS and LMS. Groups of older age (≥ 60 years), male sex, and shorter duration of HD (< median) benefitted more from exercise. Conclusion Sex, age, and exercise were the most important determinants of muscle strength in HD patients. We need to encourage patients to engage in regular home or group exercise from the beginning of dialysis and introduce new feasible forms of exercise for HD patients.

Background: Vulvar pruritus is a common complaint among women presenting to dermatologists. However, few studies have analyzed the dermatologic conditions that cause it. Objective: This retrospective study aims to evaluate the clinical features and causes of pruritic skin lesions of the female external genitalia. Methods: This study included 161 female patients with vulvar pruritus between 2008 and 2018 at CHA Bundang Medical Center. Data were collected by reviewing the electronic medical records retrospectively. The age, diagnosis, and histopathologic findings of the patients were reviewed. Results: The patients’ mean age was 49 years. On physical examination, 71.4% of patients (n=115) had definite skin lesions, and 28.6% (n=46) had ‘vulvar pruritus without skin rash’. The most common diagnostic category, confirmed by skin biopsy, was inflammatory dermatoses (53.4%, n=86), including lichen sclerosus et atrophicus, lichen simplex chronicus, nonatopic eczema, atopic eczema, and psoriasis. Moreover, 7.5% of patients (n=12) were diagnosed with infectious diseases, including candidiasis, herpes simplex virus, syphilis, and scabies; 5.6% (n=9) were diagnosed with neoplastic diseases, including vulvar intraepithelial neoplasia, squamous cell carcinoma, extramammary Paget’s disease, and Bowen’s disease. Conclusion The causes of vulvar itch are vast, and often, multiple causes coexist simultaneously. Therefore, it requires a systemic approach to establish the correct diagnosis. Dermatologists should actively participate in the diagnosis and treatment.