Background: s/Aims: The treatment landscape for hepatocellular carcinoma (HCC) has significantly evolved over the past decade. We aimed to analyze trends in treatment patterns for HCC using a nationwide claims database from the Korean Health Insurance Review and Assessment Service. Methods: This retrospective population-based cohort study analyzed 171,002 newly diagnosed HCC patients between 2008 and 2022. Etiologies and treatment modalities were categorized based on the ICD-10 codes and insurance data. Results: The annual incidence decreased from 11,814 in 2008 to 10,443 in 2022. However, patients aged ≥70 increased noticeably, with those aged ≥80 rising from 3.8% in 2008 to 13.1% in 2022. From 2008 to 2022, the predominant cause of hepatitis B virus decreased from 68.9% to 59.7%, whereas nonalcoholic fatty liver disease increased from 8.9% to 15.8%. The initial treatment trends shifted: surgical resection and systemic therapy increased from 12.2% to 21.3% and from 0.2% to 9.6%, whereas transarterial therapy decreased from 49.9% to 36.6%. Best supportive care decreased from 31.7% to 21.3%. In the subgroup analysis, laparoscopic resection rate increased from 10.6% to 60.6% among the surgical resections. Sorafenib initially accounted for 100%, lenvatinib peaked at 36.5% in 2021, and atezolizumab-bevacizumab became the most widely used (63.1%) by 2022 among the systemic therapies. Conclusions This study demonstrates the temporal changes in the treatment patterns of Korean HCC patients. Surgical resection, particularly laparoscopic liver resection, and systemic therapy has increased significantly. These changes may have been influenced by reimbursement policies and advances in clinical research.

Korea is undergoing a rapid environmental change in health and welfare. Therefore, the law mandates the establishment and implementation of plans in accordance with the changes. A total of 49 long-term plans related to health and welfare were specified by the National Law Information Center, the Korean representative legal information website managed by the Korea Ministry of Government Legislation. Of the 49 long-term plans, 10 plans (20.4%) were not yet fully constructed. Eight out of 10 non-constructive plans have been put into force for more than a year, but these plans still require further systematic planning and development. The complete construction of long-term plans is substantial to account for the changes in South Korean health and welfare. In addition, a systematic plan with solidarity and continuity between the mutual plans should be established in planning.
Information Centers ; Jurisprudence ; Korea ; Social Welfare

Spark’s nevus is a compound word composed of Spitz nevus and Clark’s nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark’s nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. A 24-year-old female presented with an asymptomatic, solitary, dark-brown-colored papule surrounded by brownish patch that looked similar to dysplastic nevus or malignant melanoma on the buttock. On dermoscopic examination, it showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, and a surrounding brownish reticular pattern that faded away. On histopathologic findings, overall asymmetrical structure, epithelioid large melanocytes containing large nuclei with abundant cytoplasm, and Kamino body were seen in the central portion. Also, lentiginous hyperplasia, bridging of the nests composed of melanocytes containing foamy cytoplasm, concentric and lamellar fibrosis along with the elongation of rete ridge, and perivascular lymphocytic infiltration were seen in the peripheral portion. The diagnosis of Spark’s nevus was made. Following its definition, this combined nevus is diagnosed histopathologically, but the clinicodermoscopic features have not been well described. Herein, we report a case of Spark’s nevus in which dermoscopy was helpful for differentiating it from malignant melanoma.

Purpose: This study aims to compare the volumetric change, degree of conversion (DOC), and cytotoxicity of 3D-printed restorations post-cured under three different conditions. Materials and Methods: 3D-printed interim restorations were post-cured under three different conditions and systems: 5 min, 30 min, and 24 h. Three-unit and six-unit fixed dental prostheses (n = 30 for each case) were printed; ten specimens from each group were post-cured and then scanned to compare their volumetric changes. Root-mean-squared (RMS) values of the data were acquired by superimposing the scanned files with original files.Thirty disk-shaped specimens were printed to evaluate the DOC ratio. Fourier transform infrared spectroscopy was used to compare the DOCs of 10 specimens from each group. Human gingival fibroblasts were used to measure the cell viability of every specimen (n = 7). The data from this experiment were employed for one-way analysis of variance and Tukey’s post-hoc comparisons. Results: Differences between the three-unit restorations were statistically insignificant, regardless of the post-curing conditions. However, for the six-unit restorations, a high RMS value was acquired when the post-curing duration was 30 min. The average DOC was approximately 56 - 62%; the difference between each group was statistically insignificant. All the groups exhibited cell viability greater than 70%, rendering them clinically acceptable. Conclusion The post-curing conditions influenced the volume when the length of the restoration was increased. However, this deviation was found to be clinically acceptable. Additionally, postcuring did not significantly influence the DOC and cytotoxicity of the restorations.

Purpose: This study aims to compare the volumetric change, degree of conversion (DOC), and cytotoxicity of 3D-printed restorations post-cured under three different conditions. Materials and Methods: 3D-printed interim restorations were post-cured under three different conditions and systems: 5 min, 30 min, and 24 h. Three-unit and six-unit fixed dental prostheses (n = 30 for each case) were printed; ten specimens from each group were post-cured and then scanned to compare their volumetric changes. Root-mean-squared (RMS) values of the data were acquired by superimposing the scanned files with original files.Thirty disk-shaped specimens were printed to evaluate the DOC ratio. Fourier transform infrared spectroscopy was used to compare the DOCs of 10 specimens from each group. Human gingival fibroblasts were used to measure the cell viability of every specimen (n = 7). The data from this experiment were employed for one-way analysis of variance and Tukey’s post-hoc comparisons. Results: Differences between the three-unit restorations were statistically insignificant, regardless of the post-curing conditions. However, for the six-unit restorations, a high RMS value was acquired when the post-curing duration was 30 min. The average DOC was approximately 56 - 62%; the difference between each group was statistically insignificant. All the groups exhibited cell viability greater than 70%, rendering them clinically acceptable. Conclusion The post-curing conditions influenced the volume when the length of the restoration was increased. However, this deviation was found to be clinically acceptable. Additionally, postcuring did not significantly influence the DOC and cytotoxicity of the restorations.

Adrenoleukodystrophy is an inborn error of metabolism characterized by adrenal insufficiency and progressive demyelmation of brain white matter and peripheral nerves. Authors experienced three cases of adrenoleukodystrophy in a 7 year old boy, a 17 and a 210 year old males that were diagnosed by increased plasma content of very long chain fatty acid(VLCFA). The clinical symptoms include seizure, visual impairment, and hemiparesis. Two cases showed typical radiological findings and sural nerve biopsy was performed in one.
Adrenal Insufficiency ; Adrenoleukodystrophy* ; Biopsy ; Brain ; Child ; Humans ; Male ; Metabolism ; Paresis ; Peripheral Nerves ; Plasma ; Seizures ; Sural Nerve

There are no reports regarding pneumomediastinum caused by thoracic epidural block complications. We believe that it is possible to experience an occurrence of pneumomediastinum caused by air in the epidural space after performing a thoracic epidural block using the loss of resistance (LOR) technique with air. We report a witnessed case where pneumomediastinum appeared after a thoracic epidural block. Pneumorrrhachis, paravertebral muscle emphysema, and pneumomediastinum were diagnosed by Positron Emission Tomography-Computed Tomography. Although extremely rare, pneumomediastinum can be caused by an epidural block using LOR technique with air. In order to avoid the above danger, the use of saline or very minimal amount of air is required during a careful LOR technique.
Electrons ; Emphysema ; Epidural Space ; Injections, Epidural ; Mediastinal Emphysema ; Muscles ; Wit and Humor as Topic

PURPOSE: This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. METHODS: The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg- negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. RESULTS: The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non- responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). CONCLUSION: The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.
DNA ; Hepatitis ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Humans ; Immunization, Secondary ; Immunoglobulins ; Infant ; Mothers ; Parturition ; Vaccination ; Vaccines, Synthetic