1.Potential etiology, prevalence of cirrhosis, and mode of detection among patients with non-B non-C hepatocellular carcinoma in Korea
Jihye KIM ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE ; Kwang Cheol KOH ; Seung Woon PAIK
The Korean Journal of Internal Medicine 2020;35(1):65-78
Background/Aims:
We systematically evaluated the clinical characteristics, prevalence of cirrhosis, and mode of detection in virus-unrelated (non-B non-C, NBNC) hepatocellular carcinoma (HCC) patients in Korea.
Methods:
A total of 447 consecutive treatment-naïve NBNC-HCC adult patients who were registered at the Samsung Medical Center HCC registry in Korea from 2010 to 2013 were analyzed. NBNC was defined as negative hepatitis B surface antigen and negative anti-hepatitis C virus antibody. Presence of cirrhosis was determined based on histological, radiological, endoscopic, and serologic results. Mode of detection was classified as either under surveillance, incidental, or symptomatic.
Results:
Heavy alcohol use was the most common potential etiology in NBNCHCC (NBNC-A, alcohol) (59.7%). Ten patients had other identifiable causes (NBNC-O, other identifiable cause) such as autoimmune hepatitis. The rest (38.0%) had no-identifiable cause (NBNC-NA-NO, non-alcohol, no-other identifiable cause). In NBNC-NA-NO group, 83.5% (96/115) of patients with available hepatitis B core immunoglobulin G antibody (HBcIgG) showed HBcIgG positivity, and 80.6% (137/170) had metabolic risk factors (diabetes, obesity, hypertension, and/ or dyslipidemia). Cirrhosis was present in 90.0%, 70.4%, and 60.0% of NBNC-O, NBNC-A, and NBNC-NA-NO patients, respectively. The proportion of patients diagnosed under surveillance was 25.5% across all patients, with specific proportions being 80.0%, 27.7%, and 18.8% for NBNC-O, NBNC-A, and NBNC-NA-NO, respectively.
Conclusions
Among NBNC-HCC patients, heavy alcohol use or any other identifiable cause was not found in 38.0%. These NBNC-NA-NO HCC patients showed a high prevalence of HBcIgG positivity and metabolic risk factors, suggesting that prior hepatitis B virus infection and metabolic risk factors may be major contributing factors in the hepatocarcinogenesis in NBNC-NA-NO patients.
2.Substantial risk of recurrence even after 5 recurrence-free years in early-stage hepatocellular carcinoma patients
Jihye KIM ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE ; Kwang Cheol KOH ; Seung Woon PAIK
Clinical and Molecular Hepatology 2020;26(4):516-528
Background/Aims:
Although hepatocellular carcinoma (HCC) is notorious for its high recurrence rate, some patients do not experience recurrence for more than 5 years after resection or radiofrequency ablation for early-stage HCC. For those with five recurrence-free period, the risk of HCC recurrence within the next 5 years remains unknown.
Methods:
A total of 1,451 consecutive patients (median, 55 years old; males, 79.0%; hepatitis B virus-related, 79.3%) with good liver function (Child-Pugh class A) diagnosed with early-stage HCC by Barcelona Clinic Liver Cancer Staging and received radiofrequency ablation or resection as an initial treatment between 2005 and 2010 were analyzed.
Results:
During a median follow-up period of 8.1 years, 961 patients (66.2%) experienced HCC recurrence. The cumulative recurrence rates increased to 39.7%, 60.3%, and 71.0% at 2, 5, and 10 years, respectively, and did not reach a plateau. Five years after HCC diagnosis, 487 patients were alive without experiencing a recurrence. Among them, during a median of 3.9 additional years of follow-up (range, 0.1–9.0 years), 127 patients (26.1%) experienced recurrence. The next 5-year cumulative recurrence rate (5–10 years from initial diagnosis) was 27.0%. Male sex, higher fibrosis-4 scores, and alpha-fetoprotein levels at 5 years were associated with later HCC recurrence among patients who did not experience recurrence for more than 5 years.
Conclusions
The HCC recurrence rate following 5 recurrence-free years after HCC treatment was high, indicating that HCC patients warrant continued HCC surveillance, even after 5 recurrence-free years.
3.Motivations, positive experiences, and concept changes of medical students in Korea after participating in an experiential entrepreneurship course: a qualitative study
Somi JEONG ; So Hyun AHN ; Hyeon Jong YANG ; Seung Jung KIM ; Yuhyeon CHU ; Jihye GWAK ; Naeun IM ; Seoyeong OH ; Seunghyun KIM ; Hye Soo YUN ; Eun Hee HA
The Ewha Medical Journal 2024;47(3):e40-
Objectives:
This study explored the experiences of medical students enrolled in an elective course titled "Healthcare Innovation and Women's Ventures II" at Ewha Womans University College of Medicine. The research questions were as follows: First, what motivated medical students to participate in the experiential entrepreneurship course? Second, what experiences did the students have during the course? Third, what changes did the students undergo as a result of the course?
Methods:
Focus group interviews were conducted with six medical students who participated in the experiential entrepreneurship course from February 13 to 23, 2024.
Results:
The analysis identified three domains, seven categories, and 17 subcategories. In terms of motivations for enrolling in the experiential entrepreneurship course, two categories were identified: "existing interest" and "new exploration." With respect to the experiences gained from the course, three categories emerged: "cognitive experiences," "emotional experiences," and "behavioral experiences." Finally, two categories were identified concerning the changes participants experienced through the course: "changes related to entrepreneurship" and "changes related to career paths."
Conclusion
Students were motivated to enroll in this course by both their existing interests and their desire to explore new areas. Following the course, they underwent cognitive, emotional, and behavioral changes. Their perceptions of entrepreneurship and career paths were significantly altered.This study is important because it explores the impact of entrepreneurship education in medical schools from the students' perspective.
4.Motivations, positive experiences, and concept changes of medical students in Korea after participating in an experiential entrepreneurship course: a qualitative study
Somi JEONG ; So Hyun AHN ; Hyeon Jong YANG ; Seung Jung KIM ; Yuhyeon CHU ; Jihye GWAK ; Naeun IM ; Seoyeong OH ; Seunghyun KIM ; Hye Soo YUN ; Eun Hee HA
The Ewha Medical Journal 2024;47(3):e40-
Objectives:
This study explored the experiences of medical students enrolled in an elective course titled "Healthcare Innovation and Women's Ventures II" at Ewha Womans University College of Medicine. The research questions were as follows: First, what motivated medical students to participate in the experiential entrepreneurship course? Second, what experiences did the students have during the course? Third, what changes did the students undergo as a result of the course?
Methods:
Focus group interviews were conducted with six medical students who participated in the experiential entrepreneurship course from February 13 to 23, 2024.
Results:
The analysis identified three domains, seven categories, and 17 subcategories. In terms of motivations for enrolling in the experiential entrepreneurship course, two categories were identified: "existing interest" and "new exploration." With respect to the experiences gained from the course, three categories emerged: "cognitive experiences," "emotional experiences," and "behavioral experiences." Finally, two categories were identified concerning the changes participants experienced through the course: "changes related to entrepreneurship" and "changes related to career paths."
Conclusion
Students were motivated to enroll in this course by both their existing interests and their desire to explore new areas. Following the course, they underwent cognitive, emotional, and behavioral changes. Their perceptions of entrepreneurship and career paths were significantly altered.This study is important because it explores the impact of entrepreneurship education in medical schools from the students' perspective.
5.Motivations, positive experiences, and concept changes of medical students in Korea after participating in an experiential entrepreneurship course: a qualitative study
Somi JEONG ; So Hyun AHN ; Hyeon Jong YANG ; Seung Jung KIM ; Yuhyeon CHU ; Jihye GWAK ; Naeun IM ; Seoyeong OH ; Seunghyun KIM ; Hye Soo YUN ; Eun Hee HA
The Ewha Medical Journal 2024;47(3):e40-
Objectives:
This study explored the experiences of medical students enrolled in an elective course titled "Healthcare Innovation and Women's Ventures II" at Ewha Womans University College of Medicine. The research questions were as follows: First, what motivated medical students to participate in the experiential entrepreneurship course? Second, what experiences did the students have during the course? Third, what changes did the students undergo as a result of the course?
Methods:
Focus group interviews were conducted with six medical students who participated in the experiential entrepreneurship course from February 13 to 23, 2024.
Results:
The analysis identified three domains, seven categories, and 17 subcategories. In terms of motivations for enrolling in the experiential entrepreneurship course, two categories were identified: "existing interest" and "new exploration." With respect to the experiences gained from the course, three categories emerged: "cognitive experiences," "emotional experiences," and "behavioral experiences." Finally, two categories were identified concerning the changes participants experienced through the course: "changes related to entrepreneurship" and "changes related to career paths."
Conclusion
Students were motivated to enroll in this course by both their existing interests and their desire to explore new areas. Following the course, they underwent cognitive, emotional, and behavioral changes. Their perceptions of entrepreneurship and career paths were significantly altered.This study is important because it explores the impact of entrepreneurship education in medical schools from the students' perspective.
6.Motivations, positive experiences, and concept changes of medical students in Korea after participating in an experiential entrepreneurship course: a qualitative study
Somi JEONG ; So Hyun AHN ; Hyeon Jong YANG ; Seung Jung KIM ; Yuhyeon CHU ; Jihye GWAK ; Naeun IM ; Seoyeong OH ; Seunghyun KIM ; Hye Soo YUN ; Eun Hee HA
The Ewha Medical Journal 2024;47(3):e40-
Objectives:
This study explored the experiences of medical students enrolled in an elective course titled "Healthcare Innovation and Women's Ventures II" at Ewha Womans University College of Medicine. The research questions were as follows: First, what motivated medical students to participate in the experiential entrepreneurship course? Second, what experiences did the students have during the course? Third, what changes did the students undergo as a result of the course?
Methods:
Focus group interviews were conducted with six medical students who participated in the experiential entrepreneurship course from February 13 to 23, 2024.
Results:
The analysis identified three domains, seven categories, and 17 subcategories. In terms of motivations for enrolling in the experiential entrepreneurship course, two categories were identified: "existing interest" and "new exploration." With respect to the experiences gained from the course, three categories emerged: "cognitive experiences," "emotional experiences," and "behavioral experiences." Finally, two categories were identified concerning the changes participants experienced through the course: "changes related to entrepreneurship" and "changes related to career paths."
Conclusion
Students were motivated to enroll in this course by both their existing interests and their desire to explore new areas. Following the course, they underwent cognitive, emotional, and behavioral changes. Their perceptions of entrepreneurship and career paths were significantly altered.This study is important because it explores the impact of entrepreneurship education in medical schools from the students' perspective.
7.Pretransplant Functional Status Predicts Postoperative Morbidity and Mortality after Liver Transplantation in Patients with Cirrhosis
Myung Ji GOH ; Jihye KIM ; Won Hyuk CHANG ; Dong Hyun SINN ; Geum-Yeon GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE ; Kwang Cheol KOH ; Seung Woon PAIK ; Jong Man KIM ; Wonseok KANG
Gut and Liver 2023;17(5):786-794
Background/Aims:
This study aimed to investigate whether pretransplant frailty can predict postoperative morbidity and mortality after liver transplantation (LT) in patients with cirrhosis.
Methods:
We retrospectively reviewed 242 patients who underwent LT between 2018 and 2020 at a tertiary hospital in Korea.
Results:
Among them, 189 patients (78.1%) received LT from a living donor. Physical frailty at baseline was assessed by the Short Physical Performance Battery (SPPB), by which patientswere categorized into two groups: frail (SPPB <10) and non-frail (SPPB ≥10). Among the whole cohort (age, 55.0±9.2 years; male, 165 [68.2%]), 182 patients were classified as non-frail and 60 patients were classified as frail. Posttransplant survival was shorter in the frail group than the non-frail group (9.3 months vs 11.6 months). Postoperative intensive care unit stay was longer in the frail group than in the non-frail group (median, 6 days vs 4 days), and the 30-day complication rate was higher in the frail group than in the non-frail group (78.3% vs 59.3%). Frailty was an independent risk factor for posttransplant mortality (adjusted hazard ratio, 2.38; 95% confidence interval, 1.02 to 5.57). In subgroup analysis, frail patients showed lower posttransplant survival regardless of history of hepatocellular carcinoma and donor type.
Conclusions
Assessment of pretransplant frailty, as measured by SPPB, provides important prognostic information for clinical outcomes in cirrhotic patients undergoing LT.