1.Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul HAN ; Pil Soo SUNG ; Soo Young PARK ; Jin Woong KIM ; Hyun Pyo HONG ; Jung-Hee YOON ; Dong Jin CHUNG ; Joon Ho KWON ; Sanghyeok LIM ; Jae Hyun KIM ; Seung Kak SHIN ; Tae Hyung KIM ; Dong Ho LEE ; Jong Young CHOI ; Research Committee of the Korean Liver Cancer Association
Gut and Liver 2024;18(5):789-802
Local ablation for hepatocellular carcinoma, a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements.Consequently, local ablation has become the first-line treatment for early-stage hepatocellular carcinoma. The lack of organized evidence and expert opinions regarding patient selection, preprocedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-Guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.
2.Surgical Results with Low-Grade Arteriovenous Malformations : A Single Center 14-Year Experience
Woo-Jun HONG ; Kang-Hee AHN ; Yong-jun LEE ; Woong-Beom KIM ; You-Sub KIM ; Tae-Sun KIM ; Sung-Pil JOO
Journal of Korean Neurosurgical Society 2024;67(5):541-549
Objective:
: Advancements in AVM surgical techniques for cerebral arteriovenous malformation (AVM) underscore its efficacy. Our research aims to showcase the positive outcomes of treating low-grade AVMs surgically, focusing on safety and effectiveness.
Methods:
: We retrospectively reviewed 55 patients (36 males and 19 females; average age 37.4 years) with Spetzler-Martin (S-M) grade 1 and 2 AVMs who underwent surgical resection between January 2009 and December 2022.
Results:
: In our study, 55 patients with S-M grade 1 and 2 AVMs underwent surgical resection, evenly divided between grades 1 (50.9%) and 2 (49.1%). Intracranial hemorrhage was the primary symptom in 74.5% of cases. Pre-operative Glasgow coma scale (GCS) scores revealed 69.1% of patients scored above 13, with 18% below 8. Successful resection was achieved in 87.3%. Postoperatively, 95.5% of ruptured and 90.9% of unruptured AVM patients showed lower or same modified Rankin scale scores. Poorer outcomes were significantly linked to lower GCS scores and intranidal/flow-related aneurysms through multivariate logistic regression. Postoperative seizures noted in nine patients, were exclusive to the ruptured AVM group.
Conclusion
: Our findings indicate surgical resection as a beneficial treatment for low-grade AVMs, yielding high cure rates and positive functional outcomes in both ruptured and unruptured cases. Preoperative GCS scores and the presence of associated aneurysms are predictive of postoperative functional status. Additionally, managing postoperative seizures effectively is key to enhancing prognosis.
3.Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association
Seungchul HAN ; Pil Soo SUNG ; Soo Young PARK ; Jin Woong KIM ; Hyun Pyo HONG ; Jung-Hee YOON ; Dong Jin CHUNG ; Joon Ho KWON ; Sanghyeok LIM ; Jae Hyun KIM ; Seung Kak SHIN ; Tae Hyung KIM ; Dong Ho LEE ; Jong Young CHOI ;
Journal of Liver Cancer 2024;24(2):131-144
Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the firstline treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and posttreatment management of patients.
4.Local Ablation for Hepatocellular Carcinoma: 2024Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul HAN ; Pil Soo SUNG ; Soo Young PARK ; Jin Woong KIM ; Hyun Pyo HONG ; Jung-Hee YOON ; Dong Jin CHUNG ; Joon Ho KWON ; Sanghyeok LIM ; Jae Hyun KIM ; Seung Kak SHIN ; Tae Hyung KIM ; Dong Ho LEE ; Jong Young CHOI ; Research Committee of the Korean Liver Cancer Association
Korean Journal of Radiology 2024;25(9):773-787
Local ablation for hepatocellular carcinoma (HCC), a non-surgical option that directly targets and destroys tumor cells, has advanced significantly since the 1990s. Therapies with different energy sources, such as radiofrequency ablation, microwave ablation, and cryoablation, employ different mechanisms to induce tumor necrosis. The precision, safety, and effectiveness of these therapies have increased with advances in guiding technologies and device improvements. Consequently, local ablation has become the first-line treatment for early-stage HCC. The lack of organized evidence and expert opinions regarding patient selection, pre-procedure preparation, procedural methods, swift post-treatment evaluation, and follow-up has resulted in clinicians following varied practices. Therefore, an expert consensus-based practical recommendation for local ablation was developed by a group of experts in radiology and hepatology from the Research Committee of the Korean Liver Cancer Association in collaboration with the Korean Society of Image-guided Tumor Ablation to provide useful information and guidance for performing local ablation and for the pre- and post-treatment management of patients.
5.Long-term Clinical Outcomes and Prognostic Factors After Endovascular Treatment in Patients With Chronic Limb Threatening Ischemia
Jung-Joon CHA ; Jong-Youn KIM ; Hyoeun KIM ; Young-Guk KO ; Donghoon CHOI ; Jae-Hwan LEE ; Chang-Hwan YOON ; In-Ho CHAE ; Cheol Woong YU ; Seung Whan LEE ; Sang-Rok LEE ; Seung Hyuk CHOI ; Yoon Seok KOH ; Pil-Ki MIN ;
Korean Circulation Journal 2022;52(6):429-440
Background and Objectives:
Endovascular therapy (EVT) first strategy has been widely adopted for the treatment of chronic limb threatening ischemia (CLTI) patients in realworld practice. This study aimed to investigate long-term outcomes of CLTI patients who underwent EVT and identify prognostic factors.
Methods:
From the retrospective cohorts of a Korean multicenter endovascular therapy registry, 1,036 patients with CLTI (792 men, 68.8 ± 9.5 years) were included. The primary endpoint was amputation-free survival (AFS) defined as the absence of major amputation or death. Secondary endpoints were major adverse limb events (MALE; a composite of major amputation, minor amputation, and reintervention).
Results:
Five-year AFS and freedom from MALE were 69.8% and 61%, respectively. After multivariate analysis, age (hazard ratio [HR], 1.476; p<0.001), end-stage renal disease (ESRD; HR, 2.340; p<0.001), Rutherford category (RC) 6 (HR, 1.456; p=0.036), and suboptimal EVT (HR, 1.798; p=0.005) were identified as predictors of major amputation or death, whereas smoking (HR, 0.594; p=0.007) was protective. Low body mass index (HR, 1.505; p=0.046), ESRD (HR, 1.648; p=0.001), femoropopliteal lesion (HR, 1.877; p=0.004), RC-6 (HR, 1.471;p=0.008), and suboptimal EVT (HR, 1.847; p=0.001) were predictors of MALE. The highest hazard rates were observed during the first 6 months for both major amputation or death and MALE. After that, the hazard rate decreased and rose again after 3–4 years.
Conclusions
In CLTI patients, long-term outcomes of EVT were acceptable. ESRD, RC-6, and suboptimal EVT were common predictors for poor clinical outcomes.
6.Long-Term Clinical Outcomes of Iliac Artery Endovascular Therapy in the Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry
Ji Woong ROH ; Sanghoon SHIN ; Young-Guk KO ; Nak-Hoon SON ; Chul-Min AHN ; Pil-Ki MIN ; Jae-Hwan LEE ; Chang-Hwan YOON ; Cheol Woong YU ; Seung Whan LEE ; Sang-Rok LEE ; Seung Hyuk CHOI ; In-Ho CHAE ; Donghoon CHOI
Korean Circulation Journal 2022;52(7):529-540
Background and Objectives:
Limited data are available regarding long-term clinical outcomes of iliac artery endovascular therapy (EVT) in real-world practice. This study investigated long-term outcomes according to Trans-Atlantic Inter-Society Consensus (TASC) classifications.
Methods:
We analyzed data from 1,705 limbs of 1,364 patients from the retrospective cohort of the multicenter Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry. The primary endpoint was target lesion revascularization (TLR)-free survival.
Results:
TASC A, B, C, and D lesions were present in 19.4%, 26.2%, 28.7%, and 25.7% of the treated limbs, respectively. The technical success rate was 96.2% and did not differ between TASC lesion types. Complications occurred in 6.8% of cases and more occurred in TASC D (11.8%). Iliac artery EVT showed a 5-year TLR-free survival of 89.2%. The TASC D group had the lowest TLR-free rate of 79.3%. TASC D (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.12–2.73; p=0.014), plain old balloon angioplasty (HR, 4.25; 95% CI, 2.03–8.88; p<0.001), current smoker (HR, 1.89; 95% CI, 1.26–2.83; p=0.002), previous bypass surgery (HR, 3.04;95% CI, 1.28–7.19; p=0.011), combined femoropopliteal treatment (HR, 4.89; 95% CI, 3.19–7.50; p<0.001), combined below the knee treatment (HR, 2.20; 95% CI, 1.25–3.89; p=0.007), and complications (HR, 1.86; 95% CI, 1.07–3.24; p=0.028) were predictors for TLR.
Conclusions
Iliac artery EVT achieved excellent technical success and 5-year TLR-free survival. TASC D showed a favorable but lower 5-year TLR-free survival rate and higher complication rate compared with other TASC groups.
7.Smoking History and Clinical Features of Cluster Headache:Results from the Korean Cluster Headache Registry
Pil-Wook CHUNG ; Byung-Su KIM ; Jeong-Wook PARK ; Jong-Hee SOHN ; Mi Ji LEE ; Byung-Kun KIM ; Min Kyung CHU ; Jin-Young AHN ; Yun-Ju CHOI ; Tae-Jin SONG ; Dae-Woong BAE ; Daeyoung KIM ; Jae-Moon KIM ; Soo-Kyoung KIM ; Kwang-Yeol PARK ; Jae Myun CHUNG ; Heui-Soo MOON ; Kyungmi OH ; Chin-Sang CHUNG ; Soo-Jin CHO
Journal of Clinical Neurology 2021;17(2):229-235
Background:
and Purpose Epidemiologic data suggest that cluster headache (CH) is significantly associated with cigarette smoking. The aim of this study was to determine differences in features between patients with a smoking history and those who are never-smokers, using data from a prospective multicenter registry.
Methods:
Data used in this study were obtained from the Korean Cluster Headache Registry that collected data from consecutive patients diagnosed with CH. We compared clinical and demographic features between ever-smokers (current or former smokers) and never-smokers.
Results:
This study enrolled 250 patients who were diagnosed with CH, of which 152 (60.8%) were ever-smokers and 98 (39.2%) were never-smokers. The age at CH onset was significantly lower in the never-smoker group than in the ever-smoker group [27.1±12.9 years vs. 30.6± 10.9 years (mean±standard deviation), p=0.024]. Seasonal rhythmicity (58.1% vs. 44.7%, p= 0.038) and triptan responsiveness (100% vs. 85.1%, p=0.001) were higher in never-smokers, while other clinical features such as pain severity, duration, attack frequency, and associated autonomic symptoms did not differ significantly between the groups. The male-to-female ratio was markedly higher in ever-smokers (29.4:1) than in never-smokers (1.7:1).
Conclusions
Most of the clinical features did not differ significantly between patients with a smoking history and never-smokers. However, the age at CH onset, sex ratio, and seasonal rhythmicity were significantly associated with smoking history.
8.Association between Body Mass Index and Clinical Outcomes of Peripheral Artery Disease after Endovascular Therapy: Data from K-VIS ELLA Registry
Chewan LIM ; Hoyoun WON ; Young-Guk KO ; Seung-Jun LEE ; Chul-Min AHN ; Pil-Ki MIN ; Jae-Hwan LEE ; Chang-Hwan YOON ; Cheol Woong YU ; Seung Whan LEE ; Sang-Rok LEE ; Seung Hyuk CHOI ; In-Ho CHAE ; Donghoon CHOI ;
Korean Circulation Journal 2021;51(8):696-707
Background and Objectives:
Few studies have investigated the obesity paradox in clinical outcomes of peripheral artery disease (PAD). We investigated the association between body massindex (BMI) and clinical outcomes in PAD patients undergoing endovascular therapy (EVT).
Methods:
Patients (n=2,914) from the retrospective Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Disease registry were categorized according to BMI: underweight (<18.5 kg/m2 , n=204), normal weight (18.5–25 kg/m2 , n=1,818), overweight (25–30 kg/m2 , n=766), or obese (≥30 kg/m2 , n=126). Groups were compared for major adverse cardiovascular events (MACE) and major adverse limb events (MALE).
Results:
The underweight and obese groups were older and had more frequent critical limb ischemia and infrapopliteal artery disease than the normal or overweight groups (all p<0.001). Hypertension and diabetes were more frequent and current smoking was less frequent in the overweight and obese groups than the underweight or normal weight groups (all p <0.001). The underweight group showed the higher rates of MACE and MALE at 3 years (17.2%, 15.7%) compared with the normal weight (10.8%, 11.7%), overweight (8.4%, 10.7%), or obese groups (8.7%, 14.3%) (log-rank p<0.001, p=0.015). In contrast, the risk of MACE was lower in the overweight than the normal weight group (adjusted hazard ratio, 0.706; 95% CI, 0.537–0.928).
Conclusions
In PAD patients undergoing EVT, underweight was an independent predictor for MACE and MALE, whereas MACE risk was lower for overweight than normal weight patients.
9.Methodology and Rationale for Ophthalmic Examinations in the Seventh and Eighth Korea National Health and Nutrition Examination Surveys (2017–2021)
Su Jeong SONG ; Kyung Seek CHOI ; Jong Chul HAN ; Donghyun JEE ; Jin Wook JEOUNG ; Young Joon JO ; Jae Yong KIM ; Ko Eun KIM ; Seong Taeck KIM ; Ji Woong LEE ; Tae Eun LEE ; Dong Hui LIM ; Chan Yun KIM ; Hyun Woong KIM ; Sang Woo PARK ; Ki Ho PARK ; Sang Jun PARK ; Min SAGONG ; Jae Pil SHIN ; Chungkwon YOO ; Yoonjung KIM ; Kyungwon OH ; Kyu Hyung PARK
Korean Journal of Ophthalmology 2021;35(4):295-303
This report provides a detailed description of the methodology for ophthalmic examinations according to the Korea National Health and Nutrition Examination Survey (KNHANES) VII and VIII (from 2017 to 2021). The KNHANES is a nationwide survey which has been performed since 1998 in representatives of whole Korean population. During the KNHANES VII and VIII, in addition to the ophthalmic questionnaire, intraocular pressure measurement, visual field test, auto refractometry, axial length and optical coherence tomography measurements were included. This new survey will provide not only provide normative and pathologic ophthalmic data including intraocular pressure, refractive error, axial length, visual field and precise measurement of anterior segment, macula and optic nerve with optical coherence tomography, but also a more accurate diagnosis for major adult blindness diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, and other ocular diseases, for the national Korean population.
10.Smoking History and Clinical Features of Cluster Headache:Results from the Korean Cluster Headache Registry
Pil-Wook CHUNG ; Byung-Su KIM ; Jeong-Wook PARK ; Jong-Hee SOHN ; Mi Ji LEE ; Byung-Kun KIM ; Min Kyung CHU ; Jin-Young AHN ; Yun-Ju CHOI ; Tae-Jin SONG ; Dae-Woong BAE ; Daeyoung KIM ; Jae-Moon KIM ; Soo-Kyoung KIM ; Kwang-Yeol PARK ; Jae Myun CHUNG ; Heui-Soo MOON ; Kyungmi OH ; Chin-Sang CHUNG ; Soo-Jin CHO
Journal of Clinical Neurology 2021;17(2):229-235
Background:
and Purpose Epidemiologic data suggest that cluster headache (CH) is significantly associated with cigarette smoking. The aim of this study was to determine differences in features between patients with a smoking history and those who are never-smokers, using data from a prospective multicenter registry.
Methods:
Data used in this study were obtained from the Korean Cluster Headache Registry that collected data from consecutive patients diagnosed with CH. We compared clinical and demographic features between ever-smokers (current or former smokers) and never-smokers.
Results:
This study enrolled 250 patients who were diagnosed with CH, of which 152 (60.8%) were ever-smokers and 98 (39.2%) were never-smokers. The age at CH onset was significantly lower in the never-smoker group than in the ever-smoker group [27.1±12.9 years vs. 30.6± 10.9 years (mean±standard deviation), p=0.024]. Seasonal rhythmicity (58.1% vs. 44.7%, p= 0.038) and triptan responsiveness (100% vs. 85.1%, p=0.001) were higher in never-smokers, while other clinical features such as pain severity, duration, attack frequency, and associated autonomic symptoms did not differ significantly between the groups. The male-to-female ratio was markedly higher in ever-smokers (29.4:1) than in never-smokers (1.7:1).
Conclusions
Most of the clinical features did not differ significantly between patients with a smoking history and never-smokers. However, the age at CH onset, sex ratio, and seasonal rhythmicity were significantly associated with smoking history.

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