Purpose: To compare the surgical outcomes of two modified Yamane techniques for sutureless scleral fixation of intraocular lenses (IOL): trocar-cannula-based fixation and 26-gauge needle-based fixation. Methods: A retrospective analysis was conducted on patients who underwent modified Yamane scleral IOL fixation between January 2023 and June 2024 with a minimum follow-up of 6 months. The outcomes assessed included best corrected visual acuity (BCVA), spherical equivalent, astigmatism, astigmatism, and postoperative complications. Measurements were taken preoperatively and at 1 day, 1 week, 1 month, and 6 months after surgery. Results: Among 86 eyes included, 44 received trocar-cannula-based fixation (trocar group) and 42 received 26-gauge needle-based fixation (needle group). Both groups showed significant improvements in BCVA and spherical equivalent at 6 months postoperatively (BCVA: p = 0.013, p = 0.001; spherical equivalent: p < 0.001, p = 0.014), with no statistically significant differences between the groups (BCVA: p = 0.139; spherical equivalent: p = 0.595). The trocar group demonstrated significantly greater improvement in astigmatism at both 1 month and 6 months (p = 0.046, p = 0.048), as well as in IOL astigmatism at 6 months (p = 0.049). Complication rates did not significantly differ between the groups. Conclusions Both modified Yamane techniques effectively improved BCVA and spherical equivalent. However, the trocar-cannula-based method yielded superior outcomes in astigmatism correction, suggesting a potential advantage in postoperative refractive stability.

Background: Alpha-fetoprotein (AFP) and its isoform AFP-L3 are well-established serum biomarkers for hepatocellular carcinoma (HCC), a common malignancy and a leading cause of cancer-related mortality worldwide. Current methods for measuring these biomarkers are primarily lectin-based assays including the liquid-phase binding assay (LiBA) and liquid chromatography–tandem mass spectrometry (LC-MS/MS), both of which have limitations in diagnostic sensitivity and clinical utility for samples with low AFP concentrations. We aimed to develop a lectin-independent LC-MS/MS method for quantifying fucosylated AFP proteins (AFP-Fuc%). Methods: We conducted analytical validation, including method comparisons, over 2 months. The analytical sensitivity and diagnostic performance of this method were evaluated using 525 human serum samples—235 from HCC patients and 290 from non-HCC individuals—and compared with those of LiBA, which measured AFP-L3 levels. Results: The LC-MS/MS method demonstrated acceptable within-laboratory imprecision (CVs < 17.1%) without detectable bias, carryover, or matrix effects. Our method exhibited a broader linear dynamic range (spanning five orders of magnitude) and 10-fold higher analytical sensitivity than LiBA. The diagnostic performance of our method was significantly superior to that of LiBA, particularly in patients with low AFP concentrations ( < 7 ng/mL, P < 0.001), with improved accuracy, sensitivity, and precision at a specificity of 96.2%. Conclusions The validated LC-MS/MS method demonstrated robust analytical performance and superior diagnostic accuracy over LiBA for HCC diagnosis while avoiding the inherent limitations of lectin-based assays. Our LC-MS/MS assay shows promise for early HCC detection and may contribute to enhanced patient care.

Objective: This study aimed to compare the long-term radiographic incidence of adjacent segment degeneration (ASD) following minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus open TLIF (O-TLIF) in a matched cohort, and to identify radiographic parameters associated with the development of kyphosis-type ASD. Methods: A retrospective matched-pair analysis was conducted involving 60 patients (30 MIS-TLIF and 30 O-TLIF) who underwent single-level TLIF between 2004 and 2009 and had a minimum follow-up of 8 years. Patients were matched for age (±3 years), sex, body mass index (±2 kg/m²), and operative level. Radiographic ASD was defined as greater than 50% disc-height loss, greater than 3 mm of listhesis, or greater than 10° of kyphotic change at the adjacent segment. Continuous variables were analyzed using independent-sample t-tests or Mann-Whitney U-tests, as appropriate, and categorical variables were analyzed using chi-square or Fisher exact tests, with statistical significance set at p<0.05. Results: The mean follow-up duration was 8.9±1.2 years. The MIS-TLIF group had a significantly shorter hospital stay than the O-TLIF group (3.4±1.7 days vs 6.0±2.3 days, p<0.001). Radiographic ASD occurred significantly less frequently in the MIS-TLIF group at 2 years (3.3% vs. 23.3%, p=0.023), but no significant difference was observed at ≥8 years of follow-up (43.3% vs. 50.0%, p=0.605). An increased Cobb angle at the superior adjacent level was significantly associated with kyphosis-type ASD (p=0.017). No demographic characteristics or preoperative magnetic resonance imaging parameters were found to predict ASD occurrence. Conclusion MIS-TLIF demonstrated an early radiographic advantage in reducing ASD compared with O-TLIF; however, this advantage diminished over time. Long-term ASD appears to be multifactorial, with sagittal imbalance playing a more prominent role in the progression of kyphosis-type ASD than the surgical approach itself.

Accurate classification of aortic dissection is essential for guiding clinical treatment and facilitating communication between radiologists and clinicians. Traditional classifications, such as the DeBakey and Stanford systems, categorize dissections according to their origin and extent, or by involvement of the ascending aorta. The Stanford classification has gained widespread use due to its clear correlation with the surgical and medical treatments available at the time. However, these traditional classifications provide limited guidance for contemporary management, particularly in the era of endovascular and hybrid surgical techniques for aortic repair. Modern classifications, such as the Type/Entry/Malperfusion (TEM) system and Type B dissection reporting standards proposed by the Society for Vascular Surgery and the Society of Thoracic Surgeons (SVS/ STS), incorporate more detailed anatomic and clinical descriptors. The TEM system expands upon the Stanford classification by adding a “non-A non-B” category for arch dissections and incorporating entry tear and malperfusion descriptors. The SVS/STS classification introduces a zone-based model that defines the dissection type by the location and extent of the entry tear.Contemporary guidelines have identified several high-risk imaging features that predict poor outcomes in otherwise uncomplicated dissections. This pictorial review compares these classifications and highlights their implications for radiologic reporting, emphasizing how detailed anatomic and risk-based descriptors better align radiologic interpretations with contemporary management strategies.

Purpose: Chronic myeloid leukemia (CML) in children, adolescents, and young adults is rare and differs from older adults. This study evaluated the outcomes of allogeneic hematopoietic stem cell transplantation (HSCT) in young Korean CML patients during the tyrosine kinase inhibitor (TKI) era. Materials and Methods: A retrospective analysis of 35 CML patients aged < 40 years who underwent allogeneic HSCT from 2009 to 2019 was conducted using Korean Blood and Marrow Transplantation Registry data. Patients were grouped by age < 20 years at HSCT (group 1, n=15) and 20-40 years at HSCT (group 2, n=20). Survival outcomes including overall survival (OS), relapse-free survival (RFS), and event-free survival (EFS) were analyzed using the Kaplan-Meier method. Results: The median time between diagnosis and HSCT was 8.9 months. All the patients achieved engraftment but platelet recovery was significantly slower in group 1 (p=0.034). Acute and chronic graft-versus-host disease occurred in 54.3% and 34.3%, respectively. Five-year OS, RFS, and EFS rates of total patients were 66.8%, 50.8%, and 47.6%, with better OS was observed in group 1 by multivariable analysis (p=0.048). Disease status at HSCT was a significant predictor of OS (p=0.028), RFS (p=0.003), and EFS (p=0.004). Disease progression occurred in 13 out of 35 patients (37.1%); treatment-related mortality accounted for 63.6% of deaths (7 out of 11). Conclusion When performed at a younger age, allogeneic HSCT result in superior outcome in CML. Achieving remission before HSCT is critical for improved outcomes, highlighting the importance of pretransplant remission via optimal TKI strategies and minimal residual disease monitoring.

and Relevance: Here, we report atypical clinicopathological features observed in the case of CEL. These findings have potential biological, diagnostic, and prognostic relevance, emphasizing the need for further studies to elucidate their clinical significance and to expand the understanding of this disease.

Objective: : A twig-like middle cerebral artery (T-MCA) is a rare condition characterized by steno-occlusion of the M1 segment of the middle cerebral artery (MCA) with nearby collateral arterial networks. Despite unclear pathophysiology, it is often classified as a congenital anomaly caused by failure of fusion of the plexiform MCA arterial plexus. We aimed to improve understanding of the pathophysiology of T-MCAs by analyzing incidental T-MCA findings and their natural history. Methods: : A retrospective chart review was performed between January 2011 and December 2023 at three medical centers treating both ischemic and hemorrhagic strokes. Patients with suspected MCA lesions were selected through radiology reports from computed tomography, magnetic resonance angiography, and digital subtraction imaging. Results: : We identified 51 T-MCA cases from a radiology report search spanning 13 years across three medical centers. The study included 9875 patients with ischemic stroke and 2097 with hemorrhagic stroke. Of the 51 T-MCA cases, incidental findings accounted for 25 (49.0%), ischemic stroke for 18 (35.3%), and hemorrhagic strokes accounted for eight cases (15.7%). T-MCA related ischemic and hemorrhagic strokes accounted for 0.18–0.38% of all strokes. The RNF213.R4810K mutation was identified in seven of 15 patients (46.7%) tested. We found three cases of a de-novo T-MCA that progressed from a normal MCA architecture. Conclusion : T-MCAs may represent an acquired secondary anomaly rather than a congenital lesion, followed by steno-occlusion of the focal MCA with new arterial network formation. Both Moyamoya angiopathy and chronic atherosclerosis likely contributed to disease progression. Formation of a microaneurysm, dilatation of the lenticulostriate artery, and hemodynamic stress can lead to stroke.

Vaccines are highly effective, but rare or delayed adverse events following immunization (AEFIs) require post-licensure surveillance beyond clinical trials. Korea lacks a comprehensive, active, database-based framework, yet key assets exist: nationwide claims databases (National Health Insurance Service/Health Insurance Review and Assessment Service), the national immunization registry (Korea Disease Control and Prevention Agency’s Immunization Registry Information System) for National Immunization Program (NIP) and non-NIP vaccines, and increasingly standardized hospital electronic health records.We propose a federated, code to data architecture with data linkages between these data.Implementation should adopt a common data model (CDM), standardized case definitions, latency accounting, and transparent public reporting under strong privacy governance. Major challenges include multi step administrative approvals for data linkage, incomplete capture of adult non-NIP vaccinations, heterogeneous hospital data structures, and strict data protection constraints. Strategic priorities are to streamline statutory and administrative processes for public health use, mandate or enable claims-based capture of adult vaccinations, enhance CDM based interoperability, and develop secure hubs for aggregated outputs. With these measures, Korea will be well positioned to establish a scalable active surveillance system capable of detecting rare AEFIs, supporting transparent and evidence-based communication, and ensuring equitable injury compensation grounded in domestic data.

Rheumatoid neutrophilic dermatitis (RND) is a rare extra-articular skin lesion associated with rheumatoid arthritis (RA). Lesions typically occur symmetrically on the extensor surfaces of the extremities and present with variable clinical features. A 78-year-old female with a 2-month history of skin rash on the right forearm and left lower leg, with no other systemic symptoms, visited the dermatology department of our hospital. She had been diagnosed with seropositive RA approximately 20 years ago. The skin rash was asymmetrically distributed and presented with localized pustules, purpura, and edema. The biopsy specimen showed dermal infiltration by neutrophils, leukocytoclasia without vasculitis, and a neutrophilic dermal abscess. No fungi or bacteria were detected on any of the stains. The patient was diagnosed with RND. Clinical improvement was noted after treatment with dapsone, followed by colchicine and methylprednisolone. In this case report, we described the case of a female patient with atypically presented RND and conducted a literature review.