1.Ulcerative colitis-associated colorectal neoplasm is increasing as a surgical indication in the biologics era:a retrospective observational study of 20 years of experience in a single tertiary center
Hyo Jun KIM ; Seung-Bum RYOO ; Jin Sun CHOI ; Han-Ki LIM ; Min Jung KIM ; Ji Won PARK ; Seung-Yong JEONG ; Kyu Joo PARK
Annals of Surgical Treatment and Research 2025;108(3):150-157
Purpose:
We aimed to identify changes in surgical indications in patients with ulcerative colitis (UC) in the biologics era in a single tertiary center.
Methods:
In this retrospective observational study, 108 patients with UC who underwent abdominal surgery for UC at Seoul National University Hospital from 2000 to 2021 were included. We compared the total number of patients undergoing UC before and after the introduction of biologic therapy.
Results:
Of the 108 patients with UC (male, 59 and female, 49; mean age, 46.8 years), 30 (27.8%) underwent surgery for neoplasms and 78 (72.2%) for medical intractability without neoplasms. The duration between diagnosis and surgery varied significantly (126.00 months vs. 60.50 months, P = 0.001). A significant difference was also noted in the surgical indications according to time (P = 0.02). Between 2000 and 2010, 12 patients (19.4%) underwent surgery for UC with neoplasms and 50 (80.6%) for UC without neoplasms, while between 2011 and 2021, 18 (39.1%) and 28 patients (60.9%) underwent surgery for UC with and without neoplasms, respectively.
Conclusion
Since 2011, when biological agents were covered by insurance in South Korea, there has been a relative increase in the incidence of surgical indications for neoplasia cases. Focusing on closely monitoring individuals with longterm UC for neoplasms is necessary.
2.Association between Skeletal Muscle Mass and Ocular Perfusion Pressure in Glaucoma
Jisoo KANG ; Ji Hong KIM ; Yu Jeong KIM ; Han Woong LIM ; Jooyoung YOON ; Won June LEE
Korean Journal of Ophthalmology 2025;39(3):246-260
Purpose:
This study aimed to investigate the relationship between body composition and glaucoma by analyzing the associations between anthropometric and ocular parameters.
Methods:
A total of 494 eyes from 247 patients were reviewed from a general health examination database at a tertiary hospital. Anthropometric parameters were assessed using a multifrequency bioelectrical impedance device. Mean ocular perfusion pressure (MOPP) was calculated based on systolic and diastolic blood pressures and intraocular pressure (IOP). Retinal thickness and other ocular parameters were analyzed for their association with body composition.
Results:
A total of 221 eyes from 221 patients, including 104 with glaucoma, were enrolled in the final analysis. The prevalence of sarcopenia was significantly higher in patients with glaucomatous damage than in those without (p = 0.025). Higher IOP showed significant associations with lower MOPP (p < 0.001), higher body mass index (BMI; p = 0.001), and higher waist to hip ratio (p = 0.001). Retinal thickness was not significantly associated with body composition parameters, including BMI and appendicular lean mass adjusted with squared height. Higher MOPP was significantly correlated with lower IOP (p < 0.001), higher BMI (p < 0.001), higher waist to hip ratio (p < 0.001), and higher appendicular lean mass divided by squared height (p = 0.009).
Conclusions
Skeletal muscle mass and BMI were significantly associated with MOPP. Since low MOPP is a known risk factor for glaucoma, its association with skeletal muscle mass may indicate a relationship between systemic muscle health, ocular blood perfusion, and glaucomatous damage. Further large-scale studies are needed to validate these associations between skeletal muscle mass and glaucoma and explore their clinical implications.
3.Hepatocellular carcinoma in Korea: an analysis of the 2016-2018 Korean Nationwide Cancer Registry
Jihyun AN ; Young CHANG ; Gwang Hyeon CHOI ; Won SOHN ; Jeong Eun SONG ; Hyunjae SHIN ; Jae Hyun YOON ; Jun Sik YOON ; Hye Young JANG ; Eun Ju CHO ; Ji Won HAN ; Suk Kyun HONG ; Ju-Yeon CHO ; Kyu-Won JUNG ; Eun Hye PARK ; Eunyang KIM ; Bo Hyun KIM
Journal of Liver Cancer 2025;25(1):109-122
Background:
s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018.
Methods:
Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018.
Results:
The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%).
Conclusions
Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.
5.Factors Influencing Cone Contrast Sensitivity in Koreans Aged 60 Years and Older
Han Eul LEE ; Hee Seung CHIN ; Na Rae KIM ; Ji Won JUNG
Journal of the Korean Ophthalmological Society 2025;66(1):55-62
Purpose:
To examine the factors impacting cone contrast sensitivity in Koreans aged > 60 years who are scheduled for cataract surgery and do not have congenital color vision deficiencies.
Methods:
The ColorDx Cone contrast test HD® (CCT-HD; Konan Medical, Inc., CA, USA) was administered to 33 Korean individuals (33 eyes) to evaluate CCT scores before and after cataract surgery, as well as changes in CCT scores according to the degree of progression by cataract type. Correlations between CCT scores and age, best corrected visual acuity (BCVA), regional retinal thickness, and length of the photoreceptor outer segment (PROS) at the fovea were analyzed in pseudophakic eyes.
Results:
Average scores for short-, medium-, and long-wavelength cone contrast sensitivity tests (S-CCT, M-CCT, and L-CCT, respectively) improved after surgery (p = 0.010, p = 0.001, and p = 0.028, respectively). Comparing CCT score changes before and after surgery by cataract progression, higher cataract grades were associated with greater CCT score changes, though the differences were not statistically significant (p > 0.05). In pseudophakic eyes, S-CCT scores negatively correlated with age (p = 0.017). No significant correlations were found between S-CCT, M-CCT, and L-CCT scores and BCVA, whereas S-CCT, M-CCT, and L-CCT scores positively correlated with PROS at the fovea (p < 0.001).
Conclusions
Cone contrast sensitivity in individuals aged > 60 years is influenced by age and cataract status and may serve as a valuable indicator of visual function in clinical research.
6.Non-Invasive Liver Fibrosis Test Using Shear Wave Elastography
Korean Journal of Medicine 2025;100(1):26-30
Noninvasive liver fibrosis assessment is vital for chronic liver disease management. Although liver biopsy remains the gold standard, it is invasive with limited feasibility. Shear wave elastography (SWE) accurately evaluates liver stiffness, detecting liver fibrosis and cirrhosis across etiologies including viral hepatitis and metabolic dysfunction-associated steatotic liver disease. Despite confounders like obesity or elevated liver enzymes, SWE also aids in predicting portal hypertension and hepatocellular carcinoma risk, serving as a key tool in clinical decision-making.
7.Association between Skeletal Muscle Mass and Ocular Perfusion Pressure in Glaucoma
Jisoo KANG ; Ji Hong KIM ; Yu Jeong KIM ; Han Woong LIM ; Jooyoung YOON ; Won June LEE
Korean Journal of Ophthalmology 2025;39(3):246-260
Purpose:
This study aimed to investigate the relationship between body composition and glaucoma by analyzing the associations between anthropometric and ocular parameters.
Methods:
A total of 494 eyes from 247 patients were reviewed from a general health examination database at a tertiary hospital. Anthropometric parameters were assessed using a multifrequency bioelectrical impedance device. Mean ocular perfusion pressure (MOPP) was calculated based on systolic and diastolic blood pressures and intraocular pressure (IOP). Retinal thickness and other ocular parameters were analyzed for their association with body composition.
Results:
A total of 221 eyes from 221 patients, including 104 with glaucoma, were enrolled in the final analysis. The prevalence of sarcopenia was significantly higher in patients with glaucomatous damage than in those without (p = 0.025). Higher IOP showed significant associations with lower MOPP (p < 0.001), higher body mass index (BMI; p = 0.001), and higher waist to hip ratio (p = 0.001). Retinal thickness was not significantly associated with body composition parameters, including BMI and appendicular lean mass adjusted with squared height. Higher MOPP was significantly correlated with lower IOP (p < 0.001), higher BMI (p < 0.001), higher waist to hip ratio (p < 0.001), and higher appendicular lean mass divided by squared height (p = 0.009).
Conclusions
Skeletal muscle mass and BMI were significantly associated with MOPP. Since low MOPP is a known risk factor for glaucoma, its association with skeletal muscle mass may indicate a relationship between systemic muscle health, ocular blood perfusion, and glaucomatous damage. Further large-scale studies are needed to validate these associations between skeletal muscle mass and glaucoma and explore their clinical implications.
9.Primary Cholangiocarcinoma of the Liver Presenting as a Complicated Hepatic Cyst: A Diagnostic Challenge
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):83-88
Primary cholangiocarcinoma is a rare bile duct epithelial neoplasm that can present with atypical clinical manifestations, complicating its diagnosis. A 62-year-old male showed symptoms suggestive of a complicated hepatic cyst that was later identified as intrahepatic cholangiocarcinoma. The patient presented with abdominal discomfort without fever. Imaging revealed a large cystic lesion in the liver. Despite the initial treatment for a presumed abscess, a biopsy confirmed cholangiocarcinoma. This case highlights the diagnostic challenge of distinguishing between benign complicated hepatic cysts and malignancies, particularly when typical markers of infection are absent. Early biopsy and vigilant assessments are crucial in such presentations to avoid a delayed diagnosis and initiate appropriate treatment.
10.Miliary Tuberculosis Initially Presenting as an Isolated Hepatic Abscess
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):78-82
Hepatic tuberculosis, typically associated with miliary tuberculosis, can occasionally present as localized liver lesions. This case report describes a 77-year-old male presenting with persistent abdominal pain and fever, following an endoscopic retrograde cholangiopancreatography for bile duct sludge removal. Subsequent computed tomography revealed focal liver lesions. Despite initial treatment with antibiotics for a suspected inflammatory liver abscess, his condition did not improve. A liver biopsy was performed, revealing caseous granulomas, and the tuberculosis polymerase chain reaction result was positive. The patient was diagnosed with primary hepatic tuberculosis, which later disseminated. Oral anti-tuberculosis therapy was initiated and is currently being closely monitored. This case emphasizes the importance of considering hepatic tuberculosis in the differential diagnosis of liver lesions, particularly in cases involving cholestatic liver function tests, and persistent symptoms unresponsive to conventional antibiotics.

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