Objective: To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model. Materials and Methods: Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups. Results: Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, P < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], P = 0.009 for parallel access;30.0% [3/10] vs. 90.0% [9/10], P = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, P < 0.001). The size of the ablation zone did not differ significantly between the two power groups (P = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablationzone size (P = 0.536, 0.463, and 0.271, respectively). Conclusion Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach.

Objective: To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model. Materials and Methods: Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups. Results: Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, P < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], P = 0.009 for parallel access;30.0% [3/10] vs. 90.0% [9/10], P = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, P < 0.001). The size of the ablation zone did not differ significantly between the two power groups (P = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablationzone size (P = 0.536, 0.463, and 0.271, respectively). Conclusion Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach.

Objective: To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model. Materials and Methods: Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups. Results: Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, P < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], P = 0.009 for parallel access;30.0% [3/10] vs. 90.0% [9/10], P = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, P < 0.001). The size of the ablation zone did not differ significantly between the two power groups (P = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablationzone size (P = 0.536, 0.463, and 0.271, respectively). Conclusion Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach.

Objective: To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model. Materials and Methods: Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups. Results: Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, P < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], P = 0.009 for parallel access;30.0% [3/10] vs. 90.0% [9/10], P = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, P < 0.001). The size of the ablation zone did not differ significantly between the two power groups (P = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablationzone size (P = 0.536, 0.463, and 0.271, respectively). Conclusion Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach.

Objective: To evaluate the effects of microwave (MW) power and antenna approach methods on extrahepatic tumor seeding and ablation zone size using an ex vivo subcapsular tumor-mimic model. Materials and Methods: Forty-one subcapsular tumor mimics were prepared by injecting a mixture of contrast media into bovine liver blocks. Ablation was performed using low- and high-power protocols (75 W and 100 W for 4 and 3 minutes, respectively). The antenna approach was assessed in two directions: parallel and perpendicular to the capsule. CT scans were obtained before and after the ablation to detect contrast leakage on the hepatic surface. The presence of leakage, ablation zone size, and the timing of the first popping sound were compared between the two groups. Results: Five cases of contrast leakage were observed in the low-power group (n = 21) and 17 in the high-power group (n = 20) (23.8% vs. 85.0%, P < 0.001). Contrast leaks were less frequently observed in the low-power protocol compared to the high-power protocol, regardless of the antenna approach (18.2% [2/11] vs. 80.0% [8/10], P = 0.009 for parallel access;30.0% [3/10] vs. 90.0% [9/10], P = 0.020 for perpendicular access). The timing of the first popping sound was significantly delayed in the low-power group compared to the high-power group (137.7 ± 51.4 s vs. 77.8 ± 31.4 s, P < 0.001). The size of the ablation zone did not differ significantly between the two power groups (P = 0.415). The parallel and perpendicular antenna approaches did not show significant differences in the number of contrast leaks, popping sound timing, or ablationzone size (P = 0.536, 0.463, and 0.271, respectively). Conclusion Low-power MW ablation may be superior to a high-power protocol in reducing the risk of tumor seeding in subcapsular tumors, regardless of the antenna approach.

Purpose: Anastomotic bleeding after colorectal surgery is a rare, mostly self-limiting, postoperative complication that could lead to a life-threatening condition. Therefore, prompt management is required. This study aimed to evaluate the efficacy and safety of endoscopic clipping for acute anastomotic bleeding after colorectal surgery. Methods: We retrospectively reviewed the data of patients pathologically diagnosed with colorectal cancer at National Cancer Center, Korea from January 2018 to November 2020, which presented with anastomotic bleeding within the first postoperative week and were endoscopically managed with clips. Results: Nine patients had anastomotic bleeding, underwent endoscopic management, and, therefore, were included in this study. All patients underwent laparoscopic (low/ultralow) anterior resection with mechanical double-stapled anastomosis. Anastomotic bleeding was successfully managed through a colonoscopy with clips on the first trial in all patients. Hypovolemic shock occurred in one patient, following anastomotic breakdown. Conclusion Endoscopic clipping seems to be an effective and safe treatment for anastomotic bleeding with minimal physiologic stress, easy accessibility, and scarce postoperative complications. However, a surgical backup should always be considered for massive bleeding.

OBJECTIVES: As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk. METHODS: Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety. RESULTS: Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD. CONCLUSIONS Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.

Purpose: To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods: Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results: The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.

OBJECTIVES: As HIV/AIDS is becoming a chronic disease, the risk of developing cardiovascular disease (CVD) among people living with HIV/AIDS is rising. Anxiety and depression, which are common among people living with HIV/AIDS, have been linked with CVD. This study investigated the risk of CVD in people living with HIV/AIDS and explored the effects of depression and anxiety on CVD risk. METHODS: Data were collected for 457 people enrolled in the Korea Cohort HIV/AIDS study after 2010. Framingham risk scores were calculated to quantify the 10-year risk of developing CVD. Depression and anxiety variables were re-coded as a single combined variable. Multivariable logistic regression analysis was performed, adjusting for age, body mass index, low-density lipoprotein (LDL) cholesterol, triglycerides (TG), duration of human immunodeficiency virus (HIV) positivity after entry into the cohort, and depression/anxiety. RESULTS: Participants with both depression and anxiety were 2.28 times more likely than those with neither depression nor anxiety to have moderate/high-risk CVD risk. The 10-year risk of developing CVD was affected by LDL cholesterol, TG, age, and duration of HIV infection. LDL cholesterol and TG levels change according to the duration of HIV infection, and metabolic disorders affect the risk of CVD. Thus, a longer duration of HIV infection is associated with a higher risk of developing CVD. CONCLUSIONS Screenings for depression and anxiety need to be provided regularly to assess the severity of those symptoms. To help decrease their risk of developing CVD, people living with HIV/AIDS should be offered behavioral modification interventions aimed at developing healthy lifestyle habits.

Purpose: To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods: Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results: The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.