Background: s/Aims: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE. Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP. Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively. Conclusions Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Background: s/Aims: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE. Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP. Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively. Conclusions Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Background: s/Aims: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE. Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter, 1.6±0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-computed tomography/magnetic resonance fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP. Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range, 3-41), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 year and 2 years, respectively. Conclusions Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.

Purpose: The purpose of this study was to analyze the influence of self-directed learning ability and self-leadership on the learning satisfaction and academic achievement of nursing students who experienced blended learning. Methods: This research was conducted from June 29 to July 17, 2023, targeting nursing students from three universities in Seoul, Gyeonggi, and Incheon who had experienced blended learning. The collected data were analyzed using a independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression utilizing IBM SPSS 25.0. Results: Self-directed learning ability, self-leadership, learning satisfaction, and academic achievement were all found to have positive correlations. The research variables that showed a significant effect on learning satisfaction were self-directed learning ability (β=.34, p<.001) and self-leadership (β=.19, p=.041), and the explanatory power was 28.0%. The research variable that showed a significant effect on academic achievement was self-directed learning ability (β=.56, p<.001), with an explanatory power of 40.0%. Conclusion To effectively apply blended learning to nursing students in the rapidly changing field of nursing education, it is important to analyze learner factors such as self-directed learning ability and self-leadership. Continuing research is needed to explore the learner factors that influence learning satisfaction and academic achievement, and systematic educational programs that can improve these factors will have to be applied.

Deceased donor liver transplantation (DDLT) raises ethical and social questions about liver transplantation for patients who are not expected to live. Patients with post-hepatectomy liver failure must have DDLT as soon as possible. Here, we detail a particular dilemma that the transplant team had while deciding whether to harvest liver from a deceased donor in the face of the recipient’s non-reactive, fully dilated pupils while they awaited a liver transplant in the intensive care unit. Despite having fixed dilated pupils during the neurologic evaluation, the patient eventually had effective DDLT, indicating that DDLT should not be done unless there is obvious brain death.

Colorectal cancer (CRC) poses a significant global health challenge, particularly with patients often experiencing liver metastases. Surgical resection remains the standard treatment; however, many patients face ineligibility due to disease status, contributing to poor prognoses. Liver transplantation (LT) is a viable alternative for select patients with advanced disease. This case report details the clinical outcomes of two CRC patients with multiple liver metastases who successfully underwent living donor LT (LDLT). Both individuals had intricate medical histories and pre-existing liver issues. Patient 1, a 58-year-old male, received extensive pre-transplant interventions, including multiple radiofrequency ablations and pulmonary resections. Patient 2, a 50-year-old male, had cirrhosis alongside colorectal cancer with liver metastases and completed chemotherapy. The cases illustrate LDLT's viability and potential advantages for complex CRC cases with liver metastases. The patients’ intricate medical backgrounds necessitate thorough pre-transplant evaluations and vigilant post-transplant supervision. Moreover, these cases highlight the critical nature of ongoing follow-up for evaluating long-term survival and recognizing possible complications.

Background: and Purpose To understand the characteristics of Korean patients with anti-3-hydroxy-3-methylglutaryl-coenxyme A reductase (HMGCR) myopathy, we measured antiHMGCR antibodies and analyzed the clinical, radiological, and pathological features of patients with anti-HMGCR myopathy. Methods: We measured titers of anti-HMGCR antibodies in the sera of 99 patients with inflammatory myopathy, 36 patients with genetic myopathy, and 63 healthy subjects using an enzyme-linked immunosorbent assay. We tested 16 myositis-specific autoantibodies (MSAs) in all patients with anti-HMGCR myopathy. Results: Positivity for the anti-HMGCR antibody was observed in 17 (4 males and 13 females) of 99 patients with inflammatory myopathy. The median age at symptom onset was 60 years.Ten (59%) of the patients with anti-HMGCR positivity had taken statins. The titer of antiHMGCR antibodies was significantly higher in the statin-naïve group (median=230 U/mL, interquartile range=170–443 U/mL) than in the statin-exposed group (median=178 U/mL, interquartile range=105–210 U/mL, p=0.045). The most common symptom was proximal muscle weakness in 15 patients (88%), followed by myalgia in 9 (53%), neck weakness in 4 (24%), dysphagia in 3 (18%), and skin lesions in 2 (12%). The median titer of anti-HMGCR antibody was 202 U/mL. We found eight different MSAs in nine (53%) patients. The median disease duration from symptom onset to diagnosis was significantly shorter in the MSA-positive group than in the MSA-negative group (p=0.027). Conclusions Our study was the first to measure anti-HMGCR antibodies in inflammatory myopathy. It has provided new findings, including the suggestion of the coexistence of other MSAs in Korean patients.

The application of artificial intelligence (AI) and deep learning (DL) in radiology is rapidly evolving. AI in healthcare has benefits for image recognition, classification, and radiological workflows from a clinical perspective. Additionally, clinical triage AI can be applied to triage systems. This review aims to introduce the concept of DL and discuss its applications in the interpretation of magnetic resonance (MR) images and the DL-based reconstruction of accelerated MR images, with an emphasis on musculoskeletal radiology. The most recent developments and future directions are also discussed briefly.

Objective: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. Methods: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. Results: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. Conclusion This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.