Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background/Aims: Combination immunotherapy, exemplified by atezolizumab plus bevacizumab, has become the standard of care for inoperable hepatocellular carcinoma (HCC). However, the lack of predictive biomarkers and limited understanding of response mechanisms remain a challenge. Methods: Using data from the IMbrave150plus cohort, we applied an immune signature score (ISS) predictor to stratify HCC patients treated with atezolizumab plus bevacizumab or with sorafenib alone into potential high and low response groups. By applying multiple statistical approaches including a Bayesian covariate prediction algorithm, we refined the signature to 10 key genes (ISS10) for clinical use while maintaining similar predictive power to the full model. We further validated ISS10 in an independent HCC cohort treated with nivolumab plus ipilimumab. Results: The study identified a significant association between the ISS and treatment response. Among patients classified as high responders, those treated with the atezolizumab plus bevacizumab combination exhibited improved overall and progression-free survival as well as better objective response rate compared to those treated with sorafenib. We also observed a significant correlation between ISS10 and response to nivolumab plus ipilimumab treatment. Analysis of immune cell subpopulations revealed distinct characteristics associated with ISS subtypes. In particular, the ISS10 high subtype displayed a more favorable immune environment with higher proportions of antitumor macrophages and activated T-cells, potentially explaining its better response. Conclusions Our study suggests that ISS and ISS10 are promising predictive biomarkers for enhanced therapeutic outcomes in HCC patients undergoing combination immunotherapy. These markers are crucial for refining patient stratification and personalized treatment approaches to advance the effectiveness of standard-of-care regimens.

Hepatocellular carcinoma (HCC) progresses through multiple stages of hepatocarcinogenesis, with each stage characterized by specific changes in vascular supply, drainage, and microvascular structure. These vascular changes significantly influence the imaging findings of HCC, enabling non-invasive diagnosis. Vascular changes in HCC are closely related to aggressive histological characteristics and treatment responses. Venous drainage from the tumor toward the portal vein in the surrounding liver facilitates vascular invasion, and the unique microvascular pattern of vessels that encapsulate the tumor cluster (known as a VETC pattern) promotes vascular invasion and metastasis. Systemic treatments for HCC, which are increasingly being used, primarily target angiogenesis and immune checkpoint pathways, which are closely intertwined. By understanding the complex relationship between histopathological vascular changes in hepatocarcinogenesis and their implications for imaging findings, radiologists can enhance the accuracy of imaging diagnosis and improve the prediction of prognosis and treatment response.This, in turn, will ultimately lead to better patient care.

Purpose: There are clinical unmet needs in predicting therapeutic response and precise strategy for the patient with advanced biliary tract cancer (BTC). We aimed to identify genomic alterations predicting therapeutic response and resistance to gemcitabine and cisplatin (Gem/Cis)-based chemotherapy in advanced BTC. Materials and Methods: Genomic analysis of advanced BTC multi-institutional cohorts was performed using targeted panel sequencing. Genomic alterations were analyzed integrating patients’ clinicopathologic data, including clinical outcomes of Gem/Cis-based therapy. Significance of genetic alterations was validated using clinical next-generation sequencing (NGS) cohorts from public repositories and drug sensitivity data from cancer cell lines. Results: 193 BTC patients from three cancer centers were analyzed. Most frequent genomic alterations were TP53 (55.5%), KRAS (22.8%), ARID1A (10.4%) alterations, and ERBB2 amplification (9.8%). Among 177 patients with BTC receiving Gem/Cis-based chemotherapy, ARID1A alteration was the only independent predictive molecular marker of primary resistance showing disease progression for 1st-line chemotherapy in the multivariate regression model (odds ratio, 3.12; p=0.046). In addition, ARID1A alteration was significantly correlated with inferior progression-free survival on Gem/Cis-based chemotherapy in the overall patient population (p=0.033) and in patients with extrahepatic cholangiocarcinoma (CCA) (p=0.041). External validation using public repository NGS revealed that ARID1A mutation was a significant predictor for poor survival in BTC patients. Investigation of multi-OMICs drug sensitivity data from cancer cell lines revealed that cisplatin-resistance was exclusively observed in ARID1A mutant bile duct cancer cells. Conclusion Integrative analysis with genomic alterations and clinical outcomes of the first-line Gem/Cis-based chemotherapy in advanced BTC revealed that patients with ARID1Aalterations showed a significant worse clinical outcome, especially in extrahepatic CCA. Well-designed prospective studies are mandatory to validate the predictive role of ARID1Amutation.