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Minseok Albert Kim,1 Heejoon Jang,1 Na Ryung Choi,1 Joon Yeul Nam,1 Yun Bin Lee,1 Eun Ju Cho,1 Jeong-Hoon Lee,1 Su Jong Yu,1 Hyo-Cheol Kim,2 Jin Wook Chung,2 Jung-Hwan Yoon,1 Yoon Jun Kim1 1Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; 2Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South KoreaCorrespondence: Yoon Jun KimDepartment of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South KoreaTel +82-2-2072-3081Fax +82-2-743-6701Email yoonjun@snu.ac.krBackground: Both trans-arterial radioembolization (TARE) and conventional trans-arterial chemoembolization (TACE) can effectively control hepatocellular carcinoma (HCC) in patients who are not suitable for curative resection. This study compared the effectiveness of TARE and conventional TACE as the initial trans-arterial treatment for hepatocellular carcinoma (HCC) assessed by tumor response and clinical outcomes.Material and Methods: Data were retrospectively analyzed the propensity score-matched cohort for overall survival (OS), progression-free survival (PFS), and intrahepatic PFS in patients who have received TARE or TACE as the first HCC treatment from March 2012 to December 2017.Results: A total of 138 patients initially treated with TARE (n = 54) or TACE (n = 84) was included in this study. Of 138 patients, median age was 59 years and the mean follow-up period was 27.6 months. TARE showed better OS (hazard ratio [HR] = 0.54, 95% confidence interval [CI] = 0.31– 0.92, log-rank P = 0.02), better PFS (HR = 0.51, 95% CI = 0.36– 0.97, log-rank P = 0.04), and better intrahepatic PFS (HR = 0.51, 95% CI = 0.30– 0.88, log-rank P = 0.01) compared with TACE. TARE was an independent prognostic factor for OS (adjusted HR [aHR] = 0.52, 95% CI = 0.30– 0.90, P = 0.02), PFS (aHR = 0.57, 95% CI = 0.35– 0.94, P = 0.03), and intrahepatic PFS (aHR = 0.49, 95% CI = 0.28– 0.84, P = 0.01).Conclusion: TARE as initial trans-arterial treatment is associated with better clinical outcomes such as longer OS compared with TACE in patients with HCC.Keywords: liver neoplasms, brachytherapy, yttrium radioisotopes, embolization

Sung Won Chung,1,* Min Kyung Park,1,* Young Youn Cho,1,2,* Youngsu Park,1 Cheol-Hyung Lee,1 Hyunwoo Oh,1 Heejoon Jang,1 Minseok Albert Kim,1 Sun Woong Kim,1 Joon Yeul Nam,1 Yun Bin Lee,1 Eun Ju Cho,1 Su Jong Yu,1 Hyo-Cheol Kim,3 Yoon Jun Kim,1 Jin Wook Chung,3 Jung-Hwan Yoon,1 Jeong-Hoon Lee1 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea; 2Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea; 3Department of Radiology, Seoul National University College of Medicine, Seoul, Korea*These authors contributed equally to this workCorrespondence: Jeong-Hoon LeeDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, KoreaTel +82-2-2072-2228Fax +82-2-743-6701Email pindra@empal.comBackground: Still in real-world practice, advanced hepatocellular carcinoma (HCC) patients are treated with transarterial chemoembolization (TACE). This study compared the therapeutic effectiveness of initial TACE treatment and initial sorafenib treatment in advanced HCC patients.Patient and Methods: Advanced HCC patients initially treated with sorafenib or TACE were included in this study. Treatment crossover due to an unfavorable response to initial treatment was allowed. Propensity score (PS) matching was applied for balancing baseline characteristics. The primary outcome was overall survival (OS) and the secondary outcomes included tumor response.Results: A total of 554 patients were included in this study: 85 were initially treated with sorafenib (the sorafenib-first group) and 469 with TACE (the TACE-first group). In the entire cohort, the TACE-first group was associated with lower risk of death [adjusted hazard ratio (HR)=0.75, P=0.04]. In the PS-matched cohort (85 patients per group), the TACE-first group showed longer OS than the sorafenib-first group in both univariable (HR=0.68, P=0.02) and multivariable analyses (adjusted HR=0.58, P=0.002). Specifically, within both the entire and the PS-matched cohorts, the TACE-first group showed longer OS in subgroups with major portal vein tumor thrombosis (HR=0.72, P=0.048; HR=0.52, P=0.003) or infiltrative HCC (HR=0.42, P< 0.001; HR=0.30, P=0.004, respectively). The objective response rate was higher in the TACE-first group (29.3% vs 14.7%, P=0.03) within the PS-matched cohort.Conclusion: For advanced HCC, initial TACE leads to longer OS with a more favorable tumor response than initial sorafenib treatment. Intrahepatic tumor control with initial locoregional therapy may be a potent strategy for advanced HCC.Keywords: liver cancer, transarterial therapy, locoregional therapy, tyrosine kinase inhibitor

Jung Wha Chung,1 Kyoung Ae Kong,2 Jin Hwa Lee,1 Seok Jeong Lee,1 Yon Ju Ryu,1 Jung Hyun Chang11Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, 2Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea Background and objective: Overlap syndrome shares features of both asthma and chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate characteristics of overlap syndrome and their effect on self-rated health (SRH). Methods: We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey of 2007–2009. Subjects with acceptable spirometry and available wheezing history were included. Subjects were classified into four groups based on forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) results and the presence or absence of self-reported wheezing for the previous 12 months: 1) COPD group, defined as having FEV1/FVC

Chi-Fuk So,1 Kup-Sze Choi,1 Thomas KS Wong,2 Joanne WY Chung2,31Centre for Integrative Digital Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, 2Department of Nursing and Health Sciences, Tung Wah College, Hong Kong, 3Department of Health and Physical Education, The Hong Kong Institute of Education, Hong KongAbstract: The race for the next generation of painless and reliable glucose monitoring for diabetes mellitus is on. As technology advances, both diagnostic techniques and equipment improve. This review describes the main technologies currently being explored for noninvasive glucose monitoring. The principle of each technology is mentioned; its advantages and limitations are then discussed. The general description and the corresponding results for each device are illustrated, as well as the current status of the device and the manufacturer; internet references for the devices are listed where appropriate. Ten technologies and eleven potential devices are included in this review. Near infrared spectroscopy has become a promising technology, among others, for blood glucose monitoring. Although some reviews have been published already, the rapid development of technologies and information makes constant updating mandatory. While advances have been made, the reliability and the calibration of noninvasive instruments could still be improved, and more studies carried out under different physiological conditions of metabolism, bodily fluid circulation, and blood components are needed.Keywords: noninvasive, glucose monitoring, diabetes mellitus, blood glucose measurement