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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

Purpose: To evaluate the safety and feasibility of percutaneous transsplenic access to the portal vein for management of vascular complication in patients with chronic liver diseases. Methods: Between Sept 2009 and April 2011, percutaneous transsplenic access to the portal vein was attempted in nine patients with chronic liver disease. Splenic vein puncture was performed under ultrasonographic guidance with a Chiba needle, followed by introduction of a 4 to 9F sheath. Four patients with hematemesis or hematochezia underwent variceal embolization. Another two patients underwent portosystemic shunt embolization in order to improve portal venous blood flow. Portal vein recanalization was attempted in three patients with a transplanted liver. The percutaneous transsplenic access site was closed using coils and glue. Results: Percutaneous transsplenic splenic vein catheterization was performed successfully in all patients. Gastric or jejunal varix embolization with glue and lipiodol mixture was performed successfully in four patients. In two patients with a massive portosystemic shunt, embolization of the shunting vessel with a vascular plug, microcoils, glue, and lipiodol mixture was achieved successfully. Portal vein recanalization was attempted in three patients with a transplanted liver; however, only one patient was treated successfully. Complete closure of the percutaneous transsplenic tract was achieved using coils and glue without bleeding complication in all patients. Conclusion: Percutaneous transsplenic access to the portal vein can be an alternative route for portography and further endovascular management in patients for whom conventional approaches are difficult or impossible. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to investigate the effects of stenting across the branching arteries on the patency and stent-tissue responses over the branching arterial orifices. Methods: Thirteen dogs were observed after placing aortic stents across the celiac arteries (CA), superior mesenteric arteries (SMA), and renal arteries (RA). The animals were grouped according to stent types: large-cell group (n = 6) and small-cell group (n = 7). Angiography was performed to evaluate the branching artery patency at 2, 6, and 12 months after stent insertion, and the stent-tissue responses covering the orifices were evaluated on histopathologic examination. Results: All branching arteries were patent on follow-up angiography; however, three patterns of stent-tissue responses over the orifices were observed: neointimal layering, bridging septa, and papillary hyperplasia. Although neointimal layering and bridging septa were evenly observed, severe papillary hyperplasia was more frequent at SMA and CA than RA. Four RA showed less than 50% ostial patency, and localized infarct was observed in six kidneys (24%). The ostial patency tended to decrease with small-cell stent during the follow-up period. Conclusions: Various stent-tissue responses over the branching artery orifices are induced by the aortic stent covering the branching arteries and may not be easily detected by conventional angiography. Subclinical renal infarct also may occur despite patent renal angiography. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe imaging appearances of hepatocellular carcinoma (HCC) supplied exclusively by the hepatic falciform artery (HFA) and safety of chemoembolization via the HFA. Methods: During the past 6 years, we have performed chemoembolization for the treatment of 12 patients with HCCs supplied exclusively by the HFA. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus. Results: Tumors were located in Couinaud segments IV (n = 7) and III (n = 5) and in subcapsular areas around the falciform ligaments. Tumor size ranged from 1.0 to 1.8 cm (mean, 1.3 cm; median, 1.3 cm). HFAs originated from A4 (n = 7), A3 (n = 4), and the left hepatic artery near the umbilical point (n = 1). All tumors were supplied exclusively by the HFA. Prophylactic embolization of the distal HFA before chemoembolization was performed using gelatin sponge particles in only one patient, and selective chemoembolization via the HFA was achieved in all patients. One patient suffered from a skin rash after chemoembolization and recovered after conservative management. Individual responses of tumors supplied exclusively by the HFA were complete response (n = 8), partial response (n = 1), and stable disease (n = 2) at the first follow-up enhanced CT scan. Conclusions: The HFA can supply HCC located in subcapsular areas around the falciform ligament, and the tumors can be safely chemoembolized without significant complications. [ABSTRACT FROM AUTHOR]

Purpose: Plain radiographs are frequently used to select appropriately sized meniscal allografts, of which the width and length cannot be always perfectly matched. The objective of this study was to decide which of these dimensions should be matched with a more priority considering proper position of the lateral meniscal transplants.Methods: The positions of 34 lateral, fresh-frozen meniscal allografts, transplanted using the central bone bridge method, were evaluated by magnetic resonance imaging (MRI) 2 days after surgery. A size mismatch was defined as a difference between preoperative radiographic size and a real dimension of the transplants. The lateral subluxation of the mid-body on the coronal plane and the anterior and posterior horn positions on the sagittal plane were estimated on the MRIs. It was evaluated whether size mismatches were associated with the meniscal subluxation beyond articular cartilage margin on each plane.Results: The mean lateral subluxation of the mid-body on the center of coronal sections was 1.7 ± 1.8 mm. The anterior and posterior horns were located 2.0 ± 2.1 mm and -3.8 ± 2.7 mm from the articular edge, respectively, in the center of sagittal images. Lateral subluxation was significantly associated with width mismatch (r = 0.415-0.486, P < 0.05), but length mismatch was not significantly correlated with the anterior or posterior horn position on sagittal images (n.s.).Conclusion: The results of this study suggest that width matching using plain radiographs would be more reliable than length matching when it is sought to assure adequate positioning of meniscal transplants, if both dimensions cannot be simultaneously matched.Level Of Evidence: II. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: To validate the hypothesis that a multisegmented approach during subtraction computed tomography (CT) angiography of the lower extremities can improve bone removal efficiency by suppressing regional motion. Materials and Methods: The institutional review board of our hospital approved this retrospective study. One hundred and one consecutive patients that had undergone the lower extremity CT angiography were included in this study. Subtraction CT angiography was performed using two different methods, namely, by single volume subtraction and by multisegmented volume subtraction. Multisegmented volume subtraction was conducted by dividing the whole volume of the CT data into three segments along the z axis of the lower extremities, performing a subtraction process for each segment, and combining segments to form as single subtracted volume. The bone removal efficiencies of the two methods was assessed by analyzing bone subtraction scores on maximum intensity projection (MIP) images for each bone segment in a blinded fashion. In addition, overall MIP image qualities were compared by displaying MIP images produced using the two methods side by side. Differences between bone subtraction scores were tested using Wilcoxon's signed rank test. Results: Multisegmented volume subtraction MIP images demonstrated significantly better bone removal for the following bone segments: pelvis (P < .0001), hip (P = .0002), thigh (P = .0258), knee (P = .0004), ankle (P = .0008), metatarsal bone (P < .0001), and toes (P < .0001). Overall bone subtraction score and subjective image qualities determined by performing side-by-side comparisons were better for the multisegmented volume subtraction method. Conclusion: Bone removal performance and overall MIP image quality can be increased by adopting multisegmented volume subtraction during subtraction CT angiography of the lower extremities. [ABSTRACT FROM AUTHOR]

This study was designed to describe tumor feeders from the intercostal artery supplying hepatocellular carcinoma (HCC) on C-arm CT and multidetector row CT. From March 2008 to May 2009, C-arm CT of the intercostal artery was prospectively performed in 24 HCC patients. Two interventional radiologists, who performed C-arm CT, evaluated tumor feeders on C-arm CT and multidetector row CT scans by consensus. In total, 35 intercostal arteries were examined by C-arm CT. All tumor feeders except one showed a sharp upward turn at or near the costochondral junction. On axial C-arm CT images, all tumor feeders were observed as an enhancing dot in the upper intercostal space along the diaphragm. On multidetector CT scans, 17 tumor feeders were observed and 18 were not. Tumor feeders from the intercostal artery are observed as an enhancing dot along the diaphragm on C-arm CT and can be seen on multidetector row CT in approximately half of patients. [ABSTRACT FROM AUTHOR]

Conclusion. After a noise-induced transient threshold shift, hypoxia occurred in the central nervous system, especially in the auditory cortex, the hippocampus, and the inferior colliculus. Objectives. Noise-induced inner ear hypoxia was shown by measurement of an increase in hypoxia-inducible factor-1 alpha, which is expressed? in the nucleus under hypoxic conditions. This study uses pimonidazole to localize site-specific hypoxic changes occurring in the mouse central auditory pathway during noise-induced auditory threshold shift. Method. BALB/c hybrid mice with normal hearing were exposed to 122 dB SPL white noise for 3 h. Immediately after exposure to the noise, and 7 d after noise exposure, the brains of mice were collected. Brains were cryosectioned into slices 15 um thick and examined by immunofluorescence after staining with pimonidazole HCl. Results. After 3 h of exposure to 120 dB SPL noise, the hearing thresholds of mice decreased to 51.1±8.6 dB SPL (n =14), but hearing recovered in 7 d. After noise exposure, pimonidazole signal increased in the auditory cortex, the hippocampus, and the inferior colliculus. The pimonidazole signal remained elevated after 7 d. In control mice, pimonidazole did not stain any brain region. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the effect of increased sympathetic outflow to muscle (by means of elevated intrathoracic pressure) on painful-area electrical activity. DESIGN: In six subjects with myofascial painful areas in trapezius muscles during normal respiration and during elevated intrathoracic pressure, electromyographic epochs were recorded from a monopolar needle electrode inserted over the painful area and advanced until action potentials were detected, a second needle electrode inserted to the same depth over a nontender control area, and surface electrodes placed nearby. RESULTS: The painful-area electromyographic activity increased (P < 0.05) from 49 +/- 53 microV during normal respiration to 121 +/- 80 microV during elevated intrathoracic pressure. The control-area electromyographic activity and the surface-electrode electromyographic activity did not increase significantly. CONCLUSION: The significant electromyographic increase from painful areas and no significant increase from control channels are consistent with the view that sympathetic neural outflow increases painful-area electrical activity. [ABSTRACT FROM AUTHOR]

Intravenous cannulation is a nursing procedure carried out in some clinical units that may induce trauma and discomfort. Nurses should be well prepared before practising the procedure with clients. Conventionally, a plastic arm was used for practice but, with innovative developments in technology, a computer program called the CathSim Intravenous Training System (CathSim ITS) is available for this purpose. This study was conducted to compare the effectiveness of learning using a plastic arm with the CathSim ITS. Twenty-eight nurses were divided into two groups and randomly assigned to the two different methods: plastic arm (control group) or CathSim ITS (experimental group). Both groups were provided with 1 hour of theory input and 2 hours of nursing laboratory work. When the nurses felt ready to practise on clients, their performances were assessed by researchers with an intravenous cannulation qualification using a validated checklist. Prior to the assessment, trait and state anxiety levels were measured using the State-Trait Anxiety Inventory (Hong Kong Chinese adaptation) to check whether anxiety would affect the performance. Following the assessment, a semi-structured interview was conducted to reveal my knowledge acquired through using the selected method. Both the control and CathSim ITS groups demonstrated a high success rate, scoring 100% and 92.86%, respectively, with their first client. The semi-structured interviews revealed that the CathSim ITS group appreciated several features of their assigned method. However, there is room for further development. [ABSTRACT FROM AUTHOR]

BACKGROUND: In-vitro and animal experiments have shown that the cyclo-oxygenase 2 inhibitor celecoxib can reduce formation of neointima within stents. We aimed to test whether celecoxib has similar effects in a clinical setting. METHODS: In a randomised two-centre trial, we enrolled 274 patients who had angina pectoris or a positive stress test and who had native coronary artery lesions for which implantation of paclitaxel-eluting stents was feasible. All patients were given aspirin (100 mg daily) and clopidogrel (75 mg daily). 136 patients were randomly assigned to receive celecoxib (400 mg before the intervention, and 200 mg twice daily for 6 months after the procedure). The primary endpoint was late luminal loss on quantitative coronary angiography at 6 months after the intervention. Secondary endpoints were cardiac death, non-fatal myocardial infarction, and revascularisation of the target lesion. Analysis was done on a modified intention-to-treat basis. This study is registered with ClinicalTrials.gov, number NCT00292721. FINDINGS: At 6 months, mean in-stent late luminal loss was lower in the celecoxib group (0.49 mm, SD 0.47) than in the control group (0.75 mm, 0.60) (absolute difference 0.26 mm; 95% CI 0.12-0.40). Frequency of secondary outcomes at 6 months was also lower in the celecoxib group, mainly because of a reduced need for revascularisation of the target lesion. INTERPRETATION: These data suggest that the adjunctive use of celecoxib for 6 months after stent implantation in patients with coronary artery disease is safe and can reduce the need for revascularisation of the target lesion. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the characteristics of out-of-office blood pressure (BP) measurements in patients with apparent treatment-resistant hypertension (aRH) enrolled from 15 tertiary care centers in South Korea. aRH was defined as having uncontrolled office BP ≥ 130/80 mmHg despite receiving three classes of antihypertensive medication or any level of BP despite receiving ≥4 classes of antihypertensive medication. Patients with complete data for office BP, 24-h ambulatory BP monitoring (ABPM), and home BP measurements at baseline were included. BP control status between ABPM and home BP measurements was compared. Out of 1457 patients, 823 meeting the enrollment criteria were included (mean age: 59.9 ± 13.6 years; 57.5% male patients). Among them, 7.2% had controlled BP, 8.7% had whitecoat uncontrolled hypertension, 15.1% had masked uncontrolled hypertension, and 69% had sustained hypertension, as measured through baseline ABPM. Additionally, 43% of patients with controlled BP based on home BP measurement had nocturnal hypertension. Relying solely on home BP measurement may result in misclassifying 70% of patients as having either controlled BP or whitecoat uncontrolled BP. This study reaffirms the circadian pattern of resistant hypertension, characterized by a higher prevalence of non-dipping and rising patterns, even in patients with BP controlled based on ABPM. Considering the persistent difference between home BP measurement and ABPM, even at a lower home BP threshold, integrating both measurements into the management of aRH is advisable., Competing Interests: Compliance with ethical standards Conflict of interest JS have nothing to declare. CJL received lecture honoraria from Novartis, Hanmi Pharmaceutical, Yuhan, Boryung Pharmaceutical, and Daiichi Sankyo. DHK received honoraria from Viatris, Organon, Boryoung, Hanmi, Daewoong, Celltrion, Daiichi Sankyo, and Chong Kun Dang and a research grant from Daewoong Pharmaceutical. SYK received honoraria from Norvatis, Amgen Korea, BMS Korea, Bayer Korea, Viatris, Boryoung, Hanmi, Menarini, JW Pharmaceutical, Inno N, Dongkook, Yuhan, Chong Kun Dang, GC Biopharma, and Daewon. JHP received honoraria from Viatris, Jeil, Boryoung, Daewoong, Hanmi, Yuhan, Chong Kun Dang, BMS. ICK received honoraria from Abbott, Novartis, Yuhan, Viatris, Organon, Boryoung, Hanmi, Daewoong, Celltrion, Servier, Daiichi Sankyo, Chong Kun Dang, and Daewon. JHL received honoraria from Daewoong Pharmaceutical, Handok Pharmaceuticals, Novartis, Chong Kun Dang Pharmaceutical Corp, Menarini Korea, Samjin Pharmaceuticals Co. Ltd, Daiichi Sankyo Korea, Hanmi Pharmaceutical, Yuhan Corporation, Boryung Pharmaceutical, Bayer. HYL received honoraria from Viatris, Organon, Boryoung, Hanmi, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, Chong Kun Dang, and Daewon, and a research grant from Daiichi Sankyo. HYL also received consultation fee from Skylab. JWC received honoraria from Bayer, Astrazeneca, Organon, Hanmi, Yuhan, Daewoong, Chong Kun Dang, JW, Boryoung, GC Corp, Donga, Handok, Ildong, Jeil, Daewon, Ahn-gook, Samjin, Daiichi Sankyo, Otsuka, Mitsubishi Tanabe, Hyundai, Kuhnil, Bukwang and Aju. JWC also received research grants from Handok, Daewon, Boryung, GC Corp, Addpharma, and Kyung Dong. SHI received honoraria from Boryoung, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, and Menarini, and a research grant from Daiichi Sankyo. SHI has received consultation fee from Skylab. JS received honoraria from Boryoung, Daiichi Sankyo, Chong Kun Dang, and Inno-N and consultaion fee from Skylab and Inbody. SP received honoraria from Viatris, Organon, Boryoung, Hanmi, Daewoong, Donga, Celltrion, Servier, Daiichi Sankyo, Chong Kun Dang, and Daewon, and a research grant from Daiichi Sankyo. SP has received consultation fee from Skylab. Also, SP has received stock option from Mediwhale. Others have nothing to declare., (© 2024. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)

Background/aim: Clear cell renal cell carcinoma (ccRCC) is the most common type of kidney cancer, accounting for approximately 75% of kidney cancers. The objective of this study was to identify novel progression markers for ccRCC based on proteomics, with the goal of stage determination and early diagnosis of kidney cancer patients., Materials and Methods: We performed quantitative global proteomics coupled with Stable Isotope Labeling by Amino Acids in Cell Culture (SILAC) and high-resolution tandem mass spectrometry on kidney-derived cells, including HEK-293, 786-O (primary ccRCC), and Caki-1 (metastatic ccRCC) cells, to investigate the novel progression factors of ccRCC., Results: In this study, a total of 1,106 proteins were quantified. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were conducted for differentially expressed proteins (DEPs) that were increased in ccRCC cells compared to HEK-293 cells. Ultimately, 99 DEPs including 75 up-regulated and 24 down-regulated proteins, that were significantly altered in both ccRCC cells, were identified. Among DEPs, vimentin was identified as the most significantly changed protein. Its increased expression in ccRCC was verified through immunoblotting in ccRCC cell lines and immunohistochemistry in kidney tumors., Conclusion: From the global proteomics data detected in ccRCC, we propose 99 DEPs including vimentin as progression factors., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: In recent decades, the analytical quality of clinical laboratory results has substantially increased because of collaborative efforts. To effectively utilize laboratory results in applications, such as machine learning through big data, understanding the level of harmonization for each test would be beneficial. We aimed to develop a quantitative harmonization index that reflects the harmonization status of real-world laboratory tests., Methods: We collected 2021-2022 external quality assessment (EQA) results for eight tests (HbA1c, creatinine, total cholesterol, HDL-cholesterol, triglyceride, alpha-fetoprotein [AFP], carcinoembryonic antigen [CEA], and prostate-specific antigen [PSA]). This EQA was conducted by the Korean Association of External Quality Assessment Service, using commutable materials. The total analytical error of each test was determined according to the bias% and CV% within peer groups. The values were divided by the total allowable error from biological variation (minimum, desirable, and optimal) to establish a real-world harmonization index (RWHI) at each level (minimum, desirable, and optimal). Good harmonization was arbitrarily defined as an RWHI value ≤ 1 for the three levels., Results: Total cholesterol, triglyceride, and CEA had an optimal RWHI of ≤ 1, indicating an optimal harmonization level. Tests with a desirable harmonization level included HDL-cholesterol, AFP, and PSA. Creatinine had a minimum harmonization level, and HbA1c did not reach the minimum harmonization level., Conclusions: We developed a quantitative RWHI using regional EQA data. This index may help reflect the actual harmonization level of laboratory tests in the field.

Purpose: To provide detailed reports on radiation doses during transarterial chemoembolization (TACE) in the cone-beam computed tomography (CBCT) era and to identify the associated factors., Methods: This retrospective study included 385 consecutive patients who underwent initial conventional TACE for hepatocellular carcinoma (HCC) between January 2016 and December 2017. In most cases, CBCT was performed at the common hepatic artery or celiac axis to confirm the location of the tumor and the three-dimensional hepatic artery anatomy. Superselective TACE was performed for all technically feasible cases. Information on total dose area product (DAP), total cumulative air kerma (CAK), fluoroscopy time, and DAP and CAK of each digital subtraction angiography (DSA) and CBCT scan was recorded. Multiple linear regression analysis was performed to identify the factors associated with increased DAP during TACE., Results: The mean values of total DAP and CAK were 165.2 ± 81.2 (Gy·cm²) and 837.1 ± 571.0 (mGy), respectively. The mean fluoroscopy time was 19.1 ± 10.3 min. The mean DAP caused by fluoroscopy, DSA, and CBCT was 51.8 ± 43.9, 28.0 ± 24.1, and 83.9 ± 42.1 Gy·cm², respectively. Male sex, a high body mass index, largest tumor size > 3 cm, presence of aberrant right and left hepatic arteries, and superselective TACE were identified as independent predictors of increased total DAP during TACE., Conclusion: We were able to provide detailed reports on radiation doses during TACE and associated factors., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)