Hepatocellular carcinoma with portal vein tumor thrombosis presents a significant therapeutic challenge due to its poor prognosis and limited treatment options. This review thoroughly examines diagnostic methods, including imaging techniques and classification systems such as the Japanese Vp and Cheng’s classifications, to aid in clinical decision-making. Treatment strategies encompass liver resection and liver transplantation, particularly living donor liver transplantation after successful downstaging, which have shown potential benefits in selected cases. Locoregional therapies, including hepatic arterial infusion chemotherapy, transarterial chemoembolization, transarterial radioembolization, and external beam radiation therapy, remain vital components of treatment. Recent advancements in systemic therapies, such as sorafenib, lenvatinib, and immune checkpoint inhibitors (e.g., atezolizumab plus bevacizumab) have demonstrated improvements in overall survival and progression-free survival. These developments underscore the importance of a multidisciplinary and personalized approach to improve outcomes for patients with hepatocellular carcinoma and portal vein tumor thrombosis.
, Soon-Hyo Kwon, Young Bok Lee, Hei Sung Kim, Jie Hyun Jeon, Gwang Seong Choi Treatment should be initiated for all suspected, clinical, or confirmed cases of scabies. Patients affected should be adequately isolated, and high-risk groups with close contact histories should be treated regardless of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and the patient's health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments include topical 10% crotamiton and oral ivermectin. After completing treatment, follow-up visits at 2 and 4 weeks are recommended to monitor the therapeutic response. Treatment is considered to have failed if scabies mites or burrows are detected, new clinical characteristics develop, or there is an aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control, should besd implemented to reduce the transmission of scabies.
Graves disease (GD) is the primary cause of hyperthyroidism in children. The standard management options—namely, antithyroid drugs (ATD), radioactive iodine, and surgery—have not changed for many years. Although ATD therapy is often the first-line treatment for pediatric patients, the low likelihood of spontaneous remission means that most children will require a more permanent solution. Recent clinical trials and systematic reviews have shed light on the long-term outcomes of ATD therapy, radioactive iodine, and surgical interventions in managing pediatric GD. Additionally, novel therapies aimed at B-cells or the thyroid-stimulating hormone receptor, both implicated in the pathogenesis of GD, are under investigation. However, their definitive role in treating childhood GD has yet to be established. This review will cover the latest developments in the treatment of childhood GD, including information on emerging targeted therapies.
Citations
, Eun Jung Park In stage IV colorectal cancer (CRC), peritoneal metastasis is associated with a poor prognosis. Hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) is an effective treatment option that offers survival benefits in patients with peritoneal metastatic CRC. For over the past several decades, a multitude of studies have been conducted on CRS and HIPEC for peritoneal metastatic diseases, and research in this area is ongoing. Proper patient selection and a meticulous preoperative assessment are crucial for achieving successful postoperative outcomes. The completeness of cytoreduction and the surgical techniques employed are key factors in improving oncologic outcomes following CRS and HIPEC. The role of HIPEC for both therapeutic and prophylactic purposes is currently being evaluated in recent clinical trials. This article reviews the fundamental principles of CRS combined with HIPEC and discusses recent clinical trials concerning the treatment of CRS and HIPEC in CRC patients with peritoneal carcinomatosis.
, Jae Hyun Kim The incidence of type 2 diabetes mellitus (T2DM) is increasing in youth, largely in correlation with an increase in childhood overweight and obesity. Youth-onset T2DM is a major public health concern worldwide, and tends to show more aggressive features than adult-onset T2DM. Early diagnosis and treatment are important to prevent the occurrence of complications and comorbidities. However, current treatment options are limited and only modestly successful in youth-onset T2DM. Over the last few decades, significant progress has been made in the understanding of youth-onset T2DM. This review summarizes the current understanding of the pathogenesis, diagnosis, and treatment of T2DM in youth. (Ewha Med J 2022;45(3):e3)
, Hyungju Kwon, Woosung Lim, Byung-In Moon, Nam Sun Paik Active surveillance (AS) of papillary thyroid microcarcinoma was first suggested by Dr. Akira Miyauchi at Kuma Hospital in 1993. Based on several subsequent evidences, AS was approved by the American Thyroid Association in 2015. AS is no longer an experimental treatment but has become an acceptable standard of care for patients with low-risk thyroid cancers. No molecular markers, such as BRAF mutations, have been identified to predict the prognosis of papillary thyroid cancer. However, future molecular studies may reveal the relationship between genetic mutations and thyroid cancer prognosis. AS involves closely monitoring thyroid cancer over time, instead of immediately treating it with surgery. Patients and medical doctors should consider these two options: observation or surgery.
The purpose of this study is to investigate the psychiatric problems of rape victims.
The author observed the psychiatric symptoms of the 10 women patients who visited psychiatric clinics immediately after rape after trauma, and made a related survey of 61 other 61 female outpatients in order to compare psychiatric symptoms of those of them who reported the history of rape trauma and those of the others who did not have such history.
Results are given as follows :
1) The most frequent psychiatric diagnosis of the victims of rather recent day's rape was posttraumatic stress disorder(4/10), followed by depression(2/10) and Schizoaffective disorder(2/10). The most frequent perpetrator was unknown person(8/10).
2) 49.2% of the other 61 patients of psychiatric clinic reported the history of abuse, including 26.2% and 36.1% of them reporting sexual abuse and physical abuse, respectively.
3) Sexual dysfunction was reported in 58.3% of the rape victims, who generally showed a tendency toward the high level of anxiety, hostility and paranoid symptoms.
4) The high scored dissociation was observed in rape victims but not in non-abuse group.
The rape trauma appears to be responsible for some psychiatric symptoms, or at least to be a precipitating factor of psychiatric disorders. The author also confirmed that aftermath of the rape trauma can continue rather perennially, for years after trauma or even for life ling.
, Jeong Wan Seo During the past decade, rates of
Citations
First
Prev
