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Background: Hair cycle arrest (HCA) is a chronic alopecic disorder in dogs. Clinical responses vary and are often insufficient. Microneedling (MN) has been used as a successful treatment for HCA in dogs; ideal protocols have not yet been established. Objectives: The objective of the study was to compare the efficacy and safety of three needle lengths for MN in dogs with HCA. Animals: Six unrelated client‐owned dogs, including five Pomeranians and one mixed‐breed dog, diagnosed with HCA. Materials and Methods: Individual alopecic sites were divided into three sections. For each section, different lengths of needles (1, 2 and 3 mm) were used. Efficacy and safety were evaluated at 1, 3 and 6 months. Treated sections were monitored for 20 months. Results: Three months after treatment with 3 mm needles, all sections showed hair regrowth. There was no hair regrowth in two of six sections treated with 2 mm needles, and four of six sections did not show a response to treatment with 1 mm needles. Two dogs developed transient pruritus. Five of six dogs had recurrent hair loss between 5 and 16 months of follow‐up. Conclusion and Clinical Relevance: Microneedling using longer needles stimulated better hair regrowth in dogs with HCA. Alopecia relapsed in most dogs and minor pruritus occurred in some dogs. [ABSTRACT FROM AUTHOR]

Background: Endoscopic full-thickness gastric resection (EFTGR) with regional lymph node dissection (LND) has been used for early gastric cancer (EGC) exceeding the indications for endoscopic submucosal dissection (ESD). The extent of the dissected lymph nodes is crucial. A 3D near-infrared (NIR) video robot system significantly enhances visualization of the lymphatic system. However, this system has not been used in EFTGR with LND. Thus, this study assessed the benefits of the 3D NIR video robot system in a clinical setting. Methods: Between February 2015 and September 2018, 24 patients with EGC exceeding the indications for ESD were treated with EFTGR and LND using a 3D NIR video system with the da Vinci surgical robot. Indocyanine green (ICG) was injected endoscopically around the tumor, and basin node (BN) dissection around the nodes was examined using the 3D NIR video system of the da Vinci Si surgical robot. Subsequently, robot-assisted EFTGR was performed. The primary outcome was the 5-year survival rate. Result: During a 5-year follow-up of all 24 patients, an 80-year-old patient with an ulcer and T2 invasion was lost to follow-up. Among the remaining 23 patients, no mortality or recurrence was observed. Conclusion: No metastasis or mortality occurred using the da Vinci robot-assisted EFTGR with LLND and a 3D NIR video system for patients who required radical gastrectomy for EGC in over 5 years. Hence, this may be a safe and effective method for radical gastrectomy; further studies are required confirming its effectiveness. [ABSTRACT FROM AUTHOR]

Cervical lymph node metastasis (CLNM) from remote primary sites is rare in head and neck cancer. The efficacy of neck dissection is still being investigated for therapeutic benefits of local management in oligometastasis from non-head and neck cancer. To evaluate the clinical efficacy of neck dissection (ND) in CLNM from distant primary cancers and identify factors contributing to improved survival. This retrospective case-control study enrolled patients who underwent ND for CLNM from distant primary cancer at Asan Medical Centre between January 2010 and December 2020. We analysed overall survival and association between clinical covariate and survival. The study included 31 (14 males, 17 females) among 114 patients. Ovarian cancer was the most common primary malignancy (32.3%). Patients with fewer than three metastatic lymph nodes, without extranodal extension and with adjuvant therapy after surgery had better survival rates. In patients with CLNM from a distant primary cancer, ND is beneficial as local treatment. And adequate selection of patients for ND is pivotal to improve prognosis. [ABSTRACT FROM AUTHOR]

This article explores the potential therapeutic effects of quantum molecular resonance (QMR) for managing mild acne. The study involved two patients with mild acne who underwent QMR treatment. After three sessions of QMR, both patients experienced clearance of their acne lesions and improvement in fine wrinkles. The study suggests that QMR may have a therapeutic effect on mild acne and could be a noninvasive alternative for its management. However, further research is needed to fully understand the mechanisms and confirm these findings. [Extracted from the article]

The purpose of the study was to which investigate whether dexamethasone, which has anti-inflammatory and immune response suppression roles, could treat noise-induced hearing loss caused by damage to hair cells in the cochlea. The experiment used 8-week-old CBA mice exposed to white noise at an intensity of 110 dB SPL for 2 h, with hearing loss confirmed by the auditory brainstem response test. Dexamethasone was administered by intraperitoneal injection for 5 days, and the therapeutic effect was investigated for 3 weeks. The experimental groups were 3 mg/kg of dexamethasone (3 mpk) and 10 mg/kg of dexamethasone (10 mpk), and the control group was a saline-administered group. The results showed that compared to the control group, the hearing threshold value was recovered by 10 dB SPL compared to the saline group from the 14th day in the 3 mpk group. In the 10 mpk group, thresholds were recovered from the 7th day compared to the saline group. This difference was similar at 4 kHz, and in the case of the 10 mpk group, the threshold was recovered by 20 dB SPL compared to the saline group. The study also confirmed the restoration of nerve cell activity and showed a recovery effect of about 20 µV in the amplitude value change in the 10 mpk group. In conclusion, the study suggests that dexamethasone has a therapeutic effect for noise-induced hearing loss by increasing the activity of nerve cells and showing a recovery effect from hair cells damaged by noise. [ABSTRACT FROM AUTHOR]

Simple Summary: To facilitate performing a lymphadenectomy during a reduced-port robotic distal gastrectomy for gastric cancer, we developed Vessel Sealer Extend® (Intuitive Surgical, Sunnyvale, CA, USA), a bipolar vessel-sealing device with an articulating jaw. Using the Vessel Sealer Extend® (Intuitive Surgical), we performed trans-umbilical lymphadenectomy using an articulating bipolar vessel-sealing device and found that reduced-port robotic distal gastrectomy with trans-umbilical lymphadenectomy using an articulating bipolar vessel-sealing device had similar outcomes to conventional laparoscopic distal gastrectomy in terms of the incidence of postoperative morbidity and the number of harvested lymph nodes. In addition, because reduced-port robotic distal gastrectomy is associated with fewer incisions, intra-abdominal adhesions can be minimized. Background: Docking the scope and instruments through a multi-channel trocar has enabled reduced-port robotic distal gastrectomy (RRDG) for gastric cancer. To facilitate lymphadenectomy over the anatomical hindrances during RRDG, we recently introduced the Vessel Sealer Extend® (VSE) (Intuitive Surgical, Sunnyvale, CA, USA), a bipolar vessel-sealing device (BVSD) with an articulating jaw. Methods: From May 2020 to August 2023, we performed RRDG to treat T1 gastric cancer. One endoscope arm and three instrument arms of the da Vinci® Xi Surgical System (Intuitive Surgical) were used. During the lymphadenectomy, the endoscope and VSE (Intuitive Surgical) were docked through a multi-channel trocar established on a trans-umbilical incision. Two Cardiere forceps were docked through cannulas established on each flank. A trans-umbilical lymphadenectomy using an articulating BVSD (TULAB) was then performed. Results: A total of 42 patients underwent planned RRDG with the TULAB technique. The number of retrieved lymph nodes did not differ between the patients who underwent RRDG and those who underwent conventional laparoscopic distal gastrectomies (CLDG) (p = 0.362). There was no statistically significant difference in postoperative complications between the RRDG and CLDG group (p = 0.189). The mean time to first semi-fluid diet was shorter in the patients who underwent RRDG than CLDG (p = 0.030), and the incidence of postoperative ileus was lower in the RRDG group than the CLDG group (0% and 9.9%, respectively, p = 0.034). Conclusions: Despite use of fewer ports, RRDG with TULAB had similar outcomes to CLDG in terms of the incidence of postoperative morbidity and the number of harvested lymph nodes. Furthermore, by reducing the number of incisions, the incidence of the intra-abdominal adhesions can potentially be lowered when RRDG is used. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to compare the clinical outcomes and long-term survival in patients who underwent isolated aortic valve replacement (AVR) with mechanical versus bioprosthetic valves.Methods: Patients aged 50-69 years who had undergone AVR from 2002 to 2018 were identified and their characteristics were collected from Korean National Health Information Database formed by the National Health Insurance Service, Republic of Korea. Of the 5792 patients, 1060 patients were excluded due to missing values on characteristics. Of the 4732 study patients, 1945 patients (41.1%) had received bioprosthetic valves (Group B) and 2787 patients (58.9%) had received mechanical valves (Group M). A propensity score-matched analysis was performed to match 1429 patients in each group. Data on mortality, cardiac mortality, reoperations, cerebrovascular accidents, and bleeding complications were obtained.Results: The overall survival rates at 5 and 10 years postoperatively were 87.8% and 75.2% in the matched Group B and 91.2% and 76.7% in the matched Group M, respectively (p = .140). Freedom from cardiac death rates at postoperative 5 and 10 years were 95.6% and 92.4% in the matched Group B and 96.0% and 92.1% in the matched Group M, respectively (p = .540). The cumulative incidence of reoperation was higher in the matched Group B than in the matched Group M (p = .007), and the cumulative incidence of major bleeding was higher in the matched Group M than in the matched Group B (p = .039).Conclusion: In patients aged 50-69 years who underwent isolated AVR, the patients who received bioprosthetic valves showed similar cardiac mortality-free survival and long-term survival rates to the patients who received mechanical valves. [ABSTRACT FROM AUTHOR]

The current study investigated the effects of a game-based intervention on cognitive function and mood for older adults in South Korea. In a nonrandomized controlled, pretest-posttest study, sixteen older adults were allocated to an intervention or control group. The intervention group received the 10-week cognitive training using Happy Table. The game-based cognitive training intervention significantly improved cognitive function and memory loss, whereas the control group maintained a similar level of impairment. However, there were no significant changes in anxiety and depression for both groups. The implementation of game-based intervention may be promising for improving cognitive abilities for older adults. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the clinical implications and prognostic value of artificial intelligence (AI)-based results for chest radiographs (CXR) in coronavirus disease 2019 (COVID-19) patients. Patients who were admitted due to COVID-19 from September 2021 to March 2022 were retrospectively included. A commercial AI-based software was used to assess CXR data for consolidation and pleural effusion scores. Clinical data, including laboratory results, were analyzed for possible prognostic factors. Total O2 supply period, the last SpO2 result, and deterioration were evaluated as prognostic indicators of treatment outcome. Generalized linear mixed model and regression tests were used to examine the prognostic value of CXR results. Among a total of 228 patients (mean 59.9 ± 18.8 years old), consolidation scores had a significant association with erythrocyte sedimentation rate and C-reactive protein changes, and initial consolidation scores were associated with the last SpO2 result (estimate −0.018, p = 0.024). All consolidation scores during admission showed significant association with the total O2 supply period and the last SpO2 result. Early changing degree of consolidation score showed an association with deterioration (odds ratio 1.017, 95% confidence interval 1.005–1.03). In conclusion, AI-based CXR results for consolidation have potential prognostic value for predicting treatment outcomes in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Patients with cartilage invasion in hypopharyngeal squamous cell carcinoma (HPSCC) would benefit from partial laryngopharyngectomy (PLP). The purpose of this study was to examine the treatment outcomes of PLP for HPSCC with cartilage invasion, with a focus on the oncological safety and the function preservation. We performed a retrospective review of 28 patients with HPSCC with thyroid or cricoid cartilage invasion who had undergone upfront surgery and were followed for more than one year between 1993 and 2019. Twelve patients treated with PLP (42.9%) and 16 patients treated with total laryngopharyngectomy (TLP) for cartilage invasion in HPSCC were identified. There was no significant difference in recurrence between the PLP group (7/12, 58.3%) and the TLP group (8/16, 50.0%) (p =.718). PLP was not associated with decreased five-year disease free survival (p =.662) or disease specific survival (p =.883) rates compared to TLP. Nine patients receiving PLP could be decannulated and retained intelligible speech (9/12, 75%). Gastrostomy tubes were placed in the PLP group (5/12, 42.9%) and TLP group (1/16, 6.2%) (p =.057). PLP appears to be a feasible option for the treatment of thyroid or cricoid cartilage invasion in HPSCC. [ABSTRACT FROM AUTHOR]

OBJECTIVES The aim of the study was to evaluate the clinical outcomes of patients with lung cancer in whom left ventricular ejection fraction (LVEF) was reduced. METHODS A total of 9814 patients with lung cancer who underwent pulmonary resection from 2010 to 2018 were included for the study. Fifty-six (0.57%) patients had LVEFs ≤45% and we performed propensity score matching (1:3) to compare postoperative clinical outcomes and survival in 56 patients (reduced LVEF group) with those in 168 patients with normal LVEFs (nonreduced LVEF group). RESULTS The data of the reduced LVEF group and nonreduced group were matched and compared. The 30- (1.8%) and 90-day (7.1%) mortality rates were higher in the reduced LVEF group than those (0% for both 30- and 90-day mortality rates) in the nonreduced LVEF group (P  < 0.001). The estimated rates of overall survival at 5-year point were similar in the nonreduced LVEF group (66.0%) and in the reduced LVEF group (60.1%). The estimated rates of overall survival at 5-year point were almost the same between in the nonreduced and reduced LVEF groups for clinical stage 1 lung cancer (76.8% vs 76.4%, respectively), but for stages 2 and 3, they were significantly better in the nonreduced LVEF group than in the reduced LVEF group (53.8% vs.39.8%, respectively). CONCLUSIONS Lung cancer surgery for selected patients with reduced LVEFs can yield favourable long-term outcomes despite the relatively high early mortality rate. A careful patient selection and meticulous postoperative care could further improve clinical outcome with reduced LVEF. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinitis and asthma share a common inflammatory mechanism and are closely related, recognized as "one airway disease." Thus, the guidelines recommend allergic rhinitis and asthma be treated together, and leukotriene antagonists and antihistamines have been administered simultaneously; however, there are few reports of the use of combination drugs so far. Methods: The aim of the study was to evaluate the treatment effects and adverse events of Monterizine® (a combination of montelukast and levocetirizine); a total of 2,254 patients with perennial allergic rhinitis and asthma were prospectively enrolled from 60 hospitals nationwide in Korea. They were followed up for 3 (Period 1) or 6 months (Period 2). Total nasal symptom score (TNSS), satisfaction, and safety data were collected and compared to baseline. Results: TNSS scores were analyzed for 2,254 subjects. At Period 1 (n = 2,024) and 2 (n = 1,861), the scores decreased significantly from baseline (−1.20 ± 2.49 and −1.63 ± 2.78, p < 0.001). The mean quality of life (QoL) was significantly improved at Period 1 and 2 relative to baseline (−3.75 ± 6.58, −4.83 ± 7.11, both p < 0.0001). There were no serious adverse drug reactions, but there were some minor reactions including nasopharyngitis (2.92%), rhinitis (0.37%), and somnolence (0.34%). Conclusions: TNSS score and QoL were significantly improved by 3–6 months' treatment with Monterizine without significant adverse reactions. These results indicate that Monterizine, as a combination drug, is effective and safe for improving nasal symptoms and quality of life in patients with allergic rhinitis who also have asthma. [ABSTRACT FROM AUTHOR]

Introduction: We evaluated the radiologic and clinical outcomes of a lateral incision single plate with and a single-incision double plating in elderly patients with osteoporotic distal femoral fractures. Materials and methods: We performed a retrospective study of 82 cases of distal femoral fractures from May 2004 to June 2018. Group A consisted of 42 patients who underwent single-plate fixation. Group B consisted of 40 patients who underwent double-plate fixation. The mean patient age was 77 years (67–87 years) and 76 years (64–86 years) in groups A and B, respectively. All patients were evaluated for procedure duration, time to union, range of knee motion, Lysholm knee score, and presence of complications. Results: The average procedure time was 81 min (66–92 min) and 110 min (95–120 min) in groups A and B, respectively (p = 0.33). One case in group B required bone grafting after 5 months. The average time to union was 14 weeks (9–19 weeks) and 12.2 weeks (8–19 weeks) (p = 0.63), and the mean range of knee motion was 105° (90–125°) and 110.7° (90°–130°) (p = 0.37) in groups A and B, respectively. There was no significant statistical difference between the two groups in the Lysholm knee score (p = 0.44) and knee society score (p = 0.53). Conclusion: The clinical and radiological outcomes were similar in the 2 groups. In elderly patients, double plate fixation for distal femoral fractures is an useful method for several advantages such as adequate exposure, easy manipulation, anatomical reduction and stable fixation. [ABSTRACT FROM AUTHOR]

Previous studies have not compared outcomes between different percutaneous coronary intervention (PCI) strategies and lesion locations in non-left main (LM) bifurcation lesions. We enrolled 2044 patients from a multicenter registry with an LAD bifurcation lesion (n = 1551) or non-LAD bifurcation lesion (n = 493). The primary outcome was target lesion failure (TLF), a composite of cardiac death, myocardial infarction, and target lesion revascularization (TLR). During a median follow-up period of 38 months, non-LAD bifurcation lesions treated with the two-stent strategy, compared with the one-stent strategy, were associated with more frequent TLF (20.7% vs. 6.3%, p < 0.01), TLR (16.7% vs. 4.7%, p < 0.01), and target vessel revascularization (TVR; 18.2% vs. 6.3%, p < 0.01). There was no significant difference in outcome among LAD bifurcation lesions treated with different PCI strategies. The two-stent strategy was associated with a higher risk of TLF (adjusted HR 4.34, CI 1.93–9.76, p < 0.01), TLR (adjusted HR 4.30, CI 1.64–11.27, p < 0.01), and TVR (adjusted HR 5.07, CI 1.69–9.74, p < 0.01) in the non-LAD bifurcation lesions. The planned one-stent strategy is preferable to the two-stent strategy for the treatment of non-LAD bifurcation lesions. [ABSTRACT FROM AUTHOR]

Heat stimulation can promote osteoblast differentiation and bone formation. Combining photothermal therapy and chemotherapy is an effective strategy for treating rheumatoid arthritis (RA). Herein, we prepared chitosan/gelatin/β-glycerophosphate-melanin-methotrexate (CMM) hydrogel that could be used to perform simultaneous chemotherapy and photothermal therapy for patients with RA. The CMM solution was successfully converted to a gel state at body temperature. Due to intrinsic photothermal properties of melanin, CMM hydrogel exhibited effective temperature increase both in vitro and in vivo with increasing time of near-infrared (NIR) laser irradiation. After NIR laser irradiation, 50 % of methotrexate was rapidly released from the hydrogel within 3 h. Its release rate showed an instantaneous increase with additional NIR laser irradiation. After CMM hydrogel was injected directly into the paw joint of each collagen-induced arthritis (CIA) mouse followed by irradiation with a NIR laser (808 nm, 0.5 W/cm2, 3 min), swelling and redness at the inflamed area were significantly alleviated at 14 days after treatment. Micro-CT analysis confirmed that treated joints of mice were similar to normal joints. Hence, CMM hydrogel could be used as an attractive RA therapeutic agent for simultaneous chemo-photothermal therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: TERT promoter mutation has recently emerged as a promising prognostic biomarker for aggressive papillary thyroid cancer (PTC), along with BRAF B600E mutation. The prevalence of the TERT promoter mutations has been reported as relatively uncommon in Asian countries. We report on a prospective study of the TERT promoter and BRAF V600E mutation in the largest number of subjects with PTC in Korea. We assume that our specific clinical settings and the favorable healthcare environment in Korea led to several distinct findings: the lowest prevalence of TERT promoter mutation ever reported, multifocal gene mutations in bilateral PTCs, and more early-stage papillary microcarcinomas included in this study. This study indicates that relevant evaluation and treatment strategies should be investigated continuously based on different circumstances. Telomerase reverse transcriptase (TERT) promoter mutation has been investigated for its clinical and prognostic significance in aggressive papillary thyroid cancer (PTC). In this study, we aimed to assess the prevalence, clinicopathologic features, and treatment outcomes of TERT mutation-positive PTCs along with the common BRAF V600E mutation. We performed mutational analyses for BRAF and the TERT promoter in thyroid cancer patients who had undergone surgery at our institution since 2019. We reviewed and analyzed 7797 patients with PTC in this study. The prevalence of BRAF V600E and TERT promoter mutations was 84.0% and 1.1%, respectively. Multifocal gene mutations in bilateral PTCs were identified. TERT promoter mutations were associated with older age, larger tumor size, tumor multifocality, tumor variants, advanced stages, more adjuvant radioactive iodine treatment (RAI), higher stimulated serum thyroglobulin level before RAI, and more uptakes in the regions outside the surgical field on a post-RAI whole-body scan. The coexistence of BRAF V600E and TERT promoter mutations exacerbated all clinicopathologic characteristics. The frequency of TERT promoter mutations was the lowest in this study, compared to previous studies. TERT promoter mutations consistently correlated with aggressive PTCs, and the synergistic effect of both mutations was evident. Specific clinical settings in our institution and in Korea may have led to these distinctive results. Prospective multicenter studies with longer follow-up periods are required to establish valuable oncologic outcomes. [ABSTRACT FROM AUTHOR]

A correction is presented to the article correcting the author's name from Bo-Ram Lee to Boram Lee.

Orthodontic treatment increasingly involves transparent aligners; however, biomechanical analysis of their treatment effects under clinical conditions is lacking. We compared the biomechanical efficacy and effectiveness of orthodontic treatment with transparent aligners and of fixed appliances in simulated clinical orthodontic treatment conditions using orthodontic finite element (FE) models. In the FE analysis, we used Model Activation/De-Activation analysis to validate our method. Fixed appliances and 0.75-mm and 0.5-mm thick transparent aligners were applied to a tooth-alveolar bone FE model with lingually-inclined and axially-rotated central incisors. Compared to the fixed appliance, the 0.75-mm and 0.5-mm transparent aligners induced 5%, 38%, and 28% and 21%, 62%, and 34% less movement of the central incisors and principal stress of the periodontal ligament and of the alveolar bone, respectively, for lingual inclination correction. For axial-rotation correction, these aligners induced 22%, 37%, and 40% and 28%, 67%, and 48% less tooth movement and principal stress of the periodontal ligament and of the alveolar bone, respectively. In conclusion, transparent aligners induced less tooth movement, it is sufficient for orthodontic treatment, but 0.5-mm aligners should be used for only mild corrections. Additionally, the Model Activation/De-Activation analysis method is suitable for FE analysis of orthodontic treatment reflecting clinical treatment conditions. [ABSTRACT FROM AUTHOR]

Background: Non-unions of clavicle fracture after conservative treatment have been treated surgically, but carry a risk of complications. The aim of this study is to report the outcomes of non-operative treatment for patients with non-union of fractures of the mid-shaft of the clavicle following initial conservative treatment. Methods: This is a retrospective study done at a single centre. Subjects with non-union after conservative treatment of clavicle mid-shaft fractures between March 2004 and February 2019 were included in this study. The exclusion criteria included follow-up period <1 year after the diagnosis of non-union and concomitant upper extremity injury. Final radiographs were assessed for fracture healing, vertical displacement, and shortening. Visual analog scale (VAS) pain scores, shoulder range of motion (ROM) and self-rated outcomes were obtained. Results: Fourteen patients (five females) with an average age of 58 (range, 29–76) years and a mean follow-up duration of 4.0 (range, 1.5–10.2) years were included in the study. The average vertical fracture displacement was 188.7 (range, 95.4–301.4) percent and the average shortening was 13.2 (range, 2.7–16.9) percent. The average VAS pain score was 0.21 (range, 0–2) points. There was no significant difference in the ROM between the injured and uninjured shoulder (p = 0.715 for forward flexion, 0.070 for abduction and 0.714 for external rotation) and the Constant shoulder score (p = 0.190). Thirteen of the 14 patients were satisfied with the treatment, and 12 returned to their pre-injury level of sports participation. Conclusions: Non-operative treatment resulted in a favourable outcome for patients with non-union of clavicle fracture after conservative treatment. Self-rated outcome score was excellent, regardless of the presence of radiographic abnormalities. Level of Evidence: Level IV (Therapeutic) [ABSTRACT FROM AUTHOR]

Patients with locally advanced HPV-positive tonsil cancer would benefit from prophylactic contralateral neck dissection (pCND). The aim of this study was to analyze rates of contralateral lymph node metastases (LNM) and their prognostic effects on locally advanced HPV-positive tonsillar squamous cell carcinoma. Medical records of 54 patients who underwent upfront primary surgery and pCND were retrospectively reviewed. Six (11.1%) patients had contralateral LNM in 54 locally advanced HPV-positive tonsil cancer. Of these, five patients had contralateral level II LNM and one patient had contralateral level II and III LNM. Contralateral LNM showed significant positive correlations with advanced T stage (p =.017) and the presence of extracapsular spread (p =.007). Contralateral lymph node metastasis had no significant association with five-year disease-specific survival. This study demonstrated no advantage in performing pCND in early stage HPV-positive tonsil cancer. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the efficacy and adverse effects of uterine artery embolization (UAE) to treat postpartum hemorrhage (PPH) and determine the factors associated with clinical outcomes. This study included 117 patients who underwent UAE for PPH between January 2010 and November 2018. Their medical records were retrospectively reviewed to assess the mode of delivery, causes of bleeding, detailed laboratory results, clinical outcomes, time from delivery to UAE, and embolizing material used. The clinical UAE success rate was 99.1%. Late complications were found in 11 patients. Two total hysterectomies were performed. Most PPH cases treated with UAE had early-onset PPH caused by uterine atony. Late-onset PPH was caused by placenta-related problems (remnant placenta, placenta accreta). Body mass index, cesarean section, the use of mixed embolizing materials, placenta abruption as the cause of PPH, and transferred patients were associated with uterine necrosis. Age, re-embolization, and the use of mixed embolizing materials were associated with adverse complications. Although UAE is a safe and effective way to manage PPH, a long-term follow-up is needed to determine the complications of UAE. When uterine necrosis is suspected, prompt and adequate treatment should be performed due to the effects of necrosis on menstrual cycles, fertility, and subsequent pregnancies. [ABSTRACT FROM AUTHOR]

Objectives: Soy and hop extracts have been investigated as alternatives for hormone replacement therapy. However, their combined efficacy is not known. We investigated the efficacy and safety of a combined soy and hop extract on postmenopausal symptoms. Design: Double-blinded, randomized controlled trial. Settings/Location: Gynecological outpatient clinic of tertiary hospital. Subjects: Seventy-eight women with moderate or severe menopausal symptoms assessed as modified Kupperman Menopoausal Index (KMI) scores >20. Interventions: They received either a combined soy and hop extract (n = 38) or placebo (n = 40). Outcome measures: Menopausal symptoms were evaluated through self-reporting of modified Kupperman Menopausal Index (KMI) scores at baseline and after 6 and 12 weeks. We assessed serum levels of bone metabolism biomarkers, ultrasonographic parameters, hormone profiles, compliance, and safety. Results: After 12 weeks of the treatment, treatment group scores decreased by 20.61 points compared with 14.80 points in the placebo group (p < 0.05). Fatigue, paresthesia, arthralgia, and myalgia, palpitation and vaginal dryness significantly improved more in the treatment group compared with the placebo group after 12 weeks (p < 0.05). Urine N-telopeptide in participants ≥50 years in the treatment group showed a reduced increase. Endometrial thickness and hormonal profiles did not show significant changes in either group. No serious adverse events were reported. Conclusion: The results suggest that 190 mg of combined soy and hop extract is safe and effective for improvement of menopausal symptoms. CRIS No.: KCT0006019. [ABSTRACT FROM AUTHOR]

During constipation, indigestible foods, such as probiotics, prebiotics, and dietary fiber, may improve the bowel environment and activity. In this randomized, double-blind, and placebo-controlled study, the effects of ID-HWS1000, composed of Lactobacillus and Bifidobacterium species, xylooligosaccharide, and dietary fiber, were evaluated to determine whether it improves the perception of bowel activity or cause changes in the gut microbiome. Thirty Korean adults with "functional constipation" according to the Rome III criteria were randomly assigned to the following groups: 20 in the ID-HWS1000 group and 10 in the placebo group. ID-HWS1000 or the placebo was consumed by the participants for 4 weeks. To assess the changes in the perception of bowel activity, clinical data and gut microbiome analyses were conducted before and after the experiment. There were significant differences between the groups in the response to 9 of the 12 survey questions (the number and duration of bowel movements, amount of feces, number of irritant bowel movements, number of times bowel movements felt incomplete, shape of the feces, amount of gas in the gut, discomfort after defecation, and discomfort owing to constipation) (P < .05). There was a decrease in the proportion of Firmicutes (Ruminococcaceae and Lachnospiraceae) and an increase in Bacteroidetes (Bacteroidaceae) (P < .05). Moreover, ID-HWS1000 directly improved the discomfort associated with bowel movements, decreased the proportion of Lachnospiraceae, and increased the proportion of Bacteroidaceae. These results confirmed that ID-HWS1000 improves the perception of bowel activity and exerts positive changes in individuals with functional constipation. [ABSTRACT FROM AUTHOR]

The effects of the Cichorium intybus root extract (Cii) on alcohol-induced liver disease were investigated using Chang liver cells and male Sprague Dawley rats. Silymarin, a liver-protective agent, was used as a positive control. In cell experiments, after 24 h of treatment with the extract, no cytotoxicity was noted, and death by alcohol was avoided. Migration of Chang liver cells increased after exposure to the extract at a concentration of 400 μg/mL. In animal experiments, alcohol was injected into 6-week-old rats for 1, 3, and 50 days. Oral administration of the drug was performed 30 min before alcohol administration. The control was treated with distilled water, and the drug groups were administered EtOH (40% EtOH + 2.5 mL/kg), EtOH + Cii L (low concentration, 2 mg/kg), EtOH + Cii H (high concentration, 10 mg/kg), or EtOH + silymarin (100 mg/kg). Increased liver weight was observed in the alcohol group, as were increased blood-alcohol concentration and liver damage indicators (glutamic oxalacetic transaminase (GOT), glutamic pyruvate transaminase (GPT), and triglycerides (TG)), decreased alcoholysis enzymes (ADH and ALDH), and increased CYP2E1. In the Cii treatment group, liver weight, blood-alcohol concentration, liver damage indicators (GOT, GPT, and TG), and CYP2E1 were decreased, while alcoholysis enzymes (ADH and ALDH) were increased. The degree of histopathological liver damage was compared visually and by staining with hematoxylin and eosin and oil red O. These results indicated that ingestion of Cii inhibited alcohol-induced liver damage, indicating Cii as a useful treatment for alcohol-induced liver injury. [ABSTRACT FROM AUTHOR]

Low treatment participation impedes successful treatment completion and reduces treatment effectiveness. This study explored relationships among treatment participation rate and individuals' symptom severities and employment statuses. A sample of 106 individuals with substance use disorders was recruited for cross-sectional investigation. Individuals who were employed at baseline or had lower symptom severities of baseline alcohol, drug use, and psychiatric issues had significantly higher treatment participation rates. Service providers should pay more attention to individuals' symptom severities and employment to encourage treatment participation. Integrated interventions including vocational services and illness management and recovery intervention could be provided to reduce individuals' symptom severities and increase employability. Implications of participation in substance abuse treatment are discussed. [ABSTRACT FROM AUTHOR]

Background: Suicide is a major cause of death in many countries, and previous suicidal attempt is known to be the predictor of future suicide. Korea is considered one of the countries with the highest suicide rate among the Organisation for Economic Co-operation and Development (OECD) members for over a decade. We aimed to investigate the epidemiologic characteristics of hospitalised patients after suicidal acts in Korea.Methods: Data from the Korean National Hospital Discharge In-depth Injury Survey were analysed, and patients older than 9 years admitted to nationwide hospitals after suicidal acts from 2005 to 2016 were included. Their epidemiologic characteristics were explored, and we divided them into groups according to suicidal means (injury vs. poisoning) and treatment outcome (good vs. poor). The association of each characteristic with injury as suicidal means and with poor treatment outcome were explored.Results: The sample included 7609 patients (corresponding to 227,571 in national population). More patients were female than male, and most were in their 40s in both sexes. Hospitalisation rate peaked in patients older than 80 years for both sexes. Male and young patients aged 10-19 years and capital residents showed relatively higher odds of choosing injury as suicidal means. Males and patients aged 40-64 and ≥65 years showed relatively higher odds of poor treatment outcome.Limitations: Some suicide attempters were excluded from the survey such as those who did not visit a hospital after the suicide attempt.Conclusions: This epidemiologic feature of suicide attempters might serve as baseline data for preventive policies regarding suicide. [ABSTRACT FROM AUTHOR]

Having a child with cancer affects the dyadic relationship between caregivers and the child. This study focused on changes in parenting and discipline among mothers after their child was diagnosed with cancer. We used semistructured interviews to explore 20 mothers' experiences of parenting a child who had been diagnosed with cancer during the prior 5 years and before the age of 19 years in South Korea. Thematic analysis yielded five themes related to parenting changes: parental overprotection, increased parental permissiveness, use of threats to ensure compliance, concern for the child's stress levels, and mothers' confusion about optimal parenting. All mothers reported uncertainty and concern regarding how best to parent their sick child to ensure optimal health outcomes. The findings inform best practices for integrating medical and mental health care to support optimal maternal parenting and encourage optimal health outcomes for children with cancer. [ABSTRACT FROM AUTHOR]

Background: Intratympanic gentamicin injection (ITG) is a well-accepted means to treat intractable Meniere's disease (MD). Aims/Objectives: To investigate change of vestibule-ocular reflex (VOR) gain and pure-tone threshold after low-dose ITG for MD. Methods: Sixteen patients with definite MD who were treated by low-dose ITG were retrospectively reviewed. We defined VOR gain difference as an amount of decreased gain in video head impulse test one month after ITG. Patients were classified into two groups: single injection vs. multiple injections. Multiple injections group was composed of patients with poor vertigo control after initial ITG who required second or third ITG later in follow up period. Results: VOR gain differences of both horizontal and posterior canal plane were higher than those of anterior canal plane. Between two groups, mean VOR gain difference of horizontal canal plane in multiple injections group was lower than that in single injection group. Only two patients showed increased pure-tone threshold more than 10 dB. Conclusion and significance: Our results suggest that ITG appears to cause a differential loss of function across three semicircular canals. Furthermore, if VOR gain difference of horizontal canal is relatively low after initial ITG, patient might have poor vertigo control and be required another ITG. [ABSTRACT FROM AUTHOR]

Background: Transcanal endoscopic ear surgery (TEES) for traumatic ossicular injuries (TOI) is not well studied. Objectives: To analyze the treatment outcomes of TEES for TOI. Material and methods: Retrospective case review of fifteen patients (15 ears) with TOI was performed. The patients underwent an either ossiculoplasty or stapes surgery according to status of the ossicular chain using ear endoscopes. Postoperative audiometric results and complications were analyzed. Results: All subjects demonstrated improvement in their air conduction threshold and air-bone gap (ABG). The mean preoperative air conduction threshold and ABG were 55.3 dB (SD: 12.8) and 33.0 dB (SD: 9.5), respectively. Postoperatively, the air conduction threshold and ABG significantly improved to 28.1 dB (SD: 16.0) and 8.1 dB (SD: 4.5), respectively. Separation of the incudomalleolar joint accompanied by defect of the tegmen, which was not discernible on preoperative imaging, could be identified without additional incision or mastoidectomy. No patients experienced complications or a sensorineural hearing loss. Conversion to open approach was not necessary for any of the 15 procedures performed. Conclusion and significance: TEES for TOI yielded favorable audiometric results without any complication. TEES can provide an alternative method to manage TOI with the advantage of avoidance of skin incisions and mastoidectomy. [ABSTRACT FROM AUTHOR]

Exergames are a form of active video game sometimes used to improve physical and cognitive functions and decrease stress levels for persons participating in various types of rehabilitation. This study reviewed exergame research articles published between January 1980 and August 2016 for their potential benefits to mental health. Based on the inclusion-exclusion criteria, 17 studies were selected. Due to moderate to high effect sizes, results show that exergames are a potentially useful tool in some therapeutic treatments for individuals with mental health disorders, although methodological limitations reflect the need for more comprehensive and focused studies. Evidence-based articles are categorized for their potential applications to mental health settings, and the games themselves are briefly described. [ABSTRACT FROM AUTHOR]

Introduction: Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture.Materials and Methods: Nineteen patients with periprosthetic femoral shaft fractures around well-fixed stemmed implants were studied between August 2012 and December 2014. Patients were followed up for at least 1 year postoperatively. Median age was 74 years (range 56-96 years). Fractures were classified according to the Unified Classification System, Vancouver classification, and Su classification.Procedure: Open reduction was performed under minimal incision and the locking plate was fixed to the lateral cortex of the femoral shaft. The part of the shaft without a stem was fixed to the plate using 5.0-mm locking screws, and the part with an underlying stem was fixed using 3.5-mm locking screws through the LAP instead of cables. Postoperatively, patients were managed using general principles for femoral shaft fractures.Results: Average follow-up was 16 months (range 12-36 months). All cases achieved fracture healing without loss of reduction. There were no cases of implant breakage or stem loosening at final follow-up. The average number of LAPs per fixation construct was 2.1 (range 1-4), and the average number of 3.5-mm locking screws through each LAP was 3.3 (range 2-4). The average value of plate screw density was 0.55 (range 0.37-0.8), and the average working length was four holes (range 2-8).Conclusions: Using the LAP to manage periprosthetic fractures with a well-fixed stem could obviate the need for cable around the stem area and yield acceptable outcomes. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy of butterfly inlay cartilage tympanoplasty and compare it with conventional underlay cartilage tympanoplasty in terms of success rate and hearing outcomes.Materials and Methods: The study included 35 patients (36 ears) who underwent butterfly inlay cartilage tympanoplasty (inlay group, 23 ears of 22 patients) or conventional underlay cartilage tympanoplasty (underlay group, 13 ears). The anatomical success rate and hearing outcomes were analysed.Results: Re-perforation occurred in 2 cases (8.7%) in the inlay group and 3 (23.1%) in the underlay group. One patient in the inlay group developed a serious infection, and one in the underlay group developed massive granulation of the tympanic membrane. In the inlay group, the air-bone gap (ABG) decreased from 19.9 (±12.6) dB HL preoperatively to 13.8 (±11.3) dB HL postoperatively (p=0.047), in the underlay group, it decreased from 23.5 (±15.8) dB HL to 18.3 (±20.6) dB HL. Regarding improvement in ABG, the difference between the group was not statistically significant (p=0.968).Conclusion: Butterfly inlay cartilage tympanoplasty is comparable with conventional underlay cartilage tympanoplasty in both anatomic and audiological success rates. Owing to its simplicity, shorter operation time, and rapid patient recovery, butterfly inlay cartilage tympanoplasty could be considered a favourable surgical option. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of tumor necrosis factor inhibitor (TNFi) treatment and inflammation control on radiographic progression in early ankylosing spondylitis (AS) over 4 years. Methods: We included a total of 215 patients with early AS (symptom duration <10 years) treated with TNFi (the TNFi group; n = 135) or with nonsteroidal antiinflammatory drugs (NSAIDs) (the control group; n = 80). Two blinded readers assessed radiographic progression using the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Inflammation control was inferred from C‐reactive protein (CRP) levels time‐averaged between 2 radiologic assessments. Linear mixed modeling was used to estimate mSASSS changes over radiographic intervals as well as the impact of clinical factors on outcomes. Results: The TNFi group had longer disease duration, a higher baseline CRP level, and a higher Bath Ankylosing Spondylitis Disease Activity Index than did controls. The time‐averaged CRP level over radiographic intervals was lower with TNFi treatment than with NSAID treatment (mean ± SD 0.27 ± 0.30 mg/dl versus 0.61 ± 0.68 mg/dl; P < 0.001). Overall, mean ± SD mSASSS change over the 2‐year interval was 1.30 ± 2.97 units. In the multivariable model adjusted for age, smoking status, baseline CRP level, and the presence of syndesmophytes at baseline, the TNFi group showed less mSASSS change over the 2‐year interval (β = −0.90 [95% confidence interval {95% CI} −1.51, −0.29]). However, when a time‐averaged CRP level was additionally included, it significantly influenced the mSASSS change (β = 1.02 [95% CI 0.32, 1.71]), decreasing the estimated group difference (β = −0.52 [95% CI −1.17, 0.14]). NSAID indices of both groups were not associated with either time‐averaged CRP levels or mSASSS changes. Conclusion: Effective suppression of inflammation by TNFi treatment decreases radiographic progression in early AS. [ABSTRACT FROM AUTHOR]

Background: Robotic modified radical neck dissection (MRND) using a gasless transaxillary approach has been reported to be a safe and meticulous technique in patients with papillary thyroid carcinoma (PTC) and lateral neck node metastasis (N1b). Few studies, however, have attempted to assess the long-term oncologic outcomes of robotic MRND in these patients. This study aimed to compare perioperative and 5-year oncologic outcomes of robotic MRND with conventional open procedures in patients with N1b PTC.Methods: Between September 2007 and February 2010, 193 patients with N1b PTC underwent total thyroidectomy and MRND by a single surgeon. Of these, 42 (21.8 %) underwent robotic procedures and 151 (78.2 %) underwent conventional open procedures. All patients received 3.7- to 5.5-GBq radioactive iodine (RAI) ablation, post-therapy whole-body scans (TxWBSs), and diagnostic WBS (DxWBSs) during follow-up. An exact 1:3 matching for age and stage was performed to minimize selection bias, and perioperative and 5-year oncologic outcomes were compared in the matched groups.Results: The mean follow-up period was 66.0 months (range 60-90 months). Number of retrieved cervical lymph nodes (LNs) (p = .102) and postoperative ablation success rates (p = .864) were similar between the two groups. TSH-suppressed serum Tg concentrations after 5 years (0.7 ± 1.5 vs. 2.4 ± 14.1 ng/ml; p = .471) and recurrence rates in the robotic and open groups (1/41 [2.4 %] vs. 3/102 [2.9 %]; p = .864) were similar for the 5-year follow-up period. Four patients experienced recurrence: Three exhibited regional lymph node metastasis, and one showed bilateral lung metastases.Conclusion: The perioperative and 5-year oncologic outcomes were similar after robotic and conventional open MRND. Large, prospective randomized controlled trials with long-term follow-up data are needed to validate these results. [ABSTRACT FROM AUTHOR]

Background: Many studies advocate hormonal treatments including high-dose oral prednisolone as an effective treatment for epileptic spasms. However, little is known about the effects of intravenous methylprednisolone pulse therapy on infantile spasms. We investigated the short-term response to intravenous methylprednisolone pulse therapy for the treatment of infantile spasms.Methods: Patients with newly diagnosed infantile spasms and hypsarrhythmia on electroencephalography (EEG) at two tertiary centers in Korea were included. Patients received intravenous infusions of 30 mg/kg/day methylprednisolone for three days with tapering doses of oral prednisolone for two to four weeks for the treatment of infantile spasms. Response to methylprednisolone pulse therapy was evaluated by seizure frequency and follow-up EEG within three weeks.Results: Fourteen patients were sudied. The mean age at the onset of spasms was 7.0 months (range, 2.0 to 11.0 months). Etiological factors included structural abnormalities (N = 11), chromosomal anomaly (N = 1), and unknown (N = 2). Nine of 14 participants (64.3%) demonstrated complete freedom from spasm and resolution of hypsarrhythmia on EEG within 3 weeks; however, only five of nine responders (55.5%) remained free of spasms after the discontinuation of oral steroids. Adverse effects, including irritability or infection, were observed in four patients but were tolerable in all.Conclusions: Short-term methylprednisolone pulse therapy for the treatment of infantile spasms or hypsarrhythmia demonstrated rapid improvement in EEG and cessation of spasms without serious adverse effects. Further studies are needed to determine the long-term effects of spasm control. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the long-term efficacy of vagus nerve stimulation (VNS) in children and adolescents with intractable epilepsy and identify predictive factors for responsiveness to VNS. Methods: Medical records of pediatric patients who underwent VNS implantation at two Korean tertiary centers were reviewed. At 0.5, 1, 3, and 5 years post-VNS implantation, the frequency of the most disabling seizures in each patient was assessed. Responders were defined as showing an overall 50 % reduction from baseline seizure frequency during follow-up. The clinical characteristics of responders and non-responders were compared. Results: Among 58 patients, approximately half (29/58) were responders. The mean age at implantation was 10.9 years (range, 2.7-20.9) and the mean follow-up duration after VNS implantation was 8.4 years (range, 1-15.5). At 0.5, 1, 3, and 5 years after implantation, 43.1, 50.0, 56.9, and 58.1 % of patients exhibited ≥50 % seizure frequency reduction disabling seizures. The patients with focal or multifocal epileptiform discharges were more likely to be responders than those with generalized epileptiform activities by video or conventional EEG at the time of VNS implantation (Pearson's and χ test, p = 0.001). No other clinical variables were found to be associated with seizure outcomes. Wound infections caused VNS removal in two cases. All other adverse events, including cough and hoarseness, were tolerable. Conclusion: VNS is a well-tolerated and effective adjuvant therapy in pediatric patients with intractable epilepsy. Notably, patients with focal epileptiform discharges alone rather than those with generalized epileptiform discharges maybe better candidates for VNS. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare and evaluate, through histomorphometric and radiological analysis, the effects of UV photofunctionalization on an implant placed over a critical defect area with and without a bone graft. Four female beagle dogs were first divided into control and bone graft groups. Each group was then subdivided into UV-treated and UV-untreated groups. The mandibular premolars in each dog were extracted. 12 weeks after extraction, implants were placed according to the condition of each group. Four and 12 weeks after implantation on left and right mandible, the dogs were sacrificed. The specimens were prepared for histomorphometric and micro-computed tomographic analysis. In both 4-week and 12-week groups, UV-treated implant surfaces showed better osseointegration than SA implant surfaces. Also, with implant surfaces placed over the critical defect with bone graft, UV photofunctionalization increased bone-to-implant contact (BIC) and new bone formation at the initial stage (4 weeks). Based on the results of this study, it can be suggested that UV photofunctionalization on the surface of implants placed over large critical defects with bone graft aids initial osseointegration and osteogenesis. [ABSTRACT FROM AUTHOR]

Hyeonggaeyeongyo-tang (HYT) is an ancient formula of oriental medicine traditionally used to treat rhinitis; however, clinical evidence has not yet been established. The aim of this study was to investigate the short-term and long-term efficacy and safety of HYT for chronic rhinitis. Adult subjects with chronic rhinitis symptoms were recruited. The subjects received HYT for 4 weeks and had follow-up period of 8 weeks. Any medicines used to treat nasal symptoms were not permitted during the study. The skin prick test was performed to distinguish the subjects with allergic rhinitis from those with nonallergic rhinitis. After treatment, the total nasal symptoms score and the Rhinoconjunctivitis Quality of Life Questionnaire score significantly improved in the whole subject group, in the allergic rhinitis group, and in the nonallergic rhinitis group, with no adverse events. This improvement lasted during a follow-up period of 8 weeks. Total IgE and eosinophil levels showed no significant difference after treatment in the allergic rhinitis group. HYT improved nasal symptoms and quality of life in patients with allergic rhinitis and nonallergic rhinitis. This is the first clinical study to evaluate the use of HYT to treat patients with rhinitis. This trial has been registered with the ClinicalTrials.gov Identifier NCT02477293. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effectiveness of chemocauterization using trichloroacetic acid with or without suturing for the small tracheocutaneous fistula closure Methods: The Seoul National University Hospital database was analyzed retrospectively for 55 patients with a small tracheocutaneous fistula measuring less than 5 × 5 mm2. Of these, 39 patients were treated by chemocauterization only, and 16 patients were treated by chemocauterization with suturing. Demographic, perioperative data, and treatment outcomes were evaluated for all patients. Results: The success rate of single trial was 56.4% (31/55), and the final success rate after repeated procedures if indicated was 80.0% (44/55). There were no statistically significant differences in age, sex, cannulation period, fistula size, presence or absence of maturation suture during tracheostomy, number of procedures, and success rates. Interval between decannulation and procedure was significantly different among 2 groups. Conclusions: Trichloroacetic acid chemocauterization could be a simple, noninvasive, and safe method to close small tracheocutaneous fistula. [ABSTRACT FROM AUTHOR]

Background: Invasive fusariosis mainly affects immunocompromised patients including haematopoietic stem cell transplant recipients and those with haematologic malignancy. There are limited studies on invasive fusariosis in the Asia‐Pacific region. Objective: To describe the clinical characteristics and outcomes of invasive and non‐invasive fusariosis in South Korea. Patients/Methods: From 2005 to 2020, patients with fusariosis who met the revised European Organisation for Research and Treatment of Cancer and the Mycoses Study Group criteria for the definition of proven or probable invasive fusariosis, and those with non‐invasive fusariosis were retrospectively reviewed in a tertiary medical centre in Seoul, South Korea. Results: Overall, 26 and 75 patients had invasive and non‐invasive fusariosis, respectively. Patients with invasive fusariosis commonly had haematologic malignancy (62%), were solid organ transplant recipients (23%), and had a history of immunosuppressant usage (81%). In non‐invasive fusariosis, diabetes mellitus (27%) and solid cancer (20%) were common underlying conditions. Disseminated fusariosis (54%) and invasive pulmonary disease (23%) were the most common clinical manifestations of invasive fusariosis; skin infection (48%) and keratitis (27%) were the most common manifestations of non‐invasive fusariosis. Twenty‐eight‐day and in‐hospital mortalities were high in invasive fusariosis (40% and 52%, respectively). In multivariate analysis, invasive fusariosis (adjusted odds ratio, 9.6; 95% confidence interval 1.3–70.8; p =.03) was an independent risk factor for 28‐day mortality. Conclusions: Patients with invasive fusariosis were frequently immunocompromised, and more than half had disseminated fusariosis. Invasive fusariosis was associated with poor prognosis. [ABSTRACT FROM AUTHOR]

Background: Published studies on laparoscopic surgery for transverse colon cancer are scarce. More studies are necessary to evaluate the feasibility, safety, and long-term oncologic outcomes of laparoscopic surgery for transverse colon cancer.Subjects and Methods: From April 1996 to December 2010, 102 consecutive patients with stage II or III disease who had undergone curative resection for transverse colon cancer were enrolled. Seventy-nine patients underwent laparoscopy-assisted colectomy (LAC), whereas 23 patients underwent conventional open colectomy (OC). Short- and long-term outcomes of the two groups were compared.Results: The OC group had a larger tumor size (7.6 ± 3.4 cm versus 5.2 ± 2.3 cm, P = .004) and more retrieved lymph nodes (26.4 ± 11.6 versus 17.5 ± 9.4, P = .002), without differences in resection margins. In the LAC group, return to diet was faster (4.5 ± 1.2 days versus 5.4 ± 1.8 days, P = .013), and postoperative hospital stay was shorter (12.1 ± 4.2 days versus 15.9 ± 4.8 days, P = .000). There were no differences in occurrence of intra- or postoperative complications. There were no statistically significant differences in overall survival rate (OS) or disease-free survival rate (DFS) between the two groups (5-year OS, 90.4% versus 90.5%, P = .670; 5-year DFS, 84.2% versus 90.7%, P = .463).Conclusions: Laparoscopic surgery for transverse colon cancer has better short-term outcomes compared with open surgery, with acceptable long-term outcomes. As in colorectal cancer of other sites, laparoscopic surgery can be a feasible alternative to conventional surgery for transverse colon cancer. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether the benefits of post-resuscitative percutaneous coronary intervention (PCI) are equally observed across out-of-hospital cardiac arrests (OHCAs) with different clinical presentations. The purpose of this study was to assess the effect of PCI in outcomes of OHCA and to compare patient prognosis by history of heart disease (HD) and presentations of nonshockable vs. shockable arrest rhythm by electrocardiogram (ECG).Methods: A population-based observational study was conducted on OHCAs of cardiac etiology in Korea who survived to admission between 2009 and 2013. Multivariable logistic regression analyses were conducted to assess the associations between PCI and outcomes (favorable neurological outcome and survival-to-discharge) and to test the interaction effects of PCI with history of HD and with presence of shockable rhythm.Results: A total of 9762 OHCAs were analyzed. PCI was done in 1140 (11.7%), and neurological recovery were observed in 45.7% of the PCI group and 13.3% of the untreated group. Effects of PCI on neurological recovery were observed similarly in patients with and without history of HD (OR=2.33 (1.62-3.35) and OR=2.37 (1.95-2.89), respectively). PCI was associated with survival-to-discharge only in patients without history of HD (OR=1.80 (1.51-2.15)). PCI was associated with neurological recovery and survival-to-discharge in both shockable and nonshockable rhythms, although the estimates were relatively higher in those with nonshockable rhythms (OR for neurological recovery=2.60 (2.04-3.32); and OR for survival=1.78 (1.46-2.17)).Conclusions: This study corroborates that PCI is an advantageous treatment option for all patients with OHCA regardless of established diagnosis with HD and presentations of shockable rhythm. [ABSTRACT FROM AUTHOR]

Carbon monoxide (CO) has been regarded as a "silent killer" for its toxicity toward biological systems. However, a low concentration of endogenously produced CO has shown a number of therapeutic benefits such as anti-inflammatory, anti-proliferative, anti-apoptosis, and cytoprotective activities. Carbon monoxide-releasing molecules (CORMs) have been developed as alternatives to direct CO inhalation, which requires a specialized setting for strict dose control. CORMs are efficient CO donors, with central transition metals (such as ruthenium, iron, cobalt, and manganese) surrounded by CO as a ligand. CORMs can stably store and subsequently release their CO payload in the presence of certain triggers including solvent, light, temperature, and ligand substitution. However, CORMs require appropriate delivery strategies to improve short CO release half-life and target specificity. Herein, we highlighted the therapeutic potential of inhalation and CORMs-delivered CO. The applications of conjugate and nanocarrier systems for controlling CO release and improving therapeutic efficacy of CORMs are also described in detail. The review concludes with some of the hurdles that limit clinical translation of CORMs. Keeping in mind the tremendous potential and growing interest in CORMs, this review would be helpful for designing controlled CO release systems for clinical applications. [Display omitted] • Controlled exposure to CO has shown useful therapeutic and biological effects. • Clinical utilization of CO is challenging due to strict dose control requirement. • CORMs have been developed as alternative to direct CO inhalation. • Delivery of CORMs in nanocarriers improves CO release t 1/2 and target specificity. • This review would help to design controlled CO release systems for clinical utility. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess treatment outcomes and compliance according to obesity among groups of patients with obstructive sleep apnea (OSA) receiving different treatments. A total of 297 patients with OSA treated between 2006 and 2009 underwent pre- and post-treatment polysomnography. One hundred and fifty-one patients were treated with continuous airway positive pressure (CPAP), 76 with mandible advancement device (MAD), and 70 with oropharyngeal surgery. All patients were classified according to obesity. Treatment success rate and compliance of CPAP were analyzed according to obesity. For each treatment modality, the overall treatment success rate was not significantly different between obese and non-obese patients. However, the oxygen desaturation index was different in patients who were treated with MAD and surgery. Additionally, obese patients with severe OSA showed an unfavorable response to CPAP treatment. For CPAP compliance, obese patients showed a tendency to be highly compliant with CPAP treatment at 12 months than non-obese patients. This study showed that obesity might be a factor in determining the success or failure of treatment. Additionally, obesity may be a predictive factor to determine CPAP compliance. [ABSTRACT FROM AUTHOR]

Background: An anastomotic stricture after colorectal surgery is principally managed by endoscopic balloon dilation (EBD). Although this intervention is effective, however, subsequent procedures or surgical interventions are often required. This study aimed to assess the long-term outcomes of EBD for anastomotic stricture arising from colorectal cancer surgery. Materials and methods: We analyzed 173 patients who received curative surgery for colorectal cancer at our hospital between January 2000 and December 2022 and had undergone EBD to manage anastomotic stricture. The medical records of these cases were retrospectively reviewed to assess the outcomes and risk factors for restenosis and permanent stoma. Results: Of the 173 study patients, 41 (23.7%) presented with restenosis with a median time to recurrence of 49 [37–150] days. The restenosis group was significantly younger (55.6 years versus 60.8 years), with a more prominent rectal location (80.5% versus 57.6%), a higher incidence of hand-sewn anastomosis (24.4% versus 5.3%), and a higher percentage of neoadjuvant radiotherapy (34.1% versus 5.3%, P < 0.001). Multivariable analysis indicated neoadjuvant radiotherapy (adjusted HR 2.48; 95% CI 1.03–5.95) and cerebral vascular disease (adjusted HR 6.97; 95% CI 2.15–22.54) as independent prognostic factors for restenosis. Fourteen patients (8.1%) required a permanent stoma due to treatment failure. All cases needing a permanent stoma were male (14 patients, 100%, P = 0.007) and this group had a higher rate of neoadjuvant radiotherapy, adjuvant chemotherapy, and hand-sewn anastomosis. Conclusion: Patients receiving neoadjuvant radiotherapy are most prone to restenosis after an EBD intervention to manage an anastomotic stricture. Neoadjuvant radiotherapy is also a strong risk factor for requiring a permanent stomas due to treatment failure. [ABSTRACT FROM AUTHOR]

Purpose: The results of medial open-wedge high tibial osteotomy (MOWHTO) according to age is inconclusive. This study aimed to compare the clinical outcomes and failure of MOWHTO in patients < 55 years and > 65 years. Methods: Consecutive patients who underwent MOWHTO from July 2009 to August 2020 were retrospectively analyzed. 205 patients were considered for analysis. A 1-to-1 propensity score matched analysis to assess clinical outcomes scores including International Knee Documentation Committee (IKDC) subjective score and Lysholm score, radiologic outcomes, complication, and Total Knee Arthroplasty (TKA) conversion between patients > 65 years and patients < 55 years was performed. Radiologic outcomes included Hip-Knee-Ankle (HKA) angle, Weight Bearing Line ratio (WBLR), posterior tibial slope (PTS), and Insall-Salvati (IS) ratio before and after surgery. Results: The follow-up period was 50.4 months in patients > 65 years and 55.3 months in patients < 55 years. There was no significant difference in the preoperative and postoperative HKA angle, WBLR, PTS, IS ratio, IKDC score and Lysholm score between the two groups. The arthroscopic evaluation of cartilage did not show any statistically significant differences between the two groups. Regarding Minimal clinically important differences (MCID), in the 26% of the older group exceeded MCID of IKDC score; 45% of the older group exceeded MCID of Lysholm score. In the younger group, 24% exceeded MCID of IKDC score and 35% exceeded MCID of Lysholm score. In older group, there were 7 (11.3%) cases of TKA conversion while no TKA conversion was recorded in the younger group. (P = 0.007) The average time to TKA conversion was 67 months. (42 months to 90 months) Kaplan–Meier analysis revealed that the survival rate was 95.2% at 4 years in the older group. Conclusion: Similar clinical results were obtained in patients over 65 years of age that were eligible for MOWHTO at minimum 2-year follow-up as in patients under 55 years of age. MOWHTO may be a viable option in older patients if proper indications are met. However, the risk of TKA conversion must be considered preoperatively and discussed with patients. Study Design: Cohort study; Level of evidence, 3. [ABSTRACT FROM AUTHOR]

Background The use of assays detecting cytomegalovirus (CMV)–specific T cell–mediated immunity may individualize the duration of antiviral prophylaxis after transplantation. Methods In this randomized trial, kidney and liver transplant recipients from 6 centers in Switzerland were enrolled if they were CMV-seronegative with seropositive donors or CMV-seropositive receiving antithymocyte globulins. Patients were randomized to a duration of antiviral prophylaxis based on immune monitoring (intervention) or a fixed duration (control). Patients in the control group were planned to receive 180 days (CMV-seronegative) or 90 days (CMV-seropositive) of valganciclovir. Patients were assessed monthly with a CMV ELISpot assay (T-Track CMV); prophylaxis in the intervention group was stopped if the assay was positive. The co-primary outcomes were the proportion of patients with clinically significant CMV infection and reduction in days of prophylaxis. Between-group differences were adjusted for CMV serostatus. Results Overall, 193 patients were randomized (92 in the immune-monitoring group and 101 in the control group), of whom 185 had evaluation of the primary outcome (87 and 98 patients). CMV infection occurred in 26 of 87 (adjusted percentage, 30.9%) in the immune-monitoring group and in 32 of 98 (adjusted percentage, 31.1%) in the control group (adjusted risk difference, −0.1; 95% confidence interval [CI], −13.0% to 12.7%; P =.064). The duration of prophylaxis was shorter in the immune-monitoring group (adjusted difference, −26.0 days; 95%, CI, −41.1 to −10.8 days; P <.001). Conclusions Immune monitoring resulted in a significant reduction of antiviral prophylaxis, but we were unable to establish noninferiority of this approach on the co-primary outcome of CMV infection. Clinical Trials Registration NCT02538172. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the outcomes of proton beam therapy (PBT) and carbon ion radiotherapy (CIRT) by a systematic review and meta‐analysis of the existing clinical evidence. Methods: A systematic literature search was performed to identify studies comparing the clinical outcomes of PBT and CIRT. The included studies were required to report oncological outcomes (local control [LC], progression‐free survival [PFS], or overall survival [OS]) or adverse events. Results: Eighteen articles comprising 1857 patients (947 treated with PBT and 910 treated with CIRT) were included in the analysis. The pooled analysis conducted for the overall population yielded average hazard ratios of 0.690 (95% confidence interval (CI), 0.493–0.967, p = 0.031) for LC, 0.952 (95% CI, 0.604–1.500, p = 0.590) for PFS, and 1.183 (0.872–1.607, p = 0.281) for OS with reference to CIRT. The subgroup analyses included patients treated in the head and neck, areas other than the head and neck, and patients with chordomas and chondrosarcomas. These analyses revealed no significant differences in most outcomes, except for LC in the subgroup of patients treated in areas other than the head and neck. Adverse event rates were comparable in both groups, with an odds ratio (OR) of 1.097 (95% CI, 0.744–1.616, p = 0.641). Meta‐regression analysis for possible heterogeneity did not demonstrate a significant association between treatment outcomes and the ratio of biologically effective doses between modalities. Conclusion: This study highlighted the comparability of PBT and CIRT in terms of oncological outcomes and adverse events. [ABSTRACT FROM AUTHOR]

Rationale Accurate assessment of the degree of scaring that results from surgical intervention for breast cancer would enable more effective pre-operative counselling. The resultant scar that accompanies an open surgical intervention may be characterized by variance in thickness, colour and contour. These factors significantly impact the overall appearance of the breast. A number of studies have addressed the mechanical and pathologic aspects of scarring. The majority of these investigations have focused on the physiologic process of scar formation and means to improve the qualities of a scar. Few studies have focused on quantifying the visual impact of scars. Methods This manuscript critically reviews current methods used to assess scars in terms of overall satisfaction after surgery. We introduce objective, quantitative measures for assessing linear breast surgical scars using digital photography. These new measurements of breast surgical scars are based on calculations of contrast and area. Results and conclusions We demonstrate, using the intra-class correlation coefficient, that the new measures are robust to observer variability in annotating the scar region on clinical photographs. As an example of the utility of the new measures, we use them to quantify the aesthetic differences of reconstruction following skin-sparing mastectomy vs. conventional mastectomy. [ABSTRACT FROM AUTHOR]