Purpose: This retrospective study evaluated the effectiveness and healing outcomes of antibiotic-loaded dicalcium phosphate dehydrate/ β-tricalcium phosphate (β-TCP/DCPD) compared to antibiotic-loaded polymethylmethacrylate (PMMA) cement in the treatment of diabetic foot osteomyelitis (DFO). Materials and Methods: The study examined 31 patients diagnosed with DFO from 2019 to 2021. The participants underwent surgical debridement accompanied by systemic antibiotic therapy, applying either antibiotic-loaded PMMA beads (group P, n=20) or antibiotic-loaded β-TCP/DCPD beads (group N, n=11). The assessment criteria included the Cierny-Mader and C-M Host classification for osteomyelitis, Wagner Diabetic Foot Ulcer classification, and the parameters for nonvascular surgical treatment. Results: The healing rates were 95% and 100% in groups P and N, respectively (p=0.543). The median healing time was 18 and 19 weeks for groups P and N, respectively (p=0.094). Amputation was necessary for one patient (5%) in group P. The DFO recurrence rates were 10% and 9% in groups P and N, respectively (p=0.534). The median hospital stay was 34 and 31 days for groups P and N, respectively (p=0.634).In particular, postoperative antibiotic bead leakage occurred in 5% and 45% of groups P and N, respectively (p=0.006). Conclusion β-TCP/DCPD, as a drug delivery system, is an effective adjunct for treating deep diabetic foot infections. Nevertheless, the higher incidence of surgical site antibiotic bead leakage with β-TCP/DCPD necessitates careful consideration of its application.

Background: and PurposeMild cognitive impairment (MCI) is a condition with diverse clinical outcomes and subgroups. Here we investigated the topographic distribution of tau in vivo using the positron emission tomography (PET) tracer [18F]THK5351 in MCI subgroups. Methods: This study included 96 participants comprising 38 with amnestic MCI (aMCI), 21 with nonamnestic MCI (naMCI), and 37 with normal cognition (NC) who underwent 3.0-T MRI, [18F]THK5351 PET, and detailed neuropsychological tests. [18F]flutemetamol PET was also performed in 62 participants. The aMCI patients were further divided into three groups: 1) verbal-aMCI, only verbal memory impairment; 2) visual-aMCI, only visual memory impairment; and 3) both-aMCI, both visual and verbal memory impairment. Voxel-wise statistical analysis and region-of-interest -based analyses were performed to evaluate the retention of [18F]THK5351 in the MCI subgroups. Subgroup analysis of amyloid-positive and -negative MCI patients was also performed. Correlations between [18F]THK5351 retention and different neuropsychological tests were evaluated using statistical parametric mapping analyses. Results: [18F]THK5351 retention in the lateral temporal, mesial temporal, parietal, frontal, posterior cingulate cortices and precuneus was significantly greater in aMCI patients than in NC subjects, whereas it did not differ significantly between naMCI and NC participants. [18F] THK5351 retention was greater in the both-aMCI group than in the verbal-aMCI and visualaMCI groups, and greater in amyloid-positive than amyloid-negative MCI patients. The cognitive function scores were significantly correlated with cortical [18F]THK5351 retention. Conclusions [18F]THK5351 PET might be useful for identifying distinct topographic patterns of [18F]THK5351 retention in subgroups of MCI patients who are at greater risk of the progression to Alzheimer's dementia.

PURPOSE: To evaluate the characteristics and the risk factors of early onset subsequent vertebral compression fractures after percutaneous vertebroplasty. MATERIALS AND METHODS: A total of 44 patients, who had a new subsequent vertebral fracture after percutaneous vertebroplasty for an osteoporotic vertebral compression fracture between January 2013 and December 2015, were recruited. The patients were divided into two groups according to the onset period of subsequent fracture. The number of patients who had a fracture within 3 months following vertebroplasty were 22 cases (Group A); after 3 months were 22 cases (Group B). Variables, including age, sex, bone mineral density (BMD), body mass index (BMI), preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, injected cement volume, restoration of vertebral body height, and correction of kyphosis, in the two groups were analyzed and compared retrospectively. RESULTS: The age, sex, BMD, BMI, preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, and correction of kyphosis were similar in the two groups. Both a greater volume of bone cement injected and a greater degree of vertebral height restoration contributed significantly to the risk of fracture within 3 months. CONCLUSION: The cement volume and degree of height restoration are risk factors for early onset fracture at the adjacent vertebrae after percutaneous vertebroplasty and close attention is needed during the follow-up period.
Body Height ; Body Mass Index ; Bone Density ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphosis ; Osteoporosis ; Retrospective Studies ; Risk Factors ; Spine ; Vertebroplasty

OBJECTIVE: The aim of this study is to assess the efficacy of cognitive health promotion workbook for community-dwelling elderlies with mild cognitive impairment and dementia performed by trained dementia partners. METHODS: The trained dementia partners performed cognitive training program with the workbook developed by Incheon Metropolitan Dementia Center to 36 participants with mild cognitive impairment or dementia at their home. The cognitive training program consisted of 60-minute sessions held twice weekly for 10 weeks. We evaluated their cognitive performances at baseline and after intervention. Pre- and post-intervention measures included Korean version of Mini-Mental Status Examination for Dementia Screening (MMSE-DS), Global Deterioration Scale, Korea Activities of Daily Living Scale, Korea Instrumental Activities of Daily Living Scale, Korean Version of Short Form Geriatric Depression Scale (SGDS-K) and Korean Quality of Life-Alzheimer's Disease (KQoL-AD). RESULTS: Participants showed significant improvements compared with their baseline in MMSE-DS (p=0.002), SGDS-K (p=0.001) and KQoL-AD (p<0.001). There were no significant differences of improvement between high cognitive function group (MMSE ≤20, n=16) and low cognitive function group (MMSE ≤20, n=20). CONCLUSION: These findings suggest that the cognitive training program with cognitive health promotion workbook can improve cognitive function, quality of life and depression for community-dwelling elderlies with mild cognitive impairment and dementia and it would be efficient that trained dementia partners perform the cognitive training program regularly at their home.
Activities of Daily Living ; Cognition ; Dementia ; Depression ; Education ; Health Promotion ; Incheon ; Korea ; Mass Screening ; Mild Cognitive Impairment ; Quality of Life

BACKGROUND AND PURPOSE: Behavioral variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia, which has clinical symptoms of progressive personality and behavioral changes with deterioration of social cognition and executive functions. The pathology of bvFTD is known to be tauopathy or TDP-43 equally. We analyzed the 18F-THK5351 positron emission tomography (PET) scans, which were recently developed tau PET, in patients with clinically-diagnosed bvFTD. METHODS: Forty-eight participants, including participants with behavioral variant frontotemporal dementia (bvFTD, n=3), Alzheimer's disease (AD, n=21) and normal cognition (NC, n=24) who completed 3T magnetic resonance images, 18F-THK5351 PET scans, and detailed neuropsychological tests were included in the study. Voxel-wise statistical analysis and region of interest (ROI)-based analyses were performed to evaluate the retention of THK in bvFTD patients. RESULTS: In the voxel-based and ROI-based analyses, patients with bvFTD showed greater THK retention in the prefrontal, medial frontal, orbitofrontal, anterior cingulate, insula, anterior inferior temporal and striatum regions compared to NC participants. Left-right asymmetry was noted in the bvFTD patients. A patient with extrapyramidal symptoms showed much greater THK retention in the brainstem. CONCLUSIONS: The distribution of THK retention in the bvFTD patients was mainly in the frontal, insula, anterior temporal, and striatum regions which are known to be the brain regions corresponding to the clinical symptoms of bvFTD. Our study suggests that 18F-THK5351 PET imaging could be a supportive tool for diagnosis of bvFTD.
Alzheimer Disease ; Brain ; Brain Stem ; Cognition ; Diagnosis ; Executive Function ; Frontotemporal Dementia* ; Gyrus Cinguli ; Humans ; Neuropsychological Tests ; Pathology ; Positron-Emission Tomography ; Tauopathies

OBJECTIVE: The provision of care for elderly people with dementia by healthy elderly caregivers is one of the new health-care paradigms in South Korea. The aim of this study was to determine whether this type of care, which includes cognitive stimulation, would improve the cognitive function of dementia patients and the quality of life of the healthy elderly caregiver. METHODS: Totals of 132 dementia patients and 197 healthy elderly caregivers participated in this study. We evaluated the cognitive function of the dementia patients at baseline and after providing the program for 6 months using the Korean version of the Consortium to Establish a Registry for Alzheimer's disease, 1st Edition (CERAD-K). We also evaluated the quality of life of the healthy elderly caregivers using the World Health Organization Quality of Life-Short Version (WHOQOL-BREF) at baseline and after 6 months. RESULTS: The word-list memory results of CERAD-K for the included dementia patients improved after 6 months (Z=-2.855, p=0.004). The WHOQOL-BREF score among the elderly caregiver also improved significantly (Z=-2.354, p=0.019). CONCLUSION: These data suggest that dementia care is associated with improvements in both the cognitive function of dementia patients and the quality of life of the healthy elderly caregivers.
Aged* ; Alzheimer Disease ; Caregivers* ; Cognition ; Dementia* ; Humans ; Korea ; Memory* ; Quality of Life* ; World Health Organization

STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%–55% had NP. METHODS: Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups. RESULTS: A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP. CONCLUSIONS: NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.
Adult* ; Back Pain ; Cross-Sectional Studies ; Diagnosis ; Hospitals, General ; Humans ; Linear Models ; Low Back Pain* ; Male ; Neuralgia* ; Prevalence* ; Quality of Life ; Visual Analog Scale

OBJECTIVE: We studied the effect of Hyu-Sig-Gong-Gan and Hye-Ah-Rim on several evaluations and compared the two programs. We then investigated factors associated with the difference between pre- and post-ratings. METHODS: Thirty-six patients were randomized to Hyu-Sig-Gong-Gan (n=23) or Hye-Ah-Rim (n=13). We tested for the effect of each program on several evaluations and compared the two programs through Zarit Burden Interview (ZBI), Center for Epidemiologic Studies-Depression Scale, Dementia Attitude Scale (DAS)-intelligence, DAS-comfort and DAS-total. We then investigated whether the difference between pre- and post-rating depends on other factors. RESULTS: We observed significant positive effect of Hyu-Sig-Gong-Gan on DAS-comfort (t=1.843, p=0.039) and significant positive effect of Hye-Ah-Rim on ZBI (t=-2.327, p=0.019), DAS-comfort (t=2.241, p=0.022), and EuroQol-5 Dimensions-Visual Analogue Scale (t=2.537, p=0.013). For comparing the two programs, we found a lack of evidence for the difference in any of the five commonly observed evaluations. In the secondary analysis, we observed a strong trend that the two programs were particularly effective for caregivers with negative pre-ratings. CONCLUSION: The two programs showed positive effects on the various evaluations, but some evaluations could not reach statistical significance. The programs appear to be particularly helpful for those who are in need before the program participation.
Aged* ; Caregivers* ; Dementia* ; Humans ; Program Evaluation

Gradual mortality of look down fish (Selene vomer) was observed in a private aquarium in Seoul, showing abnormal swimming behavior and lethargy. A bacterial pathogen from kidney was cultured, identified, and confirmed as Vibrio harveyi using Vitek System 2 and 16S rRNA gene sequencing. A predominant bacterial strain, SNUVh-LW2 was proved to be most closely related to isolates from China by phylogenetic analysis with minimum evolution method. Also, tetracycline was considered as the most sensitive antibiotic agent via antibiotic usceptibility test. The group of fish was treated according to the diagnostic result and no more mortality was observed.
China ; Genes, rRNA ; Kidney ; Lethargy ; Methods ; Mortality ; Seoul ; Swimming ; Tetracycline ; Vibrio*

BACKGROUND: Sclerostin is a secreted Wnt inhibitor produced almost exclusively by osteocytes, which inhibits bone formation. Aromatase inhibitors (AIs), which reduce the conversion of steroids to estrogen, are used to treat endocrine-responsive breast cancer. As AIs lower estrogen levels, they increase bone turnover and lower bone mass. We analyzed changes in serum sclerostin levels in Korean women with breast cancer who were treated with an AI. METHODS: We included postmenopausal women with endocrine-responsive breast cancer (n=90; mean age, 57.7 years) treated with an AI, and compared them to healthy premenopausal women (n=36; mean age, 28.0 years). The subjects were randomly assigned to take either 5 mg alendronate with 0.5 microg calcitriol (n=46), or placebo (n=44) for 6 months. RESULTS: Postmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8+/-13.6 pmol/L vs. 23.1+/-4.8 pmol/L, P<0.05). Baseline sclerostin levels positively correlated with either lumbar spine or total hip bone mineral density only in postmenopausal women (r=0.218 and r=0.233; P<0.05, respectively). Serum sclerostin levels increased by 39.9%+/-10.2% 6 months after AI use in postmenopausal women; however, no difference was observed between the alendronate and placebo groups (39.9%+/-10.2% vs. 55.9%+/-9.13%, P>0.05). CONCLUSION: Serum sclerostin levels increased with absolute deficiency of residual estrogens in postmenopausal women with endocrine-responsive breast cancer who underwent AI therapy with concurrent bone loss.
Alendronate ; Aromatase Inhibitors* ; Bone Density ; Breast Neoplasms ; Calcitriol ; Estrogens* ; Female ; Hip ; Humans ; Osteocytes ; Osteogenesis ; Osteoporosis ; Spine ; Steroids