OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

This study shows a case of neoadjuvant chemotherapy application for the management of a 34-year-old male patient diagnosed with invasive intraductal papillary mucinous neoplasm (IPMN), for which curative margin-negative resection initially seemed challenging. Five cycles of the FOLFIRINOX regimen (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) were administered preoperatively, resulting in a significant reduction of the intraductal mass size and deformity of the main vessels. The patient subsequently underwent a successful robotic pylorus-preserving pancreatoduodenectomy. Postoperatively, the patient received adjuvant chemotherapy with FOLFIRINOX, and after 5 months, showed no signs of tumor recurrence or specific complications. These findings suggest that neoadjuvant therapy can be a potentially effective strategy even in advanced invasive IPMN. Further research is necessary to establish guidelines for its application.

A 78-year-old female patient was initially treated with laparoscopic radical cholecystectomy for gallbladder cancer (pT2aN1M0, stage IIIB). The patient then received adjuvant chemotherapy with gemcitabine. After completion of adjuvant chemotherapy, multiple lymph node metastases were observed in follow-up computed tomography (CT) scan, but the patient refused to go through further chemotherapy. One year after the recurrence, carbohydrate antigen 19-9 (CA19-9) level was 1,925 U/mL with follow-up high-resolution CT/abdomen-pelvic CT showing the increased size of multiple lymph node metastases, and the patient began to undergo Viscum album therapy (0.2 mg, subcutaneously, three times a week). After the V. album therapy was initiated, a decrease in the size of metastatic lymph nodes and CA19-9 level, which was decreased to 252 U/mL, was observed. Seventeen months after continuous V. album therapy, the patient agreed to have palliative chemotherapy. The patient underwent gemcitabine plus cisplatin chemotherapy and showed stable disease during follow-up. This case report suggests that V. album therapy showed anticancer effects and may act as a bridge to palliative chemotherapy for patients with inappropriate general conditions to undergo chemotherapy for recurrent gallbladder cancer.

BACKGROUND: The presence of FLT3 internal tandem dupulication (FLT3/ITD) in patients with acute myeloid leukemia (AML) with normal karyotype was investigated in order to evaluate its clinical and prognostic significance. METHODS: The FLT3/ITD was studied by PCR assay in bone marrow samples obtained from 123 patients at diagnosis. Ninety patients who received intensive induction chemotherapy were evaluated. RESULTS: Of total 123 patients, forty-seven (38.2%) demonstrated the aberrant FLT3/ITD. Patients with FLT3/ITD had significantly higher leukocyte counts at presentation than did patients without FLT3/ITD (P=0.04). By multivariate analysis, the FLT3/ITD was an independent prognostic factor of leukemic-free survival (LFS) (P=0.01) in AML patients with normal karyotype. CONCLUSION: This study demonstrated that the presence of the FLT3/ITD was a significant factor for poor prognosis in AML patients with normal karyotype.
Bone Marrow ; Diagnosis ; Humans ; Induction Chemotherapy ; Karyotype* ; Leukemia, Myeloid, Acute* ; Leukocyte Count ; Multivariate Analysis ; Polymerase Chain Reaction ; Prognosis

PURPOSE: To evaluate the clinical and histological results after microfracture surgery for degenerative arthritis of the knee. MATERIAL AND METHOD: Thirty-five patients, who had moderate to severe pain with no improvement after conservative treatment, moderate osteoarthritic change in standing AP radiogram, and no severe angular deformity, underwent microfracture surgery. Their mean age at the time of operation was 56 years (range, 33-75 years) and mean follow-up period was 1 year (range, 6-17 months) . In the 14 cases, 'second-look' arthroscopies and biopsies were performed at 6 months following microfracture for full thickness chondral lesions. At the last follow up clinical results were evaluated with Baumgaertner's scale. The specimens were stained with H-E, Safranin-O, and Masson's trichrome. RESULTS: Most of the patients showed significant improvement clinically. 'Second-look' showed that the chondral defect areas were covered with newly grown grayish white tissues. Histologically, the regenerated tissue appears to be a hybrid of hyaline cartilage and fibrocartilage. There are viable chondrocytes in lacunae with a uniform matrix. CONCLUSION: Microfracture surgery can induce chondral resurfacing for full thickness defects of osteoarthritic knee. However, the exact nature and fate of regenerated cartilagenous tissues need further long term follow-up study.
Arthroscopy ; Biopsy ; Cartilage* ; Chondrocytes ; Congenital Abnormalities ; Fibrocartilage ; Follow-Up Studies ; Humans ; Hyaline Cartilage ; Knee* ; Osteoarthritis* ; Regeneration*

PURPOSE: To evaluate the clinical and radiological results of periprosthetic fracture treatments following total knee arthroplasty (TKA) . MATERIALS AND METHODS: Between Jan. 1991 and Jun. 1998, 16 knees in 15 patients were treated for periprosthetic fractures following TKA. Average age of the patients were 56 years (26-69 years) , and 14 patients were women and one was a man. The average follow-up period after fracture was 2 years 5 months (1 year - 8 years 2 months) . We analyzed clinical results according to the knee rating score of Hospital for Special Surgery (HSS) , bony union time and femorotibial angle. RESULTS: Among 980 knees in 633 patients with primary total knee arthroplasty, 16 knees in 15 patients developed periprosthetic fractures. The incidence was 1.6%. Three knees were treated with closed reduction and cast immobilization, seven knees were treated with Ender nailing, and six knees were treated with open reduction and internal fixation. Range of motion was 113 degrees on an average before fracture and 94 degrees at the last follow up, and HSS knee rating score averaged 88 points before fracture and 83 points at the last follow up. Radiologically, 15 knees had complete union and one knee had nonunion. CONCLUSION: The authors think that conservative management was not effective due to prolonged immobilization and late start of ROM exercise. Open reduction with internal fixations provided a better reduction of the fracture, preserving the alignment of fragment and restoring function. Also, Ender nailing was an alternative option of treatment considering less morbidity and satisfactory functional results.
Arthroplasty ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Incidence ; Knee ; Periprosthetic Fractures* ; Range of Motion, Articular

PURPOSE: To analyze functional gains after TKA in patients with hemophilic arthropathy. MATERIALS AND METHODS: From January 1989 to December 1996, 16 total knee replacements were performed in 11 patients with hemophilia. The average age at operation was 30 years and nine months. The average follow-up period was 3.2 years (range, 1 to 7 years). There were 14 knees of hemophilia A and 2 knees of hemophilia B. Preoperatively, all patients complained of severe pain and had marked knee joint deformity of grade IV or V by Arnold and Hilgartner classification. The knee rating scale of Hospital for Special Surgery was used for clinical assessment. RESULTS: The average preoperative range of motion was 87.9 degrees (range, 25-125 degrees) and 94 degrees (range, 70-125 degrees) postoperatively. The average flexion contracture was 20.7 degrees (range, 0-40 degrees) preoperatively and 4.7 degrees (range, 0-15 degrees) postoperatively. The knee rating scale improved from 44.3 points (range, 40-76) to 88.8 points (range, 81-97). There was one case of superficial necrosis of skin. CONCLUSIONS: The range of motion was not improved significantly after total knee replacements in hemophilic patients. However, knee pain and bleeding episodes have decreased prominently.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Classification ; Congenital Abnormalities ; Contracture ; Follow-Up Studies ; Hemophilia A ; Hemophilia B ; Hemorrhage ; Humans ; Knee Joint ; Knee* ; Necrosis ; Range of Motion, Articular ; Skin

PURPOSE: To analyze the clinical results of treatment for infected TKA and find a reasonable method of treatment. MATERIALS AND METHODS: Between March 1988 and August 1997, 34 patients with infection after total knee arthroplasty were treated at Kyung Hee University Hospital. The average follow-up period was 4 year 8 months. At-the time of infection management, the average age was 59 years (range, 20 to 79 years); there were 31 women and three men. Infected patients were managed with several methods. Twenty patients were treated with one-stage or two-stage reimplantation, and arthrodesis was done in 12 cases. Two cases were treated conservatively. We assessed knee function before and after revision, according to the knee rating system of The Hospital for Special Surgery. RESULTS: Prior to revision operation, the average knee score in 20 reimplantation cases was 52 points, and the average range of motion was 76. After revision, the average knee score was 84 points, and the average range of motion was 90. All patients had complete union at an average 5.3 months after arthrodesis. There were no recurrences of infection after one-stage or two-stage reimplantation, or fusion. CONCLUSIONS: Thoughtful method of treatment should be decided in managing infected total knee arthroplasty.
Arthrodesis ; Arthroplasty* ; Female ; Follow-Up Studies ; Humans ; Knee* ; Male ; Range of Motion, Articular ; Recurrence ; Replantation

BACKGROUND: It has been well known that the bone and kidney are the principle organs of parathyroid hormine (PTH) actions. Although patients with primary hyperparathyroidism show a high incidence of LVH and trophic effects of PTH on adult rat ventricular cardiomyocytes were investigated in vitro, effect of PTH on the cardiac tissue in vivo is unknown. METHODS: We examined the effects of PTH on the cardiomyocyte and interstitial tissue using adult rat heart. Twenty-two female Sprague-Dawley rats were ovariectomized bilaterally at three months old and weighing in 250 - 300 gm in order to exclude the trophic effect of estrogen. We administrated human parathyroid hormone (20 ug subcutaneously 5 times per week) to 12 rats for 4 weeks after raising for 8 weeks (PTH group):the remaining 10 rats received only normal saline (control). We measured left ventricular thickness [IVS+LVPW)/2] and number of cardiomyocytes and interstitial fibrosis on LM (H & E and Masson's trochrome stain) and EM. RESULTS: 1) LV wall thickeness tended to increase in PTH group as compared with control (2.16+/-0.31 vs 1.12+/-0.21 mm, p=0.099). 2) The number of cardiomyocyte in PTH group was significantly less than that of control (61.2+/-13.1 vs 70.5+/-14.9, p=0.003, Magnification x 400). 3) There was no significant change of interstitial fibrosis between PTH group and control. CONCLUSION: These results shggest that PTH may produce left ventricular hypertrophic effects in aged ovariectomized rat that resulted form hypertrophy of cardiomyocyte without increase of interstitial connetive tissue.
Adult ; Animals ; Estrogens ; Female ; Fibrosis ; Heart ; Humans ; Hyperparathyroidism, Primary ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Incidence ; Kidney ; Myocytes, Cardiac ; Ovariectomy ; Parathyroid Hormone* ; Rats* ; Rats, Sprague-Dawley

BACKGROUND AND OBJECTIVES: Although ovarian estrogen is believed to decrease coronary heart disease by improving plasma lipoprotein and enhancing vasodilation, estrogen effect on heart tissue has not been shown yet. So we investigated the effect of the ovariectomy and estrogen on rat heart tissue. MATERIALS AND METHODS: Female Sprague Dawley rats, about 3 months of age, were subjected to sham surgery (n=9) or bilateral ovariectomy (n=20) and maintained untreated for 8 weeks after surgery. We administered estrogen (20 mg/Kg subcutaneously, 3 times/week) to 10 ovariectomized rats for 4weeks; the remaining ovariectmized rats received only saline. Animals were divided in 3 group:group 1 (control); sham op, group 2; ovariectomized only, group 3; ovariectomy+estrogen. We measured left ventricular thickness [IVS+LVPW)/2] and number of cardiomyocytes and interstitial fibrosis on light microscope (H & E and Masson's trochrome stain) and electron microscope. RESULTS: 1) LV wall thicknesses were significantly increased in group 2 and group 3 as compared with group 1 (2.45+/-0.1 and 2.46+/-0.11 vs 2.31+/-0.15 mm). 2) There were no significant change in the number of cardiomyocyte between group 1, group 2 and group 3 (54.3+/-5.7, 60.2+/-19.4, 52.5+/-14.1). 3) Group 2 and group 3 show more interstitial edema (44% and 62.5% vs 0%) on LM and more interstitial edema and the increase of number of mitochondria on EM than group 1. CONCLUSION: Bilateral ovariectomized rats show the increase of LV wall thickness, which was caused by interstitial edema without cardomyocyte hypertrophy and these changes were not reversed by the short-term administration of estrogen for 4 weeks.
Animals ; Coronary Disease ; Edema ; Estrogens* ; Female ; Fibrosis ; Heart* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Lipoproteins ; Mitochondria ; Myocytes, Cardiac ; Ovariectomy* ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Vasodilation