In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm3 after 6 months. Myoma had the fastest decreasing rate, at 68.5%. When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume. Therefore, the HIFU method might replace other conventional treatment methods.
Adenomyosis/diagnostic imaging ; Adult ; Female ; Humans ; Leiomyoma/diagnostic imaging ; Middle Aged ; Treatment Outcome ; *Ultrasonic Therapy ; Uterine Neoplasms/physiopathology/*radiotherapy ; Uterus/physiopathology

In this study, the effects of high-intensity-focused ultrasound (HIFU) treatment on benign uterine tumor patients were examined. A total of 333 patients diagnosed with fibroids or adenomyosis using diagnostic sonography, treated with HIFU between February 4, 2010 and December 29, 2014 at a hospital in Korea, and followed up for three or six months were selected for this study. Their benign uterine tumor volume was measured, and the effects of HIFU treatment on the volume were analyzed according to age, disease, fertility, and treatment duration. The volume of benign tumors of the uterus changed by age in all age groups after conducting HIFU treatment for 3 and 6 months, respectively. The rate of decrease in individuals' in their twenties was the largest, at 64.9%. When the decreasing volume of benign tumors of the uterus was analyzed by type of disease, the treatment efficacy for adenomyosis was the best, with a decrease of 164.83 cm3 after 6 months. Myoma had the fastest decreasing rate, at 68.5%. When evaluated on the basis of fertility, the volume of benign tumors of the uterus continued to decrease until 6 months after completing all procedures. The volume has continued to decrease for 6 months after all procedures. This study showed that HIFU treatments for uterine fibroid and adenomyosis is an effective non-invasive therapy via reducing the benign uterine tumor volume. Therefore, the HIFU method might replace other conventional treatment methods.
Adenomyosis/diagnostic imaging ; Adult ; Female ; Humans ; Leiomyoma/diagnostic imaging ; Middle Aged ; Treatment Outcome ; *Ultrasonic Therapy ; Uterine Neoplasms/physiopathology/*radiotherapy ; Uterus/physiopathology

Background: This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA. Methods: Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death. Results: The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively.The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; P < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all P < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA. Conclusion TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA.

Background: A considerable proportion of patients warranting total knee arthroplasty (TKA) have night pain, neuropathic pain, and/or depressive disorder, which may not be resolved by TKA. This prospective, longitudinal cohort study aimed to document the prevalence of night pain, neuropathic pain, and depressive disorder in patients with advanced knee osteoarthritis undergoing TKA and to determine whether the specific coexisting pain and/or disorder at the time of TKA adversely affected postoperative outcomes. Methods: In this study, 148 patients undergoing TKA were longitudinally evaluated. The presence of night pain, neuropathic pain (determined using Douleur Neuropathique 4 [DN4]) and depressive disorder (determined using the Patient Health Questionnaire-9 [PHQ-9]) was determined before and 6 weeks, 3 months and 1 year after TKA. In addition, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQol-5 Dimension (EQ-5D) scores were assessed before and 1 year after TKA. Potential associations of night pain, neuropathic pain, and/or depressive disorder with pre- and postoperative WOMAC and EQ-5D scores were examined in subgroup analyses. Results: Preoperatively, 72% (n = 106) of patients reported night pain, and the prevalences of neuropathic pain and depressive disorder were 15% and 17%, respectively. Preoperatively, compared with patients without night pain, those with night pain had significantly poorer preoperative WOMAC scores, but no significant difference was seen between groups 1 year after TKA. Preoperatively, the WOMAC, EQ-5D, and EQ-5D health scores of patients with neuropathic pain were not significantly different from those of patients without neuropathic pain, and there was no difference in clinical outcome scores 1 year after TKA between these groups. Preoperatively, the patients with depressive disorder showed significantly poorer preoperative WOMAC, EQ-5D, and EQ-5D health scores than those without depressive disorder, but no significant differences in scores were observed 1 year after TKA between these groups. Conclusion This study revealed a considerable prevalence of night pain, neuropathic pain, and depressive disorder in patients undergoing TKA and that patients with these specific conditions reported poorer functional and quality of life scores preoperatively. However, such adverse effects disappeared after TKA. Our study findings suggest that TKA can provide satisfactory outcomes for patients with these specific conditions.

A 56-year-old woman with underlying liver cirrhosis was hospitalized with chief complaints of fever, which developed after eating raw fish on the previous day. On physical examination, she showed hypotension. Vibrio vulnificus and Vibrio parahaemolyticus strains were simultaneously isolated from blood cultures, and the patient recovered after treatment with antibiotics including cefotaxime. To our knowledge, simultaneous isolation of both V. vulnificus and V. parahaemolyticus from the blood has never been documented before in Korea or any other countries. When blood cultures from a patient with underlying disease such as liver disease show growth of gram-negative bacilli in the summer months, microbiologists in Korea, where Vibrio infection is prevalent, should be aware of the possibility that V. vulnificus and other Vibrio spp. can be isolated simultaneously. An accurate identification of all isolates is important, because antimicrobial susceptibility patterns, severity and prognosis of the infection are different significantly depending on species.
Anti-Bacterial Agents ; Cefotaxime ; Eating ; Female ; Fever ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver Diseases ; Middle Aged ; Physical Examination ; Prognosis ; Vibrio ; Vibrio Infections ; Vibrio parahaemolyticus* ; Vibrio vulnificus*

BACKGROUND: Infantile hemangioma (IH) is a common vascular tumor in pediatric patients, and is commonly treated with propranolol. We describe our experiences with dosage, response to treatment, and side effects in 23 IH patients treated with propranolol. METHODS: For this nonrandomized comparative cohort study, the authors enrolled 23 patients treated with propranolol. Photographs were taken before propranolol administration and at 3, 6, 9, and 12 months after treatment. Treatment responses were objectively analyzed with a computer program. RESULTS: There were three male and 20 female patients. Common tumor locations were the head and neck (13 cases, 56.5%), trunk (four cases, 17.4%), extremities (three cases, 13.0%), and combined locations (three cases, 13.0%). The response to propranolol was significantly lower in patients with two or more lesions than in patients with a single lesion in terms of both color fading (P < 0.001) and size reduction (P < 0.001). In male patients (42.2±3.9), the change in a-values, indicating coloration, was higher than in female patients (19.8 ±13.8)(P < 0.001). In patients who started treatment before 6 months after birth, the size reduction was greater than in their counterparts (62.3%; range, 3.0%–93.0% vs. 15.8%; range, 1.0%–79.0%; P < 0.001). CONCLUSIONS: Propranolol is an efficacious treatment with a good safety profile. In patients with a single lesion, the response to treatment was better in terms of color fading and size reduction. Furthermore, male patients responded better to propranolol treatment in terms of color fading than female patients, and starting treatment before 6 months after birth was more advantageous for size reduction.
Cohort Studies ; Extremities ; Female ; Head ; Hemangioma* ; Humans ; Infant* ; Male ; Neck ; Parturition ; Propranolol*

Background: At the end of 2014, we implemented an online video to inform patients of the entire process from admission to rehabilitation after total hip arthroplasty (THA). In this study, we investigated the effectiveness of online video instruction in THA patients. Methods: Electronic medical records of 184 patients undergoing THA in 2014 (pre-video group) and 182 patients in 2015 (post-video group) were reviewed. We compared 1) the time to start wheelchair ambulation, 2) walker or crutch ambulation, 3) the length of hospital stay, 4) postoperative satisfaction using visual analogue scale (0–10 points), and 5) modified Harris Hip Score (mHHS) at postoperative 6 weeks. Results: In the post-video group, the time to start wheelchair ambulation (1.8 ± 0.6 vs. 2.4 ± 3.2 days, P = 0.021) and walker/crutch ambulation were faster (2.9 ± 1.2 vs. 3.8 ± 1.0 days, P = 0.016), and the hospital stay was shorter (8.2 ± 4.7 vs. 9.9 ± 7.8 days, P = 0.001) compared to the pre-video group. The visual analogue scale for satisfaction (7.84 ± 1.62 vs. 7.68 ± 1.85 points) and mHHS (89.59 ± 9.47 vs. 89.58 ± 8.59) were similar. Conclusion Online video instruction is an effective tool to expedite ambulation and reduce the hospital stay without compromising the clinical outcome and postoperative complications after THA.

Background: Delta ceramic-on-ceramic (CoC) articulation affords excellent outcomes in primary total hip arthroplasty (THA). However, the safety and reliability of this bearing in revision THA need more evidence. This study aimed to report complications, radiological changes, clinical results, and survivorship of revision THA using Delta CoC articulation at minimum 5-year follow-up. Methods: We reviewed 118 revision THAs (113 patients: 68 men and 45 women) performed with use of Delta CoC bearing. Their mean age was 58.7 years (range, 30–90 years) and their mean body mass index was 24.6 kg/m 2 (range, 15.2–32.5 kg/m 2 ). These patients were followed up for 5–12 years (mean, 7.2 years). We evaluated squeak, grinding sensation, ceramic fracture, dislocation, periprosthetic joint infection (PJI), periprosthetic fracture, prosthetic loosening, ceramic wear, osteolysis, modified Harris hip score (mHHS), and survivorship with any reoperation after the revision as the endpoint. Results: Two patients (1.7%) had grinding sensation, but no patient had ceramic fracture. Reoperations were necessary in 9 hips (7.6%) due to PJIs in 2, stem loosening in 2, cup loosening in 2, recurrent dislocation in 2, and periprosthetic fracture in 1. No hip had measurable wear or osteolysis. The average mHHS improved from 53.3 points before the revision to 82.3 points at the final follow-up. Survivorship was 91.6% (95% confidence interval, 86.3%–96.9%) at 12 years. Conclusions The Delta ceramic bearing appeared a reliable option for revision THA, showing encouraging mid-term results with acceptable survivorship and a low complication rate.

Background: The International Hip Outcome Tool 12 (iHOT12), which is now widely adopted in clinical settings, has been established as reliable, valid, and responsive, positioning as a critical evaluation tool globally to gauge the efficacy of hip arthroscopy.This study aimed to translate the iHOT12 questionnaire into Korean and assess its feasibility, internal consistency, and validity concerning the psychometric properties of the Korean version of iHOT12 (iHOT12-K). Methods: The iHOT12 questionnaire was translated into Korean and adapted culturally, following international guidelines, involving forward translation, back-translation, and reconciliation by bilingual experts to ensure cross-cultural equivalence. A cohort of 67 patients diagnosed with femoroacetabular impingement and scheduled for hip arthroscopy between November 2015 and February 2021 participated in assessing the psychometric properties of the iHOT12-K, alongside standardized questionnaires (Korean iterations of the Short Form-36 [SF-36], Hip Disability and Osteoarthritis Outcome Score [HOOS], Korean version of Hip Outcome Score [HOS-K], and modified Harris Hip Score [mHHS]). Psychometric evaluations focusing on feasibility, internal consistency (Cronbach's alpha), and convergent validity (Spearman’s rank correlation) demonstrated the reliability and relevance of iHOT12-K. Results: In the psychometric evaluation of the adapted version, 67 participants (38 men and 29 women; median age, 41 years) were enrolled, with 59 completing the iHOT12-K. The questionnaire showed excellent internal consistency (Cronbach’s alpha, 0.896) without floor or ceiling effects, indicating good feasibility. Strong convergent validity was noted between the iHOT12-K and various hip-specific questionnaires (HOOS, HOS-K, and mHHS), except for the maximal visual analog scale score, demonstrating the reliability and applicability of the iHOT12-K for clinical assessments in Korea. Conclusions The iHOT12-K has successfully undergone transcultural adaptation, demonstrating significant feasibility, internal consistency, and validity. It has been validated for use among Korean-speaking patients undergoing hip arthroscopy, proving to be a valuable tool for clinical assessments.

Background: The International Hip Outcome Tool 12 (iHOT12), which is now widely adopted in clinical settings, has been established as reliable, valid, and responsive, positioning as a critical evaluation tool globally to gauge the efficacy of hip arthroscopy.This study aimed to translate the iHOT12 questionnaire into Korean and assess its feasibility, internal consistency, and validity concerning the psychometric properties of the Korean version of iHOT12 (iHOT12-K). Methods: The iHOT12 questionnaire was translated into Korean and adapted culturally, following international guidelines, involving forward translation, back-translation, and reconciliation by bilingual experts to ensure cross-cultural equivalence. A cohort of 67 patients diagnosed with femoroacetabular impingement and scheduled for hip arthroscopy between November 2015 and February 2021 participated in assessing the psychometric properties of the iHOT12-K, alongside standardized questionnaires (Korean iterations of the Short Form-36 [SF-36], Hip Disability and Osteoarthritis Outcome Score [HOOS], Korean version of Hip Outcome Score [HOS-K], and modified Harris Hip Score [mHHS]). Psychometric evaluations focusing on feasibility, internal consistency (Cronbach's alpha), and convergent validity (Spearman’s rank correlation) demonstrated the reliability and relevance of iHOT12-K. Results: In the psychometric evaluation of the adapted version, 67 participants (38 men and 29 women; median age, 41 years) were enrolled, with 59 completing the iHOT12-K. The questionnaire showed excellent internal consistency (Cronbach’s alpha, 0.896) without floor or ceiling effects, indicating good feasibility. Strong convergent validity was noted between the iHOT12-K and various hip-specific questionnaires (HOOS, HOS-K, and mHHS), except for the maximal visual analog scale score, demonstrating the reliability and applicability of the iHOT12-K for clinical assessments in Korea. Conclusions The iHOT12-K has successfully undergone transcultural adaptation, demonstrating significant feasibility, internal consistency, and validity. It has been validated for use among Korean-speaking patients undergoing hip arthroscopy, proving to be a valuable tool for clinical assessments.