1.Morphologic Analysis of Fracture Patterns in the Anterior Region of Femoral Intertrochanteric Fractures Using Computed Tomography
Jae-Suk CHANG ; Seonggeun CHU ; Ji-Wan KIM ; Chul-Ho KIM
The Journal of the Korean Orthopaedic Association 2025;60(1):38-45
Purpose:
Intertrochanteric fractures often involve comminuted fractures, particularly around the intertrochanteric ridge, including the greater and lesser trochanters. In cases with comminuted fractures in the posterior region, maintaining a stable reduction of the anteriormedial region of the fracture surface is essential. Therefore, this study examined the morphologic features of the anterior femur for stable reduction by analyzing the anterior region of intertrochanteric fractures using three-dimensional computed tomography.
Materials and Methods:
This retrospective study analyzed the imaging data of 51 patients aged 60 years and older who underwent a surgical treatment for intertrochanteric fractures at a single institution from April 2013 to March 2023. The sample contained 15 male patients with an average age of 81.9 years and 36 female patients with an average age of 83.7 years. Forty patients (78.4%) had two or more comorbidities. The bone mineral density was assessed in all cases except for five (9.8%).
Results:
In 49 cases (96.1%), the anterior fracture line followed the intertrochanteric line and passed through two bony prominences.In two cases (3.9%), the fracture line ran below the intertrochanteric line and involved a large fragment of the lesser trochanter. As the fracture line passed through the inferior medial bony prominence, it exhibited an S-shaped pattern rather than a straight line. The inferior medial bony prominence consisted of cortical bone, with an average thickness of 6.4±1.4 mm, which was significantly thicker than the surrounding average cortical bone thickness (1.5±0.6 mm) but thinner than the cortical bone thickness of the femoral shaft (7.3±1.3 mm).The fracture line in the superior lateral region of the intertrochanteric line included cancellous bone with a cortical bone thickness of 1.1±0.6 mm, which was thin.
Conclusion
The anterior fracture line followed the femoral intertrochanteric line and curves as it passed through the inferior medial bony prominence. The inferior medial bony prominence, consisting of cortical bone, was significantly thicker than the surrounding average cortical bone.
2.Resident shortages and their impact on surgical care, defensive medicine, and patient management: a retrospective study in South Korea
Jeong Hee HAN ; Byoung Chul LEE ; Jung Bum CHOI ; Hong Jae JO ; Jae Kyun PARK ; Hyae Jin KIM ; Eun Ji PARK ; Young Hoon JUNG ; Chang In CHOI
Korean Journal of Clinical Oncology 2025;21(1):32-39
Purpose:
This study aimed to evaluate the impact of declining surgical residency program enrollment on patient care and outcomes in colorectal cancer surgeries.
Methods:
This retrospective observational study included 676 patients (410 males; median age: 69 years) who underwent colorectal cancer surgery at Pusan National University Hospital between January 2018 and June 2024. Patients were divided into Group A (before December 31, 2023; with residents) and Group B (after January 1, 2024; without residents). All surgeries were performed by a single attending surgeon.
Results:
Preoperative variables were comparable between groups. Group A had more emergency and open surgeries, and a higher proportion of advanced-stage cancers. Overall complication rates were similar, but Group B had a longer hospital stay (9.72 days vs. 11.95 days). Specific complications such as anastomotic leakage and surgical site infections differed significantly. The overall number of surgical procedures declined markedly in 2024 compared to 2018 (77.1% vs. 49.9%).
Conclusion
The absence of residents did not increase overall complication rates but was associated with longer hospital stays and shifts in clinical practice. Greater reliance on attending surgeons contributed to more defensive decision-making and conservative patient management. Addressing these issues requires systemic reforms, including multidisciplinary collaboration and legal protections to improve surgical care.
3.Resident shortages and their impact on surgical care, defensive medicine, and patient management: a retrospective study in South Korea
Jeong Hee HAN ; Byoung Chul LEE ; Jung Bum CHOI ; Hong Jae JO ; Jae Kyun PARK ; Hyae Jin KIM ; Eun Ji PARK ; Young Hoon JUNG ; Chang In CHOI
Korean Journal of Clinical Oncology 2025;21(1):32-39
Purpose:
This study aimed to evaluate the impact of declining surgical residency program enrollment on patient care and outcomes in colorectal cancer surgeries.
Methods:
This retrospective observational study included 676 patients (410 males; median age: 69 years) who underwent colorectal cancer surgery at Pusan National University Hospital between January 2018 and June 2024. Patients were divided into Group A (before December 31, 2023; with residents) and Group B (after January 1, 2024; without residents). All surgeries were performed by a single attending surgeon.
Results:
Preoperative variables were comparable between groups. Group A had more emergency and open surgeries, and a higher proportion of advanced-stage cancers. Overall complication rates were similar, but Group B had a longer hospital stay (9.72 days vs. 11.95 days). Specific complications such as anastomotic leakage and surgical site infections differed significantly. The overall number of surgical procedures declined markedly in 2024 compared to 2018 (77.1% vs. 49.9%).
Conclusion
The absence of residents did not increase overall complication rates but was associated with longer hospital stays and shifts in clinical practice. Greater reliance on attending surgeons contributed to more defensive decision-making and conservative patient management. Addressing these issues requires systemic reforms, including multidisciplinary collaboration and legal protections to improve surgical care.
4.Resident shortages and their impact on surgical care, defensive medicine, and patient management: a retrospective study in South Korea
Jeong Hee HAN ; Byoung Chul LEE ; Jung Bum CHOI ; Hong Jae JO ; Jae Kyun PARK ; Hyae Jin KIM ; Eun Ji PARK ; Young Hoon JUNG ; Chang In CHOI
Korean Journal of Clinical Oncology 2025;21(1):32-39
Purpose:
This study aimed to evaluate the impact of declining surgical residency program enrollment on patient care and outcomes in colorectal cancer surgeries.
Methods:
This retrospective observational study included 676 patients (410 males; median age: 69 years) who underwent colorectal cancer surgery at Pusan National University Hospital between January 2018 and June 2024. Patients were divided into Group A (before December 31, 2023; with residents) and Group B (after January 1, 2024; without residents). All surgeries were performed by a single attending surgeon.
Results:
Preoperative variables were comparable between groups. Group A had more emergency and open surgeries, and a higher proportion of advanced-stage cancers. Overall complication rates were similar, but Group B had a longer hospital stay (9.72 days vs. 11.95 days). Specific complications such as anastomotic leakage and surgical site infections differed significantly. The overall number of surgical procedures declined markedly in 2024 compared to 2018 (77.1% vs. 49.9%).
Conclusion
The absence of residents did not increase overall complication rates but was associated with longer hospital stays and shifts in clinical practice. Greater reliance on attending surgeons contributed to more defensive decision-making and conservative patient management. Addressing these issues requires systemic reforms, including multidisciplinary collaboration and legal protections to improve surgical care.
5.Morphologic Analysis of Fracture Patterns in the Anterior Region of Femoral Intertrochanteric Fractures Using Computed Tomography
Jae-Suk CHANG ; Seonggeun CHU ; Ji-Wan KIM ; Chul-Ho KIM
The Journal of the Korean Orthopaedic Association 2025;60(1):38-45
Purpose:
Intertrochanteric fractures often involve comminuted fractures, particularly around the intertrochanteric ridge, including the greater and lesser trochanters. In cases with comminuted fractures in the posterior region, maintaining a stable reduction of the anteriormedial region of the fracture surface is essential. Therefore, this study examined the morphologic features of the anterior femur for stable reduction by analyzing the anterior region of intertrochanteric fractures using three-dimensional computed tomography.
Materials and Methods:
This retrospective study analyzed the imaging data of 51 patients aged 60 years and older who underwent a surgical treatment for intertrochanteric fractures at a single institution from April 2013 to March 2023. The sample contained 15 male patients with an average age of 81.9 years and 36 female patients with an average age of 83.7 years. Forty patients (78.4%) had two or more comorbidities. The bone mineral density was assessed in all cases except for five (9.8%).
Results:
In 49 cases (96.1%), the anterior fracture line followed the intertrochanteric line and passed through two bony prominences.In two cases (3.9%), the fracture line ran below the intertrochanteric line and involved a large fragment of the lesser trochanter. As the fracture line passed through the inferior medial bony prominence, it exhibited an S-shaped pattern rather than a straight line. The inferior medial bony prominence consisted of cortical bone, with an average thickness of 6.4±1.4 mm, which was significantly thicker than the surrounding average cortical bone thickness (1.5±0.6 mm) but thinner than the cortical bone thickness of the femoral shaft (7.3±1.3 mm).The fracture line in the superior lateral region of the intertrochanteric line included cancellous bone with a cortical bone thickness of 1.1±0.6 mm, which was thin.
Conclusion
The anterior fracture line followed the femoral intertrochanteric line and curves as it passed through the inferior medial bony prominence. The inferior medial bony prominence, consisting of cortical bone, was significantly thicker than the surrounding average cortical bone.
6.Morphologic Analysis of Fracture Patterns in the Anterior Region of Femoral Intertrochanteric Fractures Using Computed Tomography
Jae-Suk CHANG ; Seonggeun CHU ; Ji-Wan KIM ; Chul-Ho KIM
The Journal of the Korean Orthopaedic Association 2025;60(1):38-45
Purpose:
Intertrochanteric fractures often involve comminuted fractures, particularly around the intertrochanteric ridge, including the greater and lesser trochanters. In cases with comminuted fractures in the posterior region, maintaining a stable reduction of the anteriormedial region of the fracture surface is essential. Therefore, this study examined the morphologic features of the anterior femur for stable reduction by analyzing the anterior region of intertrochanteric fractures using three-dimensional computed tomography.
Materials and Methods:
This retrospective study analyzed the imaging data of 51 patients aged 60 years and older who underwent a surgical treatment for intertrochanteric fractures at a single institution from April 2013 to March 2023. The sample contained 15 male patients with an average age of 81.9 years and 36 female patients with an average age of 83.7 years. Forty patients (78.4%) had two or more comorbidities. The bone mineral density was assessed in all cases except for five (9.8%).
Results:
In 49 cases (96.1%), the anterior fracture line followed the intertrochanteric line and passed through two bony prominences.In two cases (3.9%), the fracture line ran below the intertrochanteric line and involved a large fragment of the lesser trochanter. As the fracture line passed through the inferior medial bony prominence, it exhibited an S-shaped pattern rather than a straight line. The inferior medial bony prominence consisted of cortical bone, with an average thickness of 6.4±1.4 mm, which was significantly thicker than the surrounding average cortical bone thickness (1.5±0.6 mm) but thinner than the cortical bone thickness of the femoral shaft (7.3±1.3 mm).The fracture line in the superior lateral region of the intertrochanteric line included cancellous bone with a cortical bone thickness of 1.1±0.6 mm, which was thin.
Conclusion
The anterior fracture line followed the femoral intertrochanteric line and curves as it passed through the inferior medial bony prominence. The inferior medial bony prominence, consisting of cortical bone, was significantly thicker than the surrounding average cortical bone.
7.Resident shortages and their impact on surgical care, defensive medicine, and patient management: a retrospective study in South Korea
Jeong Hee HAN ; Byoung Chul LEE ; Jung Bum CHOI ; Hong Jae JO ; Jae Kyun PARK ; Hyae Jin KIM ; Eun Ji PARK ; Young Hoon JUNG ; Chang In CHOI
Korean Journal of Clinical Oncology 2025;21(1):32-39
Purpose:
This study aimed to evaluate the impact of declining surgical residency program enrollment on patient care and outcomes in colorectal cancer surgeries.
Methods:
This retrospective observational study included 676 patients (410 males; median age: 69 years) who underwent colorectal cancer surgery at Pusan National University Hospital between January 2018 and June 2024. Patients were divided into Group A (before December 31, 2023; with residents) and Group B (after January 1, 2024; without residents). All surgeries were performed by a single attending surgeon.
Results:
Preoperative variables were comparable between groups. Group A had more emergency and open surgeries, and a higher proportion of advanced-stage cancers. Overall complication rates were similar, but Group B had a longer hospital stay (9.72 days vs. 11.95 days). Specific complications such as anastomotic leakage and surgical site infections differed significantly. The overall number of surgical procedures declined markedly in 2024 compared to 2018 (77.1% vs. 49.9%).
Conclusion
The absence of residents did not increase overall complication rates but was associated with longer hospital stays and shifts in clinical practice. Greater reliance on attending surgeons contributed to more defensive decision-making and conservative patient management. Addressing these issues requires systemic reforms, including multidisciplinary collaboration and legal protections to improve surgical care.
8.Characteristics of Pediatric Ulcerative Colitis at Diagnosis in Korea: Results From a Multicenter, Registry-Based, Inception Cohort Study
Jin Gyu LIM ; Ben KANG ; Seak Hee OH ; Eell RYOO ; Yu Bin KIM ; Yon Ho CHOE ; Yeoun Joo LEE ; Minsoo SHIN ; Hye Ran YANG ; Soon Chul KIM ; Yoo Min LEE ; Hong KOH ; Ji Sook PARK ; So Yoon CHOI ; Su Jin JEONG ; Yoon LEE ; Ju Young CHANG ; Tae Hyeong KIM ; Jung Ok SHIM ; Jin Soo MOON
Journal of Korean Medical Science 2024;39(49):e303-
Background:
We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea.
Methods:
This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated.
Results:
A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age.
Conclusion
This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.
9.Korean Multicenter Registry of ELUVIA Stent for Femoropopliteal Artery Disease: K-ELUVIA Registry
Joongmin KIM ; Young-Guk KO ; Seung-Jun LEE ; Chul-Min AHN ; Seung-Woon RHA ; Cheol Ung CHOI ; Pil-Ki MIN ; Jong Kwan PARK ; Ji-Yong JANG ; Young Jin YOUN ; Tae-Soo KANG ; Chang-Hwan YOON ; Donghoon CHOI
Korean Circulation Journal 2024;54(9):565-576
Background and Objectives:
The K-ELUVIA study aimed to investigate the clinical effectiveness and safety of Eluvia™, a polymer-coated, paclitaxel-eluting stent, for femoropopliteal artery disease using data from a prospective Korean multicenter registry.
Methods:
A total of 105 patients with femoropopliteal artery disease who received endovascular treatment (EVT) with Eluvia™ stents at 7 Korean sites were enrolled in a prospective cohort and followed for 2 years. The primary endpoint was the 2-year clinical patency. The secondary endpoint was 2-year freedom from clinically driven target lesion revascularization (TLR).
Results:
Mean patient age was 68.2±10.4 years, and most patients (82.7%) were male. Mean lesion length was 168.3±117.6 mm. Chronic total occlusion was found in 57.7% of patients.Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) type C or D lesions were present in 46.1% of patients. Procedural success was achieved in 99.0% of patients. The clinical patency rate was 84.4% at 1 year after EVT and 76.3% at 2 years post-EVT. The freedom from TLR rate was 89.1% at 1 year after EVT and 79.1% at 2 years post-EVT. Chronic total occlusion (hazard ratio [HR], 3.53; 95% confidence interval [CI], 1.08–11.67; p=0.039) and smaller mean stent diameter (HR, 0.40; 95% CI, 0.16– 0.98; p=0.044) were identified as independent predictors of loss of clinical patency at 2 years.
Conclusions
The K-ELUVIA study demonstrated favorable 2-year clinical effectiveness and safety outcomes of Eluvia stent for femoropopliteal artery lesions in real-world practice.
10.Hazards of Tattoo Procedures Performed by Non-Medical Personnel:1st Policy Forum of the Korean Dermatological Research Foundation
Dong Hyun KIM ; Gwang June LEE ; Sungjoo HWANG ; Si-Hyung LEE ; Hyun Chul SUNG ; Sang Ju LEE ; Ji Hwan HWANG ; Young-wook RYOO ; Dong Hun LEE ; Sung Eun CHANG ; Hoon KANG
Korean Journal of Dermatology 2024;62(10):541-549
Tattooing is an invasive procedure that involves the introduction of permanent pigments into the dermis, and is categorized as a medical procedure in Korea. Despite the medical, cosmetic, and aesthetic purposes of tattooing, legislative proposals to allow non-medical personnel to perform tattooing have consistently been rejected on public health grounds, prioritizing health and safety considerations. Professional organizations have maintained a consistent position, highlighting the risks of allowing non-medical individuals to perform tattooing. These risks include procedural complications, use of unsafe practices, and inadequate legal frameworks to ensure accountability.Addressing such issues requires careful consideration beyond economic or convenience factors, with an emphasis on public health policies. To address these concerns, the Korean Dermatological Research Foundation convened its 1st Policy Forum on October 6, 2024. The forum discussed the safety aspects, medical complications, and legal implications of tattooing performed by non-medical personnel. These findings highlight the significant risks and regulatory gaps associated with such practices, underscoring the need for a comprehensive review and stringent regulations to protect public health.

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