PURPOSE: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. MATERIALS AND METHODS: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. RESULTS: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. CONCLUSION: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.
Ankle ; Follow-Up Studies ; Foot ; Heel ; Humans ; Sutures*

We report three cases of neovascular glaucoma secondary to central retinal artery occlusion (CRAO) which were effectively managed with intravitreal bevacizumab (IVB) followed by panretinal photocoagulation (PRP). Neovascular glaucoma without peripheral anterior synechiae developed between one and five weeks following CRAO onset. All patients received 0.75 mg (0.03 ml) IVB. In all patients, complete regression of the iris and anterior chamber angle neovascularization was confirmed within one week. PRP was applied two weeks after the injection. The follow-up period was four to seven months (average, five months). Intraocular pressure was controlled in all patients using topical antiglaucoma medications alone. However, one patient experienced a recurrence of neovascularization three months after the initial combination treatment. This patient received another IVB injection and additional PRP, and the recurrent neovascularization resolved. There were no local or systemic adverse events in any patients. Therefore, intravitreal bevacizumab may be an effective adjunct in the treatment of neovascular glaucoma associated with CRAO.
Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Female ; Glaucoma, Neovascular/*drug therapy/*etiology ; Humans ; Injections ; Male ; Middle Aged ; Recurrence ; Retinal Artery Occlusion/*complications ; Retreatment ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vitreous Body

We present a case of bilateral serous retinal detachment (SRD) as a presenting sign of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). A 45-year-old woman presented with decreased vision and was found to have bilateral serous retinal detachment. Peripheral blood smears revealed leukocytosis of 53.9x10(3)/microliter with 64.6% lymphoblasts. A bone marrow aspirate revealed the presence of lymphoblasts. Cytogenetic and molecular genetic analysis detected a reciprocal translocation between chromosome 9 and 22, t(9;22) (q34;q11). A diagnosis of Ph+ ALL was made. Following systemic chemotherapy, the bilateral SRD resolved completely with full recovery of vision. The sudden appearance of SRD should raise suspicion for leukemia. Prompt recognition of this disease is important for early systemic treatment and restoration of visual function.
Antineoplastic Agents/therapeutic use ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications/diagnosis/drug therapy ; Recovery of Function ; Retinal Detachment/diagnosis/*etiology/physiopathology ; Tomography, Optical Coherence ; Visual Acuity/physiology

Purpose: This study aimed to estimate the unmet demand for INCS and the number of needed beds for fulfillment. Methods: Annual data from the Korea Health Panel (2015~2018), Health Insurance Statistical Yearbook (2015~ 2019), and published statistical data (2015~2019) were used. To measure the unmet demand, the utilization of informal nursing care services, which can be a market substitute for INCS, was used. The number of needed beds was calculated by dividing the demand by the bed occupancy rate multiplied by 365 days. Results: The unmet demand decreased every year and was estimated to be 31~47 million person-day as of 2019. It was the highest in Gyeonggi (6~8 million) and the lowest in Jeju (160~220 thousand), while the fulfilled rate was the highest in Incheon (52~61%) and the lowest in Jeonbuk (6~8%). For each type, general hospitals showed the highest unmet demand (6~10 million), followed by hospitals (5~8 million) and tertiary hospitals (4~7 million). Gyeonggi province (37,212~48,882) and general hospitals (54,955~70,962) were most needed additional INCS beds. Conclusion Tailored bed expansion strategies are necessary to satisfy each region's and hospital’s demand. Considering the multi-layered causes of unmet demand, a healthcare system reform that increases the regional self-sufficiency of INCS is required.

The identification of circulating tumor cells (CTCs) is clinically important for diagnosing cancer. We have previously developed a size-based filtration platform followed by epithelial cell adhesion molecule immunofluorescence staining for detecting CTCs. To characterize CTCs independently of cell surface protein expression, we incorporated a chromosomal fluorescence in situ hybridization (FISH) assay to detect abnormal copy numbers of chromosomes in cells collected from peripheral blood samples by the size-based filtration platform. Aneuploid cells were detected in the peripheral blood of patients with lung cancer. Unexpectedly, aneuploid cells were also detected in the control group, which consisted of peripheral blood samples from patients with benign lung diseases, such as empyema necessitatis and non-tuberculous mycobacterial lung disease. These findings suggest that chromosomal abnormalities are observed not only in tumor cells, but also in benign infectious diseases. Thus, our findings present new considerations and bring into light the possibility of false positives when using FISH for cancer diagnosis.
Aneuploidy* ; Chromosome Aberrations ; Communicable Diseases ; Diagnosis ; Empyema ; Epithelial Cells ; Filtration ; Fluorescence ; Fluorescent Antibody Technique ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Lung Diseases* ; Lung Neoplasms ; Lung* ; Neoplastic Cells, Circulating

Mutation signatures represent unique sequence footprints of somatic mutations resulting from specific DNA mutagenic and repair processes. However, their causal associations and the potential utility for genome research remain largely unknown. In this study, we performed PanCancer-scale correlative analyses to identify the genomic features associated with tumor mutation burdens (TMB) and individual mutation signatures. We observed that TMB was correlated with tumor purity, ploidy, and the level of aneuploidy, as well as with the expression of cell proliferation-related genes representing genomic covariates in evaluating TMB. Correlative analyses of mutation signature levels with genes belonging to specific DNA damage-repair processes revealed that deficiencies of NHEJ1 and ALKBH3 may contribute to mutations in the settings of APOBEC cytidine deaminase activation and DNA mismatch repair deficiency, respectively. We further employed a strategy to identify feature-driven, de novo mutation signatures and demonstrated that mutation signatures can be reconstructed using known causal features. Using the strategy, we further identified tumor hypoxia-related mutation signatures similar to the APOBEC-related mutation signatures, suggesting that APOBEC activity mediates hypoxia-related mutational consequences in cancer genomes. Our study advances the mechanistic insights into the TMB and signature-based DNA mutagenic and repair processes in cancer genomes. We also propose that feature-driven mutation signature analysis can further extend the categories of cancer-relevant mutation signatures and their causal relationships.

PURPOSE: This study was designed to evaluate the clinical efficacy of temporary K-wire fixation in F-plate fixation for displaced intraarticular calcaneal fractures. MATERIALS AND METHODS: Two groups (group 1 with F-plate fixation only and group 2 with temporary K-wire fixation and F-plate fixation) of patients were included in this study. The temporary K-wire was removed six weeks after the operation. Each group consisted of 33 cases. Rotational axis angles were measured radiographically and the foot and ankle outcome score (FAOS) was used for clinical assessment. RESULTS: In group 1, the mean rotational axis angle was reduced from 27degrees preoperatively to 5.59degrees postoperatively and the angle at last follow-up was 9.94degrees. There was an increase in angle of 4.35degrees between postoperative and the last follow-up measurement. In group 2, the mean rotational axis angle was reduced from 21.2degrees preoperatively to 4.39degrees postoperatively and the angle at last follow-up was 5.91degrees. There was an increase in angle of 1.52degrees between postoperative and the last follow-up measurement. Significant difference in the changes of rotational axis angle was observed between the two groups. However, no significant difference in FAOS was observed between the two groups. CONCLUSION: Temporary K-wire fixation can prevent reduction loss when treating displaced intra-articular calcaneal fractures with an F-plate.
Ankle ; Axis, Cervical Vertebra ; Calcaneus ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures

This study aimed to examine influenza vaccination coverage of North Korean defectors (NKD) in the Republic of Korea (Korea) and explore the factors affected the vaccination coverage. Total 378 NKD were analyzed. Four Korean control subjects were randomly matched by age and gender from the Korea National Health and Nutrition Examination Survey V (n = 1,500). The adjusted vaccination coverage revealed no statistical difference between the defectors group and indigenous group (29.1% vs. 29.5%, P = 0.915). In the aged under 50 group, the vaccination coverage of NKD was higher than that of Korean natives (37.8% vs. 25.8%, P = 0.016). However in the aged 50 yr and over group, the vaccination coverage of North Korean defectors was lower than that of the natives (28.0% vs. 37.6%, P = 0.189). Even the gap was wider in the aged 65 yr and over group (36.4% vs. 77.8%, P = 0.007). Gender and medical check-up experience within 2 yr showed association with the vaccination coverage of NKD. Influenza vaccination coverage of aged defectors' group (aged 50 yr and over) was lower than indigenous people though overall vaccination coverage was similar. Further efforts to increase influenza vaccination coverage of this group are needed.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Democratic People's Republic of Korea/epidemiology ; Female ; Humans ; Influenza Vaccines/*therapeutic use ; Influenza, Human/*epidemiology/*prevention & control ; Male ; Middle Aged ; Refugees/*statistics & numerical data ; Republic of Korea/epidemiology ; Sex Distribution ; Vaccination/*utilization ; Young Adult

BACKGROUND: Matrix metalloproteinase-2 (MMP-2) is a class of proteolytic enzymes that digest collagen type IV and other components of the basement membrane. It plays a key role in the local invasion and the formation of distant metastases by various malignant tumors. The aim of this study was to evaluate the activity of MMP-2 and its significance as a prognostic marker in resected stage I non-small cell lung cancer (NSCLC). MATERIAL AND METHOD: In this study we obtained fresh-frozen samples of tumor and non-tumor tissues from 34 patients with stage I NSCLC who underwent resection without preoperative radiotherapy or chemotherapy. After the extraction of total protein from tissue samples, MMP-2 activities were assessed by gelatin-substrate-zymography. The activities were divided into the higher or lower groups. RESULT: The MMP-2 activities were higher in tumor tissues than in non-tumor tissues. The MMP-2 activity of non-tumor tissues in recurrent group was higher than in non-recurrent group (p<0.01). Also the patients with higher MMP-2 activity of non-tumor tissues showed poor 5 year survival (p<0.01). CONCLUSION: This result indicates that the higher level of MMP-2 activity in the non-tumor tissue is associated with the recurrence and survival after the resection of stage I NSCLC. Therefore, MMP-2 activity in the non-tumor tissue could be used as a potential prognostic marker for the resected stage I-NSCLC.
Basement Membrane ; Carcinoma, Non-Small-Cell Lung* ; Collagen Type IV ; Drug Therapy ; Humans ; Lung Neoplasms ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis ; Neoplasm Proteins ; Peptide Hydrolases ; Radiotherapy ; Recurrence

There was an error in the article. Chung-Hee Sonn (Ph.D.) should have been listed as a co-corresponding author but Jhingook Kim was listed as the sole corresponding author of the article. Therefore, we ask to correct that both Chung-Hee Sonn and Jhingook Kim are co-corresponding authors.