PURPOSE: The purpose of this study is to evaluate the result of primary total knee arthroplasty(TKA) with using NexGen CR-Flex(R) (Zimmer, Warsaw, IN, USA) after a follow-up of at least 2 years. MATERIALS AND METHODS: A total of 63 patients (98 knees) were included in this study. The same surgeon performed all the TKAs between August 2005 and May 2006 with using NexGen CR-Flex(R). The patients' age ranged from 52 to 81 years, and the mean follow-up period was 28 months. The patients were assessed clinically and radiographically with using the HSS score, the possibility that they could squat or kneel, the tibiofemoral angle, the radiolucency and the posterior condylar offset. RESULTS: The mean HSS score was 58.3 points preoperatively, and it was 91.1 points at the last follow-up. The mean range of motion improved from 123.2degrees preoperatively to 137.1degrees postoperatively. Forty-nine patients (78%) were able to squat and 24 patients (38%) could kneel down at the last follow-up. The mean tibiofemoral angle was 6degrees of varus preoperatively, and 7degrees of valgus postoperatively. And there was no radiolucency in any case. The mean posterior condylar offset was 26.1mm preoperatively and 27.2 mm postoperatively. CONCLUSION: TKA with using NexGen CR-Flex(R) showed favorable results at a mean follow-up of 28 months. Adequate patient selection, restoration of the posterior condylar offset and thorough clearing of posterior condylar osteophytes are thought to be the key elements to achieve a satisfactory range of motion after TKAs.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Osteophyte ; Patient Selection ; Range of Motion, Articular

Background: We aimed to investigate the current trend of joint replacement surgery incidence in patients with rheumatoid arthritis (RA) in South Korea and to compare the incidence of joint replacement surgery in each affected joint. Methods: We performed this big data analysis to investigate the current trend of joint replacement surgery incidence in patients with RA in South Korea and to compare the incidence of joint replacement surgery in each affected joint. This retrospective study was based on data from the Korea National Health Insurance claims database. Results: The prevalence of RA increased every year (0.13% in 2008, 0.25% in 2016). The number of newly diagnosed patients increased from 29,184 in 2010 to 38,347 in 2016. The incidence rate of joint replacement surgery in patients with RA increased from 0.72% in 2010 to 4.03% in 2016. The knee (68.3%) was the most commonly replaced joint. The relative risk (RR) of additional joint replacement surgery was highest for the shoulder joint (RR,1.454; 95% confidence interval, 0.763–2.771). The median time from diagnosis to surgery was the shortest in the elbow joint (379 days) and the longest in the shoulder joint (955 days). The median time for each joint was short in order of the elbows, ankles, hips, knees, and shoulders (p < 0.01). Conclusions The most frequently and initially replaced joints were different, but the prevalence and incidence of RA, as well as those of joint replacement surgery, have recently increased in South Korea. Joint replacement surgery in RA was the highest for the knee joint. The median time from diagnosis to surgery was shortest for the elbow, followed by the ankle, hip, knee, and shoulder. Regardless of whether patients are symptomatic, evaluation of large joints such as the knee, elbow, ankle, and hip should be considered from an early stage.

We report the first Korean patient with familial hemiplegic migraine type 1, with clinical and multimodal imaging findings. A 43-yr-old man was admitted for right hemianopia and aphasia, followed by coma. MRI showed only cerebellar atrophy. CT angiography showed mild vasodilation of intracranial blood vessels and increased vascularity in the left hemisphere and perfusion-weighted imaging showed elevated cerebral blood flow. Gene analysis of the patient and his mother led to the identification of a heterozygous point mutation (1997C-->T, T666M) in exon 16 of the CACNA1A gene. Familial hemiplegic migraine should be considered in patients with episodic neurological dysfunction with cerebellar atrophy.
Asian Continental Ancestry Group/*genetics ; Atrophy/genetics/metabolism ; Calcium Channels/*genetics ; Cerebellum/blood supply/*pathology ; Cerebral Angiography ; Coma/*diagnosis ; Exons ; Heterozygote ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine with Aura/*diagnosis/genetics ; Point Mutation ; Republic of Korea ; Tomography, X-Ray Computed

BACKGROUND: An increase in the obese adolescent population is being recognized as a serious medical and social problem. The present study aimed to examine the association between neighborhood socioeconomic status (SES) and obesity in Korean adolescents based on total available resources and local social inequality models. METHODS: The present study used data from the 2013 Korea Youth Risk Behavior Web-based Survey in analyzing 72,438 Korean adolescents aged 12-18. The analysis investigated obesity odds ratio (OR) according to neighborhood SES adjusted for age and individual SES indices, which included family affluence scale (FAS), education level of parents, cohabitation with parents, and weekly allowance. Obesity OR was investigated according to neighborhood SES by FAS, and according to FAS by neighborhood SES. RESULTS: After adjusting for age and individual SES variables, there was no significant association between neighborhood SES and adolescent obesity for either boys or girls. However, girls in the high FAS group showed a pattern of lower neighborhood SES being associated with a significant increase in risk of obesity; in the high neighborhood SES group, boys showed a pattern of higher FAS being associated with a significant increase in risk of obesity, whereas girls show a pattern of decrease. CONCLUSION: Although limited, the present study demonstrated that some girl groups exhibited a pattern of lower neighborhood SES being associated with an increase in risk of obesity, as well as a gender-based difference in risk of obesity by individual SES. Therefore, measures to prevent adolescent obesity should be established with consideration for differences in risk according to individual and neighborhood SES.
Adolescent* ; Education ; Female ; Humans ; Korea* ; Obesity* ; Odds Ratio ; Parents ; Pediatric Obesity ; Residence Characteristics* ; Risk-Taking* ; Social Class* ; Social Problems ; Socioeconomic Factors

Purpose: To analyze the overall knowledge and attitude of healthcare providers regarding coronavirus disease (COVID-19) vaccine recommendations for pregnant women and factors affecting these opinions in Korea. Methods: We conducted a nationwide survey study of obstetricians and gynecologists registered in the Korean Society of Obstetrics and Gynecology. The knowledge, attitude, and factors affecting COVID-19 vaccination in pregnant women were investigated. Results: Among 258 participants, 182 (70.5%) answered that they recommended COVID-19 vaccination for pregnant women, while 76 (29.5%) answered that they did not. The administrative district of the physician's healthcare center and knowledge regarding adverse reactions to the COVID-19 vaccine were factors affecting opinions on vaccine recommendation. Physicians working in metropolitan cities were 7.3 times more likely to recommend COVID-19 vaccination to pregnant women than those working in Seoul. Physicians aware of the COVID-19 vaccine safety profiles in pregnant women were 25.36 times more likely to recommend vaccines than those who were not. A significantly higher proportion of the recommended group provided vaccine information to pregnant women compared to the nonrecommended group and also recommended booster shot vaccination. Guidelines from academic societies (70.9%) and from government and public centers (64.8%) were important factors in the recommendation group, while additional study results (57.1%) were important factors in the nonrecommendation group. This information will be useful for future reference regarding vaccine recommendations. Conclusion Providing guidelines and recent data regarding COVID-19 vaccination in pregnant populations to healthcare providers will promote obstetricians and gynecologists to recommend vaccination to pregnant patients and will thereby contribute to achieving herd immunity in Korea.

There have been ongoing social discussions on revision of the abortion law since the Constitutional Court ruled it nonconformity to the constitution on April 11, 2019. Thus, Korean Society of Obstetrics and Gynecology, Korean Society of Maternal Fetal Medicine, Korean College of Obstetricians and Gynecologists, and Korean Association of Obstetricians and Gynecologists organized 'special committee for abortion law' to support social discussion on the revision of the abortion law, and they prepared official opinions of obstetrics for medical issues including doctors' right to refuse abortion. In the future, the committee will continue to adapt to changes of medical environment especially after the revision of the abortion law by collecting its members' feedbacks.

There have been ongoing social discussions on revision of the abortion law since the Constitutional Court ruled it nonconformity to the constitution on April 11, 2019. Thus, Korean Society of Obstetrics and Gynecology, Korean Society of Maternal Fetal Medicine, Korean College of Obstetricians and Gynecologists, and Korean Association of Obstetricians and Gynecologists organized 'special committee for abortion law' to support social discussion on the revision of the abortion law, and they prepared official opinions of obstetrics for medical issues including doctors' right to refuse abortion. In the future, the committee will continue to adapt to changes of medical environment especially after the revision of the abortion law by collecting its members' feedbacks.

BACKGROUND: This study aimed to evaluate the effect of cervical cerclage on the recurrence risk for preterm birth in singleton pregnant women after a twin spontaneous preterm birth (sPTB).METHODS: This multicenter retrospective cohort study included women who had a singleton pregnancy from January 2009 to December 2018 at 10 referral hospitals and a twin sPTB before the current pregnancy. We compared the cervical lengths during pregnancy and pregnancy outcomes, according to the placement of prophylactic or emergency cerclage. We evaluated the independent risk factors for sPTB (< 37 weeks of gestation) in a subsequent singleton pregnancy.RESULTS: For the index singleton pregnancy, preterm birth occurred in seven (11.1%) of 63 women. There was no significant difference in the cervical lengths during pregnancy in women with and without cerclage. In a multivariate logistic regression analysis, the placement of emergency cerclage was an independent risk factor for subsequent singleton preterm birth (odds ratio [OR], 93.188; 95% confidence interval [CI], 1.633–5,316.628; P = 0.027); however, the placement of prophylactic cerclage (OR, 19.264; 95% CI, 0.915–405.786; P = 0.057) was not a factor. None of the women who received prophylactic cerclage delivered before 35 weeks' gestation in the index singleton pregnancy.CONCLUSION: Cerclage did not lower the risk of preterm birth in a subsequent singleton pregnancy after a twin sPTB. However, emergency cerclage was an independent risk factor for preterm birth and there was no preterm birth before 35 weeks' gestation in the prophylactic cerclage group. Therefore, close monitoring of the cervical length and prophylactic cerclage might be considered in women who have experienced a twin sPTB at extreme gestation.

Understanding the crosstalk mechanisms between perivascular cells (PVCs) and cancer cells might be beneficial in preventing cancer development and metastasis. In this study, we investigated the paracrine influence of PVCs derived from human umbilical cords on the proliferation of lung adenocarcinoma epithelial cells (A549) and erythroleukemia cells (TF-1α and K562) in vitro using Transwell® co-culture systems. PVCs promoted the proliferation of A549 cells without inducing morphological changes, but had no effect on the proliferation of TF-1α and K562 cells. To identify the factors secreted from PVCs, conditioned media harvested from PVC cultures were analyzed by antibody arrays. We identified a set of cytokines, including persephin (PSPN), a neurotrophic factor, and a key regulator of oral squamous cell carcinoma progression. Supplementation with PSPN significantly increased the proliferation of A549 cells. These results suggested that PVCs produced a differential effect on the proliferation of cancer cells in a cell-type dependent manner. Further, secretome analyses of PVCs and the elucidation of the molecular mechanisms could facilitate the discovery of therapeutic target(s) for lung cancer.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Coculture Techniques ; Culture Media, Conditioned ; Cytokines ; Epithelial Cells* ; Humans* ; In Vitro Techniques ; K562 Cells ; Leukemia, Erythroblastic, Acute ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Umbilical Cord

BACKGROUND: This study aimed to evaluate the effect of cervical cerclage on the recurrence risk for preterm birth in singleton pregnant women after a twin spontaneous preterm birth (sPTB). METHODS: This multicenter retrospective cohort study included women who had a singleton pregnancy from January 2009 to December 2018 at 10 referral hospitals and a twin sPTB before the current pregnancy. We compared the cervical lengths during pregnancy and pregnancy outcomes, according to the placement of prophylactic or emergency cerclage. We evaluated the independent risk factors for sPTB (< 37 weeks of gestation) in a subsequent singleton pregnancy. RESULTS: For the index singleton pregnancy, preterm birth occurred in seven (11.1%) of 63 women. There was no significant difference in the cervical lengths during pregnancy in women with and without cerclage. In a multivariate logistic regression analysis, the placement of emergency cerclage was an independent risk factor for subsequent singleton preterm birth (odds ratio [OR], 93.188; 95% confidence interval [CI], 1.633–5,316.628; P = 0.027); however, the placement of prophylactic cerclage (OR, 19.264; 95% CI, 0.915–405.786; P = 0.057) was not a factor. None of the women who received prophylactic cerclage delivered before 35 weeks' gestation in the index singleton pregnancy. CONCLUSION Cerclage did not lower the risk of preterm birth in a subsequent singleton pregnancy after a twin sPTB. However, emergency cerclage was an independent risk factor for preterm birth and there was no preterm birth before 35 weeks' gestation in the prophylactic cerclage group. Therefore, close monitoring of the cervical length and prophylactic cerclage might be considered in women who have experienced a twin sPTB at extreme gestation.