1.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
2.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
3.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
4.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
5.Neutralization Testing–based Immunogenicity Analysis of Recent Prevalent Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Sublineages
Eun Ju LEE ; Hyeokjin LEE ; Sang Won O ; Jee Eun RHEE ; Jeong-Min KIM ; Dong Ju KIM ; Il-Hwan KIM ; Jin Sun NO ; Ae Kyung PARK ; Jeong-Ah KIM ; Chae Young LEE ; Young-Ki CHOI ; Eun-Jin KIM
Annals of Laboratory Medicine 2024;44(3):289-293
Although WHO declared the end of the public health emergency for coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), XBB lineages continue to evolve and emerge globally. In particular, XBB.1.5 and XBB.1.16 are raising concerns because of their high immune evasion, leading to apprehensions regarding vaccine efficacy reduction and potential reinfection. We aimed to investigate the COVID-19 outbreak in Korea and predict the likelihood of reinfection by testing neutralizing activity against live viruses from the S clade and 19 Omicron sublineages.We found a significant risk of infection with the currently prevalent XBB lineage for individuals who were either vaccinated early or infected during the initial Omicron outbreak. Vaccinated individuals were better equipped than unvaccinated individuals to produce neutralizing antibodies for other SARS-CoV-2 variants upon infection. Therefore, unvaccinated individuals do not easily develop neutralizing activity against other variants and face the highest risk of reinfection by the XBB lineage. Our study provides important information to facilitate the development of strategies for monitoring populations that would be the most susceptible to new COVID-19 outbreaks.
6.Obesity in Children and Adolescents: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity
Eungu KANG ; Yong Hee HONG ; Jaehyun KIM ; Sochung CHUNG ; Kyoung-Kon KIM ; Ji-Hee HAAM ; Bom Taeck KIM ; Eun Mi KIM ; Jung Hwan PARK ; Sang Youl RHEE ; Jee-Hyun KANG ; Young-Jun RHIE
Journal of Obesity & Metabolic Syndrome 2024;33(1):11-19
The prevalence of obesity in children and adolescents has been gradually increasing in recent years and has become a major health problem. Childhood obesity can readily progress to adult obesity. It is associated with obesity-related comorbidities, such as type 2 diabetes mellitus, hypertension, obstructive sleep apnea, non-alcoholic fatty liver disease, and the risk factor for cardiovascular disease. It is important to make an accurate assessment of overweight and obesity in children and adolescents with consideration of growth and development. Childhood obesity can then be prevented and treated using an appropriate treatment goal and safe and effective treatment strategies. This article summarizes the clinical practice guidelines for obesity in children and adolescents that are included in the 8th edition of the Clinical Practice Guidelines for Obesity of the Korean Society for the Study of Obesity.
7.Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
Jaehyun BAE ; Eugene HAN ; Hye Won LEE ; Cheol-Young PARK ; Choon Hee CHUNG ; Dae Ho LEE ; Eun-Hee CHO ; Eun-Jung RHEE ; Ji Hee YU ; Ji Hyun PARK ; Ji-Cheol BAE ; Jung Hwan PARK ; Kyung Mook CHOI ; Kyung-Soo KIM ; Mi Hae SEO ; Minyoung LEE ; Nan-Hee KIM ; So Hun KIM ; Won-Young LEE ; Woo Je LEE ; Yeon-Kyung CHOI ; Yong-ho LEE ; You-Cheol HWANG ; Young Sang LYU ; Byung-Wan LEE ; Bong-Soo CHA ;
Diabetes & Metabolism Journal 2024;48(6):1015-1028
Since the role of the liver in metabolic dysfunction, including type 2 diabetes mellitus, was demonstrated, studies on non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) have shown associations between fatty liver disease and other metabolic diseases. Unlike the exclusionary diagnostic criteria of NAFLD, MAFLD diagnosis is based on the presence of metabolic dysregulation in fatty liver disease. Renaming NAFLD as MAFLD also introduced simpler diagnostic criteria. In 2023, a new nomenclature, steatotic liver disease (SLD), was proposed. Similar to MAFLD, SLD diagnosis is based on the presence of hepatic steatosis with at least one cardiometabolic dysfunction. SLD is categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related/-associated liver disease, alcoholrelated liver disease, specific etiology SLD, and cryptogenic SLD. The term MASLD has been adopted by a number of leading national and international societies due to its concise diagnostic criteria, exclusion of other concomitant liver diseases, and lack of stigmatizing terms. This article reviews the diagnostic criteria, clinical relevance, and differences among NAFLD, MAFLD, and MASLD from a diabetologist’s perspective and provides a rationale for adopting SLD/MASLD in the Fatty Liver Research Group of the Korean Diabetes Association.
8.Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
Jaehyun BAE ; Eugene HAN ; Hye Won LEE ; Cheol-Young PARK ; Choon Hee CHUNG ; Dae Ho LEE ; Eun-Hee CHO ; Eun-Jung RHEE ; Ji Hee YU ; Ji Hyun PARK ; Ji-Cheol BAE ; Jung Hwan PARK ; Kyung Mook CHOI ; Kyung-Soo KIM ; Mi Hae SEO ; Minyoung LEE ; Nan-Hee KIM ; So Hun KIM ; Won-Young LEE ; Woo Je LEE ; Yeon-Kyung CHOI ; Yong-ho LEE ; You-Cheol HWANG ; Young Sang LYU ; Byung-Wan LEE ; Bong-Soo CHA ;
Diabetes & Metabolism Journal 2024;48(6):1015-1028
Since the role of the liver in metabolic dysfunction, including type 2 diabetes mellitus, was demonstrated, studies on non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) have shown associations between fatty liver disease and other metabolic diseases. Unlike the exclusionary diagnostic criteria of NAFLD, MAFLD diagnosis is based on the presence of metabolic dysregulation in fatty liver disease. Renaming NAFLD as MAFLD also introduced simpler diagnostic criteria. In 2023, a new nomenclature, steatotic liver disease (SLD), was proposed. Similar to MAFLD, SLD diagnosis is based on the presence of hepatic steatosis with at least one cardiometabolic dysfunction. SLD is categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related/-associated liver disease, alcoholrelated liver disease, specific etiology SLD, and cryptogenic SLD. The term MASLD has been adopted by a number of leading national and international societies due to its concise diagnostic criteria, exclusion of other concomitant liver diseases, and lack of stigmatizing terms. This article reviews the diagnostic criteria, clinical relevance, and differences among NAFLD, MAFLD, and MASLD from a diabetologist’s perspective and provides a rationale for adopting SLD/MASLD in the Fatty Liver Research Group of the Korean Diabetes Association.
9.Metabolic Dysfunction-Associated Steatotic Liver Disease in Type 2 Diabetes Mellitus: A Review and Position Statement of the Fatty Liver Research Group of the Korean Diabetes Association
Jaehyun BAE ; Eugene HAN ; Hye Won LEE ; Cheol-Young PARK ; Choon Hee CHUNG ; Dae Ho LEE ; Eun-Hee CHO ; Eun-Jung RHEE ; Ji Hee YU ; Ji Hyun PARK ; Ji-Cheol BAE ; Jung Hwan PARK ; Kyung Mook CHOI ; Kyung-Soo KIM ; Mi Hae SEO ; Minyoung LEE ; Nan-Hee KIM ; So Hun KIM ; Won-Young LEE ; Woo Je LEE ; Yeon-Kyung CHOI ; Yong-ho LEE ; You-Cheol HWANG ; Young Sang LYU ; Byung-Wan LEE ; Bong-Soo CHA ;
Diabetes & Metabolism Journal 2024;48(6):1015-1028
Since the role of the liver in metabolic dysfunction, including type 2 diabetes mellitus, was demonstrated, studies on non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) have shown associations between fatty liver disease and other metabolic diseases. Unlike the exclusionary diagnostic criteria of NAFLD, MAFLD diagnosis is based on the presence of metabolic dysregulation in fatty liver disease. Renaming NAFLD as MAFLD also introduced simpler diagnostic criteria. In 2023, a new nomenclature, steatotic liver disease (SLD), was proposed. Similar to MAFLD, SLD diagnosis is based on the presence of hepatic steatosis with at least one cardiometabolic dysfunction. SLD is categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related/-associated liver disease, alcoholrelated liver disease, specific etiology SLD, and cryptogenic SLD. The term MASLD has been adopted by a number of leading national and international societies due to its concise diagnostic criteria, exclusion of other concomitant liver diseases, and lack of stigmatizing terms. This article reviews the diagnostic criteria, clinical relevance, and differences among NAFLD, MAFLD, and MASLD from a diabetologist’s perspective and provides a rationale for adopting SLD/MASLD in the Fatty Liver Research Group of the Korean Diabetes Association.
10.Obesity in Children and Adolescents: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity
Eungu KANG ; Yong Hee HONG ; Jaehyun KIM ; Sochung CHUNG ; Kyoung-Kon KIM ; Ji-Hee HAAM ; Bom Taeck KIM ; Eun Mi KIM ; Jung Hwan PARK ; Sang Youl RHEE ; Jee-Hyun KANG ; Young-Jun RHIE
Journal of Obesity & Metabolic Syndrome 2024;33(1):11-19
The prevalence of obesity in children and adolescents has been gradually increasing in recent years and has become a major health problem. Childhood obesity can readily progress to adult obesity. It is associated with obesity-related comorbidities, such as type 2 diabetes mellitus, hypertension, obstructive sleep apnea, non-alcoholic fatty liver disease, and the risk factor for cardiovascular disease. It is important to make an accurate assessment of overweight and obesity in children and adolescents with consideration of growth and development. Childhood obesity can then be prevented and treated using an appropriate treatment goal and safe and effective treatment strategies. This article summarizes the clinical practice guidelines for obesity in children and adolescents that are included in the 8th edition of the Clinical Practice Guidelines for Obesity of the Korean Society for the Study of Obesity.

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