Objective: Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder. Methods: A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework. Results: Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial. Conclusion These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

Hyperthyroidism, characterized by elevated thyroid hormone levels and thyroid gland hyperplasia or adenoma, is a prevalent endocrinopathy in older cats. Treatment options include antithyroid drugs, surgical thyroidectomy, and radioiodine therapy (RAIT), which is non-invasive treatment option that can achieve complete remission. However, efficacy and safety of RAIT in hyperthyroid cats have not been investigated in South Korea. This study includes 10 hyperthyroid cats with RAIT. Initial assessments comprised history, physical examination, blood analysis, and serum total T4 (tT4) concentration. Thyroid scintigraphy revealed hyperactivity and enlargement of thyroid gland at 24 hours before the RAIT. Radioiodine (RAI) was injected subcutaneously with 2 to 6 mCi, determined by the fixed dose or the scoring system based on severity of clinical signs, tT4 concentration, and thyroid size individually. After RAIT, the concentration of serum tT4 and liver enzymes were significantly decreased at discharge. However, no significant differences were noted in blood urea nitrogen, creatinine, symmetric dimethylarginine, hematocrits, and white blood cell counts pre- and post-treatment. Although 4 cats received RAI twice, clinical signs disappeared and tT4 levels decreased following the RAIT. All 10 cats achieved complete remission after 6 months without critical adverse effect. The safety and the effectiveness of RAIT was confirmed based on protocols reported other countries. Therefore, RAIT could be considered the treatment option and prevent adverse effects from medication or surgery. This preliminary study presents the first evaluation of RAIT for hyperthyroid cats using locally produced RAI in South Korea and provide valuable insight for clinicians and further studies.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

We describe the first reported case of grain-free diet-induced dilated cardiomyopathy (DCM) in a dog in Korea. An 11-year-old female dog was referred with abdominal distention, anorexia, and vomiting, having been fed a grain-free diet for > 5 years. Thoracic radiography revealed cardiomegaly and pulmonary edema. Atrial fibrillation was detected using electrocardiography. The dog was tentatively diagnosed with congestive heart failure (CHF) secondary to grain-free diet-induced DCM, and its diet changed to contain grain. Digoxin and diltiazem were prescribed for the atrial fibrillation, and pimobendan, enalapril, and furosemide for CHF. Significant improvements in echocardiographic indices were confirmed after 3 months.

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal. Materials and Methods: We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation. Results: Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529). Conclusion In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.

Purpose: Febrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). Materials and methods: We conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485). Results: Since January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p<0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p<0.001). Dose delay was less common (≥3 days: 18.1% vs. 23.7%, p=0.015; ≥5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047). Conclusion Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥75 years.