This retrospective study compared cement penetration, the radiolucent line (RLL) incidence, and clinical outcomes in total knee arthroplasty (TKA) using high-viscosity cement (HVC) versus low-viscosity cement (LVC) with a minimum follow-up of two years. We hypothesized that LVC would result in superior cement penetration and a reduced RLL incidence compared with HVC without differences in clinical outcomes.A total of 100 patients (50 HVC, 50 LVC) who underwent TKA with the same implant design were included. Cement penetration was assessed in four tibial and two femoral zones. Clinical outcomes including the VAS, WOMAC, KSS, KOOS and FJS were evaluated preoperatively and at the final follow-up visit. Postoperative complications were recorded. LVC demonstrated significantly greater cement penetration in the posterior tibial zone (3.03 mm vs. vs 2.82 mm; p=0.005) and posterior femoral zone (1.76 mm vs.1.39 mm; p<0.000) than HVC, and no differences were observed in other zones. The RLL incidence and rates of complications including aseptic loosening and prosthetic joint infection were comparable between groups. Both groups showed significant postoperative improvements in the WOMAC, KSS, and KOOS, with no intergroup differences preoperatively and postoperatively. LVC demonstrated superior cement penetration in select zones, which may enhance implant fixation. However, there were no differences in the RLL incidence or clinical outcomes between the HVC and LVC groups.Both cements provided satisfactory fixation and clinical results, suggesting that either may be appropriate based on surgical preferences and fixation goals.

This retrospective study compared cement penetration, the radiolucent line (RLL) incidence, and clinical outcomes in total knee arthroplasty (TKA) using high-viscosity cement (HVC) versus low-viscosity cement (LVC) with a minimum follow-up of two years. We hypothesized that LVC would result in superior cement penetration and a reduced RLL incidence compared with HVC without differences in clinical outcomes.A total of 100 patients (50 HVC, 50 LVC) who underwent TKA with the same implant design were included. Cement penetration was assessed in four tibial and two femoral zones. Clinical outcomes including the VAS, WOMAC, KSS, KOOS and FJS were evaluated preoperatively and at the final follow-up visit. Postoperative complications were recorded. LVC demonstrated significantly greater cement penetration in the posterior tibial zone (3.03 mm vs. vs 2.82 mm; p=0.005) and posterior femoral zone (1.76 mm vs.1.39 mm; p<0.000) than HVC, and no differences were observed in other zones. The RLL incidence and rates of complications including aseptic loosening and prosthetic joint infection were comparable between groups. Both groups showed significant postoperative improvements in the WOMAC, KSS, and KOOS, with no intergroup differences preoperatively and postoperatively. LVC demonstrated superior cement penetration in select zones, which may enhance implant fixation. However, there were no differences in the RLL incidence or clinical outcomes between the HVC and LVC groups.Both cements provided satisfactory fixation and clinical results, suggesting that either may be appropriate based on surgical preferences and fixation goals.

This retrospective study compared cement penetration, the radiolucent line (RLL) incidence, and clinical outcomes in total knee arthroplasty (TKA) using high-viscosity cement (HVC) versus low-viscosity cement (LVC) with a minimum follow-up of two years. We hypothesized that LVC would result in superior cement penetration and a reduced RLL incidence compared with HVC without differences in clinical outcomes.A total of 100 patients (50 HVC, 50 LVC) who underwent TKA with the same implant design were included. Cement penetration was assessed in four tibial and two femoral zones. Clinical outcomes including the VAS, WOMAC, KSS, KOOS and FJS were evaluated preoperatively and at the final follow-up visit. Postoperative complications were recorded. LVC demonstrated significantly greater cement penetration in the posterior tibial zone (3.03 mm vs. vs 2.82 mm; p=0.005) and posterior femoral zone (1.76 mm vs.1.39 mm; p<0.000) than HVC, and no differences were observed in other zones. The RLL incidence and rates of complications including aseptic loosening and prosthetic joint infection were comparable between groups. Both groups showed significant postoperative improvements in the WOMAC, KSS, and KOOS, with no intergroup differences preoperatively and postoperatively. LVC demonstrated superior cement penetration in select zones, which may enhance implant fixation. However, there were no differences in the RLL incidence or clinical outcomes between the HVC and LVC groups.Both cements provided satisfactory fixation and clinical results, suggesting that either may be appropriate based on surgical preferences and fixation goals.

Background: The Coronal Plane Alignment of the Knee (CPAK) classification system has been developed as a comprehensive system that describes 9 coronal plane phenotypes based on constitutional limb alignment and joint line obliquity (JLO). Due to the characteristics of Asian populations, which show more varus and wider distribution in lower limb alignment than other populations, modification of the boundaries of the arithmetic hip-knee-ankle angle (aHKA) and JLO should be considered. The purpose of this study was to determine the knee phenotype in a Korean population based on the original CPAK and modified CPAK classification systems. Methods: We reviewed prospectively collected data of 500 healthy and 500 osteoarthritic knees between 2021 and 2023 using radiographic analysis and divided them based on the modified CPAK classification system by widening the neutral boundaries of the aHKA to 0° ± 3° and using the actual JLO as a new variable. Using long-leg standing weight-bearing radiographs, 6 radiographic parameters were measured to evaluate the CPAK type: the mechanical HKA angle, medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), aHKA, JLO, and actual JLO. Results: From 2 cohorts of 1,000 knees, the frequency distribution representing all CPAK types was different between the healthy and arthritic groups. The most common categories were type II (38.2%) in the healthy group and type I (53.8%) in the arthritic group based on the original CPAK classification. The left and upward shift in the distribution of knee phenotypes in the original classification was corrected evenly after re-establishing the boundaries of a neutral aHKA and the actual JLO. According to the modified CPAK classification system, the most common categories were type II (35.2%) in the healthy group and type I (38.0%) in the arthritic group. Conclusions Although the modified CPAK classification corrected the uneven distribution seen when applying the original classification system in a Korean population, the most common category was type I in Korean patients with osteoarthritic knees in both classification systems. Furthermore, there were different frequencies of knee phenotypes among healthy and arthritic knees.

UI026 is an expectorant and antitussive agent which is a new combination of Pelargonium sidoides extract andCoptis extract. The bioactive compounds of Pelargonium sidoides and Coptis extracts were identified as epicatechin and berberine, respectively. This study evaluated the effect of food on the pharmacokinetics (PKs) and safety of UI026. A randomized, openlabel, single-dose, 2-treatment, parallel study in 12 healthy male subjects was performed. Subjects received a single oral dose of UI026 (27 mL of syrup) under a fed or fasted condition according to their randomly assigned treatment. Blood samples for the PK analysis were obtained up to 24 hours post-dose for berberine and 12 hours post-dose for epicatechin. The PK parameters were calculated by non-compartmental analysis. In the fed condition, the mean maximum plasma concentration (C max ) and mean area under the plasma concentrationtime curve from time zero to the last observed time point (AUC last ) for berberine were approximately 33% and 67% lower, respectively, compared with the fasted condition, both showing statistically significant difference. For epicatechin, the mean C max and mean AUC last were about 29% and 45% lower, respectively, compared to the fasting condition, neither of which showed a statistically significant difference. There were no drug-related adverse events. This finding suggests that food affects the systemic exposure and bioavailability of berberine and epicatechin.

Alpha-lipoic acid (ALA) is a naturally occurring antioxidant and has been previously used to treat diabetes and cardiovascular disease. However, the autophagy effects of ALA against oxidative stress-induced dopaminergic neuronal cell injury remain unclear. The aim of this study was to investigate the role of ALA in autophagy and apoptosis against oxidative stress in the SH-SY5Y human dopaminergic neuronal cell line. We examined SH-SY5Y phenotypes using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay (cell viability/proliferation), 4′,6-diamidino-2-phenylindole dihydrochloride nuclear staining, Live/Dead cell assay, cellular reactive oxygen species (ROS) assay, immunoblotting, and immunocytochemistry. Our data showed ALA attenuated hydrogen peroxide (H2O2)-induced ROS generation and cell death. ALA effectively suppressed Bax up-regulation and Bcl-2 and BclxL down-regulation. Furthermore, ALA increased the expression of the antioxidant enzyme, heme oxygenase-1. Moreover, the expression of Beclin-1 and LC-3 autophagy biomarkers was decreased by ALA in our cell model. Combined, these data suggest ALA protects human dopaminergic neuronal cells against H2O2-induced cell injury by inhibiting autophagy and apoptosis.

Objective: Coronavirus disease 2019 (COVID-19) has psychological effects such as anxiety and depression as well as direct infection in people. The Fear of COVID-19 scale is a scale that can measure anxiety related to COVID-19 in a short time. The purpose of this study was to verify the reliability and validity the Korean version of Fear of COVID-19 scale (KF-COVID-19S). Methods: The data of total 186 normal adults and 17 patients were finally used for the statistical analysis. For internal consistency, Cronbach’s α was calculated. For concurrent and discriminant validity, the correlations with the Hospital Anxiety and Depression scale (HADS), Patient Health Questionnaire-15 (PHQ-15), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOLBREF) were analyzed. For construct validity, exploratory and confirmatory factor analysis were conducted. Results: Cronbach alpha was 0.88. The two-factor model (factor 1: Physical fear, factor 2: Emotional fear) showed significantly positive correlations and appeared to be “good” fitness (CFI=0.906, IFI=0.907, NFI=0.902). Conclusion The KF-COVID-19S can be a useful scale that can measure the physical and emotional fears associated with COVID-19 in a short time. Because the psychiatric patients are a more vulnerable group to the fear, it is thought that the KF-COVID-19S will help to determine the patient’s level of anxiety and make a therapeutic plan for the underlying mental disorder.

Alpha-lipoic acid (ALA) is a naturally occurring antioxidant and has been previously used to treat diabetes and cardiovascular disease. However, the autophagy effects of ALA against oxidative stress-induced dopaminergic neuronal cell injury remain unclear. The aim of this study was to investigate the role of ALA in autophagy and apoptosis against oxidative stress in the SH-SY5Y human dopaminergic neuronal cell line. We examined SH-SY5Y phenotypes using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay (cell viability/proliferation), 4′,6-diamidino-2-phenylindole dihydrochloride nuclear staining, Live/Dead cell assay, cellular reactive oxygen species (ROS) assay, immunoblotting, and immunocytochemistry. Our data showed ALA attenuated hydrogen peroxide (H2O2)-induced ROS generation and cell death. ALA effectively suppressed Bax up-regulation and Bcl-2 and BclxL down-regulation. Furthermore, ALA increased the expression of the antioxidant enzyme, heme oxygenase-1. Moreover, the expression of Beclin-1 and LC-3 autophagy biomarkers was decreased by ALA in our cell model. Combined, these data suggest ALA protects human dopaminergic neuronal cells against H2O2-induced cell injury by inhibiting autophagy and apoptosis.

Objective: Coronavirus disease 2019 (COVID-19) has psychological effects such as anxiety and depression as well as direct infection in people. The Fear of COVID-19 scale is a scale that can measure anxiety related to COVID-19 in a short time. The purpose of this study was to verify the reliability and validity the Korean version of Fear of COVID-19 scale (KF-COVID-19S). Methods: The data of total 186 normal adults and 17 patients were finally used for the statistical analysis. For internal consistency, Cronbach’s α was calculated. For concurrent and discriminant validity, the correlations with the Hospital Anxiety and Depression scale (HADS), Patient Health Questionnaire-15 (PHQ-15), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOLBREF) were analyzed. For construct validity, exploratory and confirmatory factor analysis were conducted. Results: Cronbach alpha was 0.88. The two-factor model (factor 1: Physical fear, factor 2: Emotional fear) showed significantly positive correlations and appeared to be “good” fitness (CFI=0.906, IFI=0.907, NFI=0.902). Conclusion The KF-COVID-19S can be a useful scale that can measure the physical and emotional fears associated with COVID-19 in a short time. Because the psychiatric patients are a more vulnerable group to the fear, it is thought that the KF-COVID-19S will help to determine the patient’s level of anxiety and make a therapeutic plan for the underlying mental disorder.

Background: This study aimed to describe the current status of acute stroke care in Korea and explore disparities among hospitals and regions. Methods: The 2013 and 2014 national stroke audit data and the national health insurance claims data were linked and used for this study. Stroke patients hospitalized via emergency rooms within 7 days of stroke onset were selected. Results: A total of 19,608 patients treated in 216 hospitals were analyzed. Among them 76% had ischemic stroke; 15%, intracerebral hemorrhage (ICH); and 9%, subarachnoid hemorrhage (SAH). Of the hospitals, 31% provided inpatient stroke unit care. Ambulances were used in 56% of cases, and the median interval from onset to arrival was 4.5 hours. One-quarter of patients were referred from other hospitals. Intravenous thrombolysis (IVT) and endovascular treatment (EVT) rates were 11% and 4%, respectively. Three-quarters of the analyzed hospitals provided IVT and/or EVT, whereas 47% of hospitals providing IVT and 67% of hospitals providing EVT had less than one case per month. Decompressive surgery was performed on 28% of ICH patients, and clipping and coiling were performed in 17.2% and 14.3% of SAH patients, respectively. There were noticeable regional disparities between the various interventions, ambulance use, arrival time, and stroke unit availability. Conclusion This study describes the current status of acute stroke care in Korea. Despite quite acceptable quality of stroke care, it suggests regional and hospital disparities. Expansion of stroke units, stroke center certification or accreditation, and connections between stroke centers and emergency medical services are highly recommended.