Carotid artery stenting (CAS) is considered for patients with symptomatic carotid stenosis of 50% or greater. Following CAS, hemodynamic changes can alter the cerebral perfusion status. Furthermore, hypotension and bradycardia may occur due to the stimulation of carotid sinus baroreceptors. A more meticulous approach to these hemodynamic changes is required, especially in patients with bilateral carotid artery stenosis and concurrent multiple cerebrovascular stenoses. This report presents a case of posterior cerebral artery territory infarction that occurred after bilateral CAS.

Objectives: This pilot study examined the preliminary findings associated with a cognitive-load-controlled structured psychodrama program on affect, fear of negative evaluation, and general psychopathology in long-term psychiatric inpatients, most of whom had schizophrenia spectrum disorders. Methods: A single-group pre-post design was used. A total of 125 stabilized long-term psychiatric inpatients participated in a 25-session structured psychodrama program. To enhance measurement validity in consideration of participants’ cognitive characteristics, self-report measures were administered in small-group sessions with individualized explanation. Primary outcomes (Positive and Negative Affect Schedule [PANAS], Affect Balance Scale [ABS], and Brief Fear of Negative Evaluation [BFNE]) were assessed in 125 participants, and the secondary outcome (Brief Psychiatric Rating Scale [BPRS]) was assessed in a randomly selected subgroup of 53 participants. Results: After the intervention, positive affect significantly increased, whereas negative affect significantly decreased on both the PANAS and ABS (all p＜0.001). BFNE scores significantly decreased from 43.14 to 28.94 (p＜0.001). Total BPRS scores also significantly decreased from 47.49 to 34.76 (p＜0.001), with notable improvements in depressive mood, anxiety, tension, somatic concern, and emotional withdrawal. Conclusion A structured psychodrama program may be a feasible and potentially beneficial psychosocial intervention for long-term psychiatric inpatients. However, given the single-group pre-post design and other methodological limitations, the magnitude of the observed changes should be interpreted cautiously. These findings may serve as preliminary data for future controlled trials.

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds. Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included. Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between –5.90 and –4.40. In the case of visual analog scale score, the MD ranged from –1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of –2.0 to 0.4. Conclusions There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds. Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included. Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between –5.90 and –4.40. In the case of visual analog scale score, the MD ranged from –1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of –2.0 to 0.4. Conclusions There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds. Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included. Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between –5.90 and –4.40. In the case of visual analog scale score, the MD ranged from –1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of –2.0 to 0.4. Conclusions There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.

Background: Meniscal scaffold implantation has been introduced as a treatment for meniscal injuries, but there is still no clear consensus on its clinical impact, including its chondroprotective effect. This review aimed to assess the chondroprotective effects, clinical outcomes, and survivorship of meniscal scaffold implantation compared to meniscectomy, as well as among different types of scaffolds. Methods: A comprehensive search strategy was performed on the databases of PubMed, Embase, Cochrane Library, and Google Scholar, encompassing articles published until June 1, 2024. Randomized controlled trials (RCT) and comparative studies published in English that reported results using collagen meniscal implant (CMI) and polyurethane meniscal scaffold for meniscal tear were included. Results: A total of 421 studies were initially identified across databases, and a systematic review was conducted on 8 studies involving 596 patients. Among the 5 studies that addressed the chondroprotective effect, none found that meniscal scaffolds had a higher chondroprotective effect compared to meniscectomy. In studies comparing CMI and meniscectomy, the Lysholm score results showed a mean difference (MD) range between –5.90 and –4.40. In the case of visual analog scale score, the MD ranged from –1.0 to 1.0. In studies comparing polyurethane meniscal scaffolds and CMI, the Tegner score results showed an MD range of –2.0 to 0.4. Conclusions There was no superiority in chondroprotective effects for both CMI and polyurethane meniscal scaffolds compared to meniscectomy. Although meniscal scaffolds may provide improvements in clinical outcomes, no clinically relevant differences were observed in comparison to meniscectomy. There are no discernible differences between the 2 types of scaffolds.

Purpose: This study aimed to investigate the role of muscle strength exercise in the association between obesity status and knee osteoarthritis (KOA). Methods: The study subjects were 1,266 elderly women aged 65 years and older who participated in the Korea National Health and Nutrition Examination Survey from 2009 to 2011. Participants were categorized into three groups (normal, single obesity, multi-obesity) based on the presence or absence of obesity and abdominal obesity determined by body mass index and waist circumference. Additionally, they were categorized into two groups based on the presence or absence of muscle strength exercise. Logistic regression used to examine the odds ratios (OR) and 95% confidence intervals (CI) for KOA according to the independent and combined levels of obesity status and participation in strength training. Results: The multi-obesity group had a significantly higher probability of being exposed to KOA compared to the normal group (OR, 2.489; 95% CI, 1.837−3.372). However, there was no significant difference between the groups with and without participation in muscle strength exercise. We also calculated ORs for KOA exposure according to muscle strength exercise participation by obesity status. The results showed that in the multi-obesity group, the probability of KOA exposure was significantly higher in the group not participating in muscle strength exercise compared to the group participating in muscle strength exercise (OR, 2.998; 95% CI, 1.312−6.853). Conclusion This study suggests that regularly participating in muscle strength exercise may play a protective role against the risk of KOA associated with obesity and abdominal obesity.

Purpose: The Avoid Axillary Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy (ASLAN) trial aims to demonstrate the oncologic safety of omitting axillary surgery in patients with excellent response after neoadjuvant chemotherapy (NACT) for early human epidermal growth factor 2 (HER2)-positive (+)/triple-negative breast cancer (TNBC) who have undergone breast-conserving surgery (BCS) and adjuvant radiotherapy. The ASLAN trial will provide crucial information that could change the procedure in highly selected patients undergoing axillary surgery after NACT. Methods ASLAN is a prospective, multicenter, and single-arm surgical trial. The recruitment will be conducted among five tertiary care hospitals in the Republic of Korea. The total number of patients to be recruited will be 178, and we plan to complete patient enrollment by December 2023. The enrollment is considered among patients with HER2+ breast cancer (BC) or TNBC at clinical stage T1–3N0–1M0 who are expected to achieve breast pathological complete response (BpCR) based on a combination of radiologic imaging and physical examination after NACT. BCS was performed on eligible patients. After BCS, patients who showed BpCR were enrolled with the omission of sentinel lymph node biopsy (SLNB). The primary study endpoint upon completion of this trial is 5-year recurrence-free survival, and the secondary endpoints include the 5-year ipsilateral breast tumor recurrence interval, 5-year ipsilateral axillary recurrence interval, 5-year distant metastasis-free survival, 5-year BC-specific survival, 5-year overall survival, 5-year contralateral BC-free survival, re-operation rate according to breast biopsy after NACT, adverse events within 5 years, and quality of life.Discussion: Several clinical trials are currently underway to determine whether SLNB can be omitted after NACT in patients with HER2+ BC or TNBC that are expected to achieve pathologic complete response. The ASLAN trial is expected to provide valuable clues regarding the feasibility of omitting axillary surgery in highly selected patients.

Purpose: Despite the increasing use of immediate breast reconstruction (IBR), its oncologic safety in the setting of neoadjuvant chemotherapy (NACT) needs to be comprehensively clarified in breast cancer management. The objective of the present study was to analyze the oncologic safety of IBR following NACT. Methods: In total, 587 patients with breast cancer who underwent a total mastectomy (TM) with IBR after NACT between 2008 and 2017 at a single institution were retrospectively reviewed. The reviewed patients with IBR following skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) were matched 1:3 to patients who underwent TM alone after NACT. Matching variables included age, clinical T and N stages before NACT, response to NACT, pathologic T and N stages, and molecular subtypes. Results: After propensity score matching, 95 patients who underwent IBR following SSM/ NSM after NACT (IBR group) and 228 patients who underwent TM alone after NACT (TM group) were selected. The median follow-up period was 73 (range, 5–181) months after matching. After matching, there were no significant differences between the two groups in 5-year locoregional recurrence-free survival (88.8% vs. 91.2%, p = 0.516), disease-free survival (67.3% vs. 76.6%, p = 0.099), distant metastasis-free survival (71.9% vs. 81.9%, p = 0.057), or overall survival (84.1% vs. 91.5, p = 0.061) rates. In multivariate analyses, conducting IBR was not associated with increased risks for locoregional recurrence, any recurrence, distant metastasis, or overall death. Conclusion Our findings suggest that IBR following SSM/NSM elicits comparable long-term oncologic outcomes to those of TM alone in the setting of NACT.

Amyloidosis is a idiopathic clinical syndrome caused by deposition of non-soluble protein fibers in the extracellular matrix of organs and tissues. It causes chronic inflammation and destruction of the architecture and functionality of the involved tissue. Amyloidosis occurring in the upper airway tract is rare, accounting for 0.2% to 1.2% of benign tumors of the larynx. In general, the purpose of treatment is reduce the risk of dysphagia and dyspnea. Endoscopic surgery is the mainstream of the treatment because laryngeal preserving is the most important goal of treatment. However, the disadvantage of this treatment is that it can lose voice and may require multiple reoperation. In this article, we report a case in which vertical partial laryngectomy (VPL) in a patient with laryngeal amyloidosis, because the patient want her voice restoration. It was observed that voice restoration and airway patency were maintained for two years without additional surgical treatment after the surgery. Although additional studies are needed, VPL can be a good option for patients who want to preserve their voice.