Purpose: This study compared the outcomes of three commonly used reconstructive techniques—the thenar flap, partial toe pulp free flap, and radial artery superficial palmar (RASP) flap—for the reconstruction of fingertip and pulp defects, in order to provide guidance for surgeons in selecting the appropriate method based on defect size and patient characteristics. Methods: A retrospective chart review was conducted on 50 patients who underwent fingertip or pulp reconstruction. Nine patients received thenar flaps, 26 received partial toe pulp free flaps, and 15 received RASP flaps. Patient demographics, defect size, flap survival, donor site morbidity, and patient satisfaction were analyzed. Results: All flaps survived. In the RASP flap group, three cases of partial necrosis were successfully managed without additional surgical interventions. The thenar flap group had donor site pain and joint stiffness, while the partial toe pulp free flap group exhibited no donor site complications. The RASP flap group experienced hypertrophic scarring in five cases. Patient satisfaction was high across all groups, with the partial toe pulp free flap yielding the most positive outcomes. Conclusion The thenar flap is a reliable option for small defects, especially those with exposed bone, but is associated with donor site morbidity and joint stiffness. The partial toe pulp free flap provides superior functional and aesthetic results for moderate defects, though it requires more surgical expertise and has a longer recovery time. The RASP flap is optimal for larger defects, offering good cosmetic results but requiring careful donor site management to avoid hypertrophic scarring.

Purpose: This study compared the outcomes of three commonly used reconstructive techniques—the thenar flap, partial toe pulp free flap, and radial artery superficial palmar (RASP) flap—for the reconstruction of fingertip and pulp defects, in order to provide guidance for surgeons in selecting the appropriate method based on defect size and patient characteristics. Methods: A retrospective chart review was conducted on 50 patients who underwent fingertip or pulp reconstruction. Nine patients received thenar flaps, 26 received partial toe pulp free flaps, and 15 received RASP flaps. Patient demographics, defect size, flap survival, donor site morbidity, and patient satisfaction were analyzed. Results: All flaps survived. In the RASP flap group, three cases of partial necrosis were successfully managed without additional surgical interventions. The thenar flap group had donor site pain and joint stiffness, while the partial toe pulp free flap group exhibited no donor site complications. The RASP flap group experienced hypertrophic scarring in five cases. Patient satisfaction was high across all groups, with the partial toe pulp free flap yielding the most positive outcomes. Conclusion The thenar flap is a reliable option for small defects, especially those with exposed bone, but is associated with donor site morbidity and joint stiffness. The partial toe pulp free flap provides superior functional and aesthetic results for moderate defects, though it requires more surgical expertise and has a longer recovery time. The RASP flap is optimal for larger defects, offering good cosmetic results but requiring careful donor site management to avoid hypertrophic scarring.

Purpose: This study compared the outcomes of three commonly used reconstructive techniques—the thenar flap, partial toe pulp free flap, and radial artery superficial palmar (RASP) flap—for the reconstruction of fingertip and pulp defects, in order to provide guidance for surgeons in selecting the appropriate method based on defect size and patient characteristics. Methods: A retrospective chart review was conducted on 50 patients who underwent fingertip or pulp reconstruction. Nine patients received thenar flaps, 26 received partial toe pulp free flaps, and 15 received RASP flaps. Patient demographics, defect size, flap survival, donor site morbidity, and patient satisfaction were analyzed. Results: All flaps survived. In the RASP flap group, three cases of partial necrosis were successfully managed without additional surgical interventions. The thenar flap group had donor site pain and joint stiffness, while the partial toe pulp free flap group exhibited no donor site complications. The RASP flap group experienced hypertrophic scarring in five cases. Patient satisfaction was high across all groups, with the partial toe pulp free flap yielding the most positive outcomes. Conclusion The thenar flap is a reliable option for small defects, especially those with exposed bone, but is associated with donor site morbidity and joint stiffness. The partial toe pulp free flap provides superior functional and aesthetic results for moderate defects, though it requires more surgical expertise and has a longer recovery time. The RASP flap is optimal for larger defects, offering good cosmetic results but requiring careful donor site management to avoid hypertrophic scarring.

Background: The Clauss assay is widely used to quantify blood fibrinogen levels in clinical laboratories. However, by relying on thrombin as the main reagent, the Clauss assay is susceptible to interference from thrombin inhibitors, such as heparin or direct thrombin inhibitors. Here, we developed an innovative fibrinogen assay utilizing both recombinant batroxobin (rBat) and carboxymethyl chitosan (CMCS). Methods: Various biopolymers were tested to identify a suitable candidate that could enhance rBat-induced fibrin clot formation. Chromogenic substrate hydrolysis and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis showed that CMCS potentiated rBat activity. Consequently, we formulated a novel fibrinogen assay reagent, ANYFIB.C, comprising rBat and CMCS. We compared ANYFIB.C fibrinogen with an established reagent (HemosIL fibrinogen-C) with 96 clinical samples using an ACL-TOP 700 coagulation analyzer. We also evaluated the interfering effects of thrombin inhibitors on fibrinogen measurements. Results: CMCS significantly enhanced the enzymatic activity of rBat and dose-dependently reduced plasma clotting times. ANYFIB.C fibrinogen levels were comparable with those of HemosIL fibrinogen-C, with the 95% confidence intervals of the Passing–Bablok regres-sion intercept and slope being −7.4797 to 6.0185 and 0.9581 to 1.0116, respectively. Nosignificant interference was observed with heparin concentrations up to 10 U/mL or dabigatran concentrations up to 600 µg/L in the ANYFIB.C fibrinogen assays. In contrast, the HemosIL fibrinogen-C reagent demonstrated inhibitory interference at dabigatran concentrations as low as 150 µg/L. Conclusions Our results suggest that ANYFIB.C (a mixture of CMCS and rBat) can be used to measure blood fibrinogen levels effectively and protect from thrombin inhibitor interference.

Background: Flow cytometric immunophenotyping of hematolymphoid neoplasms (FCIHLN) is essential for diagnosis, classification, and minimal residual disease (MRD) monitoring. FCI-HLN is typically performed using in-house protocols, raising the need for standardization. Therefore, we surveyed the current status of FCI-HLN in Korea to obtain fundamental data for quality improvement and standardization. Methods: Eight university hospitals actively conducting FCI-HLN participated in our survey.We analyzed responses to a questionnaire that included inquiries regarding test items, reagent antibodies (RAs), fluorophores, sample amounts (SAs), reagent antibody amounts (RAAs), acquisition cell number (ACN), isotype control (IC) usage, positiveegative criteria, and reporting. Results: Most hospitals used acute HLN, chronic HLN, plasma cell neoplasm (PCN), and MRD panels. The numbers of RAs were heterogeneous, with a maximum of 32, 26, 12, 14, and 10 antibodies used for acute HLN, chronic HLN, PCN, ALL-MRD, and multiple myeloma-MRD, respectively. The number of fluorophores ranged from 4 to 10. RAs, SAs, RAAs, and ACN were diverse. Most hospitals used a positive criterion of 20%, whereas one used 10% for acute and chronic HLN panels. Five hospitals used ICs for the negative criterion. Positiveegative assignments, percentages, and general opinions were commonly reported. In MRD reporting, the limit of detection and lower limit of quantification were included. Conclusions This is the first comprehensive study on the current status of FCI-HLN in Korea, confirming the high heterogeneity and complexity of FCI-HLN practices. Standardization of FCI-HLN is urgently needed. The findings provide a reference for establishing standard FCI-HLN guidelines.

Total gastrectomy has been a standard treatment for upper-third early gastric cancer for decades. Supplementation is essential after total gastrectomy due to vitamin B12 deficiency. Additionally, postoperative complications, such as reflux esophagitis, anastomotic stricture, leakage, and malnutrition, are the main issues. Proximal gastrectomy is considered an alternative treatment for upper-third early gastric cancer. As a function-preserving gastrectomy it is known that the incidence of vitamin B12 deficiency is low and due to its various reconstruction methods we can easily overcome major postoperative complications. Therefore, we aimed to review about proximal gastrectomy, how it is reconstructed, and complications after reconstruction.

Purpose: This study aimed to conduct a systematic literature review and meta-analysis of the exercise intervention effects for the prevention of musculoskeletal injuries in military personnel. Methods: Among studies that included military personnel as participants, we identified randomized controlled trials (RCTs) and cluster-RCT studies that used exercise interventions as a method for injury prevention. Exercise encompassed all types of physical activity, and the effect size was determined by the ratio of injuries between groups.Literature searches were conducted with search terms modified to ensure common inclusion of keywords such as “Soldier,” “Injury prevention,” and “Exercise.” For the analysis of potential factors, variables selected for group differentiation included gender, risk of bias, exercise volume, injury location, exercise type, and study design. Results: Among a total of 8,598 search results, 10 papers were finally confirmed. The meta-analysis of all 10 papers showed that there was no statistically significant injury prevention effect, and significant heterogeneity was observed among the studies (incidence rate ratio, 0.82; 95% confidence interval, 0.62–1.09, I2 =83%). Subgroup analysisrevealed a significant 44% reduction in injuries in studies where exercise volume for injury prevention was relatively high. However, no significant injury prevention effects were observed in other potential factors between groups. Conclusion The results of this study suggest that the effectiveness of injury prevention exercises in military settings was not statistically significant. However, through the analysis of potential factors, it was confirmed that increasing the time spent on injury prevention exercises may have a preventive effect on injuries.

Purpose: The incidence of early-onset colorectal cancer (CRC) and associated mortality have been increasing. However, the potential benefits of CRC screening are largely unknown in young individuals. We aimed to evaluate the effect of CRC screening with colonoscopy on all-cause and CRC mortality among young (aged < 45 years) and older (aged ≥ 45 years) individuals. Materials and Methods: This cohort study included 528,046 Korean adults free of cancer at baseline who underwent a comprehensive health examination. The colonoscopic screening group was defined as those who reported undergoing colonoscopy for CRC screening. Mortality follow-up until December 31, 2019 was ascertained based on nationwide death certificate data from the Korea National Statistical Office. Results: Colonoscopic screening was associated with a lower risk of all-cause mortality in both young and older individuals. Multivariable-adjusted time-dependent hazard ratios (95% confidence intervals) for all-cause mortality comparing ever- to never-screening were 0.86 (0.75-0.99) for young individuals and 0.71 (0.65-0.78) for older individuals. Colonoscopic screenings were also associated with a reduced risk of CRC mortality without significant interaction by age, although this association was significant only among participants aged ≥ 45 years, with corresponding time-dependent hazard ratios of 0.47 (0.15-1.44) for young individuals and 0.52 (0.31-0.87) for those aged ≥ 45 years. Conclusion Colonoscopic CRC screening decreased all-cause mortality among both young and older individuals, while significantly decreased CRC mortality was observed only in those aged ≥ 45 years. Screening initiation at an earlier age warrants more rigorous confirmatory studies.

Germinal matrix-intraventricular hemorrhage (GM-IVH) is among the devastating neurological complications with mortality and neurodevelopmental disability rates ranging from 14.7% to 44.7% in preterm infants. The medical techniques have improved throughout the years, as the morbidity-free survival rate of very-low-birth-weight infants has increased; however, the neonatal and long-term morbidity rates have not significantly improved. To this date, there is no strong evidence on pharmacological management on GM-IVH, due to the limitation of well-designed randomized controlled studies. However, recombinant human erythropoietin administration in preterm infants seems to be the only effective pharmacological management in limited situations. Hence, further high-quality collaborative research studies are warranted in the future to ensure better outcomes among preterm infants with GM-IVH.