1.Recent advances in single-port robotic thyroidectomy:evolution, techniques, and clinical outcomes
Jin Kyong KIM ; Dong Wook KIM ; Jae Sang RYU ; Sungkeun KANG ; Eun Jin KIM ; Sang-Wook KANG ; Jong Ju JEONG ; Kee-Hyun NAM ; Woong Youn CHUNG
Annals of Surgical Treatment and Research 2026;110(1):3-11
Robotic thyroidectomy has progressed from multiport to single-port (SP) platforms to minimize invasiveness and improve cosmesis. The da Vinci SP system (Intuitive Surgical) combines a flexible 3-dimensional endoscope with 3 wristed instruments in a single 2.5-cm cannula-enabled concealed remote access route and mitigates external arm collisions.This review synthesized PubMed-indexed reports (2020–2025) on SP robotic thyroidectomy using the following approaches:transaxillary variants, SP areolar, retroauricular/facelift (SP-hairline variants), and transoral approach. We focused on technical refinement, learning curves, and clinical outcomes. We highlight technical refinements and clinical outcomes across access routes. Contemporary series indicate that SP thyroidectomy is feasible and safe in well-selected patients, with high cosmetic satisfaction and operative metrics comparable to those of multiport cohorts. Among the SP routes, transaxillary variants have the most mature peer-reviewed reporting and are therefore discussed in greater detail. Early applications of SP-assisted lateral neck dissection have also been described. The limitations of current SP platforms include constrained counter-traction, reduced internal workspace, and incomplete integration of advanced energy devices.Nonetheless, ongoing device innovations and the growing global experience suggest that SP systems will increasingly shape endocrine neck surgeries.
2.Conservative Treatment of Isolated Acute Anterior Cruciate Ligament Injury
Jin-Woong JEON ; Yong-Beom PARK
The Journal of the Korean Orthopaedic Association 2026;61(1):11-21
Anterior cruciate ligament (ACL) injuries are common sports-related knee injuries, with surgical treatment being widely accepted as the standard approach. An ACL reconstruction aims to restore the knee function, prevent secondary meniscal tears, and cartilage damage caused by instability. Acute isolated ACL injuries account for approximately 3%–10% of all ACL injuries, making them relatively uncommon.Various treatment methods, ranging from conservative management to ACL reconstruction, have been used, but surgical treatment is often preferred, particularly in young and active individuals. Conservative treatment allows patients to return to their previous activities, and studies have shown that its outcomes in terms of patient assessment and osteoarthritis incidence are comparable to those of surgical treatment. Nevertheless, it has some drawbacks, including a higher risk of secondary meniscal tears and mild static knee instability compared to surgery. Therefore, selecting suitable patients for conservative treatment is crucial for achieving satisfactory results. Various selection criteria have been proposed. Recent reports suggest that even young, highly active patients can return to their pre-injury activity levels if they are carefully selected for conservative treatment. With the appropriate indications and functional rehabilitation tailored to the patient’s expectations, conservative treatment can be considered a viable standard option for managing acute isolated ACL injuries. This review summarizes the clinical outcomes of conservative treatment for such injuries, focusing on appropriate indications and rehabilitation strategies based on the literature.
3.Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study
Seung-Kwon CHOI ; Jeong Woo LEE ; Seung Il JUNG ; Eu Chang HWANG ; Joongwon CHOI ; Woong Bin KIM ; Jung Sik HUH ; Jin Bong CHOI ; Yeonjoo KIM ; Jae Min CHUNG ; Ju-Hyun SHIN ; Jae Hung JUNG ; Hong CHUNG ; Sangrak BAE ; Tae-Hyoung KIM
Urogenital Tract Infection 2025;20(1):34-41
Purpose:
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN.
Materials and Methods:
Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results:
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.
4.Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study
Seung-Kwon CHOI ; Jeong Woo LEE ; Seung Il JUNG ; Eu Chang HWANG ; Joongwon CHOI ; Woong Bin KIM ; Jung Sik HUH ; Jin Bong CHOI ; Yeonjoo KIM ; Jae Min CHUNG ; Ju-Hyun SHIN ; Jae Hung JUNG ; Hong CHUNG ; Sangrak BAE ; Tae-Hyoung KIM
Urogenital Tract Infection 2025;20(1):34-41
Purpose:
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN.
Materials and Methods:
Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results:
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.
5.Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study
Seung-Kwon CHOI ; Jeong Woo LEE ; Seung Il JUNG ; Eu Chang HWANG ; Joongwon CHOI ; Woong Bin KIM ; Jung Sik HUH ; Jin Bong CHOI ; Yeonjoo KIM ; Jae Min CHUNG ; Ju-Hyun SHIN ; Jae Hung JUNG ; Hong CHUNG ; Sangrak BAE ; Tae-Hyoung KIM
Urogenital Tract Infection 2025;20(1):34-41
Purpose:
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN.
Materials and Methods:
Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results:
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.
6.Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study
Seung-Kwon CHOI ; Jeong Woo LEE ; Seung Il JUNG ; Eu Chang HWANG ; Joongwon CHOI ; Woong Bin KIM ; Jung Sik HUH ; Jin Bong CHOI ; Yeonjoo KIM ; Jae Min CHUNG ; Ju-Hyun SHIN ; Jae Hung JUNG ; Hong CHUNG ; Sangrak BAE ; Tae-Hyoung KIM
Urogenital Tract Infection 2025;20(1):34-41
Purpose:
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN.
Materials and Methods:
Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results:
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.
7.Mortality and Risk Factors for Emphysematous Pyelonephritis in Korea: A Multicenter Retrospective Cohort Study
Seung-Kwon CHOI ; Jeong Woo LEE ; Seung Il JUNG ; Eu Chang HWANG ; Joongwon CHOI ; Woong Bin KIM ; Jung Sik HUH ; Jin Bong CHOI ; Yeonjoo KIM ; Jae Min CHUNG ; Ju-Hyun SHIN ; Jae Hung JUNG ; Hong CHUNG ; Sangrak BAE ; Tae-Hyoung KIM
Urogenital Tract Infection 2025;20(1):34-41
Purpose:
Emphysematous pyelonephritis (EPN) is a life-threatening disease requiring immediate treatment. This multicenter retrospective cohort study aimed to analyze the mortality rate and risk factors associated with EPN.
Materials and Methods:
Between January 2011 and February 2021, 217 patients diagnosed with EPN via computed tomography who visited 14 teaching hospitals were retrospectively analyzed. Clinical data, including age, sex, comorbidities, Huang and Tseng classification, hydronephrosis, acute kidney injury, blood and urine tests, surgical interventions, percutaneous drainage, and conservative treatments, were compared between the survival and death groups. Risk factors for mortality due to EPN were analyzed using univariate and multivariate methods.
Results:
The mean age of survivors and deceased patients was 67.8 and 69.0 years, respectively (p=0.136). The sex distribution (male/female) was 48/146 and 8/15, respectively (p=0.298). Of the 217 patients, 23 died, resulting in a mortality rate of 10.6%. In univariate analysis, the Huang and Tseng classification (p=0.004), platelet count (p=0.005), and acute kidney injury (p=0.007) were significantly associated with mortality from EPN. In multivariate analysis, only the Huang and Tseng classification (p=0.029) was identified as a risk factor. Mortality rates according to the Huang and Tseng classification were as follows: class I (5.88%), class II (7.50%), class IIIa (14.28%), class IIIb (25.00%), and class IV (23.07%).
Conclusions
EPN is associated with a high mortality rate. Among various clinical factors, the Huang and Tseng classification was the most significant indicator for predicting mortality.
8.The Influence of Glycolytic Enzyme Expression on the Aggressiveness of Papillary Thyroid Carcinoma Using TCGA Data
Won Woong KIM ; Daham KIM ; Jin Kyong KIM ; Sang-Wook KANG ; Jandee LEE ; Jong Ju JEONG ; Kee-Hyun NAM ; Woong Youn CHUNG
Journal of Endocrine Surgery 2025;25(1):13-23
Purpose:
Several studies suggest that glycolytic enzyme expression may be linked to increased malignancy in various organs. However, the relationship between glycolytic enzyme expression and aggressiveness in papillary thyroid carcinoma (PTC) is not yet fully understood. This study aimed to determine whether glycolytic enzyme expression correlates with aggressiveness, including lymph node metastasis and extrathyroidal extension, using data from The Cancer Genome Atlas (TCGA).
Methods:
Lactate dehydrogenase A (LDHA), pyruvate kinase isoform M2 (PKM2), and glucose transporter 1 (GLUT1) mRNA expression were examined in 465 PTC samples using TCGA data. We analyzed the correlation between these glycolytic enzymes and transporter protein and the clinicopathological characteristics of PTC, with a particular focus on lymph node metastasis and recurrence.
Results:
Overexpression of LDHA, PKM2, and GLUT1 was associated with lymph node metastasis and the aggressive subtype of PTC. In the multivariate analysis, younger age, multifocality, advanced T stage (T3/T4), and increased PKM2 mRNA expression were significant predictors of lymph node metastasis. Among the variables, high PKM2 mRNA expression showed the strongest association with lymph node metastasis (odds ratio 6.907, P=0.001). However, there were no significant differences in disease-free survival rates according to LDHA, PKM2, or GLUT1 expression levels.
Conclusion
LDHA, PKM2, and GLUT1 overexpression is linked to lymph node metastasis and aggressive PTC subtypes. Of these, PKM2 mRNA expression may have particular potential as a biomarker for lymph node metastasis in PTC.
9.The effect of glycolytic enzyme expression and thyroiditis on the aggressiveness of papillary thyroid carcinoma:a retrospective cohort study
Won Woong KIM ; Daham KIM ; Jin Kyong KIM ; Sang-Wook KANG ; Jandee LEE ; Jong Ju JEONG ; Kee-Hyun NAM ; Woong Youn CHUNG
Annals of Surgical Treatment and Research 2025;109(3):169-184
Purpose:
Glycolytic enzymes have been extensively studied in various cancer types, revealing their aggressive characteristics and roles in tumor progression. This study aimed to determine whether the expression of glycolytic enzymes is associated with aggressiveness in the presence or absence of chronic lymphocytic thyroiditis (CLT).
Methods:
The expression of hexokinase 2, lactate dehydrogenase A (LDHA), pyruvate kinase isoform M2 (PKM2), glucose transporter 1 (GLUT1), and monocarboxylate transporter 4 (MCT4) was examined in 233 papillary thyroid carcinoma (PTC) specimens by immunohistochemistry. We evaluated whether the expression of these glycolytic enzymes correlates with lymph node metastasis, extrathyroidal extension (ETE), and recurrence rate, both with and without CLT. In addition, we analyzed the correlation between glycolytic enzyme messenger RNA expression and risk factors in PTC using The Cancer Genome Atlas.
Results:
All glycolytic enzymes and transporter proteins were overexpressed in PTC compared with normal tissue. PKM2 expression was most highly correlated with the other glycolytic enzymes. High PKM2 expression was significantly linked to increased recurrence risk in patients without CLT (hazard ratio, 1.76; 95% confidence interval, 1.01–3.06; P = 0.046), but this association was not observed in those with CLT.
Conclusion
Overexpression of LDHA, PKM2, GLUT1, and MCT4 is associated with PTC. CLT is significantly associated with an increased incidence of gross ETE and, paradoxically, with a reduced recurrence rate in PTC. LDHA expression was lower in the presence of CLT, whereas PKM2 remained consistently linked to a higher recurrence rate in its absence.Among the evaluated glycolytic enzymes, PKM2 may serve as a biomarker for recurrence in PTC.
10.Current Update of Stem Cell Therapy Combined High Tibial Osteotomy in Patients with Knee Osteoarthritis
Yong-Beom PARK ; Jin-Woong JEON
The Journal of the Korean Orthopaedic Association 2024;59(5):327-334
High tibial osteotomy (HTO) is the established surgical treatment option for advanced knee osteoarthritis (OA) of the medial compartment, and various treatment options are being investigated continuously to improve the long-term follow-up clinical outcomes after HTO. Stem cell therapy for the regeneration of osteoarthritic cartilage defects has recently been investigated. Nevertheless, little is known about the concomitant use of stem cell therapy in HTO to treat medial compartmental OA of the knee. Representative comparative studies on stem cell therapy combined with HTO were examined in this review. The clinical outcomes improved after stem cell therapy combined with HTO, but there was limited evidence of better clinical outcomes compared to HTO without stem cell therapy. In cartilage regeneration, regardless of the cell type used, cell concentrates or culture-expanded mesenchymal stem cells allow significant cartilage regeneration. On the other hand, there is a report about the difference in cartilage repair based on cell type. Therefore, medium- and long-term follow-up evidence would be required for continued concomitant use of stem cell therapy in HTO to treat knee OA.

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