Background: The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction. Methods: We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected. Results: Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures. Conclusions Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.

Background: Several studies have investigated the morphological risk factors contributing to posterior cruciate ligament (PCL) injury. However, no study has focused on the injury patterns of intrasubstance tears or tibial avulsion fractures in relation to morphologies and regional bone quality. This study aimed to investigate the impact of the knee morphology and regional bone quality of the proximal tibia on the PCL injury pattern. Methods: This retrospective study compared the radiological features of 76 patients with PCL injuries (PI group) and 76 matched patients with normal PCL (control group). The PI group was divided into 2 subgroups: PCL avulsion fracture (PAF subgroup; n = 43) and PCL intrasubstance tear (PIT subgroup; n = 33). Measurements included the coronal notch width index, coronal tibial slope, medial and lateral posterior tibial slopes, and medial tibial depth. Three Hounsfield unit average measurements were taken from the proximal tibia around the PCL insertion site to create a summative measure of overall bone quality. Results: The medial tibial depth and coronal notch width index were significantly lower in the PI group than those in the control group (medial tibial depth: 2.04 ± 0.77 vs. 3.02 ± 1.04, p = 0.017; coronal notch width index: 0.21 ± 0.03 vs. 0.24 ± 0.03, p = 0.041). In the subgroup analysis, medial tibial depth and Hounsfield unit were significantly lower in the PAF subgroup than in the PIT subgroup (medial tibial depth: 1.74 ± 0.66 vs. 2.43 ± 0.77, p = 0.008, Hounsfield unit: 89.48 ± 31.73 vs. 120.15 ± 29.24, p = 0.004). Binary logistic regression analysis showed that medial tibial depth (odds ratio [OR], 0.161; p < 0.001) and Hounsfield unit (OR, 0.950;p < 0.001) were independent risk factors for PCL tibial avulsion fractures. Conclusions Lower notch width index and medial tibial depth are associated with PCL injuries. Shallower medial tibial depth and lower Hounsfield unit measurements around the PCL insertion site were associated with an increased incidence of PCL avulsion fractures. These findings may assist clinicians in identifying patients at risk of distinct PCL injury patterns.

Background: The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction. Methods: We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected. Results: Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures. Conclusions Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.

Background: Several studies have investigated the morphological risk factors contributing to posterior cruciate ligament (PCL) injury. However, no study has focused on the injury patterns of intrasubstance tears or tibial avulsion fractures in relation to morphologies and regional bone quality. This study aimed to investigate the impact of the knee morphology and regional bone quality of the proximal tibia on the PCL injury pattern. Methods: This retrospective study compared the radiological features of 76 patients with PCL injuries (PI group) and 76 matched patients with normal PCL (control group). The PI group was divided into 2 subgroups: PCL avulsion fracture (PAF subgroup; n = 43) and PCL intrasubstance tear (PIT subgroup; n = 33). Measurements included the coronal notch width index, coronal tibial slope, medial and lateral posterior tibial slopes, and medial tibial depth. Three Hounsfield unit average measurements were taken from the proximal tibia around the PCL insertion site to create a summative measure of overall bone quality. Results: The medial tibial depth and coronal notch width index were significantly lower in the PI group than those in the control group (medial tibial depth: 2.04 ± 0.77 vs. 3.02 ± 1.04, p = 0.017; coronal notch width index: 0.21 ± 0.03 vs. 0.24 ± 0.03, p = 0.041). In the subgroup analysis, medial tibial depth and Hounsfield unit were significantly lower in the PAF subgroup than in the PIT subgroup (medial tibial depth: 1.74 ± 0.66 vs. 2.43 ± 0.77, p = 0.008, Hounsfield unit: 89.48 ± 31.73 vs. 120.15 ± 29.24, p = 0.004). Binary logistic regression analysis showed that medial tibial depth (odds ratio [OR], 0.161; p < 0.001) and Hounsfield unit (OR, 0.950;p < 0.001) were independent risk factors for PCL tibial avulsion fractures. Conclusions Lower notch width index and medial tibial depth are associated with PCL injuries. Shallower medial tibial depth and lower Hounsfield unit measurements around the PCL insertion site were associated with an increased incidence of PCL avulsion fractures. These findings may assist clinicians in identifying patients at risk of distinct PCL injury patterns.

Background: Several studies have investigated the morphological risk factors contributing to posterior cruciate ligament (PCL) injury. However, no study has focused on the injury patterns of intrasubstance tears or tibial avulsion fractures in relation to morphologies and regional bone quality. This study aimed to investigate the impact of the knee morphology and regional bone quality of the proximal tibia on the PCL injury pattern. Methods: This retrospective study compared the radiological features of 76 patients with PCL injuries (PI group) and 76 matched patients with normal PCL (control group). The PI group was divided into 2 subgroups: PCL avulsion fracture (PAF subgroup; n = 43) and PCL intrasubstance tear (PIT subgroup; n = 33). Measurements included the coronal notch width index, coronal tibial slope, medial and lateral posterior tibial slopes, and medial tibial depth. Three Hounsfield unit average measurements were taken from the proximal tibia around the PCL insertion site to create a summative measure of overall bone quality. Results: The medial tibial depth and coronal notch width index were significantly lower in the PI group than those in the control group (medial tibial depth: 2.04 ± 0.77 vs. 3.02 ± 1.04, p = 0.017; coronal notch width index: 0.21 ± 0.03 vs. 0.24 ± 0.03, p = 0.041). In the subgroup analysis, medial tibial depth and Hounsfield unit were significantly lower in the PAF subgroup than in the PIT subgroup (medial tibial depth: 1.74 ± 0.66 vs. 2.43 ± 0.77, p = 0.008, Hounsfield unit: 89.48 ± 31.73 vs. 120.15 ± 29.24, p = 0.004). Binary logistic regression analysis showed that medial tibial depth (odds ratio [OR], 0.161; p < 0.001) and Hounsfield unit (OR, 0.950;p < 0.001) were independent risk factors for PCL tibial avulsion fractures. Conclusions Lower notch width index and medial tibial depth are associated with PCL injuries. Shallower medial tibial depth and lower Hounsfield unit measurements around the PCL insertion site were associated with an increased incidence of PCL avulsion fractures. These findings may assist clinicians in identifying patients at risk of distinct PCL injury patterns.

Background: The nipple is a potential source of pathogens because its lactiferous ducts act as direct conduits from the nipple–areolar complex to the breast parenchyma. Our previous studies identified breast microbiota as a factor in postoperative complications following immediate breast reconstruction using silicone implants and acellular dermal matrix. This study aimed to investigate the correlation between preoperative nipple swab microbiota and the incidence of surgical site infections (SSIs) after autologous breast reconstruction. Methods: We conducted a retrospective chart review of patients who underwent autologous breast reconstruction following total mastectomy. Preoperative nipple swab cultures were obtained. Patient demographics, surgical characteristics, and complication rates were compared between culture-positive and culture-negative groups. Microbiological data, including antibiotic‑resistance profiles, were collected. Results: Among 39 reconstructed breasts, 18 (46.9%) had positive preoperative nipple cultures. The mean duration of drain placement was significantly longer in the culture‑positive group (14.39±3.96 days) than in the culture‑negative group (12.14±2.76 days, P=0.045). Methicillin‑susceptible Staphylococcus epidermidis accounted for 55.0% of isolates. Of the four SSIs observed, three occurred in patients with positive preoperative cultures. Conclusions Although pathogen strains differed between preoperative and postoperative settings, obtaining preoperative nipple microflora cultures and determining antibiotic‑resistance profiles can guide immediate antibiotic selection for SSIs and enhance postoperative management.

Background: Several studies have investigated the morphological risk factors contributing to posterior cruciate ligament (PCL) injury. However, no study has focused on the injury patterns of intrasubstance tears or tibial avulsion fractures in relation to morphologies and regional bone quality. This study aimed to investigate the impact of the knee morphology and regional bone quality of the proximal tibia on the PCL injury pattern. Methods: This retrospective study compared the radiological features of 76 patients with PCL injuries (PI group) and 76 matched patients with normal PCL (control group). The PI group was divided into 2 subgroups: PCL avulsion fracture (PAF subgroup; n = 43) and PCL intrasubstance tear (PIT subgroup; n = 33). Measurements included the coronal notch width index, coronal tibial slope, medial and lateral posterior tibial slopes, and medial tibial depth. Three Hounsfield unit average measurements were taken from the proximal tibia around the PCL insertion site to create a summative measure of overall bone quality. Results: The medial tibial depth and coronal notch width index were significantly lower in the PI group than those in the control group (medial tibial depth: 2.04 ± 0.77 vs. 3.02 ± 1.04, p = 0.017; coronal notch width index: 0.21 ± 0.03 vs. 0.24 ± 0.03, p = 0.041). In the subgroup analysis, medial tibial depth and Hounsfield unit were significantly lower in the PAF subgroup than in the PIT subgroup (medial tibial depth: 1.74 ± 0.66 vs. 2.43 ± 0.77, p = 0.008, Hounsfield unit: 89.48 ± 31.73 vs. 120.15 ± 29.24, p = 0.004). Binary logistic regression analysis showed that medial tibial depth (odds ratio [OR], 0.161; p < 0.001) and Hounsfield unit (OR, 0.950;p < 0.001) were independent risk factors for PCL tibial avulsion fractures. Conclusions Lower notch width index and medial tibial depth are associated with PCL injuries. Shallower medial tibial depth and lower Hounsfield unit measurements around the PCL insertion site were associated with an increased incidence of PCL avulsion fractures. These findings may assist clinicians in identifying patients at risk of distinct PCL injury patterns.

Background/Aims: In Korea, changes in the prevalence of irritable bowel syndrome (IBS) after the Rome IV update have not been extensively studied.The aim of this study is to compare the prevalence and psychosocial risk factors of IBS according to Rome III and Rome IV criteria in medical and nursing students. Methods: From August 13, 2021 to October 22, 2021, participants were enrolled and surveyed online. The survey includes general and specific questions for disease diagnosis and regarding participants’ social and psychological characteristics using the 36-item short form survey, the Brief Encounter Psychosocial Instrument-Korean version, and the Hospital Anxiety and Depression Scale. Results: In total, 338 medical students and 102 nursing students completed the survey. IBS was diagnosed in 78 students (17.7%) using Rome III criteria and in 51 students (11.6%) using Rome IV criteria. Significant differences in physical functioning score and severity score were observed between patients diagnosed using Rome IV criteria and patients diagnosed using Rome III criteria. Multiple logistic regression revealed that severity score (adjusted odds ratio = 1.01; 95% confidence interval: 1.00-1.21; P = 0.022) is the only predictor of IBS that differentiates Rome IV criteria from Rome III criteria. Conclusions Even after updating the Rome IV diagnostic criteria, the prevalence of IBS in medical and nursing students in Korea remained high.Patients who met the Rome IV criteria had more severe symptoms and lower quality of life than patients who met the Rome III criteria.

Background/Aims: In Korea, changes in the prevalence of irritable bowel syndrome (IBS) after the Rome IV update have not been extensively studied.The aim of this study is to compare the prevalence and psychosocial risk factors of IBS according to Rome III and Rome IV criteria in medical and nursing students. Methods: From August 13, 2021 to October 22, 2021, participants were enrolled and surveyed online. The survey includes general and specific questions for disease diagnosis and regarding participants’ social and psychological characteristics using the 36-item short form survey, the Brief Encounter Psychosocial Instrument-Korean version, and the Hospital Anxiety and Depression Scale. Results: In total, 338 medical students and 102 nursing students completed the survey. IBS was diagnosed in 78 students (17.7%) using Rome III criteria and in 51 students (11.6%) using Rome IV criteria. Significant differences in physical functioning score and severity score were observed between patients diagnosed using Rome IV criteria and patients diagnosed using Rome III criteria. Multiple logistic regression revealed that severity score (adjusted odds ratio = 1.01; 95% confidence interval: 1.00-1.21; P = 0.022) is the only predictor of IBS that differentiates Rome IV criteria from Rome III criteria. Conclusions Even after updating the Rome IV diagnostic criteria, the prevalence of IBS in medical and nursing students in Korea remained high.Patients who met the Rome IV criteria had more severe symptoms and lower quality of life than patients who met the Rome III criteria.

Background/Aims: Recently, patients with pancreatic cancer (PC) who underwent resection have exhibited improved survival outcomes, but comprehensive analysis is limited. We analyzed the trends of contributing factors. Methods: Data of patients with resected PC were retrospectively collected from the Korean Health Insurance Review and Assessment Service (HIRA) database and separately at our institution. Cox regression analysis was conducted with the data from our institution a survival prediction score was calculated using the β coefficients. Results: Comparison between the periods 2013–2015 (n=3,255) and 2016–2018 (n=3,698) revealed a difference in the median overall survival (25.9 months vs not reached, p<0.001) when analyzed with the HIRA database which was similar to our single-center data (2013–2015 [n=119] vs 2016–2018 [n=148], 20.9 months vs 32.2 months, p=0.003). Multivariable analyses revealed six factors significantly associated with better OS, and the scores were as follows: age >70 years, 1; elevated carbohydrate antigen 19-9 at diagnosis, 1; R1 resection, 1; stage N1 and N2, 1 and 3, respectively; no adjuvant treatment, 2; FOLFIRINOX or gemcitabine plus nab-paclitaxel after recurrence, 4; and other chemotherapy or supportive care only after recurrence, 5. The rate of R0 resection (69.7% vs 80.4%), use of adjuvant treatment (63.0% vs 74.3%), and utilization of FOLFIRINOX or gemcitabine plus nab-paclitaxel (25.2% vs 47.3%) as palliative chemotherapeutic regimen, all increased between the two time periods, resulting in decreased total survival prediction score (mean: 7.32 vs 6.18, p=0.004). Conclusions Strict selection of surgical candidates, more use of adjuvant treatment, and adoption of the latest combination regimens for palliative chemotherapy after recurrence were identified as factors of recent improvement.