Purpose: To evaluate the compatibility and usability of test results obtained from the IDRA and Keratograph 5M in clinical settings by comparing their performance in patients with dry eye disease. Methods: From December 27 to 30, 2022, a study was conducted on 30 patients diagnosed with dry eye utilizing both the Keratograph 5M and IDRA devices. The parameters compared and analyzed included lipid layer thickness, tear meniscus height, tear film break-up time, and meibography. A paired t-test was used for statistical comparison. The lipid layer thickness in the Keratograph 5M was graded on a scale from 0 to 4 based on thickness. Results: No significant differences were found between the two devices in tear film break-up time, tear meniscus height, and meibography (p = 0.148, 0.072, 0.124, respectively). However, the tear lipid layer thickness measured by IDRA showed a proportional relationship with the grade assigned by the Keratograph 5M (Kendall R = 0.217, p = 0.037; Spearman R = 0.260, p = 0.045). Conclusions The IDRA device offers the advantage of performing multiple dry eye tests; simultaneously, thereby saving time compared to the Keratograph 5M. Both devices can be used compatibly with IDRA particularly advantageous for providing a numerical value for tear lipid layer thickness which enhances the convenience of dry eye diagnosis and treatment.

Purpose: To evaluate the compatibility and usability of test results obtained from the IDRA and Keratograph 5M in clinical settings by comparing their performance in patients with dry eye disease. Methods: From December 27 to 30, 2022, a study was conducted on 30 patients diagnosed with dry eye utilizing both the Keratograph 5M and IDRA devices. The parameters compared and analyzed included lipid layer thickness, tear meniscus height, tear film break-up time, and meibography. A paired t-test was used for statistical comparison. The lipid layer thickness in the Keratograph 5M was graded on a scale from 0 to 4 based on thickness. Results: No significant differences were found between the two devices in tear film break-up time, tear meniscus height, and meibography (p = 0.148, 0.072, 0.124, respectively). However, the tear lipid layer thickness measured by IDRA showed a proportional relationship with the grade assigned by the Keratograph 5M (Kendall R = 0.217, p = 0.037; Spearman R = 0.260, p = 0.045). Conclusions The IDRA device offers the advantage of performing multiple dry eye tests; simultaneously, thereby saving time compared to the Keratograph 5M. Both devices can be used compatibly with IDRA particularly advantageous for providing a numerical value for tear lipid layer thickness which enhances the convenience of dry eye diagnosis and treatment.

Purpose: To evaluate the compatibility and usability of test results obtained from the IDRA and Keratograph 5M in clinical settings by comparing their performance in patients with dry eye disease. Methods: From December 27 to 30, 2022, a study was conducted on 30 patients diagnosed with dry eye utilizing both the Keratograph 5M and IDRA devices. The parameters compared and analyzed included lipid layer thickness, tear meniscus height, tear film break-up time, and meibography. A paired t-test was used for statistical comparison. The lipid layer thickness in the Keratograph 5M was graded on a scale from 0 to 4 based on thickness. Results: No significant differences were found between the two devices in tear film break-up time, tear meniscus height, and meibography (p = 0.148, 0.072, 0.124, respectively). However, the tear lipid layer thickness measured by IDRA showed a proportional relationship with the grade assigned by the Keratograph 5M (Kendall R = 0.217, p = 0.037; Spearman R = 0.260, p = 0.045). Conclusions The IDRA device offers the advantage of performing multiple dry eye tests; simultaneously, thereby saving time compared to the Keratograph 5M. Both devices can be used compatibly with IDRA particularly advantageous for providing a numerical value for tear lipid layer thickness which enhances the convenience of dry eye diagnosis and treatment.

Objective: This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion. Materials and Methods: Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology. Results: Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study.The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively;65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (P = 0.008 and 0.001, respectively). Conclusion Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.

Background: Programmed death ligand 1 (PD-L1) expression cannot currently be predicted through radiological findings. This study aimed to develop a prediction model capable of differentiating between positive and negative PD-L1 expression through a radiomics-based investigation of computed tomography (CT) images in patients with urothelial carcinoma. Methods: Sixty-four patients with urothelial carcinoma who underwent immunohistochemical testing for PD-L1 were retrospectively reviewed. The number of patients in the positive and negative PD-L1 groups (PD-L1 expression >5%) was 14 and 50, respectively. CT images obtained 90 seconds after contrast medium administration were selected for radiomic extraction. For all tumors, 1,691 radiomic features were extracted from CT using a manually segmented three-dimensional volume of interest. Univariate and multivariate logistic regression analyses were performed to identify radiomic features that were significant predictors of PD-L1 expression. For the radiomics-based model, a receiver operating characteristic (ROC) analysis was performed. Results: Among 64 patients, 14 were included in the PD-L1 positive group. Logistic regression analysis found that the following radiomic features significantly predicted PD-L1 expression: wavelet-low-pass, low-pass, and high-pass filters (LLH)_gray-level size-zone matrix (GLSZM)_SmallAreaEmphasis, wavelet-LLH_firstorder_Energy, log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis, original_shape_Maximum2DDiameterColumn, wavelet-low-pass, low-pass, and low-pass filters (LLL)_gray-level run-length matrix (GLRLM)_ShortRunEmphasis, and exponential_firstorder_Kurtosis. The radiomics signature was –4.0934+21.6224 (wavelet-LLH_GLSZM_SmallAreaEmphasis)+0.0044 (wavelet-LLH_firstorder_Energy)–4.7389 (log-sigma-0-5-mm-3D_GLSZM_SmallAreaHighGrayLevelEmphasis)+0.0573 (original_shape_Maximum2DDiameterColumn)–29.5892 (wavelet-LLL_GLRLM_ShortRunEmphasis)–0.4324 (exponential_firstorder_Kurtosis). The area under the ROC curve model representing the radiomics signature for differentiating cases that were deemed PD-L1 positive based on immunohistochemistry was 0.96. Conclusions This preliminary radiomics model derived from contrast-enhanced CT predicted PD-L1 positivity in patients with urothelial cancer.

Purpose: This study assessed the clinical outcomes of a modified Broström operation using all-suture anchors for patients with chronic lateral ankle instability. Methods: A comprehensive analysis was conducted on 22 cases with a minimum follow-up of 1 year. Clinical outcomes were assessed using the Karlsson scores and Sefton’s grading system. Results: Significant improvement was observed in patients’ symptoms postoperatively. Karlsson scores increased markedly from preoperative levels, indicating substantial clinical improvement. Most patients (20 of 22, 90.9%) were categorized as ‘excellent’ or ‘good’ according to Sefton’s grading. There was no anchor related complication. Conclusion The modified Broström operation employing all-suture anchors demonstrated favorable clinical outcomes for patients with chronic lateral ankle instability. This technique can be promising alternative for traditional modified Broström operation, offering improved stability and symptom relief.

Purpose: We investigated the association between social support, metabolic syndrome, and incident cardio-cerebrovascular disease (CCVD) in rural Koreans aged ≥50 years. Materials and Methods: We conducted a prospective study using the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population (KoGES-ARIRANG) dataset. From the baseline of 5169 adults, 1682 participants were finally included according to the exclusion criteria. For outcomes, myocardial infarction, angina, and stroke were included. For independent variables, the social support score and metabolic syndrome were used. Descriptive statistics and multivariate logistic regression were performed to investigate the association among the variables. Paired t-test was conducted to analyze the longitudinal variation of social support scores. Results: During the 6.37 years of median follow-up, 137 participants developed CCVD. The adjusted odds ratio (aOR) of metabolic syndrome with persistently high social support was 2.175 [95% confidence interval (CI): 1.479–3.119]. The aOR of metabolic syndrome with persistently low social support was 2.494 (95%CI: 1.141–5.452). The longitudinal variation of the social support score of persistently high social support group was increased significantly by 4.26±26.32. The score of the persistently low social support group was decreased by 1.34±16.87 with no statistical significance. Conclusion The presence of metabolic syndrome increases the likelihood of developing onset CCVD. Within the metabolic syndrome positive group, when social support was persistently low, the cohort developed more cardio-cerebrovascular disease compared to the persistently higher social support group. The social support score of the persistently low social support group could be improved through proper intervention. To prevent CCVD, metabolic syndrome components and low social support should be improved in the study participants.

Purpose: Although the prevalence of a discoid lateral meniscus is relatively rare, estimated at approximately 0.4% to 5.0% in the Western world, studies have shown that the incidence is significantly higher in Asia, particularly in South Korea and Japan, ranging from 10.5% to 16.6%. On the other hand, previous studies that reported the incidence of discoid lateral meniscus mainly relied on patients who underwent arthroscopic or open surgery. This study examined the incidence of discoid lateral meniscus using a magnetic resonance imaging-based diagnostic approach. Materials and Methods: This study conducted a retrospective review of the prevalence of discoid lateral meniscus in 10,810 male patients with knee pain who underwent magnetic resonance imaging at the author’s single institution between January 2013 and January 2023. The mean age of the patients was 42.55±15.93 years old (range: 12 to 82). The patient demographics, including age, were analyzed.The characteristics of the discoid lateral meniscus were also analyzed, including the subtype and presence of a combined lateral meniscus tear. Results: This study identified 1,025 patients (9.5%) with a discoid lateral meniscus, including 129 with the complete subtype, 893 with the incomplete subtype, and 3 with the Wrisberg-type subtype. Although there was no significant difference in prevalence between sexes, the highest diagnosis rate of discoid lateral meniscus was observed in the 41–60-year-old (10.1%) age group, which was statistically significant (p=0.025). Among the 164 patients with a concurrent lateral meniscus tear, the horizontal type (80 patients, 48.8%) was the most frequently observed. Conclusion While the incidence in the present study was slightly lower than that reported in previous arthroscopic-based studies, the findings still suggest a relatively high prevalence of discoid lateral meniscus in Korea compared to other countries. In contrast to earlier research that suggested a decline in incidence with age, this study found that the incidence of discoid lateral meniscus was highest among individuals aged 41–60 years.

Purpose: Myosteatosis, defined as fat infiltration in muscle tissue, has been linked to poor outcomes in various cancers. However, the prognostic impact of myosteatosis on renal cell carcinoma (RCC) remains poorly understood. This study evaluated the predictive value of myosteatosis based on an artificial intelligence (AI)-driven computed tomography (CT) analysis in patients with localized RCC who underwent partial nephrectomy. Materials and Methods: This retrospective study included 170 patients with localized RCC who underwent partial nephrectomy at a single institution between 2011 and 2017. Myosteatosis was assessed on CT scans using an AI-based tool. The patients were categorized into 2 groups according to the presence or absence of myosteatosis. The clinical outcomes, including disease-free survival (DFS), were compared to determine the prognostic significance of myosteatosis. Results: Of 170 patients, 36 (21.2%) were diagnosed with myosteatosis. These patients were older and had a higher body mass index. The myosteatosis group had a higher proportion of females than the no myosteatosis group. Lymphovascular invasion and tumor necrosis were prevalent pathological features in patients with myosteatosis. Kaplan-Meier analysis demonstrated that myosteatosis was associated with significantly shorter DFS (p<0.05). Multivariate analysis confirmed that myosteatosis independently predicted adverse outcomes in patients with localized RCC. Conclusion AI-based CT analysis of myosteatosis is a reliable method for improving the risk stratification of patients with localized RCC. Patients with myosteatosis demonstrate poor pathological features and shorter DFS. These findings highlight the potential of AI-driven body composition analysis to refine prognostic models and personalized treatment strategies.

Purpose: Although the prevalence of a discoid lateral meniscus is relatively rare, estimated at approximately 0.4% to 5.0% in the Western world, studies have shown that the incidence is significantly higher in Asia, particularly in South Korea and Japan, ranging from 10.5% to 16.6%. On the other hand, previous studies that reported the incidence of discoid lateral meniscus mainly relied on patients who underwent arthroscopic or open surgery. This study examined the incidence of discoid lateral meniscus using a magnetic resonance imaging-based diagnostic approach. Materials and Methods: This study conducted a retrospective review of the prevalence of discoid lateral meniscus in 10,810 male patients with knee pain who underwent magnetic resonance imaging at the author’s single institution between January 2013 and January 2023. The mean age of the patients was 42.55±15.93 years old (range: 12 to 82). The patient demographics, including age, were analyzed.The characteristics of the discoid lateral meniscus were also analyzed, including the subtype and presence of a combined lateral meniscus tear. Results: This study identified 1,025 patients (9.5%) with a discoid lateral meniscus, including 129 with the complete subtype, 893 with the incomplete subtype, and 3 with the Wrisberg-type subtype. Although there was no significant difference in prevalence between sexes, the highest diagnosis rate of discoid lateral meniscus was observed in the 41–60-year-old (10.1%) age group, which was statistically significant (p=0.025). Among the 164 patients with a concurrent lateral meniscus tear, the horizontal type (80 patients, 48.8%) was the most frequently observed. Conclusion While the incidence in the present study was slightly lower than that reported in previous arthroscopic-based studies, the findings still suggest a relatively high prevalence of discoid lateral meniscus in Korea compared to other countries. In contrast to earlier research that suggested a decline in incidence with age, this study found that the incidence of discoid lateral meniscus was highest among individuals aged 41–60 years.