Charcot neuroarthropathy (CN), also known as Charcot arthropathy, is a complex, progressive disorder primarily affecting the foot and ankle. This case report describes a multifaceted management strategy for a 54-year-old male with diabetes mellitus, end-stage renal disease, and presumed underlying Charcot arthropathy who experienced a traumatic ankle fracture. The initial surgical plans were delayed because of systemic infection indicators, including elevated C-reactive protein levels and high fever. The patient underwent multiple surgical interventions and faced challenges, including metal failure, implant-associated infection, and tibiotalar joint dislocation. A multidisciplinary approach involving orthopedic surgeons, nephrologists, and endocrinologists was crucial for managing the case effectively.In particular, the patient declined a below-knee amputation and opted for comprehensive surgical intervention, resulting in improved functionality at the latest follow-up. This case highlights the complexities of managing CN in patients with multiple comorbidities and emphasizes the need for a nuanced, patient-centered approach.

Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) is a neurodegenerative disorder caused by a biallelic expansion of pentanucleotide repeats in the RFC1 gene. Previous studies have reported up to 22% of patients with late-onset ataxia harbor this pathogenic repeat expansion. Despite its relatively high prevalence, CANVAS is often underdiagnosed because the disease is not well recognized and genetic testing is not performed in clinical practice. Here, we present a patient with characteristic clinical features, confirmed by genetic testing.

Purpose: To analyze prognostic factors for morphological and functional recovery after vitrectomy in patients with idiopathic epiretinal membrane (ERM). Methods: We conducted a retrospective analysis of patients with ERM who underwent vitrectomy. Postoperative outcomes were evaluated in terms of functional and morphological changes, assessing best-corrected visual acuity (BCVA) and central macular thickness (CMT) after 6 months. Logistic regression was used to identify factors influencing postoperative outcomes. Results: This study included 77 patients (35.1% men). Thirty-eight patients underwent combined vitrectomy and cataract surgery. Logistic regression revealed that better preoperative BCVA was associated with improved postoperative BCVA (p = 0.002). Among the 38 eyes that underwent combined surgery, longer preoperative axial length was linked to better visual outcomes in univariate analysis (p = 0.043), although the association was not statistically significant in multivariate analysis (p = 0.064). Younger age and thinner preoperative CMT were associated with better morphological outcomes (p = 0.034 and p = 0.001, respectively). Conclusions Preoperative BCVA, age, preoperative CMT, and axial length are predictive factors for functional and morphological outcomes after vitrectomy in patients with ERM. These findings may facilitate treatment planning and prognosis prediction before surgery.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Purpose: Recent development in perioperative treatment of resectable non–small cell lung cancer (NSCLC) have changed the landscape of early lung cancer management. The ADAURA trial has demonstrated the efficacy of adjuvant osimertinib treatment in resectable NSCLC patients; however, studies are required to show which subgroup of patients are at a high risk of relapse and require adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor treatment. This study evaluated risk factors for postoperative relapse among patients who underwent complete resection. Materials and Methods: Data were obtained from the Korean Association for Lung Cancer Registry (KALC-R), a database created using a retrospective sampling survey by the Korean Central Cancer Registry (KCCR) and the Lung Cancer Registration Committee. Results: A total of 3,176 patients who underwent curative resection was evaluated. The mean observation time was approximately 35.4 months. Among stage I to IIIA NSCLC patients, the EGFR-mutant subgroup included 867 patients, and 75.2%, 11.2%, and 11.8% were classified as stage I, stage II, and stage III, respectively. Within the EGFR-mutant subgroup, 44 (5.1%) and 121 (14.0%) patients showed early and late recurrence, respectively. Multivariate analysis on association with postoperative relapse among the EGFR-mutant subgroup showed that age, pathologic N and TNM stages, pleural invasion status, and surgery type were independent significant factors. Conclusion Among the population that underwent complete resection for early NSCLC with EGFR mutation, patients with advanced stage, pleural invasion, or limited resection are more likely to show postoperative relapse.

Charcot neuroarthropathy (CN), also known as Charcot arthropathy, is a complex, progressive disorder primarily affecting the foot and ankle. This case report describes a multifaceted management strategy for a 54-year-old male with diabetes mellitus, end-stage renal disease, and presumed underlying Charcot arthropathy who experienced a traumatic ankle fracture. The initial surgical plans were delayed because of systemic infection indicators, including elevated C-reactive protein levels and high fever. The patient underwent multiple surgical interventions and faced challenges, including metal failure, implant-associated infection, and tibiotalar joint dislocation. A multidisciplinary approach involving orthopedic surgeons, nephrologists, and endocrinologists was crucial for managing the case effectively.In particular, the patient declined a below-knee amputation and opted for comprehensive surgical intervention, resulting in improved functionality at the latest follow-up. This case highlights the complexities of managing CN in patients with multiple comorbidities and emphasizes the need for a nuanced, patient-centered approach.

Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) is a neurodegenerative disorder caused by a biallelic expansion of pentanucleotide repeats in the RFC1 gene. Previous studies have reported up to 22% of patients with late-onset ataxia harbor this pathogenic repeat expansion. Despite its relatively high prevalence, CANVAS is often underdiagnosed because the disease is not well recognized and genetic testing is not performed in clinical practice. Here, we present a patient with characteristic clinical features, confirmed by genetic testing.

BACKGROUND/OBJECTIVES: Dietary factors act on lower urinary tract symptoms (LUTS).This study examined the relationship between the overall diet quality and LUTS. SUBJECTS/METHODS: This study analyzed the data from examinees who visited a general hospital in Korea (October 13, 2014−March 12, 2020). The number of subjects in the study was 6,506 adult men. The recommended food score was used to evaluate the overall quality of the diet, and the International Prostate Symptom Score was used to quantify LUTS. Logistic regression analysis was used to derive the odds ratio (OR) and 95% confidence interval (CI) to evaluate the relationship between the dietary quality and LUTS. The influence of age, education, marital history, income, occupation, smoking, drinking, exercise, metabolic syndrome, body mass index (BMI), and prostate-specific antigen (PSA) level was analyzed to determine the net influence of the overall diet quality on LUTS. RESULTS: The group with high overall dietary quality showed a lower incidence of LUTS than the group with relatively lower dietary quality (OR, 0.88; 95% CI, 0.79–0.99). These results were also observed after correcting for other risk factors and associated variables: age, education, smoking, metabolic syndrome, BMI, and PSA level. CONCLUSION The overall diet quality and LUTS were correlated. Nevertheless, further research will be needed to find the relationship between diet quality and LUTS.