Background: Bronchiectasis has a complex and heterogeneous pathogenesis, with various etiologies, the majority being idiopathic. This study aimed to examine the characteristics of patients with idiopathic bronchiectasis in comparison to those with post-infectious bronchiectasis. Methods: We analyzed data from patients with idiopathic and post-infectious bronchiectasis (including post-tuberculosis) from the Korean Multicenter Bronchiectasis Audit and Research Collaboration (KMBARC) registry, a prospective cohort study. Results: Among the 866 patients enrolled in the study, 346 (40.0%) were classified as having idiopathic bronchiectasis, while 363 (41.9%) had post-infectious bronchiectasis. The idiopathic group demonstrated a shorter disease duration, a higher body mass index (BMI), a lower prevalence of chronic obstructive pulmonary disease (COPD), a higher prevalence of rhinosinusitis, a predominance of lower lobe distribution, less frequent use of regular respiratory treatments, better pulmonary function, and a statistically lower bronchiectasis severity index compared to the post-infectious group. A multivariable logistic regression analysis was conducted, considering factors such as gender, age, BMI, history of asthma, COPD, rhinosinusitis, rheumatoid arthritis, gastroesophageal reflux disease, and smoking status. A higher BMI (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.04 to 1.15) and a history of rhinosinusitis (OR, 3.10; 95% CI, 1.57 to 6.14) were associated with idiopathic bronchiectasis. In contrast, a history of COPD was linked to post-infectious bronchiectasis (OR, 0.57; 95% CI, 0.41 to 0.80). Conclusion Patients with idiopathic bronchiectasis are characterized by a higher BMI and a history of rhinosinusitis compared to those with post-infectious bronchiectasis. These findings may provide exploratory insights into underlying systemic or non-pulmonary factors. Further research is necessary to clarify the clinical significance of these associations.

As the prevalence of myopia has recently increased, there is growing interest in interventions to slow myopia progression. The choroid, the rearmost and largest part of the uveal layer, is a tissue rich in blood vessels located between the retina and the sclera. Recent advancements in diagnostic equipment have enabled direct imaging of the choroid, leading to increased research on its role in both normal and pathological conditions. Regarding myopia, it has been reported that; 1) the choroidal thickness decreases as the degree of myopia and axial length increase, 2) in the case of moderate to high concentrations of atropine or orthokeratology lenses, which are known to slow myopic progression, choroidal thickening is accompanied from the early stages of application, and 3) the mechanism by which choroidal thickening slows myopia progression is also being actively investigated. As a result, the choroid is being recognized as a therapeutic target for developing new interventions to slow myopia progression. Additionally, the increase in choroidal thickness has been reported as a predictive factor for the subsequent myopia progression, suggesting its potential role as a biomarker for assessing the likelihood of future myopia progression.

Background: Achilles tendon is composed of dense connective tissue and is one of the largest tendons in the body. In veterinary medicine, acute ruptures are associated with impact injury or sharp trauma. Healing of the ruptured tendon is challenging because of poor blood and nerve supply as well as the residual cell population. Platelet-rich plasma (PRP) contains numerous bioactive agents and growth factors and has been utilized to promote healing in bone, soft tissue, and tendons. Objective: The purpose of this study was to evaluate the healing effect of PRP injected into the surrounding fascia of the Achilles tendon after allograft in rabbits. Methods: Donor rabbits (n = 8) were anesthetized and 16 lateral gastrocnemius tendons were fully transected bilaterally. Transected tendons were decellularized and stored at −80°C prior to allograft. The allograft was placed on the partially transected medial gastrocnemius tendon in the left hindlimb of 16 rabbits. The allograft PRP group (n = 8) had 0.3 mL of PRP administered in the tendon and the allograft control group (n = 8) did not receive any treatment. After 8 weeks, rabbits were euthanatized and allograft tendons were transected for macroscopic, biomechanical, and histological assessment. Results: The allograft PRP group exhibited superior macroscopic assessment scores, greater tensile strength, and a histologically enhanced healing process compared to those in the allograft control group. Conclusions Our results suggest administration of PRP on an allograft tendon has a positive effect on the healing process in a ruptured Achilles tendon.

Uterine rupture is uncommon in small animals and can be caused by trauma, infection, dead fetus, or inappropriate obstetric techniques. A 4-yearold, intact female mixed-breed dog weighing 3 kg presented for elective ovariohysterectomy with a history of a motor vehicle accident two months previously. The patient showed no clinical signs of uterine abnormalities or evidence of pregnancy during physical examination. Clinical examinations, radiography, and ultrasonography revealed no significant findings. During ovariohysterectomy, a completely transected left uterine horn and dome-shaped ends were identified.The uterine layers were everted such that the endometrium could be seen outside the uterine horn. The dog recovered without post-operative complications and was discharged the following day. This report describes a rare case of an asymptomatic uterine rupture caused by trauma in a non-gravid dog.

This case report discusses the successful surgical resection of cardiac hemangiosarcoma in a dog using an articulated surgical stapler. Cardiac tumors, particularly hemangiosarcomas, have a poor prognosis. Recommended treatment involves surgical removal of the primary tumor, along with chemotherapy. However, the use of staples for cardiac tumor resection has not yet been extensively documented in the veterinary literature. A 10-year-old dachshund with pericardial effusion underwent surgery to remove a right atrial mass. An articulated linear cutting stapler was used for tumor resection. The patient experienced chylothorax as a complication but recovered well. However, the patient later developed respiratory symptoms and died, most likely due to aspiration pneumonia. The surgical stapler provided stability, convenience, and a shorter surgical time during tumor resection. Surgical resection combined with chemotherapy improves the survival of dogs with cardiac hemangiosarcoma. The stability and adjustability of the stapling device make it advantageous for cardiac tumor resection. Although complications, such as chylothorax, can arise, appropriate management can lead to positive outcomes. This case report demonstrates the feasibility and safety of using an articulated surgical stapler for cardiac tumor resection in dogs. Insights from this case can guide future research and clinical practice.

The objective of this study was to establish a cryopreservation protocol for canine pulmonary valves and assess the preservation quality of the tissue for transplantation. Pulmonary valves were harvested from six beagle dogs, with portions analyzed after antibiotic treatment, while the remaining sections were cryopreserved for six months. Following the thawing process, the cryopreserved valves were evaluated using histological and cellular analyses. The results indicated no significant structural damage in cryopreserved valves when compared to fresh valves. The trilaminar structure, consisting of the fibrosa, spongiosa, and ventricularis layers, was well-preserved, with the extracellular matrix (ECM) largely intact. The fibrosa layer, rich in collagen, exhibited minor disorganization in cryopreserved samples, which was statistically significant. The spongiosa layer, which contains proteoglycans, showed good preservation of its loose and hydrated matrix. Similarly, the ventricularis layer retained its elastic fiber network with minimal alterations. Cell density analysis revealed a mild decrease in cellularity within the fibrosa layer of cryopreserved tissues, but the overall difference in cell count between fresh and cryopreserved tissues was not statistically significant. Cellular viability was maintained, confirming the effectiveness of the cryopreservation protocol in preserving tissue quality. These findings suggest that long-term cryopreservation of canine pulmonary valves could be used for transplantation. This study provides important data for developing tissue banks in veterinary medicine and supports the potential use of cryopreserved valves in canine heart valve transplantation.

Del-Nido cardioplegia (DNc) is a single-dose cardioplegia that is widely used in human medicine because of its long duration. In this report, we describe two cases of open-heart surgery with cardiopulmonary bypass (CPB) using DNc. One dog was diagnosed with partial atrioventricular septal defect, and the other dog was diagnosed with myxomatous mitral valve disease stage D. Both dogs were treated with open-heart surgery with DNc to induce temporary cardiac arrest. No complications from DNc were observed, and the patients were discharged. Veterinary heart surgeons should consider DNc as an option for temporary cardiac arrest during open-heart surgery with CPB.

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) update 2023 proposed new definitions of chronic obstructive pulmonary disease (COPD) and COPD exacerbation. However, an agreement on the definitions has not been made, either internationally or domestically. This study aimed to reach an agreement between experts on the new definitions of COPD and COPD exacerbation in South Korea. Methods: A modified Delphi method was used to make an agreement on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023. We performed two rounds of the survey including 15 Korean experts on COPD, asthma, and tuberculosis. Results: More than two-thirds of the experts agreed on 12 of the 13 statements related to the definitions of COPD and COPD exacerbation in the two rounds of the survey. The experts agreed on the definitions of COPD and COPD exacerbation that should be revised in line with the definitions proposed by the GOLD update 2023. However, the experts showed an uncertain opinion on the statement that the definition of COPD includes patients with persistent airflow obstruction due to bronchiectasis. Conclusion Based on this Delphi survey, experts’ agreement was made on the definitions of COPD and COPD exacerbation proposed by the GOLD update 2023.

Background: There is a need to update the cardiovascular (CV) Sequential Organ Failure Assessment (SOFA) score to reflect the current practice in sepsis. We previously proposed the modified CV SOFA score from data on blood pressure, norepinephrine equivalent dose, and lactate as gathered from emergency departments. In this study, we externally validated the modified CV SOFA score in multicenter intensive care unit (ICU) patients. Methods: A multicenter retrospective observational study was conducted on ICU patients at six hospitals in Korea. We included adult patients with sepsis who were admitted to ICUs. We compared the prognostic performance of the modified CV/total SOFA score and the original CV/total SOFA score in predicting 28-day mortality. Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUROC) and the calibration curve, respectively. Results: We analyzed 1,015 ICU patients with sepsis. In overall patients, the 28-day mortality rate was 31.2%. The predictive validity of the modified CV SOFA (AUROC, 0.712; 95% confidence interval [CI], 0.677–0.746; P < 0.001) was significantly higher than that of the original CV SOFA (AUROC, 0.644; 95% CI, 0.611–0.677). The predictive validity of modified total SOFA score for 28-day mortality was significantly higher than that of the original total SOFA (AUROC, 0.747 vs. 0.730; 95% CI, 0.715–0.779; P = 0.002). The calibration curve of the original CV SOFA for 28-day mortality showed poor calibration. In contrast, the calibration curve of the modified CV SOFA for 28-day mortality showed good calibration. Conclusion In patients with sepsis in the ICU, the modified SOFA score performed better than the original SOFA score in predicting 28-day mortality.

Background: To evaluate the safety and effectiveness of empagliflozin in routine clinical settings, we collected and assessed the clinical profiles of Korean patients with type 2 diabetes mellitus. Methods: This was a post-marketing surveillance study of empagliflozin 10 and 25 mg. Information on adverse events and adverse drug reactions (ADRs) was collected as safety data sets. Available effectiveness outcomes, including glycosylated hemoglobin (HbA1c) level, fasting plasma glucose, body weight, and blood pressure, were assessed. Results: The incidence rate of ADRs was 5.14% in the safety dataset (n=3,231). Pollakiuria, pruritis genital, and weight loss were the most common ADRs. ADRs of special interest accounted for only 1.18%, and there were no serious events that led to mortality or hospitalization. In the effectiveness data set (n=2,567), empagliflozin significantly reduced the mean HbA1c level and body weight during the study period by –0.68%±1.39% and –1.91±3.37 kg (both P<0.0001), respectively. In addition, shorter disease duration, absence of dyslipidemia, and higher baseline HbA1c levels were identified as the clinical features characteristic of a “responder” to empagliflozin therapy. Conclusion Empagliflozin is a safe and potent glucose-lowering drug in routine use among Korean patients with type 2 diabetes mellitus. It is expected to have better glycemic efficacy in Korean patients with poorly controlled type 2 diabetes mellitus.