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: 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: 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: 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.

Background/Aims: Changing trends in the Helicobacter pylori (H. pylori) eradication protocol have not been investigated after the publication of the third-revised Korean guideline in 2013. We aimed to analyze the clinical characteristics of H. pylori-infected patients alongside their treatment protocols using a common data model (CDM). Materials and Methods: A 16-year electronic health record (of 1,689,604 patients from 2004 to 2019) was converted into a CDM in Kangdong Sacred Heart Hospital. We extracted records of patients who underwent the rapid urease test or serum anti-H. pylori IgG assay. The treatment protocols were visualized using a sunburst plot. We investigated the clinical characteristics and medication history of patients who underwent a urea breath test after clarithromycin-based eradication therapy. Results: Out of 29,458 patients tested for H. pylori infection, 7,647 received a treatment protocol. Among them, 72.5% received a 7~14 days protocol comprising a proton pump inhibitor (PPI), amoxicillin, and clarithromycin. The proportion of patients treated with the first-line protocol (PPI, bismuth, tetracycline, and metronidazole) slightly increased from 1.9% (before 2014) to 3.3% (after 2014) (P<0.001). The percentages of patients with of previous exposure to macrolides (14.7% vs. 5.5%, P<0.001) or amoxicillin (10.6% vs. 7.3%, P=0.006) were higher in patients with previous clarithromycin-based eradication failure. Conclusions The H. pylori treatment protocol was not significantly modified despite the updates in the clinical guideline. There was only 1.4 percentage point increase in bismuth-based quadruple therapy as first-line eradication therapy even after the announcement of revised Korean guideline in 2013.

Helicobacter pylori infection is one of the most common infectious diseases worldwide. Although the prevalence of H. pylori is gradually decreasing, approximately half of the world's population still becomes infected with this disease. H. pylori is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the H. pylori clinical practice guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of H. pylori were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of H. pylori infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future.

Background/Aims: This study examined the long-term outcomes of undifferentiated-type early gastric cancer (UD EGC) with positive horizontal margins (HMs) after endoscopic resection (ER) and compared them between additional surgery and nonsurgical management. Methods: From 2005 to 2015, a total of 1,124 patients with UD EGC underwent ER at 18 tertiary hospitals in Korea. Of them, 92 patients with positive HMs as the only noncurative factor (n=25) or with both positive HMs and tumor size >2 cm (n=67) were included. These patients underwent additional surgery (n=40), underwent additional endoscopic treatment (n=6), or were followed up without further treatment (n=46). Results: No lymph node (LN) metastasis was found in patients who underwent additional surgery. During a median follow-up of 57.7 months (interquartile range, 27.6 to 68.8 months), no LN or distant metastases or gastric cancer-related deaths occurred in the overall cohort. At baseline, the residual cancer rate was 57.8% (26/45) after additional surgery or ER. The 5-year local recurrence rate was 33.6% among patients who were followed up without additional treatment. The 5-year overall survival rates were 95.0% and 87.8% after additional surgery and nonsurgical management (endoscopic treatment or close follow-up), respectively (log-rank p=0.224). In the multivariate Cox regression analysis, nonsurgical management was not associated with an increased risk of mortality. Conclusions UD EGC with positive HMs after ER may have favorable long-term outcomes and a very low risk of LN metastasis. Nonsurgical management may be suggested as an alternative, particularly for patients with old age or chronic illness.

Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.

Background/Aims: Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for Helicobacter pylori infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea. Methods: PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model. Results: Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (P<0.01). Conclusions These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.

Background/Aims: The eradication rate of the first-line standard triple therapy (STT) for Helicobacter pylori (H. pylori) infection has decreased since 2000; therefore, other first-line therapies are required. This study was aimed at investigating the efficacy of bismuth-containing quadruple therapy (PBMT) for first-line H. pylori eradication compared to STT, sequential therapy (SQT), and concomitant therapy (CT). Materials and Methods: The Ovid-MEDLINE, Koreamed, EMBASE, KMBASE, and Cochrane Library databases were searched from January 2008 to July 2018. All identified randomized controlled trials (RCTs) comparing PBMT and non-PBMT for first-line H. pylori eradication therapy were included in the final analysis. Results: A total of 3,653 patients from seven RCTs were enrolled. The pooled eradication rates of PBMT by intention-to-treat (ITT) and per-protocol (PP) analyses were 82.1% (95% CI, 68.2~90.8%) and 88.8% (95% CI, 77.1~94.9%), respectively. However, no statistically significant difference was observed in eradication rates of the 10- or 14-day PBMT as compared to 14-day STT, 10-day SQT, and 10-day CT in ITT and PP analyses. PBMT was significantly higher in adverse events than in the other eradication regimens (RR, 1.64; 95% CI, 1.11~2.44). Considerable heterogeneity in adverse events was observed among studies (χ2=88.7; P<0.001, I2=93%). Conclusions PBMT can be the first-line treatment for H. pylori eradication in Korea when other first-line options, including STT, SQT, or CT, are unavailable due to their high adverse event rates.