Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

Background: Deep vein thrombosis (DVT) is a common complication in orthopedic surgery and has the potential to lead to fatal complications such as pulmonary thromboembolism. However, the precise incidence and risk factors for DVT in the foot and ankle fields remain unclear. This study aimed to analyze the prevalence of DVT and identify its risk factors after foot and ankle surgery. Methods: Between September 2020 and July 2023, screening duplex ultrasonography was performed on 278 patients who underwent foot and ankle surgery and required immobilization. The findings from screening duplex ultrasonography were assessed in conjunction with the symptoms present at the time of diagnosis. Heterogeneous demographic data that could serve as potential risk factors for DVT, including diagnosis, body mass index, and other medical histories, were examined alongside pertinent surgeryrelated data, such as tourniquet time. Results: Among the 278 individuals, DVT occurred in 41 patients (14.7%). Among these, 92.7% originated at the calf level and the majority were asymptomatic. The cases originating above the calf accounted for 3 cases, representing 7.3% of patients diagnosed with DVT (1.1% of the entire screened population). Acute trauma, history of previous DVT, and old age were identified as statistically significant risk factors for DVT occurrence, with odds ratios of 2.44 (p = 0.04), 6.40 (p = 0.02), and 1.16 (p = 0.03), respectively. Conclusions After foot and ankle surgery, DVT occurred in 14.7% of cases. Acute trauma, history of DVT, and old age were identified as risk factors for DVT. These findings highlight the necessity of careful monitoring and appropriate prophylactic interventions for high-risk patients. Further investigation is required to determine effective prophylactic strategies for this patient population.

We aimed to develop a cloud-based telemedicine platform for patients with intracerebral hemorrhage (ICH) at local hospitals in rural and underserved areas in Gangwon-do using artificial intelligence and non-face-to-face collaboration treatment technology. This is a prospective and multi-center development project in which neurosurgeons from four university hospitals in Gangwondo will participate. Information technology experts will verify and improve the performance of the cloud-based telemedicine collaboration platform while treating ICH patients in the actual medical field. Problems identified will be resolved, and the function, performance, security, and safety of the telemedicine platform will be checked through an accredited certification authority. The project will be carried out over 4 years and consists of two phases. The first phase will be from April 2022 to December 2023, and the second phase will be from April 2024 to December 2025. The platform will be developed by dividing the work of the neurosurgeons and information technology experts by setting the order of items through mutual feedback. This article provides information on a project to develop a cloud-based telemedicine platform for acute ICH patients in Gangwon-do.

Background: Infectious disease (ID) specialists are skilled facilitators of medical consultation who promote better outcomes in patient survival, antibiotic stewardship as well as healthcare safety in pandemic response. This study aimed to assess the working status of ID specialists and identify problems faced by ID professionals in Korea. Methods: This was a nationwide cross-sectional study in Korea. An online-based survey was conducted over 11 days (from December 17–27, 2020), targeting all active adult (n = 281) and pediatric (n = 71) ID specialists in Korea (N = 352). Questions regarding the practice areas of the specialists were divided into five categories: 1) clinical practices of outpatient care, inpatient care, and consultations; 2) infection control; 3) antibiotic stewardship; 4) research; and 5) education and training. We investigated the weekly time-use patterns for these areas of practice. Results: Of the 352 ID specialists, 195 (55.4%; 51.2% [144/281] adult and 71.8% [51/71] pediatric ID specialists) responded in the survey. Moreover, 144 (73.8%) of the total respondents were involved in all practice categories investigated. The most common practice area was outpatient service (93.8%), followed by consultation (91.3%) and inpatient service (87.7%). Specialists worked a median of 61 (interquartile range: 54–71) hours weekly: patient care, 29 (14–37) hours; research 11 (5–19) hours; infection control 4 (2–10) hours; antibiotic stewardship, 3 (1–5) hours; and education/training, 2 (2–6) hours. Conclusion ID specialists in Korea simultaneously undertake multiple tasks and work long hours, highlighting the need for training and employing more ID specialists.

PURPOSE: Transducin-like enhancer of split 1 (TLE1) is a member of the TLE family of transcriptional co-repressors that control the transcription of a wide range of genes. We investigated the prognostic significance of TLE1 protein expression in breast cancers by using immunohistochemistry and explored the relationship of TLE1 with clinicopathological parameters. METHODS: Immunohistochemistry was performed on 456 cases of breast cancer tiled on tissue microarrays. The relationship between TLE1 expression in normal breast specimens and ductal carcinoma in situ (DCIS) was also analyzed. RESULTS: TLE1 was highly expressed in 57 of 456 (12.5%) carcinoma samples. TLE1 was more frequently expressed in DCIS and invasive breast cancers than in normal breast tissue (p=0.002). High expression of TLE1 significantly correlated with negative lymph node (LN) metastasis (p=0.007), high histologic grade (p<0.001), estrogen receptor negativity (p<0.001), progesterone receptor negativity (p<0.001), human epidermal growth factor receptor 2 (HER2) positivity (p<0.001), and high Ki-67 proliferation index (p<0.001). Based on intrinsic subtypes, high TLE1 expression was strongly associated with HER2+ and triple-negative breast cancers (TNBC) (p<0.001). Survival analysis demonstrated no significant association between TLE1 expression and disease-free survival (DFS) (p=0.167) or overall survival (OS) (p=0.286). In subgroup analyses, no correlation was found between TLE1 expression and DFS or OS according to LN status or intrinsic subtype. CONCLUSION: High TLE1 expression is significantly associated with the HER2+ and TNBC subtypes. This is the first study documenting immunohistochemical expression of TLE1 in invasive breast cancer and its association with clinicopathological parameters, prognosis, and intrinsic subtype.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Co-Repressor Proteins ; Disease-Free Survival ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Triple Negative Breast Neoplasms

Syndesmotic injury can either be isolated or associated with bony or ligamentous ankle injury. When it is not associated with an ankle fracture, it may not be easy to diagnose, especially when there is no franck diastasis on a plain radiograph. Without proper treatment, syndesmotic injury can lead to chronic pain due to impingement of scar tissues and instability. It may further lead to ankle arthritis. Early diagnosis with appropriate management is a prerequisite to avoid these problems. Herein, we review and discuss the mechanism of injury, classification, diagnosis, and treatment of isolated syndesmotic injury.
Ankle ; Ankle Fractures ; Ankle Injuries* ; Arthritis ; Chronic Pain ; Cicatrix ; Classification ; Diagnosis ; Early Diagnosis ; Ligaments ; Sports

PURPOSE: The interaction of programmed death receptor 1 (PD-1) and its ligand, programmed death receptor ligand 1 (PD-L1), negatively regulates immune responses. This study aimed to clarify PD-L1 expression levels in breast cancer through immunohistochemistry (IHC) and to evaluate associations between these findings and clinicopathologic variables, including prognosis. METHODS: PD-L1 expression was analyzed using IHC on tissue microarrays of 465 invasive breast carcinomas. RESULTS: High PD-L1 expression was demonstrated in 63 of 465 tumors (13.5%). High PD-L1 expression was significantly associated with high histologic grade (p<0.001), negative lymph nodes (p=0.011), early pathologic stage (p=0.025), high tumor-infiltrating lymphocyte (TIL) (p<0.001) counts, negative estrogen receptor (p<0.001) and progesterone receptor (p=0.002) expression, positive human epidermal growth factor receptor 2 (HER2) (p=0.003), cytokeratin 5/6 (p=0.011), epidermal growth factor receptor (p<0.001), and p53 (p<0.001) expression, and high Ki-67 proliferating index (p<0.001). Based on intrinsic subtypes, high PD-L1 expression and high TIL counts were significantly associated with the HER2 and triple-negative basal type (p<0.001). PD-L1 expression was significantly associated with better disease-free survival (DFS) (p=0.041) and overall survival (OS) (p=0.026) in the univariate analysis, but not in the multivariate analysis. Higher TIL levels was an independent prognostic factor for decreased disease progression (hazard ratio [HR], 2.389; 95% confidence interval [CI], 1.284–4.445; p=0.006) and overall death (HR, 3.666; 95% CI, 1.561–8.607; p=0.003). CONCLUSION: PD-L1 protein expression in breast cancer is associated with better DFS and OS, but is not an independent prognostic factor. High PD-L1 expression was significantly associated with high TIL levels. This finding has important implications for antibody therapies targeting the PD-1/PD-L1 signaling mechanism in breast cancer.
Breast Neoplasms* ; Breast* ; Disease Progression ; Disease-Free Survival ; Estrogens ; Humans ; Immunohistochemistry ; Keratins ; Lymph Nodes ; Lymphocytes, Tumor-Infiltrating* ; Multivariate Analysis ; Prognosis* ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone