A 5-year-old, 28 kg castrated male Border Collie was referred for surgical intervention following complications from a prior total hip replacement. A physical examination revealed reduced weight-bearing and metallic crepitus on the affected limb. A radiographic assessment confirmed a fractured femoral stem. Extended trochanteric osteotomy (ETO) was performed to extract the well-fixed stem, followed by the removal of the acetabular cup. ETO stabilization was achieved with cerclage wires and a locking plate. Six months postoperatively, the radiographs indicated successful bone healing, and the dog exhibited improved limb function. The ETO technique can provide enhanced surgical access to extract well-fixed implants.

A 5-year-old, 28 kg castrated male Border Collie was referred for surgical intervention following complications from a prior total hip replacement. A physical examination revealed reduced weight-bearing and metallic crepitus on the affected limb. A radiographic assessment confirmed a fractured femoral stem. Extended trochanteric osteotomy (ETO) was performed to extract the well-fixed stem, followed by the removal of the acetabular cup. ETO stabilization was achieved with cerclage wires and a locking plate. Six months postoperatively, the radiographs indicated successful bone healing, and the dog exhibited improved limb function. The ETO technique can provide enhanced surgical access to extract well-fixed implants.

A 5-year-old, 28 kg castrated male Border Collie was referred for surgical intervention following complications from a prior total hip replacement. A physical examination revealed reduced weight-bearing and metallic crepitus on the affected limb. A radiographic assessment confirmed a fractured femoral stem. Extended trochanteric osteotomy (ETO) was performed to extract the well-fixed stem, followed by the removal of the acetabular cup. ETO stabilization was achieved with cerclage wires and a locking plate. Six months postoperatively, the radiographs indicated successful bone healing, and the dog exhibited improved limb function. The ETO technique can provide enhanced surgical access to extract well-fixed implants.

A 5-year-old, 28 kg castrated male Border Collie was referred for surgical intervention following complications from a prior total hip replacement. A physical examination revealed reduced weight-bearing and metallic crepitus on the affected limb. A radiographic assessment confirmed a fractured femoral stem. Extended trochanteric osteotomy (ETO) was performed to extract the well-fixed stem, followed by the removal of the acetabular cup. ETO stabilization was achieved with cerclage wires and a locking plate. Six months postoperatively, the radiographs indicated successful bone healing, and the dog exhibited improved limb function. The ETO technique can provide enhanced surgical access to extract well-fixed implants.

A 5-year-old, 28 kg castrated male Border Collie was referred for surgical intervention following complications from a prior total hip replacement. A physical examination revealed reduced weight-bearing and metallic crepitus on the affected limb. A radiographic assessment confirmed a fractured femoral stem. Extended trochanteric osteotomy (ETO) was performed to extract the well-fixed stem, followed by the removal of the acetabular cup. ETO stabilization was achieved with cerclage wires and a locking plate. Six months postoperatively, the radiographs indicated successful bone healing, and the dog exhibited improved limb function. The ETO technique can provide enhanced surgical access to extract well-fixed implants.

Background: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with significant morbidity and mortality, posing a considerable burden on healthcare systems. In Republic of Korea, the prevalence and incidence of AF have increased in recent years. There have also been significant changes in the trends of antiarrhythmic drug (AAD) use and procedural treatments for AF. Objectives: This study aims to review the trends in AF treatment strategies in Republic of Korea, particularly focusing on the utilization of antiarrhythmic drugs and catheter ablation. Methods: The Korean National Health Insurance Service (K-NHIS) data were used to identify AF patients from 2013 to 2022. AAD usage and catheter ablation procedures were analyzed annually. AADs were classified into Class IC and III drugs. Trends in beta-blockers, calcium channel blockers, and digoxin prescriptions were also examined. The primary endpoint was the trend of AAD use and AF catheter ablation (AFCA) over 10 years. Results: In 2022, 940,063 patients had a prior diagnosis of AF. From 2013 to 2022, the use of AADs increased from 12.1 to 16.4% among prevalent AF patients. Beta-blockers were the most commonly prescribed rate control medication, while the use of calcium channel blockers and digoxin declined. The frequency of AFCA procedures also increased, from 0.5% of prevalent AF patients in 2013 to 0.7% in 2022. Younger patients, males, and those with lower CHA2DS2-VASc scores were more likely to receive AFCA. Regional variations in treatment patterns were observed, with Seoul exhibiting higher rates of procedural treatments and AAD prescriptions. Conclusions Over the past decade, there has been a significant increase in the use of AADs and AFCA procedures in Republic of Korea. These trends reflect recent advancements in AF management advocating a refined rhythm control strategy.

Background: Preauricular sinus (PAS) is a common congenital anomaly, and complete excision is recommended to prevent recurrence. However, PAS has a high recurrence rate as a result of incomplete removal due to the high variability of the sinus ramifications, making its treatment challenging. In this study, we standardized the surgical procedure to reduce the complications and recurrence rate and compared the postoperative results between the non-standardized and the standardized groups. Methods: This retrospective study included 97 patients (120 ears) who had undergone PAS excision by a single surgeon between October 2014 and September 2022 and underwent at least 6 months of follow-up. After October 2018, all patients were treated using the standardized method, which comprised the use of magnifying glasses, exploration with a lacrimal probe, the use of methylene blue staining, and excision of a piece of surrounding normal tissue and related cartilage in continuity with the specimen. There were 38 patients (45 ears) in the non-standardized group and 59 patients (75 ears) in the standardized group. Results: Recurrence was observed in six of 120 ears, indicating an overall recurrence rate of 5.0%. Recurrence occurred in five ears (11.1%) in the non-standardized group and one ear (1.3%) in the standardized group. The standardized group had a significantly lower recurrence rate (p= 0.027) than the non-standardized group. Conclusion We defined a standardized sinectomy protocol and used it for the surgical treatment of PAS. With this standardized method, we were able to reduce the rates of complications and recurrence without the use of a long incision.

Background: Cholecystitis is an important risk factor for gallbladder cancer, but the bile microbiome and its association with gallbladder disease has not been investigated fully.We aimed to analyze the bile microbiome in normal conditions, chronic cholecystitis, and gallbladder cancer, and to identify candidate bacteria that play an important role in gallbladder carcinogenesis. Methods: We performed metagenome sequencing on bile samples of 10 healthy individuals, 10 patients with chronic cholecystitis, and 5 patients with gallbladder cancer, and compared the clinical, radiological, and pathological characteristics of the participants. Results: No significant bacterial signal was identified in the normal bile. The predominant dysbiotic bacteria in both chronic cholecystitis and gallbladder cancer were those belonging to the Enterobacteriaceae family. Klebsiella increased significantly in the order of normal, chronic cholecystitis, and gallbladder cancer. Patients with chronic cholecystitis and dysbiotic microbiome patterns had larger gallstones and showed marked epithelial atypia, which are considered as precancerous conditions. Conclusion We investigated the bile microbiome in normal, chronic cholecystitis, and gallbladder cancer. We suggest possible roles of Enterobacteriaceae, including Klebsiella, in gallbladder carcinogenesis. Our findings reveal a possible link between a dysbiotic bile microbiome and the development of chronic calculous cholecystitis and gallbladder cancer.

Background: Cholecystitis is an important risk factor for gallbladder cancer, but the bile microbiome and its association with gallbladder disease has not been investigated fully.We aimed to analyze the bile microbiome in normal conditions, chronic cholecystitis, and gallbladder cancer, and to identify candidate bacteria that play an important role in gallbladder carcinogenesis. Methods: We performed metagenome sequencing on bile samples of 10 healthy individuals, 10 patients with chronic cholecystitis, and 5 patients with gallbladder cancer, and compared the clinical, radiological, and pathological characteristics of the participants. Results: No significant bacterial signal was identified in the normal bile. The predominant dysbiotic bacteria in both chronic cholecystitis and gallbladder cancer were those belonging to the Enterobacteriaceae family. Klebsiella increased significantly in the order of normal, chronic cholecystitis, and gallbladder cancer. Patients with chronic cholecystitis and dysbiotic microbiome patterns had larger gallstones and showed marked epithelial atypia, which are considered as precancerous conditions. Conclusion We investigated the bile microbiome in normal, chronic cholecystitis, and gallbladder cancer. We suggest possible roles of Enterobacteriaceae, including Klebsiella, in gallbladder carcinogenesis. Our findings reveal a possible link between a dysbiotic bile microbiome and the development of chronic calculous cholecystitis and gallbladder cancer.