1.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
		                        		
		                        			 Objective:
		                        			Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study. 
		                        		
		                        			Methods:
		                        			This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death. 
		                        		
		                        			Results:
		                        			Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality. 
		                        		
		                        			Conclusion
		                        			This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival. 
		                        		
		                        		
		                        		
		                        	
2.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
		                        		
		                        			 Objective:
		                        			Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study. 
		                        		
		                        			Methods:
		                        			This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death. 
		                        		
		                        			Results:
		                        			Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality. 
		                        		
		                        			Conclusion
		                        			This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival. 
		                        		
		                        		
		                        		
		                        	
3.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
		                        		
		                        			 Background and Objectives:
		                        			The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM. 
		                        		
		                        			Methods:
		                        			A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years. 
		                        		
		                        			Results:
		                        			Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group. 
		                        		
		                        			Conclusions
		                        			In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients. 
		                        		
		                        		
		                        		
		                        	
4.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
		                        		
		                        			 Objective:
		                        			Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study. 
		                        		
		                        			Methods:
		                        			This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death. 
		                        		
		                        			Results:
		                        			Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality. 
		                        		
		                        			Conclusion
		                        			This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival. 
		                        		
		                        		
		                        		
		                        	
5.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
		                        		
		                        			 Background and Objectives:
		                        			The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM. 
		                        		
		                        			Methods:
		                        			A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years. 
		                        		
		                        			Results:
		                        			Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group. 
		                        		
		                        			Conclusions
		                        			In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients. 
		                        		
		                        		
		                        		
		                        	
6.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
		                        		
		                        			 Background and Objectives:
		                        			The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM. 
		                        		
		                        			Methods:
		                        			A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years. 
		                        		
		                        			Results:
		                        			Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group. 
		                        		
		                        			Conclusions
		                        			In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients. 
		                        		
		                        		
		                        		
		                        	
7.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
		                        		
		                        			 Objective:
		                        			Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study. 
		                        		
		                        			Methods:
		                        			This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death. 
		                        		
		                        			Results:
		                        			Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality. 
		                        		
		                        			Conclusion
		                        			This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival. 
		                        		
		                        		
		                        		
		                        	
8.Impact of Complete Revascularization for Acute Myocardial Infarction In Multivessel Coronary Artery Disease Patients With Diabetes Mellitus
Jeehoon KANG ; Sungjoon PARK ; Minju HAN ; Kyung Woo PARK ; Jung-Kyu HAN ; Han-Mo YANG ; Hyun-Jae KANG ; Bon-Kwon KOO ; Hyo-Soo KIM
Korean Circulation Journal 2024;54(10):603-615
		                        		
		                        			 Background and Objectives:
		                        			The clinical benefits of complete revascularization (CR) in acute myocardial infarction (AMI) patients are unclear. Moreover, the benefit of CR is unknown in AMI with diabetes mellitus (DM) patients. We sought to compare the prognosis of CR and incomplete revascularization (IR) in patients with AMI and multivessel disease, according to the presence of DM. 
		                        		
		                        			Methods:
		                        			A total of 2,150 AMI patients with multivessel coronary artery disease were analyzed. CR was defined based on the angiographic image. The primary endpoint of this study was the patient-oriented composite outcome (POCO) defined as a composite of allcause death, any myocardial infarction, and any revascularization within 3 years. 
		                        		
		                        			Results:
		                        			Overall, 3-year POCO was significantly lower in patients receiving angiographic CR (985 patients, 45.8%) compared with IR (1,165 patients, 54.2%). When divided into subgroups according to the presence of DM, CR reduced 3-year clinical outcomes in the nonDM group but not in the DM group (POCO: 11.7% vs. 23.2%, p<0.001, any revascularization:7.2% vs. 10.8%, p=0.024 in the non-DM group, POCO: 24.3% vs. 27.8%, p=0.295, any revascularization: 13.3% vs. 11.3%, p=0.448 in the DM group, for CR vs. IR). Multivariate analysis showed that CR significantly reduced 3-year POCO (hazard ratio, 0.52; 95% confidence interval, 0.36–0.75) only in the non-DM group. 
		                        		
		                        			Conclusions
		                        			In AMI patients with multivessel disease, CR may have less clinical benefit in DM patients than in non-DM patients. 
		                        		
		                        		
		                        		
		                        	
9.The Clinical Outcomes of Cervical Spine Chordoma: A Nationwide Multicenter Retrospective Study
Hangeul PARK ; Yunhee CHOI ; Sungjoon LEE ; Sun-Ho LEE ; Eun-Sang KIM ; Sun Woo JANG ; Jin Hoon PARK ; Yunseong CHO ; Giwuk JANG ; Yoon HA ; Yun-Sik DHO ; Heon YOO ; Sung Uk LEE ; Seung-Ho SEO ; Ki-Jeong KIM ; Seil SOHN ; Chun Kee CHUNG
Neurospine 2024;21(3):942-953
		                        		
		                        			 Objective:
		                        			Chordoma, a rare malignant tumor originating from embryonal notochord remnants, exhibits high resistance to conventional treatments, making surgical resection imperative. However, the factors influencing prognosis specifically for cervical spine chordoma have not been clearly identified. We investigate the prognosis of cervical spine chordoma with factors influential in a nationwide multicenter retrospective study. 
		                        		
		                        			Methods:
		                        			This study included all patients diagnosed with cervical spine chordoma at 7 tertiary referral centers from January 1998 to March 2023, excluding those with clivus and thoracic spine chordomas extending into the cervical spine. Local recurrence (LR) was identified through follow-up magnetic resonance imaging, either as reappearance in completely resected tumors or regrowth in residual tumors. The study assessed LR and overall survival, analyzing factors influencing LR and death. 
		                        		
		                        			Results:
		                        			Forty-five patients with cervical spine chordoma had a mean age of 46.4 years. Over a median follow-up of 52 months, LR and distant metastasis were observed in 21 (46.7%) and 4 patients (8.9%), respectively, and 16 patients (36%) were confirmed dead. The 5-year and 10-year cumulative LR rates were 51.3% and 60%, respectively, while the 5-year and 10-year survival rates were 82% and 53%. Age was the only significant factor affecting mortality (hazard ratio, 1.04; 95% confidence interval, 1.04–1.07; p=0.015). Notably, the degree of resection and adjuvant therapy did not statistically significantly impact local tumor control and mortality. 
		                        		
		                        			Conclusion
		                        			This study, the largest multicenter retrospective analysis of cervical spine chordoma in Korea, identified age as the only factor significantly affecting patient survival. 
		                        		
		                        		
		                        		
		                        	
10.Change in Plantar Pressure and Plain Radiography in Pediatric Flexible Flatfoot: A Retrospective Cohort Study
Sungjoon KIM ; Yong Gyun KIM ; Jun Yup KIM ; Si-Bog PARK ; Kyu Hoon LEE
Annals of Rehabilitation Medicine 2024;48(5):352-359
		                        		
		                        			 Objective:
		                        			To investigate longitudinal changes in plantar pressure examinations and plain radiographs and to assess the correlations between these two modalities in pediatric patients with flexible flatfoot (FFF). 
		                        		
		                        			Methods:
		                        			Pediatric patients diagnosed with FFF were analyzed in this retrospective cohort study. Medical records were reviewed to collect data on plain radiographs and plantar pressure examinations. Changes in radiographic angles and plantar pressure parameters were analyzed over a follow-up period exceeding 1 year. Statistical analyses included paired t-test, Wilcoxon signed rank test, and Spearman’s correlation analysis. 
		                        		
		                        			Results:
		                        			A total of 52 subjects was included in the plantar pressure analysis, with a mean age of 9.9 years at the first visit and a median follow-up duration of 52 months. The lateral tarso-first metatarsal angle decreased by 1.3° (p<0.001) and calcaneal inclination angle increased by 2.5° (p<0.001) in these patients. The percentage value of midfoot width (WMF) divided by forefoot width (WFF) decreased by an average of 9.8% p  (p<0.001), and the maximal pressure on the medial midfoot (MMF) decreased by 1.6 N/cm2 (p<0.001). However, no correlations were found between plantar pressure and radiographic changes. 
		                        		
		                        			Conclusion
		                        			During follow-up of patients with FFF, the maximal pressure on the MMF and the ratio of WMF to WFF decreased in successive plantar pressure examinations. Changes observed in plantar pressure and plain radiographs were not consistent, indicating that these two testing modalities can complement each other. 
		                        		
		                        		
		                        		
		                        	
            
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