Background: Acetabular fractures are rare and challenging to treat, and the surgeon’s learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies.Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, singlecenter studies. According to the authors’ literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year. Methods: This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta’s quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta’s radiological outcome grading and the modified Postel Merle d’Aubigné score were confirmed as radiological and functional outcomes, respectively. Results: The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age (p = 0.009), quality of reduction (p < 0.001), and the Judet and Letournel classification (p = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction (p < 0.001) and the Judet and Letournel classification (p = 0.030). Conclusions Our radiological and functional outcomes of acetabular fractures were comparable with those of other singlesurgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.

Background: Acetabular fractures are rare and challenging to treat, and the surgeon’s learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies.Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, singlecenter studies. According to the authors’ literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year. Methods: This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta’s quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta’s radiological outcome grading and the modified Postel Merle d’Aubigné score were confirmed as radiological and functional outcomes, respectively. Results: The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age (p = 0.009), quality of reduction (p < 0.001), and the Judet and Letournel classification (p = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction (p < 0.001) and the Judet and Letournel classification (p = 0.030). Conclusions Our radiological and functional outcomes of acetabular fractures were comparable with those of other singlesurgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.

Background: Acetabular fractures are rare and challenging to treat, and the surgeon’s learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies.Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, singlecenter studies. According to the authors’ literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year. Methods: This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta’s quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta’s radiological outcome grading and the modified Postel Merle d’Aubigné score were confirmed as radiological and functional outcomes, respectively. Results: The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age (p = 0.009), quality of reduction (p < 0.001), and the Judet and Letournel classification (p = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction (p < 0.001) and the Judet and Letournel classification (p = 0.030). Conclusions Our radiological and functional outcomes of acetabular fractures were comparable with those of other singlesurgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.

Background: Acetabular fractures are rare and challenging to treat, and the surgeon’s learning curve for managing these fractures is steep. The incidence of acetabular fractures is low, making it difficult to conduct single-surgeon, single-center studies.Therefore, multi-surgeon and multi-center studies may produce inconsistent outcomes compared to those of single-surgeon, singlecenter studies. According to the authors’ literature investigation, single-surgeon, single-center, large-scale studies on this topic are lacking. Thus, this study investigated the radiological and functional outcomes and prognostic factors in patients with displaced acetabular fractures treated by a single surgeon at a single center and followed up for at least 1 year. Methods: This retrospective study was conducted on 149 patients treated for acetabular fractures at Chungbuk national university hospital between January 2005 and December 2021. Demographic data, time to surgery, and complications were collected using medical records. The Judet and Letournel classification was confirmed using preoperative radiographs, and Matta’s quality of reduction was confirmed using immediate postoperative radiographs. At the latest outpatient follow-up, Matta’s radiological outcome grading and the modified Postel Merle d’Aubigné score were confirmed as radiological and functional outcomes, respectively. Results: The radiological outcome was excellent or good in 131 patients (87.9%) and fair or poor in 18 (12.1%) and influenced by age (p = 0.009), quality of reduction (p < 0.001), and the Judet and Letournel classification (p = 0.025). Functional outcome was excellent or good in 121 patients (81.2%) and fair or poor in 28 (18.8%); this was influenced by the quality of reduction (p < 0.001) and the Judet and Letournel classification (p = 0.030). Conclusions Our radiological and functional outcomes of acetabular fractures were comparable with those of other singlesurgeon, single-center studies regarding the follow-up period. Poor prognostic factors for radiological outcomes included age > 65 years, associated patterns, and poor quality of reduction. Associated patterns and poor quality of reduction were factors associated with poor functional outcomes.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Background: This study aimed to analyze the correlation between bone mineral density (BMD) and the type of 5th metatarsal fracture, as well as to demonstrate whether there is a difference in radiological findings (heel alignment angle [HAA], heel moment arm [HMA], and metatarsus angle) between fracture types. Methods: A total of 87 patients were enrolled in the study and allocated into 3 groups: the Zone 1 group (N=36), the Zone 2 group (N=33), and the Zone 3 group (N=18). The participants’ demographic data, T-scores, existing fracture or osteoporosis medications, and radiologic parameters including HAA, HMA, and metatarsus adductus angle were analyzed and compared. Results: There was a significant difference between the mean age of the participants, with the highest age in the Zone 1 group and the lowest in the Zone 3 group. Regarding the history of concurrent fracture or osteoporosis medications, there was no significant difference between the 3 groups. Similarly, no significant difference was observed between the 3 groups about the BMD values. In contrast, the HAA was statistically significant in all groups with a positive correlation of -8.9 in the Zone 1 group, a negative correlation of 3.55 in the Zone 2 group, and an inverse relationship of 6.1 in the Zone 3 group. The metatarsus adductus angle was significantly higher in the Zone 3 group than the Zone 1 and Zone 2 groups. Conclusions The location of a 5th metatarsal bone fracture is not significantly associated with BMD. However, mechanical influences, such as hindfoot varus or forefoot adductus, have a significant correlation with fracture types.

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Background: This study aimed to analyze the correlation between bone mineral density (BMD) and the type of 5th metatarsal fracture, as well as to demonstrate whether there is a difference in radiological findings (heel alignment angle [HAA], heel moment arm [HMA], and metatarsus angle) between fracture types. Methods: A total of 87 patients were enrolled in the study and allocated into 3 groups: the Zone 1 group (N=36), the Zone 2 group (N=33), and the Zone 3 group (N=18). The participants’ demographic data, T-scores, existing fracture or osteoporosis medications, and radiologic parameters including HAA, HMA, and metatarsus adductus angle were analyzed and compared. Results: There was a significant difference between the mean age of the participants, with the highest age in the Zone 1 group and the lowest in the Zone 3 group. Regarding the history of concurrent fracture or osteoporosis medications, there was no significant difference between the 3 groups. Similarly, no significant difference was observed between the 3 groups about the BMD values. In contrast, the HAA was statistically significant in all groups with a positive correlation of -8.9 in the Zone 1 group, a negative correlation of 3.55 in the Zone 2 group, and an inverse relationship of 6.1 in the Zone 3 group. The metatarsus adductus angle was significantly higher in the Zone 3 group than the Zone 1 and Zone 2 groups. Conclusions The location of a 5th metatarsal bone fracture is not significantly associated with BMD. However, mechanical influences, such as hindfoot varus or forefoot adductus, have a significant correlation with fracture types.

One third of the overall epilepsy population are estimated to be a drug refractory epilepsy (DRE), defined as the patients who failed to control seizure reduction, even tried two or more appropriate antiepileptic drugs (AEDs) trials. Those people need additional AEDs trials or other treatment options (resective surgery, neuromoulation, etc.). Here, we, clinical guideline committee of the Korean Neurological Association (KNA) introduce the recommendations of AEDs treatments including not only old and new AEDs currently available in Korea but also AEDs planned to be launched in the new future for DRE patients with literature review to help efficient decision of the clinician. The authors reviewed literatures and assessed efficacy and tolerability on 12 currently available and four newly introduced/or planned AEDs applied to DRE patients, published from November 2015 to July 2021. Brivaracetam, eslicarbazepine, canabidiol and cenobamate are the four AEDs that are newly introduced or planned to be launched soon. The reviewed articles are publications after November 2015, 2018 American Association of Neurology guideline, new AEDs which were introduced or planned to be launched as of 2021. All AEDs are classified based on the therapeutic rating scheme, generating recommendations. Overall 173 papers have been reviewed and analyzed for recommendation rationales. KNA introduce additional add-on treatment or conversional monotherapy guidelines on the drug refractory focal and generalized epilepsy. We hope these guidelines or recommendations to help clinical decision for the treatment of drug refractory epilepsy patients