Effectiveness of the COVID-19 vaccine in the Honam region of the Republic of Korea

Objectives@#In 2021, the effectiveness of the COVID-19 vaccine was analyzed among people living in the Honam region (Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju) of the Republic of Korea. And we investigated changes in the dominant virus strain. @*Methods@#This study used the data provided by the Korean Ministry of the Interior and Safety for individuals ≥12 years old in the Honam region, and the Integrated Disease and Health Management System of the Korea Centers for Disease Control and Prevention for COVID-19-vaccinated individuals as of December 31, 2021. Statistical analyzes were performed using IBM SPSS ver. 23.0. The occurrence of confirmed cases by vaccination status, the relative risk, and vaccine effectiveness by vaccine type were calculated. @*Results@#In 2021, the COVID-19 vaccination rate in Honam was 88.6%. The overall vaccine effectiveness (after 2 and 3 doses) was 98.7% (p98%, and the effect among persons who received 2 doses was >90% regardless of the vaccine type. Although vaccine effectiveness decreased because of reduced antibody levels over time (as observed in breakthrough infections), receiving a booster dose restored the neutralizing antibody levels.

Clinical Features and Prognosis of Patients with Primary Intestinal B-cell Lymphoma Treated with Chemotherapy with or without Surgery / 대한소화기학회지

Background/Aims@#This multicenter study reviewed the clinical features and prognosis according to the primary site of involvement and the treatment modality in patients with B-cell primary intestinal lymphoma (PIL). @*Methods@#Among 125 consecutive patients diagnosed with PIL, 100 patients were analyzed. @*Results@#The median age was 59 years, and the male to female ratio was 1.86:1. Diffuse large B-cell lymphoma (66/100, 66.0%) was the most common histological subtype. The estimated 5-year survival rate (5-YSR) was 48.5%. The 5-YSR was similar regardless of the type of primary treatment (chemotherapy alone vs. surgery/chemotherapy, 50.7 vs. 45.3%, p=0.582). A comparison of the survival according to the primary site of involvement revealed a 5-YSR of 32.5% (p=0.027), 64.3% (reference), 46.5% (p=0.113), and 49.8% (p=0.024) for the small intestine, ileocecal region, large intestine, and multiple sites, respectively. Multivariate analysis, however, revealed a low hemoglobin level, advanced Ann Arbor stage, and aggressive histological type to be independent prognostic factors for shorter survival but not ileocecal region involvement. @*Conclusions@#The Ann Arbor stage, hemoglobin level, and histological type were independent prognostic factors for survival, while the primary site of involvement and treatment modality did not affect the prognosis in patients with B-cell PIL.

Clinical outcomes of endovascular treatment for ruptured thoracic aortic disease

Background/Aims@#Untreated rupture of the thoracic aorta is associated with a high mortality rate. We aimed to review the clinical results of endovascular treatment for ruptured thoracic aortic disease. @*Methods@#We retrospectively reviewed data on 37 patients (mean age, 67.0 ± 15.18 years) treated for ruptured thoracic aortic disease from January 2005 to May 2016. The median follow-up duration was 308 days (interquartile range, 61 to 1,036.5). The primary end-point of the study was the composite of death, secondary intervention, endoleak, and major stroke/paraplegia after endovascular treatment. @*Results@#The etiologies of ruptured thoracic aortic disease were aortic dissection (n = 11, 29.7%), intramural hematoma (n = 7, 18.9%), thoracic aortic aneurysm (n = 14, 37.8%), and traumatic aortic transection (n = 5, 13.5%). Three patients died within 24 hours of thoracic endovascular aortic repair, and one showed type I endoleak. The technical success rate was 89.2% (33/37). The in-hospital mortality rate was 13.5% (5/37); no deaths occurred during follow-up. The composite outcome rate during follow-up was 37.8% (14/37), comprising death (n = 5, 13.5%), secondary intervention (n = 5, 13.5%), endoleak (n = 5, 13.5%), and major stroke/paraplegia (n = 3, 8.1%). Left subclavian artery revascularization and proximal landing zone were not associated with the composite outcome. Low mean arterial pressure (MAP; ≤ 60 mmHg, [hazard ratio, 13.018; 95% confidence interval, 2.435 to 69.583, p = 0.003]) was the most significant predictor and high transfusion requirement in the first 24 hours was associated with event-free survival (log rank p = 0.018). @*Conclusions@#Endovascular treatment achieves high technical success rates and acceptable clinical outcome. High transfusion volume and low MAP were associated with poor clinical outcomes.

Frequency and Characteristics of Interval Colorectal Cancer in Actual Clinical Practice: A KASID Multicenter Study

BACKGROUND/AIMS: The aims of the present study were to determine the frequency of interval colorectal cancers (CRCs) after surveillance colonoscopy and to compare the clinicopathologic features and survival outcomes with those of non-interval CRCs. METHODS: From January 2003 to December 2013, 66,016 follow-up colonoscopies for 38,412 patients performed within recommended time were reviewed retrospectively based on data from 11 tertiary hospitals in South Korea. To compare clinicopathologic features and survival rates for interval CRC, 106 patients with non-interval CRC matched in age and gender were included. RESULTS: Among the 66,016 colonoscopies performed within the surveillance period, 63 cases (63/66,016) of interval CRC were detected, and 53 were finally included in the analysis. The mean age was 69.9±8.8 years, and the male to female ratio was 1.94:1. Although the occurrence rate of cancer in the right side colon was higher than that of non-interval CRC, interval CRCs were predominantly left sided. Other clinicopathologic features and overall survival were not significantly different between the two groups. Missed lesion was suspected to be the most common cause (29 cases, 54.7%). CONCLUSIONS: The frequency of interval CRC among patients who had undergone a surveillance colonoscopy was 0.095%. While sharing some similar clinical features and survival outcomes, interval CRCs in Korea developed more often in males and on the left side in contrast to results from Western studies.

Safety and Efficacy of an Aortic Arch Stent Graft with Window-Shaped Fenestration for Supra-Aortic Arch Vessels: an Experimental Study in Swine

BACKGROUND AND OBJECTIVES: Thoracic endovascular aortic repair exhibits limitations in cases where the aortic pathology involves the aortic arch. We had already developed a fenestrated aortic stent graft (FASG) with a preloaded catheter for aortic pathology involving the aortic arch. FASG was suitable for elective cases. MATERIALS AND METHODS: An aortic arch stent graft with a window-shaped fenestration (FASG-W) for supra-aortic arch vessels is suitable for emergent cases. This study aims to test a FASG-W for supra-aortic arch vessels and to perform a preclinical study in swine to evaluate the safety and efficacy of this device. Six FASG-Ws with 1 preloaded catheter were advanced through the iliac artery in 6 swine. The presence of endoleak and the patency and deformity of the grafts were examined with computed tomography (CT) at 4 weeks postoperatively. A postmortem examination was performed at 8 weeks. The mean procedure time for FASG-W was 27.15±4.02 minutes. The mean time for the selection of the right carotid artery was 5.72±0.72 minutes. RESULTS: Major adverse events were not observed in any of the 6 pigs who survived for 8 weeks. For the FASG-W, no endoleaks, no disconnection, and no occlusion of the stent grafts were observed in the CT findings or the postmortem gross findings. CONCLUSION: The procedure with the FASG-W was able to be performed safely in a relatively short procedure time and involved an easy technique. The FASG-W was found to be safe and convenient for use in this preclinical study of swine.

Giant Brunner’s Gland Hamartoma of the Duodenal Bulb Presenting with Upper Gastrointestinal Bleeding and Obstruction

Brunner’s gland hamartomas are small benign lesions that are most commonly found in the bulb of the duodenum. They are very uncommon, and most are found incidentally during upper gastrointestinal series or esophagogastroduodenoscopy. The lesions tend to be asymptomatic, but patients may present with symptoms of duodenal obstruction or hemorrhage secondary to ulceration. Histologically, a Brunner's gland hamartoma consists of the components of Brunner's gland cells, as well as glandular, adipose and muscle cells. In this study, we report the case of a 30-year-old man who presented with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's gland hamartoma in the duodenal bulb. The hamartoma was successfully removed by endoscopic resection. No significant complications were observed. Microscopically, the lesion was found to be entirely composed of variable Brunner's glands and adipocytes.

Clinical features of Crohn's disease in Korean patients residing in Busan and Gyeongnam

BACKGROUND/AIMS: Crohn's disease (CD) is a chronic inflammatory bowel disease that presents with variable features and repeated disease aggravation. The incidence of CD is increasing in Korea. We evaluated the clinical features of CD in a study population in Busan and Gyeongnam, Korea. METHODS: A hospital-based analysis included 619 patients diagnosed with CD between March 1986 and February 2013 from seven tertiary care hospitals in Busan and Gyeongnam. Individual case records were reviewed with regard to age at diagnosis, sex, disease location, disease behavior, and medical and surgical treatments received during the follow-up period. RESULTS: The cumulative frequency of patients diagnosed with CD revealed a continued increase in the number of cases reported yearly. The male-to-female ratio was 2.5:1 and the median age at diagnosis was 24 years. At diagnosis, 114 (18.4%) had isolated small bowel disease, 144 (23.3%) had isolated colonic disease, and 358 patients (57.8%) presented with disease in the small bowel and colon. The number of patients presenting with stricturing or penetrating disease behavior was 291 (47%) at the final evaluation. In total, 111 (17.9%) patients underwent intestinal resections. CONCLUSIONS: A continued increase in the number of patients diagnosed with CD was found in Busan and Gyeongnam as observed in other regions. We report results similar to that of other Korean studies in terms of sex distribution, age, and location of disease.

Effects of Intracoronary Administration of Autologous Adipose Tissue-Derived Stem Cells on Acute Myocardial Infarction in a Porcine Model

PURPOSE: Adipose-derived stem cells (ADSCs) are known to be potentially effective in regeneration of damaged tissue. We aimed to assess the effectiveness of intracoronary administration of ADSCs in reducing the infarction area and improving function after acute transmural myocardial infarction (MI) in a porcine model. MATERIALS AND METHODS: ADSCs were obtained from each pig's abdominal subcutaneous fat tissue by simple liposuction. After 3 passages of 14-days culture, 2 million ADSCs were injected into the coronary artery 30 min after acute transmural MI. At baseline and 4 weeks after the ADSC injection, 99mTc methoxyisobutylisonitrile-single photon emission computed tomography (MIBISPECT) was performed to evaluate the left ventricular volume, left ventricular ejection fraction (LVEF; %), and perfusion defects as well as the myocardial salvage (%) and salvage index. At 4 weeks, each pig was sacrificed, and the heart was extracted and dissected. Gross and microscopic analyses with specific immunohistochemistry staining were then performed. RESULTS: Analysis showed improvement in the perfusion defect, but not in the LVEF in the ADSC group (n=14), compared with the control group (n=14) (perfusion defect, -13.0+/-10.0 vs. -2.6+/-12.0, p=0.019; LVEF, -8.0+/-15.4 vs. -15.9+/-14.8, p=0.181). There was a tendency of reducing left ventricular volume in ADSC group. The ADSCs identified by stromal cell-derived factor-1 (SDF-1) staining were well co-localized by von Willebrand factor and Troponin T staining. CONCLUSION: Intracoronary injection of cultured ADSCs improved myocardial perfusion in this porcine acute transmural MI model.

Safety and Efficacy of a Novel, Fenestrated Aortic Arch Stent Graft with a Preloaded Catheter for Supraaortic Arch Vessels: An Experimental Study in Swine

Thoracic endovascular aortic repair (TEVAR) shows limitations in cases in which the aortic pathology involves the aortic arch. The study aims were to test a fenestrated aortic arch stent graft (FASG) with a preloaded catheter for the supraaortic arch vessels and to perform a preclinical study in swine to evaluate the safety and efficacy of this device. Six FASGs with 1 preloaded catheter and 5 FASGs with 2 preloaded catheters were advanced through the iliac artery in 11 swines. The presence of endoleaks and the patency and deformity of the grafts were examined with computed tomography (CT) at 4 weeks postoperatively. A postmortem examination was performed at 8 weeks. The mean procedure time for the one and two FASG groups was 30.2 (27.9-34.5) min and 43.1 (39.2-53.7) min. The mean time for the selection of the carotid artery was 4.8 (4.2-5.5) min and 6.2 (4.6-9.4) min. Major adverse event was observed in one of 11 pigs. One pig died at 4 weeks likely because of the effects of the high dose of ketamine, while the remaining 10 pigs survived 8-week. For both the one and two FASG groups, no endoleaks, no disconnection, no occlusion of the stent grafts were observed in the CT findings and the postmortem gross findings. The procedure with the FASG could be performed safely in a relatively short procedure time and involved an easy technique. The FASG is found to be safe and convenient in this preclinical study with swine.

Comparison of the Efficacy and Tolerability between Same-day Picosulfate and Split-dose Polyethylene Glycol Bowel Preparation for Afternoon Colonoscopy: A Prospective, Randomized, Investigator-blinded Trial

BACKGROUND/AIMS: In the present study, we evaluated the efficacy and tolerability between same-day bowel preparation protocols using 2 sachets of Picosulfate and a 4 L split-dose polyethylene glycol (PEG) bowel preparation for afternoon colonoscopy. METHODS: The study had a single-center, prospective, randomized, and investigator-blinded, non-inferiority design. We evaluated bowel preparation quality according to the Ottawa scale, patient tolerability, compliance, incidence of adverse events, sleep quality, and polyp/adenoma detection rate. RESULTS: Among the 196 patients analyzed (mean age, 55.3 years; 50.3% men), 97 received the same-day regimen of 2 sachets of picosulfate (group A) and 99 received the 4 L split-dose PEG regimen (group B). The Ottawa score of the total colon was 4.05+/-1.56 in group A and 3.80+/-1.55 in group B (P=0.255). The proportion of patients having adequate bowel preparation in the same-day picosulfate group (61.5%) was slightly less than the 4 L PEG group (71.3%); however, the difference was not statistically significant (P=0.133). Tolerability of the group A regimen was superior to that of the group B regimen (P<0.000). The same-day picosulfate regimen was associated with fewer adverse events, such as abdominal bloating (P=0.037) and better sleep quality (P<0.000). CONCLUSIONS: The same-day picosulfate regimen and the 4 L split-dose PEG regimen had similar efficacy in bowel preparation for afternoon colonoscopy. However, the same-day picosulfate regimen was easier to administer, produced fewer adverse events, and enabled better sleep quality.

Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children

PURPOSE: Vitamin D deficiency has been suggested to play a role in the pathogenesis of atopic dermatitis. In addition, inverse correlationship between serum 25-hydroxyvitamin D concentration and severity of atopic dermatitis has been suggested. METHODS: Clinical and laboratory parameters including serum 25-hydroxyvitamin D level and serum total IgE of 251 patients with atopic dermatitis who were 13 months to 18 years were measured. Severity of atopic dermatitis was assessed with SCORing Atopic Dermatitis (SCORAD) index. Statistical analysis was performed using Pearson correlation coefficient, one-way analysis of variance test and chi-square test. RESULTS: Among 251 patients, vitamin D deficiency (25-hydroxyvitamin D or =30 ng/mL, group 3) was present in 74 (29.5%). There was a statistically significant inverse correlation between serum concentration of 25-hydroxyvitamin D and values of SCORAD index (R=-0.24, P<0.000). Serum concentration of 25-hydroxyvitamin D were inversely correlated with total IgE (R=-0.29, P<0.000), and age (R=-0.49, P<0.000). CONCLUSION: The results from this study indicate that serum concentration of 25-hydroxyvitamin D is inversely correlated with clinical severity of atopic dermatitis in children.

The investigation of hypoproteinemia in pediatric atopic dermatitis

PURPOSE: As a complication of atopic dermatitis (AD), the incidence of hypoproteinemia is increasing among infants with severe AD. It can be a life-threatening condition owing to hypovolemic shock as a result of hypoproteinemia. The aim of this study is to investigate the clinical feature and laboratory findings in pediatric AD patients with hypoproteinemia. METHODS: Seventy-five patients who visited pediatric allergy clinic and diagnosed as AD by a physician from January 2005 to January 2012. Patients with low serum protein level were classified as group A (n=27) and those with normal serum protein level were classified as group B (n=48). Age, sex, and parental allergic history were studied. We examined serum protein and albumin, eosinophil count, C-reactive protein (CRP), serum eosinophil cationic protein (ECP), total IgE, specific IgE, skin culture and SCORing Atopic Dermatitis (SCORAD) score. RESULTS: In group A, serum protein and albumin were lower and eosinophil count, CRP, ECP, total IgE and SCORAD score were higher than group B. Group A was sensitized more number of allergens than group B. In parental allergic history, allergic rhinitis was prominent in both group. In skin culture, other species than Staphylococcus aureus were prominent in group A. Egg sensitization was the most common in both group. Serum protein level was positively correlated with serum albumin and negatively correlated with eosinophil count, total IgE, SCORAD score and number of sensitized allergen. CONCLUSION: Risk factors for hypoproteinemia in pediatric atopic dermatitis are considered infants, severe atopic dermatitis, increased number of sensitized allergens.

The correlation between the severity of atopic dermatitis classified by SCORing atopic dermatitis index and the laboratory tests

PURPOSE: SCORing atopic dermatitis (SCORAD) index is the best validated scoring system in atopic dermatitis (AD). But this scoring system has limitation to the interobserver and intraobserver variation. This study was designed to evaluate the correlation between the severity of AD classified by the SCORAD index and the laboratory tests. METHODS: We evaluated 67 children admitted in the pediatric allergy and respiratory division of Busan St. Mary's Medical Center from April 1 to 30, 2011. SCORAD index was measured by one same physician. The patients were classified into mild to moderate and severe groups by SCORAD index. We identified sex, age and family history of allergic disease. We checked laboratory tests including mycoplasma immunoglobulin (Ig) M, total IgE, eosinophil count, eosinophil cationic protein, specific IgE, total protein, albumin, IgG, IgA, IgM, IgD, and inflammatory index (lactate dehydrogenase, C-reactive protein, erythrocyte sedimentation rate) and skin culture. RESULTS: There were no statistically significant differences between two groups in age, sex, parental allergic history, skin culture, mycoplasma IgM, specific IgE, immunoglobulin, and inflammatory index. The SCORAD index has statistically significant positive correlations with serum total eosinophil count, and total IgE, and negative correlations with total protein, and albumin. CONCLUSION: Our study suggest that serum total eosinophil count, total IgE, total protein, and albumin can be used to evaluate the severity of AD and make up for the SCORAD index.

Effects of Low Dose Pioglitazone on Restenosis and Coronary Atherosclerosis in Diabetic Patients Undergoing Drug Eluting Stent Implantation

PURPOSE: Thiazolidinediones are insulin-sensitizing agents that reduce neointimal proliferation and the adverse clinical outcomes associated with percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM). There is little data on whether or not low dose pioglitazone reduces adverse clinical outcomes. MATERIALS AND METHODS: The study population included 121 DM patients with coronary artery disease and they were randomly assigned to 60 patients taking 15 mg of pioglitazone daily in addition to their diabetic medications and 61 patients with placebo after the index procedure with drug-eluting stents (DESs). The primary end points were rate of in-stent restenosis (ISR) and change in atheroma volume and in-stent neointimal volume. The secondary end points were all-cause death, myocardial infarction (MI), stent thrombosis and re-PCI. RESULTS: There were no statistical differences in the clinical outcomes and the rate of ISR between the two groups [all-cause death; n=0 (0%) in the pioglitazone group vs. n=1 (1.6%) in the control group, p=0.504, MI; n=2 (3.3%) vs. n=1 (1.6%), p=0.465, re-PCI; n=6 (10.0%) vs. n=6 (9.8%), p=0.652, ISR; n=4 (9.3%) vs. n=4 (7.5%), p=1.000, respectively]. There were no differences in changes in neointimal volume, percent neointimal volume, total plaque volume and percent plaque volume between the two groups on intravascular ultrasonography (IVUS) study. CONCLUSION: Our study demonstrated that low dose pioglitazone does not reduce rate of ISR, neointimal volume nor atheroma volume in DM patients who have undergone PCI with DESs, despite the limitations of the study.

Percutaneous Carpal Tunnel Release Using Preoperative Ultrasonography and the Wire Rope

PURPOSE: The aims of this study were to introduce a new method of percutaneous carpal tunnel release and report its results. MATERIALS AND METHODS: After preoperative ultrasonographic mapping, a percutaneous carpal tunnel release was performed using the wire rope through two skin needle punctures. Forty wrists of 30 patients were evaluated restrospectively in terms of the symptomatic resolution and complications. The mean age of patients was 53.7 years ranging from 44 to 79 years. The mean follow-up period was 12.8 months ranging from 6 to 18 months. RESULTS: All cases showed complete relief or marked improvement of symptoms postoperatively. There was no neurovascular injury or other major complication. At postoperative 6 months follow-up, according to the Boston questionnaire, symptom severity score improved from 3.67+/-0.25 preoperatively to 1.55+/-0.33 postoperatively, and functional status score improved from 3.52+/-0.38 preoperatively to 2.09+/-0.42 postoperatively. All patients regained grip strength and pinch strength after surgery. CONCLUSION: The percutaneous carpal tunnel release using the preoperative ultrasonograhic mapping and the wire rope is an effective, reliable and safe method with the benefits of less postoperative pain and early recovery.

Two Cases of Multiple Adenomas in the Ileal Pouch after Total Proctocolectomy in Patients with Familial Adenomatous Polyposis / 대한소화기학회지

Familial adenomatous polyposis (FAP) is an inherited disease characterized by the development of hundreds of colorectal adenomas, leading to a 100% lifetime risk of colorectal cancer. A prophylactic colectomy is recommended for patients with FAP to prevent colorectal cancer. Four surgical strategies are available for patients with FAP: proctocolectomy with permanent ileostomy, colectomy with ileorectal anastomosis, proctocolectomy with Koch's pouch continent ileostomy (Koch), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Koch and IPAA, which make ileal pouch, have theoretical advantage of the elimination of the risk of colorectal cancer and adenomas and good functional outcome of reduced defecation frequency. However, recent reports have shown frequent development of adenomas and carcinomas in the ileal pouch after Koch or IPAA. We experienced 2 cases of multiple pouch adenomas after pouch surgery in FAP patients. Both patients were treated with endoscopic mucosal resection without complications. We report these 2 cases with a review of literatures.

Results of the First Fifty Minimally Invasive OxfordUnicompartmental Knee Arthroplasty / 대한정형외과학회잡지

PURPOSE: To report the advantages and the defects through an analysis of the early results of minimally invasive unicompartmental knee arthroplasty (UKA). MATERIALS AND METHODS: The first fifty consecutive minimally invasive UKA for medial osteoarthritis that were followed up for at least 2 years (2 years-2 years 10 months) were included. The surgical parameters, clinical parameters, radiological parameters and complications were examined. RESULTS: The average preoperative knee score was 47.7, which improved to 82.7, 86.7, 87.9 and 89.4 at 6 weeks, 6 months, 1 year and 2 years after surgery, respectively. The average function score was 42.2, which improved to 71.5, 77.4, 81.3 and 84.7 at the 6 weeks, 6 months, 1 year and 2 years follow up, respectively. The average range of knee motion was 124.6 degrees preoperatively, which changed to 128.4 degrees, 134.2 degrees, 136.8 degrees and 138.5 degrees at 6 weeks, 6 months, 1 year and 2 years, respectively. The preoperative tibiofemoral angle was 2.5 degrees of varus, which changed to 3.4 degrees of valgus postoperatively. Three revisions to total knee arthroplasty were performed due to two fractures of the medial tibial condyle and one dislocation of the femoral component. CONCLUSION: The early postoperative results of minimally invasive UKA showed satisfactory improvement in the knee score, function score and recovery of the range of motion. However, surgeons must be aware of the severe complications that require a revision procedure.

Access Type as A Predictor of Dialysis Dose and Efficiency in Hemodialysis Patients / 대한신장학회잡지

BACKGROUND: Use of venous catheter is associated with increased mortality in hemodialysis patients, but little data are available on impact of vascular access type on the discrepancy between dialysis prescription and dose. Dialysis prescription commonly exceeds the delivered dialysis dose. The purpose of this study are to evaluate the dialysis dose and efficiency between a tunneled cuffed catheters (TCCs) and arteriovenous fistulas (AVF) to the same patients on different dialysis days. METHODS: This study enrolled 35 hemodialysis patients. All patients started dialysis via tunneled cuffed catheters (Permcath(R)) in the internal jugular vein and a vascular surgeon created AVF later. We investigated prescribed spKT/V (pKt/V) and delivered spKt/V (dKt/V) within 2 months after the TCCs placement and after the AVF cannulation. Dialysis efficiencies (dKt/V/pKt/V) were compared over this two distinct times. RESULTS: Patient demographics were similar between two distinct times. The mean age of patients was 52.7 years (18 men, 17 women) and mean BMI was 21.9. 17 patients (48.6%) were diabetics. The mean pKt/V was not different (TCCs 1.63+/-0.30; AVF 1.62+/-0.29) but mean dKt/V was significantly different (TCCs 1.38+/-0.31; AVF 1.46+/-0.34) (p<0.05). The dialysis efficiencies were 85.14% for TCCs and 90.74% for AVF (p<0.05). There were no differences in sex, or diabetics. Underdialysis (delivered spKt/V <1.3) was greater in TCCs (17/35; 48.6 %), compared to AVF (10/35; 28.6%). Underdialysis was more common in larger patients. CONCLUSION: Our data suggest that AVF tend to receive more dialysis dose than tunneled cuffed catheters and underdialysis exposure are more common with catheter use.

The Comparison of MIPPO vs Open Plate Fixation in the Treatment of the Distal Tibia Fracture

PURPOSE: To evaluate the efficacy of the surgical treatment through the comparison of MIPPO vs open plate fixation in the treatment of the distal tibia fracture retrospectively. MATERIALS AND METHODS: 30 patients with distal tibia fracture from Jun. 2001 to Jun. 2004 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 15 patients treated with MIPPO, Group B was 15 patients treated with open plate fixation. The clinical outcomes were evaluated retrospectively from operation time, rehabilitation, ROM, interval change of postoperative CRP to assess postoperative inflammatory reaction, postoperative complications and clinical result with the use of McLennan and Ungersma criteria. RESULTS: There were no significant differences in clinical result by McLennan and Ungersma criteria in both groups. The postoperative 3 days and 7 days CRP were 4.0mg% (0.9~7.2)/0.5 mg% (0.1~1.5) in group A and 7.97mg% (2.8~14.6)/1.0mg% (0.3~1.6) in group B, shows more minimal tissue injury and early recovery in group A. Operation time in group A was shorter than group B. Normal recovery of ROM was quicker in Group A. In complications, group A showed one superficial infection and one angular deformity and group B showed one superficial infection, one infected nonunion and two ankle stiffness. CONCLUSION: There were no significant differences in clinical result and bony union. MIPPO technique is superior to group B in view of the minimal tissue injury, complications, operation time and postoperative rehabilitation.

Total Knee Arthroplasty-associated Acquired Hemophilia: A Case Report / 대한정형외과학회잡지

Acquired hemophilia due to the acquisition of antibodies to factor VIII is quite rare, and is associated with conditions such as pregnancy, lymphoma and autoimmune disorders. However, surgical trauma has not been recognized as a cause of factor VIII inhibitors. There have only been 4 cases (3 abdominal surgery, 1 coronary bypass surgery) reported in the world thus far. We experienced acquired hemophilia associated with Total Knee Arthroplasty. This syndrome presents with abrupt bleeding in the first few days after surgery and may cause life-threatening complications. We report a case of acquired hemophilia that was cured with immunosuppressive therapy with a review of the relevant literature.