Background: Both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are well-established treatments for medial knee osteoarthritis (OA). However, over the past 20 years, results of comparisons of long-term survival rates and outcomes have remained controversial. Furthermore, in patients at the boundary age, from 50 to 70 years, considering age as a treatment indication, selecting a surgical method is difficult. Therefore, we aimed to investigate conversion rates to total knee arthroplasty (TKA) and perioperative adverse outcomes between the two surgical methods in mid-age patients. Methods: We extracted data from the Korean National Health Insurance claims database. A total of 70,464 patients aged between 50 and 70 years, considered as mid-age patients were included in the final study population. We used a multivariable Cox proportional hazard regression model, adjusting for potential confounders such as age, sex, insurance type, region of residence, hospital type, comorbidities, and the Charlson comorbidity Index (CCI). Results: Of the 70,464 patients, 21,194 were treated with UKA and 49,270 were treated with HTO. HTO showed a higher risk of revision than UKA at five, and 10 years and during the whole observation period. The incidence of deep vein thromboembolism, and surgical site infection was significantly higher in UKA than in HTO. Conclusions: It is important to choose an appropriate surgical method considering that UKA has better results in terms of long-term survival rates but may have a higher incidence of various complications.

We aimed to evaluate the association between daily dietary calcium intake and the risk of cardiovascular disease (CVD) in postmenopausal women using data from the Korean National Health and Nutrition Examination Survey (KNHANES). This cross-sectional study included 12,348 women aged 45–70 years who had reached natural menopause. They were classified into three groups according to daily dietary calcium intake: 800 mg. The risks of CVD, stroke, angina, and myocardial infarction were assessed in each group. Further, we performed subgroup analysis according to the post-menopause duration (≤10 vs. >10 postmenopausal years). We performed logistic regression analysis with adjustment for age, menopausal age, income, urban area, education, insulin use, body mass index, hypertension, diabetes mellitus, dyslipidemia, high alcohol intake, smoking, exercise, oral contraceptive use, and hormonal therapy use. Calcium intake level was not significantly associated with the risk of CVD in the total population and the ≤10 postmenopausal years subgroup. However, in the >10 postmenopausal years subgroup, daily calcium intake >800 mg was associated with significantly decreased risks of all CVD (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.11–0.64), stroke (OR, 0.06; 95% CI, 0.01–0.42), and myocardial infarction (OR, 0.27; 95% CI, 0.11–0.64). Our findings suggest that a dietary calcium intake of >800 mg/day decreases the risk of CVD events in women who have been menopausal for >10 years.

Kim S, et al. J Korean Med Sci. 2023 Nov;39(1):e9. https://doi.org/10.3346/jkms.2024.39.e9

Large-scale studies elucidating sex differences in factors impacting prognosis and sex-specific prognossis factors scoring in patients with lung cancer are insufficient. The present study aimed to develop a model to predict sex-specific prognosis factors in Korean patients with lung cancer. This nationwide cohort study included 96,255 patients aged ≥19 years diagnosed with lung cancer and underwent Korean National Health Insurance Service health examinations between January 1, 2005 and December 31, 2015 and followed until 2020. Factors associated with prognosis were estimated using multivariable Cox proportional hazards regression analyses, and separate prognosis scores were calculated for male and female patients. The sex-specific risk scoring models were validated with Kaplan–Meier survival curves and c-statistic. During a mean follow-up of 2.8 years, 60.5% of the patients died. In male patients with lung cancer, age ≥ 65 years (24 points) had the highest mortality risk score, followed by chemotherapy in combination with radiotherapy (16 points), chemotherapy (14 points), and radiotherapy (11 points). In female patients with lung cancer, chemotherapy in combination with radiotherapy (19 points) had the highest mortality risk score, followed by chemotherapy (16 points), age ≥ 65 years (13 points), and radiotherapy (13 points). The analysis of patients categorized into three risk groups based on risk scores revealed that the fatality rates within 5 years were 7%, 54%, and 89% in the low-, intermediate-, and high-risk groups for male patients and 3%, 46%, 85% in the low-, intermediate-, and high-risk groups for female patients, respectively. The c-statistic was 0.86 for male patients and 0.85 for female patients. The strongest fatality risk factors in lung cancer were age ≥ 65 years in male patients and chemotherapy in female patients. The present study developed sex-specific prognosis scoring models to predict fatality risk in patients with lung cancer.

Song JY, et al. Cardiometab Syndr J. 2023 Mar;3:e12. https://doi.org/10.51789/cmsj.2023.3.e12

Background/Objectives: The prognosis of endometriosis-related ovarian clear cell carcinoma (OCCC) versus non-endometriosis-associated OCCC remains unclear. We examined the impact of endometriosis on OCCC diagnosis and progression and assessed whether prior surgical intervention for endometriotic ovarian cysts affects prognosis. Methods: In this retrospective study (2006–2024), OCCC patients were classified as non-endometriosis-associated or endometriosis-related. A subgroup analysis compared endometriosis-related OCCC patients with and without a history of endometriotic ovarian cyst surgery. Results: The average CA-125 level was 104.20 (29.90, 347.70) in the non-endometriosis-associated OCCC group and 80.70 (32.40, 247.90) in the endometriosis-related OCCC group (p = 0.32). Early-stage diagnosis occurred in 62.77% and 75.21% of these groups, respectively (p = 0.046). The average age at diagnosis was 53.95 ± 9.71 years for the non-endometriosis-associated group and 45.68 ± 7.98 years for the endometriosis-related group (p < 0.001). Mortality or poor prognosis was observed in 24.11% and 17.80% of these groups, respectively (p = 0.226). In endometriosis-related OCCC, comparisons were made between patients with and without a history of endometriotic ovarian cyst surgery. The average age at diagnosis was 45.84 ± 8.24 years for those without a surgical history and 44.71 ± 6.35 years for those with a surgical history (p = 0.59). Early-stage diagnosis was observed in 77.23% and 62.50%, respectively (p = 0.339). Mortality or poor prognosis occurred in 14.85% of those without a surgical history and 35.29% of those with a surgical history (p = 0.008). The hazard ratio for women with a surgical history was 3.48 (1.29–8.69) (p = 0.008). The incidence rate was 3.17 per 1000 person-years (PYRs) for individuals without surgery and 13.36 per 1000 PYRs for those with a history of surgical intervention (p = 0.008). Conclusions: Endometriosis did not impact the prognosis of women with OCCC. However, women with endometriosis-related OCCC were diagnosed at earlier stages and at younger ages. A history of endometriotic ovarian cyst surgery did not influence OCCC detection but was linked to poorer survival outcomes.