Prognostic Value of A/T/N Biomarkers: Comparing Plasma and Imaging Modalities in Alzheimer Disease.

Background: Alzheimer disease (AD) is characterized by amyloid-β plaques (A), tau tangles (T), and neurodegeneration (N), collectively defining the ATN framework. While imaging biomarkers are well-established, the prognostic value of plasma biomarkers in predicting cognitive decline remains underexplored. This study compares plasma and imaging A/T/N biomarkers in predicting cognitive decline and evaluate the impact of combining biomarkers across modalities.

The Clinical Impact of Intravascular Imaging-Guided Percutaneous Coronary Intervention in Acute Myocardial Infarction Patients with High Thrombus Burden.

Despite the established clinical efficacy following intravascular imaging (IVI)-guided percutaneous coronary intervention (PCI) than angiography-guided PCI, evidence regarding prognostic benefits of IVI-guided PCI in acute myocardial infarction (AMI) patients with high thrombus burden remains limited. Using the nationwide registries of KAMIR-NIH and KAMIR-V, we evaluated the prognostic impact of IVI-guided PCI in AMI patients with high thrombus burden. A total of 4,074 patients with AMI and TIMI thrombus grades 4 or 5 who underwent aspiration thrombectomy were selected, of whom 892 patients (21.

Development of a prediction tool for kidney function decline in children with chronic kidney disease.

Background: A paucity of literature exists on the development of predictive tools for the decline of kidney function in pediatric chronic kidney disease (CKD). The objective of this study is to develop and internally validate a tool for the short-term prediction of a kidney function decline in pediatric patients with CKD.

Methods: A total of 539 patients participating in the KNOW-PedCKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease) were evaluated for 48 variables related to sociodemographic characteristics, laboratory data, and treatment use.

Left ventricular geometry and the risk of heavy coronary artery calcification in patients with pre-dialysis chronic kidney disease: the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD).

Background: The association between abnormal left ventricular geometry (LVG) patterns and the presence of coronary artery calcification is unclear in patients with CKD.

Methods: A total of 2,038 patients with pre-dialysis CKD at stages 1 to 5 were categorized by LVG patterns, which were echocardiographically determined by the presence or absence of left ventricular hypertrophy (LVH) and relative wall thickness (RWT): normal, concentric remodeling, eccentric LVH, and concentric LVH. The study outcome was the presence of heavy coronary artery calcification, which is defined as coronary artery calcium score >1,000 Agatston units.

OM-85 and Respiratory Symptoms in Korean COPD: A Multicenter Observational Study.

Background: Although OM-85 may lessen respiratory symptoms and reduce acute exacerbations in chronic obstructive pulmonary disease (COPD), its overall effectiveness remains incompletely proven.

Methods: This prospective, observational, single-arm study was conducted at four university hospitals in South Korea from June 2022 to December 2023. Adults with spirometry-confirmed COPD who were prescribed OM-85 were enrolled and followed for six months (3-months treatment, 3-months observation).

Impact of medical crisis on the critical care system in South Korea.

Background: The ongoing medical crisis in Korea has severely impacted the operational environment of intensive care units (ICU), posing significant challenges to quality care for critically ill patients. This study aimed to evaluate the effects of the ongoing crisis on ICUs.

Methods: A survey was conducted in July 2024 among intensivists in charge of ICUs at institutions accredited by the Korean Society of Critical Care Medicine for critical care.

Immediate versus staged complete revascularisation during index admission in patients with ST-segment elevation myocardial infarction and multivessel disease (OPTION-STEMI): a multicentre, non-inferiority, open-label, randomised trial.

Background: The optimal timing of complete revascularisation for patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease remains unclear. We aimed to assess whether immediate complete revascularisation was non-inferior to staged complete revascularisation during the index admission.

Methods: We conducted an open-label, randomised, non-inferiority trial at 14 hospitals in South Korea.

Association of mean platelet volume-to-platelet count ratio for 24-hour mortality in patients with severe trauma.

Mean platelet volume (MPV) may be associated with trauma patients' outcomes. However, the relationship between the MPV-to-platelet count ratio (MPR) and the result of severe trauma has not been reported. This study aimed to analyze and compare the prognostic performances of MPV and MPR in severe trauma.

Dual red and near-infrared LED therapy inhibits MRSA biofilm in otitis media.

Otitis media (OM), particularly when caused by methicillin-resistant (MRSA), can become refractory due to biofilm formation, which contributes to resistance against conventional antimicrobial treatments. Photobiomodulation using light-emitting diode (LED) therapy has recently emerged as a promising non-antibiotic strategy for managing refractory infections by targeting biofilm-associated pathology. However, especially in the context of MRSA-induced OM, its therapeutic efficacy and underlying mechanisms remain incompletely elucidated.

Myocardial perfusion and oxidative metabolism in healthy subjects: sex-specific insights from vasodilatory stress C-acetate PET.

Background: C-acetate positron emission tomography (PET) enables simultaneous quantification of myocardial blood flow (MBF) and oxidative metabolism; however, sex-specific normative data under vasodilator stress remain insufficiently defined. We aimed to characterize these parameters in healthy individuals.

Results: Eighteen healthy individuals (9 males and 9 females, age/sex-matched; median age 43 years [range 34-65]) with normal echocardiography and no underlying cardiovascular disease underwent one-day rest-stress dynamic C-acetate PET with adenosine.

Cross-Reactive NSAID Hypersensitivity: Clinical Findings From Aspirin Provocation and Alternative Drug Challenge Testing.

Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity reactions are commonly reported but often overestimated due to reliance on clinical history alone. Accurate diagnosis and identification of safe alternative medications are essential for appropriate management. This retrospective study aimed to evaluate the clinical manifestations of NSAID hypersensitivity, assess the diagnostic value and safety of aspirin oral provocation testing, and investigate the tolerability of alternative medications, including acetaminophen, meloxicam, and celecoxib.

Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial.

Importance: Data from randomized clinical trials on a long-term anticoagulation strategy for patients after catheter-based ablation for atrial fibrillation (AF) are lacking.

Objective: To evaluate whether discontinuing oral anticoagulant therapy provides superior clinical outcomes compared with continuing oral anticoagulant therapy in patients without documented atrial arrhythmia recurrence after catheter ablation for AF.

Design, Setting, And Participants: A randomized clinical trial including 840 adult patients (aged 19-80 years) who were enrolled and randomized from July 28, 2020, to March 9, 2023, at 18 hospitals in South Korea.

Oxiracetam and physical activity in preventing cognitive decline after stroke: A multicenter, randomized controlled trial.

Introduction: This multicenter, double-blind, placebo-controlled trial, commissioned by South Korea's Ministry of Food and Drug Safety, evaluated the effect of oxiracetam for preventing post-stroke cognitive impairment (PSCI) and explored potential interaction with physical activity using neuroimaging.

Patients And Methods: Patients at high risk of PSCI, reporting subjective cognitive decline ⩾3 months after stroke, were randomized 1:1 to receive oxiracetam or placebo for 36 weeks. Physical activity was tracked via wrist-worn actigraphy.

Temporal modulation of antiplatelet therapy in high-risk patients undergoing complex percutaneous coronary intervention: the TAILORED-CHIP randomized clinical trial.

Background And Aims: Limited data exist on optimal antiplatelet strategies for high-risk patients undergoing complex percutaneous coronary intervention (PCI). This study aimed to investigate the efficacy and safety of tailored antiplatelet treatment with temporal modulation of the intensity of platelet inhibition in patients undergoing complex high-risk PCI.

Methods: We randomly assigned 2018 patients with high-risk anatomical or clinical characteristics undergoing complex PCI to a tailored antiplatelet strategy with early escalation (low-dose ticagrelor at 60 mg twice daily plus aspirin <6 months) and late de-escalation (clopidogrel monotherapy >6 months) or dual antiplatelet therapy (clopidogrel plus aspirin for 12 months).

Factors influencing the perception of shared decision-making among parents of children with type 1 diabetes mellitus: A cross-sectional study guided by the Ottawa Decision Support Framework.

This study examined the effects of treatment-related decisional conflict, parental self-efficacy, and nursing support on parents' perceptions of shared decision-making for children with type 1 diabetes, using the ODSF (Ottawa Decision Support Framework). It also sought to provide foundational data for developing nursing interventions that enhance these perceptions METHODS: Data were collected with a structured questionnaire measuring decisional conflict, parental self-efficacy, nurse-parent support, and shared decision-making. Participants were 137 primary caregivers of children diagnosed with type 1 diabetes mellitus who were receiving outpatient or inpatient care.

Conventional versus advanced imaging selection for endovascular treatment of basilar artery occlusion strokes.

Introduction: Endovascular thrombectomy (EVT) is an effective treatment for basilar artery occlusion (BAO) stroke in select patients. While there is a growing body of literature suggesting that advanced imaging modalities such as computed tomography perfusion (CTP) and magnetic resonance (MR) may not be necessary for selecting anterior circulation large vessel occlusion stroke patients for EVT, whether advanced imaging may be superior to conventional imaging (non-contrast CT and CT angiography) in identifying good treatment candidates among BAO patients is less clear.

Patients And Methods: This was a multicenter retrospective cohort study of BAO EVT patients treated from 2013 to 2022 in the Stroke Thrombectomy and Aneurysm Registry.

Population Pharmacokinetic Modeling of Piperacillin/Tazobactam in Healthy Adults and Exploration of Optimal Dosing Strategies.

Current dosing recommendations for piperacillin/tazobactam suggest adjustments only for patients with creatinine clearance (CrCl) below 40 mL/min, potentially neglecting the variability in drug exposure among patients with a CrCl greater than 40 mL/min. This study aimed to develop a population pharmacokinetic (PK) model for piperacillin/tazobactam and explore optimal dosage regimens tailored by renal function and pathogen susceptibility. : Twelve healthy adults received a single intravenous dose of piperacillin/tazobactam (4 g/0.

High-Quality Targeted Temperature Management After Cardiac Arrest; Results from the Korean Hypothermia Network Prospective Registry.

Most out-of-hospital cardiac arrest (OHCA) survivors are comatose due to hypoxic ischemic brain injury. Targeted temperature management (TTM) is the only evidence-based neuroprotective intervention for this condition; however, the optimal implementation of TTM has yet to be determined. The concept of high-quality TTM has been proposed to improve patient outcomes, but its clinical impact has not been thoroughly evaluated.

Clinical Relevance of Fractional Flow Reserve-Guided Percutaneous Coronary Interevention According to Left Ventricular Ejection Fraction in Patients With Acute Myocardial Infarction and Multivessel Disease.

Background: Fractional flow reserve (FFR)-guided or angiography-guided complete revascularization has not been evaluated in patients with acute myocardial infarction (AMI) with multivessel disease and reduced left ventricular ejection fraction (LVEF). This study sought to evaluate the impact of FFR-guided percutaneous coronary intervention (PCI) for patients with AMI with multivessel disease according to left ventricular systolic function.

Methods: We performed a prespecified analysis of the FRAME-AMI (Fractional Flow Reserve Versus Angiography-Guided Strategy in Acute Myocardial Infarction With Multivessel Disease) trial, which randomly allocated 562 patients to undergo either FFR-guided PCI (FFR ≤0.

Comparing Lesion Volume Dynamics Between Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder During Remission Using Machine-Learning Segmentation.

Background And Purpose: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory demyelinating conditions of the central nervous system that have distinct pathological mechanisms. There is a paucity of studies comparing the accumulation of subclinical lesions between MS and NMOSD, especially during the clinical remission period. Recent advances in neuroimaging techniques, those particularly involving the use of machine learning (ML) methods for lesion segmentation, have provided new opportunities to quantitatively assess the volumes of brain lesions and how they change over time.

Tenecteplase in Acute Ischemic Stroke: A Scientific Statement From the Korean Stroke Society.

Background And Purpose: Tenecteplase (TNK) is a promising alternative thrombolytic agent for the treatment of acute ischemic stroke (AIS). However, its potential use is being impeded by the lack of regulatory approval and reimbursement policies for TNK in AIS in many countries, including South Korea. To address this therapeutic gap, the Korean Stroke Society developed scientific statement intended to inform policy changes and support the introduction of TNK in regions where it is not yet accessible, with the aim of enabling AIS patients to benefit from this advancement in thrombolytic therapy.

Update of the Korean Clinical Practice Guidelines for Stroke: Blood Pressure Management.

Hypertension is a major risk factor for stroke, and appropriate management of blood pressure (BP) is crucial for both prevention and treatment. Since the 2009 publication of the Clinical Practice Guideline (CPG) by the Korean Stroke Society (KSS), significant advances have been made in BP management for stroke patients, particularly in cases involving intracerebral hemorrhage and in the context of endovascular reperfusion therapy for ischemic stroke. In light of recent evidence, the CPG Committee of the KSS initiated an update of the guidelines for BP management in acute stroke.

Intravascular Imaging-Guided PCI vs Coronary Artery Bypass Grafting for Left Main or 3-Vessel Disease.

Background: Previous trials have shown that coronary artery bypass graft (CABG) has better clinical outcomes compared with percutaneous coronary intervention (PCI) for patients with left main coronary artery or 3-vessel disease. However, it is unclear whether intravascular imaging (IVI)-guided PCI would reduce the difference in clinical events compared to CABG.

Objectives: The present study sought to compare the clinical outcomes of patients with left main or 3-vessel disease who underwent IVI-guided PCI with those who underwent CABG.

The influence of pneumococcal positivity on clinical outcomes among patients hospitalized with COVID-19: A retrospective cohort study.

Background: Bacterial co-infection has been associated with adverse outcomes in patients with COVID-19. Streptococcus pneumoniae is a common cause of community-acquired pneumonia and may contribute to poor clinical outcomes when co-detected in COVID-19 patients. This study aimed to investigate the clinical significance of pneumococcal positivity in hospitalized patients with COVID-19.