Purpose: To evaluate the short-term efficacy and safety of latanoprostene bunod 0.024% in patients with primary open-angle glaucoma. Methods: A retrospective study was conducted from September 2022 to September 2023, involving 29 eyes from patients diagnosed with primary open-angle glaucoma. The study analyzed the intraocular pressure (IOP)-lowering effects of latanoprostene bunod 0.024% at 1 and 3 months after administration. Additionally, adverse events reported by patients at each visit were documented. Results: The mean age of patients at the start of treatment was 64.46 years. The baseline IOP was 17.46 ± 4.03 mmHg, which significantly decreased to 15.07 ± 4.23 mmHg (p = 0.002) at 1 month (29 eyes) and 14.93 ± 3.86 mmHg (p = 0.002) at 3 months (28 eyes) after latanoprostene bunod administration. After 1 month, 9 patients reported adverse events, including conjunctival hyperemia (1 eye, 3.5%), itching (2 eyes, 6.9%), foreign body sensation (2 eyes, 6.9%), stinging (2 eyes, 6.9%), ocular pain (2 eyes, 6.9%), and deepening of the upper eyelid sulcus (1 eye, 3.5%). The patient who experienced deepening of the upper eyelid sulcus discontinued treatment. After 3 months, 2 eyes with itching discontinued treatment due to conjunctival allergy. Conclusions Latanoprostene bunod 0.024% demonstrated short-term efficacy in reducing IOP and a manageable safety profile in patients with primary open-angle glaucoma.

Purpose: This study developed a thermoelectric element (TEE) tourniquet integrating a tourniquet with a temperature control device capable of delivering heat or cold therapy. A randomized controlled trial was conducted to evaluate the effects of the TEE tourniquet on pain, stress, and satisfaction during venipuncture. Methods: In total, 118 hospitalized adults were randomly assigned to heat therapy (40~45°C), cold therapy (0~10°C), thermal grill illusion therapy (alternating heat and cold), or the control group. The TEE tourniquet was applied 10 cm above the puncture site. A temperature intervention began 5 seconds before cannulation and was maintained during the procedure, typically lasting 10 to 30 seconds. The control group received the TEE tourniquet without temperature activation. Outcomes included perceived pain and stress (numerical rating scale), observed pain (Wong-Baker FACES), SpO2, stress index, and participant satisfaction. Results: Significant differences were found among groups in perceived pain (F = 4.82, p = .003), observed pain (F = 5.50, p = .001), and perceived stress (F = 4.72, p = .004). The heat therapy group reported significantly lower pain and stress than the control group. No significant differences were found in SpO₂, the stress index, or satisfaction. Conclusion Heat therapy via the TEE tourniquet significantly reduced venipuncture-related pain and stress. Given its short application time and usability, this device may serve as a clinically useful nursing intervention to improve comfort during invasive procedures.

This study aimed to assess the utilization trends of pulmonary rehabilitation (PR) among lung cancer patients in Korea using the National Health Insurance Service (NHIS) database (2017 to 2021). PR was introduced and covered under the NHIS in 2016, primarily for chronic obstructive pulmonary disease, but recent evidence suggests its benefits for lung cancer patients. Data extraction was based on Korea Informative Classification of Diseases 8th revision codes C33 and C34, with PR prescriptions identified by codes MM440 and MM290.Descriptive statistical analysis was performed, and propensity score matching was used for comparison between PR and non-PR groups. Results showed a significant increase in PR utilization, with the number of patients receiving PR (MM440) rising from 1,002 in 2017 to 3,723 in 2021, indicating a 3.7-fold increase. However, the proportion of patients receiving PR remained low at 2.9% in 2021. Enhanced access to PR services and improved evaluation strategies are essential for optimizing patient outcomes.

Purpose: To evaluate the short-term efficacy and safety of latanoprostene bunod 0.024% in patients with primary open-angle glaucoma. Methods: A retrospective study was conducted from September 2022 to September 2023, involving 29 eyes from patients diagnosed with primary open-angle glaucoma. The study analyzed the intraocular pressure (IOP)-lowering effects of latanoprostene bunod 0.024% at 1 and 3 months after administration. Additionally, adverse events reported by patients at each visit were documented. Results: The mean age of patients at the start of treatment was 64.46 years. The baseline IOP was 17.46 ± 4.03 mmHg, which significantly decreased to 15.07 ± 4.23 mmHg (p = 0.002) at 1 month (29 eyes) and 14.93 ± 3.86 mmHg (p = 0.002) at 3 months (28 eyes) after latanoprostene bunod administration. After 1 month, 9 patients reported adverse events, including conjunctival hyperemia (1 eye, 3.5%), itching (2 eyes, 6.9%), foreign body sensation (2 eyes, 6.9%), stinging (2 eyes, 6.9%), ocular pain (2 eyes, 6.9%), and deepening of the upper eyelid sulcus (1 eye, 3.5%). The patient who experienced deepening of the upper eyelid sulcus discontinued treatment. After 3 months, 2 eyes with itching discontinued treatment due to conjunctival allergy. Conclusions Latanoprostene bunod 0.024% demonstrated short-term efficacy in reducing IOP and a manageable safety profile in patients with primary open-angle glaucoma.

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.

Background and Objectives: Heart failure is a potentially fatal event caused by diverse cardiovascular diseases, leading to high morbidity and mortality. Histone deacetylase (HDAC) inhibitors positively influence cardiac hypertrophy, fibrosis, hypertension, myocardial infarction, and heart failure, causing some side effects. We aimed to investigate the effect of the novel HDAC inhibitor YAK577 on the heart failure mouse model and its underlying mechanism. Methods: New hydroxamic acid YAK577 was prepared via methyl-2,3-diphenylpropanoate synthesis using carboxylic acids. We used a micro-osmotic pump, including isoproterenol (ISO; 80 mg/kg/day), to induce a heart failure with reduced ejection fraction. Cardiac hypertrophy was assessed by heart weight to body weight ratio and cross-sectional area.The left ventricular (LV) function was assessed by echocardiography. Fibrosis was evaluated using picrosirius red staining. Overexpression and knockdown experiments were performed to investigate the association between HDAC8 and matrix metalloproteinase 12 (MMP12). Results: YAK577 treatment restored ISO-induced reduction in LV fractional shortening and ejection fraction (n=9–11). YAK577 significantly downregulated cardiac hypertrophy marker genes (natriuretic peptide B, NPPB, and myosin heavy chain 7, MYH7) and cardiomyocyte size in vitro but not in vivo. YAK577 ameliorated cardiac fibrosis and fibrosis-related genes in vivo and in vitro. Additionally, YAK577 reduced elevated HDAC8 and MMP12 mRNA and protein expressions in ISO-infused mice, H9c2 cells, and rat neonatal cardiomyocytes.HDAC8 overexpression stimulated MMP12 and NPPB mRNA levels, while HDAC8 knockdown downregulated these genes. Conclusions YAK577 acts as a novel heart failure drug through the HDAC8/MMP12 pathway.

Background/Aims: Rectal hyposensitivity (RH), as defined by the London Classification, has been linked to sensory dysfunction caused by diabetes mellitus and Parkinson’s disease (PD); however, its clinical interpretation has not been sufficiently validated. In this study, we aim to explore the correlations between rectal sensory thresholds and the clinical characteristics of patients with functional defecatory disorders. Methods: We reviewed data from patients who underwent high-resolution anorectal manometry and acquired their clinical characteristics using a standardized questionnaire. The associations between RH based on either 1 (borderline RH) or 2 (RH) abnormal rectal sensory thresholds and patients’ clinical and demographic characteristics were analyzed using linear and logistic regression models in the overall sex-stratified populations. Results: We enrolled 2540 patients, of whom 1046 (41.2%) were men. Overall, 150 (5.9%) patients were diagnosed with RH, whereas 422 (16.6%) had borderline RH. Multivariate linear regression analysis revealed that the Cleveland Clinic Constipation Score (CCCS) increased linearly with the increase in the number of abnormal rectal sensory thresholds (effect per threshold: 0.900 [standard deviation: 0.188]). Upon stratification by sex, borderline RH was positively associated with diabetes mellitus, PD, and CCCS (adjusted odds ratio [aOR] = 2.11, 95% confidence interval [1.08, 4.15]; aOR = 1.49 [1.03, 2.14]; aOR = 1.03 [1.01, 1.05], respectively) in women. However, RH was positively associated with only the CCCS. Conclusions Defining RH based on 1 or more abnormal sensory thresholds showed better clinical correlation with patient characteristics. However, further prospective studies are needed to validate these findings before proposing revisions to the current London classification criteria.

Background/Aims: Fexuprazan, a novel potassium-competitive acid blocker, was developed for treating acid-related disorders. Pharmacokinetic and pharmacodynamic properties of fexuprazan, unlike those of proton pump inhibitors, are independent of food effect. This study aims to evaluate differences in efficacy and safety of fexuprazan in patients with erosive esophagitis (EE) according to the timing of dosing. Methods: In this multicenter, open-label noninferiority study, patients who had typical reflux symptoms with endoscopically confirmed EE were randomized 1:1 to receive fexuprazan 40 mg daily 30 minutes before or after meal. Treatment was completed after 2 weeks or 4 weeks when healing was endoscopically confirmed. The primary endpoint was the proportion of patients with healed EE confirmed by endoscopy up to week 4. Safety endpoints included treatment-emergent adverse events (TEAEs). Results: In the prior-to-meal group (n = 89) and after-meal group (n = 86), 4-week EE healing rates were 98.77% and 100.00% (difference, 0.01%; 95% CI, –0.01% to 0.04%) and 2-week EE healing rates were 95.77% and 97.14% (difference, 0.01%; 95% CI, –0.05% to 0.07%), respectively. TEAEs were 9.78% and 8.70% in the prior-to-meal group and the after-meal group, respectively. Conclusions Non-inferiority analysis revealed that taking fexuprazan after meal was non-inferior to taking fexuprazan before meals in patients with EE. The frequency of adverse events was similar between the 2 study groups. The drug is safe and effective for healing EE regardless of the timing of dosing.

Background: Although an appropriate weight management strategy is essential for obese individuals, weight loss can have adverse effects on bone mineral density (BMD). We conducted a systematic review of randomized controlled trials to evaluate changes in BMD after the implementation of various weight loss strategies. Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were searched to find articles published from database inception until June 2023. Randomized controlled trials of various treatments for obese patients that reported changes in BMD were selected. The primary outcome was BMD of the whole body, lumbar spine, and total hip, measured using dual X-ray absorptiometry. Results: Eighteen randomized controlled trials involving 2,510 participants with obesity were included in the analysis. At follow-up examination, the BMD of the lumbar spine decreased significantly after metabolic surgery (mean difference [MD]= –0.40 g/cm2 ; 95% confidence interval [CI], –0.73 to –0.07; I2 = 0%); lifestyle and pharmacological interventions did not result in a significant decrease in BMD at any location. Metabolic surgery also produced the most substantial difference in weight, with an MD of –3.14 (95% CI, –3.82 to –2.47). Conclusion This meta-analysis is the first to examine the effects of all categories of anti-obesity strategies, including the use of anti-obesity medications, on BMD. Bariatric metabolic surgery can have adverse effects on BMD. Moreover, medications can be used as a treatment for weight loss without compromising bone quality.