Background and Objectives: In chronic heart failure (HF), natriuretic peptide (NP) levels are higher in atrial fibrillation (AF) compared to sinus rhythm (SR). However, due to the loss of atrial contraction, AF patients are prone to hemodynamic decompensation at earlier stages.Since NP levels reflect disease severity, acutely decompensated AF patients may exhibit lower NP levels compared to SR patients, who retain greater hemodynamic reserve. Methods: We analyzed 5,048 patients with acute HF from the Korea Acute Heart Failure registry with available NP data. NP levels and echocardiographic parameters were compared between AF and SR patients. The association of NP levels with in-hospital and one-year mortality was also assessed according to cardiac rhythm. Results: Brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured in 2,027 and 3,021 patients, respectively. NP levels were lower in AF than in SR (median BNP, 740 vs. 1,044 pg/mL; median NT-proBNP, 4,420 vs. 5,198 pg/mL), particularly in HF with reduced or mildly reduced ejection fraction. A similar trend was observed regardless of HF onset or etiology. AF patients had smaller left ventricular (LV) end-diastolic diameter and larger left atrial size compared to SR patients. Higher NP tertiles were associated with increased in-hospital and one-year mortality in both groups. Conclusions In acute HF, NP levels are lower in AF than in SR. AF patients also exhibited smaller LV chamber sizes. Nevertheless, NP levels remain strong predictors of outcomes in both AF and SR patients.

Purpose: This study aimed to develop a flexible eye shield phantom to acquire artifact-free computed tomography (CT) images for electron beam radiotherapy. Methods: A flexible eye shield phantom for a newly designed eye shield was fabricated. Because of metal artifacts caused by an eye shield composed of high-density materials such as tungsten or lead, CT image acquisition is not appropriate for treatment planning because of inaccurate dose calculation and organ-at-risk delineation. To acquire artifact-free CT images, a mold of the same size as the outer dimension of the metallic eye shield was manufactured using 3D printing. The flexible eye shield phantom was imaged using a Philips Brilliance CT Big Bore under the same condition as the measurement. The phantom image with an average of 200 Hounsfield unit (HU) was imported into the treatment planning systems (TPS) and assigned a value of 26,750 HU to consider the material density of tungsten. The dosimetric comparison using a 6-MeV electron beam was performed. Measurement was performed using a metal oxide semiconductor field effect transistor detector for point doses at 3 and 10 mm. Results: The artifact-free CT images using a flexible eye shield phantom without air bubbles were transferred into the TPS. The dose at 10 mm calculated using the TPS agreed with the ionchamber measurements within 2 cGy. Conversely, a larger dose discrepancy between the measured and calculated doses was found at 3 mm depth. Conclusions The flexible eye shield phantom was successfully fabricated to apply electron treatment planning by acquiring artifact-free CT images. The dose calculated using the artifact-free image was comparable to the measured dose at lens depth when applying an eye shield.

With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea.

Purpose: This study aimed to develop a flexible eye shield phantom to acquire artifact-free computed tomography (CT) images for electron beam radiotherapy. Methods: A flexible eye shield phantom for a newly designed eye shield was fabricated. Because of metal artifacts caused by an eye shield composed of high-density materials such as tungsten or lead, CT image acquisition is not appropriate for treatment planning because of inaccurate dose calculation and organ-at-risk delineation. To acquire artifact-free CT images, a mold of the same size as the outer dimension of the metallic eye shield was manufactured using 3D printing. The flexible eye shield phantom was imaged using a Philips Brilliance CT Big Bore under the same condition as the measurement. The phantom image with an average of 200 Hounsfield unit (HU) was imported into the treatment planning systems (TPS) and assigned a value of 26,750 HU to consider the material density of tungsten. The dosimetric comparison using a 6-MeV electron beam was performed. Measurement was performed using a metal oxide semiconductor field effect transistor detector for point doses at 3 and 10 mm. Results: The artifact-free CT images using a flexible eye shield phantom without air bubbles were transferred into the TPS. The dose at 10 mm calculated using the TPS agreed with the ionchamber measurements within 2 cGy. Conversely, a larger dose discrepancy between the measured and calculated doses was found at 3 mm depth. Conclusions The flexible eye shield phantom was successfully fabricated to apply electron treatment planning by acquiring artifact-free CT images. The dose calculated using the artifact-free image was comparable to the measured dose at lens depth when applying an eye shield.

Purpose: This study aimed to develop a flexible eye shield phantom to acquire artifact-free computed tomography (CT) images for electron beam radiotherapy. Methods: A flexible eye shield phantom for a newly designed eye shield was fabricated. Because of metal artifacts caused by an eye shield composed of high-density materials such as tungsten or lead, CT image acquisition is not appropriate for treatment planning because of inaccurate dose calculation and organ-at-risk delineation. To acquire artifact-free CT images, a mold of the same size as the outer dimension of the metallic eye shield was manufactured using 3D printing. The flexible eye shield phantom was imaged using a Philips Brilliance CT Big Bore under the same condition as the measurement. The phantom image with an average of 200 Hounsfield unit (HU) was imported into the treatment planning systems (TPS) and assigned a value of 26,750 HU to consider the material density of tungsten. The dosimetric comparison using a 6-MeV electron beam was performed. Measurement was performed using a metal oxide semiconductor field effect transistor detector for point doses at 3 and 10 mm. Results: The artifact-free CT images using a flexible eye shield phantom without air bubbles were transferred into the TPS. The dose at 10 mm calculated using the TPS agreed with the ionchamber measurements within 2 cGy. Conversely, a larger dose discrepancy between the measured and calculated doses was found at 3 mm depth. Conclusions The flexible eye shield phantom was successfully fabricated to apply electron treatment planning by acquiring artifact-free CT images. The dose calculated using the artifact-free image was comparable to the measured dose at lens depth when applying an eye shield.

Purpose: This study aimed to develop a flexible eye shield phantom to acquire artifact-free computed tomography (CT) images for electron beam radiotherapy. Methods: A flexible eye shield phantom for a newly designed eye shield was fabricated. Because of metal artifacts caused by an eye shield composed of high-density materials such as tungsten or lead, CT image acquisition is not appropriate for treatment planning because of inaccurate dose calculation and organ-at-risk delineation. To acquire artifact-free CT images, a mold of the same size as the outer dimension of the metallic eye shield was manufactured using 3D printing. The flexible eye shield phantom was imaged using a Philips Brilliance CT Big Bore under the same condition as the measurement. The phantom image with an average of 200 Hounsfield unit (HU) was imported into the treatment planning systems (TPS) and assigned a value of 26,750 HU to consider the material density of tungsten. The dosimetric comparison using a 6-MeV electron beam was performed. Measurement was performed using a metal oxide semiconductor field effect transistor detector for point doses at 3 and 10 mm. Results: The artifact-free CT images using a flexible eye shield phantom without air bubbles were transferred into the TPS. The dose at 10 mm calculated using the TPS agreed with the ionchamber measurements within 2 cGy. Conversely, a larger dose discrepancy between the measured and calculated doses was found at 3 mm depth. Conclusions The flexible eye shield phantom was successfully fabricated to apply electron treatment planning by acquiring artifact-free CT images. The dose calculated using the artifact-free image was comparable to the measured dose at lens depth when applying an eye shield.

Purpose: This study aimed to develop a flexible eye shield phantom to acquire artifact-free computed tomography (CT) images for electron beam radiotherapy. Methods: A flexible eye shield phantom for a newly designed eye shield was fabricated. Because of metal artifacts caused by an eye shield composed of high-density materials such as tungsten or lead, CT image acquisition is not appropriate for treatment planning because of inaccurate dose calculation and organ-at-risk delineation. To acquire artifact-free CT images, a mold of the same size as the outer dimension of the metallic eye shield was manufactured using 3D printing. The flexible eye shield phantom was imaged using a Philips Brilliance CT Big Bore under the same condition as the measurement. The phantom image with an average of 200 Hounsfield unit (HU) was imported into the treatment planning systems (TPS) and assigned a value of 26,750 HU to consider the material density of tungsten. The dosimetric comparison using a 6-MeV electron beam was performed. Measurement was performed using a metal oxide semiconductor field effect transistor detector for point doses at 3 and 10 mm. Results: The artifact-free CT images using a flexible eye shield phantom without air bubbles were transferred into the TPS. The dose at 10 mm calculated using the TPS agreed with the ionchamber measurements within 2 cGy. Conversely, a larger dose discrepancy between the measured and calculated doses was found at 3 mm depth. Conclusions The flexible eye shield phantom was successfully fabricated to apply electron treatment planning by acquiring artifact-free CT images. The dose calculated using the artifact-free image was comparable to the measured dose at lens depth when applying an eye shield.

Objectives: In this study, we aimed to compare the genetic architecture of schizophrenia (SCZ) and bipolar disorder (BD) in a Korean population by analyzing polygenic risk scores (PRS) derived from large-scale psychiatric disorder genome-wide association study data, based on genetic information collected from SCZ, BD, and healthy control groups. Methods: The study included 713 Korean patients with SCZ, 1,317 with BD, 526 healthy controls. Genotyping was performed using the Korean Biobank Array. PRS-continuous shrinkage method was used to calculate the PRS. Analysis of covariance (ANCOVA) was conducted to determine the association between SCZ or BD disorder and PRS after adjusting for sex. Results: ANCOVA revealed significant differences in PRS values by diagnosis for PRS for SCZ (F=215.281, p<0.001), PRS for BD (F=13.811, p<0.001), and PRS for major depressive disorder (F=6.042, p=0.002). Post-hoc analysis showed that PRS for SCZ was highest in SCZ, followed by BD, and healthy controls. PRS for BD was elevated in both BD and SCZ compared to healthy controls. Conclusion Our study revealed quantitative differences in genetic architecture between SCZ and BD compared to healthy controls, while also suggesting a shared genetic background between the two disorders.

Background: Positron emission tomography (PET) viability scan is used to determine whether patients with a myocardial scar on single-photon emission computed tomography (SPECT) may need revascularization. However, the clinical utility of revascularization decision-making guided by PET viability imaging has not been proven yet. The purpose of this study was to investigate the impact of PET to determine revascularization on clinical outcomes. Methods: Between September 2012 and May 2021, 53 patients (37 males; mean age = 64 ± 11 years) with a myocardial scar on MIBI SPECT who underwent PET viability test were analyzed in this study. The primary outcome was a temporal change in echocardiographic findings.The secondary outcome was all-cause mortality. Results: Viable myocardium was presented by PET imaging in 29 (54.7%) patients.Revascularization was performed in 26 (49.1%) patients, including 18 (34.0%) with percutaneous coronary intervention (PCI) and 8 (15.1%) with coronary artery bypass grafting.There were significant improvements in echocardiographic findings in the revascularization group and the viable myocardium group. All-cause mortality was significantly lower in the revascularization group than in the medical therapy-alone group (19.2% vs. 44.4%, log-rank P = 0.002) irrespective of viable (21.4% vs. 46.7%, log-rank P = 0.025) or non-viable myocardium (16.7% vs. 41.7%, log-rank P = 0.046). All-cause mortality was significantly lower in the PCI group than in the medical therapy-alone group (11.1% vs. 44.4%, log-rank P < 0.001). Conclusion Revascularization improved left ventricular systolic function and survival of patients with a myocardial scar on SPECT scans, irrespective of myocardial viability on PET scans.