Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Complete revascularization has demonstrated better outcomes in patients with acute myocardial infarction (AMI) and multivessel disease. However, in the case of left main (LM) culprit lesion AMI with multivessel disease, there is limited evidence to suggest that complete revascularization is better. Methods: We reviewed 16,831 patients in the Korea Acute Myocardial Infarction Registry who were treated from July 2016 to June 2020, and 399 patients were enrolled with LM culprit lesion AMI treated with percutaneous coronary intervention. We categorized the patients as those treated with complete revascularization (n=295) or incomplete revascularization (n=104). The study endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause death, myocardial infarction, ischemia-driven revascularization, stent thrombosis, and stroke. We performed propensity score matching (PSM) and analyzed the incidence of MACCE at 1 year. Results: After PSM, the two groups were well balanced. There was no significant difference between the two groups in MACCE at 1 year (12.1% vs. 15.2%; hazard ratio, 1.28; 95% confidence interval, 0.60–2.74; p=0.524) after PSM. The components of MACCE and major bleeding were also not significantly different. Conclusion There was no significant difference in clinical outcomes between the groups treated with complete or incomplete revascularization for LM culprit lesion AMI with multivessel disease.

Background: Recent global trends indicate a rise in pediatric obesity, reflecting patterns also observed in South Korea. Given its significant impact on chronic disease prevalence in adulthood, pediatric obesity poses potential societal challenges. For pediatric obesityrelated prevention or management programs in community level to operate effectively, there needs to be a clear understanding of barriers and facilitators of the programs. This study aims to establish a foundation for policy implementation, contributing to pediatric obesity prevention and management (POPM) in Korea. Methods: A survey was conducted among program providers involved in domestic POPM programs. A total of 577 individuals completed the survey, including those working in elementary and middle schools (n = 508) and public health centers (n = 69) nationwide. The questionnaire comprised 67 questions covering characteristics of respondents, purpose and contents of POPM programs, measurement of program outcome, level of inter- and intrainstitutional linkage, difficulties in operating programs and factors that facilitate programs.A 5-point Likert scale was used for most questions. Descriptive statistics was employed to analyze characteristics of respondents in POPM programs. The level of linkage in POPM programs was assessed using perceived importance and actual degree of linkage. The difficulties in operating POPM programs were analyzed based on agreement responses, and facilitating factors of program activation were analyzed based on importance responses. Results: The domestic POPM program showed low actual linkage compared to its perceived importance, both between institutions and among professions within institutions.Difficulties in operating the program included securing availability of students, encouraging participation of reluctant students and development of new programs. The survey suggested that schools require support from parents, guardians and family members, while public health centers need professional providers to facilitate such programs. Conclusion The study highlights the urgent need for strategies to address pediatric obesity in South Korea. Weak institutional linkages hinder effective programs. Challenges include student availability, participation, and the need for innovative programs. New approaches to build partnerships in harmony among institutions are necessary. Implementing findings into policy can help prevent obesity in Korean children and adolescents.

Background: Recent global trends indicate a rise in pediatric obesity, reflecting patterns also observed in South Korea. Given its significant impact on chronic disease prevalence in adulthood, pediatric obesity poses potential societal challenges. For pediatric obesityrelated prevention or management programs in community level to operate effectively, there needs to be a clear understanding of barriers and facilitators of the programs. This study aims to establish a foundation for policy implementation, contributing to pediatric obesity prevention and management (POPM) in Korea. Methods: A survey was conducted among program providers involved in domestic POPM programs. A total of 577 individuals completed the survey, including those working in elementary and middle schools (n = 508) and public health centers (n = 69) nationwide. The questionnaire comprised 67 questions covering characteristics of respondents, purpose and contents of POPM programs, measurement of program outcome, level of inter- and intrainstitutional linkage, difficulties in operating programs and factors that facilitate programs.A 5-point Likert scale was used for most questions. Descriptive statistics was employed to analyze characteristics of respondents in POPM programs. The level of linkage in POPM programs was assessed using perceived importance and actual degree of linkage. The difficulties in operating POPM programs were analyzed based on agreement responses, and facilitating factors of program activation were analyzed based on importance responses. Results: The domestic POPM program showed low actual linkage compared to its perceived importance, both between institutions and among professions within institutions.Difficulties in operating the program included securing availability of students, encouraging participation of reluctant students and development of new programs. The survey suggested that schools require support from parents, guardians and family members, while public health centers need professional providers to facilitate such programs. Conclusion The study highlights the urgent need for strategies to address pediatric obesity in South Korea. Weak institutional linkages hinder effective programs. Challenges include student availability, participation, and the need for innovative programs. New approaches to build partnerships in harmony among institutions are necessary. Implementing findings into policy can help prevent obesity in Korean children and adolescents.

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to significant global casualties. This study examines the postoperative impact of COVID-19 on patients who underwent gastrointestinal surgery, considering their heightened vulnerability to infections and increased morbidity and mortality risk. Methods: This retrospective observational study was conducted at a tertiary center and patients who underwent gastrointestinal surgery between January 2022 and February 2023 were included. Postoperative COVID-19 infection was defined as the detection of severe acute respiratory syndrome coronavirus 2 RNA by RT-PCR within 14 days after surgery. Propensity score matching was performed including age, sex, American Society of Anesthesiology physical status classification, and emergency operation between the COVID-19-negative (–) and -positive (+) groups. Results: Following 1:2 propensity score matching, 21 COVID-19(+) and 42 COVID-19(–) patients were included in the study. In the COVID-19(+) group, the postoperative complication rate was significantly higher (52.4% vs. 23.8%, P = 0.023).Mechanical ventilator requirement, intensive care unit (ICU) admission, and readmission rate did not significantly differ between the 2 groups. The median length of ICU (19 days vs. 4 days, P < 0.001) and hospital stay (18 vs. 8 days, P = 0.015) were significantly longer in the COVID-19(+) group. Patients with COVID-19 had a 2.4 times higher relative risk (RR) of major complications than patients without COVID-19 (RR, 2.37; 95% confidence interval, 1.254–4.467; P = 0.015). Conclusion COVID-19 infection during the postoperative period in gastrointestinal surgery may have adverse outcomes which may increase the risk of major complications. Preoperative COVID-19 screening and protocols for COVID-19 prevention in surgical patients should be maintained.

Viral load and the duration of viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important determinants of the transmission of coronavirus disease 2019.In this study, we examined the effects of viral doses on the lung and spleen of K18-hACE2 transgenic mice by temporal histological and transcriptional analyses. Approximately, 1×105 plaque-forming units (PFU) of SARS-CoV-2 induced strong host responses in the lungs from 2 days post inoculation (dpi) which did not recover until the mice died, whereas responses to the virus were obvious at 5 days, recovering to the basal state by 14 dpi at 1×102 PFU. Further, flow cytometry showed that number of CD8+ T cells continuously increased in 1×102 PFU-virusinfected lungs from 2 dpi, but not in 1×105 PFU-virus-infected lungs. In spleens, responses to the virus were prominent from 2 dpi, and number of B cells was significantly decreased at 1×105PFU; however, 1×102 PFU of virus induced very weak responses from 2 dpi which recovered by 10 dpi. Although the defense responses returned to normal and the mice survived, lung histology showed evidence of fibrosis, suggesting sequelae of SARS-CoV-2 infection. Our findings indicate that specific effectors of the immune response in the lung and spleen were either increased or depleted in response to doses of SARS-CoV-2. This study demonstrated that the response of local and systemic immune effectors to a viral infection varies with viral dose, which either exacerbates the severity of the infection or accelerates its elimination.

Purpose: This study aims to develop a tool to systematically assess the risk of collapse in the delivery infrastructure and apply it to 42 districts in Gyeonggi Province. The ultimate goal is to provide data for preventive and improvement strategies tailored to regional needs. Methods: Hospitals performing over 50 deliveries annually were identified. Regions were categorized as 'none,' 'one,' or 'more than two' delivery hospitals, with further subdivision by annual delivery volume. Regions were then classified into 5 categories: 'relatively stable,' 'low-risk,' 'moderate-risk,' 'high-risk,' and 'collapsed.' Results: Of the 42 districts, 23 were classified as relatively stable, 3 as low-risk, 1 as moderate-risk, 4 as highrisk, and 11 as collapsed. Notably, areas where the delivery infrastructure has collapsed or is at high risk of collapse accounted for approximately 36% of the total. Conclusion Tailored strategies and urgent policy support are required for high-risk regions. While perinatal regionalization may be a future direction, stable infrastructure must be maintained until the maternal care delivery system is established.