Background/Aims: Studies on the clinical outcomes after detecting low-grade dysplasia (LGD) in patients with inflammatory bowel disease (IBD) are insufficient. This study evaluated the clinical features, frequency, and risk factors for advanced neoplasia in patients with IBD after an LGD diagnosis. Methods: The medical records of 166 patients with IBD from six university hospitals in Korea from 2010 to 2019 were reviewed retrospectively. LGD was diagnosed in all patients during surveillance. The frequency and risk factors for advanced neoplasia were evaluated, and the clinical features of patients with and without advanced neoplasia were compared. Results: Advanced neoplasia developed in 12 patients (six with large LGD, three with tubulovillous adenoma, and three with high-grade dysplasia), and all cases developed from UC. Patients with advanced neoplasia had significantly higher Mayo scores, and colitis-associated dysplasia was more common than sporadic lesions (83.3% vs. 29.9%; p<0.001). Multivariate analysis showed that colitis-associated LGD significantly increased the risk of developing advanced neoplasia (odds ratio [OR], 10.516; 95% confidence interval [CI], 2.064–53.577). Among patients with colitis-associated lesions, a significant risk factor for advanced neoplasia was a prior history of LGD (OR, 9.429; 95% CI, 1.330–66.863). Conclusions Advanced neoplasia developed in 7.2% of patients with IBD and LGD. Most advanced neoplasms developed from colitis-associated lesions, and the risk was higher in patients with a history of LGD before index colonoscopy.

High-flow nasal cannula (HFNC) is a noninvasive respiratory support system that delivers air that is heated at 31°C−38°C, humidified 100%, and oxygen-enriched at a constant high flow rate of 15−60 L/min. Because of its numerous physiological benefits, convenience, and minimal side effects, HFNC has been increasingly used over the past decade in patients with acute hypoxemic respiratory failure, yet the clinical benefits of long-term HFNC remain uncertain. Several studies have suggested its potential use as an alternative home oxygen therapy for patients with chronic stable lung diseases, such as chronic obstructive pulmonary disease (COPD), interstitial lung disease, and bronchiectasis. The use of long-term home HFNC in patients with chronic respiratory failure is an emerging area with promising potential. Despite limited clinical research, this review aims to describe the physiology of HFNC use and summarize the current evidence on its long-term application, to provide healthcare providers with insights and perspectives on the potential role of long-term home HFNC.

Connective tissue disease (CTD), comprising a range of autoimmune disorders, is often accompanied by lung involvement, which can lead to life-threatening complications. The primary types of CTDs that manifest as interstitial lung disease (ILD) include rheumatoid arthritis, systemic sclerosis, Sjögren’s syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematosus. CTD-ILD presents a significant challenge in clinical diagnosis and management due to its heterogeneous nature and variable prognosis. Early diagnosis through clinical, serological, and radiographic assessments is crucial for distinguishing CTD-ILD from idiopathic forms and for implementing appropriate therapeutic strategies. Hence, we have reviewed the multiple clinical manifestations and diagnostic approaches for each type of CTD-ILD, acknowledging the diversity and complexity of the disease. The importance of a multidisciplinary approach in optimizing the management of CTD-ILD is emphasized by recent therapeutic advancements, which include immunosuppressive agents, antifibrotic therapies, and newer biological agents targeting specific pathways involved in the pathogenesis. Therapeutic strategies should be customized according to the type of CTD, the extent of lung involvement, and the presence of extrapulmonary manifestations. Additionally, we aimed to provide clinical guidance, including therapeutic recommendations, for the effective management of CTD-ILD, based on patient, intervention, comparison, outcome (PICO) analysis.

Purpose: Improvement of left ventricular (LV) diastolic dysfunction (DD) is known to be a good prognostic factor in patients with heart failure with reduced ejection fraction (EF). In the present study, we investigated the predisposing risk factors affecting the reversibility of LV diastolic filling pattern (DFP) in patients with preserved EF. Materials and Methods: A total of 600 patients with pseudonormal LVDFP and preserved EF who underwent follow-up echocardiography were enrolled between 2011 and 2020. We compared their index and follow-up echocardiography findings and determined the predisposing risk factor affecting the reversibility of LVDFP. Results: Comparing the index and follow-up echocardiography findings showed that 379 (63%) patients had improved to normal or impaired relaxation LVDFP (improved group) and 221 (37%) patients had maintained or worsened LVDFP (unimproved group).The incidence of paroxysmal atrial fibrillation (PAF) was significantly higher in the unimproved group than in the improved group (4.7% vs. 9.5%, p=0.026). After adjustment for relevant clinical risk factors of diastolic dysfunction, PAF was determined to be an independent predisposing risk factor for the unimproved LVDFP (odds ratio: 2.10, 95% confidence interval: 1.06–4.15, p=0.033).Among the parameters of diastolic dysfunction in follow-up echocardiography, the left atrial volume index, mean E/A ratio, and E/e' were significantly improved in patients without PAF but remained in patients with PAF. Conclusion We identified that PAF was an independent predisposing risk factor of the unimproved LVDFP in patients with pseudonormal LVDFP and preserved EF. Therefore, early detection and management of PAF might be required in patients with LVDD and preserved EF to prevent adverse cardiovascular events.

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Background: Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients. Methods: The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income. Results: MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90). Conclusion MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.