Limited data exist regarding the real-world practices and clinical outcomes in patients with ischemic heart failure with reduced left ventricular ejection fractions (LVEFs).Using nationwide registry data from South Korea, we aimed to investigate long-term outcomes and clinical practices, especially implantable cardioverter defibrillators (ICDs) implantation, in patients with reduced LVEFs at least 40 days after acute myocardial infarction (AMI). Of 13,056 patients with AMI between 2011 and 2015, we analyzed 350 (median age, 66 years [interquartile range, 56-75]) who had LVEFs <40% on follow-up transthoracic echocardiogram 40 days after the index event. The primary outcome was cardiac-cause mortality at 3 years. Secondary outcomes comprised major cardiovascular events as well as outcomes defined by the use of ICDs, cardiac resynchronization therapy defibrillators (CRT-Ds), and electrophysiology studies. Among 350 patients, 39 (11.1%) died from cardiac causes during 3 years of follow-up. Eleven (3.1%) were hospitalized for ventricular tachycardia. The rate of ICD or CRT-D implantation up to 3 years was 5.7% (20/350). Cox time-to-event analysis revealed older age, LVEF <30%, diabetes mellitus, and previous MI or revascularization as positively associated with cardiac death, whereas the use of statins and body weight <67 kg were negatively associated. This nationwide Korean registry demonstrated that only 5.7% of patients who had reduced LVEFs after 40 days of AMI underwent ICD implantations over 3 years. Considering the high mortality, concerted efforts are needed to improve clinical outcomes for patients who may have been candidates for ICD implantation.

Purpose: Developmentally regulated GTP-binding protein 2 (DRG2) regulates microtubule dynamics and G2/M arrest during docetaxel treatment. Poly ADP-ribose polymerase (PARP) acts as an important repair system for DNA damage caused by docetaxel treatment. This study investigated whether DRG2 expression affects response to PARP inhibitors (olaparib) using prostate cancer cell lines PC3, DU145, LNCaP-FGC, and LNCaP-LN3. Materials and Methods: The cell viability and DRG2 expression levels were assessed using colorimetric-based cell viability assay and western blot. Cells were transfected with DRG2 siRNA, and pcDNA6/V5-DRG2 was used to overexpress DRG2. Flow cytometry was applied for cell cycle assay and apoptosis analysis using the Annexing V cell death assay. Results: The expression of DRG2 was highest in LNCaP-LN3 and lowest in DU145 cells. Expressions of p53 in PC3, DU145, and the two LNCaP cell lines were null-type, high-expression, and medium-expression, respectively. In PC3 (DRG2 high, p53 null) cells, docetaxel increased G2/M arrest without apoptosis; however, subsequent treatment with olaparib promoted apoptosis. In DU145 and LNCaP-FGC (DRG2 low), docetaxel increased sub-G1 but not G2/M arrest and induced apoptosis, whereas olaparib had no additional effect. In LNCaP-LN3 (DRG2 high, p53 wild-type), docetaxel increased sub-G1 and G2/M arrest, furthermore olaparib enhanced cell death. Docetaxel and olaparib combination treatment had a slight effect on DRG2 knockdown PC3, but increased apoptosis in DRG2-overexpressed DU145 cells. Conclusions DRG2 and p53 expressions play an important role in prostate cancer cell lines treated with docetaxel, and DRG2 levels can predict the response to PARP inhibitors.

In patients with type 2 diabetes mellitus (T2DM), diabetic kidney disease (DKD) is diagnosed based on clinical features. A kidney biopsy is used only in selected cases. This study aimed to reconsider the role of a biopsy in predicting renal outcomes. Methods: Clinical and laboratory parameters and renal biopsy results were obtained from 237 patients with T2DM who underwent renal biopsies at Soonchunhyang University Cheonan Hospital between January 2000 and March 2020 and were analyzed. Results: Of 237 diabetic patients, 29.1% had DKD only, 61.6% had non-DKD (NDKD), and 9.3% had DKD with coexisting NDKD (DKD/NDKD). Of the patients with DKD alone, 43.5% progressed to end-stage kidney disease (ESKD), while 15.8% of NDKD patients and 36.4% of DKD/NDKD patients progressed to ESKD (p < 0.001). In the DKD-alone group, pathologic features like ≥50% global sclerosis (p < 0.001), tubular atrophy (p < 0.001), interstitial fibrosis (p < 0.001), interstitial inflammation (p < 0.001), and the presence of hyalinosis (p = 0.03) were related to worse renal outcomes. The Cox regression model showed a higher risk of progression to ESKD in the DKD/NDKD group compared to the DKD-alone group (hazard ratio [HR], 2.73; p = 0.032), ≥50% global sclerosis (HR, 3.88; p < 0.001), and the degree of mesangial expansion (moderate: HR, 2.45; p = 0.045 and severe: HR, 6.22; p < 0.001). Conclusion: In patients with T2DM, a kidney biopsy can help in identifying patients with NDKD for appropriate treatment, and it has predictive value.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, leading to the coronavirus disease 2019 (COVID-19) pandemic. Because a significant proportion of the COVID-19 confirmed cases were concentrated in the capital metropolitan area of South Korea, and a large proportion of the population in the area had been adequately vaccinated against COVID-19, we conducted a seroprevalence surveillance study focusing on the residents of the capital metropolitan area in South Korea. Methods: We used a quota-sampling method to obtain blood samples from 1,000 individuals per round, equally stratified across seven age categories and sexes and regions, from five medical institutions located within the capital metropolitan area of South Korea. During five consecutive months (rounds) between January 2022 and May 2022, a total of 5,000 samples were analyzed for anti-spike (S) and anti-nucleocapsid (N) antibodies. Results: High anti-S seropositivity was observed in all age groups, which corresponded to the vaccine coverage during the study period. Both the cumulative incidence based on polymerase chain reaction (PCR) and the estimated seroprevalence based on anti-N seropositivity increased in the fourth and fifth rounds, which corresponded to April 2022 and May 2022. Seroprevalence coincided with the cumulative incidence during the first three rounds, but exceeded from the fourth survey onwards when infection with omicron variants was increased rapidly in Korea. Conclusion Seroprevalence confirmed the number of infection cases outside of PCR testing-based surveillance. Seroepidemiological surveillance can help us understand vaccine responses and detect hidden infections, thereby providing appropriate public health guidance for achieving population-level immunity.

Background: Evidence on the association between obesity parameters, including body mass index (BMI) and waist circumference (WC), and osteoarthritis is limited. This study aimed to investigate these associations in Korean adults. Methods: This nationwide cross-sectional study used data from 24,101 adults aged ≥19 years who participated in the Korea National Health and Nutrition Examination Survey 2016–2020. Odds ratios (ORs) and 95% confidence intervals (CIs) for osteoarthritis according to BMI and WC were analyzed using multivariable logistic regression analyses. Results: The prevalence of osteoarthritis was higher in individuals with general (10.0%) and abdominal obesity (12.8%) compared with those without. Greater BMI and WC were associated with a higher prevalence (P<0.001) and risk of osteoarthritis (Model 3, P for trend <0.001). Individuals with general and abdominal obesity were associated with a 1.50-fold (OR, 1.50; 95% CI, 1.35–1.67) and 1.64-fold (OR, 1.64; 95% CI, 1.47–1.84) increased risk of osteoarthritis, compared with those without. Similar associations were observed in subgroups according to age, sex, smoking status, and presence of diabetes mellitus. The odds of osteoarthritis 1.73-fold increased (OR, 1.73; 95% CI, 1.53–1.95) in individuals with both general and abdominal obesity compared with those without any of them. Conclusion Greater BMI, WC, and general and abdominal obesity were associated with an increased risk of osteoarthritis in Korean adults. Appropriate management of abdominal and general obesity may be important to reduce the risk of osteoarthritis.

Many countries have published clinical practice guidelines for appropriate clinical decisions, optimal treatment, and improved clinical outcomes in patients with acute coronary syndrome. Developing guidelines that are specifically tailored to the Korean environment is crucial, considering the treatment system, available medications and medical devices, racial differences, and level of language communication. In 2017, the Korean Society of Myocardial Infarction established a guideline development committee. However, at that time, it was not feasible to develop guidelines, owing to the lack of knowledge and experience in guideline development and the absence of methodology experts. In 2022, the National EvidenceBased Healthcare Collaborating Agency collaborated with a relevant academic association to develop internationally reliable guidelines, with strict adherence to the methodology for evidence-based guideline development. The first Korean acute coronary syndrome guideline starts from the 9 key questions for pharmacotherapy.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.

Many countries have published clinical practice guidelines for appropriate clinical decisions, optimal treatment, and improved clinical outcomes in patients with acute coronary syndrome. Developing guidelines that are specifically tailored to the Korean environment is crucial, considering the treatment system, available medications and medical devices, racial differences, and level of language communication. In 2017, the Korean Society of Myocardial Infarction established a guideline development committee. However, at that time, it was not feasible to develop guidelines, owing to the lack of knowledge and experience in guideline development and the absence of methodology experts. In 2022, the National EvidenceBased Healthcare Collaborating Agency collaborated with a relevant academic association to develop internationally reliable guidelines, with strict adherence to the methodology for evidence-based guideline development. The first Korean acute coronary syndrome guideline starts from the 9 key questions for pharmacotherapy.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.