Objective: This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses. Methods: From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness. Results: Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001).Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020).As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017). Conclusion Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.

Background: Health-adjusted life expectancy (HALE) is an indicator of the average lifespan in good health. Through this study, we aimed to identify regional disparities in the gap between HALE and life expectancy, considering the trends that have changed over time in Korea. Methods: We employed a group-based multi-trajectory modeling approach to capture trends in the gap between HALE and life expectancy at the regional level from 2008 to 2019. HALE was calculated using incidence-based “years lived with disability.” This methodology was also employed in the Korean National Burden of Disease Study. Results: Based on five different information criteria, the most fitted number of trajectory groups was seven, with at least 11 regions in each group. Among the seven groups, one had an exceptionally large gap between HALE and life expectancy compared to that of the others.This group was assigned to 17 regions, of which six were metropolitan cities. Conclusion Based on the results of this study, we identified regions in which health levels have deteriorated over time, particularly within specific areas of metropolitan cities. These findings can be used to design comprehensive policy interventions for community health promotion and urban regeneration projects in the future.

Objective: This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses. Methods: From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness. Results: Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001).Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020).As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017). Conclusion Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.

Objective: This study aimed to empirically evaluate the effectiveness of chronic disease management services utilizing ICT for patients with chronic illnesses. Methods: From May to December, 2023, 452 people who were diagnosed with hypertension and diabetes at 9 participating public health centers were provided with customized health care services for 24 weeks, and 15 performance indicators were analyzed to evaluate their effectiveness. Results: Health behavior indicators and health risk factors decreased before and after participation in the project, blood pressure control rate, hypertension and diabetes management rate, medication compliance, weight, BMI, BP, WC, FBG, and HDL-cholesterol improved(p<0.001).Service factors that influence the improvement of health behaviors included the number of activity monitor transmissions(p=0.049), confirmed concentrated consultations on physical activity(p=0.003) and nutrition(p=0.005), and the adherence to medication missions for hypertension(p=0.020).As for service factors influencing chronic disease management, the improvement in blood pressure regulation rate was due to the number of times the blood pressure monitor was linked(p=0.004), and the number of confirmed intensive consultations on physical activity(p=0.026), and nutrition(p=0.049); the improvement in hypertension control rate was due to the number of times the activity monitor and blood pressure monitor were linked(p<0.001), and the number of hypertension medication missions carried out (p=0.004); and the improvement in diabetes control rate was due to the number of times the blood pressure monitor(p=0.022) and blood sugar system were linked(p=0.017). Conclusion Although this study has limitations as a comparative study before and after the service, it has proved that chronic disease management using ICT has a positive effect on improvement of health behavior indicator, reduction of health risk factors, hypertension, diabetes management index, weight, BMI, TG, BP, FBG improvement.

Purpose: A “Smart Cancer Care” platform that integrates patient-reported outcomes (PROs) with management has been established in Korea. This study focused on improving health behaviors and connecting patients to welfare services by introducing and assessing the feasibility of “Smart Cancer Care 2.0,” an enhanced version designed for monitoring complications post-cancer treatment. Materials and Methods: Smart Cancer Care 2.0 was developed by conducting a literature review and consulting with expert panels to identify symptoms or variables requiring monitoring and management guidelines based on the treatment type. Qualitative and quantitative surveys were conducted to assess the feasibility of the app and web system based on the experiences of patients with cancer and healthcare workers. Results: A total of 81 symptoms or variables (chemotherapy-, surgery-, radiotherapy-, rehabilitation-, and health management-related) were selected for management in Smart Cancer Care 2.0. PROs for these symptoms were basically categorized into three severity grades: preventive management, self-treatment, and consultation with a healthcare worker or visit to a healthcare institution. The overall mean scores in the feasibility evaluation by patients and healthcare workers were 3.83 and 3.90 points, respectively, indicating high usefulness. Conclusion Smart Cancer Care 2.0 leverages the existing information and communication technologies–based platform, Smart Cancer Care, and further includes health behaviors and welfare services. Smart Cancer Care 2.0 may play a crucial role in establishing a comprehensive post-discharge management system for patients with cancer as it provides suitable interventions based on patients’ responses and allows the regularly collected PROs to be easily viewed for streamlined care.

Purpose: With the revision of the Organ and Transplantation Act in 2018, the hand has become legal as an area of transplantable organs in Korea. In January 2021, the first hand allotransplantation since legalization was successfully performed, and we have performed a total of three successful hand transplantation since then. By comparing and incorporating our experiences, this study aimed to provide a comprehensive reconstructive solution for hand amputation in Korea. Materials and Methods: Recipients were selected through a structured preoperative evaluation, and hand transplantations were performed at the distal forearm level. Postoperatively, patients were treated with three-drug immunosuppressive regimen, and functional outcomes were monitored. Results: The hand transplantations were performed without intraoperative complications. All patients had partial skin necrosis and underwent additional surgical procedures in 2 months after transplantation. After additional operations, no further severe complications were observed. Also, patients developed acute rejection within 3 months of surgery, but all resolved within 2 weeks after steroid pulse therapy. Motor and sensory function improved dramatically, and patients were very satisfied with the appearance and function of their transplanted hands. Conclusion Hand transplantation is a viable reconstructive option, and patients have shown positive functional and psychological outcomes. Although this study has limitations, such as the small number of patients and short follow-up period, we should focus on continued recovery of hand function, and be careful not to develop side effects from immunosuppressive drugs. Through the present study, we will continue to strive for a bright future regarding hand transplantation in Korea.

Purpose: This single-arm phase II trial investigate the efficacy and safety of S-1 plus oxaliplatin (SOX) in patients with metastatic breast cancer. Materials and Methods: Patients with metastatic breast cancer previously treated with anthracyclines and taxanes were enrolled. Patients received S-1 (40-60 mg depending on patient’s body surface area, twice a day, day 1-14) and oxaliplatin (130 mg/m2, day 1) in 3 weeks cycle until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumor 1.1. Secondary endpoints included time-to-progression (TTP), duration-of-response (DoR), overall survival (OS), and adverse events. Results: A total of 87 patients were enrolled from 11 institutions in Korea. Hormone receptor was positive in 54 (62.1%) patients and six (6.9%) had human epidermal growth factor receptor 2–positive disease. Forty-eight patients (85.1%) had visceral metastasis and 74 (55.2%) had more than three sites of metastases. The ORR of SOX regimen was 38.5% (95% confidence interval [CI], 26.9 to 50.0) with a median TTP of 6.0 months (95% CI, 5.1 to 6.9). Median DoR and OS were 10.3 months (95% CI, 5.5 to 15.1) and 19.4 (95% CI, not estimated) months, respectively. Grade 3 or 4 neutropenia was reported in 28 patients (32.1%) and thrombocytopenia was observed in 23 patients (26.6%). Conclusion This phase II study showed that SOX regimen is a reasonable option in metastatic breast cancer previously treated with anthracyclines and taxanes.

The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure.

Objective: Religious behaviors are considered as complex brain-based phenomena that may be associated with structural brain change. To identify the pattern of regional brain volume change in nuns, we investigated structural alterations in the brains of nuns using a fast processing automated segmentation method based on deep learning algorithms. Methods: We retrospectively reviewed the medical records of the catholic sisters between the ages of 31 and 80 who are members of the charity of St. Vincent de Paul of Korea. A total of 193 asymptomatic subjects (86 nuns and 107 control subjects) received comprehensive health screening and underwent brain MRI scans. We compared cortical and sub-cortical volume between groups across multiple locations using our in-house U-Net++ deep learning-based automatic segmentation tool. Results: Compared to the control group, the nun group displayed increased gray matter volume in the right lingual cortex, left isthmus-cingulate, posterior-cingulate, rostral-middle-frontal, superior-frontal, supramarginal, temporal-pole cortices, and bilateral pars-triangularis cortices after correction for multiple comparisons. On the other hand, the nun group showed reduced gray matter volume in the temporal and parietal regions relative to healthy controls. Conclusion Our study suggests that spiritual practice may affect brain structure, especially in several frontal regions involved in a higher level of insight function.

Asthma is a chronic inflammatory disease of the airways characterized by varying and recurrent symptoms, reversible airway obstruction, and bronchospasm. In this paper, clinical important studies on asthma published between March 2021 and February 2022 were reviewed. A study on the relationship between asthma and chronic rhinosinusitis, bronchiectasis, and hormone replacement therapy was published. A journal on the usefulness of fractional exhaled nitric oxide for the prediction of severe acute exacerbation was also introduced. Studies on the effect of inhaler, one of the most important treatments for asthma, were published. Studies on the control of severe asthma continued. Phase 2 and 3 studies of new biologics were also published. As the coronavirus disease 2019 (COVID-19) pandemic has been prolonged, many studies have explored the prevalence and mortality of COVID-19 infection in asthma patients.