Purpose: The aim of this study is to compare the detection ability of quality of life (QoL) changes and responsiveness of the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS)-40 and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ). Materials and Methods: A multicenter prospective observational study was conducted to evaluate QoL changes after various gastrectomies between January 2021 and April 2022. Participants were instructed to complete the KOQUSS-40 and EORTC QLQ-C30/STO22 preoperatively and at 1, 3, 6, and 12 months postoperatively. QoL changes over time and QoL responsiveness were assessed for each questionnaire. Results: Data from 491 patients who underwent curative gastrectomy for gastric cancer at 22 institutions were analyzed. The summary scores of the KOQUSS-40 and EORTC QLQ-STO22 showed significant differences between the total and proximal gastrectomy groups (p=0.044 and p=0.038, respectively), but no difference was observed for the EORTC QLQ-C30. Dysphagia on the KOQUSS-40 was significantly different between the total and proximal gastrectomy groups (p=0.031); however, dysphagia on the EORTC QLQ-STO22 did not differ. The responsiveness of the KOQUSS-40 was similar to that of the EORTC QLQ in patients who experienced ≥ 10% body weight loss, but approximately 10% less in patients receiving adjuvant chemotherapy than the EORTC QLQ. Conclusion KOQUSS-40 has several advantages over EORTC QLQ-C30/STO22 when comparing QoL between the total and proximal gastrectomy groups. The findings provide information for researchers investigating the QoL of patients who have undergone curative gastrectomy for gastric cancer.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Background: Pulse pressure, reflecting arterial wall stiffness, is a cardiovascular disease risk factor but is highly variable. This study investigated the association of the pulse pressure index (PPI) with 10-year cardiovascular disease risk and its clinical utility by examining its correlations with diabetes mellitus (DM) and chronic kidney disease (CKD). Methods: This cross-sectional study included 3,604 hypertensive adults (30–79 years) from the 2019–2021 Korea National Health and Nutrition Examination Survey. We categorized PPI as <30, 30 to 40, 40 to 50, and ≥50. The Framingham risk score assessed 10-year cardiovascular disease risk, and multiple regressions analyzed its relationship with the PPI category. Binary logistic regressions evaluated the relationship between PPI, DM, and CKD. Results: Adjusted for other variables, higher PPI levels are associated with an increased 10-year cardiovascular disease risk (P<0.001). PPI ≥50 was associated with CKD, and all PPI groups, except <30, were associated with DM. Conclusion PPI predicts 10-year CVD risk and is associated with DM presence. PPI can be considered a risk factor for both cardiovascular disease and DM. Additionally, PPI ≥50 is associated with CKD.

Background: Pulse pressure, reflecting arterial wall stiffness, is a cardiovascular disease risk factor but is highly variable. This study investigated the association of the pulse pressure index (PPI) with 10-year cardiovascular disease risk and its clinical utility by examining its correlations with diabetes mellitus (DM) and chronic kidney disease (CKD). Methods: This cross-sectional study included 3,604 hypertensive adults (30–79 years) from the 2019–2021 Korea National Health and Nutrition Examination Survey. We categorized PPI as <30, 30 to 40, 40 to 50, and ≥50. The Framingham risk score assessed 10-year cardiovascular disease risk, and multiple regressions analyzed its relationship with the PPI category. Binary logistic regressions evaluated the relationship between PPI, DM, and CKD. Results: Adjusted for other variables, higher PPI levels are associated with an increased 10-year cardiovascular disease risk (P<0.001). PPI ≥50 was associated with CKD, and all PPI groups, except <30, were associated with DM. Conclusion PPI predicts 10-year CVD risk and is associated with DM presence. PPI can be considered a risk factor for both cardiovascular disease and DM. Additionally, PPI ≥50 is associated with CKD.

Background: Pulse pressure, reflecting arterial wall stiffness, is a cardiovascular disease risk factor but is highly variable. This study investigated the association of the pulse pressure index (PPI) with 10-year cardiovascular disease risk and its clinical utility by examining its correlations with diabetes mellitus (DM) and chronic kidney disease (CKD). Methods: This cross-sectional study included 3,604 hypertensive adults (30–79 years) from the 2019–2021 Korea National Health and Nutrition Examination Survey. We categorized PPI as <30, 30 to 40, 40 to 50, and ≥50. The Framingham risk score assessed 10-year cardiovascular disease risk, and multiple regressions analyzed its relationship with the PPI category. Binary logistic regressions evaluated the relationship between PPI, DM, and CKD. Results: Adjusted for other variables, higher PPI levels are associated with an increased 10-year cardiovascular disease risk (P<0.001). PPI ≥50 was associated with CKD, and all PPI groups, except <30, were associated with DM. Conclusion PPI predicts 10-year CVD risk and is associated with DM presence. PPI can be considered a risk factor for both cardiovascular disease and DM. Additionally, PPI ≥50 is associated with CKD.

Background: Pulse pressure, reflecting arterial wall stiffness, is a cardiovascular disease risk factor but is highly variable. This study investigated the association of the pulse pressure index (PPI) with 10-year cardiovascular disease risk and its clinical utility by examining its correlations with diabetes mellitus (DM) and chronic kidney disease (CKD). Methods: This cross-sectional study included 3,604 hypertensive adults (30–79 years) from the 2019–2021 Korea National Health and Nutrition Examination Survey. We categorized PPI as <30, 30 to 40, 40 to 50, and ≥50. The Framingham risk score assessed 10-year cardiovascular disease risk, and multiple regressions analyzed its relationship with the PPI category. Binary logistic regressions evaluated the relationship between PPI, DM, and CKD. Results: Adjusted for other variables, higher PPI levels are associated with an increased 10-year cardiovascular disease risk (P<0.001). PPI ≥50 was associated with CKD, and all PPI groups, except <30, were associated with DM. Conclusion PPI predicts 10-year CVD risk and is associated with DM presence. PPI can be considered a risk factor for both cardiovascular disease and DM. Additionally, PPI ≥50 is associated with CKD.

Background: and Purpose The influence of imaging features of brain frailty on outcomes were investigated in acute ischemic stroke patients with minor symptoms and large-vessel occlusion (LVO). Methods: This was a retrospective analysis of a prospective, multicenter, nationwide registry of consecutive patients with acute (within 24 h) minor (National Institutes of Health Stroke Scale score=0–5) ischemic stroke with anterior circulation LVO (acute minor LVO). Brain frailty was stratified according to the presence of an advanced white-matter hyperintensity (WMH) (Fazekas grade 2 or 3), silent/old brain infarct, or cerebral microbleeds. The primary outcome was a composite of stroke, myocardial infarction, and all-cause mortality within 1 year. Results: In total, 1,067 patients (age=67.2±13.1 years [mean±SD], 61.3% males) were analyzed. The proportions of patients according to the numbers of brain frailty burdens were as follows: no burden in 49.2%, one burden in 30.0%, two burdens in 17.3%, and three burdens in 3.5%. In the Cox proportional-hazards analysis, the presence of more brain frailty burdens was associated with a higher risk of 1-year primary outcomes, but after adjusting for clinically relevant variables there were no significant associations between burdens of brain frailty and 1-year vascular outcomes. For individual components of brain frailty, an advanced WMH was independently associated with an increased risk of 1-year primary outcomes (adjusted hazard ratio [aHR]=1.33, 95% confidence interval [CI]=1.03–1.71) and stroke (aHR=1.32, 95% CI=1.00–1.75). Conclusions The baseline imaging markers of brain frailty were common in acute minor ischemic stroke patients with LVO. An advanced WMH was the only frailty marker associated with an increased risk of vascular events. Further research is needed into the association between brain frailty and prognosis in patients with acute minor LVO.

Background: A decline in masticatory function may indicate brain dysfunction related to dementia, but the relationship between masticatory function and dementia risk remains unclear. This study aimed to investigate whether masticatory function is associated with the risk of cognitive decline and dementia. Methods: Data were obtained from the nationwide prospective cohort study of randomly sampled community-dwelling Koreans aged ≥ 60 years. The 5,064 non-demented participants, whose number of chewing cycles per bite was assessed by clinical interview, were followed for 8 years with biennial assessments of cognitive performance and clinical diagnoses of all-cause dementia and Alzheimer’s disease (AD). Structural brain magnetic resonance imaging was collected from a subset of cohort participants and their spouses for imaging analyses. Results: Males who chewed ≥ 30 cycles/bite had faster decline in global cognition and memory function and were at higher risk for incident all-cause dementia (hazard ratio [HR], 2.91; 95% confidence interval [CI], 1.18–7.18) and AD (HR, 3.22; 95% CI, 1.14–9.11) compared to males with less than 10 cycles/bite. Additionally, increased chewing cycles in males were associated with reduced brain volume, particularly in regions involved in compensatory cognitive control of mastication. There was no significant association between chewing cycles and the risk of dementia or brain volume in females. Conclusion Older men who frequently chew their meals could be considered a notable population at risk for dementia who should be carefully assessed for their cognitive trajectories.