1.Clinical Outcome Prediction by High-Resolution Computed Tomography and Echocardiography Assessment of Pulmonary Hypertension in Patients with Bronchiectasis
Inhan LEE ; Joon-Sung JOH ; Ji Yeon LEE ; Joohae KIM ; Sooim SIN ; Hyeon-Kyoung KOO ; Ina JEONG
Tuberculosis and Respiratory Diseases 2026;89(2):297-305
Background:
To evaluate the association between pulmonary hypertension and hospital admission rates in patients with bronchiectasis.
Methods:
We retrospectively analyzed data from 130 bronchiectasis patients at the National Medical Center, Korea (November 2012 to October 2022). Pulmonary hypertension was evaluated using high-resolution computed tomography (CT) and echocardiography. Patients were categorized into two groups based on the diameter of the main pulmonary artery (mPA). Logistic regression analysis was performed to identify risk factors associated with hospitalization.
Results:
Forty patients had suspected pulmonary hypertension on echocardiography. A higher percentage of patients with mPA diameter >29 mm (n=61) had a history of previous exacerbations, elevated echocardiographic parameters related to pulmonary hypertension, and reduced lung function, compared to those with mPA diameter ≤29 mm (n=69). In univariate analysis, the hospitalization group showed increased mPA diameter; pulmonary artery to aorta ratio; involvement of lung lobes, cavities, and nodules; and increased systolic pulmonary artery pressure and peak tricuspid regurgitation velocity. In multivariate analysis, mPA diameter >29 mm (adjusted odds ratio [OR], 2.47; 95% confidence interval [CI], 1.14 to 5.32) and the involvement of more than two lobes (adjusted OR, 2.57; 95% CI, 1.14 to 5.77) were significant risk factors for hospitalization.
Conclusion
The CT parameters demonstrated comparable accuracy to models that incorporated echocardiographic data to predict hospitalization in bronchiectasis patients.
2.Korean Guidelines for Diagnosis and Management of Idiopathic Nonspecific Interstitial Pneumonia
Yong Suk JO ; Hyun-Kyung LEE ; Sun Hyo PARK ; Joon Sung JOH ; Hye Jin JANG ; Jong Sun PARK ;
Tuberculosis and Respiratory Diseases 2025;88(2):237-246
Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.
3.Korean Guidelines for Diagnosis and Management of Idiopathic Nonspecific Interstitial Pneumonia
Yong Suk JO ; Hyun-Kyung LEE ; Sun Hyo PARK ; Joon Sung JOH ; Hye Jin JANG ; Jong Sun PARK ;
Tuberculosis and Respiratory Diseases 2025;88(2):237-246
Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.
4.Korean Guidelines for Diagnosis and Management of Idiopathic Nonspecific Interstitial Pneumonia
Yong Suk JO ; Hyun-Kyung LEE ; Sun Hyo PARK ; Joon Sung JOH ; Hye Jin JANG ; Jong Sun PARK ;
Tuberculosis and Respiratory Diseases 2025;88(2):237-246
Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.
5.Korean Guidelines for Diagnosis and Management of Idiopathic Nonspecific Interstitial Pneumonia
Yong Suk JO ; Hyun-Kyung LEE ; Sun Hyo PARK ; Joon Sung JOH ; Hye Jin JANG ; Jong Sun PARK ;
Tuberculosis and Respiratory Diseases 2025;88(2):237-246
Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.
6.Korean Guidelines for Diagnosis and Management of Idiopathic Nonspecific Interstitial Pneumonia
Yong Suk JO ; Hyun-Kyung LEE ; Sun Hyo PARK ; Joon Sung JOH ; Hye Jin JANG ; Jong Sun PARK ;
Tuberculosis and Respiratory Diseases 2025;88(2):237-246
Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.
7.Safety and Efficacy of Everolimus-Eluting Bioresorbable Vascular Scaffold Versus Second-Generation Drug-Eluting Stents in Real-World Practice
Joo Myung LEE ; Hyun Sung JOH ; Ki Hong CHOI ; David HONG ; Taek Kyu PARK ; Jeong Hoon YANG ; Young Bin SONG ; Jin-Ho CHOI ; Seung-Hyuk CHOI ; Jin-Ok JEONG ; Jong-Young LEE ; Young Jin CHOI ; Jei-Keon CHAE ; Seung-Ho HUR ; Jang-Whan BAE ; Ju-Hyeon OH ; Kook-Jin CHUN ; Hyun-Joong KIM ; Byung Ryul CHO ; Doosup SHIN ; Seung Hun LEE ; Doyeon HWANG ; Hyun-Jong LEE ; Ho-Jun JANG ; Hyun Kuk KIM ; Sang Jin HA ; Eun-Seok SHIN ; Joon-Hyung DOH ; Joo-Yong HAHN ; Hyeon-Cheol GWON ; On behalf of the SMART-REWARD Investigators
Journal of Korean Medical Science 2023;38(5):e34-
Background:
The risk of device thrombosis and device-oriented clinical outcomes with bioresorbable vascular scaffold (BVS) was reported to be significantly higher than with contemporary drug-eluting stents (DESs). However, optimal device implantation may improve clinical outcomes in patients receiving BVS. The current study evaluated mid-term safety and efficacy of Absorb BVS with meticulous device optimization under intravascular imaging guidance.
Methods:
The SMART-REWARD and PERSPECTIVE-PCI registries in Korea prospectively enrolled 390 patients with BVS and 675 patients with DES, respectively. The primary endpoint was target vessel failure (TVF) at 2 years and the secondary major endpoint was patientoriented composite outcome (POCO) at 2 years.
Results:
Patient-level pooled analysis evaluated 1,003 patients (377 patients with BVS and 626 patients with DES). Mean scaffold diameter per lesion was 3.24 ± 0.30 mm in BVS group.Most BVSs were implanted with pre-dilatation (90.9%), intravascular imaging guidance (74.9%), and post-dilatation (73.1%) at proximal to mid segment (81.9%) in target vessel.Patients treated with BVS showed comparable risks of 2-year TVF (2.9% vs. 3.7%, adjusted hazard ratio [HR], 1.283, 95% confidence interval [CI], 0.487–3.378, P = 0.615) and 2-year POCO (4.5% vs. 5.9%, adjusted HR, 1.413, 95% CI, 0.663–3.012,P = 0.370) than those with DES. The rate of 2-year definite or probable device thrombosis (0.3% vs. 0.5%, P = 0.424) was also similar. The sensitivity analyses consistently showed comparable risk of TVF and POCO between the 2 groups.
Conclusion
With meticulous device optimization under imaging guidance and avoidance of implantation in small vessels, BVS showed comparable risks of 2-year TVF and device thrombosis with DES.
8.Two Years of Experience and Methodology of Korean COVID-19 Living Clinical Practice Guideline Development
Miyoung CHOI ; Hyeon-Jeong LEE ; Su-Yeon YU ; Jimin KIM ; Jungeun PARK ; Seungeun RYOO ; Inho KIM ; Dong Ah PARK ; Young Kyung YOON ; Joon-Sung JOH ; Sunghoon PARK ; Ki Wook YUN ; Chi-Hoon CHOI ; Jae-Seok KIM ; Sue SHIN ; Hyun KIM ; Kyungmin HUH ; In-Seok JEONG ; Soo-Han CHOI ; Sung Ho HWANG ; Hyukmin LEE ; Dong Keon LEE ; Hwan Seok YONG ; Ho Kee YUM
Journal of Korean Medical Science 2023;38(23):e195-
Background:
In Korea, during the early phase of the coronavirus disease 2019 (COVID-19) pandemic, we responded to the uncertainty of treatments under various conditions, consistently playing catch up with the speed of evidence updates. Therefore, there was high demand for national-level evidence-based clinical practice guidelines for clinicians in a timely manner. We developed evidence-based and updated living recommendations for clinicians through a transparent development process and multidisciplinary expert collaboration.
Methods:
The National Evidence-based Healthcare Collaborating Agency (NECA) and the Korean Academy of Medical Sciences (KAMS) collaborated to develop trustworthy Korean living guidelines. The NECA-supported methodological sections and 8 professional medical societies of the KAMS worked with clinical experts, and 31 clinicians were involved annually. We developed a total of 35 clinical questions, including medications, respiratory/critical care, pediatric care, emergency care, diagnostic tests, and radiological examinations.
Results:
An evidence-based search for treatments began in March 2021 and monthly updates were performed. It was expanded to other areas, and the search interval was organized by a steering committee owing to priority changes. Evidence synthesis and recommendation review was performed by researchers, and living recommendations were updated within 3–4 months.
Conclusion
We provided timely recommendations on living schemes and disseminated them to the public, policymakers and various stakeholders using webpages and social media.Although the output was successful, there were some limitations. The rigor of development issues, urgent timelines for public dissemination, education for new developers, and spread of several new COVID-19 variants have worked as barriers. Therefore, we must prepare systematic processes and funding for future pandemics.
9.Validation for models for tumor recurrence after liver transplantation in hepatectomy patients
Sung Joon KIM ; Jong Man KIM ; Nam-Joon YI ; Gyu-Seong CHOI ; Kwang-Woong LEE ; Kyung-Suk SUH ; Jae-Won JOH
Annals of Surgical Treatment and Research 2022;102(3):131-138
Purpose:
Early recurrence of hepatocellular carcinoma (HCC) remains a challenging issue after hepatic resection (HR) because of the associated poor prognosis. Models for tumor recurrence after liver transplantation (MoRAL) have been designed to predict tumor recurrence in HCC patients in the liver transplantation setting. This study aimed to validate the predictability of MoRAL for HCC recurrence or patient death and to evaluate the predictors of early HCC recurrence in hepatectomy patients with treatment-naïve solitary HCC.
Methods:
This study included 443 patients with HCC recurrence after HR from January 2005 to December 2011. Patients were stratified into early recurrence (n = 312) and late recurrence (n = 131) groups according to the development of recurrence either within or more than 2 years after hepatectomy.
Results:
The median levels of alpha-fetoprotein and protein induced by vitamin K absence-II and the median MoRAL score were significantly higher in the early recurrence group than in the late recurrence group. Regarding pathologic characteristics, the median tumor size, prevalence of tumor grade 3 or 4, microvascular invasion, presence of tumor necrosis, and macrovascular invasion in the early recurrence group were greater than those in the late recurrence group.Multivariate analysis showed that tumor grade 3 or 4, microvascular invasion, and high preoperative MoRAL score were predisposing factors for early HCC recurrence after HR.
Conclusion
The MoRAL score can be used to predict early recurrence in patients with HCC who undergo curative HR.Using this model, other treatments could be considered for patients with early recurrence predicted after HR.
10.Factors Related to Successful Tuberculosis Treatment in Vulnerable Groups
Younghyun KIM ; Ji Yeon LEE ; Ina JEONG ; Junghyun KIM ; Joohae KIM ; Jiyeon HAN ; Eunjin JEONG ; Ah Yeon HAN ; Joon-Sung JOH ; Jung-Duck PARK
Korean Journal of Medicine 2022;97(1):50-59
Background/Aims:
Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019).
Methods:
We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome.
Results:
The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners.
Conclusions
Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important.

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