1.Individualized strategy of treatment for ruptured abdominal aortic aneurysm using causal inference model: a retrospective observational study
Youngki SOHN ; Youngje WOO ; Sangkyun MOK ; Eunju JANG ; Ki-Yoon MOON ; Sun Cheol PARK ; Sang Seob YUN ; Jang Yong KIM
Annals of Surgical Treatment and Research 2026;110(4):259-272
Purpose:
This study was performed to predict individualized treatment strategies in ruptured abdominal aortic aneurysm (rAAA) by estimating the survival benefit of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) based on anatomical and physiological features using a causal inference model.
Methods:
This retrospective study included 45 patients with de novo rAAA who underwent EVAR or OSR between 2012 and 2024. Thirty-three variables were analyzed. The model estimated individualized treatment effects (ITE) for 30-day survival.Model interpretability was assessed using Shapley Additive Explanations (SHAP) analysis. Five-fold cross-validation, receiver operating characteristic (ROC) analysis, and calibration plots were used for model evaluation. A clinical decision tree was developed to derive simplified decision rules.
Results:
The mean ITE was 0.22 ± 0.42, with 33% of patients classified as OSR-benefit candidates. SHAP analysis revealed that suprarenal angle, infrarenal angle, iliac anatomy, and proximal neck characteristics strongly influenced treatment effects. However, some predictors, such as low hemoglobin and systolic blood pressure favoring OSR, conflicted with clinical intuition. ROC analysis showed an area under the curve of 1.00, but calibration suggested overfitting due to a small sample size. Treatment-matched patients had a higher 30-day mortality rate than mismatched patients, suggesting potential bias or unmeasured confounding. The decision tree identified clinically relevant features but displayed structural inconsistencies and impractical cutoff values due to the limited sample size.
Conclusion
The X-learner model demonstrated the feasibility of individualized treatment prediction in rAAA but suffered from overfitting and limited generalizability. Validation with larger multicenter cohorts is necessary to confirm clinical applicability.
2.Process of developing basic veterinary clinical performance guidelines based on common clinical manifestations in Korea
Kichang LEE ; Heungshik S. LEE ; Yong Jun KIM ; Incheol PARK ; Kangmoon SEO ; Seong Mok JEONG ; Kyu-Woan CHO ; Jin Young CHUNG ; Dongbin LEE ; Chun-Sik BAE ; Sung-Lim LEE ; Ki-Jeong NA ; Sooyoung CHOI ; Inseong JEONG ; Pan Dong RYU ; Sang-Soep NAHM
Journal of Veterinary Science 2026;27(2):e24-
Objective:
To explain process of developing basic veterinary clinical performance guidelines, based on frequently observable clinical manifestations, thereby supporting competencybased veterinary education in Korea.
Methods:
A structured review of learning outcomes established by Korean Association of Veterinary Medical Colleges (KAVMC) was conducted by a planning committee including veterinary educators, practitioners, and advisory members. Owner-oriented descriptions were used to frame each performance task, and each was mapped to corresponding learning outcomes. These tasks were aligned with learning outcomes recommended by the KAVMC to support the development of communication, clinical reasoning, and performance-related competencies among veterinary students, thereby enhancing day-one clinical readiness.
Results:
In total, 63 clinical manifestations for a guidebook format that can be used for clinical education were identified and categorized by organ systems that are described in language understandable to animal owners.
Conclusions
and Relevance: The basic veterinary clinical performance guidelines based on common clinical manifestations would serve as a vital component in veterinary education to reinforce core graduation competencies.
3.Palliative Care and Hospice for Heart Failure Patients: Position Statement From the Korean Society of Heart Failure
Seung-Mok LEE ; Hae-Young LEE ; Shin Hye YOO ; Hyun-Jai CHO ; Jong-Chan YOUN ; Seong-Mi PARK ; Jin-Ok JEONG ; Min-Seok KIM ; Chi Young SHIM ; Jin Joo PARK ; Kye Hun KIM ; Eung Ju KIM ; Jeong Hoon YANG ; Jae Yeong CHO ; Sang-Ho JO ; Kyung-Kuk HWANG ; Ju-Hee LEE ; In-Cheol KIM ; Gi Beom KIM ; Jung Hyun CHOI ; Sung-Hee SHIN ; Wook-Jin CHUNG ; Seok-Min KANG ; Myeong Chan CHO ; Dae-Gyun PARK ; Byung-Su YOO
International Journal of Heart Failure 2025;7(1):32-46
Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.
4.Efficacy and Safety of Hyaluronic Acid Eye Drops in Dry Eye: A 1-Month Observational Study
Jong Woo KIM ; Sung Kun CHUNG ; Sang-Mok LEE
Journal of the Korean Ophthalmological Society 2025;66(12):461-467
Purpose:
We evaluated the short-term efficacy and safety of hyaluronic acid (HA) eye drops over a 1-month observational period in patients treated with different HA concentrations for dry eye disease.
Methods:
This prospective, non-interventional, multicenter observational study included patients aged ≥ 19 years who were diagnosed with dry eye at participating medical institutions and treated with HA eye drops (Xenobella SD; ChongKunDang Pharm., Seoul, Korea). In total, 886 eyes from 886 patients were analyzed. Efficacy was evaluated by changes in tear film break-up time (TBUT), ocular surface staining score, dry eye severity, ocular discomfort scale, and the Ocular Surface Disease Index (OSDI) from baseline to 1 month after treatment. Subgroup analyses were conducted to assess efficacy according to age, contact lens use, and HA concentration. Safety was evaluated using a questionnaire on adverse events.
Results:
After 1 month of treatment, all dry eye parameters―ocular surface staining score, TBUT, ocular discomfort scale, OSDI, and dry eye severity―improved significantly. Subgroup analyses revealed greater improvement in selected parameters, including TBUT, among patients <60 years, contact lens users, and those treated with higher concentrations of HA (0.18% or 0.3%), compared to patients aged ≥60 years, non–contact lens users, and those receiving the lower concentration of HA (0.1%). Only five mild adverse events were reported.
Conclusions
This 1-month observational study demonstrated that HA eye drops significantly improved both signs and symptoms of dry eye with minimal adverse events. Therapeutic benefits were more pronounced in younger patients, contact lens users, and those treated with higher HA concentrations (≥0.18%).
5.Framingham risk score is a useful indicator of posttransplant cardiovascular events and survival among Korean kidney transplant recipients: a nationwide, prospective cohort study
Jeonghwan LEE ; Hong Suk CHANG ; Hyejin MO ; In Mok JUNG ; Boram WEON ; Soie KWON ; Chun Soo LIM ; Yon Su KIM ; Sang-Ho LEE ; Yu Ho LEE ; Jeong-Hoon LEE ; Jaeseok YANG ; Myoung Soo KIM ; Jung Pyo LEE ;
Kidney Research and Clinical Practice 2025;44(4):679-692
Cardiovascular disease is an important risk factor for mortality among kidney transplant recipients. In this study, we aimed to investigate the association between cardiovascular risk score at kidney transplantation and long-term outcomes of patients. Methods: In this prospective, observational cohort study, we enrolled kidney transplant recipients who participated in the Korean Organ Transplantation Registry and underwent transplantation between April 2014 and December 2019. The cardiovascular risk status of kidney transplant recipients was assessed using the Framingham risk score. All-cause mortality, major adverse cardiovascular events, allograft failure, estimated glomerular filtration rates (eGFRs), and composite outcomes were evaluated after kidney transplantation. Results: Of the 4,682 kidney transplant recipients, 96 died during 30.7 ± 19.1 months of follow-up. The Kaplan-Meier survival analysis results showed that high Framingham risk scores were associated with all-cause mortality, major adverse cardiovascular events, and composite outcomes. According to the multivariable Cox analysis, high Framingham risk scores were associated with an increased risk of mortality (hazard ratio [HR], 3.20; 95% confidence interval [CI], 1.30–7.91), major adverse cardiovascular events (HR, 8.43; 95% CI, 2.41–29.52), and composite outcomes (HR, 2.05; 95% CI, 1.19–3.46). The eGFRs after transplantation were significantly higher among patients in the low Framingham risk score group (p < 0.001). However, Framingham risk scores were not associated with graft loss or rapid decline in eGFRs. Conclusion: The Framingham risk score is a useful indicator of cardiovascular events, mortality, and kidney function after kidney transplantation.
6.2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT)
Cherry KIM ; Chul Hwan PARK ; Bae Young LEE ; Chan Ho PARK ; Eun-Ju KANG ; Hyun Jung KOO ; Kakuya KITAGAWA ; Min Jae CHA ; Rungroj KRITTAYAPHONG ; Sang Il CHOI ; Hwan Seok YONG ; Sung Min KO ; Sung Mok KIM ; Sung Ho HWANG ; Nguyen Ngoc TRANG ; Whal LEE ; Young Jin KIM ; Jongmin LEE ; Dong Hyun YANG
Korean Journal of Radiology 2024;25(4):331-342
The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.
7.2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT)
Cherry KIM ; Chul Hwan PARK ; Bae Young LEE ; Chan Ho PARK ; Eun-Ju KANG ; Hyun Jung KOO ; Kakuya KITAGAWA ; Min Jae CHA ; Rungroj KRITTAYAPHONG ; Sang Il CHOI ; Hwan Seok YONG ; Sung Min KO ; Sung Mok KIM ; Sung Ho HWANG ; Nguyen Ngoc TRANG ; Whal LEE ; Young Jin KIM ; Jongmin LEE ; Dong Hyun YANG
Cardiovascular Imaging Asia 2024;8(2):21-31
The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.
8.Developing veterinary basic clinical skill items based on Korean Veterinary Entrustable Professional Activity
Kichang LEE ; Heungshik S. LEE ; Seong Mok JEONG ; Jongil KANG ; Seungjoon KIM ; Jin-Young CHUNG ; Sang-Soep NAHM ; Pan Dong RYU
Journal of Veterinary Science 2024;25(5):e71-
Objective:
This study aimed to establish the basic veterinary clinical skills required to ensure graduates of Korean veterinary universities have the day-one competency to independently perform their professional duties.
Methods:
The Education Committee of the Korean Association of Veterinary Medical Colleges, composed of veterinary school professors and an experienced veterinarian in the clinic, reviewed domestic and international veterinary education-related materials to define basic clinical skills.
Results:
The Korean Veterinarian Entrustable Professional Activities (KVEPA) was introduced, followed by the subsequent development of 54 essential clinical skills based on the KVEPA.
Conclusions
and Relevance: The veterinary basic clinical skills established through this study can be used as a specific guide for clinical education in Korean veterinary school, and is expected to play an important role in meeting the needs of the educational sector of the veterinary education accreditation standards.
9.Asymptomatic Uterine Rupture Caused by Trauma in a Small-Sized Non-Gravid Dog
Ye-Eun KIM ; Sang-Hyun NAM ; Won-Jong LEE ; Chang-Hwan MOON ; Geum-Lan HONG ; Ju-Young JUNG ; Jae-Min JEONG ; Hae-Beom LEE ; Seong-Mok JEONG ; Dae-Hyun KIM
Journal of Veterinary Clinics 2024;41(2):112-116
Uterine rupture is uncommon in small animals and can be caused by trauma, infection, dead fetus, or inappropriate obstetric techniques. A 4-yearold, intact female mixed-breed dog weighing 3 kg presented for elective ovariohysterectomy with a history of a motor vehicle accident two months previously. The patient showed no clinical signs of uterine abnormalities or evidence of pregnancy during physical examination. Clinical examinations, radiography, and ultrasonography revealed no significant findings. During ovariohysterectomy, a completely transected left uterine horn and dome-shaped ends were identified.The uterine layers were everted such that the endometrium could be seen outside the uterine horn. The dog recovered without post-operative complications and was discharged the following day. This report describes a rare case of an asymptomatic uterine rupture caused by trauma in a non-gravid dog.
10.Establishing veterinary graduation competencies and its impact on veterinary medical education in Korea
Sang-Soep NAHM ; Kichang LEE ; Myung Sun CHUN ; Jongil KANG ; Seungjoon KIM ; Seong Mok JEONG ; Jin Young CHUNG ; Pan Dong RYU
Journal of Veterinary Science 2023;24(3):e41-
Competencies are defined as an observable and assessable set of knowledge, skills, and attitudes. Graduation competencies, which are more comprehensive, refer to the required abilities of students to perform on-site work immediately after graduation. As graduation competencies set the goal of education, various countries and institutions have introduced them for new veterinary graduates. The Korean Association of Veterinary Medical Colleges has recently established such competencies to standardize veterinary education and enhance quality levels thereof. The purpose of this study is to describe the process of establishing graduation competencies as well as their implication for veterinary education in Korea.Graduation competencies for veterinary education in Korea comprise 5 domains (animal health care and disease management, one health expertise, communication and collaboration, research and learning, and veterinary professionalism). These are further divided into 11 core competencies, and 33 achievement standards, which were carefully chosen from previous case analyses and nation-wide surveys. Currently, graduation competencies are used as a standard for setting clear educational purposes for both instructors and students. Establishing these competencies further initiated the development of detailed learning outcomes, and of a list of basic veterinary clinical performances and skills, which is useful for assessing knowledge and skills. The establishment of graduation competencies is expected to contribute to the continuous development of Korean veterinary education in many ways. These include curriculum standardization and licensing examination reform, which will eventually improve the competencies of new veterinary graduates.

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