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.

Background: Bronchiectasis has a complex and heterogeneous pathogenesis, with various etiologies, the majority being idiopathic. This study aimed to examine the characteristics of patients with idiopathic bronchiectasis in comparison to those with post-infectious bronchiectasis. Methods: We analyzed data from patients with idiopathic and post-infectious bronchiectasis (including post-tuberculosis) from the Korean Multicenter Bronchiectasis Audit and Research Collaboration (KMBARC) registry, a prospective cohort study. Results: Among the 866 patients enrolled in the study, 346 (40.0%) were classified as having idiopathic bronchiectasis, while 363 (41.9%) had post-infectious bronchiectasis. The idiopathic group demonstrated a shorter disease duration, a higher body mass index (BMI), a lower prevalence of chronic obstructive pulmonary disease (COPD), a higher prevalence of rhinosinusitis, a predominance of lower lobe distribution, less frequent use of regular respiratory treatments, better pulmonary function, and a statistically lower bronchiectasis severity index compared to the post-infectious group. A multivariable logistic regression analysis was conducted, considering factors such as gender, age, BMI, history of asthma, COPD, rhinosinusitis, rheumatoid arthritis, gastroesophageal reflux disease, and smoking status. A higher BMI (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.04 to 1.15) and a history of rhinosinusitis (OR, 3.10; 95% CI, 1.57 to 6.14) were associated with idiopathic bronchiectasis. In contrast, a history of COPD was linked to post-infectious bronchiectasis (OR, 0.57; 95% CI, 0.41 to 0.80). Conclusion Patients with idiopathic bronchiectasis are characterized by a higher BMI and a history of rhinosinusitis compared to those with post-infectious bronchiectasis. These findings may provide exploratory insights into underlying systemic or non-pulmonary factors. Further research is necessary to clarify the clinical significance of these associations.

Background: The incidence of preterm birth in Korea increased from 6.5% in 2013 to 9.7% in 2020. Very low birth weight (VLBW) infants, defined as those weighing < 1,500 g, are particularly vulnerable to numerous health risks. Breast milk provision reduces the incidence of complications in this vulnerable population. The objective of this study was to examine the rate and factors associated with breast milk provision at neonatal intensive care unit (NICU) discharge and to investigate its potential effects on growth and developmental outcomes at 18–24 months corrected age (CA). Methods: We conducted this cohort study using data from over 70 NICUs participating in the Korean Neonatal Network. VLBW infants born between January 2019 and December 2020 at a gestational age of 23 +0 to 31 +6 weeks were included. Discharge feeding types were analyzed of 2,490 infants, while follow-up assessments of growth and neurodevelopmental outcomes at 18–24 months of CA were available for 1,426 infants. Propensity score matching was used for comparative analysis. Results: The rate of breast milk provision at discharge among VLBW infants was 55.9% in 2019 and 56.5% in 2020. Factors that were positively associated with breast milk feeding included higher maternal education level and antenatal steroid use. In contrast, maternal hypertensive disorders, cesarean section, and severe neonatal morbidities (e.g., necrotizing enterocolitis) were correlated with lower breast milk feeding rates at the time of discharge.The provision of breast milk at discharge was not associated with a higher risk of suboptimal growth (below two standard deviations) compared to control infants at 18–24 months of CA. Neurodevelopmental assessments indicated that breast milk was associated with a reduced risk of developmental delay (adjusted odds ratio, 0.72; 95% confidence interval, 0.56–0.94) at follow-up. Conclusion Breast milk provision to VLBW infants at NICU discharge in Korea was comparable to that in other countries. This nationwide study highlights the critical role of breast milk in promoting the neurodevelopment of VLBW infants. Future efforts should focus on identifying the barriers to breast milk provision to improve health outcomes in vulnerable populations.

Purpose: Identifying and managing risk factors for lower urinary tract symptoms (LUTS) is crucial because it impacts the quality of life of elderly individuals. Lifestyle factors, including physical activity (PA), and their relationship with LUTS have not been well studied. This objective of this study was to investigate the association between PA and LUTS. Materials and Methods: A total of 7,296 men were included in this cross-sectional study. PA was quantified in metabolic equivalent (MET)-hours per week, and LUTS severity was assessed using the international prostate symptom score. Logistic regression was used to analyze the association between PA and LUTS, including voiding and storage symptoms. Results: The average age of the participants was 57.8 years, and the prevalence of LUTS was 41.3%. After adjusting for potential confounders, PA was inversely associated with the prevalence and severity of moderate-to-severe LUTS, showing a dose-response pattern (all p for trend <0.01). Compared to the minimal activity group, which engaged in <5 MET-hours per week of PA, the odds ratios for moderate to severe LUTS were 0.83 (95% confidence interval [CI]: 0.72–0.97) for men engaging in 15–30 MET-hours per week, 0.82 (95% CI: 0.71–0.95) for 30–60 MET-hours per week, and 0.72 (95% CI: 0.62–0.84) for ≥60 MET-hours per week. The possible protective effect of PA was still observed in the additional analysis for voiding and storage symptoms showing the same dose-response pattern (all p for trend <0.01). Conclusions A higher PA level was associated with a lower prevalence and severity of total, voiding, and storage LUTS in a dose-dependent manner in Korean men.

Objective: Acute coronary syndrome often requires urgent intervention. The 2023 European Society of Cardiology guidelines recommend invasive procedures within 24 hours for high-risk cases. Nevertheless, there have been limited studies on non-ST-segment elevation myocardial infarction (NSTEMI) in South Korea. This study compared the risk of complications based on the timing of intervention. Methods: A retrospective observational study was conducted on patients with chest pain and elevated high-sensitivity troponin T from January to December 2021 in the emergency department. Patients were categorized into early (≤24 hr) and late (>24 hr) intervention groups. Primary outcomes (death, restenosis, or stroke) at 12 months were compared. Survival and subgroup analyses were performed to examine the factors affecting the outcomes in the two groups. Results: Three hundred seventy six patients were enrolled in the study, and 115 patients were excluded. Among 261 patients, 106 and 155 patients were in the early intervention group (≤24 hr), and late intervention group (>24 hr), respectively. The primary outcome (death or restenosis) showed no significant difference (hazard ratio [HR] in the early intervention group at 12 mo; 1.03; 95% confidence interval [CI], 0.63-1.70; P=0.905). However, risk of stroke was lower in the early intervention group (HR in the early, 0.08; 95% CI, 0.00-0.66; P=0.013). Subgroup analysis showed no significant advantage for early intervention. Conclusion In NSTEMI patients, early intervention does not reduce death or restenosis but lowers stroke incidence. No specific risk factors favored early intervention.

Background: Factors influencing the decline in forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV1 / FVC decline in patients with COPD. Methods: This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV1 /FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV1 /FVC. Results: Among 1,725 patients, 435 exhibited rapid FEV1 /FVC decline, with an annual change of −2.5%p (interquartile range, −3.5 to −2.0). Rapid FEV1 /FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV1 , higher post-BD FEV1 / FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV1 /FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV1 decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV1 , low STAR stage, high forced mid-expiratory flow (FEF 25-75% ), accelerated FEV1 decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV1 /FVC decline. Conclusion We identified the risk factors for rapid FEV1 /FVC decline, including BMI, smoking, symptoms deterioration, FEV1 decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV1 /FVC decline.

Background: Factors influencing the decline in forced expiratory volume in one second (FEV1 )/forced vital capacity (FVC) for chronic obstructive pulmonary disease (COPD) progression remain uncertain. We aimed to identify risk factors associated with rapid FEV1 / FVC decline in patients with COPD. Methods: This multi-center observational study was conducted from January 2012 to December 2022. Eligible patients were monitored with symptoms, spirometric tests, and treatment patterns over 3 years. Rapid FEV1 /FVC decliners were defined as the quartile of patients exhibiting the highest annualized percentage decline in FEV1 /FVC. Results: Among 1,725 patients, 435 exhibited rapid FEV1 /FVC decline, with an annual change of −2.5%p (interquartile range, −3.5 to −2.0). Rapid FEV1 /FVC decliners exhibited lower body mass index (BMI), higher smoking rates, elevated post-bronchodilator (BD) FEV1 , higher post-BD FEV1 / FVC, and a lower prevalence of Staging of Airflow Obstruction by Ratio (STAR) stage IV. Rapid FEV1 /FVC decline was not linked to the annual exacerbation rate, but there was an association with symptom deterioration and FEV1 decline. In multivariable analyses, low BMI, current smoking, increased modified Medical Research Council dyspnoea score, low post-BD FEV1 , low STAR stage, high forced mid-expiratory flow (FEF 25-75% ), accelerated FEV1 decline, and not initiating dual BD therapy were identified as independent risk factors for rapid FEV1 /FVC decline. Conclusion We identified the risk factors for rapid FEV1 /FVC decline, including BMI, smoking, symptoms deterioration, FEV1 decline, and adherence to standard inhaler treatment. Our findings underscore the potential benefits of maintaining consistent use of long-acting beta-agonist/long-acting muscarinic antagonist even in the presence of worsening symptoms, in attenuating FEV1 /FVC decline.