The femoral artery is the preferred access route for neurointerventions. The transfemoral approach (TFA) offers advantages such as a large diameter and easy access. However, it also entails disadvantages such as patient discomfort and high risk of complications. Following the initial report of coronary angiography using the transradial approach (TRA) in 1989, cardiologists discovered the advantages of TRA over the TFA and gradually replaced it with the TRA. In 1997, Matsumoto et al. used the TRA for cerebral angiography and neurointervention. Thereafter, the adoption of TRA for neurointervention gradually increased and good outcomes were reported. However, despite these developments, the adoption rate of TRA is relatively low. We reviewed the relevant studies to increase the accessibility of TRA for neurointerventionists.

The femoral artery is the preferred access route for neurointerventions. The transfemoral approach (TFA) offers advantages such as a large diameter and easy access. However, it also entails disadvantages such as patient discomfort and high risk of complications. Following the initial report of coronary angiography using the transradial approach (TRA) in 1989, cardiologists discovered the advantages of TRA over the TFA and gradually replaced it with the TRA. In 1997, Matsumoto et al. used the TRA for cerebral angiography and neurointervention. Thereafter, the adoption of TRA for neurointervention gradually increased and good outcomes were reported. However, despite these developments, the adoption rate of TRA is relatively low. We reviewed the relevant studies to increase the accessibility of TRA for neurointerventionists.

The femoral artery is the preferred access route for neurointerventions. The transfemoral approach (TFA) offers advantages such as a large diameter and easy access. However, it also entails disadvantages such as patient discomfort and high risk of complications. Following the initial report of coronary angiography using the transradial approach (TRA) in 1989, cardiologists discovered the advantages of TRA over the TFA and gradually replaced it with the TRA. In 1997, Matsumoto et al. used the TRA for cerebral angiography and neurointervention. Thereafter, the adoption of TRA for neurointervention gradually increased and good outcomes were reported. However, despite these developments, the adoption rate of TRA is relatively low. We reviewed the relevant studies to increase the accessibility of TRA for neurointerventionists.

The femoral artery is the preferred access route for neurointerventions. The transfemoral approach (TFA) offers advantages such as a large diameter and easy access. However, it also entails disadvantages such as patient discomfort and high risk of complications. Following the initial report of coronary angiography using the transradial approach (TRA) in 1989, cardiologists discovered the advantages of TRA over the TFA and gradually replaced it with the TRA. In 1997, Matsumoto et al. used the TRA for cerebral angiography and neurointervention. Thereafter, the adoption of TRA for neurointervention gradually increased and good outcomes were reported. However, despite these developments, the adoption rate of TRA is relatively low. We reviewed the relevant studies to increase the accessibility of TRA for neurointerventionists.

Background: Sepsis is a leading cause of intensive care unit (ICU) admission. However, few studies have evaluated how the ICU model affects the outcomes of patients with sepsis. Methods: This post hoc analysis of data from the Management of Severe Sepsis in Asia’s Intensive Care Units II study included 537 patients with sepsis admitted to 27 ICUs in Korea. The outcome measures of interest were compared between the closed ICU group, patients admitted under the full responsibility of an intensivist as the primary attending physician, and the open ICU group. The association between a closed ICU and ICU mortality was evaluated using a logistic regression analysis. Results: Altogether, 363 and 174 enrolled patients were treated in open and closed ICUs, respectively. Compliance with the sepsis bundles did not differ between the two groups; however, the closed ICU group had a higher rate of renal replacement therapy and shorter duration of ventilator support. The closed ICU group also had a lower ICU mortality rate than the open ICU group (24.7% vs. 33.1%). In a logistic regression analysis, management in the closed ICU was significantly associated with a decreased ICU mortality rate even after adjusting for potential confounding factors (adjusted odds ratio, 0.576; 95% CI, 0.342–0.970), and that association was observed for up to 90 days. Conclusions Sepsis management in closed ICUs was significantly associated with improved ICU survival and decreased length of ICU stay, even though the compliance rates for the sepsis bundles did not differ between open and closed ICUs.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Objective: This study compared the status of chronic diseases among immigrants and the Korean population. Methods: This study was conducted on 153 immigrants living in Gwangju Metropolitan City in 2022.For comparison, 459 Koreans were selected using the 2021 Korea National Health and Nutrition Examination Survey (KNHANES). A survey was conducted on the management status of hypertension, diabetes, and hyperlipidemia using a questionnaire. Results: Immigrants were significantly more likely to have hypertension (50.3% vs. 24.2%, p<0.001) and diabetes (19.0% vs. 11.5%, p=0.002) than Koreans. In awareness, immigrants had significantly lower rates of hypertension (57.1% vs. 73.0%, p=0.031) and hyperlipidemia (immigrants 25.4% vs. 44.5%, p=0.006). In treatment rates, immigrants had significantly lower rates of hypertension (40.3% vs. 69.4%, <0.001) and hyperlipidemia (17.9% vs. 39.6%, p=0.003). In control rates, immigrants had significantly lower rates of hypertension (18.2% vs. 62.2%, <0.001) than Koreans. Conclusions Chronic diseases are common among immigrants, but awareness, treatment, and control rates are low, so education and prevention policies are critical to improving immigrants’ access to medical care and raising awareness.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.

Objective: This study compared the status of chronic diseases among immigrants and the Korean population. Methods: This study was conducted on 153 immigrants living in Gwangju Metropolitan City in 2022.For comparison, 459 Koreans were selected using the 2021 Korea National Health and Nutrition Examination Survey (KNHANES). A survey was conducted on the management status of hypertension, diabetes, and hyperlipidemia using a questionnaire. Results: Immigrants were significantly more likely to have hypertension (50.3% vs. 24.2%, p<0.001) and diabetes (19.0% vs. 11.5%, p=0.002) than Koreans. In awareness, immigrants had significantly lower rates of hypertension (57.1% vs. 73.0%, p=0.031) and hyperlipidemia (immigrants 25.4% vs. 44.5%, p=0.006). In treatment rates, immigrants had significantly lower rates of hypertension (40.3% vs. 69.4%, <0.001) and hyperlipidemia (17.9% vs. 39.6%, p=0.003). In control rates, immigrants had significantly lower rates of hypertension (18.2% vs. 62.2%, <0.001) than Koreans. Conclusions Chronic diseases are common among immigrants, but awareness, treatment, and control rates are low, so education and prevention policies are critical to improving immigrants’ access to medical care and raising awareness.

Background: Bulky or multiple lymph node (LN) metastases are associated with poor prognosis in cervical cancer, and the size or number of LN metastases is not yet reflected in the staging system and therapeutic strategy. Although the therapeutic effects of surgical resection of bulky LNs before standard treatment have been reported in several retrospective studies, wellplanned randomized clinical studies are lacking. Therefore, the aim of the Korean Gynecologic Oncology Group (KGOG) 1047/DEBULK trial is to investigate whether the debulking surgery of bulky or multiple LNs prior to concurrent chemoradiation therapy (CCRT) improves the survival rate of patients with cervical cancer IIICr diagnosed by imaging tests. Methods The KGOG 1047/DEBULK trial is a phase III, multicenter, randomized clinical trial involving patients with bulky or multiple LN metastases in cervical cancer IIICr. This study will include patients with a short-axis diameter of a pelvic or para-aortic LN ≥2 cm or ≥3 LNs with a short-axis diameter ≥1 cm and for whom CCRT is planned. The treatment arms will be randomly allocated in a 1:1 ratio to either receive CCRT (control arm) or undergo surgical debulking of bulky or multiple LNs before CCRT (experimental arm). CCRT consists of extended-field external beam radiotherapy/pelvic radiotherapy, brachytherapy and LN boost, and weekly chemotherapy with cisplatin (40 mg/m 2 ), 4–6 times administered intravenously.The primary endpoint will be 3-year progression-free survival rate. The secondary endpoints will be 3-year overall survival rate, treatment-related complications, and accuracy of radiological diagnosis of bulky or multiple LNs.