Objectives: Ischemic stroke is influenced by long-term metabolic and renal deterioration; however, many risk prediction frameworks rely on single time-point measurements. We examined whether multi-period patterns in national health screening indicators are associated with incident ischemic stroke in Korea. Methods: Using customized National Health Insurance Service data with 3 biennial screenings (P1: 2013–2014; P2: 2015–2016; P3: 2017–2018), we identified incident ischemic stroke during 2019–2023 (Korean Standard Classification of Diseases-7 I63). After applying eligibility criteria and excluding individuals with missing screening values, we performed 1:1 propensity score matching on sex, 1-year age strata, and insurance type (97 454 matched pairs; n=194 908). Multi-period indicators included waist circumference increase ≥10%, sustained blood pressure ≥130/80 mmHg, sustained fasting glucose ≥126 mg/dL, proteinuria progression, and creatinine elevation in ≥2 periods (sex-specific thresholds). Associations were evaluated using conditional logistic regression; a comparator model used P3-only indicators. Results: In the multi-period model, stroke was associated with waist circumference increase ≥10% (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01 to 1.08), sustained blood pressure ≥130/80 mmHg (OR, 1.34; 95% CI, 1.31 to 1.37), sustained fasting glucose ≥126 mg/dL (OR, 1.66; 95% CI, 1.60 to 1.73), creatinine elevation in ≥2 periods (OR, 1.08; 95% CI, 1.06 to 1.10), and proteinuria progression (OR, 1.36; 95% CI, 1.32 to 1.39). In the P3-only model, all single-time-point indicators were associated with incident stroke (ORs, 1.08 to 1.47). Conclusions Multi-year patterns in metabolic screening indicators were associated with incident ischemic stroke. Repeated health screening measurements may complement single time-point assessments and support continuous risk-factor monitoring and patient-centered prevention.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

The restoration process for patients with collapsed occlusion or those requiring extensive rehabilitation often involves various trials and errors. Accurately transferring the patient’s oral information to the articulator is key to producing esthetically pleasing and stable prostheses. This necessitates precise master model fabrication and accurate jaw relation records. For patients undergoing extensive implant-supported fixed prostheses, several techniques for recording the jaw relationship are available, including the use of record bases with wax rims, bite blocks with temporary abutments and pattern resin, or provisional prostheses.Among these, using provisional prostheses directly for mounting on the master model can help minimize errors during the jaw relation recording phase. The patient in this case was a 55-year-old female patient, who presented for implant-supported fixed prosthetic rehabilitation. She exhibited multiple tooth loss due to periodontal disease, necessitating comprehensive mouth rehabilitation involving extractions and implant placements. After evaluating esthetics and occlusion with provisional prostheses, the same provisional prostheses were used for mounting on the master model, which enabled the fabrication of customized implant abutments and zirconia prostheses. The final result was a successful restoration, both esthetically and functionally.

Purpose: The purpose of this phase II trial was to evaluate whether the addition of simvastatin, a synthetic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, to preoperative chemoradiotherapy (CRT) with capecitabine confers a clinical benefit to patients with locally advanced rectal cancer (LARC). Materials and Methods: Patients with LARC (defined by clinical stage T3/4 and/or lymph node positivity) received preoperative radiation (45-50.4 Gy in 25-28 daily fractions) with concomitant capecitabine (825 mg/m2 twice per day) and simvastatin (80 mg, daily). Curative surgery was planned 4-8 weeks after completion of the CRT regimen. The primary endpoint was pathologic complete response (pCR). The secondary endpoints included sphincter-sparing surgery, R0 resection, disease-free survival, overall survival, the pattern of failure, and toxicity. Results: Between October 2014 and July 2017, 61 patients were enrolled; 53 patients completed CRT regimen and underwent total mesorectal excision. The pCR rate was 18.9% (n=10) by per-protocol analysis. Sphincter-sparing surgery was performed in 51 patients (96.2%). R0 resection was achieved in 51 patients (96.2%). One patient experienced grade 3 liver enzyme elevation. No patient experienced additional toxicity caused by simvastatin. Conclusion The combination of 80 mg simvastatin with CRT and capecitabine did not improve pCR in patients with LARC, although it did not increase toxicity.

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

Background: Currently, there is no consensus on the treatment of psoriasis in Korean patients. Objective: This study aimed to establish a consensus on the basic therapeutic principles for Korean patients with plaque psoriasis. Methods: Using the modified Delphi method, a steering committee proposed 53 statements for the first Delphi round, which covered five subjects: (1) the goal of treatment and evaluation of disease severity, (2) topical therapy, (3) phototherapy, (4) conventional systemic therapy, and (5) biologic therapy. The panel of dermatologists scored the level of agreement for each statement on a ten-point scale with scores ranging from 1 (strongly disagree) to 10 (strongly agree). After discussing the results of the first round, the committee reformulated 41 statements. Finally, consensus was defined as more than 70% of the second round scores being ≥7. Results: The panel participants strongly agreed that the ideal treatment goals for Korean patients with plaque psoriasis should include complete skin clearance and high dermatological quality of life. A strong consensus was also reached on the use of topical agents for psoriasis of any severity, the consideration of phototherapy before biologics therapy, the conventional systemic agents for moderate-to-severe psoriasis, and the recommendation of biologic for retractable psoriasis to conventional systemic therapy and phototherapy. Conclusion This modified Delphi panel established an expert consensus on the therapeutic approach for Korean patients with plaque psoriasis. This consensus may improve the treatment outcomes for psoriasis in Korea.

Background: In this study, with the aim of improving the quality of transitional care service for discharged patients, the Health Care Quality and Outcomes Indicators of the Organization for Economic Co-operation and Development and National Health Service Outcomes Framework of the UK were applied to derive service items for provision and develop evaluation indicators under categories of effectiveness, safety, and patient-centeredness.Method: A scoping review was conducted to derive core concepts and evidence materials/data for transitional care service. For the derived items of transitional care service and evaluation indicators, a three-round Delphi study was conducted with experts in the fields of healthcare/ medicineursing/social welfare. Results: First, as a result of the scoping review, components of transitional care service (assessment of need by period of transitional care service, multi-professional team, connection to community resources, etc.) and themes for outcome indicators (effectiveness, patient safety, patient-centeredness) were derived. Second, by classifying the items for assessment according to the hospitalization and transition period and conducting a Delphi study to derive service items for transitional care service, during the hospitalization period, presence/absence of a caregiver and need for a caregiver, activities of daily living, and necessity for home-based care services were identified as items of high priority. Regarding patient safety, risk of falls and fractures during hospitalization, and necessity for medication reconciliation were identified as the items of high importance. For the transition period, provision of education regarding adequate responses and handling of emergencies, provision of information and guidance on application of services for basic livelihood security program beneficiaries, and education for patient skills in self-management of health were derived as items of high priority. Third, for the derivation of outcome indicators for transitional care service, in the “effectiveness” category, the experts rated a reduction in the 30-day readmission rate as an item of high importance along with a decrease in emergency department visits, reduction in preventable admissions as indicators of high relevance. In terms of “patient safety,” a decrease in drug adverse reactions, and reduction in the incidence of falls and pressure ulcers were identified as indicators of high priority. Finally, for the category of “patient-centeredness,” patient experience assessment, level of service satisfaction reported by patients and their caregivers, and reducing burden on caregivers were identified as indicators of high priority. Conclusion This study suggest practical implications for the service with high relevance and necessity for transitional period. It also presented outcome indicators of transitional care service to contribute toward an improvement in the quality of care.