Many countries have published clinical practice guidelines for appropriate clinical decisions, optimal treatment, and improved clinical outcomes in patients with acute coronary syndrome. Developing guidelines that are specifically tailored to the Korean environment is crucial, considering the treatment system, available medications and medical devices, racial differences, and level of language communication. In 2017, the Korean Society of Myocardial Infarction established a guideline development committee. However, at that time, it was not feasible to develop guidelines, owing to the lack of knowledge and experience in guideline development and the absence of methodology experts. In 2022, the National EvidenceBased Healthcare Collaborating Agency collaborated with a relevant academic association to develop internationally reliable guidelines, with strict adherence to the methodology for evidence-based guideline development. The first Korean acute coronary syndrome guideline starts from the 9 key questions for pharmacotherapy.

Background and Objectives: Although various cardiac parameters on echocardiography have clinical importance, their measurement by conventional manual methods is time-consuming and subject to variability. We evaluated the feasibility, accuracy, and predictive value of an artificial intelligence (AI)-based automated system for echocardiographic analysis in patients with ST-segment elevation myocardial infarction (STEMI). Methods: The AI-based system was developed using a nationwide echocardiographic dataset from five tertiary hospitals, and automatically identified views, then segmented and tracked the left ventricle (LV) and left atrium (LA) to produce volume and strain values. Both conventional manual measurements and AI-based fully automated measurements of the LV ejection fraction and global longitudinal strain, and LA volume index and reservoir strain were performed in 632 patients with STEMI. Results: The AI-based system accurately identified necessary views (overall accuracy, 98.5%) and successfully measured LV and LA volumes and strains in all cases in which conventional methods were applicable. Inter-method analysis showed strong correlations between measurement methods, with Pearson coefficients ranging 0.81–0.92 and intraclass correlation coefficients ranging 0.74–0.90. For the prediction of clinical outcomes (composite of all-cause death, re-hospitalization due to heart failure, ventricular arrhythmia, and recurrent myocardial infarction), AI-derived measurements showed predictive value independent of clinical risk factors, comparable to those from conventional manual measurements. Conclusions Our fully automated AI-based approach for LV and LA analysis on echocardiography is feasible and provides accurate measurements, comparable to conventional methods, in patients with STEMI, offering a promising solution for comprehensive echocardiographic analysis, reduced workloads, and improved patient care.

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated systemic disorder characterized by inflammatory, proliferative, and fibrotic lesions that can affect any body organ. The severity and extent of organ involvement vary significantly among individuals. Diagnosis of IgG4-RD necessitates a comprehensive assessment, including clinical presentation, radiological findings, laboratory tests, and histopathological examination. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria offer a valuable framework for diagnosing IgG4-RD. Although glucocorticoids and rituximab are the primary treatment options, the optimal long-term management strategy for IgG4-RD remains undetermined.

Platelet-rich plasma (PRP) is a promising biomaterial rich in bioactive growth factors, offering potential as a therapeutic agent for various diseases. However, its effectiveness in central nervous system disorders like vascular dementia (VaD) remains underexplored. This study investigated the potential of PRP to mitigate VaD progression in vivo. A rat model of VaD was established via bilateral common carotid artery occlusion and hypovolemia operation. Rats were randomly assigned to receive either PRP or platelet-poor plasma (PPP)—the latter being a byproduct of PRP preparation and used as a reference standard—resulting in the groups designated as ‘operated group (OP)+PRP’ and ‘OP+PPP’, respectively. PRP or PPP (500 μl) was administered intraperitoneally on the day of the operation and postoperative days 2, 4, 6, and 8. Cognitive function was assessed using the Y-maze, Barnes maze, and passive avoidance tests. On postoperative day 8, hippocampal samples were subjected to histological and semi-quantitative analyses. OP exhibited significant memory decline compared to controls, while the ‘OP+PRP’ group showed notable improvement. Histological analysis revealed increased neuronal loss and neuroinflammation in OP hippocampi, mitigated in ‘OP+PRP’. Semi-quantitative analysis showed decreased expression of brain-derived neurotrophic factor (BDNF) and its receptor tropomyosin receptor kinase B (TrkB) in OP, restored in ‘OP+PPP’ and further in ‘OP+PRP’. These results highlight PRP’s protective effects against VaD-induced hippocampal damage and cognitive impairment, partially attributed to BDNF/TrkB pathway upregulation.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Many countries have published clinical practice guidelines for appropriate clinical decisions, optimal treatment, and improved clinical outcomes in patients with acute coronary syndrome. Developing guidelines that are specifically tailored to the Korean environment is crucial, considering the treatment system, available medications and medical devices, racial differences, and level of language communication. In 2017, the Korean Society of Myocardial Infarction established a guideline development committee. However, at that time, it was not feasible to develop guidelines, owing to the lack of knowledge and experience in guideline development and the absence of methodology experts. In 2022, the National EvidenceBased Healthcare Collaborating Agency collaborated with a relevant academic association to develop internationally reliable guidelines, with strict adherence to the methodology for evidence-based guideline development. The first Korean acute coronary syndrome guideline starts from the 9 key questions for pharmacotherapy.

Background and Objectives: Although various cardiac parameters on echocardiography have clinical importance, their measurement by conventional manual methods is time-consuming and subject to variability. We evaluated the feasibility, accuracy, and predictive value of an artificial intelligence (AI)-based automated system for echocardiographic analysis in patients with ST-segment elevation myocardial infarction (STEMI). Methods: The AI-based system was developed using a nationwide echocardiographic dataset from five tertiary hospitals, and automatically identified views, then segmented and tracked the left ventricle (LV) and left atrium (LA) to produce volume and strain values. Both conventional manual measurements and AI-based fully automated measurements of the LV ejection fraction and global longitudinal strain, and LA volume index and reservoir strain were performed in 632 patients with STEMI. Results: The AI-based system accurately identified necessary views (overall accuracy, 98.5%) and successfully measured LV and LA volumes and strains in all cases in which conventional methods were applicable. Inter-method analysis showed strong correlations between measurement methods, with Pearson coefficients ranging 0.81–0.92 and intraclass correlation coefficients ranging 0.74–0.90. For the prediction of clinical outcomes (composite of all-cause death, re-hospitalization due to heart failure, ventricular arrhythmia, and recurrent myocardial infarction), AI-derived measurements showed predictive value independent of clinical risk factors, comparable to those from conventional manual measurements. Conclusions Our fully automated AI-based approach for LV and LA analysis on echocardiography is feasible and provides accurate measurements, comparable to conventional methods, in patients with STEMI, offering a promising solution for comprehensive echocardiographic analysis, reduced workloads, and improved patient care.

Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated systemic disorder characterized by inflammatory, proliferative, and fibrotic lesions that can affect any body organ. The severity and extent of organ involvement vary significantly among individuals. Diagnosis of IgG4-RD necessitates a comprehensive assessment, including clinical presentation, radiological findings, laboratory tests, and histopathological examination. The 2019 American College of Rheumatology/European League Against Rheumatism classification criteria offer a valuable framework for diagnosing IgG4-RD. Although glucocorticoids and rituximab are the primary treatment options, the optimal long-term management strategy for IgG4-RD remains undetermined.