Cardio-oncology is a critical field due to the escalating significance of cardiovascular toxicity as a side effect of anti‑ cancer treatments. Cancer therapy-related cardiac dysfunction (CTRCD) is a prevalent condition associated with car‑ diovascular toxicity, necessitating effective strategies for prediction, monitoring, management, and tracking. This comprehensive review examines the definition and risk stratification of CTRCD, explores monitoring approaches during anticancer therapy, and highlights specific cardiovascular toxicities linked to various cancer treatments. These include anthracyclines, HER2-targeted agents, vascular endothelial growth factor inhibitors, immune checkpoint inhibitors, chimeric antigen receptor T-cell therapies, and tumor-infiltrating lymphocytes therapies. Incorporating the Korean data, this review offers insights into the regional nuances in managing CTRCD. Using systematic follow-up incorporating cardiovascular imaging and biomarkers, a better understanding and management of CTRCD can be achieved, optimizing the cardiovascular health of both cancer patients and survivors.

Objective: The Scales for Outcomes in Parkinson’s Disease–Cognition (SCOPA-Cog) was developed to assess cognition in patients with Parkinson’s disease (PD). In this study, we aimed to evaluate the validity and reliability of the Korean version of the SCOPACog (K-SCOPA-Cog). Methods: We enrolled 129 PD patients with movement disorders from 31 clinics in South Korea. The original version of the SCOPA-Cog was translated into Korean using the translation-retranslation method. The test–retest method with an intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient were used to assess reliability. Spearman’s rank correlation analysis with the Montreal Cognitive Assessment-Korean version (MOCA-K) and the Korean Mini-Mental State Examination (K-MMSE) were used to assess concurrent validity. Results: The Cronbach’s alpha coefficient was 0.797, and the ICC was 0.887. Spearman’s rank correlation analysis revealed a significant correlation with the K-MMSE and MOCA-K scores (r = 0.546 and r = 0.683, respectively). Conclusion Our results demonstrate that the K-SCOPA-Cog has good reliability and validity.

Objective: With the increase in the elderly population worldwide, there has been a corresponding increase in the proportion of elderly patients who visit the emergency department (ED). Therefore, research on the elderly not only aids in the treatment of diseases but also assists in the efficient utilization of limited medical resources. Respiratory symptoms are one of the most common and sometimes life-threatening symptoms in elderly patients. Knowing the factors that can predict the prognosis in advance can help with rapid diagnosis and immediate treatment. Methods: A retrospective study was conducted from September 2019 to March 2020 at an ED in an urban area. Patients with respiratory symptoms who were treated in the critical care area of the ED were reviewed. The ED clinical data were compared with the outcomes in the ED. Results: A total of 750 patients were screened, of which 703 were elderly patients. Many clinical factors showed variations between the elderly and non-elderly patients. Oxygen volume, elevated lactate level, elevated troponin level, hypocalcemia, and hypothermia were related with ED death or ICU admission among the elderly. Conclusion We identified several clinical factors with respect to elderly ED patients with respiratory symptoms that were related to the clinical outcomes and can be used for decision-making and prediction of poor outcomes.

Objective: This study aimed to determine the clinical factors associated with positive brain magnetic resonance imaging (MRI) findings in patients presenting to the emergency department (ED) with acute altered mental status (AMS). Methods: Patients with acute AMS who presented to the ED were retrospectively analyzed from September 2019 to March 2020. Non-traumatic patients with abnormal alert, verbal, pain, unresponsive (AVPU) scale scores and exhibiting acute change in mental status were included in the study. We evaluated the clinical characteristics of patients with acute AMS according to the results of their brain MRI. A multivariable logistic regression model was used to determine the clinical factors associated with positive brain MRI findings. Results: During the study period, 138 patients underwent brain MRI in the ED, with 36 (26.1%) positive results. A majority of patients with positive brain MRI findings had underlying malignancies, cerebrovascular disease, higher serum total bicarbonate (TCO2) levels, TCO2≥22 mmol/L, lower blood urea nitrogen levels, abnormal findings on brain computed tomography and abnormal findings on neurologic examination. In the multivariable analysis, serum TCO2≥22 mmol/L (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.09-4.12) and the presence of cranial nerve abnormalities (OR, 3.88; 95% CI, 1.55-9.68) and extremity abnormalities (OR, 2.76; 95% CI, 1.11-6.88) were significantly associated with positive brain MRI results. Conclusion Serum TCO2 level and the presence of cranial nerve and extremity abnormalities in the neurologic examinations were significantly associated with positive brain MRI results in patients with acute AMS.

Objective: The cutaneous manifestation of decompression sickness (DCS) known as cutis marmorata (CM) is generally mild, but it is often accompanied by severe DCS or may be a prognostic sign. We aimed to analyze the clinical course of patients with CM to improve our understanding of CM. Methods: From January 2016 to December 2020, a retrospective cohort single-center study was conducted on patients with acute DCS who underwent emergency recompression therapy. We analyzed their data and the clinical outcomes after recompression therapy. In addition, we reviewed relevant literature. Results: A total of 341 people were enrolled during the study period. Of them 94 (27.6%) patients presented with CM and the symptoms appeared at an average of about 60.5 minutes after surfacing. Among the CM patients, 76.6% had accompanying DCS type II, and in 23.4%, had accompanying DCS type I (P=0.011). With single recompression therapy, 88.3% of patients with CM immediately recovered. Among these 95.4% of patients with DCS type I and 86.1% with DCS type II recovered immediately. However, there were no statistical differences in the immediate treatment outcomes according to the delay time from the onset of symptoms to recompression therapy, accompanying symptomatic DCS classification, and recompression modalities. Ultimately, all the patients recovered from CM. Conclusion CM by itself can be considered a mild DCS in terms of treatment progress, but prompt treatment is required to prevent complications. In addition, greater focus is needed on other accompanying DCS symptoms in patients with CM, and the treatment method should be determined accordingly.

Objective: Decreases in the hemoglobin level compared to the pre-injury lab results are often observed in patients with elderly hip fractures visiting the emergency department (ED). This decrease could be the outcome of the fracture itself or a complication caused by comorbidities. This study examined whether significant hemoglobin decreases, as detected in the ED, are related to other-than-hip-fracture bleeding focus or clinical outcomes. Methods: The electronic medical records were reviewed retrospectively at a single university ED from January 2012 to March 2019. ED diagnoses of hip fractures were screened and enrolled if the patient was 60 years or older and had hemoglobin levels recorded within the previous 6 months. A significant decrease in the hemoglobin level is defined as more than 2 g/dL. Results: Three hundred patients were enrolled in this study. Significant hemoglobin decreases were apparent in 43 patients (14.3%). Only four patients (1.3%) had an other-than-hip-fracture bleeding focus. One of those had a significant hemoglobin decrease. In a “significant decrease” versus “non-significant decrease” intergroup comparison, length of hospital stays (median and interquartile range: 17.0 [15.0-21.5] vs. 17.0 [12.0-21.0], P=0.55), survival discharge (4.7% vs. 2.3%, P=0.72), and other-than-hip-fracture bleeding focus (2.3% vs. 1.2%, P>0.99) did not differ significantly. Conclusion A decrease in hemoglobin level is common among elderly hip fracture patients. On the other hand, the incidence of other-than-hip-fracture bleeding focus was rare and unrelated to a decrease in significant hemoglobin levels. Similarly, neither the hospital length of stay nor survival discharge was unrelated to the hemoglobin level decrease.

Background: Cytoplasmic polyadenylation element binding (CPEB) proteins are sequencespecific RNA-binding proteins that control translation via cytoplasmic polyadenylation. We previously reported that CPEB1 or CPEB4 knockdown suppresses TAK1 and SMAD signaling in an in vitro study. Objective: This study aimed to investigate whether suppression of CPEB1 or CPEB4 expression inhibits scar formation in a mice model of acute dermal wound healing. Methods: CPEB1 and CPEB4 expression levels were suppressed by siRNA treatment. Skin wounds were created by pressure-induced ulcers in mice. Images of the wound healing were obtained using a digital camera and contraction was measured by ImageJ. mRNA and protein expression was analyzed using quantitative real time polymerase chain reaction and western blotting, respectively. Results: Wound contraction was significantly decreased by pre-treatment with CPEB1 or CPEB4 siRNA compared to the control. Suppression of CPEB1 or CPEB4 expression decreased TAK1 signaling by reducing the levels of TLR4 and TNF-α, phosphorylated TAK1, p38, ERK, JNK, and NF-κB-p65. Decreased levels of phosphorylated SMAD2 and SMAD3 indicated a reduction in SMAD signaling as well. Consequently, the expression of α-SMA, fibronectin, and type I collagen decreased. Conclusion CPEB1 siRNA or CPEB4 siRNA inhibit scar formation by modulating the TAK1 and SMAD signaling pathways. Our study highlights CPEB1 and CPEB4 as potential therapeutic targets for the treatment of scar formation.

Purpose: To derive the optimized intraocular lens (IOL) constants from automated and manifest refraction after cataract surgery in Korean patients, and to evaluate whether there is a difference in optimized IOL constants according to the refraction method. Methods: This retrospective multicenter cohort study enrolled 4,103 eyes of 4,103 patients who underwent phacoemulsification and in-the-bag IOL implantation at 18 institutes. Optimized IOL constants for the SRK/T, Holladay, Hoffer Q, and Haigis formulas were calculated via autorefraction or manifest refraction of samples using the same biometry and IOL. The IOL constants derived from autorefraction and manifest refraction were compared. Results: Of the 4,103 eyes, the majority (62.9%) were measured with an IOLMaster 500 followed by an IOLMaster 700 (15.2%). A total of 33 types of IOLs were used, and the Tecnis ZCB00 was the most frequently used (53.0%). There was no statistically significant difference in IOL constants derived from autorefraction and manifest refraction when IOL constants were optimized with a large number of study subjects. On the other hand, optimized IOL constants derived from autorefraction were significantly smaller than those from manifest refraction when the number of subjects was small. Conclusions It became possible to use the IOL constants optimized from Koreans to calculate the IOL power. However, if the IOL constant is optimized using autorefraction in a small sample group, the IOL constant tends to be small, which may lead to refractive error after surgery.

Objective: We investigated the factors that affect the time from the onset of acute stroke symptoms to arrival at the emergency department (ED). Methods: Between July 2019 and February 2020, patients with acute stroke symptoms who visited a public hospital were evaluated by retrospective analysis using a prospective survey. The data for this study was gathered from baseline interviews with patients enrolled in stroke surveys. The primary outcome was time to arrival at the ED, evaluated as a binary variable with a value of 4.5 hours. Results: Overall, 205 patients were included in the final analysis. Among them, 47% (n=96) of patients with acute stroke symptoms arrived at the ED later than 4.5 hours from the time of onset of acute stroke symptoms. After multivariable logistic regression analyses, it was found that patients with higher National Institutes of Health Stroke Scale (NIHSS) scores, patients who did not live with their family members, and patients who were found by a passerby were associated with early ED arrival post onset of acute stroke symptoms. Among patients diagnosed with acute stroke, those with higher NIHSS scores or underlying malignant diseases were found to present earlier at the ED. Conclusion Approximately half of the patients (47%) with acute stroke symptoms presented to the ED within 4.5 hours. Higher NIHSS scores and the presence of underlying malignancy were identified as the key factors that were associated with an early presentation at the ED from the time of onset of acute stroke.

Objective: Hyperbaric oxygen therapy (HBOT) is the most crucial treatment for decompression sickness (DCS), which needs to be administered as swiftly as possible. This study evaluates the therapeutic responses of DCS patients and analyzes the major factors for clinical outcomes. Methods: This is a retrospective cohort single-center study on patients who arrived at our hospital’s emergency department for diving-related symptoms and were diagnosed with DCS and administered HBOT. Results: Totally, 337 patients were enrolled from June 2015 to May 2020. The proportion of SCUBA diving, rapid ascent, and inter-facility transport cases was higher in the recreational group, with a longer lag time from symptom onset to HBOT. The professional group had a higher proportion of cases with previous DCS history, total diving time, bottom time, in-water decompression, and repetitive diving. Examination of treatment outcomes revealed more type I cases and a shorter lag time from symptom onset to HBOT in the complete recovery group. Conversely, the incomplete recovery group had a higher proportion of type II cases and aggravation of symptoms before HBOT was administered. Conclusion DCS can occur regardless of professional or recreational divers. Both groups showed a similar level of severity. It is recommended that recreational divers should be cautious of accidents related to safety (such as rapid ascent) and receive swift treatment in case of the onset of symptoms. Occupational divers need more active efforts to get HBOT rather than just performing in-water recompression or home O2 therapy.