Background and Objectives: Clinical characteristics and outcomes in acute heart failure (AHF) vary by phenotype. We assessed phenotype-specific features, treatment patterns, and outcomes in a nationwide Korean cohort. Methods: The Korean Heart Failure III registry prospectively enrolled 7,351 AHF admissions at 47 hospitals. Among 6,777 patients with available left ventricular ejection fraction (EF), phenotypes were defined as heart failure with reduced EF (HFrEF, ≤40%), mildly reduced EF (HFmrEF,41–49%), or preserved EF (HFpEF, ≥50%). The primary endpoint was a 12-month composite of all-cause death or heart transplantation, evaluated from index admission and, among hospital survivors, from discharge. We used inverse probability weighting (multinomial generalized boosted models with stabilized, trimmed weights) and weighted Cox proportional-hazards models to estimate hazard ratios (HRs). Results: Phenotype distribution was 58.9% HFrEF, 13.6% HFmrEF, and 27.5% HFpEF. Crude 12-month composite rates from index admission were 13.4% (HFrEF), 12.7% (HFmrEF), and 16.8% (HFpEF). After weighting, from index admission, HFmrEF (HR, 0.892; 95% confidence interval [CI], 0.731–1.088) and HFpEF (HR, 1.101; 95% CI, 0.939–1.291) did not differ from HFrEF; from discharge, HFpEF had modestly higher risk (HR, 1.207; 95% CI, 1.008–1.445) whereas HFmrEF did not (HR, 1.039; 95% CI, 0.844–1.279). Hyponatremia and chronic kidney disease were consistent adverse markers, while angiotensin-converting enzyme inhibitor/ angiotensin II receptor blocker use at discharge was protective. Conclusions Across the EF spectrum, phenotypes showed distinct profiles and risk. Postdischarge risk was modestly higher in HFpEF, supporting phenotype-tailored care and systematic discharge optimization in Korean patients with AHF.

In patients with differentiated thyroid cancer (DTC), initial recurrence risk stratification based on clinical, histopathological, and perioperative data remains the key determinant for guiding management strategies during the first 1-2 years post-treatment. However, the adoption of ongoing risk stratification (ORS), which dynamically reassesses risk by integrating longitudinal clinical data and treatment response, enables more precise long-term prognostic assessment and facilitates highly individualized management. Building upon recent guidelines, the 2026 KTA guideline has been further refined by incorporating robust evidence from large-scale national cohorts and comprehensive systematic reviews. These updated recommendations outline contemporary concepts of ORS, risk-adapted TSH suppression targets, optimized surveillance modalities for recurrence detection, and disease-specific long-term follow-up strategies. Reflecting the paradigm shift toward de-escalated treatment, this revision integrates evolved perspectives on TSH suppression intensity, the clinical interpretation of thyroglobulin levels, and tailored follow-up intervals. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the large proportion of patients with excellent prognosis after initial therapy, while ensuring that each patient receives appropriately tailored and effective long-term management.

Abrupt vessel closure (AVC) is a complication of percutaneous coronary intervention (PCI) and is defined as the sudden cessation of forward coronary blood flow due to a variety of mechanisms. The incidence of AVC has markedly decreased from approximately 3.0% in the early era to about 0.3% today. Nevertheless, cardiovascular interventionists must remain prepared to manage AVC effectively, given its significant impact on clinical outcomes.AVC can arise from several mechanisms, including dissection, intramural hematoma, intracoronary thrombosis, air embolism, vasospasm, and no-reflow. The clinical impact of AVC varies depending on the extent of myocardium affected, ranging from asymptomatic events or transient ischemic chest pain to cardiogenic shock or cardiac arrest. Both a general approach for stabilizing hemodynamic consequences and an etiology-specific management strategy are essential. Hasty decision-making may worsen the situation, whereas a structured approach—focused on hemodynamic stabilization, logical diagnostic processes, and targeted interventions—can improve outcomes. In this narrative review, we describe the mechanisms underlying each etiology, outline mechanism-specific management strategies, and discuss general approaches to managing patients with AVC through logical diagnostic and treatment processes. We hope this review offers valuable insights into this uncommon but significant complication and enhances readers’ skills in managing AVC more effectively during PCI.

Background/Aims: We examined the association between diabetes duration and hyperuricemia in Korean subjects based on data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This cross-sectional study included 4,575 subjects aged 30 years and older with type 2 diabetes mellitus based on data from the KNHANES from 2016 to 2021. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL. Univariable and multivariable logistic regression models were used calculate adjusted odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The mean age of subjects was 61.0 years, 56.5% were male, and the mean body mass index (BMI) was 25.6 kg/m2. Compared to those with diabetes duration 5 to < 10 years, those with shorter or longer diabetes duration had higher serum uric acid levels and higher prevalence of hyperuricemia. In multivariable logistic regression models, a U-shaped association between diabetes duration and hyperuricemia was observed after adjusting for age, sex, income, smoking status, alcohol consumption, regular exercise, and presence of hypertension, dyslipidemia, or chronic kidney disease. Compared to those with new-onset diabetes mellitus, the adjusted OR (95% CI) for hyperuricemia was 0.55 (0.38–0.82) in those with diabetes duration 5 to < 10 years. The results were consistent in subgroup analysis according to age, sex, BMI, and chronic kidney disease. Conclusions The U-shaped association between diabetes duration and hyperuricemia was observed in a representative sample of Korean adults.

Background: Despite evidence suggesting a bidirectional relationship between psychological factors and skin disease, psychological distress and personality traits remain underexplored in dermatological care. Objective: This study aimed to compare psychopathological symptoms and personality traits between female outpatients with dermatological conditions and healthy controls. Methods: In total, 159 outpatients with dermatological conditions and 160 healthy controls (all female) completed the Symptom Check List-90-Revised (SCL-90-R), and a shortened version of the NEO-Personality Inventory-Revised. Between-group comparisons were conducted using t-tests, and stepwise regression analysis was used to identify the psychopathological predictors of neuroticism. Results: Compared with controls, the dermatology outpatient group demonstrated significantly higher SCL-90-R scores for all nine clinical scales and neuroticism, scoring lower in extraversion, openness, and agreeableness. Within the dermatology outpatient group, neuroticism was positively associated with all psychopathological dimensions (r=0.265–0.583; p<0.01). Depression, somatization, and obsessive-compulsive symptoms were significant predictors of neuroticism (F=33.969; p<0.001). Conclusion Female outpatients with dermatological conditions may experience considerable psychological distress and elevated neuroticism, even in the absence of clinical psychiatric diagnoses. Screening for psychological symptoms—including neuroticism, depression, somatization, and obsessive-compulsive features—should be considered in dermatological settings to better address patients’ emotional well-being and optimize care outcomes.

Objectives: This study investigated medication perceptions, adherence patterns, self-discontinuation experiences, and information sources among psychiatric outpatients to provide evidence for improving adherence strategies. Methods: A cross-sectional survey was conducted with 79 outpatients from a University Hospital, Department of Psychiatry. Self-administered questionnaires assessed diagnostic awareness, medication perceptions, adherence behaviors, discontinuation experiences, side effects, and information sources. Results: Overall, 89.7% knew their psychiatric diagnosis and 88.2% perceived medication as effective. While 73.1% rarely forgot medication, 35.9% had previously self-discontinued treatment. Medication adherence was significantly associated with previous discontinuation experience (p=0.006), whereas diagnostic awareness and efficacy perception were not. Primary discontinuation reasons were symptom improvement (53.6%) and physical discomfort (35.7%). Common side effects included weight gain (n=31), daytime drowsiness (n=26), memory impairment (n=24), and concentration problems (n=22). Patients primarily obtained side effect information from TV/internet (27.8%) rather than healthcare providers (20.3%). Most patients desired additional information about side effects (57.0%) and medication effects (54.4%). Conclusion Daily medication-taking behaviors were more predictive of treatment discontinuation than cognitive factors in this outpatient sample. Discontinuation due to symptom improvement and reliance on non-medical information sources highlights the need for enhanced patient education regarding relapse risks and systematic provision of accurate medication information.

Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection that rarely involves the periorbital region. We report an unusual case of periorbital NF caused by methicillin-sensitive Staphylococcus aureus (MSSA) in a previously healthy 48-year-old woman, originating from a neglected, recurrent hordeolum—an otherwise benign eyelid condition. The infection resulted in an extensive fullthickness defect of the upper eyelid and adjacent temporal area, presenting major reconstructive challenges. Reconstruction was performed using a radial forearm free flap combined with a buccal mucosal graft to restore both anterior and posterior lamellae, achieving functional eyelid protection and improved visual acuity. This case highlights the potential for seemingly minor, recurrent eyelid infections to progress rapidly to devastating NF even in the absence of systemic symptoms or risk factors. Early recognition and multidisciplinary management were critical to preventing further morbidity. To our knowledge, MSSA has not previously been reported as a causative agent of periorbital NF, underscoring the need for clinical vigilance and timely intervention in common eyelid conditions to avoid catastrophic complications.

Purpose: Guidelines from the aromatase inhibitor era for early breast cancer (EBC) treatment recommend maintaining a body mass index (BMI) below 25. In the current era of cyclin-dependent kinase (CDK) 4/6 inhibitors, now standard in metastatic breast cancer (MBC), limited data exist on treatment outcomes in obese patients. This study investigates how adiposity affects the treatment outcome of CDK 4/6 inhibitors in patients with hormone receptor–positive, human epidermal growth factor receptor 2–negative MBC. Materials and Methods: We searched PubMed, MEDLINE, and Embase databases, assessing efficacy outcomes such as progression-free survival (PFS) based on obesity markers, including BMI and visceral adipose tissue (VAT) index. Results: Twelve studies were reviewed, with seven studies and 1,812 patients included in a pooled meta-analysis. Among patients with BMI ≥ 25, modest improvement in PFS was observed, with a pooled hazard ratio (HR) of 0.944 (95% confidence interval [CI], 0.909 to 0.980; p=0.003). Besides, add-on analysis using VAT to define obesity revealed a notable PFS improvement, with a pooled HR of 0.452 (95% CI, 0.256 to 0.798; p=0.006). Conclusion While BMI-defined obesity showed slight PFS improvement with CDK 4/6 inhibitors and endocrine therapy, using VAT to define obesity revealed significant PFS gains. This highlights the need for further research on biomarker to clarify the role of adiposity in MBC, which may differ from its impact in EBC.

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.