Purpose: Central venous catheter (CVC) insertion is a fundamental skill required for trainees to become proficient. Simulation-based training (SBT) has been shown to improve trainees’ CVC insertion performance effectively. However, implementing a CVC curriculum requires substantial costs and resources. Currently, there is a lack of validated CVC curricula that institutions can adopt as frameworks. This study aimed to evaluate the effectiveness of our institution’s CVC simulation curriculum in improving residents’ confidence and comfort with CVC insertion and management. Materials and Methods: First-year residents (n=118) participated in SBT between 2017 and 2023. Among them, 57 (48%) participants completed surveys before training and 6 months post-training to assess changes in comfort levels across various aspects of CVC insertion. Survey responses were analyzed to evaluate the overall changes in comfort by year and items. Results: Overall comfort increased from 42.1% before training to 81.3% after training (P<0.01), with notable improvements in nonprocedural aspects. Comfort with performing the unsupervised procedure increased by 16.7% (P<0.05) but remained low post-training (29.6%). Conclusion These findings suggest that the curriculum effectively enhances residents’ comfort, particularly in nonprocedural aspects, but only partially prepares them for unsupervised CVC insertions. This indicates a gap in procedural skill acquisition despite the overall positive trends. Implementing a similar CVC curriculum may help institutions reduce CVC insertion-associated complications.

BACKGROUND/OBJECTIVES: This study aimed to use plasma metabolites to identify clusters of breast cancer survivors and to compare their dietary characteristics and health-related factors across the clusters using unsupervised machine learning. SUBJECTS/METHODS: A total of 419 breast cancer survivors were included in this crosssectional study. We considered 30 plasma metabolites, quantified by high-throughput nuclear magnetic resonance metabolomics. Clusters were obtained based on metabolites using 4 different unsupervised clustering methods: k-means (KM), partitioning around medoids (PAM), self-organizing maps (SOM), and hierarchical agglomerative clustering (HAC). The t-test, χ2 test, and Fisher’s exact test were used to compare sociodemographic, lifestyle, clinical, and dietary characteristics across the clusters. P-values were adjusted through a false discovery rate (FDR). RESULTS: Two clusters were identified using the 4 methods. Participants in cluster 2 had lower concentrations of apolipoprotein A1 and large high-density lipoprotein (HDL) particles and smaller HDL particle sizes, but higher concentrations of chylomicrons and extremely large very-low-density-lipoprotein (VLDL) particles and glycoprotein acetyls, a higher ratio of monounsaturated fatty acids to total fatty acids, and larger VLDL particle sizes compared with cluster 1. Body mass index was significantly higher in cluster 2 compared with cluster 1 (FDR adjusted-PKM < 0.001; PPAM = 0.001; PSOM < 0.001; and PHAC = 0.043). CONCLUSION The breast cancer survivors clustered on the basis of plasma metabolites had distinct characteristics. Further prospective studies are needed to investigate the associations between metabolites, obesity, dietary factors, and breast cancer prognosis.

Pulmonary hypertension is more common in preterm infants compared to term infants, and the incidence increases as gestational age decreases. In preterm infants, pulmonary hypertension is a risk factor that increases mortality. Inhaled nitric oxide (iNO) is an approved treatment for pulmonary hypertension in preterm infants in Korea. Since January 2021, iNO has been used for hypoxic respira tory failure associated with early acute persistent pulmonary hypertension of the newborn (PPHN) in preterm infants. Although studies suggest that iNO improves oxygenation and reduces mortality in preterm infants with pulmonary hypertension, there are concerns about its effectiveness and potential adverse effects. In addition, there are several challenges in administering iNO therapy to pre­term infants in Korea that need to be addressed. The current therapeutic indications in Korea allow iNO therapy to be administered only if treatment is started within 14 days of life, so it cannot be used for late pulmonary hypertension. Additionally, iNO therapy requires meeting the criteria for hypoxic respiratory failure, which includes calculating the oxygenation index (OI) using PaO 2 values obtained from arterial blood gas analysis (ABGA). To evaluate treatment response, PaO 2 values from ABGA are also necessary. However, invasive arterial blood sampling is a particularly challenging procedure in preterm infants. Therefore, alternative criteria beyond OI are needed. Furthermore, echocardiographic findings are essential to determine the therapeutic indication for PPHN in iNO therapy. However, not all neonatal intensive care units have consistent access to echocardiography. These issues must be addressed and resolved through further research and evidence.

Background/Aims: Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia. This research aimed to evaluate the clinical features and outcomes of PVT in patients with IBD at a leading hospital in South Korea. Methods: This retrospective analysis reviewed adult patients diagnosed with both IBD and PVT from 1989 to 2021 at a renowned South Korean medical center. The study focused on patient characteristics, specifics of PVT, administered treatments, and outcomes, all confirmed through enhanced CT scans. Results: A total of 78 patients met the study’s criteria. Notably, only 20.5% (16/78) were treated with oral anticoagulants; however, a vast majority (96.2%; 75/78) achieved complete radiographic resolution (CRR). When comparing patients receiving anticoagulants to those who did not, a significant preference for anticoagulant use was observed in cases where the main portal vein was affected, as opposed to just the left or right veins (p = 0.006). However, multivariable analysis indicated that neither anticoagulant use nor previous surgeries significantly impacted CRR. Conclusions Patients with IBD and PVT generally had favorable outcomes, regardless of anticoagulant use.

Purpose: Central venous catheter (CVC) insertion is a fundamental skill required for trainees to become proficient. Simulation-based training (SBT) has been shown to improve trainees’ CVC insertion performance effectively. However, implementing a CVC curriculum requires substantial costs and resources. Currently, there is a lack of validated CVC curricula that institutions can adopt as frameworks. This study aimed to evaluate the effectiveness of our institution’s CVC simulation curriculum in improving residents’ confidence and comfort with CVC insertion and management. Materials and Methods: First-year residents (n=118) participated in SBT between 2017 and 2023. Among them, 57 (48%) participants completed surveys before training and 6 months post-training to assess changes in comfort levels across various aspects of CVC insertion. Survey responses were analyzed to evaluate the overall changes in comfort by year and items. Results: Overall comfort increased from 42.1% before training to 81.3% after training (P<0.01), with notable improvements in nonprocedural aspects. Comfort with performing the unsupervised procedure increased by 16.7% (P<0.05) but remained low post-training (29.6%). Conclusion These findings suggest that the curriculum effectively enhances residents’ comfort, particularly in nonprocedural aspects, but only partially prepares them for unsupervised CVC insertions. This indicates a gap in procedural skill acquisition despite the overall positive trends. Implementing a similar CVC curriculum may help institutions reduce CVC insertion-associated complications.

This study aimed to provide basic data for promoting healthy food choices by evaluating the energy and nutrient content of ready-to-cook or ready-to-heat home meal replacement snacks. Eight hundred and ninety-four flour-based home meal replacement (HMR) products were analyzed, including 367 noodle dishes, 230 tteokbokki products, and 297 dumpling items. The serving sizes were determined by the product labeling. If not indicated, the total weight was used as the serving size if it could be considered a single serving. A serving size of 150 g was applied to dumplings sold in large packages. The average serving size was 249.9 g for noodles and 210.0 g for tteokbokki. The energy content varied significantly: noodles, tteokbokki, and dumplings had 439.8 kcal, 433.0 kcal, and 292.7 kcal, respectively (P＜0.001). The carbohydrate content were higher in noodles (87.9 g) and tteokbokki (87.6 g) compared to dumplings (32.0 g) (P＜0.001), while the sugar content was highest in tteokbokki (13.5 g) (P＜0.001). The protein content was highest in noodles (11.7 g), followed by dumplings (10.9 g) and tteokbokki (9.9 g) (P＜0.001). The sodium content was highest in noodles (1,777.9 mg), followed by tteokbokki (1,152.3 mg) and dumplings (583.7 mg) (P＜0.001). The price per serving was highest for noodles (3,303.9 KRW) (P＜0.001). The nutrient content varied within the same product type depending on the flavor, temperature (hot vs. cold), and whether a broth was included.These findings highlight the considerable differences in nutritional profiles among HMR snack foods and underscore the importance of selecting products based on their intended dietary use.

Obesity is a chronic disease associated with substantial health consequences, including cardiovascular disease, type 2 diabetes, and certain cancers. Although lifestyle modifications remain foundational to treatment, pharmacotherapy has become a crucial strategy, particularly for patients unable to achieve sustained weight loss. This review aims to provide an updated overview of long-term anti-obesity medications, discussing their mechanisms of action, efficacy, safety profiles, clinical applicability, and future perspectives on emerging therapeutic agents.Current Concepts: Recent pharmacological advancements have substantially transformed obesity management. Glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide (2.4 mg) and the dual glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonist tirzepatide (15 mg) have demonstrated significant weight loss effects (15–21%) and have shown benefits across various obesity-related comorbidities, including type 2 diabetes, cardiovascular disease, and heart failure with preserved ejection fraction. Additionally, investigational agents such as CagriSema, retatrutide, and oral GLP-1 receptor agonists hold promise for enhanced efficacy and improved patient convenience. These developments underscore a shift toward personalized, mechanism-based pharmacotherapy.Discussion and Conclusion: Despite encouraging outcomes, significant challenges remain. Issues such as weight regain after discontinuation, limited long-term safety data, and access barriers due to high treatment costs continue to present obstacles. In Korea, the absence of insurance reimbursement for most anti-obesity medications severely restricts patient access, even among high-risk populations. Given the recognition of obesity as a chronic, relapsing disease, treatment strategies should incorporate the individual patient's comorbidity profile and personal needs. Alongside pharmacologic advancements, healthcare policies must evolve to ensure equitable medication access and optimize clinical outcomes.

Purpose: This study compares the clinical features of children who underwent Hotz’s operation for epiblepharon before and after the COVID-19 pandemic focusing on body mass index (BMI). Methods: We retrospectively reviewed the randomized charts of 976 children diagnosed with epiblepharon who underwent Hotz’s operation in our hospital from March 2016 to December 2022. Patients were divided into two groups: those who underwent surgery from March 2016 to December 2019 (before the pandemic, group 1) and those who had it from August 2020 to December 2022 (after the pandemic, group 2). Patients were further categorized into age groups (0-2, 3-5, 6-8, 9-11, and 12-14 years) for comparison of clinical features. Results: Groups 1 and 2 included 714 and 262 patients, respectively. In group 2, BMI was significantly higher in the 6-8 and 9-11 groups and skin fold height was also higher. Conclusions In regard to clinical features, BMI was greater after the COVID-19 pandemic in children aged 6–11 years, and skin fold height was higher across all age groups. These changes are likely due to lifestyle modifications associated with the pandemic.

Purpose: To investigate the impact of nasal septal deviation and septoplasty on dacryocystorhinostomy progression. Methods: From March 2015 to January 2022, we reviewed the medical records of primary acquired nasolacrimal duct obstruction (PANDO) patients who underwent dacryocystorhinostomy at Konyang University Hospital. Patients were categorized into groups: those without septal deviation (group 1), those with septal deviation on the same side as the surgical site (group 2), and those with septal deviation on the opposite side (group 3). Septoplasty was performed in cases of symptomatic septal deviation on the same side. We assessed whether the presence, type, and correction of septal deviation influenced the postoperative outcome of dacryocystorhinostomy. Results: The study included 204 patients: 94 in group 1, 60 in group 2, and 50 in group 3. No significant differences were observed in the type, degree of nasal septum deviation, surgery duration, success rate, and symptom improvement period across the groups. When group 2 was subdivided into those who did not undergo septoplasty (group 2A) and those who did (group 2B), no differences were noted. Conclusions Nasal septum deviation and septoplasty did not influence the outcomes of dacryocystorhinostomy. Septoplasty may be unnecessary for PANDO patients without symptomatic nasal septum deviation.