1.A Nationwide Survey on Infection Prevention and Control in Acute Care Hospitals of Korea
Sun Hee NA ; Yubin SEO ; Hye Jin SHI ; In Sun HWANG ; Kyong A SHIN ; Kwang Yul SON ; Sung Ran KIM ; Myoungjin SHIN ; Hee-jung SON ; Ji Youn CHOI ; Heekyung CHUN ; Sook-Kyung PARK ; Jeongsuk SONG ; Namyi KIM ; Jacob LEE ; Joong Sik EOM
Journal of Korean Medical Science 2025;40(4):e41-
		                        		
		                        			 Background:
		                        			Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. 
		                        		
		                        			Methods:
		                        			From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. 
		                        		
		                        			Results:
		                        			Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. 
		                        		
		                        			Conclusion
		                        			This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities. 
		                        		
		                        		
		                        		
		                        	
2.A Nationwide Survey on Infection Prevention and Control in Acute Care Hospitals of Korea
Sun Hee NA ; Yubin SEO ; Hye Jin SHI ; In Sun HWANG ; Kyong A SHIN ; Kwang Yul SON ; Sung Ran KIM ; Myoungjin SHIN ; Hee-jung SON ; Ji Youn CHOI ; Heekyung CHUN ; Sook-Kyung PARK ; Jeongsuk SONG ; Namyi KIM ; Jacob LEE ; Joong Sik EOM
Journal of Korean Medical Science 2025;40(4):e41-
		                        		
		                        			 Background:
		                        			Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. 
		                        		
		                        			Methods:
		                        			From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. 
		                        		
		                        			Results:
		                        			Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. 
		                        		
		                        			Conclusion
		                        			This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities. 
		                        		
		                        		
		                        		
		                        	
3.Discordance in Claudin 18.2Expression Between Primary and Metastatic Lesions in Patients With Gastric Cancer
Seung-Myoung SON ; Chang Gok WOO ; Ok-Jun LEE ; Sun Kyung LEE ; Minkwan CHO ; Yong-Pyo LEE ; Hongsik KIM ; Hee Kyung KIM ; Yaewon YANG ; Jihyun KWON ; Ki Hyeong LEE ; Dae Hoon KIM ; Hyo Yung YUN ; Hye Sook HAN
Journal of Gastric Cancer 2025;25(2):303-317
		                        		
		                        			 Purpose:
		                        			Claudin 18.2 (CLDN18.2) has emerged as a promising therapeutic target for CLDN18.2-expressing gastric cancer (GC). We sought to examine the heterogeneity of CLDN18.2 expression between primary GC (PGC) and metastatic GC (MGC) using various scoring methods. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively analyzed data from 102 patients with pathologically confirmed paired primary and metastatic gastric or gastroesophageal junction adenocarcinomas. CLDN18.2 expression was evaluated through immunohistochemistry on formalin-fixed paraffin-embedded tissue samples. We assessed CLDN18.2 positivity using multiple scoring approaches, including the immunoreactivity score, H-score, and the percentage of tumor cells showing moderate-to-strong staining intensity. We analyzed the concordance rates between PGC and MGC and the association of CLDN18.2 positivity with clinicopathological features. 
		                        		
		                        			Results:
		                        			CLDN18.2 positivity varied from 25% to 65% depending on the scoring method, with PGC consistently showing higher expression levels than MGC. Intratumoral heterogeneity was noted in 25.5% of PGCs and 19.6% of MGCs. Intertumoral heterogeneity, manifesting as discordance in CLDN18.2 positivity between PGC and MGC, was observed in about 20% of cases, with moderate agreement across scoring methods (κ=0.47 to 0.60).In PGC, higher CLDN18.2 positivity correlated with synchronous metastasis, presence of peritoneal metastasis, poorly differentiated grade, and biopsy specimens. In MGC, positivity was associated with synchronous metastasis, presence of peritoneal metastasis, and metastatic peritoneal tissues. 
		                        		
		                        			Conclusions
		                        			CLDN18.2 expression demonstrates significant heterogeneity between PGC and MGC, with a 20% discordance rate. Comprehensive tissue sampling and reassessment of CLDN18.2 status are crucial, especially before initiating CLDN18.2-targeted therapies. 
		                        		
		                        		
		                        		
		                        	
4.Discordance in Claudin 18.2Expression Between Primary and Metastatic Lesions in Patients With Gastric Cancer
Seung-Myoung SON ; Chang Gok WOO ; Ok-Jun LEE ; Sun Kyung LEE ; Minkwan CHO ; Yong-Pyo LEE ; Hongsik KIM ; Hee Kyung KIM ; Yaewon YANG ; Jihyun KWON ; Ki Hyeong LEE ; Dae Hoon KIM ; Hyo Yung YUN ; Hye Sook HAN
Journal of Gastric Cancer 2025;25(2):303-317
		                        		
		                        			 Purpose:
		                        			Claudin 18.2 (CLDN18.2) has emerged as a promising therapeutic target for CLDN18.2-expressing gastric cancer (GC). We sought to examine the heterogeneity of CLDN18.2 expression between primary GC (PGC) and metastatic GC (MGC) using various scoring methods. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively analyzed data from 102 patients with pathologically confirmed paired primary and metastatic gastric or gastroesophageal junction adenocarcinomas. CLDN18.2 expression was evaluated through immunohistochemistry on formalin-fixed paraffin-embedded tissue samples. We assessed CLDN18.2 positivity using multiple scoring approaches, including the immunoreactivity score, H-score, and the percentage of tumor cells showing moderate-to-strong staining intensity. We analyzed the concordance rates between PGC and MGC and the association of CLDN18.2 positivity with clinicopathological features. 
		                        		
		                        			Results:
		                        			CLDN18.2 positivity varied from 25% to 65% depending on the scoring method, with PGC consistently showing higher expression levels than MGC. Intratumoral heterogeneity was noted in 25.5% of PGCs and 19.6% of MGCs. Intertumoral heterogeneity, manifesting as discordance in CLDN18.2 positivity between PGC and MGC, was observed in about 20% of cases, with moderate agreement across scoring methods (κ=0.47 to 0.60).In PGC, higher CLDN18.2 positivity correlated with synchronous metastasis, presence of peritoneal metastasis, poorly differentiated grade, and biopsy specimens. In MGC, positivity was associated with synchronous metastasis, presence of peritoneal metastasis, and metastatic peritoneal tissues. 
		                        		
		                        			Conclusions
		                        			CLDN18.2 expression demonstrates significant heterogeneity between PGC and MGC, with a 20% discordance rate. Comprehensive tissue sampling and reassessment of CLDN18.2 status are crucial, especially before initiating CLDN18.2-targeted therapies. 
		                        		
		                        		
		                        		
		                        	
5.A Nationwide Survey on Infection Prevention and Control in Acute Care Hospitals of Korea
Sun Hee NA ; Yubin SEO ; Hye Jin SHI ; In Sun HWANG ; Kyong A SHIN ; Kwang Yul SON ; Sung Ran KIM ; Myoungjin SHIN ; Hee-jung SON ; Ji Youn CHOI ; Heekyung CHUN ; Sook-Kyung PARK ; Jeongsuk SONG ; Namyi KIM ; Jacob LEE ; Joong Sik EOM
Journal of Korean Medical Science 2025;40(4):e41-
		                        		
		                        			 Background:
		                        			Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. 
		                        		
		                        			Methods:
		                        			From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. 
		                        		
		                        			Results:
		                        			Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. 
		                        		
		                        			Conclusion
		                        			This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities. 
		                        		
		                        		
		                        		
		                        	
6.Discordance in Claudin 18.2Expression Between Primary and Metastatic Lesions in Patients With Gastric Cancer
Seung-Myoung SON ; Chang Gok WOO ; Ok-Jun LEE ; Sun Kyung LEE ; Minkwan CHO ; Yong-Pyo LEE ; Hongsik KIM ; Hee Kyung KIM ; Yaewon YANG ; Jihyun KWON ; Ki Hyeong LEE ; Dae Hoon KIM ; Hyo Yung YUN ; Hye Sook HAN
Journal of Gastric Cancer 2025;25(2):303-317
		                        		
		                        			 Purpose:
		                        			Claudin 18.2 (CLDN18.2) has emerged as a promising therapeutic target for CLDN18.2-expressing gastric cancer (GC). We sought to examine the heterogeneity of CLDN18.2 expression between primary GC (PGC) and metastatic GC (MGC) using various scoring methods. 
		                        		
		                        			Materials and Methods:
		                        			We retrospectively analyzed data from 102 patients with pathologically confirmed paired primary and metastatic gastric or gastroesophageal junction adenocarcinomas. CLDN18.2 expression was evaluated through immunohistochemistry on formalin-fixed paraffin-embedded tissue samples. We assessed CLDN18.2 positivity using multiple scoring approaches, including the immunoreactivity score, H-score, and the percentage of tumor cells showing moderate-to-strong staining intensity. We analyzed the concordance rates between PGC and MGC and the association of CLDN18.2 positivity with clinicopathological features. 
		                        		
		                        			Results:
		                        			CLDN18.2 positivity varied from 25% to 65% depending on the scoring method, with PGC consistently showing higher expression levels than MGC. Intratumoral heterogeneity was noted in 25.5% of PGCs and 19.6% of MGCs. Intertumoral heterogeneity, manifesting as discordance in CLDN18.2 positivity between PGC and MGC, was observed in about 20% of cases, with moderate agreement across scoring methods (κ=0.47 to 0.60).In PGC, higher CLDN18.2 positivity correlated with synchronous metastasis, presence of peritoneal metastasis, poorly differentiated grade, and biopsy specimens. In MGC, positivity was associated with synchronous metastasis, presence of peritoneal metastasis, and metastatic peritoneal tissues. 
		                        		
		                        			Conclusions
		                        			CLDN18.2 expression demonstrates significant heterogeneity between PGC and MGC, with a 20% discordance rate. Comprehensive tissue sampling and reassessment of CLDN18.2 status are crucial, especially before initiating CLDN18.2-targeted therapies. 
		                        		
		                        		
		                        		
		                        	
7.A Nationwide Survey on Infection Prevention and Control in Acute Care Hospitals of Korea
Sun Hee NA ; Yubin SEO ; Hye Jin SHI ; In Sun HWANG ; Kyong A SHIN ; Kwang Yul SON ; Sung Ran KIM ; Myoungjin SHIN ; Hee-jung SON ; Ji Youn CHOI ; Heekyung CHUN ; Sook-Kyung PARK ; Jeongsuk SONG ; Namyi KIM ; Jacob LEE ; Joong Sik EOM
Journal of Korean Medical Science 2025;40(4):e41-
		                        		
		                        			 Background:
		                        			Healthcare-associated infections impose a significant burden on antibiotic usage, healthcare expenditures, and morbidity. Therefore, it is crucial to revise policies to minimize such losses. This nationwide survey aimed to evaluate infection prevention and control (IPC) components in healthcare facilities and encourage improvements in acute care hospitals with inadequate infection prevention settings. This study aims to enhance the infection control capabilities of healthcare facilities. 
		                        		
		                        			Methods:
		                        			From December 27, 2021, to May 13, 2022, we conducted a survey of 1,767 acute care hospitals in the Republic of Korea. A survey was conducted to evaluate the infection control components in 1,767 acute care hospitals. Infection control officers provided direct responses to a systematically developed questionnaire. Subsequently, 10% of the respondents were randomly selected for the site investigation. 
		                        		
		                        			Results:
		                        			Overall, 1,197 (67.7%) hospitals responded to the online survey. On-site investigations were conducted at 125 hospitals. Hospitals with ≥ 150 beds are advised to have an IPC team under Article 3 of the Medical Service Act; however, only 87.0% (598/687) of hospitals with ≥ 100 beds had one. Conversely, 22.7% (116/510) of hospitals with < 100 beds had an IPC team. Regulations for hand hygiene, waste management, healthcare worker protection and safety, environmental cleaning, standard precautions, and prevention of the transmission of multidrug-resistant pathogens were present in 84.2%, 80.1%, 77.4%, 76.2%, 75.8%, and 63.5% of the hospitals, respectively. Hospitals with < 100 beds had low availability of all categories of standard operating procedures. 
		                        		
		                        			Conclusion
		                        			This study is the first national survey of acute care hospitals in the Republic of Korea. The data presented in the current study will improve the understanding of IPC status and will help establish a survey system. Our survey provides a basis for improving policies related to IPC in healthcare facilities. 
		                        		
		                        		
		                        		
		                        	
8.Contemporary diagnosis and treatment of valvular heart disease in Korea: a nationwide hospital‑based registry study
Hyung Yoon KIM ; Hee Jeong LEE ; In‑Cheol KIM ; Jung‑Woo SON ; Jun‑Bean PARK ; Sahmin LEE ; Eun Kyoung KIM ; Seong‑Mi PARK ; Woo‑Baek CHUNG ; Jung Sun CHO ; Jin‑Sun PARK ; Jeong‑Sook SEO ; Sun Hwa LEE ; Byung Joo SUN ; Chi Young SHIM ; Hyungseop KIM ; Kye Hun KIM ; Duk‑Hyun KANG ; Jong‑Won HA ;
Journal of Cardiovascular Imaging 2024;32(1):37-
		                        		
		                        			 Background:
		                        			This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea. 
		                        		
		                        			Methods:
		                        			A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocar‑ diographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical out‑ come was in-hospital mortality. 
		                        		
		                        			Results:
		                        			Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall inhospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regur‑ gitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037). 
		                        		
		                        			Conclusions
		                        			This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes. 
		                        		
		                        		
		                        		
		                        	
9.Contemporary diagnosis and treatment of valvular heart disease in Korea: a nationwide hospital‑based registry study
Hyung Yoon KIM ; Hee Jeong LEE ; In‑Cheol KIM ; Jung‑Woo SON ; Jun‑Bean PARK ; Sahmin LEE ; Eun Kyoung KIM ; Seong‑Mi PARK ; Woo‑Baek CHUNG ; Jung Sun CHO ; Jin‑Sun PARK ; Jeong‑Sook SEO ; Sun Hwa LEE ; Byung Joo SUN ; Chi Young SHIM ; Hyungseop KIM ; Kye Hun KIM ; Duk‑Hyun KANG ; Jong‑Won HA ;
Journal of Cardiovascular Imaging 2024;32(1):37-
		                        		
		                        			 Background:
		                        			This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea. 
		                        		
		                        			Methods:
		                        			A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocar‑ diographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical out‑ come was in-hospital mortality. 
		                        		
		                        			Results:
		                        			Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall inhospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regur‑ gitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037). 
		                        		
		                        			Conclusions
		                        			This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes. 
		                        		
		                        		
		                        		
		                        	
10.Contemporary diagnosis and treatment of valvular heart disease in Korea: a nationwide hospital‑based registry study
Hyung Yoon KIM ; Hee Jeong LEE ; In‑Cheol KIM ; Jung‑Woo SON ; Jun‑Bean PARK ; Sahmin LEE ; Eun Kyoung KIM ; Seong‑Mi PARK ; Woo‑Baek CHUNG ; Jung Sun CHO ; Jin‑Sun PARK ; Jeong‑Sook SEO ; Sun Hwa LEE ; Byung Joo SUN ; Chi Young SHIM ; Hyungseop KIM ; Kye Hun KIM ; Duk‑Hyun KANG ; Jong‑Won HA ;
Journal of Cardiovascular Imaging 2024;32(1):37-
		                        		
		                        			 Background:
		                        			This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea. 
		                        		
		                        			Methods:
		                        			A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocar‑ diographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical out‑ come was in-hospital mortality. 
		                        		
		                        			Results:
		                        			Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall inhospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regur‑ gitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037). 
		                        		
		                        			Conclusions
		                        			This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes. 
		                        		
		                        		
		                        		
		                        	
            
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