1.Comparison of Short- and Long-Term Dual-Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: One-Year Outcomes
Jun-Hyok OH ; Jinmi KIM ; Jeong-Su KIM ; Hye Won LEE ; Sun Hack LEE ; Jeong Cheon CHOE ; Min Sun KIM ; Jinhee AHN ; Jung Hyun CHOI ; Han Cheol LEE ; Kwang Soo CHA
Journal of Korean Medical Science 2024;39(47):e294-
Background:
The optimal duration and net clinical benefit of dual antiplatelet therapy (DAPT) after transcatheter aortic valve replacement (TAVR) have not been elucidated in realworld situations.
Methods:
Using nationwide claims data from 2013 to 2021, we selected patients who underwent TAVR and categorized them into two groups: short- and long-term (≤ 3 and > 3 months, respectively) DAPT group. Propensity score matching was used to balance baseline characteristics. The primary endpoint was the occurrence of net adverse clinical events (NACEs), including all-cause death, myocardial infarction, stroke, any coronary and peripheral revascularization, systemic thromboembolism, and bleeding events, at 1 year. Survival analyses were conducted using Kaplan-Meier estimation and Cox proportional hazards regression.
Results:
Patients who met the inclusion criteria (1,695) were selected. Propensity score matching yielded 1,215 pairs of patients: 416 and 799 in the short- and long-term DAPT groups, respectively. In the unmatched cohort, the mean ages were 79.8 ± 6.1 and 79.7 ± 5.8 years for the short- and long-term DAPT groups, respectively. In the matched cohort, the mean ages were 80.6 ± 5.9 and 79.9 ± 5.9 years for the short- and long-term DAPT groups, respectively. Over one year in the unmatched cohort, the NACE incidence was 11.9% and 11.5% in the short- and long-term DAPT groups, respectively (P = 0.893). The all-cause mortality rates were 7.4% and 4.7% (P = 0.042), composite ischemic event rates were 2.5% and 4.7% (P = 0.056), and bleeding event rates were 2.7% and 4.7% (P = 0.056) in the shortand long-term groups, respectively. In the matched cohort, the incidence of NACE was 9.6% in the short-term DAPT group and 11.6% in the long-term DAPT group, respectively (P = 0.329).The all-cause mortality rates were 6.5% and 4.9% (P = 0.298), composite ischemic event rates were 1.4% and 4.5% (P = 0.009), and bleeding event rates were 2.2% and 4.4% (P = 0.072) in the short- and long-term groups, respectively.
Conclusion
In patients who successfully underwent transfemoral TAVR, the short- and longterm DAPT groups exhibited similar one-year NACE rates. However, patients in the long-term DAPT group experienced more bleeding and ischemic events.
2.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
3.Comparison of Short- and Long-Term Dual-Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: One-Year Outcomes
Jun-Hyok OH ; Jinmi KIM ; Jeong-Su KIM ; Hye Won LEE ; Sun Hack LEE ; Jeong Cheon CHOE ; Min Sun KIM ; Jinhee AHN ; Jung Hyun CHOI ; Han Cheol LEE ; Kwang Soo CHA
Journal of Korean Medical Science 2024;39(47):e294-
Background:
The optimal duration and net clinical benefit of dual antiplatelet therapy (DAPT) after transcatheter aortic valve replacement (TAVR) have not been elucidated in realworld situations.
Methods:
Using nationwide claims data from 2013 to 2021, we selected patients who underwent TAVR and categorized them into two groups: short- and long-term (≤ 3 and > 3 months, respectively) DAPT group. Propensity score matching was used to balance baseline characteristics. The primary endpoint was the occurrence of net adverse clinical events (NACEs), including all-cause death, myocardial infarction, stroke, any coronary and peripheral revascularization, systemic thromboembolism, and bleeding events, at 1 year. Survival analyses were conducted using Kaplan-Meier estimation and Cox proportional hazards regression.
Results:
Patients who met the inclusion criteria (1,695) were selected. Propensity score matching yielded 1,215 pairs of patients: 416 and 799 in the short- and long-term DAPT groups, respectively. In the unmatched cohort, the mean ages were 79.8 ± 6.1 and 79.7 ± 5.8 years for the short- and long-term DAPT groups, respectively. In the matched cohort, the mean ages were 80.6 ± 5.9 and 79.9 ± 5.9 years for the short- and long-term DAPT groups, respectively. Over one year in the unmatched cohort, the NACE incidence was 11.9% and 11.5% in the short- and long-term DAPT groups, respectively (P = 0.893). The all-cause mortality rates were 7.4% and 4.7% (P = 0.042), composite ischemic event rates were 2.5% and 4.7% (P = 0.056), and bleeding event rates were 2.7% and 4.7% (P = 0.056) in the shortand long-term groups, respectively. In the matched cohort, the incidence of NACE was 9.6% in the short-term DAPT group and 11.6% in the long-term DAPT group, respectively (P = 0.329).The all-cause mortality rates were 6.5% and 4.9% (P = 0.298), composite ischemic event rates were 1.4% and 4.5% (P = 0.009), and bleeding event rates were 2.2% and 4.4% (P = 0.072) in the short- and long-term groups, respectively.
Conclusion
In patients who successfully underwent transfemoral TAVR, the short- and longterm DAPT groups exhibited similar one-year NACE rates. However, patients in the long-term DAPT group experienced more bleeding and ischemic events.
4.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
5.Comparison of Short- and Long-Term Dual-Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: One-Year Outcomes
Jun-Hyok OH ; Jinmi KIM ; Jeong-Su KIM ; Hye Won LEE ; Sun Hack LEE ; Jeong Cheon CHOE ; Min Sun KIM ; Jinhee AHN ; Jung Hyun CHOI ; Han Cheol LEE ; Kwang Soo CHA
Journal of Korean Medical Science 2024;39(47):e294-
Background:
The optimal duration and net clinical benefit of dual antiplatelet therapy (DAPT) after transcatheter aortic valve replacement (TAVR) have not been elucidated in realworld situations.
Methods:
Using nationwide claims data from 2013 to 2021, we selected patients who underwent TAVR and categorized them into two groups: short- and long-term (≤ 3 and > 3 months, respectively) DAPT group. Propensity score matching was used to balance baseline characteristics. The primary endpoint was the occurrence of net adverse clinical events (NACEs), including all-cause death, myocardial infarction, stroke, any coronary and peripheral revascularization, systemic thromboembolism, and bleeding events, at 1 year. Survival analyses were conducted using Kaplan-Meier estimation and Cox proportional hazards regression.
Results:
Patients who met the inclusion criteria (1,695) were selected. Propensity score matching yielded 1,215 pairs of patients: 416 and 799 in the short- and long-term DAPT groups, respectively. In the unmatched cohort, the mean ages were 79.8 ± 6.1 and 79.7 ± 5.8 years for the short- and long-term DAPT groups, respectively. In the matched cohort, the mean ages were 80.6 ± 5.9 and 79.9 ± 5.9 years for the short- and long-term DAPT groups, respectively. Over one year in the unmatched cohort, the NACE incidence was 11.9% and 11.5% in the short- and long-term DAPT groups, respectively (P = 0.893). The all-cause mortality rates were 7.4% and 4.7% (P = 0.042), composite ischemic event rates were 2.5% and 4.7% (P = 0.056), and bleeding event rates were 2.7% and 4.7% (P = 0.056) in the shortand long-term groups, respectively. In the matched cohort, the incidence of NACE was 9.6% in the short-term DAPT group and 11.6% in the long-term DAPT group, respectively (P = 0.329).The all-cause mortality rates were 6.5% and 4.9% (P = 0.298), composite ischemic event rates were 1.4% and 4.5% (P = 0.009), and bleeding event rates were 2.2% and 4.4% (P = 0.072) in the short- and long-term groups, respectively.
Conclusion
In patients who successfully underwent transfemoral TAVR, the short- and longterm DAPT groups exhibited similar one-year NACE rates. However, patients in the long-term DAPT group experienced more bleeding and ischemic events.
6.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
7.Comparison of Short- and Long-Term Dual-Antiplatelet Therapy After Transcatheter Aortic Valve Replacement: One-Year Outcomes
Jun-Hyok OH ; Jinmi KIM ; Jeong-Su KIM ; Hye Won LEE ; Sun Hack LEE ; Jeong Cheon CHOE ; Min Sun KIM ; Jinhee AHN ; Jung Hyun CHOI ; Han Cheol LEE ; Kwang Soo CHA
Journal of Korean Medical Science 2024;39(47):e294-
Background:
The optimal duration and net clinical benefit of dual antiplatelet therapy (DAPT) after transcatheter aortic valve replacement (TAVR) have not been elucidated in realworld situations.
Methods:
Using nationwide claims data from 2013 to 2021, we selected patients who underwent TAVR and categorized them into two groups: short- and long-term (≤ 3 and > 3 months, respectively) DAPT group. Propensity score matching was used to balance baseline characteristics. The primary endpoint was the occurrence of net adverse clinical events (NACEs), including all-cause death, myocardial infarction, stroke, any coronary and peripheral revascularization, systemic thromboembolism, and bleeding events, at 1 year. Survival analyses were conducted using Kaplan-Meier estimation and Cox proportional hazards regression.
Results:
Patients who met the inclusion criteria (1,695) were selected. Propensity score matching yielded 1,215 pairs of patients: 416 and 799 in the short- and long-term DAPT groups, respectively. In the unmatched cohort, the mean ages were 79.8 ± 6.1 and 79.7 ± 5.8 years for the short- and long-term DAPT groups, respectively. In the matched cohort, the mean ages were 80.6 ± 5.9 and 79.9 ± 5.9 years for the short- and long-term DAPT groups, respectively. Over one year in the unmatched cohort, the NACE incidence was 11.9% and 11.5% in the short- and long-term DAPT groups, respectively (P = 0.893). The all-cause mortality rates were 7.4% and 4.7% (P = 0.042), composite ischemic event rates were 2.5% and 4.7% (P = 0.056), and bleeding event rates were 2.7% and 4.7% (P = 0.056) in the shortand long-term groups, respectively. In the matched cohort, the incidence of NACE was 9.6% in the short-term DAPT group and 11.6% in the long-term DAPT group, respectively (P = 0.329).The all-cause mortality rates were 6.5% and 4.9% (P = 0.298), composite ischemic event rates were 1.4% and 4.5% (P = 0.009), and bleeding event rates were 2.2% and 4.4% (P = 0.072) in the short- and long-term groups, respectively.
Conclusion
In patients who successfully underwent transfemoral TAVR, the short- and longterm DAPT groups exhibited similar one-year NACE rates. However, patients in the long-term DAPT group experienced more bleeding and ischemic events.
8.Effects of Cessation of Single-Room Isolation on Transmission of Vancomycin-Resistant Enterococcus in a Hospital
Si-Ho KIM ; Yu Jin LEE ; Ji Hong PARK ; Seran CHEON ; Jeong Seon RYU ; Jung Min SHIN ; Nam Sun HONG ; Yi-Rang JEONG ; Cheon Hoo JEON ; Yu Mi WI
Journal of Korean Medical Science 2024;40(5):e11-
Background:
Single room isolation with contact precautions is widely regarded as a fundamental strategy to prevent the transmission of multidrug-resistant organisms (MDROs). However, its implementation demands substantial resources, limiting its universal application to all MDROs. In this study, we assessed the effect of discontinuing single room isolation for vancomycin-resistant Enterococcus (VRE).
Methods:
This is a retrospective, observational study conducted at a single 750-bed tertiary center. We conducted an interrupted time series analysis to compare incidence rates and trends of new-onset VRE colonization and bacteremia during the one year before and after the strategy change on January 1, 2023.
Results:
Single-room occupancy decreased from 79.7% pre-intervention to 23.6% postintervention (P < 0.001). The incidence rate of new-onset VRE colonization was 0.452 and 0.535 per 1,000 patient-days in the pre- and post-intervention periods, respectively, with no statistically significant difference (P = 0.202). However, there was a slightly increasing trend (0.036 [95% confidence interval, −0.002, 0.074] increase per month, P = 0.066). The new-onset VRE bacteremia incidence rate was not differed in incidence (0.060 and 0.055, P= 0.571) or trend (P = 0.720).
Conclusion
Our study suggests that discontinuing single-room isolation for VRE patients may not affect the incidence of new-onset VRE bacteremia, but caution is needed due to the potential increase in colonization.
9.Clinical Practice Recommendations for the Use of Next-Generation Sequencing in Patients with Solid Cancer: A Joint Report from KSMO and KSP
Miso KIM ; Hyo Sup SHIM ; Sheehyun KIM ; In Hee LEE ; Jihun KIM ; Shinkyo YOON ; Hyung-Don KIM ; Inkeun PARK ; Jae Ho JEONG ; Changhoon YOO ; Jaekyung CHEON ; In-Ho KIM ; Jieun LEE ; Sook Hee HONG ; Sehhoon PARK ; Hyun Ae JUNG ; Jin Won KIM ; Han Jo KIM ; Yongjun CHA ; Sun Min LIM ; Han Sang KIM ; Choong-kun LEE ; Jee Hung KIM ; Sang Hoon CHUN ; Jina YUN ; So Yeon PARK ; Hye Seung LEE ; Yong Mee CHO ; Soo Jeong NAM ; Kiyong NA ; Sun Och YOON ; Ahwon LEE ; Kee-Taek JANG ; Hongseok YUN ; Sungyoung LEE ; Jee Hyun KIM ; Wan-Seop KIM
Cancer Research and Treatment 2024;56(3):721-742
In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.
10.Comparative Analysis of Bone Mineral Density of the Lumbar Spine, Hip, and Proximal Humerus in Patients with Unilateral Rotator Cuff Tears
Woo-Yong LEE ; Yoo-Sun JEON ; Kyung‑Cheon KIM ; Hyun-Dae SHIN ; Yong-Bum JOO ; Hyung-Jin CHUNG
Clinics in Orthopedic Surgery 2024;16(5):751-760
Background:
The proximal humerus, a common site for osteoporotic fractures, is frequently overlooked in osteoporosis evaluations. This study aimed to evaluate the relationship between the conventional bone mineral density (BMD) measurement (at the lumbar spine and femur) and the BMD measurement at both proximal humeri (the asymptomatic side and the side with a rotator cuff tear [RCT]) in patients with unilateral RCT. Furthermore, we investigated clinical features indicative of osteoporosis in RCT patients and assessed the utility of proximal humerus BMD measurements.
Methods:
From April 2020 to September 2020, 87 patients who underwent arthroscopic repairs for unilateral RCTs were examined for age, onset, body mass index, menopause duration, passive range of motion, global fatty degeneration index, and RCT and retraction size. The regions of interest (ROIs) for the conventional BMD included the lumbar spine, femur neck, femur trochanter, and total femur. For the proximal humerus BMD, the ROIs included the head, lesser tuberosity, greater tuberosity (medial, middle, and lateral rows), and total humerus.
Results:
The conventional BMD of the lumbar spine, femur neck, femur trochanter, and femur total were 1.090, 0.856, 0.781, and 0.945 g/cm2 , respectively. The head, lesser tuberosity, greater tuberosity (medial, middle, and lateral rows), and total BMD of the asymptomatic-side proximal humerus were 0.547, 0.544, 0.697, 0.642, 0.554, and 0.610 g/cm2 , respectively. The average of proximal humerus BMD was significantly lower than that of conventional BMD (p < 0.001). All ROIs BMD of the RCT-side proximal humerus were 0.497, 0.507, 0.619, 0.598, 0.517, and 0.560 g/cm2 . There was no correlation between the conventional BMD and each proximal humerus BMD. All ROI BMD of the RCT-side proximal humerus was not significant in the multiple regression analysis with age, onset, body mass index, passive range of motion, global fatty degeneration index, and RCT and retraction size (p > 0.05).
Conclusions
The proximal humerus BMD showed a completely different trend from that of conventional BMD and had no significant association with clinical features. Therefore, the proximal humerus BMD needs to be measured separately from the conventional BMD, as it may provide important information before rotator cuff repair surgery.

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