Objective: Our goal was to review outcomes of patients with heterotopic pregnancies who under went surgical treatment. Methods: From January 1, 2005 to December 31, 2021, 27 women with heterotopic pregnancies who had undergone surgical treatment were enrolled. We investigated pregnancy outcomes based on clinical records and follow-up telephone interviews. Three of the 27 patients were excluded because we were unable to contact them. Results: Of the 24 patients included in the study, 17 underwent salpingectomies for tubal pregnan cies, 5 underwent wedge resections for cornual pregnancies, and 1 underwent a unilateral salpingooophorectomy for ovarian pregnancy. One patient with a suspected heterotopic cervical pregnancy had undergone extraction with forceps and curettage under abdominal ultrasound guidance. Three patients had spontaneous abortions after treatment for heterotopic pregnancies (2 tubal pregnancies, one cervical pregnancy). Twenty-one of 24 patients had heterotopic pregnancies that occurred after assisted reproductive technology. Three cases were heterotopic pregnancies that occurred without reproductive interventions. Among 24 patients who underwent surgical treatment, 18 patients (75.0%) had full-term deliveries. Conclusion There were no hospitalizations due to preterm labor, and 21 deliveries (87.5%) were either late preterm or full-term. There were no fetal abnormalities or maternal complications. Although the development of assisted reproductive technologies has increased the incidence of heterotopic pregnancy, the outcomes of heterotopic pregnancies are generally good.

Objective: Our goal was to review outcomes of patients with heterotopic pregnancies who under went surgical treatment. Methods: From January 1, 2005 to December 31, 2021, 27 women with heterotopic pregnancies who had undergone surgical treatment were enrolled. We investigated pregnancy outcomes based on clinical records and follow-up telephone interviews. Three of the 27 patients were excluded because we were unable to contact them. Results: Of the 24 patients included in the study, 17 underwent salpingectomies for tubal pregnan cies, 5 underwent wedge resections for cornual pregnancies, and 1 underwent a unilateral salpingooophorectomy for ovarian pregnancy. One patient with a suspected heterotopic cervical pregnancy had undergone extraction with forceps and curettage under abdominal ultrasound guidance. Three patients had spontaneous abortions after treatment for heterotopic pregnancies (2 tubal pregnancies, one cervical pregnancy). Twenty-one of 24 patients had heterotopic pregnancies that occurred after assisted reproductive technology. Three cases were heterotopic pregnancies that occurred without reproductive interventions. Among 24 patients who underwent surgical treatment, 18 patients (75.0%) had full-term deliveries. Conclusion There were no hospitalizations due to preterm labor, and 21 deliveries (87.5%) were either late preterm or full-term. There were no fetal abnormalities or maternal complications. Although the development of assisted reproductive technologies has increased the incidence of heterotopic pregnancy, the outcomes of heterotopic pregnancies are generally good.

Objective: Our goal was to review outcomes of patients with heterotopic pregnancies who under went surgical treatment. Methods: From January 1, 2005 to December 31, 2021, 27 women with heterotopic pregnancies who had undergone surgical treatment were enrolled. We investigated pregnancy outcomes based on clinical records and follow-up telephone interviews. Three of the 27 patients were excluded because we were unable to contact them. Results: Of the 24 patients included in the study, 17 underwent salpingectomies for tubal pregnan cies, 5 underwent wedge resections for cornual pregnancies, and 1 underwent a unilateral salpingooophorectomy for ovarian pregnancy. One patient with a suspected heterotopic cervical pregnancy had undergone extraction with forceps and curettage under abdominal ultrasound guidance. Three patients had spontaneous abortions after treatment for heterotopic pregnancies (2 tubal pregnancies, one cervical pregnancy). Twenty-one of 24 patients had heterotopic pregnancies that occurred after assisted reproductive technology. Three cases were heterotopic pregnancies that occurred without reproductive interventions. Among 24 patients who underwent surgical treatment, 18 patients (75.0%) had full-term deliveries. Conclusion There were no hospitalizations due to preterm labor, and 21 deliveries (87.5%) were either late preterm or full-term. There were no fetal abnormalities or maternal complications. Although the development of assisted reproductive technologies has increased the incidence of heterotopic pregnancy, the outcomes of heterotopic pregnancies are generally good.

Objective: Our goal was to review outcomes of patients with heterotopic pregnancies who under went surgical treatment. Methods: From January 1, 2005 to December 31, 2021, 27 women with heterotopic pregnancies who had undergone surgical treatment were enrolled. We investigated pregnancy outcomes based on clinical records and follow-up telephone interviews. Three of the 27 patients were excluded because we were unable to contact them. Results: Of the 24 patients included in the study, 17 underwent salpingectomies for tubal pregnan cies, 5 underwent wedge resections for cornual pregnancies, and 1 underwent a unilateral salpingooophorectomy for ovarian pregnancy. One patient with a suspected heterotopic cervical pregnancy had undergone extraction with forceps and curettage under abdominal ultrasound guidance. Three patients had spontaneous abortions after treatment for heterotopic pregnancies (2 tubal pregnancies, one cervical pregnancy). Twenty-one of 24 patients had heterotopic pregnancies that occurred after assisted reproductive technology. Three cases were heterotopic pregnancies that occurred without reproductive interventions. Among 24 patients who underwent surgical treatment, 18 patients (75.0%) had full-term deliveries. Conclusion There were no hospitalizations due to preterm labor, and 21 deliveries (87.5%) were either late preterm or full-term. There were no fetal abnormalities or maternal complications. Although the development of assisted reproductive technologies has increased the incidence of heterotopic pregnancy, the outcomes of heterotopic pregnancies are generally good.

Objective: Our goal was to review outcomes of patients with heterotopic pregnancies who under went surgical treatment. Methods: From January 1, 2005 to December 31, 2021, 27 women with heterotopic pregnancies who had undergone surgical treatment were enrolled. We investigated pregnancy outcomes based on clinical records and follow-up telephone interviews. Three of the 27 patients were excluded because we were unable to contact them. Results: Of the 24 patients included in the study, 17 underwent salpingectomies for tubal pregnan cies, 5 underwent wedge resections for cornual pregnancies, and 1 underwent a unilateral salpingooophorectomy for ovarian pregnancy. One patient with a suspected heterotopic cervical pregnancy had undergone extraction with forceps and curettage under abdominal ultrasound guidance. Three patients had spontaneous abortions after treatment for heterotopic pregnancies (2 tubal pregnancies, one cervical pregnancy). Twenty-one of 24 patients had heterotopic pregnancies that occurred after assisted reproductive technology. Three cases were heterotopic pregnancies that occurred without reproductive interventions. Among 24 patients who underwent surgical treatment, 18 patients (75.0%) had full-term deliveries. Conclusion There were no hospitalizations due to preterm labor, and 21 deliveries (87.5%) were either late preterm or full-term. There were no fetal abnormalities or maternal complications. Although the development of assisted reproductive technologies has increased the incidence of heterotopic pregnancy, the outcomes of heterotopic pregnancies are generally good.

Background: This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice. Methods: This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit. Results: Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula. Conclusion A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

Background: The benefits of transradial access (TRA) over transfemoral access (TFA) for bifurcation percutaneous coronary intervention (PCI) are uncertain because of the limited availability of device selection. This study aimed to compare the procedural differences and the in-hospital and long-term outcomes of TRA and TFA for bifurcation PCI using secondgeneration drug-eluting stents (DESs). Methods: Based on data from the Coronary Bifurcation Stenting Registry III, a retrospective registry of 2,648 patients undergoing bifurcation PCI with second-generation DES from 21 centers in South Korea, patients were categorized into the TRA group (n = 1,507) or the TFA group (n = 1,141). After propensity score matching (PSM), procedural differences, in-hospital outcomes, and device-oriented composite outcomes (DOCOs; a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization) were compared between the two groups (772 matched patients each group). Results: Despite well-balanced baseline clinical and lesion characteristics after PSM, the use of the two-stent strategy (14.2% vs. 23.7%, P = 0.001) and the incidence of in-hospital adverse outcomes, primarily driven by access site complications (2.2% vs. 4.4%, P = 0.015), were significantly lower in the TRA group than in the TFA group. At the 5-year follow-up, the incidence of DOCOs was similar between the groups (6.3% vs. 7.1%, P = 0.639). Conclusion The findings suggested that TRA may be safer than TFA for bifurcation PCI using second-generation DESs. Despite differences in treatment strategy, TRA was associated with similar long-term clinical outcomes as those of TFA. Therefore, TRA might be the preferred access for bifurcation PCI using second-generation DES.

Background/Aims: The ursodeoxycholic acid (UDCA) response score (URS) was developed to identify poor responders to UDCA before treatment, in order to offer timely and proactive intervention. However, validation of the URS in Asian population is warranted. Methods: A total of 173 Asian patients diagnosed with primary biliary cholangitis (PBC) between 2007 and 2016 at seven academic institutions in Korea who started UDCA treatment were analyzed to validate the performance of URS. UDCA response was defined as an alkaline phosphatase level less than 1.67 times the upper limit of normal after 1-year of UDCA treatment. In addition, prognostic performance of URS for liver-related events, defined as newly developed hepatic decompensation or hepatocellular carcinoma was evaluated. Results: After 1 year of UDCA treatment, 133 patients (76.9%) achieved UDCA response. UDCAresponse rate was 98.7% for those with URS ≥1.41 (n=76) and 58.8% for those with URS <1.41(n=97). The area under the receiver operating characteristic curve of URS in predicting UDCAresponse was 0.84 (95% confidence interval, 0.78 to 0.88). During a median follow-up of 6.5years, liver-related events developed in 18 patients (10.4%). Among 117 patients with PBC stage I-III by histological evaluation, the 5-year liver-related event-free survival rate differed accordingto the URS; 100% for URS ≥1.41 and 86.5% for URS <1.41 (p=0.005). Conclusions URS demonstrated good performance in predicting a UDCA treatment response in Asian PBC patients. In addition, the risk of liver-related events differed according to the URS for the PBC stage. Thus, URS can be used to predict the response and clinical outcome in patients with PBC.

Background/Aims: While switching strategies of P2Y12 receptor inhibitors (RIs) have sometimes been used in acute myocardial infarction (AMI) patients, the current status of in-hospital P2Y12RI switching remains unknown. Methods: Overall, 8,476 AMI patients who underwent successful revascularization from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) were divided according to in-hospital P2Y12RI strategies, and net adverse cardiovascular events (NACEs), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), stroke, or thrombolysis in myocardial infarction (TIMI) major bleeding during hospitalization were compared. Results: Patients with in-hospital P2Y12RI switching accounted for 16.5%, of which 867 patients were switched from clopidogrel to potent P2Y12RI (C-P) and 532 patients from potent P2Y12RI to clopidogrel (P-C). There were no differences in NACEs among the unchanged clopidogrel, the unchanged potent P2Y12RIs, and the P2Y12RI switching groups. However, compared to the unchanged clopidogrel group, the C-P group had a higher incidence of non-fatal MI, and the P-C group had a higher incidence of TIMI major bleeding. In clinical events of in-hospital P2Y12RI switching, 90.9% of non-fatal MI occurred during pre-switching clopidogrel administration, 60.7% of TIMI major bleeding was related to pre-switching P2Y12RIs, and 71.4% of TIMI major bleeding was related to potent P2Y12RIs. Only 21.6% of the P2Y12RI switching group switched to P2Y12RIs after a loading dose (LD); however, there were no differences in clinical events between patients with and without LD. Conclusions In-hospital P2Y12RI switching occurred occasionally, but had relatively similar clinical outcomes compared to unchanged P2Y12RIs in Korean AMI patients. Non-fatal MI and bleeding appeared to be mainly related to pre-switching P2Y12RIs.

Echinostoma mekongi was reported as a new species in 2020 based on specimens collected from humans in Kratie and Takeo Province, Cambodia. In the present study, its metacercarial stage has been discovered in Filopaludina martensi cambodjensis snails purchased from a local market nearby the Tonle Sap Lake, Pursat Province, Cambodia. The metacercariae were fed orally to an experimental hamster, and adult flukes were recovered at day 20 post-infection. They were morphologically examined using light and scanning electron microscopes and molecularly analyzed by sequencing of their mitochondrial cox1 and nad1 genes. A total of 115 metacercariae (1-8 per snail) were detected in 60 (60.0%) out of 100 Filopaludina snails examined. The metacercariae were round, 174 µm in average diameter (163-190 µm in range), having a thin cyst wall, a head collar armed with 37 collar spines, and characteristic excretory granules. The adult flukes were elongated, ventrally curved, 7.3 (6.4-8.2)×1.4 (1.1-1.7) mm in size, and equipped with 37 collar spines on the head collar (dorsal spines in 2 alternating rows), being consistent with E. mekongi. In phylogenetic analyses, the adult flukes showed 99.0-100% homology based on cox1 sequences and 98.9-99.7% homology based on nad1 sequences with E. mekongi. The results evidenced that F. martensi cambodjensis snails act as the second intermediate host of E. mekongi, and hamsters can be used as a suitable experimental definitive host. As local people favor to eat undercooked snails, these snails seem to be an important source of human infection with E. mekongi in Cambodia.