This manuscript represents the official position of the Korean Society of Echocardiography on valvular heart diseases.This position paper focuses on the clinical management of valvular heart diseases with reference to the guidelines recently published by the American College of Cardiology/American Heart Association and the European Society of Cardiology. The committee tried to reflect the recently published results on the topic of valvular heart diseases and Korean data by a systematic literature search based on validity and relevance. In part I of this article, we will review and discuss the current position of aortic valve disease in Korea.

This manuscript represents the official position of the Korean Society of Echocardiography on valvular heart diseases.This position paper focuses on the diagnosis and management of valvular heart diseases with referring to the guide‑ lines recently published by the American College of Cardiology/American Heart Association and the European Society of Cardiology. The committee sought to reflect national data on the topic of valvular heart diseases published to date through a systematic literature search based on validity and relevance. In the part II of this article, we intend to pre‑ sent recommendations for diagnosis and treatment of mitral valve disease and tricuspid valve disease.

Background: Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022. Methods: Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022. Results: Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did. Conclusion This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods: We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results: Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.

OBJECTIVES: This study was conducted to investigate the effect of a 6-week low-calorie diet (LCD) program including high protein-low carbohydrate protein bar on weight loss, blood pressure, and blood lipid profile in 40 overweight women according to dietary compliance.METHODS: Subjects were 62 healthy overweight women (BMI ≥ 23.0 or body fat percentage ≥ 28%), aged 20~59 yrs who were provided a high protein-low carbohydrate protein bar (each 35 g, 154 kcal, protein energy %: 28.6%, carbohydrate energy %: 38.7%) as part of dinner for 6 weeks. Forty subjects who completed the whole diet program were categorized into high compliance (HC) group (days of eating protein bar ≥ 5 weeks) or low compliance (LC) group (days < 5 weeks).RESULTS: Energy intake significantly decreased from 1,867.5 kcal at baseline to 1,137.4 kcal at 6 weeks for the HC group and from 1,971.7 kcal to 1,362.2 kcal for the LC group, respectively. On the other hand, a significant increase in protein energy percentage was observed in each group (HC group: 3.5%, LC group: 2.2%). Both groups showed significant decreases in weight (HC group: 1.8 kg, LC group: 1.1 kg), BMI, fat mass, systolic blood pressure, total cholesterol, and LDL-cholesterol. Reduction of body fat percentage and diastolic blood pressure were only observed in the HC group.CONCLUSIONS: The inclusion of a high protein-low carbohydrate protein bar as part of a low-calorie diet for a short period can be effective to achieve weight loss and concomitantly improve blood cholesterol level without serious physiological side effects. More evident results can be achieved by eating a diet with low calorie diet including high protein-low carbohydrate protein bar for more than 5 weeks.
Adipose Tissue ; Blood Pressure ; Caloric Restriction ; Cholesterol ; Compliance ; Diet ; Eating ; Energy Intake ; Female ; Hand ; Humans ; Meals ; Overweight ; Weight Loss

OBJECTIVES: This study was conducted to examine the relationship between white rice and Kimchi intakes and the risk of metabolic syndrome (Mets) in Korean adults. METHODS: Dietary intake and health data of 8289 subjects aged 19 years and over from the 2013–2015 Korea National Health and Nutrition Examination Survey (KNHANES) were used. Daily total intake of white rice and Kimchi was assessed by 24-hour recall data. Multivariate logistic regression analysis was used to estimate the risk of Mets according to the daily intake of white rice and Kimchi. RESULTS: The highest intake of white rice and Kimchi was associated with a higher risk of metabolic syndrome (Q1 vs Q5, multivariable adjusted OR=1.45, 95% CI: 1.03–2.03) in women. In addition, a significantly increased risk of elevated blood pressure (multivariable adjusted P for trend 0.0459) was associated with a higher intake of white rice and Kimchi in women. There was no significant trend in the risk of metabolic syndrome according to the intake of white rice and Kimchi in men. CONCLUSIONS: A higher intake of white rice and Kimchi was only associated with an increased risk of metabolic syndrome in women indicating it is necessary to consume more various food groups beside white rice and Kimchi, especially in women.
Adult ; Blood Pressure ; Female ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Odds Ratio

OBJECTIVES: This study was conducted to examine the relationship between white rice and Kimchi intakes and the risk of metabolic syndrome (Mets) in Korean adults. METHODS: Dietary intake and health data of 8289 subjects aged 19 years and over from the 2013–2015 Korea National Health and Nutrition Examination Survey (KNHANES) were used. Daily total intake of white rice and Kimchi was assessed by 24-hour recall data. Multivariate logistic regression analysis was used to estimate the risk of Mets according to the daily intake of white rice and Kimchi. RESULTS: The highest intake of white rice and Kimchi was associated with a higher risk of metabolic syndrome (Q1 vs Q5, multivariable adjusted OR=1.45, 95% CI: 1.03–2.03) in women. In addition, a significantly increased risk of elevated blood pressure (multivariable adjusted P for trend 0.0459) was associated with a higher intake of white rice and Kimchi in women. There was no significant trend in the risk of metabolic syndrome according to the intake of white rice and Kimchi in men. CONCLUSIONS: A higher intake of white rice and Kimchi was only associated with an increased risk of metabolic syndrome in women indicating it is necessary to consume more various food groups beside white rice and Kimchi, especially in women.
Adult ; Blood Pressure ; Female ; Humans ; Korea ; Logistic Models ; Male ; Nutrition Surveys ; Odds Ratio