1.Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke
Jun Yup KIM ; Beom Joon KIM ; Jihoon KANG ; Do Yeon KIM ; Moon-Ku HAN ; Seong-Eun KIM ; Heeyoung LEE ; Jong-Moo PARK ; Kyusik KANG ; Soo Joo LEE ; Jae Guk KIM ; Jae-Kwan CHA ; Dae-Hyun KIM ; Tai Hwan PARK ; Kyungbok LEE ; Hong-Kyun PARK ; Yong-Jin CHO ; Keun-Sik HONG ; Kang-Ho CHOI ; Joon-Tae KIM ; Dong-Eog KIM ; Jay Chol CHOI ; Mi-Sun OH ; Kyung-Ho YU ; Byung-Chul LEE ; Kwang-Yeol PARK ; Ji Sung LEE ; Sujung JANG ; Jae Eun CHAE ; Juneyoung LEE ; Min-Surk KYE ; Philip B. GORELICK ; Hee-Joon BAE ;
Journal of Stroke 2025;27(1):102-112
Background:
and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.
Methods:
We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data.
Results:
Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4.
Conclusion
Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.
2.Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke
Jun Yup KIM ; Beom Joon KIM ; Jihoon KANG ; Do Yeon KIM ; Moon-Ku HAN ; Seong-Eun KIM ; Heeyoung LEE ; Jong-Moo PARK ; Kyusik KANG ; Soo Joo LEE ; Jae Guk KIM ; Jae-Kwan CHA ; Dae-Hyun KIM ; Tai Hwan PARK ; Kyungbok LEE ; Hong-Kyun PARK ; Yong-Jin CHO ; Keun-Sik HONG ; Kang-Ho CHOI ; Joon-Tae KIM ; Dong-Eog KIM ; Jay Chol CHOI ; Mi-Sun OH ; Kyung-Ho YU ; Byung-Chul LEE ; Kwang-Yeol PARK ; Ji Sung LEE ; Sujung JANG ; Jae Eun CHAE ; Juneyoung LEE ; Min-Surk KYE ; Philip B. GORELICK ; Hee-Joon BAE ;
Journal of Stroke 2025;27(1):102-112
Background:
and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.
Methods:
We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data.
Results:
Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4.
Conclusion
Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.
3.Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke
Jun Yup KIM ; Beom Joon KIM ; Jihoon KANG ; Do Yeon KIM ; Moon-Ku HAN ; Seong-Eun KIM ; Heeyoung LEE ; Jong-Moo PARK ; Kyusik KANG ; Soo Joo LEE ; Jae Guk KIM ; Jae-Kwan CHA ; Dae-Hyun KIM ; Tai Hwan PARK ; Kyungbok LEE ; Hong-Kyun PARK ; Yong-Jin CHO ; Keun-Sik HONG ; Kang-Ho CHOI ; Joon-Tae KIM ; Dong-Eog KIM ; Jay Chol CHOI ; Mi-Sun OH ; Kyung-Ho YU ; Byung-Chul LEE ; Kwang-Yeol PARK ; Ji Sung LEE ; Sujung JANG ; Jae Eun CHAE ; Juneyoung LEE ; Min-Surk KYE ; Philip B. GORELICK ; Hee-Joon BAE ;
Journal of Stroke 2025;27(1):102-112
Background:
and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.
Methods:
We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data.
Results:
Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4.
Conclusion
Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.
4.Transcultural Adaptation of the Korean Version of the International Hip Outcome Tool 12
Ki-Tae PARK ; Jung-Wee PARK ; Samuel Jaeyoon WON ; Joon Hwan AN ; Jonghwa WON ; Minji HAN ; Young-Kyun LEE
Clinics in Orthopedic Surgery 2024;16(6):890-896
Background:
The International Hip Outcome Tool 12 (iHOT12), which is now widely adopted in clinical settings, has been established as reliable, valid, and responsive, positioning as a critical evaluation tool globally to gauge the efficacy of hip arthroscopy.This study aimed to translate the iHOT12 questionnaire into Korean and assess its feasibility, internal consistency, and validity concerning the psychometric properties of the Korean version of iHOT12 (iHOT12-K).
Methods:
The iHOT12 questionnaire was translated into Korean and adapted culturally, following international guidelines, involving forward translation, back-translation, and reconciliation by bilingual experts to ensure cross-cultural equivalence. A cohort of 67 patients diagnosed with femoroacetabular impingement and scheduled for hip arthroscopy between November 2015 and February 2021 participated in assessing the psychometric properties of the iHOT12-K, alongside standardized questionnaires (Korean iterations of the Short Form-36 [SF-36], Hip Disability and Osteoarthritis Outcome Score [HOOS], Korean version of Hip Outcome Score [HOS-K], and modified Harris Hip Score [mHHS]). Psychometric evaluations focusing on feasibility, internal consistency (Cronbach's alpha), and convergent validity (Spearman’s rank correlation) demonstrated the reliability and relevance of iHOT12-K.
Results:
In the psychometric evaluation of the adapted version, 67 participants (38 men and 29 women; median age, 41 years) were enrolled, with 59 completing the iHOT12-K. The questionnaire showed excellent internal consistency (Cronbach’s alpha, 0.896) without floor or ceiling effects, indicating good feasibility. Strong convergent validity was noted between the iHOT12-K and various hip-specific questionnaires (HOOS, HOS-K, and mHHS), except for the maximal visual analog scale score, demonstrating the reliability and applicability of the iHOT12-K for clinical assessments in Korea.
Conclusions
The iHOT12-K has successfully undergone transcultural adaptation, demonstrating significant feasibility, internal consistency, and validity. It has been validated for use among Korean-speaking patients undergoing hip arthroscopy, proving to be a valuable tool for clinical assessments.
5.Transcultural Adaptation of the Korean Version of the International Hip Outcome Tool 12
Ki-Tae PARK ; Jung-Wee PARK ; Samuel Jaeyoon WON ; Joon Hwan AN ; Jonghwa WON ; Minji HAN ; Young-Kyun LEE
Clinics in Orthopedic Surgery 2024;16(6):890-896
Background:
The International Hip Outcome Tool 12 (iHOT12), which is now widely adopted in clinical settings, has been established as reliable, valid, and responsive, positioning as a critical evaluation tool globally to gauge the efficacy of hip arthroscopy.This study aimed to translate the iHOT12 questionnaire into Korean and assess its feasibility, internal consistency, and validity concerning the psychometric properties of the Korean version of iHOT12 (iHOT12-K).
Methods:
The iHOT12 questionnaire was translated into Korean and adapted culturally, following international guidelines, involving forward translation, back-translation, and reconciliation by bilingual experts to ensure cross-cultural equivalence. A cohort of 67 patients diagnosed with femoroacetabular impingement and scheduled for hip arthroscopy between November 2015 and February 2021 participated in assessing the psychometric properties of the iHOT12-K, alongside standardized questionnaires (Korean iterations of the Short Form-36 [SF-36], Hip Disability and Osteoarthritis Outcome Score [HOOS], Korean version of Hip Outcome Score [HOS-K], and modified Harris Hip Score [mHHS]). Psychometric evaluations focusing on feasibility, internal consistency (Cronbach's alpha), and convergent validity (Spearman’s rank correlation) demonstrated the reliability and relevance of iHOT12-K.
Results:
In the psychometric evaluation of the adapted version, 67 participants (38 men and 29 women; median age, 41 years) were enrolled, with 59 completing the iHOT12-K. The questionnaire showed excellent internal consistency (Cronbach’s alpha, 0.896) without floor or ceiling effects, indicating good feasibility. Strong convergent validity was noted between the iHOT12-K and various hip-specific questionnaires (HOOS, HOS-K, and mHHS), except for the maximal visual analog scale score, demonstrating the reliability and applicability of the iHOT12-K for clinical assessments in Korea.
Conclusions
The iHOT12-K has successfully undergone transcultural adaptation, demonstrating significant feasibility, internal consistency, and validity. It has been validated for use among Korean-speaking patients undergoing hip arthroscopy, proving to be a valuable tool for clinical assessments.
6.Transcultural Adaptation of the Korean Version of the International Hip Outcome Tool 12
Ki-Tae PARK ; Jung-Wee PARK ; Samuel Jaeyoon WON ; Joon Hwan AN ; Jonghwa WON ; Minji HAN ; Young-Kyun LEE
Clinics in Orthopedic Surgery 2024;16(6):890-896
Background:
The International Hip Outcome Tool 12 (iHOT12), which is now widely adopted in clinical settings, has been established as reliable, valid, and responsive, positioning as a critical evaluation tool globally to gauge the efficacy of hip arthroscopy.This study aimed to translate the iHOT12 questionnaire into Korean and assess its feasibility, internal consistency, and validity concerning the psychometric properties of the Korean version of iHOT12 (iHOT12-K).
Methods:
The iHOT12 questionnaire was translated into Korean and adapted culturally, following international guidelines, involving forward translation, back-translation, and reconciliation by bilingual experts to ensure cross-cultural equivalence. A cohort of 67 patients diagnosed with femoroacetabular impingement and scheduled for hip arthroscopy between November 2015 and February 2021 participated in assessing the psychometric properties of the iHOT12-K, alongside standardized questionnaires (Korean iterations of the Short Form-36 [SF-36], Hip Disability and Osteoarthritis Outcome Score [HOOS], Korean version of Hip Outcome Score [HOS-K], and modified Harris Hip Score [mHHS]). Psychometric evaluations focusing on feasibility, internal consistency (Cronbach's alpha), and convergent validity (Spearman’s rank correlation) demonstrated the reliability and relevance of iHOT12-K.
Results:
In the psychometric evaluation of the adapted version, 67 participants (38 men and 29 women; median age, 41 years) were enrolled, with 59 completing the iHOT12-K. The questionnaire showed excellent internal consistency (Cronbach’s alpha, 0.896) without floor or ceiling effects, indicating good feasibility. Strong convergent validity was noted between the iHOT12-K and various hip-specific questionnaires (HOOS, HOS-K, and mHHS), except for the maximal visual analog scale score, demonstrating the reliability and applicability of the iHOT12-K for clinical assessments in Korea.
Conclusions
The iHOT12-K has successfully undergone transcultural adaptation, demonstrating significant feasibility, internal consistency, and validity. It has been validated for use among Korean-speaking patients undergoing hip arthroscopy, proving to be a valuable tool for clinical assessments.
7.Transcultural Adaptation of the Korean Version of the International Hip Outcome Tool 12
Ki-Tae PARK ; Jung-Wee PARK ; Samuel Jaeyoon WON ; Joon Hwan AN ; Jonghwa WON ; Minji HAN ; Young-Kyun LEE
Clinics in Orthopedic Surgery 2024;16(6):890-896
Background:
The International Hip Outcome Tool 12 (iHOT12), which is now widely adopted in clinical settings, has been established as reliable, valid, and responsive, positioning as a critical evaluation tool globally to gauge the efficacy of hip arthroscopy.This study aimed to translate the iHOT12 questionnaire into Korean and assess its feasibility, internal consistency, and validity concerning the psychometric properties of the Korean version of iHOT12 (iHOT12-K).
Methods:
The iHOT12 questionnaire was translated into Korean and adapted culturally, following international guidelines, involving forward translation, back-translation, and reconciliation by bilingual experts to ensure cross-cultural equivalence. A cohort of 67 patients diagnosed with femoroacetabular impingement and scheduled for hip arthroscopy between November 2015 and February 2021 participated in assessing the psychometric properties of the iHOT12-K, alongside standardized questionnaires (Korean iterations of the Short Form-36 [SF-36], Hip Disability and Osteoarthritis Outcome Score [HOOS], Korean version of Hip Outcome Score [HOS-K], and modified Harris Hip Score [mHHS]). Psychometric evaluations focusing on feasibility, internal consistency (Cronbach's alpha), and convergent validity (Spearman’s rank correlation) demonstrated the reliability and relevance of iHOT12-K.
Results:
In the psychometric evaluation of the adapted version, 67 participants (38 men and 29 women; median age, 41 years) were enrolled, with 59 completing the iHOT12-K. The questionnaire showed excellent internal consistency (Cronbach’s alpha, 0.896) without floor or ceiling effects, indicating good feasibility. Strong convergent validity was noted between the iHOT12-K and various hip-specific questionnaires (HOOS, HOS-K, and mHHS), except for the maximal visual analog scale score, demonstrating the reliability and applicability of the iHOT12-K for clinical assessments in Korea.
Conclusions
The iHOT12-K has successfully undergone transcultural adaptation, demonstrating significant feasibility, internal consistency, and validity. It has been validated for use among Korean-speaking patients undergoing hip arthroscopy, proving to be a valuable tool for clinical assessments.
8.Outcomes of Hip Arthroplasty in Patients with Preoperative Thrombocytopenia
Jong Jin GO ; Minji HAN ; Tae Woo KIM ; Byung Kyu PARK ; Jung-Wee PARK ; Young-Kyun LEE
Clinics in Orthopedic Surgery 2024;16(5):711-717
Background:
Thrombocytopenia is a condition where platelet counts are below the normal range (< 150 ×103 /µL), resulting in a higher risk of bleeding and affecting the results of hip arthroplasty. We assessed the impact of preoperative platelet counts on the clinical results of patients who underwent hip arthroplasty.
Methods:
Between April 2003 and March 2023, 437 patients (451 hips), who had preoperative thrombocytopenia of less than 150 ×103 /µL platelets, underwent hip arthroplasty. Preoperative platelet levels were categorized into severe thrombocytopenia (< 50 ×103 /µL) and non-severe thrombocytopenia (50–149 ×103 /µL). Total blood loss, operation time, requirement of transfusion, amount of transfusion, duration of surgical wound oozing, length of hospital stay, mortality rate at 1 year after surgery, and any complication were compared between the 2 groups.
Results:
No notable differences were observed in the surgery time or the total amount of blood loss between the groups. The requirement of transfusion and the amount of transfused blood were higher in the severe thrombocytopenia group. Prolonged oozing was found in around 18% in both groups, while periprosthetic joint infections occurred in 3 of the non-severe thrombocytopenia group. No significant difference was noted in the duration of hospital stay (25.6 ± 18.3 days vs. 19.4 ± 16.6 days, p = 0.067) and 1-year mortality (22.2% vs. 11.8%, p = 0.110).
Conclusions
Hip arthroplasties are safe for patients with low platelet counts and do not lead to prolonged hospital stays. On the other hand, patients with severe thrombocytopenia tend to need blood transfusions more frequently than those with less severe thrombocytopenia.
9.Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry
Do Yeon KIM ; Tai Hwan PARK ; Yong-Jin CHO ; Jong-Moo PARK ; Kyungbok LEE ; Minwoo LEE ; Juneyoung LEE ; Sang Yoon BAE ; Da Young HONG ; Hannah JUNG ; Eunvin KO ; Hyung Seok GUK ; Beom Joon KIM ; Jun Yup KIM ; Jihoon KANG ; Moon-Ku HAN ; Sang-Soon PARK ; Keun-Sik HONG ; Hong-Kyun PARK ; Jeong-Yoon LEE ; Byung-Chul LEE ; Kyung-Ho YU ; Mi Sun OH ; Dong-Eog KIM ; Dong-Seok GWAK ; Soo Joo LEE ; Jae Guk KIM ; Jun LEE ; Doo Hyuk KWON ; Jae-Kwan CHA ; Dae-Hyun KIM ; Joon-Tae KIM ; Kang-Ho CHOI ; Hyunsoo KIM ; Jay Chol CHOI ; Joong-Goo KIM ; Chul-Hoo KANG ; Sung-il SOHN ; Jeong-Ho HONG ; Hyungjong PARK ; Sang-Hwa LEE ; Chulho KIM ; Dong-Ick SHIN ; Kyu Sun YUM ; Kyusik KANG ; Kwang-Yeol PARK ; Hae-Bong JEONG ; Chan-Young PARK ; Keon-Joo LEE ; Jee Hyun KWON ; Wook-Joo KIM ; Ji Sung LEE ; Hee-Joon BAE ;
Journal of Korean Medical Science 2024;39(34):e278-
This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.
10.Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach
Tae-Han KIM ; In-Ho KIM ; Seung Joo KANG ; Miyoung CHOI ; Baek-Hui KIM ; Bang Wool EOM ; Bum Jun KIM ; Byung-Hoon MIN ; Chang In CHOI ; Cheol Min SHIN ; Chung Hyun TAE ; Chung sik GONG ; Dong Jin KIM ; Arthur Eung-Hyuck CHO ; Eun Jeong GONG ; Geum Jong SONG ; Hyeon-Su IM ; Hye Seong AHN ; Hyun LIM ; Hyung-Don KIM ; Jae-Joon KIM ; Jeong Il YU ; Jeong Won LEE ; Ji Yeon PARK ; Jwa Hoon KIM ; Kyoung Doo SONG ; Minkyu JUNG ; Mi Ran JUNG ; Sang-Yong SON ; Shin-Hoo PARK ; Soo Jin KIM ; Sung Hak LEE ; Tae-Yong KIM ; Woo Kyun BAE ; Woong Sub KOOM ; Yeseob JEE ; Yoo Min KIM ; Yoonjin KWAK ; Young Suk PARK ; Hye Sook HAN ; Su Youn NAM ; Seong-Ho KONG ;
Journal of Gastric Cancer 2023;23(1):3-106
Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

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