Construction of surface-rich MoS2 nanoflowers decorated on 2D layered MXene nanohybrid heterostructure for highly efficient and rapid degradation of oxytetracycline.

In this study, we successfully developed a hybrid architecture referred to as MoS2@MX, involving the integration of MoS2 layered onto MXene using a straightforward co-precipitation method. This innovative hybrid photocatalyst exhibited remarkable efficiency in removing oxytetracycline (OTC) molecules from aqueous solutions under visible-light irradiation. During the photocatalytic process, both MoS2 and MX played distinct yet complementary roles. MoS2 facilitated efficient electron transfer, while MX contributed to the generation of radicals. This unique collaboration resulted in a noteworthy 99 % oxidation efficiency for OTC degradation within a brief 60 min of visible light exposure in an aqueous environment. The radicals 1O2 and •OH were identified as the principal drivers behind OTC degradation, underscoring the vital role of the hybrid material. Mechanistically, the degradation of OTC involved several key steps, including C-H bond cleavage, de-carboxylation, C-N bond oxidation, and de-chlorination. Importantly, the MoS2@MX hybrid composite demonstrated remarkable stability, maintaining a noteworthy photocatalytic efficiency of 89 % for targeted OTC removal after undergoing five consecutive cycles. In conclusion, this study emphasizes the potential of the MoS2@MX hybrid material as an effective agent for degrading organic OTC compounds within aquatic environments. The hybrid's multifaceted roles and exceptional performance suggest promising applications in sustainable water treatment.

Tuning of interfacial HGO@CLS nanohybrid S-scheme heterojunction with improved carrier separation and photocatalytic activity towards RhB degradation.

Herein, we premeditated and invented the innovative hybrid photocatalyst 2D/2D CuLa2S4 on holey graphene oxide (HGO) (HGO@CLS) via the hydrothermal method. Electrochemical techniques demonstrate the action of HGO in the HGO@CLS photocatalyst as an effective medium for electron transfer. Combining bimetallic sulfides on porous HGO synergistically provides a higher negative conduction band edge (-0.141 V), greater photo response (10.8 mA/cm2), smaller charge transfer resistance (Rct = 1.79Ω), and lower photoluminescence (PL) spectral intensity. According to our research, the catalytic recitals are sped up when HGO is assimilated into CLS photocatalyst hetero-junction. Additionally, it lowers the reassimilation rate due to the combined mesh nanostructures and functionality of CLS and HGO. UV-Vis DRS, Mott-Schottky, PL, and Electrochemical impedance spectra (EIS) results manifested that the CuLa2S4/HGO makes the spatial separation competent and transference of charge carriers due to the photon irradiation and exhibits superior photocatalytic ability. Electron spin resonance (ESR) analysis confirmed that •OH and h+ were the predominant radical species responsible for Rhodamine B(RhB) degradation. Moreover, conceivable degradation ways of RhB were deduced according to the identified intermediates which are responsible for the degradation of recalcitrant products. To check the stability of the photocatalyst, revival tests were also carried out. Similarly, the oxidative byproducts created in the deprivation courses were looked at, and a thorough explanation for the mechanism of degradation was given.

Detecting Changes in Correlation Networks with Application to Functional Connectivity of fMRI Data.

Research questions in the human sciences often seek to answer if and when a process changes across time. In functional MRI studies, for instance, researchers may seek to assess the onset of a shift in brain state. For daily diary studies, the researcher may seek to identify when a person's psychological process shifts following treatment. The timing and presence of such a change may be meaningful in terms of understanding state changes. Currently, dynamic processes are typically quantified as static networks where edges indicate temporal relations among nodes, which may be variables reflecting emotions, behaviors, or brain activity. Here we describe three methods for detecting changes in such correlation networks from a data-driven perspective. Networks here are quantified using the lag-0 pair-wise correlation (or covariance) estimates as the representation of the dynamic relations among variables. We present three methods for change point detection: dynamic connectivity regression, max-type method, and a PCA-based method. The change point detection methods each include different ways to test if two given correlation network patterns from different segments in time are significantly different. These tests can also be used outside of the change point detection approaches to test any two given blocks of data. We compare the three methods for change point detection as well as the complementary significance testing approaches on simulated and empirical functional connectivity fMRI data examples.

Preclinical Evaluation of an Everolimus-Eluting Bioresorbable Vascular Scaffold Via a Long-Term Rabbit Iliac Artery Model

BACKGROUND@#Biodegradable poly (l-lactic acid) (PLLA), a bio safe polymer with a large elastic modulus, is widely used in biodegradable medical devices. However, because of its poor mechanical properties, a PLLA strut must be made twice as thick as a metal strut for adequate blood vessel support. Therefore, the mechanical properties of a drug-eluting metal-based stents (MBS) and a bioresorbable vascular scaffolds (BVS) were evaluated and their safety and efficacy were examined via a long-term rabbit iliac artery model. @*METHODS@#The surface morphologies of the MBSs and BVSs were investigated via optical and scanning electron microscopy. An everolimus-eluting (EE) BVS or an EE-MBS was implanted into rabbit iliac arteries at a 1.1:1 stent-toartery ratio. Twelve months afterward, stented iliac arteries from each group were analyzed via X-ray angiography, optical coherence tomography (OCT), and histopathologic evaluation. @*RESULTS@#Surface morphology analysis of the EE coating on the MBS confirmed that it was uniform and very thin (4.7 lm). Comparison of the mechanical properties of the EE-MBS and EE-BVS showed that the latter outperformed the former in all aspects (radial force (2.75 vs. 0.162 N/mm), foreshortening (0.24% vs. 1.9%), flexibility (0.52 vs. 0.19 N), and recoil (3.2% vs. 6.3%). At all time points, the percent area restenosis was increased in the EE-BVS group compared to the EE-MBS group. The OCT and histopathological analyses indicate no significant changes in strut thickness. @*CONCLUSION@#BVSs with thinner struts and shorter resorption times should be developed. A comparable long-term safety/efficacy evaluation after complete absorption of BVSs should be conducted.

Full mouth rehabilitation with fixed implant-supported prosthesis using temporary denture and double digital scanning technique: a case report / 대한치과보철학회지

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis.

Introduction to Digital Therapeutics / 대한이비인후과학회지

Digital therapeutics are defined as “deliver evidence-based therapeutic interventions to patients which are driven by high-quality software programs to prevent, manage, or treat medical conditions.” Advances in information and communication technology, artificial intelligence, big data, and digital therapeutics are attracting attention in the healthcare market. Limited access to medical care due to the global epidemic of COVID-19 and the increasing demand for medical care from chronic disease patients owing to the aging of the population have facilitated the expansion of interest in digital health care. As the market size grows, there are currently more than 60 digital therapeutics that have been approved by US Food and Drug Administration, but digital therapeutics are still at an early stage in the market that is not fully established. In this article, we will briefly review the outline of digital therapeutics, the current landscape, future perspectives, and applications of digital therapeutics in the field of otolaryngology.

The Practical Multidisciplinary Management of the Indeterminate Biliary Stricture and/or Dilatation -Radiological Differential Diagnosis: Challenging but Essential- / 대한췌담도학회지

The most important aspect of the imaging role for indeterminate bile duct stricture is to make a differential diagnosis on whether the stricture is highly likely to be malignant or benign. Compared to benign stricture, malignant stricture is longer, thicker, and has indistinct outer border and irregularity of the lumen in contrastenhanced computed tomography and magnetic resonance (MR). Also, in the contrast-enhanced portal phase, malignant stricture has a stronger enhancement than the liver parenchyma. There are studies to differentiate between malignant and benign stricture in diffusion weighted image, a functional MR image, but there remains controversial. Sometimes, malignant biliary stricture may be caused by bile duct invasion of gallbladder cancer, pancreatic cancer, hepatocellular carcinoma, biliary metastasis, and lymphoma. Among the potential causes of indeterminate biliary stricture, the characteristics of multifocal biliary stricture mainly suggest benign sclerosing cholangitis, and various external compression factors that cause biliary stricture can be differentiated by radiologic imaging. There are causes of biliary dilatation without obstructive lesion, radiologic diagnosis can be made by considering various characteristics.

The influence of changes in-hospital infection control protocols and cardiopulmonary resuscitation environment to treatment outcomes on out-of-hospital cardiac arrest due to the COVID-19 pandemic: a single center retrospective observational study

Objective@#Coronavirus disease 2019 (COVID-19) pandemic has been affecting the safety of hospital healthcare workers and the outcome of out-of-hospital cardiac arrest patients. This study aimed to analyze the influence of the changes inhospital infection control protocols (ICP) and cardiopulmonary resuscitation (CPR) environment on the treatment outcomes of out-of-hospital cardiac arrest patients. @*Methods@#The medical records of patients who visited the emergency room were retrospectively reviewed for the period from March 13, 2019 to March 13, 2021. Patient data were analyzed before and after March 13, 2020, when the “in-hospital CPR guidelines related to COVID-19 infection” was recommended by the Korean Society of Emergency Medicine. We performed a comparison and analysis of the first epinephrine administration time and the intubation time with other CPR-related factors in both groups. The in-hospital return of spontaneous circulation (ROSC) and the over 24-hour survival rate were defined as treatment outcomes. @*Results@#A total number of 453 patients were included in the study. After ICP, the in-hospital ROSC was increased (29.8% vs. 42.1%, P=0.006), whereas the over 24-hour survival rate was decreased (67.2% vs. 40.6%, P=0.001). The time intervals from the hospital visit to the first epinephrine administration—1.0 (0-1.0) vs. 1.0 (0-2.0), P=0.007—and tracheal intubation—1.0 (0-1.0) vs. 1.0 (1.0-2.8), P<0.001—were statistically significantly higher than those before ICP application. In our multivariable analysis, the ICP application and pre-hospital emergency medical service (EMS) response time were factors associated with the treatment outcome. @*Conclusion@#After the application of the ICP, both the first epinephrine administration time and the tracheal intubation time from the patient’s hospital visit were prolonged. The application of ICP and the delayed EMS response time were factors associated with the treatment outcome.

Impact of Comorbid Disease Burden on Clinical Outcomes of Female Acute Myocardial Infarction Patients / 전남의대학술지

Owing to the paucity of information on the clinical outcomes in female patients with acute myocardial infarction (AMI) in relation to the comorbid disease burden, we explored the differences in their clinical outcomes and identified predictive indicators.A total of 3,419 female AMI patients were stratified into two groups: Group A (those with zero or one comorbid diseases) (n=1,983) and Group B (those with two to five comorbid diseases) (n=1,436). Five comorbid conditions were considered: hypertension, diabetes mellitus, dyslipidemia, prior coronary artery disease, and prior cerebrovascular accidents. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs). The incidence of MACCEs was higher in Group B than in Group A in both the unadjusted and propensity score-matched data. Among the comorbid conditions, hypertension, diabetes mellitus, and prior coronary artery disease were found to be independently associated with an increased incidence of MACCEs. Higher comorbid disease burden was positively associated with adverse outcomes in the female population with AMI. Since both hypertension and diabetes mellitus are modifiable and independent predictors of adverse outcomes after AMI, it may be necessary to focus on the optimal management of blood pressure and glucose levels to improve cardiovascular outcomes.

Revealing Joseon period People’s single nucleotide polymorphism associated with lactase gene by ancient DNA analysis of human remains from archaeological sites in Korea / 대한해부학회지

Lactase non-persistence (LNP), one of the causes of lactose intolerance, is related to lactase gene associated single nucleotide polymorphisms (SNPs). Since the frequency of LNP varies by ethnic group and country, the research to reveal the presence or absence of LNP for specific people has been conducted worldwide. However, in East Asia, the study of lactase gene associated SNPs have not been sufficiently examined so far using ancient human specimens from archaeological sites. In our study of Joseon period human remains (n=14), we successfully revealed genetic information of lactase gene associated SNPs (rs1679771596, rs41525747, rs4988236, rs4988235, rs41380347, rs869051967, rs145946881 and rs182549), further confirming that as for eight SNPs, the pre-modern Korean people had a lactase non-persistent genotype. Our report contributes to the establishment of LNP associated SNP analysis technique that can be useful in forthcoming studies on human bones and mummy samples from East Asian archaeological sites.

Enhanced Adsorption of Tetracycline by Thermal Modification of Coconut Shell-Based Activated Carbon.

Tetracycline (TC) is one of the most frequently detected antibiotics in various water matrices, posing adverse effects on aquatic ecosystems. In this study, coconut shell-based powdered activated carbon (PAC) was thermally modified under various temperatures to enhance TC adsorption. The PAC subjected to 800 °C (PAC800) showed the best TC adsorption. PAC and PAC800 were characterized using N2 adsorption/desorption isotherm, X-ray photoelectron spectroscopy, Raman spectroscopy, XRD, Boehm titration, and zeta potential analyses. Increases in the specific surface area, C/O ratio, C=O, surface charge, basic groups, and the number of stacked graphene layers along with a decrease in structural defects were observed for PAC800 compared to PAC. The TC adsorption was significantly improved for PAC800 compared to that of PAC, which is attributable to the enhanced electrostatic attraction and π-π EDA interactions induced by the changes in the properties. The Freundlich isotherm was the best fit indicating the heterogeneous nature, and the Freundlich constant of PAC and PAC800 increased from 85.8 to 119.5 and 132.1 to 178.6 (mg/g)‧(L/mg)1/n, respectively, when the temperature was increased from 296.15 to 318.15 K. The kinetics were well described by the pseudo-second-order adsorption model and the rate constant of PAC and PAC800 increased from 0.80 to 1.59 and from 0.72 to 1.29 × 10-3 g/mg‧min, respectively, as the temperature was increased. The activation energy of PAC and PAC800 was 23.7 and 19.6 J/mol, respectively, while the adsorption enthalpy was 196.7 and 98.5 kJ/mol, respectively, indicating endothermic nature. However, it was suggested that TC adsorption onto PAC800 was more favorable and was more contributed to by physisorption than that onto PAC. These results strongly suggest that the properties, adsorption capacity, and adsorption mechanisms of carbonaceous adsorbents can be significantly changed by simple thermal treatment. More, the results provide valuable information about the design of carbonaceous adsorbents with better performance where the structures and functional groups, which positively affect the adsorption, must be improved.

Changes in the catalytic activity of oxygen-doped graphitic carbon nitride for the repeated degradation of oxytetracycline.

Metal-free carbonaceous catalysts have gained growing interest because of their excellence in organic pollutant degradation. However, most of them suffer from deactivation after use, and the origins have not been investigated or understood. In this study, the changes in the characteristics after multiple uses of a carbonaceous catalyst, i.e., oxygen-doped graphitic carbon nitride (O-gCN), were investigated to identify the key factors affecting its reactivity. The O-gCN was repeatedly used to remove an antibiotic (oxytetracycline, OTC) in the presence of peroxymonosulfate (PMS). OTC removal was significantly reduced as the O-gCN was repeatedly used. The reactivity of O-gCN used five times (O-gCN5) corresponded well with the decreased signals of DMPO-X, DMPO-O2•-, and TEMP-1O2 in electron paramagnetic resonance spectra. These signal changes were accompanied by a shift of the involved reactive species from 1O2 and OH• for O-gCN to 1O2 and SO4•- for O-gCN5. The changes in activity and involved reactive species were attributed to the changes in the properties of O-gCN, considering the negligible OTC adsorption and slight PMS consumption. The results of X-ray diffraction, Raman spectroscopy, and X-ray photoelectron spectroscopy showed a decrease in the degree of defects, graphene-like layers, and crystallinity in graphitic structures, but an increase in the fractions of N and O, for O-gCN5. However, the OTC degradation pathways and intermediates were not significantly different for O-gCN and O-gCN5. These results provide valuable information for developing strategies for the design, practical use, and regeneration of carbonaceous catalysts.

A Case of Nasal Desmoid Tumor / 대한이비인후과학회지

Desmoid fibromatosis is a very slowly growing benign fibroblast tumor. Locally aggressive and non-metastasizing, it is a well-differentiated, unencapsulated monoclonal myofibroblastic proliferation that has a tendency for local invasion and recurrence. About 15% of all desmoidtype fibromatosis develops within the head and neck. The majority of head and neck desmoid tumor is located in the neck, but less frequently in the face, scalp, oral cavity, mandible, paranasal sinuses, orbit, ear and other structures. We report a very rare case in a 55-year-old female of a desmoid fibromatosis arising from the lateral nasal wall of anterior portion of uncinated process. We discuss the clinicopathologic features and successful treatment of nasal desmoid tumor with a literature review.

The Effect of Stress on Anxiety and Depressed Mood and the Mediating Effect of Resilience in Medical Residents and Interns During Coronavirus Disease-19 Event / 정신신체의학

Objectives@#: In this study, we evaluate psychological stress, symptoms of anxiety and depressed mood and resilience which medical residents and interns perceived during COVID-19 event, then investigate the associations between stress and the symptoms and mediating effect of resilience on the associations. @*Methods@#: In this study, we made a self-reporting form to evaluate psychological stress with perceived stress scale (PSS), symptoms of anxiety and depressed mood with Hospital anxiety and depression scale (HAD), and resilience with Conner-Davidson Resilience Scale (CD-RISC). Medical residents and interns, who worked in a hospital during COVID-19 event, filled the self-reporting forms from july, 2020 to august, 2020. We conducted a Pearson correlation coefficient and a multiple regression to confirm association between psychological stress and symptoms of anxiety and depressed mood, then mediating effect of resilience. @*Results@#: The higher stress perceived, the more symptoms of anxiety and depressed mood were reported by medical residents and interns. The higher resilience is associated with lower stress and less symptoms of anxiety and depressed mood, which resilience is proven to mediate partially the association between stress and symptoms of depressed mood. @*Conclusions@#: This study shows that resilience has a partial mediating effects on the association between stress and psychological pathology especially depressed mood, given that medical residents and interns were under psychological distress during COVID-19 event. This suggests that resilience is the key for medical trainees to overcome the future crisis like COVID-19 event.

The Effect of Second-Generation Antipsychotics Administration for 1-Year on the Platelet Activities in Patients With Schizophrenia: Retrospective Study / 정신신체의학

Objectives@#：This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. @*Methods@#：The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. @*Results@#：The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. @*Conclusions@#：This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.

Revisiting diaphragmatic hernia of Joseon period Korean mummy by three-dimensional liver and heart segmentation and model reconstruction / 대한해부학회지

A three-dimensional (3D) segmentation and model reconstruction is a specialized tool to reveal spatial interrelationship between multiple internal organs by generating images without overlapping structures. This technique can also be applicable to mummy studies, but related reports have so far been very rare. In this study, we applied 3D segmentation and model reconstruction to computed tomography images of a Korean mummy with congenital diaphragmatic hernia. As originally revealed by the autopsy in 2013, the current 3D reconstruction reveals that the mummy’s heart is shifted to the left due to the liver pushing up to thoracic cavity thorough diaphragmatic hernial defect. We can generate 3D images by calling up the data exclusively from mummy’s target organs, thus minimizing the confusion of diagnosis that could be caused by overlapping organs.

Treatment delay and outcomes of ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention during the COVID-19 era in South Korea

Background/Aims@#Little is known about the clinical characteristics and treatment outcomes of ST-segment elevation myocardial infarction (STEMI) in Korea during the coronavirus disease 2019 (COVID-19) era. We aimed to evaluate the clinical characteristics and treatment outcomes of patients with STEMI in the COVID-19 era. @*Methods@#A total of 588 consecutive patients with STEMI who underwent primary percutaneous coronary intervention were included in this study. The patients were categorized into the COVID-19 (from January 20, 2020 to December 31, 2020) and control groups (from January 20, 2019 to December 31, 2019). @*Results@#The COVID-19 group showed pre-hospital and in-hospital delays than the control group. The control group underwent more thrombus aspiration and had a higher proportion of left main coronary artery diseases, while the COVID-19 group had a higher proportion of multivessel diseases with a marked increase in the number and total length of stents than the control group. As for the prescribed medications, the COVID-19 group was administered more beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and statins than the control group. The clinical outcomes were comparable between the groups, except for higher incidences of atrioventricular block and temporary pacemaker implantation in the COVID-19 group. @*Conclusions@#Reperfusion after STEMI treatment during the COVID-19 period was delayed; therefore, efforts should be made to improve on reperfusion.

Laryngotracheal Separation for Intractable Aspiration in Severe Brain Damage / 대한연하장애학회지

Laryngotracheal separation (LTS) is one of the treatment options for intractable aspiration. Here, we present two cases of LTS with successful prevention of intractable aspiration.The first case was a 60-year-old man with severe hypoxic brain damage caused by hydrogen sulfide (H2S) intoxication; he was admitted to our department for comprehensive rehabilitation. Frequent tracheal suction was required due to the excess secretion from saliva aspiration. Matters were complicated when he suffered frequent regurgitation and vomiting, which was followed by tracheal aspiration. In the second case, a 78-year-old man presented with a severe traumatic brain injury. He had experienced recurrent aspiration pneumonia, which was unresponsive to conventional therapy. In both cases, LTS was performed to prevent intractable aspiration pneumonia. Subsequent to the LTS procedure, videofluoroscopic swallowing study showed complete prevention of the aspiration in both patients. Moreover, tracheal secretion was reduced, and tracheal suction was no longer required. Post-surgery, there was no development of aspiration pneumonia during their hospital stays.

Long-term outcomes in ST-elevation myocardial infarction patients treated according to hospital visit time

Background/Aims@#Rapid percutaneous coronary intervention (PCI) is the cornerstone of treatment for ST-elevation myocardial infarction (STEMI). However, there have been conflicting results regarding the differences in clinical outcomes between on-hours and off-hours presentation in STEMI patients. We aimed to examine the difference in long-term outcomes between off-hours and on-hours PCI in patients with STEMI. @*Methods@#The characteristics and clinical outcomes of 5,364 STEMI patients between November 2011 and June 2015 from the Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) registry were analyzed. Patients were divided into two groups: the off-hours group (weekdays from 6:01 PM to 7:59 AM, weekends, and legal holidays) and the on-hours group (weekdays from 8:00 AM to 6:00 PM). Major adverse cardiac and cerebrovascular events (MACCEs) were defined as a composite of allcause mortality, non-fatal myocardial infarction, any revascularization, cerebrovascular accident, and stent thrombosis. The primary endpoint was the occurrence of MACCEs, and all other clinical outcomes were analyzed. @*Results@#A total of 3,119 patients (58.1%) underwent primary PCI due to STEMI during off-hours and 2,245 patients (41.9%) during on-hours. At 36 months, the clinical outcomes of the off-hours group were similar to those of the on-hours group in both the unadjusted and propensity score weighting-adjusted analyses. @*Conclusions@#Our analysis revealed that the long-term outcomes in STEMI patients admitted to hospitals during off-hours were similar to outcomes of those admitted during on-hours.

Off-hour presentation and outcomes for percutaneous coronary intervention in acute myocardial infarction with Killip III–IV

Background/Aims@#Acute myocardial infarction (AMI) is conventionally recognized as an urgent medical condition requiring timely and effective reperfusion therapy. However, the results of studies on the clinical outcomes in AMI according to hospital visit timings are inconclusive. To explore the difference in long-term outcomes between off- and on-hour percutaneous coronary interventions (PCI) in patients with AMI of Killip functional classification III–IV (Killip III–IV AMI). @*Methods@#Data on the characteristics and clinical outcomes of 1,751 patients with Killip III–IV AMI between November 2011 and June 2015 from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry were analyzed. All participants were allocated into two groups: off-hour (weekdays from 6:00 PM to 8:00 AM, weekends, and legal holidays) and on-hour (weekdays from 8:00 AM to 6:00 PM) groups. The incidence of major adverse cardiac and cerebrovascular events, defined as a composite of all-cause mortality, nonfatal myocardial infarction, any revascularization, cerebrovascular accident, and stent thrombosis, was the primary endpoint. @*Results@#Among the 1,751 patients, 572 (39.1%) underwent PCI during on-hours and 892 (60.9%) during off-hours. At the 3-year follow-up, no significant difference was found in the clinical outcomes between the two groups in both the unadjusted and propensity-score weighing-adjusted analyses. @*Conclusions@#The outcomes of patients with Killip III–IV AMI admitted during off- and on-hours were similar.