Background: Liver transplantation (LT) may be associated with massive blood loss and the need for allogeneic blood transfusion. Intraoperative blood salvage autotransfusion (IBSA) can reduce the need for allogeneic blood transfusion. This study aimed to investigate the effectiveness of blood salvage in LT. Methods: Among 355 adult patients who underwent elective living-donor LT between January 1, 2019, and December 31, 2022, 59 recipients without advanced hepatocellular carcinoma received IBSA using Cell Saver (CS group). Based on sex, age, model for end-stage liver disease (MELD) score, preoperative laboratory results, and other factors, 118 of the 296 recipients who did not undergo IBSA were matched using propensity score (non-CS group). The primary outcome was the amount of intraoperative allogenic red blood cell (RBC) transfusion. Comparisons were made between the two groups regarding the amount of other blood components transfused and postoperative laboratory findings. Results: The transfused allogeneic RBC for the CS group was significantly lower than that of the non-CS group (1,506.0 vs. 1,957.5 ml, P = 0.026). No significant differences in the transfused total fresh frozen plasma, platelets, cryoprecipitate, and estimated blood loss were observed between the two groups. The postoperative allogeneic RBC transfusion was significantly lower in the CS group than in the non-CS group (1,500.0 vs. 2,100.0 ml, P = 0.039). No significant differences in postoperative laboratory findings were observed at postoperative day 1 and discharge. Conclusions Using IBSA during LT can effectively reduce the need for perioperative allogeneic blood transfusions without causing subsequent coagulopathy.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.

Background: s/Aims: The recent increase in medical school admissions has potentially altered the working conditions of hospitalists in South Korea. This study investigated how these changes have affected the work patterns and responsibilities of hospitalists, particularly in light of the ongoing exodus of medical trainees that began on February 22, 2024. Methods: We surveyed members of the Korean Society of Hospital Medicine and the Korean Society of Surgery Hospital Medicine Study Group working as hospitalists from April 2 to 30, 2024. The survey was conducted via email and excluded personally identifiable information. Respondents’ characteristics, work types, hours, patient loads, support staff availability, and changes in job scope post-policy were analyzed. Results: Sixty-three hospitalists responded, with an equitable gender distribution and a median age of 39 years. A significant shift in work patterns was noted, with full-day shifts increasing from 22.2% to 39.7%, and a corresponding decrease in weekday daytime shifts. Work hours also significantly increased from a median of 40 to 45 hours per week. Changes in patient distribution were observed, with fewer hospitalists managing mid-range patient numbers and more handling smaller or larger loads. Despite the increased demands in the latter case, more than 50% of hospitalists reported a lack of support staff and a significant portion did not receive overtime compensation. Conclusions The increase in medical school admissions and subsequent shifts in hospitalist workloads and hours indicate a strained healthcare system. Hospitalists are taking on more intensive and extended roles. The absence of adequate support staff and adjustments in compensation suggest that further systemic changes are necessary to sustain the efforts of hospitalists, thereby ensuring patient safety and care quality.

An African swine fever (ASF) outbreak in wild boars was first reported on October 2, 2019, in South Korea. Since then, additional cases were reported in South Korea's border areas. We here report the identification of ASF virus (ASFV) DNAs from two out of eight environmental abiotic matter samples collected from areas where ASF-positive wild boar carcasses were found. Comparative genomic investigations suggested that the contaminating ASFV DNAs originated from the wild boar whose carcass had been found near the positive sample sites.This is the first report on the identification of ASF viral material in wild boar habitats.

An African swine fever (ASF) outbreak in wild boars was first reported on October 2, 2019, in South Korea. Since then, additional cases were reported in South Korea's border areas. We here report the identification of ASF virus (ASFV) DNAs from two out of eight environmental abiotic matter samples collected from areas where ASF-positive wild boar carcasses were found. Comparative genomic investigations suggested that the contaminating ASFV DNAs originated from the wild boar whose carcass had been found near the positive sample sites.This is the first report on the identification of ASF viral material in wild boar habitats.

The homeostasis of microenvironment in central nervous system, essential for normal function, is maintained by blood-brain barrier (BBB). ZO-1 in tight junctions (TJs) plays an important role in maintaining BBB endothelial ion and solute barriers. Malfunction of BBB by reactive oxygen species has been attributed to disruption of TJs. This study examined H2 O2 effects on paracellular permeability and changes in TJ protein ZO-1 using primary culture of bovine brain microvessel endothelial cells. The BBB permeability,measured as TER, increased in a dose-and time-dependent manner when treated with H2O2 (0.01, 0.1, 1.0 mM). Cytotoxicity test revealed that H2O2 did not cause cell death below 1 mM H2 O2 within 4 hr. H2O2 caused intermittent disruption and loss of ZO-1 at tight junctions, but ZO-1 maintained steady state levels of expression. In conclusion, we report that H2O2 induces increased paracellular permeability of BBB that is accompanied with alterations in localization of ZO-1.
Blood-Brain Barrier ; Brain ; Cell Death ; Central Nervous System ; Endothelial Cells ; Homeostasis ; Microvessels ; Oxidative Stress* ; Permeability ; Reactive Oxygen Species ; Tight Junctions*

Endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD) has been developed as an alternative drainage method in patients with malignant cystic duct obstruction. However, the procedure of track dilation is difficult in case of severe gallbladder wall thickening with tumor involvement or inflammation. The rendezvous technique via external fistulous track is considered in failed attempts to dilate an internal track between the gallbladder and the stomach/duodenum using conventional approach of EUS-GBD. This report presents a 56-year-old man with pancreatic cancer with malignant cystic duct obstruction who underwent percutaneous transhepatic gallbladder drainage. The patient was successfully treated using rendezvous EUS-GBD technique after he failed the conventional EUS-GBD procedure of internal track dilation.
Cystic Duct* ; Drainage* ; Endosonography ; Gallbladder* ; Humans ; Inflammation ; Methods ; Middle Aged ; Pancreatic Neoplasms

PURPOSE: To access the predictive value of the European Randomized Screening of Prostate Cancer Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) in the Korean population. MATERIALS AND METHODS: We retrospectively analyzed the data of 517 men who underwent transrectal ultrasound guided prostate biopsy between January 2008 and November 2010. Simple and multiple logistic regression analysis were performed to compare the result of prostate biopsy. Area under the receiver operating characteristics curves (AUC-ROC) and calibration plots were prepared for further analysis to compare the risk calculators and other clinical variables. RESULTS: Prostate cancer was diagnosed in 125 (24.1%) men. For prostate cancer prediction, the area under curve (AUC) of the ERSPC-RC was 77.4%. This result was significantly greater than the AUCs of the PCPT-RC and the prostate-specific antigen (PSA) (64.5% and 64.1%, respectively, p<0.01), but not significantly different from the AUC of the PSA density (PSAD) (76.1%, p=0.540). When the results of the calibration plots were compared, the ERSPC-RC plot was more constant than that of PSAD. CONCLUSION: The ERSPC-RC was better than PCPT-RC and PSA in predicting prostate cancer risk in the present study. However, the difference in performance between the ERSPC-RC and PSAD was not significant. Therefore, the Western based prostate cancer risk calculators are not useful for urologists in predicting prostate cancer in the Korean population.
Asian Continental Ancestry Group ; Biopsy ; *Diagnosis, Computer-Assisted ; Early Detection of Cancer/*methods ; Humans ; Logistic Models ; Male ; Predictive Value of Tests ; Prostatic Neoplasms/*diagnosis/ethnology/pathology ; Republic of Korea/ethnology ; Retrospective Studies ; Risk Assessment/*methods