Background: The potential benefits and risks of probiotic use in kidney transplant (KT) recipients remain unclear. This study aimed to evaluate the effects of probiotic supplementation on KT outcomes. Methods: A retrospective analysis was performed using medical records from 354 KT recipients between January 2010 and December 2020. Only patients who received probiotics within the first year following transplantation were included, and transplant outcomes were assessed at 1–3 years after KT. Results: Among the 354 patients, 97 (27%) received probiotics during the study period, and 36 (10%) used them for more than 3 months. Probiotic types included Lactobacillus species (45.4%), Bacillus subtilis (14.4%), and others (40.2%). The average supplementation duration was 104.8 days. No significant differences in estimated glomerular filtration rate at 1 and 3 years posttransplantation were observed between the probiotic and nonprobiotic groups. Cytomegalovirus (CMV) viremia developed in 61 patients, with a significantly higher incidence observed in the probiotic group (25.8% vs. 14.0%).However, there were no significant differences in BK viremia or coronavirus disease 2019 infection rates between groups. During the study period, 116 patients received antibiotics for more than 1 week, and the prevalence of bacterial infections was not significantly different between the two groups. After propensity score matching, probiotic supplementation remained significantly associated only with the development of CMV viremia. Conclusions This study identified a significant association between probiotic use and the occurrence of CMV viremia in KT recipients. To better define the safety and efficacy of probiotics in immunocompromised patients, large-scale prospective studies are necessary to establish comprehensive evidence.

Pulmonary tumoral thrombotic microangiopathy (PTTM) is a rare but fatal complication in patients with cancer that causes death due to sudden respiratory distress, pulmonary hypertension, and right ventricular dysfunction. Early diagnosis and intensive treatment are important for improving patient prognosis. Herein, we describe the clinical and CT findings of 10 patients who were clinically diagnosed with PTTM at our hospital over the past 18 years. In patients with cancer complaining of dyspnea and hypoxia, CT findings such as right ventricular and pulmonary artery dilatation, perivascular or subpleural ground-glass opacity or consolidation, micronodules with a ground-glass halo, peripheral pulmonary vessel dilatation, and interlobular septal thickening may suggest PTTM.

Pulmonary tumoral thrombotic microangiopathy (PTTM) is a rare but fatal complication in patients with cancer that causes death due to sudden respiratory distress, pulmonary hypertension, and right ventricular dysfunction. Early diagnosis and intensive treatment are important for improving patient prognosis. Herein, we describe the clinical and CT findings of 10 patients who were clinically diagnosed with PTTM at our hospital over the past 18 years. In patients with cancer complaining of dyspnea and hypoxia, CT findings such as right ventricular and pulmonary artery dilatation, perivascular or subpleural ground-glass opacity or consolidation, micronodules with a ground-glass halo, peripheral pulmonary vessel dilatation, and interlobular septal thickening may suggest PTTM.

BACKGROUND/OBJECTIVES: Inflammation and ferroptosis are implicated in various diseases and lipopolysaccharides (LPS) have been linked with these disorders. Recently, many edible insects, such as Gryllus bimaculatus, Protaetia brevitarsis larvae (PB) and Tenebrio molitor larvae, have been recommended as alternative foods because they contain lots of nutritional sources.In this study, we explored the potential of PB extract in preventing LPS-induced inflammation and ferroptosis in Hep3B cells.MATERIALS/METHODS: PB powder was extracted using 70% ethanol and applied to Hep3B cells. Co-treatment with LPS was conducted to induce ferroptosis and inflammation. The antiinflammatory and anti-ferroptosis mechanisms of the PB extract were confirmed using Western blot, enzyme-linked immunosorbent assay, and real-time polymerase chain reaction analysis. RESULTS: PB extract effectively prevented LPS-induced cell death and restored LPS-induced inflammatory cytokine production, NF-κB signaling, endoplasmic reticulum (ER) stress and ferroptosis. Interestingly, PB extract reduced LPS-induced ceramide increase and acid sphingomyelinase (ASMase) expression. The use of the ASMase inhibitor, desipramine, also demonstrated a reduction in these pathways, highlighting the pivotal role of ASMase in inflammation and ferroptosis. Treatment with each inhibitor revealed that ferroptosis causes ER stress and that NF-κB and MAP kinase pathways are involved in inflammation. CONCLUSION PB emerges as a potential functional food with inhibitory effects on LPS-induced inflammation and ferroptosis, making it a promising candidate for nutritional interventions.

The use of chatbot technology, particularly chat generative pre-trained transformer (ChatGPT) with an impressive 175 billion parameters, has garnered significant attention across various domains, including Obstetrics and Gynecology (OBGYN). This comprehensive review delves into the transformative potential of chatbots with a special focus on ChatGPT as a leading artificial intelligence (AI) technology. Moreover, ChatGPT harnesses the power of deep learning algorithms to generate responses that closely mimic human language, opening up myriad applications in medicine, research, and education. In the field of medicine, ChatGPT plays a pivotal role in diagnosis, treatment, and personalized patient education. Notably, the technology has demonstrated remarkable capabilities, surpassing human performance in OBGYN examinations, and delivering highly accurate diagnoses. However, challenges remain, including the need to verify the accuracy of the information and address the ethical considerations and limitations. In the wide scope of chatbot technology, AI systems play a vital role in healthcare processes, including documentation, diagnosis, research, and education. Although promising, the limitations and occasional inaccuracies require validation by healthcare professionals. This review also examined global chatbot adoption in healthcare, emphasizing the need for user awareness to ensure patient safety. Chatbot technology holds great promise in OBGYN and medicine, offering innovative solutions while necessitating responsible integration to ensure patient care and safety.

OBJECTIVES: Adolescent depression and suicidality are serious health problems worldwide. Lower plain water intake has been proposed as a risk factor for depression in adults. This study investigated the association of daily plain water intake with self-reported depression and suicidality among Korean adolescents. METHODS: We used nationwide data from 112,250 students aged 12-18 years who participated in the Korean Youth Risk Behavior Web-based Surveys in 2019 and 2020. Daily plain water intake was categorized as <1 glass, 1-2 glasses, and ≥3 glasses. The adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for self-reported depression and suicidality were calculated using multiple regression analyses. RESULTS: The weighted prevalence rates of self-reported depression, suicidal ideation, suicide planning, and suicide attempts were 26.7%, 12.0%, 3.8%, and 2.5%, respectively. Of the participants, 3.9%, 18.5%, and 77.7% were categorized into the <1 glass/day, 1-2 glass/day, and ≥3 glass/day groups, respectively. Compared to the reference group (≥3 glass/day), the lowest level of water intake (<1 glass/day) was associated with higher odds of self-reported depression (aOR, 1.30; 95% CI, 1.20 to 1.39), suicidal ideation (aOR, 1.39; 95% CI, 1.27 to 1.55), suicide planning (aOR, 1.46; 95% CI, 1.25 to 1.69), and suicide attempts (aOR, 1.38; 95% CI, 1.15 to 1.67). Moderately lower water intake (1-2 glass/day) showed slightly increased odds of self-reported depression (aOR, 1.05; 95% CI, 1.01 to 1.10) and suicidal ideation (aOR, 1.08; 95% CI, 1.03 to 1.14). CONCLUSIONS Lower plain water intake was significantly associated with a higher risk of self-reported depression and suicidality among Korean adolescents. Since this cross-sectional study is unable to establish a causal relationship, it underscores the need for additional longitudinal research.

Purpose: This study examined the impact of adolescents’ dietary behavior on their quality of life using the nutrition quotient for adolescents (NQ-A) for some high school students in Seoul. Methods: The subjects were 176 high school students living in Seoul. The NQ-A was used to assess the dietary quality, and the quality of life was assessed by categorizing it into life satisfaction, environment, health, participation and safety, leisure activities, and emotional factors using survey questions validated through previous studies. Results: The NQ score of the survey subjects was 49.30 points. Based on the NQ scores, 7.4%, 46.6%, and 46.0% of participants were categorized as the ‘high’, ‘medium’, and ‘low’ groups, respectively. The total NQ score and balance, diversity, and practice factor scores were positively correlated with life satisfaction, environment, health, participation and safety, and leisure activities among the quality of life subscales. Regression analysis showed that the total NQ score was positively associated with life satisfaction, health, leisure activities, and emotions; the moderation factor was negatively associated with life satisfaction and health. The balance factor was positively associated with the environmental factor. The practice factor was positively associated with health, leisure activities, and emotions, and the environment factor was negatively associated with emotions. Conclusion These results show that adolescents’ quality of life is closely related to their diet, so it is necessary to maintain a balanced and varied food intake and desirable eating behaviors to improve adolescents’ quality of life. Furthermore, adolescents’ quality of life is influenced by other factors. Therefore, further research is needed to assess the quality of life, including dietary factors, as well as physical, emotional, psychological, and social development.

Pulmonary tumoral thrombotic microangiopathy (PTTM) is a rare but fatal complication in patients with cancer that causes death due to sudden respiratory distress, pulmonary hypertension, and right ventricular dysfunction. Early diagnosis and intensive treatment are important for improving patient prognosis. Herein, we describe the clinical and CT findings of 10 patients who were clinically diagnosed with PTTM at our hospital over the past 18 years. In patients with cancer complaining of dyspnea and hypoxia, CT findings such as right ventricular and pulmonary artery dilatation, perivascular or subpleural ground-glass opacity or consolidation, micronodules with a ground-glass halo, peripheral pulmonary vessel dilatation, and interlobular septal thickening may suggest PTTM.

Objective: To evaluate the relationship between respiratory muscle strength, diaphragm thickness (DT), and indices of sarcopenia. Methods: This study included 45 healthy elderly volunteers (21 male and 24 female) aged 65 years or older. Sarcopenia indices, including hand grip strength (HGS) and body mass index-adjusted appendicular skeletal muscle (ASM/BMI), were measured using a hand grip dynamometer and bioimpedance analysis, respectively. Calf circumference (CC) and gait speed were also measured. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were obtained using a spirometer, as a measure of respiratory muscle strength. DT was evaluated through ultrasonography. The association between indices of sarcopenia, respiratory muscle strength, and DT was evaluated using Spearman’s rank correlation test, and univariate and multiple regression analysis. Results: ASM/BMI (r=0.609, p<0.01), CC (r=0.499, p<0.01), HGS (r=0.759, p<0.01), and gait speed (r=0.319, p<0.05) were significantly correlated with DT. In the univariate linear regression analysis, MIP was significantly associated with age (p=0.003), DT (p<0.001), HGS (p=0.002), CC (p=0.013), and gait speed (p=0.026). MEP was significantly associated with sex (p=0.001), BMI (p=0.033), ASM/BMI (p=0.003), DT (p<0.001), HGS (p<0.001), CC (p=0.001) and gait speed (p=0.004). In the multiple linear regression analysis, age (p=0.001), DT (p<0.001), and ASM/BMI (p=0.008) showed significant association with MIP. DT (p<0.001) and gait speed (p=0.050) were associated with MEP. Conclusion Our findings suggest that respiratory muscle strength is associated with DT and indices of sarcopenia. Further prospective studies with larger sample sizes are needed to confirm these findings.

Purpose: The study aimed to translate the Paternal Postnatal Attachment Scale (PPAS) into Korean and to evaluate the validity and reliability of the Korean version of the PPAS (K-PPAS). Methods: The PPAS was translated, back-translated, and reviewed by 12 experts and 5 fathers following the World Health Organization's guideline. A convenience sample of 396 fathers with infants in their first 12 months participated in this study. For construct validity, an underlying factor structure and model fit was assessed with an exploratory and confirmatory factor analysis. Convergent and discriminant validity and reliability of the K-PPAS were evaluated. Results: The construct validity of the K-PPAS with 11 items was identified by two-factor structures: healthy attachment relationship, and patience and tolerance. The final model fit was shown acceptable with the normed chi-square = 1.94, comparative fit index = .94, Tucker–Lewis index = .92, root mean square error of approximation = .07, and standardized root mean square residual = .06. This model had acceptable convergent and discriminant validity for each construct with the values of the composite reliability and heterotrait–monotrait ratio at a satisfactory level. Discriminant validity with known groups showed that fathers with no postnatal depression had significantly higher scores on the K-PPAS than those with postnatal depression. Cronbach's α and McDonald's omega coefficient of the K-PPAS was .84 and .83. Conclusions The K-PPAS would be beneficial to measure postnatal attachment among fathers with infants aged 12 months or younger in Korea. However, further studies are suggested to evaluate the applicability of the scale considering the various family structures, such as single or foster parents and multicultural families that exist within the Korean population.