Arterial pH reflects both metabolic and respiratory distress in cardiac arrest and has prognostic implications. However, it was excluded from the 2024 update of the Utstein out-of-hospital cardiac arrest (OHCA) registry template. We investigated the rationale for including arterial pH into models predicting clinical outcomes. Methods: Data were sourced from the Korean Cardiac Arrest Research Consortium, a nationwide OHCA registry (NCT03222999). Prediction models were constructed using logistic regression, random forest, and eXtreme Gradient Boosting frameworks. Each framework included three model types: pH, low-flow time, and combined models. Then the area under the receiver operating characteristic curve (AUROC) of each predicting model was compared. The primary outcome was 30- day death or neurologically unfavorable status (cerebral performance category ≥3). Results: Among the 15,765 patients analyzed, 92.2% experienced death or unfavorable neurological outcomes. The predicting performance of the models including pH (AUROC, 0.92–0.94) were comparable to the models including low-flow time in all frameworks (0.93–0.94) (all P>0.05). Inclusion of pH into low-flow time models consistently showed higher AUROCs than individual models in all frameworks (AUROC, 0.93–0.95; all P<0.05). Conclusions: The predicting performance of models including arterial pH was comparable to models including low-flow time, and addition of arterial pH into low-flow time models could increase the performance of the models. Key Words: blood pH; hydrogen-ion con

Background: This study investigates the relationship between changes in physical activity levels and risk of metabolic syndrome. Methods: This study examined 1,686 adults aged 40 to 69 years from a community-based cohort study with complete 1st to 4th follow-up data between 2011 and 2020. Changes in physical activity were evaluated through baseline and follow-up surveys using physical activity questionnaires. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. A survival analysis was conducted using a multivariate extended Cox regression model with a significance level set at P<0.05. Results: Participants were divided into groups according to physical activity levels. The newly inactive group (vigorous physical activity ≤150 minutes at first follow-up) had a 36% increase in the hazard ratio (HR) for metabolic syndrome compared with the consistently inactive group (≤150 minutes at both baseline and first followup) (HR, 1.36; 95% confidence interval [CI], 1.04 to 1.79). The newly active group (walking ≤420 minutes per week at baseline and >420 minutes per week at first follow-up) had a 25% decrease in the HR for metabolic syndrome compared with the consistently inactive group (walking ≤420 minutes per week at both baseline and first follow-up) (HR, 0.75; 95% CI, 0.57 to 0.98). Conclusion Changes in physical activity levels are associated with risk of metabolic syndrome. These results provide important insights for future investigations into the link between physical activity changes and disease occurrence.

Background: This study investigates the relationship between changes in physical activity levels and risk of metabolic syndrome. Methods: This study examined 1,686 adults aged 40 to 69 years from a community-based cohort study with complete 1st to 4th follow-up data between 2011 and 2020. Changes in physical activity were evaluated through baseline and follow-up surveys using physical activity questionnaires. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. A survival analysis was conducted using a multivariate extended Cox regression model with a significance level set at P<0.05. Results: Participants were divided into groups according to physical activity levels. The newly inactive group (vigorous physical activity ≤150 minutes at first follow-up) had a 36% increase in the hazard ratio (HR) for metabolic syndrome compared with the consistently inactive group (≤150 minutes at both baseline and first followup) (HR, 1.36; 95% confidence interval [CI], 1.04 to 1.79). The newly active group (walking ≤420 minutes per week at baseline and >420 minutes per week at first follow-up) had a 25% decrease in the HR for metabolic syndrome compared with the consistently inactive group (walking ≤420 minutes per week at both baseline and first follow-up) (HR, 0.75; 95% CI, 0.57 to 0.98). Conclusion Changes in physical activity levels are associated with risk of metabolic syndrome. These results provide important insights for future investigations into the link between physical activity changes and disease occurrence.

Background: This study investigates the relationship between changes in physical activity levels and risk of metabolic syndrome. Methods: This study examined 1,686 adults aged 40 to 69 years from a community-based cohort study with complete 1st to 4th follow-up data between 2011 and 2020. Changes in physical activity were evaluated through baseline and follow-up surveys using physical activity questionnaires. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. A survival analysis was conducted using a multivariate extended Cox regression model with a significance level set at P<0.05. Results: Participants were divided into groups according to physical activity levels. The newly inactive group (vigorous physical activity ≤150 minutes at first follow-up) had a 36% increase in the hazard ratio (HR) for metabolic syndrome compared with the consistently inactive group (≤150 minutes at both baseline and first followup) (HR, 1.36; 95% confidence interval [CI], 1.04 to 1.79). The newly active group (walking ≤420 minutes per week at baseline and >420 minutes per week at first follow-up) had a 25% decrease in the HR for metabolic syndrome compared with the consistently inactive group (walking ≤420 minutes per week at both baseline and first follow-up) (HR, 0.75; 95% CI, 0.57 to 0.98). Conclusion Changes in physical activity levels are associated with risk of metabolic syndrome. These results provide important insights for future investigations into the link between physical activity changes and disease occurrence.

Purpose: Liver fibrosis is a critical health issue with limited treatment options. This study investigates the potential of PGC-Sec, a secretome derived from peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α)-overexpressing adipose-derived stem cells (ASCs), as a novel therapeutic strategy for liver fibrosis. Methods: Upon achieving a cellular confluence of 70%–80%, ASCs were transfected with pcDNA-PGC-1α. PGC-Sec, obtained through concentration of conditioned media using ultrafiltration units with a 3-kDa cutoff, was assessed through in vitro assays and in vitro mouse models. Results: In vitro, PGC-Sec significantly reduced LX2 human hepatic stellate cell proliferation and mitigated mitochondrial oxidative stress compared to the control-secretome. In an in vivo mouse model, PGC-Sec treatment led to notable reductions in hepatic enzyme activity, serum proinflammatory cytokine concentrations, and fibrosis-related marker expression. Histological analysis demonstrated improved liver histology and reduced fibrosis severity in PGC-Sec–treated mice. Immunohistochemical staining confirmed enhanced expression of PGC-1α, optic atrophy 1 (a mitochondrial function marker), and peroxisome proliferator-activated receptor alpha (an antifibrogenic marker) in the PGC-Sec–treated group, along with reduced collagen type 1A expression (a profibrogenic marker). Conclusion These findings highlight the therapeutic potential of PGC-Sec in combating liver fibrosis by enhancing mitochondrial biogenesis and function, and promoting antifibrotic processes. PGC-Sec holds promise as a novel treatment strategy for liver fibrosis.

Granular cell tumor is a rare disease, and it is even rarer in the male breast. Although it is typically a benign tumor, due to its features and image findings, it can be easily misdiagnosed and managed as a malignant tumor. Therefore, the extent of the surgery can inappropriately be expanded. To avoid misdiagnosis and overtreatment, surgeons must perform a careful evaluation. We describe a case of a granular cell tumor of the male breast treated with mastectomy.

Purpose: The treatment of male breast cancer (MBC) has been extrapolated from female breast cancer (FBC) because of its rarity despite their different clinicopathologic characteristics. We aimed to investigate the distribution of intrinsic subtypes based on immunohistochemistry, their clinical impact, and treatment pattern in clinical practice through a multicenter study in Korea. Materials and Methods: We retrospectively analyzed clinical data of 248 MBC patients from 18 institutions across the country from January 1995 to July 2016. Results: The median age of MBC patients was 63 years (range, 25 to 102 years). Among 148 intrinsic subtype classified patients, 61 (41.2%), 44 (29.7%), 29 (19.5%), and 14 (9.5%) were luminal A, luminal B, human epidermal growth factor receptor 2, and triple-negative breast cancer, respectively. Luminal A subtype showed trends for superior survival compared to other subtypes. Most hormone receptor-positive patients (166 patients, 82.6%) received adjuvant endocrine treatment. Five-year completion of adjuvant endocrine treatment was associated with superior disease-free survival (DFS) in patients classified with an intrinsic subtype (hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.04 to 0.49; p=0.002) and in all patients (HR, 0.16; 95% CI, 0.05 to 0.54; p=0.003). Conclusion Distribution of subtypes of MBC was similar to FBC and luminal type A was most common. Overall survival tended to be improved for luminal A subtype, although there was no statistical significance. Completion of adjuvant endocrine treatment was associated with prolonged DFS in intrinsic subtype classified patients. MBC patients tended to receive less treatment. MBC patients should receive standard treatment according to guidelines as FBC patients.

Purpose: In patients who have previously undergone subtotal gastrectomy (STG), the remnant stomach is supplied with arterial blood through the splenic artery. It is currently unclear whether the remnant stomach can be safely preserved when performing distal pancreatosplenectomy (DPS) in these patients. Thus, this study aimed to evaluate the safety and feasibility of performing DPS in patients who had undergone a previous STG. Methods: A multicenter cohort study was performed to identify patients who underwent DPS. Electronic medical data of Clinical Data Warehouse from 7 representative high-volume centers in 5 cities were retrospectively reviewed. A propensity score-matched analysis was performed to match patients who had no history of upper abdominal surgery with patients who had undergone a previous STG. Results: Fourteen DPS patients who had a history of STG (STG group) were studied and matched to 70 patients who underwent DPS without any history of upper abdominal surgery (non-STG group). All patients in the STG group had the remnant stomach preserved. In most patients, the blood vessel supplying blood to the remnant stomach was the left inferior phrenic artery. There was no significant difference in the incidence of stomach-related complications or length of hospital stay between the 2 groups. Conclusion Our study results suggest that the remnant stomach could be safely preserved when performing DPS in patients with a prior STG. However, it is necessary to carefully evaluate the vascular structure of the remnant stomach through preoperative imaging study and closely observe changes to the blue stomach during the operation.