Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Background/Aims: This study aimed to evaluate the performance of the Model for End-Stage Liver Disease (MELD) 3.0 for predicting mortality and liver-related complications compared with the Child-Pugh classification, albumin-bilirubin (ALBI) grade, the MELD, and the MELD sodium (MELDNa) score. Methods: We evaluated a multicenter retrospective cohort of incorporated patients with cirrhosis between 2013 and 2019. We conducted comparisons of the area under the receiver operating characteristic curve (AUROC) of the MELD3.0 and other models for predicting 3-month mortality. Additionally, we assessed the risk of cirrhosis-related complications according to the MELD3.0 score. Results: A total of 3,314 patients were included. The mean age was 55.9±11.3 years, and 70.2% of the patients were male. Within the initial 3 months, 220 patients (6.6%) died, and the MELD3.0had the best predictive performance among the tested models, with an AUROC of 0.851, outperforming the Child-Pugh classification, ALBI grade, MELD, and MELDNa. A high MELD3.0score was associated with an increased risk of mortality. Compared with that of the group with a MELD3.0 score <10 points, the adjusted hazard ratio of the group with a score of 10–20 pointswas 2.176, and that for the group with a score of ≥20 points was 4.892. Each 1-point increase inthe MELD3.0 score increased the risk of cirrhosis-related complications by 1.033-fold. The risk of hepatorenal syndrome showed the highest increase, with an adjusted hazard ratio of 1.149, followed by hepatic encephalopathy and ascites. Conclusions The MELD3.0 demonstrated robust prognostic performance in predicting mortality in patients with cirrhosis. Moreover, the MELD3.0 score was linked to cirrhosis-related complications, particularly those involving kidney function, such as hepatorenal syndrome and ascites.

Objectives: ：This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR. Methods: ：We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test. Results: ：When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared. Conclusions ：This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.

Objectives: ：This study aims to explore the prevalence of depressive symptoms among elderly residents in the relatively stable rural areas of Jeju and to examine the relationships between levels of depression, sociodemographic factors, and health habits. Methods: ：The study site was within rural Jeju, where elderly individuals aged 65 and older were randomly selected from the ‘Agricultural Cohort’ registered at the Centers for Farmers` Safety and Health Center. Trainedinterviewers conducted surveys using the Short Form Geriatric Depression Scale (sGDS-K), defining those withscores of 6 or above as experiencing depressive symptoms for the analysis. Other variables such as sex, age, educational level, marital status, annual income, subjective health status, underlying disease, perceived stress levels, smoking, and drinking status were also recorded Results：Out of 533 subjects, the prevalence of depressive symptoms was 35.3%, with 28.5% in male and 45.6%in female (p<0.001). Factors significantly associated with the prevalence of depressive symptoms included maritalstatus (p=0.014), educational level (p<0.001), annual income (p=0.034), subjective health status (p<0.001), perceived stress level (p<0.001), feeling of despair (p<0.001) and suicidal ideas (p<0.001). Multivariate logistic regression analysis revealed that subjective health status, perceived stress level, and feelings of despair were associated with the prevalence of depressive symptoms. Conclusions ：The high prevalence of depressive symptoms among the rural elderly in Jeju highlights the need for targeted mental health interventions. Addressing sociocultural factors and improving early detection and intervention strategies can help reduce the socioeconomic impact of depression in this population.

Objectives: ：This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR. Methods: ：We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test. Results: ：When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared. Conclusions ：This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.

Objectives: ：This study aims to explore the prevalence of depressive symptoms among elderly residents in the relatively stable rural areas of Jeju and to examine the relationships between levels of depression, sociodemographic factors, and health habits. Methods: ：The study site was within rural Jeju, where elderly individuals aged 65 and older were randomly selected from the ‘Agricultural Cohort’ registered at the Centers for Farmers` Safety and Health Center. Trainedinterviewers conducted surveys using the Short Form Geriatric Depression Scale (sGDS-K), defining those withscores of 6 or above as experiencing depressive symptoms for the analysis. Other variables such as sex, age, educational level, marital status, annual income, subjective health status, underlying disease, perceived stress levels, smoking, and drinking status were also recorded Results：Out of 533 subjects, the prevalence of depressive symptoms was 35.3%, with 28.5% in male and 45.6%in female (p<0.001). Factors significantly associated with the prevalence of depressive symptoms included maritalstatus (p=0.014), educational level (p<0.001), annual income (p=0.034), subjective health status (p<0.001), perceived stress level (p<0.001), feeling of despair (p<0.001) and suicidal ideas (p<0.001). Multivariate logistic regression analysis revealed that subjective health status, perceived stress level, and feelings of despair were associated with the prevalence of depressive symptoms. Conclusions ：The high prevalence of depressive symptoms among the rural elderly in Jeju highlights the need for targeted mental health interventions. Addressing sociocultural factors and improving early detection and intervention strategies can help reduce the socioeconomic impact of depression in this population.

Atopic dermatitis (AD) is the most prevalent inflammatory skin condition, with approximately 80% of cases originating in childhood and some emerging in adulthood. In South Korea, the estimated prevalence of AD ranges between 10% and 20% in children and 1% and 3% in adults. Severe/recalcitrant AD manifests as a chronic, relapsing skin disorder, persisting with uncontrolled symptoms even after topical steroid treatment. Corticosteroids and systemic immunosuppression, conventionally the standard care for difficult-to-treat diseases, cause numerous undesirable side effects. When AD persists despite topical steroid application, systemic therapies like cyclosporine or systemic steroids become the second treatment strategy. The desire for targeted treatments, along with an enhanced understanding of AD’s pathophysiology, has spurred novel therapeutic development. Recent advances introduce novel systemic options, such as biological agents and small-molecule therapy, tailored to treat severe or recalcitrant AD. Notably, dupilumab, a monoclonal antibody inhibiting interleukin 4 and 13, marked a transformative breakthrough upon gaining approval from the U.S. Food and Drug Administration (FDA) in 2017, leading to a paradigm shift in the systemic treatment of AD. Furthermore, both dupilumab and Janus kinase inhibitors, including baricitinib, abrocitinib, and tofacitinib, now approved by the Korean FDA, have established their applicability in clinical practice. These innovative therapeutic agents have demonstrated favorable clinical outcomes, effectively addressing moderate to severe AD with fewer side reactions than those associated with previous systemic immunosuppressants. This review summarizes the latest advancements and evidence regarding systemic treatments for AD, including newly approved drugs in Korea.

Purpose: Risk factors predicting distant metastasis (DM) in extrahepatic bile duct cancer (EHBDC) patients treated with curative resection were investigated. Materials and Methods: Medical records of 1,418 EHBDC patients undergoing curative resection between Jan 2000 and Dec 2015 from 14 institutions were reviewed. After resection, 924 patients (67.6%) were surveilled without adjuvant therapy, 297 (21.7%) were treated with concurrent chemoradiotherapy (CCRT) and 148 (10.8%) with CCRT followed by chemotherapy. To exclude the treatment effect from innate confounders, patients not treated with adjuvant therapy were evaluated. Results: After a median follow-up of 36.7 months (range, 2.7 to 213.2 months), the 5-year distant metastasis-free survival (DMFS) rate was 57.7%. On multivariate analysis, perihilar or diffuse tumor (hazard ratio [HR], 1.391; p=0.004), poorly differentiated histology (HR, 2.014; p < 0.001), presence of perineural invasion (HR, 1.768; p < 0.001), positive nodal metastasis (HR, 2.670; p < 0.001) and preoperative carbohydrate antigen (CA) 19-9 ≥ 37 U/mL (HR, 1.353; p < 0.001) were significantly associated with inferior DMFS. The DMFS rates significantly differed according to the number of these risk factors. For validation, patients who underwent adjuvant therapy were evaluated. In patients with ≥ 3 factors, additional chemotherapy after CCRT resulted in a superior DMFS compared with CCRT alone (5-year rate, 47.6% vs. 27.7%; p=0.001), but the benefit of additional chemotherapy was not observed in patients with 0-2 risk factors. Conclusion Tumor location, histologic differentiation, perineural invasion, lymph node metastasis, and preoperative CA 19-9 level predicted DM risk in resected EHBDC. These risk factors might help identifying a subset of patients who could benefit from additional chemotherapy after resection.