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/Aims: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on Helicobacter pylori (HP)-associated gastritis according to sex. Methods: Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of IL-1B-511 C/T, IL-1RN variable number of tandem repeats, IL-6-572 G/C, IL-8-251 A/T, IL-8-781 C/T, IL-10-1082 G/A, IL-10-592 C/A, TNF-A-308 G/A, and transforming growth factor (TGF)-B-509 C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system. Results: Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in IL-1B-511 CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, IL-8-251 AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the IL-8-251 TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the IL-10-592 CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227). Conclusions Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.

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/Aims: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on Helicobacter pylori (HP)-associated gastritis according to sex. Methods: Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of IL-1B-511 C/T, IL-1RN variable number of tandem repeats, IL-6-572 G/C, IL-8-251 A/T, IL-8-781 C/T, IL-10-1082 G/A, IL-10-592 C/A, TNF-A-308 G/A, and transforming growth factor (TGF)-B-509 C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system. Results: Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in IL-1B-511 CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, IL-8-251 AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the IL-8-251 TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the IL-10-592 CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227). Conclusions Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.

Background/Aims: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on Helicobacter pylori (HP)-associated gastritis according to sex. Methods: Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of IL-1B-511 C/T, IL-1RN variable number of tandem repeats, IL-6-572 G/C, IL-8-251 A/T, IL-8-781 C/T, IL-10-1082 G/A, IL-10-592 C/A, TNF-A-308 G/A, and transforming growth factor (TGF)-B-509 C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system. Results: Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in IL-1B-511 CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, IL-8-251 AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the IL-8-251 TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the IL-10-592 CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227). Conclusions Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.

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/Aims: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on Helicobacter pylori (HP)-associated gastritis according to sex. Methods: Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of IL-1B-511 C/T, IL-1RN variable number of tandem repeats, IL-6-572 G/C, IL-8-251 A/T, IL-8-781 C/T, IL-10-1082 G/A, IL-10-592 C/A, TNF-A-308 G/A, and transforming growth factor (TGF)-B-509 C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system. Results: Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in IL-1B-511 CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, IL-8-251 AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the IL-8-251 TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the IL-10-592 CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227). Conclusions Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.

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: 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/Aims: There are few reports regarding mixed carcinoma, defined as a mixture of glandular and poorly cohesive components, in patients with gastric cancer (GC). The aim of this study was to evaluate the proportion and characteristics of mixed carcinoma in GC patients. Methods: A total of 7,215 patients diagnosed with GC at Seoul National University Bundang Hospital were enrolled from March 2011 to February 2020. GC was divided into four groups (wellmoderately differentiated GC, poorly differentiated GC, poorly cohesive carcinoma, and mixed carcinoma). The proportion of each GC type and the clinicopathological features were analyzed and divided into early GC and advanced GC. Results: The proportion of mixed carcinoma was 10.9% (n=787). In early GC, submucosal invasion was the most common in poorly differentiated (53.7%), and mixed carcinoma ranked second (41.1%). Mixed carcinoma showed the highest proportion of lymph node metastasis in early GC (23.0%) and advanced GC (78.3%). In advanced GC, the rate of distant metastasis was 3.6% and 3.9% in well-moderately differentiated GC and mixed carcinoma, respectively, lower than that in poorly differentiated GC (6.4%) and poorly cohesive carcinoma (5.7%), without statistical significance. Conclusions Mixed carcinoma was associated with lymph node metastasis compared to other histological GC subtypes. And it showed relatively common submucosal invasion in early GC, but the rates of venous invasion and distant metastasis were lower in advanced GC. Further research is needed to uncover the mechanism underlying these characteristics of mixed carcinoma (Trial registration number: NCT04973631).