Background: A systematic evaluation of potential living liver donors is essential to ensure donor safety and optimize recipient outcomes in living donor liver transplantation (LDLT). This study aimed to assess donor acceptance rates and reasons for disqualification among individuals evaluated for LDLT at a high-volume transplant center over a one-year period. Methods: We retrospectively reviewed 1,087 potential living liver donors who presented for LDLT evaluation in 2023. Of these, 991 candidates advanced beyond the initial screening (Stage 1) and underwent comprehensive clinical, imaging, and pathological assessments (Stages 2 and 3). Candidates who discontinued after Stage 1 were excluded due to the absence of documented reasons for non-progression. Results: Among the 991 candidates who proceeded beyond initial screening, 473 (47.7%) completed the full donor evaluation, of whom 466 were judged to be suitable donors. Among suitable donors, 384 (82.4%) proceeded to donor hepatectomy, whereas 82 did not, primarily due to recipient-related factors such as clinical deterioration or withdrawal of consent. Donor ineligibility was determined in 422 candidates (42.6%), most commonly due to inadequate remnant liver volume (52.8%), hepatic steatosis (20.6%), and insufficient graft size (10.2%). Among candidates undergoing Stage 2 evaluation, 162 (16.3%) failed to meet steatosis criteria; 126 were excluded solely for steatosis and advised weight reduction, and 39 subsequently became eligible and successfully donated. Conclusion In this high-volume LDLT center, donor disqualification was primarily driven by remnant liver volume and hepatic steatosis. Targeted interventions such as weight reduction enabled successful donation in a subset of initially ineligible candidates, underscoring the importance of individualized donor evaluation and pre-donation optimization.

Background: The exposome encompasses all factors people encounter through life, with the skin constantly exposed. While particulate matter (PM) and sleep deprivation are known to contribute to barrier dysfunction, their combined effects remain unclear. Objective: To evaluate the independent and combined effects of PM exposure and short-term sleep deprivation on skin barrier function. Methods: Forty healthy Korean women (aged 24–58 years) were enrolled in this study. Forearms were divided into 4 sites: control, PM exposure, sleep deprivation, and PM plus sleep deprivation. Parameters such as trans-epidermal water loss (TEWL), hydration, elasticity, roughness, and redness were measured at baseline and post-exposure. RNA sequencing and reverse transcription-polymerase chain reaction were conducted on tape-stripped skin samples. Results: PM exposure significantly increased TEWL (+25.59%, p<0.01), roughness (+21.9%, p<0.01), and redness (+13.7%, p<0.0001) while reducing elasticity (−3.98%, p<0.01). Sleep deprivation modestly reduced elasticity (−1.39%, p<0.05) without affecting other parameters.Combined PM and sleep deprivation did not further exacerbate barrier dysfunction compared to PM alone. RNA sequencing revealed reduced FLG and LORICRIN expression and upregulated endoplasmic reticulum (ER) stress markers (HSP90B1, CANX) in both PM and sleep deprivation conditions. Conclusion PM exposure impaired skin barrier function, while short-term sleep deprivation alone did not significantly affect the barrier, either independently or in combination with PM.However, it was observed that the sleep deprivation-only, while not directly causing barrier damage, induced changes in ER stress-related gene expression in tape-stripped skin samples, like the PM exposure-only. This suggests that such signaling pathways could potentially exacerbate skin barrier deterioration.

Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.

Basal cell adenocarcinoma, considered to be the malignant counterpart of basal cell adenoma, is a rare, low-grade malignant tumor of the salivary glands, accounting for 1-2% of salivary gland malignancies. It predominantly affects the parotid gland, while involvement of the minor salivary glands is exceptionally rare. This report presented a case of basal cell adenocarcinoma involving the left retromolar trigone in a 54-year-old woman. The initial provisional diagnosis suggested a benign or low-grade malignant salivary tumor. Advanced magnetic resonance imagingtechniques, including diffusion-weighted imaging and apparent diffusion coefficient analysis, aided in the preoperative prediction of malignancy, and an incisional biopsy confirmed the diagnosis of basal cell adenocarcinoma. This caseunderscored the challenge of distinguishing basal cell adenocarcinoma from benign salivary tumors, as clinical and imaging features often overlap. Surgical excision remains the primary treatment, yielding favorable outcomes;however, long-term follow-up is crucial due to the risk of recurrence.

Basal cell adenocarcinoma, considered to be the malignant counterpart of basal cell adenoma, is a rare, low-grade malignant tumor of the salivary glands, accounting for 1-2% of salivary gland malignancies. It predominantly affects the parotid gland, while involvement of the minor salivary glands is exceptionally rare. This report presented a case of basal cell adenocarcinoma involving the left retromolar trigone in a 54-year-old woman. The initial provisional diagnosis suggested a benign or low-grade malignant salivary tumor. Advanced magnetic resonance imagingtechniques, including diffusion-weighted imaging and apparent diffusion coefficient analysis, aided in the preoperative prediction of malignancy, and an incisional biopsy confirmed the diagnosis of basal cell adenocarcinoma. This caseunderscored the challenge of distinguishing basal cell adenocarcinoma from benign salivary tumors, as clinical and imaging features often overlap. Surgical excision remains the primary treatment, yielding favorable outcomes;however, long-term follow-up is crucial due to the risk of recurrence.

Basal cell adenocarcinoma, considered to be the malignant counterpart of basal cell adenoma, is a rare, low-grade malignant tumor of the salivary glands, accounting for 1-2% of salivary gland malignancies. It predominantly affects the parotid gland, while involvement of the minor salivary glands is exceptionally rare. This report presented a case of basal cell adenocarcinoma involving the left retromolar trigone in a 54-year-old woman. The initial provisional diagnosis suggested a benign or low-grade malignant salivary tumor. Advanced magnetic resonance imagingtechniques, including diffusion-weighted imaging and apparent diffusion coefficient analysis, aided in the preoperative prediction of malignancy, and an incisional biopsy confirmed the diagnosis of basal cell adenocarcinoma. This caseunderscored the challenge of distinguishing basal cell adenocarcinoma from benign salivary tumors, as clinical and imaging features often overlap. Surgical excision remains the primary treatment, yielding favorable outcomes;however, long-term follow-up is crucial due to the risk of recurrence.

Objective: This study aimed to evaluate the prevalence of urinary incontinence (UI) and its associated risk factors among pregnant Korean women, as UI significantly impacts their quality of life. Methods: A cross-sectional study involving singleton pregnant women was conducted between April and December 2023. Data were collected using a questionnaire assessing demographic information and UI symptoms. The International Consultation on Incontinence Questionnaire-UI short form was used to diagnose UI. Results: A total of 824 pregnant women from three centers participated, with an overall prenatal UI prevalence of 40.2% (331/824). Stress UI was most common (77.1%), followed by mixed UI (16.9%), and urgency UI (6.0%). Risk factors for UI included prior delivery mode, specifically vaginal delivery (adjusted odds ratio [aOR], 5.61; 95% confidence interval [CI], 1.40-22.50; P=0.015) and combined vaginal and cesarean delivery (aOR, 23.14; 95% CI, 1.77-302.74; P=0.017). Additionally, second trimester (aOR, 1.99; 95% CI, 1.19-3.32; P=0.009) and third trimester (aOR, 4.44; 95% CI, 2.65-7.40; P<0.001) were associated with increased UI risk. Conversely, drinking alcohol before pregnancy was a protective factor (aOR, 0.72; 95% CI, 0.53-0.99; P=0.046). Conclusion Approximately 40% of Korean pregnant women experience prenatal UI. Prior delivery mode and advanced gastrointestinal age are significant risk factors. Further research with postpartum and long-term follow-ups is needed.

Objective: This study aimed to evaluate the prevalence of urinary incontinence (UI) and its associated risk factors among pregnant Korean women, as UI significantly impacts their quality of life. Methods: A cross-sectional study involving singleton pregnant women was conducted between April and December 2023. Data were collected using a questionnaire assessing demographic information and UI symptoms. The International Consultation on Incontinence Questionnaire-UI short form was used to diagnose UI. Results: A total of 824 pregnant women from three centers participated, with an overall prenatal UI prevalence of 40.2% (331/824). Stress UI was most common (77.1%), followed by mixed UI (16.9%), and urgency UI (6.0%). Risk factors for UI included prior delivery mode, specifically vaginal delivery (adjusted odds ratio [aOR], 5.61; 95% confidence interval [CI], 1.40-22.50; P=0.015) and combined vaginal and cesarean delivery (aOR, 23.14; 95% CI, 1.77-302.74; P=0.017). Additionally, second trimester (aOR, 1.99; 95% CI, 1.19-3.32; P=0.009) and third trimester (aOR, 4.44; 95% CI, 2.65-7.40; P<0.001) were associated with increased UI risk. Conversely, drinking alcohol before pregnancy was a protective factor (aOR, 0.72; 95% CI, 0.53-0.99; P=0.046). Conclusion Approximately 40% of Korean pregnant women experience prenatal UI. Prior delivery mode and advanced gastrointestinal age are significant risk factors. Further research with postpartum and long-term follow-ups is needed.

Background: s/Aims: Systematic investigations into the prognostic impact of the longitudinal tumor location in gallbladder cancer (GBC) remain insufficient. To address the limitations of our pilot study, we conducted a multicenter investigation to clarify the impact of the longitudinal tumor location on the oncological outcomes of GBC. Methods: A retrospective multicenter study was conducted on 372 patients undergoing radical resections for GBC from January 2010 to December 2019 across seven hospitals that belong to the Daejeon–Chungcheong branch of the Korean Association of Hepato-Biliary-Pancreatic Surgery. Patients were divided into GBC in the fundus/body (FB-GBC) and GBC in the neck/cystic duct (NC-GBC) groups, based on the longitudinal tumor location. Results: Of 372 patients, 282 had FB-GBC, while 90 had NC-GBC. NC-GBC was associated with more frequent elevation of preoperative carbohydrate antigen (CA) 19-9 levels, requirement for more extensive surgery, more advanced histologic grade and tumor stages, more frequent lymphovascular and perineural invasion, lower R0 resection rates, higher recurrence rates, and worse 5-year overall and disease-free survival rates. Propensity score matching analysis confirmed these findings, showing lower R0 resection rates, higher recurrence rates, and worse survival rates in the NC-GBC group. Multivariate analysis identified elevated preoperative CA 19-9 levels, lymph node metastasis, and non-R0 resection as independent prognostic factors, but not longitudinal tumor location. Conclusions NC-GBC exhibits more frequent elevation of preoperative CA 19-9 levels, more advanced histologic grade and tumor stages, lower R0 resection rates, and poorer overall and disease-free survival rates, compared to FB-GBC. However, the longitudinal tumor location was not analyzed as an independent prognostic factor.

Purpose: Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems.To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program. Methods: K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation. Results: Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea. Conclusion This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.