Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

The applicability of the Phoenix criteria and Phoenix Sepsis Score in higher-resource pediatric intensive care units (PICUs) outside the United States requires further validation. A retrospective cohort study analyzed electronic health records of 1,304 PICU admissions under 18 years old with suspected infection between February 2017 and December 2023. The score was calculated using two methods: 24-hour assessment, based on worst sub-scores within 24 hours of admission, and prompt assessment, using values closest to admission within 6 hours before or after. Based on the 24-hour assessment, in-hospital mortality was 8.3% for sepsis and 10.3% for septic shock. The score demonstrated an area under the precision-recall curve of 0.42 (95% confidence interval, 0.31–0.55) for in-hospital mortality. Results were consistent across both assessment methods. The Phoenix criteria and the Phoenix Sepsis Score are reliable predictors of mortality outcomes. Further investigation in diverse clinical settings is warranted.

Purpose: Skeletal muscle atrophy, characterized by a reduction in muscle mass and size, is known to be associated with inflammation and oxidative stress. This study aimed to examine the effect of blackcurrant extract on tumor necrosis factor-alpha (TNF)-α-induced myotube atrophy. Methods: C2C12 myotubes were treated with blackcurrant extract and cultured with TNF-α for 24 hours. The myotubes were stained using May-Grunwald Giemsa staining to measure the myotube diameter. In addition, reactive oxygen species (ROS) levels were assessed.The mRNA expression of inflammation-related markers such as interleukin (IL)-6, IL-1β, cyclooxygenase-2 (COX-2), inducible NO synthase (iNOS), as well as mitochondria dynamicsrelated markers, including mitochondrial fission protein 1 (Fis1), optic atrophy 1 (Opa1) were measured by quantitative real-time polymerase chain reaction. The expression of muscle protein degradation markers, including muscle ring finger protein 1 (MuRF-1), atrogin-1, and forkhead box protein O3 (FoXO3), as well as mitochondrial biogenesis markers such as silent information regulator T1 (Sirt1) and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α), were assessed by western blot analysis. Results: Treatment with blackcurrant extract increased the myotube diameter, which was decreased in TNF-α-induced myotube atrophy. Treatment with TNF-α increased ROS levels and the expression of MuRF-1 and atrogin-1, and these increases were significantly inhibited by treatment with the blackcurrant extract. In contrast, the phosphorylation of FoXO3 was increased by the blackcurrant extract. Furthermore, the blackcurrant extract treatment decreased the mRNA expression of IL-6, IL-1β, COX-2, and iNOS elevated by TNF-α treatment. Additionally, blackcurrant extract treatment suppressed the expression of Fis1, while increasing the expression of Opa1, Sirt1, and PGC-1α. Conclusion These results suggest that blackcurrant extract reduces TNF-α-induced muscle protein degradation by the enhancement of mitochondrial biogenesis and mitochondrial dynamics. Thus, this study provides foundational data supporting the potential of blackcurrant extract as a functional ingredient for the prevention of muscle atrophy.

Background: The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs). Methods: We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs. Results: PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The areas under the curve (AUC [95% CI]) in the receiver operating characteristic curve analysis for the three-minute preoxygenation ORi for PPCs were 0.64 (0.55–0.73). After a subgroup analysis, multivariate logistic regression showed that the three-minute preoxygenation ORi was significantly associated with PPCs among patients who underwent thoracic surgery (OR: 0.01, 95% CI [0.00–0.19], P = 0.006). The AUC of the three-minute preoxygenation ORi for PPCs was 0.72 (0.57–0.86) in patients who underwent thoracic surgery. Conclusions A low ORi measured after 3 min of preoxygenation for general anesthesia was associated with an increased risk of PPCs, including those undergoing thoracic surgery. This study demonstrated the potential of ORi, measured after oxygen administration, as a tool for evaluating lung function that complements traditional lung function tests and scoring systems.

Purpose: Skeletal muscle atrophy, characterized by a reduction in muscle mass and size, is known to be associated with inflammation and oxidative stress. This study aimed to examine the effect of blackcurrant extract on tumor necrosis factor-alpha (TNF)-α-induced myotube atrophy. Methods: C2C12 myotubes were treated with blackcurrant extract and cultured with TNF-α for 24 hours. The myotubes were stained using May-Grunwald Giemsa staining to measure the myotube diameter. In addition, reactive oxygen species (ROS) levels were assessed.The mRNA expression of inflammation-related markers such as interleukin (IL)-6, IL-1β, cyclooxygenase-2 (COX-2), inducible NO synthase (iNOS), as well as mitochondria dynamicsrelated markers, including mitochondrial fission protein 1 (Fis1), optic atrophy 1 (Opa1) were measured by quantitative real-time polymerase chain reaction. The expression of muscle protein degradation markers, including muscle ring finger protein 1 (MuRF-1), atrogin-1, and forkhead box protein O3 (FoXO3), as well as mitochondrial biogenesis markers such as silent information regulator T1 (Sirt1) and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α), were assessed by western blot analysis. Results: Treatment with blackcurrant extract increased the myotube diameter, which was decreased in TNF-α-induced myotube atrophy. Treatment with TNF-α increased ROS levels and the expression of MuRF-1 and atrogin-1, and these increases were significantly inhibited by treatment with the blackcurrant extract. In contrast, the phosphorylation of FoXO3 was increased by the blackcurrant extract. Furthermore, the blackcurrant extract treatment decreased the mRNA expression of IL-6, IL-1β, COX-2, and iNOS elevated by TNF-α treatment. Additionally, blackcurrant extract treatment suppressed the expression of Fis1, while increasing the expression of Opa1, Sirt1, and PGC-1α. Conclusion These results suggest that blackcurrant extract reduces TNF-α-induced muscle protein degradation by the enhancement of mitochondrial biogenesis and mitochondrial dynamics. Thus, this study provides foundational data supporting the potential of blackcurrant extract as a functional ingredient for the prevention of muscle atrophy.

Background: The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs). Methods: We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs. Results: PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The areas under the curve (AUC [95% CI]) in the receiver operating characteristic curve analysis for the three-minute preoxygenation ORi for PPCs were 0.64 (0.55–0.73). After a subgroup analysis, multivariate logistic regression showed that the three-minute preoxygenation ORi was significantly associated with PPCs among patients who underwent thoracic surgery (OR: 0.01, 95% CI [0.00–0.19], P = 0.006). The AUC of the three-minute preoxygenation ORi for PPCs was 0.72 (0.57–0.86) in patients who underwent thoracic surgery. Conclusions A low ORi measured after 3 min of preoxygenation for general anesthesia was associated with an increased risk of PPCs, including those undergoing thoracic surgery. This study demonstrated the potential of ORi, measured after oxygen administration, as a tool for evaluating lung function that complements traditional lung function tests and scoring systems.

Objective: To evaluate the clinical efficacy of ultrafast dynamic contrast-enhanced (DCE)-MRI using a compressed sensing (CS) technique for differentiating benign and malignant soft-tissue tumors (STTs) and to evaluate the factors related to the grading of malignant STTs. Materials and Methods: A total of 165 patients (96 male; mean age, 61 years), comprising 111 with malignant STTs and 54 with benign STTs according to the 2020 WHO classification, underwent DCE-MRI with CS between June 2018 and June 2023. The clinical, qualitative, and quantitative parameters associated with conventional MRI were also obtained. During post-processing of the early arterial phase of DCE-MRI, the time-to-enhance (TTE), time-to-peak (TTP), initial area under the curve at 60 s (iAUC60), and maximum slope were calculated. Furthermore, the delayed arterial phase parameters of DCEMRI, including Ktrans , Kep, Ve, and iAUC values and time-concentration curve (TCC) types, were determined. Clinical and MRI parameters were statistically analyzed to differentiate between benign and malignant tumors and their correlation with tumor grading. Results: According to logistic regression analysis, the TTE value (P < 0.001) of the early arterial phase and Ve (P = 0.039) and iAUC (P = 0.006) values of the delayed arterial phase, as well as age, location, peritumoral edema, and contrast heterogeneity on conventional MRI, were significant (P = 0.001–0.015) in differentiating benign and malignant tumors. Among all the quantitative parameters, the TTE value had the highest accuracy, with an area under the receiver operating characteristic curve of 0.902. The grading of malignant tumors was significantly correlated with peritumoral edema; CE heterogeneity; visual diffusion restriction; minimum and mean ADC; TTP, Kep, and Ve values; and the TCC graph (all P < 0.05). Conclusion Among the quantitative parameters obtained using ultrafast DCE-MRI, early arterial phase TTE was the most accurate for distinguishing between benign and malignant tumors.