1.Individualized strategy of treatment for ruptured abdominal aortic aneurysm using causal inference model: a retrospective observational study
Youngki SOHN ; Youngje WOO ; Sangkyun MOK ; Eunju JANG ; Ki-Yoon MOON ; Sun Cheol PARK ; Sang Seob YUN ; Jang Yong KIM
Annals of Surgical Treatment and Research 2026;110(4):259-272
Purpose:
This study was performed to predict individualized treatment strategies in ruptured abdominal aortic aneurysm (rAAA) by estimating the survival benefit of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) based on anatomical and physiological features using a causal inference model.
Methods:
This retrospective study included 45 patients with de novo rAAA who underwent EVAR or OSR between 2012 and 2024. Thirty-three variables were analyzed. The model estimated individualized treatment effects (ITE) for 30-day survival.Model interpretability was assessed using Shapley Additive Explanations (SHAP) analysis. Five-fold cross-validation, receiver operating characteristic (ROC) analysis, and calibration plots were used for model evaluation. A clinical decision tree was developed to derive simplified decision rules.
Results:
The mean ITE was 0.22 ± 0.42, with 33% of patients classified as OSR-benefit candidates. SHAP analysis revealed that suprarenal angle, infrarenal angle, iliac anatomy, and proximal neck characteristics strongly influenced treatment effects. However, some predictors, such as low hemoglobin and systolic blood pressure favoring OSR, conflicted with clinical intuition. ROC analysis showed an area under the curve of 1.00, but calibration suggested overfitting due to a small sample size. Treatment-matched patients had a higher 30-day mortality rate than mismatched patients, suggesting potential bias or unmeasured confounding. The decision tree identified clinically relevant features but displayed structural inconsistencies and impractical cutoff values due to the limited sample size.
Conclusion
The X-learner model demonstrated the feasibility of individualized treatment prediction in rAAA but suffered from overfitting and limited generalizability. Validation with larger multicenter cohorts is necessary to confirm clinical applicability.
2.Validating the Korean Geriatric Assessment Tool in Elderly Multiple Myeloma Patients: A Multicenter Study
Ji Yun LEE ; Sang-A KIM ; Youngil KOH ; Ho-Young YHIM ; Gyeong-Won LEE ; Chang-Ki MIN ; Young Rok DO ; Hyo Jung KIM ; Sung Hwa BAE ; Hyeon-Seok EOM ; Sung-Hoon JUNG ; Hyunkyung PARK ; Seung-Hyun NAM ; Ji Hyun LEE ; Sung-Hyun KIM ; Hyun Jung LEE ; Young Seob PARK ; Soo-Mee BANG
Cancer Research and Treatment 2026;58(1):311-319
Purpose:
This study evaluates the Korean Cancer Study Group Geriatric Score-7 (KG-7) frailty screening tool’s effectiveness in elderly multiple myeloma (MM) patients to prevent under and overtreatment.
Materials and Methods:
This prospective pilot cohort study included 100 elderly patients aged 70 and older with newly diagnosed MM who had not undergone transplantation from August 2020 to January 2022.
Results:
The median age was 77 years, and 73.0% of patients were classified at International Staging System stages 2 or 3. Using a 5-point cutoff on the KG-7 index (non-frail, score ≥ 5; frail, score < 5), 31% were categorized as frail. After a median follow-up of 26.8 months, the 3-year overall survival rate was 73.0%. There was no statistically significant association between any frailty index and the risk of death. However, frail patients defined by the simplified frailty index (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.09 to 5.95; p=0.030) and by KG-7 (HR, 2.43; 95% CI, 1.03 to 5.86; p=0.043) had a significantly higher risk of grade 3-4 non-hematologic toxicity, whereas the International Myeloma Working Group definition did not. Over a 24-month tracking period, vulnerability as measured by KG-7 either improved or deteriorated.
Conclusion
The pilot study, which had a limited number of participants, did not demonstrate KG-7’s effectiveness in predicting survival; however, it successfully predicted severe non-hematologic toxicities. We plan to conduct larger studies in elderly MM patients to determine whether KG-7 can help tailor their treatment regimens.
3.Microglial galectin-3 increases with aging in the mouse hippocampus
Hyun Joo SHIN ; So Jeong LEE ; Hyeong Seok AN ; Ha Nyeoung CHOI ; Eun Ae JEONG ; Jaewoong LEE ; Kyung Eun KIM ; Bong-Hoi CHOI ; Seung Pil YUN ; Dawon KANG ; Sang Soo KANG ; Gu Seob ROH
The Korean Journal of Physiology and Pharmacology 2025;29(2):215-225
Microglial activation during aging is associated with neuroinflammation and cognitive impairment. Galectin-3 plays a crucial role in microglial activation and phagocytosis. However, the role of galectin-3 in the aged brain is not completely understood. In the present study, we investigated aging-related mechanisms and microglial galectin-3 expression in the mouse hippocampus using female 6-, 12-, and 24-month-old C57BL/6 mice. Western blot analysis revealed neurodegeneration, blood-brain barrier leakage, and increased levels of neuroinflammation-related proteins in 24-month-old mice compared to 6- and 12-month-old mice. Immunohistochemistry revealed an increase in activated microglia in the hippocampus of 24-month-old mice compared to 6- and 12-month-old mice. Furthermore, we found more galectin-3 and triggering receptor expressed on myeloid cells-2-positive microglia in 24-month-old mice compared to 6- and 12-month-old mice. Using primary mouse microglial cells, galectin -3 was also increased by lipopolysaccharide treatment. These findings suggest that galectin-3 may play an important role in microglial activation and neuroinflammation during brain aging.
4.Microglial galectin-3 increases with aging in the mouse hippocampus
Hyun Joo SHIN ; So Jeong LEE ; Hyeong Seok AN ; Ha Nyeoung CHOI ; Eun Ae JEONG ; Jaewoong LEE ; Kyung Eun KIM ; Bong-Hoi CHOI ; Seung Pil YUN ; Dawon KANG ; Sang Soo KANG ; Gu Seob ROH
The Korean Journal of Physiology and Pharmacology 2025;29(2):215-225
Microglial activation during aging is associated with neuroinflammation and cognitive impairment. Galectin-3 plays a crucial role in microglial activation and phagocytosis. However, the role of galectin-3 in the aged brain is not completely understood. In the present study, we investigated aging-related mechanisms and microglial galectin-3 expression in the mouse hippocampus using female 6-, 12-, and 24-month-old C57BL/6 mice. Western blot analysis revealed neurodegeneration, blood-brain barrier leakage, and increased levels of neuroinflammation-related proteins in 24-month-old mice compared to 6- and 12-month-old mice. Immunohistochemistry revealed an increase in activated microglia in the hippocampus of 24-month-old mice compared to 6- and 12-month-old mice. Furthermore, we found more galectin-3 and triggering receptor expressed on myeloid cells-2-positive microglia in 24-month-old mice compared to 6- and 12-month-old mice. Using primary mouse microglial cells, galectin -3 was also increased by lipopolysaccharide treatment. These findings suggest that galectin-3 may play an important role in microglial activation and neuroinflammation during brain aging.
5.Microglial galectin-3 increases with aging in the mouse hippocampus
Hyun Joo SHIN ; So Jeong LEE ; Hyeong Seok AN ; Ha Nyeoung CHOI ; Eun Ae JEONG ; Jaewoong LEE ; Kyung Eun KIM ; Bong-Hoi CHOI ; Seung Pil YUN ; Dawon KANG ; Sang Soo KANG ; Gu Seob ROH
The Korean Journal of Physiology and Pharmacology 2025;29(2):215-225
Microglial activation during aging is associated with neuroinflammation and cognitive impairment. Galectin-3 plays a crucial role in microglial activation and phagocytosis. However, the role of galectin-3 in the aged brain is not completely understood. In the present study, we investigated aging-related mechanisms and microglial galectin-3 expression in the mouse hippocampus using female 6-, 12-, and 24-month-old C57BL/6 mice. Western blot analysis revealed neurodegeneration, blood-brain barrier leakage, and increased levels of neuroinflammation-related proteins in 24-month-old mice compared to 6- and 12-month-old mice. Immunohistochemistry revealed an increase in activated microglia in the hippocampus of 24-month-old mice compared to 6- and 12-month-old mice. Furthermore, we found more galectin-3 and triggering receptor expressed on myeloid cells-2-positive microglia in 24-month-old mice compared to 6- and 12-month-old mice. Using primary mouse microglial cells, galectin -3 was also increased by lipopolysaccharide treatment. These findings suggest that galectin-3 may play an important role in microglial activation and neuroinflammation during brain aging.
6.Microglial galectin-3 increases with aging in the mouse hippocampus
Hyun Joo SHIN ; So Jeong LEE ; Hyeong Seok AN ; Ha Nyeoung CHOI ; Eun Ae JEONG ; Jaewoong LEE ; Kyung Eun KIM ; Bong-Hoi CHOI ; Seung Pil YUN ; Dawon KANG ; Sang Soo KANG ; Gu Seob ROH
The Korean Journal of Physiology and Pharmacology 2025;29(2):215-225
Microglial activation during aging is associated with neuroinflammation and cognitive impairment. Galectin-3 plays a crucial role in microglial activation and phagocytosis. However, the role of galectin-3 in the aged brain is not completely understood. In the present study, we investigated aging-related mechanisms and microglial galectin-3 expression in the mouse hippocampus using female 6-, 12-, and 24-month-old C57BL/6 mice. Western blot analysis revealed neurodegeneration, blood-brain barrier leakage, and increased levels of neuroinflammation-related proteins in 24-month-old mice compared to 6- and 12-month-old mice. Immunohistochemistry revealed an increase in activated microglia in the hippocampus of 24-month-old mice compared to 6- and 12-month-old mice. Furthermore, we found more galectin-3 and triggering receptor expressed on myeloid cells-2-positive microglia in 24-month-old mice compared to 6- and 12-month-old mice. Using primary mouse microglial cells, galectin -3 was also increased by lipopolysaccharide treatment. These findings suggest that galectin-3 may play an important role in microglial activation and neuroinflammation during brain aging.
7.Evaluation of health-related quality of life and performance in intestinal transplant and rehabilitation patients: a cross-sectional study
Eunju JANG ; Mi-hyeong KIM ; Jeong-kye HWANG ; Sun Cheol PARK ; Sang Seob YUN ; Myung Duk LEE ; Jae Hee CHUNG
Annals of Surgical Treatment and Research 2025;108(1):31-38
Purpose:
We aimed to evaluate health-related quality of life (HRQoL) in intestinal failure (IF) patients after different modes of intestinal rehabilitation.
Methods:
HRQoL was assessed using the generic 36-item Short Form Survey (SF-36, ver. 2) and visual analogue scale (VAS) in 6 different areas: diet, sleep, gastrointestinal (GI) symptoms, diarrhea, musculoskeletal pain, and other symptoms.
Results:
Twenty-two patients completed the questionnaires, of which 7 had received intestinal transplant (ITx), 9 were continuing home total parenteral nutrition (HPN), and 6 had tapered off total parenteral nutrition (TPN). SF-36 physical component summary scores were highest in the ITx group (median, 65.6; interquartile range [IQR], 31.6–80.3) compared to the HPN (median, 48.4; IQR, 44.7–66.3) or tapered group (median, 54.2; IQR, 45.2–61.6). Mental component summary scores were lowest in the ITx group (median, 48.8; IQR, 37.1–63.6), compared to the TPN (median, 60.2; IQR, 41.6–78.5) or tapered group (median, 51.0; IQR, 48.8–56.0). Differences were not significant in all items of the SF-36. VAS scores showed that patients in the ITx group showed the best results in diet (0.9), gastrointestinal (GI) symptoms (1.4), and musculoskeletal pain (2.4). There was a significant difference in sleep (P = 0.036), with the ITx (1.43) and HPN groups (1.33) showing better outcomes compared with the tapered group (4.67). Patients in the tapered group showed the least favorable results in all performance areas, except GI symptoms.
Conclusion
SF-36 did not show a significant difference between the ITx, HPN, and tapered groups, but VAS showed a significant difference in sleep between groups. Further studies, including serial data, will allow a better understanding of the effects of different modes of intestinal rehabilitation.
8.Evaluation of health-related quality of life and performance in intestinal transplant and rehabilitation patients: a cross-sectional study
Eunju JANG ; Mi-hyeong KIM ; Jeong-kye HWANG ; Sun Cheol PARK ; Sang Seob YUN ; Myung Duk LEE ; Jae Hee CHUNG
Annals of Surgical Treatment and Research 2025;108(1):31-38
Purpose:
We aimed to evaluate health-related quality of life (HRQoL) in intestinal failure (IF) patients after different modes of intestinal rehabilitation.
Methods:
HRQoL was assessed using the generic 36-item Short Form Survey (SF-36, ver. 2) and visual analogue scale (VAS) in 6 different areas: diet, sleep, gastrointestinal (GI) symptoms, diarrhea, musculoskeletal pain, and other symptoms.
Results:
Twenty-two patients completed the questionnaires, of which 7 had received intestinal transplant (ITx), 9 were continuing home total parenteral nutrition (HPN), and 6 had tapered off total parenteral nutrition (TPN). SF-36 physical component summary scores were highest in the ITx group (median, 65.6; interquartile range [IQR], 31.6–80.3) compared to the HPN (median, 48.4; IQR, 44.7–66.3) or tapered group (median, 54.2; IQR, 45.2–61.6). Mental component summary scores were lowest in the ITx group (median, 48.8; IQR, 37.1–63.6), compared to the TPN (median, 60.2; IQR, 41.6–78.5) or tapered group (median, 51.0; IQR, 48.8–56.0). Differences were not significant in all items of the SF-36. VAS scores showed that patients in the ITx group showed the best results in diet (0.9), gastrointestinal (GI) symptoms (1.4), and musculoskeletal pain (2.4). There was a significant difference in sleep (P = 0.036), with the ITx (1.43) and HPN groups (1.33) showing better outcomes compared with the tapered group (4.67). Patients in the tapered group showed the least favorable results in all performance areas, except GI symptoms.
Conclusion
SF-36 did not show a significant difference between the ITx, HPN, and tapered groups, but VAS showed a significant difference in sleep between groups. Further studies, including serial data, will allow a better understanding of the effects of different modes of intestinal rehabilitation.
9.Microglial galectin-3 increases with aging in the mouse hippocampus
Hyun Joo SHIN ; So Jeong LEE ; Hyeong Seok AN ; Ha Nyeoung CHOI ; Eun Ae JEONG ; Jaewoong LEE ; Kyung Eun KIM ; Bong-Hoi CHOI ; Seung Pil YUN ; Dawon KANG ; Sang Soo KANG ; Gu Seob ROH
The Korean Journal of Physiology and Pharmacology 2025;29(2):215-225
Microglial activation during aging is associated with neuroinflammation and cognitive impairment. Galectin-3 plays a crucial role in microglial activation and phagocytosis. However, the role of galectin-3 in the aged brain is not completely understood. In the present study, we investigated aging-related mechanisms and microglial galectin-3 expression in the mouse hippocampus using female 6-, 12-, and 24-month-old C57BL/6 mice. Western blot analysis revealed neurodegeneration, blood-brain barrier leakage, and increased levels of neuroinflammation-related proteins in 24-month-old mice compared to 6- and 12-month-old mice. Immunohistochemistry revealed an increase in activated microglia in the hippocampus of 24-month-old mice compared to 6- and 12-month-old mice. Furthermore, we found more galectin-3 and triggering receptor expressed on myeloid cells-2-positive microglia in 24-month-old mice compared to 6- and 12-month-old mice. Using primary mouse microglial cells, galectin -3 was also increased by lipopolysaccharide treatment. These findings suggest that galectin-3 may play an important role in microglial activation and neuroinflammation during brain aging.
10.Evaluation of health-related quality of life and performance in intestinal transplant and rehabilitation patients: a cross-sectional study
Eunju JANG ; Mi-hyeong KIM ; Jeong-kye HWANG ; Sun Cheol PARK ; Sang Seob YUN ; Myung Duk LEE ; Jae Hee CHUNG
Annals of Surgical Treatment and Research 2025;108(1):31-38
Purpose:
We aimed to evaluate health-related quality of life (HRQoL) in intestinal failure (IF) patients after different modes of intestinal rehabilitation.
Methods:
HRQoL was assessed using the generic 36-item Short Form Survey (SF-36, ver. 2) and visual analogue scale (VAS) in 6 different areas: diet, sleep, gastrointestinal (GI) symptoms, diarrhea, musculoskeletal pain, and other symptoms.
Results:
Twenty-two patients completed the questionnaires, of which 7 had received intestinal transplant (ITx), 9 were continuing home total parenteral nutrition (HPN), and 6 had tapered off total parenteral nutrition (TPN). SF-36 physical component summary scores were highest in the ITx group (median, 65.6; interquartile range [IQR], 31.6–80.3) compared to the HPN (median, 48.4; IQR, 44.7–66.3) or tapered group (median, 54.2; IQR, 45.2–61.6). Mental component summary scores were lowest in the ITx group (median, 48.8; IQR, 37.1–63.6), compared to the TPN (median, 60.2; IQR, 41.6–78.5) or tapered group (median, 51.0; IQR, 48.8–56.0). Differences were not significant in all items of the SF-36. VAS scores showed that patients in the ITx group showed the best results in diet (0.9), gastrointestinal (GI) symptoms (1.4), and musculoskeletal pain (2.4). There was a significant difference in sleep (P = 0.036), with the ITx (1.43) and HPN groups (1.33) showing better outcomes compared with the tapered group (4.67). Patients in the tapered group showed the least favorable results in all performance areas, except GI symptoms.
Conclusion
SF-36 did not show a significant difference between the ITx, HPN, and tapered groups, but VAS showed a significant difference in sleep between groups. Further studies, including serial data, will allow a better understanding of the effects of different modes of intestinal rehabilitation.

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