Purpose: The relationship between tacrolimus intrapatient variability (IPV) and its metabolism-associated singlenucleotide polymorphisms (SNPs) in liver transplantation (LT) remains unclear. Moreover, the influence of donor SNP on recipient IPV is poorly understood. Our objective was to investigate how SNPs affect tacrolimus IPV by analyzing both donor and recipient SNP data in LT. Methods: This retrospective study examined the association between tacrolimus IPV and eight specific SNPs in 50 adult LT recipients and 50 LT donors genotyped for CYP3A5, ABCB1, ABCC2, and POR genes and their SNPs. Recipients were divided into high IPV (≥30) and low IPV (<30) groups based on 3–12 months after LT IPV calculations. Multivariate logistic regression was used to identify risk factors for high IPV. Post-LT long-term outcomes were also compared between the groups. Results: Two SNPs were significantly associated with high IPV in multivariate analysis. Recipient ABCB1 1236C>T genotypes CT and CC (odds ratio [OR], 13.969; 95% confidence interval [CI], 1.738–112.300; P = 0.013), donors’ CYP3A5 6986A>G genotypes GA and GG (OR, 4.390; 95% CI, 1.005–19.178; P = 0.049), and glucose ≥120 mg/dL at 3 months (OR, 6.494; 95% CI, 1.300–32.168; P = 0.024) were associated with high IPV. However, post-LT long-term outcomes were similar between the groups. Conclusion SNPs of donor CYP3A5 and recipient ABCB1 can significantly influence tacrolimus IPV in patients undergoing living donor LT. Identifying these SNPs can help determine high IPV-prone patients, facilitate close monitoring of high IPVsusceptible groups, and improve outcomes.

Medication is a potential factor influencing frailty. However, the relationship between pharmaceutical treatments and frailty remains unclear. Therefore, we conducted the present systematic review to summarize the association between drug therapy and the risk of incident frailty in older adults. We systematically searched the MEDLINE electronic database for articles indexed between January 1, 2000, and December 31, 2021, for randomized controlled trials (RCTs) and cohort studies reporting frailty changes associated with drug therapy. A total of six RCTs and 13 cohort studies involving 211,948 participants were identified, and their treatments were categorized into six medication classes: analgesics, cardiometabolic medication, chemotherapy, central nervous system (CNS)-active medication, hormonal therapy, and nutritional supplements. While the analysis revealed that only CNS-active medications were associated with an elevated risk of frailty, other medication classes also affected frailty; however, this is not conclusively attributable to a class-wide effect.

Background: Challenging clinical circumstances and high demand for liver transplantation have led to a refinement in the recipient selection criteria. This study aims to investigate the hypothesis that surgical outcomes in living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) have improved over time with the shift from morphological to biological criteria. Methods: A retrospective analysis was conducted on 942 adult HCC patients underwent LDLT at Seoul National University Hospital between 2000 and 2022. Study populations were divided into Group A (2000.01.01–2011.06.30, n=314) and Group B (2011.07.01–2022.06.30, n=628). Baseline characteristics, perioperative factors, and survival outcomes were compared. Results: Group B demonstrated higher recurrence-free survival (RFS) compared to Group A (p=0.03). Additionally, Group B exhibited superior overall survival rates at the 1-, 3-, and 5-year intervals (95.9%, 87.9%, 84.6%, p<0.01). Moreover, Group B had a significantly lower recurrence rate (p=0.02) and mortality rate (p<0.01). The median time to recurrence was 9.1 months (interquartile range [IQR] 3.9–21.8) for Group A and 11.4 months (IQR 6.6–18.5) for Group B (p=0.92). Furthermore, Group A’s median tumor-bearing survival was 12.3 months (IQR 5.2–26.1), which was significantly shorter than Group B’s 20.0 months (IQR 5.4–25.7) (p<0.01). Conclusion The use of biological tumor markers in patient selection criteria has significantly improved the effectiveness of HCC treatment in LDLT and should be encouraged for pervasive use.

Objectives: The study aims to investigate the influence of oral health service experience on oral health behavior of North Korean defectors and contribute to the development and implementation of oral health education among this population. Methods: A self-reporting questionnaire survey was conducted with 161 North Korean defectors in Hanawon from April, 2015 to September, 2015. Of these participants, 50 were excluded owing to insufficient questionnaire data. The questionnaire was developed based on the WHO’s Oral Health Survey (OHS) and the Korean National Oral Health Survey (KNOHS). Three categories were included in the questionnaire: demographic characteristics, dental service experience in North Korea, and oral health behavior. Results: Males had higher levels of perceived oral health compared to females, with differences according to the region they are from in North Korea. Those who received tooth brushing instruction in North Korea showed a greater tendency to practice tooth brushing after lunch, while those who received oral health examination showed a higher level of use of oral rinses. Further, the experience of dental scaling significantly influenced both practicing tooth brushing after lunch and use of oral rinses. Conclusions This study confirmed that the previous experience of oral health service in North Korea positively influenced current oral health behavior of North Korean defectors. Continued oral health education can enhance their oral health behavior, oral health, and quality of life. Thus, it is suggested that policies and oral health education should be developed according to their characteristics and oral health service experience in North Korea.