Background: The heart donor allocation system in South Korea is divided into three regions, with priority given to recipients within the same region over those in other regions of the same tier. It is commonly believed that heart transplantation (HT) within the same region can reduce ischemic time (IT), although its clinical impact remains unclear. The purpose of this study is to compare the characteristics and outcomes of intra-region HT and inter-region HT. Methods: From 2014 to 2022, a total of 115 adult patients underwent isolated HT at a tertiary hospital. Of these, 58 recipients (54.5 ± 10.3 years, female, 36.2%) underwent intra-region HT and 57 recipients (53.9 ± 14.1 years, female, 31.6%) underwent inter-region HT. Extracorporeal membrane oxygenation-bridged HTs accounted for 50.0% and 54.4% of cases, respectively (P = 0.638). There were no differences in preoperative characteristics between the two groups. Results: The median inter-hospital distance (38.0 [32.0–112.0] km vs. 351.0 [300.0–390.5] km, P < 0.001) and total IT (153 [123–170] minute vs. 265 [243–298] minute, P < 0.001) were longer in the inter-region group than intra-region group. Despite these differences, both groups showed similar clinical outcomes. The 30-day mortality rates were 5.2% and 5.3% (P < 0.99), respectively. There were no differences in postoperative cardiac index, early adverse outcomes, or long-term survival between the two groups. The inter-hospital distance and cold IT showed a strong positive correlation (time [minute] = 39.462 + 0.410 × distance [km]). Conclusion Despite the difference in IT, there was no difference in postoperative outcomes between the two groups. Based on these findings, the effect of donor location on the outcomes of HT in South Korea is not considered significant.

Background: This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027. Methods: We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models. Results: The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000. Conclusion The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.

Objective: This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD). Methods: Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5.Logistic regression analyses were conducted. Results: Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education. Conclusion The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.

Background: The 16S rRNA-targeted next-generation sequencing (NGS) has been widely used as the primary tool for microbiome analysis. However, whether the sequenced microbial diversity absolutely represents the original sample composition remains unclear. This study aimed to evaluate whether 16S rRNA gene-targeted NGS accurately captures bacterial community composition. Methods: Mock communities were constructed using equal amounts of DNA from 18 bacterial strains in three formats: genomic DNA, recombinant plasmids, and polymerase chain reaction (PCR) templates. The V3V4 region of the 16S rRNA gene was amplified and sequenced using the Illumina MiSeq. Results: Data regression analysis revealed that the recombinant plasmid produced more accurate and precise correlation curve than that by the gDNA and PCR products, with a slope closest to 1 (1.0082) and the highest R² value (0.9975). Despite the same input amount of bacterial DNA, the NGS read distribution varied across all three mock communities. Using multiple regression analysis, we found that the guanine-cytosine (GC) content of the V3V4 region, 16S rRNA gene, size of gDNA, and copy number of 16S rRNA were significantly associated with the NGS output of each bacterial species. Conclusion This study demonstrated that recombinant plasmids are the preferred option for quality control and that NGS output is biased owing to certain bacterial characteristics, such as %GC content, gDNA size, and 16S rRNA gene copy number. Further research is required to develop a system that compensates for NGS process biases using mock communities.

Although histone deacetylase 6 (HDAC6) is considered a therapeutic target for Alzheimer’s disease (AD), its role in cholinergic dysfunction in AD patients remains unclear. This study investigated the effects of (E)-3-(2-(4-fluorostyryl)thiazol-4-yl)-N-hydroxypropanamide (4-FHA), a new synthetic HDAC6 inhibitor, on cognitive and memory impairments in a scopolamine-induced-AD mouse model. Behaviorally, 4-FHA improved scopolamine-induced memory impairments in the Y-maze, passive avoidance, and Morris water maze tests. In addition, 4-FHA ameliorated scopolamine-induced cognitive impairments in the novel object recognition and place recognition tests. Furthermore, 4-FHA increased acetylation of α-tubulin (a major HDAC6 substrate); the expression of BDNF; and the phosphorylation of ERK 1/2, CREB, and ChAT in the hippocampus of scopolamine-treated mice. In summary, according to our data 4-FHA, an HDAC6 inhibitor, improved the cognitive and memory deficits of the AD mouse model by normalizing BDNF signaling and synaptic transmission, suggesting that 4-FHA might be a potential therapeutic candidate for AD.

Purpose: Cancer poses a significant global health challenge, demanding precise genomic testing for individualized treatment strategies. Targeted-panel sequencing (TPS) has improved personalized oncology but often lacks comprehensive coverage of crucial cancer alterations. Whole-genome sequencing (WGS) addresses this gap, offering extensive genomic testing. This study demonstrates the medical potential of WGS. Materials and Methods: This study evaluates target-enhanced WGS (TE-WGS), a clinical-grade WGS method sequencing both cancer and matched normal tissues. Forty-nine patients with various solid cancer types underwent both TE-WGS and TruSight Oncology 500 (TSO500), one of the mainstream TPS approaches. Results: TE-WGS detected all variants reported by TSO500 (100%, 498/498). A high correlation in variant allele fractions was observed between TE-WGS and TSO500 (r=0.978). Notably, 223 variants (44.8%) within the common set were discerned exclusively by TE-WGS in peripheral blood, suggesting their germline origin. Conversely, the remaining subset of 275 variants (55.2%) were not detected in peripheral blood using the TE-WGS, signifying them as bona fide somatic variants. Further, TE-WGS provided accurate copy number profiles, fusion genes, microsatellite instability, and homologous recombination deficiency scores, which were essential for clinical decision-making. Conclusion TE-WGS is a comprehensive approach in personalized oncology, matching TSO500’s key biomarker detection capabilities. It uniquely identifies germline variants and genomic instability markers, offering additional clinical actions. Its adaptability and cost-effectiveness underscore its clinical utility, making TE-WGS a valuable tool in personalized cancer treatment.

Background: The heart donor allocation system in South Korea is divided into three regions, with priority given to recipients within the same region over those in other regions of the same tier. It is commonly believed that heart transplantation (HT) within the same region can reduce ischemic time (IT), although its clinical impact remains unclear. The purpose of this study is to compare the characteristics and outcomes of intra-region HT and inter-region HT. Methods: From 2014 to 2022, a total of 115 adult patients underwent isolated HT at a tertiary hospital. Of these, 58 recipients (54.5 ± 10.3 years, female, 36.2%) underwent intra-region HT and 57 recipients (53.9 ± 14.1 years, female, 31.6%) underwent inter-region HT. Extracorporeal membrane oxygenation-bridged HTs accounted for 50.0% and 54.4% of cases, respectively (P = 0.638). There were no differences in preoperative characteristics between the two groups. Results: The median inter-hospital distance (38.0 [32.0–112.0] km vs. 351.0 [300.0–390.5] km, P < 0.001) and total IT (153 [123–170] minute vs. 265 [243–298] minute, P < 0.001) were longer in the inter-region group than intra-region group. Despite these differences, both groups showed similar clinical outcomes. The 30-day mortality rates were 5.2% and 5.3% (P < 0.99), respectively. There were no differences in postoperative cardiac index, early adverse outcomes, or long-term survival between the two groups. The inter-hospital distance and cold IT showed a strong positive correlation (time [minute] = 39.462 + 0.410 × distance [km]). Conclusion Despite the difference in IT, there was no difference in postoperative outcomes between the two groups. Based on these findings, the effect of donor location on the outcomes of HT in South Korea is not considered significant.

Background: This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027. Methods: We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models. Results: The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000. Conclusion The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.

Background: This study was performed to compare the thickness of the ganglion cell-inner plexiform layer (GCIPL) depending on the presence or absence of fixation preference in patients with intermittent exotropia (IXT) with refractive values close to emmetropia and with no amblyopia. Methods: The study recruited pediatric patients diagnosed with IXT with a spherical equivalent within ±1.25 diopter and no amblyopia. The patients were categorized into two groups: a monocular exotropia group with fixation preference and an alternating exotropia group without fixation preference. GCIPL thickness was measured using spectral domain optical coherence tomography, and the macula was divided into nine sectors according to the Early Treatment Diabetic Retinopathy Study (ETDRS). GCIPL thickness in each sector was compared between the monocular and alternating exotropia groups. Results: In the monocular exotropia group, GCIPL thickness was significantly thinner in the dominant eye than in the nondominant eye in the S1 sector (91.2±7.4 μm vs. 93.3±5.2 μm, p=0.019). However, in the alternating exotropia group, there were no significant differences between the eyes across all ETDRS sectors. When comparing the interocular differences in GCIPL thickness between the two groups, the monocular exotropia group (absolute value of the dominant eye minus the nondominant eye) exhibited significantly greater differences in several ETDRS sectors than the alternating exotropia group (absolute value of the right eye minus the left eye). Conclusion The significant interocular difference in GCIPL thickness in the monocular exotropia group suggests that fixation preference may influence the anatomical structure of the macula in patients with IXT.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.