Background: An ideal lung allocation system should reduce waiting list deaths, improve transplant survival, and ensure equitable organ allocation. This study aimed to develop a novel lung allocation score (LAS) system, the MaxBenefit LAS, to maximize transplant benefits. Methods: This study retrospectively analyzed data from the Korean Network for Organ Sharing database, including 1,599 lung transplant candidates between September 2009 and December 2020. We developed the MaxBenefit LAS, combining a waitlist mortality model and a post-transplant survival model using elastic-net Cox regression, was assessed using area under the curve (AUC) values and Uno’s C-index. Its performance was compared to the US LAS in an independent cohort. Results: The waitlist mortality model showed strong predictive performance with AUC values of 0.834 and 0.818 in the training and validation cohorts, respectively. The post-transplant survival model also demonstrated good predictive ability (AUC: 0.708 and 0.685). The MaxBenefit LAS effectively stratified patients by risk, with higher scores correlating with increased waitlist mortality and decreased post-transplant mortality. The MaxBenefit LAS outperformed the conventional LAS in predicting waitlist death and identifying candidates with higher transplant benefits. Conclusion The MaxBenefit LAS offers a promising approach to optimizing lung allocation by balancing the urgency of candidates with their likelihood of survival post-transplant. This novel system has the potential to improve outcomes for lung transplant recipients and reduce waitlist mortality, providing a more equitable allocation of donor lungs.

Background: An ideal lung allocation system should reduce waiting list deaths, improve transplant survival, and ensure equitable organ allocation. This study aimed to develop a novel lung allocation score (LAS) system, the MaxBenefit LAS, to maximize transplant benefits. Methods: This study retrospectively analyzed data from the Korean Network for Organ Sharing database, including 1,599 lung transplant candidates between September 2009 and December 2020. We developed the MaxBenefit LAS, combining a waitlist mortality model and a post-transplant survival model using elastic-net Cox regression, was assessed using area under the curve (AUC) values and Uno’s C-index. Its performance was compared to the US LAS in an independent cohort. Results: The waitlist mortality model showed strong predictive performance with AUC values of 0.834 and 0.818 in the training and validation cohorts, respectively. The post-transplant survival model also demonstrated good predictive ability (AUC: 0.708 and 0.685). The MaxBenefit LAS effectively stratified patients by risk, with higher scores correlating with increased waitlist mortality and decreased post-transplant mortality. The MaxBenefit LAS outperformed the conventional LAS in predicting waitlist death and identifying candidates with higher transplant benefits. Conclusion The MaxBenefit LAS offers a promising approach to optimizing lung allocation by balancing the urgency of candidates with their likelihood of survival post-transplant. This novel system has the potential to improve outcomes for lung transplant recipients and reduce waitlist mortality, providing a more equitable allocation of donor lungs.

Background: An ideal lung allocation system should reduce waiting list deaths, improve transplant survival, and ensure equitable organ allocation. This study aimed to develop a novel lung allocation score (LAS) system, the MaxBenefit LAS, to maximize transplant benefits. Methods: This study retrospectively analyzed data from the Korean Network for Organ Sharing database, including 1,599 lung transplant candidates between September 2009 and December 2020. We developed the MaxBenefit LAS, combining a waitlist mortality model and a post-transplant survival model using elastic-net Cox regression, was assessed using area under the curve (AUC) values and Uno’s C-index. Its performance was compared to the US LAS in an independent cohort. Results: The waitlist mortality model showed strong predictive performance with AUC values of 0.834 and 0.818 in the training and validation cohorts, respectively. The post-transplant survival model also demonstrated good predictive ability (AUC: 0.708 and 0.685). The MaxBenefit LAS effectively stratified patients by risk, with higher scores correlating with increased waitlist mortality and decreased post-transplant mortality. The MaxBenefit LAS outperformed the conventional LAS in predicting waitlist death and identifying candidates with higher transplant benefits. Conclusion The MaxBenefit LAS offers a promising approach to optimizing lung allocation by balancing the urgency of candidates with their likelihood of survival post-transplant. This novel system has the potential to improve outcomes for lung transplant recipients and reduce waitlist mortality, providing a more equitable allocation of donor lungs.

Background: An ideal lung allocation system should reduce waiting list deaths, improve transplant survival, and ensure equitable organ allocation. This study aimed to develop a novel lung allocation score (LAS) system, the MaxBenefit LAS, to maximize transplant benefits. Methods: This study retrospectively analyzed data from the Korean Network for Organ Sharing database, including 1,599 lung transplant candidates between September 2009 and December 2020. We developed the MaxBenefit LAS, combining a waitlist mortality model and a post-transplant survival model using elastic-net Cox regression, was assessed using area under the curve (AUC) values and Uno’s C-index. Its performance was compared to the US LAS in an independent cohort. Results: The waitlist mortality model showed strong predictive performance with AUC values of 0.834 and 0.818 in the training and validation cohorts, respectively. The post-transplant survival model also demonstrated good predictive ability (AUC: 0.708 and 0.685). The MaxBenefit LAS effectively stratified patients by risk, with higher scores correlating with increased waitlist mortality and decreased post-transplant mortality. The MaxBenefit LAS outperformed the conventional LAS in predicting waitlist death and identifying candidates with higher transplant benefits. Conclusion The MaxBenefit LAS offers a promising approach to optimizing lung allocation by balancing the urgency of candidates with their likelihood of survival post-transplant. This novel system has the potential to improve outcomes for lung transplant recipients and reduce waitlist mortality, providing a more equitable allocation of donor lungs.

OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

PURPOSE: The purpose of this study was to examine the effect of a group coaching program (GCP) on depression, anxiety, and hope in women breast cancer patients undergoing chemotherapy. METHODS: A total of 152 patients were enrolled and randomly assigned to an experimental group receiving the GCP (N=76) and an untreated control group (N=76). Data collection consisted of three measurements of depression, anxiety, and hope (pre, post, and 3weeks later). The intervention was a one-time GCP consisting of 5 subparts for 30~40 minutes for a group of 3~4 people, conducted by a single nurse. RESULTS: The scores of depression, anxiety, and hope changed significantly over time (p<.001, p<.001, p<.001). Depression, anxiety, and hope changes were significantly different between the experimental and control groups (p<.001, p<.001, p<.001). There was a difference in depression, anxiety, and hope among the groups according to the implementation of the GCP (p<.001, p<.001, p<.001). In the experimental group, depression, anxiety, and hope level were significantly different between the pre- and post-test (p<.001), pre- and 3weeks later-test (p<.001), but not in the control group. CONCLUSION: The GCP for women breast cancer patients receiving chemotherapy was effective in reducing depression and anxiety, and increasing hope.
Anxiety* ; Breast Neoplasms* ; Breast* ; Data Collection ; Depression* ; Drug Therapy* ; Female ; Hope* ; Humans

PURPOSE: The purpose of this study was to examine the effect of black soybean (CJ-3) testa extracts on lipid profiles in streptozotocin (STZ)-induced diabetic rats. METHODS: One control group and four STZ-induced diabetic groups with different doses of black soybean (CJ-3) testa extracts treatment [0 mg/kg (diabetic control, EX), 250 mg/kg (EX-250), 500 mg/kg (EX-500), 1,000 mg/kg (EX-1000)] were orally administered for 4 weeks. RESULTS: All CJ-3 treatment groups had remarkably lower serum triglyceride (TG) levels than that of EX group (p < 0.05) whereas hepatic TG contents did not show any differences. Results from serum total cholesterol (TC) concentrations of EX-250 and EX-1000 groups were decreased compared to EX group (p < 0.05). Furthermore, protein levels of 3-hydroxy-3-methyl-glutaryl-Coenzyme A (HMG-CoA) reductase from the liver decreased in all treatment groups (p < 0.05). However, significant differences were not observed in serum glucose and insulin, and glucose transporter 4 (GLUT-4) protein expression in skeletal muscle tissue. CONCLUSION: These results suggest that black soybean testa extracts could be useful for improvement of hyperlipidemia and hypercholesteremia in diabetes.
Animals ; Anthocyanins ; Blood Glucose ; Cholesterol ; Glucose Transport Proteins, Facilitative ; Hypercholesterolemia ; Hyperlipidemias ; Insulin ; Liver ; Muscle, Skeletal ; Oxidoreductases ; Rats* ; Soybeans* ; Streptozocin ; Triglycerides

Chemotherapy-induced acral erythema (CIAE) is an uncommon, self-limited local skin reaction that usually occurs after high-dose chemotherapy. There is no specific treatment for this disease and it disappears within three to five weeks. In this case report, we present a 16-year-old female with acute lymphoblastic leukemia who developed severe CIAE. The lesions appeared as a well-defined erythema of the hands, feet, and back with symmetrically well-defined borders 5 days after low-dose MTX treatment. The erythema progressed to bullae formation and desquamation. It resolved spontaneously within 2 weeks. CIAE is very uncommon in children; however we should consider acral erythema as a differential diagnosis when bullous skin reaction occurs in a patient who receives chemotherapy.
Adolescent ; Child ; Diagnosis, Differential ; Drug Therapy ; Erythema ; Female ; Foot ; Hand ; Hand-Foot Syndrome ; Humans ; Methotrexate ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Skin

BACKGROUND AND OBJECTIVES: Carotid intima-media thickness (IMT) is associated with chronic inflammation, and C-reactive protein (CRP) level is elevated in patients with atrial fibrillation (AF). We investigated the impacts of CRP and AF on carotid atherosclerosis and ischemic stroke in patients with suspected ischemic cerebrovascular disease. SUBJECTS AND METHODS: One-hundred forty patients (78 males) with suspected ischemic cerebrovascular disease underwent carotid ultrasonography. The mean common carotid artery IMT, mean internal carotid artery (ICA) IMT, and plaque score were measured. Patients were divided into four groups according to the presence of AF and elevated CRP level {n=46 for AF(-)CRP(-), n=38 for AF(-)CRP(+), n=43 for AF(+)CRP(-), and n=13 for AF(+)CRP(+)}. RESULTS: Common carotid artery IMT was significantly higher in the AF(-)CRP(+) (0.98+/-0.51 mm) and AF(+)CRP(+) (0.96+/-0.27 mm) groups compared to the AF(-)CRP(-) (0.80+/-0.32 mm) and AF(+)CRP(-) (0.77+/-0.19 mm) groups (p=0.027). Although there was no significant difference in mean ICA IMT among the groups, plaque score was the highest in the AF(+)CRP(+) (4.18+/-3.84 mm) group, followed by AF(-)CRP(+) (3.87+/-2.78 mm), AF(+)CRP(-) (1.34+/-2.61 mm), and AF(-)CRP(-) (1.17+/-2.02 mm) (p<0.001). The AF(+)CRP(+) group showed significantly higher incidence of ischemic stroke than the other groups (all p<0.05). Binary logistic regression analysis showed that age {odds ratio (OR)=1.033, p=0.001}, elevated CRP (OR=3.884, p=0.001), and the presence of AF (OR=1.375, p=0.018) were significantly correlated with incidence of ischemic stroke. CONCLUSION: Elevated plasma CRP concentration may be a reliable surrogate marker for predicting carotid atherosclerosis in patients with AF, which may be related to increased risk of ischemic stroke.
Atrial Fibrillation* ; Biomarkers ; C-Reactive Protein* ; Carotid Artery Diseases* ; Carotid Artery, Common ; Carotid Artery, Internal ; Carotid Intima-Media Thickness ; Cohort Studies* ; Humans ; Incidence ; Inflammation ; Logistic Models ; Plasma ; Retrospective Studies* ; Stroke* ; Ultrasonography

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) infection appears to subvert the human iron regulatory mechanism and thus upregulates hepcidin, resulting in unexplained iron-deficiency anemia (IDA). We evaluated serum prohepcidin levels before and after eradication of H. pylori in IDA patients to assess whether it plays a role in IDA related to H. pylori infection. METHODS: Subjects diagnosed with unexplained IDA underwent upper gastrointestinal endoscopy and colonoscopy to confirm H. pylori infection and to exclude gastrointestinal bleeding. Blood was sampled before treatment to eradicate H. pylori and again 1 month later. Serum prohepcidin levels were measured using a commercial enzyme-linked immunosorbent assay kit. RESULTS: Serum prohepcidin levels decreased significantly after oral iron replacement combined with H. pylori eradication (p = 0.011). The reduction ratio of serum prohepcidin levels after the treatment did not differ among the combined oral iron replacement and H. pylori eradication groups, the H. pylori eradication only group, and the iron replacement only group (p = 0.894). CONCLUSIONS: Serum prohepcidin levels decrease after both H. pylori eradication and oral iron administration, with improvement in IDA. Serum concentration of prohepcidin is related to the anemia status, rather than to the current status of H. pylori infection, in IDA patients.
Administration, Oral ; Adult ; Aged ; Anemia, Iron-Deficiency/*blood/drug therapy/*microbiology ; Antimicrobial Cationic Peptides/*blood ; Endoscopy, Gastrointestinal ; Female ; Follow-Up Studies ; Helicobacter Infections/*blood/*complications/pathology ; *Helicobacter pylori ; Humans ; Iron/administration & dosage ; Male ; Middle Aged ; Prospective Studies ; Protein Precursors/*blood ; Severity of Illness Index