Impact of medical crisis on the critical care system in South Korea.

Background: The ongoing medical crisis in Korea has severely impacted the operational environment of intensive care units (ICU), posing significant challenges to quality care for critically ill patients. This study aimed to evaluate the effects of the ongoing crisis on ICUs.

Methods: A survey was conducted in July 2024 among intensivists in charge of ICUs at institutions accredited by the Korean Society of Critical Care Medicine for critical care.

Predictive value of early warning scores in in-hospital mortality of patients readmitted to the surgical intensive care unit after major abdominal surgery.

Background/aims: Early warning scores are simple scores obtained by measuring physiological parameters and have been regarded as useful tools for detecting clinical deterioration. This study aimed to evaluate the impact of early warning scores in predicting in-hospital mortality in critically ill patients readmitted to the surgical intensive care unit.

Methods: The study was conducted at a tertiary referral teaching hospital in South Korea.

Evaluating the effect of age on postoperative and clinical outcomes in patients admitted to the intensive care unit after gastrointestinal cancer surgery.

Background: This study aimed to compare postoperative and clinical outcomes according to age and analyze the effect of age on mortality in patients admitted to the intensive care unit immediately after gastrointestinal cancer surgery.

Methods: A total of 477 patients admitted to the intensive care unit after gastrointestinal cancer surgery between March 2018, and February 2020, were classified into 3 groups according to age: young (<65 years), older (65-79 years), and oldest (≥80 years) groups. We compared their disease severity scores as well as postoperative and clinical outcomes including mortality.

Clinical application of protein-enhanced diet using mealworms in patients undergoing hepato-pancreato-biliary surgery.

Objective: Patients with or without cancers who undergo major gastrointestinal surgery experience malnutrition owing to their catabolic status during the postoperative period. In this study, we evaluated the effect of the clinical application of protein-enhanced diet using mealworms in patients who underwent hepato-pancreato-biliary surgeries.

Methods: This study was designed as a prospective, two-armed, and double-blinded phase III study.

Immune-modulating Effect of Korean Red Ginseng by Balancing the Ratio of Peripheral T Lymphocytes in Bile Duct or Pancreatic Cancer Patients With Adjuvant Chemotherapy.

Background/aim: We aimed to clarify the clinical effect of Korean Red ginseng administered with adjuvant chemotherapy on the immune function of patients with bile duct or pancreatic cancer.

Patients And Methods: This was a prospective, randomized controlled trial conducted at a single tertiary center. Twenty-six consecutive patients who underwent curative resection for bile duct or pancreatic cancer followed by 5-fluorouracil/leucovorin or gemcitabine chemotherapy were included.

LASSO-Based Machine Learning Algorithm for Prediction of Lymph Node Metastasis in T1 Colorectal Cancer.

Purpose: The role of tumor-infiltrating lymphocytes (TILs) in predicting lymph node metastasis (LNM) in patients with T1 colorectal cancer (CRC) remains unclear. Furthermore, clinical utility of a machine learning-based approach has not been widely studied.

Materials And Methods: Immunohistochemistry for TILs against CD3, CD8, and forkhead box P3 in both center and invasive margin of the tumor were performed using surgically resected T1 CRC slides.

Clinical application of invalid foods using mealworms and evaluation of nutrition status and immune function: a study protocol for a randomized, double blind, placebo-controlled trial.

Background: Protein intake is important for the recovery of the immune system, physical strength, and wound healing after surgery. Sarcopenia is associated with a poor prognosis when compared to patients without sarcopenia in cancer patients. Recently, edible insects, such as mealworms, have been recognized as having a high protein content.

Specific protein 1(SP1) regulates the epithelial-mesenchymal transition via lysyl oxidase-like 2(LOXL2) in pancreatic ductal adenocarcinoma.

Specific protein 1 (SP1) is associated with aggressive behavior, invasive clinical phenotype and poor clinical outcomes in various cancers. We studied whether SP1 exerts its effect on invasiveness and promotion of the epithelial-mesenchymal transition (EMT) by regulating lysyl oxidase-like 2 (LOXL2) in pancreatic ductal adenocarcinoma (PDAC) cell lines. We showed that silencing of SP1 in MIA Paca-2 cell significantly decreased cell invasion and migration.

Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker.

Purpose: Predicting the need for surgical intervention among patients with intestinal obstruction is challenging. The delta neutrophil index (DNI) has been suggested as a useful marker of immature granulocytes, which indicate an infection or sepsis. In this study, we evaluated the impact of the DNI as an early predictor of operation among patients with intestinal obstruction.

Multiple Myeloma Mimics Bone Metastasis From a Rectal Adenocarcinoma.

A presumptive diagnosis of bone metastasis can be easily made when a patient with a history of colorectal cancer develops bone lesions that are seen on follow-up imaging. In this case report, we describe a patient whose multiple bone lesions were wrongly attributed to a recurrence of rectal cancer rather than being identified as multiple myeloma lesions. When clinicians detect new, abnormal, bony lesions in a patient with a previous history of cancer, they should consider diseases such as multiple myeloma in their differential diagnosis.

Impact of Pre-Transplant Bacterial Infections on Post-Operative Outcomes in Patients after Liver Transplantation.

Background: In contrast to studies evaluating the negative effect of bacterial infections on clinical outcomes after liver transplantation, there is little evidence with regard to pre-transplant bacterial infections. We aimed to investigate the impact of pre-transplant bacterial infections on post-transplant outcomes in patients after liver transplantation.

Patients And Methods: We retrospectively analyzed clinical data from 33 consecutive patients who underwent primary liver transplantations.

The efficacy of cap-assisted colonoscopy performed by a single endoscopist in patients after colorectal resection.

Background: The use of a transparent cap is regarded as a simple method to obtain better outcomes compared with standard colonoscopy. In this study, we investigated whether cap-assisted colonoscopy can improve the quality of procedure-related outcomes in patients with a history of colorectal resection.

Methods: This study was designed as a prospective, randomized, controlled trial conducted at a single tertiary center by a single endoscopist (Kang J.

Impact of prior abdominal surgery on postoperative prolonged ileus after ileostomy repair.

Background And Aims: Postoperative ileus (POI) is one of the most common reasons for sustained hospital stays after ileostomy repair. Although many factors have been investigated as POI risk factors, the investigation of the impact of prior abdominal surgery (PAS) before rectal cancer surgery has been limited. This study aimed to identify the impact of PAS as a risk factor for POI after ileostomy repair.

In Vitro Adenosine Triphosphate-Based Chemotherapy Response Assay as a Predictor of Clinical Response to Fluorouracil-Based Adjuvant Chemotherapy in Stage II Colorectal Cancer.

Purpose: We evaluated the usefulness of the in vitro adenosine triphosphate-based chemotherapy response assay (ATP-CRA) for prediction of clinical response to fluorouracil-based adjuvant chemotherapy in stage II colorectal cancer.

Materials And Methods: Tumor specimens of 86 patients with pathologically confirmed stage II colorectal adenocarcinoma were tested for chemosensitivity to fluorouracil. Chemosensitivity was determined by cell death rate (CDR) of drug-exposed cells, calculated by comparing the intracellular ATP level with that of untreated controls.

Effect of preoperative colonoscopic tattooing on lymph node harvest in T1 colorectal cancer.

Objective: This study aimed to identify the impact of preoperative colonoscopic tattooing (PCT) on lymph node harvest in T1 colorectal cancer patients.

Material And Methods: One hundred and forty-three patients were included who underwent curative resection and were diagnosed with T1 colorectal cancer. These patients were categorized into the tattooing group and the non-tattooing group depending on whether preoperative India ink tattooing was done.

The impact of lymph node size to predict nodal metastasis in patients with rectal cancer after preoperative chemoradiotherapy.

Purpose: During restaging after preoperative chemoradiotherapy (CRT), the assessment of lymph node (LN) metastasis is vital for selecting further treatment strategies. This study aimed to evaluate the impact of LN size to predict LN metastasis in rectal cancer patients after preoperative CRT.

Methods: A total of 30 consecutive patients who underwent preoperative CRT followed by curative resection of primary rectal cancer were selected as a study group (CRT group).

Clinical implications of microsatellite instability in T1 colorectal cancer.

Purpose: The estimation of regional lymph node metastasis (LNM) risk in T1 colorectal cancer is based on histologic examination and imaging of the primary tumor. High-frequency microsatellite instability (MSI-H) is likely to decrease the possibility of metastasis to either regional lymph nodes or distant organs in colorectal cancers. This study evaluated the clinical implications of MSI in T1 colorectal cancer with emphasis on the usefulness of MSI as a predictive factor for regional LNM.

Underweight body mass index as a predictive factor for surgical site infections after laparoscopic appendectomy.

Purpose: Analyses of risk factors associated with surgical site infections (SSIs) after laparoscopic appendectomy (LA) have been limited. Especially, the association of an underweight body mass index (BMI) with SSIs has not been clearly defined. This study aimed to identify the impact of underweight BMI in predicting SSIs after LA.

Laparoscopic-assisted resection of jejunojejunal intussusception caused by a juvenile polyp in an adult.

Most bowel intussusceptions in adults have a leading point. However, there have been few reports of jejunojejunal intussusception secondary to a solitary juvenile polyp in adult. We report herein the case of a 19-year-old female with a solitary juvenile polyp in the jejunum causing intussusception.

Feasibility and safety of a fold-over diverting ileostomy reversal after rectal cancer surgery: case-matched comparison to the resection technique.

Purpose: Compared to the stapling technique, the fold-over technique (FO) has the benefit of avoiding the sacrifice of the bowel segment. The aim of this study was to compare short-term outcomes between the FO and a conventional resection.

Methods: Between June 2008 and March 2012, a total of 242 patients who underwent a diverting ileostomy reversal after rectal cancer surgery were selected.

Is prior laparoscopy experience required for adaptation to robotic rectal surgery?: Feasibility of one-step transition from open to robotic surgery.

Purpose: The objective of this study is to ascertain the impact of laparoscopic colorectal surgery (LCS) experience on the learning curve of robotic rectal cancer surgery (RRS). Whether LCS experience is mandatory on overcoming the learning curve of RRS or not remains undetermined.

Methods: Before starting the robotic procedure, surgeon A had a limited experience of less than 30 LCS cases, whereas surgeon B had performed more than 300 cases of LCS.

Laparoscopic right hemicolectomy with complete mesocolic excision.

Background: Complete mesocolic excision (CME) has recently been reemphasized as a technical approach for anatomical dissection during colon cancer surgery. Although a laparoscopic approach for right colon cancer is performed frequently, identifying an adequate dissection plane is not always easy. In our practice, the patient lies in a modified lithotomy position.

A high-throughput assay of NK cell activity in whole blood and its clinical application.

Natural killer (NK) cells are lymphocytes of the innate immune system and have the ability to kill tumor cells and virus-infected cells without prior sensitization. Malignant tumors and viruses have developed, however, strategies to suppress NK cells to escape from their responses. Thus, the evaluation of NK cell activity (NKA) could be invaluable to estimate the status and the outcome of cancers, viral infections, and immune-mediated diseases.