Characteristics and management of mechanically ventilated patients in South Korea compared with other high-income Asian countries and regions.

Background: This study investigated the characteristics of mechanically ventilated patients in South Korean intensive care units (ICUs).

Methods: We conducted a subgroup analysis of a multinational observational study. Data from 271 mechanically ventilated patients in South Korean ICUs were analyzed for demographics, ventilation practices, and mortality, and were compared with those of 327 patients from other high-income Asian countries.

Concept of Depth of Invasion can Improve Staging Performance in Patients with Resected Distal Cholangiocarcinoma: Validation of the American Joint Committee on Cancer Staging System.

Purpose: The American Joint Committee on Cancer (AJCC) staging system for distal cholangiocarcinoma (dCC) has evolved significantly. However, the prognostic correlation of the newly proposed staging system remains unclear. Therefore, we aimed to compare the staging performance between AJCC 7th and 8th editions for dCC.

Evaluation of clinical research priorities in Asian intensive care units (ERA-ICU).

Background: Practice and delivery of critical care in Asia varies according to healthcare structure, income setting, and cultural factors. Identifying research priorities specific to ICU patients and healthcare workers in Asia is needed to guide advancement of critical care in the region.

Methods: This was an international cross-sectional survey study with adapted methods from nominal group techniques.

Evaluating Tumor Regression and Survival Outcomes in Pancreatic Ductal Adenocarcinoma After Neoadjuvant Treatment according to CAP Grading System: Clinical Usefulness and Limitations.

Background: Neoadjuvant treatment (NAT) is increasingly employed for pancreatic ductal adenocarcinoma (PDAC), necessitating reliable methods to assess tumor response. The College of American Pathologists (CAP) grading system is widely used to predict chemo-responsiveness and survival, but consensus on the most effective grading system and treatment regimen remains elusive.

Patients And Methods: This retrospective study included 462 patients with PDAC who underwent resection after NAT between 2009 and 2023.

Evaluation of feasibility and clinical outcomes of robot-assisted pancreaticoduodenectomy after neoadjuvant treatment for patients with advanced pancreatic ductal adenocarcinoma: a retrospective propensity score-matched cohort study.

Purpose: With neoadjuvant treatment (NAT) broadening the surgical indication for advanced pancreatic cancer, the growing use of robotic platforms in pancreaticoduodenectomy (PD) necessitates the evaluation of its feasibility in advanced pancreatic cancer patients who have undergone NAT.

Methods: We compared clinicopathological outcomes of advanced pancreatic cancer patients who received either robot-assisted or open PD after NAT at a tertiary hospital from 2015 to 2023. Propensity score matching was performed based on age, sex, and TNM staging.

Cell viability measured by cytotoxicity assay as a biomarker of chronic obstructive pulmonary disease exacerbation: a prospective cohort study.

Acute severe exacerbation of chronic obstructive pulmonary disease (COPD) is related to high mortality; however, a robust blood biomarker for COPD exacerbation has not been established. Impaired clearance of apoptotic cells is a possible pathogenesis of COPD development. We evaluated the clinical utility of serum cell viability as a predictive biomarker for COPD exacerbation.

Long-term oncologic outcomes of robot-assisted pancreaticoduodenectomy versus open pancreaticoduodenectomy for pancreatic cancer.

Background: Robot-assisted pancreaticoduodenectomy (RPD) has been gaining attention for its potential benefits in short-term surgical outcomes compared with open pancreaticoduodenectomy (OPD) in pancreatic cancer. However, the evidence of its long-term oncological efficacy is limited.

Methods: This retrospective study compared the long-term outcomes of RPD and OPD in patients with pancreatic cancer at Seoul National University Hospital between January 2015 and October 2023.

Long-term exposure to air pollution and lung cancer incidence: findings from improved exposure assessment and extended population.

Purpose: Accumulating evidence suggested long-term exposure to air pollution as a risk factor of lung cancer. Recent efforts confirmed the association based on extended population and individual exposure by leveraging administrative databases and complete address information. However, few studies achieved simultaneous improvements.

Changing Clinical Meaning of Resection Margin Status According to the Treatment Paradigm and the Potential Role of Perioperative Radiotherapy for Patients with Pancreatic Ductal Adenocarcinoma: An Updated Multicenter Retrospective Cohort Study.

Background: Surgeons have focused on obtaining microscopically negative margins and developing perioperative treatment strategies for pancreatic head cancer. However, the clinical significance of resection margin and radiotherapy remains unclear, particularly in neoadjuvant chemotherapy (NAC) settings. Therefore, this study aimed to evaluate the prognostic impact of margin status and perioperative radiotherapy.

Impact of Resection Margin Status on Recurrence and Possible Candidates for Adjuvant Radiotherapy in Resected Distal Cholangiocarcinoma.

Objective: To evaluate the prognostic impact of resection margin in distal cholangiocarcinoma (dCC).

Background: Due to the relatively low prevalence of dCC in Western countries and the use of various definitions of resection margin status, the prognostic impact of bile duct resection margin status remains unclear.

Methods: This study included consecutive patients who underwent curative surgery and were diagnosed with dCC between 2000 and 2022.

Temperature-Controlled pNIB/PTX Micelles for Improved Paclitaxel Delivery in Ovarian Cancer Treatment.

Paclitaxel (PTX) is a widely used anticancer drug for ovarian cancer treatment, but its clinical application is limited by poor water solubility and dose-limiting toxicities. To overcome these challenges, we developed a thermoresponsive, multistep drug delivery system, pNIB/PTX, designed to improve PTX solubility and provide controlled drug release. The pNIB/PTX-3 complex exhibited an initial rapid drug release phase followed by sustained slow release, optimizing both short-term and long-term therapeutic efficacy.

Efficacy of Portable Ultrasonography for Early Detection of Pneumothorax Following Lung Biopsy.

Background: Pneumothorax is a notable complication of lung biopsy, and its early detection is crucial. This study aimed to compare the sensitivities of handheld portable lung ultrasonography and chest radiography in identifying early pneumothorax post-lung biopsy.

Methods: Upright chest radiography and lung ultrasonography were conducted at 3 and 24 hours following lung biopsy.

Impact of Nutritional Changes on the Prognosis in Pancreatic Cancer Patients Underwent Curative Surgery After Neoadjuvant Chemotherapy.

Background: Pancreatic cancer is a highly aggressive malignancy with a poor prognosis. Neoadjuvant chemotherapy (NAC) is increasingly used to improve survival in patients with pancreatic cancer; however, it often results in nutritional deterioration, which may negatively impact patient outcomes. Therefore, this study aimed to assess the effect of changes in nutritional status on the long-term outcomes of patients with pancreatic cancer who underwent curative surgery after NAC.

Diagnostic Yield and Synergistic Impact of Needle Aspiration and Forceps Biopsy With Electromagnetic Navigation Bronchoscopy for Peripheral Pulmonary Lesions: A Randomized Controlled Trial.

Background: Electromagnetic navigation bronchoscopy (ENB) is an advanced imaging-guided technique used to diagnose peripheral pulmonary lesions. However, the optimal strategy for selecting biopsy devices remains unclear.

Research Question: Does the combination of needle aspiration and forceps biopsy improve diagnostic yield compared with using a single device alone?

Study Design And Methods: We conducted a randomized crossover study during ENB performed under moderate sedation.

Resident and nurse attitudes toward a rapid response team in a tertiary hospital in South Korea.

Background: Residents and nurses who activate rapid response teams (RRTs) are well positioned to offer insights on its effectiveness. Here, we assess such evaluation of RRTs and identify barriers to activation in a 1,400-bed teaching hospital.

Methods: We conducted a 24-item Likert-scale survey from January to May 2017 among residents and ward nurses with RRT experience.

Primed Mesenchymal Stem Cells by IFN-γ and IL-1β Ameliorate Acute Respiratory Distress Syndrome through Enhancing Homing Effect and Immunomodulation.

Acute Respiratory Distress Syndrome (ARDS) is a severe condition characterized by extensive lung inflammation and increased alveolar-capillary permeability, often triggered by infections or systemic inflammatory responses. Mesenchymal stem cells (MSCs)-based therapy holds promise for treating ARDS, as MSCs manifest immunomodulatory and regenerative properties that mitigate inflammation and enhance tissue repair. Primed MSCs, modified to augment specific functionalities, demonstrate superior therapeutic efficacy in targeted therapies compared to naive MSCs.

Efficacy of Neoadjuvant Radiotherapy After Chemotherapy and the Optimal Interval from Radiotherapy to Surgery for Borderline Resectable and Resectable Pancreatic Cancer.

Background: Benefits of neoadjuvant treatment for pancreatic cancer with major vessel invasion has been demonstrated through randomized controlled trials; however, the optimal neoadjuvant treatment strategy remains controversial, especially for radiotherapy. Therefore, we aimed to evaluate the efficacy and safety of neoadjuvant radiotherapy followed by chemotherapy and the optimal time interval to undergo surgery after radiotherapy in (borderline) resectable pancreatic cancer.

Methods: Between 2013 and 2022, patients with (borderline) resectable pancreatic cancer with vessel contact who received 5-fluorouracil with leucovorin, oxaliplatin, and irinotecan or gemcitabine and nanoparticle albumin-bound paclitaxel as initial treatment following surgery were included.

Understanding of Patients with Severe COVID-19 Using Lung Ultrasound.

Background: Lung ultrasound (LUS) has proven valuable in the initial assessment of coronavirus disease 2019 (COVID-19), but its role in detecting pulmonary fibrosis following intensive care remains unclear. This study aims to assess the presence of pulmonary sequelae and fibrosis-like changes using LUS in survivors of severe COVID-19 pneumonia one month after discharge.

Methods: We prospectively enrolled patients with severe COVID-19 who required mechanical ventilation in the intensive care unit (ICU) and conducted LUS assessments from admission to the outpatient visit after discharge.

Inhibition of Differentiation of 3T3-L1 Cells by Increasing Glioma-Associated Oncogene Expression in L. Using KCTC 3115.

The inhibitory effect of L. on adipocyte differentiation can be enhanced by lactic acid bacteria (LAB) fermentation. In this study, we assessed the cellulose resolution, L.

NOS inhibition sensitizes metaplastic breast cancer to PI3K inhibition and taxane therapy via c-JUN repression.

Metaplastic breast cancer (MpBC) is a highly chemoresistant subtype of breast cancer with no standardized therapy options. A clinical study in anthracycline-refractory MpBC patients suggested that nitric oxide synthase (NOS) inhibitor NG-monomethyl-l-arginine (L-NMMA) may augment anti-tumor efficacy of taxane. We report that NOS blockade potentiated response of human MpBC cell lines and tumors to phosphoinositide 3-kinase (PI3K) inhibitor alpelisib and taxane.

Transcriptomic Analysis of Air-Liquid Interface Culture in Human Lung Organoids Reveals Regulators of Epithelial Differentiation.

To develop in vitro respiratory models, it is crucial to identify the factors involved in epithelial cell differentiation. In this study, we comprehensively analyzed the effects of air-liquid interface (ALI) culture on epithelial cell differentiation using single-cell RNA sequencing (scRNA-seq). ALI culture induced a pronounced shift in cell composition, marked by a fivefold increase in ciliated cells and a reduction of more than half in basal cells.

Continuous preperitoneal versus thoracic epidural analgesia in open pancreatoduodenectomy: randomized clinical trial.

Background: Thoracic epidural analgesia (TEA), once the standard for pain management in major abdominal operations, is associated with postoperative complications, making preperitoneal continuous wound infiltration (CWI) a promising alternative. This study aimed to compare the effectiveness of CWI and TEA in managing postoperative pain after open pancreatoduodenectomy.

Methods: In a single-centre, randomized, open-label non-inferiority trial, adult patients undergoing elective open pancreatoduodenectomy were assigned to either CWI or TEA for pain management.

Biochemical simulation of mutation synthesis and repair during SARS-CoV-2 RNA polymerization.

We biochemically simulated the mutation synthesis process of SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) complex (nsp7/nsp8/nsp12) involving two sequential mechanistic steps that occur during genomic replication: misinsertion (incorporation of incorrect nucleotides) and mismatch extension. Then, we also simulated mismatch repair process catalyzed by the viral nsp10/nsp14 ExoN complex. In these mechanistic simulations, while SARS-CoV-2 RdRp displays efficient mutation synthesis capability, the viral ExoN complex was able to effectively repair the mismatch primers generated during the mutation synthesis.