Background: Since the introduction of heated tobacco products (HTPs) in Korea in 2017, their annual sales have increased. Several studies have investigated the perceptions of HTPs and smoking cessation behaviors. For the first time, In 2019, questions focused on HTP use were introduced in the Korea National Health and Nutrition Examination Survey (KNHNES). This study aimed to compare smoking cessation behaviors between HTP users and conventional cigarette smokers using KNHANES data. Methods: Data of 947 current adult smokers from the 8th KNHNES (2019) were analyzed. Current smokers were divided into conventional cigarette (CC)–only, HTP-only, and dual-use groups. The general characteristics of the three groups were investigated. Differences in current intention to quit smoking and past attempts to quit smoking among the three groups were analyzed using multivariate logistic regression analysis by IBM SPSS ver. 25.0. Results: HTP-only users demonstrated fewer future smoking cessation plans (adjusted odds ratio [AOR], 0.398; 95% confidence interval [CI], 0.195–0.813; P=0.012) and fewer smoking cessation attempts in the past year (AOR, 0.533; 95% CI, 0.298–0.954; P=0.034) than CC-only smokers. However, there was no significant difference between dual-use (CC+HTP) and CC-only smokers. Conclusion While dual-use and CC-only smokers showed similar smoking cessation behaviors, HTP-only users had fewer previous attempts to quit smoking and were less likely to be currently ready to quit smoking. These findings can be explained by a decrease in the need to quit smoking due to the convenience of HTP and the perception that HTPs are less harmful than CC.

PURPOSE: When it comes to cancer care, the psychological well-being of family caregivers has gotten its deserved attention. However, the specific roles that the family caregivers take have not been examined as much. The current study aimed to investigate the distribution of family caregivers' roles, particularly in a family-oriented culture, Korea. MATERIALS AND METHODS: A sample of 439 participants was recruited from 11 national and regional cancer centers in Korea. The participants who were 60 years old or above went through treatments for their gastric, colorectal, or lung cancer. The individual survey included questions regarding the family type, living arrangement, and the sources of support when it comes to their physical, emotional, financial, and decision-making needs. RESULTS: The responses from the participants showed that cancer caregiving is shared by multiple family caregivers; the major source of support for elderly cancer patients on diverse domains was their spouse; patients' reliance on their daughter(s) increased for emotional support; and patients' reliance on their son(s) stood out for financial support and decision-making support. Also, the older the patients were, the heavier their reliance was on the adult children, including sons, daughters, and daughters-in-law. CONCLUSION: Future support programs for elderly cancer patients are suggested to involve multiple family caregivers to encourage effective and efficient intervention. Also, the limitations of the current study and the suggestions for future research are discussed.
Adult Children ; Aged ; Caregivers ; Financial Support ; Humans ; Korea ; Lung Neoplasms ; Nuclear Family ; Republic of Korea ; Residence Characteristics ; Spouses

We studied a Monte Carlo simulation of the proton beam delivery system at the National Cancer Center (NCC) using the Geant4 Monte Carlo toolkit and tested its feasibility as a dose verification framework. The Monte Carlo technique for dose calculation methodology has been recognized as the most accurate way for understanding the dose distribution in given materials. In order to take advantage of this methodology for application to externalbeam radiotherapy, a precise modeling of the nozzle elements along with the beam delivery path and correct initial beam characteristics are mandatory. Among three different treatment modes, double/single.scattering, uniform scanning and pencil beam scanning, we have modeled and simulated the double.scattering mode for the nozzle elements, including all components and varying the time and space with the Geant4.8.2 Monte Carlo code. We have obtained simulation data that showed an excellent correlation to the measured dose distributions at a specific treatment depth. We successfully set up the Monte Carlo simulation platform for the NCC proton therapy facility. It can be adapted to the precise dosimetry for therapeutic proton beam use at the NCC. Additional Monte Carlo work for the full proton beam energy range can be performed.
Proton Therapy ; Protons* ; Radiotherapy

Recurrence of Rathke’s cleft cysts (RCC) following surgery is not uncommon. We present a 33-yearold male patient with chronic headache and visual disturbances whose MRI showed mostly cystic, suprasellar mass with peripheral enhancement. Endoscopic extended transsphenoidal approach and tumor resection was performed and RCC was pathologically confirmed postoperatively. Early recurrence was first suspected at 3 months following surgery, and his serial MRIs showed a recurred mass without associated clinical symptoms. Upon further histopathological study, extensive squamous metaplasia and high Ki-67 were seen. Also, in this study, we discuss important factors associated with cyst recurrence following surgery.

Objective: Pesticide poisoning is one of the leading causes of death, and it is important to classify high-risk patients. Lactate measurement could be used to assess the triage level and decide and prioritize treatment even within the same triage group. This study investigates whether point-of-care lactate measurement helps to triage pesticide poisoning patients in the emergency department (ED). Methods: This retrospective study was done for pesticide poisoning patients between January 2018 to December 2021. Demographic data and laboratory results were collected by reviewing medical records. Statistical analysis was performed by dividing patients into death and survival groups. Univariable and multivariable logistic regression analyses were done. Receiver operating characteristic curves were obtained for variables with significant differences, and area under the curves (AUC) were calculated and compared. Results: Among the 288 patients evaluated, there were 24 (8.33%) mortalities and 264 (91.67%) survivals during hospitalization. Age, the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, pH and base excess, and lactate levels were analyzed via univariable and multivariable logistic regression tests. We found that old age and high lactate were independent factors in predicting mortality for pesticide poisoning patients. AUCs with 95% confidence interval for age and lactate were 0.784 (0.653-0.915) and 0.803 (0.674-0.932), respectively. Conclusion Lactate measurement may be useful during triage of alert and consciousness patients presenting with pesticide poisoning and having stable vital signs in ED. This study has several limitations, and it is necessary to reconfirm the results through a well-designed prospective study.

In this paper, we systematically review the literature on papillary thyroid carcinoma (PTC) metastasis to the mandible. This is a rare oc-currence, especially in young, asymptomatic patients. We propose appropriate surgical and adjuvant therapy guidelines based on our findings. A systematic PubMed search (up to July 2023) identified 10 eligible cases of papillary or follicular thyroid carcinoma with metastasis to the mandible. Studies of patients with different histologic types or without confirmed distant metastasis were excluded. A rare case of PTC metastasizing to the mandible in a young male highlights an unusual presentation. Surgical treatment of both primary and metastatic sites, along with aggressive adjuvant therapy after surgery, had a positive impact on survival.

In this paper, we systematically review the literature on papillary thyroid carcinoma (PTC) metastasis to the mandible. This is a rare oc-currence, especially in young, asymptomatic patients. We propose appropriate surgical and adjuvant therapy guidelines based on our findings. A systematic PubMed search (up to July 2023) identified 10 eligible cases of papillary or follicular thyroid carcinoma with metastasis to the mandible. Studies of patients with different histologic types or without confirmed distant metastasis were excluded. A rare case of PTC metastasizing to the mandible in a young male highlights an unusual presentation. Surgical treatment of both primary and metastatic sites, along with aggressive adjuvant therapy after surgery, had a positive impact on survival.

In this paper, we systematically review the literature on papillary thyroid carcinoma (PTC) metastasis to the mandible. This is a rare oc-currence, especially in young, asymptomatic patients. We propose appropriate surgical and adjuvant therapy guidelines based on our findings. A systematic PubMed search (up to July 2023) identified 10 eligible cases of papillary or follicular thyroid carcinoma with metastasis to the mandible. Studies of patients with different histologic types or without confirmed distant metastasis were excluded. A rare case of PTC metastasizing to the mandible in a young male highlights an unusual presentation. Surgical treatment of both primary and metastatic sites, along with aggressive adjuvant therapy after surgery, had a positive impact on survival.

This study examined the dosimetric influence of implanted gold markers in proton therapy and the effects of their positions in the spread-out Bragg peak (SOBP) proton beam. The implanted cylindrical gold markers were 3 mm long and 1.2 mm in diameter. The dosimetric influence of the gold markers was determined with markers at various locations in a proton-beam field. Spatial dose distributions were measured using a three-dimensional moving water phantom and a stereotactic diode detector with an effective diameter of 0.5 mm. Also, a film dosimetry was performed using Gafchromic External Beam Treatment (EBT) film. The GEANT4 simulation toolkit was used for Monte-Carlo simulations to confirm the measurements and to construct the dose-volume histogram with implanting markers. Motion data were obtained from the portal images of 10 patients to investigate the effect of organ motions on the dosimetric influence of markers in the presence of a rectal balloon. The underdosed volume due to a single gold marker, in which the dose was less than 95% of a prescribed amount, was 0.15 cc. The underdosed volume due to the presence of a gold marker is much smaller than the target volume. However, the underdosed volume is inside the gross tumor volume and is not smeared out due to translational prostate motions. The positions of gold markers and the conditions of the proton-beam field give different impacts on the dose distribution of a target with implanted gold markers, and should be considered in all clinical proton-based therapies.
Film Dosimetry ; Humans ; Prostate ; Prostatic Neoplasms ; Proton Therapy ; Protons ; Tumor Burden ; Water

TomoTherapy has a merit to treat cancer with Intensity modulated radiation and combines precise 3-D imaging from computerized tomography (CT scanning) with highly targeted radiation beams and rotating beamlets. In this paper, we comparing the dose distribution between TomoTherapy and linear accelerator based intensity modulated radiotherapy (IMRT) for 10 Head & Neck patients using TomoTherapy which is newly installed and operated at National Cancer Center since Sept. 2006. Furthermore, we estimate how the homogeneity and Normal Tissue Complication Probability (NTCP) are changed by motion of target. Inverse planning was carried out using CadPlan planning system (CadPlan R.6.4.7, Varian Medical System Inc. 3100 Hansen Way, Palo Alto, CA 94304-1129, USA). For each patient, an inverse IMRT plan was also made using TomoTherapy Hi-Art System (Hi-Art2_2_4 2.2.4.15, TomoTherapy Incorporated, 1240 Deming Way, Madson, WI 53717-1954, USA) and using the same targets and optimization goals. All TomoTherapy plans compared favorably with the IMRT plans regarding sparing of the organs at risk and keeping an equivalent target dose homogeneity. Our results suggest that TomoTherapy is able to reduce the normal tissue complication probability (NTCP) further, keeping a similar target dose homogeneity.
Head ; Humans ; Imaging, Three-Dimensional ; Neck ; Organs at Risk ; Particle Accelerators ; Radiotherapy, Intensity-Modulated