The aim of this video is to present the procedural details of laparoscopic right hemicolectomy with aortocaval (infrarenal aortic bifurcation) lymphadenectomy, partial resection of the pelvic peritoneum (peritoneal carcinomatosis index, 3), and hyperthermic intraperitoneal chemotherapy in a patient who received neoadjuvant chemotherapy for stage IVc colorectal cancer. The total operation time was 290 minutes, and the patient was discharged on a postoperative day 13 without any complications. No postoperative complications occurred until postoperative day 60. The pathological stage of the tumor was determined to be T3N2bM1c. The pelvic peritoneal nodule was pathologically confirmed as a metastatic lesion. Among the 12 harvested aortocaval lymph nodes, 6 were metastatic lymph nodes. The minimally invasive approach was safe and feasible in this highly selected patient with colon cancer, aortocaval lymph nodes, and peritoneal metastases.

OBJECTIVES: We reviewed digital epidemiological studies to characterize how researchers are using digital data by topic domain, study purpose, data source, and analytic method. METHODS: We reviewed research articles published within the last decade that used digital data to answer epidemiological research questions. Data were abstracted from these articles using a data collection tool that we developed. Finally, we summarized the characteristics of the digital epidemiological studies. RESULTS: We identified six main topic domains: infectious diseases (58.7%), non-communicable diseases (29.4%), mental health and substance use (8.3%), general population behavior (4.6%), environmental, dietary, and lifestyle (4.6%), and vital status (0.9%). We identified four categories for the study purpose: description (22.9%), exploration (34.9%), explanation (27.5%), and prediction and control (14.7%). We identified eight categories for the data sources: web search query (52.3%), social media posts (31.2%), web portal posts (11.9%), webpage access logs (7.3%), images (7.3%), mobile phone network data (1.8%), global positioning system data (1.8%), and others (2.8%). Of these, 50.5% used correlation analyses, 41.3% regression analyses, 25.6% machine learning, and 19.3% descriptive analyses. CONCLUSIONS: Digital data collected for non-epidemiological purposes are being used to study health phenomena in a variety of topic domains. Digital epidemiology requires access to large datasets and advanced analytics. Ensuring open access is clearly at odds with the desire to have as little personal data as possible in these large datasets to protect privacy. Establishment of data cooperatives with restricted access may be a solution to this dilemma.
Cell Phones ; Communicable Diseases ; Data Collection ; Dataset ; Epidemiologic Studies* ; Epidemiological Monitoring ; Epidemiology* ; Geographic Information Systems ; Humans ; Information Storage and Retrieval ; Internet ; Life Style ; Machine Learning ; Mental Health ; Methods ; Privacy ; Public Health Surveillance ; Social Media

Seizure is the second most common neurologic complication after liver transplantation and may be caused by metabolic abnormalities, electrolyte imbalance, infection, and immunosuppressant toxicity. A 61-year-old male patient underwent liver transplantation due to hepatitis B virus-related liver cirrhosis with portal systemic encephalopathy. The immediate postoperative course of the patient was uncomplicated. However, on postoperative day (POD) 6, weakness developed in both lower extremities. No abnormal findings were detected on a brain computed tomography (CT) scan on POD 8, but a generalized tonic clonic seizure developed which was difficult to control even with multiple antiepileptic drugs. A follow-up brain CT scan on POD 15 showed a 2.7 cm sized acute intracranial hemorrhage (ICH) in the left parietal lobe. The patient's mental status improved after 2 months and he was able to communicate through eye blinking or head shaking. Our case reports an acute ICH that manifested into a refractory seizure in a patient who underwent a liver transplant.
Anticonvulsants ; Blinking ; Brain ; Brain Diseases ; Follow-Up Studies ; Head ; Hepatic Encephalopathy ; Hepatitis B ; Humans ; Intracranial Hemorrhages* ; Liver Cirrhosis ; Liver Transplantation ; Liver* ; Lower Extremity ; Male ; Middle Aged ; Parietal Lobe ; Seizures* ; Tissue Donors* ; Tomography, X-Ray Computed

Due to an increasing proportion of older individuals and the adoption of a westernized lifestyle, the incidence rate of breast cancer is expected to rapidly increase within the next 10 years in Korea. The National Cancer Screening Program (NCSP) of Korea recommends biennial breast cancer screening through mammography for women aged 40–69 years old and according to individual risk and preference for women above 70 years old. There is an ongoing debate on how to most effectively screen for breast cancer, with many proponents of personalized screening, or screening according to individual risk, for women under 70 years old as well. However, to accurately stratify women into risk categories, further study using more refined personalized characteristics, including potentially incorporating a polygenic risk score (PRS), may be needed. While most breast cancer risk prediction models were developed in Western countries, the Korean Breast Cancer Risk Assessment Tool (KoBCRAT) was developed in 2013, and several other risk models have been developed for Asian women specifically. This paper reviews these models compared to commonly used models developed using primarily Caucasian women, namely, the modified Gail, Breast Cancer Surveillance Consortium, Rosner and Colditz, and Tyrer-Cuzick models. In addition, this paper reviews studies in which PRS is included in risk prediction in Asian women. Finally, this paper discusses and explores strategies toward development and implementation of personalized screening for breast cancer in Korea.

Lymphomas arising in the central nervous system (CNS) of immunocompromised hosts are most commonly non-Hodgkin’s lymphomas and are highly associated with Epstein-Barr virus (EBV). Here we report an autopsy case of EBV-associated CNS diffuse large B-cell lymphoma (DLBCL) in a host suffering from systemic lupus erythematosus who underwent immunosuppressive therapy. After autopsy, EBV-associated CNS DLBCL as well as pulmonary mixed aspergillosis and Pneumocystis jirovecii pneumonia were added to the cause of clinical manifestations of complicated pneumonia and cerebral hemorrhage in this immunocompromised patient. In conclusion, complex disease processes were revealed by autopsy in this case, indicating that the clinicopathological correlations observed through autopsy can improve our understanding of disease progression and contribute to the management of similar patients in the future.
Aspergillosis ; Autopsy ; B-Lymphocytes ; Central Nervous System ; Cerebral Hemorrhage ; Disease Progression ; Herpesvirus 4, Human ; Humans ; Immunocompromised Host ; Lupus Erythematosus, Systemic ; Lymphoma ; Lymphoma, B-Cell ; Pneumocystis jirovecii ; Pneumonia

This study analyzes the role of the Sorting Hat in structuring the identity of the characters in the Harry Potter series written by J. K. Rowling. In the different stages of adolescence, one explores and re-establishes one's identity. One's sense of identity is determined by the commitments made regarding personal and social traits. However, it is difficult to establish a concrete identity formation process theory that is communicable to adolescents. In Harry Potter, the characters' identities are reflected upon the Sorting Hat and are continuously molded throughout the book. The Sorting Hat provides nurturing experiences based on temperament. Based primarily on their temperament, it sorts the students into four houses, each with their own distinct characteristics. Once sorted, the houses become the living and learning communities in which the students share the same dormitory and classes until their graduation. Within the community, the students seek connections, supportive relationships, and understanding within the group. The taking on of the group identity is an explanatory variable in the formation of individual identity. The Sorting Hat provides the students with stability and a safe boundary. After being sorted based on their temperament, the inexperienced and immature adolescents can explore different options under the guidance of the Hat before making a definite commitment. By presenting them with an appropriate environment (such as a mentor, friend, or family member), the Hat further shapes their identity and integrates the identity elements ascribed in the beginning. By providing experiences and interactions based on their unique temperament and environment, the Sorting Hat plays a crucial role in establishing the students' identities. The Sorting Hat can be an ideal model for finding one's identity during adolescence.
Adolescent* ; Friends ; Fungi ; Humans ; Learning ; Mentors ; Sociological Factors ; Temperament

OBJECTIVE: To identify the effects of overactive bladder (OAB) symptoms on the health-related quality of life (HRQOL) in stroke patients since OAB symptoms are common in such patients, but their effects on stroke rehabilitation over time are unclear. METHODS: This study included 30 post-acute stroke patients who had been admitted for rehabilitation treatments. All participants completed a questionnaire evaluating urinary symptoms, including the Overactive Bladder Symptom Score (OABSS) and general HRQOL with a Short-Form 36 (SF-36) health survey. We assessed their performance in terms of the Function Ambulation Category, Modified Rankin Scale (MRS), Modified Barthel Index, and Mini-Mental State Examination (MMSE). All assessments were carried out twice at baseline and at 3 months. We divided patients into an OAB and non-OAB group with OABSS. A correlation analysis and multivariate regression were then performed. RESULTS: All performance scales showed an improvement over 3 months in the non-OAB group (n=18; p < 0.02), but, MRS and MMSE scores did not improve significantly in the OAB group (n=12) (p=0.15 and p=0.20, respectively). In the OAB group, the vitality and mental health scores significantly decreased over 3 months (p=0.011 and p=0,041, respectively), and the mental component summary (MCS) score showed a marginal decrease over 3 months (p=0.05). A multivariate regression analysis revealed that OAB symptoms were negatively correlated with the 3 months MCS score (B=−8.15, p=0.034). CONCLUSION: These results indicated that OAB symptoms could have negative effects on HRQOL and performance in patients suffering from a stroke.
Health Surveys ; Humans ; Mental Health ; Quality of Life* ; Rehabilitation ; Stroke* ; Urinary Bladder, Overactive* ; Walking ; Weights and Measures

OBJECTIVE: To identify the effects of overactive bladder (OAB) symptoms on the health-related quality of life (HRQOL) in stroke patients since OAB symptoms are common in such patients, but their effects on stroke rehabilitation over time are unclear. METHODS: This study included 30 post-acute stroke patients who had been admitted for rehabilitation treatments. All participants completed a questionnaire evaluating urinary symptoms, including the Overactive Bladder Symptom Score (OABSS) and general HRQOL with a Short-Form 36 (SF-36) health survey. We assessed their performance in terms of the Function Ambulation Category, Modified Rankin Scale (MRS), Modified Barthel Index, and Mini-Mental State Examination (MMSE). All assessments were carried out twice at baseline and at 3 months. We divided patients into an OAB and non-OAB group with OABSS. A correlation analysis and multivariate regression were then performed. RESULTS: All performance scales showed an improvement over 3 months in the non-OAB group (n=18; p < 0.02), but, MRS and MMSE scores did not improve significantly in the OAB group (n=12) (p=0.15 and p=0.20, respectively). In the OAB group, the vitality and mental health scores significantly decreased over 3 months (p=0.011 and p=0,041, respectively), and the mental component summary (MCS) score showed a marginal decrease over 3 months (p=0.05). A multivariate regression analysis revealed that OAB symptoms were negatively correlated with the 3 months MCS score (B=−8.15, p=0.034). CONCLUSION: These results indicated that OAB symptoms could have negative effects on HRQOL and performance in patients suffering from a stroke.
Health Surveys ; Humans ; Mental Health ; Quality of Life* ; Rehabilitation ; Stroke* ; Urinary Bladder, Overactive* ; Walking ; Weights and Measures

OBJECTIVES: Families of ethnic minority persons with dementia often seek help at later stages of the disease. Little is known about the effectiveness of various methods in supporting ethnic minority dementia patients' caregivers. The objective of the study was to identify smartphone and computer usage among family caregivers of dementia patients (i.e., Korean and Vietnamese Americans) to develop dementia-care education programs for them. METHODS: Participants were asked various questions related to their computer or smartphone usage in conjunction with needs-assessment interviews. Flyers were distributed at two ethnic minority community centers in Southern California. Snowball recruitment was also utilized to reach out to the families of dementia patients dwelling in the community. RESULTS: Thirty-five family caregivers, including 20 Vietnamese and 15 Korean individuals, participated in this survey. Thirty participants (30 of 35, 85.7%) were computer users. Among those, 76.7% (23 of 30) reported daily usage and 53% (16 of 30) claimed to use social media. A majority of the participants (31 of 35, 88.6%) reported that they owned smartphones. More than half of smartphone users (18 of 29, 62%) claimed to use social media applications. Many participants claimed that they could not attend in-class education due to caregiving and/or transportation issues. CONCLUSIONS: Most family caregivers of dementia patients use smartphones more often than computers, and more than half of those caregivers communicate with others through social media apps. A smartphone-app-based caregiver intervention may serve as a more effective approach compared to the conventional in-class method. Multiple modalities for the development of caregiver interventions should be considered.
Asian Americans* ; Asian Continental Ancestry Group* ; California ; Caregivers* ; Dementia* ; Education* ; Humans ; Methods ; Minority Groups ; Smartphone* ; Social Media ; Transportation

Purpose: This study conducted a job analysis of visiting nurses in the process of change. Methods: Participants were the visiting nurses working for the Seoul Metropolitan city. On the basis of the Public Health Intervention Wheel model, two times of the focus group interview (FGI) with seven visiting nurses and one time of the Developing a Curriculum (DACUM) with 34 visiting nurses were performed. A questionnaire survey of 380 visiting nurses was conducted to examine the frequency, importance and difficulty levels of the tasks created by using the FGI and DACUM. Results: Visiting nurses’ job was derived as the theme of present versus transitional roles. The present role was categorized as ‘providing individual- and group-focused services’ and ‘conducting organization management’, while the transitional role was categorized as ‘providing district-focused services’ and ‘responding to new health issues’. The job generated 13 duties, 28 tasks, and 73task elements. The tasks showed the levels of frequency (3.65 scores), importance (4.27 scores), and difficulty (3.81 scores). All the tasks were determined as important, exceeding the average 4.00 scores. The group- and district-focused services of the tasks were recognized as more difficult but less frequent tasks. Conclusion The visiting nurses exert both present and transitional roles. The transitional roles identified in the present study should be recognized as an extended role of visiting nurses in accordance with the current changing healthcare needs in South Korea. Finally, the educational curriculum for visiting nurses that reflects the transitional roles from the present study is needed.