Conventional open thyroidectomy is a safe procedure, but it has the disadvantage of leaving noticeable scars on the neck. Bilateral axillo-breast approach (BABA) robotic thyroidectomy was developed as an alternative technique to remove thyroid glands without making incisions in the neck. In traditional BABA robotic thyroidectomy, dividing the isthmus is a routine step to improve the efficiency of the dissection during thyroid surgery. However, there are safety concerns when performing this procedure on patients with thyroid cancer located in the isthmus. We report a case of BABA robotic total thyroidectomy carried out without dividing the isthmus in a patient with isthmic papillary thyroid carcinoma. Our experience suggests that BABA robotic surgery can be a feasible and safe option for selected patients with isthmic papillary thyroid carcinoma.

Purpose: This study was conducted to develop a couple-centered antenatal education program and to test the program’s feasibility. Methods: With a preliminary-experimental study design, 33 pregnant couples who were expecting their first child participated in this study. The program consisted of four sessions (1 hour/session/week) of education and counseling. Data were collected before and after the intervention from September 2018 to April 2019 at a women’s hospital in Daejeon, Korea, with demographic data forms, the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Maternal–Fetal Attachment Scale, Korean Newborn Care Confidence Scale, Wijma Delivery Expectancy/Experience Questionnaire, and Dyadic Adjustment Scale-10. Results: The pregnant women and their husbands were on average 32.30±3.11 and 33.21±6.25 years old, respectively. The mean marriage duration was 2.34±1.63 years, the gestational age was 31.30±2.66 weeks, and 78.8% of the couples had a planned pregnancy. After the program, both the pregnant women and their husbands showed significant improvements in attachment to the fetus and confidence in providing infant care. Prenatal depression, prenatal stress, and fear of childbirth in pregnant women significantly decreased after completing the program. However, the dyadic adjustment score did not change significantly either in the pregnant women or their husbands. Conclusion A couple-centered antenatal education program seems to be effective for couples adjusting to parenthood, but further studies should explore ways to have a positive impact on couples’ relationships.

Purpose: This study was conducted to develop a couple-centered antenatal education program and to test the program’s feasibility. Methods: With a preliminary-experimental study design, 33 pregnant couples who were expecting their first child participated in this study. The program consisted of four sessions (1 hour/session/week) of education and counseling. Data were collected before and after the intervention from September 2018 to April 2019 at a women’s hospital in Daejeon, Korea, with demographic data forms, the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, Maternal–Fetal Attachment Scale, Korean Newborn Care Confidence Scale, Wijma Delivery Expectancy/Experience Questionnaire, and Dyadic Adjustment Scale-10. Results: The pregnant women and their husbands were on average 32.30±3.11 and 33.21±6.25 years old, respectively. The mean marriage duration was 2.34±1.63 years, the gestational age was 31.30±2.66 weeks, and 78.8% of the couples had a planned pregnancy. After the program, both the pregnant women and their husbands showed significant improvements in attachment to the fetus and confidence in providing infant care. Prenatal depression, prenatal stress, and fear of childbirth in pregnant women significantly decreased after completing the program. However, the dyadic adjustment score did not change significantly either in the pregnant women or their husbands. Conclusion A couple-centered antenatal education program seems to be effective for couples adjusting to parenthood, but further studies should explore ways to have a positive impact on couples’ relationships.

Recently, there has been a growing demand for natural preservatives because of increased consumer interest in health. In this study, we produced Lactobacillus rhamnosus cell-free supernatant (LCFS) and evaluated and compared its antimicrobial activity with existing natural preservatives against pathogenic microorganisms and in chicken breast meat contaminated with Escherichia coli and Staphylococcus aureus. Lactobacillus rhamnosus cell-free supernatant possessed 30 units of lysozyme activity and contained 18,835 mg/L of lactic acid, 2,051 mg/L of citric acid and 5,060 mg/L of acetic acid. Additionally, LCFS inhibited the growth of fourteen pathogenic bacteria, S. aureus, Bacillus cereus, Listeria monocytogenes, Vibrio parahaemolyticus, Listeria innocua, S. epidermidis, L. ivanovii, E. coli, Pseudomonas aeruginosa, Shigella sonnei, Shi. flexneri, Proteus vulgaris, Pseudomonas fluorescens, and Klebsiella pneumoniae. The antibacterial activity of LCFS was stronger than that of egg white lysozyme (EWL), Durafresh (DF) and grapefruit seed extract (GSE). Additionally, LCFS maintained its antimicrobial activity after heat treatment at 50℃~95℃ and at pH values of 3~9. Moreover, LCFS inhibited the growth of E. coli and S. aureus in chicken breast meat. In conclusion, it is expected that LCFS, which contains both lysozyme and three organic acids, will be useful as a good natural preservative in the food industry.
Acetic Acid ; Bacillus cereus ; Bacteria ; Breast ; Chickens ; Citric Acid ; Citrus paradisi ; Egg White ; Escherichia coli ; Food Industry ; Hot Temperature ; Hydrogen-Ion Concentration ; Klebsiella pneumoniae ; Lactic Acid ; Lactobacillus rhamnosus ; Lactobacillus ; Listeria ; Listeria monocytogenes ; Meat ; Muramidase ; Proteus vulgaris ; Pseudomonas aeruginosa ; Pseudomonas fluorescens ; Shigella sonnei ; Staphylococcus aureus ; Vibrio parahaemolyticus

Purpose: The objective of this study was to identify the significance of 24-hour postreduction ultrasonography (US) in pediatric patients with intussusception. Methods: A total of 229 patients with intussusception who were treated with saline reduction at Severance Children’s Hospital between January 2014 and September 2020 were retrospectively reviewed. The 229 patients with successful saline reduction were divided into two groups: a recurrence at 24 hours group (R, n=41) and a non-recurrence group (NR, n=188). The full patient sample was divided into two groups: follow-up US (FU) or no followup US (NFU); the recurrence group was divided into follow-up (R-FU) and non-follow-up (R-NFU) subgroups, and stratified analyses were performed. Results: There were no significant differences in age, sex, laboratory findings, symptoms, and sonographic findings between the NR and R groups. In the R group, 24 patients underwent follow-up US, and 17 patients did not. Specific sonographic findings were statistically significant in the R-FU group compared to the R-NFU group (p=0.002). The R-FU group had fewer admissions (p=0.012) and longer mean hospitalization times (p<0.001) than the R-NFU group. The NFU group had a 12.2% recurrence rate, while the R-FU group recurrence rate was 25.8% (p=0.0099), suggesting that the omission of some recurrent events and follow-up US was a significant variable in the recurrence of intussusception. The median time to recurrence was 21 hours which supports the 24-hour follow-up protocol. Conclusion Twenty-four-hour follow-up US was shown to be valuable for detecting early recurrence of intussusception.

This study aimed to evaluate the academic effectiveness of non–face-to-face classes in deciduous tooth morphology practice. Under the course name dental morphology, a total of 60 dental students took face-to-face classes while 55 pre-dental students took non-face-to-face classes. Students were required to submit their practical assignments after 5 weeks of practical classes. To evaluate the academic effectiveness of non-faceto- face classes, practical assignments were scored by an evaluator and compared with face-to-face classes using the Mann-Whitney U test and the chi-square test. The results showed that the practical score in face-to-face classes was 77.43 ± 5.97 and the practical score in non-face-to-face classes was 76.04 ± 5.83. There was no significant difference in the academic effectiveness of face-to-face classes compared to non-faceto- face classes in deciduous tooth morphology practice (p > 0.05). This study suggests that non-face-to-face classes on introductory practice such as the dental morphology course can provide comparable quality to the education taught in traditional face-toface classes.

BACKGROUND: Usually, high-flow nasal cannula (HFNC) therapy is indicated for de novo acute hypoxemic respiratory failure (AHRF). Although only a few researches have examined the effectiveness of HFNC therapy for respiratory failure with hypercapnia, this therapy is often performed under such conditions for various reasons. We investigated the effectiveness of HFNC therapy for AHRF patients with hypercapnia compared to those without hypercapnia.METHODS: All consecutive patients receiving HFNC therapy between January 2012 and June 2018 at a university hospital were enrolled and classified into nonhypercapnic and hypercapnic groups. We compared the outcomes of both groups and adjusted the outcomes with propensity score matching.RESULTS: A total of 862 patients were enrolled, of which 202 were included in the hypercapnic group. HFNC weaning success rates were higher, and intensive care unit (ICU) and hospital mortality was lower in the hypercapnic group than in the nonhypercapnic group (all P < 0.05). However, no statistical differences in HFNC weaning success (adjusted P = 0.623, matched P = 0.593), ICU mortality (adjusted P = 0.463, matched P = 0.195), and hospital mortality (adjusted P = 0.602, matched P = 0.579) were noted from the propensity-adjusted and propensity-matched analyses. Additionally, in the propensity score-matched subgroup analysis (according to chronic lung diseases and causes of HFNC application), there was also no significant difference in outcomes between the two groups.CONCLUSION: In AHRF with underlying conditions, HFNC therapy might be helpful for patients with hypercapnia. Large prospective and randomized controlled trials are required for firm conclusions.

BACKGROUND: Usually, high-flow nasal cannula (HFNC) therapy is indicated for de novo acute hypoxemic respiratory failure (AHRF). Although only a few researches have examined the effectiveness of HFNC therapy for respiratory failure with hypercapnia, this therapy is often performed under such conditions for various reasons. We investigated the effectiveness of HFNC therapy for AHRF patients with hypercapnia compared to those without hypercapnia. METHODS: All consecutive patients receiving HFNC therapy between January 2012 and June 2018 at a university hospital were enrolled and classified into nonhypercapnic and hypercapnic groups. We compared the outcomes of both groups and adjusted the outcomes with propensity score matching. RESULTS: A total of 862 patients were enrolled, of which 202 were included in the hypercapnic group. HFNC weaning success rates were higher, and intensive care unit (ICU) and hospital mortality was lower in the hypercapnic group than in the nonhypercapnic group (all P < 0.05). However, no statistical differences in HFNC weaning success (adjusted P = 0.623, matched P = 0.593), ICU mortality (adjusted P = 0.463, matched P = 0.195), and hospital mortality (adjusted P = 0.602, matched P = 0.579) were noted from the propensity-adjusted and propensity-matched analyses. Additionally, in the propensity score-matched subgroup analysis (according to chronic lung diseases and causes of HFNC application), there was also no significant difference in outcomes between the two groups. CONCLUSION In AHRF with underlying conditions, HFNC therapy might be helpful for patients with hypercapnia. Large prospective and randomized controlled trials are required for firm conclusions.

OBJECTIVES: Intra-individual variability of cognitive performance across different tests or domains has been reported as an important index of cognitive function. The aim of the current study is to examine the intra-individual variability across different cognitive domains and tests in patients with schizophrenia, their unaffected siblings, and normal controls. We also compared the variability among three patient sub-groups divided according to the duration of illness. METHODS: Comprehensive neurocognitive tests were administered in order to stabilize patients with schizophrenia (n=129), healthy siblings (n=38) of the patients, and normal controls (n=110). Intra-individual variability was computed from the variance of the scores of six cognitive domains of the Measurement and Treatment Research to Improve Cognition in Schizophrenia consensus battery. We examined intra-individual variability across six factor-based cognitive scores and individual test scores of each cognitive domain. RESULTS: Compared to the normal control and sibling groups, patients showed significantly increased intra-individual variability across six cognitive domains and individual cognitive tests of each domain. Compared to the normal control, siblings showed significantly increased intra-individual variability only across individual tests of the processing of speed domain. Among patient sub-groups, those with the longest duration of illness (> or =11 years) showed significantly higher intra- individual variability across six cognitive domains and across individual tests of the processing of speed domain compared to the other two groups. CONCLUSION: This study identified cognitive dissonances across six cognitive domain schizophrenia patients. These cognitive characteristics were not observed in the sibling groups and seemed to progress during the course of illness.
Cognition ; Cognitive Dissonance ; Consensus ; Humans ; Neuropsychological Tests* ; Schizophrenia* ; Siblings*

OBJECTIVE: This study investigated the most common errors on death certificates written by resident trainees of the emergency department and evaluated the effects of education on how to write a death certificate. METHODS: A casebook of 31 deaths was prepared based on actual death cases in the emergency room in 2016. Ten residents completed 31 death certificates for the death casebook without any prior notice and then received education on ‘How to write the death certificate.’ They completed the death certificates again for the same casebook after receiving the education and the number of errors on all death certificates was again determined and divided into major and minor errors. The average number of error types was compared before and after the education. RESULTS: Major errors occurred in 55% of all death certificates, but decreased to 32% after education. Minor errors decreased from 81% before education to 54% after education. The most common major error was ‘unacceptable cause of death’ (mean±standard deviation [SD], 10.2±8.2), and the most common minor error was ‘absence of time interval’ (mean±SD, 24.0±7.7), followed by ‘absence of other significant conditions’ (mean±SD, 14.6±6.1) before education. CONCLUSION: Education on ‘how to write a death certificate’ can help reduce errors on death certificates and improve the quality of death certificates.
Death Certificates ; Education* ; Emergencies* ; Emergency Service, Hospital* ; Guidelines as Topic