PURPOSE: Breast-conserving surgery (BCS) with radiotherapy has become a standard treatment for early stage breast cancer, since the installation of NSABP B-06. One of the serious problems in BCS is that of local recurrence. There are many risk factors for local recurrence, such as large tumor size, multiple tumors, axillary lymph node involvement, young age, high nuclear grade, and so on. The aim of this study is to identify patients with a higher risk of local recurrence of breast cancer. METHODS: Between January 2002 and December 2006, 447 patients with breast cancer, and who had undergone BCS with immediate breast reconstruction, were enrolled in the study. The follow-up period was 5 years from the time of operation and we analyzed local recurrence, disease-free survival (DFS), and overall survival (OS). The analysis included various clinicopathological factors such as age, chemotherapy, radiotherapy, hormone therapy, pathologic characteristics, and margin status. Statistical analysis was performed with log-rank test and Kaplan-Meier method. The p-value <0.05 was considered statistically significant. RESULTS: The mean follow-up period was 88 months and local recurrence of breast cancer occurred only in 16 cases (3.6%). The actual 5-year DFS, and OS rates were 90.6% and 93.3%, respectively. For the local recurrence of breast cancer, positive margin status, multiple margin positivity, conversed margin cases, T/N stages showed statistical significance in univariate analysis. However, only multiple margin positivity was identified as an independent risk factor for local recurrence in multivariate analysis. CONCLUSION: When the multiple margin positivity is diagnosed on intraoperative frozen biopsy, surgeons should consider a much wider excision of the breast and a more aggressive management.
Biopsy ; Breast ; Breast Neoplasms ; Disease-Free Survival ; Female ; Follow-Up Studies ; Frozen Sections ; Humans ; Lymph Nodes ; Mammaplasty ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Recurrence ; Risk Factors

In an effort to improve the blood safety management system, Korea Centers for Disease Control and Prevention visited the national agencies and blood centers of foreign countries. In Japan, the management system for Human T-lymphotropic virus positive donors is operated. In Germany, Red Cross Blood Centers provide 75~80% of national blood consumption, and hospital blood centers provided 15~20%. In addition, the Paul Ehrlich Institut is engaged in blood center management and blood product safety, and the Robert Koch Institut manages transfusion-transmitted infection. The standard temperature of RBC transport is 1~10degrees C. In Austria, haemovigilance is operated by the National Blood Authority and adverse reactions following transfusion are investigated by Blood Centers. In Britain, blood is provided by National Health Service Blood and Transplant, and the Serious Hazards of Transfusion, haemovigilance system is operated. Universal leukoreduction has been performed since 1999 in order to prevent transmission of variant Creutzfeldt-Jakob disease.
Austria ; Blood Safety* ; Centers for Disease Control and Prevention (U.S.) ; Creutzfeldt-Jakob Syndrome ; Germany ; Humans ; Japan ; Korea ; National Health Programs ; Red Cross ; Tissue Donors ; Viruses

In the bilateral axillo-breast approach (BABA), the camera is inserted through the areolar incision, and this raises the concern it might be difficult to identify the lymph nodes (LN). The purpose of this study is to evaluate the feasibility of the Firefly for central lymph node dissection (CLND) in robotic thyroidectomy using the BABA. This study evaluated 18 patients who underwent robotic surgery using Firefly between December 2015 and March 2016. For LN mapping, 0.05 ml of ICG was injected into the thyroid 3~4 minutes before CLND. Green-stained LN could be detected easily through a near-infrared camera. The number of retrieved LNs was 7.8±3.0 after CLND using the Firefly, which was higher than the 6.7±0.2 reported in previous surgeries. In addition, it helped to distinguish between the parathyroid and the LNs. The Firefly technology was helpful in identifying the LNs, guiding the CLND and performing a complete CLND.
Fireflies* ; Humans ; Indocyanine Green ; Lymph Node Excision* ; Lymph Nodes* ; Thyroid Gland ; Thyroidectomy*

BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The “spicy & fried meat and fish” dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The “fish, egg, meat, and fruits & vegetables” dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.
Breakfast ; Child* ; Cohort Studies ; Diet ; Follow-Up Studies ; Fruit ; Humans ; Lunch ; Meals ; Meat ; Mortality* ; Mortality, Premature ; Obesity ; Overweight* ; Ovum ; Principal Component Analysis ; Prospective Studies ; Seoul ; Weight Gain

In recent da Vinci robot systems (Intuitive Surgical), near-infrared f luorescence imaging (Firef ly technology) has been used. With this technique, it is possible for surgeons to see important structures well beyond the limits of their eyes; hence, surgeons can safely operate and make critical decisions accurately using image-guided surgery. Because parathyroid glands (PTGs) are small and embedded in the surrounding tissues, such as lymph nodes and fat, it is often very hard for surgeons to identify PTGs. To preserve PTGs well, the surgeon must be able to accurately identify PTGs, preserve the vasculature surrounding, and maintain the perfusion to PTGs. Herein, we report an assessment of PTG perfusion using indocyanine green angiography in transoral robotic thyroidectomy.

Objectives: The aim of this study was to provide baseline data for the assessment of exposure to indium and to prevent adverse health effects among workers engaged in the electronics and related industries in Republic of Korea. Methods: Total (n = 369) and respirable (n = 384) indium concentrations were monitored using personal air sampling in workers at the following 19 workplaces: six sputtering target manufacturing companies, four manufacturing companies of panel displays, two companies engaged in cleaning of sputtering components, two companies dedicated to the cleaning of sputtering target, and five indium recycling companies. Results: The level of exposure to total indium ranged from 0.9 to 609.3 μg/m3 for the sputtering target companies; from 0.2 to 2,782.0 μg/m3 for the panel display companies and from 0.5 to 2,089.9 μg/m3 for the indium recycling companies. The level of exposure to respirable indium was in the range of 0.02 to 448.6 μg/m3 for the sputtering target companies; 0.01 to 419.5 μg/m3 for the panel display companies; and 0.5 to 436.3 μg/m3 for the indium recycling companies. The indium recycling companies had the most samples exceeding the exposure standard for indium, followed by sputtering target companies and panel display companies. Conclusions The main finding from this exposure assessment is that many workers who handle indium compounds in the electronics industry are exposed to indium levels that exceed the exposure standards for indium. Hence, it is necessary to continuously monitor the indium exposure of this workforce and take measures to reduce its exposure levels.

Objectives: The aim of this study was to provide baseline data for the assessment of exposure to indium and to prevent adverse health effects among workers engaged in the electronics and related industries in Republic of Korea. Methods: Total (n = 369) and respirable (n = 384) indium concentrations were monitored using personal air sampling in workers at the following 19 workplaces: six sputtering target manufacturing companies, four manufacturing companies of panel displays, two companies engaged in cleaning of sputtering components, two companies dedicated to the cleaning of sputtering target, and five indium recycling companies. Results: The level of exposure to total indium ranged from 0.9 to 609.3 μg/m3 for the sputtering target companies; from 0.2 to 2,782.0 μg/m3 for the panel display companies and from 0.5 to 2,089.9 μg/m3 for the indium recycling companies. The level of exposure to respirable indium was in the range of 0.02 to 448.6 μg/m3 for the sputtering target companies; 0.01 to 419.5 μg/m3 for the panel display companies; and 0.5 to 436.3 μg/m3 for the indium recycling companies. The indium recycling companies had the most samples exceeding the exposure standard for indium, followed by sputtering target companies and panel display companies. Conclusions The main finding from this exposure assessment is that many workers who handle indium compounds in the electronics industry are exposed to indium levels that exceed the exposure standards for indium. Hence, it is necessary to continuously monitor the indium exposure of this workforce and take measures to reduce its exposure levels.

Background: The increasing number of vaccines and the complexity of immunization programs, along with continuous changes in the epidemiology of infectious diseases, necessitate a systematic approach to vaccine effectiveness (VE) evaluation. This study presents a preliminary survey to establish a VE evaluation framework in Korea, focusing on the National Immunization Program. Methods: Experts’ opinions were collected through a two-round online survey targeting key stakeholders. The first round consisted of two multiple-choice questions and two openended questions. The second round was a quantitative survey with 17 questionnaires based on five domains derived by analyzing the results of the first-round survey. Results: The results emphasize the necessity and urgency of a government-led VE evaluation system and the establishment of a multidisciplinary evaluation organization. Key considerations include personnel, budget, data integration, legal standards, and surveillance system enhancements. Conclusion These findings provide valuable insights for policymakers, emphasizing the need for collaboration, financial support, and robust data management in developing evidence-based vaccination policies.

Purpose: In total mastectomy (TM), sentinel lymph node biopsy (SLNB) is recommended but can be omitted for breast-conserving surgery (BCS) in patients with ductal carcinoma in situ (DCIS). However, concerns regarding SLNB-related complications and their impact on quality of life exist. Consequently, further research is required to evaluate the role of axillary surgeries, including SLNB, in the treatment of TM. We aimed to explore the clinicopathological factors and outcomes associated with axillary surgery in patients with a final diagnosis of pure DCIS who underwent BCS or TM. Methods: We retrospectively analyzed large-scale data from the Korean Breast Cancer Society registration database, highlighting on patients diagnosed with pure DCIS who underwent surgery and were categorized into two groups: BCS and TM. Patients were further categorized into surgery and non-surgery groups according to their axillary surgery status. The analysis compared clinicopathological factors and outcomes according to axillary surgery status between the BCS and TM groups. Results: Among 18,196 patients who underwent surgery for DCIS between 1981 and 2022, 11,872 underwent BCS and 6,324 underwent TM. Both groups leaned towards axillary surgery more frequently for large tumors. In the BCS group, clinical lymph node status was associated with axillary surgery (odds ratio, 11.101; p = 0.003). However, in the TM group, no significant differences in these factors were observed. Survival rates did not vary between groups according to axillary surgery performance. Conclusion The decision to perform axillary surgery in patients with a final diagnosis of pure DCIS does not affect the prognosis, regardless of the breast surgical method.Furthermore, regardless of the breast surgical method, axillary surgery, including SLNB, should be considered for high-risk patients, such as those with large tumors. This may reduce unnecessary axillary surgery and enhance the patients’ quality of life.

With a recent increase in dietary supplements (DS) consumption among children in Korea, this study was performed to examine the influencing factors on children's DS consumption. A nationwide survey was conducted employing 3 representative samples of children for summer & fall of 2008 and spring of 2009 by stratified multistage sampling of 120 survey sites per season based on the 2005 census population. Approximately 30 households from each survey site were screened for residing children of 0-19 years and about 1,700 households remained as eligible samples per season. Trained dietitians visited households to perform face-to-face interview to children and/or parents regarding DS consumption including health functional foods (HFF), vitamins/minerals (V/M) supplements and other food supplements during 1 month prior to interview. Out of 5,328 children responded, 18.7% reported DS consumption. Consumption rate was higher in boys (19.9% vs. 17.3% in girls, P < 0.05) and youngsters (22.8% compared to 15.0% in adolescents, P < 0.001). Children from higher income family (P < 0.001), those living in apartments (P < 0.001), those residing in metropolitan area (P < 0.001), and those of mothers with higher education (P < 0.001) were more likely to take DS. Also, mother's employment status and occupation were significantly associated with children's DS consumption. The most popular DS was HFF (72.1%), which was consumed more in children of higher income family. It is revealed that socioeconomic factors affect children's DS consumption significantly. Also it is necessary to estimate children's V/M intake from DS and foods together especially because there are tolerable upper limits set for V/M for safety purposes.
Adolescent ; Censuses ; Child ; Dietary Supplements ; Employment ; Family Characteristics ; Functional Food ; Humans ; Korea ; Mothers ; Occupations ; Parents ; Seasons ; Socioeconomic Factors