Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy.The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.

Background: This retrospective study aimed to determine the treatment patterns and the surgical and oncologic outcomes after completion lobectomy (CL) in patients with locoregionally recurrent stage I non-small cell lung cancer (NSCLC) who previously underwent sublobar resection. Methods: Data from 36 patients who initially underwent sublobar resection for clinical, pathological stage IA NSCLC and experienced locoregional recurrence between 2008 and 2016 were analyzed. Results: Thirty-six (3.6%) of 1,003 patients who underwent sublobar resection for NSCLC experienced locoregional recurrence. The patients’ median age was 66.5 (range, 44–77) years at the initial operation, and 28 (77.8%) patients were men. Six (16.7%) patients underwent segmentectomy and 30 (83.3%) underwent wedge resection as the initial operation.The median follow-up from the initial operation was 56 (range, 9–150) months. Ten (27.8%) patients underwent CL, 22 (61.1%) underwent non-surgical treatments (chemotherapy, radiation, concurrent chemoradiation therapy), and 4 (11.1%) did not receive treatment or were lost to follow-up after recurrence. Patients who underwent CL experienced no significant complications or deaths. The median follow-up time after CL was 64.5 (range, 19–93) months. The 5-year overall survival (OS) and post-recurrence survival (PRS) were higher in the surgical group than in the non-surgical (p<0.001) and no-treatment groups (p<0.001). Conclusion CL is a technically demanding but safe procedure for locoregionally recurrent stage I NSCLC after sublobar resection. Patients who underwent CL had better OS and PRS than patients who underwent non-surgical treatments or no treatments; however, a larger cohort study and long-term surveillance are necessary.

Purpose: Sleeve lobectomy is a safe and effective surgical procedure for centrally located non-small cell lung cancer (NSCLC). However, the use of video-assisted thoracoscopic surgery (VATS) on bronchial sleeve resection is still controversial due to a lack of evidence. In this study, we describe our experience on VATS sleeve lobectomy and evaluate its feasibility for treating NSCLC. Methods: From January 2010 to May 2019, VATS sleeve lobectomy was attempted in 19 patients with NSCLC at Samsung Medical Center. Their baseline characteristics, perioperative data, and survival outcome were collected and analyzed retrospectively. Results: Of the 19 patients, 10 underwent VATS sleeve lobectomy successfully. The mean age of the patients who underwent successful VATS was 53.5± 15.8 years, and all the patients were men. Seven patients (70%) had squamous cell carcinoma. The mean postoperative chest tube drainage duration was 5.3± 2.3 days, and the median hospital stay duration was 7 days (interquartile range, 6.25 to 11.5 days). Among the patients who underwent successful VATS, two had postoperative bronchial stenosis: One patient underwent complete pneumonectomy, and one patient was observed without any intervention. During the median follow-up duration of 3.5 years, two patients with squamous cell carcinoma who underwent successful VATS died. Of these, one died 70 days postoperatively because of acute respiratory distress syndrome and one died 18 months postoperatively from an unknown cause. No patient had locoregional recurrence. Conclusion VATS sleeve lobectomy is a feasible surgical procedure for centrally located tumors without vascular invasion.

PURPOSE: This clinical pilot study was performed to determine the effectiveness of dual-energy cone-beam computed tomography (DE-CBCT) in measuring bone mineral density (BMD).MATERIALS AND METHODS: The BMD values obtained using DE-CBCT were compared to those obtained using calibrated multislice computed tomography (MSCT). After BMD calibration with specially designed phantoms, both DE-CBCT and MSCT scanning were performed in 15 adult dental patients. Three-dimensional (3D) Digital Imaging and Communications in Medicine data were imported into a dental software program, and the defined regions of interest (ROIs) on the 3-dimensional surface-rendered images were identified. The automatically-measured BMD values of the ROIs (g/cm³), the differences in the measured BMD values of the matched ROIs obtained by DE-CBCT and MSCT 3D images, and the correlation between the BMD values obtained by the 2 devices were statistically analyzed.RESULTS: The mean BMD values of the ROIs for the 15 patients as assessed using DE-CBCT and MSCT were 1.09±0.07 g/cm³ and 1.13±0.08 g/cm³, respectively. The mean of the differences between the BMD values of the matched ROIs as assessed using DE-CBCT and calibrated MSCT images was 0.04±0.02 g/cm³. The Pearson correlation coefficient between the BMD values of DE-CBCT and MSCT images was 0.982 (r=0.982, P<0.001).CONCLUSION: The newly developed DE-CBCT technique could be used to measure jaw BMD in dentistry and may soon replace MSCT, which is expensive and requires special facilities.
Adult ; Bone Density ; Calibration ; Cone-Beam Computed Tomography ; Dentistry ; Humans ; Jaw ; Methods ; Miners ; Multidetector Computed Tomography ; Pilot Projects

PURPOSE: Metabolic syndrome is an important cluster of coronary heart disease risk factors. However, it remains unclear to what extent metabolic syndrome is associated with demographic and potentially modifiable lifestyle factors among Korean persons with physical disabilities. This study aimed to determine the prevalence and influencing factors of metabolic syndrome among persons with physical disabilities using the Korean National Health Insurance Service—National Sample Cohort. METHODS: The Adult Treatment Panel III criteria were used to define metabolic syndrome influencing factors and prevalence, which were evaluated in a representative sample from the 2013 Korean National Health Insurance Service—National Sample Cohort database. Characteristics were compared based on frequency using the χ2 test. The associations between metabolic syndrome and its risk factors were estimated using logistic multivariable regression analysis. RESULTS: Metabolic syndrome was detected in 31.5% of the surveyed persons with physical disabilities. Female sex, age of ≥65 years, smoking, greater alcohol consumption, physical inactivity, higher body mass index, and a family history of diabetes were associated with increased risks of metabolic syndrome. CONCLUSION: The major risk factors for metabolic syndrome among persons with physical disabilities were obesity and older age. Performing physical activity was associated with a lower risk of metabolic syndrome. Therefore, we recommend using a continuous obesity management program and physical activity to prevent metabolic syndrome among persons with physical disabilities.
Adult ; Alcohol Drinking ; Body Mass Index ; Cohort Studies ; Coronary Disease ; Disabled Persons ; Female ; Humans ; Life Style ; Metabolic Syndrome X ; Motor Activity ; National Health Programs ; Obesity ; Prevalence* ; Risk Factors ; Smoke ; Smoking

PURPOSE: This study aimed to evaluate the clinical factors that could influence the length of hospital stay (LHS) of infants with acute bronchiolitis using the bronchiolitis severity score (BSS). METHODS: The medical records of 105 infants aged 0–12 months with acute bronchiolitis who were admitted to a tertiary hospital between December 2014 and May 2015 were reviewed. The BSS was composed 5 factors, namely general condition, wheezing, chest retraction, respiration rate, and peripheral oxygen saturation, which were evaluated at admission. In addition, the age of the infants, LHS, body weight, birth history, familial history, laboratory test result, chest X-ray, and treatment modalities were reviewed. Subjects were classified into 3 groups according to their BSS, and logistic regression analysis was used to identify the association of the BSS with longer LHS. RESULTS: Among subjects, 62 were studied. Their mean LHS and age were 5.5±2.0 days and 3.9±2.7 months, respectively. Twelve infants were classified as mild (20.3%), 43 as moderate (68.8%), and 7 as severe (10.9%). Venous blood gas pH value and white blood cell count were the best predictors of disease severity. The LHS was associated with the BSS, age, body weight and pCO2 by venous blood gas analysis (P<0.05). CONCLUSION: The LHS was associated with the BSS, age, body weight, and pCO₂ by venous blood gas analysis at admission. The BSS could be a useful tool to predict disease severity and decide treatment strategies for infants with acute bronchiolitis who have no known risk factors.
Blood Gas Analysis ; Body Weight ; Bronchiolitis* ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Infant* ; Length of Stay* ; Leukocyte Count ; Logistic Models ; Medical Records ; Oxygen ; Reproductive History ; Respiratory Rate ; Respiratory Sounds ; Risk Factors ; Tertiary Care Centers ; Thorax

PURPOSE: This study aimed to evaluate the correlation, according to postnatal age, between plasma B-type natriuretic peptide (BNP) levels and echocardiographic parameters for the assessment of patent ductus arteriosus (PDA) in preterm infants with respiratory distress. METHODS: We enrolled 42 preterm infants with respiratory distress who underwent serial echocardiographic evaluation with simultaneous plasma BNP measurements until ductal closure. The correlations between BNP levels and the following 4 representative echocardiographic parameters were studied: diameter of the ductus arteriosus (DA), ratio of the left atrial diameter to the aortic diameter (LA/Ao), ratio of the PDA diameter to the infant's left pulmonary artery diameter (PDA/LPA), and the antegrade diastolic flow of LPA (DFLPA). RESULTS: BNP levels were significantly correlated to the magnitude of the ductal shunt, comprising the DA diameter, PDA/LPA ratio, LA/Ao ratio, and antegrade DFLPA for the overall study period. The earliest significant correlation, starting from postnatal day 2, was observed between the LA/Ao ratio and BNP levels. The PDA/LPA ratio and the antegrade DFLPA showed significant correlations with BNP levels postnatal day 3 onward, and with the DA diameter, postnatal day 5 onward. CONCLUSION: BNP levels and echocardiographic parameters showed a positive correlation, but the significance of the correlations differed according to the postnatal age, especially during the first few days of life.
Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Echocardiography* ; Humans ; Infant, Newborn ; Infant, Premature* ; Natriuretic Peptide, Brain* ; Plasma ; Pulmonary Artery

No abstract available.
Ageusia* ; Humans ; Myasthenia Gravis* ; Thymoma

PURPOSE: Bedside electrocardiograph (ECG) monitoring is continuously used for assessing patients' cardiac status in intensive care units. However, it has not been explored whether it is used with proper knowledge and nursing practices; if not, its usage will be limited and the risk for compromised patient safety might be significant. This study, therefore, explored knowledge and nursing practices regarding bedside ECG monitoring in nurses working at intensive care units. METHODS: Participants in this survey research were a convenience sample of 156 nurses from 25 intensive care units distributed in five hospitals with more than 1,000 beds each in Seoul, South Korea. RESULTS: Participants showed limited and incorrect knowledge and nursing practices. Only 4 (2.6%) participants correctly answered to all electrode placement sites of RA, LA, LL, and V1. Lead II was the most frequently monitored unit regardless of the main purpose of ECG monitoring, and nursing practices to manage noisy signals did not include skin care at the top priorities. CONCLUSION: Educators and clinicians alike need to make an effort to ensure that a safe level of knowledge and practices for the monitoring is maintained in order to make sure that patient outcomes are not compromised.
Electrocardiography* ; Electrodes ; Humans ; Intensive Care Units* ; Korea ; Nursing* ; Patient Safety ; Seoul ; Skin Care

PURPOSE: This study was done to identify the effects of Type D personality on compassion fatigue, burnout, compassion satisfaction, and job stress in clinical nurses. METHODS: A descriptive cross-sectional design was used. Data were collected from a convenience sample of 172 clinical nurses working in two tertiary hospitals. The structured questionnaires included Type D personality scale, compassion fatigue, burnout, compassion satisfaction, and job stress scales. RESULTS: About 79.7% of participants were classified as Type D personality group. The Type D personality was not related to general characteristics of clinical nurses. The Type D personality group showed statistically significant higher compassion fatigue, burnout, and job stress and lower compassion satisfaction compared to the non-Type D personality group. In addition, compassion fatigue and burnout were positively correlated with job stress and compassion fatigue was positively correlated with burnout. However, compassion satisfaction was negatively correlated with burnout. CONCLUSION: As the prevalence of Type D personality is high in clinical nurses, it is necessary to assess stress-related personality. In addition, management for the nurse with Type D personality is required to alleviate compassion fatigue, burnout, and job stress and to improve compassion satisfaction.
Empathy* ; Fatigue* ; Prevalence ; Surveys and Questionnaires ; Tertiary Care Centers ; Type D Personality* ; Weights and Measures