Objective: This study aimed to investigate the closure rate and adverse effects of combination therapy with acetaminophen and ibuprofen for hemodynamically significant patent ductus arteriosus (hsPDA) compared with monotherapy with ibuprofen in extremely preterm infants (EPTs). Methods: This was a single-center, retrospective, and historical control study of infants with hsPDA born at <28 weeks of gestation and a birth weight <1,000 g. Based on the first-line therapeutic policy for hsPDA, the cohort was classified into a monotherapy group (period I: January 2019-July 2021) and a combination therapy group (period II: September 2021-August 2023). Baseline characteristics, treatment outcomes, adverse effects, and morbidities were compared between the groups. Results: Of the 43 EPTs with hsPDA, 26 received monotherapy with ibuprofen during period I, and 17 received combination therapy with acetaminophen and ibuprofen during period II. The successful closure rates after the first medical therapy were 42.3% in the monotherapy group vs. 76.5% in the combination therapy group (P=0.027). No significant difference in adverse effects during medication use was observed between the groups. Conclusion Combination therapy with acetaminophen and ibuprofen improved the closure rate for hsPDA without detectable adverse effects. Combination therapy could be considered the first therapeutic option for hsPDA in EPTs. Further well-designed studies are needed to define the safety and effectiveness of combination therapy.

Objective: This study aimed to investigate the closure rate and adverse effects of combination therapy with acetaminophen and ibuprofen for hemodynamically significant patent ductus arteriosus (hsPDA) compared with monotherapy with ibuprofen in extremely preterm infants (EPTs). Methods: This was a single-center, retrospective, and historical control study of infants with hsPDA born at <28 weeks of gestation and a birth weight <1,000 g. Based on the first-line therapeutic policy for hsPDA, the cohort was classified into a monotherapy group (period I: January 2019-July 2021) and a combination therapy group (period II: September 2021-August 2023). Baseline characteristics, treatment outcomes, adverse effects, and morbidities were compared between the groups. Results: Of the 43 EPTs with hsPDA, 26 received monotherapy with ibuprofen during period I, and 17 received combination therapy with acetaminophen and ibuprofen during period II. The successful closure rates after the first medical therapy were 42.3% in the monotherapy group vs. 76.5% in the combination therapy group (P=0.027). No significant difference in adverse effects during medication use was observed between the groups. Conclusion Combination therapy with acetaminophen and ibuprofen improved the closure rate for hsPDA without detectable adverse effects. Combination therapy could be considered the first therapeutic option for hsPDA in EPTs. Further well-designed studies are needed to define the safety and effectiveness of combination therapy.

Objective: This study aimed to investigate the closure rate and adverse effects of combination therapy with acetaminophen and ibuprofen for hemodynamically significant patent ductus arteriosus (hsPDA) compared with monotherapy with ibuprofen in extremely preterm infants (EPTs). Methods: This was a single-center, retrospective, and historical control study of infants with hsPDA born at <28 weeks of gestation and a birth weight <1,000 g. Based on the first-line therapeutic policy for hsPDA, the cohort was classified into a monotherapy group (period I: January 2019-July 2021) and a combination therapy group (period II: September 2021-August 2023). Baseline characteristics, treatment outcomes, adverse effects, and morbidities were compared between the groups. Results: Of the 43 EPTs with hsPDA, 26 received monotherapy with ibuprofen during period I, and 17 received combination therapy with acetaminophen and ibuprofen during period II. The successful closure rates after the first medical therapy were 42.3% in the monotherapy group vs. 76.5% in the combination therapy group (P=0.027). No significant difference in adverse effects during medication use was observed between the groups. Conclusion Combination therapy with acetaminophen and ibuprofen improved the closure rate for hsPDA without detectable adverse effects. Combination therapy could be considered the first therapeutic option for hsPDA in EPTs. Further well-designed studies are needed to define the safety and effectiveness of combination therapy.

Objective: This study aimed to investigate the closure rate and adverse effects of combination therapy with acetaminophen and ibuprofen for hemodynamically significant patent ductus arteriosus (hsPDA) compared with monotherapy with ibuprofen in extremely preterm infants (EPTs). Methods: This was a single-center, retrospective, and historical control study of infants with hsPDA born at <28 weeks of gestation and a birth weight <1,000 g. Based on the first-line therapeutic policy for hsPDA, the cohort was classified into a monotherapy group (period I: January 2019-July 2021) and a combination therapy group (period II: September 2021-August 2023). Baseline characteristics, treatment outcomes, adverse effects, and morbidities were compared between the groups. Results: Of the 43 EPTs with hsPDA, 26 received monotherapy with ibuprofen during period I, and 17 received combination therapy with acetaminophen and ibuprofen during period II. The successful closure rates after the first medical therapy were 42.3% in the monotherapy group vs. 76.5% in the combination therapy group (P=0.027). No significant difference in adverse effects during medication use was observed between the groups. Conclusion Combination therapy with acetaminophen and ibuprofen improved the closure rate for hsPDA without detectable adverse effects. Combination therapy could be considered the first therapeutic option for hsPDA in EPTs. Further well-designed studies are needed to define the safety and effectiveness of combination therapy.

Objective: This study aimed to investigate the closure rate and adverse effects of combination therapy with acetaminophen and ibuprofen for hemodynamically significant patent ductus arteriosus (hsPDA) compared with monotherapy with ibuprofen in extremely preterm infants (EPTs). Methods: This was a single-center, retrospective, and historical control study of infants with hsPDA born at <28 weeks of gestation and a birth weight <1,000 g. Based on the first-line therapeutic policy for hsPDA, the cohort was classified into a monotherapy group (period I: January 2019-July 2021) and a combination therapy group (period II: September 2021-August 2023). Baseline characteristics, treatment outcomes, adverse effects, and morbidities were compared between the groups. Results: Of the 43 EPTs with hsPDA, 26 received monotherapy with ibuprofen during period I, and 17 received combination therapy with acetaminophen and ibuprofen during period II. The successful closure rates after the first medical therapy were 42.3% in the monotherapy group vs. 76.5% in the combination therapy group (P=0.027). No significant difference in adverse effects during medication use was observed between the groups. Conclusion Combination therapy with acetaminophen and ibuprofen improved the closure rate for hsPDA without detectable adverse effects. Combination therapy could be considered the first therapeutic option for hsPDA in EPTs. Further well-designed studies are needed to define the safety and effectiveness of combination therapy.

Purpose: This study aimed to compare the intraoperative and postoperative outcomes between robotic and laparoscopic transperitoneal adrenalectomies. Methods: In this retrospective study, 93 patients underwent adrenalectomy using 2 surgical modalities: 45 patients underwent adrenalectomy using the da Vinci Xi system (robotic group), and 48 patients using laparoscopic devices (laparoscopic group). We compared the operation time, intraoperative bleeding, and hospital stay according to the surgical modality and tumor characteristics. Results: There were no significant differences in the operative time (P = 0.827), hospital stay (P = 0.177), and intraoperative bleeding (P = 0.174) between the groups. However, the robotic group showed a lower coefficient of variation in total operative time than that of the laparoscopic group (100.6 ± 23.3 minutes vs. 101.9±32.7 minutes, 0.230 vs. 0.321). When divided into 2 subgroups based on the tumor size (<3 cm and ≥3 cm), the robotic group with a tumor sized >3 cm had a shorter operative time than that of the laparoscopic group (P = 0.032). The robotic group also had fewer cases of intraoperative bleeding (P = 0.034). Conclusions Compared to the laparoscopic transperitoneal adrenalectomy, the robotic one achieved a lower deviation in total operative time and showed less bleeding and a shorter operative time, especially for tumors sized >3 cm.

Purpose: The purpose of this study is to develop and apply a neonatal supportive positioning (NSP) training video program for premature infants, using a position support mat for nurses in neonatal intensive care units (NICUs), and to verify its effect on nurses' performance. Methods: Thirty-five NICU nurses were included in the study. For the pre-test, preliminary check-ups were conducted, questionnaires about NSP knowledge on preterm infants were distributed, and NSP performance using neonatal dolls were video recorded for each participant. PowerPoint presentations and videos were used to educate participants on NSP. Furthermore, a 20-minute one-on-one training session was conducted using an NPS kit. Two weeks after the training, we repeated the process of distributing questionnaires about NSP knowledge and recording nurses’ performance videos using neonatal dolls. Questionnaires and videos collected before and after the training were compared. Results: After NSP training, the mean knowledge score of the participants improved significantly from 23.71 ± 3.62 to 29.51 ± 2.29 (Z = −5.09, p < .001). The performance score for postural supportive positioning was 38.03 ± 7.46 before training and 80.06 ± 9.85 after receiving training, indicating a high-performance score after NSP training (Z = −5.16, p < .001). Conclusion Our NSP training video program increased nurses’ NSP knowledge and performance. Continuous training NICU nurses on NSP, using a standardized training video program, can help improve the care of premature infants.

Objective: : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods: : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results: : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo- LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669–35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941–41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

Cranial ultrasound (CUS) is an initial screening imaging tool used to evaluate the neonatal brain. It is an accessible, inexpensive, and harmless technique that can be used at bedside as frequently as required. Timely focused CUS in the neonatal care unit can play a major role in the diagnosis, follow-up, and management of brain damage. Despite the increasing use of point-of-care ultrasonography by intensive care physicians, neonatologist-performed CUS remains unusual. This review aims to provide an overview of neonatal CUS to neonatologists, focusing on the optimal settings, standard planes of the brain, and main pathologies in preterm infants. Adding Doppler studies allows evaluation of the patency of intracranial arteries and veins, flow velocities, and indices. This may provide an opportunity for earlier targeted circulatory support to prevent brain injury and improve long-term neurodevelopmental outcomes.

Purpose: Patients who have undergone gastrectomy have unique symptoms that are not appropriately assessed using currently available tools. This study developed and validated a symptom-focused quality of life (QoL) questionnaire for patients who have received gastrectomy for gastric cancer. Materials and Methods Based on a literature review, patient interviews, and expert consultation by the KOrean QUality of life in Stomach cancer patients Study group (KOQUSS), the initial item pool was developed. Two large-scale developmental studies were then sequentially conducted for exploratory factor analyses for content validity and item reduction. The final item pool was validated in a separate cohort of patients and assessed for internal consistency, test-retest reliability, construct validity, and clinical validity. Results The initial questionnaire consisted of 46-items in 12 domains. Data from 465 patients at 11 institutions, followed by 499 patients at 13 institutions, were used to conduct item reduction and exploratory factor analyses. The final questionnaire (KOQUSS-40) comprised 40 items within 11 domains. Validation of KOQUSS-40 was conducted on 413 patients from 12 hospitals. KOQUSS-40 was found to have good model fit. The mean summary score of the KOQUSS-40 was correlated with the EORTC QLQ-C30 and STO22 (correlation coefficients, 0.821 and 0.778, respectively). The KOQUSS-40 score was also correlated with clinical factors, and had acceptable internal consistency (> 0.7). Test-retest reliability was greater than 0.8. Conclusion The KOQUSS-40 can be used to assess QoL of gastric cancer patients after gastrectomy and allows for a robust comparison of surgical techniques in clinical trials.