Background and Objectives: Pediatric chronic rhinosinusitis (CRS) significantly affects children’s quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS. Methods: A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively. Results: In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control. Conclusion FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.

Background and Objectives: Pediatric chronic rhinosinusitis (CRS) significantly affects children’s quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS. Methods: A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively. Results: In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control. Conclusion FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.

Background and Objectives: Pediatric chronic rhinosinusitis (CRS) significantly affects children’s quality of life and learning abilities. This study aimed to evaluate the postoperative outcomes in pediatric patients who underwent functional endoscopic sinus surgery (FESS) for CRS. Methods: A retrospective review was conducted on pediatric patients who underwent FESS for CRS at 11 university hospitals. The inclusion criteria were patients under 20 years old with bilateral disease who were operated on between January 2005 and December 2021. The data collected included demographics, clinical history, blood tests, preoperative computed tomography, and preoperative and postoperative symptom control. The Kruskal-Wallis and Fisher exact tests were used to compare the quantitative and qualitative data, respectively. Results: In total, 213 patients were enrolled. The mean age was 13.4±3.0 years, and 145 (68.1%) were male. One hundred sixty-four patients (77.0%) had nasal polyps and 33 patients (15.5%) underwent revision FESS. The preoperative symptoms, in order of prevalence, included nasal obstruction (87.8%), rhinorrhea (71.8%), a sense of postnasal drip (58.2%), hyposmia (44.6%), cough (24.4%), and facial fullness (18.3%). These symptoms were significantly alleviated for up to 3 years after surgery (p<0.001). At the time of the last follow-up, 121 patients (56.8%) were controlled, 80 (37.6%) were partly controlled, and 12 (5.6%) were uncontrolled. Patients in the uncontrolled group had higher Lund-Mackay scores, longer follow-up durations, and more instances of revision surgery compared to those in the controlled and partly controlled groups. When age was categorized into three groups, those aged 16 years or older tended to have lower Lund-Mackay scores and better control. Conclusion FESS significantly improves both the postoperative symptoms and the long-term quality of life in pediatric CRS patients. Better symptom control is associated with older age and a lower disease burden.

Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery. Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1. Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups. Conclusions OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.

Background: In this study, we aimed to investigate whether opioid-sparing anesthesia (OSA) reduces postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic gynecological surgery. Methods: Adult patients undergoing elective laparoscopic gynecological surgery were randomly assigned to either the opioid-using anesthesia (OUA) or the OSA groups. In the OUA group, remifentanil was administered as an opioid during general anesthesia. In the OSA group, apart from a single dose of 5 μg/kg of alfentanil for tracheal intubation, no other opioids were used. In both groups, a multimodal intravenous non-opioid analgesic regimen was used preferentially in the post-anesthesia care unit (PACU). The primary outcome was the incidence of PONV, assessed by symptoms until the postoperative day 1. Results: A total of 120 patients were included in this study. The incidence of nausea in the PACU was significantly lower in the OSA group compared to in the OUA group (31.7% in the OSA group vs. 51.7% in the OUA group, P = 0.026). Pain scores and the incidence of opioid analgesic administration were lower in the OSA group during PACU stay, resulting in a significantly lower number of patients requiring rescue opioid analgesics (3.3% vs. 18.3%, P = 0.008). There were no significant differences in intraoperative vital signs, hemodynamic interventions, or duration of PACU and hospital stay between the two groups. Conclusions OSA significantly reduced postoperative nausea, pain scores, and the need for rescue analgesics in the PACU without increasing hemodynamic instability in patients undergoing laparoscopic gynecological surgery.

Measurable residual disease (MRD) testing, a standard procedure in B-lymphoblastic leukemia (B-ALL) diagnostics, is assessed using multiparametric flow cytometry (MFC) and next-generation sequencing (NGS) analysis of immunoglobulin gene rearrangements. We evaluated the concordance between eight-color, two-tube MFC-MRD the LymphoTrack NGS-MRD assays using 139 follow-up samples from 54 pediatric patients with B-ALL. We also assessed the effect of hemodilution in MFC-MRD assays. The MRD-concordance rate was 79.9% (N = 111), with 25 (18.0%) and 3 (2.2%) samples testing positive only by NGSMRD (MFC − NGS + MRD) and MFC-MRD (MFC + NGS − MRD), respectively. We found a significant correlation in MRD values from total nucleated cells between the two methods (r = 0.736 [0.647–0.806], P < 0.001). The median MRD value of MFC − NGS + MRD samples was estimated to be 0.0012% (0.0001%–0.0263%) using the NGS-MRD assays. Notably, 14.3% of MFC − NGS + MRD samples showed NGS-MRD values below the limit of detection in the MFC-MRD assays. The percentages of hematogones detected in MFC-MRD assays significantly differed between the discordant and concordant cases (P < 0.001). MFC and NGS-MRD assays showed relatively high concordance and correlation in MRD assessment, whereas the NGS-MRD assay detected MRD more frequently than the MFC-MRD assay in pediatric B-ALL. Evaluating the hematogone percentages can aid in assessing the impact of sample hemodilution.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Objectives: ：This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR. Methods: ：We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test. Results: ：When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared. Conclusions ：This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Objectives: ：This study was aimed to determine whether the presence or absence of psychotic symptoms inmood disorders is statistically significantly related to the difference between NLR, MLR, PLR. Methods: ：We retrospectively reviewed the medical records of 408 patients who were hospitalized with a diagnosis of bipolar disorder type 1 (BP-I) and major depressive disorder (MDD) and underwent complete blood count.Groups were divided based on the presence or absence of psychotic symptoms. The statistical significance of the differences in NLR, MLR, and PLR between each group was examined using t-test. Results: ：When 382 mood disorder patients were divided into groups based solely on the presence or absence ofpsychotic symptoms, the difference between NLR and MLR was statistically significant (NLR: p=0.009, MLR:p=0.016). When dividing the mood disorder patients into subgroups of 176 BP-I patients and 206 MDD patients and using the same method for each subgroup, the tendency for higher NLR and MLR was maintained, but the sta-tistical significance disappeared. Conclusions ：This study suggests the possibility of relationship between psychotic symptoms and NLR and MLR in mood disorders, but additional research appears to be necessary to clarify the possibility.