Background: This study aims to delineate the characteristic features of adjustment disorder (AjD) from those of posttraumatic stress disorder (PTSD) and assess the discriminant validity of Diagnostic and statistical manual of mental disorders (DSM)-5 PTSD measures by comparing self-reported data from an outpatient cohort. Methods: The study participants included psychiatric outpatients at a university-affiliated hospital in South Korea.Psychological assessments comprised the Post-Traumatic Stress Disorder Checklist for DSM-5, the National Stressful Events Survey-PTSD Short Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Insomnia Severity Index, and the Short Form-8 Health Survey. Results: A total of 149 responses (51 participants with AjD and 98 with PTSD) were analyzed. It was observed that workplace conflict was the most common stressor among AjD patients (29%), while traffic accidents were the primary trauma source for PTSD patients (39%). Individuals with AjD reported significantly lower levels of PTSD, depression, anxiety, and insomnia symptoms, along with a higher quality of life. After controlling for educational level as a covariate, the differences in PTSD and depressive symptoms remained significant. Conclusion The findings of this study support the discriminant validity of DSM-5 PTSD measures for AjD and reinforce the notion that that AjD represents a milder form within the stress response spectrum.

Background: This study aims to delineate the characteristic features of adjustment disorder (AjD) from those of posttraumatic stress disorder (PTSD) and assess the discriminant validity of Diagnostic and statistical manual of mental disorders (DSM)-5 PTSD measures by comparing self-reported data from an outpatient cohort. Methods: The study participants included psychiatric outpatients at a university-affiliated hospital in South Korea.Psychological assessments comprised the Post-Traumatic Stress Disorder Checklist for DSM-5, the National Stressful Events Survey-PTSD Short Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Insomnia Severity Index, and the Short Form-8 Health Survey. Results: A total of 149 responses (51 participants with AjD and 98 with PTSD) were analyzed. It was observed that workplace conflict was the most common stressor among AjD patients (29%), while traffic accidents were the primary trauma source for PTSD patients (39%). Individuals with AjD reported significantly lower levels of PTSD, depression, anxiety, and insomnia symptoms, along with a higher quality of life. After controlling for educational level as a covariate, the differences in PTSD and depressive symptoms remained significant. Conclusion The findings of this study support the discriminant validity of DSM-5 PTSD measures for AjD and reinforce the notion that that AjD represents a milder form within the stress response spectrum.

Background: This study aims to delineate the characteristic features of adjustment disorder (AjD) from those of posttraumatic stress disorder (PTSD) and assess the discriminant validity of Diagnostic and statistical manual of mental disorders (DSM)-5 PTSD measures by comparing self-reported data from an outpatient cohort. Methods: The study participants included psychiatric outpatients at a university-affiliated hospital in South Korea.Psychological assessments comprised the Post-Traumatic Stress Disorder Checklist for DSM-5, the National Stressful Events Survey-PTSD Short Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Insomnia Severity Index, and the Short Form-8 Health Survey. Results: A total of 149 responses (51 participants with AjD and 98 with PTSD) were analyzed. It was observed that workplace conflict was the most common stressor among AjD patients (29%), while traffic accidents were the primary trauma source for PTSD patients (39%). Individuals with AjD reported significantly lower levels of PTSD, depression, anxiety, and insomnia symptoms, along with a higher quality of life. After controlling for educational level as a covariate, the differences in PTSD and depressive symptoms remained significant. Conclusion The findings of this study support the discriminant validity of DSM-5 PTSD measures for AjD and reinforce the notion that that AjD represents a milder form within the stress response spectrum.

Background: This study aims to delineate the characteristic features of adjustment disorder (AjD) from those of posttraumatic stress disorder (PTSD) and assess the discriminant validity of Diagnostic and statistical manual of mental disorders (DSM)-5 PTSD measures by comparing self-reported data from an outpatient cohort. Methods: The study participants included psychiatric outpatients at a university-affiliated hospital in South Korea.Psychological assessments comprised the Post-Traumatic Stress Disorder Checklist for DSM-5, the National Stressful Events Survey-PTSD Short Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Insomnia Severity Index, and the Short Form-8 Health Survey. Results: A total of 149 responses (51 participants with AjD and 98 with PTSD) were analyzed. It was observed that workplace conflict was the most common stressor among AjD patients (29%), while traffic accidents were the primary trauma source for PTSD patients (39%). Individuals with AjD reported significantly lower levels of PTSD, depression, anxiety, and insomnia symptoms, along with a higher quality of life. After controlling for educational level as a covariate, the differences in PTSD and depressive symptoms remained significant. Conclusion The findings of this study support the discriminant validity of DSM-5 PTSD measures for AjD and reinforce the notion that that AjD represents a milder form within the stress response spectrum.

Background: This study aims to delineate the characteristic features of adjustment disorder (AjD) from those of posttraumatic stress disorder (PTSD) and assess the discriminant validity of Diagnostic and statistical manual of mental disorders (DSM)-5 PTSD measures by comparing self-reported data from an outpatient cohort. Methods: The study participants included psychiatric outpatients at a university-affiliated hospital in South Korea.Psychological assessments comprised the Post-Traumatic Stress Disorder Checklist for DSM-5, the National Stressful Events Survey-PTSD Short Scale, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Insomnia Severity Index, and the Short Form-8 Health Survey. Results: A total of 149 responses (51 participants with AjD and 98 with PTSD) were analyzed. It was observed that workplace conflict was the most common stressor among AjD patients (29%), while traffic accidents were the primary trauma source for PTSD patients (39%). Individuals with AjD reported significantly lower levels of PTSD, depression, anxiety, and insomnia symptoms, along with a higher quality of life. After controlling for educational level as a covariate, the differences in PTSD and depressive symptoms remained significant. Conclusion The findings of this study support the discriminant validity of DSM-5 PTSD measures for AjD and reinforce the notion that that AjD represents a milder form within the stress response spectrum.

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Ectopic thymic neoplasm, particularly ectopic thymic carcinoma, is a rare disease that presents as a neck mass. Here, we present a case of ectopic thymic squamous carcinoma in a 65-year-old man who presented with persistent hoarseness. After fine needle aspiration cytology, the patient underwent total thyroidectomy with lymph node dissection. The final histopathological examination revealed the ectopic thymic squamous carcinoma. The patient was discharged without any postoperative complications. The patient received adjuvant radiation therapy and did not progress during the 1-year follow-up period.

Purpose: To analyze and compare the results of robotic partial nephrectomy (RPN) at a single center with the previous large-scale studies in terms of perioperative and oncological outcomes. Materials and Methods: We retrospectively evaluated 1,013 cases of RPN in our center database from December 2008 to August 2018. Total 11 cases were excluded in final analysis. We evaluated perioperative outcomes as the Trifecta achievement, which is defined as no positive surgical margin (PSM), no perioperative complications greater than Clavien-Dindo classification I and a warm ischemia time of <25 minutes. In addition, we analyzed pathological and oncological outcomes; recurrence, metastasis, all-cause deaths, cancer-specific deaths, and 5-year survival rates. Results: In 1,002 cases, the Trifecta achievement was 61.1% (n=612). The postoperative complication was 18.4% (n=184) but most were grade 2 or less (14.9%, n=145). Ninety-three cases (9.28%) had benign and 907 cases (90.5%) had malignant pathologies. A local recurrence were 14 cases (1.54%) and distant metastasis were 20 cases (2.2%) during follow-up periods. Allcause death rate was 1.2% (n=11) and cancer-specific death rate was 0.2% (n=2). The median follow-up period was 39 months. A 5-year recurrence-free survival rate, cancer-specific survival rate, and overall survival rate were 95.2%, 99.7%, and 98.4%. Conclusions In summary, our data shows comparable perioperative outcomes to other largescale studies of RPN in terms of the Trifecta achievement with similar baseline characteristics. In terms of oncological outcomes, there was lower rate of PSM and similar recurrence free survival rate.

Purpose: To analyze and compare the results of robotic partial nephrectomy (RPN) at a single center with the previous large-scale studies in terms of perioperative and oncological outcomes. Materials and Methods: We retrospectively evaluated 1,013 cases of RPN in our center database from December 2008 to August 2018. Total 11 cases were excluded in final analysis. We evaluated perioperative outcomes as the Trifecta achievement, which is defined as no positive surgical margin (PSM), no perioperative complications greater than Clavien-Dindo classification I and a warm ischemia time of <25 minutes. In addition, we analyzed pathological and oncological outcomes; recurrence, metastasis, all-cause deaths, cancer-specific deaths, and 5-year survival rates. Results: In 1,002 cases, the Trifecta achievement was 61.1% (n=612). The postoperative complication was 18.4% (n=184) but most were grade 2 or less (14.9%, n=145). Ninety-three cases (9.28%) had benign and 907 cases (90.5%) had malignant pathologies. A local recurrence were 14 cases (1.54%) and distant metastasis were 20 cases (2.2%) during follow-up periods. Allcause death rate was 1.2% (n=11) and cancer-specific death rate was 0.2% (n=2). The median follow-up period was 39 months. A 5-year recurrence-free survival rate, cancer-specific survival rate, and overall survival rate were 95.2%, 99.7%, and 98.4%. Conclusions In summary, our data shows comparable perioperative outcomes to other largescale studies of RPN in terms of the Trifecta achievement with similar baseline characteristics. In terms of oncological outcomes, there was lower rate of PSM and similar recurrence free survival rate.

Purpose: This study aimed to evaluate the effects of bladder cuff method on oncological outcomes in patients who underwent radical nephroureterectomy (RNU) for upper tract urothelial carcinoma. Materials and Methods: The records of 1,095 patients treated with RNU performed at our hospital between 1994 and 2018 were retrospectively reviewed; 856 patients with no bladder tumor history were enrolled in the present study. The management of bladder cuff was divided into two categories: extravesical ligation (EL) or transvesical resection (TR). Survival was analyzed using the Kaplan-Meier method and Cox regression analyses were performed to determine which factors were associated with intravesical recurrence (IVR)–free survival (IVRFS), cancer-specific survival (CSS), and overall survival (OS). Results: The mean patient age was 64.8 years and the median follow-up was 37.7 months. Among the 865 patients, 477 (55.7%) underwent the TR and 379 (44.3%) the EL. Significantly higher IVRFS (p=0.001) and OS (p=0.013) were observed in the TR group. In multivariable analysis, IVR, CSS, and OS were independently associated with the EL. Among 379 patients treated with the EL, eight underwent remnant ureterectomy. Based on radical cystectomy–free survival, significant difference was not observed between the two groups. However, significantly higher IVRFS was observed in the TR group when the tumor was located in the renal pelvis. Conclusion Intramural complete excision of the distal ureter during RNU should be the gold standard approach compared with EL for the management of distal ureter in terms of oncological outcomes.