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This study compared the surgical outcomes of transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transoral robotic thyroidectomy (TORT) in papillary thyroid cancer (PTC).The TOETVA and TORT groups comprised 119 and 121 patients between November 2016 and May 2022. Clinico-surgical outcomes and operation times were retrospectively reviewed.The TORT group showed a higher number of retrieved central compartment lymph nodes, shorter hospital stays, and lower pain score after 48 h than the TOETVA group. No significant difference was observed in the other postoperative complications, including permanent vocal cord palsy. Total operation, working space creation, and endoscopic or robotic surgery times of the TORT group were longer than those of the TOETVA group.TORT and TOETVA are feasible and safe. TORT may have some advantages, such as central compartment node dissection, shorter hospital stays, and pain score after 48 h in PTC, despite a longer operative time.

The ranked discrepancy model (RDM) is a relatively novel needs assessment approach and is optimized for addressing ordinal and non-normally distributed data. This study aimed to explore the viability of the RDM by comparing the results obtained from it with those obtained using two other long-standing needs assessment models, and to prioritize the learning needs of secondary school career guidance teachers in South Korea using the RDM as an initial effort to improve the pre-service and in-service educational programs of teachers. Data were collected from 75 career guidance teachers by using a survey questionnaire. The results from the RDM, the weighted total index (WTI) approach, and the Borich model demonstrated a great deal of consistency in terms of the rankings of career guidance teachers’ learning needs. This implies that the RDM is a useful quantitative method for needs assessment in cases involving ordinal items, cross-sectional data, or non-normally distributed data. This study also revealed that “providing and utilizing occupational information” is the biggest shortfall among the job tasks required of secondary school career guidance teachers, compared to its importance. Uncertainty about the future might make it more difficult for career guidance teachers to provide students with the appropriate occupational guidance.

At a time of global economic crisis, professional programs in universities are demanded to make continuous improvements based on new information on performance gaps of novice incumbents, in order to make their graduates more competitive, which ultimately leads to their job security and decent work. Accordingly, this study aimed to assess discrepancies in the importance and performance levels of professional capabilities required of novice Human Resource Development (HRD) practitioners and priorities in instructional needs, as perceived by immediate superiors as an initial effort to improve the curricula of undergraduate HRD courses. Data were collected from 193 HRD supervisors in organizations in South Korea and were analyzed using paired t-test and the ranked discrepancy model. These findings indicated that instructional needs in terms of professional capabilities were high in the following order: instructional design, learning science, career and leadership development, coaching, training delivery and facilitation, knowledge management, and technology application. The results implied that most undergraduate courses developed for the education of prospective HRD practitioners need to be updated and improved. This study also proposed an idiosyncratic and periodic formative evaluation process for the ongoing improvement of professional programs in universities as a part of efforts to sustain the global economic growth.

Background The aim of this study was to examine the accuracy of radiologic complete response (rCR) in predicting pathologic complete response (pCR), and determine whether rCR is a predictor of favorable survival outcomes. Materials and methods We retrospectively reviewed breast cancer patients treated with neoadjuvant chemotherapy (NAC) followed by surgery from September 2007 to June 2016. Breast lesions and axillary nodes were measured by MRI and categorized into either disappeared (breast rCR) or residual disease (breast non-rCR) and either normalized (axillary rCR) or abnormal findings (axillary non-rCR) in the axillary nodes. Correlation between rCR and pCR were compared using Cohen’s Kappa statistics, and the recurrence-free survival (RFS) and overall survival (OS) rates were calculated by the Kaplan-Meier method. Results Out of the 1017 eligible patients, 287 (28.2%) achieved breast pCR, 165 (16.2%) achieved breast rCR, 529 (52.0%) had axillary pCR, and 274 (26.9%) achieved axillary rCR. The correlation between a breast rCR and pCR showed a Cohen’s Kappa value of 0.459, and between axillary rCR and pCR, the value was 0.384. During a median follow-up time of 48.0 months, the 5-year RFS rates were 90.6% for breast rCR, and 69.2% for breast non-rCR. The 5-year RFS rates were 82.3% for axillary rCR, and 68.8% for axillary non-rCR. Patients without breast rCR had a 2.4-fold significant increase in the risk of recurrence (p = 0.004) compared to patients with breast rCR. Conclusion Although rCR correlated with pCR by only moderate to fair degrees, breast rCR was a strong predictor for a favorable RFS outcome.

Introduction: The aim of this study was to evaluate the prognostic value of the number of lymph nodes removed in breast cancer patients who undergo axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NAC). Methods: We included patients who were diagnosed with invasive breast cancer and cytology with proven involved axillary node metastasis at diagnosis and treated with NAC followed by curative surgery at Samsung Medical Center between January 2007 and December 2015. The primary outcomes were disease-free survival (DFS) and overall survival (OS). Results: Among 772 patients with NAC and ALND, there were 285 ypN0, 258 ypN1, 135 ypN2, and 94 ypN3 cases. The median follow-up duration was 69.0 months. The group with less than 10 lymph nodes number (

The purpose of this study was to evaluate pathologic lymph node metastasis in breast cancer with cytology-proven axillary metastasis. This study was designed prospectively. We performed axillary lymph node dissections (ALND) after lymphatic mapping by near-infrared (NIR) fluorescence imaging with Indocyanine Green (ICG). We evaluated 72 breast cancer patients with cytology-proven axillary metastasis by curative surgery at the Samsung Medical Center between May of 2016 and December of 2017. Among the 72 patients with cytology-proven axillary metastasis, 14 of 39 patients (35.9%) with one or two sentinel lymph nodes containing metastases were metastasized to post-sentinel lymph node. Thirteen of fourteen patients had additional non-sentinel lymph node metastases, seven of thirteen patients also had additional level II lymph node metastases, and one patient had only one additional level II lymph node metastasis. Of T1 or T2 stage patients, 10 of 33 patients (30.3%) with one or two sentinel lymph nodes containing metastases were metastasized to post-sentinel lymph node. Even in patients without SLN metastasis, 50% of the patients had at least three LN metastases, and 40% in the T1 or T2 stage patients. Sentinel lymph node biopsy without ALND might be not safe for patients with cytology-proven axillary metastasis.

This study aimed to empirically examine the factors affecting full-time undergraduate students’ satisfaction and academic performance measured by grades using an existing large administrative dataset. The sample consisted of 21,662 undergraduate students who took online liberal arts courses offered by a large traditional Korean university in the spring semester of 2020. The theoretical framework of this study was formulated by selectively adopting and slightly modifying some of the factors from Choi’s conceptual model for adult dropout from online degree programs. The findings indicated that gender, previous GPA, campus, type of online course, the relevance of the course, adequacy of assignments and assessments, learner-instructor interaction, and learner-content interaction significantly affect students’ degree of satisfaction with online liberal arts courses. This study also found that students who considered the course less relevant to their goals or interests, had a low previous GPA, had frequent learner-instructor interactions, few learner-content interactions, and a low level of course satisfaction are more likely to earn a grade of B, C, or lower than to receive an A in online liberal arts courses.

Many breast cancer patients receive sentinel lymph node biopsy after neoadjuvant chemotherapy (NAC). We evaluated the axillary pathologic complete response (pCR) in relation to achievement of breast pCR. We evaluated 1044 patients who were diagnosed with invasive breast cancer and were treated with NAC followed by curative surgery at the Samsung Medical Center between January 2008 and December 2016. The pathologic node-positive rates in breast pCR patients were compared for different breast cancer subtypes and clinical nodal stages. Axillary pCR was achieved in 51.9% of the patients after NAC. In this case, the axillary pCR was associated with a biologic subtype (P

Numerous studies have shown that vitamins reduce the risk of cancers, but the relationship between serum vitamin levels and breast cancer is still controversial. In this study, we evaluated serum levels of vitamins in Korean patients with benign breast disease or breast cancer and investigated their associations with clinical and laboratory parameters. Concentrations of vitamin A, D, and E, together with homocysteine and methylmalonic acid as biomarkers of vitamin B12 deficiency, were measured by high-performance liquid chromatography (HPLC) or liquid chromatography with tandem mass spectrometry (LC-MS/MS) in the serum of 104 breast cancer patients, 62 benign breast disease patients, and 75 healthy Korean females. We further assessed possible associations between vitamin levels and breast cancer subtypes, the presence of lymph node metastasis, and tumor stages. Serum concentrations of vitamins A and E were significantly lower in breast cancer patients and in benign breast disease patients than in healthy controls. Severe vitamin D deficiency was more prevalent in breast cancer patients than in healthy controls. Vitamin D level was significantly lower in breast cancer patients with estrogen receptor-negative or triple-negative subtypes than in those with other subtypes. Further research with a larger study population is required to elucidate the role of vitamins in breast cancer.

Background/Aim: The aim of the study was to use a triple-negative breast cancer (TNBC) patient-derived orthotopic xenograft (PDOX) model to examine the efficacy of oral recombinant methioninase (o-rMETase) against this recalcitrant disease. Materials and Methods: The TNBC tumor from a patient was implanted in the right 4(th) inguinal mammary fat pad of nude mice. Two weeks later, the mice underwent tumorectomy with grossly-negative surgical margins. Two days after tumorectomy the mice were divided in two groups: one control and one treated with o-rMETase. Results: Tumors recurred in all mice. On day 11, the mean recurrent tumor volumes were 936.7 mm(3) in the control group and 450.9 mm(3) in the o-rMETase group (p

Using large samples from multiple online degree programs, this study aimed to empirically identify the direct and indirect relationships between major adult dropout factors (i.e., basic scholastic aptitude, physical constraints, interaction with course content, satisfaction, and GPA) and provide educational practitioners with insights that will enable them to indirectly handle uncontrollable adult dropout factors based on the empirical evidence. To achieve these purposes, we formulated and empirically tested a hypothesized path model encompassing multiple hypotheses derived from related literature. We found that the physical constraints variable has statistically significant direct and indirect relationships through interactions with course content, satisfaction, and GPA with adult students dropout decisions, and the basic scholastic aptitude variable has an indirect relationship with dropout decisions through interactions with course content and GPA. This paper concludes by discussing the implications of our findings for educational practitioners in online degree programs. We present a path-analytic model of adult dropout that is statistically acceptable.Physical constraint has direct and indirect effects on dropout decision.The effect of scholastic aptitude is not as strong as that of physical constraint.The relationship between internal dropout factors is clearly identified.

PURPOSE This study aimed to evaluate the rate, patterns, and risk factors associated with tumor recurrence in patients with T1N0 gastric cancer. MATERIALS AND METHODS The medical records of 8,753 patients with pathological T1N0M0 gastric cancer who underwent gastrectomy between 1994 and 2014 at Sungkyunkwan University School of Medicine were examined. RESULTS Among the 8,753 patients, 95 patients (1.1%) experienced tumor recurrence; this included 31 remnant, 27 hematogenous, 9 lymph nodal, 5 peritoneal, and 23 multiple-site recurrences. When patients were divided into two groups according to the presence of tumor recurrence, the following characteristics were higher in the recurrence group than in the non-recurrence group: older age (≥65 years), male gender, undifferentiated histology, submucosal invasion, and venous invasion. In multivariate analysis, older age, male gender, tumor depth (sm2 and sm3 invasion), and venous invasion were independent risk factors for tumor recurrence. The recurrence rates were 0.7% in patients with less than two risk factors, 1.7% in those with two risk factors, 3.0% in those with three risk factors, and 6.3% in those with four risk factors (P

The main purpose of this study was to identify the effects of two major components (ie, video and group discussion) of problem-based video instruction (PBVI) on college students’ learning. To achieve this purpose, this study examined whether or not PBVI can improve learner satisfaction, comprehension and retention by comparing the results from three dependent variables in PBVI with two other kinds of instruction: (1) problem-based text instruction (PBTI) and (2) PBVI without group discussion. According to the findings, there were significant differences in learner satisfaction, comprehension, and delayed retention between PBVI and PBTI groups, whereas there were no significant differences in learners’ satisfaction, comprehension, and delayed retention between PBVI and PBVI without group discussion. This study implies that PBVI in college courses have the potential to enhance student satisfaction, comprehension and delayed retention.

The purpose of this study was to investigate the potential of a constructivist approach to context-based video instruction for enhancing learning. To achieve this purpose, the authors examined whether video-based instruction that was developed using constructivist theory can affect student learning (i.e., comprehension and retention) and motivation (i.e., attention, relevance, confidence, and satisfaction) by comparing learners' perceptions of both video-based instruction and traditional text-based instruction in an online context-based lesson. There was a significant difference in learners' motivation in terms of attention between the video-based instruction and traditional text-based instruction. In addition, the learners reported that the video-based instruction was more memorable than the traditional text-based instruction. This study implies that context-based videos in online courses have the potential to enhance learners' retention and motivation.