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Background/Aims@#The treatment for gastric mucosa-associated lymphoid tissue lymphoma (MALToma) generally involves eradication of Helicobacter pylori. However, MALToma lesions may recur even without H. pylori re-infection. Furthermore, the remission rate of H. pylori-negative MALToma after eradication is low. Therefore, herein, we report on endoscopic submucosal dissection (ESD) as a treatment strategy for gastric MALToma. @*Methods@#We retrospectively reviewed the data of all patients of gastric MALToma who underwent endoscopic resection at our institution between January 2000 and December 2021. Clinical remission was defined as complete histological remission or probable minimal residual disease according to the GELA grading system for post-treatment evaluation of gastric MALToma. @*Results@#Six patients with gastric MALToma underwent ESD. Two patients were diagnosed with gastric MALToma, which improved after eradication treatment and relapsed approximately 36 and 41 months later, respectively. These patients had singular lesions localized to the mucosa and did not experience H. pylori re-infection. The lesions were successfully removed via ESD. The remaining four patients had H. pylori-negative gastric MALToma. These patients also had single, localized lesions that were removed via ESD. All the patients remained in clinical remission until the final follow-up. @*Conclusions@#ESD is a safe and effective intervention for H. pylori-negative gastric MALToma when the lesion is single and confined to the mucosal layer.
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Background/Aims@#Identification of Helicobacter pylori infection status is necessary as H. pylori is associated with gastric malignancy. Recently, a red linear scrape-like appearance on the gastric mucosa, called the “scratch sign,” was reported to be associated with H. pylori-negative gastric mucosal status. Herein, we aimed to validate the association between the scratch sign and H. pylori infection status. @*Methods@#The data of patients who underwent screening endoscopy at Bundang Jesaeng General Hospital between March 2023 and April 2023 were reviewed. Patients were classified as having an H. pylori current infection or non-infection status based on the results of rapid urease tests. Patients who had undergone H. pylori eradication therapy were excluded. Endoscopic features of the gastric mucosa were assessed using the Kyoto classification of gastritis. @*Results@#The scratch sign appeared more frequently in patients with non-infection than in those with current infection status (32.7% vs. 10.6%, respectively; P<0.001). Multivariate analysis showed that only the presence of sticky mucus was significantly associated with the presence of the scratch sign. Patient without the scratch sign had a higher prevalence of open-type atrophy, intestinal metaplasia, enlarged folds, and diffuse redness, which reflected a higher Kyoto score. @*Conclusions@#Presence of the gastric mucosal scratch sign, a novel endoscopic marker, is indicative of H. pylori-negative status and appears to be inversely correlated with the presence of sticky mucus. In addition to the Kyoto classification of gastritis, detection of the scratch sign may facilitate identification of the H. pylori infection status.
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Gastritis is common worldwide. The combination of Helicobacter pylori (H. pylori) infection with background gastritis, including atrophic gastritis or intestinal metaplasia is implicated as an important etiopathogenetic contributor to gastric cancer. Since the gastritis classification proposed by Schindler, research has focused on classification of gastritis for accurate diagnosis and prediction of prognosis. Advances in endoscopic technology have enabled more accurate visualization of the gastric mucosa and ‘targeted’ biopsies with the emergence of newer classifications based on visual findings (Kimura-Takemoto classification) and more specific histopathological findings using targeted biopsies (Whitehead classification). Following the discovery of H. pylori, it is mandatory to consider its role as an important contributor to gastritis. Therefore, it was necessary to redefine the classification of gastritis and arrive at a consensus, which led to the establishment of an international consensus classification, referred to as the Sydney system. However, the Sydney system alone cannot predict the gastric cancer risk, and scoring systems such as the Operative Link for Gastritis Assessment and the Operative Link on Gastritis Assessment based on Intestinal Metaplasia were proposed. These systems are based on histopathological findings observed in endoscopic biopsy specimens. However, availability of high-definition images following technological advances has facilitated the emergence of a visual classification, the Kyoto classification. In contrast to the Sydney system, the Kyoto classification is based exclusively on interpretation of visual findings and focuses on detection of H. pylori infection and gastric cancer prediction. In this review, we summarize the history and background of the various classifications of gastritis.
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Objectives@#Gastrointestinal cytomegalovirus (CMV) disease is a major contributor to mortality in immunocompromised patients. Few studies have discussed upper gastrointestinal CMV (UGICMV) disease in immunocompetent patients. We compared the clinical outcomes of UGI-CMV between immunocompromised and immunocompetent patients. @*Methods@#This retrospective study included patients with UGI-CMV disease from five tertiary hospitals across Korea (2010– 2022). Patients’ clinical data and outcomes were recorded. @*Results@#UGI-CMV was diagnosed in 54 patients; 27 (50.0%) had esophageal, 24 (44.4%) had gastric, and 3 patients (5.6%) had duodenal involvement. Patients’ median age was 64 years (interquartile range 53–75 years), and the most common comorbidities included hypertension (57.4%) and diabetes (38.9%). The predominant symptom was abdominal pain (46.3%), and the most common endoscopic finding was ulcers (70.4%). Antiviral treatment was administered to 31 patients, and 23 patients underwent observation without treatment. We investigated 32 immunocompromised (59.3%) and 22 immunocompetent (40.7%) patients and observed no intergroup differences in comorbidities and in laboratory and endoscopic findings. Immunocompromised patients had longer length of hospitalization (median 46.2 days vs. 20.0 days, p=0.001). However, treatment outcomes, including the need for intensive care unit admission and mortality did not significantly differ. The overall mortality rate was 13.0%; one patient from the immunocompromised group died of UGI-CMV disease. The treatment success rate was higher in immunocompromised patients who received antiviral therapy (p=0.011). @*Conclusions@#UGI-CMV disease is not uncommon in immunocompetent patients, although symptoms are milder than those in immunocompromised patients. Our findings emphasize the importance of clinical vigilance for accurate diagnosis of CMV infection, particularly in susceptible symptomatic patients and highlight the need for active antiviral treatment for management of immunocompromised patients.
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Background@#The Omicron variant has become the most prevalent SARS-CoV-2 variant. Omicron is known to induce milder lesions compared to the original Wuhan strain. Fatal infection of the Wuhan strain into the brain has been well documented in COVID-19 mouse models and human COVID-19 cases, but apparent infections into the brain by Omicron have not been reported in human adult cases or animal models. In this study, we investigated whether Omicron could spread to the brain using K18-hACE2 mice susceptible to SARS-CoV-2 infection. @*Results@#K18-hACE2 mice were intranasally infected with 1 × 105 PFU of the original Wuhan strain and the Omicron variant of SARS-CoV-2. A follow-up was conducted 7 days post infection. All Wuhan-infected mice showed > 20% body weight loss, defined as the lethal condition, whereas two out of five Omicron-infected mice (40%) lost > 20% body weight. Histopathological analysis based on H&E staining revealed inflammatory responses in the brains of these two Omicron-infected mice. Immunostaining analysis of viral nucleocapsid protein revealed severe infection of neuron cells in the brains of these two Omicron-infected mice. Lymphoid depletion and apoptosis were observed in the spleen of Omicron-infected mice with brain infection. @*Conclusion@#Lethal conditions, such as severe body weight loss and encephalopathy, can occur in Omicron-infected K18-hACE2 mice. Our study reports, for the first time, that Omicron can induce brain infection with lymphoid depletion in the mouse COVID-19 model.
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Pancreatic pseudoaneurysm is a potentially life-threatening complication often associated with pancreatitis or pancreatic surgery. As the rupture of pancreatic pseudoaneurysms can lead to catastrophic bleeding and is associated with high mortality rates, clinical suspicion and early diagnosis are essential to improve patient outcomes. In the management of pseudoaneurysms, transarterial embolization (TAE) could be effective; however, there have been limited local studies on the outcomes of TAE for patients with pseudoaneurysm rupture associated with pancreatitis. Here, we describe patients who were diagnosed with pseudoaneruysm rupture associated with pancreatitis and treated with TAE.
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Individuals with Asia type DEL blood group, the RhD-variant that classified as serologically RhD-negative, do not produce anti-D even when exposed to the D-antigen. Therefore, it is considered safe to transfuse RhD-positive blood products to them. However, such transfusions are still rare in medical institutions, with only two cases reported in Korea. Here, we present cases of two additional patients based on our experience. A 60-year-old female patient undergoing extra corporeal membrane oxygenation (ECMO) for myocarditis presented with severe anemia.The patient was serologic RhD-negative. Due to the lack of RhD-negative RBC inventory for emergency transfusion, RhD-positive blood was transfused. After confirming the patient’s RHD genotype as Asia type DEL, the planned RhD-positive blood transfusion was continued. A total of 13 units of RhD-positive RBCs and 26 units of single donor platelets (SDPs) were transfused over 25 days. Throughout this period, all unexpected antibody tests were negative. The second patient, a 50-year-old male diagnosed with myelodysplastic syndrome (MDS), was serologic RhD-negative, and the RHD genotyping confirmed Asia type DEL. During the hospitalization period, a total of 113 units of RhD-positive SDPs and 10 units of fresh frozen plasma (FFP) were transfused over 64 days, and all unexpected antibody tests were negative. These two cases suggest the transfusion of RhD-positive blood products to patients with Asia type DEL is safe.
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Maturity-onset diabetes of the young (MODY) is a rare, autosomal dominant disease characterized by non-ketogenic diabetes mellitus (DM). MODY type 4, caused by PDX1 mutation, is a very rare subtype of MODY, especially in Korea. We report a case of a 10-year-old, nonobese girl with a family history of type 2 DM. After diagnosis, the patient’s serum glucose level was well controlled using metformin monotherapy; however, the glycated hemoglobin level increased to 9.0% approximately 2 years after treatment. No obesity or lifestyle problems were observed, and serum fasting C-peptide level was within the normal range. Furthermore, no islet-related autoantibodies were detected. A genetic screening for MODY using a next-generation sequencing panel was performed, and a likely heterozygous pathogenic PDX1 mutation (p.Gly246ArgfsTer21) was identified. The PDX1 variant was not detected in her mother, implying that the mutation had arisen de novo in the proband. She was prescribed insulin degludec in addition to metformin therapy, which improved her hyperglycemia. This report presents a novel MODY type 4 phenotype and highlights the importance of genetic screening in patients with MODY characteristics.
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Background@#ABO genotyping is performed when the exact ABO blood type cannot be determined through serological testing. Conventionally, only exons 6 and 7 of the ABO gene have been analyzed, but our laboratory introduced additional analysis of the proximal promoter and intron 1 ＋5.8 kb site. Accordingly, we report the clinical use of ABO genotyping and distribution of the ABO subgroups based on our experience over the past 5 years. @*Methods@#A total of 265 samples tested at the Samsung Medical Center from August 2017 to July 2022 were retrospectively analyzed at their request. Serological ABO blood typing and direct sequencing of exons 6 and 7 were performed on all samples, and additional analysis of the regulatory region of the ABO gene was performed on 17 samples. Since some of the ABO discrepant cases revealed multiple causes, a total of 339 causes among 238 ABO discrepant cases were analyzed. @*Results@#Among the total of 265 samples, 89.8% (238/265) exhibited ABO discrepancies. Weak red cell reactivity (51.6%, 175/339) was the most common cause of ABO discrepancy, followed by extra serum reactivity (35.7%, 121/339). Among the samples, 40.8% (108/265) were identified as ABO subgroups. Among the 108 ABO subgroup alleles, cisAB.01 in exons 6 and 7 accounted for 82 cases (75.9%, 82/108), and two g.10925C＞T mutations in intron 1 ＋5.8 kb were identified. @*Conclusion@#Through our recent experience of the last 5 years of ABO genotyping, we elucidated the cause of ABO discrepancies and ABO subgroup alleles. The extended sequencing of the regulatory region of the ABO gene was helpful for further understanding the ABO discrepancy caused by weak red cell reactivity. (Korean J Blood Transfus 2023;34:12-20)
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Background and Objectives@#The aim of this study was to identify the frequency of indicators of National Health Insurance (NHI) coverage for positive airway pressure (PAP) therapy and to investigate the changes in patients receiving coverage for PAP therapy after the alterations were made in the insurance benefit standards for mild obstructive sleep apnea (OSA).Subjects and Method We divided the mild OSA patients into two groups according to altered categorization in insurance benefit standards (Mild1: 5≤AHI<10; Mild2: 10≤AHI<15). Eight indicators related to the NHI coverage were identified: four symptoms, three complications, and the minimal blood oxygen saturation during polysomnography (min SpO2) of ≤85% during polysomnography. We also investigated the change in the number of patients receiving insurance benefits under the altered insurance benefit standards. @*Results@#Of the 233 OSA patients, 66, 57, and 110 patients were diagnosed as mild, moderate and severe OSA, respectively. For all of them, the most common indicator related to NHI coverage for PAP therapy was the minimum SpO2 of less than 85% during polysomnography, and the second most common indicator was daytime sleepiness. In the mild OSA group, however, daytime sleepiness was found to be the most common indicator, found in 46 (70%) patients, followed by 38 (58%) patients with min SpO2 of less than 85%. In this group, 59 (89.4%) would have been benefited before the change in the insurance benefit standards whereas 51 patients (77.3%) would now be benefited under the changed insurance benefit standards. @*Conclusion@#Daytime sleepiness was the most commonly observed indicator in the mild OSA patients. The number of patients receiving insurance benefits for PAP therapy significantly decreased after the change was made in the NHI benefit standards for mild OSA
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Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.
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Objective@#To develop and evaluate a deep learning-based artificial intelligence (AI) model for detecting skull fractures on plain radiographs in children. @*Materials and Methods@#This retrospective multi-center study consisted of a development dataset acquired from two hospitals (n = 149 and 264) and an external test set (n = 95) from a third hospital. Datasets included children with head trauma who underwent both skull radiography and cranial computed tomography (CT). The development dataset was split into training, tuning, and internal test sets in a ratio of 7:1:2. The reference standard for skull fracture was cranial CT. Two radiology residents, a pediatric radiologist, and two emergency physicians participated in a two-session observer study on an external test set with and without AI assistance. We obtained the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity along with their 95% confidence intervals (CIs). @*Results@#The AI model showed an AUROC of 0.922 (95% CI, 0.842–0.969) in the internal test set and 0.870 (95% CI, 0.785–0.930) in the external test set. The model had a sensitivity of 81.1% (95% CI, 64.8%–92.0%) and specificity of 91.3% (95% CI, 79.2%–97.6%) for the internal test set and 78.9% (95% CI, 54.4%–93.9%) and 88.2% (95% CI, 78.7%– 94.4%), respectively, for the external test set. With the model’s assistance, significant AUROC improvement was observed in radiology residents (pooled results) and emergency physicians (pooled results) with the difference from reading without AI assistance of 0.094 (95% CI, 0.020–0.168; p = 0.012) and 0.069 (95% CI, 0.002–0.136; p = 0.043), respectively, but not in the pediatric radiologist with the difference of 0.008 (95% CI, -0.074–0.090; p = 0.850). @*Conclusion@#A deep learning-based AI model improved the performance of inexperienced radiologists and emergency physicians in diagnosing pediatric skull fractures on plain radiographs.
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Background and Objectives@#The aim of this study was to compare adherence to positive airway pressure (PAP) therapy in patients with obstructive sleep apnea (OSA) of different severity.Subjects and Method We conducted a retrospective study including 270 adult OSA patients who used a PAP device for at least 3 months. We assessed the percentage of days on which the device was used, the percentage of days on which the device was used for ≥4 h, and the average duration of PAP device usage at 12 weeks of PAP therapy. We also evaluated adequate adherence to PAP therapy using a PAP device for ≥4 h/day and during ≥70% of nights. @*Results@#The percentage of days on which a PAP device used did not differ significantly according to OSA severity (median [Q1-Q3]; mild: 91.40% [81.25%-97.65%], moderate: 94.50% [86.90%-100%], severe: 95.90% [88.10%-100%], p=0.268). We also found that the percentage of days on which a PAP device was used during sleep for ≥4 h was not significantly different in patients with different OSA severity (median [Q1-Q3], mild: 76.20% [69.70%-89.90%], moderate: 89.30% [67.65%-95.70%], severe: 85.70% [75.85%-95.45%], p=0.097). The percentage of patients with adequate PAP adherence did not differ significantly according to OSA severity (mild: 74.2%, moderate: 72.1%, severe: 83.0%, p=0.084). Moreover, the mean duration (minutes) of PAP device usage during sleep did not differ significantly according to OSA severity in the mild, moderate, and severe OSA groups (mean±standard deviation, mild: 348.03± 47.78 min, moderate: 358.58±85.22 min, severe: 363.79±57.21 min, p=0.440). @*Conclusion@#Adherence to PAP therapy did not differ significantly according to OSA severity. Therefore, it is necessary to continuously expand and maintain the insurance for health promotion in OSA patient in South Korea.
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Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.
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Purpose@#This study investigated the impact of coronavirus disease 2019 (COVID-19) on body mass index (BMI) of children and adolescents. @*Methods@#From May to July 2020, the obesity rate of children and adolescents was compared retrospectively to the corresponding rate in the same period in 2019. The change in height, weight, and BMI of the girls who received a gonadotropin releasing hormone agonist (GnRHa) for precocious puberty (n=53) and the controls (n=31) who visited a growth clinic for early breast budding but were not treated with GnRHa in the first half of 2020 were compared to the corresponding change in the first half of 2019 using a paired t-test. @*Results@#The rate of overweight or obesity in new outpatients (n=113, 83 girls, 30 boys) who visited growth clinics from May to July 2019 was 25.3% for girls and 23.3% for boys. The corresponding rate for the same period in 2020 (n=201, 153 girls, 48 boys) was 31.4% for girls and 45.8% for boys. There was a significant increase in the rate of overweight or obesity. The BMI of the GnRHa treatment group increased significantly from May to July 2019 than during the same period in 2020 (P<0.01). There was no significant difference in BMI between those periods in the control group. @*Conclusion@#During the social distancing period, the incidence of obesity was higher in boys than in girls. The obesity rate in girls who visited the growth clinic for early breast budding during routine follow-ups did not increase.
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Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Such cardiopulmonary complications are usually temporary, and most patients recover without sequelae. However, these events may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.
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Phthalates and bisphenol A (BPA) are synthetic chemicals widely used in daily life. This study investigated urinary phthalate and BPA levels in Korean children and their associations with obesity. Methods: A total of 2,351 children aged 3 to 17 years who participated in the Korean National Environmental Health Survey 2015 to 2017 were included. Urinary dilution was corrected using covariate-adjusted standardization (CAS). We examined the geometric mean (GM) concentrations of urinary phthalate metabolites, including di (2-ethylhexyl) phthalate (DEHP) metabolites (mono [2-ethyl-5-hydroxyhexyl] phthalate, mono [2-ethyl-5-oxohexyl] phthalate, and mono [2-ethyl-5-carboxypentyl] phthalate [MECPP]), mono-benzyl-phthalate (MBzP), mono (carboxyoctyl) phthalate (MCOP), mono (carboxy-isononyl) phthalate (MCNP), mono (3-carboxypropyl) phthalate, and mono-n-butyl-phthalate (MnBP), and BPA. We also analyzed the odds ratio (OR) for obesity according to the quartiles of each analyte. Results: The urinary GM levels of DEHP metabolites and MnBP were notably higher among Korean children than among American, Canadian, and German children. The CAS-applied GM concentrations of most analytes, except for MBzP, MCOP, and MCNP, were higher in children aged 3 to 5 years than in those aged 6 to 17 years. The OR for obesity in the highest quartile of MECPP was significantly higher than in the lowest quartile after adjusting for covariates. However, the other phthalate metabolites and BPA were not significantly associated with obesity. Conclusion: The concentrations of urinary DEHP metabolites and MnBP were higher in Korean children than in children in Western countries. Urinary MECPP exposure, but not other phthalates or BPA, showed a positive association with obesity in Korean children. Further studies are required to elucidate the causal relationships.
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Background@#The current trend of using short femoral stems in total hip arthroplasty (THA) is associated with angular deviation of the femoral stem towards the native femoral axis. The purpose of this study was to compare the difference in stem tilt angle between two different stems with a similar design except for the stem length. @*Methods@#This is a retrospective review of 66 patients who underwent primary THA between April 2012 and May 2016, using a trans-gluteal direct lateral approach by a single surgeon. We evaluated the femoral stem tilt angle in both the coronal and sagittal planes and performed multivariate logistic regression analysis to evaluate possible risk factors. We also simulated the range of motion (ROM) of the hip joint using three-dimensional computer-aided design software (SolidWorks, 2016) to examine the clinical significance of femoral stem tilt. @*Results@#The mean coronal tilt angle was 1.8° ± 1.0° in the conventional stem group and 1.6° ± 1.1° in the short stem group, showing no statistically significant difference between the groups (p = 0.570). However, the mean sagittal tilt angle was 4.0° ± 2.0° in the conventional stem group and 7.8° ± 2.0° in the short stem group (p < 0.001). The stem type and stem length had a linear correlation with the sagittal tilt angle (p < 0.001) in multivariate regression analysis. A simulated hip ROM demonstrated a 3.8° decrease in extension in proportion to a 3.8° increase in the mean sagittal stem tilt angle of the short femoral stem. @*Conclusions@#Anterior femoral stem tilting in the sagittal plane was prominent when the shorter stem was used, and anterior tilting was responsible for decreased ROM in hip extension.
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Background and Objectives@#The aim of this study was to evaluate the effect of sleep position and nasal cavity dimension according to minimal cross-sectional area (MCA) on the severity of obstructive sleep apnea (OSA).Subjects and Method This study enrolled 528 consecutive patients who completed overnight polysomnography (PSG) and acoustic rhinometry. Positional sleep time and apnea-hypopnea index (AHI) were compared between the right and left lateral sleep positions (RLSP vs. LLSP), and between the wide and narrow lateral side sleep position (WLSP vs. NLSP) according to MCA. @*Results@#The sleep time was longer for LSP than for WLSP (20.35%±19.69% and 15.92%±16.35%, respectively) with a statistically significant difference (p=0.001). However, the AHI was not significantly different between the two groups. The sleep time was longer for RLSP than for LLSP (20.65%±19.31% and 15.39%±16.05%, respectively) with a statistically significant difference (p<0.001). In the RLSP-dominant group, there were fewer left nasal cavity narrowed patients than right nasal cavity narrowed patients (91 vs. 129, respectively). Furthermore, in the LLSP-dominant group, there were fewer right nasal cavity narrowed patients than left nasal cavity narrowed patients (60 vs. 85, respectively, p=0.001). However, we found that the AHI value was not significantly different according to sleep posture and nasal cavity dimension. @*Conclusion@#Snoring patients preferred RLSP to LLSP, and preferred to sleep on the lateral side of the narrow nasal cavity. The OSA severity was not different according to sleep position and nasal cavity dimension.
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Background and Objectives@#The head and neck multidisciplinary team (MDT) approach plays a crucial role in bringing together the ideas of various medical professionals. This study aimed to evaluate the early characteristics of the MDT approach for head and neck cancer and analyzed patients’ satisfaction.Subjects and Method We analyzed 450 head and neck cancer patients who received MDT care from August 2014 to June 2022. Patient satisfaction with MDT care was evaluated by selfadministered questionnaires consisting of 9 questions. @*Results@#Of 450, 298 (66.2%) were male and 152 (33.8%) were female. The mean age was 60.8±14.7 year. The most common primary site was the larynx (17.3%), followed by the oral cavity and oropharynx. A total of 726 cases of the MDT approach were performed in 266 MDT sessions, and the mean number of patients per MDT session was 2.74. The number of medical professionals participating in MDT ranged from a minimum of 3 to a maximum of 9, with a mean of 5.11. The mean running time of MDT meetings per case was 19.51 minutes. The time of the 2nd MDT was significantly shorter than that of the 1st or 3rd MDT. The mean score was close to very satisfactory in each of the 9 patient satisfaction questions. @*Conclusion@#We believe that the MDT approach is feasible and recommend its introduction for the treatment of head and neck cancer as most patients have shown very high satisfaction. Further studies on the role and efficacy of MDT care for head and neck cancer are necessary.