ABSTRACT
Background@#Burnout syndrome (BOS) is defined by the World Health Organization (WHO) as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. This study aims to create the Korean version burnout syndrome scale (KBOSS) that conforms to WHO’s definition of BOS and present the cut-off points for screening. @*Methods@#We developed the KBOSS based on WHO’s definition of BOS. An online survey was conducted through a specialized online research company. We recruited 444 workers for this research. The validity of the KBOSS was assessed using factor analysis and Pearson’s correlation. The KBOSS reliability was assessed using Cronbach’s alpha coefficient. The cut-off points for each of the three dimensions were derived using the upper quartile score. @*Results@#The validity and reliability of the KBOSS were good. Regarding reliability, the scale’s overall Cronbach’s alpha was 0.813. Cronbach’s alpha of each three-dimension was as follows: exhaustion, 0.916; cynicism, 0.865; and professional inefficacy, 0.819. The cut-off points of BOS three dimensions are exhaustion ≧ 21; cynicism ≧ 18; and inefficacy ≧ 15. @*Conclusion@#The developed questionnaire (KBOSS) can be a useful tool for screening of BOS.
ABSTRACT
Objectives@#Cadmium is widely used, leading to extensive environmental and occupational exposure. Unlike other organs, for which the harmful and carcinogenic effects of cadmium have been established, the hepatotoxicity of cadmium remains unclear. Some studies detected correlations between cadmium exposure and hepatotoxicity, but others concluded that they were not associated. Thus, we investigated the relationship between cadmium and liver damage in the general population. @*Methods@#In total, 11 838 adult participants from National Health and Nutrition Examination Survey 1999-2015 were included. Urinary cadmium levels and the following liver function parameters were measured: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), total bilirubin (TB), and alkaline phosphatase (ALP). Linear and logistic regression analyses were performed to assess the associations between urinary cadmium concentrations and each liver function parameter after adjusting for age, sex, race/ethnicity, annual family income, smoking status, alcohol consumption status, physical activity, and body mass index. @*Results@#The covariate-adjusted results of the linear regression analyses showed significant positive relationships between log-transformed urinary cadmium levels and each log-transformed liver function parameter, where beta±standard error of ALT, AST, GGT, TB, and ALP were 0.049±0.008 (p<0.001), 0.030±0.006 (p<0.001), 0.093±0.011 (p<0.001), 0.034±0.009 (p<0.001), and 0.040±0.005 (p<0.001), respectively. Logistic regression also revealed statistically significant results. The odds ratios (95% confidence intervals) of elevated ALT, AST, GGT, TB, and ALP per unit increase in log-transformed urinary cadmium concentration were 1.360 (1.210 to 1.528), 1.307 (1.149 to 1.486), 1.520 (1.357 to 1.704), 1.201 (1.003 to 1.438), and 1.568 (1.277 to 1.926), respectively. @*Conclusions@#Chronic exposure to cadmium showed positive associations with liver damage.
ABSTRACT
Background@#Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes. @*Methods@#Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and LundMackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes. @*Results@#In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis (P 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [−0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) − 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed. @*Conclusion@#Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS.
ABSTRACT
Background@#Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes. @*Methods@#Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and LundMackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes. @*Results@#In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis (P 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [−0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) − 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed. @*Conclusion@#Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS.
ABSTRACT
Background and Objectives@#The purpose of this study was to investigate the prevalence of incidental paranasal sinus (PNS) opacification in nasal septal deviation (NSD) using computed tomography (CT) and to identify contributing factors.Subjects and Method: We analyzed 216 patients who underwent septoplasty for the correction of NSD and who underwent preoperative PNS CT. We assessed the prevalence of incidental PNS opacification in these patients and determined the type of NSD according to Mladina classification. We also evaluated whether the direction of NSD affected the presence of PNS opacification on CT, and whether the presence of PNS opacification was associated with other rhinologic symptoms. @*Results@#Of 216 patients with NSD, 86 showed opacified PNS on CT. According to Mladina classification, NSD patients were classified as type I (24.1%), type II (36.1%), type III (20.8%), type IV (5.6%), type V (9.7%), type VI (2.3%), or type VII (1.4%). Patients with type II NSD showed a significantly higher incidence of PNS opacification compared with other types of NSD (p=0.001). However, the direction of NSD did not significantly influence the presence of incidental PNS opacification. Furthermore, regardless of the presence of PNS opacification, there was no significant difference in rhinologic symptoms such as olfactory dysfunction, among others. @*Conclusion@#We found that incidental PNS opacification on CT was common in NSD patients, especially in patients with type II NSD. Thus, we suggest that CT evaluation of patients with NSD may be helpful for assessing comorbid PNS pathologies as well as objectively identifying nasal septal deformities.
ABSTRACT
Subject(s)
Adult , Humans , Cross-Sectional Studies , Dermatitis, Atopic , Diagnosis , Epidemiologic Studies , Health Surveys , Immune System , Information Services , Korea , Odds Ratio , Parks, Recreational , Rhinitis, AllergicABSTRACT
The purpose of this study was to determine whether eating non-home-prepared meals (NHPM), including fast food, ready-to-eat foods, and frozen foods, was associated with self-reported infertility in the United States women. Methods: Data on diet and infertility from women aged 20-49 years who participated in the 2013-2014 and 2015-2016 National Health and Nutrition Examination Surveys were analyzed (n=2143). Dietary information, including the number and types of NHPM consumed, was obtained from a self-reported questionnaire, and infertility status was analyzed using the following question, “Have you ever attempted to become pregnant over a period of at least a year without becoming pregnant?” Results: The frequency of NHPM consumption was positively associated with self-reported infertility after adjusting for confounding effects (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.48 to 5.38 of >1 vs. 0 NHPM/d). The odds of infertility were 2-3 times higher in women who consumed fast food than in those who did not consume fast food (OR, 2.73; 95% CI, 1.15 to 6.48 of >1 vs. 0 times/d). Conclusions: The frequency and types of NHPM may be a factor contributing to infertility. Although our findings require confirmation, they suggest that eating out may be deleterious to women fecundity.
ABSTRACT
Background and Objectives@#Although patients with chronic rhinosinusitis (CRS) present a similar degree of olfactory dysfunction, their impairments in threshold, discrimination, and identification test results may vary. We investigated factors related to each of these components using the Korean version of the Sniffin’ Sticks test II in CRS patients.Subjects and Method A total of 120 CRS patients with olfactory dysfunction were enrolled and assigned to hyposmia and anosmia groups. Correlation between the three components were examined in both groups. We also subdivided patients into higher- and lower-score groups according to the threshold, discrimination, and identification scores within the hyposmia and anosmia groups to determine associated factors among the demographic factors, CRS severity on computed tomography (CT) and endoscopic findings. @*Results@#Threshold, discrimination, and identification scores were significantly correlated in hyposmia patients. Age [odds ratio (OR), 0.94] was associated with the threshold score, and the anterior olfactory cleft opacification score (OR, 1.31) on CT was associated with identification difficulties in hyposmia patients. The posterior olfactory cleft opacification score was associated with threshold (OR, 2.76) and identification difficulties (OR, 1.68) in anosmia patients. However, we could not identify significant risk factors for discrimination in both groups. @*Conclusion@#We demonstrated that the three components of the olfactory function test for CRS are significantly correlated in patients with hyposmia. Age was associated with threshold score in hyposmia patients and CRS severity, and with discrimination scores in both hyposmia and anosmia patients. These findings will help the understanding of pathophysiology of CRSrelated olfactory dysfunction.Korean J Otorhinolaryngol-Head Neck Surg 2020;63(8):358-68
ABSTRACT
Subject(s)
Humans , Medical Records , Methods , Pruritus , Recurrence , Rhinitis , Rhinitis, Allergic , Skin , SneezingABSTRACT
Subject(s)
Actinomyces , Actinomycosis , Anti-Bacterial Agents , Aspergillosis , Aspergillus , Paranasal Sinuses , Rare Diseases , Recurrence , Sinusitis , VentilationABSTRACT
BACKGROUND@#Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults.@*METHODS@#In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service.@*RESULTS@#The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively.@*CONCLUSIONS@#We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.
ABSTRACT
BACKGROUND@#Although many epidemiological studies have reported the inverse associations between greenness and health outcomes, inconsistent associations in allergic diseases remain an issue. We aimed to identify associations between greenness and allergic diseases among Korean adults.@*METHODS@#In total, 219,298 adults from the 2009 Korea Community Health Survey were included in this study. Individuals' allergy-related conditions, such as atopic dermatitis and allergic rhinitis, were evaluated. To identify the amount of green areas (m²) per capita in each administrative region, we used the 2009 data for green areas from the Korean Statistical Information Service.@*RESULTS@#The risk for atopic dermatitis in the highest quartile of green areas was significantly lower compared with that of the lowest quartile. Physician's diagnosis and current treatment of odds ratios (ORs) with 95% confidence intervals (CIs) were 0.82 (0.73–0.91) and 0.77 (0.64–0.92), respectively. Similarly, the association results for allergic rhinitis showed that the highest level of green areas was significantly associated with a decreased risk of allergic rhinitis in full-adjustment model quartiles. Physician's diagnosis and current treatment of OR (95% CI) were 0.94 (0.89–0.99) and 0.91 (0.82–1.00), respectively.@*CONCLUSIONS@#We observed inverse associations of green areas with atopic dermatitis and allergic rhinitis in Korean adults.
ABSTRACT
BACKGROUND: Ambient air pollution has a negative effect on many diseases, such as cardiovascular and respiratory diseases. Recent studies have reported a relationship between air pollution and renal function, but the results were limited to exposure to particulate matter (PM). This study was to identify associations between various air pollutants and renal function among Korean adults. METHODS: Nationwide survey data for a total of 24,407 adults were analyzed. We calculated the estimated glomerular filtration rate (eGFR) for each individual to assess their renal function and used this to categorize those with chronic kidney disease (CKD). To evaluate exposure to ambient air pollution, we used the annual mean concentrations of four ambient air pollutants: PM with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO). RESULTS: We identified significant inverse relationships between the air pollutants PM10 and NO2 and eGFR in all statistical adjustment models (all p 0.05). CONCLUSIONS: Exposures to PM10 and NO2 were significantly associated with decreases in eGFR levels, but not CKD, in Korean adults.
Subject(s)
Adult , Humans , Air Pollutants , Air Pollution , Carbon Monoxide , Glomerular Filtration Rate , Nitrogen Dioxide , Particulate Matter , Renal Insufficiency, Chronic , Sulfur DioxideABSTRACT
BACKGROUND AND OBJECTIVES: The demand for rhinoplasty has been high for both men and women over the years; recently, however, it is rapidly increasing for men as their interest in aesthetics has heightened. This study investigated the psychological characteristics of male patients who underwent rhinoplasty through questionnaire-guided consultation. In addition, we investigated the difference between patients and surgeons regarding their aesthetic concerns for rhinoplasty. SUBJECTS AND METHOD: Of the male patients who underwent rhinoplasty from January 2006 to December 2012, 124 patients who had completed the questionnaires were included. The questionnaire for rhinoplasty asked about the basic personality traits of patients, patients' complaints about their nose, reasons for receiving the operation and expectation for postoperative change. RESULTS: Patients responded most to the item, “I have high expectations for the surgery” for the question regarding personality characteristics, followed by the response, “I am concerned about my health.” Regarding questions about reasons for rhinoplasty, complaints about their dorsum were high; among these patients, they were most concerned about the appearance of the ‘crooked nose’ when viewed from the front. On the other hand, the concern for the ‘poorly defined nasal tip’ was not high, whereas it was defined as one of the problems mentioned by the surgeons. CONCLUSION: These results show differences regarding aesthetic concerns between the patients and the surgeon, especially regarding the nasal tip. It would be helpful for both patient and surgen to plan the surgery after careful consultation based on the questionnaire, accurate understanding of the patients' complaints and expectations to obtain satisfactory results for both.
Subject(s)
Female , Humans , Male , Anxiety , Esthetics , Hand , Methods , Nose , Psychology , Rhinoplasty , SurgeonsABSTRACT
BACKGROUND AND OBJECTIVES: The skin prick test is a widely used test that uses three methods (allergen/histamine ratio method, erythema size method, and wheal size method) to interpret the results. However, there has been no comparison of these methods. The aim of this study is to compare the three different interpretation methods and define the relationship among them. SUBJECTS AND METHOD: A total of 139 patients who visited our allergy clinic complaining of nasal symptoms were enrolled. Three interpretation methods were used for defining positivity in the skin prick test, and their results were compared. The validity of each interpretation method was evaluated by total nasal symptom score. RESULTS: Positivity in the skin prick test was reported in 48.2% of patients according to the allergen/histamine ratio method and in 64.0% of patients according to the wheal size method and erythema size method. The proportion of subjects who showed a negative result with the allergen/histamine ratio method but positive results with the wheal size method or erythema size method was 15.8%. This group had a significantly higher total nasal symptom score, especially rhinorrhea and nasal obstruction, than subjects who showed negative results on all three methods. CONCLUSION: When diagnosing allergic rhinitis patients using the skin prick test, the wheal size method and erythema size method should be considered rather than the allergen/histamine ratio method.
Subject(s)
Humans , Diagnosis , Erythema , Hypersensitivity , Methods , Nasal Obstruction , Rhinitis, Allergic , Skin Tests , SkinABSTRACT
PURPOSE: Progesterone resistance is thought to be a major factor that contributes to progression of endometriosis. However, it is not clear what causes progesterone resistance in endometriosis. This study aimed to assess whether cytokines or peritoneal fluid can affect progesterone receptor (PR) expression in endometrial cells and to verify whether PR expression is reduced in endometriosis. MATERIALS AND METHODS: The PR-B/A ratio was measured via real-time polymerase chain reaction after in vitro culture, in which endometrial cells were treated with either tumor necrosis factor-alpha (TNF-α), interleukin-1 beta, or peritoneal fluid obtained from women with advanced-stage endometriosis. Immunohistochemistry was performed to compare PR-B expression between eutopic and ectopic endometrial tissues from women with and without advanced-stage endometriosis. RESULTS: The PR-B/A ratio was significantly decreased by treatment with either TNF-α (p=0.011) or peritoneal fluid from women with advanced-stage endometriosis (p=0.027). Immunoreactivity of PR-B expression was significantly lower during the secretory phase than during the proliferative phase in endometrial tissues from control subjects (p<0.001). PR-B expression was significantly reduced in the eutopic endometrium (p=0.031) and ovarian endometrioma (p=0.036) from women with advanced-stage endometriosis compared with eutopic endometrium tissues from control subjects. CONCLUSION: Progesterone resistance in endometriosis may be caused by proinflammatory conditions in the pelvic peritoneal microenvironment.
Subject(s)
Female , Humans , Ascitic Fluid , Cytokines , Endometriosis , Endometrium , Immunohistochemistry , In Vitro Techniques , Interleukin-1beta , Progesterone , Real-Time Polymerase Chain Reaction , Receptors, Progesterone , Tumor Necrosis Factor-alphaABSTRACT
PURPOSE: Progesterone resistance is thought to be a major factor that contributes to progression of endometriosis. However, it is not clear what causes progesterone resistance in endometriosis. This study aimed to assess whether cytokines or peritoneal fluid can affect progesterone receptor (PR) expression in endometrial cells and to verify whether PR expression is reduced in endometriosis. MATERIALS AND METHODS: The PR-B/A ratio was measured via real-time polymerase chain reaction after in vitro culture, in which endometrial cells were treated with either tumor necrosis factor-alpha (TNF-α), interleukin-1 beta, or peritoneal fluid obtained from women with advanced-stage endometriosis. Immunohistochemistry was performed to compare PR-B expression between eutopic and ectopic endometrial tissues from women with and without advanced-stage endometriosis. RESULTS: The PR-B/A ratio was significantly decreased by treatment with either TNF-α (p=0.011) or peritoneal fluid from women with advanced-stage endometriosis (p=0.027). Immunoreactivity of PR-B expression was significantly lower during the secretory phase than during the proliferative phase in endometrial tissues from control subjects (p<0.001). PR-B expression was significantly reduced in the eutopic endometrium (p=0.031) and ovarian endometrioma (p=0.036) from women with advanced-stage endometriosis compared with eutopic endometrium tissues from control subjects. CONCLUSION: Progesterone resistance in endometriosis may be caused by proinflammatory conditions in the pelvic peritoneal microenvironment.
Subject(s)
Female , Humans , Ascitic Fluid , Cytokines , Endometriosis , Endometrium , Immunohistochemistry , In Vitro Techniques , Interleukin-1beta , Progesterone , Real-Time Polymerase Chain Reaction , Receptors, Progesterone , Tumor Necrosis Factor-alphaABSTRACT
OBJECTIVES: Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene early B-cell factor 1 (EBF1), which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults. METHODS: A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling. RESULTS: The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model (p(int)<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model (p(int)<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05). CONCLUSIONS: These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.
Subject(s)
Adult , Humans , Adiposity , B-Lymphocytes , Cardiovascular Diseases , Chronic Disease , Gene-Environment Interaction , Genome-Wide Association Study , Genotype , Intra-Abdominal Fat , Linkage Disequilibrium , Models, Genetic , Obesity , Obesity, Abdominal , Polymorphism, Single Nucleotide , Waist-Hip RatioABSTRACT
OBJECTIVE: This study investigated the impact of occupation on cognitive and physical function within an occupational window of the past 15 years using a nationally representative sample in Korea. METHODS: A total of 4,408 subjects aged 60 and older were selected from the Korean Longitudinal Study of Aging (KLoSA). Functional health was evaluated using the Korean versions of the Mental State Examination (K-MMSE), Instrumental Activities of Daily Living (K-IADL), and Activities of Daily Living (K-ADL) measures. RESULTS: The prevalence of lower function was higher among women than among men, and employed persons had better cognitive and physical function compared with the retired and unemployed. Longer work duration during the past 15 years significantly and positively affected all measures of function in men, whereas it only improved physical function in women. Manual laborers exhibited improved functional capacity with longer work durations over the past 15 years, although they presented lower functional scores compared with non-manual laborers. There was a curvilinear relationship of work duration with cognitive and physical function among men and manual laborers. CONCLUSION: In our population, longer work duration, especially for men and for manual laborers, appears to be a significant contributor to the cognitive and physical function of older people.
Subject(s)
Adult , Female , Humans , Male , Activities of Daily Living , Aging , Korea , Longitudinal Studies , Occupations , PrevalenceABSTRACT
OBJECTIVE: To report on our experiences with thoracoamniotic shunting and/or the injection of a sclerosing agent (OK-432) to treat fetuses diagnosed with macrocystic congenital cystic adenomatoid malformation (CCAM) of the lung. METHODS: A retrospective study was undertaken in six fetuses with macrocystic CCAM at our institute that had been confirmed by postnatal surgery between August 1999 and January 2012. RESULTS: Six fetuses that had been diagnosed with macrocystic CCAM were analyzed. The median gestational age at diagnosis was 23.5 weeks (range, 19.5-31.0 weeks), and at the time of primary treatment was 24.0 weeks (range, 20.5-31.0 weeks). The mean size of the largest cyst at the initial assessment was 42.5+/-15 mm. Four fetuses were associated with mediastinal shifting, and one also showed fetal hydrops. All fetuses underwent a shunting procedure within the cysts, one case among them was also treated with OK-432. After the completion of all procedures, the mean size of the largest cyst was all decreased (14.2+/-12 mm). The median gestational age at delivery was 38.0 weeks (range, 32.4-40.3 weeks). All of the newborns underwent the surgical resection at a median age of 6 days (range, 1-136 days) and are currently doing well without any complications. CONCLUSION: We suggest that intrauterine decompression therapy to manage fetal macrocystic CCAM is recommendable treatment for good perinatal outcome.