Psychometric Properties of the Korean Version of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool.

BACKGROUND AND PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a multidimensional symptom cluster induced by neurotoxic chemotherapy agents among patients with cancer. A well-developed tool for assessing CIPN can help with the early detection and timely management of patients. This study assessed the reliability and validity of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT) in Korean women with breast cancer who were treated with chemotherapy. METHODS: A psychometric analysis of the Korean version of CIPNAT was conducted with 207 patients with breast cancer who were treated with chemotherapy. Patients were assessed using the CIPNAT and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy-20 (CIPN-20). Analyses of internal consistency reliability, concurrent validity, and construct validity (based on structural and discriminant validity testing) were performed to evaluate the psychometric properties. RESULTS: The Korean version of the CIPNAT had good internal consistency (Cronbach's alpha = 0.95; the item-total correlation coefficients ranged 0.34-0.76). The CIPNAT and CIPN-20 were moderately correlated (r = .67). Confirmatory factor analyses showed a four-factor structural model with acceptable model fit indices. Discriminant validity was supported by differences between individuals treated with and without taxane-based chemotherapy (p < .001). IMPLICATIONS FOR PRACTICE: The Korean version of the CIPNAT was a valid and reliable screening tool for identification of CIPN symptoms and functional interference in Korean women who received chemotherapy for breast cancer. The instrument can be useful for the timely and routine assessment of CIPN symptoms and functional limitations of patients with cancer by oncology nurses.

Evaluating the impact of interbasin water transfer on water quality in the recipient river basin with SWAT.

During the second half of the 20th century in South Korea, interbasin water transfers (IBWTs) have been used to supply the water demands of basins with insufficient water using water from reservoirs in neighboring basins with ample water. However, since 2000, frequent droughts have resulted in water resource imbalances in donor basins, and basin residents have begun to claim their water rights. Recipient basins have also experienced water shortages and water quality deterioration due to gradual urban growth, agricultural activities, and climate change impacts. In this study, the Mangyeong River basin (1602 km2) was investigated. This basin has received 380 million m3/year of water since 2002 from the Yongdam multipurpose dam (YDD), which is located in another basin. For IBWT modeling, the Soil and Water Assessment Tool (SWAT) model and an inlet function were applied to model the recipient and donor water quality. Eight scenarios related to water transfer quantity and quality were applied with SWAT to analyze the effects of IBWT on the water quality in the recipient basin. The results showed that an increase in the IBWT amount helped to reduce the nutrient and suspended solids concentrations in the recipient basin when the donor's nutrient and suspended solids concentrations were lower than those in the recipient basin. The IBWT quantity scenarios had a greater impact on the water quality of the recipient basin than the IBWT quality scenarios. These results could provide basic information for use in deciding on the quantity and quality of IBWT between basins that are in conflict.

Long-Term Survival and Tumor Recurrence in Patients with Superficial Esophageal Cancer after Complete Non-Curative Endoscopic Resection: A Single-Center Case Series.

BACKGROUND/AIMS: To report the long-term survival and tumor recurrence outcomes in patients with superficial esophageal cancer (SEC) after complete non-curative endoscopic resection (ER). METHODS: We retrieved ER data for 24 patients with non-curatively resected SEC. Non-curative resection was defined as the presence of submucosal and/or lymphovascular invasion on ER pathology. Relevant clinical and tumor-specific parameters were reviewed. RESULTS: The mean age of the 24 study patients was 66.3±8.3 years. Ten patients were closely followed up without treatment, while 14 received additional treatment. During a mean follow-up of 59.0±33.2 months, the 3- and 5-year survival rates of all cases were 90.7% and 77.6%, respectively. The 5-year overall survival rates were 72.9% in the close observation group and 82.1% in the additional treatment group (p=0.958). The 5-year cumulative incidences of all cases of recurrence (25.0% vs. 43.3%, p=0.388), primary EC recurrence (10.0% vs. 16.4%, p=0.558), and metachronous EC recurrence (16.7% vs. 26.7%, p=0.667) were similar between the two groups. CONCLUSION: Patients with non-curatively resected SEC showed good long-term survival outcomes. Given the similar oncologic outcomes, close observation may be an option with appropriate caution taken for patients who are medically unfit to receive additional therapy.

The Efficacy of a Newly Designed, Easy-to-Manufacture Training Simulator for Endoscopic Biopsy of the Stomach.

BACKGROUND/AIMS: We developed a new endoscopic biopsy training simulator and determined its efficacy for improving the endoscopic biopsy skills of beginners. METHODS: This biopsy simulator, which presents seven biopsy sites, was constructed using readily available materials. We enrolled 40 participants: 14 residents, 11 first-year clinical fellows, 10 second-year clinical fellows, and five staff members. We recorded the simulation completion time for all participants, and then simulator performance was assessed via a questionnaire using the 7-point Likert scale. RESULTS: The mean times for completing the five trials were 417.7±138.8, 145.2±31.5, 112.7±21.9, and 90.5±20.0 seconds for the residents, first-year clinical fellows, second-year clinical fellows, and staff members, respectively. Endoscopists with less experience reported that they found this simulator more useful for improving their biopsy technique (6.8±0.4 in the resident group and 5.7±1.0 in the first-year clinical fellow group). The realism score of the simulator for endoscopic handling was 6.4±0.5 in the staff group. CONCLUSIONS: This new, easy-to-manufacture endoscopic biopsy simulator is useful for biopsy training for beginner endoscopists and shows good efficacy and realism.

Unexpected Delayed Colon Perforation after the Endoscopic Submucosal Dissection with Snaring of a Laterally Spreading Tumor.

Colonic perforation may occur as a complication of diagnostic and therapeutic colonoscopy. The risk factors for perforation after colorectal endoscopic submucosal dissection (ESD) include an inexperienced endoscopist, a large tumor size, and submucosal fibrosis. The mechanisms of perforation include unintended endoscopic resection/dissection and severe thermal injury. Here, we report a case of colon perforation that occurred after ESD with snaring of a laterally spreading tumor. The perforation was completely unexpected because there were no colorectal ESD-associated risk factors for perforation, deep dissection, or severe coagulation injury in our patient.

Potential of self-drilling orthodontic microimplants under immediate loading.

INTRODUCTION: The aim of this study was to investigate clinically and histologically the efficiency of self-drilling microimplants as orthodontic anchorage with immediate, continuous, and constant loadings. METHODS: Titanium-alloy microimplants with diameters of 1.2 to 1.3mm were manually placed into the buccal sides of both jaws, including the interradicular areas, in 3 dogs. Implants were placed without predrilling in thin cortical bone areas; in thick cortical bone areas, a 2-mm deep pilot hole was drilled. Thirty-six microimplants, subjected to approximately 200g of immediate horizontal loading, served as the study group. The remaining 8 received no loading and were the controls over the 9-week observation period. The distances of reciprocally loaded microimplants and crevicular pockets were measured at the beginning and end of loading. Serially undecalcified and decalcified sections of the microimplants and surrounding tissues were studied with light and fluorescent microscopes. After 9 weeks of observation, 22 fixtures were easily removed with a screwdriver. Two were broken, and 1 was movable. RESULTS: Histologic analysis showed good osseointegration in all stable samples, and new bone formation and bone apposition to the surface of the threads in loaded and unloaded samples. Histomorphometric evaluation showed high bone-to-implant contact values in the loaded samples, but no significant statistical differences from the unloaded ones. CONCLUSIONS: Titanium alloy microimplants with small diameters (1.2-1.3mm) are strong enough for self-drilling and immediate loading in thin cortical bone areas, but, to reduce the chance of breakage, a drilling of a pilot hole is suggested in thick cortical bone areas.