Association between commuting time and work-related low back pain with respect to sports and leisure activities in Korean workers.

Long commuting times can induce work-related low back pain (LBP), which can be exacerbated by reduced sports and leisure activities. However, there is a lack of empirical research on commuting time and work-related LBP in Korea. In this study, we aimed to investigate the relationship between commuting time and work-related LBP as well as the effect of sports and leisure activities on Korean workers. We utilized data from the sixth Korean Working Conditions Survey to analyze the relationship between commuting time and work-related LBP using multivariable logistic regression. The total number of included workers was 28,202. Workers without sports and leisure activities, and long commuting times (40-59, 60-79, and ≥80 min) showed significantly higher odds ratios for work-related LBP (1.29 [95% Confidence intervals=1.12-1.49], 1.42 [1.22-1.65], and 1.96 [1.68-2.28], respectively). However, in workers with sports and leisure activities, the results were significant only for commuting times of 60-79 and ≥80 min (1.41 [1.13-1.75], 1.60 [1.28-1.99], respectively). Long commuting times were associated with work-related LBP, and engagement in sports and leisure activities was found to play a role in mitigating the impact among Korean wage workers.

Combined effect of work from home and work during nonwork time on sleep disturbance.

Background: Owing to the coronavirus disease 2019 pandemic, being exposed to work from home and work during nonwork time simultaneously can lead to sleep disturbance; however, their combined effect is unclear. We aimed to investigate the combined effect of work from home and work during nonwork time on sleep disturbance. Methods: This study used data from the Sixth Korean Working Condition Survey and included 27,473 paid workers. Logistic regression analysis was conducted to investigate the relationship between work from home, work during nonwork time, and sleep disturbance according to sex. We re-classified participants into 4 groups based on their working from home (No/Yes) and working during nonwork time (No/Yes). The relative excess risk due to interaction was calculated to examine the effect of exposure to both telecommuting and non-regular work hours on sleep disturbance. Results: Workers exposed to work from home and work during nonwork time had significantly higher risks of sleep disturbance for all, men, and women workers (OR [95% CI]: 1.71 [1.46-2.02], 1.79 [1.43-2.23], and 1.64 [1.29-2.08] for work from home and 3.04 [2.70-3.42], 3.61 [3.09-4.22], and 2.41 [2.01-2.90] for work during nonwork time, respectively). Compared to those who were not exposed to both factors, when workers had both job factors, the ORs (95% CI) of sleep disturbance for all, men, and women were 3.93 (2.80-5.53), 5.08 (3.21-8.03), and 2.91 (1.74-4.87), respectively. The relative excess risk due to interaction of work from home and work during nonwork time was not significant for sleep disturbance. Conclusions: Work from home and work during nonwork time were each associated with sleep disturbance, but the interaction between the two factors on sleep disturbance was not observed in both men and women.

Association Between Commuting Time and Subjective Well-Being in Relation to Regional Differences in Korea.

BACKGROUND: Long commuting times have a negative impact on mental health. However, few studies have explored the relationship between commuting time and well-being based on urbanization by region. Our study examines this relationship as well as the effect of regional differences on Korean workers. METHODS: We used data from the sixth Korean Working Conditions Survey. Commuting time and occupational factors were assessed using a questionnaire, and subjective well-being was assessed using the World Health Organization-5 Well-Being Index. Regions were divided into the cities and the provinces based on Korea's administrative divisions. Logistic regression analysis was performed to investigate the association between commuting time and well-being. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for well-being were estimated, using participants commuting time of < 20 minutes as a reference group. RESULTS: The total number of workers was 29,458 (13,855 men, 15,603 women). We found higher aORs for low well-being among workers with long commuting times (aOR, 1.23; 95% CI, 1.11-1.36 and aOR, 1.28; 95% CI, 1.16-1.42 for 60-79 and ≥ 80 minutes, respectively). When stratified by sex and region, higher aORs for low well-being were found only in the workers who lived in cities. CONCLUSION: Long commuting time was negatively associated with well-being in Korean wage workers living in the cities. Policies for reducing commuting time should be discussed to address the mental health of workers, especially those living in metropolitan cities.

Association between split shift work and work-related injury and disease absence.

BACKGROUND: Shift work (particularly split shifts) has been noted among the working conditions that hinder sustainable work. However, little is known regarding the effects of split shifts on health. This study aimed to investigate the association between split shift work and work-related injury and disease absence. METHODS: This study used data from the fifth Korean Working Conditions Survey and included 4,042 paid shift workers. Shift work type and self-reported work-related injury and disease absence were investigated using a questionnaire. Logistic regression analysis was performed to investigate the association between split shift work and work-related absence with rotating shift worker as the reference group. RESULTS: Of the 4,042 shift workers, 980 (24.3%) were split shift workers. The adjusted odds ratio (aOR) of split shift for absence due to work-related injury was high at 2.94 (95% confidence interval [CI]: 1.85-4.68) and the aOR of split shift for absence due to work-related disease was also high at 1.58 (95% CI: 1.09-2.29) compared to rotating shift. CONCLUSIONS: Split shift work leads to an increased risk of absences due to work-related injury and disease.

Effects of work organization on the occurrence and resolution of sleep disturbances among night shift workers: a longitudinal observational study.

This study aimed to investigate the association between work organization and the trajectories of insomnia patterns among night shift workers in a hospital. The health examination data of hospital workers, recorded from January 2014 to December 2018, were collected; 6765 records of 2615 night shift workers were included. Insomnia was defined as a score of ≥ 15 on the Insomnia Severity Index (ISI). Participants were categorized into five groups according to insomnia patterns derived from the analysis of their ISI scores. Work organization and socio-demographic characteristics were also investigated. Generalized estimating equation models and linear mixed models were constructed to analyze the longitudinal data. Of the total participants, 53.0% reported insomnia at least once during the follow-up period. The lack of nap opportunities and work-time control was associated with the occurrence of insomnia, whereas more than 5 years of shift work experience was related to the resolution of insomnia. All work-related factors were significantly related to insomnia risk; however, the effects were not significant in the sustained insomnia group. Although sleep problems are inevitable in night shift workers, well-designed work schedules and better work organization can help reduce the occurrence of insomnia among them.

Clinicoradiopathological features and prognosis according to genomic alterations in patients with resected lung adenocarcinoma.

BACKGROUND: We investigated the clinicoradiopathological features and prognosis according to genomic alterations in patients with surgically resected lung adenocarcinoma. METHODS: Patients who underwent surgical resection for pathologic stage I, II, or IIIA lung adenocarcinoma between 2009 and 2016 and for whom results regarding EGFR mutation, ALK immunohistochemistry (IHC), and KRAS mutation were available were included. Clinicoradiopathological characteristics, genomic alterations, and disease-free survival were analyzed retrospectively. RESULTS: Of 164 patients, 86 (52.4%) were female and 94 (57.3%) were never-smokers. The most common imaging patterns were part-solid lesion (67.7%) followed by solid (26.2%) and non-solid (6.1%) lesions. EGFR mutation, ALK IHC, and KRAS mutation were positive in 95 (57.9%), 9 (5.5%), and 11 (6.7%) patients, respectively. EGFR mutation positivity was associated with female sex, never-smoker, subsolid pattern on radiological examination, and acinar or papillary predominant histologic subtype. ALK IHC positivity was associated with longer maximal diameter, advanced stage, solid pattern on radiological examination, solid predominant histologic subtype, and distant metastasis during follow-up. KRAS mutation positivity was associated with male sex, smoker, solid pattern on radiological examination, and invasive mucinous adenocarcinoma on histologic analysis. In multivariable analysis, ALK IHC positivity and lymph node involvement were independently associated with recurrence. However, solidity was not an independent risk factor for recurrence. CONCLUSIONS: Genomic alterations are associated with clinicoradiopathologic features in patients with resected lung adenocarcinoma. Identifying genomic alterations could help to predict the prognosis of early-stage lung adenocarcinoma.

Combined effect of emotional labor and job insecurity on sleep disturbance among customer service workers.

BACKGROUND: Job insecurity and emotional labor are poor job-related factors that are known to cause sleep disturbances in customer service workers. This study investigates the combined effect of emotional labor and job insecurity on sleep disturbance. METHODS: This study used data from the Fifth Korean Working Condition Survey and included 15,147 paid workers who serve customers below 65 years. We re-classified into 6 groups based on whether the degree of emotional labor increased (Rarely/Sometimes/Always) or whether job insecurity (No/Yes) was present. We performed propensity score matching for several covariates and calculated odds ratio (OR) and 95% confidence intervals (CIs) for sleep disturbance by logistic regression models using only matched subjects. RESULTS: Workers exposed to emotional labor and job insecurity had significantly higher risk for 3 dimensions of sleep disturbance (difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue) (OR [95% CI]: 1.44 [1.22-1.69], 1.18 [0.99-1.40], 1.52 [1.30-1.79] for emotional labor; and 2.00 [1.75-2.29], 2.20 [1.91-2.53], 1.67 [1.45-1.92] for job insecurity). Compared to those who were exposed to both emotional labor rarely and without job insecurity, when workers had both poor job factors, the OR (95% CI) for sleep disturbance for difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue were 3.05 (2.42-3.86), 2.89 (2.26-3.69), and 2.60 (2.06-3.29), respectively. The relative excess risk due to Interaction of job insecurity and emotional labor was significant only for difficulty falling asleep, but not the other 2 sleep disturbance dimensions. CONCLUSIONS: Customer service workers suffered from severe sleep disturbances according to the existing degree of emotional labor and job insecurity. The combined effect of both could have an additive influence on serious sleep disturbance among customer service workers.

Association between change in working time arrangements and sleep disturbance.

BACKGROUND: Change in working time arrangement (WTA) can be harmful to workers' sleep and health. This study aimed to investigate the association between change in working time arrangement and sleep disturbance. METHODS: This study used data from the Fifth Korean Working Condition Survey and included 33,203 paid workers. We performed a stratified analysis by sex. After dividing the participants into 6 groups based on whether or not they experienced WTA changes, and their weekly working hours (≤40, 41-52, ≥53 hours), we calculated odds ratio (OR) using the weekly working hours ≤40 hours and with no WTA change as the reference group. RESULTS: Of the 33,203 paid workers, participants who experienced change in working time arrangement had higher prevalence of all three types of sleep disturbance symptoms (difficulty in falling asleep, waking up repeatedly during sleep, and waking up with a feeling of exhaustion and fatigue) in both sexes. Compared to the reference group at 95% confidence interval (CI), the group with change in WTA showed elevated OR values of 1.91 (95% CI: 1.73-2.11), 1.93 (95% CI: 1.74-2.14), 2.47 (95% CI: 2.26-2.71) for male workers; and 1.93 (95% CI: 1.73-2.16), 2.02 (95% CI: 1.80-2.27), 2.24 (95% CI: 2.01-2.50) for female workers, for difficulty in falling asleep, waking up repeatedly during the sleep, waking up with a feeling of exhaustion, and fatigue, respectively. CONCLUSIONS: Workers who experience change in work time arrangement show a high risk of sleep disturbance in both sexes.

Short rest between shifts and risk of hypertension in hospital workers.

OBJECTIVES: Shift work is related to hypertension and other cardiovascular diseases, and short shift intervals of less than 11 h (quick returns) are reported to be related to health problems, including sleep disturbance and fatigue. However, its cardiovascular effect has rarely been examined. The purpose of this study was to investigate the relationship between quick returns, consecutive night shifts, and risk of hypertension in hospital workers. METHODS: Data collected from a medical examination of 1372 nonhypertensive shift workers in a hospital were retrospectively followed up. Demographic factors (sex and age), lifestyle habits (smoking, alcohol use, exercise, and obesity), and work-related factors (working hours, shift work experience, consecutive night shifts, and quick returns status) were included in the analyses. Multivariate Cox proportional-hazard models were conducted to estimate hazard ratio and 95% confidence interval (CI). RESULTS: The findings showed that quick returns was related to an increased risk of hypertension (hazard ratio, 95% CI: 1.88, 1.00-3.54), whereas consecutive night shifts were not. However, the risk of hypertension was significantly higher in workers with quick returns and 2-3 days of consecutive night shifts (3.33, 1.18-9.39) and those with quick returns and at least 4 days of consecutive night shifts (3.79, 1.22-11.76), compared with the reference group. CONCLUSION: The findings of this study indicate that short shift intervals and consecutive night shifts are related to an increased risk of hypertension in shift-working hospital workers.

Management of incidental pulmonary nodules: current strategies and future perspectives.

Introduction: Detection and characterization of pulmonary nodules is an important issue, because the process is the first step in the management of lung cancers.Areas covered: Literature review was performed on May 15 2019 by using the PubMed, US National Library of Medicine National Institutes of Health, and the National Center for Biotechnology information. CT features helping identify the druggable mutations and predict the prognosis of malignant nodules were presented. Technical advancements in MRI and PET/CT were introduced for providing functional information about malignant nodules. Advances in various tissue biopsy techniques enabling molecular analysis and histologic diagnosis of indeterminate nodules were also presented. New techniques such as radiomics, deep learning (DL) technology, and artificial intelligence showing promise in differentiating between malignant and benign nodules were summarized. Recently, updated management guidelines for solid and subsolid nodules incidentally detected on CT were described. Risk stratification and prediction models for indeterminate nodules under active investigation were briefly summarized.Expert opinion: Advancement in CT knowledge has led to a better correlation between CT features and genomic alterations or tumor histology. Recent advances like PET/CT, MRI, radiomics, and DL-based approach have shown promising results in the characterization and prognostication of pulmonary nodules.

The association between dependent self-employment and self-reported depression/anxiety and sleep disorder in South Korea.

BACKGROUND: Dependent self-employment is precarious employment, which can be vulnerable to mental health problems. This study aimed to investigate the association of dependent self-employment with depression, anxiety, and sleep disorder in South Korea. METHODS: This study used data from the Fourth Korean Working Conditions Survey and included 32,691 paid workers. Dependent self-employment and self-reported depression/anxiety, and sleep disorder were investigated using a questionnaire. Logistic regression analysis was performed to investigate the association between dependent self-employment and mental health problems. RESULTS: Of the 32,691 paid workers, 2,371 (7.3%) were dependent self-employed workers. The odds ratio (OR) of dependent self-employment for self-reported depression/anxiety was 1.78 (95% confidence interval [CI]: 1.29-2.45) and the OR of dependent self-employment for self-reported sleep disorder was 1.26 (95% CI: 1.01-1.59) compared to other paid workers. CONCLUSIONS: Dependent self-employment is related to an increased risk of self-reported depression/anxiety and sleep disorder in South Korea.

Irregular work schedule and sleep disturbance in occupational drivers-A nationwide cross-sectional study.

BACKGROUND: The objective of this study was to investigate the relationship between irregular work schedules and sleep disturbance and compare the impacts of work schedule on sleep disturbance between occupational drivers and office workers. METHODS: Using data from the 3rd and 4th Korean Working Conditions Survey, 3,070 occupational drivers and 9,898 office workers were included in this study. The subjects' days of night work, evening work, and subjective complaints of sleep disturbance were investigated along with other covariates. RESULTS: In the multivariate logistic regression analyses, occupational drivers (odds ratio [OR], 95% confidence interval [CI]: 1.51, 1.11-2.05), workers who were engaged in more night work (2.49, 1.84-3.38 for 1-15 days, and 3.80, 2.67-5.41 for 16-30 days) and evening work (2.22, 1.66-2.97 for 1-15 days, and 1.76, 1.26-2.45) were more likely to report sleep disturbance. Moreover, occupational driving showed significant interaction effects with both night and evening work on sleep disturbance, and therefore, showed higher ORs for sleep disturbance in the 16-30 days night (5.38, 3.40-8.52) and evening (3.13, 1.97-4.98) compared to no night and evening working office workers. CONCLUSIONS: Occupational drivers who are exposed to night work and evening work are at higher risks for sleep disturbance. Therefore, for the public and drivers' safety, optimal work schedules for minimising sleep disturbance should be developed.

Impact of near work on perceived stress according to working hours: The Korea National Health and Nutrition Examination Survey VI (2013-2015).

The purpose of this study was to investigate the relationships among working hours, near work time, and perceived stress. In total, data of 3,776 workers from the Korea National Health and Nutrition Examination Survey VI were examined. The workers' working hours per week, daily near work time, and complaints of perceived stress were analyzed in conjunction with other sociodemographic and occupation-related variables. Multivariate logistic analysis found that workers with 3 and ≥4 hours of near work were more likely to report high perceived stress than were the reference group who had <1 hour per day of near work, with odds ratios (ORs) (95% confidence intervals [CIs]) of 1.34 (1.01-1.78) and 1.94 (1.53-2.46), respectively. Additionally, those working 50 and more hours a week were more likely to report high perceived stress with ORs of 1.51 (1.19-1.90) and 1.88 (1.42-2.48), respectively. When stratified by working hours, workers with daily near work time of ≥4 hours were more likely to report high perceived stress with ORs of 2.21 (1.45-3.37), 2.27 (1.30-3.97), and 3.47 (1.80-6.69), among the workers with 40-49, 50-59, and ≥60 weekly working hours, respectively. Workers with greater near work time are at risk for high perceived stress. Moreover, this risk was found to be higher among workers with longer working hours. Therefore, work cycle modification and reductions in near work time are necessary to prevent stress-related health outcomes.

Pulmonary Function Impairment From Exposure to Mixed Organic Solvents in Male Shipyard Painters.

OBJECTIVES: This study aimed to examine the effects of chronic exposure to organic solvents on lung function in a shipyard painters. METHODS: Male workers in the shipyard painting department were selected as the organic solvents exposure group. Exposure was classified according to the type of work usually performed, and the cumulative exposure index was obtained using the results of biological monitoring. These were then used to divide the exposure group into low-exposure and high-exposure groups, and the dose-response relationships were examined for decreased lung function. For ventilation indices, we obtained the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the FEV1/FVC ratio, and the maximal mid-expiratory flow (MMF) from the forced expiratory flow-volume curve and also calculated these as percentages of the predicted values. RESULTS: FVC and FEV1 showed no significant differences among the control, and low-exposure and high-exposure groups, but FEV1 as a percentage of its predicted value (%FEV1) decreased with increasing exposure at 90.0%, 90.9%, and 90.0% in the control, low-exposure, and high-exposure groups, respectively. MMF% predicted also decreased significantly at 98.5%, 90.1%, and 88.4% in the control, low-exposure, and high-exposure group, respectively, indicating that workers exposed to organic solvents showed obstructive respiratory disease. CONCLUSION: Exposure to organic solvents is associated with obstructive pulmonary dysfunction rather than restrictive pulmonary dysfunction.

Effects of changes in occupational stress on the depressive symptoms of Korean workers in a large company: a longitudinal survey.

BACKGROUND: Prospective studies on occupational stress and depression among Korean workers are scarce. This study aimed to investigate the causal relationship between changes in occupational stress and the presence of depression. METHODS: This study analyzed data from a survey conducted with workers in a large Korean company (2015-2016). Occupational stress was measured using the Korean Occupational Stress Scale, and depression was screened using the WHO-5 Well-being Index. The levels of occupational stress were grouped in quartiles based on subjects' occupational stress scores in 2015, and changes in occupational stress were measured using the score changes between the 2015 and 2016 surveys. Subjects were divided into four groups according to the presence or absence of depression in 2015 and 2016: a non-depressed group whose mental health did not change, a non-depressed group whose mental health deteriorated, a depressed group that continued to be depressed, and a depressed group whose symptoms of depression were alleviated. Logistic regression analysis was used to calculate the odds ratios (ORs) and confidence intervals (CIs) of the subjects' deterioration in mood or alleviation of depression by occupational stress levels and changes. RESULTS: The OR for developing depressive symptoms was 2.51 (95% CI 1.46-4.33) and 2.73 (95% CI 1.39-5.36) in the third and the fourth quartiles of occupational stress, respectively, compared to the first quartile. When the occupational stress score increased by 1 point, the OR for increasing depressive symptoms was 1.07 (95% CI 1.04-1.10). There was no significant difference in the alleviation of depressive symptoms between the groups by level of occupational stress. However, when the occupational stress score decreased by 1 point, the OR for alleviating depressive symptoms was 1.08 (95% CI 1.05-1.11). CONCLUSION: The results showed that increased occupational stress increased the presence of depressive symptoms, and that reduced occupational stress suppressed the development of depressive symptoms. More attention should be paid to stress management among workers.

Genome-wide analysis of DNA methylation in bronchial washings.

Background: The objective of this study was to discover DNA methylation biomarkers for detecting non-small lung cancer (NSCLC) in bronchial washings and understanding the association between DNA methylation and smoking cessation. Methods: DNA methylation was analyzed in bronchial washing samples from 70 NSCLCs and 53 hospital-based controls using Illumina HumanMethylation450K BeadChip. Methylation levels in these bronchial washings were compared to those in 897 primary lung tissues of The Cancer Genome Atlas (TCGA) data. Results: Twenty-four CpGs (p < 1.03E-07) were significantly methylated in bronchial washings from 70 NSCLC patients compared to those from 53 controls. The CpGs also had significant methylation in the TCGA cohort. The 123 participants were divided into a training set (N = 82) and a test set (N = 41) to build a classification model. Logistic regression model showed the best performance for classification of lung cancer in bronchial washing samples: the sensitivity and specificity of a marker panel consisting of seven CpGs in TFAP2A, TBX15, PHF11, TOX2, PRR15, PDGFRA, and HOXA11 genes were 87.0 and 83.3% in the test set, respectively. The area under the curve (AUC) was equal to 0.87 (95% confidence interval = 0.73-0.96, p < 0.001). Methylation levels of two CpGs in RUNX3 and MIR196A1 genes were inversely associated with duration of smoking cessation in the controls, but not in NSCLCs, after adjusting for pack-years of smoking. Conclusions: The present study suggests that NSCLC may be detected by analyzing methylation changes of seven CpGs in bronchial washings. Furthermore, smoking cessation may lead to decreased DNA methylation in nonmalignant bronchial epithelial cells in a gene-specific manner.

Molecular Screening of Small Biopsy Samples Using Next-Generation Sequencing in Korean Patients with Advanced Non-small Cell Lung Cancer: Korean Lung Cancer Consortium (KLCC-13-01).

BACKGROUND: Non-small cell lung cancer (NSCLC) is a common type of cancer with poor prognosis. As individual cancers exhibit unique mutation patterns, identifying and characterizing gene mutations in NSCLC might help predict patient outcomes and guide treatment. The aim of this study was to evaluate the clinical adequacy of molecular testing using next-generation sequencing (NGS) for small biopsy samples and characterize the mutational landscape of Korean patients with advanced NSCLC. METHODS: DNA was extracted from small biopsy samples of 162 patients with advanced NSCLC. Targeted NGS of genomic alterations was conducted using Ion AmpliSeq Cancer Hotspot Panel v2. RESULTS: The median age of patients was 64 years (range, 32 to 83 years) and the majority had stage IV NSCLC at the time of cancer diagnosis (90%). Among the 162 patients, 161 patients (99.4%) had novel or hotspot mutations (range, 1 to 21 mutated genes). Mutations were found in 41 genes. Three of the most frequently mutated genes were TP53 (151, 93.2%), KDR (104, 64.2%), and epidermal growth factor receptor (EGFR; 69, 42.6%). We also observed coexistence of EGFR and other oncogene (such as KRAS, PIC3CA, PTEN, and STK11) mutations. Given that 69.6% (48/69) of EGFR mutant patients were treated with EGFR tyrosine kinase inhibitors, EGFR mutant status had higher prognostic ability in this study. CONCLUSIONS: These results suggest that targeted NGS using small biopsy samples is feasible and allows for the detection of both common and rare mutations in NSCLC.

Outcomes of Pulmonary Resection and Mediastinal Node Dissection by Video-Assisted Thoracoscopic Surgery Following Neoadjuvant Chemoradiation Therapy for Stage IIIA N2 Non-Small Cell Lung Cancer.

BACKGROUND: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). METHODS: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcomes, postoperative drainage, postoperative complications, and mortality were retrospectively analyzed. RESULTS: VATS was completed in 17 patients. Thoracotomy was performed in 18 patients, with 13 planned thoracotomies and 5 conversions from the VATS approach. The median age was 62.7±7.9 years in the VATS group and 60±8.7 years in the thoracotomy group. The patients in the VATS group tended to have a lower diffusing capacity for carbon monoxide (p=0.077). There were no differences between the 2 groups in the method of diagnosing the N stage, tumor response and size after induction, tumor location, or histologic type. Complete resection was achieved in all patients. More total and mediastinal nodes were dissected in the VATS group than in the thoracotomy group (p<0.05). The median chest tube duration was 5.3 days (range, 1 to 33 days) for the VATS group and 7.2 days (range, 2 to 28 days) for the thoracotomy group. The median follow-up duration was 36.3 months. The 5-year survival rates were 76% in the VATS group and 57.8% in the thoracotomy group (p=0.39). The 5-year disease-free survival rates were 40.3% and 38.9% in the VATS and thoracotomy groups, respectively (p=0.8). CONCLUSION: The VATS approach following neoadjuvant treatment was safe and feasible in selected patients for the treatment of stage IIIA N2 NSCLC, with no compromise of oncologic efficacy.

Exposure assessment of particulate matter and blood chromium levels in people living near a cement plant.

This study evaluates the effect of air pollution caused by cement plants on nearby residential areas and performs an exposure assessment of particulate matter (PM) and total Cr, Cr6+, Pb, and Al. Further, the blood Cr levels of residents exposed to PM released by cement plants are also assessed. Nine buildings (eight residential and one elementary school building) close to cement plants were selected for this study, which were located in Pyeongtaek port, in west of Gyeonggi Province, South Korea. A total of 51 suspended particulate samples were collected at a flow rate of 2.0 L/min. Total Cr was more widely detected in residents' houses and elementary schools. PM levels were higher at distances of 4.1 and 4.8 km than those at closer distances of 2.7 km. This was due to the influence of wind direction. The estimated mean blood level of Cr for the study participants was 3.80 µg/L, which is higher than levels estimated by other studies on Cr blood levels. Therefore, cement plants could cause an increase in total Cr and blood Cr levels in residential areas, and more continuous monitoring is necessary to better understand their impacts.

Are There Any Additional Benefits to Performing Positron Emission Tomography/Computed Tomography Scans and Brain Magnetic Resonance Imaging on Patients with Ground-Glass Nodules Prior to Surgery?

BACKGROUND: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. METHODS: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. RESULTS: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). CONCLUSION: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.