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Simon Roh,Mark D. Iannettoni,John Keech,Evgeny V. Arshava,Anthony Swatek,Miriam B. Zimmerman,Ronald J. Weigel,Kalpaj R. Parekh 대한흉부외과학회 2019 Journal of Chest Surgery (J Chest Surg) Vol.52 No.1
Background: Neoadjuvant chemoradiation therapy (nCRT) has become the standard of care for esophageal cancer patients prior to esophagectomy. However, the optimal timing for surgery after completion of nCRT remains unclear. Methods: A retrospective review was performed of patients who underwent esophagectomy with cervical anastomosis for esophageal cancer at a single institution between January 2000 and June 2015. Patients were categorized into 3 cohorts: those who did not receive nCRT prior to esophagectomy (no nCRT), those who underwent esophagectomy within 35 days after nCRT (≤35d), and those who underwent esophagectomy more than 35 days after nCRT (>35d). Results: A total of 366 esophagectomies were performed during the study period, and 348 patients met the inclusion criteria. Anastomotic leaks occurred in 11.8% of all patients included in the study (41 of 348). Within each cohort, anastomotic leaks were detected in 14.7% of patients (17 of 116) in the no nCRT cohort, 7.3% (13 of 177) in the ≤35d cohort, and 20.0% (11 of 55) in the >35d cohort (p=0.020). Significant differences in the occurrence of anastomotic leaks were observed between the no nCRT and ≤35d cohorts (p=0.044), and between the ≤35d and >35d cohorts (p=0.007). Conclusion: Esophagectomy with cervical anastomosis within 35 days of nCRT resulted in a lower percentage of anastomotic leaks.
Sang Won Jeon,Changsu Han,Young-Hoon Ko,Seo Young Yoon,Chi-Un Pae,Joonho Choi,Yong Chon Park,Jong-Woo Kim,Ho-Kyoung Yoon,Seung-Duk Ko,Ashwin A. Patkar,Mark Zimmerman 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.1
Objective: This study was aimed at evaluating the diagnostic validity of the Korean version of the Clinically Useful Depression Outcome Scale (CUDOS) with varying follow-up in a typical clinical setting in multiple centers. Methods: In total, 891 psychiatric outpatients were enrolled at the time of their intake appointment. Current diagnostic character-istics were examined using the Structured Clinical Interview for DSM-IV (41% major depressive disorder). The CUDOS was meas-ured and compared with three clinician rating scales and four self-report scales. Results: The CUDOS showed excellent results for internal consistency (Cronbach’s α ,0.91), test-retest reliability (patients at intake, r =0.81; depressed patients in ongoing treatment, r =0.89), and convergent and discriminant validity (measures of depres-sion, r =0.80; measures of anxiety and somatization, r =0.42). The CUDOS had a high ability to discriminate between different levels of depression severity based on the rating of Clinical Global Impression for depression severity and the diagnostic classi-fication of major depression, minor depression, and non-depression. The ability of the CUDOS to identify patients with major depression was high (area under the receiver operating characteristic curve=0.867). A score of 20 as the optimal cutoff point was suggested when screening for major depression using the CUDOS (sensitivity=89.9%, specificity=69.5%). The CUDOS was sensitive to change after antidepressant treatment: patients with greater improvement showed a greater decrease in CUDOS scores ( p <0.001). Conclusion: The results of this multi-site outpatient study found that the Korean version of the CUDOS is a very useful measure-ment for research and for clinical practice.