TOPOT may be an effective and safe approach for robotic thyroid surgery.

································································································································································································································Purpose: The present study was conducted to investigate whether near work with smartphone could induce the change of accommodative function. Methods: Total 63 subjects(26 male and 37 female) in their 20s were firstly examined their visual functions related to accommodation and uncorrected spherical equivalent power as the control. After that, the subjects were asked to read a book for 30 min and sequentially watch a movie on smartphone for the same time after 30 min-break under the indoor light or as it was in the reverse order to avoid time-ordered effect. Their accommodative functions, 1) accommodative amplitude, 2) accommodative facility, 3) relative positive/negative accommodation, and 4) accommodative lag and their uncorrected spherical equivalent power were examined again following each task and compared with the control values. Results: The monocular accommodative amplitude was significantly decreased after smartphone watching compared with it after reading. The monocular and binocular accommodative facilities were tended to reduce after smartphone watching and book reading but were not significantly different. Neither significant change in positive relative accommodation was determined after smartphone watching nor book reading. Negative relative accommodation after smartphone watching was almost unchanged unlike reading a book. The accommodative lag after smartphone work was significantly higher than after book reading. Conclusions: The near work with a smartphone for 30 min induced the change of some accommodative functions, which was significantly greater than when reading under the same working environment.Key words: Accommodative amplitude, Accommodative facility, Accommodative lag, Near work, Relative accommodation, Smartphone ································································································································································································································ INTRODUCTIONIn recent years, the use of small electronic devices such as tablet computers, PDAs, and smartphones has increased worldwide as easier and faster execution of various tasks such as information retrieval by internet access and schedule management is possible without any restrictions by time or place. An estimated 32.7% of the world's population are now internet users, ranging from 78.4% of the population of North America to 13.5% of that of Africa, which is a 4% increase from 2010.[1,2] The rapid expansion of internet usage has been facilitated by the increased penetration rates of mobile phones, including smartphones. SUBJECTS AND METHODS . [5,6] Based on data from a previous study [7] and the recommendation from the Korea Ministry of Employment and Labor, [17] the working angle for reading a book or viewing a smartphone wa...

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Tamoxifen is known to reduce the risk of breast cancer in women at high risk and also reduces mammographic breast density (MD) in a preventive setting. We investigated the efficacy of MD reduction (MDR) for predicting recurrence in estrogen receptor (ER)-positive patients in an adjuvant setting. A total of 1,066 ER-positive breast cancer patients who were enrolled in this study underwent curative surgery and received adjuvant tamoxifen for at least 2 years at our institution between January 2003 and December 2008. Using a computerized system, a single radiologist reviewed all mammograms and classified MD patterns on the basis of the Breast Imaging Reporting and Data System. MDR was assessed using the baseline mammogram taken before surgery (preMD) and the followup mammogram taken after the start of adjuvant tamoxifen(postMD). MDR positivity was defined as downgrading of the postMD grade, with the preMD grade as a reference.Patients were divided into 2 groups, MDR-positive and MDR-negative, for statistical analysis. Patients who showed MDR after an average of 19 months of adjuvant tamoxifen treatment had a 65 % lower risk of recurrence than patients who did not show MDR. Furthermore, significant risk reduction according to MDR had a predictive power for any type of recurrence pattern including loco-regional recurrence(87 % reduction) and systemic recurrence (52 %reduction) in ER-positive breast cancer patients, especially in women ≤50 years. In our study, only 4 patients (0.4 %)showed contralateral breast recurrence during the mean 61-month follow-up period and none of them experienced MDR. In conclusion, MDR during adjuvant tamoxifen therapy was independently associated with a lower risk of systemic and loco-regional recurrence in ER-positive breast cancer patients, especially in young women. For patients who do not experience MDR after approximately 1.5 years of tamoxifen therapy, more caution should be taken and other treatment strategies are warranted.

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Traction injury of swine RLNs causes loss of signal at a power of 2.83 MPa. However, all injured nerves recovered within 7 days with no observed structural damage.

PurposeThe aim of this study was to examine molecular subtype conversions in patients who underwent neoadjuvant chemotherapy (NAC) and analyze their clinical implications.Materials and MethodsWe included consecutive breast cancer patients who received NAC at the National Cancer Center, Korea, between August 2002 and June 2011, and had available data on estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) receptor status prior to NAC. Molecular subtypes, hormone receptor (HR) status, and ER and PR Allred scores before and after NAC were compared, and the long-term outcomes were analyzed.ResultsOf 322 patients, 32 (9.9%) achieved a pathologic complete response after NAC. HR+/HER2– tumors tended to convert into triple negative (TN) tumors (10.3%), whereas 34.6% of TN tumors gained HR positivity to become HR+/HER2– tumors. Clinical outcomes of molecular subtype conversion groups were compared against patients who remained as HR+/HER2– throughout. The HR+/HER2– to TN group had significantly poorer recurrence-free survival (RFS) (hazard ratio, 3.54; 95% confidence interval [CI], 1.60 to 7.85) and overall survival (OS) (hazard ratio, 3.73; 95% CI, 1.34 to 10.38). Patients who remained TN throughout had the worst outcomes (for RFS: hazard ratio, 3.70; 95% CI, 1.86 to 7.36; for OS: hazard ratio, 5.85; 95% CI, 2.53 to 13.51), while those who converted from TN to HR+/HER2–showed improved comparable survival outcomes.ConclusionMolecular subtypes of breast cancers changed frequently after NAC, resulting in different tumor prognostication. Tumor subtyping should be repeated after NAC in patients with breast cancer.

With its magnified stereoscopic three-dimensional vision, elimination of tremor, and ability to articulate and rotate surgical instruments, the da Vinci-S® robotic system may be an ideal surgical tool for the operation of adrenal lesions. Robotic adrenalectomy appears to be a safe and effective alternative to traditional laparoscopic adrenalectomy.