The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is an ultrasound-based risk stratification system for thyroid nodules that has been widely applied for the diagnosis and management of thyroid nodules since 2016. This review article provides an overview of the use of the K-TIRADS compared with other risk stratification systems. Moreover, this review describes the challenges in the clinical application of the K-TIRADS, as well as future development directions toward the personalized management of patients with thyroid nodules.

The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is an ultrasound-based risk stratification system for thyroid nodules that has been widely applied for the diagnosis and management of thyroid nodules since 2016. This review article provides an overview of the use of the K-TIRADS compared with other risk stratification systems. Moreover, this review describes the challenges in the clinical application of the K-TIRADS, as well as future development directions toward the personalized management of patients with thyroid nodules.

BACKGROUNDS: It is to find out ins and outs of falls, and then to study risky factors that are preventable. METHODS: Total 260 elderly people living in Nonsan who are 60 years old and over were analyzed for data. Stereotyped of those are populational, social specific, physical functions, and basis diseases. And concerning falls, it was analyzed if they have had experience of up to 5 times within 3 years recently. RESULTS: The analyzed are total 260 people, men 112(43%), and women 148(57%). And the ones who answered they have had experience of falls are 108(41.6%), men 31(28.7%), and women 77(71.3%), showing a distinguishable difference between two groups. Women have had more experience than men have(p<0.001), and according to their age, the average age of those experienced falls showed to be higher than the one of those who have not(p=0.036). And according to their education, the ones who did not go to any schools have had more experience than those who did, showing the education has something to do with falls(p<0.001). The mean mass index(p=0.043) and average weight(p=0.023) also showed a mere difference between the group of the people who have had experience and the one of those who have not. Taking into account the fact that there were more women in the group who have had experienced falls, it is shown that there is nothing practical to pay attention to. In Activity of Daily Living(ADL) the experienced is 10.8(+/-4.2), and the unexperienced 9.1(+/-3.1), showing a mere difference between two groups(p<0.000). Concerning chronic diseases, there was no difference between those two groups, but individual patient histories showed that the experienced group had less rheumatic trouble than the unexpedenced(p=0.033). Looking at the difference of the causes for the falls according to their gender, the range of their movements(p=0.043), illumination(p=0.012), influence of alcoho1(p=0.001), and the shoes when they were falling down(p<0.001), the first aid treatments after falls(p=0.014), and influence of medications(p<0.001) showed a mere difference between men and women, while did not show any difference in seasons, time of falls, places, and the descriptions of the surfaces of the places. The mean number of falls within recent 3 years of the experienced was 1.79 times, and the comparison of the relation between the frequency and the causes of falls was done between the ones with experience of I fall, and the ones with experience of more twice falls. The average height(p=0.046) was much higher thai those with experience of more than 2 falls. There was also a mere difference between two groups in movements(p=0.009), illumination(p=0.005), influence of alcohol(p=0.003), the shoes (p=0.048), and first aid treatments after falls(p<0.001). CONCLUSION: The group with higher risk rate includes women, age, poor education, skinny physical figures, and lack of ability to act in daily life. Therefore, those results should be considered when a preventive program of falls for elderly people is designed.
Aged* ; Asian Continental Ancestry Group ; Chronic Disease ; Chungcheongnam-do ; Education ; Female ; First Aid ; Humans ; Male ; Middle Aged ; Prevalence* ; Seasons ; Shoes

BACKGROUND AND OBJECTIVES: Hearing outcomes and prognostic factors of idiopathic sudden sensorineural hearing loss (SSNHL) were investigated in patients who underwent combined intratympanic and systemic steroid therapy. SUBJECTS AND METHOD: This study was performed by retrospective chart review. Clinical outcomes and prognostic factors were evaluated in 147 patients who received intratympanic steroid plus systemic steroid therapy. RESULTS: Complete hearing recovery was achieved in 36.7% (n=54) of the patients, partial recovery in 12.9% (n=19), slight recovery in 12.3% (n=18), and total recovery in 61.9% (n=91). Age was identified as an independent, negative prognostic factor for hearing recovery. The recovery rates of the down sloping and profound types were poorer than those of the up sloping type as determined by audiography. CONCLUSION: The results of this study suggest that the combined treatment of intratympanic and systemic steroids for idiopathic SSNHL results in high hearing recovery rates, and that the down-sloping and profound types of audiogram patterns and age are negative prognostic factors.
Ear, Middle ; Hearing Loss ; Hearing Loss, Sensorineural* ; Hearing* ; Humans ; Methods ; Prognosis ; Retrospective Studies ; Steroids

BACKGROUND: As the metabolic syndrome is increased, the prevalence of non-alcoholic fatty liver disease (NAFLD) is increased. In recent studies, metabolic syndrome is related to serum uric acid. And some authors reported the association of uric acid and NAFLD. We have studied the association of serum uric acid and NAFLD. METHODS: The authors conducted a cross-sectional survey of 3,430 subjects out of 6,731 individuals who had visited the Health Promotion Center at the National Insurance Corporation Ilsan Hospital for the purpose of a regular check-up from January 2005 to April 2008. We excluded who showed evidence of more than moderate alcohol consumption, hepatitis B or C, or severe hepatic dysfunction. RESULTS: Among 3,430 participants, 1,775 subjects (51.7%) were diagnosed with NAFLD and 1,655 subjects (48.3%) were control. Age, BMI, triglyceride, fasting glucose, uric acid were greater in the patients with NAFLD than in the controls. The severity of NAFLD is related to uric acid. When uric acid is divided in 4 groups, elevation of uric acid is associated with risk for NAFLD. This relationship is showed in similar pattern when adjusting for age, sex, BMI, triglyceride, fasting glucose. The uric acid elevation of 1mg/dL is associated with the increase of 1.11 fold in risk for NAFLD. CONCLUSION: The risk for non-alcoholic fatty liver disease is related to uric acid. And the severity of non-alcoholic fatty liver disease is associated with uric acid.
Alcohol Drinking ; Cross-Sectional Studies ; Fasting ; Fatty Liver ; Glucose ; Health Promotion ; Hepatitis B ; Humans ; Insurance ; Prevalence ; Uric Acid

PURPOSE: The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease. METHODS: The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed. RESULTS: The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more physical stigmata. Chromosome breakage tests were positive in 9 out of 11 available patients. The median follow-up duration was 69.5 months. The Kaplan-Meier (KM) survival of all patients was 83.3% at 10 years and 34.7% at 20 years, respectively. Seven patients underwent 9 stem cell transplantations (SCTs). Among them, 5 were alive by the end of the study. Ten-year KM survival after SCT was 71.4% with a median follow-up of 3.4 years. All 5 patients treated with supportive treatment alone died of infection or progression at the median age of 13.5 years, except for one with short follow-up duration. Acute leukemia developed in 2 patients at 15.4 and 18.1 years of age. Among 6 patients who are still alive, 3 had short stature and 1 developed insulin-dependent diabetes mellitus. CONCLUSION: We provide information on the long-term outcomes of FA patients in Korea. A nation-wide FA registry that includes information of the genotypes of Korean patients is required to further characterize ethnic differences and provide the best standard of care for FA patients.
Bone Marrow ; Christianity ; Chromosome Breakage ; Diabetes Mellitus, Type 1 ; Diagnosis ; Fanconi Anemia* ; Follow-Up Studies* ; Genotype ; Humans ; Jeollanam-do ; Korea ; Leukemia ; Medical Records ; Retrospective Studies ; Standard of Care ; Stem Cell Transplantation ; Treatment Outcome*

Quadricuspid aortic valve is a rare congenital abnormality but it is well recognized as the cause of significant aortic regurgitation. We describe 5 patients who underwent surgery for severe aortic regurgitation associated with quadricuspid valve. In all patients, this abnormality had been incidentally detected during surgery. Two of the patients had infective endocarditis. In accordance with the Hurwitz and Roberts classification, two valves were type d, two were type a, and one was type c.
Aortic Valve Insufficiency ; Aortic Valve* ; Classification ; Congenital Abnormalities ; Endocarditis ; Humans

Focal nodular hyperplasia-like nodules (FNH-like nodules) are hypervascular lesions that occur in the cirrhotic liver. Histologically,they are similar to classical FNH in an otherwise normal liver. Radiologically, FNH-like nodules may mimic hepatocellular carcinoma (HCC), and they have been misdiagnosed as HCC based on radiological findings. Their pathogenesis and etiology are unclear, but they may arise from a local hyperplastic response to vascular alterations like classical FNH. Rarely, these nodules transform into malignant tumors and cause complications. We report the case of a 28-year-old man with multiple FNH-like nodules in congenital liver cirrhosis.
Adult ; Carcinoma, Hepatocellular ; Focal Nodular Hyperplasia ; Humans ; Hydrazines ; Liver ; Liver Cirrhosis

This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. ‘Nutrition intervention’ was 4.5 ± 0.5 for task importance, ‘nutrition assessment’ was 4.0 ± 0.7 for performance, and ‘nutrition diagnosis’ was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were ‘checking basic information,’‘checking medical history and therapy plan,’‘decision of nutritional needs,’‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ The tasks with high importance but low performance were ‘derivation of nutrition diagnosis,’‘planning of nutrition intervention,’‘monitoring of nutrition intervention process.’ The tasks of both high importance and high difficulty were ‘derivation of nutrition diagnosis,’‘planning of nutrition intervention,’‘supply of foods and nutrients,’‘education of nutrition and self-management,’ and ‘monitoring of nutrition intervention process.’ The tasks of both high performance and high difficulty were ‘documentation of nutrition assessment,’‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’
Hospitals, General ; Nutritionists* ; Tertiary Care Centers

BACKGROUND: Transcranial Doppler ultrasonography (TCD) can detect microembolic signals (MES) in the patients with a potential embolic source. Clinical significance of MES has not been demonstrated in patients with prosthetic mechanical heart valves. We studied the correlation between cerebral thromboemoblic events after the mechanical heart valve surgery (MHVS) and residual MES during TCD monitoring with 100% oxygen inhalation in patients with mechanical heart valves. MATERIAL AND METHOD: Twenty patients with previous cerebral thromboemoblic events after MHVS and a sex- and age-matched control group (n=30) were studied. TCD monitoring was performed from unilateral middle cerebral artery. After baseline monitoring for 20 minutes, 6L of oxygen was inspired for 40 minutes. RESULT: The site of valve and the duration after MHVS of the patients did not differ from those of controls. During baseline monitoring, there was no significant difference in MES prevalence or counts compared to controls. During oxygen inhalation, patients showed a higher MES prevalence (55%, 27.6%, p=0.045) and a more frequent MES counts (p=0.027) compared to controls. CONCLUSION: TCD monitoring with oxygen inhalation may be useful to differentiate clinically significant MES in patients with mechanical heart valve.
Embolism ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Humans ; Inhalation* ; Middle Cerebral Artery ; Oxygen* ; Prevalence ; Ultrasonography ; Ultrasonography, Doppler, Transcranial