Anaplastic transformation of differentiated thyroid cancer at distant metastatic sites is extremely rare and has a poor prognosis. It usually occurs in the thyroid gland or cervical lymph nodes. Here we report a case of anaplastic transformation arising at multiple distant metastatic sites including the lung, liver, adrenal gland, bone, and lymph nodes in a patient 3 years after total thyroidectomy for follicular thyroid cancer.
Adrenal Glands* ; Humans ; Liver* ; Lung* ; Lymph Nodes ; Prognosis ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

OBJECTIVES: The purpose of this study was to correct the statistical errors in the previous article on "The Development of the 'Mental Fitness' Scale" (MFS) and to confirm the validity of factor structure via confirmatory factor analysis. METHODS: Based on re-analysis of the factor structure of 25 preliminary items using the original dataset, we identified 22 items of the MFS and assessed test-retest reliability. Concurrent validity was assessed by correlating the new set of MFS with total scores of the Beck Depression Inventory and Positive and Negative Affect Schedule. We also performed confirmatory factor analysis (CFA) in order to verify the factor structure resulting from the exploratory factor analysis. RESULTS: Re-analysis yielded five factors of 22 items, which is different from four factors of 20 items in the previous paper. 'Self-understanding' was added as one of the five factors. The test-retest reliability coefficients were significantly high, ranging between 0.57-0.73. Internal consistency was computed, and Cronbach's alpha for five factors ranged between 0.67-0.86, and was 0.91 for the total score. Concurrent validity and discriminant validity were both significant. The validity of five factor structure based on CFA was verified as root mean square error of approximation was significant. CONCLUSION: Based on results of confirmatory factor analysis, the validity and utility of the revised MFS was increased.
Appointments and Schedules ; Depression ; Factor Analysis, Statistical*

Background: Osteoporosis is one of the inevitable diseases affecting an aging society, substantially impacting the quality of life of its population. Protein intake has been shown to be beneficial in reducing the incidence of osteoporosis, and the effects of both animal and vegetable proteins have been studied. However, the relationship between processed meat consumption and osteoporosis has not been studied in Korea. Therefore, we aimed to analyze the correlation between processed meat consumption and incident osteoporosis in adults. Methods: Our analysis included 1,260 adults aged 50 years and older from the Korean Genome and Epidemiology Study (KoGES), recruited between 2005 and 2020. Participants were categorized into two groups according to their processed meat intake, assessed using a semi-quantitative 103-food item food frequency questionnaire. Diagnosis of osteoporosis was based on questionnaire answers. Multiple Cox hazard regression analyses were conducted to examine the association between processed meat intake and incident osteoporosis. Results: During an average follow-up period of 8.8 years, 230 participants developed osteoporosis. According to the Cox proportional regression models, the hazard ratio (95% confidence interval) of incident osteoporosis in the high intake group was 0.62 (0.41–0.94), compared to the low intake group after adjusting for confounding variables. Conclusion These findings reveal that processed meat protein intake is inversely related to the incidence of osteoporosis in adults aged 50 years and older. This in turn suggests that processed meat intake can be proposed as an additional strategy to prevent osteoporosis.

Background: Osteoporosis is one of the inevitable diseases affecting an aging society, substantially impacting the quality of life of its population. Protein intake has been shown to be beneficial in reducing the incidence of osteoporosis, and the effects of both animal and vegetable proteins have been studied. However, the relationship between processed meat consumption and osteoporosis has not been studied in Korea. Therefore, we aimed to analyze the correlation between processed meat consumption and incident osteoporosis in adults. Methods: Our analysis included 1,260 adults aged 50 years and older from the Korean Genome and Epidemiology Study (KoGES), recruited between 2005 and 2020. Participants were categorized into two groups according to their processed meat intake, assessed using a semi-quantitative 103-food item food frequency questionnaire. Diagnosis of osteoporosis was based on questionnaire answers. Multiple Cox hazard regression analyses were conducted to examine the association between processed meat intake and incident osteoporosis. Results: During an average follow-up period of 8.8 years, 230 participants developed osteoporosis. According to the Cox proportional regression models, the hazard ratio (95% confidence interval) of incident osteoporosis in the high intake group was 0.62 (0.41–0.94), compared to the low intake group after adjusting for confounding variables. Conclusion These findings reveal that processed meat protein intake is inversely related to the incidence of osteoporosis in adults aged 50 years and older. This in turn suggests that processed meat intake can be proposed as an additional strategy to prevent osteoporosis.

Background: Osteoporosis is one of the inevitable diseases affecting an aging society, substantially impacting the quality of life of its population. Protein intake has been shown to be beneficial in reducing the incidence of osteoporosis, and the effects of both animal and vegetable proteins have been studied. However, the relationship between processed meat consumption and osteoporosis has not been studied in Korea. Therefore, we aimed to analyze the correlation between processed meat consumption and incident osteoporosis in adults. Methods: Our analysis included 1,260 adults aged 50 years and older from the Korean Genome and Epidemiology Study (KoGES), recruited between 2005 and 2020. Participants were categorized into two groups according to their processed meat intake, assessed using a semi-quantitative 103-food item food frequency questionnaire. Diagnosis of osteoporosis was based on questionnaire answers. Multiple Cox hazard regression analyses were conducted to examine the association between processed meat intake and incident osteoporosis. Results: During an average follow-up period of 8.8 years, 230 participants developed osteoporosis. According to the Cox proportional regression models, the hazard ratio (95% confidence interval) of incident osteoporosis in the high intake group was 0.62 (0.41–0.94), compared to the low intake group after adjusting for confounding variables. Conclusion These findings reveal that processed meat protein intake is inversely related to the incidence of osteoporosis in adults aged 50 years and older. This in turn suggests that processed meat intake can be proposed as an additional strategy to prevent osteoporosis.

Background: Osteoporosis is one of the inevitable diseases affecting an aging society, substantially impacting the quality of life of its population. Protein intake has been shown to be beneficial in reducing the incidence of osteoporosis, and the effects of both animal and vegetable proteins have been studied. However, the relationship between processed meat consumption and osteoporosis has not been studied in Korea. Therefore, we aimed to analyze the correlation between processed meat consumption and incident osteoporosis in adults. Methods: Our analysis included 1,260 adults aged 50 years and older from the Korean Genome and Epidemiology Study (KoGES), recruited between 2005 and 2020. Participants were categorized into two groups according to their processed meat intake, assessed using a semi-quantitative 103-food item food frequency questionnaire. Diagnosis of osteoporosis was based on questionnaire answers. Multiple Cox hazard regression analyses were conducted to examine the association between processed meat intake and incident osteoporosis. Results: During an average follow-up period of 8.8 years, 230 participants developed osteoporosis. According to the Cox proportional regression models, the hazard ratio (95% confidence interval) of incident osteoporosis in the high intake group was 0.62 (0.41–0.94), compared to the low intake group after adjusting for confounding variables. Conclusion These findings reveal that processed meat protein intake is inversely related to the incidence of osteoporosis in adults aged 50 years and older. This in turn suggests that processed meat intake can be proposed as an additional strategy to prevent osteoporosis.

A system for assessing the burdens imposed by disease and injury was developed to meet healthcare, priority setting, and policy planning needs. The first such system, the Global Burden of Disease (GBD), was implemented in 1990. However, problems associated with limited data and assumed disability weightings remain to be resolved. The purpose of the present study was to estimate national burdens of injuries in Korea using more reliable data and disability weightings. The incidences of injuries were estimated using the Korean National Hospital Discharge Survey and the mortality data from the Korean National Statistical Office in 2010. Additionally, durations of injuries and age at injury onset were used to calculate disability-adjusted life years (DALY) using disability weightings derived from the Korean Burden of Disease (KBD) study. Korea had 1,581,072 DALYs resulting from injuries (3,170 per 100,000), which was 22.9% higher than found by the GBD 2010 study. Males had almost twice as heavy an injury burden as females. Road injury, fall, and self-harm ranked 1st, 2nd, and 3rd in terms of burden of injury in 2010. Total injury burden peaked in the forties, while burden per person declined gradually from early adulthood. We hope that this study contributes to the reliable evaluation of injury burden and a better understanding of injury-related health status using nation-specific, dependable data.
Death Certificates* ; Delivery of Health Care ; Female ; Health Care Surveys ; Hope ; Humans ; Incidence ; Korea ; Male ; Mortality

The purpose of this study was to estimate the national burden of mental substance disorders on medical care utilization in Korea using National Health Insurance System (NHIS) data and updated disability weight, in terms of disability-adjusted life years (DALYs). For each of the 24 disorders, the incident years lived with disability (YLDs) was calculated, using NHIS data to estimate prevalence and incidence rates. The DisMod-II software program was used to model duration and remission. The years of life lost (YLLs) due to premature death were calculated from causes of death statistics. DALYs were computed as the sum of YLDs and YLLs, and time discounting and age weighting were applied. The year examined was 2012, and the subjects were divided into 9 groups according to age. In 2012, the Korean burden of mental and substance use disorders was 945,391 DALYs. More than 98% of DALYs were from YLDs, and the burden in females was greater than that in males, though the burden in males aged less than 19 years old was greater than that in females. Unipolar depressive disorders, schizophrenia, and anxiety disorders were found to be major diseases that accounted for more than 70% of the burden, and most DALYs occurred in their 30–59. Mental and substance use disorders accounted for 6.2% of the total burden of disease and were found to be the 7th greatest burden of disease. Therefore, mental and substance use disorders need to be embraced by mainstream health care with resources commensurate with the burden.
Anxiety Disorders ; Cause of Death ; Delivery of Health Care ; Depressive Disorder ; Female ; Humans ; Incidence ; Korea ; Male ; Mortality, Premature ; National Health Programs ; Prevalence ; Schizophrenia ; Substance-Related Disorders*

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Vocal fold paralysis secondary to sarcoidosis is extremely rare but it can develop as a result of compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We report the case of a 56-year-old woman who presented with unilateral vocal fold paralysis and enlarged supraclavicular lymph nodes. Computed tomography of the neck revealed multiple, enlarged, and matted lymph nodes at the cervical level of IV. An ultrasound-guided core needle biopsy of the lymph node was performed, and a histopathological diagnosis of sarcoidosis was made by validating the presence of noncaseating granuloma. After implementation of steroid therapy, the patient exhibited immediate recovery from vocal fold paralysis. Although an extremely rare disease, sarcoidosis should be included in the differential diagnosis of vocal fold paralysis. Accurate diagnosis and prompt steroid treatment may reduce the morbidity of patients with vocal fold paralysis secondary to sarcoidosis.
Biopsy, Large-Core Needle ; Diagnosis ; Diagnosis, Differential ; Female ; Granuloma ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Paralysis ; Rare Diseases ; Sarcoidosis ; Vocal Cords

BACKGROUND/AIMS: In type 2 diabetic patients, coronary artery disease (CAD) is usually detected at an advanced stage due to a lack of symptoms. The aim of this study was to define which clinical parameters or non-invasive tests predict CAD in asymptomatic type 2 diabetic patients. METHODS: One hundred fourteen asymptomatic type 2 diabetic patients were divided into two groups based on the number of cardiovascular disease (CVD) risk factors (group A > or =2, group B < or =1). Treadmill exercise ECG tests (TMT) were conducted in all cases, and coronary artery angiography was performed on TMT-positive patients. Clinical parameters, diabetic status, and coronary angiographic findings were analyzed. RESULTS: The prevalence of CAD was 41.0% in group A and 16.7% in group B. The number of risk factors was significantly correlated with the prevalence of CAD, but not with the severity of CAD. Multivariate analysis showed that family history of CAD (odds ratio [OR]=9.41; 95% confidence interval [CI], 1.60-55.49) and diabetes duration > or =10 years (OR=3.28; 95% CI, 1.29-8.84) were independent CAD risk factors in asymptomatic patients. CONCLUSIONS: We recommend a routine screening for CAD in type 2 diabetic patients who have a longer (> or =10 years) diabetic duration or a family history of CAD, even if they are asymptomatic for CAD.
Adult ; Aged ; Coronary Artery Disease/*diagnosis ; Diabetes Mellitus, Type 2/*complications ; Early Diagnosis ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors