We report here on a rare case of concurrent papillary thyroid carcinoma and medullary thyroid carcinoma on each of the lobes of the thyroid gland. A 43-year-old female presented with a one-week history of throat discomfort. A neck ultrasonogram (US) was done, along with fine needle aspiration biopsy (FNAB) of the left thyroid nodule, and the results showed papillary cancer. This patient underwent total thyroidectomy and central compartment neck dissection. The pathologic diagnosis of the nodule at the left lobe of the thyroid was papillary thyroid carcinoma (PTC) and the right thyroid nodule was medullary thyroid carcinoma (MTC).
Adult ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Medullary* ; Diagnosis ; Female ; Humans ; Neck ; Neck Dissection ; Pharynx ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.
Adult ; Asthma ; Dermatitis, Atopic ; Diagnosis ; Family Characteristics ; Household Products ; Humans ; Hypersensitivity ; Korea ; Logistic Models ; Seoul

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.
Adult ; Asthma ; Dermatitis, Atopic ; Diagnosis ; Family Characteristics ; Household Products ; Humans ; Hypersensitivity ; Korea ; Logistic Models ; Seoul

The purpose of this study was to evaluate the relationship between the use of certain household products (HPs) at home and atopic dermatitis (AD) in adults. The study was conducted on 1,500 households in Seoul, South Korea. We obtained information on general characteristics, the use of HPs, and AD through an online panel survey in July 2018. HPs were selected as 23 kinds of products with associated risks that are management targets of the Ministry of Environment. The international study of asthma and allergies in childhood was used for the AD questionnaires. Logistic regression analysis was used to identify AD affected by the use of HPs. Average number of used HPs was 13.44 out of 23, and average usage frequency of HPs was 3.52 times a month at home in Seoul for the last 1 year. Compared with subjects with a low number of HPs used (reference), subjects with a high number of used HPs (4th quartile) were more likely to have lifetime diagnosis of AD (odds ratio (OR) = 1.77, 95% confidence interval (CI); 1.23-2.54), symptoms of AD in the last 12 months (OR = 2.66, 95% CI; 1.92-3.70), and treatment of AD in the last 12 months (OR = 2.37, 95% CI; 1.48-3.80). Compared with subjects with a low HPs usage frequency (reference), subjects with a high HPs usage frequency (4th quartile) were more likely to have lifetime diagnosis of AD (OR = 1.88, 95% CI; 1.31-2.70), symptoms of AD in the last 12 months (OR = 2.14, 95% CI; 1.54-2.96), and treatment of AD in the last 12 months (OR = 2.23, 95% CI; 1.39-3.60). Therefore, the use of HPs was significantly associated with AD. The findings of this study might be useful as basic data for managing allergic diseases and establishing preventive measures.

Intracranial germ cell tumors (ICGCT) occur in 2-11% of children with brain tumors between 0-19 years of age. For treatment of germinoma, relatively low radiation doses with or without chemotherapy show excellent 10 year survival rate of 80-100%. Past studies showed that neoadjuvant chemotherapy combined with focal radiotherapy resulted in unacceptably high rates of periventricular tumor recurrence. The use of generous radiation volume which covers the whole ventricular space with later boost treatment to primary site is considered as standard treatment of intracranial germinomas. For non-germinomatous germ cell tumors (NGGCT), 10-year overall survival rate is still much inferior than that of intracranial germinoma despite intensive chemotherapy and high-dose radiotherapy. Craniospinal radiotherapy combined with cisplatin-based chemotherapy provides the best treatment outcome for NGGCT; 60-70% of overall survival rate. There is a debate on the surgical role whether surgery can contribute to improved treatment outcome of NGGCT when added to combined chemoradiotherapy. Because higher dose of radiotherapy is required for treatment of NGGCT than for germinoma, it is tested whether whole ventricular irradiation can replace craniospinal irradiation in intermediate risk group of NGGCT to minimize radiation-related late toxicity in the recent studies. To minimize the treatment-related neural deficit and late sequelae while maintaining long-term survival rate of ICGCT patients, optimized administration of chemotherapy and radiotherapy should be selected. Use of technically upgraded radiotherapy modalities such as intensity-modulated radiotherapy or proton beam therapy is expected to bring an improved neurocognitive outcome with longitudinal assessment of the patients.
Biology ; Brain Neoplasms ; Chemoradiotherapy ; Child ; Craniospinal Irradiation ; Drug Therapy ; Germinoma ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Proton Therapy ; Radiotherapy* ; Radiotherapy, Intensity-Modulated ; Recurrence ; Survival Rate ; Treatment Outcome

OBJECTIVES: Antimicrobial chemicals are used in a variety of household and personal care products. Exposure to antimicrobial household products has been hypothesized to lead to allergic diseases in children. METHODS: We investigated antimicrobial household product exposure and allergic symptoms in Korean children. An antimicrobial exposure (AE) score was derived. To examine the symptoms of allergic diseases (current wheeze, current rhinitis, and current eczema) in the past 12 months, we used a questionnaire based on the core module of the International Study of Asthma and Allergies in Children. Complete data for the analysis were available for 25,805 of the 35,590 (72.5%) children. RESULTS: The prevalence of current allergic diseases was as follows: wheeze, 5.6%; allergic rhinitis, 32.6%; and eczema, 17.7%. The mean (standard deviation) AE score was 14.3 (9.3) (range: 0-40). Compared with subjects with a low AE score (reference), subjects with a high AE score (fourth quartile) were more likely to have symptoms of wheezing and allergic rhinitis (adjusted odds ratio [aOR] for wheezing 1.24, 95% confidence interval [CI], 1.05-1.45, p for trend=0.24; aOR for allergic rhinitis 1.30, 95% CI, 1.20-1.40, p<0.01). CONCLUSIONS: These findings suggest that frequent use of antimicrobial household products was associated with current wheeze and current allergic rhinitis.
Asthma ; Child ; Eczema ; Family Characteristics ; Household Products* ; Humans ; Hypersensitivity ; Odds Ratio ; Prevalence ; Respiratory Sounds ; Rhinitis ; Triclosan ; Surveys and Questionnaires

PURPOSE: To evaluate the efficacy of catheter-directed thrombolysis in treating symptomatic deep venous thrombosis (DVT) in lower limbs. METHODS: Between Jan. 1999 and Dec. 2002, 29 consecutive patients with DVT had received thrombolytic therapy. The male: female ratio was 6: 23 and the mean age was 50.3+/-13.5 years. The mean duration of symptom was 9.9+/-22.1 days. Catheter-directed infusions of urokinase were administrated via ipsilateral popliteal veins and the angioplasty and stent placement performed after the thrombolytic procedure. The mean dosage of urokinase and duration of thrombolysis were 2, 435, 000+/-887, 000 units and mean duration of thrombolysis was 36.8+/-17.9 hours. Oral medication of warfarin continued at least six months or more. To evaluate the venous patency, duplex ultrasonography or CT venography were performed. RESULTS: Lysis was complete in 17 patients (58.6%, all acute DVT), partial in 11 (37.9%), with only one patient failing. Iliac vein stenosis had shown in 16 patient after thrombdysis. Which were treated with balloon angioplasty and stent insertion. As a postprocedural complication, vaginal bleeding occurred in two patients; one was treated with transfusion but the other stopped without treatment. CONCLUSION: Catheter-directed thrombolysis with urokinase is effective for the treatment of DVT in lower limbs. However further study will be reguired to evaluate the relationship between the incidence of postthrombotic syndrome and thrombolytic therapy alone.
Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic ; Female ; Humans ; Iliac Vein ; Incidence ; Lower Extremity ; Male ; Phlebography ; Popliteal Vein ; Postthrombotic Syndrome ; Stents ; Thrombolytic Therapy ; Ultrasonography ; Urokinase-Type Plasminogen Activator* ; Uterine Hemorrhage ; Venous Thrombosis* ; Warfarin

Background: and Purpose: To identify biomarkers for prediction of the progression to dementia in mild cognitive impairment (MCI) patients, evaluation of brain structure changes has been validated by a comprehensive visual grading scale (CVRS) through magnetic resonance imaging (MRI). In this study, we specifically elucidated for the cognitive change of MCI patients classified based on AT(N) pathological status classification during the follow-up period of 3 years through the CVRS. Methods: The 301 patients with initial MCI visited at least once for follow-up period. The data used in this study were obtained from the Alzheimer's disease (AD) Neuroimaging Initiative study. Brain atrophy was assessed by CVRS using MRI. AT(N) profiles were classified by cerebrospinal fluid abnormality. Based on the AT(N) assessment, all individuals in this study were divided into 3 groups (normal state biomarker, suspected non-Alzheimer's pathology [SNAP], or Alzheimer's continuum). The cox regression was used to analyze the hazard ratios of CVRS for progression to dementia. Results: Sixty-three progressed and 238 remained stable to dementia and the CVRS (mean±standard deviation) had significant difference between progressive MCI and stable MCI (p<0.001). Univariate and multivariate cox regression results (p<0.001) showed the independence of initial CVRS as a predictor for the progression to dementia. Moreover, comparing the classified AT(N) pathology group, SNAP and AD, effectiveness of CVRS as a predictor was verified only in Alzheimer's continuum. Conclusions The initial CVRS score as a predictor of dementia progression was independently validated at the stage of Alzheimer's progression among AT(N) pathologically differentiated MCI.

The aim of this study was to examine the incidence and trends of clinically relevant venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) after hip and knee replacement arthroplasty (HKRA) in Korea. Between January 1 and December 31, 2010, 22,127 hip replacement arthroplasty (HRA) patients and 52,882 knee replacement arthroplasty (KRA) patients were enrolled in the analysis using the administrative claims database of the Health Insurance Review and Assessment Service (HIRA). All available parameters including procedure history and clinically relevant VTE during the 90 days after HKRA were identified based on diagnostic and electronic data interchange (EDI) codes. The overall incidence of VTE, DVT, and PE during the 90 days was 3.9% (n=853), 2.7% (n=597), and 1.5% (n=327) after HRA, while the incidence was 3.8% (n=1,990), 3.2% (n=1,699), and 0.7% (n=355) after KRA. The incidence of VTE after HKRA was significantly higher in patients who had previous VTE history (odds ratio [OR], 10.8 after HRA, OR, 8.5 after KRA), chronic heart failure (2.1, 1.3), arrhythmia (1.8, 1.7), and atrial fibrillation (3.4, 2.1) than in patients who did not. The VTE incidence in patients with chemoprophylaxis was higher than that in patients without chemoprophylaxis. The incidence of VTEs revealed in this retrospective review was not low compared with the results of the studies targeting other Asian or Caucasian populations. It may warrant routine prevention including employment of chemoprophylaxis. However, the limitation of the reviewed data mandates large scale prospective investigation to affirm this observation.
Adult ; Aged ; Aged, 80 and over ; *Arthroplasty, Replacement, Hip ; *Arthroplasty, Replacement, Knee ; Databases, Factual ; Female ; Humans ; Incidence ; Male ; Middle Aged ; National Health Programs ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Venous Thromboembolism/*diagnosis/epidemiology

PURPOSE: Popliteal artery entrapment syndrome (PAES) is rare but major cause of non-atheromatous popliteal arterial insufficiency in young. Because of its rareness, it is often neglected or misdiagnosed as thrombosis or embolism. Consequently surgeons would lose the appropriate time of treatment. METHOD: We reviewed 11 cases of PAES from 1994 to 2002 regarding to clinical characteristics, image findings, management and their results. RESULT: Two of 11 patients had bilateral involvement. All patients were male and aged 12 to 45 year old (mean; 32.1). Intermittent claudication was presented as initial symptom in all. One had toe gangrene. Conventional arteriography (11 cases) was used as initial diagnostic method. CT (7 cases) and MR (4 cases) angiography were also used to make diagnosis. Type II PAES were most common in 7 limbs. 11 limbs of 10 patients underwent operation. One was managed conservatively because of advanced liver cirrhosis. Resection of medial head of gastrocnemius and popliteal arterial bypass were performed in 7 limbs. One myectomy with femoroposterotibial bypass, one femoropopliteal bypass without myectomy, and myectomy with patch angioplasty were performed. Postoperative complication occurred in two limbs. One had occlusion of graft, another had occluded segment of endarterectomised popliteal artery. Primary graft patency at 6 mo, 1 yr and 3 yr were 81% 81%, 81% respectively. CONCLUSION: In young patients with claudication who have localized lesion at popliteal artery, clinicians should pay attention to rule out PAES. Accurate diagnosis can be achieved by CT or MR angiography. Early surgical correction is recommended to minimize surgical procedure and reduce complication of the disease.
Angiography ; Angioplasty ; Diagnosis ; Embolism ; Extremities ; Gangrene ; Head ; Humans ; Intermittent Claudication ; Liver Cirrhosis ; Male ; Middle Aged ; Popliteal Artery* ; Postoperative Complications ; Thrombosis ; Toes ; Transplants