Radioiodine has been effectively applied for the management of hyperthyroidism and differentiated thyroid cancers in most countries of the world. The majority of thyroid cancers are differentiated thyroid cancer that has an overall excellent prognosis, which attributed to appropriate treatment of the disease including administration of radioiodine, I-131. I-131 therapy has usually been undertaken for the ablation of remnant tissue or adjuvant treatment after surgical resection of the thyroid. I-131 therapy was routinely recommended for patients with high-risk disease, and should be considered for intermediate-risk disease as an adjuvant purpose. Several latest studies refute worries of increase cancer risk with I-131 treatment for thyroid cancer. Thus, recent ATA guidelines have shifted toward a more individual and stratified approach, because of benign nature of the differentiated thyroid cancer as well as awareness of side effects including potential increasing incidence of second primary malignancy after I-131 treatment. While some retrospective studies also pointed out that potential increases in cancer development after I-131 treatment for hyperthyroidism recently. Treatment decisions regarding the use of radioiodine therapy should consider the balance of risks and benefits for individual patients with low risk differentiated thyroid cancer and hyperthyroidism, if it is true. Thus, we will review current understanding for the association of increased secondary malignancy and I-131 treatment of thyroid diseases.

No abstract available.
Animals ; Gonadotropin-Releasing Hormone* ; Rats* ; RNA, Messenger* ; Testis*

Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged > or = 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population.
Activities of Daily Living ; Aged ; Aged, 80 and over ; *Aging ; Body Composition ; Cognition Disorders/epidemiology ; Cross-Sectional Studies ; Demography ; Disabled Persons ; Female ; Geriatric Assessment/*statistics & numerical data ; *Health Status ; Humans ; Interviews as Topic ; Male ; Prevalence ; Quality of Life ; Republic of Korea/epidemiology ; Rural Population ; Sarcopenia/epidemiology

PURPOSE: Adenosine myocardial perfusion SPECT has proven to be useful in the detection of coronary artery disease, in the follow up the success of various therapeutic regimens and in assessing the prognosis of coronary artery disease. The purpose of this study is to define the reproducibility of myocardial perfusion SPECT using adenosine stress testing between two consecutive Tc-99m sestaMIBI (MIBI) SPECT studies in the same subjects. METHODS: Thirty patients suspected of coronary artery disease in stable condition underwent sequential Tc-99m MIBI SPECT studies using intravenous adenosine. Gamma camera, acquisition and processing protocols used for the two tests were identical and no invasive procedures were performed between two tests. Mean interval between two tests were 4.1 days (range: 2-11 days). The left ventricular wall was divided into 18 segments and the degree of myocardial tracer uptake was graded with four-point scoring system by visual analysis. Images were interpretated by two independent nuclear medicine physicians and consensus was taken for final decision, if segmental score was not agreeable. RESULTS: Hemodynamic responses to adenosine were not different between two consecutive studies. There were no serious side effects to stop infusion of adenosine and side effects profile was not different. When myocardial uptake was divided into normal and abnormal uptake, 481 of 540 segments were concordant (agreement rate 89%, Kappa index 0.74). With four-grade scoring system, exact agreement was 81.3% (439 of 540 segments, tau b=0.73). One and two-grade differences were observed in 97 segments (18%) and 4 segments (0.7%) respectively, but three-grade difference was not observed in any segment. Extent and severity scores were not different between two studies. The extent and severity scores of the perfusion defect revealed excellent positive correlation between two test (r value for percentage extent and severity score is 0.982 and 0.965, p< 0.001) CONCLUSION: Hemodynamic responses and side effects profile were not different between two consecutive adenosine stress tests in the same subjects. Adenosine Tc-99m sestaMIBI SPECT is highly reproducible, and could be used to assess temporal changes in myocardial perfusion in individual patients.
Adenosine* ; Consensus ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Exercise Test ; Follow-Up Studies ; Gamma Cameras ; Hemodynamics ; Humans ; Nuclear Medicine ; Perfusion ; Prognosis ; Tomography, Emission-Computed, Single-Photon*

The interactions between the tumor microenvironment and tumor cells determine the behavior of the primary tumors. Whether cancer-associated fibroblasts (CAF) have a tumor progressive or a protective role likely depends on the type of tumor cells and the CAF subpopulation. In the present study, we analyzed the prognostic significance of CAF subpopulations in colorectal cancer (CRC). CAF phenotypes were analyzed in 302 CRC patients by using antibodies against podoplanin (PDPN), alpha-smooth muscle actin (alpha-SMA), and S100A4. The relationship between the CAF phenotypes and 11 clinicopathological parameters were evaluated and their prognostic significance was analyzed from the disease-free and overall survival times. We observed that at the tumor invasive front, PDPN CAFs were present in 40% of the cases, and S100A4 or alpha-SMA CAFs were detected in all the cases. PDPN/S100A4 and alpha-SMA/S100A4 dual-stained CAFs were observed in 10% and 40% of the cases, respectively. The PDPN+ CAFs were associated with 6 favorable clinicopathological parameters and prolonged disease-free survival time. The PDPN-/alpha-SMA(high) CAFs were associated with 6 aggressive clinicopathological parameters and tended to exhibit shorter disease-free survival time. On the other hand, the PDPN-/S100A4(high) CAFs were associated with 2 tumor progression parameters, but not with disease prognosis. The PDPN+ CAF phenotype is distinct from the alpha-SMA or S100A4 CAFs in that it is associated with less aggressive tumors and a favorable prognosis, whereas the PDPN-/alpha-SMA(high) or PDPN-/S100A4(high) CAFs are associated with tumor progression in CRC. These findings suggest that CAFs can be a useful prognostic biomarker or potential targets of anti-cancer therapy in CRC.
Actins/immunology/*metabolism ; Adult ; Aged ; Aged, 80 and over ; Antibodies/immunology ; Carcinoembryonic Antigen/blood ; Colorectal Neoplasms/*diagnosis/mortality/pathology ; Disease-Free Survival ; Female ; Fibroblasts/cytology/metabolism ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Membrane Glycoproteins/immunology/*metabolism ; Middle Aged ; Neoplasm Staging ; Phenotype ; Prognosis ; S100 Proteins/immunology/*metabolism ; Tumor Markers, Biological/metabolism

BACKGROUND: The p16 protein is a cyclin-dependent kinase inhibitor (CDKI) that inhibits cell cycle progression from phase G1 to phase S in the cell cycle. Many p16 gene mutations have been noted in many cancer-cell lines and in some primary cancers. These mutated genes caused abnormal or aberrant expression of the p16 protein, which might have contributed to the malignant progression of the cells by deranging the cell cycle. This study was to examine the abnormal or aberrant expression of the p16 protein in breast cancer tissue by using p16 protein specific immunohistochemical staining. METHODS: p16-protein-specific immunohistochemical staining was performed on 31 breast-cancer tissue samples. Twenty-four cases among the 31 tissue staining slides simultaneously showed a normal breast-tissue portion on the same staining slide. Microscopic photographs of both the breast-cancer and the normal- tissue portion were taken at the same magnification to compare the statistically analyzed fraction of red or brown colored p16 stained nuclei. RESULTS: In the breast cancer tissue, 7 (22.6%) showed totally negative, with less than 5% of the nuclei staining. The completely negative cases were not related to the stage of the disease (p=0.096) or to the histopathologic grade (p=0.20). The staining ratios of the breast-cancer tissue and the normal tissue were 26.2 ( +/- 18.7)% and 72.4 ( +/- 18.8)%, respectively. In the breast-cancer tissue, the ratio of expression of the p16 protein was significantly lower than in the normal tissue (p=0.001). CONCLUSIONS: In the carcinogenesis of some breast cancers, low expression of the p16 protein may play an important role in the unlimited proliferation of tumor cell due to a loss of the cell-cycle-regulating role of the p16 protein.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p16* ; Genes, p16 ; Humans* ; Phosphotransferases

Purpose: We evaluated whether there is an association between sequential changes in kinetic profiles by computer-aided detection (CAD) during neoadjuvant chemotherapy (NAC) and pathologic complete response (pCR) and residual cancer burden (RCB) in dynamic contrast-enhanced MRI (DCE-MRI) of patients with invasive breast cancer. Materials and Methods: This retrospective study involved 51 patients (median age, 48 years; range, 33–60 years) who underwent pre-, interim-, and post-NAC DCE-MRIs at 3 T. The tumor size and CAD-generated kinetic profiles (peak enhancement and delayed enhancement [persistent, plateau, and washout] components) were measured. Percentage changes in pre- and interim-NAC (ΔMRI value1) and pre- and post-NAC (ΔMRI value2) were compared between pCR and non-pCR cases, and according to RCB. Receiver operating characteristic curve analysis was performed to evaluate the association between pCR and MRI parameters (including CAD-generated kinetic profiles). Results: The pCR rate was 19.6% (10/51). There were statistically significant differences in Δtumor size2 (p < 0.01), Δpeak enhancement2 (p = 0.01), Δpersistent2 (p = 0.01), Δplateau2 (p = 0.02), and Δwashout2 (p = 0.03) between pCR and non-pCR. ΔTumor size2 provided very good diagnostic accuracy for pCR (cut-off, -90%; area under the curve, 0.88). There were differences in Δtumor size2, Δpeak enhancement2, Δplateau2, and Δwashout2 between RCB classes (p < 0.01). Conclusion DCE-MRI using CAD has the potential for predicting pCR and RCB classes.

Cholesterol embolism is due to dislodgment of cholesterol crystals from the atheromatous aorta resulting in an occlusion of small arteries. Cholesterol emboli may occur spontaneously but usually develops as a complication of vascular procedures. The organs most frequently involved are the skin and the kidneys but any organ can be affected. Cutaneous manifestations include livedo reticularis, indurated firm violaceous painful plaques and noduli tending to show central necrosis and tender blue toes. We report two cases of cutaneous cholesterol embolization of lower extremities with the impairment of renal function after coronary angiography, proven by skin biopsy.
Aorta ; Arteries ; Biopsy* ; Cholesterol* ; Coronary Angiography* ; Embolism ; Embolism, Cholesterol* ; Kidney ; Livedo Reticularis ; Lower Extremity ; Necrosis ; Skin* ; Toes

No abstract available.
Aneurysm* ; Coronary Vessels*

BACKGROUND: Amiodarone is an effective antiarrhythmic agent, but it is used restrictively due to several side effects. Amiodarone has been caused thyroid dysfunction, thyroid hyperfunction or hypofunction in several clinical studies. In this study, we assessed the clinical features, frequency and nature of thyroid dysfunction in patients with amiodarone therapy METHODS: A total of 150 patients (Male;n=71, Female;n=79) was assessed. They had never had the history of thyroid disease and had been received amiodarone therapy. All the patient's medical records on therapeutic dose and duration, body weight, height, body mass index and thyroid function test were reviewed. Patient's underlying diseases were supraventricular arrhythmia (n=54) and ventricular arrhythmia (n=96). The dose of amiodarone was between 100 mg and 400 mg, and the mean duration of therapy was 36 months. We defined decreased TSH with elevated T3 and T4 as thyrotoxicosis, and elevated TSH as hypothyroidism RESULTS: Thyroid dysfunction was observed in 56 (37.3%) patients and their mean body mass index (BMI) was 23.6 kg/m2. Of them, thyrotoxicosis and hypothyroidism were observed in 5 (3.3%) patients and 51 (34%) patients, respectively. The difference of sex in hypothyroidism was almost not visible (male;n=24, female;n=27), also the correlation with BMI and thyroid function was not (mean BMI=23.7 kg/m2). Amiodarone was maintained for 46 months in hypothyroidism patients, that was more longer duration than normal thyroid patients (30 months). CONCLUSION: In korean patients with amiodarone therapy, one third patients presented thyroid dysfunction and most of them were hypothyroidism. No correlation was found between thyroid dysfunction and sex and BMI. Hypothyroidism prevalances in patients with long duration of amiodarone therapy, but high dose therapy may induce thyrotoxicosis.
Amiodarone ; Arrhythmias, Cardiac ; Body Height ; Body Mass Index ; Body Weight ; Humans ; Hypothyroidism ; Incidence* ; Medical Records ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland* ; Thyrotoxicosis