PURPOSE: We conducted a comparative study to evaluate the diagnostic values of Tl-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. MATERIALS AND METHODS: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or more times of I-131 retreatments (33 cases). In all patients, Tl-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the RESULTS were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. RESULTS: Positive rates (PR) of Tc-99m MIBI, Tl-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant Tl-201 and I-131 scans were in the order of therapeutic 131 scan 71%, Tl-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between Tl-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). CONCLUSION: Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. Tl-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these patients.
Biopsy ; Diagnosis ; Follow-Up Studies* ; Humans ; Iodine ; Retreatment ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

Background: There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. Methods: Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. Results: Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. Conclusion PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

Background: There has been controversy regarding the association between primary aldosteronism (PA) and dyslipidemia and few studies considered the effects of diabetes and renal function on lipid metabolism. We analyzed lipid profiles of PA patients and compared them to propensity-score (PS)-matched essential hypertension (EH) patients adjusting for glycemic status and renal function. Methods: Patients who were diagnosed with PA using a saline-infusion test at Seoul National University Hospital from 2000 to 2018 were retrospectively analyzed. EH patients who had aldosterone-renin ratio (ARR) results were selected as controls. Covariates, including diabetes, were PS-matched for patients with PA, lateralized PA, non-lateralized PA, and high ARR to EH patients, respectively. Results: Among a total of 80 PA and 80 EH patients, total cholesterol (TC) and triglyceride (TG) levels were significantly lower in the PA patients than in the EH patients (least-squares mean±standard error: 185.5±4.4 mg/dL vs. 196.2±4.4 mg/dL, P=0.047, for TC; and 132.3±11.5 mg/dL vs. 157.4±11.4 mg/dL, P=0.035, for TG) in fully adjusted model (adjusting for multiple covariates, including diabetes status, glycosylated hemoglobin level, and estimated glomerular filtration rate). There were no significant differences in high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol levels between the two groups. According to increments in aldosterone levels, an increasing tendency of HDL-C and decreasing tendencies of TG and non-HDL-C were observed. Conclusion PA patients had lower TC and TG levels than EH patients, independent of glycemic status and renal function.

PURPOSE: Orphan lung diseases are defined as lung diseases with a prevalence of 1 or less in 2,000 individuals. Despite an increase in the numbers of patients with such diseases, few studies on Korean children have appeared. To obtain epidemiologic and demographic data on these diseases, we systematically reviewed reports on pediatric orphan lung diseases in Korea over the last 50 years. METHODS: We reviewed 223 articles that have appeared since 1958 on orphan lung diseases in Korean children. These articles described a total of 519 patients aged between 0 and 18 years. We classified patients by year of publication, diagnosis, geographic region, and journal. RESULTS: Of 519 patients, 401 had congenital cystic lung diseases and 66 had bronchiolitis obliterans. About 80% of patients were described in reports published in three journals, Pediatric Allergy and Respiratory Disease (Korea), the Korean Journal of Pediatrics, and the Korean Journal of Thoracic and Cardiovascular Surgery, in which papers on 157 (30.2%), 138 (26.6%), and 111 (21.4%) patients appeared, respectively. The frequency of publication of case reports has increased since 1990. Of the 519 patients, 401 (77.3%) were from Seoul/Gyeonggi-do and 72 (13.9%) from Busan/Gyeongsangnam-do. CONCLUSION: The prevalence of pediatric orphan lung disease has increased since 1990, and some provinces of Korea have a higher incidence of these diseases than do others. Studies exploring the incidence of pediatric orphan lung diseases in Korea are needed for effective disease management.
Aged ; Bronchiolitis Obliterans ; Child ; Child, Orphaned ; Disease Management ; Humans ; Hypersensitivity ; Incidence ; Korea ; Lung ; Lung Diseases ; Pediatrics ; Prevalence ; Publications

Although laryngomalacia is the most common cause of congenital stridor in infancy, it is a benign, self-limited disease which usually resolves by the age of 18 months with no long- term sequelae. Nevertheless, infants who suffered from recurrent stridor and respiratory distress should be evaluated for other causes of stridor such as cardiopulmonary anomalies. We report 3 cases of infants who had recurrent stridor and respiratory distress from their early infancy. Case 1 had a double aortic arch and a tracheomalacia, case 2 had a hypoplasia of the right lung, and case 3 had a horseshoe lung as well as scimitar syndrome. Physicians should be alert for the possibility of the congenital cardiopulmonary abnormalities in infants with recurrent stridor and/or respiratory distress.
Aorta, Thoracic ; Dyspnea ; Humans ; Infant ; Laryngomalacia ; Lung ; Respiratory Sounds ; Scimitar Syndrome ; Tracheomalacia

Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.
Abdominal Pain ; Aged ; Capsule Endoscopes* ; Capsule Endoscopy ; Diagnosis ; Female ; Gastrointestinal Stromal Tumors* ; Hemorrhage ; Humans ; Incidence ; Jejunum ; Male ; Melena ; Ulcer

PURPOSE: In treating carcinoma of the esophagus, a gastric drainage procedure seems to be necessary with esophago gastrostomies because of the inevitable incidental bilateral truncal vagotomy which occurs during the esophagectomy. There are potential hazards with a pyloroplasty such as jeopardizing the blood supply to the mobilized stmach, shortening its length for substitution, leakage, dumping syndrome, and bile reflux gastritis. The aims of the study are to compare the postoperative outcome of patients with and without pyloroplasty after an esophagectomy for esophageal cancer, and to evaluate the necessity of pyloroplasty in the vagotomized intrathoracic stomach after esophageal surgery. METHODS: During the years 1996 to 2001, 23 patients with carcinoma of the esophagus underwent an esophagectomy followed by esophagogastrostomy with or without pyloroplasty. The medical records of the patients were evaluated retrospectively. RESULTS: There were no statiscally significant differences between the pyloroplasty group and the no-pyloroplasty group with regards to the average hospital stay, resumption of oral feeding, removal of the nasogastric tube, and the daily gastric drainage. CONCLUSION: Postoperative symptomatic evaluation of patients who had esophageal cancer and underwent an esoph-agectomy and an esophagogastrostomy, with or without pyloroplasty supports the concept that the drainage procedure is unnecessary in the gastric replacement of the esophagus.
Bile Reflux ; Drainage ; Dumping Syndrome ; Esophageal Neoplasms ; Esophagectomy* ; Esophagus* ; Gastritis ; Gastrostomy ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Stomach ; Vagotomy, Truncal

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens of nosocomial infections. Especially in intensive care units (ICUs) and nasal carriage of Staphylococcus aureus has been known as a major risk factor of staphylococcal infections. In Korea, MRSA is the most common pathogen of nosocomial infections in ICUs. We performed this study to investigate the effects of conventional control measures and the additional effect of intranasal fusidic acid in prevention of MRSA nasal carriage and infection in ICUs of one educational hospital in Korea. METHOD: All patients admitted to medical ICU and surgical ICU in Samsung medical center from April to September 1999 were studied prospectively. Surveillance culture was done in all patients and health care workers by nasal swab culture. We tried to control MRSA infection by conventional methods in the first period April-June 1999) and by additional intranasal fusidic acid application in the second period (July-September 1999) RESULTS: Comparing the first with second periods, new nasal MRSA colonization rate among patients was significantly decreased from 14.8% to 1.8% in surgical ICU (P=0.016). Although there was no statistical difference between the first and second periods in medical ICU (14.6% vs 5.9%, P=0.192), the new nasal colonization of the first period was significantly decreased than that of the previous study which was performed in 1996 (14.6% vs 36.2%, P=0.015). And new MRSA infection rate was much more decreased than the previous study, but there was no statistical significance (11.7% vs 2.0%, P=0.066). CONCLUSION: Conventional methods for MRSA control decreased new MRSA nasal colonization of patients in ICUs. Application of intranasal fusidic acid was considered as an additional control measure for reducing MRSA nasal colonization. For evaluating effect of intranasal fusidic acid for preventing of MRSA infection in ICUs, further study with larger scale of study population is warranted.
Colon ; Cross Infection ; Delivery of Health Care ; Furosemide* ; Fusidic Acid* ; Humans ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcal Infections ; Staphylococcus aureus

BACKGROUND: The aim of this study was to investigate the status of BRCA1/2 genetic testing practices in Korea in 2014. METHODS: A structured questionnaire was provided to the specialist in charge of BRCA1/2 genetic testing via e-mail between 28 July and 10 August 2015. A total of 11 genetic testing professionals from 14 organizations responded to the survey that asked about the status of BRCA1/2 genetic testing in the year 2014. RESULTS: The average number of BRCA1/2 genetic tests executed was 192; 6 organizations had executed less than 100 tests, and 5 organizations had conducted more than 100 tests. The primary testing method used was Sanger sequencing (100%), and 2 institutes performed multiplex ligation-dependent probe amplification (MLPA). The analysis software differed across the various organizations, with Sequencher (81.81%), Seqscape (27.27%), and Codoncode Aligner (9.09%) reported as utilized. We found that the guidelines for the interpretation of the genetic tests were different at each institution. CONCLUSIONS: Although this study only examined the status of the 2014 BRCA1/2 genetic testing practices of 11 institutions, it illustrates the necessity for standardized genetic testing or interpretation guidelines in Korea.
Academies and Institutes ; Electronic Mail ; Genetic Testing* ; Korea* ; Methods ; Multiplex Polymerase Chain Reaction ; Specialization ; Surveys and Questionnaires

OBJECTIVE: To assess the effect of motivation for treatment and to find out causes of dropping out from treatment in performing the constraint-induced movement therapy (CIMT). METHOD: Forty six stroke patients were treated with CIMT for 2 weeks. Prior to and after treatment, Fugl-Meyer motor assessment (FMA), Wolf motor function test (WMFT), box and block test (BBT), and 9 hole peg test, motor activity log (MAL) were performed, and for the evaluation of treatment motivation, motivation score (MS) was assessed in 24 patients. RESULTS: After 2 weeks of CIMT treatment, the mean value of FMA increased by 15.1%, WMFT by 19.5%, BBT by 35.8%, the time of 9 hole peg test decreased by 20.2%, and the "How well" sub-score of the increased MAL was 59.6% (p<0.05). Larger improvement of FMA score was observed in patients with high MS (p<0.05). Twelve out of 46 patients were dropped, 5 patients (18.5%) among 27 right side hemiplegic patients and 7 patients (38.9%) of 19 left side hemiplegic patients gave up the treatment in the middle, and the MS score of the quitted patients (35.3 point) was lower than that of patients who did not quit (40.5 point) (p<0.05). CONCLUSION: After 2 weeks of CIMT treatment, larger improvement of movement capacity was observed in patients with high motivation. Among patients with low treatment motivation and old age, many patients were dropped out during CIMT.
Humans ; Motivation ; Motor Activity ; Paresis ; Stroke ; Wolves