The association of thyroid carcinoma and Hashimotos thyroiditis in same thyroid gland is controversial. Incidence of carcinoma who has Hashimotos thyroiditis has been reported from 0.5 to 22.5 per cent by Crile and by Hirabayashi et al. The reason that there are such great diffarences in the reported incidences of carcinoma in Hashimotos disease is the result of the way the material is reported. The carcinomas of the thyroid which occur in association with Hashirnotos thyroiditis are predominently papillary tumors of lower grade malignancy. Thyroid carcinoma need not be feared in patimts with Hashimotos thymiditis, if one examines the ghmd catefully. When patients with Hashimotos disease are treated with thyroxine, there is little or no tendency for Hashimotos disease propess to clinieally detectable carcinoma of the thymid, and the microcarcinoma does not appear. In this case, single thyroid nodule was detected in Hashiimotos disease patient who was treated with thyroxine. There was no significant volume change of thyroid nodule despite of TSH suppression therapy during six months. Therefore we perforrned FNABC twice, the results were highly suspicious thyroid malignancy and subtotoal thyroidectomy was performed. The final pathologic result was microscopic papillary carcinoma with background Hashlmotos thyroiditis. In conclusion, we experienced a case of subsequent microscopic papillary carcinoma of the thyroid in patient with Hashimotos thyroiditis who was TSH suppression therapy with thyroxine.
Carcinoma, Papillary ; Hashimoto Disease ; Humans ; Incidence ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Thyroiditis ; Thyroxine

BACKGROUND: Malnutrition is a frequent nutritional problem among ICU patients, and their nutritional status is known to affect clinical prognosis. We conducted this study to examine nutritional status and actual nutrition delivery in the ICU patients and its relations to clinical outcomes. METHODS: This study was a multicenter retrospective observational study based on the medical records of 163 patients admitted to ICU of tertiary teaching hospitals in Korea. We included the patients who were treated with mechanical ventilation for 3 or more days and received enteral or parenteral nutrition. RESULTS: According to albumin and total lymphocyte count levels, 54.6% of the subjects were moderately or severely malnourished. Mean percentage of calorie and protein delivery to estimated needs for 10 days were 55.8 +/- 29.3% and 46.1 +/- 30.1%, respectively. While parenteral nutrition (PN) started at 1.6 +/- 1.4 days after admission, enteral nutrition (EN) did at 3.6 +/- 2.1 days. Days to PN and EN start, the calorie and protein amount via EN or PN were significantly different among 6 hospitals. No clinical outcomes differed by the levels of calorie or protein delivery. In-hospital mortality was significantly higher in the severely malnourished group at admission as compared to the other 2 groups (54.3% vs. 31.2% vs. 27.7%, p < 0.05) CONCLUSIONS: Malnutrition prevalence is high among Korean intensive care unit patients, but current nutritional therapy practice is inconsistent across institutions and far below the international guidelines. Systematic efforts should be made to develop nutritional support guidelines for Korean ICU patients.
Critical Illness ; Enteral Nutrition ; Hospital Mortality ; Hospitals, Teaching ; Humans ; Critical Care ; Intensive Care Units ; Korea ; Lymphocyte Count ; Malnutrition ; Medical Records ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition ; Prevalence ; Prognosis ; Respiration, Artificial ; Retrospective Studies

BACKGROUND: The aim of this study was to elucidate the relationship of environmental tobacco smoke (ETS) exposure and the urine cotinine concentrations in Korean adolescents. METHODS: The study population was 1st grade high school adolescents (n = 1467, girls 22.2%) recruited from four high schools, two from Seoul, one from Kangleung and one from Woolsan. We obtained information on active smoking and ETS exposure through self-reported questionnaire and urine cotinine concentrations. RESULTS: The prevalence of active smoking was 6.9% in boys and 0.9% in girls. Median urine cotinine concentrations were 19.5 microgram/L (range, 0-2341 microgram/L) among smokers, and 0 microgram/L (range, 0-1359 microgram/L) among nonsmokers. The positive rate of urine cotinine among nonsmokers exposed to ETS was 2.9%. Boys were exposed to ETS in the order of frequency in PC room (79.6%), home (39.4%), school (11.5%), and public places (5.9%); girls were exposed in the order of frequency in home (40.9%), PC room (33.2%), public places (28.0%), and school (15.2%). The frequency and duration of ETS exposure were significantly larger and longer in boys than in girls. Boys contacted friends who smoked more than girls did (32.6% vs. 17.1%). Parents; smoking status was similar both in boys and girls. Any information on ETS exposure did not differ according to the detectable urine cotinine among nonsmoking adolescents. CONCLUSION: Low positive rate of urine cotinine and no association of urine cotinine with various ETS exposure history reflect that urine cotinine may not be a good marker for ETS exposure in Korean adolescents.
Adolescent ; Cotinine ; Friends ; Humans ; Prevalence ; Smoke ; Smoking ; Tobacco ; Surveys and Questionnaires

BACKGROUND: The worldwide prevalence of obesity and allergic diseases has increased. We aimed to explore the relation of overweight to asthma, atopic dermatitis, allergic rhinitis and conjunctivitis in a sample of Korean adolescents. METHODS: We investigated the prevalence of symptoms of asthma and other allergic diseases by using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The survey was conducted among 1,499 high school students in 3 regions of Korea. RESULTS: The lifetime prevalence of wheezing (21.2% vs. 15.7%, P = 0.04), the 12 months-prevalence of wheezing (4.5% vs. 2.0%, P = 0.04), exercise induced wheezing (13.8% vs. 9.3%, P = 0.04), treatment of asthma (3.3% vs. 1.1%, P = 0.01) and the prevalence of symptoms of allergic rhinitis (11.0% vs. 5.1%, P = 0.001) were signifi cantly higher in overweight boys than normal weight boys, but not in girls. However, there were no signifi cant differences of the prevalence of symptoms and past history of atopic dermatitis and allergic conjunctivitis between overweight and normal weight groups. In boys, overweight increased the risk of the lifetime prevalence of wheezing (OR 1.54, 95% CI: 1.05-2.24) and 12 months-prevalence of exercise induced wheezing (OR 1.64, 95% CI: 1.05-2.55) after adjusting for confounding variables. CONCLUSION: Overweight could be a risk factor for the development of symptoms of asthma and allergic rhinitis in adolescent boys, whereas it was not a signifi cant risk factor for allergic diseases in girls.
Adolescent ; Asthma ; Confounding Factors (Epidemiology) ; Conjunctivitis ; Conjunctivitis, Allergic ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Korea ; Obesity ; Overweight ; Prevalence ; Respiratory Sounds ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.