Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed recommendations for the optimal use of radiofrequency ablation for thyroid tumors in 2012. As new meaningful evidences have accumulated, KSThR decided to revise the guidelines. The revised guideline is based on a comprehensive analysis of the current literature and expert consensus.
Advisory Committees ; Catheter Ablation* ; Consensus ; Humans ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

BACKGROUND AND OBJECTIVES: We sought to investigate the relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the infarct size and left ventricular (LV) volume after acute myocardial infarction (MI). SUBJECTS AND METHODS: Eighty-six patients with acute ST-elevation MI underwent delayed enhancement multidetector computed tomography immediately after they underwent percutaneous coronary intervention to determine the infarct size. LV function and remodeling were assessed by echocardiography. Hs-CRP and NT-proBNP were measured at admission, 24 hours and two months later. RESULTS: Both hs-CRP and NT-proBNP at 24 hours showed a positive correlation with infarct size and a negative correlation with LV ejection fraction at the baseline and two months later. NT-proBNP at two months correlated with infarct size, LV ejection fraction, and LV end diastolic and systolic volume indices at two months. In patients with high NT-proBNP levels at 24 hours and two months, infarct size was larger and LV ejection fraction was lower. NT-proBNP was higher in patients who developed LV remodeling at two months: 929 pg/mL vs. 134 pg/mL, p=0.002. In contrast, hs-CRP at two months showed no relationship to infarct size, LV function, or LV volumes at two months. CONCLUSION: Elevated hs-CRP level 24 hours after the onset of acute MI is associated with infarct size and LV dysfunction, whereas elevated levels of NT-proBNP 24 hours and two months after the onset of acute MI are both correlated with infarct size, LV dysfunction, and LV remodeling.
C-Reactive Protein* ; Echocardiography ; Humans ; Multidetector Computed Tomography ; Myocardial Infarction* ; Percutaneous Coronary Intervention

BACKGROUND: Nefopam is a centrally acting non-opioid analgesic agent. Its analgesic properties may be related to the inhibitions of monoamine reuptake and the N-methyl-D-aspartate (NMDA) receptor. The antinociceptive effect of nefopam has been shown in animal models of acute and chronic pain and in humans. However, the effect of nefopam on diabetic neuropathic pain is unclear. Therefore, we investigated the preventive effect of nefopam on diabetic neuropathic pain induced by streptozotocin (STZ) in rats. METHODS: Pretreatment with nefopam (30 mg/kg) was performed intraperitoneally 30 min prior to an intraperitoneal injection of STZ (60 mg/kg). Mechanical and cold allodynia were tested before, and 1 to 4 weeks after drug administration. Thermal hyperalgesia was also investigated. In addition, the transient receptor potential ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) expression levels in the dorsal root ganglion (DRG) were evaluated. RESULTS: Pretreatment with nefopam significantly inhibited STZ-induced mechanical and cold allodynia, but not thermal hyperalgesia. The STZ injection increased TRPM8, but not TRPA1, expression levels in DRG neurons. Pretreatment with nefopam decreased STZ-induced TRPM8 expression levels in the DRG. CONCLUSIONS: These results demonstrate that a nefopam pretreatment has strong antiallodynic effects on STZ-induced diabetic rats, which may be associated with TRPM8 located in the DRG.
Animals ; Ankyrins ; Chronic Pain ; Diabetic Neuropathies ; Diagnosis-Related Groups ; Ganglia, Spinal ; Humans ; Hyperalgesia ; Injections, Intraperitoneal ; Models, Animal ; N-Methylaspartate ; Nefopam* ; Neuralgia* ; Neurons ; Rats* ; Streptozocin

OBJECTIVES: The purpose of the study was to compare plaque characteristics by coronary computed tomography angiography (CCTA) with those by virtual histology-intravascular ultrasound (VH-IVUS). METHODS: We enrolled 50 asymptomatic patients with diabetes mellitus or more than two risk factors for coronary artery disease such as hypertension, smoking, and hyperlipidemia. If the patient had a coronary lesion (plaque with more than 50% stenosis or calcium score more than 100), we recommended coronary angiography and VH-IVUS and compared CCTA findings with VH-IVUS findings. RESULTS: 35 patients (70%) had coronary lesions, and we performed both CCTA and VH-IVUS in 23 patients. All 23 patients had multiple risk factors, and the majority of target lesions were located at left anterior descending artery (73.9%), and calcium score of lesion site was 106+/-162 with plaque volume of 232+/-153 mm3 by CCTA. Calcium score of lesion site was significantly greater in diabetic patients (n=14) than non-diabetic patients (n=9) (118+/-159 vs. 88+/-175, p=0.038). By VH-IVUS, plaque volume was 174+/-127 mm3, absolute necrotic core (NC) volume was 22+/-21 mm3, and relative NC volume was 20.8+/-8.7%. Absolute dense calcium (DC) volume and absolute NC volumes were significantly greater in diabetic patients than non-diabetic patients (11.5+/-13.8 mm3 vs. 9.1+/-11.0 mm3, p=0.028, and 23.9+/-24.7 mm3 vs. 18.1+/-14.3 mm3, p=0.035, respectively). Plaque volume by CCTA correlated with that of VH-IVUS (r=0.742, p<0.001), and plaque volume by CCTA correlated with absolute NC volume by VH-IVUS (r=0.621, p<0.001), and calcium score of lesion site by CCTA correlated with absolute dense calcium volume by VH-IVUS (r=0.478, p=0.028). CONCLUSION: Coronary lesion was detected by CCTA in 70% of asymptomatic patients with multiple coronary risk factors, and parameters detected by CCTA correlated well with those detected by VH-IVUS.
Angiography* ; Arteries ; Calcium ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Disease* ; Diabetes Mellitus ; Humans ; Hyperlipidemias ; Hypertension ; Risk Factors* ; Smoke ; Smoking ; Ultrasonography*

BACKGROUND: Nefopam is a centrally acting non-opioid analgesic agent. Its analgesic properties may be related to the inhibitions of monoamine reuptake and the N-methyl-D-aspartate (NMDA) receptor. The antinociceptive effect of nefopam has been shown in animal models of acute and chronic pain and in humans. However, the effect of nefopam on diabetic neuropathic pain is unclear. Therefore, we investigated the preventive effect of nefopam on diabetic neuropathic pain induced by streptozotocin (STZ) in rats. METHODS: Pretreatment with nefopam (30 mg/kg) was performed intraperitoneally 30 min prior to an intraperitoneal injection of STZ (60 mg/kg). Mechanical and cold allodynia were tested before, and 1 to 4 weeks after drug administration. Thermal hyperalgesia was also investigated. In addition, the transient receptor potential ankyrin 1 (TRPA1) and TRP melastatin 8 (TRPM8) expression levels in the dorsal root ganglion (DRG) were evaluated. RESULTS: Pretreatment with nefopam significantly inhibited STZ-induced mechanical and cold allodynia, but not thermal hyperalgesia. The STZ injection increased TRPM8, but not TRPA1, expression levels in DRG neurons. Pretreatment with nefopam decreased STZ-induced TRPM8 expression levels in the DRG. CONCLUSIONS: These results demonstrate that a nefopam pretreatment has strong antiallodynic effects on STZ-induced diabetic rats, which may be associated with TRPM8 located in the DRG.
Animals ; Ankyrins ; Chronic Pain ; Diabetic Neuropathies ; Diagnosis-Related Groups ; Ganglia, Spinal ; Humans ; Hyperalgesia ; Injections, Intraperitoneal ; Models, Animal ; N-Methylaspartate ; Nefopam ; Neuralgia ; Neurons ; Rats ; Streptozocin

BACKGROUND: Recent studies have shown that blood transfusions, and especially red blood cells, are associated with potential adverse outcomes. This study was designed to investigate the effects of red blood cell transfusion according to the hematocrit on the clinical outcomes after cardiac surgery. METHODS: The 433 patients who were undergoing cardiac surgery were randomized to two groups. One group was transfused red blood cells with a hematocrit of 20%, and the other group was transfused red blood cells with a hematocrit of 20~25%. The amounts of intraoperative and postoperative transfusion and various parameters of the clinical outcomes were checked. RESULTS: In the hematocrit <20% group, the amount of infused crystalloid during operation was larger than that of the hematocrit >20% group, and the postoperative hemoglobin and hematocrit were lower than that of the hematocrit >20% group. But there were no differences of the amounts of intraoperative and postoperative transfusion, the use of inotropics, the platelet count, the prothrombin time (PT), the activated partial thromboplastin time (aPTT), the levels of aspartate aminotransferase (AST), the levels of alanine aminotransferase (ALT), blood urea nitrogen (BUN), serum creatinine (Cr), brain natriuretic peptide (BNP) and creatine kinase MB (CK-MB), the extubation time and the ICU stay time between the two groups. CONCLUSION: A hematocrit lower than 20% was tolerated by the cardiac surgical patients and it was not related to the postoperative morbidity and outcomes.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Transfusion ; Blood Urea Nitrogen ; Creatine Kinase ; Creatinine ; Erythrocyte Transfusion ; Erythrocytes ; Hematocrit ; Hemoglobins ; Humans ; Isotonic Solutions ; Natriuretic Peptide, Brain ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Thoracic Surgery

BACKGROUND AND OBJECTIVE: Epidermal growth factor receptor(EGFR) and TGF beta1 have been known as a central regulator in airway remodeling. There have been some reports demonstrating expression of EGFR and TGF beta1 in airway mucosa of asthmatic patients. However, the expression of EGFR and TGF beta1 in bronchial epithelium of TDI-induced asthmatics has not been observed. The aim of this study was to observe expression of EGFR and TGF beta1 and evaluate their roles in pathogenic mechanism of TDI-induced asthma. METHODS: EGFR and TGF beta1 expression were compared using immunohistochemistry technique in bronchial mucosa from 22 subjects with TDI-induced asthma(group I: 10 newly diagnosed, group II: 12 TDI-induced asthma patients with persistent asthma symptoms for more than 5 years after diagnosis), 7 non-asthmatics undergoing pneumonectomy from lung tumor, and 3 healthy subjects. The intensity of expression was analyzed by two observers. The grade of intensity was presented from 0 to 3. Subepithelial basement membrane (SBM) thickness was measured using an image analyzer. RESULTS: EGFR expression was significantly higher in asthmatic patients than in wntrois (p>0.05), while no significant difference were nosed in TGF beta1 expression (p>0.05). There was no significant difference in EGFR expression between group I and II (p>0.05). However, grade of TGF beta1 expression was significantly higher in group II than those of group I (p<0.05). There was a significant difference in EGFR/TGF beta1 ratio between between group I and II (2.31+/-0.27 vs 1.28+/-0.11, p<0.05). SBM thickness of TDI-induced asthma was significantly higher than those of non-asthmatics (p<0.05), while there was no significant difference between group I and II (p>0.05). CONCLUSION: These findings suggest that EGFR and TGF beta1 may contribute to pathogenesis of TDI-induced asthma. However, further studies are required to evaluate the role of EGFR and TGF beta1 in the pathogenesis of TDI-induced asthma.
Airway Remodeling ; Asthma* ; Basement Membrane ; Epidermal Growth Factor* ; Epithelium ; Humans ; Immunohistochemistry ; Lung ; Mucous Membrane* ; Nose ; Pneumonectomy ; Receptor, Epidermal Growth Factor* ; Toluene 2,4-Diisocyanate* ; Toluene* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

BACKGROUND: GenediaTM H. pylori ELISA is a newly developed diagnostic method which detects serum anti-H. pylori IgG antibody. The aim of this study was to assess the accuracy of GenediaTM H. pylori ELISA for the diagnosis of H. pylori infection in Korean population. METHODS: GenediaTM H. pylori ELISA and GAP-IgG were performed in 353 adult sera and Pyloriset-IgG EIA in 184 subjects. In children, 43 serum samples were tested with GenediaTM H. pylori ELISA. H. pylori infection was determined by rapid urease test, histology, culture or 13C-urea breath test in adults. In children, the subject was considered to be H. pylori positive if 13C-urea breath test was positive. RESULTS: In adults, the sensitivity and specificity of GenediaTM H. pylori ELISA were 93.2% and 83.5% with positive and negative predictive values of 85.1% and 92.5%. Those for GAP-IgG and Pyloriset-IgG EIA were 67.2%, 82.4%, 79.3%, 71.4% and 89.1%, 88.4%, 71.9%, 96.1%, respectively. In children, sensitivity, specificity, positive and negative predictive values of GenediaTM H. pylori ELISA were 80%, 84.8%, 61.5%, and 93.3%. Sensitivity and negative predictive value of GenediaTM H. pylori ELISA were significantly higher than those of GAP-IgG (93.2% vs. 67.2%; plt;0.005 and 92.5% vs 71.4%; p<0.005, respectively). CONCLUSION: GenediaTM H. pylori ELISA is a relatively accurate method for the serodiagnosis of H. pylori infection in Korean subjects compared to GAP-IgG. These results may suggest the clinical use of GenediaTM H. pylori ELISA for epidemiological studies of H. pylori infection in Korea.
Adult ; Breath Tests ; Child ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Korea ; Sensitivity and Specificity ; Serologic Tests ; Urease

BACKGROUND AND OBJECTIVE: Assessment of quality of life (QOL) of patients with chronic illness requires reasonable tools which reflect the patients' cultural and behavioral properties. We developed the quality of life questionnaire for adult Korean asthmatics (QLQAKA) on the basis of the Korean life style and evaluated its reliability and validity. METHODS: The QLQAKA consisted of four domains; symptoms (six items), daily activity (five items), emotion (three items) and reaction to environmental stimuli (three items). Patients answered each item according to a five-response scale. The reproducibility and validity of the questionnaire was estimated from the responses of 244 patients who visited the clinics in 15 institutes within a 2-week interval. RESULTS: Items with the most frequent complaints were dyspnea (87%), difficulty in sputum discharge or throat clearing (87%), limitation in strenuous activity (84%) and coughing (82.4%). The QLQAKA reflected the changes of patients' status very well. The value of minimal important differences, such as the clinically significant minimal change in the QOL score, was 0.5. The questionnaire was also highly reproducible with the value of intraclass correlation coefficiency and intraclass standard deviation as 0.940 (p<0.001) and 0.180, respectively. The changes of mean total QLQAKA score correlated weakly with the changes of FEV1 and PEFR values. CONCLUSION: The adult version of QLQAKA was valid and may be a reproducible tool for evaluating and monitoring Korean adult asthma patients.
Academies and Institutes ; Adult* ; Asthma ; Chronic Disease ; Cough ; Dyspnea ; Humans ; Life Style ; Peak Expiratory Flow Rate ; Pharynx ; Quality of Life* ; Reproducibility of Results ; Sputum ; Surveys and Questionnaires

BACKGROUND: Helicobacter pylori infection occurs throughout the world and causes various gastroduodenal diseases in all age groups. The prevalence of H. pylori infection varies among countries and races. The aim of this study was to evaluate the seroprevalence of H. pylori infection in healthy people in Korea. METHODS: From March 1998 to October 1998, 5,732 asymptomatic subjects responded to the self-assessment questionnaires from 54 hospitals were enrolled. Serum level of anti-H. pylori IgG was measured by ELISA test. RESULTS: The overall prevalence of H. pylori infection was 46.6% and showed no significant difference between male (47.2%) and female (45.9%). According to the geographic areas, the highly prevalent provinces were Kangwon (53.4%), Cheju (52.9%) and Jeonra provinces (50.6%), while Seoul (41.9%) was the lowest prevalent area. The seroprevalence increased with age and was the highest at 40's (78.5%). The characteristic feature of this study was that the infection rate increased steeply in three age groups (10-12, 16-19 years old and 30's). In Seoul, there was no different prevalence rate among the districts studied. CONCLUSION: The nation-wide seroprevalence of H. pylori infection in Korea is higher than that of the developed countries. We hope that this study provides the landmark for the study of H. pylori infection in Korea.
Continental Population Groups ; Developed Countries ; Enzyme-Linked Immunosorbent Assay ; Female ; Gangwon-do ; Helicobacter pylori* ; Helicobacter* ; Hope ; Humans ; Immunoglobulin G ; Jeju-do ; Korea* ; Male ; Prevalence ; Self-Assessment ; Seoul ; Seroepidemiologic Studies* ; Surveys and Questionnaires