PURPOSE: The main issue with the current ultrasonography (US) guidelines is the overestimation of malignant and indeterminate nodules as they do not aid in making decisions to treat patients. To overcome this, new US guidelines for thyroid nodules that have been shown to be better correlated with cytologic results have been proposed. We also suggested specific indications for US-guided fine needle aspiration (FNA) using the new US guidelines. METHODS: Clinical and pathologic data from 925 patients and 1,419 thyroid nodules were retrospectively collected. All subjects underwent US- and US-guided FNA at Department of Surgery, Wonju Christian Hospital, between March 2010 and July 2011. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both the current guidelines and the new guidelines. RESULTS: The accuracy, sensitivity, specificity, PPV, and NPV for the current guidelines in predicting malignancy were 24.1%, 99.3%, 62.2%, 25.0%, and 99.8%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV for the new guidelines in predicting malignancy were 66.0%, 96.0%, 86.7%, 47.7%, and 99.4%, respectively. CONCLUSION: The use of the new US guidelines allow for a more accurate and specific diagnosis and a better treatment plan than the current guidelines. Additionally, the use of the new FNA guidelines may help prevent unnecessary FNAs and promote cost-effective follow-up for patients.
Biopsy, Fine-Needle ; Follow-Up Studies ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

Acute suppurative thyroiditis is uncommon in children. The relative rarity of thyroid infection is thought to reflect its complete fibrous encapsulation, generous vascular and lymphatic supply and high local iodine level. The bacterial involvement include the normal oropharyngeal microflora, and broad spectrum antibiotic therapy including anaerobic coverage should be utilized initially. We have experienced three cases of acute suppurative throiditis. All of them had painfull swelling on anterior cervical area and diagnosed by clinical and radiological features. Since two of them occured repeatedly, we report with brief review of literatures.
Child* ; Humans ; Iodine ; Thyroid Gland ; Thyroiditis, Suppurative*

Human Papillomaviruses(HPVs) are regarded as sexually transmitable and closely associated with precancerous lesions or invasive cancers of the vulva, vagina, and cer V1X. In situ hybridization, besides showing higher sensitivity, allowed the identification of specific viral types. We studied 12 cases of condylomata accuminata for HPV typing by in situ hybridization techenique. Ten cases(83.3 % ) showed positive for HPV type 6/11, and 2 cases(16.7% ) were positive for HPV type 16/18.
DNA Probes* ; DNA* ; Humans* ; In Situ Hybridization* ; Vagina ; Vulva

Pulmonary endometriosis is an uncommon disease, and usually detected by catamenial hemoptysis. Treatment of pulmonary endometriosis may be medical(hormone therapy) or surgical. Since hormone therapy may cause sterility, most of patients who wish to conceive usually choose surgical resection. Although video-assisted thoracic surgery(VATS) has advantage of small scar, reducing postoperative pain and shortening hospital stay, it is not easy to locate the precise lesion and resect whole endometrial tissue not to be remained. 17 years old female with catamenial hemoptysis was treated sucessfully with a partial resection of the lung using VATS, and has been asymptomatic for 7months since the operation.
Adolescent ; Cicatrix ; Endometriosis* ; Female ; Hemoptysis ; Humans ; Infertility ; Length of Stay ; Lung ; Pain, Postoperative ; Thoracic Surgery, Video-Assisted*

Leber's hereditary optic neuropathy is caused by a single nucleotide change in the mitochondrial deoxynucleic acid(mtDNA) and accounts for 30% of bilateral optic atrophy of unknown etiology. The authors found 11778 mtDNA mutation in 12 patients and evaluated the clinical manifegtations. We confirmed various phenotypes exist in Leber's hereditary optic neuropathy in Korea.
DNA, Mitochondrial* ; Humans ; Korea ; Optic Atrophy ; Optic Atrophy, Hereditary, Leber* ; Phenotype

Subcutaneous fat necrosis of newborn (SCFNN) is a rare disease. Characteristically, full-term infants with associated perinatal problems such as hypoxia, hypothermia, and obstetric trauma are affected in the first week of life. We report a case of SCFNN, which presented as an erythematous subcutaneous mass on the back of a male neonate who suffered from meconium aspiration pneumonia with neonatal sepsis.
Anoxia ; Humans ; Hypothermia ; Infant ; Infant, Newborn* ; Male ; Meconium Aspiration Syndrome* ; Meconium* ; Necrosis* ; Pneumonia ; Rare Diseases ; Sepsis ; Subcutaneous Fat*

Bronchopleural fistula (BPF) is relatively rare, but it has high morbidity and mortality rates and it is associated with a prolonged hospital stay and high costs. Surgical treatment is the treatment of choice, but other minimal invasive forms of conservative management, and particularly bronchoscopy, have recently been investigated. We report here on the bronchoscopic treatment of a bronchopleural fistula accompanied necrotizing pneumonia, and we used coils and fibrin glue to treat the fistula.
Bronchi ; Bronchoscopy ; Fibrin Tissue Adhesive* ; Fibrin* ; Fistula* ; Length of Stay ; Mortality ; Pleural Diseases ; Pneumonia

Objective: Dizziness is a common symptom in the emergency department. Identifying central causes, such as acute ischemic stroke (AIS), is essential in patients with dizziness. This study examined the usefulness of computed tomographic angiography (CTA) for the safe disposition of patients with dizziness when brain magnetic resonance imaging (MRI) is difficult to perform. Methods: This study was a retrospective observational study. Patients who underwent CTA and MRI to determine the cause of dizziness were included in this study between January 2019 and December 2019. Clinical and radiological characteristics, including the CTA findings, were compared in groups with and without AIS in MRI. Univariate and multivariate logistic regression analyses were performed. The area under the receiver operating characteristic curve (AUROC) was assessed. Results: Three hundred and fifty patients were included in the study. Of these patients, 63 patients had AIS in MRI. The group with AIS was more frequently male (65.1% vs. 44.3%, P=0.003), had dysarthria (9.5% vs. 2.4%, P=0.016), and relevant vertebral or basilar artery stenosis or occlusion on CTA (66.7% vs. 3.5%, P<0.001). In logistic regression, relevant vertebral or basilar artery stenosis or occlusion was significantly associated with AIS in MRI (odds ratio, 47.941; 95% confidence interval, 20.857-110.195; P<0.001). In the receiver operating characteristic curve, the relevant vertebral or basilar artery stenosis or occlusion on CTA was a feasible predictive value for diagnosing AIS (AUROC, 0.816). Conclusion This study showed that the CTA findings were feasible for predicting the safety disposition of patients with dizziness when MRI is difficult to perform.

Purpose: Laparoscopic sleeve gastrectomy (SG) is now frequently performed as a definitive bariatric procedure. The aim of the study was to evaluate the detailed morphology of remnant stomachs after SG with respect to volume and sleeve migration. Materials and Methods: We performed a retrospective review of prospectively collected data on patients that completed a 12-month postop examination, which included CT volumetry of sleeve, and a questionnaire that addressed postop food tolerance. CT volumetry study included total sleeve volume (TSV), tube volume (TV), antral volume (AV), tube/antral volume ratio (TAVR), and the presence of intrathoracic sleeve migration (ITSM). Results: Fifty-five patients were included in this retrospective study. Mean %TWL (% total weight loss) at 12 months postop was 32.8% (14.3-55.5), and mean TSV, TV, AV, and TAVR were 166.6±63.3 ml, 68.9±35.4 ml, 97.7±42.9 ml, and 0.8±0.6 respectively. TSV was not correlated significantly with %TWL at 12 months postop (r=−0.069, P=0.619). Fourteen patients (14/55, 25.5%) showed ITSM by CT. Patients with ITSM had a significantly lower mean GER score (5.1±2.0 vs. 7.3±2.0, P=0.001), a lower total food tolerance score (21.6±3.8 vs. 24.4±4.6, P=0.048), and a higher proportion showed suboptimal weight loss (35.7% vs. 9.8%, P=0.023). Conclusion Mean TSV was not found to be significantly correlated with %TWL at 12 months postop.Patients with suboptimal weight loss had higher mean TAVR, and the presence of ITSM indicated more frequent GER symptoms, lower food tolerance, and a higher probability of suboptimal weight loss.

PURPOSE: External beam radiotherapy (EBRT) plays a controversial role in the management of differentiated thyroid cancer. We reviewed the outcomes of patients at our institution who had been treated with EBRT for advanced differentiated thyroid cancer. METHODS: Subjects included 35 patients who received thyroidectomy and EBRT at Yonsei University Wonju College of Medicine, Wonju Christian Hospital under the diagnosis of papillary thyroid cancer from January 1989 to September 2011. RESULTS: The 5 year overall locoregional control rate was 74.4%. No significant differences were found in locoregional progression- free survival for patients with complete resection, microscopic residual disease, or gross residual disease. CONCLUSION: The results of our study have shown that EBRT is effective for locoregional control of selected locally advanced papillary thyroid cancer, even with gross residual disease.
Diagnosis ; Gangwon-do ; Humans ; Radiotherapy* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy