PURPOSE: Graves' disease can be treated with antithyroid medication, radioiodine, or a thyroidectomy. Antithyroid medication is less likely to achieve a permanent remission than radioiodine or thyroidectomy. Radioiodine is preferred in the United States and antithyroid medication is used more often in Europe. However a thyroidectomy is less preferred as a primary therapy and is used only in the cases of recurrence or no response to medication. METHODS: We studied 152 patients with Graves' disease who had been treated at Samsung Medical Center. Fifty seven patients of them were surgically managed after antithyroid medication, and the rest of them were managed medically. Patient's age, sex, symptoms, thyroid fuction, autoantibody, treatment method and recurrence were retrospectively analyzed. RESULTS: Women had Graves' disease more frequently than men a thyroidectomy was performed more often in women and relatively young patients. The symptoms of Graves' disease were neck mass, palpitation, eye symptoms, weight loss and etc. The response to treatment was much higher in the thyroidectomy group than in the medically treated group. And more patients in surgically treatmented group had their thyroid function normalized. A subtotal thyroidectomy was performed in all patient and a mean of 7.4 g of thyroid tissue was remained. Hypothyroidism was noted in 7 patients (12.3%), permanent hypocalcemia in 1 (1.8%), vocal cord paralysis in 1 (1.8%) and transient hoarseness, transient hypocalcemia in the others. Recurrences were noted in 4 patients. There was no correlation between recurrence and remnant thyroid mass. However, preoperative TBII (thyrotropine binding inhibiting immunoglobulin) values were higher in recurrence group and immediate and late postoperative values were also higher than in the recovered group. CONCLUSION: A thyroidectomy is the treatment of choice in Graves' disease. However, further investigation will be needed to predict thyroid the function after a thyroidectomy for Graves' disease
Europe ; Female ; Graves Disease* ; Hoarseness ; Humans ; Hypocalcemia ; Hypothyroidism ; Male ; Neck ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroidectomy ; United States ; Vocal Cord Paralysis ; Weight Loss

PURPOSE: Graves' disease can be treated with antithyroid medication, radioiodine, or a thyroidectomy. Antithyroid medication is less likely to achieve a permanent remission than radioiodine or thyroidectomy. Radioiodine is preferred in the United States and antithyroid medication is used more often in Europe. However a thyroidectomy is less preferred as a primary therapy and is used only in the cases of recurrence or no response to medication. METHODS: We studied 152 patients with Graves' disease who had been treated at Samsung Medical Center. Fifty seven patients of them were surgically managed after antithyroid medication, and the rest of them were managed medically. Patient's age, sex, symptoms, thyroid fuction, autoantibody, treatment method and recurrence were retrospectively analyzed. RESULTS: Women had Graves' disease more frequently than men a thyroidectomy was performed more often in women and relatively young patients. The symptoms of Graves' disease were neck mass, palpitation, eye symptoms, weight loss and etc. The response to treatment was much higher in the thyroidectomy group than in the medically treated group. And more patients in surgically treatmented group had their thyroid function normalized. A subtotal thyroidectomy was performed in all patient and a mean of 7.4 g of thyroid tissue was remained. Hypothyroidism was noted in 7 patients (12.3%), permanent hypocalcemia in 1 (1.8%), vocal cord paralysis in 1 (1.8%) and transient hoarseness, transient hypocalcemia in the others. Recurrences were noted in 4 patients. There was no correlation between recurrence and remnant thyroid mass. However, preoperative TBII (thyrotropine binding inhibiting immunoglobulin) values were higher in recurrence group and immediate and late postoperative values were also higher than in the recovered group. CONCLUSION: A thyroidectomy is the treatment of choice in Graves' disease. However, further investigation will be needed to predict thyroid the function after a thyroidectomy for Graves' disease
Europe ; Female ; Graves Disease* ; Hoarseness ; Humans ; Hypocalcemia ; Hypothyroidism ; Male ; Neck ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroidectomy ; United States ; Vocal Cord Paralysis ; Weight Loss

OBJECTIVES: The aim of the present study is to evaluate the long term effects of estrogen-progestogen therapy (EPT) on uterine myomas volume in postmenopausal women. METHODS: We performed a retrospective analysis on postmenopausal women with asymptomatic uterine myoma during the period between April, 2008 and September, 2012. Postmenopause was defined as amenorrhea for longer than a year or serum follicle stimulating hormone levels higher than 40 IU/L. The volume of the myoma was assessed by transvaginal ultrasonography for every 6 months after administration of EPT. RESULTS: Thirty-eight women were included in the study, with 32 in the EPT group and 6 in the control group. Overall, uterine myoma volume (mean +/- standard deviation, cm3) in the EPT group was 19.5 +/- 24.6 at baseline, and those at 6 and 12 months were 24.7 +/- 35.1 and 28.5 +/- 56.4, respectively. Myoma volume did not change significantly with EPT, and these changes were not significantly different from the control group. Myoma volume changes were not significantly different in the subgroups according to the route of estrogen administrations and the method of progestogen administrations. Clinically significant volume increases during one year of EPT was noted in 28.1% (9/32), however, only one showed transient increases. CONCLUSION: Our results suggest that treating postmenopausal woman with EPT on a long-term basis does not increase the volume of uterine myomas.
Amenorrhea ; Estrogens ; Female ; Follicle Stimulating Hormone ; Humans ; Leiomyoma* ; Methods ; Myoma ; Postmenopause ; Progesterone ; Retrospective Studies ; Ultrasonography ; Uterus

To provide a nationwide representative dataset for the study on health impact of air pollution, we combined the data from the Korea National Health and Nutrition Examination Survey with the daily air quality and weather data by matching the date of examination and the residential address of the participants. The database of meteorological factors and air quality as sources of exposure data were estimated using the Community Multiscale Air Quality model. The linkage dataset was merged by three ways; administrative district, si-gun-gu (city, county, and district), and geocode (in latitude and longitude coordinate units) based on the participants’ residential address, respectively. During the study period, the exposure dataset of 85,018 individuals (38,306 men and 46,712 women) whose examination dates were recorded were obtained. According to the definition of exposure period, the dataset was combined with the data on short-term, mid-term, and long-term exposure to air pollutants and the meteorological indices. Calculation of the daily merged dataset’s average air pollution linked by si-gun-gu and geocode units showed similar results. This study generated a daily average of meteorological indices and air pollution exposure dataset for all regions including rural and remote areas in Korea for 11 years. It is expected to provide a platform for the researchers studying the health impact of air pollution and climate change on the representative population and area, which may facilitate the establishment of local health care plans by understanding the residents’ health status at the local as well as national level.

To provide a nationwide representative dataset for the study on health impact of air pollution, we combined the data from the Korea National Health and Nutrition Examination Survey with the daily air quality and weather data by matching the date of examination and the residential address of the participants. The database of meteorological factors and air quality as sources of exposure data were estimated using the Community Multiscale Air Quality model. The linkage dataset was merged by three ways; administrative district, si-gun-gu (city, county, and district), and geocode (in latitude and longitude coordinate units) based on the participants’ residential address, respectively. During the study period, the exposure dataset of 85,018 individuals (38,306 men and 46,712 women) whose examination dates were recorded were obtained. According to the definition of exposure period, the dataset was combined with the data on short-term, mid-term, and long-term exposure to air pollutants and the meteorological indices. Calculation of the daily merged dataset’s average air pollution linked by si-gun-gu and geocode units showed similar results. This study generated a daily average of meteorological indices and air pollution exposure dataset for all regions including rural and remote areas in Korea for 11 years. It is expected to provide a platform for the researchers studying the health impact of air pollution and climate change on the representative population and area, which may facilitate the establishment of local health care plans by understanding the residents’ health status at the local as well as national level.

PURPOSE: This phase I trial evaluated the question of whether the standard starting dose of axitinib could be administered in combination with therapeutic doses of cisplatin/capecitabine in patients with previously untreated advanced gastric cancer, and assessed overall safety, pharmacokinetics, and preliminary antitumor activity of this combination. MATERIALS AND METHODS: Patients in dose level (DL) 1 received axitinib 5 mg twice a day (days 1 to 21) with cisplatin 80 mg/m2 (day 1) and capecitabine 1,000 mg/m2 twice a day (days 1 to 14) in 21-day cycles. Maximum tolerated dose (MTD) was the highest dose at which < or = 30% of the first 12 patients experienced a dose-limiting toxicity (DLT) during cycle 1. Ten additional patients were enrolled and treated at the MTD in order to obtain additional safety and pharmacokinetic data. RESULTS: Three DLTs occurred during cycle 1 in three (25%) of the first 12 patients: ruptured abdominal aortic aneurysm, acute renal failure, and > 5 consecutive days of missed axitinib due to thrombocytopenia. DL1 was established as the MTD, since higher DL cohorts were not planned. Common grade 3/4 non-hematologic adverse events in 22 patients treated at DL1 included hypertension (36.4%) and decreased appetite and stomatitis (18.2% each). Cisplatin/capecitabine slightly increased axitinib exposure; axitinib decreased capecitabine and 5-fluorouracil exposure. Eight patients (36.4%) each had partial response or stable disease. Median response duration was 9.1 months; median progression-free survival was 3.8 months. CONCLUSION: In patients with advanced gastric cancer, standard doses of axitinib plus therapeutic doses of cisplatin and capecitabine could be administered in combination. Adverse events were manageable.
Acute Kidney Injury ; Aortic Aneurysm, Abdominal ; Appetite ; Cisplatin* ; Cohort Studies ; Disease-Free Survival ; Fluorouracil ; Humans ; Hypertension ; Maximum Tolerated Dose ; Pharmacokinetics ; Stomach Neoplasms* ; Stomatitis ; Thrombocytopenia

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.