The prevalence of thyroid cancer in pregnant women is unknown; however, given that thyroid cancer commonly develops in women, especially young women of childbearing age, new cases are often diagnosed during pregnancy. This recommendation summarizes the follow-up and treatment when thyroid cancer is diagnosed during pregnancy and when a woman with thyroid cancer becomes pregnant. If diagnosed in the first trimester, surgery should be postponed until after delivery, and the patient should be monitored with ultrasound. If follow-up before 24–26 weeks of gestation shows that thyroid cancer has progressed, surgery should be considered. If it has not progressed at 24–26 weeks of gestation or if papillary thyroid cancer is diagnosed after 20 weeks of pregnancy, surgery should be considered after delivery.

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.

Background: The number of revision total knee arthroplasty (TKA) has been increasing. Although many studies have analyzed the causes of revision TKA in Western countries, a limited number of studies have analyzed changes in causes of or trends in revision TKA in Asia. This study analyzed and determined the frequency and causes of failures after TKA in our hospital. We also analyzed the differences and trends over the past 17 years. Methods: A total of 296 revision TKAs performed in a single institution from 2003 to 2019 were analyzed. During the 17-year study period, patients who had undergone primary TKA between 2003 and 2011 were classified into a past group, while those who had undergone primary TKA from 2012 to 2019 were classified into a recent group. A revision performed within 2 years after primary TKA was defined as early revision. Further, differences in causes of revision TKA according to the interval from primary TKA to revision TKA were determined. The causes of revision TKA were analyzed through a comprehensive analysis of patients’ medical records. Results: Overall, infection was the most common cause of failure (151/296 cases, 51.0%). Compared to the past group, the recent group had a relatively higher proportion of patients undergoing revision TKA for mechanical loosening (past group, 19.1% vs.recent group, 31.9%) and instability (11.2% vs. 13.5%) and a relatively lower proportion of patients undergoing revision TKA for infection (56.2% vs. 48.8%), polyethylene (PE) wear (9.0% vs. 2.9%), osteolysis (2.2% vs. 1.9%), and malalignment (2.2% vs. 1.0%).On comparison according to the interval from primary TKA to revision TKA, the rate of infection relatively decreased, whereas the rate of mechanical loosening and instability relatively increased in the late revision TKA compared to the early revision TKA. Conclusions Infection and aseptic loosening were the most common reasons of revision TKA in both past and recent groups.Compared to the past, revision TKA due to PE wear has decreased significantly and revision TKA due to mechanical loosening has relatively increased recently. Orthopedic surgeons need to be aware of recent trends in mechanisms of failure and should try to recognize and address the probable causes in TKA

Background: Prohibitin (PHB) regulates intracellular signal pathways, transcription, and cell cycles. Aberrant expression of the PHB gene is known to be related totumorigenesis, tumor progression, and chronic metabolic and inflammatory diseases. The present study aimed to develop a one-step quantitative reverse transcription PCR (RT-qPCR) kit for quantifying PHB mRNA levels and evaluate its performance in the laboratory. Methods: TaqMan chemistry was used to develop the one-step PHB1 and PHB2 RT-qPCR kit. Normal peripheral blood cells from healthy individuals (N=20) and leukemia cells from patients initially diagnosed with acute myeloid leukemia (AML, N=20), chronic myeloid leukemia (CML, N=13), and acute lymphoid leukemia (ALL, N=7) were enrolled to evaluate the laboratory performance of the kit using commercially available total human RNA controls. Results: The intra-assay and inter-assay precision of the kit developed in this study was less than 2%. The distribution of PHB1 mRNA expression of AML, CML, and ALL was 0.898-0.993 (median: 0.936), 0.817-0.976 (0.918), and 0.844-1.074 (0.973), respectively. The distribution of PHB2 mRNA expression of AML, CML, and ALL was 0.957-1.024 (median: 0.985), 0.988-1.047 (1.002), and 0.937-1.059 (1.004), respectively. The sensitivity, specificity, positive and negative predictive value, and test effectiveness of the developed PHB1 and PHB2 kit were greater than 50% for each parameter. Conclusions Our developed kit would be useful for diagnosing leukemia as well as detecting residual disease. Additionally, this kit could be used for monitoring and conducting molecular pathophysiological studies of obesity, metabolic, and inflammatory diseases.

The aim of this study was to investigate the influence of light-curing on the translucency change and color-stability of amine(tertiary)-free dual-cured resin cements after accelerated aging. Two curing modes (dual-curing and self-curing) were applied on three dual-cured resin cements (Duo-Link Universal [DLU], Nexus Third Generation [NX3] and RelyX Ultimate [RXU]) in this study. Ten specimens were fabricated for each group. In dual-cured groups only, light-activation was performed with polywave-LED curing unit (Bluphase, Ivoclar Vivadent, Schaan, Liechtenstein), where each sides of the samples were photo-polymerized for 60 seconds. Self-cured groups were kept in the dark storage for 24 hours. The color of the specimens was measured with spectrocolorimeter (NF999, Nippon Denshoku, Japan) after 24 hours of making samples. After the initial color measurements, the specimens were subjected to accelerated aging procedure. Spectrophotometric analysis was carried out on day 7, day 14, day 21 and day 28 of accelerated aging in 60 ℃ of distilled water. The color characteristics, color difference (ΔE*), and translucency parameter (TP) of specimens were calculated according to the CIE L*a*b* color system before and after aging. All the ΔE* values and TP values were analyzed by 2-way analysis of variance. After aging, all groups revealed clinically perceptible color differences (ΔE*>3.3). Differences in ΔE* values of self-cured groups were significantly higher than those of dual-cured groups in NX3 and RXU. But there were no significant differences in ΔE* between dual-cured mode and self-cured mode of DLU. All mean b* values increased after aging. All mean L* values decreased after aging except for self-cured RXU cement. TP values also decreased with aging. TP values of self-cured groups were significantly lower than those of dual-cured groups in NX3 and RXU. Hence, in conclusion, despite the absence of tertiary amine in the dual-cured resin cements, such resin cements should be polymerized with the dual-cure modes to ensure long-term color-stability.
Aging ; Polymers ; Resin Cements ; Water

No abstract available.
Hematopoietic Stem Cells ; Receptors, Aryl Hydrocarbon

BACKGROUND: Mitochondrial DNA (mtDNA) mutations may regulate the progression and chemosensitivity of leukemia. Few studies regarding mitochondrial aberrations and haplogroups in acute myeloid leukemia (AML) and their clinical impacts have been reported. Therefore, we focused on the mtDNA length heteroplasmies minisatellite instability (MSI), copy number alterations, and distribution of mitochondrial haplogroups in Korean patients with AML. METHODS: This study investigated 74 adult patients with AML and 70 controls to evaluate mtDNA sequence alterations, MSI, mtDNA copy number, haplogroups, and their clinical implications. The hypervariable (HV) control regions (HV1 and HV2), tRNA(leu1)gene, and cytochrome b gene of mtDNA were analyzed. Two mtDNA minisatellite markers, 16189 poly-C (¹⁶¹⁸⁴CCCCCTCCCC¹⁶¹⁹³, 5CT4C) and 303 poly-C (³⁰³CCCCCCCTCCCCC³¹⁵, 7CT5C), were used to examine the mtDNA MSI. RESULTS: In AML, most mtDNA sequence variants were single nucleotide substitutions, but there were no significant differences compared to those in controls. The number of mtMSI patterns increased in AML. The mean mtDNA copy number of AML patients increased approximately 9-fold compared to that of controls (P < 0.0001). Haplogroup D4 was found in AML with a higher frequency compared to that in controls (31.0% vs. 15.7%, P=0.046). None of the aforementioned factors showed significant impacts on the outcomes. CONCLUSION: AML cells disclosed more heterogeneous patterns with the mtMSI markers and had increased mtDNA copy numbers. These findings implicate mitochondrial genome instability in primary AML cells. Therefore, mtDNA haplogroup D4 might be associated with AML risk among Koreans.
Adult ; Cytochromes b ; DNA, Mitochondrial ; Genome, Mitochondrial* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Minisatellite Repeats

OBJECTIVE: To evaluate the reliability of the practical life space in post-stroke patients using the Korean version of the Life-Space Assessment (K-LSA) questionnaire and to assess the relationships between the K-LSA and physical function, daily activity, quality of life, and post-stroke depression. METHODS: The LSA questionnaire was translated into Korean, and the translated version was authorized by the author of the LSA questionnaire. In a cross-sectional study, the performance of the K-LSA was evaluated in 34 stroke patients (20 males and 14 females; mean age 65.11±2.39 years) who were receiving physical and occupational therapy at the outpatient clinic in the rehabilitation medicine department of a university medical center at the time of evaluation. Performances were assessed twice by one examiner at a 2-week interval to test the reliability. The patients were evaluated using the Functional Ambulation Category (FAC) scale, Functional Independence Measure (FIM) scale, and mobility subscale of the FIM to assess their relationships with the K-LSA. They were also evaluated using the EuroQol 5 Dimensions questionnaire (EQ-5D) and Geriatric Depression Scale (GDS) to determine the relationship with quality of life and post-stroke depression. RESULTS: Test-retest reliability at the first (62.20±32.14) and second (63.15±32.22) assessment was 0.993 (p<0.01). The K-LSA showed significant correlations with the FAC (r=0.848, p<0.01), FIM (r=0.765, p<0.01), mobility category of the FIM (r=0.764, p<0.01), GDS (r=-0.657, p<0.01), and EQ-5D (r=0.506, p<0.01). CONCLUSION: This study suggests that the practical life space of post-stroke patients, assessed by the K-LSA, has a significant correlation with patients' functional mobility, independence in daily activity, quality of life, and depression.
Academic Medical Centers ; Ambulatory Care Facilities ; Cross-Sectional Studies ; Depression ; Female ; Humans ; Male ; Occupational Therapy ; Quality of Life ; Rehabilitation ; Reproducibility of Results ; Stroke* ; Walking

PURPOSE: The purpose of this study is to evaluate the clinical and radiologic results of plate fixation in the Vancouver B1 and C periprosthetic femoral fracture (PFF). MATERIALS AND METHODS: Twenty patients who had sustained a Vancouver type B1 and C periprosthetic fracture after hip arthroplasty (years 2002-2012) were identified. The mean age was 66.0 years (range, 43-85 years) and the mean follow-up duration of the group was 38 months (range, 12-102 months). The dynamic compression plate (DCP) group included 12 patients and the locking compression plate (LCP) group included eight patients. Harris hip score (HHS) and walking ability, knee joint range of motion (ROM) were compared before injury and last follow-up. Fracture union rate and period were compared. RESULTS: The mean HHS score was 90.7 (64-96). There was no statistical difference between the two groups. At the last follow-up, knee joint ROM was 103.3degrees (105degrees-140degrees) in the DCP group and 118.4degrees (110degrees-140degrees) in the LCP group, showing good results in the LCP group (p=0.043). No significant difference in the fracture union rate and union periods was observed between the two groups. CONCLUSION: A better result for the postoperative knee flexion exercise capacity was observed in the LCP group. Use of LCP plate fixation is a good option in management of Vancouver classification B1 and C PFF.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Femoral Fractures ; Follow-Up Studies ; Hip ; Humans ; Knee ; Knee Joint ; Periprosthetic Fractures* ; Range of Motion, Articular ; Walking

OBJECTIVE: To evaluate the reliability and validity of Korean version of AST (K-AST) as a bedside screening test of apraxia in patients with stroke for early and reliable detection. METHODS: AST was translated into Korean, and the translated version received authorization from the author of AST. The performances of K-AST in 26 patients (21 males, 5 females; mean age 65.42±17.31 years) with stroke (23 ischemic, 3 hemorrhagic) were videotaped. To test the reliability and validity of K-AST, the recorded performances were assessed by two physiatrists and two occupational therapists twice at a 1-week interval. The patient performances at admission in Korean version of Mini-Mental State Examination (K-MMSE), self-care and transfer categories of Functional Independence Measure (FIM), and motor praxis area of Loewenstein Occupational Therapy Cognitive Assessment, the second edition (LOTCA-II) were also evaluated. Scores of motor praxis area of LOTCA-II was used to assess the validity of K-AST. RESULTS: Inter-rater reliabilities were 0.983 (p<0.001) at the first assessment and 0.982 (p<0.001) at the second assessment. For intra-rater (test-retest) reliabilities, the values of four raters were 0.978 (p<0.001), 0.957 (p<0.001), 0.987 (p<0.001), and 0.977 (p<0.001). K-AST showed significant correlation (r=0.758, p<0.001) with motor praxis area of LOTCA-II test. K-AST also showed positive correlations with the total FIM score (r=0.694, p<0.001), the selfcare category of FIM (r=0.705, p<0.001) and the transfer category of FIM (r=653, p<0.001). CONCLUSION: K-AST is a reliable and valid test for bedside screening of apraxia.
Apraxias* ; Female ; Humans ; Male ; Mass Screening ; Occupational Therapy ; Reproducibility of Results* ; Self Care ; Stroke ; Upper Extremity