Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy typically associated with dismal outcomes. Most patients present with advanced disease, often precluding curative resection. We report a case of intrathyroidal ATC incidentally identified in a 72-year-old male who underwent diagnostic lobectomy for a low-suspicion, predominantly cystic huge thyroid nodule. Final pathology revealed a completely resected, intrathyroidal ATC without extrathyroidal extension. Postoperative imaging showed no evidence of residual or metastatic disease. Based on multidisciplinary discussion, the patient underwent completion thyroidectomy and central neck dissection without adjuvant therapy. No residual malignancy was identified, and the patient remains recurrence-free at six months. This case highlights that early-stage intrathyroidal ATC may present without overt malignant features and can be curatively treated with complete surgical excision. Careful evaluation and multidisciplinary decision-making are essential in managing rapidly enlarging thyroid nodules with atypical features.

Suicidal cases involving sodium nitrite have been reported worldwide. However, postmortem features, such as brownish or grayish livor mortis, remain difficult to interpret, especially as decomposition advances. Here, we present three fatal cases (2020-2023) presumably caused by sodium nitrite ingestion. In these cases, characteristic nitrite-induced changes were inconsistent or obscured by decomposition, but ingestion traces (cup or bottle near the decedents) were observed at each scene. Additionally, containers labeled “sodium nitrite” were found in two cases; however, since sodium nitrite is designated a suicide-hazardous material in South Korea, future scenes may rarely reveal such clear labeling. Although autopsy, including methemoglobin testing, can confirm the cause of death, any delay in the investigative process risks the loss of critical evidence about the ingestion process and other factors. This underscores the importance of focusing on early scene evidence, particularly ingestion traces, and conducting thorough chemical and forensic examinations. Our findings illustrate that timely detection of ingestion-related evidence and subsequent forensic analysis, in conjunction with autopsy results, can elucidate a decedent’s cause and manner of death and clarify any criminal implications.

Background and Objectives: The aim of this study was to confirm the effect of intralesional triamcinolone acetonide injections (TRIAM) to treat granulomatous tissue surrounding the tracheostomy stoma.Subjects and Method We reviewed and documented the medical charts of 20 patients who were administered with TRIAM to treat granulomatous tissue surrounding the tracheostomy stoma from January 2018 to June 2019 were. The surface area of the granulomatous tissue was measured using Image J. The differences between the area of the granulomatous tissue after conventional treatment and after TRIAM on the same patient were compared. Results: A total of 20 patients consisting of 12 males and 8 females were included, with the patients’ average age being 60.0±14.3 years. The initial surface area of granulation tissue was 1.266±0.449 cm2, and 1.243±0.432 cm2 after conventional treatment, showing no statistically significant difference in the tissue area (p=0.143). The pre-injection surface area of granulation tissue was 1.243±0.432 cm2, and the area on the 7th day after the third injection was 0.477±0.217 cm2, showing a significant difference (p<0.001). Conclusion Compared to the conventional treatment, the surface area of granulomatous tissue surrounding the tracheostomy stoma significantly decreased after being treating with TRIAM. This finding suggests the effectiveness of TRIAM as a treatment of granulomatous tissue surrounding the tracheostomy stoma without complications such as bleeding.

Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules, recurrent thyroid cancers (RTCs), and primary thyroid microcarcinomas. The Korean Society of Thyroid Radiology (KSThR) initially developed recommendations for the optimal use of RFA for thyroid tumors in 2009 and revised them in 2012 and 2017. As new meaningful evidence has accumulated since 2017 and in response to a growing global interest in the use of RFA for treating malignant thyroid lesions, the task force committee members of the KSThR decided to update the guidelines on the use of RFA for the management of RTCs based on a comprehensive analysis of current literature and expert consensus.

Objective: The Daegu region experienced the first wave of the pandemic at the beginning of the coronavirus disease 2019 (COVID-19) outbreak in Korea. Other non-COVID-19-related treatments during a community outbreak, such as cardiovascular diseases, were expected to impact emergency departments. In acute myocardial infarctions, time is an important factor affecting the patient outcome. This study examined how community COVID-19 outbreak affected STsegment elevated myocardial infarction (STEMI) care in emergency departments. Methods: A retrospective analysis was performed on patients visiting five emergency departments in the Daegu area who were diagnosed with STEMI from February 18 to April 17 each year from 2018 to 2020. The demographic characteristics, prehospital variables, in-hospital time variables, and treatment results were collected. The cases were divided into the pre-COVID period and the COVID period for comparison. Results: The study included 254 patients (194 pre-COVID, 60 during COVID). The symptom-to-door time did not differ. Although the door-to-first doctor time was shortened (4 min vs. 2 min, P=0.01), the rate of coronary angiogram along with the door-to-angiogram time and the door-to-balloon time did not change. The length of stay in the emergency department was delayed during COVID-19 (median, 136 min vs. 404 min; P<0.01). The in-hospital length of stay and mortality were similar in both groups. Conclusion The time to treat STEMI was not delayed significantly during the first wave of the COVID-19 outbreak in the Daegu area compared with the pre-pandemic period. Mortality did not change. The length of stay was elongated significantly in the emergency department but not in the hospital.

Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy typically associated with dismal outcomes. Most patients present with advanced disease, often precluding curative resection. We report a case of intrathyroidal ATC incidentally identified in a 72-year-old male who underwent diagnostic lobectomy for a low-suspicion, predominantly cystic huge thyroid nodule. Final pathology revealed a completely resected, intrathyroidal ATC without extrathyroidal extension. Postoperative imaging showed no evidence of residual or metastatic disease. Based on multidisciplinary discussion, the patient underwent completion thyroidectomy and central neck dissection without adjuvant therapy. No residual malignancy was identified, and the patient remains recurrence-free at six months. This case highlights that early-stage intrathyroidal ATC may present without overt malignant features and can be curatively treated with complete surgical excision. Careful evaluation and multidisciplinary decision-making are essential in managing rapidly enlarging thyroid nodules with atypical features.

Anaplastic thyroid carcinoma (ATC) is a rare and highly aggressive malignancy typically associated with dismal outcomes. Most patients present with advanced disease, often precluding curative resection. We report a case of intrathyroidal ATC incidentally identified in a 72-year-old male who underwent diagnostic lobectomy for a low-suspicion, predominantly cystic huge thyroid nodule. Final pathology revealed a completely resected, intrathyroidal ATC without extrathyroidal extension. Postoperative imaging showed no evidence of residual or metastatic disease. Based on multidisciplinary discussion, the patient underwent completion thyroidectomy and central neck dissection without adjuvant therapy. No residual malignancy was identified, and the patient remains recurrence-free at six months. This case highlights that early-stage intrathyroidal ATC may present without overt malignant features and can be curatively treated with complete surgical excision. Careful evaluation and multidisciplinary decision-making are essential in managing rapidly enlarging thyroid nodules with atypical features.

Suicidal cases involving sodium nitrite have been reported worldwide. However, postmortem features, such as brownish or grayish livor mortis, remain difficult to interpret, especially as decomposition advances. Here, we present three fatal cases (2020-2023) presumably caused by sodium nitrite ingestion. In these cases, characteristic nitrite-induced changes were inconsistent or obscured by decomposition, but ingestion traces (cup or bottle near the decedents) were observed at each scene. Additionally, containers labeled “sodium nitrite” were found in two cases; however, since sodium nitrite is designated a suicide-hazardous material in South Korea, future scenes may rarely reveal such clear labeling. Although autopsy, including methemoglobin testing, can confirm the cause of death, any delay in the investigative process risks the loss of critical evidence about the ingestion process and other factors. This underscores the importance of focusing on early scene evidence, particularly ingestion traces, and conducting thorough chemical and forensic examinations. Our findings illustrate that timely detection of ingestion-related evidence and subsequent forensic analysis, in conjunction with autopsy results, can elucidate a decedent’s cause and manner of death and clarify any criminal implications.

Background and Objectives: The aim of this study was to confirm the effect of intralesional triamcinolone acetonide injections (TRIAM) to treat granulomatous tissue surrounding the tracheostomy stoma.Subjects and Method We reviewed and documented the medical charts of 20 patients who were administered with TRIAM to treat granulomatous tissue surrounding the tracheostomy stoma from January 2018 to June 2019 were. The surface area of the granulomatous tissue was measured using Image J. The differences between the area of the granulomatous tissue after conventional treatment and after TRIAM on the same patient were compared. Results: A total of 20 patients consisting of 12 males and 8 females were included, with the patients’ average age being 60.0±14.3 years. The initial surface area of granulation tissue was 1.266±0.449 cm2, and 1.243±0.432 cm2 after conventional treatment, showing no statistically significant difference in the tissue area (p=0.143). The pre-injection surface area of granulation tissue was 1.243±0.432 cm2, and the area on the 7th day after the third injection was 0.477±0.217 cm2, showing a significant difference (p<0.001). Conclusion Compared to the conventional treatment, the surface area of granulomatous tissue surrounding the tracheostomy stoma significantly decreased after being treating with TRIAM. This finding suggests the effectiveness of TRIAM as a treatment of granulomatous tissue surrounding the tracheostomy stoma without complications such as bleeding.