1.Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients
Jae Won CHO ; Cheong-Sil RAH ; Won Woong KIM ; Yu-mi LEE ; Seong Chul KIM ; Jung Hwan BAEK ; Dong Eun SONG ; Won Gu KIM ; Ki-Wook CHUNG ; Suck Joon HONG ; Tae-Yon SUNG
Yonsei Medical Journal 2025;66(1):43-50
Purpose:
Pediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence.This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.
Materials and Methods:
This retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.
Results:
We analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other’s presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.
Conclusion
Multifocality and bilaterality were not independent risk factors of each other’s presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.
2.Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients
Jae Won CHO ; Cheong-Sil RAH ; Won Woong KIM ; Yu-mi LEE ; Seong Chul KIM ; Jung Hwan BAEK ; Dong Eun SONG ; Won Gu KIM ; Ki-Wook CHUNG ; Suck Joon HONG ; Tae-Yon SUNG
Yonsei Medical Journal 2025;66(1):43-50
Purpose:
Pediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence.This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.
Materials and Methods:
This retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.
Results:
We analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other’s presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.
Conclusion
Multifocality and bilaterality were not independent risk factors of each other’s presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.
3.Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients
Jae Won CHO ; Cheong-Sil RAH ; Won Woong KIM ; Yu-mi LEE ; Seong Chul KIM ; Jung Hwan BAEK ; Dong Eun SONG ; Won Gu KIM ; Ki-Wook CHUNG ; Suck Joon HONG ; Tae-Yon SUNG
Yonsei Medical Journal 2025;66(1):43-50
Purpose:
Pediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence.This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.
Materials and Methods:
This retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.
Results:
We analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other’s presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.
Conclusion
Multifocality and bilaterality were not independent risk factors of each other’s presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.
4.Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients
Jae Won CHO ; Cheong-Sil RAH ; Won Woong KIM ; Yu-mi LEE ; Seong Chul KIM ; Jung Hwan BAEK ; Dong Eun SONG ; Won Gu KIM ; Ki-Wook CHUNG ; Suck Joon HONG ; Tae-Yon SUNG
Yonsei Medical Journal 2025;66(1):43-50
Purpose:
Pediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence.This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.
Materials and Methods:
This retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.
Results:
We analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other’s presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.
Conclusion
Multifocality and bilaterality were not independent risk factors of each other’s presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.
5.Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients
Jae Won CHO ; Cheong-Sil RAH ; Won Woong KIM ; Yu-mi LEE ; Seong Chul KIM ; Jung Hwan BAEK ; Dong Eun SONG ; Won Gu KIM ; Ki-Wook CHUNG ; Suck Joon HONG ; Tae-Yon SUNG
Yonsei Medical Journal 2025;66(1):43-50
Purpose:
Pediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence.This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.
Materials and Methods:
This retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.
Results:
We analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other’s presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.
Conclusion
Multifocality and bilaterality were not independent risk factors of each other’s presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.
6.Relationship Between Trauma, Discrimination, and Suicidal Ideation Among North Korean Defectors
Kyungho LIM ; Jiwon BAEK ; Hokon KIM ; Ocksim KIM ; Sang Hui CHU ; Young-Chul JUNG
Psychiatry Investigation 2024;21(11):1203-1210
Objective:
This study aimed to explore the relationship between suicidal ideation and specific trauma and social discrimination among North Korean defectors.
Methods:
A total of 448 North Korean defectors were recruited from online and offline communities and counseling centers. Participants provided sociodemographic and psychiatric history information via an online survey. Various assessment tools, including the Traumatic Event Checklist for North Korean Defectors, International Trauma Questionnaire, Experiences of Discrimination Scale, UCLA Loneliness Scale (short-form), and World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), were employed. Multiple logistic regression analysis was used to examine the association between suicidal ideation and different types of trauma and discrimination.
Results:
Among participants, 38.4% reported experiencing suicidal ideation. The most prevalent trauma was “unwanted separation from spouse, parent, or sibling” (69.4%), and the primary form of discrimination was “unfairness during employment” (35.7%). After adjusting for relevant variables, experiencing “extreme life-threatening hardship,” “unwanted separation from a child,” and “discrimination in income” significantly increased the likelihood of suicidal ideation. Importantly, unlike other refugee groups, interpersonal violence like torture or sexual abuse did not significantly contribute to suicidal ideation in this population. These findings highlight the unique vulnerabilities of North Korean defectors and suggest that income-related discrimination, unwanted separation from children, and life-threatening hardships are critical factors influencing suicidal ideation. Limitations such as recall biases and the cross-sectional nature of the data should be acknowledged.
Conclusion
This study underscores the need for tailored psychiatric support for North Korean defectors, recognizing their distinctive needs compared to other refugee populations.
7.Relationship Between Trauma, Discrimination, and Suicidal Ideation Among North Korean Defectors
Kyungho LIM ; Jiwon BAEK ; Hokon KIM ; Ocksim KIM ; Sang Hui CHU ; Young-Chul JUNG
Psychiatry Investigation 2024;21(11):1203-1210
Objective:
This study aimed to explore the relationship between suicidal ideation and specific trauma and social discrimination among North Korean defectors.
Methods:
A total of 448 North Korean defectors were recruited from online and offline communities and counseling centers. Participants provided sociodemographic and psychiatric history information via an online survey. Various assessment tools, including the Traumatic Event Checklist for North Korean Defectors, International Trauma Questionnaire, Experiences of Discrimination Scale, UCLA Loneliness Scale (short-form), and World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), were employed. Multiple logistic regression analysis was used to examine the association between suicidal ideation and different types of trauma and discrimination.
Results:
Among participants, 38.4% reported experiencing suicidal ideation. The most prevalent trauma was “unwanted separation from spouse, parent, or sibling” (69.4%), and the primary form of discrimination was “unfairness during employment” (35.7%). After adjusting for relevant variables, experiencing “extreme life-threatening hardship,” “unwanted separation from a child,” and “discrimination in income” significantly increased the likelihood of suicidal ideation. Importantly, unlike other refugee groups, interpersonal violence like torture or sexual abuse did not significantly contribute to suicidal ideation in this population. These findings highlight the unique vulnerabilities of North Korean defectors and suggest that income-related discrimination, unwanted separation from children, and life-threatening hardships are critical factors influencing suicidal ideation. Limitations such as recall biases and the cross-sectional nature of the data should be acknowledged.
Conclusion
This study underscores the need for tailored psychiatric support for North Korean defectors, recognizing their distinctive needs compared to other refugee populations.
8.Risk Factors for the Mortality of Patients With Coronavirus Disease 2019Requiring Extracorporeal Membrane Oxygenation in a Non-Centralized Setting: A Nationwide Study
Tae Wan KIM ; Won-Young KIM ; Sunghoon PARK ; Su Hwan LEE ; Onyu PARK ; Taehwa KIM ; Hye Ju YEO ; Jin Ho JANG ; Woo Hyun CHO ; Jin-Won HUH ; Sang-Min LEE ; Chi Ryang CHUNG ; Jongmin LEE ; Jung Soo KIM ; Sung Yoon LIM ; Ae-Rin BAEK ; Jung-Wan YOO ; Ho Cheol KIM ; Eun Young CHOI ; Chul PARK ; Tae-Ok KIM ; Do Sik MOON ; Song-I LEE ; Jae Young MOON ; Sun Jung KWON ; Gil Myeong SEONG ; Won Jai JUNG ; Moon Seong BAEK ;
Journal of Korean Medical Science 2024;39(8):e75-
Background:
Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO.
Methods:
We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method.
Results:
Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004).
Conclusion
Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.
9.Relationship Between Trauma, Discrimination, and Suicidal Ideation Among North Korean Defectors
Kyungho LIM ; Jiwon BAEK ; Hokon KIM ; Ocksim KIM ; Sang Hui CHU ; Young-Chul JUNG
Psychiatry Investigation 2024;21(11):1203-1210
Objective:
This study aimed to explore the relationship between suicidal ideation and specific trauma and social discrimination among North Korean defectors.
Methods:
A total of 448 North Korean defectors were recruited from online and offline communities and counseling centers. Participants provided sociodemographic and psychiatric history information via an online survey. Various assessment tools, including the Traumatic Event Checklist for North Korean Defectors, International Trauma Questionnaire, Experiences of Discrimination Scale, UCLA Loneliness Scale (short-form), and World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), were employed. Multiple logistic regression analysis was used to examine the association between suicidal ideation and different types of trauma and discrimination.
Results:
Among participants, 38.4% reported experiencing suicidal ideation. The most prevalent trauma was “unwanted separation from spouse, parent, or sibling” (69.4%), and the primary form of discrimination was “unfairness during employment” (35.7%). After adjusting for relevant variables, experiencing “extreme life-threatening hardship,” “unwanted separation from a child,” and “discrimination in income” significantly increased the likelihood of suicidal ideation. Importantly, unlike other refugee groups, interpersonal violence like torture or sexual abuse did not significantly contribute to suicidal ideation in this population. These findings highlight the unique vulnerabilities of North Korean defectors and suggest that income-related discrimination, unwanted separation from children, and life-threatening hardships are critical factors influencing suicidal ideation. Limitations such as recall biases and the cross-sectional nature of the data should be acknowledged.
Conclusion
This study underscores the need for tailored psychiatric support for North Korean defectors, recognizing their distinctive needs compared to other refugee populations.
10.Relationship Between Trauma, Discrimination, and Suicidal Ideation Among North Korean Defectors
Kyungho LIM ; Jiwon BAEK ; Hokon KIM ; Ocksim KIM ; Sang Hui CHU ; Young-Chul JUNG
Psychiatry Investigation 2024;21(11):1203-1210
Objective:
This study aimed to explore the relationship between suicidal ideation and specific trauma and social discrimination among North Korean defectors.
Methods:
A total of 448 North Korean defectors were recruited from online and offline communities and counseling centers. Participants provided sociodemographic and psychiatric history information via an online survey. Various assessment tools, including the Traumatic Event Checklist for North Korean Defectors, International Trauma Questionnaire, Experiences of Discrimination Scale, UCLA Loneliness Scale (short-form), and World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), were employed. Multiple logistic regression analysis was used to examine the association between suicidal ideation and different types of trauma and discrimination.
Results:
Among participants, 38.4% reported experiencing suicidal ideation. The most prevalent trauma was “unwanted separation from spouse, parent, or sibling” (69.4%), and the primary form of discrimination was “unfairness during employment” (35.7%). After adjusting for relevant variables, experiencing “extreme life-threatening hardship,” “unwanted separation from a child,” and “discrimination in income” significantly increased the likelihood of suicidal ideation. Importantly, unlike other refugee groups, interpersonal violence like torture or sexual abuse did not significantly contribute to suicidal ideation in this population. These findings highlight the unique vulnerabilities of North Korean defectors and suggest that income-related discrimination, unwanted separation from children, and life-threatening hardships are critical factors influencing suicidal ideation. Limitations such as recall biases and the cross-sectional nature of the data should be acknowledged.
Conclusion
This study underscores the need for tailored psychiatric support for North Korean defectors, recognizing their distinctive needs compared to other refugee populations.

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