Objectives: Early diagnosis of upper gastrointestinal (UGI) amyloidosis and the establishment of appropriate treatment and follow-up strategies remains challenging. This study aimed to elucidate the endoscopic characteristics and clinical courses of patients with isolated UGI amyloidosis. Methods: We retrospectively reviewed 11 patients diagnosed with isolated UGI amyloidosis at Chonnam National University Hospital and Chonnam National University Hwasun Hospital. None of the patients exhibited systemic involvement or multiple myeloma. Clinical data, including endoscopic features, presenting symptoms, and outcomes such as disease progression and mortality, were analyzed. Results: The cohort included seven males (63.6%) and four females (36.4%), with a median age of 72 (37–82) years. Isolated gastric amyloidosis was identified in four patients, and five patients had disease confined to the duodenum. Two patients (18.2%) presented with gastric or duodenal involvement. Endoscopic findings were heterogeneous, with diffuse yellowish linear lesions being the most frequently observed in four patients (36.4%). Histopathological analysis revealed AA amyloidosis in three patients, whereas five patients exhibited only amorphous deposits without amyloid A, amyloid P, or light chains. Six patients (54.5%) were asymptomatic at diagnosis, whereas gastrointestinal bleeding was observed in two patients (18.2%). Only one patient (9.1%) experienced disease progression that necessitated systemic chemotherapy. The mean follow-up duration was 20 months, and the 3-year mortality rate was 9.1%. Conclusions Isolated UGI amyloidosis is a heterogeneous condition that can be easily misdiagnosed. Familiarity with the characteristic endoscopic features and natural disease course is essential for appropriate management.

This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

This study aimed to establish a foundation for future collaborations aimed at preparing for and responding to infectious diseases by examining the vaccine injury compensation programs (VICPs) of East Asian countries. We reviewed the current status of VICPs in the Republic of Korea, Japan, and Taiwan by searching national government websites and reviewing relevant literature. Additionally, we conducted email inquiries targeting experts from Japan and Taiwan.Through the comprehensive analysis of VICPs in these 3 countries covered various aspects,we identified several similarities and differences in the VICPs across these countries. Whilethe governments of the Republic of Korea, Japan, and Taiwan play a central role in supporting investigations into vaccine injuries and managing compensation procedures based on legalstatutes, they differ in terms of financial resources for compensation, the range of vaccinescovered, and the criteria for assessing causality. In the Republic of Korea, Japan, and Taiwan,compensation is typically paid in a lump sum, although the specific benefits available vary bycountry. This study on VICPs in the Republic of Korea, Japan, and Taiwan provides valuable insights for the further development and management of domestic systems.

Background: This systematic review was conducted to identify and summarize key factors, including economic methods, topics, results, and indicators, within relevant economic evaluation research on thyroid cancer. Materials and Methods: A literature search on the economic evaluation of thyroid cancer treatment was conducted using the MEDLINE database up to May 2021. Data on population, intervention, comparison, outcome, time, setting, and study design were extracted from each study. The economic evaluation method in each study was re-classified according to the theoretical criteria defined by the international economic evaluation guidelines. Results: A total of 49 studies were included, involving cost analysis (CA, n=9), cost-minimization analysis (CMA, n=3), cost-effectiveness analysis (CEA, n=29), and cost-utility analysis (CUA, n=8). When CEA and CUA were classified as one method, the consistency between the methods of the reviewers based on the theoretical criteria and those from the original studies was 77% (95% confidence interval, 0.63-0.92). Most studies dealt with specific period-related controversial issues including comparison between treatment strategies, and cost-effectiveness of the prophylactic central neck dissection, molecular testing, and rhTSH. Contrasting results have been obtained when different economic evaluation methods were applied for the same topic (e.g., total thyroidectomy [TT] was more dominant than hemithyroidectomy [HT] in CEA, but HT was more dominant than TT in CUA), and different clinical and economic inputs were applied. All studies included direct medical costs, which were mostly derived from Medicare and input probabilities in each economic model, and utility scores for outcomes were mostly based on literature reviews.Few studies included non-medical direct costs and indirect costs. Conclusion Our systematic review provides information on how to design and proceed to overcome the limitations of existing studies and ensure validity.

Background: Postoperative thyroid stimulating hormone (TSH) suppression therapy is recommended for patients with intermediate- and high-risk differentiated thyroid cancer to prevent the recurrence of thyroid cancer. With the recent increase in small thyroid cancer cases, the extent of resection during surgery has generally decreased. Therefore, questions have been raised about the efficacy and long-term side effects of TSH suppression therapy in patients who have undergone a lobectomy. Methods: This is a multicenter, prospective, randomized, controlled clinical trial in which 2,986 patients with papillary thyroid cancer are randomized into a high-TSH group (intervention) and a low-TSH group (control) after having undergone a lobectomy. The principle of treatment includes a TSH-lowering regimen aimed at TSH levels between 0.3 and 1.99 μIU/mL in the low-TSH group. The high-TSH group targets TSH levels between 2.0 and 7.99 μIU/mL. The dose of levothyroxine will be adjusted at each visit to maintain the target TSH level. The primary outcome is recurrence-free survival, as assessed by neck ultrasound every 6 to 12 months. Secondary endpoints include disease-free survival, overall survival, success rate in reaching the TSH target range, the proportion of patients with major cardiovascular diseases or bone metabolic disease, the quality of life, and medical costs. The follow-up period is 5 years. Conclusion The results of this trial will contribute to establishing the optimal indication for TSH suppression therapy in low-risk papillary thyroid cancer patients by evaluating the benefit and harm of lowering TSH levels in terms of recurrence, metabolic complications, costs, and quality of life.

Background: Postoperative thyroid stimulating hormone (TSH) suppression therapy is recommended for patients with intermediate- and high-risk differentiated thyroid cancer to prevent the recurrence of thyroid cancer. With the recent increase in small thyroid cancer cases, the extent of resection during surgery has generally decreased. Therefore, questions have been raised about the efficacy and long-term side effects of TSH suppression therapy in patients who have undergone a lobectomy. Methods: This is a multicenter, prospective, randomized, controlled clinical trial in which 2,986 patients with papillary thyroid cancer are randomized into a high-TSH group (intervention) and a low-TSH group (control) after having undergone a lobectomy. The principle of treatment includes a TSH-lowering regimen aimed at TSH levels between 0.3 and 1.99 μIU/mL in the low-TSH group. The high-TSH group targets TSH levels between 2.0 and 7.99 μIU/mL. The dose of levothyroxine will be adjusted at each visit to maintain the target TSH level. The primary outcome is recurrence-free survival, as assessed by neck ultrasound every 6 to 12 months. Secondary endpoints include disease-free survival, overall survival, success rate in reaching the TSH target range, the proportion of patients with major cardiovascular diseases or bone metabolic disease, the quality of life, and medical costs. The follow-up period is 5 years. Conclusion The results of this trial will contribute to establishing the optimal indication for TSH suppression therapy in low-risk papillary thyroid cancer patients by evaluating the benefit and harm of lowering TSH levels in terms of recurrence, metabolic complications, costs, and quality of life.