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 benefits of transradial access (TRA) over transfemoral access (TFA) for bifurcation percutaneous coronary intervention (PCI) are uncertain because of the limited availability of device selection. This study aimed to compare the procedural differences and the in-hospital and long-term outcomes of TRA and TFA for bifurcation PCI using secondgeneration drug-eluting stents (DESs). Methods: Based on data from the Coronary Bifurcation Stenting Registry III, a retrospective registry of 2,648 patients undergoing bifurcation PCI with second-generation DES from 21 centers in South Korea, patients were categorized into the TRA group (n = 1,507) or the TFA group (n = 1,141). After propensity score matching (PSM), procedural differences, in-hospital outcomes, and device-oriented composite outcomes (DOCOs; a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization) were compared between the two groups (772 matched patients each group). Results: Despite well-balanced baseline clinical and lesion characteristics after PSM, the use of the two-stent strategy (14.2% vs. 23.7%, P = 0.001) and the incidence of in-hospital adverse outcomes, primarily driven by access site complications (2.2% vs. 4.4%, P = 0.015), were significantly lower in the TRA group than in the TFA group. At the 5-year follow-up, the incidence of DOCOs was similar between the groups (6.3% vs. 7.1%, P = 0.639). Conclusion The findings suggested that TRA may be safer than TFA for bifurcation PCI using second-generation DESs. Despite differences in treatment strategy, TRA was associated with similar long-term clinical outcomes as those of TFA. Therefore, TRA might be the preferred access for bifurcation PCI using second-generation DES.

Objectives: This study aims to reveal the relationship between social relations and physical activity in the young-old and old-old elderly. Methods: Data from 2020 National survey of Older Koreans were used, and a total of 10,097 subjects over the age of 65 were included in analysis. The dependent variable was physical activity, and the independent variables were social relations barrier and motivational factors. x2 -test and binary logistic regression were performed for data analysis. Results: The physical activity rate in the elderly were 40.8% in the young-old and 29.2% in the old-old. The socio-demographic characteristics affecting physical activity were the young-old elderly were sex, residential area, employment status and household income, and the old-old elderly were sex, age, residential area, education level and household income. The social relations barrier factors affecting physical activity were the young-old elderly were number of close friends, family care, exercise information search and video viewing, and the old-old elderly were household type, number of close friends, participation in exercise education, exercise information search and video viewing. The social relations motivational factors affecting physical activity were the young-old elderly were call with children/relative/friend, participation in sports activity, access time from home to parks, and the old-old elderly were call with children/relative/friend, participation in sports activity, satisfaction with green spaces. Conclusions It was found that social relations barrier and motivational factors of the elderly are important factors to consider when developing physical activity promotion strategy, and there are also difference between the age of the elderly.

Background: Metabolic syndrome (MetS) is reportedly a crucial risk factor for coronavirus disease 2019 (COVID-19). Since the epidemiological studies that examine this association are few and include small samples, we investigated the relationship between MetS and COVID-19 severity and death using a larger sample in the Republic of Korea. Methods: We analyzed 66,321 patients, 4,066 of whom had COVID-19. We used chi-square tests to examine patients’ characteristics. We performed logistic regression analysis to analyze differences in COVID-19 infection and clinical outcomes according to the presence of MetS. Results: Although MetS was not significantly associated with COVID-19 risk, acquiring MetS was significantly associated with the risk of severe COVID-19 outcomes (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.34 to 2.91; P=0.001). The mortality risk was significantly higher in COVID-19 patients with MetS (OR, 1.74; 95% CI, 1.17 to 2.59; P=0.006). Patients with abnormal waist circumference were approximately 2.07 times more likely to develop severe COVID-19 (P<0.001), and high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with COVID-19; the mortality risk due to COVID-19 was 1.74 times higher in men with an HDL-C level of <40 mg/dL and in women with an HDL-C level of <50 mg/dL (P=0.012). Conclusion COVID-19 is likely associated with severity and death in patients with MetS or in patients with MetS risk factors. Therefore, patients with MetS or those with abnormal waist circumference and HDL-C levels need to be treated with caution.

Objectives: This study aimed to identify the vaccination coverage for hepatitis B among aged 19 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The survey was conducted through a Mixed-Mode Random Digit Dialing Survey (RDD) method. The survey included hepatitis B vaccination status, reasons of vaccination and non-vaccination, sources of information on vaccination, and other related factors. Results: The vaccination coverage for hepatitis B among adults 19 years of age and older were 38.0%, 32.5%, and 26.9% for the first, second, and third doses. A related factors with high rate of hepatitis B vaccination was women, younger than 65 years of age, rural residents, having a job, highly educated, health insurance subscribers, living with spouse, family members living together. In addition, the vaccination rate was higher in those who was aware of the states recommended adult vaccination, were explained by a doctor about the need for adult vaccination, kept their vaccination records, and recognized that it helped prevent infectious diseases, and had seen promotional materials. Conclusions In the future, it is necessary to check the antibody retention rate along with the hepatitis B vaccination coverage of adults on a regular basis. In addition, in order to accurately and quickly identify the hepatitis B vaccination coverage, it is necessary to prepare a plan to improve the computerized registration rate to manage adult vaccination records.

Calcium hydroxide has been widely used for root canal dressing material in endodontic treatment. This report describes that when the accurate diagnosis and proper nonsurgical endodontic retreatment is applied to periapical lesion with accidentally extruded calcium hydroxide paste, the lesion can be successfully treated. Overfilled calcium hydroxide can affect the healing process, so the overextension of calcium hydroxide agent should be avoided.

Objectives: This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. Results: The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. Conclusions In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country's infection control policy.

The purpose of this comparison of case reports is to introduce the results of the application of new devices for the management of growing Class III malocclusions in children. Two 8-year-old boys had a chief complaint of anterior crossbite. Anterior crossbite correction using a tandem traction bow appliance (TTBA) or a Carriere Motion 3D Class III appliance with a Transforce appliance was planned. By comparing cephalometric radiographs before and after treatment, changes in skeletal growth and incisor inclination to the Frankfort horizontal (FH) plane could be measured. Both devices increased SNA and ANB angles, N –| Pg-A, U1 to SN, and U1 to FH. Both appliances improved facial features and resolution of anterior crossbite. The TTBA and Carriere Motion 3D Class III appliance had similar effects when applied as early treatment for growing mesio-occlusions and anterior crossbite in two boys. However, long-term outcome assessments and well-designed comparative studies are still required.

Bone turnover markers (BTMs) have important role in the management of osteoporosis. Recently the clinical application of BTMs has achieved significant progress and measurement of BTMs give us better understanding of pathogenesis of osteoporosis. However, the use of BTMs is still insufficient in Korea. We summarized the available methods and standard interval of the BTMs in Korea. Also we reviewed published literatures on pre-analytical variability in the measurement of BTMs and provided recommendations for standardized sample handling and patient preparation for reducing those pre-analytical variabilities. The clinical application of BTMs in patients with chronic kidney disease who have a higher fracture risk than the general population is summarized.
Biomarkers ; Bone Remodeling ; Humans ; Korea ; Osteoporosis ; Renal Insufficiency, Chronic

OBJECTIVES: The purpose of this study was factors affecting self-efficacy of cardiopulmonary resuscitation (CPR) in adults. Therefore, the provide basic data for strategy development to improve the performance rate of bystander CPR. METHODS: The data were collected from 164,165 adults of the 2016 Korean Community Health Survey. The survey method was 1:1 interview with households, and the survey period was from August 16, 2016 to October 31, 2016. The survey variables were as follows: self-efficacy of CPR, awareness of CPR, training experience of CPR, demographic characteristics, medical characteristics, health promoting behaviors, and safety practices. RESULTS: The rate of self-efficacy of CPR in adults was 60.6%. Factors affecting self-efficacy of CPR were age, sex, residence, education level, occupation, marital status, any CPR training, CPR training within the last 2 years, CPR training with manikin within the last 2 years, emergency room visit within the last 1 year, physical activity status, drive a bicycle, seat belts on rear seat, seat belts when riding a bus were statistically significant. CONCLUSIONS: In conclusion, in order to improve the self-efficacy of CPR in adults, the recent experience rate of CPR education, the practice rate of health promotion behavior, and the practice rate of safety behavior should be improved. The government should expand the provision of education programs to improve the self-efficacy of CPR and actively prepare national-level public advertisements strategies.
Adult ; Cardiopulmonary Resuscitation ; Education ; Emergency Service, Hospital ; Family Characteristics ; Health Promotion ; Health Surveys ; Humans ; Manikins ; Marital Status ; Motor Activity ; Occupations ; Seat Belts ; Surveys and Questionnaires