Purpose: To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance. Materials and Methods: Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis. Results: Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS. Conclusion US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.

Purpose: To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance. Materials and Methods: Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis. Results: Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS. Conclusion US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.

Purpose: To identify US findings suggestive of malignancy in thyroid nodules with follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN) on fine-needle aspiration cytology (FNAC) and evaluate the diagnostic performance. Materials and Methods: Seventy FLUS (n = 57) or FN (n = 13) nodules on FNAC that underwent surgical excision between February 2018 and November 2020 were selected. US findings were retrospectively reviewed. Orientation, margin, echogenicity, calcification, additional findings of the rim, echogenicity, heterogeneity of the solid portion, and the ratio of anterior posterior diameter to lateral diameter (criteria) were assessed. The diagnostic performances of US findings, criteria, and the Korean Society of Thyroid Radiology Thyroid Imaging Reporting and Data System (K-TIRADS) were evaluated using logistic regression analysis. Results: Microcalcification, homogeneous solid echotexture, and thickened rims were suggestive of malignancy. Our criteria showed a highest area under the ROC curve (AUC) value of 0.771, sensitivity of 97.14%, accuracy of 77.14%, positive predictive value of 93.33%, negative predictive value of 95.24%, and specificity of 97.14%. The criteria showed a significantly higher AUC value than K-TIRADS. Conclusion US findings of homogenous solid portions, thick rims, and microcalcifications suggested malignancy in nodules with FLUS or FN on FNAC. These additional US findings could improve the diagnostic performance of K-TIRADS.

Background: Mercury, particularly in its methylmercury form, significantly affects neurological and developmental functions. In Gyeongsangbuk-do, Republic of Korea, blood mercury levels are elevated due to high fish consumption, especially shark meat. Vulnerable groups, such as pregnant women, are at increased risk as methylmercury can cross the placenta and accumulate in breast milk. This study aimed to investigate the risks of mercury exposure from shark meat consumption among young and middle-aged women in Gyeongsangbuk-do. Methods: The data of women aged 19–55 years from the 2018 Gyeongsangbuk-do Community Health Survey were included. Survey questions focused on frequency and amount of shark meat consumption, as well as pregnancy status, recent childbirth, and breastfeeding status. The Complex Sample Analysis was used to determine the prevalence and risk of overconsumption. Weekly mercury intake was calculated for respondents who reported their body weight, and the population size exceeding Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (JECFA) and Ministry of Food and Drug Safety (MFDS)’s threshold was estimated. Results: Regions where the consumption rate of shark meat exceeds the average for Gyeongsangbuk-do are found to be distributed in the southeastern part of the province. Population estimates revealed that approximately 9,895 women aged 19–55, including 255 who had breastfed in the past year, consumed shark meat exceeding the recommended intake. Based on the maximum recorded mercury concentration (8.93 μg/g), an estimated 2,645 women surpassed the JECFA’s mercury exposure threshold, while 845 exceeded the MFDS’s threshold. Conclusions In young and middle-aged women of Gyeongsangbuk-do, approximately 7.1% exceed the single intake limit, while up to 1.9% exceed the JECFA’s provisional tolerable weekly intake (PTWI) and 0.6% exceed the MFDS’s PTWI, suggesting considerable risk that warrants monitoring and guidance. More stringent advisory measures regarding shark meat consumption and updated standards on mercury concentration in shark meat are essential for young and middle-aged women in the province.

BACKGROUND: Pedicled transverse rectus abdominis musculocutaneous flaps typically sacrifice the entire muscle. In our experience, the lateral strip of the rectus abdominis muscle can be spared in an attempt to maintain function and reduce morbidity. When the intercostal nerves are injured, muscle atrophy appears with time. The severed intercostal nerve was reinserted into the remnant lateral strip of the rectus abdominis muscle to reduce muscle atrophy. METHODS: The authors retrospectively reviewed 9 neurotized cases and 10 non-neurotized cases. Abdominal computed tomography was performed to determine the area of the rectus muscles. Electromyography (EMG) was performed to check contractile function of the remnant muscle. A single investigator measured the mean areas of randomly selected locations (second lumbar spine) using ImageJ software in a series of 10 cross-sectional slices. We compared the Hounsfield unit (HU) pre- and postoperatively to evaluate regeneration quality. RESULTS: In the neurotization group, 7 of 9 cases maintained the mass of remnant muscle. However, in the non-neurotization group, 8 of 10 lost their mass. The number of totally atrophied muscles in each of the two groups was significantly different (P=0.027). All of the remnant muscles showed contractile function on EMG. The 9 remaining remnant rectus abdominis muscles showed declined the HU value after surgery but also within a normal range of muscle. CONCLUSIONS: Neurotization was found to be effective in maintaining the mass of remnant muscle. Neurotized remnant muscle had contractile function on EMG and no fatty degeneration by HU value.
Electromyography ; Humans ; Intercostal Nerves ; Multidetector Computed Tomography ; Muscles ; Muscular Atrophy ; Nerve Transfer ; Rectus Abdominis ; Reference Values ; Regeneration ; Research Personnel ; Retrospective Studies

PURPOSE: In this study, we attempted to analyze the effectiveness of the atopic dermatitis camp for primary school students in the Seoul area. METHODS: Seoul city's atopy camp 2010 was conducted 10 times from May 22nd to October 24th for primary school students at an atopy friendly school and their parents. A total of 374 atopic dermatitis patients participated in the camp and questionnaires for 363 were analyzed, except 11 participants who had left several questions unanswered. In a 3-month follow-up survey, 167 participants out of 374 responded to the mailing questionnaire to evaluate the efficiency of the camp. The response rate was 44.7%. RESULTS: Satisfaction with the educational program of the camp was higher for lower grade students than for higher grade students.(P<0.001) Before camp, higher grade students (P<0.001) or students with severe symptoms were more knowledgeable of atopic dermatitis.(P<0.01) After the camp, the higher the grade, the more the knowledge the student had about atopic dermatitis.(P<0.001) Three months after the camp, there was positive change in the lifestyle of atopic dermatitis patients.(P<0.001) CONCLUSION: Knowledge on atopic dermatitis increased and the lifestyle of atopic dermatitis patients was improved due to the camp. Consequently, Seoul city's atopy camp can be utilized as a method to improve the quality of life of atopic dermatitis patients and their family. And Seoul city's atopy camp is expected to be a model for atopy camps in other local communities.
Dermatitis, Atopic ; Follow-Up Studies ; Humans ; Life Style ; Parents ; Patient Education as Topic ; Postal Service ; Quality of Life ; Surveys and Questionnaires

OBJECTIVES: Childhood allergic diseases are a major concern because they lead to a heavy economic burden and poor quality of life. The purpose of this study was to investigate the prevalence of childhood atopic dermatitis, asthma, allergic rhinitis, and the comorbidity of allergic diseases in Seoul, Korea. METHODS: We conducted a cross-sectional survey between May and October 2010 to evaluate the prevalence of childhood allergic diseases, including atopic dermatitis, asthma, and allergic rhinitis, using a questionnaire from the International Study of Asthma and Allergies in Childhood group. Each questionnaire was completed by the parent or guardian of a child. RESULTS: In the 31,201 children studied, the prevalence of atopic dermatitis symptoms in the past 12 months was 19.3% in children 0 to 3 years of age, 19.7% in children 4 to 6 years of age, 16.7% in children 7 to 9 years of age, and 14.5% in children 10 to 13 years of age (p for trend < 0.001). The prevalence of asthma in these age groups was 16.5%, 9.8%, 6.5%, and 5.4%, respectively (p for trend < 0.001). The prevalence of allergic rhinitis in these age groups was 28.5%, 38.0%, 38.5%, and 35.9%, respectively (p for trend = 0.043). The percentage of subjects with both atopic dermatitis and asthma, both asthma and allergic rhinitis, or both atopic dermatitis and allergic rhinitis was 2.5%, 4.7%, and 8.7%, respectively. The prevalence of comorbid allergic diseases decreased with age (p for trend < 0.001). CONCLUSIONS: Our study revealed that the prevalence of some allergic diseases, such as atopic dermatitis and asthma, was relatively high in very young children and that all of the principal allergic diseases in children often co-exist.
Asthma ; Child ; Comorbidity ; Cross-Sectional Studies ; Dermatitis, Atopic ; Humans ; Hypersensitivity ; Parents ; Prevalence ; Quality of Life ; Rhinitis ; Rhinitis, Allergic, Perennial ; Surveys and Questionnaires

Attention-deficit/hyperactivity disorder (ADHD) is one of the common psychiatric problems in childhood. The symptoms of ADHD tend to last for adulthood and the patients suffer from various comorbid problems and functional impairments. Methylphenidate (MPH) is the first choice of pharmacotherapy for ADHD and many researches have demonstrated its efficacy. We reviewed the clinical trials for efficacy of MPH focusing on Osmotic-Controlled Release Oral delivery System Methylphenidate (OROS MPH). It was identified that MPH improved core symptom of ADHD, peer relationship and health related quality of life and might improve various aspects of cognitive function. It was proved that the efficacy of OROS MPH was better than placebo and comparable to immediate release MPH (IR MPH) dosed three times daily in various studies. Especially, parent's preference of OROS MPH was better than IR MPH. The efficacy of MPH for academic achievement was equivocal. Long-term efficacy of OROS MPH was also inconclusive and further study is necessary.
Achievement ; Humans ; Methylphenidate ; Phenazines ; Quality of Life

Attention-deficit/hyperactivity disorder (ADHD) is one of the common psychiatric problems in childhood. The symptoms of ADHD tend to last for adulthood and the patients suffer from various comorbid problems and functional impairments. Methylphenidate (MPH) is the first choice of pharmacotherapy for ADHD and many researches have demonstrated its efficacy. We reviewed the clinical trials for efficacy of MPH focusing on Osmotic-Controlled Release Oral delivery System Methylphenidate (OROS MPH). It was identified that MPH improved core symptom of ADHD, peer relationship and health related quality of life and might improve various aspects of cognitive function. It was proved that the efficacy of OROS MPH was better than placebo and comparable to immediate release MPH (IR MPH) dosed three times daily in various studies. Especially, parent's preference of OROS MPH was better than IR MPH. The efficacy of MPH for academic achievement was equivocal. Long-term efficacy of OROS MPH was also inconclusive and further study is necessary.
Achievement ; Humans ; Methylphenidate ; Phenazines ; Quality of Life

OBJECTIVES: This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). METHODS: Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, average dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, voluntarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. RESULTS: Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). CONCLUSION: We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.
Adolescent ; Anxiety Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Consensus ; Depressive Disorder ; Humans ; Psychiatry ; Texas ; Tic Disorders ; Surveys and Questionnaires