The increasing detection of papillary thyroid microcarcinoma (PTMC) has raised concerns about overtreatment.For low-risk PTMC, either immediate surgery or active surveillance (AS) can be considered. To support AS implementation, the Korean Thyroid Association convened a multidisciplinary panel and developed the first Korean guideline. AS is recommended to adults with pathologically proven Bethesda V-VI PTMC without clinical evidence of lymph node or distant metastasis, gross extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, or aggressive histology. Baseline assessment requires high‑resolution cervical ultrasound by experienced operators to rule out extrathyroidal extension, tracheal or recurrent laryngeal nerve invasion, and lymph node metastasis;contrast‑enhanced neck computed tomography is optional. Patient characteristics such as age, comorbidities, and capacity for long-term follow-up should be assessed. Shared decision-making should weigh the benefits and risks of surgery and AS, expected oncologic outcomes, complications, quality of life, anxiety, medical cost, and patient preference. Follow-up includes cervical ultrasound and thyroid function test every six months for two years, then annually. Disease progression, defined as significant tumor growth or newly detected nodal or distant metastasis, warrants surgery. Despite remaining uncertainties, this guideline offers a framework to ensure oncologic safety and support patient-centered active surveillance.

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.
Adult* ; Biopsy ; Cough ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Dyspnea ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Lung Diseases ; Magnetic Resonance Imaging ; Male* ; Polydipsia ; Smoke ; Smoking ; Smoking Cessation ; Thoracic Surgery, Video-Assisted ; Water Deprivation

Thrombocytosis and coagulation systems activation are commonly associated with disease progression and are suggested poor prognostic factors in patients with malignancies. This study aimed to investigate the prevalence and prognostic significance of thrombocytosis and elevated fibrinogen levels in patients with advanced non-small cell lung cancer (NSCLC). Initial platelet counts and fibrinogen levels were reviewed in 854 patients with histologically proven NSCLC. Thrombocytosis was defined as platelet counts > 450 x 10(9)/L. A serum fibrinogen level > 4.5 g/L was considered high. At the time of diagnosis, initial platelet counts and serum fibrinogen levels were evaluated before treatment. Clinicopathologic data including histological type, tumor, node, metastasis (TNM) stage, performance status, treatment method, and survival time were evaluated. Initial thrombocytosis was found in 6.9% of patients, and elevated fibrinogen levels were found in 55.1% of patients. Patients with thrombocytosis had a significantly poorer prognosis than patients with normal platelet counts (P < 0.001). In multivariate survival analysis, thrombocytosis was an independent prognostic factor (P < 0.001). An elevated serum fibrinogen level was associated with poor prognosis (P < 0.001). In conclusion, initial thrombocytosis and a high fibrinogen level are independent factors for predicting poor prognosis in patients with advanced NSCLC.
Aged ; Blood Platelets/*cytology ; Carcinoma, Non-Small-Cell Lung/*diagnosis/mortality/pathology ; Female ; Fibrinogen/*analysis ; Humans ; Lung Neoplasms/*diagnosis/mortality/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Platelet Count ; Prognosis ; Retrospective Studies ; Survival Rate ; Thrombocytosis/complications/diagnosis

PURPOSE: As the influence of mass media increases, the general standard of attractiveness or beauty of a face also changes. The primary purpose of the study is to find out the factors of the attractive and beautiful face recognized by public. METHODS: We picked out standard model photography and operated with Adobe(R) Photoshop(R) and Monariza(R) virtual plastic surgery program. The contour of face, eye, nose, forehead, zygoma, chin and proportion of upper, middle, lower face were changed. The interview survey was conducted through structured standard photo for 310 respondents. That was utilized in the final analysis. Multiple regression analysis was executed by SPSS 12.0. It was used to deal with statistical data and all the other necessary analysis. RESULTS: According to general characteristics of the respondents, many differences were found in preferred face and facial aesthetic subunits. The younger generation preferred the lozenge and inverted triangle shape contour. The respondents over 40 of age preferred the egg shape contour. In chin and zygoma contour, the respondents at the age of 20 preferred distinctly small chin and relatively small lower face. On the other hand, the respondents over 40 of age preferred the wide zygoma relatively. In the proportion of upper, middle, lower face, 51.0% of respondents answered 1:1:1. If they want to have an aesthetic operation, they preferred protruding forehead. Also they preferred the small chin and V-shaped chin in frontal view. CONCLUSION: Many respondents preferred to have a plastic surgery for the better facial subunit. The statistical evidence from this study suggests that the harmony and balance of facial aesthetic subunits make attractive and beautiful face.
Beauty ; Chin ; Surveys and Questionnaires ; Eye ; Forehead ; Hand ; Mass Media ; Nose ; Ovum ; Photography ; Surgery, Plastic ; Zygoma

BACKGROUND: It is regarded that contemporary Korean diet, the combination of carbohydrates-based Korean traditional diet and the Western eating patterns, increases the vulnerability to chronic diseases such as coronary vascular disease, diabetes mellitus, and hypertension. Therefore, there is a rising interest in carbohydrate sources with low glycemic index; many researches have proven the medical benefits of low glycemic index diet. Barley has recently drawn attention and various benefits of barley, such as improvements of obesity and bowel function, have been suggested. It seems that the beta-glucan, a content of barley helps to lower blood sugar level. This study aimed to evaluate the advantages of barley consumption compared to wheat consumption in blood sugar and blood lipid profile levels. METHODS: Twenty-four healthy Korea University students were randomly assigned to two groups: 12 of barley bread consumption group (treatment group) and 12 of wheat bread consumption group (control group). Both groups took bread on an empty stomach and the changes of their blood sugar and lipid levels were measured, compared, and analyzed every hour for four hours. RESULTS: The blood sugar level one hour later in the barley bread consumption group was statistically low. In addition, the area under curve of the barley bread intake group was found to be statistically smaller. However, the blood lipid profiles between the two groups did not show meaningful difference. CONCLUSION: This study suggests that the consumption of food containing barley could bring various medical benefits to one's health by lowering blood sugar.
Area Under Curve ; Blood Glucose ; Bread ; Chronic Disease ; Diabetes Mellitus ; Diet ; Eating ; Glycemic Index ; Hordeum ; Humans ; Hypertension ; Korea ; Lipid Metabolism ; Obesity ; Stomach ; Triticum ; Vascular Diseases

PURPOSE : In a recent study of Wilms' tumors, a new X chromosome gene, Wilms' tumor gene on the X chromosome (WTX), was discovered that was found to harbor small deletions and point mutations. The WTX protein negatively regulates Wnt/beta-catenin signaling, and is considered to be a tumor suppressor gene. One of the questions about the WTX gene is whether the genetic alterations of the WTX gene are specific only to Wilms' tumors. The aim of this study was to explore whether the WTX gene mutation is a characteristic of human non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : In the current study, we analyzed the part of the WTX gene encoding the N-terminal of WTX, where most of the WTX point mutations have been detected in Wilms' tumors. Forty-eight NSCLC tissues were analyzed by a single-strand conformation polymorphism assay and DNA sequencing. RESULTS : SSCP analysis revealed no evidence of somatic mutations in the DNA sequences encoding the N-terminal of the WTX gene in the 48 NSCLC tissues. CONCLUSION : The data presented here indicate that the WTX gene may not be somatically-mutated in human NSCLCs, and suggest that NSCLCs may not utilize mutational events of the WTX gene in the process of pathogenesis
Base Sequence ; Carcinoma, Non-Small-Cell Lung ; Genes, Tumor Suppressor ; Humans ; Point Mutation ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Wilms Tumor ; X Chromosome

As the improved medical techniques and environmental changes have increased the frequency of general anesthesia for uncommon congenital anomalies. The airway management for a patient with congenital anomaly gives significant challenges to the anesthesiologist. The purpose of this report is to review the authors' experience with airway management and ventilatory support during the perioperative period in children with congenital anomalies with airway involvement, and to summarize anesthetic implications associated with particular congenital anomalies by literature review. Total 46 cases of general anesthesia for operation of congenital anomalies were performed from January 2000 to August 2005 in our hospital. Most common congenital anomaly is a Down syndrome (17 cases, 37%), and most common cause of surgery is the orthopedic surgery for correction of deformed spine (18 cases, 41%). Direct laryngoscopy was successfully used to establish an airway in 35 (76.1%) cases, whereas 5 (11%) cases required the use of fiberoptic bronchoscopy to establish an airway before surgery.
Airway Management ; Anesthesia* ; Anesthesia, General ; Bronchoscopy ; Child ; Craniofacial Abnormalities ; Down Syndrome ; Humans ; Laryngoscopy ; Orthopedics ; Perioperative Period ; Spine

An 8-year-old boy presented with abdominal pain and poor oral intake for two months. Serum amylase and lipase levels were elevated. CT of the abdomen and chest X-ray showed two pseudocysts at the pancreatic uncinate process, pancreatitis with a parenchymal defect, a large amount of ascites, and a right pleural effusion. MR cholangiography and endoscopic retrograde cholangiopanreaticography revealed a pancreatic duct disruption. The patient was successfully treated with a chest tube placement and percutaneous drainage. After surgery, his general condition improved; the serum level of amylase normalized and the pleural effusion resolved. Pancreatic injuries are rare in pediatric blunt trauma; however, diagnostic difficulty is common with isolated blunt trauma. Therefore, a high index of suspicion should follow such an injury. We report the case of an 8-year-old boy with pancreas transection, ductal disruption, ascites, and pleural effusion who was successfully treated.
Abdomen ; Abdominal Pain ; Amylases ; Ascites ; Chest Tubes ; Child* ; Cholangiography ; Drainage ; Humans ; Lipase ; Male ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Pleural Effusion* ; Thorax

We present a 4-years-old Russell-Silver syndrome patient who underwent surgical correction of left auricular abnormality. He had a triangular face with hypoplastic mandible. Because of facial manifestations of this syndrome, the anesthesiologist should prepare for a difficult endotracheal intubation and mask fitting. These patients may be prone especially to hypoglycemia and hypothermia during intraoperative period, therefore close monitoring and appropriate care for hypoglycemia and hypothermia is required. In this case, gentle direct laryngoscopy was performed to assess the airway. Hypoglycemia and hypothermia was not observed. We discuss anesthetic considerations in management.
Anesthesia ; Humans ; Hypoglycemia ; Hypothermia ; Intraoperative Period ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Mandible ; Masks ; Silver-Russell Syndrome

Angiogenesis is considered to be an integral process to the growth and spread of solid tumors. Anti-angiogenesis therapy recently has been found to be one of the most promising anti-cancer therapeutic strategies. In this study, we provide several lines of evidences showing that KR-31831, a new benzopyran derivative, has anti-angiogenic activities. KR-31831 inhibited the proliferation, migration, invasion and tube formation of bovine aortic endothelial cells (BAECs), and suppressed the release of matrix metalloproteinase-2 (MMP-2) of BAECs. KR-31831 also inhibited in vivo angiogenesis in mouse Matrigel plug assay. Furthermore, the mRNA expressions of basic fibroblast growth factor (bFGF), fibroblast growth factor receptor-2 (FGFR-2), and vascular endothelial growth factor receptor-2 (VEGFR-2) were decreased by KR-31831. Taken together, these results suggest that KR-31831 acts as a novel angiogenesis inhibitor and might be useful for treating hypervascularized cancers.
Vascular Endothelial Growth Factor Receptor-2/metabolism ; Receptor, Fibroblast Growth Factor, Type 2/metabolism ; Neovascularization, Physiologic/drug effects ; Neovascularization, Pathologic/*drug therapy ; Models, Biological ; Mice, Inbred C57BL ; Mice ; Matrix Metalloproteinase 2/metabolism ; Male ; Ischemia/drug therapy ; Imidazoles/*pharmacology/therapeutic use ; Fibroblast Growth Factor 2/metabolism ; Endothelial Cells/drug effects ; Cells, Cultured ; Cell Movement/drug effects ; Cattle ; Benzopyrans/*pharmacology/therapeutic use ; Animals ; Angiogenesis Inhibitors/*pharmacology/therapeutic use