Mutational dysphonia, a condition in which a pre-adolescent voice persists into adulthood, can significantly impact personal and professional life but is treatable with voice therapy. A patient with mutational dysphonia usually has a voice that is weak, breathy, or diplophonic, often classified as a “falsetto” voice. In this case report, we present a 20-year-old male who had a typical voice of a boy before adolescence, making it difficult to diagnose as mutational dysphonia. After voice therapy, he successfully gained his post-adolescent voice, highlighting the importance of thorough diagnosis and personalized treatment for mutational dysphonia.

Mutational dysphonia, a condition in which a pre-adolescent voice persists into adulthood, can significantly impact personal and professional life but is treatable with voice therapy. A patient with mutational dysphonia usually has a voice that is weak, breathy, or diplophonic, often classified as a “falsetto” voice. In this case report, we present a 20-year-old male who had a typical voice of a boy before adolescence, making it difficult to diagnose as mutational dysphonia. After voice therapy, he successfully gained his post-adolescent voice, highlighting the importance of thorough diagnosis and personalized treatment for mutational dysphonia.

Mutational dysphonia, a condition in which a pre-adolescent voice persists into adulthood, can significantly impact personal and professional life but is treatable with voice therapy. A patient with mutational dysphonia usually has a voice that is weak, breathy, or diplophonic, often classified as a “falsetto” voice. In this case report, we present a 20-year-old male who had a typical voice of a boy before adolescence, making it difficult to diagnose as mutational dysphonia. After voice therapy, he successfully gained his post-adolescent voice, highlighting the importance of thorough diagnosis and personalized treatment for mutational dysphonia.

Background: Staged operations are commonly employed in the management of high-energy tibial plateau fractures (TPF) complicated by acute compartment syndrome (ACS); however, complications, such as nonunion, deep wound infection, and traumatic arthritis, often occur due to severe bone and soft-tissue damage. We aimed to report the radiological and clinical outcomes of staged surgical interventions performed following complete closure of the fasciotomy wound for the treatment of TPF complicated by ACS.Additionally, we analyzed factors associated with complications arising from these procedures. Methods: Thirty patients with TPF and ACS were included (23 men and 7 women; average age, 59.7 years). The mean followup period was 33.2 months (range, 12–85 months). An external fixator was initially applied with emergency fasciotomy, and open reduction and plate fixation were performed after complete closure of the fasciotomy wound and soft-tissue stabilization (mean, 31 days; range, 9–55 days). Radiological evaluation of bone union and alignment was conducted, functional evaluation of the knee and ankle joints was performed using the Knee Society and American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications and related factors were analyzed. Results: Primary bone union was achieved in 29 of the 30 cases (96.7%) at an average of 20.8 weeks (range, 12–35 weeks). Malalignment was not observed in any case. At the final follow-up examination, the mean Knee Society and AOFAS scores were 92.5 (range, 65–100) and 95.5 (range, 74–100), respectively. Complications included 1 case of nonunion (3.3%), 2 cases of deep wound infection (6.7%), and 5 cases of traumatic arthritis (16.7%). A statistically significant correlation was noted between complications and patients who underwent dual approaches for the fixation of bicondylar TPFs. Conclusions A staged operation coupled with sufficient soft-tissue healing can achieve excellent bone union and functional outcomes in patients with TPF and ACS. However, complications may occur more often in patients undergoing dual approaches for bicondylar TPFs, necessitating vigilant monitoring and management.

Background: Staged operations are commonly employed in the management of high-energy tibial plateau fractures (TPF) complicated by acute compartment syndrome (ACS); however, complications, such as nonunion, deep wound infection, and traumatic arthritis, often occur due to severe bone and soft-tissue damage. We aimed to report the radiological and clinical outcomes of staged surgical interventions performed following complete closure of the fasciotomy wound for the treatment of TPF complicated by ACS.Additionally, we analyzed factors associated with complications arising from these procedures. Methods: Thirty patients with TPF and ACS were included (23 men and 7 women; average age, 59.7 years). The mean followup period was 33.2 months (range, 12–85 months). An external fixator was initially applied with emergency fasciotomy, and open reduction and plate fixation were performed after complete closure of the fasciotomy wound and soft-tissue stabilization (mean, 31 days; range, 9–55 days). Radiological evaluation of bone union and alignment was conducted, functional evaluation of the knee and ankle joints was performed using the Knee Society and American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications and related factors were analyzed. Results: Primary bone union was achieved in 29 of the 30 cases (96.7%) at an average of 20.8 weeks (range, 12–35 weeks). Malalignment was not observed in any case. At the final follow-up examination, the mean Knee Society and AOFAS scores were 92.5 (range, 65–100) and 95.5 (range, 74–100), respectively. Complications included 1 case of nonunion (3.3%), 2 cases of deep wound infection (6.7%), and 5 cases of traumatic arthritis (16.7%). A statistically significant correlation was noted between complications and patients who underwent dual approaches for the fixation of bicondylar TPFs. Conclusions A staged operation coupled with sufficient soft-tissue healing can achieve excellent bone union and functional outcomes in patients with TPF and ACS. However, complications may occur more often in patients undergoing dual approaches for bicondylar TPFs, necessitating vigilant monitoring and management.

Background: Staged operations are commonly employed in the management of high-energy tibial plateau fractures (TPF) complicated by acute compartment syndrome (ACS); however, complications, such as nonunion, deep wound infection, and traumatic arthritis, often occur due to severe bone and soft-tissue damage. We aimed to report the radiological and clinical outcomes of staged surgical interventions performed following complete closure of the fasciotomy wound for the treatment of TPF complicated by ACS.Additionally, we analyzed factors associated with complications arising from these procedures. Methods: Thirty patients with TPF and ACS were included (23 men and 7 women; average age, 59.7 years). The mean followup period was 33.2 months (range, 12–85 months). An external fixator was initially applied with emergency fasciotomy, and open reduction and plate fixation were performed after complete closure of the fasciotomy wound and soft-tissue stabilization (mean, 31 days; range, 9–55 days). Radiological evaluation of bone union and alignment was conducted, functional evaluation of the knee and ankle joints was performed using the Knee Society and American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications and related factors were analyzed. Results: Primary bone union was achieved in 29 of the 30 cases (96.7%) at an average of 20.8 weeks (range, 12–35 weeks). Malalignment was not observed in any case. At the final follow-up examination, the mean Knee Society and AOFAS scores were 92.5 (range, 65–100) and 95.5 (range, 74–100), respectively. Complications included 1 case of nonunion (3.3%), 2 cases of deep wound infection (6.7%), and 5 cases of traumatic arthritis (16.7%). A statistically significant correlation was noted between complications and patients who underwent dual approaches for the fixation of bicondylar TPFs. Conclusions A staged operation coupled with sufficient soft-tissue healing can achieve excellent bone union and functional outcomes in patients with TPF and ACS. However, complications may occur more often in patients undergoing dual approaches for bicondylar TPFs, necessitating vigilant monitoring and management.

Background: Staged operations are commonly employed in the management of high-energy tibial plateau fractures (TPF) complicated by acute compartment syndrome (ACS); however, complications, such as nonunion, deep wound infection, and traumatic arthritis, often occur due to severe bone and soft-tissue damage. We aimed to report the radiological and clinical outcomes of staged surgical interventions performed following complete closure of the fasciotomy wound for the treatment of TPF complicated by ACS.Additionally, we analyzed factors associated with complications arising from these procedures. Methods: Thirty patients with TPF and ACS were included (23 men and 7 women; average age, 59.7 years). The mean followup period was 33.2 months (range, 12–85 months). An external fixator was initially applied with emergency fasciotomy, and open reduction and plate fixation were performed after complete closure of the fasciotomy wound and soft-tissue stabilization (mean, 31 days; range, 9–55 days). Radiological evaluation of bone union and alignment was conducted, functional evaluation of the knee and ankle joints was performed using the Knee Society and American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications and related factors were analyzed. Results: Primary bone union was achieved in 29 of the 30 cases (96.7%) at an average of 20.8 weeks (range, 12–35 weeks). Malalignment was not observed in any case. At the final follow-up examination, the mean Knee Society and AOFAS scores were 92.5 (range, 65–100) and 95.5 (range, 74–100), respectively. Complications included 1 case of nonunion (3.3%), 2 cases of deep wound infection (6.7%), and 5 cases of traumatic arthritis (16.7%). A statistically significant correlation was noted between complications and patients who underwent dual approaches for the fixation of bicondylar TPFs. Conclusions A staged operation coupled with sufficient soft-tissue healing can achieve excellent bone union and functional outcomes in patients with TPF and ACS. However, complications may occur more often in patients undergoing dual approaches for bicondylar TPFs, necessitating vigilant monitoring and management.

Based on the clinical, histopathological, and perioperative data of a patient with differentiated thyroid cancer (DTC), risk stratification based on their initial recurrence risk is a crucial follow-up (FU) strategy during the first 1–2 years after initial therapy. However, restratifiying the recurrence risk on the basis of current clinical data that becomes available after considering the response to treatment (ongoing risk stratification, ORS) provides a more accurate prediction of the status at the final FU and a more tailored management approach. Since the 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and DTC, the latest guidelines that include the National Comprehensive Cancer Network clinical practice and European Association for Medical Oncology guidelines have been updated to reflect several recent evidence in ORS and thyroid-stimulating hormone (TSH) suppression of DTC. The current clinical practice guideline was developed by extracting FU surveillance after the initial treatment section from the previous version of guidelines and updating it to reflect recent evidence. The current revised guideline includes recommendations for recent ORS, TSH target level based on risk stratification, FU tools for detection of recurrence and assessment of disease status, and long-term FU strategy for consideration of the disease status. These evidence-based recommendations are expected to avoid overtreatment and intensive FU of the majority of patients who will have a very good prognosis after the initial treatment of DTC patients, thereby ensuring that patients receive the most appropriate and effective treatment and FU options.

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.

Objective: To assess whether computed tomography (CT) conversion across different scan parameters and manufacturers using a routable generative adversarial network (RouteGAN) can improve the accuracy and variability in quantifying interstitial lung disease (ILD) using a deep learning-based automated software. Materials and Methods: This study included patients with ILD who underwent thin-section CT. Unmatched CT images obtained using scanners from four manufacturers (vendors A-D), standard- or low-radiation doses, and sharp or medium kernels were classified into groups 1–7 according to acquisition conditions. CT images in groups 2–7 were converted into the target CT sty le (Group 1: vendor A, standard dose, and sharp kernel) using a RouteGAN. ILD was quantified on original and converted CT images using a deep learning-based software (Aview, Coreline Soft). The accuracy of quantification was analyzed using the dice similarity coefficient (DSC) and pixel-wise overlap accuracy metrics against manual quantification by a radiologist. Five radiologists evaluated quantification accuracy using a 10-point visual scoring system. Results: Three hundred and fifty CT slices from 150 patients (mean age: 67.6 ± 10.7 years; 56 females) were included. The overlap accuracies for quantifying total abnormalities in groups 2–7 improved after CT conversion (original vs. converted: 0.63vs. 0.68 for DSC, 0.66 vs. 0.70 for pixel-wise recall, and 0.68 vs. 0.73 for pixel-wise precision; P < 0.002 for all). The DSCs of fibrosis score, honeycombing, and reticulation significantly increased after CT conversion (0.32 vs. 0.64, 0.19 vs. 0.47, and 0.23 vs. 0.54, P < 0.002 for all), whereas those of ground-glass opacity, consolidation, and emphysema did not change significantly or decreased slightly. The radiologists’ scores were significantly higher (P < 0.001) and less variable on converted CT. Conclusion CT conversion using a RouteGAN can improve the accuracy and variability of CT images obtained using different scan parameters and manufacturers in deep learning-based quantification of ILD.