Minimally invasive treatment of symptomatic thyroid nodules is now commonplace. Ethanol ablation (EA) of thyroid cystic nodules has been performed since the 1990s, but there is no global consensus or guideline. Although various limitations of EA have been described, recommendations for practical application are necessary. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology initiated the present consensus statement and here we provide recommendations for the role of EA in the management of symptomatic thyroid nodules. These recommendations are based on evidence to date from the literature and expert opinion.
Advisory Committees ; Consensus ; Ethanol ; Expert Testimony ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule

BACKGROUND: Human adipose tissue is routinely discarded as medical waste. However, this tissue may have valuable clinical applications since methods have been devised to effectively isolate adipose-derived extracellular matrix (ECM), growth factors (GFs), and stem cells. In this review, we analyze the literature that devised these methods and then suggest an optimal method based on their characterization results. METHODS: Methods that we analyze in this article include: extraction of adipose tissue, decellularization, confirmation of decellularization, identification of residual active ingredients (ECM, GFs, and cells), removal of immunogens, and comparing structural/physiological/biochemical characteristics of active ingredients. RESULTS: Human adipose ECMs are composed of collagen type I–VII, laminin, fibronectin, elastin, and glycosaminoglycan (GAG). GFs immobilized in GAG include basic fibroblast growth factor (bFGF), transforming growth factor beta 1(TGF-b1), insulin like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), BMP4 (bone morphogenetic protein 4), nerve growth factor (NGF), hepatocyte growth factor (HGF), and epithermal growth factor (EGF). Stem cells in the stromal-vascular fraction display mesenchymal markers, self-renewal gene expression, and multi-differentiation potential. CONCLUSION: Depending on the preparation method, the volume, biological activity, and physical properties of ECM, GFs, and adipose tissue-derived cells can vary. Thus, the optimal preparation method is dependent on the intended application of the adipose tissue-derived products.
Adipose Tissue ; Collagen ; Elastin ; Extracellular Matrix ; Fibroblast Growth Factor 2 ; Fibronectins ; Gene Expression ; Hepatocyte Growth Factor ; Humans ; Insulin ; Intercellular Signaling Peptides and Proteins ; Laminin ; Medical Waste ; Methods ; Nerve Growth Factor ; Platelet-Derived Growth Factor ; Stem Cells ; Transforming Growth Factor beta ; Vascular Endothelial Growth Factor A

OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.

Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed recommendations for the optimal use of radiofrequency ablation for thyroid tumors in 2012. As new meaningful evidences have accumulated, KSThR decided to revise the guidelines. The revised guideline is based on a comprehensive analysis of the current literature and expert consensus.
Advisory Committees ; Catheter Ablation* ; Consensus ; Humans ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA-PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
Aluminum Compounds ; therapeutic use ; Calcification, Physiologic ; physiology ; Calcium Compounds ; therapeutic use ; Crystallization ; Dental Pulp Cavity ; microbiology ; Dentin ; microbiology ; Drug Combinations ; Enterococcus faecalis ; ultrastructure ; Humans ; Methylmethacrylates ; therapeutic use ; Microscopy, Electron, Scanning ; Oxides ; therapeutic use ; Root Canal Filling Materials ; therapeutic use ; Root Canal Obturation ; methods ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Time Factors ; Zinc Oxide-Eugenol Cement ; therapeutic use

BACKGROUND AND OBJECTIVES: The use of several approaches, involving different cerebellopontine angles, has enabled vestibular schwannoma removal to be tailored to each patient's pathology and physiological status. The retrosigmoid approach provides simple and direct access to cerebello-pontine angle lesions. SUBJECTS AND METHODS: We retrospectively assessed outcomes in 35 consecutive patients who underwent vestibular schwannoma removal via the retrosigmoid approach. RESULTS: Of the 35 patients, 12 were men and 23 women; their age was 52.5+/-10.4 years (range, 35-75 years). One tumor was small (< or =1 cm), 18 were medium (1-3 cm), and 16 (45.7%) were large (>3 cm). Symptoms included hearing disturbance (31 patients, 89%), tinnitus (14 patients, 40%), headache (12 patients, 34%), vertigo (11 patients, 31%), and facial palsy (9 patients, 25%). Postoperative complications included facial palsy, intracranial hemorrhage, dysphagia, and disseminated intravascular coagulopathy, with facial palsy remaining permanently. Four patients (11.4%) had tumor regrowth, at a mean of 36.3 months after primary surgery. The mean diameter of regrowing tumors was 20.5+/-4.4 mm (range 14.5-25.0 mm). CONCLUSIONS: The retrosigmoid approach for vestibular schwannoma removal was associated with higher rates of facial palsy and hearing loss. This approach, however, can minimize injury to the lower cranial nerve.
Cerebellopontine Angle ; Cranial Nerves ; Deglutition Disorders ; Facial Paralysis ; Headache ; Hearing ; Hearing Loss ; Humans ; Intracranial Hemorrhages ; Male ; Neuroma, Acoustic ; Postoperative Complications ; Retrospective Studies ; Tinnitus ; Vertigo

BACKGROUND AND OBJECTIVES: The use of several approaches, involving different cerebellopontine angles, has enabled vestibular schwannoma removal to be tailored to each patient's pathology and physiological status. The retrosigmoid approach provides simple and direct access to cerebello-pontine angle lesions. SUBJECTS AND METHODS: We retrospectively assessed outcomes in 35 consecutive patients who underwent vestibular schwannoma removal via the retrosigmoid approach. RESULTS: Of the 35 patients, 12 were men and 23 women; their age was 52.5+/-10.4 years (range, 35-75 years). One tumor was small (< or =1 cm), 18 were medium (1-3 cm), and 16 (45.7%) were large (>3 cm). Symptoms included hearing disturbance (31 patients, 89%), tinnitus (14 patients, 40%), headache (12 patients, 34%), vertigo (11 patients, 31%), and facial palsy (9 patients, 25%). Postoperative complications included facial palsy, intracranial hemorrhage, dysphagia, and disseminated intravascular coagulopathy, with facial palsy remaining permanently. Four patients (11.4%) had tumor regrowth, at a mean of 36.3 months after primary surgery. The mean diameter of regrowing tumors was 20.5+/-4.4 mm (range 14.5-25.0 mm). CONCLUSIONS: The retrosigmoid approach for vestibular schwannoma removal was associated with higher rates of facial palsy and hearing loss. This approach, however, can minimize injury to the lower cranial nerve.
Cerebellopontine Angle ; Cranial Nerves ; Deglutition Disorders ; Facial Paralysis ; Headache ; Hearing ; Hearing Loss ; Humans ; Intracranial Hemorrhages ; Male ; Neuroma, Acoustic ; Postoperative Complications ; Retrospective Studies ; Tinnitus ; Vertigo

BACKGROUND: Intrathecal opioids in combination with bupivacaine has been shown to provide adequate sensory blockade and early recovery from spinal anesthesia. This study was investigated the added effects of intrathecal fentanyl 10 microgram to bupivacaine for spinal anesthesia. METHODS: Sixty patients undergoing lower extremity surgery were into three groups. Group I received bupivacaine 10 mg (0.5%), gruop II received bupivacaine 5 mg with normal saline 1 ml, and group III received bupivacaine 5 mg with fentanyl 10 microg and normal saline 0.8 ml. RESULTS: There was no significant difference between group I and group III in the peak level and duration of sensory block. But the intensity of motor blockade was decreased in group III compared with group I and side effects of spinal anesthesia with local anesthetics was decreased in group III compared with group I. In Group II, 7 patients were complained the pain during surgery. CONCLUSIONS: Intrathecal fentanyl 10 microgram with bupivacaine 5 mg on spinal blockade provide reliable anesthesia for lower extremity surgery.
Analgesics, Opioid ; Anesthesia ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Fentanyl ; Humans ; Lower Extremity

Children with abnormal sex development may present with ambiguous genitalia in the newborn period or lacking of secondary sexual characteristics in puberty. Clinicians should make a prompt and accurate diagnosis and counsel parents on therapeutic options to minimize or avoid medical and psychological complications. 5alpha-reductase deficiency is a rare autosomal recessive disorder of sex development caused by a mutation of the 5alpha-reductase type 2 gene. As a result, there is an abnormality in conversion of testosterone (T) to dihydrotestosterone (DHT) and children with 5alpha-reductase deficiency are born with ambiguous genitalia. Here, we report identical twins who presented with ambiguous genitalia with a 46,XY karyotype and were diagnosed as 5alpha-reductase deficiency.
Child ; Dihydrotestosterone ; Disorders of Sex Development ; Humans ; Infant, Newborn ; Karyotype ; Parents ; Puberty ; Sexual Development ; Testosterone ; Twins, Monozygotic

According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.
Dental Implants* ; Dentistry ; Emergency Service, Hospital ; Hematoma ; Hemorrhage ; Humans ; Jaw Fractures ; Mandible ; Mandibular Fractures ; Maxillary Sinus ; Nasal Cavity ; Peri-Implantitis ; Sinusitis ; Tooth