Background and Objectives: Most laryngeal imaging modalities used continuous light source. However, videostroboscopy adopted the unique stroboscopic flashing light triggered externally and is consistent with fundamental voice frequencies. If laryngeal stroboscopic effect could be obtained in the field of continuous illumination, it woud be more compatible with conventional video. In this study, we established the mathematical algorithm for stroboscopic effect with continuous light and tried to determine the feasibility of laryngeal stroboscopic effect with conventional laryngoscopy using continuous light in the mechanical model.Materials and Method The mechanical model of fan motor system was used to validate to the present study. Rotational images of the fan motor were captured using conventional laryngoscope with continuous light source. Results: On the basis of the mathematical model, the optimal ranges of the frequency for stroboscopic effect were expected as (multiples of sampling rate [S])±(S/5). In the fan motor model, the stroboscopic effects could be confirmed on the basis of the mathematical model using conventional videolaryngoscopy with continuous light source. Conclusion Laryngeal stroboscopic effect with continuous light source might be feasible. The stroboscopic effect with continuous light would be expected to provide greater compatibility to integrate with the other imaging modalities for the vocal folds.

BACKGROUND: Prophylaxis for hepatitis B virus (HBV) recurrence is essential after liver transplantation (LT) in HBV-associated recipients. We conducted real-world analysis of HBV prophylaxis after LT in the Korean population.METHODS: Korean Organ Transplantation Registry (KOTRY) database and additionally collected data (n = 326) were analyzed with special reference to types of HBV prophylaxis.RESULTS: The study cohort comprised 267 cases of living-donor LT and 59 cases of deceased-donor LT. Hepatocellular carcinoma (HCC) was diagnosed in 232 (71.2%) of these subjects. Antiviral agents were used in 255 patients (78.2%) prior to LT. HBV DNA was undetectable in 69 cases (21.2%) and detectable over wide concentrations in the other 257 patients (78.8%) prior to LT. Polymerase chain reaction analysis of the store blood samples detected HBV DNA in all patients, with 159 patients (48.9%) showing concentrations > 100 IU/mL. Post-transplant HBV regimens during the first year included combination therapy in 196 (60.1%), hepatitis B immunoglobulin (HBIG) monotherapy in 121 (37.1%), and antiviral monotherapy in 9 (2.8%). In the second post-transplant year, these regimens had changed to combination therapy in 187 (57.4%), HBIG monotherapy in 112 (34.4%), and antiviral monotherapy in 27 (8.3%). Trough antibody to hepatitis B surface antigen titers > 500 IU/mL and >1,000 IU/mL were observed in 61.7% and 25.2%, respectively. The mean simulative half-life of HBIG was 21.6 ± 4.3 days with a median 17.7 days. Up to 2-year follow-up period, HCC recurrence and HBV recurrence developed in 18 (5.5%) and 6 (1.8%), respectively. HCC recurrence developed in 3 of 6 patients with HBV recurrence.CONCLUSION: Combination therapy is the mainstay of HBV prophylaxis protocols in a majority of Korean LT centers, but HBIG was often administered excessively. Individualized optimization of HBIG treatments using SHL is necessary to adjust the HBIG infusion interval.
Antiviral Agents ; Carcinoma, Hepatocellular ; Cohort Studies ; DNA ; Follow-Up Studies ; Half-Life ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B ; Hepatitis ; Humans ; Immunoglobulins ; Korea ; Liver Transplantation ; Liver ; Organ Transplantation ; Polymerase Chain Reaction ; Recurrence ; Transplants

Objectives: . This study aimed to investigate whether optical coherence tomography (OCT) provides useful information about the microstructures of the middle and inner ear via extratympanic approach and thereby could be utilized as an alternative diagnostic technology in ear imaging. Methods: . Five rats and mice were included, and the swept-source OCT system was applied to confirm the extent of visibility of the middle and inner ear and measure the length or thickness of the microstructures in the ear. The cochlea was subsequently dissected following OCT and histologically evaluated to compare with the OCT images. Results: . The middle ear microstructures such as ossicles, stapedial artery and oval window through the tympanic membrane with the OCT could be confirmed in both rats and mice. It was also possible to obtain the inner ear images such as each compartment of the cochlea in the mice, but the bone covering bulla needed to be removed to visualize the inner ear structures in the rats which had thicker bulla. The bony thickness covering the cochlea could be measured, which showed no significant differences between OCT and histologic image at all turns of cochlea. Conclusion . OCT has been shown a promising technology to assess real-time middle and inner ear microstructures noninvasively with a high-resolution in the animal model. Therefore, OCT could be utilized to provide additional diagnostic information about the diseases of the middle and inner ear.

BACKGROUND: Prophylaxis for hepatitis B virus (HBV) recurrence is essential after liver transplantation (LT) in HBV-associated recipients. We conducted real-world analysis of HBV prophylaxis after LT in the Korean population. METHODS: Korean Organ Transplantation Registry (KOTRY) database and additionally collected data (n = 326) were analyzed with special reference to types of HBV prophylaxis. RESULTS: The study cohort comprised 267 cases of living-donor LT and 59 cases of deceased-donor LT. Hepatocellular carcinoma (HCC) was diagnosed in 232 (71.2%) of these subjects. Antiviral agents were used in 255 patients (78.2%) prior to LT. HBV DNA was undetectable in 69 cases (21.2%) and detectable over wide concentrations in the other 257 patients (78.8%) prior to LT. Polymerase chain reaction analysis of the store blood samples detected HBV DNA in all patients, with 159 patients (48.9%) showing concentrations > 100 IU/mL. Post-transplant HBV regimens during the first year included combination therapy in 196 (60.1%), hepatitis B immunoglobulin (HBIG) monotherapy in 121 (37.1%), and antiviral monotherapy in 9 (2.8%). In the second post-transplant year, these regimens had changed to combination therapy in 187 (57.4%), HBIG monotherapy in 112 (34.4%), and antiviral monotherapy in 27 (8.3%). Trough antibody to hepatitis B surface antigen titers > 500 IU/mL and >1,000 IU/mL were observed in 61.7% and 25.2%, respectively. The mean simulative half-life of HBIG was 21.6 ± 4.3 days with a median 17.7 days. Up to 2-year follow-up period, HCC recurrence and HBV recurrence developed in 18 (5.5%) and 6 (1.8%), respectively. HCC recurrence developed in 3 of 6 patients with HBV recurrence. CONCLUSION Combination therapy is the mainstay of HBV prophylaxis protocols in a majority of Korean LT centers, but HBIG was often administered excessively. Individualized optimization of HBIG treatments using SHL is necessary to adjust the HBIG infusion interval.

BACKGROUND AND OBJECTIVES: High-speed videolaryngoscopy (HSV) is the only technique that captures the true intra-cycle vibratory behavior of the vocal folds by capturing full images of the vocal folds. However, it has problems of no immediate feedback during examination, considerable waiting time for digital kymography (DKG), recording duration limited to a few seconds, and extreme demands for storage space. Herein, we demonstrate a new post-processing method that converts HSV images to two-dimensional digital kymography (2D-DKG) images, which adopts the algorithm of 2D videokymography (2D VKG). MATERIALS AND METHODS: HSV system was used to capture images of vocal folds. HSV images were post-processed in Kay image-process software (KIPS), and conventional DKG images were retrieved. Custom-made post-processing system was used to convert HSV images to 2D-DKG images. The quantitative parameters of the post-processed 2D-DKG images was validated by comparing these parameters with those of the DKG images. RESULTS: Serial HSV images for all phases of vocal fold vibratory movement are included. The images were converted by the scanning method using U-medical image-process software. Similar to conventional DKG, post-processed 2D DKG image from the HSV image can provide quantitative information on vocal fold mucosa vibration, including the various vibratory phases. Differences in amplitude symmetry index, phase symmetry index, open quotient, and close quotient between 2D-DKG and DKG were analyzed. There were no statistical differences between the quantitative parameters of vocal fold vibratory movement in 2D-DKG and DKG. CONCLUSION: The post-processing method of converting HSV images to 2D DKG images could provide clinical information and storage economy.
Kymography ; Methods ; Mucous Membrane ; Vibration ; Vocal Cords ; Voice

BACKGROUND AND OBJECTIVES: The aims of this study were to evaluate the rate and risk factors involved in bilateral central lymph node metastasis in patients with papillary thyroid cancer (PTC) found in the isthmus and compared them to tumors located in other thyroid regions, using those findings to establish a surgical strategy for treating these tumors. SUBJECTS AND METHOD: We compared the clinical and pathological data of 48 patients with isthmic PTC and 141 patients with PTC found in other thyroid regions, all of whom underwent total thyroidectomy and bilateral central neck dissection. RESULTS: The rates of bilateral central lymph node metastasis were higher in the isthmus group than in the non-isthmus group (29.2% vs. 9.9%; p=0.001). On multivariate analysis, the isthmic location of the tumor was an independent risk factor for bilateral central lymph node metastasis (OR=3.458; p=0.005). But the positional relationship between the tracheal midline and the nodule was not clear in lymph node metastasis in the isthmus group. CONCLUSION: Bilateral central neck dissection should be considered for isthmic PTC regardless of the relation between nodule and tracheal midline because of the high rate of bilateral central lymph node metastasis.
Humans ; Lymph Nodes* ; Lymphatic Metastasis ; Methods ; Multivariate Analysis ; Neck Dissection ; Neoplasm Metastasis* ; Risk Factors ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

BACKGROUND/AIMS: The purpose of this study was to compare the diagnostic validity of two-dimensional (2D) and three-dimensional (3D) ultrasonography (US) when predicting the extrathyroidal extension of papillary thyroid cancer. METHODS: All 2D data were interpreted in real time and 3D data were stored, rendered using tomographic ultrasound imaging (TUI), and then reviewed retrospectively. RESULTS: Extrathyroidal extension was present in 17 papillary thyroid cancers(24.3%) on pathology reports. The presence of contact was significantly associated with extrathyroidal extension on both 2D and 3D US (p = 0.007 and p = 0.003), and the sensitivity and specificity were not significantly different between 2D and 3D US (p = 1.000 and p = 0.754). The coexistence of protrusion and contact was not significantly associated with extrathyroidal extension on either 2D or 3D sonogram. CONCLUSIONS: Three-dimensional images rendered with TUI algorithms alone do not seem to be markedly superior to real-time 2D US in predicting the extrathyroidal extension of papillary thyroid cancer.
Adolescent ; Adult ; Aged ; Algorithms ; Carcinoma/*diagnostic imaging/pathology ; Female ; Humans ; *Image Interpretation, Computer-Assisted ; *Imaging, Three-Dimensional ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Predictive Value of Tests ; Retrospective Studies ; Thyroid Neoplasms/*diagnostic imaging/pathology ; Ultrasonography/*methods ; Young Adult

OBJECTIVES: To clarify the anatomical distribution of the lingual artery in normal adult subjects through histopathologic evaluations. METHODS: Eighteen healthy cadaveric tongues were used to produce 8 paraffin-embedded tissue sections each. Length from midline raphe, depth from dorsum of tongue and the whole transverse length tongue were measured. The lateral distance, depth, and proportion of lateral distance of deep lingual artery were determined from tip to base of tongue gradually. Lateral distance is length from median raphe to the center of deep lingual artery lumen. Depth is vertical distance from dorsal surface of tongue to the center of deep lingual artery. Proportion of lateral distance is obtained by dividing lateral distance with transverse length from median raphe to lateral border of tongue. The degree of symmetry between right and left sides and the difference between selected spots were evaluated. RESULTS: Right and left sides of the lingual artery were symmetric. The lingual artery was lateralized as it run posterior. The lingual artery runs gradually deeper from the surface as it goes near the base of tongue. Both length and depth of the lingual artery gradually increased between 0%–75% of the mobile tongue, but 75%–100% zone of the lingual artery showed no significant difference. There was no anastomosis between right and left side of the lingual arteries. The lingual artery was located within 50% of the transverse length of tongue from median raphe. CONCLUSION: The present study reveals 3-dimensional information on the anatomical distributions of the lingual artery in normal adult subjects. These findings gives us beneficial information about the handling of the lingual artery during oral and base of tongue-related surgery.
Adult* ; Arteries* ; Cadaver* ; Humans ; Surgery, Oral ; Tongue*

Despite a low risk of liver failure and preserved liver function, non-cirrhotic hepatocellular carcinoma (HCC) has a poor prognosis. In the current study, we evaluated an active regulator of SIRT1 (AROS) as a prognostic biomarker in non-cirrhotic HCC. mRNA levels of AROS were measured in tumor and non-tumor tissues obtained from 283 non-cirrhotic HCC patients. AROS expression was exclusively up-regulated in recurrent tissues from the non-cirrhotic HCC patients (P=0.015) and also in tumor tissues irrespective of tumor stage (P<0.001) or BCLC stage (P<0.001). High mRNA levels of AROS were statistically significantly associated with tumor stage (P<0.001), BCLC stage (P=0.007), alpha fetoprotein (AFP) level (P=0.013), microvascular invasion (P=0.001), tumor size (P=0.036), and portal vein invasion (P=0.005). Kaplan-Meir curve analysis demonstrated that HCC patients with higher AROS levels had shorter disease-free survival (DFS) in both the short-term (P<0.001) and long-term (P=0.005) compared to those with low AROS. Cox regression analysis demonstrated that AROS is a significant predictor for DFS along with large tumor size, tumor multiplicity, vascular invasion, and poor tumor differentiation, which are the known prognostic factors. In conclusion, AROS is a significant biomarker for tumor aggressiveness in non-cirrhotic hepatocellular carcinoma.
Adult ; Age Distribution ; Aged ; Biomarkers, Tumor/*metabolism ; Carcinoma, Hepatocellular/*epidemiology/*metabolism/pathology ; Disease-Free Survival ; Female ; Humans ; Liver Cirrhosis/epidemiology/metabolism/pathology ; Liver Neoplasms/*epidemiology/*metabolism/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Nuclear Proteins/*metabolism ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Factors ; Sensitivity and Specificity ; Sex Distribution ; Transcription Factors/*metabolism ; Young Adult

BACKGROUND/AIMS: Obesity is correlated with numerous diseases, including thyroid cancer, but the clinical significance of obesity with regard to the clinical characteristics of thyroid cancer remains unclear. Neck circumference is an index of upper-body adipose tissue distribution. METHODS: In total, 401 patients with papillary thyroid carcinoma (PTC) measuring < or = 2 cm were included. Neck circumference was measured horizontally at the level just below the thyroid cartilage on preoperative neck computed tomographic images. RESULTS: Neck circumference correlated significantly with tumor size in men (p = 0.001) but not in women (p = 0.930). Body mass index (BMI) did not significantly correlate with tumor size in either sex. Neck circumference was significantly larger in men with lateral lymph node (LN) metastasis than in those without (p = 0.004). Neck circumference and BMI did not differ significantly in women according to other factors such as tumor size, multifocality, extrathyroid extension, and LN metastasis. Tumor size and the prevalence of lateral LN metastasis in men tended to increase in the middle/large neck circumference subgroup compared with those in the low neck circumference subgroup. Multivariate logistic regression analysis revealed that neck circumference (p = 0.009) was a predictor for the presence of lateral LN metastasis in men. BMI was not a predictive factor for lateral LN involvement in either sex. CONCLUSIONS: Neck circumference, an indicator of central or visceral obesity but not BMI, may be associated with some prognostic factors in men with small PTC.
Adiposity ; Adolescent ; Adult ; Aged ; Anthropometry ; Body Mass Index ; Carcinoma/*secondary/surgery ; Chi-Square Distribution ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Lymph Nodes/*pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neck/*pathology ; Obesity/*diagnosis/pathology/physiopathology ; Odds Ratio ; Predictive Value of Tests ; Prognosis ; Risk Factors ; Sex Factors ; Thyroid Neoplasms/*pathology/secondary/surgery ; Tomography, X-Ray Computed ; *Tumor Burden ; Young Adult