Background and Objectives: Surgical decision-making for papillary thyroid cancer (PTC) relies on accurate preoperative staging, where ultrasonography plays a crucial role in predicting outcomes. We aimed to analyze the predictive effects of preoperative sonographic findings on pathological characteristics. Materials and Methods: Retrospective study was performed using ultrasonographic images and clinico-pathologic data of papillary thyroid cancer patients who underwent total thyroidectomy or lobectomy between March 2016 and May 2020. Finally, 152 patients and 169 tumors were analyzed. Results: Mean age of patients was 54.2±14.2 years and the proportion of female was 75.7%. Tumor size was 13.6±10.3 mm and the proportions of extrathyroidal extension (ETE) and lymph node (LN) involvement were 52.2% and 23.0%, respectively. Preoperative sonographic findings, including ETE, tumor margin, echogenicity, and K-TIRDAS, were significantly associated with pathological ETE.Other pathological characteristics, including LN involvement, lymphovascular invasion, and resection margin positivity, were more observed in patients with more aggressive findings on preoperative sonography; however, we could not find statistical significances. Conclusion This study showed that preoperative sonographic characteristics, such as sonographic ETE, tumor margin, echogenicity, and K-TIRADS, can provide valuable insights into predicting pathological ETE in PTC patients.

Background and Objectives: Surgical decision-making for papillary thyroid cancer (PTC) relies on accurate preoperative staging, where ultrasonography plays a crucial role in predicting outcomes. We aimed to analyze the predictive effects of preoperative sonographic findings on pathological characteristics. Materials and Methods: Retrospective study was performed using ultrasonographic images and clinico-pathologic data of papillary thyroid cancer patients who underwent total thyroidectomy or lobectomy between March 2016 and May 2020. Finally, 152 patients and 169 tumors were analyzed. Results: Mean age of patients was 54.2±14.2 years and the proportion of female was 75.7%. Tumor size was 13.6±10.3 mm and the proportions of extrathyroidal extension (ETE) and lymph node (LN) involvement were 52.2% and 23.0%, respectively. Preoperative sonographic findings, including ETE, tumor margin, echogenicity, and K-TIRDAS, were significantly associated with pathological ETE.Other pathological characteristics, including LN involvement, lymphovascular invasion, and resection margin positivity, were more observed in patients with more aggressive findings on preoperative sonography; however, we could not find statistical significances. Conclusion This study showed that preoperative sonographic characteristics, such as sonographic ETE, tumor margin, echogenicity, and K-TIRADS, can provide valuable insights into predicting pathological ETE in PTC patients.

Background and Objectives: Surgical decision-making for papillary thyroid cancer (PTC) relies on accurate preoperative staging, where ultrasonography plays a crucial role in predicting outcomes. We aimed to analyze the predictive effects of preoperative sonographic findings on pathological characteristics. Materials and Methods: Retrospective study was performed using ultrasonographic images and clinico-pathologic data of papillary thyroid cancer patients who underwent total thyroidectomy or lobectomy between March 2016 and May 2020. Finally, 152 patients and 169 tumors were analyzed. Results: Mean age of patients was 54.2±14.2 years and the proportion of female was 75.7%. Tumor size was 13.6±10.3 mm and the proportions of extrathyroidal extension (ETE) and lymph node (LN) involvement were 52.2% and 23.0%, respectively. Preoperative sonographic findings, including ETE, tumor margin, echogenicity, and K-TIRDAS, were significantly associated with pathological ETE.Other pathological characteristics, including LN involvement, lymphovascular invasion, and resection margin positivity, were more observed in patients with more aggressive findings on preoperative sonography; however, we could not find statistical significances. Conclusion This study showed that preoperative sonographic characteristics, such as sonographic ETE, tumor margin, echogenicity, and K-TIRADS, can provide valuable insights into predicting pathological ETE in PTC patients.

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1–2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

PURPOSE: Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. METHODS: The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008–2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L. RESULTS: Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07–2.95) after adjusting for age, gender, obesity, and metabolic syndrome. CONCLUSION: Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.
Adolescent ; Alanine Transaminase ; Blood Pressure ; Body Mass Index ; Child ; Cholesterol ; Glucose ; Humans ; Male ; Non-alcoholic Fatty Liver Disease ; Nutrition Surveys ; Obesity ; Triglycerides ; Vitamin D Deficiency ; Vitamin D ; Vitamins ; Waist Circumference

Recently, the prevalence of prostate cancer has been increased with the screening of prostate-specific antigen and the increase in the elderly population. In particular, the diagnosis of the low-risk prostate cancer has increased greatly, and social interest for overtreatment has been heightened in Korea. Therefore, this review aimed to provide evidence-based treatment guidelines in low-risk prostate cancer based on Korean population. The literature provides evidence on treatment options, such as watchful waiting, active surveillance, radical prostatectomy, and radiation therapy according to the life expectancy of patients with low-risk prostate cancer. Furthermore, this review provides information on the efficacy of pelvic lymph node dissection and adjuvant radiation therapy during/after radical prostatectomy in low-risk prostate cancer.
Aged ; Diagnosis ; Evidence-Based Medicine ; Humans ; Korea ; Life Expectancy ; Lymph Node Excision ; Mass Screening ; Medical Overuse ; Neoplasms, Second Primary ; Prevalence ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Watchful Waiting

PURPOSE: Pediatric Crohn's disease (CD) is directly related to growth and has a high probability of requiring surgical intervention(s); therefore, more active treatment for CD is required for children. This study investigated the impact of biologics on growth and disease course associated with surgery. METHODS: This was a retrospective cohort study involving patients diagnosed with CD at the Seoul National University Children's Hospital (Seoul, Korea) between January 2006 and October 2017. The aim was to determine the characteristics of pediatric patients with CD and whether biologics affected growth and the surgical disease course. RESULTS: Among patients who underwent surgery for CD, the mean number of operations per patient was 1.89. The mean time from initial diagnosis to surgery was 19.3 months. The most common procedure was fistulectomy (34%), followed by incision and drainage (25%). In all patients, the use of biologics increased the height (p=0.002) and body mass index (BMI) (p=0.005). Among patients who underwent surgery, height (p=0.004) and BMI (p=0.048) were increased in the group using biologics. Patients who used biologics exhibited a low operation rate only within 2 years after diagnosis, with no differences thereafter (p=0.027). CONCLUSION: Although biologics could not mitigate the operation rate in pediatric patients who underwent surgery for CD, biological therapy delayed disease progression within 2 years of disease onset. Additionally, biologics conferred growth and BMI benefits in this window period. Therefore, it may be helpful to use biologics for optimal growth in pediatric patients with a high probability of undergoing future surgery.
Biological Products ; Biological Therapy ; Body Mass Index ; Child ; Cohort Studies ; Crohn Disease ; Diagnosis ; Disease Progression ; Drainage ; Humans ; Infliximab ; Retrospective Studies ; Seoul

We report a case of acute pancreatitis secondary to pancreatic neuroendocrine tumor. A 46-year old man presented with upper abdominal pain. The serum amylase and lipase were elevated. Abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a 1.7 cm sized mass at the pancreas body with a dilatation of the upstream pancreatic duct and mild infiltrations of peripancreatic fat. An endoscopic ultrasound-guided fine needle biopsy was performed for the pancreatic mass, but only necrotic tissue was observed on the pathologic examination. A chest and neck CT scan revealed anterior mediastinal, paratracheal, and cervical lymph node enlargement, which were indicative of metastasis. An ultrasound-guided core needle biopsy was performed for the enlarged neck lymph node, and pathologic examination revealed a metastatic poorly differentiated carcinoma. Immunohistochemical analysis showed positive staining for synaptophysin, chromogranin A, and CD 56, indicative of a neuroendocrine carcinoma.
Abdominal Pain ; Amylases ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle ; Carcinoma, Neuroendocrine ; Cholangiopancreatography, Magnetic Resonance ; Chromogranin A ; Dilatation ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Lipase ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Synaptophysin ; Thorax ; Tomography, X-Ray Computed

Imatinib mesylate is a targeted therapy that acts by inhibiting tyrosine kinase of the bcr-abl fusion oncoprotein, which is specific to chronic myeloid leukemia (CML), and the c-transmembrane receptor, which is specific to gastrointestinal stromal tumors. Interstitial pneumonitis is a rare adverse event of imatinib therapy. It is clinically difficult to distinguish from infectious pneumonia, which can frequently occur due to the underlying disease. The standard treatment for imatinib-induced pneumonitis is to discontinue the medication and optionally administer corticosteroids. However, there are a few cases of successful retrial with imatinib. We describe a case of successful rechallenge of imatinib in a patient with imatinib-induced interstitial pneumonitis and CML without a recurrence of the underlying disease after 3 months of follow-up.
Adrenal Cortex Hormones ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lung Diseases, Interstitial ; Mesylates* ; Pneumonia* ; Protein-Tyrosine Kinases ; Recurrence ; Imatinib Mesylate

PURPOSE: The purpose of this study was to analyze the expierience of the Wonju Disaster Medical Assistant Team (DMAT)'s activities during the Chun-cheon landslide (AM 00:08 on July 7th, 2011) and to present damages caused by the landslide. The scale of the domestic DMAT in the landslide disaster was also assessed. METHODS: In a retrograde study, victims were analyzed video camera recordings and medical records at the landslide disaster. Follow-up surveys of patients taken to the hospital after the Chun-cheon landslide were also analyzed. In addition, pertinence of the Wonju DMAT's activities during the rescue activity, designated by National Emergency Management, were evaluated. RESULTS: Rescue efforts continued until 13:00 on July 7th, 2011. The number of casualties was forty one, consisted of three immediate patients, six delayed patients, nineteen minimal patients, and thirteen expectant patients. The Wonju DMAT arrived at the scene of the landslide disaster at AM 02:30 on July 7th, 2011. After installing a medical office, they categorized patients by ID-ME classification and provided medical treatment to twenty-two patients, including local residents and rescue workers. CONCLUSION: The cause of death in the landslide disaster was suffocation. A small-scale DMAT rescue, composed on five to six people, is more proper for disaster response in a landslide disaster.
Asphyxia ; Cause of Death ; Classification ; Disasters* ; Emergencies ; Follow-Up Studies ; Humans ; Landslides* ; Medical Assistance ; Medical Records ; Rescue Work