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Diagnostic Performance of Core Needle Biopsy for Characterizing Thyroidectomy Bed Lesions

  • So Yeong Jeong;Jung Hwan Baek;Sae Rom Chung;Young Jun Choi;Dong Eun Song;Ki-Wook Chung;Won Woong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.1019-1027
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    • 2022
  • Objective: Thyroidectomy bed lesions frequently show suspicious ultrasound (US) features after thyroid surgery. Fine-needle aspiration (FNA) may not provide definitive pathological information about the lesions. Although core-needle biopsy (CNB) has excellent diagnostic performance in characterizing suspicious thyroid nodules, no published studies have evaluated the performance of CNB specifically for thyroidectomy bed lesions. Therefore, we aimed to evaluate the diagnostic performance and safety of CNB for characterizing thyroidectomy bed lesions. Materials and Methods: A total of 124 thyroidectomy bed lesions in 113 patients (79 female and 34 male; age, 23-85 years) who underwent US-guided CNB between December 2008 and December 2020 were included. We reviewed the US imaging features of the target lesions and the histories of previous biopsies. The pathologic results, diagnostic performance for malignancy, and complications of CNB were analyzed. Results: All samples (100%) obtained by CNB were adequate for pathological analysis. Pathological analysis revealed inconclusive results in two lesions (1.6%). According to the reference standard, 50 lesions were ultimately malignant (40.3%), and 72 were benign (58.1%), excluding the two inconclusive lesions. The performance of CNB for diagnosing malignant thyroidectomy bed lesions in the 122 lesions had a sensitivity of 98.0% (49/50), a specificity of 100% (72/72), positive predictive value of 100% (49/49), and negative predictive value of 98.6% (72/73). Eleven lesions were referred for CNB after prior inconclusive FNA results in thyroidectomy bed lesions, for all of which CNB yielded correct conclusive pathologic diagnoses. According to the pathological analysis of CNB, there were various benign lesions (58.9%, 73/124) besides recurrence, including benign postoperative lesions other than suture granuloma (32.3%, 40/124), suture granuloma (15.3%, 19/124), remnant thyroid tissue (5.6%, 7/124), parathyroid lesions (4%, 5/124), and abscesses (1.6%, 2/124). No major or minor complications were associated with the CNB procedure. Conclusion: US-guided CNB is accurate and safe for characterizing thyroidectomy bed lesions.

Study of the Derive of Core Habitats for Kirengeshoma koreana Nakai Using HSI and MaxEnt (HSI와 MaxEnt를 통한 나도승마 핵심서식지 발굴 연구)

  • Sun-Ryoung Kim;Rae-Ha Jang;Jae-Hwa Tho;Min-Han Kim;Seung-Woon Choi;Young-Jun Yoon
    • Korean Journal of Environment and Ecology
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    • v.37 no.6
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    • pp.450-463
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    • 2023
  • The objective of this study is to derive the core habitat of the Kirengeshoma koreana Nakai utilizing Habitat Suitability Index (HSI) and Maximum Entropy (MaxEnt) models. Expert-based models have been criticized for their subjective criteria, while statistical models face difficulties in on-site validation and integration of expert opinions. To address these limitations, both models were employed, and their outcomes were overlaid to derive the core habitat. Five variables were identified through a comprehensive literature review and spatial analysis based on appearance coordinates. The environmental variables encompass vegetation zone, forest type, crown density, annual precipitation, and effective soil depth. Through surveys involving six experts, importance rankings and SI (Suitability Index) scores were established for each variable, subsequently facilitating the creation of an HSI map. Using the same variables, the MaxEnt model was also executed, resulting in a corresponding map, which was merged to construct the definitive core habitat map. Out of 16 observed locations of K. koreana, 15 were situated within the identified core habitat. Furthermore, an area historically known to host K. koreana but not verified in the present, Mt. Yeongchwi, was found to lack a core habitat. These findings suggest that the developed models exhibit a high degree of accuracy and effectively reflect the current ecological landscape.

Surgical Outcomes of Cervical Esophageal Cancer: A Single-Center Experience

  • Yoonseo Lee;Jeonghee Yun;Yeong Jeong Jeon;Junghee Lee;Seong Yong Park;Jong Ho Cho;Hong Kwan Kim;Yong Soo Choi;Young Mog Shim
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.62-69
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    • 2024
  • Background: Cervical esophageal cancer is a rare malignancy that requires specialized care. While definitive chemoradiation is the standard treatment approach, surgery remains a valuable option for certain patients. This study examined the surgical outcomes of patients with cervical esophageal cancer. Methods: The study involved a retrospective review and analysis of 24 patients with cervical esophageal cancer. These patients underwent surgical resection between September 1994 and December 2018. Results: The mean age of the patients was 61.0±10.2 years, and 22 (91.7%) of them were male. Furthermore, 21 patients (87.5%) had T3 or T4 tumors, and 11 (45.8%) exhibited lymph node metastasis. Gastric pull-up with esophagectomy was performed for 19 patients (79.2%), while 5 (20.8%) underwent free jejunal graft with cervical esophagectomy. The 30-day operative mortality rate was 8.3%. During the follow-up period, complications included leakage at the anastomotic site in 9 cases (37.5%) and graft necrosis of the gastric conduit in 1 case. Progression to oral feeding was achieved in 20 patients (83.3%). Fifteen patients (62.5%) displayed tumor recurrence. The median time from surgery to recurrence was 10.5 months, and the 1-year recurrence rate was 73.3%. The 1-year and 3-year survival rates were 75% and 33.3%, respectively, with a median survival period of 17 months. Conclusion: Patients with cervical esophageal cancer who underwent surgical resection faced unfavorable outcomes and relatively poor survival. The selection of cases and decision to proceed with surgery should be made cautiously, considering the risk of severe complications.

Sinus floor elevation and implant-supported fixed dental prosthesis in the posterior area, with full-digital system: a case report (완전 디지털 시스템을 이용한 상악동 거상술 및 구치부 임플란트 고정성 보철 수복 증례)

  • Gang Soo Park;Sunjai Kim;Se-Wook Pyo;Jae-Seung Chang
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.157-164
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    • 2024
  • A variety of digital technologies are being used throughout the entire implant treatment process of diagnosis, surgery, impression, design, and fabrication of prostheses. In this case, using a digital surgical guide, sinus floor elevation was performed without complications, and the implants were placed in the planned position. After the healing period for osseointegration, CAD-CAM (Computer-aided design-Computer-aided manufacturing) customized abutments and provisional prostheses were delivered. While using the provisional prosthesis, occlusal change was observed. To transfer the intermaxillary relationship and abutment position that reflect occlusal change and axial displacement, double scanning and abutment-level digital impressions were taken. Abutment superimposition was used to capture the subgingival margin without gingival retraction. Then, the definitive prosthesis was designed and fabricated with digital system. We report a case applying digital system, to achieve the predictable result as well as the efficient treatment process from implant surgery to fabricating prosthesis in the posterior area.

Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty

  • Troy Li;Akiro H. Duey;Christopher A. White;Amit Pujari;Akshar V. Patel;Bashar Zaidat;Christine S. Williams;Alexis Williams;Carl M. Cirino;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.231-237
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    • 2023
  • Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA. Methods: Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival. Results: At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure. Conclusions: When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.

Mother's Emotional Expressivity, Young Children's Self-regulation and Peer Competency (어머니의 정서표현성과 유아의 자기조절능력 및 또래 유능성)

  • Lee, Young Soon;Chong, Young Sook;Lee, Ki Young
    • Korean Journal of Childcare and Education
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    • v.2 no.1
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    • pp.41-63
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    • 2006
  • The purpose of this study is to investigate the differences among mother's feeling expression, children's self-regulation, and children's peer competency by socio-demographic background and provide a basic material to develop the parents' education for mother's promosing emotional environment to help development of children by understanding the correlation among mother's feeling expression children's self-regulation, and children's peer competency. The research objects were 361 of 4 to 6-year-old children and their mothers. The tool adapted by Woo Sookyong(2002) was used for Mother's emotional expressivity, and the tool of Lee Jeongran(2003) for the of self regulation and the tool of park Joohee and Lee Eunhae for the children's peer competency. Data analysis was performed with population, percentage, t-test, Cronbach $\alpha$, F-test, and co-relation of LSD posteriori test. The summary of this study are as follows; First, the more negative expressivity was shown as mother's academic career was higher and the more positive one was appeared as family income was greater according to the background of socio-demography. Female children showed the higher self-regulation, and the self-decision and action control were greater as their age was higher. Children's peer competency was higher as they were social and friendly personality. Second, there was the strong relationship among the mother's feeling expressivity, children's self-regulation and peer competency one. Mother's positive expressivity had the relationship with children's self-regulation and peer competency one while weak expressivity had it with self-decision, regulation and children's peer competency. But the strong negative heartstrings' expressivity was an improper co-relation with action control and no relation with similar age competent ability. A definitive relation existed between all low level area except the emotion of self-regulation and children's peer competency. Form the above study, it was Known that there was the relationship among the mother's feeling expressivity, children's self-regulation and peer competency. In particular, there was strong relationship between positive and weak positive expressivity, and children's self-regulation and peer competency. These results could be reflected to parents' heartstrings education by knowing the impact of a positive emotional expressivity and weak-negative one.

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Early Diagnosis of Fatty Liver-Hemorrhagic Syndrome using Blood Biochemistry in Commercial Layers (산란계의 혈액화학치 측정에 의한 지방간 출혈 증후군의 조기 진단)

  • So, H.H.;Jeon, E.O.;Byun, S.H.;Mo, I.P.
    • Korean Journal of Poultry Science
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    • v.36 no.2
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    • pp.165-175
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    • 2009
  • Fatty liver-hemorrhagic syndrome (FLHS) is a common nutritional disease in commercial layers and breeders. The most important clinical sign of FLHS is a sudden drop in egg production and increased mortality which causes significant economic loss in the poultry industry. However, the current diagnostic method for FLHS is based on the gross findings at necropsy which is not helpful to reduce the economic loss because of lateness of diagnosis. Therefore, we need early diagnosis and diagnostic methods before chickens were affected by FLHS. In this study we tried to evaluate the effectiveness of clinical pathology including blood chemistry as an early diagnostic method for FLHS in commercial chickens. Profiles of blood biochemistry were compared between two flocks selected in the same commercial layer farm based on the presence of FLHS clinical sings. A flock with clinical signs of FLHS was designated as FLHS and other flock without clinical signs of FLHS as Non-FLHS. Several parameters of blood biochemistry were selected and compared between FLHS and Non-FLHS to evaluate the possibility of early diagnosis. Average concentrations of serum cholesterol, serum calcium, aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK) were $139.4\;{\pm}\;87.2$ (mg/dL), $24.5\;{\pm}\;5.4$ (mg/dL), $153.6\;{\pm}\;23.1$ (IU/L), $1238.3\;{\pm}\;475.2$ (IU/L) and $1107.3\;{\pm}\;422.8$ (IU/L) in Non-FLHS flock, respectively, and $210.2\;{\pm}\;173.2$ (mg/dL), $25.2\;{\pm}\;4.1$ (mg/dL), $174.3\;{\pm}\;53.5$ (IU/L), $1694.9\;{\pm}\;691.3$ (IU/L) and $1104.9\;{\pm}\;472.9$ (IU/L) in FLHS flock, respectively. The activities of serum cholesterol, AST and LDH except CK, were significantly higher in FLHS than those in Non-FLHS flock (p<0.05). Some birds of FLHS flock showed 2~17 times greater than in Non-FLHS flock. For the definitive diagnosis of FLHS in the flocks tested for blood chemistry, we analyzed fat content and histological lesion score in the liver sampled from both FLHS and Non-FLHS flock. Average liver fat contents based on dry weight were $16.1\;{\pm}\;0.4$ (%) in Non-FLHS flock and were $21.6\;{\pm}\;16.0$ (%) in FLHS flock. These result confirmed that FLHS flock was definitely affected by FLHS. The above results suggest that selected parameters of blood biochemistry, particularly AST, could be useful to diagnose FLHS before significant liver damage occurred in commercial layers.

Study on the Usefulness of Ultrasonography for Postpartum Depression and Thyroid Disease (출산 후 우울증과 갑상선질환에 대한 초음파검사의 유용성에 관한 연구)

  • Lee, Yun-Yi;Lim, Cheong-Hwan;Jung, Hong-Ryang;Park, Mi-Ja;You, In-Gyu
    • Journal of radiological science and technology
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    • v.35 no.3
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    • pp.237-248
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    • 2012
  • Postpartum depression(PPD) of women with depression increased frequency of thyroid disease, and so the correlations for depression and thyroid disease has been the subject of discussed whether. The purpose of this study was to predict the prevalence of PPD and the correlation between PPD and thyroid disease through ultrasonography. January 2010 to November 2011, Obstetrics & Gynecology in M-clinical center admitted 230 patients within 1 year postpartum were enrolled. EPDS by PPD scale depression screening and general characteristics of subjects were investigated and thyroid was examined that ultrasonography and thyroid blood tests. A total of 230 patients non PPD group were 53.0% and PPD group were 47.0%. In ultrasonography, among 27 patients who changed in size of thyroid, non PPD group were 14.8% and PPD group were 85.2%. Among 124 patients who thyroid nodules were presence, non PPD were 35.8% and PPD group were 64.2%. In ultrasonography, PPD group were higher incidence than non PPD group were changes in size of thyroid and the presence of nodules. There was significant difference between the changed in size of thyroid and thyroid nodules were presence the two group. Definitive histopathological diagnosis was benign in 33 patients (non PPD group were 45.5%, PPD group were 54.5%), malignancy in 5 patients (only PPD group were 100%), thyroiditis in 3 patients (non PPD group were 33.3%, PPD group were 66.7%). The results of thyroid blood tests, abnormal TSH level were 7 patients (non PPD group were 28.6%, PPD group were 71.4%) and abnormal Free T4 level were 9 patients (non PPD group were 44.4%, PPD group were 55.6%). There was no significant difference between the abnormal TSH level and Free T4 level of the two group. 5 patients were diagnosed as thyroid dysfunction. Of these, 2 patients were subclinical hyperthyroidism in non PPD group, 2 patients were subclinical hyperthyroidism and 1 patient was subclinical hyperthyroidism in PPD group. This study was significant the correlation between PPD and thyroid gland disease through ultrasonography. And the objective results of this study might be able to provide guideline that understanding, prevention and treatment for PPD and thyroid disease.

The Role of Radiation Therapy on Local Recurrence of Rectal Cancer (직장암에서 수술후 방사선치료의 역활)

  • Chung, Woong-Ki;Ahn, Sung-Ja;Nam, Taek-Keun;Nah, Byung-Sik;Kim, Young-Jin
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.205-212
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    • 1992
  • Ninety five patients of rectal cancer treated with surgery with or without adjuvant radiation therapy since January 1982 to December 1990 at the Chonnam University Hospital were analysed retrospectively regarding local failure. Of these 95 patients 72 patients were treated with surgery alone and remaining 23 patients received postoperative radiation therapy to pelvis. There were 45 men and 50 women with 53 years of median age. Minimum follow-up period was 19 months and median was47 months (range, 19-125 months). Kaplan-Meier method was used to calculate actuarial risk of local recurrence and survival rate. Comparison between two groups was evaluated by Log rank test. Of total 95 patients twenty seven patients ($28.4\%$) developed local recurrence and 13 patients ($17.3\%$) developed local and distant metastasis concomitantly. Eighty nine percent (24/27) of patients developed local recurrence within 24 months. Pelvic organ adjacent to the primary tumor area was the most common site of initial local recurrence. Of 72 patients treated with surgery alone local recurrence developed in 24 patients. Of 17 patients with stage A and 81 (Gunderson-Sosin modification of Dukes' staging system) 6 patients experienced local recurrence ($31.2\%$). The local recurrence rate of B2 and B3 group was $29.9\%$ (7/33) and that of C2 and C3 was $54.7\%$ (11/19), respectively. There was statistically significant difference between two groups (p<0.05). Of 23 patients treated with definitive surgery and radiation therapy $10\%$ (1/10) recurred in B2 and B3 patients. This was slightly lower than C2 and C3 patients ($22.2\%$, 2/10) of similar policy, but revealed no statistically significant difference (p>0.05). In the patients of B2+3 local failure rate decreased when radiation therapy was added ($29.9\%$ vs $10\%$, p>0.05) and also similar results in C2+3 group ($34.7\%$ vs $22.2\%$, p<0.05). The local failure rate in relation to distance from the anal verge had no statistically significant difference.

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Treatment Outcome of Locally Advanced Non-small Cell Lung Cancer (국소적으로 진행된 비소세포폐암의 치료성적)

  • Lee, Heui-Kwan;Lee, Sun-Young;Kim, Jung-Soo;Kwon, Hyoung-Cheol
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.237-242
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    • 2006
  • $\underline{Purpose}$: We evaluated retrospectively the outcome of locally advanced non-small cell lung cancer patients treated with definitive radiotherapy to find out prognostic factros affecting survival. $\underline{Materials\;and\;Methods}$: 216 cases of stage IIIB non-small cell lung cancer were with treated radiotherapy at our Hospital between 1991 to 2002 and reviewed retrospectively. Cases were classified by mode of treatment and response to treatment. Patients showing complete response or partial response to treatment were included in the "response group", while those showing stable or progressive cancer were included in the "non-response group". $\underline{Results}$: 30 patients completed the planned radiotherapy treatments and 39 patients completed combined treatments or chemoradiotherapy. Median survival was 4.6 months for patients treated with radiotherapy and 9.9 months for those undergoing combined radiotherapy and chemotherapy. Survival rates for the first year were 13.3% with radiotherapy and 35.9% with chemoradiotherapy. In the second year, 3.3% of the radiotherapy patients survived and 20.5% of the patients receiving chemoradiotherapy survived. By the third year, 15.4% of the patients receiving the combined treatments survived. None of the patients treated with radiotherapy alone lived to the third year, however. Overall survival was significantly different between the radiotherapy patients and the combined chemoradiotherapy patients (p<0.001). In the response group, median survival was 7.2 months with radiotherapy and 16.5 months with combined therapy. In the non-response group, median survival was 4.4 months with radiotherapy and 6.7 months with combined treatments. Severe acute complications (grade 3) occurred in 2 cases using radiotherapy, and in 7 cases using combined therapy. $\underline{Conclusion}$: When the patients with stage IIIB non-small cell lung cancer received chemoradiotherapy, treatment response rate and overall survival was greater than with radiation alone.