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Thyroid Radiology Practice: Diagnosis and Interventional Treatment of Patients with Thyroid Nodules (갑상선 영상의학 진료: 갑상선 결절 환자의 진단과 중재적 치료)

  • Jung Hwan Baek;Dong Gyu Na
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.530-548
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    • 2020
  • Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

A Study on the Incidence of Thyroid Cancer in Gender Ultrasound (초음파검사에서 성별에 따른 갑상샘 암의 빈도에 관한 연구)

  • Kwak, Eun-Suk;Lim, Cheong-Hwan;Yang, Oh-Nam
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.145-153
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    • 2015
  • Thyroid nodules are an endocrine disease often found in clinical practice, and patients with thyroid nodules found by chance have rapidly increased alongside development of thyroid ultrasound techniques for health examination purposes. This study analyzes the subjects' general characteristics, thyroid ultrasounds, and fine needle aspiration cytology in order to find out the relationship between male and female thyroid nodules and thyroid cancer frequency. An ultrasound examination of the thyroid was performed for 32,973 individuals who visited the K Hospital of Health Examination. Subjects have no history of thyroid disease and are 20 years old or over. Data of general characteristics, diabetes) was collected by a written survey completed by the subject, and the ultrasound of the thyroid(thyroid nodules existence, size, number) and FNAC was used to find out the malignancy rate. Frequency of patients with thyroid nodule was 4,611(26.1%) in men and 5,341(34.9%) in women between 32,973 individuals. Women's prevalence rate is significantly higher than men, and the prevalence rate significantly increased with age in men and women(p < 0.05). The prevalence of multiple nodules was significantly higher in women(43.5%) than in men(35.6%), and significantly increased with age in men and women(p < 0.05). The fine needle aspiration cytology was performed in 692(men 342, women 350) subjects who showed signs of malignancy through ultrasound. Prevalence of malignancy of the nodules was higher in men(33.3%) than in women(29.4%) although it is not statistically significant. It is known that thyroid nodule prevalence in women is much higher than in men. But this study shows the men's prevalence rate was not too low compared with women, and the men showed a rather higher malignancy rate in nodules than women. It is considered that the role of thyroid ultrasound is both important in men and women.

The Feasibility of Cathepsin B Level in Preoperatively Screening Patients with Thyroid Cancer and Nodular Hyperplasia (갑상선암 및 결절성 증식증 환자의 수술전 스크리닝을 위한 cathepsin B의 발현 양상)

  • Choi, Young-Sik;Kim, Young-Ok;Kim, Woo-Mi
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1514-1521
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    • 2009
  • To evaluate the feasibility of cathepsin-B levels in preoperatively screening patients with thyroid cancer, we assigned these patients to either the thyroid cancer group (n=32) or the nodular hyperplasia group (n=7). Five healthy volunteers served as controls (n=5). We quantified cathepsin-B expressions in cancerous lesions with follicular carcinoma and hyperplastic lesions with nodular hyperplasia, and compared the degrees to those of normal thyroid tissue, which was obtained from matched contralateral lobe. The activity of serum cathepsin B was significantly higher in patients with thyroid carcinoma ($284.87{\pm}79.32$, ${\times}10^{-2}\;mU$) and those with nodular hyperplasia ($255.45{\pm}95.68$, ${\times}10^{-2}\;mU$) than compared to normal control ($168.94{\pm}15.10$, ${\times}10^{-2}\;mU$) (p<0.05). Based on the results of immunoassay, the concentrations of cathepsin B in the thyroid cancer group ($15.50{\pm}7.86\;ng/ml$) and the nodular hyperplasia group ($17.64{\pm}7.49\;ng/ml$) were higher than those of the control group ($4.85{\pm}0.61\;ng/ml$). The degree of cathepsin-B mRNA expression was significantly higher in cancerous or hyperplastic lesions than normal thyroid tissues from matched contralateral lobe with follicular carcinoma or non-neoplastic thyroid disease. Our results indicate that the activity of serum cathepsin B is a useful indicator in screening patients with nodular hyperplasia or neoplastic thyroid disease and it may be involved in the abnormal proliferation of cells.

Suprascapular Nerve Entrapment Syndrome Caused by Ganglion (결절종에 의한 견갑상신경 포착 증후군)

  • Kim Soung Yon;An Sung Chan;Chun Jae Myeung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.65-70
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    • 2002
  • Purpose : To review the operative results and find out better method of a treatment of suprascapular nerve entrapment syndrome caused by ganglion. Materials and Methods : From March of 1996 to May of 2001, thirteen cases of suprascapular nerve entrapment syndrome caused by ganglion were reviewed which were diagnosed using physical examination, EMG and MRI. All of them were treated with open exision of ganglion, nerve decompression and arthroscopic examination. The clinical results were evaluated using subjective recovery of muscle power and ASES (American Shoulder and Elbow Surgeons) score. Results : Nine cases (69$\%$) showed residual symptom such as intermittent pain, insufficient recovery of muscle power, persistent muscle atrophy. Complete recovery in four cases (31$\%$). Mean value of ASES score was 86.4 (70-99.8) points. Postopertively, pain was relieved in 84$\%$ of patients and muscle power was improved in 53$\%$ of the patients but the atrophy persisted. Conclusions : Excision of ganglion is insuffient to relieve the nerve entrapment. Not only excision of ganglion but also treatment of intraarticular lesion, decompression of suprascapular and spinoglenoid notch which attributable to entrapment should be considered for the better clinical results.

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Fine Needle Aspiration Cytology vs. Core Needle Biopsy for Thyroid Nodules: A Prospective, Experimental Study Using Surgical Specimen (갑상선 결절에 대한 세침 흡인 세포 검사와 중심부 바늘 생검의 비교: 수술 검체를 기반으로 한 전향적, 실험적 비교 연구)

  • Hyuk Kwon;Jandee Lee;Soon Won Hong;Hyeong Ju Kwon;Jin Young Kwak;Jung Hyun Yoon
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.645-657
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    • 2022
  • Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.

Image Classification of Thyroid Ultrasound Nodules using Machine Learning and GLCM (머신러닝과 GLCM을 이용하여 갑상샘 초음파영상의 결절분류에 관한 연구)

  • Ye-Na Jung;Soo-Young Ye
    • Journal of the Korean Society of Radiology
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    • v.18 no.4
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    • pp.317-325
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    • 2024
  • This study aimed to classify normal and nodule images in thyroid ultrasound images using GLCM and machine learning. The research was conducted on 600 patients who visited S Hospital in Busan and were diagnosed with thyroid nodules using thyroid ultrasound. In the thyroid ultrasound images, the ROI was set to a size of 50x50 pixels, and 21 parameters and 4 angles were used with GLCM to analyze the normal thyroid patterns and thyroid nodule patterns. The analyzed data was used to distinguish between normal and nodule diagnostic results using the SVM model and KNN model in MATLAB. As a result, the accuracy of the thyroid nodule classification rate was 94% for SVM model and 91% for the KNN model. Both models showed an accuracy of over 90%, indicating that the classification rate is excellent when using machine learning for the classification of normal thyroid and thyroid nodules. In the ROC curve, the ROC curve for the SVM model was generally higher compared to the KNN model, indicating that the SVM model has higher within-sample performance than the KNN model. Based on these results, the SVM model showed high accuracy in diagnosing thyroid nodules. This result can be used as basic data for future research as an auxiliary tool for medical diagnosis and is expected to contribute to the qualitative improvement of medical services through machine learning technology.

Periosteal Ganglion of the Distal Fibula - A Case Report - (원위 비골에서 발생한 골막하 결절종 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.178-181
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    • 2008
  • In contrast to ganglion of the soft tissue, periosteal ganglion occurring within or beneath the periosteum is a rare disorder. The differential diagnosis includes periosteal chondroma, lipoma, giant cell tumor of tendon sheath and periosteal osteosarcoma. Most common location for periosteal ganglion is the tibia, followed by radius, femur and ulna. To our knowledge, only 1 case of periosteal ganglion of the fibula has been reported in the literature. We report a case of periosteal ganglion of the distal fibula in a thirty-year-old woman treated with excision of the cyst and the adjacent periosteum.

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Intraneural Ganglion Cyst of the Peripheral Nerve: Two Cases Report (말초 신경에 발생한 신경 내 결절종: 2예 보고)

  • Kim, Tai-Seung;Jo, Young-Hoon;Paik, Seung-Sam;Kim, Sung-Jae
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.83-86
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    • 2013
  • Ganglion cysts that occurred within sheaths of peripheral nerves have been documented in literatures, but it is relatively rare condition. The peroneal nerve is the most common site of involvement. Other reported sites of involvement are the radial, ulnar, median, sciatic, tibial and posterior interosseous nerves. We report a case of the intraneual ganglion cyst within peroneal nerve and another case of the intraneural ganglion cyst within a medial plantar nerve that were successfully excised without neurologic complication.

Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Shoulder - A Case Report - (견관절 색소 융모 결절성 활막염의 관절경적 치료 - 증례 보고 -)

  • Lee, Seoung-Joon;Yoo, Jae-Chul;Lim, Kyung-Sub
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.140-145
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    • 2007
  • Pigmented villonodular synovitis(PVNS) is a benign proliferative lesion, involving synovial tissue in joints, tendon sheaths, and bursae. Pigmented villonodular synovitis is a rare and usually monoarticular condition and primarily affects the knee joint and hand. Polyarticular PVNS appears in less than 1% of all case and its occurrence in the shoulder is rare(<2%). We present a 64-year-old male who had pigmented villonodular synovitis of both shoulder joints, which was treated by arthroscopic total synovectomy.

Subperiosteal Ganglion Cyst of the Tibia - A Case Report - (경골 골막하 결절종 - 증례보고 -)

  • Min, Kyoung-Dae;Kim, Choeng-Kwan;Yoo, Jee-Soo;Lee, Byung-Ill
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.11-15
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    • 2015
  • A subperiosteal ganglion is a very rare benign soft tissue tumor characterized by mucoid degeneration and cyst formation within the periosteum, which may results in cortical erosion. When evaluating a periosteal mass in out-patient clinic, ultrasonography can be used to define the location and cystic nature of the subperiosteal ganglion. A 48 years old woman had two month history of the protruding mass over the anteromedial aspect of right proximal tibia. Ultrasonography was used for the diagnosis of the subperiosteal ganglion in out-patient clinic and mass was excised uneventfully. We report the case of a subperiosteal ganglion of the proximal tibia with literature review.

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