• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.119-124
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• 1995

Traditionally, wound drainage after thyroid or parathyroid surgery has been widely used to prevent airway obstruction due to accumulation of hematoma or seroma within the paratracheal dead space. Recently, however, the routine use of drains after thyroid or parathyroid surgery has become a matter of controversy. To determine whether the rouine use of drains after thyroid or parathyroid surgery is warranted, a prospective study on the complications after various types of thyroid or parathyroid surgery without wound drains was conducted. Three hunded sixty-six consecutive patients underwent thyroid or parathyorid surgeries by one surgeon from January through December 1994 were included in this study. Of these, only 38 patients (10.4%) required the wound drains. Indications for drainage included the patients with a large dead space(n=9) or wet operative field at the conclusion of surgery(n=11), and patients with radical neck disection(n=18). In the remaining 328 patients(89.6%), the wounds were closed without drains after thyroid lobectomy and isthmusectomy(n=226), bilateral subtotal thyroidectomy(n=21), total or near-total thyroidectomy(n=62), isthmusectomy(n=9) and parathyroid surgery(n=l0). Histologic findings revealed benign tumors in 214(65.2%), carcinoma in 89(27.1%), Graves' disease in 15(4.7%), hyperparathyroidism in 7(2.1%) and parathyroid cyst in 3(0.9%). Among the 328 patients without drain used, wound related complications were seen in only 15 patients(4.6%); 12 patients with seroma and 3 patients with hematoma. All but one complications could be controlled by two or three aspirations, and the remaining one patient required re-exploration. There were no instances of laryngeal nerve palsy or wound infection. The mean length of hospital stay after surgery was 2.8 days with a range of 1 to 11 days. These results support the routine use of drains is not warranted in most thyroid or parathyroid surgeries.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3477-3482
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• 2016

Background: Thyroid cancer is the most common endocrine malignancy, and exact causes remain unknown. The role of CYP450 1A1 (CYP1A1) in cancer initiation and progression has been investigated. The aim of this work was to analyze, for the first time, CYP1A1 gene expression and its relationship with several clinicopathological factors in Mexican patients diagnosed with thyroid cancer. Materials and Methods: Real-time PCR analysis was conducted on 32 sets of thyroid tumors and benign pathologies. Expression levels were tested for correlations with clinical and pathological data. All statistical analysis were performed using GraphPad Prism version 3.0 software. Results: We found that female gender was associated with thyroid cancer risk (P<0.05). A positive relationship was identified between CYP1A1 mRNA levels and the presence of chronic disease, alcohol use, tumor size, metastasis and an advanced clinical stage (P<0.05). Conclusions: The results suggest that CYP1A1 gene expression could be used as a marker for thyroid cancer.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.184-191
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• 2008

Purpose: To evaluate the degree of malignancy of incident thyroid lesion found in $^{18}F$-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods: A retrograde study was conducted of 800 patients who were admitted in E hospital to receive $^{18}F$-FDG PET/CT examination. One patient who was diagnosed as primary thyroid cancer and received $^{18}F$-FDG PET/CT examination was excluded. The number of final patients of this study was 799, the reasons of $^{18}F$-FDG PET/CT examination of these patients were follow-up of old cancer or suspicious tumorous lesion in 696 and disease screening in 103. $^{18}F$-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal $^{18}F$-FDG PET/CT image (1 hr) and then 1 hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid $^{18}F$-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1 hr later, we took a 1 bed-delayed image and then made a comparative study between measured $SUV_{max}$ of 1 hr-abnormal uptake image and that of 2 hr-delayed image. Results and Conclusion: In this $^{18}F$-FDG PET/CT study among the patients who showed incidental $^{18}F$-FDG thyroidal uptake the number of thyroid incidentaloma was 5 (0.63%), all of then showed benign findings. And in the case of incidental $^{18}F$-FDG uptake in thyroid, $SUV_{max}$ variance obtained from 2 hr delayed image can be a indirect criteria in differentiating benign tumor from malignancy and decrease finding error. In the cases found thyroid incidentaloma when 1) $SUV_{max}$ of focal thyroid lesion is above 5.0 and 2) $SUV_{max}$ variance between normal $^{18}F$-FDG PET/CT exam and 2 hr delayed is $1.0{\pm}0.5$, they are suspected as malignancy and confirming biopsy is to be followed. Otherwise, I also think that distinct follow-up PET or CT image study is a reasonable diagnostic method.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.112-115
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• 2009

Purpose: The test had been applied for outpatient by end of 2006, however, it has been included in the medical examination since January 2007, as demand and interests have been gradually increasing in the thyroid gland disease and cancer. thus, we would necessarily evaluate usefulness of the test by comparing the number of patients who are diagnosed as "benignancy" by the medical test with the number of outpatient who attend and are diagnosed as autoimmune thyroid disease among the benign patient, in samsung medical center for a certain period. Materials and Methods: Based on the result for Anti-TPO Antibody test by RIA for the 12,937 patients in samsung medical center from October 2007 to March 2008, for six months, benignancy rate classified by sex and age is measured statistically and number of the patients who are diagnosed as autoimmune thyroid disease are kept tracked on. Results: According to the analysis of the Anti-TPO antibody test 1,135 of 12,937, which is 8.77% are benign and 218 treated patient of them, which is 19.2%, were diagnosed as autoimmune thyroid disease. Conclusions: Based on the statistics, usefulness of the test seem to have co relationship with derivation of autoimmune thyroid disease. this is 19.2% of probability relatively high. this figure, however, does not have strong relationship with specialty of the disease. Thus screening test seems to have somewhat effectiveness, considering other experiments and their margin.

• Korean Journal of Head & Neck Oncology
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• v.8 no.2
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• pp.106-111
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• 1992

Ten patients with $H\"{u}rthle$ cell tumor of the thyroid gland from Dec. 1987 to Sep. 1992 were reviewed to delinate an acceptable policy of treatment. Patients varied from age 23 years to 66 and consisted of nine females and one male, most of whom had an asymptomatic solitary cold nodule. Four patients had benign neoplasm and six patients had malignant neoplasm proven by capsular or vascular invasion or nodal metastasis. Associated thyroid lesions occurred in five patients, three adenomatous goiter, one Graves' disease and one follicular cell carcinoma. Surgery consisting of lobectomy and isthmectomy in four patients, bilateral subtotal thyroidectomy in one patients, total thyroidectomy in five patients. Lymph node dissection was not performed. Only one patient was experienced transient hypocalcemia. The period of observation varied from 15 to 58 months(mean, 30.5 months). Although our case was small and short follow up period, there were no recurrences or deaths. We suggested early aggressive surgical approach was appropriate because of lower recurrence rate and fewer operation, high bilateralism, lower surgical complication.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4689-4692
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• 2013

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.42-47
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• 2001

Purpose: To evaluate the usefulness of ultrasonogram as a preoperative diagnostic tool in thyroid nodular diseases, this study was carried out. Materials and Methods: From January 1998 to December 1999, 51 patients who underwent thyroidectomy were analyzed retrospectively. We compared the finally histopathological results to ultrasonographical findings such as internal consistency, multiplicity of nodules, nodular ehogenicity, nodular capsule or margin, calcification of nodules. Results: There were 47 females and 4 males with 25 benign tumor, 23 malignant tumor and 3 occult carcinoma in histopathological diagnosis. The solid tumors in ultrasonography carried a probability of malignancy as 66.7%(16/24 cases) whereas cystic or mixed tumors as 16.7%(1/6cases) or 23.8%(5/21cases) (p=0.006). The single nodular diseases carried a high probability of malignancy as 50%(13/26cases) whereas multiple diseases as 28.6%(6/21cases). The hypoechogenicity of thyroid nodular disease showed a probability of malignancy as 60%(9/15cases) whereas mixed-echogenicity as 36.4%(4/11cases). The nodules with poorly-defined margin in ultrasonographic findings showed higher probability of malignancy as 63.6% (7/11cases) than the nodules with well -defined margin as 26.5%(9/34 cases) (p=0.025). The nodules with calcification in ultrasonographic findings were represented to high probability of malignancy as 70.6%(12/17cases) compared to those without calcification as 29.4%(10/34cases) (p=0.005). The differency between ultrasonic and histopathological diagnosis was high in solid nodules(33%), 3-4cm sized nodules (28.6%) and mixed echogenecity(27.3%) whereas low in complex nodules with cystic and solid nature(4.8%), 2-3 cm sized nodules(8.3%) and pooly defined margin(9.1%). The accuracies of sonography in differentiating malignacy from benign thyroid nodules were 7.1% of false positivity, 39.1% of false negativity, 60.9% of sensitivity, 92.9% of specificity and 78.4% of accuracy. Conclusion: Sonographic examination was relatively excellent test as a preoperative diagnostic tool in thyroid nodular diseases when detailed checklists were applied such as internal consistency, multiplicity of nodules, nodular ehogenicity, nodular capsule or margin and calcification of nodules.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4247-4250
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• 2016

Background: Pax8 and peroxisome proliferator-activated receptor gamma 1 gene (Pax8-$PPAR{\gamma}1$) are important factors in tumors. Several studies have suggested that follicular thyroid cancer may arise from Pax8- $PPAR{\gamma}1$ rearrangement. In order to have a better understanding of the association between Pax8-$PPAR{\gamma}1$ rearrangement and follicular thyroid cancer, we conducted the presenmt meta-analysis. Materials and Methods: The information was extracted from PubMed, EMBASE and Web of Science. Statistic analysis was performed with Stata12.0 software. Odds ratios (ORs) were calculated using a fixed-effects model. We also performed heterogeneity and publication bias analyses. Results: Nine studies including 198 follicular thyroid cancer patients and 268 controls were considered eligible. The frequency of Pax8-$PPAR{\gamma}1$ rearrangement was significantly higher in the follicular thyroid cancer group than in the control group, with a pooled OR of 6.63 (95%CI=3.50-12.7). In addition, through subgroup analysis, the OR between Pax8-$PPAR{\gamma}1$ rearrangement and follicular thyroid cancer was 6.04 (95%CI = 3.18-11.5) when using benign tumor tissues as controls. The OR for the method subgroup was 9.99 (95% CI =4.86-20.5) in the RT-PCR. Conclusions: The final results demonstrated that Pax8-$PPAR{\gamma}1$ rearrangement has significant association with follicular thyroid cancer.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.244-252
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• 1998

The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.51-57
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• 1997

A mass appearing in the anterior or lateral side of neck often can be a diagnostic challenge. Differential diagnosis of the neck mass covers a broad spectrum of diseases and the proper evaluation and management of a neck mass requires an impressive amount of anatomic and pathologic information. Because improper diagnosis and management may convert a potentially curable malignant metastasis into incurable disease, a differential diagnosis must be considered in all patients who present with a neck mass. Authors reviewed 2,148 cases of neck mass who were diagnosed by surgical resection, biopsy or aspiration during the period between October 1982 to December 1993, excluding those with thyroid and parathyroid disease. The evaluated characteristics were age, sex, site of lesion, and pathologic diagnosis. The results were as follows: Of 2,148 cases of neck mass, the overall ratio of benign to malignant tumor was 3 : 1. In 1,603 cases of benign mass lesion, the most common disease was lymphadenitis(non-specific and tuberculosis) showing 53% incidence, the second was salivary gland tumor(13%), and the third was congenital lesion(12%). The minor problems such as lipoma and sebaceous cyst were 21 %. In the age distribution of benign lesion, tuberculous lymphadenitis showed peak incidence in second decade, non-specific lymphadenitis was main disease of childhood, salivary gland tumor was peak in fourth decade, and most of congenital lesions were diagnosed at the age below 15. In 545 malignant tumors, the most common lesion was metastatic cancer to cervical lymph nodes yielding 71 % incidence(head and neck primary 52%, infraclavicular primary 42%, unknown primary 5%), the second common disease was lymphoma(19%), and the third was salivary gland cancer(9%). In the age incidence of malignant tumor, 60% of them developed in the fifth and sixth decade, head and neck primary was more common in the fifth decade than sixth, however lymphoma showed higher incidence in sixth decade. In the analysis of mass location according to lymph node level grouping(I - V), lymphadenitis developed mostly in level V nodes, the next common occurring site was level IV in tuberculous lymphadenitis and level II in non-specific lymphadenitis. The majority of metastatic cancers were found in level IV and III, and common occurring site of lymphoma was in level II and IV. Pathologic diagnosis of neck masses were made by fine needle aspiration cytology 80 cases, incisional biopsy 533 cases, excisional surgery 1,399 cases, and neck dissection 116 cases. For the proper management of neck mass, a proper diagnostic modality should be selected from imaging techniques, cytology, biopsy or neck dissection, with the consideration of patient's age, history and clinical findings. The scapel biopsy could be used freely in the inflammatory disease or inoperable metastatic cancer, but it should be reserved in the curable metastatic cancer or clinically possible malignancy.