• Korean Journal of Radiology
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• v.23 no.6
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• pp.664-673
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• 2022

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction. Materials and Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping with FS (i.e., FS T2 mapping) or without FS (i.e., conventional T2 mapping) of EOMs were compared between the two groups. Independent predictors of treatment response to IVGC were identified using multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the prediction models. Differences between the models were examined using the DeLong test. Results: Compared to the unresponsive group, the responsive group had a shorter disease duration, lower kurtosis (FS-kurtosis), lower standard deviation, larger 75th, 90th, and 95th (FS-95th) T2 relaxation times in FS mapping and lower kurtosis in conventional T2 mapping. Multivariable analysis revealed that disease duration, FS-95th percentile, and FS-kurtosis were independent predictors of treatment response. The combined model, integrating all identified predictors, had an optimized area under the ROC curve of 0.797, 88.4% sensitivity, and 62.5% specificity, which were significantly superior to those of the imaging model (p = 0.013). Conclusion: An integrated combination of disease duration, FS-95th percentile, and FS-kurtosis was a potential predictor of treatment response to IVGC in patients with active and moderate-to-severe TAO. FS T2 mapping was superior to conventional T2 mapping in terms of prediction.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.910-917
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• 2022

Immunoglobulin G4 (IgG4) related disease (IgG4-RD) is currently considered an immune-mediated condition and is recognized as a disorder group with common pathological, hematological, and clinical characteristics. This disease may involve diverse organs of the head and neck, and include mainly the lacrimal gland, orbit, thyroid gland, pituitary gland, and the meninges. Here, we report a case of IgG4-RD in a 65-year-old female showing head- and neck-limited but synchronously and mainly manifesting as otalgia and facial neuritis.

• Proceedings of the Korean Operations and Management Science Society Conference
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• 1987.10a
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• pp.3-3
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• 1987

현재 국내에서의 의료 부분의 전문가 시스템에 대한 개발이 시작 단계에 있다. 의료부문 전문가시스템 개발에 있어서 주요 촛점은 관련분야의 전문의들로부터 어떻게 시간적, 비용적 낭비없이 효과적으로 지식 획득(Knowledge acquisition)을 knowledge engineers가 하겠는가이며, 또한 어떠한 체계(Framework)로 전문가 시스템을 구성할 것인가이다. 본 발표에서는 현재 본 연구실에서 CASNET 및 INTERNET를 바탕으로 개발중인 산부인과의 불임 진료 및 내과의 갑상선 질환 진단, 치료에 관련된 전문가 시스템 개발의 초기단계를 보임으로써 의료 관련 전문가 시스템 개발의 일반적인 기본 방향을 제시하고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8425-8430
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• 2016

Purpose: To study the safety of prophylactic level VII nodal dissection regarding hypoparathyroidism (temporary and permanent) and vocal cord dysfunction (temporary and permanent) and its impact on disease free survival. Materials and Methods: This prospective study concerned 63 patients with papillary thyroid carcinoma with N0 neck node involvement (clinically and radiologically) in the period from December 2009 to May 2013. All patients underwent total thyroidectomy and prophylactic central neck dissection including levels VI and VII lymph nodes in group A (31 patients) and level VI only in group B (32 patients). The thyroid gland, level VI and level VII lymph nodes were each examined histopathologically separately for tumor size, multicentricity, bilaterality, extrathyroidal extension, number of dissected LNs and metastatic LNs. Follow-up of both groups, regarding hypoparathyroidism, vocal cord dysfunction and DFS, ranged from 6-61 months. Results: The mean age was 34.8 and 34.3, female predominance in both groups with F: M 24:7 and 27:5 in groups A and B, respectively. Mean tumor size was 12.6 and 14.7mm. No statistical differences were found between both groups regarding age, sex, bilaterality, multicentricity or extrathyroidal extension. The mean no. of dissected level VI LNs was 5.06 and 4.72 and mean no. of metastatic level VI was 1 and 0.84 in groups A and B, respectively. The mean no. of dissected level VII LNs was 2.16 and mean no. of metastatic LNs was 0.48. Postoperatively temporary hypoparathyroidism was detected in 10 and 7 patients and permanent hypoparathyroidism in 2 and 3 patients; temporary vocal cord dysfunction was detected in 4 patients and one patient, and permanent vocal cord dysfunction in one and 2 patients in groups A and B, respectively. No significant statistical differences were noted between the 2 groups regarding hypoparathyroidism (P=0.535) or vocal cord dysfunction (P=0.956). The number of dissected LNs at level VI only significantly affected the occurrence of hypoparathyroidism (<0.001) and vocal cord dysfunction (<0.001).The DFS was significantly affected by bilaterality, multicentricity and extrathyroidal extension. Conclusions: Level VII nodal dissection is a safe procedure complementary to level VI nodal dissection with prophylactic central neck dissection for papillary thyroid carcinoma.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.158-162
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• 2010

Purpose : Turner syndrome (TS) is a disorder in which various anomalies can be accompanied, especially cardiovascular, renal, thyroid and auditory problems. The aim of this study is to identify the incidence of these disorders in patients with TS according to karyotype. Methods : We reviewed medical records of 90 patients with TS diagnosed by chromosomal analysis in 4 hospitals from Jan 1998 to Dec 2007. We evaluated these cases by prepared protocol of 4 medical problems.Results : The distribution of karyotype was 45,X (47.8%), mosaic pattern (34.4%) and structural aberration group (17.8%). Renal anomalies, cardiovascular anomalies, thyroid disorders and auditory problems are accompanied in 4.4%, 10.0 %, 11.1% and 5.6%, respectively. 45,X group had renal anomalies (7.0%), cardiovascular anomalies (18.6%), thyroid disorders (9.3%) and auditory problems (11.6%). Mosaic group had renal anomalies (3.2%), thyroid disorders (12.9%), no cardiovascular anomalies and auditory problems. Structural aberration group had cardiovascular anomalies (6.3%), thyroid disorders (12.5%) and no other 2 problems. Patients with 45,X group had a significant higher incidence of cardiovascular anomalies (P =0.025). Conclusion : Our results indicate that there are differences clinically according to karyotype of TS, especially in incidence of cardiovascular anomalies.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.139-141
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• 2019

The causes of vocal cord paralysis include iatrogenic injury during thyroid or cervical surgery, heart and chest surgery, and tumorous lesion such as laryngeal cancer and lung cancer. In addition to these common causes, rarely, cardiovascular disease can also cause vocal fold paralysis. A disease known as Cardiovocal syndrome, or Ortner's syndrome, causes left vocal fold paralysis when the left recurrent laryngeal nerve is compressed by the pulmonary artery and aorta, which is occurred by pulmonary hypertension from heart disease. We report for the first case in Korea the diagnosis of vocal fold paralysis caused by Ortner's syndrome.

• Korean Journal of Head & Neck Oncology
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• v.36 no.2
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• pp.73-77
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• 2020

Ovarian cancer is common malignant disease with high mortality in the female. However, lymph node metastasis in the head and neck of ovarian cancer is very rare than in para-aortic, pelvic lymph node. A 49-year-old female patient came to our clinic with a left neck mass. After total thyroidectomy and left selective neck dissection for the cervical neck level II, III, IV, V, VI for ovarian cancer and thyroid cancer, she had already undergone chemotherapy (Paclitaxel+Carboplatin) 18 month ago. CT scan showed only lymph node enlargement in left neck level II. Positron emission tomography-computed tomography (PET-CT) revealed a hypermetabolic lesion in same area but no other hypermetabolic lesion, especially in the pelvic and abdominal cavity. Fine needle aspiration cytology revealed metastatic carcinoma. The serum level of CA-125 was elevated to 43.8U/mL, whereas other tumor markers (CA 19-9, CEA) were in the normal range. She underwent a revision of selective neck lymph node dissection for the cervical neck levels I, II, and III, and on the review of surgical pathology, metastatic carcinoma was suspected. Thus, we performed immunohistochemical staining for the tissue; as a result, it was finally diagnosed as metastatic ovarian cancer (positive for CK7, ER and PR, and negative for CK20). Adjuvant chemotherapy (Paclitaxel+Carboplatin) was planned on the tumor board, and the patient successfully received chemotherapy.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.3-6
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• 1994

Neck dissection has become an integral part of the staging and management of head and neck tumors. This paper reports a series of head and neck patients who had pathological findings in their neck dissection specimens, which were unrelated to their primary tumors. In 7 cases, there was unexpected pathology in the cervical lymph nodes which was not related to the primary tumor. Four cases were squamous cell carcinomas and 3 were thyroid carcinomas. In 3 cases of squamous cell carcinomas, there were no evidence of metastatic squamous cell carcinoma in neck dissection specimen; however, the lymph nodes were found to be involved by metastatic papillary carcinoma in one larynx cancer, metastatic adenocarcinoma in the other larynx cancer, tuberculosis in one nasopharynx cancer. In three of neck dissection specimen of carcinoma(two thyroid carcinomas, one laryngeal carcinoma), dual nodal pathology was found: Each of these specimen contained carcinoma with tuberculosis of the lymph nodes in three cases. In one thyroid carcinoma, there was no evidence of metastasis; however, the lymph nodes were found to be involved by tuberculosis. Preoperative assessment did not reveal any findings to alert us to the possibility of a synchronous pathological process in the cervical nodes of this group of 7 patients. In particular, there was no evidence of active pulmonary tuberculosis in the 5 patients with active lymph node disease.

• The Journal of Internal Korean Medicine
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• v.32 no.3
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• pp.425-434
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• 2011

Objectives : Hypothyroidism is the most common pathological disease of the endocrine system. Morinda Officinalis Radix has been used in treatment of Yang deficiency. In this study, we investigated the therapeutic effects of Morinda Officinalis Radix on a rat model of hypothyroidism induced by 6-propyl, 2-thiouracil (PTU). Methods : Two-month-old Sprague-Dawley male rats were used with injection of PTU which induced rats into hypo-thyroidism. During 2 weeks, rats were treated with Morinda Officinalis Radix and thyroxine. Body weights were checked every week, the after 4 weeks, biochemical analyses were performed. The levels of T3, T4 and TSH was measured by EILSA. Results : In the Morinda Officinalis Radix group, we could observe the level of T4 significantly increased and TSH level significantly decreased. Conclusions : Morinda Officinalis Radix could help the thyroid to produce thyroid hormones under PTU suppression. There is no harm effect on liver and kidney function, or other metabolism. According to these results it could help to treat hypothyroidism patients and relieve their symptoms.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2507-2513
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• 2015

Background: Serum vitamin D status can affect the prognosis of breast cancer patients. Our aim was to determine the association between alterations in the 25-hydroxyvitamin D [25(OH)D] status during follow-up and the prognosis of breast cancer patients. Additionally, we evaluated the association between the 25(OH)D status at the time of diagnosis and the prognosis using a detailed age and stage categorization. Materials and Methods: Four hundred and sixty-nine Korean breast cancer patients were included. We collected patient clinicopathological data, including their serum 25(OH)D concentration at diagnosis and at the annual follow-up until 4 years after diagnosis. The patients were divided according to their 25(OH)D status at diagnosis into a deficient (<20 ng/ml) and a non-deficient (${\geq}20ng/ml$) group. At follow-up, patients were categorized into the four following groups according to 25(OH)D status alterations: persistently deficient, improved, deteriorated and persistently non-deficient. Results: At diagnosis, 118 patients were classified into the deficient group and 351 into the non-deficient group. After a median follow-up period of $85.8{\pm}31.0$ months, the patients with advanced-stage disease or an older age in the non-deficient group showed a significantly better survival compared with the deficient group. Furthermore, at the 1-year follow-up of 25(OH)D status, the persistently non-deficient group and the improved group had better survival compared with the other two groups. Conclusions: Our results suggest that maintaining an optimal 25(OH)D status at diagnosis and during the 1-year follow-up period is important for improving breast cancer patient survival.