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The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.
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Background@#South Korea has one of the world’s fastest aging populations and is witnessing increased age-related hearing impairment cases as well as an increase in the number of hearing aid users. The aim of this study was to analyze complications caused by hearing aid mold materials. In addition, we hope to raise awareness of the harm and danger that inexperienced hearing aid providers can cause to patients. @*Methods@#We retrospectively reviewed the medical records of 11 patients who were diagnosed with hearing aid mold material as a foreign body in the ear at a tertiary center between 2016 and 2020. The following data were analyzed: symptoms, endoscopic findings, audiometry, temporal bone CT images, treatment methods, and complications after removal. The currently available literature was also reviewed to develop clinical guidelines, to identify the systematic weaknesses in the South Korean hearing aid market, and to identify policies that warrant better quality control. @*Results@#Among the 11 cases, 9 were restricted to the external auditory canal, all of which were successfully removed under endoscopy with minor complications. Two cases with middle ear involvement resulted in infection and thus required surgical removal with mastoidectomy. The average age of these patients was 76.4, and all patients received their molding procedure at private hearing aid shops without an otolaryngologist’s examination. @*Conclusion@#Thorough patient history-taking and otologic examination must be performed to identify patients at higher risk of complications. Such patients should be referred to an otolaryngologist. If a patient exhibits alarming symptoms, early referral is critical since prompt surgery can minimize complications. A CT scan is highly recommended to determine an optimal approach for foreign body removal. Systematic and regulatory changes in hearing aid dispensers, such as requiring apprenticeship, raising the required level of education, and legally mandating referrals, can help reduce these complications.
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The present study investigated the risk of active tuberculosis in patients with inflammatory bowel disease (IBD) treated with vedolizumab or ustekinumab, in actual clinical settings in a country with an intermediate tuberculosis burden. The medical records of 238 patients with IBD who received vedolizumab or ustekinumab were retrospectively reviewed at a tertiary referral center in South Korea. All patients had ≥ 3 months of follow-up duration and underwent a latent tuberculosis infection screening test before initiation of the administration of these drugs. Of the 238 patients enrolled, 181 had Crohn’s disease, and 57 had ulcerative colitis. During the median 18.7 months of follow-up, active tuberculosis did not develop in any patient treated with vedolizumab or ustekinumab. Therefore, we concluded that the risk of tuberculosis appears to be low in patients with IBD treated with vedolizumab or ustekinumab in South Korea.
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Objectives@#. We evaluated changes in income levels in a hearing-impaired population. @*Methods@#. The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. @*Results@#. Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1–5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). @*Conclusion@#. The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.
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Objectives@#. We evaluated changes in income levels in a hearing-impaired population. @*Methods@#. The study subjects were selected from the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 of Koreans ≥40 years old. In total, 5,857 hearing-impaired subjects were matched with 23,428 comparison participants. Differences between the initial income level and income levels at 1, 2, 3, 4, and 5 years post-enrollment were compared between the hearing-impaired and comparison groups. The interaction of time and hearing impairment/comparison was estimated. @*Results@#. Both the hearing-impaired group and the comparison group showed increased income levels over time. In the hearing-impaired group, the income levels at 4 and 5 years post-enrollment were higher than the initial income level (each P<0.001). In the comparison group, the income levels of all the participants after 1–5 years were higher than the initial income level (each P<0.001). The interaction of time and hearing impairment was statistically significant (P=0.021). @*Conclusion@#. The increase in income over time was relatively lower in the hearing-impaired adult population; therefore, the income gap widened between this population and the normal-hearing population.
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Background@#Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR). @*Methods@#In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment. @*Results@#In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. –10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017). @*Conclusion@#Simultaneous PR improved pulmonary function, particularly in measures of FEV1, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR’s effects during thoracic radiotherapy.
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Src family kinases (SFKs), an important group of non-receptor tyrosine kinases, are suggested to be excessively activated during various types of tissue fibrosis. The present study investigated the effect of KF-1607, an orally active and a newly synthesized Src kinase inhibitor (SKI) with proposed low toxicity, in preventing the progression of renal interstitial fibrosis. Unilateral ureteral obstruction (UUO) surgery was performed in 6-week-old male C57BL/6 mice to induce renal interstitial fibrosis. Either KF-1607 (30 mg/kg, oral gavage) or PP2 (2 mg/kg, intraperitoneal injection), a common experimental SKI, was administered to mice for seven days, started one day prior to surgery. UUO injury-induced SFK expression, including Src, Fyn, and Lyn kinase. SFK inhibition by KF-1607 prevented the progression of tubular injury in UUO mice, as indicated by decreases in albuminuria, urinary KIM-1 excretion, and kidney NGAL protein expression. Renal tubulointerstitial fibrosis was attenuated in response to KF-1607, as shown by decreases in α-SMA, collagen I and IV protein expression, along with reduced Masson’s trichrome and collagen-I staining in kidneys. KF-1607 also inhibited inflammation in the UUO kidney, as exhibited by reductions in F4/80 positive-staining and protein expression of p-NFκB and ICAM. Importantly, the observed effects of KF-1607 were similar to those of PP2. A new pan Src kinase inhibitor, KF-1607, is a potential pharmaceutical agent to prevent the progression of renal interstitial fibrosis.
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Menalocytic nevi are benign localized pigmented lesions, which usually occur on the cutaneous surface of the body but rarely on the mucous membranes. It is comparatively easy to encounter pigmented lesions of the oral cavity, but the melanocytic nevi of the pharyngeal wall are extremely rare worldwide and, to the best of our knowledge, there is no reported case of melanocytic nevus arising from pharyngeal wall. We report a case of a pigmented lesion on the posterior wall of pharynx, which was microscopically confirmed as oropharyngeal blue nevus.
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Tardive dystonia and tardive dyskinesia (TDs) are rare extrapyramidal side effects that develop after long-term use of antipsychotics, but they are different syndromes and rarely occur at the same time. Olanzapine is an atypical antipsychotic drug associated with a low risk of extrapyramidal side effects in schizophrenia, but its associations with tardive movements are not clear. We present a case of a 19-year-old Asian female patient with schizophrenia and intellectual disabilities who developed concurrent TDs after long-term use of olanzapine. At her 10-month follow-up examination, her concurrent TDs had been treated successfully with clozapine. This case demonstrates that although the use of olanzapine to treat psychosis and behavioral disturbances is increasing due to its high efficacy and low rate of extrapyramidal side effects, concurrent TDs should be carefully assessed after long-term use of this antipsychotic, especially in patients with schizophrenia and intellectual disabilities. Clozapine, by preventing or reversing the debilitating consequences of concurrent TDs, may be an effective treatment for these patients.
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BACKGROUND AND OBJECTIVES: Acute epiglottitis is a life-threatening condition that can result in airway obstruction. The present study reports clinical features, management and patient outcomes in an acute epiglottitis. SUBJECTS AND METHOD: Included in our retrospective study were 315 patients who were admitted with the diagnosis of acute epiglottitis between January 2006 and July to the department Otolaryngology-Head and Neck surgery, Hallym University Sacred Heart Hospital 2018. The diagnosis of acute epiglottitis was established by confirmation of inflamed epiglottis using laryngoscope or computed tomography. RESULTS: Among 315 patients, 89 cases (28%) and 83 cases (26%) were found in the fifth and fourth decades, respectively. The mean age of patients was 45.0±13.94 years. The male to female ratio was 1.33:1. A total of 75 patients (23.8%) had co-morbidities, with hypertension (13.6%) being the most common. Fever was relatively uncommon, whereas most patients complained of sore throat. Ceftriaxone was the most common empirical antibiotic regimen prescribed and the use of steroids did not affect the length of hospital stay. Nine patients required airway intervention, including eight who underwent endotracheal intubation and one emergency tracheostomy. In patients who need airway intervention, systolic blood pressure, body temperature, respiratory rate, heart rate, white blood cells and the proportion of dyspnea were significantly higher in comparison to the patients without airway intervention. CONCLUSION: Although acute epiglottitis often has nonspecific symptoms, it may lead to sudden dyspnea and unstable vital signs, so an in-depth understanding of this disease is needed.
Subject(s)
Female , Humans , Male , Airway Obstruction , Anti-Bacterial Agents , Blood Pressure , Body Temperature , Ceftriaxone , Clinical Study , Diagnosis , Dyspnea , Emergencies , Epiglottis , Epiglottitis , Fever , Heart , Heart Rate , Hypertension , Intubation, Intratracheal , Korea , Laryngoscopes , Length of Stay , Leukocytes , Methods , Neck , Pharyngitis , Respiratory Rate , Retrospective Studies , Steroids , Tracheostomy , Vital SignsABSTRACT
PURPOSE: Chronic rhinosinusitis (CRS) is a complex immunological condition, and novel experimental modalities are required to explore various clinical and pathophysiological endotypes; mere evaluation of nasal polyp (NP) status is inadequate. Therefore, we collected patient nasal secretions on filter paper and characterized the proteomes. METHODS: We performed liquid chromatography-mass spectrometry (MS)/MS in the data-dependent acquisition (DDA) and data-independent acquisition (DIA) modes. Nasal secretions were collected from 10 controls, 10 CRS without NPs (CRSsNP) and 10 CRS with NPs (CRSwNP). We performed Orbitrap MS-based proteomic analysis in the DDA (5 controls, 5 CRSsNP and 5 CRSwNP) and the DIA (5 controls, 5 CRSsNP and 5 CRSwNP) modes, followed by a statistical analysis and a hierarchical clustering to identify differentially expressed proteins in the 3 groups. RESULTS: We identified 2,020 proteins in nasal secretions. Canonical pathway analysis and gene ontology (GO) evaluation revealed that interleukin (IL)-7, IL-9, IL-17A and IL-22 signaling and neutrophil-mediated immune responses like neutrophil degranulation and activation were significantly increased in CRSwNP compared to control. The GO terms related to the iron ion metabolism that may be associated with CRS and NP development. CONCLUSIONS: Collection of nasal secretions on the filter paper is a practical and non-invasive method for in-depth study of nasal proteomics. Our proteomic signatures also support that Asian NPs could be characterized as non-eosinophilic inflammation features. Therefore, the proteomic profiling of nasal secretions from CRS patients may enhance our understanding of CRS endotypes.
Subject(s)
Humans , Asian People , Gene Ontology , Inflammation , Interleukin-17 , Interleukin-9 , Interleukins , Iron , Metabolism , Methods , Nasal Polyps , Neutrophils , Proteome , Proteomics , Sinusitis , Spectrum AnalysisABSTRACT
OBJECTIVES: To evaluate the relationship among smoking, alcohol consumption, and obesity and benign or malignant parotid tumors in a Korean population. METHODS: The Korean National Health Insurance Service-Health Screening Cohort (for ≥40-year-olds) was assessed from 2002 to 2013. In total, 336 benign parotid tumors and 46 malignant parotid tumors were matched with controls at a ratio of 1 to 4 with respect to age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed previous histories of smoking, alcohol consumption, and obesity. By unconditional logistic regression analyses, the crude and adjusted odds ratios (ORs) were investigated and the 95% confidence intervals (CIs) were counted. RESULTS: The estimated annual incidence of the benign parotid tumors was 5.66 per 100,000, and that of the malignant parotid tumor was 0.81 per 100,000. The adjusted ORs of smoking for the benign parotid tumors was 2.52 (95% CI, 1.84 to 3.46). This finding was consistent in the subgroups of <60 years old, ≥60 years old, and men. The adjusted ORs of alcohol consumption for the benign parotid tumors showed the statistical significance only in women (adjusted OR, 2.35; 95% CI, 1.10 to 5.00). Obesity did not reach a statistical significance in any analysis. CONCLUSION: Benign parotid tumor was related with smoking, and it was linked with alcohol consumption in women only.
Subject(s)
Female , Humans , Male , Alcohol Drinking , Case-Control Studies , Cohort Studies , Dyslipidemias , Ethanol , Hypertension , Incidence , Logistic Models , Mass Screening , National Health Programs , Obesity , Odds Ratio , Salivary Glands , Smoke , Smoking , NicotianaABSTRACT
BACKGROUND AND OBJECTIVES@#Acute epiglottitis is a life-threatening condition that can result in airway obstruction. The present study reports clinical features, management and patient outcomes in an acute epiglottitis.SUBJECTS AND METHOD: Included in our retrospective study were 315 patients who were admitted with the diagnosis of acute epiglottitis between January 2006 and July to the department Otolaryngology-Head and Neck surgery, Hallym University Sacred Heart Hospital 2018. The diagnosis of acute epiglottitis was established by confirmation of inflamed epiglottis using laryngoscope or computed tomography.@*RESULTS@#Among 315 patients, 89 cases (28%) and 83 cases (26%) were found in the fifth and fourth decades, respectively. The mean age of patients was 45.0ñ13.94 years. The male to female ratio was 1.33:1. A total of 75 patients (23.8%) had co-morbidities, with hypertension (13.6%) being the most common. Fever was relatively uncommon, whereas most patients complained of sore throat. Ceftriaxone was the most common empirical antibiotic regimen prescribed and the use of steroids did not affect the length of hospital stay. Nine patients required airway intervention, including eight who underwent endotracheal intubation and one emergency tracheostomy. In patients who need airway intervention, systolic blood pressure, body temperature, respiratory rate, heart rate, white blood cells and the proportion of dyspnea were significantly higher in comparison to the patients without airway intervention.@*CONCLUSION@#Although acute epiglottitis often has nonspecific symptoms, it may lead to sudden dyspnea and unstable vital signs, so an in-depth understanding of this disease is needed.
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No abstract available.
Subject(s)
Humans , Colitis , Dasatinib , Leukemia, Myelogenous, Chronic, BCR-ABL PositiveABSTRACT
BACKGROUND: The objective of this study was to compare post-operative (post-op) visits for sinusitis between adenoidectomy and non-adenoidectomy participants (control). METHODS: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, we used 1:4 matching to select 2,593 adenoidectomy participants and 10,372 control participants. Post-op visits for sinusitis were measured from post-op 1 year through post-op 9 years. Equivalence testing was used. Margin of equivalence of difference was set as −0.5 to 0.5 in this study. RESULTS: There were trivial differences between the two groups from post-op 1 to 2 years. However, there was no difference between the two groups from post-op 3 through 9 years. Visits for sinusitis gradually decreased in both groups. In the rare and frequent pre-operative sinusitis group, there were minor differences in both groups from post-op 1 to 2 years. In contrast, there were no differences between the two groups in rare and frequent pre-operative sinusitis groups from post-op 3 through 9 years. In the 0–4 years old group, there were minor differences between both groups from post-op 1 to 2 years. However, no differences in the number of visits for sinusitis were found between the two groups during follow up periods from post-op 3 through 9 years. Additionally, there were no differences between the two groups during the entire follow up period. CONCLUSION: Adenoidectomy does not reduce post-op visits for sinusitis. Sinusitis decreased over time whether adenoidectomy was performed or not.
Subject(s)
Adenoidectomy , Case-Control Studies , Cohort Studies , Follow-Up Studies , Insurance, Health , SinusitisABSTRACT
BACKGROUND: Previous research has related obesity to body dissatisfaction and low self-esteem. This study aimed to evaluate this relation between obesity and distress about appearance. METHODS: We performed a cross-sectional study using data from the Korea Youth Risk Behavior Web-based Survey for 288,390 participants assessed from 2009 to 2012. The participants were categorized according to body mass index; obese, overweight, healthy weight, and underweight. The relation between obesity and distress was analyzed using simple and multiple logistic regression with complex sampling adjusted for age, sex, region of residence, economic level, parental education level, alcohol consumption, and smoking habits as confounders. RESULTS: The adjusted odds ratio (AOR) was higher for participants with obesity (AOR for healthy weight = 1.15 [95% confidence interval {CI}, 1.08–1.22]; AOR for overweight = 1.85 [95% CI, 1.72–1.98]; AOR for obese = 2.45 [95% CI, 2.27–2.64]; reference = underweight, P < 0.001). In males, healthy weight was associated with an AOR below 1 (AOR for healthy weight = 0.92 [95% CI, 0.85–0.99]; AOR for overweight = 1.26 [95% CI, 1.14–1.38]; AOR for obese = 1.66 [95% CI, 1.50–1.84], P < 0.001). In females, higher AORs were associated with obesity (AOR for healthy weight = 1.44 [95% CI, 1.33–1.57]; AOR for overweight = 2.71 [95% CI, 2.45–2.99]; AOR for obese = 3.71 [95% CI, 3.32–4.14], P < 0.001). CONCLUSION: Obesity is related to distress about appearance, and the relation is stronger in girls than in boys.
Subject(s)
Adolescent , Female , Humans , Male , Alcohol Drinking , Beauty , Body Mass Index , Physical Appearance, Body , Cross-Sectional Studies , Education , Korea , Logistic Models , Obesity , Odds Ratio , Overweight , Parents , Risk-Taking , Smoke , Smoking , Stress, Psychological , ThinnessABSTRACT
OBJECTIVES@#This study aimed to describe recent patterns in the types of statistical test used in original articles that were published in Journal of the Korean Association of Oral and Maxillofacial Surgeons.@*MATERIALS AND METHODS@#Thirty-six original articles published in the Journal in 2015 and 2016 were ascertained. The type of statistical test was identified by one researcher. Descriptive statistics, such as frequency, rank, and proportion, were calculated. Graphical statistics, such as a histogram, were constructed to reveal the overall utilization pattern of statistical test types.@*RESULTS@#Twenty-two types of statistical test were used. Statistical test type was not reported in four original articles and classified as unclear in 5%. The four most frequently used statistical tests constituted 47% of the total tests and these were the chi-square test, Student's t-test, Fisher's exact test, and Mann-Whitney test in descending order. Regression models, such as the Cox proportional hazard model and multiple logistic regression to adjust for potential confounding variables, were used in only 6% of the studies. Normality tests, including the Kolmogorov-Smirnov test, Levene test, Shapiro-Wilk test, and Scheffé's test, were used diversely but in only 10% of the studies.@*CONCLUSION@#A total of 22 statistical tests were identified, with four tests occupying almost half of the results. Adoption of a nonparametric test is recommended when the status of normality is vague. Adjustment for confounding variables should be pursued using a multiple regression model when the number of potential confounding variables is numerous.
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BACKGROUND AND OBJECTIVES: This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. MATERIALS AND METHODS: The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. RESULTS: Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p < 0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p < 0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). CONCLUSION: Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.
Subject(s)
Humans , Edema , Medical Records , Microsurgery , Noise , Papilloma , Polyps , Prognosis , Retrospective Studies , Vocal Cords , VoiceABSTRACT
OBJECTIVES: This study aimed to describe recent patterns in the types of statistical test used in original articles that were published in Journal of the Korean Association of Oral and Maxillofacial Surgeons. MATERIALS AND METHODS: Thirty-six original articles published in the Journal in 2015 and 2016 were ascertained. The type of statistical test was identified by one researcher. Descriptive statistics, such as frequency, rank, and proportion, were calculated. Graphical statistics, such as a histogram, were constructed to reveal the overall utilization pattern of statistical test types. RESULTS: Twenty-two types of statistical test were used. Statistical test type was not reported in four original articles and classified as unclear in 5%. The four most frequently used statistical tests constituted 47% of the total tests and these were the chi-square test, Student's t-test, Fisher's exact test, and Mann-Whitney test in descending order. Regression models, such as the Cox proportional hazard model and multiple logistic regression to adjust for potential confounding variables, were used in only 6% of the studies. Normality tests, including the Kolmogorov-Smirnov test, Levene test, Shapiro-Wilk test, and Scheffé's test, were used diversely but in only 10% of the studies. CONCLUSION: A total of 22 statistical tests were identified, with four tests occupying almost half of the results. Adoption of a nonparametric test is recommended when the status of normality is vague. Adjustment for confounding variables should be pursued using a multiple regression model when the number of potential confounding variables is numerous.