Analysis of Relationship between Prognostic Factors and Number of Fine-Needle Aspiration Cytology (FNAC) Prior to Surgery for Papillary Thyroid Microcarcinoma According to Size / 대한내분비외과학회지

PURPOSE: Papillary thyroid microcarcinoma (PTMC) is defined as a papillary thyroid carcinoma 10 mm. Indication of FNAC based only on tumor size is still in debate. Some favor the criteria of a size 5 mm, n=156) and the prognostic factors and number of pre-surgical FNAC procedures were compared. RESULTS: There were no significant differences in gender, age, site, accompanying benign disease, multifocality and bilaterality. Group 2 patients displayed more advanced features than group 1 patients concerning capsular invasion, lymph node metastasis and tumor stage. The number of FNAC procedures prior to the decision of surgery was not different in the two groups. CONCLUSION: PTMC exceeding 5 mm in size showed advanced features than smaller tumors. Further study about the use of FNAC according only to the size of thyroid nodules is warranted.

Risk Factors for Hypothyroidism after Thyroid Lobectomy with Papillary Thyroid Crcinoma according to Existence of Thyroiditis / 대한내분비외과학회지

PURPOSE: This study evaluated the risk factors for hypothyroidism after lobectomy for low risk papillary thyroid carcinoma according to existence of thyroiditis, especially on preoperative thyroid stimulating hormone (TSH) level and remnant thyroid volume. METHODS: The clinical records of 169 patients who underwent thyroid lobectomy due to papillary thyroid carcinoma were reviewed. We maintain the TSH level between 0.10~0.50 mU/L with thyroid hormone until 6 to 12 months after lobectomy. Then we stopped medication and check TSH level at intervals of 2~6 months. The patients were divided into 2 groups; hypothyroid (n=63) and euthyroid (n=106) state after lobectomy. Euthyroid state was defined as an TSH level between 0.50~5.0 mU/L, hypothyroid state as an elevated TSH level above 10 mU/L and need thyroid hormone. RESULTS: Factor for age, sex, type of operation, result of biopsy were not significant to postoperative hypothyroidism. Presence of thyroid autoantibody was significantly different (P0.05). When patient didn't have thyroiditis, there was high possibility of postoperative hypothyroidism when preoperative TSH is in high normal level and remnant thyroid volume ratio is below 50% (P<0.01). CONCLUSION: One can check the presence of thyroiditis with thyroid autoantibody and can predict the possibility of postoperative hypothyroidism after lobectomy in patients with low risk papillary thyroid carcinoma with preoperative TSH level and remnant thyroid volume.

Analysis of Clinicopathologic Features in Papillary Thyroid Carcinoma Patients Younger than Thirty

PURPOSE: This study analyzed clinicopathologic features in patients with thyroid papillary carcinoma, who were younger than thirty, compared with patients aged thirty and forty-five. METHODS: The clinical records of 337 patients who underwent thyroidectomy because of papillary thyroid carcinoma were reviewed. Among them, 62 patients who were younger than thirty were placed in group I. And 275 patients between thirty and forty-five were placed in to group II. Clinicopathologic features between the two groups were analyzed. RESULTS: There was no significant difference between two groups in age, gender, tumor extension, and multifocality. Symptoms before detection of papillary thyroid carcinoma such as palpable mass, compressive symptoms or hoarseness were significantly higher in group I (P=0.008). In tumor size, rate of microcarcinoma is significantly higher in group II (P=0.024). Lymph node metastasis was found to be more significant in group I (P=0.010). The operative methods were different between the two groups. Rate of total thyroidectomy was increased in group I (P=0.021). CONCLUSION: This study shows that patients with thyroid papillary carcinoma, younger than thirty have more clinical symptoms and more large sized masses, more lymph node metastases at the time of surgery compared with those aged between thirty and forty-five.

Analysis of the Possibility of Operative Treatment in Pediatric Intussusception and its Scoring

PURPOSE: Owing to the trend of a nuclear family the concern and protection are still more increasing than before. The patients admitted to hospital for intussusception, as well as their parents, seem to be under great stress when non- operative treatments fail. In order to identify those patients likely to fail an attempted non-operative treatment, and to administer prompt treatment, the patients that came to our hospital for pediatric intussusception were analyzed. METHODS: 285 cases, between 2000 and 2003 were reviewed. They were divided into two groups from their medical records, and retrospectively compared. Group I included 243 pneumoreduction cases and group II 42 operation cases. To find the probability of non-operative treatment failure, an attempt was made to analyze and score the risk factors that increase the possibility of operative treatment. RESULTS: The factors contributing to an increased possibility of operative treatment were fever, leukocyte count, plain abdominal X-ray findings and duration of symptoms. CONCLUSION: This study revealed that fever, leukocyte count, plain abdominal X-ray findings and duration of symptoms contributed to an increased possibility of operative treatment. An increase in the sum of the scores of each factor increased the possibility of operative treatment. This simple scoring system could eliminate excessive and repeated pneumoreduction, thus indicating its potential value as a useful aid in surgical decision making for high failure rate cases of pneumoreduction in intussusception.