Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 207
Filter
1.
Article in English | WPRIM | ID: wpr-926755

ABSTRACT

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

2.
Article in English | WPRIM | ID: wpr-925093

ABSTRACT

Lenvatinib prolongs the survival of patients with advanced thyroid cancer. At initiation of lenvatinib therapy, advanced thyroid cancer patients frequently have lung metastasis and are vulnerable to pulmonary complications due to concealed lung damage caused by previous therapies including radioactive iodine (RAI) therapy. Among 24 patients treated with lenvatinib, pulmonary events were observed in three patients with lung metastasis, including one with interstitial lung disease (ILD) and two with pneumothorax. One patient who was previously treated with 750 mCi RAI developed uncontrolled ILD after lenvatinib therapy and died of respiratory failure. Two pneumothorax cases had previous cavitation of metastatic lung nodules. Pneumothorax resolved spontaneously in both patients. Pulmonary events in patients with lung metastases treated with lenvatinib are uncommon and manageable in most cases, but may be fatal if detection and management are delayed. Special attention should be given to patients with lung metastasis treated with high cumulative dose of RAI therapy or cavitary changes that develop after lenvatinib therapy.

3.
Article in English | WPRIM | ID: wpr-924856

ABSTRACT

Objective@#To investigate associations between baseline serum serotonin levels and short- and long-term treatment outcomes in outpatients with depressive disorders in a naturalistic one-year prospective study design. @*Methods@#Patients were recruited at a University hospital in South Korea from March 2012 to April 2017. At baseline, blood samples were obtained from 1,094 patients who received initial antidepressant monotherapy (Step 1). After the Step 1 treatment, further treatment steps (at least Steps 2−4) could be administered every 3 weeks during the acute treatment phase (3, 6, 9, and 12 weeks; n = 1,086), and every 3 months during the continuation treatment phase (6, 9, and 12 months; n = 884). In cases showing an insufficient response or intolerable side effects, patients were asked to choose whether to remain at the current step or enter the next treatment step, with alternative strategies including switching, augmentation, combination, and a mixture of these approaches. Remission was defined as a Hamilton Depression Rating Scale score of ≤ 7. @*Results@#The remission group had significantly higher baseline serum serotonin levels among patients who received Step 1 monotherapy in both acute and continuation treatment phases. These associations remained significant after adjustment for relevant covariates. No associations were found with any other treatment steps. @*Conclusion@#Baseline serum serotonin levels may be used as a biomarker for predicting short- and long-term treatment outcomes in antidepressant monotherapy-treated patients with depressive disorders in a real-world clinical setting.

4.
Article in English | WPRIM | ID: wpr-903504

ABSTRACT

Purpose@#The aim of this study was to evaluate the relationship between the patient's occlusion and a cracked tooth by using T-scan occlusal analysis and a quantitative light-induced fluorescence (QLF) technology. @*Materials and Methods@#This study was carried out on 51 patients having cracked teeth between January, 2019 and December, 2020. The tooth crack was determined with a Q-ray pen and QLF parameters (ΔFmax and ΔRmax) were obtained by a Q-ray software. T-scan tests were conducted to all subjects and then, the occlusal force and disclosing time were analyzed. Mann-Whitney U test was performed to compare the occlusal force and disclosing time between cracked teeth groups and contra-lateral normal teeth groups (α = .05). Mann-Whitney U test was performed to compare ΔFmax and ΔRmax according to the results of cold/bite tests (α = .05). A Spearman correlation analysis was run to determine the relationship between ΔFmax or ΔRmax and occlusal force or disclosing time (α=.05). @*Results@#The mean occlusal force and disclosing time were significantly higher on cracked teeth than on normal teeth (P .05). There was no correlation between ΔFmax or ΔRmax and occlusal force or disclosing time (P > .05). @*Conclusion@#There was a significant relationship between occlusion and cracked tooth syndrome. QLF has the potential to be a valuable tool for the diagnosis of tooth crack in clinical practice.

5.
Article in English | WPRIM | ID: wpr-902581

ABSTRACT

Purpose@#This study aimed to develop the following scales on women’s environmental health and to examine their validity and reliability: severity, susceptibility, response efficacy, self-efficacy, benefit, barrier, personal health behavior, and community health behavior scales. @*Methods@#The item pool was generated based on related scales, a wide literature review, and in-depth interviews on women’s environmental health according to the revised Rogers’ protection motivation theory model. Content validity was verified by three nursing professionals. Exploratory factor analysis, convergent validity, and internal consistency reliability were examined. @*Results@#The scales included 10 items on severity, 11 on susceptibility, 10 on response efficacy, 14 on self-efficacy, 8 on benefits, 10 on barriers, 17 on personal health behavior, and 16 on community health behavior. Convergent validity with the environmental behavior scale for female adolescents was supported. The Cronbach’s α values for internal consistency were good for all scales: severity, .84; susceptibility, .92; response efficacy, .88; self-efficacy, .90; benefits, .91; barriers, .85; personal health behavior, .90; and community health behavior, .91. @*Conclusion@#The evaluation of the psychometric properties shows that these scales are valid and reliable measures of women’s environmental health awareness and behaviors. These scales may be helpful for assessing women’s environmental health behaviors, thereby contributing to efforts to promote environmental health.

6.
Article in Korean | WPRIM | ID: wpr-899578

ABSTRACT

Purpose@#The purpose of this study was to explore the forgiveness of wives of alcoholics and examine factors contributing to their forgiveness. @*Methods@#A total of 166 females selected through convenience sampling participated in this study. Data were collected from January 2019 to September 2019 through self-reporting questionnaires. Data were analyzed using the IBM SPSS/WIN 25.0 program. @*Results@#Forgiveness was significantly correlated with resilience, self-esteem, spirituality, and co-dependency. Self-esteem, spirituality, and co-dependency were significant factors explaining approximately 53.2% of the variance in forgiveness. @*Conclusion@#The results of the study show that self-esteem, spirituality, and co-dependency are important determinants of forgiveness in wives of alcoholics. Based on these results, it is suggested that forgiveness should be considered as a therapeutic factor of intervention for wives of alcoholics.

7.
Article in Korean | WPRIM | ID: wpr-899501

ABSTRACT

Purpose@#This study aimed to develop and examine the effects of a prenatal program on environmental health behavior using cartoon comics among Korean pregnant women. @*Methods@#This study used a non-equivalent control group pre-test/post-test design. The program used cartoon comics to explore environmental health behaviors during pregnancy. The program consisted of the following four components: environmental toxicants during pregnancy, avoiding particulate matter during pregnancy, environmental toxicants during baby care, and making a healthy environment for children. In total, 35 pregnant women participated in the study: 18 in the experimental group and 17 in the control group. Data collection and program adaptation were conducted between November 3, 2020 and January 19, 2021. The effect of the prenatal education program was evaluated by t-test and repeated measures ANOVA. @*Results@#Learning experience (t = - 2.35, p = .025), feasibility (t = - 2.46, p = .019), satisfaction (t = - 2.23, p = .032) were higher in the experimental group than in the control group in the first post-test. Feasibility (t = - 2.40, p = .022) was higher in the experimental group than in the control group in the second post-test. Repeated-measures ANOVA showed significant interactions between time and group in environmental susceptibility (F = 9.31, p < .001), self-efficacy (F = 3.60, p = .033), and community behavior (F = 5.41, p = .007). @*Conclusion@#This study demonstrates the need for a prenatal education program to promote environmental health perceptions and behavior during pregnancy. We suggest a prenatal class adopting the creative cartoon comics to promote the maternal environmental health behaviors.

8.
Article in English | WPRIM | ID: wpr-898226

ABSTRACT

Background@#Programmed cell death-ligand 1 (PD-L1) has an important role in regulating immune reactions by binding to programmed death 1 (PD-1) on immune cells, which could prevent the exacerbation of autoimmune thyroid disease (AITD). The aim of this study was to evaluate the association of PD-L1 polymorphism with AITD, including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). @*Methods@#A total of 189 GD patients, 234 HT patients, and 846 healthy age- and sex-matched controls were enrolled in this study. We analyzed PD-L1 single nucleotide polymorphism (SNP) (rs822339) and investigated the associations with clinical disease course and outcome. @*Results@#Genotype frequency at the PD-L1 marker RS822339 in GD (P=0.219) and HT (P=0.764) patients did not differ from that among healthy controls. In patients with GD, the A/G or G/G genotype group demonstrated higher TBII titer (20.6±20.5 vs. 28.0± 25.8, P=0.044) and longer treatment duration (39.0±40.4 months vs. 62.4±65.0 months, P=0.003) compared to the A/A genotype group. Among patients in whom anti-thyroid peroxidase (TPO) antibody was measured after treatment of GD, post-treatment antiTPO positivity was higher in the A/G or G/G genotype group compared to the A/A genotype group (48.1% vs. 69.9%, P=0.045). Among patients with HT, there was no significant difference of anti-TPO antibody positivity (79.4% vs. 68.6%, P=0.121), anti-thyroglobulin antibody positivity (80.9% vs. 84.7%, P=0.661), or development to overt hypothyroidism (68.0% vs. 71.1%, P=0.632) between the A/A genotype group and the A/G or G/G genotype group. @*Conclusion@#The genotype frequency of PD-L1 (rs822339) is not different in patients with AITD compared with healthy controls. The intact PD-1/PD-L1 pathway in GD and HT might be important to maintain chronicity of AITD by protecting immune tolerance. However, the PD-L1 SNP could be associated with difficulty in achieving remission in patients with GD, which may be helpful to predict the possibility of longer treatment. Further studies are required to investigate the complex immune tolerance system in patients with AITD.

9.
Article in English | WPRIM | ID: wpr-898197

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

10.
Article in English | WPRIM | ID: wpr-898171

ABSTRACT

Background@#Thyroid immune-related adverse events (IRAEs) have been reported in patients treated with programmed cell death protein-1 (PD-1) and programmed cell death protein-ligand 1 (PD-L1) inhibitors. We investigated the incidence and clinical course of PD-1/PD-L1 inhibitor-induced thyroid IRAEs, and identified predictable clinical risk factors of thyroid IRAEs, in particular, overt hypothyroidism (OH). @*Methods@#We retrospectively reviewed the medical records of 325 cancer patients receiving PD-1/PD-L1 inhibitor in a tertiary referral center. @*Results@#A total of 50.5% (164/325) of patients experienced at least one abnormal thyroid function following PD-1/PD-L1 inhibitor. Eighty-four patients (51.2%) of them recovered to normal thyroid function during follow-up. In overall population, 25 patients (7.7%) required thyroid hormone replacement therapy due to PD-1/PD-L1 inhibitor-induced OH. Patients who progressed to OH showed significantly higher baseline thyroid stimulating hormone level and longer duration of PD-1/PD-L1 inhibitor therapy than those without thyroid dysfunction or OH (both P<0.001). Median time interval to the development of OH was 3 months after the therapy. OH was significantly associated with positive anti-thyroid peroxidase antibody at baseline and anti-thyroglobulin antibody during the therapy than those without thyroid dysfunction or OH (P=0.015 and P=0.005, respectively). We observed no patients with OH who were able to stop levothyroxine replacement after the cessation of PD-1/PD-L1 inhibitor therapy. @*Conclusion@#PD-1/PD-L1 inhibitor-induced thyroid dysfunctions are considerably reversible; however, OH is irreversible requiring levothyroxine replacement even after stopping the therapy. Positive thyroid autoantibodies may predict the progression to OH.

11.
Chonnam Medical Journal ; : 211-218, 2021.
Article in English | WPRIM | ID: wpr-897507

ABSTRACT

This study was conducted to evaluate the efficacy and safety of once-weekly dulaglutide therapy as add-on to oral antidiabetic drugs (OADs) and basal insulin in Korean patients with type 2 diabetes mellitus (T2DM) in real-world clinical practice. We retrospectively reviewed the medical records of 112 patients who received dulaglutide in a tertiary referral center. The primary efficacy endpoint was a change in glycated hemoglobin (HbA1c) between baseline and 6 months. The secondary endpoints were the percentage of patients achieving HbA1c <7.0% or ≤6.5% and the change of body weight at 6 months. At baseline, the mean HbA1c was 8.7 % (8.8% in the OAD combination and 8.5% in the basal insulin combination group). The mean adjusted HbA1c at 6 months decreased by −1.13% in all patients (p<0.001), and by −1.36 and −0.74% in the OAD combination and basal insulin combination group, respectively. A significant reduction of −2.9 kg in body weight was observed in all patients at 6 months (p<0.001). Approximately 34.8% and 23.2% of patients achieved HbA1c <7.0% and ≤6.5%, respectively. Higher baseline HbA1c and no previous insulin therapy were associated with positive responses to dulaglutide on multivariate analysis. Mild gastrointestinal issues (23.2%) were the most frequently observed adverse events. Dulaglutide is an effective and durable treatment option as OAD and basal insulin combination therapy in Korean patients with T2DM.

12.
Article in English | WPRIM | ID: wpr-895800

ABSTRACT

Purpose@#The aim of this study was to evaluate the relationship between the patient's occlusion and a cracked tooth by using T-scan occlusal analysis and a quantitative light-induced fluorescence (QLF) technology. @*Materials and Methods@#This study was carried out on 51 patients having cracked teeth between January, 2019 and December, 2020. The tooth crack was determined with a Q-ray pen and QLF parameters (ΔFmax and ΔRmax) were obtained by a Q-ray software. T-scan tests were conducted to all subjects and then, the occlusal force and disclosing time were analyzed. Mann-Whitney U test was performed to compare the occlusal force and disclosing time between cracked teeth groups and contra-lateral normal teeth groups (α = .05). Mann-Whitney U test was performed to compare ΔFmax and ΔRmax according to the results of cold/bite tests (α = .05). A Spearman correlation analysis was run to determine the relationship between ΔFmax or ΔRmax and occlusal force or disclosing time (α=.05). @*Results@#The mean occlusal force and disclosing time were significantly higher on cracked teeth than on normal teeth (P .05). There was no correlation between ΔFmax or ΔRmax and occlusal force or disclosing time (P > .05). @*Conclusion@#There was a significant relationship between occlusion and cracked tooth syndrome. QLF has the potential to be a valuable tool for the diagnosis of tooth crack in clinical practice.

13.
Article in English | WPRIM | ID: wpr-894877

ABSTRACT

Purpose@#This study aimed to develop the following scales on women’s environmental health and to examine their validity and reliability: severity, susceptibility, response efficacy, self-efficacy, benefit, barrier, personal health behavior, and community health behavior scales. @*Methods@#The item pool was generated based on related scales, a wide literature review, and in-depth interviews on women’s environmental health according to the revised Rogers’ protection motivation theory model. Content validity was verified by three nursing professionals. Exploratory factor analysis, convergent validity, and internal consistency reliability were examined. @*Results@#The scales included 10 items on severity, 11 on susceptibility, 10 on response efficacy, 14 on self-efficacy, 8 on benefits, 10 on barriers, 17 on personal health behavior, and 16 on community health behavior. Convergent validity with the environmental behavior scale for female adolescents was supported. The Cronbach’s α values for internal consistency were good for all scales: severity, .84; susceptibility, .92; response efficacy, .88; self-efficacy, .90; benefits, .91; barriers, .85; personal health behavior, .90; and community health behavior, .91. @*Conclusion@#The evaluation of the psychometric properties shows that these scales are valid and reliable measures of women’s environmental health awareness and behaviors. These scales may be helpful for assessing women’s environmental health behaviors, thereby contributing to efforts to promote environmental health.

14.
Article in Korean | WPRIM | ID: wpr-891874

ABSTRACT

Purpose@#The purpose of this study was to explore the forgiveness of wives of alcoholics and examine factors contributing to their forgiveness. @*Methods@#A total of 166 females selected through convenience sampling participated in this study. Data were collected from January 2019 to September 2019 through self-reporting questionnaires. Data were analyzed using the IBM SPSS/WIN 25.0 program. @*Results@#Forgiveness was significantly correlated with resilience, self-esteem, spirituality, and co-dependency. Self-esteem, spirituality, and co-dependency were significant factors explaining approximately 53.2% of the variance in forgiveness. @*Conclusion@#The results of the study show that self-esteem, spirituality, and co-dependency are important determinants of forgiveness in wives of alcoholics. Based on these results, it is suggested that forgiveness should be considered as a therapeutic factor of intervention for wives of alcoholics.

15.
Article in Korean | WPRIM | ID: wpr-891797

ABSTRACT

Purpose@#This study aimed to develop and examine the effects of a prenatal program on environmental health behavior using cartoon comics among Korean pregnant women. @*Methods@#This study used a non-equivalent control group pre-test/post-test design. The program used cartoon comics to explore environmental health behaviors during pregnancy. The program consisted of the following four components: environmental toxicants during pregnancy, avoiding particulate matter during pregnancy, environmental toxicants during baby care, and making a healthy environment for children. In total, 35 pregnant women participated in the study: 18 in the experimental group and 17 in the control group. Data collection and program adaptation were conducted between November 3, 2020 and January 19, 2021. The effect of the prenatal education program was evaluated by t-test and repeated measures ANOVA. @*Results@#Learning experience (t = - 2.35, p = .025), feasibility (t = - 2.46, p = .019), satisfaction (t = - 2.23, p = .032) were higher in the experimental group than in the control group in the first post-test. Feasibility (t = - 2.40, p = .022) was higher in the experimental group than in the control group in the second post-test. Repeated-measures ANOVA showed significant interactions between time and group in environmental susceptibility (F = 9.31, p < .001), self-efficacy (F = 3.60, p = .033), and community behavior (F = 5.41, p = .007). @*Conclusion@#This study demonstrates the need for a prenatal education program to promote environmental health perceptions and behavior during pregnancy. We suggest a prenatal class adopting the creative cartoon comics to promote the maternal environmental health behaviors.

16.
Article in Korean | WPRIM | ID: wpr-915127

ABSTRACT

Purpose@#The purpose of this study was to analyze the factors influencing the health promoting behavior(s) of office worker males in the COVID-19 pandemic by applying Pender’s health promotion model. @*Methods@#The participants in this study were 149 male office workers at companies located in S, G and S cities. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficient and a stepwise multiple regression using the SPSS Window 25.0 program. @*Results@#The subject’s health promoting behaviors and prior related behaviors (r=.58, p<.001), perceived benefits of action (r=.41, p<.001), self-efficacy (r=.53, p<.001), social support (r=.39, p<.001), self-esteem (r=.47, p<.001) and commitment to a plan of action (r=.67, p<.001) showed a high positive correlation. The factpors affecting the subjects’ health promoting behaviors were the commitment to a plan of action (β=.35, p<.001), self-esteem (β=.27, p=.005), prior related behavior (β=.26, p<.001), health status (good) (β=.20, p=.001) and self-efficacy (β=.14, p=.047). These variables explained 63.0% of the subjects’ health promoting behaviors. @*Conclusion@#During the COVID-19 pandemic, subjects are more likely to be exposed to disease due to reduced outdoor activity time and irregular eating habits due to the strengthening of social distancing. Health promoting behaviors are an important concept that can maintain health and prevent diseases. To improve the health promoting behaviors of men engaged in office work, it is necessary to develop and operate a health promotion behaviors program considering those variables.

17.
Endocrinology and Metabolism ; : 1078-1085, 2021.
Article in English | WPRIM | ID: wpr-914253

ABSTRACT

Background@#Hürthle cell carcinoma (HCC), a type of thyroid carcinoma, is rare in South Korea, and few studies have investigated its prognosis. @*Methods@#This long-term multicenter retrospective cohort study evaluated the clinicopathological features and clinical outcomes in patients with HCC who underwent thyroid surgery between 1996 and 2009. @*Results@#The mean age of the 97 patients included in the study was 50.3 years, and 26.8% were male. The mean size of the primary tumor was 3.2±1.8 cm, and three (3.1%) patients had distant metastasis at initial diagnosis. Ultrasonographic findings were available for 73 patients; the number of nodules with low-, intermediate-, and high suspicion was 28 (38.4%), 27 (37.0%), and 18 (24.7%), respectively, based on the Korean-Thyroid Imaging Reporting and Data System. Preoperatively, follicular neoplasm (FN) or suspicion for FN accounted for 65.2% of the cases according to the Bethesda category, and 13% had malignancy or suspicious for malignancy. During a median follow-up of 8.5 years, eight (8.2%) patients had persistent/recurrent disease, and none died of HCC. Older age, gross extrathyroidal extension (ETE), and widely invasive types of tumors were significantly associated with distant metastasis (all P<0.01). Gross ETE (hazard ratio [HR], 27.7; 95% confidence interval [CI], 2.2 to 346.4; P=0.01) and widely invasive classification (HR, 6.5; 95% CI, 1.1 to 39.4; P=0.04) were independent risk factors for poor disease-free survival (DFS). @*Conclusion@#The long-term prognosis of HCC is relatively favorable in South Korea from this study, although this is not a nation-wide data, and gross ETE and widely invasive cancer are significant prognostic factors for DFS. The diagnosis of HCC by ultrasonography and cytopathology remains challenging.

18.
Endocrinology and Metabolism ; : 1268-1276, 2021.
Article in English | WPRIM | ID: wpr-914249

ABSTRACT

Background@#The association between Graves’ disease (GD) and co-existing thyroid cancer is still controversial and most of the previously reported data have been based on surgically treated GD patients. This study investigated the clinicopathological findings and prognosis of concomitant thyroid cancer in GD patients in the era of widespread application of ultrasonography. @*Methods@#Data of GD patients who underwent thyroidectomy for thyroid cancer between 2010 and 2019 in three tertiary hospitals in South Korea (Asan Medical Center, Chonnam National University Hwasun Hospital, and Pusan National University Hospital) were collected and analyzed retrospectively. In the subgroup analysis, aggressiveness and clinical outcomes of thyroid cancer were compared nodular GD and non-nodular GD groups according to the presence or absence of the thyroid nodules other than thyroid cancer (index nodules). @*Results@#Of the 15,159 GD patients treated at the hospitals during the study period, 262 (1.7%) underwent thyroidectomy for coexisting thyroid cancer. Eleven patients (4.2%) were diagnosed with occult thyroid cancer and 182 patients (69.5%) had microcarcinomas. No differences in thyroid cancer aggressiveness, ultrasonographic findings, or prognosis were observed between the nodular GD and non-nodular GD groups except the cancer subtype. In the multivariate analysis, only lymph node (LN) metastasis was an independent prognostic factor for recurrent/persistent disease of thyroid cancer arising in GD (P=0.020). @*Conclusion@#The prevalence of concomitant thyroid cancer in GD patients was considerably lower than in previous reports. The clinical outcomes of thyroid cancer in GD patients were also excellent but, more cautious follow-up is necessary for patients with LN metastasis in the same way as for thyroid cancer in non-GD patients.

19.
Article in English | WPRIM | ID: wpr-890522

ABSTRACT

Background@#Programmed cell death-ligand 1 (PD-L1) has an important role in regulating immune reactions by binding to programmed death 1 (PD-1) on immune cells, which could prevent the exacerbation of autoimmune thyroid disease (AITD). The aim of this study was to evaluate the association of PD-L1 polymorphism with AITD, including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT). @*Methods@#A total of 189 GD patients, 234 HT patients, and 846 healthy age- and sex-matched controls were enrolled in this study. We analyzed PD-L1 single nucleotide polymorphism (SNP) (rs822339) and investigated the associations with clinical disease course and outcome. @*Results@#Genotype frequency at the PD-L1 marker RS822339 in GD (P=0.219) and HT (P=0.764) patients did not differ from that among healthy controls. In patients with GD, the A/G or G/G genotype group demonstrated higher TBII titer (20.6±20.5 vs. 28.0± 25.8, P=0.044) and longer treatment duration (39.0±40.4 months vs. 62.4±65.0 months, P=0.003) compared to the A/A genotype group. Among patients in whom anti-thyroid peroxidase (TPO) antibody was measured after treatment of GD, post-treatment antiTPO positivity was higher in the A/G or G/G genotype group compared to the A/A genotype group (48.1% vs. 69.9%, P=0.045). Among patients with HT, there was no significant difference of anti-TPO antibody positivity (79.4% vs. 68.6%, P=0.121), anti-thyroglobulin antibody positivity (80.9% vs. 84.7%, P=0.661), or development to overt hypothyroidism (68.0% vs. 71.1%, P=0.632) between the A/A genotype group and the A/G or G/G genotype group. @*Conclusion@#The genotype frequency of PD-L1 (rs822339) is not different in patients with AITD compared with healthy controls. The intact PD-1/PD-L1 pathway in GD and HT might be important to maintain chronicity of AITD by protecting immune tolerance. However, the PD-L1 SNP could be associated with difficulty in achieving remission in patients with GD, which may be helpful to predict the possibility of longer treatment. Further studies are required to investigate the complex immune tolerance system in patients with AITD.

20.
Article in English | WPRIM | ID: wpr-890493

ABSTRACT

Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients’ health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.

SELECTION OF CITATIONS
SEARCH DETAIL