A Case of Severe Recurrent Painless Thyroiditis Requiring Thyroidectomy / 대한갑상선학회지

The course of painless thyroiditis is usually transient with a thyrotoxicosis phase that lasts for 2 months before recovery. Therefore, no treatment is required. This case is unusual because of the recurrence and severity of thyrotoxicosis, which required surgery of the thyroid gland to prevent a thyrotoxic crisis. A 43-year-old female who presented with severe thyrotoxicosis was found to have low radioactive iodine uptake, negative test results for TSH receptor antibodies, normal erythrocyte sedimentation rate and diffuse goiter without pain or tenderness; these findings suggested a diagnosis of painless thyroiditis. She was treated for relapsed painless thyroiditis for 10 years. However, in May 2014, she developed recurrent painless thyroiditis with severe thyrotoxicosis; free T4 41.5 ng/dL, TSH <0.005 mlU/mL. Owing to the severity and recurrence of thyrotoxicosis, total thyroidectomy was performed to prevent a thyrotoxic storm.

The Benefit of Added Coronal Reformation Images in the MDCT Diagnosis of Acute Appendicitis for Emergency Physicians

PURPOSE: We compared diagnostic accuracy using transverse scans and combined transverse and coronal reformation images in the MDCT diagnosis of acute appendicitis. METHODS: MDCT was performed in 100 patients with acute non-traumatic abdominal pain who visited the emergency department. One half was diagnosed acute appendicitis by radiologic and histologic findings and the other half was not. Transverse scan and combined transverse and coronal reformation images were interpreted by six emergency physicians. Emergency physicians included two board physicians, two senior residents, and two junior residents. For comparison of diagnostic value, the chi-square test and cross tabs test were done. RESULTS: For all emergency physicians except one senior resident, the added coronal reformation images tended to increase the diagnostic accuracy. For board physicians, it increased the diagnostic accuracy from 81.5% to 91% (p=0.003). Senior residents increased from 82.5% to 91.5% (p=0.005), junior residents increased from 75.5% to 87% (p=0.002). The diagnostic accuracy of board physicians and senior residents were higher than junior residents for both image types. CONCLUSION: Coronal reformation images improve the accuracy of emergency physicians in the MDCT diagnosis of acute appendicitis.

Surgical Treatment of Spondylolysis: A Report of 7 Cases / 대한정형외과학회잡지

Three main types of operative teehnique are in general use today in the treatment of spondylolysis or spondylolisthesis: namely, total laminectomy alone, total laminectomy and posterior fusion, and anterior interbody fusion. According to Hoover(1968), above operations have yielded satisfactory results in approximately 70% of the cases. In recent years, Watkins, Adkins and Rombold have independently reported their cxperience with posterolateral intertransverse fusion, which they claim is based on a more sound mechanical basis and has yielded better results. The author performed anterior interbody fusion in 4 cases and posterolateral intertransverse fusion in 3 cascs at Seoul Naval Hospital during the 2 year period from May 1968 through May 1970 The postoperative follow-up period was maximum one year and minimum six months. Only one casc of anterior interbody fusion has shown sound fusion, while all ihe three posterolateral intertransverse fusions with posterior H-graft have yielded sound fusion with satisfactory clinical improvement by six months after operation.