Clinical Menifestation and Anaylsis of Thyroid Follicular Carcinoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Follicular thyroid carcinoma (FTC) is the second most common thyroid malignancy after papillary thyroid carcinoma. We performed this study to obtain further understanding and more supporting ideas for the diagnosis and treatment of thyroid follicular carcinoma. SUBJECTS AND METHOD: Over a 12-year period, 126 patients surgically treated for FTC with an average follow-up of 57.5 months were retrospectively studied. RESULTS: Eighteen (14.3%) patients had distant metastasis at presentation and completion thyroidectomy was performed for 58 patients (46%) after partial thyroidectomy. This implies how difficult it is to diagnosis this type of cancer at the preoperative or intra-operative stage of treatment. Fine-needle aspiration cytology has been shown to be an ineffective method for the diagnosis of FTC. Five patients developed recurrent distant metastasis 6 month after their initial treatment and 3 patients died of persistent distant metastatic disease. The 10-year overall survival rate were 97.6%, and 10-year disease free survival rate was 82.5%. The patients with minimally invasive follicular carcinoma (n=92) and low risk group according to AMES classification, stage IV in TNM classification had more favorable prognosis. But the results showed no statistically significant difference. CONCLUSION: Several staging systems can be applied specifically to patients with FTC. The distinction of FTC in minimally invasive and widely invasive carcinoma, analysis of prognostic factor (recurrence, local invasion, distant metastasis, age, tumor size) is important in identifying low risk patients for a more conservative treatment.

Nonrecurrent Inferior Laryngeal Nerve Related to Thyroid Surgery : Review of Ten Cases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The nonrecurrent inferior laryngeal nerve (NRILN) is a rare anomaly of the recurrent inferior laryngeal nerve (RILN), associated with abnormal development of the aortic arch that can be associated with an increased risk of vocal fold paralysis. This study will describe preoperative diagnosis and intraoperative findings. SUBJECTS AND METHOD: We describe 10 cases (0.53%) of the NRILN observed during 1890 surgical procedure between January 2006 and December 2008. RESULTS: The NRILN was observed on the right side in all cases. Although the NRILN was preserved, immediately after the surgery, vocal fold paralysis was present in one patient who completely recovered one month later. CONCLUSION: Injury due to RILN that results in vocal fold paralysis is one of the serious complications in thyroid and parathyroid surgery. If the RILN is not found in the classic position during surgery, this can be a possibility of the presence of the NRILN

Contributions of the Radiocarpal and Midcarpal Jointin Flexion-extension Motion of Wrist / 대한정형외과학회잡지

PURPOSE: Flexion and extension of the wrist occurs at the radiocarpal and midcarpal joints. This study examined the angular contribution of the radiocarpal and midcarpal joints to the total arc of motion. MATERIALS AND METHODS: Five healthy adults were selected and ten wrists were tested. Lateral X-rays were taken with the wrist in the neutral position, 30 degrees flexion, 60 degrees flexion, 90 degrees flexion, 30 degrees extension, 60 degrees extension, and 90 degrees extension. The radiocarpal and midcarpal angle were measured. The angular contribution of the radiocarpal and midcarpal angle was calculated at each phase of motion; neutral to 30 degrees, 30 degrees to 60 degrees, 60 degrees to 90 degrees. RESULTS: During wrist flexion, the angular contribution of the midcarpal joint was 65%, 72%, 71% at each phase of motion, respectively. During wrist extension, the angular contribution of midcarpal joint was 37%, 53%, 78% at each phase of motion, respectively. Therefore, during wrist extension, the main contributor of motion is changed from the radiocarpal joint in the early phase to the midcarpal joint in the late phase. CONCLUSION: It is suggested that the proximal carpal low is not moved passively by just the link system but the motion is guided by the peculiar shape of midcarpal articulation and ligaments complex at each phase. The link system is believed to act in the early phase of flexion and in late phase of extension.