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대한갑상선학회> International Journal of Thyroidology

International Journal of Thyroidology update

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수록정보
수록범위 : 1권1호(2008)~13권1호(2020) |수록논문 수 : 324
International Journal of Thyroidology
13권1호(2020년 05월) 수록논문
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1The Significance of Transcriptomic Signatures in the Multifocal Papillary Thyroid Carcinoma: Two mRNA Expression Patterns with Distinctive Clinical Behavior from The Cancer Genome Atlas (TCGA) Database

저자 : Yea Eun Kang , Boyoung Hwang , Ju Hee Lee , Minho Shong , Hyon-seung Yi , Bon Seok Koo , Dong Jin Lee

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 1-12 (12 pages)

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Background and Objectives: The association between multifocal papillary thyroid carcinoma (PTC) and tumor aggressiveness remains controversial. The aim of study is to evaluate molecular subtypes of multifocal PTCs using multiplatform genomic analysis. Materials and Methods: Statistical analysis and genomic analysis were performed for gene expression data and clinical data of multifocal PTCs in The Cancer Genome Atlas data. Clinicopathologic findings, recurrence-free survival (RFS), copy number alteration and somatic mutation status in patients in relation to molecular subtypes were analyzed. Results: Multiplatform genomic analysis revealed that multifocal PTCs (n=226) were divided into two distinct molecular subgroups. Participants in cluster 2 showed significantly increased risk of extrathyroidal extension, lymph node metastasis, and BRAFV600E mutation compared to patients in cluster 1. To exclude the effect of BRAF mutation and RAS mutation on tumor aggressiveness, we compared clinical parameters between two clusters in patients without BRAF or RAS mutation. Cluster 2 showed significantly higher risk of lymph node metastasis compared to cluster 1. Conclusion: Multifocal PTC has two distinct molecular subtypes with distinctive clinical behaviors. Our data suggested the clinical implications of the transcriptomic signature to predict clinical outcomes of multifocal PTC.

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2Antenatal Thyroid Function Does Not Increase Risk of Gestational Diabetes Mellitus in a Multi-Ethnic Pregnancy Cohort

저자 : Christopher Alan Muir , Ashish Munsif , Kenrick Blaker , Yvonne Feng , Mario D'souza , Shailja Tewari

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 13-18 (6 pages)

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Background and Objectives: Subclinical hypothyroidism in pregnancy has been inconsistently associated with an increased risk of developing gestational diabetes mellitus (GDM). Materials and Methods: We retrospectively examined whether an antenatal thyroid stimulating hormone (TSH) level ≥2.5 mIU/L was associated with increased risk of GDM in 1147 pregnant women residing in a multi-ethnic suburban area of Sydney, Australia. Results: Despite a high prevalence of GDM and hypothyroidism in our study, women with antenatal TSH concentrations ≥2.5 mIU/L were not at increased risk for development of gestational diabetes. Traditional risk factors for GDM, such as maternal body mass index, ethnicity, previous GDM pregnancy and family history of type 2 diabetes were significant predictors of incident GDM on multivariable analyses. Conclusion: Mild elevations in antenatal TSH concentration did not significantly increase risk of incident GDM compared to healthy euthyroid women.

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3Effect of Multiple Exposure to Perfluorinated Chemicals on Thyroid Function among Adults in the US: The National Health and Nutrition Examination Survey 2007-2008 and 2011-2012

저자 : Young Seok Sohn , Shinje Moon , Young Joo Park

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 19-29 (11 pages)

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Background and Objectives: Perfluoroalkyl substances (PFASs) are known to disrupt the thyroid hormone system. However, no study has assessed the association between multiple exposure to PFASs and the thyroid hormone system. This study aimed to identify the singular effects of each PFAS and the effects of multiple exposure to PFASs on the thyroid hormone profile in a representative sample of the US population. Materials and Methods: We used data from the US National Health and Nutrition Examination Survey (NHANES) 2007-2008 and 2011-2012. To assess the effect of simultaneous exposure to multiple PFASs on thyroid function, principal component (PC) analysis with varimax rotation was performed. Multivariate linear regression analysis was conducted to identify the effect of each PFAS and PC on thyroid function. Results: In this study, perfluorooctanoate (PFOA) was associated with a decrease in total T4 and Free T4 levels. Perfluorooctane sulfonate (PFOS) was associated with a decrease in total T4 level and perfluorononanoate (PFNA) and perfluorodecanoate (PFDeA) were associated with decreases in TSH levels. In PC analysis, two PCs were identified. PC1 included PFOA, PFOS, perfluorohexane sulfonate (PFHxS), PFNA and 2-(N-methyl-perfluorooctane sulfonamido) acetic acid with high loading. PC2 included PFNA, PFDeA, and perfluoroundecanoate (PFUA). In the multivariate linear regression analysis, PC1 showed negative correlations with total T4 and Free T4 levels, whereas PC2 showed a negative correlation with TSH level. Conclusion: We found that singular and multiple exposure to PFASs was associated with a disruption in thyroid hormone system.

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4갑상선암 환자들의 관심사 및 정보추구행위: 온라인 커뮤니티 분석을 중심으로

저자 : 박경아 ( Kyung Ah Park ) , 김상희 ( Sanghee Kim ) , 이용상 ( Yong Sang Lee ) , 장항석 ( Hang-seok Chang ) , 박정수 ( Cheong Soo Park )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 30-36 (7 pages)

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Background and Objectives: Many patients with thyroid cancer are participating in the online community. Thyroid cancer patients write and read a variety of posts in the online community, and there is a great deal of data generated in the digital environment. However, few studies have analyzed the online community of thyroid cancer patients. The purpose of this study is to analyze the online community to understand the interests and information seeking behavior of thyroid cancer patients. Materials and Methods: Data were collected from August 2017 to September 2019 using statistics from an online community of thyroid cancer patients. The frequency analysis was performed by collecting the members' gender, age, average usage time, time-of-day views, average monthly visits, device distribution, online community inflow query, query within online community, and content of a post with more than 1000 views per month. Results: Analyzing the online community of thyroid cancer patients, women accounted for 80.4% of the total, and the age group of people in their 30s and 40s accounted for 77.5%. Online community subscribers averaged 0.7 visits a day using mobile, with the most frequent use time between 10pm and 12pm. Frequently used queries are medical staff names, surgery, recurrence and scar. Posts showed informational and emotional exchanges. Conclusion: Patients with thyroid cancer have searched for a lot of information about surgery and recurrence. Analyzing the online community will help to understand the experience of thyroid cancer patients and contribute to the development of online community intervention.

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5갑상선유두암에서 18F-FDG PET/CT의 진단적 유용성

저자 : 김현기 ( Hyungi Gim ) , 이동근 ( Dong Kun Lee ) , 박헌수 ( Heon Soo Park ) , 정영진 ( Yeong Jin Jeong )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 37-42 (6 pages)

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Background and Objectives: PET/CT is widely used to determine whether metastasis or recurrence will occur following initial treatment of thyroid cancer. However, there are not much research on diagnostic usefulness of preoperative PET/CT imaging for papillary thyroid cancer (PTC). We analyzed the correlation between the preoperative maximum standard uptake value (SUVmax) of PET/CT and prognostic factors of PTC to evaluate the diagnostic usefulness of PET/CT. Materials and Methods: Of the 133 patients who underwent surgery for PTC, 88 patients who had an increased uptake in thyroid mass in preoperative PET/CT were enrolled. They were divided into two groups according to B-RAF gene mutation, extrathyroidal extension (ETE), lymph node metastasis, and recurrence. The average of the SUVmax for each group was analyzed through multiple regression analysis. Correlation analysis were performed on changes in SUVmax according to the size of the thyroid tumor. Statistical analysis was performed to determine whether there were stage differences between the 47 patients who had no increased uptake in PET/CT and the others who had. Results: There were no statistical correlation between recurrence, the presence of central/lateral lymph node metastasis, ETE, stage and the SUVmax in PET/CT (p=0.513, p=0.8, p=0.73, p=0.01, p=0.9). There were statistical correlations between the size of tumor (p=0.001), the presence of the B-RAF mutation (p=0.024) and SUVmax. Statistical correlations between the presence of the hypermetabolic uptake and high stage were found by the chi-square test (p=0.012). Conclusion: The size of tumor, B-RAF are major factors in determining prognosis of PTC. There is a possibility that there is a correlation between preoperative SUVmax and prognosis of PTC.

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6변형 근치적 림프절 곽청술 시행 중 발생한 상완신경총 손상에 대한 신경봉합술 치료 1례

저자 : 이민기 ( Min Ki Lee ) , 강현택 ( Hyun Tag Kang ) , 김신영 ( Shin Young Kim ) , 이승원 ( Seung-won Lee )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 43-46 (4 pages)

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The brachial plexus originates from the ventral rami of spinal nerves C5–T1 and lies between the anterior and middle scalene muscles. Brachial plexus injury can occur as a rare complication of neck dissection or in association with trauma, malignancy, or radiotherapy. We performed modified radical neck dissection in a female with cervical lymph node metastasis of a recurrent papillary thyroid carcinoma. Brachial plexus injury occurred because of severe adhesion and anatomical distortion during the surgical revision and was immediately treated via end-to-end neurorrhaphy. After surgery, the patient felt pain and numbness in her right shoulder and arm. Motor function was grade 0 on right shoulder flexion, arm abduction and elbow flexion. After 1 year of follow-up, both motor and sensory function had fully recovered. This is the first reported case of complete motor function restoration after brachial plexus neurorrhaphy in a patient treated in the Republic of Korea.

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7Thoracic Duct Embolization for Chyle Leakage after Thyroid Surgery

저자 : Inhwa Lee , Hyeung Kyoo Kim , Jeonghun Lee , Euy Young Soh , Jinoo Kim

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 47-50 (4 pages)

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Chyle leakage (CL) due to lymphatic injuries is one of the rare complications that can develop after thyroidectomy. There are few studies on lymphatic embolization performed in case of CL after thyroid surgery. We report two cases of CL after thyroid surgery that were effectively treated by thoracic duct embolization. The patients had previously undergone total thyroidectomy with central compartment neck dissection with or without modified radical neck dissection. The amount of drainage from the operative site was >1000 mL per day in one patient and >500 mL per day in the other. In both cases, CL stopped after the thoracic duct embolization. Thoracic duct embolization seems to be an effective and important treatment option for CL after thyroid surgery.

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8갑상선 종양으로 오인된 상위 쇄골하동맥

저자 : 김대환 ( Dae Hwan Kim ) , 류소미 ( Somi Ryu ) , 원성준 ( Seongjun Won ) , 박정제 ( Jung Je Park )

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 51-54 (4 pages)

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Anterior neck mass is a common symptom that is seen in otolaryngology surgery centers. Common types include thyroid tumor and thyroglossal duct cyst. In an elderly patient, a differentiated thyroid carcinoma should be suspected especially if it moves when swallowing. We encountered a typical presentation of a solitary thyroid nodule-like mass without pulsation in an 81-year-old female. We presented a rare diagnosis of pulsatile anterior neck swelling in which a high-riding subclavian artery should be considered as a differential diagnosis. Ultrasonography, Doppler scan, and contrast CT scan revealed that the neck mass corresponds to the high-riding subclavian artery. Therefore, ultrasonography is essential to detect any vascular lesion prior to biopsy or fine needle aspiration cytology as to avoid catastrophic hemorrhage.

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9Coexistent Papillary Thyroid Carcinoma and Its Anaplastic Transformation in Cervical Lymph Node Metastasis

저자 : Seulki Song , Dong-han Lee , Hyojin Kim , Woo-jin Jeong

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 55-59 (5 pages)

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The transformation of papillary thyroid carcinoma (PTC) to anaplastic thyroid carcinoma (ATC) is well documented in the literature but is an exceptionally rare occurrence in metastatic foci outside the primary thyroid lesion. Even rarer is the simultaneous occurrence of PTC and ATC in the cervical lymph nodes. We report the case of an 85-year-old man who presented with a rapidly growing neck mass diagnosed as PTC. Following surgery, multiple ATC foci in the metastatic cervical lymph node were found coexisting with PTC, whereas in the thyroid, only PTC was found. This case is of high clinical significance because transformation of PTC to ATC outside the thyroid gland per se is very rare and because it suggests rapidly growing tumors in an elderly patient. The use of core needle biopsies in cases with suspected rapid tumor growth can aid in proper diagnosis, surgical decision making, and patient counselling.

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10Successful Treatment of Cavernous Sinus Metastasis from Follicular Thyroid Carcinoma with Lenvatinib

저자 : Tee Sin Lee , Anna See , Caleb Lim , Xin Yong Huang

발행기관 : 대한갑상선학회 간행물 : International Journal of Thyroidology 13권 1호 발행 연도 : 2020 페이지 : pp. 60-63 (4 pages)

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Radioiodine-refractory distant metastases in well-differentiated thyroid carcinomas are rare but pose a significant diagnostic and management challenge. Follicular thyroid carcinoma which is a type of well-differentiated carcinoma, is known for its hematogenous spread. Various sites of distant metastasis have been described. We report the first-ever case of radioiodine-refractory metastasis at the cavernous sinus, arising from follicular thyroid carcinoma. The atypical site of metastasis and management complexity of radioiodine-refractory disease is discussed in this article.

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