측경부 낭종으로 발현된 유두상 갑상선암

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갑상선 종괴로 의심되었던 전종격동 성숙 낭성 기형종

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아급성 갑상선염

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Impact of Age-Related Genetic Differences on the Therapeutic Outcome of Papillary Thyroid Cancer

The incidence of papillary thyroid carcinoma (PTC) has been increasing worldwide. PTC is the most common type of differentiated thyroid cancer and usually shows good prognosis. However, some PTC is driven to advanced stage by epithelial-mesenchymal transition (EMT)-mediated drug resistance, which is particularly noticeable in pediatric patients. There are limited options for systemic treatment, necessitating development of new clinical approaches. Here, we aimed to clarify genetic differences due to age of patients with PTC, and thereby aid in developing novel therapeutics. Patients with biochemically and histologically confirmed PTC were included in this study. PTC cells were acquired from young and older patients showing drug resistance, and were compared via microarray analysis. Cellular proliferation and other properties were determined after treatments with lenvatinib and sorafenib. In vivo, tumor volume and other properties were examined using a mouse xenograft model. Lenvatinib-treated group showed obvious suppression of markers of anti-apoptosis, EMT, and the FGFR signaling pathway, compared with control and Sorafenib-treated group. In the xenograft models, lenvatinib treatment induced significant tumor shrinkage and blocked the proto-oncogene Bcl-2 (B cell lymphoma/leukemia gene-2) and FGFR signaling pathway, along with reduced levels of EMT markers, compared with control and Sorafenib-treated group. Our findings clarify the age-dependent characteristics of pediatric PTC, giving insights into the relationship between young age and poor prognosis. Furthermore, it provides a basis for developing novel therapeutics tailored to the age at diagnosis.ope

갑상선암 수술 환자들이 원하는 교육은?

Background and Objectives: To prevent getting wrong information and improve high quality of life, it is necessary to provide accurate information and patient education. This study aimed to collect basic data and develop educational program for thyroid cancer patient by understanding their educational needs. Materials and Methods: Between April 16 and June 15, 2012, 159 patients who underwent thyroid cancer surgery were enrolled. This survey consisted of 5 areas including management of the symptom and the complication after surgery, postoperative wound and dietary management, treatment plan after discharge, medication management, and daily life. Results: The most common way for the patients to acquire information about the disease was Internet and the patients who used INTERNET as their information source were 54.7%. Doctors (76.1%) and nurses (21.4%) were the preferred educators for the patients, and small group education was the preferred education method. Specifically the need for "management of the symptom and the complication after surgery" was the highest (3.33), followed by "treatment plan after discharge" (3.31), "medication management" (3.19), "postoperative wound and dietary management" (3.17). Conclusion: Medical team including doctors and nurses should be the center to activate small group education for patients. Professional and individualized education program should be developed to give the proper education to patients and their family.ope

일반화된 디리클레 사전확률을 이용한 비지도적 음원 분리 방법

학위논문 (박사)-- 서울대학교 대학원 : 융합과학기술대학원 융합과학부, 2018. 2. 이교구.Music source separation aims to extract and reconstruct individual instrument sounds that constitute a mixture sound. It has received a great deal of attention recently due to its importance in the audio signal processing. In addition to its stand-alone applications such as noise reduction and instrument-wise equalization, the source separation can directly affect the performance of the various music information retrieval algorithms when used as a pre-processing. However, conventional source separation algorithms have failed to show satisfactory performance especially without the aid of spatial or musical information about the target source. To deal with this problem, we have focused on the spectral and temporal characteristics of sounds that can be observed in the spectrogram. Spectrogram decomposition is a commonly used technique to exploit such characteristicshowever, only a few simple characteristics such as sparsity were utilizable so far because most of the characteristics were difficult to be expressed in the form of algorithms. The main goal of this thesis is to investigate the possibility of using generalized Dirichlet prior to constrain spectral/temporal bases of the spectrogram decomposition algorithms. As the generalized Dirichlet prior is not only simple but also flexible in its usage, it enables us to utilize more characteristics in the spectrogram decomposition frameworks. From harmonic-percussive sound separation to harmonic instrument sound separation, we apply the generalized Dirichlet prior to various tasks and verify its flexible usage as well as fine performance.Chapter 1 Introduction 1 1.1 Motivation 1 1.2 Task of interest 4 1.2.1 Number of channels 4 1.2.2 Utilization of side-information 5 1.3 Approach 6 1.3.1 Spectrogram decomposition with constraints 7 1.3.2 Dirichlet prior 11 1.3.3 Contribution 12 1.4 Outline of the thesis 13 Chapter 2 Theoretical background 17 2.1 Probabilistic latent component analysis 18 2.2 Non-negative matrix factorization 21 2.3 Dirichlet prior 23 2.3.1 PLCA framework 24 2.3.2 NMF framework 26 2.4 Summary 28 Chapter 3 Harmonic-Percussive Source Separation Using Harmonicity and Sparsity Constraints . . 30 3.1 Introduction 30 3.2 Proposed method 33 3.2.1 Formulation of Harmonic-Percussive Separation 33 3.2.2 Relation to Dirichlet Prior 35 3.3 Performance evaluation 37 3.3.1 Sample Problem 37 3.3.2 Qualitative Analysis 38 3.3.3 Quantitative Analysis 42 3.4 Summary 43 Chapter 4 Exploiting Continuity/Discontinuity of Basis Vectors in Spectrogram Decomposition for Harmonic-Percussive Sound Separation 46 4.1 Introduction 46 4.2 Proposed Method 51 4.2.1 Characteristics of harmonic and percussive components 51 4.2.2 Derivation of the proposed method 56 4.2.3 Algorithm interpretation 61 4.3 Performance Evaluation 62 4.3.1 Parameter setting 63 4.3.2 Toy examples 66 4.3.3 SiSEC 2015 dataset 69 4.3.4 QUASI dataset 84 4.3.5 Subjective performance evaluation 85 4.3.6 Audio demo 87 4.4 Summary 87 Chapter 5 Informed Approach to Harmonic Instrument sound Separation 89 5.1 Introduction 89 5.2 Proposed method 91 5.2.1 Excitation-filter model 92 5.2.2 Linear predictive coding 94 5.2.3 Spectrogram decomposition procedure 96 5.3 Performance evaluation 99 5.3.1 Experimental settings 99 5.3.2 Performance comparison 101 5.3.3 Envelope extraction 102 5.4 Summary 104 Chapter 6 Blind Approach to Harmonic Instrument sound Separation 105 6.1 Introduction 105 6.2 Proposed method 106 6.3 Performance evaluation 109 6.3.1 Weight optimization 109 6.3.2 Performance comparison 109 6.3.3 Effect of envelope similarity 112 6.4 Summary 114 Chapter 7 Conclusion and Future Work 115 7.1 Contributions 115 7.2 Future work 119 7.2.1 Application to multi-channel audio environment 119 7.2.2 Application to vocal separation 119 7.2.3 Application to various audio source separation tasks 120 Bibliography 121 초 록 137Docto

Factors Affecting Postoperative Occupational Changes and Sick Leave in Patients with Thyroid Cancer

Background and Objectives: Most thyroid cancers progress slowly, have high survival rates, and have good prognosis. Therefore, the management of patients with thyroid cancer should be viewed from a long-term perspective, taking into account a return to normal social life. Cancer patients have a higher risk of unemployment than the general population, and so unemployment can be an economic problem for thyroid cancer patients. However, there have been few studies on factors affecting return to work in thyroid cancer patients. The purpose of this study is to investigate occupational changes and the period of leave of absence for patients with thyroid cancer and to identify factors that affect the return to work after surgery. Materials and Methods: A total of 427 questionnaires of thyroid cancer patients were used for the analysis. The occupational changes and sick leave periods were analyzed according to general characteristics, disease-related characteristics, and side effects. Results: The factors related to occupational change and leave of absence in thyroid cancer patients were sex and type of occupation. Women had more occupational changes and longer leave of absence than men, office workers had the least change in occupation, and professional workers had a longer period of sick leave. Fatigue was the primary side effect that affected the leave of absence. Conclusion: Occupation is very important in the life of a thyroid cancer patient. Informing the patient of possible complications and planning proper leave of absence will help the patient return to work and improve the quality of life.ope

Diagnostic Approach and Treatment for Parathyroid Cyst

Purpose: Parathyroid cysts are rare clinical entities of the neck and superior mediastinum. These cysts often present a difficult diagnostic challenge. They often present as a solitary thyroid nodule and may be difficult to differentiate clinically. The objectives of this study were to review our 27 cases of parathyroid cyst and to suggest the method of diagnostic approach and treatment for parathyroid cyst. Methods: A retrospective study was performed for a 24-year period (1981∼2004), on 27 patients operated of parathyroid cyst. Results: Most of these patients (22/27) complained asymptomatic anterior neck mass at presentation. Preoperative radiologic examinations included ultrasonography (70.4%), computed tomography (25.9%), and 99mTc thyroid scan (22.2%). Hypercalcemia was detected in 3 cases with high serum calcium (11.3 mg/dl) and intact PTH (158.1 pg/mL). Fine Needle Aspiration (FNA) was performed in nineteen cases. It revealed crystal clear aspirate in non-functioning cysts and hemorrhagic in functioning cysts. In the analysis of the aspirate, mean N-terminal PTH (n=10) and intact PTH (n=9) were 22.5 pg/mL (9.3∼45.0) and 686.5 pg/mL (138.0∼1500.0), respectively. Mean size of the cysts was 4.0 cm (1.0∼9.2) and the left inferior parathyroid glands were most commonly involved (63.0%). All parathyroid cysts were surgically removed. Conclusion: Parathyroid cysts need to be differentiated from other cystic lesions in the neck and superior mediastinum. Aspiration of crystal clear fluid is highly suggestive of a parathyroid cyst. The aspirate should be analyzed for PTH levels as these are always elevated in parathyroid cysts,regardless of the function. Nonfunctioning cysts may be treated with aspiration alone or sclerosing agents. Surgical excision is indicated for functioning cysts and recurrent case of nonfunctioning cysts.ope

갑상선 편측형성부전

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C1q/TNF-α--Related Protein 1 (CTRP1) Maintains Blood Pressure Under Dehydration Conditions

Rationale: Circulating C1q/TNF-α-related protein 1 (CTRP1) levels are increased in hypertensive patients compared to in healthy subjects. Nonetheless, little is known about the molecular and physiological function of CTRP1 in blood pressure (BP) regulation. Objective: To investigate the physiological/pathophysiological role of CTRP1 in BP regulation. Methods and Results: CTRP1 production was increased to maintain normotension under dehydration conditions, and this function was impaired in inducible CTRP1 knockout mice (CTRP1ΔCAG). The increase in CTRP1 under dehydration conditions was mediated by glucocorticoids, and the antagonist mifepristone prevented the increase in CTRP1 and attenuated BP recovery. Treatment with a synthetic glucocorticoid increased the transcription, translation, and secretion of CTRP1 from skeletal muscle cells. Functionally, CTRP1 increases BP through the stimulation of the angiotensin II receptor 1 (AT1R)-Ras homolog gene family (Rho)/Rho kinase (ROCK) signaling pathway to induce vasoconstriction. CTRP1 promoted AT1R plasma membrane trafficking through phosphorylation of AKT and AKT substrate of 160 kDa (AS160). In addition, the administration of an AT1R blocker, losartan, recovered the hypertensive phenotype of CTRP1 transgenic (TG) mice. Conclusions: For the first time, we provide evidence that CTRP1 contributes to the regulation of BP homeostasis by preventing dehydration-induced hypotension.ope