The rate of detection of thyroid nodules and carcinomas has increased with the widespread use of ultrasonography (US), which is the mainstay for the detection and risk stratification of thyroid nodules as well as for providing guidance for their biopsy and nonsurgical treatment. The Korean Society of Thyroid Radiology (KSThR) published their first recommendations for the US-based diagnosis and management of thyroid nodules in 2011. These recommendations have been used as the standard guidelines for the past several years in Korea. Lately, the application of US has been further emphasized for the personalized management of patients with thyroid nodules. The Task Force on Thyroid Nodules of the KSThR has revised the recommendations for the ultrasound diagnosis and imaging-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature and the consensus of experts.

The detection of thyroid nodules has become more common with the widespread use of ultrasonography (US). US is the mainstay for detecting and making the differential diagnosis of thyroid nodules as well as for providing guidance for a biopsy. The Task Force on Thyroid Nodules of the Korean Society of Thyroid Radiology has developed recommendations for the US diagnosis and US-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature, the results of multicenter studies and from the consensus of experts.

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Complex biological systems are very robust to genetic and environmental changes at all levels of organization. Many biological functions of Escherichia coli metabolism can be sustained against single-gene or even multiple-gene mutations by using redundant or alternative pathways. Thus, only a limited number of genes have been identified to be lethal to the cell. In this regard, the reactioncentric gene deletion study has a limitation in understanding the metabolic robustness. Here, we report the use of flux-sum, which is the summation of all incoming or outgoing fluxes around a particular metabolite under pseudo-steady state conditions, as a good conserved property for elucidating such robustness of E. coli from the metabolite point of view. The functional behavior, as well as the structural and evolutionary properties of metabolites essential to the cell survival, was investigated by means of a constraints-based flux analysis under perturbed conditions. The essential metabolites are capable of maintaining a steady flux-sum even against severe perturbation by actively redistributing the relevant fluxes. Disrupting the flux-sum maintenance was found to suppress cell growth. This approach of analyzing metabolite essentiality provides insight into cellular robustness and concomitant fragility, which can be used for several applications, including the development of new drugs for treating pathogens. cellular robustness ͉ flux-sum ͉ metabolic networks A vailability of the complete genome sequences for well characterized organisms has led to the reconstruction of genome-scale metabolic networks, which represent a complex web of metabolites and their interconversions catalyzed by the gene products. Robustness, the inherent property of metabolic networks, enables the maintenance of cellular functions under various internally and externally perturbed conditions. This robustness has been experimentally demonstrated such that even the disruption of a considerable portion of genes could not affect the cell viability (1, 2). Although studies on the topological and functional properties of metabolic networks have achieved much progress (3-6), they still provide only a limited understanding of metabolic robustness. The conventional attempt to study such robustness relies on the identification of the genes or reactions indispensable to a cell. However, universal metabolic pathways across species, such as the tricarboxylic acid (TCA) cycle or glycolytic pathways, have relatively few lethal reactions (1, 7). This fact indicates that the more important a reaction is, the higher is the chance to have a backup pathway (7). Thus, the functionally important reactions are not necessarily lethal, and this point places a limitation to the reaction-centric approach with studying lethality by observing the gene deletion effects. In this regard, we have investigated the interplay between cellular robustness and the underlying metabolism from the metabolite point of view, and how the robustness can be accomplished at the level of the metabol...

http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101164/-/DC1.

No abstract

In patients with thyroid cancer, CT improved surgical planning by enhancing the sensitivity for lymph node metastasis and by detecting lymph node metastasis that was overlooked with ultrasound alone.

Based on US, the majority of MTCs can be classified as suspiciously malignant due to the presence of micro- or macro-calcifications. Small MTC size (≤ 10 mm) and a smooth margin may be factors predicting false-negative FNA results.