Remote impacts of 2009 and 2015 El Niño on oceanic and biological processes in a marginal sea of the Northwestern Pacific.

The significance of long-term teleconnections derived from the anomalous climatic conditions of El Niño has been a highly debated topic, where the remote response of coastal hydrodynamics and marine ecosystems to El Niño conditions is not completely understood. The 14-year long data from a ship-borne acoustic Doppler current profiler was used to examine the El Niño's impact, in particular, 2009 and 2015 El Niño events, on oceanic and biological processes in coastal regions across the Korea/Tsushima Strait. Here, it was revealed that the summer volume transport could be decreased by 8.7% (from 2.46 ± 0.39 to 2.24 ± 0.26 Sv) due to the anomalous northerly winds in the developing year of El Niño. Furthermore, the fall mean volume backscattering strength could be decreased by 1.8% (from - 97.09 ± 2.14 to - 98.84 ± 2.10 dB) due to the decreased surface solar radiation after the El Niño events. Overall, 2009 and 2015 El Niño events remotely affected volume transport and zooplankton abundance across the Korea/Tsushima Strait through climatic teleconnections.

Sea Fog Dissipation Prediction in Incheon Port and Haeundae Beach Using Machine Learning and Deep Learning.

Sea fog is a natural phenomenon that reduces the visibility of manned vehicles and vessels that rely on the visual interpretation of traffic. Fog clearance, also known as fog dissipation, is a relatively under-researched area when compared with fog prediction. In this work, we first analyzed meteorological observations that relate to fog dissipation in Incheon port (one of the most important ports for the South Korean economy) and Haeundae beach (the most populated and famous resort beach near Busan port). Next, we modeled fog dissipation using two separate algorithms, classification and regression, and a model with nine machine learning and three deep learning techniques. In general, the applied methods demonstrated high prediction accuracy, with extra trees and recurrent neural nets performing best in the classification task and feed-forward neural nets in the regression task.

Coastal Visibility Distance Estimation Using Dark Channel Prior and Distance Map Under Sea-Fog: Korean Peninsula Case.

Commercial visibility sensors among meteorological sensors estimate the visibility distance based on transmission, backward scattering, and forward scattering principle. These optical visibility sensors yield comparatively accurate local visibility distance. However, it is still difficult to obtain comprehensive visibility information for a wide area, such as the coast or harbor due to the sensor structure using straightness and scattering properties of light. In this paper, we propose a novel visibility distance estimation method using dark channel prior (DCP) and distance map based on a camera image. The proposed method improves the local limit of optical visibility sensor and detects the visibility distance of a wide area more precisely. First, the dark channel for an input sea-fog image is calculated. The binary transmission image is obtained by applying a threshold to the estimated transmission from the dark channel. Then, the sum of the distance values of pixels, corresponding to the sea-fog boundary, is averaged, in order to derive the visibility distance. This paper also proposes a novel air-light and transmission estimation technique in order to extract the visibility distance for an abnormal sea-fog image, including any light source, such as sunlight, reflection light, and illumination light, etc. The estimated visibility distance was compared with optical visibility distance of an optical visibility sensor and their agreement was evaluated.

Thyroidectomy without lateral neck dissection for papillary thyroid carcinoma with lateral neck lymph node metastases and negative intraoperative frozen section.

BACKGROUND: The purpose of this study was to investigate the outcomes of patients with papillary thyroid cancer (PTC) with lateral neck metastasis according to their permanent pathology report but negative frozen section findings who did not undergo lateral neck dissection. METHODS: Between September 2009 and December 2011, 575 patients at Gangnam Severance Hospital (Seoul, Korea) underwent frozen section analysis for a suspicious lateral neck lymph node. In 16 patients, the intraoperative findings were negative, but lateral neck metastasis was diagnosed on the basis of permanent pathology findings. The outcomes of these patients who underwent thyroidectomy but not lateral neck dissection were retrospectively investigated. RESULTS: One patient underwent a subsequent lateral neck dissection. After a mean (SD) follow-up period of 42.1 (8.5) months, none of the patients had distant metastasis. CONCLUSION: Total thyroidectomy with subsequent lateral neck dissection is not necessary in patients with PTC who are diagnosed with lateral neck metastasis according to their permanent pathology report but have negative intraoperative frozen section findings.

Recovery from Permanent Hypoparathyroidism After Total Thyroidectomy.

BACKGROUND: Permanent hypoparathyroidism after total thyroidectomy is a rare but potentially serious iatrogenic complication. The aim of this study was to investigate the rate of recovery from postoperative, permanent hypoparathyroidism in patients undergoing thyroidectomy without parathyroid autotransplantation. METHODS: This study was a prospective case series with a postoperative follow-up of up to 3 years. We enrolled patients with thyroid cancer who underwent total thyroidectomy with central compartment dissection, with or without lateral neck dissection, and who had postoperative permanent hypoparathyroidism, defined as serum levels of intact parathyroid hormone (PTH) <15 pg/mL for at least 1 year. In the postoperative follow-up period, the serum levels of PTH and calcium were measured regularly. Recovery from permanent hypoparathyroidism was defined as return to normal serum levels of PTH (15-65 pg/mL) and calcium (8.5-10.1 mg/dL) without calcium and/or vitamin D supplementation. RESULTS: In the 1467 patients who underwent total thyroidectomy, 22 presented with permanent postoperative hypoparathyroidism. In 5 of these 22 patients, the PTH levels increased steadily and returned to normal in 27.6±2.9 months, after which supplementation of calcium and vitamin D could be discontinued. CONCLUSIONS: Although recovery from permanent hypoparathyroidism is rare, patients should be monitored for serum PTH levels so that unnecessary treatments such as calcium and vitamin D supplementation can be avoided.

Prognostic significance of tumor multifocality in papillary thyroid carcinoma and its relationship with primary tumor size: a retrospective study of 2,309 consecutive patients.

BACKGROUND: Tumor multifocality is frequently observed in papillary thyroid carcinoma (PTC), but its prognostic value is controversial. We investigated the prognostic significance of multifocality in PTCs larger than 1 cm and papillary thyroid microcarcinomas (PTMC). METHODS: Medical records and pathologic results of 2,309 patients who received thyroidectomy and lymph node dissection for PTC were retrospectively reviewed. We identified 648 patients who had PTC with a primary tumor exceeding 1 cm, and 1,661 patients with PTMC. In each group, we compared patients with unifocal and multifocal disease. Cox regression analyses of disease persistence and recurrence were performed to identify the prognostic significance of multifocality. RESULTS: The mean follow-up period was 5.6 years. In the analyses of PTCs larger than 1 cm, the multifocal group included more extensive thyroid surgeries (p = 0.039), radioactive iodine therapies with higher doses (p < 0.001), and significantly higher rates of disease persistence and recurrence (p = 0.001) compared with the unifocal group. In analogous analyses of patients with PTMC, disease persistence and recurrence did not differ significantly between the unifocal and multifocal groups. Cox regression analyses indicated that multifocality was an independent risk factor for disease persistence and recurrence in patients who had PTC with a tumor exceeding 1 cm, but not in patients with PTMC. CONCLUSION: Tumor multifocality appears to be an important prognostic factor for PTCs larger than 1 cm, but may have little or no prognostic significance for PTMC.

On-site ultrasound-guided localization for impalpable nodal recurrences in papillary thyroid carcinoma patients.

PURPOSE: The cervical lymph nodes are the most common sites of locoregional recurrence in patients with papillary thyroid carcinoma (PTC). Accurate tumor localization is important for the successful removal of impalpable recurrences in the cervical lymph nodes. We evaluated the benefits of ultrasound-guided localization (UGL) performed by a single surgeon on site. METHODS: Of 53 PTC patients who underwent reoperation for impalpable nodal recurrences, 32 (group 1) were assessed only using preoperative imaging, while 21 (group 2) were additionally evaluated by on-site UGL performed by the operating surgeon. Postoperative outcomes were compared between the two groups. RESULTS: Operation times were significantly shorter (P < 0.001) and the mean size of the resected lymph nodes were smaller (P = 0.013) for group 2 patients. More lymph nodes were identified and resected in group 1 (3.56 vs. 3.19), but the rate of positive lymph nodes was significantly higher in group 2 (P < 0.001). There were no differences between the two groups in terms of resection success rate, complication rate, and postoperative hospital stay. During a mean follow-up period of 27.6 months, 52 patients (98.1%) showed no evidence of recurrence on routine ultrasound, and serum thyroglobulin concentrations remained < 1 ng/mL in 49 patients (92.5%). CONCLUSION: On-site UGL performed by the operating surgeon is useful for accurate resection of impalpable nodal recurrences in PTC patients.

Tumor margin histology predicts tumor aggressiveness in papillary thyroid carcinoma: a study of 514 consecutive patients.

Histologic patterns at tumor margins may be related to prognosis in several malignancies. We investigated tumor aggressiveness with respect to tumor margin histology in patients with papillary thyroid carcinoma (PTC). Five hundred fourteen consecutive patients who underwent surgery for primary PTC between January and July 2009 were assigned to two groups, one with an infiltrative pattern (I-type, n = 347) at tumor margins and one with an expanding pattern (E-type, n = 167). Tumor aggressiveness was assessed by analyzing relationships between these patterns and known prognostic factors. The analysis showed that unfavorable prognostic factors such as tumor multiplicity (P = 0.002), extrathyroidal extension (P < 0.001), lateral neck lymph node metastasis (P < 0.001) and advanced TNM stage (P = 0.001) were significantly more prevalent in patients with I-type PTC than in those with the E-type. Central neck node metastases were more prevalent without statistical significance in the I-type patients (P = 0.376). Tumor margin histology was not related to gender or tumor size. These results suggest that histologic patterns at tumor margins predict aggressiveness in PTC.