• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.575-583
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• 1993

Background: Mediastinal masses are not uncommon, and an overall incidence of one case per 100,000 population per year in individuals of all ages and with no difference in sex incidence may be a reasonable estimation. At least half of all mediastinal masses are asymptomatic and this proportion has increased in recent decades with wider use of screening chest roentgenography. Symptoms in patients with mediastinal mass lesions are usually due to compression or invasion of nearby intrathoracic structures. Most mediastinal mass lesions have characteristic predilectional locations. The basic focus of diagnostic evaluation is an orderly preparation for obtaining a tissue diagnosis but even lesions discovered to be benign must generally be removed. Seldom is this status known for certain preoperatively. In additaion, benign tumors may continue to enlarge, thus compromising vital organs; they may rupture, hemorrhage, become infected or have the possibility of various malignant degeneration. Therefore, all mediastinal masses must be surgically removed whether they are malignant or benign. Methods: We reviewed the medical records of 344 cases previously confirmed as mediastinal tumors or cysts from January, 1960 to August, 1992 and investigated the clinical findings. Results: Neurogenic tumors were the most common(24.7%) and thymomas were distinctively increased recently. Overall ratio between males and females was 1.1:1 and age distribution was relatively even among all age groups. Predilectional sites were posterior for neurogenic tumors, and anterior for teratodermoid tumors, thymomas and lymphomas. Dyspnea was the most common symptom in the patients of the mediastinal tumors and asymptomatic patients were 19.5%, Benign mediastinal mass lesions were 66.0% and malignant, 34.0%, Complete or partial resection was done in 42.4%. Conclusion: We could find the increasing incidence and the tendency of aggressive resection as possible in the mediastinal tumors. We expect the discovery of more mediastinal tumors with wider use of regular check-up and development of diagnostic methods.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.153-160
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• 2010

Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.846-851
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• 2003

Background: To clarify the clinical significance of the aortic nodes in resected non-small cell lung cancer of the left upper lobe. Material and Method: One hundred fifty six patients with resected non-small cell lung cancer of the left upper lobe were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. Result: In N2 left upper lobe tumors, aortic nodes comprised 52.7% of the metastatic mediastinal lymph nodes. In single station N2 disease, a frequently metastasized station was aortic node (64.3%). 5-year actuarial survival according to the N status was 65.0% in N0, 30.4% in N1, and 17.9% in N2. There was no statistically significant difference in survival between N1 and N2 diseases (p=0.06). The patients with metastasis to aortic node alone had a comparatively good prognosis (5-year survival: 35.6%) than other N2 diseases (5-year survival: 4.6%) (p=0.01) and had a similar survival outcome as N1 diseases (p=0.97). Considering the aortic node as N1 node, 5-year survival according to the N status was 65.0% in N0, 31.2% in N1, 4.6% in N2 and significant survival difference was observed between N1 and N2 disease (p=0.00). In multivariate analysis, the male sex (hazard ratio 6.892, p=0.011) and the involvement to the aortic node alone (hazards ratio 2.799, p=0.009) were the significant factors affecting postoperative survival. Conclusion: According to the our data, involvement to the aortic node alone in left upper lobe tumors should be grouped with N1 disease because this combined category reflects the surgical outcome more accurately.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.339-346
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• 1999

Background : Non-small cell lung carcinoma is a common tumor with a poor prognosis. Of all malignancies, it is the main cause of death for male and female patients in the Western world. Resection remains the most effective treatment when feasible. Accurate description and classification of the extent of cancer growth are important in planning treatment, estimating prognosis, evaluating end results of therapy, and exchanging information on human cancer research. Until effective systemic therapy is available for non-small cell lung cancer, development of new treatment strategies depends on knowledge of the end results achieved for carefully staged groups of patients in the lung cancer populations. For these reasons, we investigated the survival rate in radically resected non-small cell lung cancer patients by newly revised staging system adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. Methods: Clinical, surgical-pathologic and follow-up informations on 84 consecutive, previously untreated, patients who received their primary treatment for non-small cell lung cancer were investigated. Staging definitions for the T(primary tumor), N(reginal lymph node), and M(distant metastasis) components were according to the International Staging System for Lung Cancer. Death from any causes was the primary target of the evaluation. Results: The median survival rates were as follows; stage I ;79.1 months, stage II ;47.3 months, stage IIIa; 22.7 months, stage IIIb; 16.1 months, and stage IV;15.2 months versus newly revised stage Ia;58.5 months, stage I b;76.0 months, stage IIa; not available, stage IIb;43.0 months, stage IIIa;22.5 months, stage IIIb; 16.1 months, and stage IV;15.2 months. The survival rates were not significantly different between old and newly revised staging system. Cumulative percent survival at 36months after treatment was 100% in stage Ia, 80% in stage Ib, not available in stage IIa, 26 % in stage IIb, and 21 % in stage m a respectively. Conclusions: Although these data were not significantly different statistically, the newly revised lung cancer staging system might be more promising for the accurate evaluation of the prognosis in the non-small cell lung caner patients.

• Applied Microscopy
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• v.37 no.2
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• pp.83-91
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• 2007

The present study examined the epidermal changes of adhesive disks which occur during attachment in Parthenocissus tricuspidata using scanning and transmission electron microscopy. Several adhesive disks, each covered with a bract, develop from the shoot apical meristem during early development. In the initial stage, the adhesive disks are club-shaped and their upper and lower epidermis are indistinguishable. However, in the actively growing stage, they become spherical and both epidermis are clearly differentiated into the adventitious roots. Prior to wall attachment, the adhesive disks exhibit adaxial convex and abaxial concave shapes, and electron-dense substances are abundant in the vacuoles of epidermal cells. The peripheral area of the adhesive disk is adhered first to the wall surface, while the central area is drawn inward in a vacuum-like state during attachment. As the attachment progresses and the electron-dense substances continue to discharge, the upper and lower epidermis rapidly undergo deterioration and the disks shrink considerably. At this stage, structural changes of the lower epidermis occur much faster than in the upper one. The discharged substance is accumulated on the wall surface, and this aids the attachment of adhesive disks on the wall for long periods. In this manner, the shape and structure of the adhesive disk epidermis change drastically from initial growth to the mature stage. Further, the role of electron-dense substance and shrinkage of the disk during attachment has been discussed in Parthenocissus tricuspidata.

• Applied Microscopy
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• v.37 no.2
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• pp.93-102
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• 2007

Secretory leukocyte protease inhibitor (SLPI) was known as one of bacterial lipopolysaccharide (LPS)-induced products of macrophage. Macrophages play an important role in the development of inflammatory responses by secreting an array of cytokines and chemokines in a tissue microenvironment. To identify the function and relationship between potent growth factors and SLPI after LPS stimulation, we conducted reverse transcriptase polymerase chain reaction (RT-PCR) and Western blots for the detection of mRNA and protein expression of SLPI and growth factors such as VEGF, PDGF, bFGF after 100 ng LPS stimulation on the RAW264.7 cells. The result of RT-PCR was showed SLPI mRNA expression was increased from 60 min to 48h in RAW 264.7 cells after incubation with LPS. VEGF and PDGF mRNA was expressed highly at initial stage by LPS stimulation. The mRNA of bFGF and type I collagen was very weakly expressed after LPS stimulation. SLPI protein level was increased likely the mRNA levels in RAW 267.7 cells. Additionally, phase contrast and scanning electron microscopic observation demonstrated that the LPS induce the change of morphology of the RAW264.7 cells. From these results, it suggest that expression of SLPI by LPS treatment may associate with VEGF and PDGF expression in RAW264.7 cells.

• Journal of Chest Surgery
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• v.40 no.6 s.275
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• pp.435-440
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• 2007

Background: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. Material and Method: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2000. They all had malignant lymphoma on the pathologic examination of the lung wit no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. Result: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seer with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. Conclusiian: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.448-463
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• 2000

Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.54-59
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• 2017

Purpose The present study aimed at assessing the effectiveness of the respiratory gating method used in the flow mode and additional localized respiratory-gated imaging, which differs from the step and go method. Materials and Methods Respiratory gated imaging was performed in the flow mode to twenty patients with lung cancer (10 patients with stable signals and 10 patients with unstable signals), who underwent PET/CT scanning of the torso using Biograph mCT Flow PET/CT at Bundang Seoul University Hospital from June 2016 to September 2016. Additional images of the lungs were obtained by using the respiratory gating method. SUVmax, SUVmean, and Tumor Volume ($cm^3$) of non-gating images, gating images, and additional lung gating images were found with Syngo,bia (Siemens, Germany). A paired t-test was performed with GraphPad Prism6, and changes in the width of the amplitude range were compared between the two types of gating images. Results The following results were obtained from all patients when the respiratory gating method was applied: $SUV_{max}=9.43{\pm}3.93$, $SUV_{mean}=1.77{\pm}0.89$, and $Tumor\;Volume=4.17{\pm}2.41$ for the non-gating images, $SUV_{max}=10.08{\pm}4.07$, $SUV_{mean}=1.75{\pm}0.81$, and $Tumor\;Volume=3.56{\pm}2.11$ for the gating images, and $SUV_{max}=10.86{\pm}4.36$, $SUV_{mean}=1.77{\pm}0.85$, $Tumor\;Volume=3.36{\pm}1.98$ for the additional lung gating images. No statistically significant difference in the values of $SUV_{mean}$ was found between the non-gating and gating images, and between the gating and lung gating images (P>0.05). A significant difference in the values of $SUV_{max}$ and Tumor Volume were found between the aforementioned groups (P<0.05). The width of the amplitude range was smaller for lung gating images than gating images for 12 from 20 patients (3 patients with stable signals, 9 patients with unstable signals). Conclusion In PET/CT scanning using the respiratory gating method in the flow mode, any lesion movements caused by respiration were adjusted; therefore, more accurate measurements of $SUV_{max}$, and Tumor Volume could be obtained from the gating images than the non-gating images in this study. In addition, the width of the amplitude range decreased according to the stability of respiration to a more significant degree in the additional lung gating images than the gating images. We found that gating images provide information that is more useful for diagnosis than the one provided by non-gating images. For patients with irregular signals, it may be helpful to perform localized scanning additionally if time allows.