• Title/Summary/Keyword: Great vessel invasion

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Invasion of the great vessels or atrium predicts worse prognosis in thymic carcinoma

  • Eom, Keun-Yong;Kim, Hak Jae;Wu, Hong-Gyun;Kim, Young Tae;Heo, Dae Seog;Kim, Young Whan
    • Radiation Oncology Journal
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    • v.31 no.3
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    • pp.131-137
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    • 2013
  • Purpose: We evaluated treatment outcomes of thymic carcinomas to determine prognostic factors for survival. Materials and Methods: Between May 1988 and May 2009, 41 patients had pathologic diagnosis of thymic carcinoma in Seoul National University Hospital, Seoul, Korea. Of these, 40 patients were followed up to 188 months after treatment. The mean age of all patients was 58.3 years and male to female ratio was 23 to 17. Results: Among 30 patients who underwent surgical resection, 26 achieved R0 resection and postoperative radiotherapy (PORT) was performed in 22 patients (73%). Various chemotherapeutic regimens were given with local treatment modalities, surgery and/or radiotherapy, in 12 patients. The 5-year locoregional control (LRC), distant metastasis-free survival, progression-free survival (PFS), and overall survival were 79.4%, 53.0%, 42.6%, and 63.6%, respectively. Patients with Masaoka stage I or II showed excellent prognosis of 5-year PFS around 90%. In advanced stages, invasion of the great vessels or atrium by thymic carcinomas was negative prognostic factor for PFS in univariate analysis. Lymph node involvement was statistically significant factor for LRC and PFS. Local or regional recurrence was infrequent after surgical resection followed by PORT, while distant metastasis was the major component of treatment failure. Conclusion: Complete resection followed by PORT provided remarkable local control without severe acute toxicities in patients with stage II and favorable stage III thymic carcinoma. Invasion of the great vessels or atrium was statistically significant prognostic factor for PFS.

LNG Boil-Off Rate Estimation for LNG Carrier by Unsteady Heat Transfer Analysis (LNG선의 BOR평가를 위한 비정상상태 열전달 해석)

  • Cho, Jin-Rae;Park, Hee-Chan
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 2008.04a
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    • pp.166-171
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    • 2008
  • LNG carrier is a special-purpose vessel to transport natural gas (NG) from the place of origin to each consuming country. To increase the capacity of canying LNG carrier, the natural gas is conveyed as a state of liquid called LNG (Liquefied Natural Gas) during a voyage because the total volume of NG is surprisingly reduced when it is cooled down to $-162^{\circ}C$. That is why the design of insulation of the carriers is important to protect LNG from the external heat invasion, and it has been a great challenging subject for several decades in the shipbuilding industry. For this ultimate goal, the boil-off rate (BOR) needs to be accurately estimated during a voyage. Therefore, the goal of this study is to propose a numerical method for estimating the BOR of LNG for given insulation containment subject to external temperature conditions during voyage.

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Surgical Treatment for T4 Non-small Cell Lung Cancer Invading Mediastinal Structures (종격동 구조물을 침범한 T4 비소세포폐암의 수술적 치료)

  • 황은구;이해원;정진행;박종호;조재일;심영목;백희종
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.349-355
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    • 2004
  • Non-small cell lung cancer (NSCLC) with invasion of mediastinal structures is classified as stage IIIB, and has been considered surgically unresectable However, in a selected group of these patients, better results after surgical resection compared to non-surgical group have been reported. The aim of this study is to evaluate the role of surgical resection in treatment of mediastinal T4 NSCLC. Material and Method: Among 1067 patients who underwent surgical intervention for non-small cell lung cancer from Aug 1987 to Dec 2001 in Korea cancer center hospital, 82 patients had an invasion of T4 mediastinal structures (7.7%). Resection was possible in 63patients (63/82 resectability 76.8%). Their medical records in Data Base were reviewed, and they were followed up completely until Jun 2002. Surgical results and prognostic factors of NSCLC invading mediastinal structures were evaluated retrospectively. Result Lung cancer was resected completely in 52 patients (63.4%, 52/82). Lung resection was lobectomy (or more) in 14, pneumonectomy in 49. The mediastinal structures invaded by primary tumor were great vessel (61.9%), heart (19%), vagus nerve (9.5%), esophagus (7.9%), and vertebral body (7.9%). Nodal status was N0 in 11, N1 in 24, and N2 in 28 (44.4%). Neoadjuvant therapy was done in 6 (9.5%, 5 chemotherapy, 1 radiotherapy), and adjuvant therapy was added in 44 (69.8%, 15 chemotherapy, 29 radiotherapy) in resection group (n=63). Complication was occurred in 23 (31.7%), and operative mortality was 9.5% in resection group. Median and 5 year overall survival including operative mortality was 18.1 months and 21.7% in resection group (n=63), 6.2months and 0% in exploration only group (n=19, p=.001), 39 months and 32.9% in N2 (-) resection group (n=35), and 8.8 months and 8.6% in N2 (+) resection group (n=28, p=.007). The difference of overall survival by mediastinal structure was not significant. Conclusion: The operative risk of NSCLC invading mediastinal structures was high but acceptable, and long-term result of resection was favorable in selected group. Aggressive resection is recommended in well selected pateints with good performace and especially N2 (-) NSCLC with mediastinal invasion.

Teratoma Presenting as An Unilateral Mediastinal Mass with Contralateral Pleural Effusion (편측성 종격동 종괴와 반대측 흉수로 발현된 기형종 1예)

  • Ha, Eun Sil;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Jo, Won Min;Lee, Sang Yeub;Kim, Je-Hyeong;Lee, Eung Seok;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.347-352
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    • 2006
  • A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.

Surgical Experience of Pathological Stage IIIB Non-Small Cell Lung Cancer (병리학적 병기 IIIB폐암의 외과적 체험)

  • 백희종;이종목
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.517-523
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    • 1996
  • From May 1988 to June 1994, )73 patients underwent exploratory thoracotomy for resection of non- small cell lung cancer, and 48 patients staged pathologically as lIIB were analyzed. 74 lesions were involvement of great vessel (n=26), heart (n=5), ipsilateral lung metastasis(n=4), esophagus (n=4), carina(n=3), mediastinum (n=2), trachea(n=1), spine (n=1) and 13lourO seeding(A=15). N3 lesions were involved in 6 patients. Extended pulmonary resection with radical mediastinal node dissection was possible in 25 patients, and exploration only was performed in 23 patients. The most frequent cause of unresectability was pleural seeding. Postoperative morbidity was )2 % (8125) and mortality was 16 % (41 25) in resected group. The adjutant therapy was given to 37 patients. The 1 year and 3 year survival for resected group ncluding operative deaths was 57.2%, and 2).8 % (median 15 months), but 48.4%, and 0 % (median 7 months) for exploration only group (Log-Rank test, p : 0.17). Our results suggest that extended pulmonary resection might be helpful for carefully selected patients with 74 non-small cell lung cancer, but meticulous preoperative work-up for staging, especially to detect pleural seeding and Invasion to the irlediastinal structures is a prerequisite to avoid unnecessary thoracotomy.

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