• Korean Journal of Head & Neck Oncology
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• v.26 no.2
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• pp.183-186
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• 2010

Purpose : Papillary thyroid carcinoma (PTC) is known for malignant tumor which has a favorable prognosis and long-term survival. Although the prognosis for patients with PTC is generally good, PTC tends to have highly metastatic property. The purpose of this study was to analyze the central compartment lymph node in papillary thyroid cancer with no lymph node metastasis clinically and to assess the significance of prophylactic node dissection. Methods : A retrospective review was carried out in 394 patients with PTC who underwent surgery for the period from January 2004 to December 2006. The positive rate of the lymph node metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' age, gender, tumor size, exrathyroidal extension(ETE), multifocality, and bilaterality were comparatively analyzed in PTC patients with preoperative no lymph node metastasis. Results : The enrolled patients were 40 male and 354 female cases. The 118 cases of them were found to have cervical lymph node metastasis. The mean age was 46 years(range, 15-77years). Tumor size(p=0.000), ETE(p=0.001), multifocality(p=0.014), and bilaterality(p=0.001) were significantly related factors for cervical lymph node metastasis clinically in papillary thyroid cancer. However, age and gender were not significantly related with lymph node metastasis. Conclusion : Although no lymph node metastasis clinically, prophylactic neck node dissection can be performed to avoid risks of local recurrence and reoperation in the light of PTC nature. The pathological status and high positive rate of central compartment lymph node relate to tumor size and extrathyroidal extension. Close surveillance for nodal status is required in follow-up.

• Journal of Gastric Cancer
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• v.20 no.1
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• pp.1-18
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• 2020

Splenic hilar lymph node dissection has been the standard treatment for advanced proximal gastric cancer. Splenectomy is typically performed as part of this procedure. However, splenectomy has some disadvantages, such as increased risk of postoperative complications, especially pancreatic fistula. Moreover, patients who underwent splenectomy are vulnerable to potentially fatal infection caused by encapsulated bacteria. Furthermore, several studies have shown an association of splenectomy with cancer development and increased risk of thromboembolic events. Therefore, splenectomy should be avoided if it does not confer a distinct oncological advantage. Most studies that compared patients who underwent splenectomy and those who did not failed to demonstrate the efficacy of splenectomy. Based on the results of a randomized controlled trial conducted in Japan, prophylactic dissection with splenectomy is no longer recommended in patients with gastric cancer with no invasion of the greater curvature. However, patients with greater curvature invasion or those with remnant gastric cancer still need to undergo splenectomy to facilitate splenic hilar node dissection. Spleen-preserving splenic hilar node dissection is a new procedure that may help delink splenic hilar node dissection and splenectomy. In this review, we examine the evidence pertaining to the efficacy and disadvantages of splenectomy. We discuss the possibility of spleen-preserving surgery for prophylactic splenic hilar node dissection to overcome the disadvantages of splenectomy.

• Journal of Computing Science and Engineering
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• v.11 no.2
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• pp.49-57
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• 2017

This paper proposes a new IPv6 networking paradigm as a counter answer to the rationale for locator/identifier separation. Instead of involving separate number spaces each for node identifiers and locators, the context of the IP address as a node identifier alone is utilized and no additional locators are incorporated. That is, there are only node addresses and no locators, and location information is indirectly derived from neighbor relations between nodes. In order to accomplish this, no subnet IDs are utilized; the ID value is set to zero for all subnets. The paper details how to construct this paradigm through novel choice of operational policies in various IPv6 protocols and some trivial modifications. Especially, inherent provision of intra-domain node- as well as subnet-mobility by use of standard link-state intra-domain routing protocols is discussed. A number of important advantages of this paradigm over the canonical IPv6 networking and various known solutions of locator/identifier separation are discussed. Tailoring for multi-area domains and IPv4 is left for further study.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.485-488
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• 2009

Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis. Methods: A 60 - year - old male patient presented with nodular mass at his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67 - year - old man presented with pigmented lesion at his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Results: In the first case, $2.5{\times}2.5cm$ sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date(18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis. Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work - up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.

• Journal of Breast Cancer
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• v.21 no.4
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• pp.433-4341
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• 2018

Purpose: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. Methods: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND. Results: The median follow-up time was 51 months (range, 3-122 months) and the median number of retrieved SLNs was 5 (range, 2-9). The SLN identification rate was 98.3% (234/238 patients), and the false negative rate of SLNB after NAC was 7.5%. There was no significant difference in axillary recurrence-free survival (p=0.118), disease-free survival (DFS; p=0.578) or overall survival (OS; p=0.149) among groups A, B, and C. In the subgroup analysis of breast pathologic complete response (pCR) status, there was no significant difference in DFS (p=0.271, p=0.892) or OS (p=0.207, p=0.300) in the breast pCR and non-pCR patients. Conclusion: These results suggest that SLNB can be feasible and oncologically safe after NAC for cytology-determined axillary node metastasis patients and could help reduce arm morbidity and lymphedema by avoiding ALND in SLN-negative patients.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.65 no.12
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• pp.2218-2224
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• 2016

Opportunistic routing is designed for an environment where there is no stable end-to-end routing path between source node and destination node, and messages are forwarded via intermittent contacts between nodes and routed using a store-carry-forward mechanism. In this paper, we consider PRoPHET(Probabilistic Routing Protocol using History of Encounters and Transitivity) protocol as a base opportunistic routing protocol and propose an efficient context-aware opportunistic routing protocol by using the context information of delivery predictability and node type, e.g., pedestrian, car, and tram. In the proposed protocol, the node types of sending node and receiving node are checked. Then, if either sending node or receiving node is tram, messages are forwarded by comparing the delivery predictability of receiving node with predefined delivery predictability thresholds depending on the combination of sending node and receiving node types. Otherwise, messages are forwarded if the delivery predictability of receiving node is higher than that of sending node, as defined in PRoPHET protocol. Finally, we analyze the performance of the proposed protocol from the aspect of delivery ratio, overhead ratio, and delivery latency. Simulation results show that the proposed protocol has better delivery ratio, overhead ratio, and delivery latency than PRoPHET protocol in most of the considered simulation environments.

• Journal of the Optical Society of Korea
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• v.20 no.6
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• pp.678-685
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• 2016

The standard high-availability seamless redundancy (HSR) protocol utilizes duplicated frame copies of each sent frame for zero fail over time. This means that even in cases of a node or link failure, the destination node will receive at least one copy of the sent frame, resulting in no network downtime. However, the standard HSR is mostly based on the electrical signal connection inside the node, which leads to the production of considerable latency at each node due to frame processing. Therefore, in a large scale HSR ring network, the accumulated latencies become significant and can often restrict the mission-critical real-time application of HSR. In this paper, we present a novel design for optical HSR (OHSR) that uses beam splitting/combining techniques. The proposed OHSR passes the frames directly to adjacent nodes without frame processing at each node, thereby theoretically generating no latency in any node. Various simulations for network samples, made to validate the OHSR design and its performance, show that the OHSR outperforms the standard HSR.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.583-587
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• 2013

This study aimed to investigate tumor microvessel density (MVD) and lymphatic vessel density (LVD) using the Chalkley method as predictive markers for the risk of axillary lymph node metastasis and their relationship to other clinicopathological parameters in primary breast cancer cases. Forty two node-positive and eighty node-negative breast cancers were immunostained for CD34 and D2-40. MVD and LVD were counted by the Chalkley method at x400 magnification. There was a positive significant correlation of the MVD with the tumor size, coexisting ductal carcinoma in situ (DCIS) and lymph node metastases (P<0.05). In multivariate analysis, the MVD (2.86-4: OR 5.87 95%CI 1.05-32; >4: OR 20.03 95%CI 3.47-115.55), lymphovascular invasion (OR 3.46, 95% CI 1.13-10.58), and associated DCIS (OR 3.1, 95%CI 1.04-9.23) independently predicted axillary lymph node metastasis. There was no significant relationship between LVD and axillary lymph node metastasis. However, D2-40 was a good lymphatic vessel marker to enhance the detection of lymphatic invasion compared to H and E staining. In conclusion, MVD by the Chalkley method, lymphovascular invasion and associated DCIS can be additional predictive factors for axillary lymph node metastases in breast cancer. No relationship was identified between LVD and clinicopathological variables, including axillary lymph node metastasis.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3151-3154
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• 2013

Introduction: Colorectal cancers are in the top of the cancer-related causes of death in the world and lymph node metastasis is accepted as the primary prognostic factor. In this study, correlations of FGF19 staining pattern with local invasion and lymph node metastasis in a series of colorectal cancers were investigated. Methods: This studyincluded 81 colorectal cancer patients who underwent surgery in our hospital with no evidence of preoperative radiological distant metastasis. Routine pathological examination of the resection material was performed in order to identify vascular, perineural and serosal infiltration, regional lymph node metastasis and the degree of differentiation. Tumor tissue samples were stained with an immunohistochemistry method for FGF 19 evaluation and the staining pattern was statistically compared with the above mentioned characteristics of the tumors. Results: The patient population consisted of 47 females and 34 males with a median age of 70 years. In 40 patients regional lymph nodes were positive and 51%, 32% and 38% had serosal, perineural and vascular invasion. While 64 cases were moderately-differentiated, 11 cases were well-differentiated and 6 poorlydifferentiated, there was no association with FGF 19 staining, including intensity. Conclusion: No evidence of significant statistically correlation was found between FGF 19 staining pattern and serosal, perineural, vascular invasion, lymph node involvement and degree of differentiation.

• Journal of Chest Surgery
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• v.54 no.4
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• pp.239-245
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• 2021

Video-assisted thoracoscopic surgery (VATS) has been established as the surgical approach of choice for lobectomy in patients with early-stage non-small cell lung cancer (NSCLC). Patients with clinical stage I NSCLC with no lymph node metastasis are considered candidates for VATS lobectomy. To rule out the presence of metastasis to lymph nodes or distant organs, patients should undergo meticulous clinical staging. Assessing patients' functional status is required to ensure that there are no medical contraindications, such as impaired pulmonary function or cardiac comorbidities. Although various combinations of the number, size, and location of ports are available, finding the best method of port placement for each surgeon is fundamental to maximize the efficiency of the surgical procedure. When conducting VATS lobectomy, it is always necessary to comply with the following oncological principles: (1) the vessels and bronchus of the target lobe should be individually divided, (2) systematic lymph node dissection is mandatory, and (3) touching the lymph node itself and rupturing the capsule of the lymph node should be minimized. Most surgeons conduct the procedure in the following sequence: (1) dissection along the hilar structure, (2) fissure division, (3) perivascular and peribronchial dissection, (4) individual division of the vessels and bronchus, (5) specimen retrieval, and (6) mediastinal lymph node dissection. Surgeons should obtain experience in enhancing the exposure of the dissection target and facilitating dissection. This review article provides the basic principles of the surgical techniques and practical maneuvers for performing VATS lobectomy easily, safely, and efficiently.