• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.3-8
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• 2010

Background : Though papillary microcarcinoma(PMC) of thyroid gland is known to have very favorable long-term prognosis, the recurrence in the neck and distant metastasis have been often reported. The predictive factors of node metastasis and tumor recurrence in clinical course were investigated to define surgical decision or guidelines in surgery of papillary microcarcinoma. Methods : The authors conducted a retrospective analysis of 216 patients of PMC treated with surgery at Department of Surgery, Busan Paik Hospital for the period from 1997 to 2007. Of these patients, 58 cases showing cervical lymph node metastasis at initial surgery were studied. Results : In overall 216 patients, the sex ratio of male to female was 1 : 9.3(male 21, female 195 cases), the mean age at the time of diagnosis was 44.7 years and the median tumor size was 6.61mm. Neck lymph node metastasis was found in 58 patients(26.9%), thyroid capsular invasion was 56 cases(25.9%), multifocality and bilaterality were found in 32(14.8%) and 29 cases(13.4%), respectively. Through statistical analysis, sex, capsular invasion, ETE, and tumor size(>5mm) were considered to be predictive factors of cervical lymph nodes metastasis. Of them, capsular invasion was the most predictive indicator of cervical lymph node metastasis on multivariate analysis. Nodal recurrence was observed in 6 of 58 patients of node positive at initial surgery. Conclusion : The cervical lymph node metastasis is known to be a risk factor of prognosis in PMC of thyroid gland. The results of this study showed four statistically significant independent predictive factors of cervical lymph node metastasis in PMC : capsular invasion, tumor size(>5mm), ETE, and sex. On multivariate analysis, capsular invasion was a great influencing factor in prediction of lymph node metastasis. Basically, patients who has predictive factors of cervical lymph node metastasis should have a thorough investigation, and close surveillance for nodal status is required in follow-up.

• Radiation Oncology Journal
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• v.30 no.4
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• pp.173-181
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• 2012

Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2993-2998
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• 2015

Background: Distance from anal verge and abdominoperineal resection are risk factors for circumferential resection margin (CRM) positivity in rectal cancer. Induction chemotherapy (IC) before concurrent chemoradiation (CRT) has emerged as a new treatment modification. Impact of IC before concurrent CRT on CRM positivity in low rectal cancer remains to be independently studied. The objective of this study was to determine CRM positivity in low rectal cancer, with and without prior IC, and to identify predictors of disease free and overall survival. Materials and Methods: Patients who underwent surgery for rectal cancer between 2005 and 2011 were retrospectively reviewed and divided into two groups. Group 1 received IC before CRT and Group 2 did not. Demographics, clinicopathological variables and CRM status were compared. Actuarial 5 year disease free survival (DFS), overall survival (OS) and independent predictors of survival were determined. Results: Patients in the IC group presented with advanced stage (Stage 3=89.2% versus 75.4%) (P=0.02) but a high rate of total mesorectal excision (TME) (100% versus 93.4%) (P=0.01) and sphincter preservation surgery (54.9 % versus 22.9%) (P=0.001). Patients with low rectal cancer who received IC had a significantly low positive CRM rate (9.2% versus 34%) (P=0.002). Actuarial 5 year DFS in IC and no IC groups were 39% and 43% (P=0.9) and 5 year OS were 70% and 47% (P=0.003). Pathological tumor size [HR: 2.2, CI: 1.1-4.5, P=0.01] and nodal involvement [HR: 2, CI: 1.08-4, P=0.02] were independent predictors of relapse while pathological nodal involvement [HR: 2.6, CI: 1.3-4.9, P=0.003] and IC [HR: 0.7, CI: 0.5-0.9, P=0.02] were independent predictors of death. Conclusions: In low rectal cancer, induction chemotherapy before CRT may significantly decrease CRM positivity and improve 5 year overall survival.

• Journal of the Computational Structural Engineering Institute of Korea
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• v.15 no.2
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• pp.293-303
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• 2002

Recently, the use of the high strength materials and development of construction techniques have resulted in more flexible and longer spanning in the stadium systems. So the natural frequency of stadium structures are became low. Stadium stand could be led to significant dynamic response as like resonance due to spectator rhythmical activities. The accurate analysis of dynamic behavior of stadium systems and the precise investigation of the dynamic loads on stadium structures are demanded for effective design. It is desirable to apply measured dynamic loads created by spectator activities because these dynamic loads are not easy to express numerical formula. As the floor mesh of stadium stand is refined, the number of divided elements increases in numerical analysis. the rise of the number of elements makes the numbers of nodal points increased and numerous computer memory required. So it is difficult to analysis refine full model of stadium structures by using the commercial programs. In this study, the various dynamic loads induced by spectator movements are measured and analyzed. And a new modeling method that reduce the nodal points are introduced. Vibration analysis of stadium stands is executed to inspect accuracy and efficiency of proposed method in this paper.

• Tuberculosis and Respiratory Diseases
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• v.47 no.2
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• pp.272-278
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• 1999

The primary lymphoma in the lung is very rare. Moot of the primary pulmonary lymphomas, which represent 3-4 % of extra-nodal lymphomas, are low-grade B-cell lymphoma. The low-grade B-cell lymphomas progress slowly and the prognosis of these are more favorable than that of the nodal lymphomas. However, high-grade forms progress rapidly with more severe course. The diagnosis of primary pulmonary lymphomas generally relies on the histopathologic findings of lung specimens obtained by surgical excision of the lesions or open-lung biopsy. Recently, less aggressive biopsies(transbronchial, transthoracic) and/or immunocyto-chemical, immunochemical and gene rearrangement studies on materials obtained by bronchoalveolar lavage have been used occasionally. The treatment of the primary pulmonary lymphomas has not been precisely codified. Several clinical data suggest that limited surgery or non-aggressive chemotherapy can provide long-term survival in patients with such slowly developing neoplasm, and demonstrated the need for the development of noninvasive diagnootic methods. In this study, we report a case of high-grade B-cell lymphoma of the lung which was treated with combination chemotherapy.

• Journal of Gastric Cancer
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• v.13 no.3
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• pp.149-156
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• 2013

Purpose: Clinical stage of gastric cancer is currently assessed by computed tomography. Accurate clinical staging is important for the tailoring of therapy. This study evaluated the accuracy of clinical N staging using stomach protocol computed tomography. Materials and Methods: Between March 2004 and November 2012, 171 patients with gastric cancer underwent preoperative stomach protocol computed tomography (Jeju National University Hospital; Jeju, Korea). Their demographic and clinical characteristics were reviewed retrospectively. Two radiologists evaluated cN staging using axial and coronal computed tomography images, and cN stage was matched with pathologic results. The diagnostic accuracy of stomach protocol computed tomography for clinical N staging and clinical characteristics associated with diagnostic accuracy were evaluated. Results: The overall accuracy of stomach protocol computed tomography for cN staging was 63.2%. Computed tomography images of slice thickness 3.0 mm had a sensitivity of 60.0%; a specificity of 89.6%; an accuracy of 78.4%; and a positive predictive value of 78.0% in detecting lymph node metastases. Underestimation of cN stage was associated with larger tumor size (P<0.001), undifferentiated type (P=0.003), diffuse type (P=0.020), more advanced pathologic stage (P<0.001), and larger numbers of harvested and metastatic lymph nodes (P<0.001 each). Tumor differentiation was an independent factor affecting underestimation by computed tomography (P=0.045). Conclusions: Computed tomography with a size criterion of 8 mm is highly specific but relatively insensitive in detecting nodal metastases. Physicians should keep in mind that computed tomography may not be an appropriate tool to detect nodal metastases for choosing appropriate treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6691-6696
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• 2015

Background: Endometrial carcinoma is the most common gynecological cancer and its treatment is still controversial, especially in its early stages. There are conflicting data about the efficacy of retroperitoneal lymphadenectomy during abdominal hysterectomy and bilateral salpingoophrectomy treatment. Lymphadenectomy carries a risk of severe complications, especially in women with co-morbidities. Selective lymphadenectomy has been widely employed for staging evaluation of endometrial carcinoma because it is simple and seems to provide reliable data regarding nodal metastasis. This study was designed to evaluate accuracy of sentinel node sampling in detecting lymph node metastasis in primary endometrial carcinoma during staging laparotomy. Materials and Methods: Ninety-three women with endometrial carcinoma at high-risk for nodal metastasis were studied. During laparotomy, methylene blue dye was injected into sub-serosal myometrium, then retroperitoneal spaces were opened and blue lymph nodes within pelvic and para-aortic regions were removed as separate specimens for histopathological examination (sentinel lymph nodes = SLNs). Hysterectomy and selective lymphadenectomy then performed for all women included in this study. Results: Deposition of methylene dye into at least one lymph node was observed in 73.1% (68/93) of studied cases. 18.3% (17/93) of studied women had positive lymph node metastasis and 94.1% (16/17) of them had positive metastasis in SLNs. In this study, SNLs had 94.4% sensitivity and 100% specificity in prediction of lymph node metastasis. Mean number of lymph nodes removed from each case decreased when SLNs biopsy were taken. Conclusions: SLNs are the key lymph nodes in endometrial tumor metastasis and their involvement could be an indicator for whether or not complete systematic lymphadenectomy is needed during staging laparotomy.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1413-1418
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• 2012

Background: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand was investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Design: Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. Results: 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Conclusions: Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.

• 한국지구물리탐사학회:학술대회논문집
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• 2006.06a
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• pp.213-219
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• 2006

The Yongjang mine is located in Masan City, Gyeongsangnamdo, which consists of a black shale possessing quartzite veins with othercompositions such as gold, silver, and sublimated sulfur. The average width of the veins is $9{\sim}17cm$ and the average degrees of the gold and silver are 3.6 g/t and 113.6 g/t respectively. A regional and a detailed scale electrical resistivity surveys are conducted to determine the existence of the mineralization zones and the linear structures in the study area. In addition, surveys of a several different array methods are conducted such as dipole-dipole array in the surface and borehole-to-surface array, surface-to-borehole array, and dipole-dipole array in the borehole. The method of element division can be applied to the region in which the borehole is curved, inclined or the distance between the electrodes is shorter than that of nodal points, because the coordinate of each electrode cannot be assigned directly to the nodal point if several electrodes are in an element. Yongjang vein is extended longer under the subsurface than on the surface in the images reconstructed from the 3D inversion. Therefore, it is recognized that the 3-D interpretation of the electrical resistivity survey is a very useful method to figure out the existence of strike and extension direction because the mineralization zones and the linear structures are shown in each depth.

• Radiation Oncology Journal
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• v.4 no.1
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• pp.29-34
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• 1986

Thirty-six patients with carcinoma of the tonsillar region treated with radical radiotherapy at Yonsei Cancer Center between Jan. 1971 and Dec. 1980 were retrospectively reviewed. The purpose of this study is to evaluate the clinical characteristics and the treatment results. Seventy-five per cent of patients were in advanced stage when they were first seen. Incidence of nodal involvement at the time of initial presentation was $64\%$. Bilateral nodal involvement was found in $19\%$ of cases. Three-year local control rates for T1, T2, T3, and T4 were $88\%,\;46\%,\;25\%,\;and\;11\%$, respectively. Advanced neck nodes were poorly controlled $(N1\;70\%,\;N2\;20\%,\;N3\;12\%)$. The prognosis is mainly affected by the status of the primary and neck nodes Overall three-year local control rate was $42\%$.