• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.205-209
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• 2001

Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

• Journal of KIISE:Information Networking
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• v.34 no.6
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• pp.475-482
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• 2007

Mobile nodes in ad-hoc wireless networks play roles of router as well as host. Movement of nodes causes network topology changes, which make existing routing information be modified. Therefore many routing protocols for ad-hoc networks were suggested in the literature. In this paper, we suggest an enhanced automatic route shortening method for dynamic source routing(DSR) protocol. DSR is a request/response based protocol which has low routing overhead owing to node movement. The current automatic route shortening is performed on the only nodes which belong to the source route of packets. On the contrary, our suggested method allows all neighbor nodes hearing the packet to participate in automatic route shortening. It makes all possible route shortenings be performed. So we maintain maximal shortened routes of ongoing data connections. Simulation results with ns2 show that our method pays small extra protocol overhead for ARS, but increases the ratio of successful packet transmissions and the number of ARSs performed in our mechanism is from 2 to 5 times higher than in original ARS mechanism and therefore it will improve the network-wide energy consumption in wireless ad-hoc networks.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1169-1174
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• 2016

Purpose: To review clinical characteristics, treatment outcomes and prognostic factors in patients with parotid gland tumors treated with surgery and postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 69 patients with parotid gland tumors, with a median follow-up of 52 months (range, 2-228 months). and a median radiotherapy dose of 60Gy (range, 30-69 Gy). Results: There were 24 (35%) females and 45 (65%) males, at a ratio of 1/1.9. Median age at presentation was $58.9{\pm}17.2$ (range 13-88) years. The most common histology was adenoid cystic carcinoma (33%) and mucoepidermoid carcinoma (28%). The mean overall survival (OS) was $65.3{\pm}8$ (95% confidence interval [CI], 49.6-81.1) months and the median overall survival was $40.0{\pm}7$ (95% CI, 26.2-53.7) months. The -1, -3, -5 and -10 year OS rates were 78%, 52.4%, 35.3% and 19.6% respectively. The mean disease free survival (DFS) was $79.2{\pm}10$ (95% CI, 59.3-97.1) months and the median disease free survival was $38{\pm}13$ (95% CI, 7.05-88.7) months. The -1,-3,-5 and -10 year DFS rates were 71.9%, 50.1%, 43.7% and 30.1% respectively. On univariate analysis, the OS was significantly better with female sex (p<0.005), < 50 age (p<0.021), T stage (p<0.0001), absence of lymph node involvement (p<0.0001), lower tumor grade (p<0.0001), absence of lymphovascular invasion (p<0.002), absence of perineural invasion (p<0.0001), absence of extracapsuler extension (p<0.0001), surgical margin negativity (p<0.006), ${\leq}60Gy$ radiotherapy dose (p<0.0001) and absence of distant metastasis (p<0.027). Conclusions: Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be mainly effective in patients with parotid gland carcinomas.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.54-60
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• 1998

Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

• Journal of Chest Surgery
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• v.53 no.3
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• pp.104-113
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• 2020

Background: Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). Methods: A retrospective study was conducted in which 544 patients with stage I (T1abc-T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. Results: In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12-2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04-1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89-8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. Conclusion: Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

• Journal of Environmental Health Sciences
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• v.38 no.6
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• pp.541-549
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• 2012

Objectives: This study was undertaken in order to evaluate a potential mechanism involved in gastro-intestinal problems observed in autistic subjects and uses an animal model of autism investigation. Methods: BTBR T+tf/J, a mouse strain with typical socio-behavioral characteristics of autistic subjects and FVB mice with highly social behaviors as the control strain were used. Both genders of mice aged three weeks and six months were used from four separate litters for each strain. Serum was prepared following cardiac puncture, and mesenteric lymph nodes were collected for in vitro stimulation and enumeration of major immune cell proportion. Results: The level of serum IgA was significantly enhanced in six-month-old BTBR mice compared with three-week-old BTBR, which was not observed with the FVB control mice. The serum IgE level was also higher among BTBR mice than among age-sex matched FVB mice, respectively. Considering the ratio of interleukin-4 vs interferon-gamma production from mesenteric lymph node T cells, skewedness toward type-2 reactivities was observed. In addition, the proportion of B cells in mesenteric lymph nodes was significantly higher in BTBR mice than in FVB mice. Conclusion: Upregulation of mucosal immunity related with enhanced type-2 immune reactivity observed in BTBR mice could be involved with the etiology of gastro-intestinal abnormalities in autism.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5385-5388
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• 2015

Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5675-5680
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• 2013

Background: Preexisting type 2 diabetes mellitus (T2DM) affects the prognosis and mortality of patients with some cancers. Insulin like growth factor (IGF) and insulin receptor (IR) signaling axes play important roles in both cancer and diabetes development. We aimed to explore the expression characteristics of proteins in IGF/IR axis in non-small cell lung cancer (NSCLC) cases with preexisting T2DM. Methods: Fifty-five NSCLC patients with preexisting T2DM were retrospectively included and matched by 55 NSCLC without diabetes at a 1:1 ratio. The expression of proteins in IGF/IR axis was detected by immunohistochemical staining. Clinicopathological data were collected to analyze their relationship with the protein expression. Results: Both IGF 1 receptor (IGF-1R) and insulin receptor substrate 2 (IRS-2) showed higher expression in the NSCLC with T2DM group, compared with those without T2DM. The high expression of IGF-1R and IRS-2 were found to be negatively associated with lymph node metastases and T staging in the T2DM group, respectively, and IRS-2 expression was also found more in the subgroup whose T2DM duration was more than 4 years. No difference was detected in the expression of IRS-1, IGF-1, IGF-2, IGFBP3, IR and mTOR between groups with or without T2DM. Conclusion: Our study found higher expression of IGF-1R and IRS-2 proteins in NSCLC patients with preexisting T2DM, and that there was an association with early stage NSCLC, which suggested that IGF signaling may play an important early event in development of NSCLC associated with diabetes.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2329-2334
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• 2012

Introduction: Many studies have reported that microRNA-21 (miR-21) mihght predict the survival outcome in non-small cell lung cancers (NSCLCs) but the opposite opinion has also been expressed. The aim of this study was to summarize the evidence for a prognostic role of miR-21. Materials and Methods: All the eligible studies was searched by Medline and EMBASE and patients' clinical characteristics and survival outcome were extracted. Then a meta-analysis was performed to clarify the prognostic role of the miR-21 expression in different subgroups. Results: A total of 8 eligible articles were yielded covering survival outcomes or clinical characteristics. The combined hazard ratio (HR) and 95% confidence interval (95% CI) for overall survival (OS) was 2.19 [0.76, 6.30], while the combined HR (95% CI) of Asian group for OS had a significant result, 5.49 [2.46, 12.27]. The combined HR (95% CI) for recurrence free survival or disease free survival (RFS/DFS) was 2.31 [1.52, 3.49]. Odds ratios (ORs) showed that the miR-21 expression was associated with lymph node status and histological type. Conclusion: miR-21 expression could predict the prognostic outcome of NSCLC in Asians, despite some deficiencies in the study data.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.17 no.7
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• pp.1589-1596
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• 2013

Recently, spectral efficiency or reliability is required to be improved in the scenario of multiple access. In this paper, we consider a scenario where two source nodes access one destination node. Different with conventional multiple access studies, in our research, a part of the allocated resource is shared by two source nodes and this scheme is called partial multiplexing. Let $R_s$ denote the ratio of the amount of the shared resource to that of the resource allocated to each user. We analyze and optimize the performance of the partial multiplexing in term of $R_s$. We show that the optimal $R_s$ to maximize the throughput is 1 or 0 based on approximated bit error rate (BER). In addition, if we set a constraint on frame error rate (FER), $R_s$ can have a value between 0 and 1. We also find the approximated $R_s$ to meet the constraint as a closed form. Partial multiplexing can be a novel multiple access scheme.