• Tuberculosis and Respiratory Diseases
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• 제65권1호
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• pp.52-56
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• 2008

저자들은 갑상샘 암의 림프절 전이를 동반한 30세 사르코이드증 환자를 경험하였기에 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8425-8430
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• 2016

Purpose: To study the safety of prophylactic level VII nodal dissection regarding hypoparathyroidism (temporary and permanent) and vocal cord dysfunction (temporary and permanent) and its impact on disease free survival. Materials and Methods: This prospective study concerned 63 patients with papillary thyroid carcinoma with N0 neck node involvement (clinically and radiologically) in the period from December 2009 to May 2013. All patients underwent total thyroidectomy and prophylactic central neck dissection including levels VI and VII lymph nodes in group A (31 patients) and level VI only in group B (32 patients). The thyroid gland, level VI and level VII lymph nodes were each examined histopathologically separately for tumor size, multicentricity, bilaterality, extrathyroidal extension, number of dissected LNs and metastatic LNs. Follow-up of both groups, regarding hypoparathyroidism, vocal cord dysfunction and DFS, ranged from 6-61 months. Results: The mean age was 34.8 and 34.3, female predominance in both groups with F: M 24:7 and 27:5 in groups A and B, respectively. Mean tumor size was 12.6 and 14.7mm. No statistical differences were found between both groups regarding age, sex, bilaterality, multicentricity or extrathyroidal extension. The mean no. of dissected level VI LNs was 5.06 and 4.72 and mean no. of metastatic level VI was 1 and 0.84 in groups A and B, respectively. The mean no. of dissected level VII LNs was 2.16 and mean no. of metastatic LNs was 0.48. Postoperatively temporary hypoparathyroidism was detected in 10 and 7 patients and permanent hypoparathyroidism in 2 and 3 patients; temporary vocal cord dysfunction was detected in 4 patients and one patient, and permanent vocal cord dysfunction in one and 2 patients in groups A and B, respectively. No significant statistical differences were noted between the 2 groups regarding hypoparathyroidism (P=0.535) or vocal cord dysfunction (P=0.956). The number of dissected LNs at level VI only significantly affected the occurrence of hypoparathyroidism (<0.001) and vocal cord dysfunction (<0.001).The DFS was significantly affected by bilaterality, multicentricity and extrathyroidal extension. Conclusions: Level VII nodal dissection is a safe procedure complementary to level VI nodal dissection with prophylactic central neck dissection for papillary thyroid carcinoma.

• 대한두경부종양학회지
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• 제20권2호
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• pp.135-142
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• 2004

Objectives: The purpose of this study was to evaluate for prognostic significance of VEGF expression and tumor angiogenesis in papillary carcinomas of the thyroid. Materials and Methods: The materials were 79 cases of papillary thyroid carcinomas, and age, sex, tumor size, multiplicity of tumor, capsular invasion, lymph node metastasis, recurrence, TNM stage, DeGroot stage and AMES scale were evaluated. An immunohistochemical stains for CD 34 to estimate microvessel density (MVD), and VEGF were done. MVD was defined as an average count of vessels per ${\times}400$ power field in the most vascularized area. VEGF expression was interpreted as 1+ and 2+ according to staining intensity and percentages of positive cells. Results: Mean score of MVD was $39.7{\pm}16.9.$ MVD were significantly higher in cases with capsular invasion (p=0.0001), lymph node metastasis (p=0.0001), TNM stage III (p=0.0022), DeGroot stage III (p=0.0163) and high risk group by AMES scale (p=0.0001). VEGF 2+ expression rate was significantly increased in cases with capsular invasion and lymph node metastasis (p=0.0006, p=0.0013), and in cases with TNM stage III, DeGroot stage III and high risk group by AMES scale (p=0.0236, p=0.0003, p=0.0293). In VEGF 2 + expression group, MVD was significantly higher than in VEGF 1 + group (p=0.0008), and MVD showed positive relation to VEGF 2 + expression (r=0.4616). Conclusion: VEGF expression and high MVD were significantly correlated to capsular invasion, lymph node metastasis, TNM stage III, DeGroot stage III and high risk group by AMES scale. The expression of VEGF and high MVD could be considered to be one of prognostic factor in papillary thyroid carcinomas.

• 대한두경부종양학회지
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• 제19권2호
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• pp.127-132
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• 2003

Objectives: The best treatment for the malignant parotid tumor still remains to be defined, and a better knowledge about the tumor features that predict the treatment result is needed. The aim of this study is to evaluate the treatment outcomes and to suggest the optimal treatment modality for the parotid cancer. Materials and Methods: The clinicopathologic characteristics of 113 patients who were treated for parotid cancer from January 1990 to December 2002 were retrospectively analysed. Univalate analyses were performed to establish the prognostic influence of pateint age, gender, tumor size, histologic grade and lymph node metastasis. Results: The mean age was 46.4 years old (15-81 years) and. The male to female ratio was 1 : 1.1. The chief complaint was a palpable mass in 85%, pain was in 12.4% and facial nerve palsy was accompanied with 2.7%. The mean tumor size was 3.5cm in diameter. The most common malignant tumor was mucoepidermoid carcinoma (33.6%), followed by acinic cell carcinoma (15%), adenoid cystic carcinoma (11%), carcinoma expleomorhpic adenoma (11%), basal cell carcinoma (7%). The most common operative procedure was total parotidectomy (47.8%) and various types of cervical lymph node dissection were added in 69.9%. Postoperative radiotherapy was done in 61.1 %. Postoperative complications developed in 54 cases (47.8%), including 46 cases (40.7%) of facial nerve palsy and 9 cases (8%) of Frey's syndrome. Recurrences developed in 21 cases (18.6%) and deaths in 15 (13.3%). Cumulative survival at 5 year was 75.4%. Univariate analysis of clinical factors showed that histologic grade and positive cervical lymph node significantly influenced survival (p<0.05). Conclusion: These results suggests that the radical resection with lymph node dissection and postopertaive XRT would be necessary to improve the survival of the patients with high grade cancer or positive lymphnode metastasis.

• 대한기관식도과학회지
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• 제6권1호
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• pp.80-86
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• 2000

Background : Stomal recurrence that occasionally follows total laryngectomy is associated with very poor prognosis regardless of treatment modality, so it is very important to identify high risk patients to prevent stomal recurrence. Objectives : We attempted to select an optimal management method to prevent stomal recurrence by analyzing risk factors in each patient who was found to have stomal recurrence following total laryngectomy. Materials and Methods : Risk factors in each of eleven patients who had stomal recurrence out of 159 patients who underwent total laryngectomy in the last ten years were analyzed retrospectively. Data were gathered on risk factors such as the presence of subglottic extension, extralaryngeal extension, thyroid gland invasion, lymph node metastasis, timing of tracheotomy, tumor stage, postoperative radiotherapy, and inclusion of the stoma in the radiotherapy field. Results : There were eight cases of subglottic extension, six cases of extralaryngeal invasion, one case of pharyngocutaneous fistula that occurred as a postoperative complication, and one case who was taken completion laryngectomy following conservation surgery. With the exception of one case who was taken tracheotomy prior to total laryngectomy, all tracheotomies were performed intra-operatively after endotracheal intubation. There was no evidence of paratracheal lymph node or prelaryngeal lymph node metastasis on preoperative neck CT scan. There were six cases of T4 tumors, four cases of T3 tumors, and one case of T2 tumor. Salvage surgery was performed following radiotherapy in three cases, and aside from one case who was not taken post-operative radiotherapy, postoperative radiotherapy including the stoma was performed in the remaining seven cases within one month after surgery. Conclusion : Total laryngectomy with wide paratracheal lymph node dissection, thyroidectomy, and tracheotomy should be performed for patients who have high risk factors such as subglottic extension and advanced stage. We believe that tracheotomy should be precede endotracheal intubation. Efforts should be made to prevent stomal recurrence by utilizing postoperative radiotherapy and by minimizing postoperative complications such as infection and fistula.

• IMMUNE NETWORK
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• 제12권1호
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• pp.18-26
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• 2012

Background: Vitamin C is an essential nutrient for maintaining human life. Vitamin C insufficiency in the plasma is closely related with the development of scurvy. However, in vivo kinetics of vitamin C regarding its storage and consumption is still largely unknown. Methods: We used $Gulo^{-/-}$ mice, which cannot synthesize vitamin C like human. Vitamin C level in plasma and organs from $Gulo^{-/-}$ mice was examined, and it compared with the level of wild-type mice during 5 weeks. Results: The significant weight loss of $Gulo^{-/-}$ mice was shown at 3 weeks after vitamin C withdrawal. However, there was no differences between wild-type and vitamin C-supplemented $Gulo^{-/-}$ mice (3.3 g/L in drinking water). The concentration of vitamin C in plasma and organs was significantly decreased at 1 week after vitamin C withdrawal. Vitamin C is preferentially deposited in adrenal gland, lymph node, lung, and brain. There were no significant changes in the numbers and CD4/CD8 ratio of splenocytes in $Gulo^{-/-}$ mice with vitamin C withdrawal for 4 weeks. And the architecture of spleen in $Gulo^{-/-}$ mice was disrupted at 5 weeks after vitamin C withdrawal. Conclusion: The vitamin C level of $Gulo^{-/-}$ mice was considerably decreased from 1 week after vitamin C withdrawal. Vitamin C is preferentially stored in some organs such as brain, adrenal gland and lung.

• 대한두경부종양학회지
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• 제18권1호
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• pp.65-70
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• 2002

Background and Objectives: Recently the tenn 'papillary microcarcinoma' has been proposed to designate carcinoma of 10 mm or less in diameter. In some cases, cervical lymph node metastasis preceding the occurrence of the primary tumor may be the first and sole manifestation of the disease. The objective of this study is to assess the clinical features of cervical metastasis in papillary microcarcinoma of thyroid glands. Materials and Methods: 9 cases with papillary microcarcinoma with neck metastasis were analyzed retrospectively. 5 cases are men and 4 are women. All patients complained of painless, movable neck mass. The symptom had been present from 1 month to 36 months. We reviewed clinical history, imaging studies, the results of fine needle aspiration, the surgical method, the pathologic results. Results: In 9 cases, no abnormalities of the thyroid gland were shown by imaging studies and thyroid scan. 3 cases were diagnosed by fine needle aspiration cytology. the others were not. Total thyroidectomy and neck dissection were performed in 9 cases and then pathology reports showed 2 case of multiple, 2 case of contralateral single and 5 cases of unilateral single thyroid microcarcinoma. They have no recurrence during follow-up period. Conclusions: Cervical metastasis from papillary microcarcinoma is variable clinical manifestation. The diagnosis of cervical metastasis from papillary microcarcinoma should be considered in patient with neck mass. We recommend total thyroidectomy with neck dissection and postoperative radioactive iodine ablation therapy in neck metastasis from papillary thyroid microcarcinoma.

• 치과방사선
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• 제23권2호
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• pp.365-372
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• 1993

Branchial cleft cyst is the most common lateral neck cyst; the vast majority are of the second branchial cleft origin. This presumably reflects the greater depth and longer persistence of the second cleft, compared with the first, third, and fourth clefts. We experienced a 49-year-old male whose chief complaint was a abnormal mass of the left parotid gland area and neck. As a result of careful analysis of clinical, radiological, and histopathological findings, we diagnosed it as a second branchial cleft cyst in the neck and obtained results as follows: 1. In clinical examination, there was a 10×15㎝ sized, fluctuant painful mass in the left neck and parotid area. 2. In radiographic examination, a low echogenic mass with internal cystic change in the inferior parotid gland area was noted sonographically. Computed tomograph showed a 3×4㎝ sized, well-defined cystic mass with heterogenous solid component in the anterior border of sternocleidomastoid muscle. MRI revealed 5×6㎝ sized, well-marginated multi separated mass in the same area. 3. In histopathological examination, lining of cyst was stratified squamous epithelium with typical lymph node pattern and inflammatory cell infiltration.

• 대한치과의사협회지
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• 제55권11호
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• pp.789-799
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• 2017

Ultrasound images are noninvasive, can be observed in real time, have no radiation exposure, do not cause pain, and are not restricted in use depending on the patient's prosthetic implant or medical condition. Since the use of ultrasound in the dental field was first applied for tooth preparation in 1957, the use of diagnostic ultrasound for the first time in 1963 has been reported. Currently, it is used in the diagnosis of soft tissue lesions such as malignant tumor or salivary gland disease, fine needle aspiration test, temporomandibular joint disease, lymph node metastasis, measurement of muscle thickness and inflammatory diseases, differentiation of periapical cyst and granulation tissue, measurement of periodontal tissue thickness. The ultrasound image can be visualized in real time. The clinician can explain the structure to the patient while consulting the patient and consult the patient. When injecting the drug into a specific site or aspirating a specific site or substance, So that it can be confirmed and practiced. Recently, ultrasonic equipment specialized in the dental field has been developed and marketed, and it is expected that the use of ultrasonic waves will become active in the dentistry. In the future, development of popular equipment with size and frequency suitable for dental diagnosis and various researches on maxillofacial ultrasonic anatomy. If clinical studies are continuously carried out to demonstrate efficacy, ultrasound is expected to aid in accurate diagnosis and treatment throughout the dentistry.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.196-200
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• 2008

Kimura씨 병은 원인이 알려지지 않은 만성 염증성 질환으로 주로 동양의 젊은 남자에게 호발되는 드문 질환이다. 주로 두경부의 피하 조직이나 타액선에 무통성의 종괴로 발생하며, 주변의 국소 림프 병증을 동반하기도 한다. 말초 혈액에 호산구 증가증과 혈청 IgE 증가를 나타내고, 조직학적으로 이환된 림프절의 과증식된 배중심과 호산구 등의 염증세포 침윤의 병리 소견을 보인다. 치료 방법으로는 스테로이드 치료, 방사선 치료 및 수술적 치료 등이 있으며 예후는 양호하다. 저자들은 28세 남자 환자의 좌측 상완 원위부 내측에 발생한 종괴를 변연부 절제술을 시행하여, 병리 조직학적으로 Kimura씨 병으로 확진한 1예를 문헌 고찰과 함께 보고하는 바이다.