• Journal of Digestive Cancer Research
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• v.11 no.2
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• pp.93-98
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• 2023

Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.1
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• pp.113-117
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• 2022

Gallbladder cancer has a poor prognosis, especially in peritoneal carcinomatosis related to perforation of the gallbladder followed by bile spillage. Previously, curative-intent treatment was not considered in carcinomatosis from cancer of the biliary tract. A 72-year-old male was referred to the hospital with a perforated gallbladder cancer. Intraoperatively, the tumor was confined to the gallbladder and liver. We presented a case of intention-to-curative resection of perforated gallbladder cancer followed by intraoperative hyperthermic intraperitoneal chemotherapy.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.50-55
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• 2002

Objectives: Thyroid cancer is the most common endocrine malignancy with favorable histologic and prognostic characteristics. Total or near total thyroidectomy has been used as a standard surgical procedure. The aims of this study are to determine the extent of resection of thyroid gland and to find the influencing factors of lymph node metastasis. Materials and Methods: The authors reviewed the records of 194 patients of thyroid cancer surgically treated at Department of General Surgery, Inje University Busan Paik Hospital from January, 1996 to December, 2000. Pathologic classifications, surgical procedures, and lymph node metastasis were analyzed. Results: There were 163 women and 31 men. The age ranged from 12 to 79 years old (mean age 43.2 years). The histological classifications of 194 cases revealed papillary cancer in 171 cases (88.1%), follicular cancer in 17 cases (8.8%), undifferentiated cancer in 3 cases (1.6%), medullary cancer in 2 cases (1.0%) and mixed cancer in 1 case (0.5%). Among the 194 patients, lobectomy was perfomed in 31 patients, subtotal thyroidectomy in 30 patients, near total thyroidectomy in 82 patients and total thyroidectomy in 51 patients. In the subgroup of papillary carcinoma 141 cases with lymph node dissection, lymph node metastasis had no statistical significance according to sex, age and primary tumor size. Conclusions: The mainly performed surgical procedures were total thyroidectomy and near total thyroidectomy. In thyroid cancer surgery, the extent of resection was influenced by age, differentiation and primary tumor size. The lymph node dissection should be decided by lymph node metastasis identified by preoperative radiologic evaluation or intraoperative lymph node findings.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.373-376
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• 2015

Background: EVA1A (eva-1 homolog A) is a novel gene that regulates programmed cell death through autophagy and apoptosis. Our objective was to investigate the expression profiles and potential role of EVA1A in normal and neoplastic human pancreatic tissues. Materials and Methods: The expression pattern of EVA1A in normal pancreatic tissue was examined by indirect immunofluorescence and confocal microscopy. Protein levels in paraffin-embedded specimens from normal and diseased pancreatic and matched non-tumor tissues were evaluated by immunohistochemistry. Results: EVA1A colocalized with glucagon but not with insulin, demonstrating production in islet alpha cells. Itwas strongly expressed in chronic pancreatitis, moderately or weakly expressed in the plasma membrane and cytoplasm in pancreatic acinar cell carcinoma, and absent in normal pancreatic acinar cells. Although the tissue architecture was deformed, EVA1A was absent in the alpha cells of pancreatic ductal adenocarcinomas, intraductal papillary mucinous neoplasms, mucinous cystadenomas, solid papillary tumors and pancreatic neuroendocrine tumors. Conclusions: EVA1A protein is specifically expressed in islet alpha cells, suggesting it may play an important role in regulating alpha-cell function. The ectopic expression of EVA1A in pancreatic neoplasms may contribute to their pathogenesis and warrants further investigation.

• The Korean Journal of Cytopathology
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• v.19 no.1
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• pp.27-33
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• 2008

Although subacute granulomatous thyroiditis(SGT) is usually diagnosed clinically, papillary carcinoma or other thyroid conditions must be considered in the differential diagnosis. We retrospectively reviewed the clinical and fine-needle aspiration(FNA) cytologic findings seen in 10 SGT cases to decide what are the most reliable cytologic findings and the most helpful molecular tools for reaching a confident cytologic diagnosis. The most representative smear slides were retrieved to perform immunocytochemistry for cytokeratin 19(CK19) and Ret protein. Five papillary carcinomas(PTCs) were included as controls. The constant and typical cytologic findings of SGT were multinucleated giant cells(MGCs) (100%), epithelioid granulomas(90%), an inflammatory dirty background(90%) and plump transformed follicular cells(80%) without fire-flare cells, oncocytic cells or transformed lymphocytes. The immunoreactivities for CK19(37.5%) and Ret(10%) of the follicular cells of SGT were less than those(CK19 and Ret:100%) of PTC. CK19 immunoreactivity of the MGCs was seen in only one case of PTC. There was no significant difference between CK19 and Ret immunocytochemical staining for the MGCs of both SGT and PTC. The results of this study demonstrate that the cytological diagnosis of SGT can be improved by employing a combination of the typical and constant diagnostic cytological features and immunocytochemical results.

• Tuberculosis and Respiratory Diseases
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• v.65 no.1
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• pp.52-56
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• 2008

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. Since Brincker first noted a statistically significant increase of malignant tumors among sarcoidosis patients, there have been several reports on simultaneously developed sarcoidosis and malignancy. A 30-year-old man was admitted to our hospital because of multiple enlarged mediastinal lymph nodes. The patient had been well until approximately 10 days before admission, when he developed a cough. Chest X-ray and computed tomography (CT) of the chest that were performed at the outpatient department revealed multiple enlarged mediastinal lymph nodes. Cervical lymph node biopsy revealed both non-caseating granuloma and metastatic papillary carcinoma, whereas the mediastinal lymph node showed only non-caseating granuloma. The thyroid gland surgical specimen showed papillary carcinoma. We report here on a case of a 30-year-old man who had sarcoidosis and thyroid cancer, and we include a review of the literature.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.13-19
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• 2016

Background : The 2015 American thyroid association (ATA) guidelines greatly expanded section on risk stratification of thyroid cancer. Definition of "Low risk of recurrence" has expanded, by inclusion of small volume lymph node involvement, such as less than 5 lymph node metastases each smaller than 2mm in central compartment. Purpose : We evaluated the number of positive nodes, Positive node ratio (PNR), recurrence, and radioablation therapy. Also, evaluated the safety of omitting strategy of radioablation after total thyroidectomy with PTC, especially on low-PNR N1a patients compared with high-PNR N1a patients. Methods : Consecutive 147 N1a and 216 N0 patients who underwent total thyroidectomy with central neck dissection between 2003 and 2004 were enrolled. We divided 147 N1a patients into two groups, such as 96 high-PNR versus 51 low-PNR group according to 50% of PNR, and compared these two groups with N0 group. Results: 7.2% (26/363) recurrences were occurred, and 21/147 (14.3 %) recurrences were on N1a patients, and 5/216 (2.3 %) were on N0 patients. Of these 21 recurrences in N1a stage patients, 20 (95.2 %) recurrences were occurred in high-PNR N1a group and only 1 (4.8 %) recurrence was in low-PNR N1a group. The recurrence of low-PNR N1a group was significantly lower than high-PNR N1a group (Log-rank p value = 0.003), but significantly not different from N0 group (Log-rank p value = 0.889). Although this study was a retrospective non-randomized trial with small number of patients, the 10-year recurrence of omitting RAI in low-PNR N1a patients with less than 50% of PNR were shown to be comparable with 216 N0 low risk patients. Conclusion : Positive node ratio could be a useful predictor of recurrence and useful guidance postoperative management -rather than absolute number of positive node.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.7-11
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• 2016

Background and Objectives: Quality of voice may be deteriorated after thyroidectomy without any injury to recurrent laryngeal nerve. While there have been several studies showing the change of acoustic parameters after thyroidectomy, factors related to deteriorated voice quality have been rarely studies. In this study, we sought to analyze the factors associated to deteriorated voice quality after thyroidectomy. Materials and Methods: We made a retrospective review of 35 patients who underwent thyroidectomy for papillary thyroid carcinoma. Voice analysis including acoustic analysis, voice handicap index 10 (VHI-10), and GRBAS score was conducted before and 3 months after surgery. Patients were grouped according to the amount of increase in VHI-10 after surgery ; group A (${\Delta}VHI<7$) and group B (${\Delta}VHI{\geq}7$). Clinicopathologic factors associated to patients of group B were analyzed and changes of parameters from acoustic analysis in each group were evaluated. Results : Patients of group B were associated with age ${\geq}45$ years (p=0.025) and showed borderline association to total thyroidectomy (p=0.075) and tumor size ${\geq}1cm$ (p=0.086). Multivariate analysis demonstrated that those with age ${\geq}45$ years were independently associated to deteriorated quality of voice (p=0.014, HR=18.38). Patients of group B were also associated to significant deterioration of high pitch (p<0.001) and Grade score with borderline significance (p=0.054). Conclusion: Patients older than 45 years may have higher risk of deterioration of quality of voice after thyroidectomy based on increase of VHI-10 score (${\Delta}VHI{\geq}7$). Association with deterioration of high pitch should also be considered in these patients.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.511-515
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• 2004

Purpose: The sodium-iodide symporter (NIS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NIS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression ot NIS using two different methods (RT-PCR and immunoshistochemical staining) and compared the results. Materials & Methods: We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 7 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. Results: By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NIS. By immunohistochemical staining, 15 of 19 papaillary carcinomas express NIS, but 1 follicular lancer didn't express NIS. There was a significant correlation between the semiquautitative results of RT-PCR and immunohistochemical staining of NIS expression. (p<0.01) Conclusion: Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.

• The Korean Journal of Nuclear Medicine
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• v.16 no.1
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• pp.41-48
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• 1982

113 patients with nodular goiter were studied cytologically by needle aspiration for differential diagnosis at the department of internal medicine, Chung Nam National University Hospital since October 1980 till July 1981, and the final diagnosis taken from biopsies were compared with the cytologic method on the 44 cases who received operation. The results were obtained as follows: 1. Among the 113 cases of total patients, male were 15 cases (13.3%) and female were 98 cases (86.7%) and the sex ratio (M:F) was 1 : 6.5. The peak age incidence was in the third decade followed by forth and second decades. 2. The findings of cytological diagnosis in 113 cases showed benign adenoma in 69 cases (61.1 %), Subacute and chronic thyroiditis in 22 cases(19.5%), papillary carcinoma in 15 cases (13.3%) and follicular carcinoma in 7 cases (6.2%), respectively, and 48 cases (69.6%) of the.adenomas and 2 cases(9.1%) of papillary carcinomas showed combined cystic degeneration of the nodules. 3. The diameter of the nodules by palpation revealed within $2\sim5cm$ in 88 cases (77.9%) out of 113 cases, below 2 cm in 17 cases and over 5cm in 8 cases and there were no significant relationship between the size of the nodule and disease entity. 4. The findings of thyroid scintigram using $^{131}I$ in 113 cases of nodular goiter showed "cold nodule" in 111 cases (98.2%) and normal scan (radioactivity) in 2 cases (1.8%) which showed adenoma in cytology and there was no cases with "hot nodule". 5. The thyroid functions of the 113 cases revealed as euthyroidism in 108 cases (95. 6%), hypothyroidism in 2 cases (1.8%) who showed chronic thyroiditis and hyperthyroidism in 3 cases (2.7%) in adenomas but there was no evidence that the nodules of the above 3 cases were the reason of hyperthyroidism. 6. In 44 operated cases, the histological diagnosis revealed 23 cases of adenoma out of 27 cases(85.2%) who were diagnosed as adenoma by cytology and 15 cases of malignancy out of 17 cases (88.2 %), and the overall diagnostic accuracy of aspiration cytology was 86.4 %.