• Journal of Chest Surgery
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• v.20 no.2
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• pp.348-352
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• 1987

A 51 year-old male was admitted with the chief complaints of swallowing difficulty and pain on neck and upper chest for 2 months prior to admission: He was taken biopsy under esophagoscopy, and the result was squamous cell carcinoma. Preoperatively we studied the esophagogram and chest CT. On these, we found the main appreciable mass at midesophagus easily. But, we missed the upper cervical unexpected mass. So we performed the esophagectomy and lymph node dissection from upper clavicle level to the esophagogastric junction by thoracic approach as wide as possible, and cervical esophagostomy and feeding gastrostomy also. At that evening we reviewed the studied films in detail, and we found another mass lesion at C4-C6 level of cervical esophagus. We performed the 2nd operation e.g. cervical esophagectomy on next morning without hesitation. Between these two masses, there was almostly normally looking skip area grossly. The squamous cell carcinoma of the esophagus could be multicentric in character and may have skip area. But, we heard little reports until now. The two masses could be different in origin or be same probably by submucosal spreading. Anyway, it was an alarming case to the surgeon not to neglect the another possible lesions in squamous cell type. Postoperative course was uneventful, he took G-tube feeding with no problems on 7th postoperative day. Now he took the postoperative irradiation at out patient department.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.79-82
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• 2009

A 73-year-old man presented with a chief complaint of progressive left knee pain for two months. He had a history of total thyroidectomy and central lymph node dissection due to papillary thyroid carcinoma three months ago. MRI images revealed a solid mass in the left patella. A solid mass demonstrated low signal on T1 weighed image, and high signal on T2 weighed image. And whole body bone scan showed focal photon defect in same lesion of left patella. The histologic result of left knee lesion was adenocarcinoma, consistent with metastatic papillary thyroid carcinoma. Although patellar metastasis of papillary thyroid carcinoma is very rare, when knee pain and radiologic abnormality are noted, differential diagnosis of metastasis is necessary.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.825-830
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• 1990

Esophageal cancer is relatively uncommon except in isolated endemic areas, but it generally devastating to the patient. Usually, by the time the disease becomes clinically evident, it is incurable. The aim of treatment is then relegated to attempting to palliate the symptoms in the best possible manner with the least morbidity and mortality. Squamous cell carcinoma in by far the commonest type of malignancy involving the body of the esophagus, accounting for more than 95 percent of all esophageal malignancies. Because the tumor’s microscopic spread is much greater than its macroscopic extent, it is necessary to resect a sufficiently long segment of the esophagus. And second tumors may occur either in the esophagus as a manifestation of a field change or in other organs. Recently we had experienced a case with in situ carcinoma away from the invasive squamous cell carcinoma of the esophagus. A 58 year-old male was admitted with the chief complaint of swallowing difficulty for a month prior to admission. While we studied the esophagogram and chest CT, we found that the mass was protruded to the lumen of esophagus at the level of the 7th-9th thoracic vertebral columns. We performed esophagectomy with lymph node dissection and esophagogastrostomy by thoracic and abdominal approaches. The pathologic result showed separation of another in situ carcinoma away from the invasive squamous cell carcinoma of esophagus at the level of esophagogastric junctions. Postoperative course was uneventful. Now he is taking the postoperative irradiation at out patient department.

• Tuberculosis and Respiratory Diseases
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• v.61 no.1
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• pp.60-64
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• 2006

Pulmonary aspergillosis presents as the following three different types depending on the immune status of the host: invasive aspergillosis, allergic bronchopulmonary aspergillosis (ABPA), and aspergilloma. Aspergilloma develops as a result of an aspergillus growth inside a pre-existing lung cavity. However, endobronchial aspergilloma without a lung parenchymal lesion is quite rare. We encountered a case of endobronchial aspergilloma that developed in a healthy 75 year-old woman that led to necrotizing pneumonia of the right lower lobe. The chief complaints were fever, cough and yellowish sputum. The chest film revealed haziness with cavity-like shadows on the right lower lobe, and the chest CT scan showed endobronchial calcified density in the basal bronchus of the right lower lobe with peribronchial lymph node enlargement. Bronchoscopy revealed an obstruction of the basal orifice of the right lower lobe by blackish stone-like material, and the aspergilloma was confirmed by the bronchoscopic biopsy. The pneumonia improved after bronchoscopic removal of this lesion. We report this case along with a review of the relevant literature.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.129-135
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• 2007

Purpose : Kikuchi disease is a subacute necrotizing lymphadenitis characterized by fever, cervical lymphadenopathy and benign self-limiting course in young women especially, but rare in children. Their etiopathology is still unknown, but involved viruses and autoimmune mechanism were proposed. We investigated the clinical and laboratory characteristics of Kikuchi disease in children. Methods : Five patients were diagnosed of Kikuchi disease from January 2001 to June 2006 in Kyunghee University Hospital. We reviewed their medical records retrospectively and analyzed clinical and laboratory findings. Results : The mean age of 5 patients (male to female ratio; 2:3) was 9 yr 9 mon(range: 8 yr 2 mon-12 yr 6 mon). The chief complaints were sustained fever and cervical lymph node that was unilateral, tender and swollen. All patients were treated with antibiotics before diagnosis was made, and rash developed in 2 patients. One patient showed necrotic change in ultrasound with which we suspected Kikuchi disease. Three patients were examined by CT scan additionally. The interval between admission and cervical lymph node excisional biopsy ranged from 6 days to 15 days, and mean period was 9.6 days. All pathological findings were compatible to necrotizing lymphandenitis. Conclusion : Unnecessary laboratory and imaging studies, and treatment with antibiotics tend to be done before making diagnosis, and that caused prolonged hospitalization. Therefore we studied the clinical and laboratory characteristics of Kikuchi disease in children.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6761-6766
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• 2014

Background: CD44v6 (CD44 variant exon 6) is the chief CD44 variant isoform regulating tumor invasion, progression, and metastasis. The prognostic value of CD44v6 expression in non small cell lung cancer (NSCLC) has been evaluated in many studies, but the results have remained controversial. Thus, we performed a meta-analysis of currently available studies to investigate the prognostic value of CD44v6 expression in NSCLC patients and the relationship between the expression of CD44v6 and clinicopathological features. Materials and Methods: Two independent reviewers searched the relevant literature in Pubmed, Medline and Embase from 1946 to January 2014. Overall survival (OS) and various clinicopathological features were collected from included studies. This meta-analysis was accomplished using STATA 12.0 and Revman 5.2 software. Pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated to estimate the effects. Results: A total of 921 NSCLC patients from ten studies met the inclusion criteria. The results showed that CD44v6 high expression was a prognostic factor for poor survival (HR=1.91, 95%CI=1.12-3.26, p<0.05). With respect to clinicopathological features, CD44v6 high expression was related to histopathologic type (squamous cell carcinoma versus adenocarcinoma: OR=2.72, 95%CI=1.38-5.38, p=0.004), and lymph node metastasis (OR=3.02, 95%CI=1.93-4.72, p<0.00001). Conclusions: Our results suggested CD44v6 high expression as a poor prognostic factor for NSCLC, and CD44v6 expression is associated with lymph node metastasis and histopathologic type. Therefore, CD44v6 expression can be used as a novel prognostic marker in NSCLC cases.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.136-141
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• 1999

Broncholith is a calcified lymph node which partially or completely erodes into the bronchial lumen and broncholithiasis is a relatively rare condition which related to late tissue response to healing granulomatous pulmonary infections, most commonly histoplasmosis or tuberculosis. The prominent symptoms of broncholithiasis are coughing followed by hemoptysis and symptoms related to bronchial obstruction. The complications include bronchoesophageal fistula and aortotracheal fistula. We report one case of broncholithiasis caused by Aspergillus. The case was a 53 year-old house wife whose chief complaints were recurrent fever, chill and malaise. The chest film revealed an avoid hazziness on the right middle lobe and chest cr scan showed consolidation of lateral segment of right middle lobe with calcified small low attenuated lesion in right middle lobe bronchus. Aspergillosis confirmed by pathology after bronchoscopic removal of impacted Aspergillus containing muddy plug from lateral segmental branch of right middle lobe bronchus.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.2
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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.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.10 no.10
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• pp.4883-4901
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• 2016

Energy efficiency in Wireless Sensor Networks (WSNs) is very appealing research area due to serious constrains on resources like storage, processing, and communication power of the sensor nodes. Due to limited capabilities of sensing nodes, such networks are composed of a large number of nodes. The higher number of nodes increases the overall performance in data collection from environment and transmission of packets among nodes. In such networks the nodes sense data and ultimately forward the information to a Base Station (BS). The main issues in WSNs revolve around energy consumption and delay in relaying of data. A lot of research work has been published in this area of achieving energy efficiency in the network. Various techniques have been proposed to divide such networks; like grid division of network, group based division, clustering, making logical layers of network, variable size clusters or groups and so on. In this paper a new technique of group based WSNs is proposed by using some features from recent published protocols i.e. "Energy-Efficient Multi-level and Distance Aware Clustering (EEMDC)" and "Energy-Efficient Multi-level and Distance Aware Clustering (EEUC)". The proposed work is not only energy-efficient but also minimizes the delay in relaying of data from the sensor nodes to BS. Simulation results show, that it outperforms LEACH protocol by 38%, EEMDC by 10% and EEUC by 13%.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.135-142
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• 1991

We reviewed 15 cases of mesothelioma of the pleura, of which three cases were localized benign form and 12 cases were malignant diffuse form. The tumors were distributed equally in both sexes, and occured most commonly in fifth to seventh decades. The history of exposure to asbestos was present in only one case. The chief complaints were mainly chest pain and dyspnea. Associated symptoms were cough, sputum, hemoptysis, weight loss, anorexia, chill. On physical examination, unilateral, decreased breathing sound was main feature. The simple chest radiograph showed masses in all localized mesotheliomas (100%) and in 2 diffuse mesotheliomas (17%). 8 cases of diffuse mesotheliomas (67%) showed unilateral pleural effusions. Pleural effusions were mainly bloody (67%), and almost all were exudates. In all localized mesotheliomas, final diagnosis was made by open thoracotomy. In diffuse mesotheliomas, final diagnosis was made by open thoracotomy in 7 cases, chest wall mass biopsy in 2 cases, thoracoscopic biopsy in 1 case, pleural biopsy in 1 case, and pleural biopsy combined with axillary lymph node biopsy in 1 case. Localized mesotheliomas were treated by simple excision with good prognosis. In diffuse mesotheliomas, surgical treatment (pleuropneumonectomy, pleurectomy), chemotherapy, or radiotherapy, alone or in combination, were used with dismal prognosis. The prognostic factors were not found due to the small number of cases, incomplete follow up, and early drop out.