• Title/Summary/Keyword: Isolated node

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Factors Predicting Microinvasion in Ductal Carcinoma in situ

  • Ozkan-Gurdal, Sibel;Cabioglu, Neslihan;Ozcinar, Beyza;Muslumanoglu, Mahmut;Ozmen, Vahit;Kecer, Mustafa;Yavuz, Ekrem;Igci, Abdullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.55-60
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    • 2014
  • Background: Whether sentinel lymph node biopsy (SLNB) should be performed in patients with pure ductal carcinoma in situ (DCIS) of the breast has been a question of debate over the last decade. The aim of this study was to identify factors associated with microinvasive disease and determine the criteria for performing SLNB in patients with DCIS. Materials and Methods: 125 patients with DCIS who underwent surgery between January 2000 and December 2008 were reviewed to identify factors associated with DCIS and DCIS with microinvasion (DCISM). Results: 88 patients (70.4%) had pure DCIS and 37 (29.6%) had DCISM. Among 33 DCIS patients who underwent SLNB, one patient (3.3%) was found to have isolated tumor cells in her biopsy, whereas 1 of 14 (37.8%) patients with DCISM had micrometastasis (7.1%). Similarly, of 16 patients (18.2%) with pure DCIS and axillary lymph node dissection (ALND) without SLNB, none had lymph node metastasis. Furthermore, of 20 patients with DCISM and ALND, only one (5%) had metastasis. In multivariate analysis, the presence of comedo necrosis [relative risk (RR)=4.1, 95% confidence interval (CI)=1.6-10.6, P=0.004], and hormone receptor (ER or PR) negativity (RR=4.0, 95%CI=1.5-11, P=0.007), were found to be significantly associated with microinvasion. Conclusions: Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with comedo necrosis or hormone receptor negativity are more likely to have a microinvasive component in definitive pathology following surgery, and should be considered for SLNB procedure along with patients who will undergo mastectomy due to DCIS.

Cervical lymph node metastasis form non-head & neck sites: below diaphragm (횡격막 아래 장기에서 발생한 악성 종양의 경부림프절 전이 사례 분석)

  • KIM, Jinil;SONG, Seulki;SEOK, Jungirl;LEE, Minhyung;HAN, Sung Jun;JUNG, Young Ho;AHN, Soon Hyun;JEONG, Woo-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.17-21
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    • 2018
  • Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

Epidemiological aspects of Salmonella spp infections of domestic animals in Gyeongbuk province (경북지역 가축에서 Salmonella속 균 감염증에 대한 역학적 특성)

  • Kim, Sang-Yun;Lee, Hee-Moo;Kim, Sin;Hong, Hyon-Pyo;Kwon, Heon-Il
    • Korean Journal of Veterinary Service
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    • v.24 no.1
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    • pp.51-68
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    • 2001
  • The result of studying the epidemiological characteristics of Salmonella strains which have been isolated from the domestic animals in Gyeongbuk province from February 1998 to August 2000 were summarized as follows. The isolation rates of Salmonella strains were 2.0% from cattle feces, 6.3% from cattle lymph node, 9.5% from pig feces, and 25.1% from pig lymph node. In poultry, the isolation rates were 30.3%. The isolates of Salmonella showed positive reaction for MUCAP test, methyl red test, but showed negative reaction for urea test, indole test, Voges Proskauer test. On TSI agar, the isolates showed acid butt, alkaline slant. Also, the isolates were identified as Salmonella strain by API 20E kit. Non H$_2$S Production Salmonella strains isolated from poultry were identified as S gallinarum. As a result of serotyping, B group were the most common in cattle and pig, Dl in chickens. 21 serovars were found. the common serovar from the domestic animals was S typhimurium, S derby, S agona, S schwarzenground, S enteritidis and S gallinarum. The most commonly encountered serovars in cattle were S agona and S typhirimurium in pig, S gallinarum in chicken. As a result of antimicrobial susceptibility test, all Salmonella isolates were susceptible to amikacin, ciprofloxacin, norfloxacin; cefotaxime and polumcin B. The resistance rates to tetracycline and streptomycin was 58% and 56%, respectively. 69.3% of all isolates were resistant to more than one antimicrobial agent. Out of the resistant isolates, the isolates resistant to streptomycin and tetracycline was 36%. There were 24 strains of multiresistant isolates resistant to more than 5 antimicrobial agents. S typhimurium were resistant to all antimicrobial agents, also had a lot of multiresistant strains. Therefore, S typhimurium was considered as a major agent of antimicrobial resistance.

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Morphological and Phylogenetic Characteristics of Nematophagous Fungi (식물기생성 선충 포식곰팡이의 형태 및 계통분류학적 특성)

  • Kang, Doo-Sun;Jeon, Han-Ki;Son, Hee-Seong;Whang, Kyung-Sook;Cho, Cheon-Whi
    • Applied Biological Chemistry
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    • v.50 no.2
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    • pp.101-106
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    • 2007
  • Twenty-two strains of nematophagous fungi were isolated from 100 soil samples. Nematophagous fungi were classified into three categories; 3-dimensional adhesive nets (A group), 2-dimensional adhesive nets (B group) and constricting ring (C group). Nine strains were selected and identified on the basis of morphological characteristics (hypha, conidiophore, form and size of conidia, number of conidia, node of conidophore, number and location of septa, size and color of chlamydospore) and ITS (internal transcribed spacer) region of rDNA sequences. As the results, the isolated were identified as belonging to the species of Monacrosporium thaumasium (Kan-2, Kan-4, Kan-11), Arthrobotrys oligospora (Kan-9, Kan-13, Kan-20, Kan-21), A. musiformis (Kan-12), and A. dactyloides (Kan-22).

Effects of Adenosine on the Action Potentials of Rabbit SA Nodal Cells (동방결절 활동전압에 대한 아데노신 효과)

  • Kim, Ki-Whan;Ho, Won-Kyung
    • The Korean Journal of Physiology
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    • v.18 no.1
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    • pp.19-35
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    • 1984
  • Since the first report of Drury and $Szent-Gy{\ddot{o}}rgyi$ in 1929, the inhibitory influences of adenosine on the heart have repeatedly been described by many investigators. These studies have shown that adenosine and adenine nucleotides have overall depressant effects, similar to those of acetylcholine. Heart beats become slow and weak. It is also well known that adenosine is a potent endogenous coronary vasodilator. Many investigations on the working mechanisms of adenosine have been focused mainly on the effects of the coronary blood flow. However, the cellular mechanisms underlying the inhibitory action of adenosine on sinus node are not well understood yet. Thus, this study was undertaken to examine the behavior of rabbit SA node under influence of adenosine. In these series of experiments three kinds of preparations were used: whole atrial pair, left atrial strip, and isolated SA node preparations. The electrical activity of SA node was recorded with conventional glass microelectrodes 30 to 50 $M{\Omega}$. The preparations were superfused with bicarbonate-buffered Tyrode solution of pH 7.35 and aerated with a gas mixture of $3%\;CO_2-97%\;O_2$ at $35^{\circ}C$. In whole atrial pair, adenosine suppressed sinoatrial rhythm in a dose-dependent manner. Effect of adenosine on atrial rate appeared at the concentration of $10^{-5}M$ and was enhanced in parallel with the increase in adenosine concentration. Inhibitory action of adenosine on pacemaker activity was more prominent in the preparation pretreated with norepinephrine, which can steepen the slope of pacemaker potential by increasing permeability of $Ca^{+2}$. Calcium ions in perfusate slowly produced a marked change in sinoatrial rhythm. Elevation of the calcium concentration from 0.3 to 8 mM increased the atrial rate from 132 to 174 beats/min, but over 10 mM $Ca^{+2}$ decreased. The inhibitory effect of adenosine on sinoatrial rhythm developed very rapidly. Atrial rate was recovered promptly from the adenosine-induced suppression by the addition of norepinephrine, but extra $Ca^{+2}$ was less suitable to restore the suppression of atrial rate. Adenosine suppressed also atrial contractility in the same dosage range that restricted pacemaker activity, even in the reserpinized preparation. In isolated SA node preparation, spontaneous firing rate of SA node at $35^{\circ}C$(mean{\pm}SEM, n=16) was $154{\pm}3.3\;beats/min. The parameters of action potentials were: maximum diastolic potential(MDP), $-73{\pm}1.7\;mV: overshoot(OS), $9{\pm}1.4\;mV: slope of pacemaker potential(SPP), $94{\pm}3.0\;mV/sec. Adenosine suppressed the firing rate of SA node in a dose-dependent manner. This inhibitory effect appeared at the concentration of $10^{-6}M$ and was in parallel with the increase in adenosine concentration. Changes in action potential by adenosine were dose-dependent increase of MDP and decrease of SPP until $10^{-4}M$. Above this concentration, however, the amplitude of action potential decreased markedly due to the simultaneous decrease of both MDP and OS. All these effects of adenosine were not affected by pretreatment of atropine and propranolol. Lowering extra $Ca^{2+}$ irom 2 mM to 0.3 mM resulted in a marked decrease of OS and SPP, but almost no change of MDP. However, increase of perfusate $Ca^{2+}$ from 2 mM to 6 or 8 mM produced a prominent decrease of MDP and a slight increase of OS and SPP. Dipyridamole(DPM), which is known to block the adenosine transport across the cell membrane, definately potentiated the action of adenosine. The results of this experiment suggest that adenosine suppressed pacemaker activity and atrial contractility simultaneously and directly, by decreasing $Ca^{2+}-permeability$ of nodal and atrial cell membranes.

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Characteristics of the Conditioned Medium Produced by CA-12 Lymph Node Stromal Cells

  • Lee, Sang-Han;Lee, Dong-Sun;Seu, Young-Bae;Kim, Jong-Guk;Tsuruo, Takashi;Hong, Soon-Duck
    • Journal of Microbiology and Biotechnology
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    • v.8 no.1
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    • pp.74-80
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    • 1998
  • CS-2l lymphoma cells that preferentially metastasize to lymph nodes after s.c. inoculation into BALB/c mice were grown in vitro in the presence of CA- 12 stromal cells isolated from lymph nodes. In order to obtain fundamental data on the identification and characterization of the soluble factors produced by CA-12 stromal cells, the conditioned medium of CA-12 stromal cells that inhibited apoptosis of CS-21 cells was examined. Various analytical treatments revealed that the soluble factors in CA-12 conditioned medium are very sensitive to heat treatment and trypsinization. Moreover CA-12 conditioned medium has an affinity with heparin but not with Con-A. In addition to these, the activity of CA-12 conditioned medium was blocked by H-7, a PKC inhibitor, but the conditioned medium could not induce the differentiation of thymocytes. We concluded that CA-12 conditioned medium contains stromal cell-derived apoptosis-inhibitory molecules that play an important role in proliferation of CS-2l cells by suppressing cell apoptosis.

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Endoscopic Mucosal Resection (내시경 점막 절제술)

  • Kim, Gwang Ha
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.23-28
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    • 2011
  • Diagnosis of early esophageal cancer has become more frequent as a result of improved endoscopic technology, surveillance programmes, and increasing experience and awareness on the part of endoscopists. In early esophageal cancer, squamous cell carcinoma and early adenocarcinoma must be managed differently because they have different origins, pathogenesis. and clinical characteristics. The current treatment options vary widely, from extended resection with lymphadenectomy to endoscopic mucosal resection (EMR) or ablation. None of these treatment options can be recommended universally. Instead, an individualized strategy should be based on the depth of tumor infiltration into the mucosa or submucosa, the presence or absence of lymph node metastases, the multicentricity of tumor growth, the length of the segment of intestinal metaplasia, and comorbidities of the patient. EMR has become increasingly important, both as a diagnostic tool for the staging of esophageal carcinomas and as a method of carrying out definitive treatment when the cancer meets certain criteria in which the risk of lymph-node metastasis is negligible. EMR may be sufficient in a subset of patients who have m1 or m2 squamous cell carcinoma and in patients who have isolated foci of high-grade intraepithelial neoplasia or mucosal cancer.

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Patterns of initial failure after resection for gallbladder cancer: implications for adjuvant radiotherapy

  • Kim, Tae Gyu
    • Radiation Oncology Journal
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    • v.35 no.4
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    • pp.359-367
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    • 2017
  • Purpose: This study sought to identify potential candidates for adjuvant radiotherapy and patterns of regional failure in patients who underwent curative-intent surgery for gallbladder cancer. Materials and Methods: Records for 70 patients with gallbladder cancer who underwent curative resection at a single institution between 2000 and 2016 were analysed retrospectively. No patients received adjuvant radiotherapy. Initial patterns of failure were evaluated. Regional recurrence was categorized according to the definitions of lymph node stations suggested by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Results: Median follow-up was 23 months. Locoregional recurrence as any component of first failure occurred in 29 patients (41.4%), with isolated locoregional recurrence in 13 (18.6%). Regional recurrence occurred in 23 patients, and 77 regional recurrences were identified. Commonly involved regional stations were #13, #12a2, #12p2, #12b2, #16a2, #16b1, #9, and #8. Independent prognostic factors for locoregional recurrence were ${\geq}pT2$ disease (hazard ratio [HR], 5.510; 95% confidence interval [CI], 1.260-24.094; p = 0.023) and R1 resection (HR, 6.981; 95% CI, 2.378-20.491; p < 0.001). Conclusion: Patients with pT2 disease or R1 resection after curative surgery for gallbladder cancer may benefit from adjuvant radiotherapy. Our findings on regional recurrence may help physicians construct a target volume for adjuvant radiotherapy.

Sentinel Node Biopsy Examination for Breast Cancer in a Routine Laboratory Practice: Results of a Pilot Study

  • Khoo, Joon-Joon;Ng, Chen-Siew;Sabaratnam, Subathra;Arulanantham, Sarojah
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1149-1155
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    • 2016
  • Background: Examination of sentinel lymph node (SLN) biopsies provides accurate nodal staging for breast cancer and plays a key role in patient management. Procurement of SLNs and the methods used to process specimens are equally important. Increasing the level of detail in histopathological examination of SLNs increases detection of metastatic tumours but will also increase the burden of busy laboratories and thus may not be carried out routinely. Recommendation of a reasonable standard in SLN examination is required to ensure high sensitivity of results while maintaining a manageable practice workload. Materials and Methods: Twenty-four patients with clinically node-negative breast cancer were recruited. Combined radiotracer and blue dye methods were used for identification of SLNs. The nodes were thinly sliced and embedded. Serial sectioning and immunohistochemical (IHC) staining against AE1/AE3 were performed if initial H&E sections of the blocks were negative. Results: SLNs were successfully identified in all patients. Ten cases had nodal metastases with 7 detected in SLNs and 3 detected only in axillary nodes (false negative rate, FNR=30%). Some 5 out of 7 metastatic lesions in the SLNs (71.4%) were detected in initial sections of the thinly sliced tissue. Serial sectioning detected the remaining two cases with either micrometastases or isolated tumour cells (ITC). Conclusions: Thin slicing of tissue to 3-5mm thickness and serial sectioning improved the detection of micro and macro-metastases but the additional burden of serial sectioning gave low yield of micrometastases or ITC and may not be cost effective. IHC validation did not further increase sensitivity of detection. Therefore its use should only be limited to confirmation of suspicious lesions. False negative cases where SLNs were not involved could be due to skipped metastases to non-sentinel nodes or poor technique during procurement, resulting in missed detection of actual SLNs.

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis in a Lymph Node - A Case Report - (림프절에 발생한 랑게르한스 세포 조직구증의 세침흡인 세포소견 -1예 보고-)

  • Kim, Min-Jung;Kim, Gou-Young;Cho, Hyun-Yee;Chung, Dong-Hae;Kim, Na-Rae;Ha, Seung-Yeon
    • The Korean Journal of Cytopathology
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    • v.18 no.1
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    • pp.87-91
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    • 2007
  • Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.