• 대한두경부종양학회지
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• 제18권2호
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• pp.157-162
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• 2002

Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

• 대한수의학회지
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• 제47권3호
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• pp.315-319
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• 2007

Fibrinopurulent peritonitis and abdominal abscesses associated with Streptococcus (S.) equi subsp. zooepidemicus is reported in a 1-year-old female thoroughbred horse. The horse died after showing 5-day history of the cold, severe abdominal distention, abdominal breathing, hyperthermia, anorexia, and loss of intestinal sound. At necropsy, several liters of turbid yellowish green fluid were seen in the abdominal cavity. Yellowish creamy and fibrinous or bloody materials were presented on the serosa of various abdominal organs that were intensively adhered with each other. Spleen and mesenteric lymph node were remarkably enlarged. Affected lobes of the lung showed severe congestion, hemorrhage and doughy consistency. Histologically, the lung showed hemorrhagic pneumonia with diffuse congestion and edema. Severe diffuse fibrinopurulent peritonitis with Gram-positive bacterial cocci and adjacent fibrosis were showed in the serosa of various abdominal organs such as liver, spleen, stomach, and intestine. And multifocal abscess pouches were presented in the granulation tissue of abdominal viscera. S. equi subsp. zooepidemicus was isolated from the peritoneal swab, abdominal organs, and lung. Hematogenous dissemination of bacteria from hemorrhagic pneumonia is proposed as the route of infection in this case.

• 대한핵의학회지
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• 제35권3호
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• pp.117-124
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• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• 대한한방소아과학회지
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• 제22권3호
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• pp.105-137
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• 2008

Objectives : The purpose of this study is to investigate the effect of Gupoongjeseuptang (GPJST) on atopic dermatitis by in vivo experiment using NC/Nga atopic dermatitis mouse, which has histological and clinical similarities to the atopic dermatitis of human. Methods : To investigate the effect of GPJST on atopic dermatifis, we evaluated atopic dermatitis-like skin lesions by clinical skin index and analyzed immunological parameters in peripheral blood mononuclear cells (PBMCs), splenocytes, draining lymph node (DLN) and performed skin histology in ears and dorsal skin of atopic dermatitis-like skin NC/Nga mouse in vivo. Results : In vivo, clinical skin severity score were significantly lower in GPJST group than control group. IgE, IL-6, $TNF-{\alpha}$, IgG1, IgM, IgG2a and IgG2b levels in serum decreased remarkably in GPJST group than control group. Also, total absolute number of $CD3^+CD69^+$, and $CCR3^+$ cells recovered as normal in PBMCs and $CD3^+$, $CD3^+CD69^+$ decreased significantly compared with control group in isolated DLN from NC/Nga mouse and total absolute number of $CD11b^+Gr-1^+$, $CCR3^+CD3^+$ in dorsal skin of NC/Nga mouse decreased by GPJST. We analyzed ear and neck-back skin after biopsy and dyeing by hematoxyline/eosin (H&E) and toluidine staining (mast cells marker) and obtained results that GPJST are very effective to histological symptoms (dermal and epidermal thickening, hyperkeratosis and inflammatory cell (CD4, $CCR3^+$) infiltration). Conclusions : This study demonstrates immunological activity of GPJST on atopic dermatitis-like model mice.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1725-1730
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• 2014

Management of patients with stage II colorectal carcinomas remains challenging as 20 - 30% of them will develop recurrence. It is postulated that these patients may harbour nodal micrometastases which are imperceptible by routine histopathological evaluation. The aims of our study were to evaluate (1) the feasibility of multilevel sectioning method utilizing haematoxylin and eosin stain and immunohistochemistry technique with cytokeratin AE1/AE3, in detecting micrometastases in histologically-negative lymph nodes, and (2) correlation between nodal micrometastases with clinicopathological parameters. Sixty two stage I and II cases with a total of 635 lymph nodes were reviewed. Five-level haematoxylin and eosin staining and one-level cytokeratin AE1/AE3 immunostaining were performed on all lymph nodes retrieved. The findings were correlated with clinicopathological parameters. Two (3.2%) lymph nodes in two patients (one in each) were found to harbour micrometastases detected by both methods. With cytokeratin AE1/AE3, we successfully identified four (6.5%) patients with isolated tumour cells, but none through the multilevel sectioning method. Nodal micrometastases detected by both multilevel sectioning and immunohistochemistry methods were not associated with larger tumour size, higher depth of invasion, poorer tumour grade, disease recurrence or distant metastasis. We conclude that there is no difference between the two methods in detecting nodal micrometastases. Therefore it is opined that multilevel sectioning is a feasible and yet inexpensive method that may be incorporated into routine practice to detect nodal micrometastases in centres with limited resources.

• Earthquakes and Structures
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• 제9권3호
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• pp.603-623
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• 2015

The scale and nature of the recent earthquakes in the world and the related earthquake disaster index coerce the concerned community to become anxious about it. Therefore, it is crucial that seismic lateral load effect will be appropriately considered in structural design. Application of seismic isolation system stands as a consistent alternative against this hazard. The objective of the study is to evaluate the structural and economic feasibility of reinforced concrete (RC) buildings with base isolation located in medium risk seismic region. Linear and nonlinear dynamic analyses as well as linear static analysis under site-specific bi-directional seismic excitation have been carried out for both fixed based (FB) and base isolated (BI) buildings in the present study. The superstructure and base of buildings are modeled in a 3D finite element model by consistent mass approach having six degrees of freedom at each node. The floor slabs are simulated as rigid diaphragms. Lead rubber bearing (LRB) and High damping rubber bearing (HDRB) are used as isolation device. Change of structural behaviors and savings in construction costing are evaluated. The study shows that for low to medium rise buildings, isolators can reduce muscular amount of base shears, base moments and floor accelerations for building at soft to medium stiff soil. Allowable higher horizontal displacement induces structural flexibility. Though incorporating isolator increases the outlay, overall structural cost may be reduced. The application of base isolation system confirms a potential to be used as a viable solution in economic building design.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2008년도 춘계 종합학술대회 논문집
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• pp.771-775
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• 2008

상수관망의 유지보수와 파괴부분의 수리를 위해서 상수관망의 일부분을 차폐할 경우가 자주 발생한다. 상수관망의 노후화로 인하여 이와 같은 부분차폐의 필요성은 증대되고 있다. 상수관망의 부분적인 차폐는 설치된 제수밸브를 닫아야 한다. 그러나 상수관망에 설치된 제수밸브의 위치와 갯수를 미리 파악하여 대처하는 것이 추가적인 피해를 방지하는데 필수적이다. 본 연구에서는 차폐하고자하는 상수관망의 위치에 따라서 필요한 제수밸브를 결정하기 위하여 세가지 matrix에 기반을 둔 알고리즘을 개발하였다. 세가지 matrix는 상수관망의 network topology를 반영하는 node-arc matrix, 제수밸브의 위치정보를 담고 있는 valve location matrix, 그리고 제수밸브가 설치되지 않은 위치정보를 담고 있는 valve deficiency matrix로 구성된다. 개발된 제수밸브 결정 알고리즘을 캐나다 오타와시의 상수관망에 적용하여 이의 적용성과 효율성을 검증하였다.

• Journal of Chest Surgery
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• 제54권5호
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• pp.361-368
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• 2021

Background: In general, a 2-cm surgical margin is recommended for limited resection to obtain equivalent oncologic outcomes to lobectomy for lung cancer. This study aimed to examine the patterns of recurrence and prognostic factors for recurrence in patients with a close parenchymal resection margin. Methods: From January 2009 to April 2017, 156 patients with stage I lung cancer who underwent segmentectomy with a close resection margin (<2 cm) were enrolled. Recurrence-free survival and overall survival were assessed. In addition, predisposing factors for recurrence were evaluated. Results: The mean tumor size was 1.7±0.8 cm and the parenchymal resection margin was 1.1±0.6 cm. Recurrence developed in 17 (10.7%) of the 156 patients, and the 5-year recurrence-free survival rate was 88.9%. Distant metastasis (7.7%) was the predominant recurrence pattern. The isolated local recurrence rate was 1.9%. Multivariate Cox regression analysis revealed that age, tumor size, mediastinal lymph node dissection, postoperative complications, and histologic type were significant predisposing factors for recurrence. However, parenchymal margin distance did not significantly affect the long-term prognosis. Conclusion: Segmentectomy with a close resection margin for early-stage lung cancer in selected patients resulted in acceptable recurrence and survival. However, patients with tumors larger than 2 cm, squamous cell carcinoma histology, and insufficient mediastinal evaluation should be carefully followed up for recurrence.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.180-188
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• 2023

Backgrounds/Aims: The present study looked at the role of radical surgery in gallbladder cancers (GBC) with limited metastatic disease. Methods: The retrospective observational study was conducted to screen the database from 1st January 2010 to 31st December 2019. Patients of GBC found to have low-volume metastatic disease upon surgical exploration were included. Results: Of the 1,040 patients operated for GBC, 234 patients had low-volume metastatic disease (microscopic disease in station 16b1 node or N2 disease isolated port-site metastases, or low burden peritoneal disease with deposits less than 1 cm, in adjacent omentum or adjacent diaphragm or Morrison's pouch or a solitary discontinuous liver metastasis in adjacent liver parenchyma) detected intraoperative. Of these, 62 patients underwent radical surgery for R-0 metastatic disease followed by systemic therapy, while the remaining 172 patients did not undergo radical surgery and were given palliative systemic chemotherapy. Patients who underwent radical surgery had significantly superior overall survival (19 months versus 12 months, p < 0.01) and superior progression-free survival (10 months versus 5 months, p < 0.01) when compared to the rest. This difference in survival was more significant amongst patients when operated on after neoadjuvant chemotherapy. Regression analysis showed that a sub-group of patients with incidental GBC with limited metastases showed more favorable outcomes with radical surgery. Conclusions: Authors suggest a possible role for radical treatment of advanced GBC with a limited metastatic burden. Neoadjuvant chemotherapy can be used for preferentially selecting patients of favorable disease biology for curative treatment.

• 한국간담췌외과학회지
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• 제26권2호
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• pp.138-143
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• 2022

Backgrounds/Aims: Pancreaticoduodenectomy (PD) is a standard surgical procedure for patients with periampullary cancer. During the follow-up period after PD, recurrence can be observed in various places with different prognosis. The aim of this study was to clarify the pattern of recurrence and factors affecting the survival of patients with periampullary cancer. Methods: Overall, 88 patients who received PD for distal common bile duct cancer or ampulla of Vater cancer were finally included and their clinical characteristics were analyzed. Patients were divided into three groups: recurrence-free (RF) group, an isolated locoregional recurrence (LR) group, and a distant metastasis (DM) group. Prognostic factors affecting recurrence in each group were analyzed and a survival analysis was performed. Results: Perineural invasion (PNI), T stage, and lymphovascular invasion (LVI) were significant risk factors for LR and PNI, lymph node metastasis, LVI, and T stage were associated with DM group compared to RF group in univariate analysis, respectively. N stage and PNI were significant risk factors (p = 0.046, p = 0.041) in overall survival of the LR and the DM groups. There was no significant difference in 5-year overall survival between the LR and DM groups. Conclusions: T stage was a significant risk factor of LR, while PNI was a significant risk factor of DM. There was no significant difference in overall survival depending on the site of recurrence.