• Title/Summary/Keyword: LNS

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Preoperative Nodal 18F-FDG Avidity Rather than Primary Tumor Avidity Determines the Prognosis of Patients with Advanced Gastric Cancer

  • Kwon, Hyun Woo;An, Liang;Kwon, Hye Ryeong;Park, Sungsoo;Kim, Sungeun
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.218-229
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    • 2018
  • Purpose: This study investigated whether the metabolic avidity of primary tumors and/or metastatic lymph nodes (LNs) measured by $^{18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative $^{18}F-FDG$ PET/CT and curative resection were included. The $^{18}F-FDG$ avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of $^{18}F-FDG$ PET/CT was calculated, and the prognostic significance of $^{18}F-FDG$ avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3-81 months); 119 (70.8%) and 33 (19.6%) patients showed $^{18}F-FDG$-avid primary tumors and LNs, respectively. $^{18}F-FDG$ PET/CT showed high sensitivity (73.8%) for the detection of advanced pathologic T ($pT{\geq}3$) stage and high specificity (92.2%) for the detection of advanced pN (${\geq}2$) stage. $^{18}F-FDG$ avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that $^{18}F-FDG$ avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: $^{18}F-FDG$ avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative $^{18}F-FDG$ PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

Prophylactic Level VII Nodal Dissection as a Prognostic Factor in Papillary Thyroid Carcinoma: a Pilot Study of 27 Patients

  • Fayek, Ihab Samy
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4211-4214
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    • 2015
  • Background: Prognostic value of prophylactic level VII nodal dissection in papillary thyroid carcinoma has been highlighted. Materials and Methods: A total of 27 patients with papillary thyroid carcinoma with N0 neck underwent total thyroidectomy with level VI and VII nodal dissection through same collar neck incision. Multicentricity, bilaterality, extrathyroidal extension, level VI and VII lymph nodes were studied as separate and independent prognostic factors for DFS at 24 months. Results: 21 females and 6 males with a mean age of 34.6 years old, tumor size was 5-24 mm. (mean 12.4 mm.), multicentricity in 11 patients 2-4 foci (mean 2.7), bilaterality in 8 patients and extrathyroidal extension in 8 patients. Dissected level VI LNs 2-8 (mean 5 LNs) and level VII LNs 1-4 (mean 1.9). Metastatic level VI LNs 0-3 (mean 1) and level VII LNs 0-2 (mean 0.5). Follow-up from 6-51 months (mean 25.6) with 7 patients showed recurrence (3 local and 4 distant). Cumulative DFS at 24 months was 87.8% and was significantly affected in relation to bilaterality (p-value <0.001), extrathyroidal extension (p-value <0.001), level VI positive ((p-value <0.001) and level VII positive ((p-value <0.001) LNs. No recurrences were detected during the follow-up period in the absence of level VI and level VII nodal involvement. Conclusions: Level VII prophylactic nodal dissection is an important and integral prognostic factor in papillary thyroid carcinoma. A larger multicenter study is crucial to reach a satisfactory conclusion about the necessity and safety of this approach.

Validation of CT-Based Risk Stratification System for Lymph Node Metastasis in Patients With Thyroid Cancer

  • Yun Hwa Roh;Sae Rom Chung;Jung Hwan Baek;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.24 no.10
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    • pp.1028-1037
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    • 2023
  • Objective: To evaluate the computed tomography (CT) features for diagnosing metastatic cervical lymph nodes (LNs) in patients with differentiated thyroid cancer (DTC) and validate the CT-based risk stratification system suggested by the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) guidelines. Materials and Methods: A total of 463 LNs from 399 patients with DTC who underwent preoperative CT staging and ultrasound-guided fine-needle aspiration were included. The following CT features for each LN were evaluated: absence of hilum, cystic changes, calcification, strong enhancement, and heterogeneous enhancement. Multivariable logistic regression analysis was performed to identify independent CT features associated with metastatic LNs, and their diagnostic performances were evaluated. LNs were classified into probably benign, indeterminate, and suspicious categories according to the K-TIRADS and the modified LN classification proposed in our study. The diagnostic performance of both classification systems was compared using the exact McNemar and Kosinski tests. Results: The absence of hilum (odds ratio [OR], 4.859; 95% confidence interval [CI], 1.593-14.823; P = 0.005), strong enhancement (OR, 28.755; 95% CI, 12.719-65.007; P < 0.001), and cystic changes (OR, 46.157; 95% CI, 5.07-420.234; P = 0.001) were independently associated with metastatic LNs. All LNs showing calcification were diagnosed as metastases. Heterogeneous enhancement did not show a significant independent association with metastatic LNs. Strong enhancement, calcification, and cystic changes showed moderate to high specificity (70.1%-100%) and positive predictive value (PPV) (91.8%-100%). The absence of the hilum showed high sensitivity (97.8%) but low specificity (34.0%). The modified LN classification, which excluded heterogeneous enhancement from the K-TIRADS, demonstrated higher specificity (70.1% vs. 62.9%, P = 0.016) and PPV (92.5% vs. 90.9%, P = 0.011) than the K-TIRADS. Conclusion: Excluding heterogeneous enhancement as a suspicious feature resulted in a higher specificity and PPV for diagnosing metastatic LNs than the K-TIRADS. Our research results may provide a basis for revising the LN classification in future guidelines.

Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer

  • Kim, Wan Wook;Lee, Jeeyeon;Jung, Jin Hyang;Park, Ho Yong;Kim, Won Hwa;Kim, Hye Jung;Park, Ji-Young;Tufano, Ralph P.
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.302-307
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    • 2020
  • Background: This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon's palpation in papillary thyroid cancer. Methods: This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness. Results: Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively. Conclusion: Determination of central LN metastasis by a surgeon's palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

An LNS-based Low-power/Small-area FFT Processor for OFDM Systems (OFDM 시스템용 로그 수체계 기반의 저전력/저면적 FFT 프로세서)

  • Park, Sang-Deok;Shin, Kyung-Wook
    • Journal of the Institute of Electronics Engineers of Korea SD
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    • v.46 no.8
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    • pp.53-60
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    • 2009
  • A low-power/small-area 128-point FFT processor is designed, which is based on logarithmic number system (LNS) and some design techniques to minimize both hardware complexity and arithmetic error. The complex-number multiplications and additions/subtractions for FFT computation are implemented with LNS adders and look-up table (LUT) rather than using conventional two's complement multipliers and adders. Our design reduces the gate counts by 21% and the memory size by 16% when compared to the conventional two's complement implementation. Also, the estimated power consumption is reduced by about 18%. The LNS-based FFT processor synthesized with 0.35 ${\mu}m$ CMOS standard cell library has 39,910 gates and 2,880 bits memory. It can compute a 128-point FIT in 2.13 ${\mu}s$ with 60 MHz@2.5V, and has the average SQNR of 40.7 dB.

Engineering Properties of Cement Mortar Using Organic Fiber Rehabilitation Materials (유기질 섬유보강재를 사용한 시멘트 모르터의 공학적 특성)

  • Shin Hyun-Sup;Park Yong-Kyu;Kim Kyoung-Min;Lee Gun-Cheol;Hwang In-Sung;Han Cheon-Goo
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2005.11a
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    • pp.39-42
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    • 2005
  • This study investigates influence of organic fiber reinforced materials, affecting crack reduction of cement mortar using low grade natural sand(LNS). According to the test, for the properties of fresh mortar, the mortar using natural sand(NS) exhibited that flow value increased until adding most of fiber less than 1$\%$, except for Polyvinly alchol fiber(PVA), and then it decreased. Meanwhile, the mortar mixed with LNS showed that increase of fiber content decrease flow value, regardless of fiber type. Air content increased in the mortar adding nylon fiber(NY) and polypropylene fiber(PP), while it maintained or decreased in the mortar adding cellulose fiber(CL) and PVA. Compressive strength of the mortar does not affect during early age, but mortar using NS and adding 0.1$\%$ of fiber content increased the value, except for PP, at 28 age days, while the mortar mixed with LNS decreased. For the properties of tensile strength, mortar, using NS and adding individually PP and PVA, exhibited higher value. Especially 0.1$\%$ of NY provided the highest value. In addition, the mortar mixed with LNS resulted in improved tensile value as fiber content increased. It is demonstrated that mortar using LNS led to higher length change ratio than natural sand.

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Clinico-pathologic Factors and Machine Learning Algorithm for Survival Prediction in Parotid Gland Cancer (귀밑샘 암종에서 생존 예측을 위한 임상병리 인자 분석 및 머신러닝 모델의 구축)

  • Kwak, Seung Min;Kim, Se-Heon;Choi, Eun Chang;Lim, Jae-Yol;Koh, Yoon Woo;Park, Young Min
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.17-24
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    • 2022
  • Background/Objectives: This study analyzed the prognostic significance of clinico-pathologic factors including comprehensive nodal factors in parotid gland cancers (PGCs) patients and constructed a survival prediction model for PGCs patients using machine learning techniques. Materials & Methods: A total of 131 PGCs patients were enrolled in the study. Results: There were 19 cases (14.5%) of lymph nodes (LNs) at the lower neck level and 43 cases (32.8%) involved multiple level LNs metastases. There were 2 cases (1.5%) of metastases to the contralateral LNs. Intraparotid LNs metastasis was observed in 6 cases (4.6%) and extranodal extension (ENE) findings were observed in 35 cases (26.7%). Lymphovascular invasion (LVI) and perineural invasion findings were observed in 42 cases (32.1%) and 49 cases (37.4%), respectively. Machine learning prediction models were constructed using clinico-pathologic factors including comprehensive nodal factors and Decision Tree and Stacking model showed the highest accuracy at 74% and 70% for predicting patient's survival. Conclusion: Lower level LNs metastasis and LNR have important prognostic significance for predicting disease recurrence and survival in PGCs patients. These two factors were used as important features for constructing machine learning prediction model. Our machine learning model could predict PGCs patient's survival with a considerable level of accuracy.

Lesch-Nyhan syndrome: a case report

  • Han Ick Park;Gu-Hwan Kim;Kang-Min Ahn
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.4
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    • pp.228-232
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    • 2023
  • Lesch-Nyhan syndrome (LNS) is a rare X-linked recessive disorder caused by a mutation in the hypoxanthine phosphoribosyltransferase 1 (HPRT1) gene. This syndrome is characterized by excessive production of uric acid, mental retardation, self-mutilation, choreoathetosis, and spasticity. The most distinctive symptom is compulsive self-mutilation. For patients with LNS, different methods have been tried to reduce self-biting behaviors including restraints, behavioral treatment, medications, deep brain stimulation, tooth extraction and botulinum toxin A injection. In this report, we present a case of LNS undergoing cheiloplasty due to self-mutilation and tooth extraction of the left deciduous maxillary canine.

Safety and Prognostic Impact of Prophylactic Level VII Lymph Node Dissection for Papillary Thyroid Carcinoma

  • Fayek, Ihab Samy;Kamel, Ahmed Ahmed;Sidhom, Nevine FH
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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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.

Discrimination of Cucumber mosaic virus and Broad bean wilt virus 2 Using Local Lesions on Vigna sinensis (동부(Vigna sinensis)의 국부병반을 이용한 Cucumber mosaic virus와 Broad bean wilt virus 2의 구별)

  • Bae, Sun-Hwa;Kim, Mi-Soon;Jung, Min-Young;Kwon, Soon-Bae;Ryu, Ki-Hyun;Kim, Kook-Hyung;Choi, Jang-Kyung
    • Research in Plant Disease
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    • v.12 no.3
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    • pp.221-225
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    • 2006
  • Cucumber mosaic virus(CMV) and Broad bean wilt virus 2(BBWV2) were isolated from Gentiana scabra plants showing typical mosaic and yellowing symptoms. When the inoculum of mosaic symptom propagated in Nicotiana benthamiana was inoculated to primary leaves of Vigna sinensis, the local lesions of different types was developed. Type one produced a small necrotic spot(SNS) of pinpoint type, while the other one showed a large necrotic spot(LNS) of halo type. LNS on primary leaves of V. sinensis was also induced by inoculum from yellowing symptom on G scabra. Single lesion from SNS induced a typical mosaic symptom on N. Benthamiana. On the other hand, LNS produced a chlorotic ring symptom on inoculated leaves and mosaic plus necrotic ringspot on upper leaves of N. benthamiana. An isolate of CMV from SNS and BBWV2 from LNS were detected by using dsRNA analysis, RT-PCR and agar gel double-diffusion test. Thus, our results should provide a tool of a simple method for discrimination from mixed infected plants by CMV and BBWV2.