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Use of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Patients with Axillary Node-Positive Breast Cancer in Diagnosis

  • Choi, Hee Jun;Kim, Isaac;Alsharif, Emad;Park, Sungmin;Kim, Jae-Myung;Ryu, Jai Min;Nam, Seok Jin;Kim, Seok Won;Yu, Jonghan;Lee, Se Kyung;Lee, Jeong Eon
    • Journal of Breast Cancer
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    • v.21 no.4
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    • pp.433-4341
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    • 2018
  • Purpose: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. Methods: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND. Results: The median follow-up time was 51 months (range, 3-122 months) and the median number of retrieved SLNs was 5 (range, 2-9). The SLN identification rate was 98.3% (234/238 patients), and the false negative rate of SLNB after NAC was 7.5%. There was no significant difference in axillary recurrence-free survival (p=0.118), disease-free survival (DFS; p=0.578) or overall survival (OS; p=0.149) among groups A, B, and C. In the subgroup analysis of breast pathologic complete response (pCR) status, there was no significant difference in DFS (p=0.271, p=0.892) or OS (p=0.207, p=0.300) in the breast pCR and non-pCR patients. Conclusion: These results suggest that SLNB can be feasible and oncologically safe after NAC for cytology-determined axillary node metastasis patients and could help reduce arm morbidity and lymphedema by avoiding ALND in SLN-negative patients.

Mixture Bombyx mori L. and Liriopis seu Ophiopogonis Tuber effects on T cells in Thymus, Lymph Nodes (누에, 맥문동복합물의 흉선 림프절내 T세포 활성 유도 효능 연구)

  • Kim, Il Gyu;Park, Hae-Jin;Kim, Kyeong Jo;Kim, Soo Hyun;Kim, Min Ju;Lee, Jin A;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.33 no.5
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    • pp.47-52
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    • 2018
  • Objectives : The purpose of this study is to investigate effects on the immune system of Bombyx mori L. and Liriopis seu Ophiopogonis Tuber mixture (BL) in Thymus, Lymph Nodes. Methods : Eight-week-old male Balb/c mice were divided into five groups : Group one included the normal mice (Nor). Positive control group two administrated with red ginseng (RG) 100 mg/kg. Group three administrated with Bombyx mori L. (BX) 300 mg/kg. Group four administrated with Liriopis seu Ophiopogonis Tuber (LP) 300 mg/kg. Group five administrated with the mixture of Bombyx mori L. and Liriopis seu Ophiopogonis Tuber (BL) 300 mg/kg. After 2 weeks administration, mice were sacrified and antigen receptor in Thymus, Lymph Nodes was analyzed by using Fluorescence Activated Cellorter Sorting (FACS). we counted the total of Thymus and Lymph Nodes cells. GOT (glutamlc oxaloacetic transaminase), GPT (glutamlc pyruvic transamlnase) in serum were analyzed after experiment. Results : In Effects of Nor, RG, BX, LP, BL on the ratio of CD4+CD8+, CD4+CD69+ and CD4+CD25+ T cell in Thymus and Lymphnode, BL is higher than other groups except Nor in CD4+, CD4+CD69+, CD4+CD25+ T cell. The number of Thymus and Lymph Nodes increased in BL. In the level of GOT and GPT, BL decreased comparing to others group except Nor. Conclusions : BL may have effect on T cells in Thymus, Lymph Nodes. In addition, Bombyx mori could be immune functional material with others herb materials.

Long-term Outcome after Minimally Invasive Treatment for Early Gastric Cancer beyond the Indication of Endoscopic Submucosal Dissection (내시경점막하박리술의 적응증을 넘어선 조기위암의 미세침습 치료 후 장기 추적 결과)

  • Weon Jin Ko;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.44-49
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    • 2017
  • Background: Recently, endoscopic submucosal dissection (ESD) with laparoscopic sentinel lymph node dissection, named ESN or endoscopic full-thickness gastric resection with laparoscopic sentinel lymph node dissection, named Hybrid-natural orifice transluminal endoscopic surgery (NOTES) was suggested the possibility of minimally invasive treatment for patients with early gastric cancer (EGC) who were beyond the indication of ESD. This study aimed to evaluate the outcomes of ESN or Hybrid-NOTES. Methods: We retrospectively analyzed patients treated with these therapies from January 2009 to May 2013 in terms of short- and long-term outcomes. Each patient was diagnosed with EGC but was not included in ESD indications and had the high risk of lymph node metastasis (LNM). Results: A total of 42 patients with EGC treated by ESN or Hybrid-NOTES. Of the 21 patients who underwent ESN, a total of 4 patients underwent additional gastrectomy, 1 with LNM, 1 with surgical complication, and 2 with noncurative resection. Of the 21 patients who underwent Hybrid-NOTES, a total of 5 patients underwent additional surgery, 1 with LNM, 2 with surgical complication, and 2 with noncurative resection. Overall survival was 100% over a mean follow-up of 75 months, but 3 patients underwent ESD or gastrectomy with metachronous lesion. And 1 patient who had received ESN was found to have a metastatic lymph node and undergo palliative chemotherapy. Conclusion: ESN or Hybrid-NOTES showed favorable short-and long-term outcomes. These methods may be utilized as a bridge between ESD and gastrectomy in the case of EGC which is more likely to have LNM beyond the ESD indications.

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Clinical Analysis of Esophageal Cancer Patient (식도암의 임상적 고찰)

  • 임창영
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.856-862
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    • 1988
  • The survival rate after resectional operation for carcinoma of the esophagus is still very low and many factors contribute to these poor results. We analyze the clinical results of 56 operated patients among 62 esophageal cancer patients between March, 1974 and July, 1988. Among the 62 patients, 52 patients were squamous cell carcinoma and 8 were adenocarcinoma, one was leiomyosarcoma and one was adenosquamous cell carcinoma. The classification of esophageal cancer was based on TNM classification of American Joint Committee on cancer". Among the operated patients, stage I was 5[9.6%], stage II was 13[25%], stage III was 26[50%], stage IV was 8[15.4%]. And its one year survival rate was 80%, 69%, 11.5%, 0% for each stages. The rate of resectability was 30.3% and resection of esophagus with esophagogastrostomy and extended lymph node dissection was performed on 17 patients without distant metastasis or adjacent organ invasion. Substernal esophago-colono-gastrostomy, Celestine tube insertion and feeding gastrostomy was performed on remained 39 patients. The analysis of postoperative survival duration revealed the superiority of esophagectomy with extended lymph node dissection over other palliative operation. [1 year survival rate: 79% versus 21%] We concluded that the survival rate of esophageal resection with lymph node dissection group was superior to nonresective palliative operation group. And transthoracic approach was superior to extrathoracic approach in involved lymph node dissection and esophageal resection in locally invaded cases.ases.

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A Case Report of Pancreatic Cancer Treated With Lymph Node Metastasis (림프절 전이를 동반한 췌장암환자 1례에 대한 보고)

  • Bang, Sun-Hwi;Lee, Jong-Hoon;Cho, Jung-Hyo;Lee, Yeon-Weol;Son, Chang-Gue;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.948-955
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    • 2007
  • Objectives : We present a case of pancreatic carcinoma patient with lymph node metastasis. Methods : We analyzed the medical record of a pancreatic carcinoma patient with lymph node metastasis who had been treated with traditional Korean medicine from 2006 until 2007. He complained of abdominal pain, dyspepsia and anorexia. We prescribed him HAD, PSM, BKH and other oriental medicines. Results : For 18 months he was treated with oriental medicine. Over this time, the pancreatic tumor remains stable disease (SD) and most symptoms have disappeared. Cconclusions : When it comes to the therapeutic effects, it could be suggested that oriental medicine has effects on keeping SD and improving symptoms.

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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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Primary Pulmonary Amyloidosis with Mediastinal Lymphadenopathy

  • Kim, Dohun;Lee, Yong-Moon;Kim, Si-Wook;Kim, Jong-Won;Hong, Jong-Myeon
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.218-220
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    • 2016
  • We report a case of inadvertent hoarseness after surgery for primary pulmonary amyloidosis. A 55-year-old male was transferred to our facility due to a lung mass. Chest computed tomography revealed a solitary pulmonary nodule. Positron emission tomography-computed tomography showed fluorodeoxyglucose uptake in the main mass and in the mediastinal lymph nodes. To confirm the pathology of the mass, wedge resection and thorough lymph node dissection were performed via video-assisted thoracic surgery (VATS). No complications except for hoarseness were observed; hoarseness developed soon after surgery and lasted for 3 months. The main mass was diagnosed as amyloidosis, but this was not found in the lymph nodes. In conclusion, VATS wedge resection for peripheral amyloidosis is a feasible and safe procedure. However, mediastinal lymph node dissection is not recommended unless there is evidence of a clear benefit.

THE IMPORTANCE OF THE PROPHYLACTIC NECK DISSECTION IN THE EARLY-STAGE TONGUE CANCER (초기설암치료시 예방적 경부곽청술의 의의)

  • Hong, Chang-Soo;Kim, Chin-Soo;Jang, Hyun-Joong;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.73-81
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    • 1995
  • The poor survival rates of patients with carcinoma of a tongue, despite of modern therapy, is well recognized. One of the most important prognostic factors is status of the cervical lymph nodes. There have been a long-standing debate about the treatment of cervical lymph nodes in early-stage tongue cancer. There are two major treatment opinion. The one is surgical excision of primary tumor with prophylactic neck dissection, simultaneously, and the other is to delay the cervical therapy until cervical lymph node is palpable. Recently we have experienced the early cervical metastasis in three patients who had been diagnosed as a carcinoma of the tongue. They were T1, T2 lesion and no palpable node was found. But histopathologic examination showed the occult metastasis or delayed cervical metastasis was occured. By the review of literature and clinical experience, we could conclude the prophylactic neck dissection offers a better chance for success than therapeutic neck dissection of palpable lymph nodes, in case of oral tongue cancer.

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A Case of Pulmonary Cryptococcosis in an Immunocompetent Male Patient Diagnosed by a Percutaneous Supraclavicular Lymph Node Biopsy

  • Sung, Ji Hee;Kim, Do Hoon;Oh, Mi-Jung;Lee, Kyoung Ju;Bae, Young A;Kwon, Kye Won;Lee, Seung Min;Kang, Ho Joon;Choi, Jinyoung
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.276-280
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    • 2015
  • Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.

Fine Needle Aspiration Cytology of Langerhans Cell Histiocytosis (Langerhans세포 조직구증의 세침흡인 세포학적 소견 - 1 예 보고 -)

  • Kwak, Jeong-Ja;Jin, So-Young;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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    • pp.140-145
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    • 1993
  • Langerhans cell histiocytosis or histiocytosis X is a disease of unknown etiology characterized by proliferation of mature histiocytes. While a few descriptions of the cytologic features of eosinophilic granuloma ocurring in the bone have been published, reports of cytologic findings of lymph node-based Langerhans cell histiocytosis are very rare. We report the cytologic findings of a case of Langerhans cell histiocytosis diagnosed by fine needle aspiration cytology from the left supraclavicular and right inguinal lymph nodes in a 65-year-old male. Cytologic smears showed characteristic reticuloendothelial cells which have elongated, folded, grooved nuclei and abundant pale cytoplasms. Particularly, nuclei were highly irregular and multilobated. A few mitotic figures were present. The cytologic diagnosis was confirmed by tissue biopsies from the left supraclavicular and right inguinal lymph nodes. Proliferation of histiocytes were also present in the skin. Immunohistochemistry for S-100 protein, vimentin, $\alpha1-antichymotrypsin$ and lysozyme showed positive staining. Electron microscopy disclosed Birbeck granules.

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