• Journal of Chest Surgery
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• 제39권6호
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• pp.470-474
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• 2006

배경: 종격동 림프절 전이 여부는 비소세포폐암의 병기 결정과 예후에 중요한 인자이며, 정확한 진단이 치료 방법결정에 필수적이다. 종격동경검사는 조직병리학적으로 종격동 림프절 전이 여부를 진단할 수 있는 방법으로, 그 유용성에 대해 알아보고자 하였다. 대상 및 방법: 1999년 6월부터 2005년 8월까지 비소세포폐암으로 진단 받고 종격동경검사를 시행하였던 환자 348명을 대상으로 환자의 특성, 방사선학적 검사 결과, 종격동경검사 결과 및 최종 병리학적 병기 등을 후향적으로 조사하여 종격동경검사의 안전성과 유용성을 평가하였다. 결과: 연구대상 환자 348명 중 남자가 263명 여자가 85명이었고 평균 연령은 $62.1{\pm}8.5$세이었다. 203명은 방사선검사에서 종격동 림프절 전이가 없는 것으로 진단되었고 145명에서는 전이가 있는 것으로 진단되었다. 종격동경검사에 걸린 시간은 평균 $55.5{\pm}16.5$분이었고, 평균 $2.2{\pm}1.0$개의 림프절군에서 생검을 하였다. 검사 중 5예(1.7%)의 일시적인 합병증이 발생하였으나, 그 외의 합병증이나 사망은 없었다. 종격동경검사의 위음성률은 7.8%였다. 종격 동경검사는 민감도(77.5% vs 71.9%, p=0.012), 특이도(100% vs 74.4%, p=0.00) 및 정확도(92.2% vs 73.6%, p=0.00) 등이 방사선 검사에 비해 유의하게 높았다. 결론: 종격동경검사는 절제가능한 비소세포폐암에서 치료 전 종격동 림프절 전이 여부에 대해 진단할 수 있는 안전하고 효과적인 방법이다.

• Journal of Gastric Cancer
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• 제1권2호
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• pp.77-82
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• 2001

Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.284-290
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• 2006

목적: 위암 발생에서 cyclooxygenase-2 (COX-2)가 혈관신생을 유도한다는 연구보고는 많으나 COX-2와 림프관신생과의 연관성은 잘 알려져 있지 않다. 이에 위암에서 COX-2와 VEGF-C의 상관관계 및 다른 임상병리학적 인자들과 비교 분석하여 COX-2가 림프관신생 및 전이를 유도하는지 여부를 알고자 하였다. 대상 및 방법: 1995년 7월부터 2001년 6월까지 본원에서 위암으로 진단받고 수술을 시행 받은 100명의 환자를 대상으로 COX-2와 VEGF-C에 대한 면역조직화학 검사를 시행하였으며, 이 두 인자들의 상관관계 및 성별, 병기, 림프절 전이, 종양 위치, Lauren 분류법, 혈관침범등과의 관계를 비교 분석하였다. 결과: COX-2는 86%, VEGF-C는 70%에서 양성 반응을 보였다. VEGF-C와 COX-2 모두 림프절 전이와 유의한 상관관계를 보였고(P=0.033 and P=0.012) VEGF-C와 COX-2의 발현은 밀접한 상관관계를 보였다(P=0.026). 그러나 다른 인자들과는 유의한 상관관계를 보이지 않았다. 결론: 위암환자에서 COX-2 발현은 VEGF-C 발현과 유의한 상관관계가 있었고, 이 두 인자들은 모두 림프절 전이와 연관이 있었다. 이에 COX-2 발현은 VEGF-C 발현을 매개로 림프관신생에 관여한다고 할 수 있겠다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.105-115
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• 2005

Purpose: The lymph node status assessed by conventional histological examination is the most important prognostic factor in patients undergoing surgery for oral squamous cell carcinoma. The presence of lymph node metastasis has a strong adverse impact on patient survival even after extended radical resection. Despite these findings, tumour recurrence is not rare after surgery, even when histological examination shows no lymph node metastasis. Recently, molecular-genetically and immunohistochemically demonstrated micrometastasis to the lymph nodes has been shown to have a significant adverse influence on survival in patients with squamous cell carcinoma and histologically negative nodes. The present study sought to determine the incidence and clarify the clinical significance of molecular-genetically and immunohistochemically demonstrated nodal micrometastases and to correlate these data with the stage of oral cancer. Methods: Lymph nodes systematically removed from 71 patients who underwent curative resection between 1998 and 2003 with head and neck squamous cell carcinoma were examined molecular-genetically to detect cytokeratin 5 mRNA with RT-PCR and immunohistochemically to detect cells that stained positively for cytokeratins with the monoclonal antibody cocktail AE1/AE3. The postoperative course and survival rates were compared among patients with and without micrometastases, after numerical classification of overt metastatic nodes. Results: micrometastases were detected in 43(60%) of 71 patients by RT-PCR and 26(36%) of 71 patients by immunohistochemistry. By RT-PCR analysis, patients exhibiting a positive band for CK 5 mRNA had a significantly worse prognosis than those were RT-PCR negative. By immunohistochemistry, the presence of micrometastasis did not predict patient outcome. Conclusion: Micrometastases detected by RT-PCR may be of clinical value in identifying patients who may be at high risk for recurrence and who are therefore likely to benefit from systemic adjuvant therapy.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.312-315
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• 2008

Purpose: Amelanotic melanoma represents a melanoma with an absence or a small number of melanin pigments and comprises 2% of all melanomas. These melanomas are frequently misdiagnosed, probably because of its nonspecific clinical features and difficulty in diagnosis, resulting in delayed diagnosis and treatment. We report a patient with amelanotic melanoma, who underwent surgical treatment with sentinel lymph node biopsy using gamma probe. Methods: A 32-year-old female was presented with a slowly growing ill-defined, hypopigmented nonerythematous lesion with nail defect on right index finger tip. Preoperative punch biopsy was performed, showing an amelanotic melanoma. Sentinel lymph node biopsy was done using gamma probe(Crystal probe system, CRYSTAL PHOTONICS GmbH, Germany) and confirmed no evidence of regional lymph node metastases. The patient underwent amputation at the proximal interphalangeal joint. Results: Histopathologic findings showed superficial spreading melanoma. There were no melanin pigments in Hematoxylin & Eosin stain but positive immunohistochemical stainings for S-100 protein and Hmb45, which were consistent with amelanotic melanoma. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor in 6 months follow-up period. Conclusion: Amelanotic melanoma is extremely rare subtype of malignant melanoma with histopathologic findings of atypical melanocytes without melanin pigments. Early detection is crucial since survival is strongly related to tumor thickness and tissue invasion at the time of diagnosis. Wide excision is the treatment of choice and other conjunctive therapy has not been successful.

• Toxicological Research
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• 제19권2호
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• pp.133-139
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• 2003

Allergic contact dermatitis may be caused by a wide variety of chemicals. A murine local lymph node assay (LLNA) has been developed as an alternative to guinea pig models for assessing the contact sensitization potential of chemical. However, there is a need to develop a nonradioisotopic endpoint for the LLNA, because of the radioisotopic method's requiring the use of special facilities. In this study, we investigated the development of a nonradioisotopic endpoint for LLNA using ELISA (enzyme-linked immunosorbent assay). Female Balb/c mice were treated by the topical application on the dorsum of both ears with four different strong sensitizers, 2,4-dinitrochlorobenzene (DNCB), oxazolone (OXZ), toluene diisocyanate (TDI), and trimellitic anhydride (TMA), and a strong irritant, sodium lauryl sulfate (SLS), once daily for three consecutive days. The proliferation of cells in the auricular Iymph node was analyzed by means of the labelling index (Ll) of bromodeoxyuridine (BrdU) incorporation into cells. The weights of the Iymph nodes in the mice treated with allergens, DNCB, OXZ, TDl and TMA were increased compared to the vehicle control. The stimulation index (Sl) of mice treated with DNCB, OXZ, TDl, and TMA was over three-fold increase compared to the vehicle control. However, the S1 of mice exposed to SLS was not significantly increased compared to the vehicle control, while the lymph node weight of SLS was significantly increased. These results suggest that the LLNA modified endpoint using ELISA based on BrdU incorporation could provide a useful method of screening for irritants and allergens.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권4호
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• pp.213-220
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• 2009

Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

• Journal of Chest Surgery
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• 제31권11호
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• pp.1081-1084
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• 1998

연구배경 : 식도암은 근치율이 낮고, 광범위 림프절 절제후에도 그 성적이 나쁜 편이다. 따라서 경부 림프절 절제가 식도수술결과에 미치는 효과를 알아보고자 식도수술 환자에서 경부림프절 전이가 된 환자를 조사하였다 대상 및 방법 : 1994년부터 1996년 6월까지 본원에서 흉부식도암 수술을 받은 32명의 환자 중 고식적 수술을 시행받은 25명의 환자를 대상으로 하여 경부림프절 절제의 유무를 기준으로 두 그룹으로 나뉘어 연구하였다. 두 그룹 모두 흉부식도 전절제술과 동반하여 종격림프절과 복부림프절 절제를 시행하였으나 B그룹은 양측 경부림프절 절제를 추가하여 시행하였다. 결과 : 수술합병증은 두 그룹 사이에서 의미있게 차이가 나지않았다. t수술사망과 병원사망은 두 그룹 모두에서 보이지 않았다. 그러나 평균 마취시간은 B그룹에서 의밌게 더 길었다.(평균 마취시간 90분). B그룹에서 27%가 경부림프절 전이를 보였다 결론 : 그러므로 경부림프절 절제는 흉부식도암 수술에서 의미있는 수술방법이라고 할 수 있다. 장기생존율의 비교가 더 필요하리라고 생각한다.

• Applied Microscopy
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• 제20권1호
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• pp.77-89
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• 1990

The ultrastructures of the hemal node and the hemolymph node in the Korean native goat were observed by transmission and scanning elelctron microscopies for their morphological features. The sinus of hemal node was lined by endothelial-like reticular cells that had an euchromatin-rich nucleus and many cytoplasmic processes by which reticular fibers were surrounded. In the hemolymph node, the mast cell and the plasma cell were closely contact each other by the cytoplasmic process. The hemal node had venous sinusal-like vessels which were different from the deep sinus, and the hemolymph node had lymph capillaries. The lymph vessels with valves were observed in the capsule of the hemolymph node.

• 대한두경부종양학회지
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• 제25권2호
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• pp.163-167
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• 2009

Sinonasal malignant tumors comprise less than 1% of all cancers and 3% of all malignant tumors of the head and neck, which explains a lack of large series addressing the clinical characteristics and management of these tumors. Neck node metastasis occurs in only about 7% to 15% of malignant tumors compared with other head and neck cancers. A 90-yr-old woman presented with left palpable neck mass and right nasal mass occupying nasal cavity. Fine needle aspiration biopsy of left neck mass results in metastatic squamous cell carcinoma(SCC). PET/CT shows intense FDG uptake in right nasal cavity with bone invasion. Histopathologic examination of excised lesion in the right nasal cavity revealed SCC. We report here on a primary sinonasal SCC with contralateral lymph node metastasis.