• Title/Summary/Keyword: Nodal station

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Five-year Survival Associated with Stage I Gastric Cancer after Resection of Early Recurrence at Nodal Station No. 14v: a Case Report

  • Abe, Iku;Kinoshita, Takahiro;Kaito, Akio;Sunagawa, Hideki;Watanabe, Masahiro;Sugita, Shizuki;Tonouchi, Akiko;Sato, Reo
    • Journal of Gastric Cancer
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    • v.17 no.2
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    • pp.186-191
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    • 2017
  • The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

Model Development for the Spatial Diffusion Effect Estimation of Nodal Accessibility Increment in the Subway Network (지하철 접근성 증가의 공간적 파급효과 산출모형 개발)

  • 이금숙
    • Journal of the Economic Geographical Society of Korea
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    • v.1 no.1
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    • pp.137-149
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    • 1998
  • It is likely that the spatial structure of the intraurban accessibility as well as the accessibility value of each of the nodes in the subway network is affected by the addition of new linkages. The changes in the accessibility at individual nodes also affect the accessibility in the surrounding areas at some distances away from the nodes. Graph-theoretic algorithms have been developed as a proper measurement scheme for the nodal accessibility in tracked transport networks such as subway networks. However, the graph-theoretic measurements have limitations to estimate the spatial diffusion effect on the surrounding areas. This study proposes a new model for the spatial diffusion effect estimation of nodal accessibility increment in the subway network toward the surrounding areas. Since the distance decay trend of subway station use reflect the spatial diffusion effect of the accessibility of subway station toward the surrounding area. The model is deduced from the subway station use density function which is formulated by the questionnaire survey data.

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Lymph Node Status after Neoadjuvant Chemoradiation Therapy for Esophageal Cancer according to Radiation Field Coverage

  • Kim, Sang Yoon;Park, Samina;Park, In Kyu;Kim, Young Tae;Kang, Chang Hyun
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.353-359
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    • 2019
  • Background: To explore the effect of radiation on metastatic lymph nodes (LNs) after neoadjuvant chemoradiation therapy (nCRT), we examined the metastatic features of LNs according to their inclusion in the radiation field. Methods: The patient group included 88 men and 2 women, with a mean age of $61.1{\pm}8.1$ years, who underwent esophagectomy and lymphadenectomy after nCRT. Dissected LNs were compared in terms of clinical suspicion of metastasis, nodal station, and inclusion in the radiation field. Results: LN positivity did not differ between LNs that were inside (in-field [IF]) and outside (out-field [OF]) of the radiation field (IF: 40 of 465 [9%], OF: 40 of 420 [10%]; p=0.313). In clinical N+ nodal stations, IF stations had a lower incidence of metastasis than OF stations (IF/cN+: 16 of 142 [11%], OF/cN+: 9/30 [30%]; p=0.010). However, in clinical N- nodal stations, pathological positivity was not affected by whether the nodal stations were included in the radiation field (IF/cN-: 24 of 323 [7%], OF/cN-: 31 of 390 [8%]; p=0.447). Conclusion: Radiation therapy for nCRT could downstage clinically suspected nodal metastasis. However, such therapy was ineffective when used to treat nodes that were not suspicious for metastasis. Because significant numbers of residual metastases were identified irrespective of coverage by the radiation field, lymphadenectomy should be performed to ensure complete removal of residual nodal metastases after nCRT.

Nodal Station as a Prognostic Factor in Resected Stage IIIA N2 Non-Small Cell Lung Cancer (절제된 IIIA N2 병기 비소세포형 폐암에 있어서 Nodal Station의 의의)

  • 김대준;김길동;김치영;정경영
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.489-496
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    • 2003
  • To clarify the prognostic implication of the location and number of the metastatic mediastinal nodes in resected stage IIIA N2 non-small cell lung cancer. Material and Method: One hundred and seventy-four patients with resected non-small cell lung cancer who eventually proved to have pathologic stage IIIA N2 disease were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. Result: In upper lobe tumors, there was no difference in 5-year survival according to the involvement of lower mediastinal nodes (32.3% vs 25.6%, p=0.86). In lower lobe tumors, no difference was found in 5-year survival according to the involvement of upper mediastinal nodes (25.1% vs 14.1%, p=0.33). There was no significant difference in 5-year survival between patients with or without metastatic subcarinal node (20.9% vs 25.6%, p=0.364). In terms of the number of metastatic mediastinal nodes, 5-year survival was better in single station group (26.3%) than multiple station group (18.3%) (p=0.048). In multiple station N2 group, the patients who received postoperative chemotherapy and radiation therapy had better 5-year survival (34.2%) (p=0.01). Cox's proportional hazards model revealed that the age $\geq$60 (O.R: 1.682, p=.006), multiple station N2 (O.R: 1.503. p=0.021), pneumonectomy (O.R: 1.562, p=0.018), postoperative chemotherapy and radiation therapy (O.R: 0.625, p=0.012) were the factors affecting the postoperative survival. Conclusion: Multiple station N2 disease was the important prognostic factor for postoperative survival in resected stage IIIA N2 non-small cell lung cancer. Postoperative chemotherapy and radiotherapy were thought to improve the survival in case of multiple station N2 disease.

Analysis on the Estimation Error of the Lowest and Highest Astronomical Tides using the Wido Tidal Elevation Data (위도 검조자료를 이용한 최저-최고 천문조위 추정 오차 분석)

  • Jeong, Shin Taek;Yoon, Jong Tae;Cho, Hongyeon;Ko, Dong Hui;Kang, Keum Seok
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.28 no.2
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    • pp.101-108
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    • 2016
  • In designing of the wind power facilities, the highest and lowest astronomical tides (HAT and LAT) are needed in terms of an international design tidal water levels. The AHHW and ALLW, however, have been used as the design tidal levels in Korea. The HAT and LAT in the Wido coastal sea should be estimated to satisfy the standard because the pilot wind power facilities will be located in the adjacent Wido coastal sea. In this study, the HAT and LAT are estimated using the 31-years hourly tidal elevation data of the Wido tidal gauging station and the nodal variation patterns of the major lunar components, such as $M_2$, $O_1$, and $K_1$, are analysed to check the expected long-term lunar cycle, i.e., 18.61-year's nodal variation patterns. The temporal amplitude variations of the $M_2$, $O_1$, and $K_1$ clearly show the 18.61-years periodic patterns in case of the no-nodal correction condition. In addition, the suggested HAT and LAT elevations, estimated as the upper and lower confidence limits of the yearly HAT and LAT elevations, show 40 cm greater than AHHW and 35 cm lower than ALLW, respectively.

Study on Design Capacity of Stormwater Pipe and Pumping Station considering Peak Rainfall Intensity (첨두강우강도를 고려한 우수관로 및 빗물펌프장의 설계용량 검토)

  • Chung, Gunhui;Sim, Kyu Bum;Kim, Eung Seok
    • Journal of Korea Water Resources Association
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    • v.47 no.9
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    • pp.777-787
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    • 2014
  • Stormwater pipe systems are most commonly used to discharge rainwater from the urban catchment covered by the impervious area. To design stormwater pipe and rainwater pumping station, frequency analysis is implemented using historical rainfall and the design rainfall is timely distributed using theoretical shape such as Huff distribution. This method cannot consider the rainfall intensity variation caused by climate change which is type of uncertainty. Therefore, in this study, runoff from Gasan1 stormwater pumping stations catchment is calculated using design rainfall distributed by the 2nd quartile distribution method and the historical rainfall events. From the analysis, the nodal flooding in the urban catchment is likely caused by the high peak rainfall event rather than the large amount of rainfall. The linear regression analysis is implemented. As a result, when several storms have the same amount of rainfall, the nodal flooding in the stormwater pipe systems could be caused by the high peak of storm events. Since as the storm duration become short, the peak rainfall become high, the nodal flooding likely become severe with the short storm duration. The uncertainty in the peak data of design rainfall is analyzed and this uncertainty has to be consider in the stormwater pipe design process.

Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

THE INTERFACE CONFIGURATION OF OVERSEA STATIONS AND OPERATION PLAN FOR KOMPSAT-2 LEOP

  • Baek Hyun-Chul;Kim Hae-Dong;Ahn Sang-Il;Kim Eun-Kyou
    • Proceedings of the KSRS Conference
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    • 2005.10a
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    • pp.557-560
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    • 2005
  • The Korea Multi-Purpose SATellite-2 (KOMPSAT -2) will be launched into a circular sun synchronous orbit in Dec. 2005. For the mission operation of the KOMPSAT-2 satellite, KARl Ground Station (KGS) consists of the Mission Control Elements (MCE), Image Reception & Processing Elements (IRPE) and the overseas stations. For the oversea stations, the Kongsberg Satellite Services (KSAT) is the prime supplier of support service. KSAT has the capability to provide Tracking Telemetry and Commanding (TT&C) nominal, contingency and anomaly support for every single orbit for most polar orbiting satellites. Also KSAT provides nodal service through the network management functionality for all oversea ground stations. This paper describes the oversea stations and the support for Launch and nominal TT&C services for KOMPSAT-2 and the operation plan for KOMPSAT-2.

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The Significance of Serum Carcinoembryonic Antigen in Lung Adenocarcinoma

  • Kim, Jae Jun;Hyun, Kwanyong;Park, Jae Kil;Moon, Seok Whan
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.335-344
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    • 2015
  • Background: A raised carcinoembryonic antigen (CEA) may be associated with significant pathology during the postoperative follow-up of lung adenocarcinoma. Methods: We reviewed the medical records of 305 patients who underwent surgical resections for primary lung adenocarcinoma at a single institution between April 2006 and February 2013. Results: Preoperative CEA levels were significantly associated with age, smoking history, pathologic stage including pT (pathologic tumor stge), pN (pathologic nodal stage) and overall pathological stage, tumor size and differentiation, pathologically positive total lymph node, N1 and N2 lymph node, N2 nodal station (0/1/2=1.83/2.94/7.21 ng/mL, p=0.019), and 5-year disease-free survival (0.591 in group with normal preoperative CEA levels vs. 0.40 in group with high preoperative CEA levels, p=0.001). Preoperative CEA levels were significantly higher than postoperative CEA levels (p<0.001, Wilcoxon signed-rank test). Postoperative CEA level was also significantly associated with disease-free survival (p<0.001). A follow-up serum CEA value of >2.57 ng/mL was found to be the appropriate cutoff value for the prediction of cancer recurrence with sensitivity and specificity of 71.4% and 72.3%, respectively. Twenty percent of patients who had recurrence of disease had a CEA level elevated above this cutoff value prior to radiographic evidence of recurrence. Postoperative CEA, pathologic stage, differentiation, vascular invasion, and neoadjuvant therapy were identified as independent predictors of 5-year disease-free survival in a multivariate analysis. Conclusion: The follow-up CEA level can be a useful tool for detecting early recurrence undetected by postoperative imaging studies. The perioperative follow-up CEA levels may be helpful for providing personalized evaluation of lung adenocarcinoma.

Limited Clinical Significance of Splenectomy and Splenic Hilar Lymph Node Dissection for Type 4 Gastric Cancer

  • Kunitomo, Aina;Misawa, Kazunari;Ito, Yuichi;Ito, Seiji;Higaki, Eiji;Natsume, Seiji;Kinoshita, Takashi;Abe, Tetsuya;Komori, Koji;Shimizu, Yasuhiro
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.392-402
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    • 2021
  • Purpose: Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC. Materials and Methods: The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node. Results: Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92. Conclusions: The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.