• Title/Summary/Keyword: Node ratio

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A Case of Bronchopulmonary Atypical Carcinoid Tumor with Liver Metastasis (간전이를 동반한 폐기관지 비정형 카르시노이드 종양 1예)

  • Lee, Dong Soo;Lee, Tae Won;Kim, Gye Yean;Kim, Hwi Jung;Song, So Hyang;Kim, Seok Chan;Kim, Young Kyoon;Song, Jung Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.623-629
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    • 1996
  • Bronchial carcinoid tumors are uncommon, constituting approximately 5% of all primary lung cancers. Carcinoid tumors belong to the calss of neuroendocrine tumors that consist of cells that can store and secrete neuramines and neuropeptides. Neuroendocrine tumors of the lung include three pathologic types : a low-grade malignancy, the so-called 'typical carcinoid', a more aggressive tumor, the "atypical carcinoid", and the most aggressive malignant neoplasm, the small-cell carcinoma. Atypical carcinoid tumor have a higher malignant potential, is more commonly peripheral than is the typical carcinoid tumor. Histologic features would characterize a carcinoid as hitologically atypical : increased mitotic activity, pleomorphism and irregularity of neuclei with promonent nucleoli, hyperchromatin, and abnormal nuclear-cytoplasmic ratio, areas of increased cellularity with disorganization of architecture, and areas of tumor necrosis. Metastatic involvement of regional lymph nodes and distant organ is common. The prognosis is related to size of the tumor, typical of atypical appearance, endoluminal of extraluminal growth, vascular invasion, node metastasis, Pulmonary resection is the treatement of choice for bronchial carcinoid. We experienced one case of bronchopulmonary atypical carcinoid tumor. In the case, radiologic study showed solitary lung mass with liver metastasis and the level of 5-HIAA was elevated. There was no history of cutaneous flushing, diarrhea, valvular heart disease. The authors reported a case of bronchopulmonary atypical carcinoid tumor with review of literatures.

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Growth and Cut-Flower Productivity of Spray Rose as Affected by Shading Method during High Temperature Period (차광방법에 따른 고온기 절화용 스프레이 장미의 생장 및 절화 생산성)

  • Cheong, Dong-Chun;Lee, Jin-Jae;Choi, Chang-Hak;Song, Young-Ju;Kim, Hee-Jun;Jeong, Jong-Sung
    • Horticultural Science & Technology
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    • v.33 no.2
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    • pp.227-232
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    • 2015
  • This experiment was carried out to investigate the effects of shading materials (aluminum specific-shading screen and polypropylene non-woven fabric) and shading ratio (50% and 70%) on climatic changes, cut-flower quality, and yield of spray rose cultivars for export during high temperature periods. The daily cumulative solar radiations were higher with the aluminum specific-shading screen, especially with 50% shading compared to polypropylene non-woven fabric. Air temperature and root zone temperature within rockwool media greatly decreased with the aluminum specific-shading screen, but relative air humidity was not different among shading methods. Chlorophyll contents (SPAD values) were slightly higher with aluminum-specific shading screen than with polypropylene non-woven fabric, and were higher with 50% than with 70% aluminum specific-shading screen. Except for 'Lovely Lydia', marketable and exportable yields of all cultivars were higher with 50% than with 70% aluminum shading treatment. In addition, flowers talk length, stem diameter, number of node and 7ea-leaflet, and floret number tended to be better with aluminum specific-shading screen. Flower stalk length was higher with 70% than with 50% aluminum shading treatment. Chromaticity of petals slightly increased, and vase life was 0.5-2.5 days longer for each cultivar with aluminum specific-shading screen than with polypropylene non-woven fabric.

Finite Element Vibration Analysis of Laminated Composite Folded Structures With a Channel Section using a High-order Shear deformation Plate Theory (고차전단변형 판이론을 이용한 채널단면을 갖는 복합적층 절판 구조물의 유한요소 진동 해석)

  • 유용민;장석윤;이상열
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.17 no.1
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    • pp.21-30
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    • 2004
  • This study deals with free vibrations of laminated composite structures with a channel section using finite element method. In this paper, the mixed finite element method using Lagrangian and Hermite interpolation functions is adopted and a high-order plate theory is used to analyze laminated composite non-prismatic folded plates with a channel section more accurately for free vibration. The theory accounts for parabolic distribution of the transverse shear stress and requires no shear correction factors supposed in the first-order plate theory. An 32×32 matrix is assembled to transform the system element matrices from the local to global coordinates using a coordinate transformation matrix, in which an eighth drilling degree of freedom (DOF) per node is appended to the existing 7-DOF system. The results in this study are compared with those of available literatures for the conventional and first-order plate theory. Sample studies are carried out for various layup configurations and length-thickness ratio, and geometric shapes of plates. The significance of the high-order plate theory in analyzing complex composite structures with a channel section is enunciated in this paper.

Parathyroid Carcinoma (부갑상선암)

  • Cho Eun-Chol;Sub Jin-Hak;Chung Woong-Yun;Kim Ho-Geun;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.205-209
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    • 2001
  • Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

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A Route Shortening Mechanism for DSR protocol in Mobile Ad-Hoc Networks (이동 애드혹 네트워크에서 DSR 프로토콜을 위한 경로 축소 방법)

  • Ha, Eun-Yong
    • Journal of KIISE:Information Networking
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    • v.34 no.6
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    • pp.475-482
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    • 2007
  • Mobile nodes in ad-hoc wireless networks play roles of router as well as host. Movement of nodes causes network topology changes, which make existing routing information be modified. Therefore many routing protocols for ad-hoc networks were suggested in the literature. In this paper, we suggest an enhanced automatic route shortening method for dynamic source routing(DSR) protocol. DSR is a request/response based protocol which has low routing overhead owing to node movement. The current automatic route shortening is performed on the only nodes which belong to the source route of packets. On the contrary, our suggested method allows all neighbor nodes hearing the packet to participate in automatic route shortening. It makes all possible route shortenings be performed. So we maintain maximal shortened routes of ongoing data connections. Simulation results with ns2 show that our method pays small extra protocol overhead for ARS, but increases the ratio of successful packet transmissions and the number of ARSs performed in our mechanism is from 2 to 5 times higher than in original ARS mechanism and therefore it will improve the network-wide energy consumption in wireless ad-hoc networks.

Prognostic Factors and Clinical Outcome in Parotid Gland Tumors: a Single Institution Experience from the Eastern Black Sea Region of Turkey

  • Kandaz, Mustafa;Soydemir, Gulsen;Bahat, Zumrut;Canyilmaz, Emine;Yoney, Adnan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1169-1174
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    • 2016
  • Purpose: To review clinical characteristics, treatment outcomes and prognostic factors in patients with parotid gland tumors treated with surgery and postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 69 patients with parotid gland tumors, with a median follow-up of 52 months (range, 2-228 months). and a median radiotherapy dose of 60Gy (range, 30-69 Gy). Results: There were 24 (35%) females and 45 (65%) males, at a ratio of 1/1.9. Median age at presentation was $58.9{\pm}17.2$ (range 13-88) years. The most common histology was adenoid cystic carcinoma (33%) and mucoepidermoid carcinoma (28%). The mean overall survival (OS) was $65.3{\pm}8$ (95% confidence interval [CI], 49.6-81.1) months and the median overall survival was $40.0{\pm}7$ (95% CI, 26.2-53.7) months. The -1, -3, -5 and -10 year OS rates were 78%, 52.4%, 35.3% and 19.6% respectively. The mean disease free survival (DFS) was $79.2{\pm}10$ (95% CI, 59.3-97.1) months and the median disease free survival was $38{\pm}13$ (95% CI, 7.05-88.7) months. The -1,-3,-5 and -10 year DFS rates were 71.9%, 50.1%, 43.7% and 30.1% respectively. On univariate analysis, the OS was significantly better with female sex (p<0.005), < 50 age (p<0.021), T stage (p<0.0001), absence of lymph node involvement (p<0.0001), lower tumor grade (p<0.0001), absence of lymphovascular invasion (p<0.002), absence of perineural invasion (p<0.0001), absence of extracapsuler extension (p<0.0001), surgical margin negativity (p<0.006), ${\leq}60Gy$ radiotherapy dose (p<0.0001) and absence of distant metastasis (p<0.027). Conclusions: Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be mainly effective in patients with parotid gland carcinomas.

Thyroid Tumors in Children - Review of Surgically Treated Cases - (소아에서의 갑상선 종양 - 수술적 체험 예들의 임상 고찰 -)

  • Yang Sung-Hwan;Kim Gab-Tae;Oh Sung-Su;Chung Eul-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.54-60
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    • 1998
  • Objectives: We'd like to give help in diagnosis and treatment of children's thyoid tumor through our clinical experiences and reference consideration. Materials and Methods: The authors report their experiences with 33 cases of thyroid tumor in patients younger than 16 years of age who were treated at Presbyterian Medical Center from 1979 to 1995. Results: 1) Girls were more predominant than boys by a ratio of 5.6:1. The peak incidence was in the 15 years old of age. 2) The final diagnosis in the 33 patients were thyroid carcinoma in 12 cases, nodular goiter in 6 cases, adenoma in 6 cases, Graves disease in 4 cases, Hasimoto's disease in 4 cases and cyst in 1 case. 3) All of 12 patients with thyroid cancer had nodular tumor. 4) In 5 of 6 patients with palpable cervical lymphadenopathy, the final diagnosis was thyroid carcinoma. 5) Delayed diagnosis arose in 6 of 12 thyroid carcinomas which were treated for long periods as benign disease. 6) The surgical procedures were total thyroidectomy in 3 cases, subtotal thyroidectomy in 13 cases and thyroid lobectomy in 17 cases. 7) 11 of 12 patients with thyroid carcinoma had subtotal or total thyroidectomy with lymphnode dissection and only one had lobectomy. 8) The overall rate of postoperative complication was 3%(1 of 33 patient). 9) Postoperative $^{131}I$ therapy was done in 7 case because of recurrence and distant metastasis in six and severe local invasion in one. 10) In thyroid cancer, the metastatic rate of lymph node at initial surgery was 81%(9/11) and rate of recurrence was 50%(6/12). 11) Patients with thyroid carcinoma were followed up for a mean of 12 years but only one died as a result of thyroid carcinoma 3.5 years later. Conclusion: The authors suggest that thyroid tumors in childhood should receive the benifit of joint management by endocrine pediatrician and experianced surgeons with an agreed protocol of diagnosis and management. We, also, recommend aggressive surgical and $^{131}I$ treatment as the most effective regimen for children with thyroid carcinoma.

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Nodal Outcomes of Uniportal versus Multiportal Video-Assisted Thoracoscopic Surgery for Clinical Stage I Lung Cancer

  • Choi, Jung Suk;Lee, Jiyun;Moon, Young Kyu;Moon, Seok Whan;Park, Jae Kil;Moon, Mi Hyoung
    • Journal of Chest Surgery
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    • v.53 no.3
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    • pp.104-113
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    • 2020
  • Background: Accurate intraoperative assessment of mediastinal lymph nodes is a critical aspect of lung cancer surgery. The efficacy and potential for upstaging implicit in these dissections must therefore be revisited in the current era of uniportal video-assisted thoracoscopic surgery (VATS). Methods: A retrospective study was conducted in which 544 patients with stage I (T1abc-T2a, N0, M0) primary lung cancer were analyzed. To assess risk factors for nodal upstaging and to limit any imbalance imposed by surgical choices, we constructed an inverse probability of treatment-weighted (IPTW) logistic regression model (in addition to non-weighted logistic models). We also evaluated risk factors for early locoregional recurrence using IPTW logistic regression analysis. Results: In the comparison of uniportal and multiportal VATS, the resected lymph node count (14.03±8.02 vs. 14.41±7.41, respectively; p=0.48) and rate of nodal upstaging (6.5% vs. 8.7%, respectively; p=0.51) appeared similar. Predictors of nodal upstaging included tumor size (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.12-2.70), carcinoembryonic antigen level (OR, 1.11; 95% CI, 1.04-1.18), and histologically confirmed pleural invasion (OR, 3.97; 95% CI, 1.89-8.34). The risk factors for locoregional recurrence within 1 year were found to be number of resected N2 nodes, age, and nodal upstaging. Conclusion: Uniportal and multiportal VATS appear similar with regard to accuracy and thoroughness, showing no significant difference in the extent of nodal dissection.

Evaluation of Mucosal Immunity in BTBR T+tf/J Mice Resembling Autism Spectrum Disorder (자폐증 유사증상 발현 마우스의 점액 면역에 대한 연구)

  • Hwang, So Ryeon;Jo, Ji Hoon;Shin, Kyeong Min;Jang, Yun Young;Kim, Ji Youn;Yeo, Kyeong Uk;Kim, Hyoung Ah;Heo, Yong
    • Journal of Environmental Health Sciences
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    • v.38 no.6
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    • pp.541-549
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    • 2012
  • Objectives: This study was undertaken in order to evaluate a potential mechanism involved in gastro-intestinal problems observed in autistic subjects and uses an animal model of autism investigation. Methods: BTBR T+tf/J, a mouse strain with typical socio-behavioral characteristics of autistic subjects and FVB mice with highly social behaviors as the control strain were used. Both genders of mice aged three weeks and six months were used from four separate litters for each strain. Serum was prepared following cardiac puncture, and mesenteric lymph nodes were collected for in vitro stimulation and enumeration of major immune cell proportion. Results: The level of serum IgA was significantly enhanced in six-month-old BTBR mice compared with three-week-old BTBR, which was not observed with the FVB control mice. The serum IgE level was also higher among BTBR mice than among age-sex matched FVB mice, respectively. Considering the ratio of interleukin-4 vs interferon-gamma production from mesenteric lymph node T cells, skewedness toward type-2 reactivities was observed. In addition, the proportion of B cells in mesenteric lymph nodes was significantly higher in BTBR mice than in FVB mice. Conclusion: Upregulation of mucosal immunity related with enhanced type-2 immune reactivity observed in BTBR mice could be involved with the etiology of gastro-intestinal abnormalities in autism.

Presentation and Outcomes of Gastric Cancer at a University Teaching Hospital in Nepal

  • Sah, Jayant Kumar;Singh, Yogendra P;Ghimire, Bikal
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5385-5388
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    • 2015
  • Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.