• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.38-41
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• 2011

Background and Objectives : Although it is well established that patients with papillary thyroid microcarcinoma (PTMC) have a highly favorable prognosis, the extent of thyroid surgery for PTMC remains unclear. According to the 2011 revised Korean Thyroid Association guideline, the choice of surgical strategy(total thyroidectomy versus lobectomy) for PTMC depends on solely preoperative diagnostic scrutinies-ultrasonography and fine needle aspiration cytology. We want to know how accurately these preoperative diagnostic scrutinies define the choice of surgical strategy for PTMC. Materials and Methods : For 119 patients who underwent total thyroidectomy with central neck dissection for PTMC, retrospectively, we compared the choice of surgery according to preoperative work up and postoperative pathologic findings. Results : Overall accuracy of the choice of surgery by preoperative work up was 61%. Among patients recommended lobectomy on preoperative work up, completion thyroidectomy on postoperative pathology might be necessary for 60% of patients and hidden central node metastasis was revealed in 31% of patients. Conclusions : The results of this study compel us to reinvestigate the current treatment guideline for PTMC. On current guideline according to the sonography and fine needle aspiration cytology, it might be thought to be better to choose more aggressive surgical strategy.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.53-56
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• 2011

Vocal cord paralysis (VCP) is a common complication after thyroidectomy despite the continuity of the recurrent laryngeal nerve (RLN) is preserved. Much efforts have been made into preventing VCP, but few of them focuses on the treatment strategies and prognosis after VCP take place. In this case, patient visited the clinic for papillary thyroid cancer in Rt. thyroid gland without VCP. She underwent total thyroidectomy with central neck dissection. During dissection, Rt main mass was encircling Rt. RLN. To make matters worse, Lt. RLN was severed due to tight attachment with Berry's ligament. After that, intratumoural dissection of Rt. RLN and end to end anastomosis of Lt. RLN were performed with microscopy to preserve the functions of RLNs as much as possible, otherwise permanent bilateral VCPs were inevitable. We report this case, since both vocal cords recovered from VCPs with symmetric, synchronous movements at postoperative follow up.

• Molecules and Cells
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• v.41 no.9
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• pp.853-867
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• 2018

As the most common type of endocrine malignancy, papillary thyroid cancer (PTC) accounts for 85-90% of all thyroid cancers. In this study, we presented the hypothesis that SDC4 gene silencing could effectively attenuate epithelial mesenchymal transition (EMT), and promote cell apoptosis via the $Wnt/{\beta}-catenin$ signaling pathway in human PTC cells. Bioinformatics methods were employed to screen the determined differential expression levels of SDC4 in PTC and adjacent normal samples. PTC tissues and adjacent normal tissues were prepared and their respective levels of SDC4 protein positive expression, in addition to the mRNA and protein levels of SDC4, $Wnt/{\beta}-catenin$ signaling pathway, EMT and apoptosis related genes were all detected accordingly. Flow cytometry was applied in order to detect cell cycle entry and apoptosis. Finally, analyses of PTC migration and invasion abilities were assessed by using a Transwell assay and scratch test. In PTC tissues, activated $Wnt/{\beta}-catenin$ signaling pathway, increased EMT and repressed cell apoptosis were determined. Moreover, the PTC K1 and TPC-1 cell lines exhibiting the highest SDC4 expression were selected for further experiments. In vitro experiments revealed that SDC4 gene silencing could suppress cell migration, invasion and EMT, while acting to promote the apoptosis of PTC cells by inhibiting the activation of the $Wnt/{\beta}-catenin$ signaling pathway. Besides, $si-{\beta}-catenin$ was observed to inhibit the promotion of PTC cell migration and invasion caused by SDC4 overexpression. Our study revealed that SDC4 gene silencing represses EMT, and enhances cell apoptosis by suppressing the activation of the $Wnt/{\beta}-catenin$ signaling pathway in human PTC.

• Tuberculosis and Respiratory Diseases
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• v.68 no.2
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• pp.93-96
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• 2010

A 23-year old woman was admitted to our hospital with hemoptysis. The chest X-ray showed reticulonodular opacity and multiple cysts throughout the entire lung field. The chest CT scan revealed numerous bilateral cysts with various sizes, some of them with thickened walls. An open lung wedge resection was performed. The resected specimen showed scattered small nodules, 0.3 to 0.6 cm in size. Microscopically, each nodule was composed of atypical glands with an occasional papillary architecture spreading to the alveolar septa, which were morphologically consistent with a papillary adenocarcinoma with a bronchioloalveolar carcinoma growth pattern. Immunochemically, the tumor cells were negative for the S-100 protein. The patient was diagnosed with an adenocarcinoma of the lung. A variety of diseases can produce or mimic multiple, thin-walled cysts in the lung. Lung cancer with multiple cysts is quite rare. Nevertheless, adenocarcinoma should be a diagnostic consideration. We report a case of a multiple cystic adenocarcinoma of the lung.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.195-200
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• 2023

Backgrounds/Aims: We aimed to build a machine learning tool to help predict low-grade intraductal papillary mucinous neoplasms (IPMNs) in order to avoid unnecessary surgical resection. IPMNs are precursors to pancreatic cancer. Surgical resection remains the only recognized treatment for IPMNs yet carries some risks of morbidity and potential mortality. Existing clinical guidelines are imperfect in distinguishing low-risk cysts from high-risk cysts that warrant resection. Methods: We built a linear support vector machine (SVM) learning model using a prospectively maintained surgical database of patients with resected IPMNs. Input variables included 18 demographic, clinical, and imaging characteristics. The outcome variable was the presence of low-grade or high-grade IPMN based on post-operative pathology results. Data were divided into a training/validation set and a testing set at a ratio of 4:1. Receiver operating characteristics analysis was used to assess classification performance. Results: A total of 575 patients with resected IPMNs were identified. Of them, 53.4% had low-grade disease on final pathology. After classifier training and testing, a linear SVM-based model (IPMN-LEARN) was applied on the validation set. It achieved an accuracy of 77.4%, with a positive predictive value of 83%, a specificity of 72%, and a sensitivity of 83% in predicting low-grade disease in patients with IPMN. The model predicted low-grade lesions with an area under the curve of 0.82. Conclusions: A linear SVM learning model can identify low-grade IPMNs with good sensitivity and specificity. It may be used as a complement to existing guidelines to identify patients who could avoid unnecessary surgical resection.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.178-182
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• 2005

Insular carcinoma(poorly differentiated thyroid cancer) is defined as a aggressive, follicular-derived thyroid carcinoma with behavior intermediate between follicular/papillary and anaplastic carcinomas. It was described by Carcangiu in 1984, but its prognosis, classification and the origin is not yet clear. And preoperative fine needle aspiration cytology of insular carcinoma has not been satisfactory. We experienced a case of advanced thyroid insular carcinoma with invasion of the sternum. So we intend to present the case with a review of the related literatures.

• Journal of Yeungnam Medical Science
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• v.39 no.3
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• pp.250-255
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• 2022

In 2010, the World Health Organization classified mucin-producing bile duct tumors of the liver into two distinct entities; mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct. We present the case of a patient with MCN-L having a uniquely pedunculated shape. A 32-year-old woman was referred to our institution with a diagnosis of biliary cystic neoplasm. She had undergone left salpingo-oophorectomy for ovarian cancer 15 years ago. Imaging studies showed an 8 cm-sized well defined, multiloculated cystic lesion suggesting a mucinous cystic neoplasm. The cystic mass was pedunculated at the liver capsule and pathologically diagnosed as MCN-L. The mass was resected with partial hepatectomy. The patient recovered uneventfully. She was discharged 7 days postoperatively. The patient has been doing well for 6 months after the operation. The patient will be followed up annually because of the favorable postresection prognosis of MCN-L.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.373-376
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• 2015

Background: EVA1A (eva-1 homolog A) is a novel gene that regulates programmed cell death through autophagy and apoptosis. Our objective was to investigate the expression profiles and potential role of EVA1A in normal and neoplastic human pancreatic tissues. Materials and Methods: The expression pattern of EVA1A in normal pancreatic tissue was examined by indirect immunofluorescence and confocal microscopy. Protein levels in paraffin-embedded specimens from normal and diseased pancreatic and matched non-tumor tissues were evaluated by immunohistochemistry. Results: EVA1A colocalized with glucagon but not with insulin, demonstrating production in islet alpha cells. Itwas strongly expressed in chronic pancreatitis, moderately or weakly expressed in the plasma membrane and cytoplasm in pancreatic acinar cell carcinoma, and absent in normal pancreatic acinar cells. Although the tissue architecture was deformed, EVA1A was absent in the alpha cells of pancreatic ductal adenocarcinomas, intraductal papillary mucinous neoplasms, mucinous cystadenomas, solid papillary tumors and pancreatic neuroendocrine tumors. Conclusions: EVA1A protein is specifically expressed in islet alpha cells, suggesting it may play an important role in regulating alpha-cell function. The ectopic expression of EVA1A in pancreatic neoplasms may contribute to their pathogenesis and warrants further investigation.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.29-33
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• 2017

Verrucous carcinoma was first described by Ackerman who reported a case of verrucous carcinoma of the oral cavity. While it is primarily occurred in oral cavity, larynx is the second most affected site, accounting for nearly 35% of cases. It is a rare variant of well-differentiated squamous cell carcinoma and comprises 1% to 4% of all laryngeal carcinomas. It is characterized by locally invasive, slow growth and the surface shows papillary fronds with prominent hyperkeratosis. Because of the benign appearance and difficulty of the tissue diagnosis, it is often undiagnosed or misdiagnosed. The primary treatment modality is surgery and the extent of surgical resection may be guided by T stage. We experienced a case of verrucous carcinoma of larynx in a patient with hoarseness lasted for about 2 years and had difficult to diagnosis and treatment. Therefore we report this case with a brief review of literature.