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Patterns of Axillary Lymph Node Metastasis in Breast Cancer: A Prospective Single-Center Study

  • Choi, Hee Jun;Kim, Jae-Myung;Ryu, Jai Min;Kim, Isaac;Nam, Seok Jin;Yu, Jonghan;Lee, Se Kyung;Lee, Jeong Eon;Kim, Seok Won
    • Journal of Breast Cancer
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    • v.21 no.4
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    • pp.447-452
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    • 2018
  • Purpose: The recent trend in breast cancer treatment is to minimize axillary dissection. However, no pattern of axillary metastasis has been precisely established. The purpose of this study was to evaluate the metastatic lymphatic pattern using near-infrared fluorescence imaging with indocyanine green (ICG) in breast cancer with cytologically proven axillary metastasis. Methods: This was a prospective single-center study. We evaluated 147 patients with breast cancer involving cytologically proven axillary metastasis, and compared physiological and nonphysiological lymphatic metastasis. Results: We performed lymphatic mapping for 64 patients who exhibited level II lymphatic flow on near-infrared fluorescence imaging with ICG, and found that all had axillary metastasis: 51 patients who did not receive neoadjuvant chemotherapy (NAC) and 13 patients post-NAC. Of patients who did not receive NAC, 32 had physiological lymphatic metastasis and 19 had nonphysiological lymphatic metastasis. The risk factors for nonphysiological lymphatic metastasis were age ${\geq}55$ years, high Ki-67 index (>20%), and perinodal extension in both univariate and multivariate analysis (p<0.05). Conclusion: Patients with identified risk factors in cytologically-proven axillary metastasis who did not receive NAC may have nonphysiological lymphatic metastasis.

Estimating Radiation Therapy Toxicity and Tolerability with Comprehensive Assessment Parameters in Geriatric Cancer Patients

  • Ulger, Sukran;Kizilarslanoglu, Muhammet Cemal;Kilic, Mustafa Kemal;Kilic, Diclehan;Cetin, Bekir Eren;Ulger, Zekeriya;Karahacioglu, Eray
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1965-1969
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    • 2015
  • Cancer prevalance and incidence is increasing with aging of populations and age is a critical factor in decision-making for anti-cancer treatment. However it is believed that chronological age is not enough to guide management in elderly cancer patients. Multidisciplinary evaluation and comprehensive geriatric assessment has gained importance regarding the treatment selection especially for definitive anti-cancer therapy recently. We here aimed to analyse the effect of the comprehensive geriatric assessment parameters on radiotherapy toxicity and tolerability in a series of geriatric cancer patients in Turkey.

Eye Irritation, Skin Irritation and Skin Sensitization tests for Aloewhite in Animals

  • Kim, Hyung-Sik;Kwack, Seung-Jun;Kim, Kyu-Bong;Lee, Seung-Ki;Park, Hyun-Sun;Hong, Che-Young;Ahn, Mi-Young;Jo, Tea-Hyung;Oh, Sun-Tack
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.250-250
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    • 1996
  • Eye irritation, primary skin irritation and skin sensitization tests for Aloewhite were tested in New Zealand White rabbits and Hartley guinea pig. In primary skin irritation test of male New Zealand White rabbits, body weights were not significantly changed and primary Irritation Index(PII) was 0.47, indicating Aloewhite as mildly irritating material, In ocular irritation test, any injury on iris, conjunctival membrane, and cornea in New Zealand White rabbits was not observed. No injuries of the ocular mucous membrane were also recorded. Skin sensitization was tested in guinea Peg after intradermal and epicutaneous induction and graded I with zero % sensitization rate. These results indicate that Aloewhite was not considered to be irritant in test organs of animals.

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Gastric Adenocarcinoma with Thymic Metastasis after Curative Resection: A Case Report

  • Matsunaga, Tomoyuki;Saito, Hiroaki;Miyatani, Kozo;Takaya, Seigo;Fukumoto, Yoji;Osaki, Tomohiro;Ikeguchi, Masahide
    • Journal of Gastric Cancer
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    • v.14 no.3
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    • pp.207-210
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    • 2014
  • The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. In contrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man who previously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after the initial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracic surgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasize to unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.

Co-existence of relapsing polychondritis and Crohn disease treated successfully with infliximab

  • Jung, Hye-In;Kim, Hyun Jung;Kim, Ji-Min;Lee, Ju Yup;Park, Kyung Sik;Cho, Kwang Bum;Lee, Yoo Jin
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.70-73
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    • 2021
  • Relapsing polychondritis (RP) is a rare, progressive immune-mediated systemic inflammatory disease of unknown etiology, characterized by recurrent inflammation of cartilaginous structures. Approximately 30% of RP cases are associated with other autoimmune diseases. However, the co-occurrence of RP and Crohn disease (CD) has rarely been reported. Herein, we present a 35-year-old woman diagnosed with RP and CD, who was refractory to initial conventional medications, including azathioprine and glucocorticoid, but who subsequently responded to infliximab (IFX). For both diseases, remission was sustained with IFX. There has been no previous report regarding the successful treatment of co-existing RP and CD with IFX.

X-linked Agammaglobulinemia Assiociated with Bronchiectasis : A Case Report (기관지 확장증을 동반한 X연관 무감마글로불린혈증 1예)

  • Yu, Chang-Min;Koh, Won-Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Ki, Chang-Seok;Kim, Jong-Won
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.6
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    • pp.628-634
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    • 2003
  • Bronchiectasis is defined as an abnormal, irreversible dilatation of the bronchi, which may result from a number of possible causes, and the recognition of these causes may lead to a specific management strategy. Immunodeficiency is known as one of the conditions associated with bronchiectasis. X-linked agammaglobulinemia is a rare inheritable immunodeficiency disorder, caused by a differentiation block, leading almost to the complete absence of B lymphocytes and plasma cells. The affected protein is a cytoplasmic protein tyrosine kinase, Bruton's tyrosine kinase. The early detection and treatment with immunoglobulin replacement are most important for the management of recurrent infections and for reducing severe complications. We report a 20-year-old male patient, with X-linked agammaglobulinemia associated with bilateral bronchiectasis, carrying a missense mutation(R520P) in the BTK gene.

Smooth versus Textured Tissue Expanders: Comparison of Outcomes and Complications in 536 Implants

  • Omar Allam;Jacob Dinis;Mariana N. Almeida;Alexandra Junn;Mohammad Ali Mozaffari;Rema Shah;Lauren Chong;Olamide Olawoyin;Sumarth Mehta;Kitae Eric Park;Tomer Avraham;Michael Alperovich
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.42-51
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    • 2024
  • Background Increasing concerns regarding the safety of textured surface implants have resulted in surgeons transitioning from textured tissue expanders (TEs) to smooth TEs. Given this change has only recently occurred, this study evaluated outcomes between smooth and textured TEs. Methods Women who underwent two-stage breast reconstruction using TEs from 2013 to 2022 were included. TE-specific variables, perioperative information, pain scores, and complications were collected. Chi-squared, t-test, and linear regression analyses were performed. Results A total of 320 patients received a total of 384 textured and 152 smooth TEs. Note that 216 patients received bilateral reconstruction. TEs were removed in 9 cases. No significant differences existed between groups regarding comorbidities. Smooth TEs had a higher proportion of prepectoral placement (p < 0.001). Smooth TEs had less fills (3±1 vs. 4±2, p < 0.001), shorter expansion periods (60±44 vs. 90±77 days, p < 0.001), smaller expander fill volumes (390±168 vs. 478±177 mL, p < 0.001), and shorter time to exchange (80±43 vs. 104±39 days, p < 0.001). Complication rates between textured and smooth TEs were comparable. Smooth TE had a greater proportion of TE replacements (p = 0.030). On regression analysis, pain scores were more closely associated with age (p = 0.018) and TE texture (p = 0.046). Additional procedures at time of TE exchange (p < 0.001) and textured TE (p = 0.017) led to longer operative times. Conclusion As many surgeons have transitioned away from textured implants, our study shows that smooth TEs have similar outcomes to the textured alternatives.

Role and Clinical Importance of Progressive Changes in Echocardiographic Parameters in Predicting Outcomes in Patients With Hypertrophic Cardiomyopathy

  • Kyehwan Kim;Seung Do Lee;Hyo Jin Lee;Hangyul Kim;Hye Ree Kim;Yun Ho Cho;Jeong Yoon Jang;Min Gyu Kang;Jin-Sin Koh;Seok-Jae Hwang;Jin-Yong Hwang;Jeong Rang Park
    • Journal of Cardiovascular Imaging
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    • v.31 no.2
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    • pp.85-95
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    • 2023
  • BACKGROUND: The prognostic utility of follow-up transthoracic echocardiography (FU-TTE) in patients with hypertrophic cardiomyopathy (HCM) is unclear, specifically in terms of whether changes in echocardiographic parameters in routine FU-TTE parameters are associated with cardiovascular outcomes. METHODS: From 2010 to 2017, 162 patients with HCM were retrospectively enrolled in this study. Using echocardiography, HCM was diagnosed based on morphological criteria. Patients with other diseases that cause cardiac hypertrophy were excluded. TTE parameters at baseline and FU were analyzed. FU-TTE was designated as the last recorded value in patients who did not develop any cardiovascular event or the latest exam before event development. Clinical outcomes were acute heart failure, cardiac death, arrhythmia, ischemic stroke, and cardiogenic syncope. RESULTS: Median interval between the baseline TTE and FU-TTE was 3.3 years. Median clinical FU duration was 4.7 years. Septal trans-mitral velocity/mitral annular tissue Doppler velocity (E/e'), tricuspid regurgitation velocity, left ventricular ejection fraction (LVEF), and left atrial volume index (LAVI) at baseline were recorded. LVEF, LAVI, and E/e' values were associated with poor outcomes. However, no delta values predicted HCM-related cardiovascular outcomes. Logistic regression models incorporating changes in TTE parameters had no significant findings. Baseline LAVI was the best predictor of a poor prognosis. In survival analysis, an already enlarged or increased size LAVI was associated with poorer clinical outcomes. CONCLUSIONS: Changes in echocardiographic parameters extracted from TTE did not assist in predicting clinical outcomes. Cross-sectionally evaluated TTE parameters were superior to changes in TTE parameters between baseline and FU at predicting cardiovascular events.