• 제목/요약/키워드: Sinus node

검색결과 66건 처리시간 0.027초

Elective neck treatment in clinically node-negative paranasal sinus carcinomas: impact on treatment outcome

  • Lee, Won Hee;Choi, Seo Hee;Kim, Se-Heon;Choi, Eun Chang;Lee, Chang Geol;Keum, Ki Chang
    • Radiation Oncology Journal
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    • 제36권4호
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    • pp.304-316
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    • 2018
  • Purpose: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. Materials and Methods: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. Results: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. Conclusion: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.

Cyclosporin A로 유도된 생쥐 림프절의 세포성 면역억제에 관한 면역조직화학적 연구 -T 림프구, IL-2 수용기 및 NK세포의 변화를 중심으로- (Immunohistochemical Study on the Suppression of Cell mediated immunity in Lymph node of mouse by Cyclosporin A -Based on the change of T lymphocytes, Il-2 receptors, and NK cells-)

  • 김진택;박인식;안상현;최난희;김동환
    • 동국한의학연구소논문집
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    • 제6권2호
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    • pp.99-107
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    • 1998
  • 본 실험은 cyclosporin A(CsA)에 의한 시간의 경과에 따른 림프절에서의 세포성 면역억제를 조사하기 위해서 시행된 것으로 BALB/C계 생쥐에 10일동안 CsA(45mg/kg/day) 투여 후 림프절에서의 T 림프구, IL-2 수용기 그리고 자연살해(NK)세포의 분포 변화를 관찰하였다. 대조군의 림프절에서는 L3T4(CD4)에 양성반응을 보이는 도움 T림프구, Ly2(CD8)에 양성반응을 보이는 세포독성 T 림프구 그리고 CD25R에 양성반응을 보이는 IL-2 수용기를 가진 세포는 곁피질(paracortex)과 수질동(medullary sinus)에서 분포하였다. CsA 투여 후 처음 3일까지는 이들 양성반응세포의 분포 변화는 없었으며 양성반응성의 변화도 없었다. 그러나 CsA 투여 7일부터 양성반응 세포수의 감소와 양성반응성의 약화가 관찰되기 시작하였으며 이러한 변화는 시간이 경과하여 14일에 이르렀을 때 가장 큰 감소추세로 나타났다. 한편 NK1.1(CD56)에 양성반응을 보이는 자연살해세포는 피질과 수질에 분포하였으며 CsA 투여 후 시간의 경과에 따라 양성반응 세포수가 감소하였으며, 이러한 감소는 14일에서 가장 큰 것으로 나타났다. 이상의 결과로 미루어보아 CsA 투여는 림프절에서의 IL-2 분비저해를 통해 T 림프구와 NK세포의 활성을 차단하여 선택적이면서 효과적인 세포성 면역억제작용을 하고 있는 것으로 사료된다.

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결핵성 임파결절에 의한 기관 협착증 치험 1 (Surgical treatment of tracheal stenosis due to paratracheal tuberculous lymphadenitis.*)

  • 강채규
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.213-217
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    • 1987
  • ; A 15 years old girl was operated due to tuberculous paratracheal lymph node enlargement resulted in marked narrowing of lower part of trachea. She had suffered from sputum expectoration difficulty, which was developed dyspnea and cyanosis. 1st operation was simple removal of enlarged paratracheal lymph node through Rt. thoracotomy but restenosis sign developed 2 months later in spite of Anti-Tbc. medication. 2nd operation was resection of constricted tracheal portion [2.5cm] 8 end to end anastomosis under Extra Corporeal Circulation. Under Extra Corporeal Circulation trachea reconstruction offered many conveniences during operation. Till now, she has been follow up checked for one year, she was very good post-operation state without any restenosis signs.

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고리췌장을 동반한 초극소저체중출생아에서 나타난 굴기능부전증후군 1례 (A Case of Sick Sinus Syndrome in Extremely Low Birth Weight Infant with Annular Pancreas)

  • 김지은;바우어 지그프리드;부윤정;이장훈;장기영;최병민;박문성
    • Neonatal Medicine
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    • 제18권2호
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    • pp.395-398
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    • 2011
  • 굴기능부전증후군은 매우 드물지만 신생아에서도 발생할 수 있으며 소아 환자의 경우 대부분 선천심장병이 있거나 심장수술 후에 발생한다. 그러나 이와 같은 심질환의 선행 요인이 없는 신생아에서도 발생할 수 있기 때문에 이에 대한 인지가 필요하다. 굴기능부전증후군은 대부분 특발성으로 발생하며 증상도 다양하고 24시간 심전도 검사상에서도 다양한 형태로 관찰된다. 본 증례에서는 초극소저체중출생아에서 선천심장병 없이 발생한 굴기능부전증후군에 대해 보고하였다. 환아는 심전도상 굴느린맥과 함께 심방세동이 동반된 느린맥과 빠른맥이 반복되어 관찰되었으며 무호흡, 산소포화도의 저하, 청색증의 징후를 나타냈다. 증상이 있는 굴기능부전증후군의 경우 대부분 심장박동조율기의 삽입이 필요하나 본 환아는 당시 체중 750 g으로 심장박동조율기의 삽입에 실패하여 약물 치료를 시작하였다. Isoproterenol과 atropine으로 치료하면서 환아의 체중이 1,500 g을 넘어서자 증상과 심전도상의 호전을 보였다. 향후 본 환아에서처럼 심장박동조율기의 삽입이 어려운 소아 환자의 경우에 대한 치료 체계에 대해 많은 연구가 필요하다.

고라니 혈절과 혈림프절에 관한 형태학적 연구 (Morphological studies on hemal nodes and hemolymph nodes in the water deer(Hydropotes inermis))

  • 윤여성;이준섭
    • 대한수의학회지
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    • 제37권3호
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    • pp.463-469
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    • 1997
  • This study was performed to investigate the gross anatomical features and microscopical structures of the hemal nodes and the hemolymph nodes in the water deer (Hydropotes inermis) found in Kangwon-do, Korea. The hemal nodes and hemolymph nodes were observed mainly in the periphery of the thoracic and abdominal aortae of the animals. The size of hemal nodes was generally smaller than that of the hemolymph nodes, and the shape of the both organs was spherical or ovoid. The color of the hemal nodes was red or black while that of the hemolymph nodes was gray with red bands. The hemal nodes were surrounded by a thin connective tissue capsule and there were extensive subcapsular and deep sinuses distended by a great number of erythrocytes. Although a few number of lymphatic nodules and small areas of diffuse lymphatic tissues were observed in the parenchyma, no typical cortex and medulla were defined in the hemal node. Small numbers of blood vessels were found at the connective tissue capsule but lymph vessel was not observed microscopically in this organ. The hemolymph nodes were covered by a relatively thick connective tissue capsule and there was a hilus in each node. The parenchyma was divided into cortex and medulla. The cortex was composed of a few numbers of lymphatic nodules and some diffuse lymphatic tissues. The medulla comprised medullary sinus and cords. Afferent and efferent lymph vessels were observed at the periphery of the capsule and the hilus, respectively. The subcapsular and medullary sinuses were not extensive but filled with small numbers of erythrocytes. The stroma of hemal node and hemolymph node was composed of reticular cells and fibers, and the capsule and trabecula consisted of collagenous fibers with smooth muscle fibers.

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토끼 동방결절 활동전압에 대한 Na, K, Ca 및 Mg 이온의 영향 (Effect of Na, K, Ca and Mg ions on the Action Potential of the Sinoatrial Node in the Rabbit)

  • 이정렬;엄융의
    • Journal of Chest Surgery
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    • 제18권1호
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    • pp.1-6
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    • 1985
  • Isolated sinus node cells of the rabbit were used to assess the effects of extracellular Na, K, Ca and Mg concentrations on cardiac pacemaker activity. With intracellular glass micro-electrodes spontaneous action potentials of SA node were recorded and the effects of various ions and their blockers were analyzed in terms of the cycle length, the amplitude and the duration of action potentials, the results obtained were as follows. 1. Sodium reduction [up to 30%] decreased the amplitude of action potential and lengthened the cycle length. TTX, specific blocker of Na channel slightly lengthened the cycle length. 2. Increasing potassium ion concentration, the duration of action potential decreased and the frequency increased in 6mM, however, spontaneous action potential was stopped in 24 mM. Barium ion known to be decreasing K conductance increased the duration of action potential but no significant change in the cycle length was noticed. 3. Calcium ion has shortening effect on the duration and the cycle length of action potential but not with dose-dependent manner. Cadmium ion .[0.02mM] lengthened cycle length and the duration of action potential. 4. Increasing the concentration of magnesium ion the cycle length was lengthened, significantly.

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HIV 음성 환자에서 형질모세포종의 세침흡인 세포소견 - 1예 보고 - (Fine Needle Aspiration Cytology of the Plasmablastic Lymphoma in Human Immunodeficiency Virus (HIV) Negative Patient - A Case Report -)

  • 이향임;구현령;한은미;공경엽;서철원;류민희;강윤구;박찬정;허주령
    • 대한세포병리학회지
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    • 제16권1호
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    • pp.47-51
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    • 2005
  • Plasmablastic lymphoma (PBL) is a recently described aggressive B-cell neoplasm, which usually manifests as a localized disease of the oral mucosa in individuals infected with human immunodeficiency virus (HIV). Recently we encountered a case of plasmablastic lymphoma manifesting in the left maxillary sinus and cervical lymph node of a previously healthy HIV-negative man, 48 years of age. we conducted a fine-needle aspiration smear of the cervical lymph node, and this was found to be highly cellular with numerous large cells exhibiting eccentrically positioned nuclei, prominent nucleoli, and moderate quantities of basophilic cytoplasm. A biopsy of the mass in the maxillary sinus evidenced diffuse growth of similar plasmablastic cells. These tumor cells were negative for the leukocyte common antigens, CD20, CD3, CD30, and EMA. However, the cells tested positive for CD79a and CD138/syndecan-1. The tumor cells also exhibited L-light-chain restriction. The Ki-67 proliferation index was measured at almost 100%. The patient was diagnosed with plasmablastic lymphoma. After three cycles of combination chemotherapy and radiotherapy, the patient went into complete remission, and currently remains in this state.

한국재래산양 혈절과 혈림프절의 미세구조 (Ultrastructure of hemal node and hemolymph node in Korean native goat)

  • 윤여성;신재원;이준섭
    • 대한수의학회지
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    • 제39권5호
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    • pp.855-864
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    • 1999
  • Hemal nodes and hemolymph nodes are lymphoid organs that share morphologic and functional characteristics of lymph nodes and spleens. The aim of the present study was to obtain new informations on the distinct morphological structures of hemal nodes and hemolymph nodes according to ages, and to get the basic data for their functions in Korean native goats. Goats were divided into 5 groups, consisting of 3 animals aged 1, 3, 6, 10 and 12 months, respectively. Ultrastructural features of the organs were observed by transmission and scanning electron microscopes. The sinuses of hemal nodes and hemolymph nodes were lined by endothelial-like reticular cells which had euchromatin-rich nuclei and many cytoplasmic processes, surrounding collagen fibrils. Macrophages containing phagocytosed erythrocytes were often noted in the diffuse lymphatic tissues of hemal nodes and hemolymph nodes. Some mast cells were in contact with the plasma cells near the blood vessel. Hemal nodes and hemolymph nodes had venous sinusal-like vessels which were different from the deep sinus. The lymph vessels with valves were observed in the capsule of the hemolymph node. There were no ultrastructural differences of the organs in the age different groups of the animals. These results suggest that hemal nodes and hemolymph nodes may take part in hemopoiesis, blood filtration and immune reaction in Korean native goats.

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종격동에서 발생한 Rosai-Dorfman 질병의 증례 - 1례 보고 - (Extranodal Rosai-Dorfman Disease in Mediastinum - A Case Report -)

  • 최주원;오태윤;조은윤;장운하
    • Journal of Chest Surgery
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    • 제35권10호
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    • pp.768-772
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    • 2002
  • Sinus histiocytosis with massive lymphadenopathy는 Rosai-Dorfman 질환(이후 RDD)으로 불리는 조직구증 증후군의 드문 형태의 질환으로, 주로 소아나 청소년기에 발생하며 대부분 경부 림프절을 침범하여 무통성의 심한 림프절 종대를 특징적으로 보이는 질환이다. 림프절외 부위 침범은 약 25∼43%의 환자에서 보고되며, 일부에서는 림프절의 병변없이 림프절외 부위 침범만을 보이기도 한다. 림프절외 질환에서 침범되는 기관은 안구와 부속기관 두경부, 상기도, 유방, 위장관, 중추신경계 등의 다양한 장기에서 보고되고 있다. 최근 저자들은 35세 남자환자에서 수술전 방사선학적 검사상 전종격동 종괴가 발견되어 임상적으로 침윤성 흉선 종의 의진 하에 수술을 시행하였으며, 수술 후 조직검사에서 RDD 질환으로 확진된 1예를 경험하여 보고하고자 한다.

고압산소요법으로 치료한 뇌기저부 방사선골괴사 1예 (Management of Skull Base Osteoradionecrosis with Hyperbaric Oxygen Therapy)

  • 황은;이종주;신유섭;김철호
    • 대한두경부종양학회지
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    • 제27권1호
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    • pp.66-69
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    • 2011
  • Skull base osteoradionecrosis(ORN)is a rare complication of radiotherapy for nasopharyngeal carcinoma, but is one of the most severe and possibly fatal condition followed by radiotherapy. However, the treatment of skull base ORN has seldom been thoroughly described yet. Here we report a case of skull base ORN that was successfully treated with hyperbaric oxygen therapy(HBO). A 52-year-old man visited our department complaining of trismus and foul odor. He was diagnosed with nasopharyngeal cancer with multiple lymph node metastasis one year ago and underwent concurrent chemoradiotherapy. On the physical examination, mucopus and crusts with exposed necrotic bone was seen in the right nasopharynx. On the paranasal sinus magnetic resonance imaging, osteoradionecrosis which was extending from the right nasopharynx to the clivus, petrous apex, and cavernous sinus was noted. Nasopharynx biopsy resulted of ulcer with no malignant cells. HBO therapy was performed with debridement of nasopharynx for 3 months. There was no sign of recurrence or residual ORN 18 months after HBO therapy.