• Title/Summary/Keyword: staging

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Impact of Additional Preoperative Computed Tomography Imaging on Staging, Surgery, and Postsurgical Survival in Patients With Papillary Thyroid Carcinoma

  • So Yeong Jeong;Sae Rom Chung;Jung Hwan Baek;Young Jun Choi;Sehee Kim;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1284-1292
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    • 2023
  • Objective: We investigated the impacts of computed tomography (CT) added to ultrasound (US) for preoperative evaluation of patients with papillary thyroid carcinoma (PTC) on staging, surgical extent, and postsurgical survival. Materials and Methods: Consecutive patients who underwent surgery for PTC between January 2015 and December 2015 were retrospectively identified. Of them, 584 had undergone preoperative additional thyroid CT imaging (CT + US group), and 859 had not (US group). Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to adjust for 14 variables and balance the two groups. Changes in nodal staging and surgical extent caused by CT were recorded. The recurrence-free survival and distant metastasis-free survival after surgery were compared between the two groups. Results: In the CT + US group, discordant nodal staging results between CT and US were observed in 94 of 584 patients (16.1%). Of them, CT accurately diagnosed nodal staging in 54 patients (57.4%), while the US provided incorrect nodal staging. Ten patients (1.7%) had a change in the extent of surgery based on CT findings. Postsurgical recurrence developed in 3.6% (31 of 859) of the CT + US group and 2.9% (17 of 584) of the US group during the median follow-up of 59 months. After adjustment using IPTW (580 vs. 861 patients), the CT + US group showed significantly higher recurrence-free survival rates than the US group (hazard ratio [HR], 0.52 [95% confidence interval {CI}, 0.29-0.96]; P = 0.037). PSM analysis (535 patients in each group) showed similar HR without statistical significance (HR, 0.60 [95% CI, 0.31-1.17]; P = 0.134). For distant metastasis-free survival, HRs after IPTW and PSM were 0.75 (95% CI, 0.17-3.36; P = 0.71) and 0.87 (95% CI, 0.20-3.80; P = 0.851), respectively. Conclusion: The addition of CT imaging for preoperative evaluation changed nodal staging and surgical extent and might improve recurrence-free survival in patients with PTC.

NO Reduction and High Efficiency Combustion by Externally Oscillated Staging Burner

  • Lim, Mun-Sup;Yang, Won;Chun, Young-Nam
    • Environmental Engineering Research
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    • v.14 no.3
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    • pp.158-163
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    • 2009
  • It is difficult for a burner to achieve an increase in combustibility and a reduction of NOx emission, simultaneously. The reason is because thermal NOx could be reduced at low temperature, while the combustibility should be decreased. To solve this problem, an externally oscillated staging burner was developed, and experiment was conducted according to effective parameters. The combustibility could be improved through the accelerated transfer of heat, mass and momentum obtained by external oscillation. Also, NO is reduced by the decrease of residence time of burning gas in the local highest-temperature spot, which is decreased by the external oscillation and fuel staging. Experiments on variables were conducted to determine the reference flame, and the flame generating the lowest NO concentration was selected. The conditions of reference flame were oscillation frequency 250 Hz, sound pressure 1 VPP, and air ratio 1.1, and NO and CO concentrations were 1ppm and 20 ppm, respectively.

TNM Stages and Prognostic Features of Colorectal and Mucinous Adenocarcinoma Patients: a Meta Analysis

  • Chen, Jing-Xiang;Tang, Xu-Dong;Xiang, De-Bing;Dong, Xiao-Ling;Peng, Fang-Yi;Sun, Gui-Yin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3427-3430
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    • 2012
  • Aim: The significance of the mucinous adenocarcinoma in TNM staging and prognosis for colorectal tumor patients is still controversial. The aim was to provide a meta-analysis for TNM staging and prognostic features of colorectal tumors. Methods: 30 individual case-control studies were finally included into this meta-analysis, involving a total of 444,489 cancer cases and 45,050 mucinous adenocarcinomas, of relations with TNM staging and prognostic features. Results: Compared to non-mucinous adenocarcinoma patients, the TNM IV stage accounted for a larger percentage of mucinous adenocarcinomas (OR=1.48, 95%CI 1.28-1.71, POR<0.001) and the prognosis was significantly poor (HR=1.06, 95%CI 1.04-1.08, P<0.001). After heterogeneity testing, the results was similar to the holistic approach outcome (HR=1.48, 95%CI 1.35-1.62, P<0.001). Conclusion: Compared to patients with non-mucinous adenocarcinomas, mucinous adenocarcinoma patients with later TNM staging make up a big percentage, and mucinous adenocarcinoma is an independent risk factor for poor prognosis.

A Basic Study of Fuel 2-staging Y-jet Atomizer to Reduce NOx in Liquid Fuel Burner (액체 연료용 버너에서 NOx 저감을 위한 연료2단 분사 Y-jet 노즐에 관한 기초연구)

  • Song, Si-Hong;Lee, Gi-Pung;Kim, Hyeok-Je;Park, Seok-Ho
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.25 no.11
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    • pp.1616-1623
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    • 2001
  • A basic experimental study has been carried out to find out the design parameters of fuel 2-staging atomizers in order to reduce nitrogen oxides(NOx) rate emitted from the steam boilers used the liquid fuel. The heavy fuel oil(B-Coil) and fuel 2-staging Y-jet twin-fluid atomizers were adopted in this study. The results of this paper were obtained from the real as well as the model scale atomizers. In the case of model atomizers test, NOx reduction rate was strongly dependent on the staged fuel rate, but it was weakly dependent on the injection hole arrangement and air swirl conditions. The real scale atomizers was designed and manufactured on the base of these test results, and those was mounted and operated in the real boiler generates 185 ton steam per an hour. The reduction rate of the model and real plant was reached 10∼30% of base NOx by atomizers. but dust was sharply increased in the low O$_2$combustion region of the real plant.

Experimental Investigation of NOX Reduction using a Hybrid Fuel Lean Reburning System (NOx 저감을 위한 하이브리드 연료희박 재연소 연구)

  • Kim, Hak-Young;Baek, Seung-Wook;Hwang, Chang-Hwan
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.34 no.3
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    • pp.283-290
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    • 2010
  • The main goal of this study is to examine the use of a hybrid -fuel lean reburning system with air staging for $NO_X$ reduction. The experimental variables include the reburn fuel fraction, sizes of reburn- fuel-injection nozzles, oxygen enrichment ratio, and location of reburn- fuel- injection. The effect of the flow field induced by air- staging combustion on $NO_X$ reduction is considered, and then, the $NO_X$ reduction rate is compared with only fuel lean reburning system. On the basis of the effectiveness of each De-$NO_X$ process, the advantage of using the hybrid reburning system with air staging is determined and discussed.

Staging with PET-CT in Patients with Locally Advanced Non Small Cell Lung Cancer is Superior to Conventional Staging Methods in Terms of Survival

  • Mutlu, Hasan;Buyukcelik, Abdullah;Erden, Abdulsamet;Aslan, Tuncay;Akca, Zeki;Kaya, Eser;Kibar, Mustafa;Seyrek, Ertugrul;Yavuz, Sinan;Calikusu, Zuleyha
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3743-3746
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    • 2013
  • Background: Of patients with non small cell lung cancer (NSCLC), around one third are locally advanced at the time of diagnosis. Because only a proprotion of stage III patients can be cured by surgery, in order to improve the outcomes, sequential or concurrent chemoradiation, or concurrent chemoradiation with induction or consolidation is offered to the patients with locally advanced NSCLC. Today, PET combined with computerized tomography (PET-CT) is accepted as the most sensitive technique for detecting mediastinal lymph node and extracranial metastases from NSCLC. We aimed to compare PET-CT and conventional staging procedures for decisions regarding curative treatment of locally advanced NSCLC. Materials and Methods: A total of 168 consecutive patients were included from Acibadem Kayseri Hospital, Acibadem Adana Hospital and Kayseri Research and Training Hospital in this study. Results: While the median PFS was $13.0{\pm}1.9$ months in the PET-CT group, it was only $6.0{\pm}0.9$ in the others (p<0.001). The median OS values were $20.5{\pm}15.6$ and $11.5{\pm}1.5$ months, respectively (p<0.001). Discussion: As a result, we found that staging with PET CT has better results in terms of survival staging. This superiority leads to survival advantage in patients with locally advanced NSCLC.

Characteristics of UBC and NOx Emission in Air Staging Combustion (공기 다단 연소 기법 적용에 따른 미연탄소분 및 질소산화물 배출특성)

  • Kim, Jeong Woo;Lim, Ho;Go, Young Gun;Jeon, Chung Hwan
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.40 no.10
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    • pp.637-644
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    • 2016
  • The purpose of this study is to understand the characteristics of unburned carbon (UBC) and NOx emissions for pulverized coal when air staging combustion is applied. A two-staged drop tube furnace capable of applying air staging combustion was designed and installed. The combustion of sub-bituminous (Tanito) has been investigated. UBC and the NOx concentration were measured under various temperatures and stoichiometric ratios in unstaged and staged combustion. As a result, UBC decreased and the NOx concentration increased with an increase in stoichiometric ratio and temperature. In particular, the NOx reduction mechanism was activated when the temperature in the fuel rich zone increased. Both UBC and the NOx concentration decreased as the temperature increased in the fuel rich zone. A high NOx reduction effect was obtained, compared to the UBC increase, when the air staging technique was applied.

Chronic Lymphocytic Leukemia and Prognostic Factors

  • Mozaheb, Zahra;NazarAbadi, Mohamad Hasan Hasanzadeh;Aghaee, Monavar Afzal
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3009-3013
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    • 2012
  • Background: The clinical course of individual chronic lymphocytic leukemia (CLL) is highly variable and clinical staging systems do not help us to predict if and at what rate there will be disease progression in an individual patient diagnosed with early stage disease. Recently, several important observations related to other prognostic factors including lymphocyte doubling time (LDT), ${\beta}_2$-microglobulin (${\beta}_2$-MG), and percent of smudge cell in peripheral blood smears, cytogenetic and molecular analysis have been made. The aim of this study was to evaluate a range of prognostic factors in our CLL patients. Design and methods: Seventy patients with CLL were enrolled. Prognostic factors of disease including Binet staging, LDT, ${\beta}_2$-MG, ESR, LDH, percent of smudge cell in peripheral blood smear, absolute lymphocyte count, and conventional cytogenetic (CC) analysis were evaluated at diagnosis, and the patients were followed up to determine their outcome. We compared factors with each other and with Binet staging and prognosis. Results: Enrolled patients aged 37-85 years at diagnosis or during follow up. There was no relationship between serum LDH level (P=0.3), ESR (P=0.11), percent of smudge cells in peripheral blood smear (P=0.94), and absolute lymphocyte count (P=0.18) with the stage of disease and prognosis, but the ${\beta}_2$ macroglobulin level (p<0.0001), LDT (p<0.001) had direct and significant relation with staging and outcome. In 19% of patients cytogenetic alteration were seen. Conclusion: The detection of cytogenetic alteration only using the CC method is not sufficient and we need to use FISH, but because FISH study is an expensive method not available in all areas, instead we believe that ${\beta}_2$ MG can be applied in its place as a good prognostic factor for CLL at diagnosis and during follow up. We suggest to add it to Binet staging for prognostic subgrouping of CLL.

The Use of FDG PET for Nodal Staging of Non-Small-Cell Lung Cancer (비소세포폐암 환자의 국소 림프절 전이 발견을 위한 FDG PET의 이용)

  • 백희종;박종호;최창운;임상무;최두환;조경자;원경준;조재일
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.910-915
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    • 1999
  • Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

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THE EXPRESSION OF MMP-2, MMP-3, MMP-10, MMP-13 IN SQUAMOUS CELL CARCINOMA OF THE TONGUE (혀의 편평상피세포암에서 MMP-2, MMP-3, MMP-10, MMP-13의 발현 양상)

  • Yun, Kyoung-In;Pyo, Sung-Woon;Kim, Young-Sill;Lee, Cheol-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.3
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    • pp.182-187
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    • 2002
  • Matrix metalloproteinase(MMP) is the proteolytic enzyme of the extracellular matrix. MMPs play a role in the invasion and metastasis of malignant tumor, but it is not known whether the expression of MMPs in squamous cell carcinoma of the tongue is related to the prognostic factors of this tumor. In this study, 32 paraffin-embedded tumor specimens were examined immunohistochemically using monoclonal antibodies of MMP-2, MMP-3, MMP-10 and MMP-13. The possible relationships between the expressions of the MMPs and TNM staging, the differentiation of tumor cells, size of tumor mass and lymph node metastasis were anlaysed statistically. The results were as follows. 1. The expression of MMP-2 increased according to TNM staging (P<0.05) and lymph node metastasis (P<0.05) and the expression of MMP-2 was not affected by the differentiation of tumor cells or tumor size. 2. The expression of MMP-3 increased with increasing tumor size (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. 3. The expression of MMP-10 was unrelated to TNM staging, differentiation of tumor cells, lymph node metastasis or tumor size. 4. The expression of MMP-13 increased as tumor size increased (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. We concluded that the expression patterns of MMP-2, MMP-3, and MMP-13 may play a role in the diagnosis, treatment plan and prognostic evaluation of malignant tumors of the tongue.