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      • Lateral Lymph Node Metastasis in Papillary Thyroid Carcinoma: Results of Therapeutic Lymph Node Dissection

        Chung, Yoo Seung,Kim, Jee Young,Bae, Ja-Seong,Song, Byung-Joo,Kim, Jeong Soo,Jeon, Hae Myung,Jeong, Sang-Seol,Kim, Eung Kook,Park, Woo-Chan Mary Ann Liebert 2009 Thyroid Vol.19 No.3

        <P>BACKGROUND: Cervical lymph node metastases are quite common in papillary thyroid cancer (PTC) and they usually spread in a contiguous fashion. However, 'skip metastasis,' defined as lateral lymph node metastasis without central lymph node metastasis, also occurs in patients with PTC. There is little information regarding skip metastasis in papillary thyroid microcarcinoma (PTMC). The goal of this study was to determine the prevalence and associated clinical and imaging features of skip metastasis in PTMC. METHODS: We performed a retrospective study of 245 patients with PTMC who underwent either thyroidectomy and central lymph node dissection or thyroidectomy, central lymph node dissection, and lateral lymph node dissection if preoperative ultrasonography or computed tomography suggested lateral node metastasis. Clinicopathologic results were reviewed, and the patterns of cervical lymph node metastasis were analyzed. RESULTS: Cervical lymph node metastases were present in 26.5% of cases. The frequency of lymph node metastases was 21.8% in the group that only had thyroidectomy and central lymph node dissection and 51.3% in the group that had thyroidectomy, central lymph node dissection, and lateral lymph node dissection. Younger age, larger tumor size, multiplicity, bilaterality, encapsulation, extrathyroid extension, and lymphatic invasion were associated with metastasis to nodes in the central or lateral compartment. Lateral lymph node dissection was performed in 15.9% of patients. Skip metastasis was observed in 7.7% of the cases in which combined central and lateral node dissection was performed. No features of the primary thyroid tumor could be associated with the development of skip metastasis. CONCLUSIONS: Skip metastases occur in a minority of patients with PTMC. We recommend, therefore, that preoperative studies in patients suspected of having PTMC focus not only on nodes in the central compartment but also lateral cervical nodes since the information obtained would guide the extent of surgery.</P>

      • 꽃가루 농도와 알레르기 유발과의 연관성 연구

        오영철 ( Yung Chul Oh ),김현아 ( Hyun A Kim ),정지태 ( Jee Tae Cheong ),강임주 ( Im Joo Kang ),김성원 ( Seong Won Kim ),박강서,김봉성 ( Bong Seong Kim ),국명희 ( Myung Hee Kook ),이하백 ( Ha Baik Lee ),오재원 ( Jae Won Oh ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2009 소아알레르기 및 호흡기학회지 Vol.19 No.4

        목적: 꽃가루와 연관되어 유발되는 알레르기 질환을 화분증(pollinosis)이라 부르며, 최근에는 우리나라에서도 공증화분에 의한 알레르기비염, 천식 및 알레르기성 각결막염 둥 꽃가루연관 질환이 증가하고 있어 알레르기 환자와 일반 국민을 위한 알레르기 예보식 개발이 시급하다. 이에 알레르기를 유발하는 식물들 종별로 꽃가루 수와 알레르기증상과의 상관성에 대한 연구가 필요하며, 우리 나라 고유의 알레르기 지수가 절대적으로 필요하게 되어 이에 대한 연구를 시행하게 되었다. 방법: 2007년 3월 1일부터 2008 10월 3l일까지 8개월간 전국적으로 서울, 구리, 강릉, 충주, 대구, 광주, 부산, 제주 등 8개 지역을 대상으로 선정하여 대상 건물의 옥상에 지면으로부터 1.5미터 높이에 Burkard seven days Sampler률 설치하여 공중화분을 매일 측정하여 수집된 글리세린 접착 비닐을 Calberla`s fuchsin 용액으로 염색하여 광학현미경으로 공중화분을 관찰 동정하여, 평방미터 당 각 공중화분 수를 계산하여 기록하였다. 알레르기성 꽃가루에 대한 감작률올 조사하기 위하여 각 해당 병원에서 알레르기 증상을 호소하는 환자를 대상으로 알레르기 피부시험과 혈액 검사 등 자료를 수집하였으며, 지역별 등으로 분류하여 정리하였다. 환자의 증상을 객관적으로 기록하기 위하여 10개 항목의 증상 지수를 이용하여 주 3회 전화 설문으로 증상 중증도를 분류하고, 증상지수와 꽃가루 수를 비교하여 상관관계를 분석하였다. 결과: 알레르기 꽃가루에 대한 감작률을 조사한 결과 전체적으로 돼지풀(5.9%), 산쑥(5.8%), 오리나무(4.9%), 자작나무(4.8%) 순으로 감작률이 높게 나타났다. 대상 알레르기 환자들에게 전화 통화를 통해 질문을 하여 발생한 증상에 대해 증상지수를 기록하여 해당일의 꽃가루 수와의 상관관계를 비교한 결과 증상지수와 꽃가루 수가 유의한 상관관계를 나타냈다. 결론: 꽃가루 지수와 환자발생과의 관계를 직접적으로 밝힐 수 있는 방법으로 계절성 알레르기 환자를 지역별로 수집하여 임상증상과 꽃가루 수의 상관관계를 조사한 바 꽃가루 수와 알레르기 환자의 임상증상 간에 의미 있는 상관성을 나타냈다. 이런 결과를 기초로 하여 우리나라 고유의 알레르기 증상 등급을 개발하였고, 이를 이용하여 꽃가루 예보제를 시행할 수 있을 것으로 기대한다. Purpose: The distribution of pollens in the air is mainly related to the weather conditions, especially temperature and humidity. This study focused on the evaluation of the relationship between pollen count and the outbreak of allergic diseases (symptom index) from allergic patients in Korea in order to determine Korean own allergy risk grade for the pollen forecasting system. Methods: Airborne particles carrying allergens were collected daily in nationwide 8 stations (Seoul, Guri, Daejeon, Daegu, Kwangju Busan, Kangneung, and Jeju) by using 7 day-Burkard sampler in South Korea for 8 months (March 1, 2008-October 31, 2008). They were counted and recorded along with weather factors. Symptom index was calculated and recorded by phone calling to allergic patients 3 times a week. Results: Airborne pollens have 2 peak seasons (May and September) in Korea. In the skin prick test, ragweed was the highest sensitization rate (5.9%), followed by mugwort (5.8%), alder (4.9%), birch (4.8%) and oak grasses among the pollen extracts in Korean school-aged children. There are significant relationship between symptom index of allergic patients and allergic pollen concentrations. Korean own risk grade of pollen allergy was made by using the data from this study. Conclusion: Risk grade of pollens for allergy pollen forecast among each allergic plant was established. Further studies are needed to confirm it our result. [Pediatr Allergy Respir Dis (Korea) 2009;19:354-364]

      • 소아 알레르기 유발 가능성과 화분(꽃가루)농도와의 관련성

        오재원 ( Jae Won Oh ),강임주 ( Im Ju Kang ),김성원 ( Sung Won Kim ),국명희 ( Myung Hee Kook ),김봉성 ( Bong Seong Kim ),정지태 ( Jee Tae Cheong ),이하백 ( Ha Baik Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2009 소아알레르기 및 호흡기학회지 Vol.19 No.1

        Pollinosis is one of the allergic diseases which caused by airborne pollens from allergic plants, such as allergic rhinitis, asthma, and allergic conjunctivitis. The distribution of pollens in the air is fully related to weather condition, especially temperature and humidity, etc. This study is focused on the evaluation of the relation between pollen count and the outbreak of allergic diseases (symptom index) from allergic patients in Korea and this data would be necessary to evaluate Korean own allergy index for pollen forecasting system. Airborne particles carrying allergens were collected daily from nationwide 8 stations (Seoul, Guri, Daejeon, Daegu, Kwangju, Busan, Kangneung, and Jeju) by using 7 days-Burkard sampler (Burkard Manufacturing Co Ltd, Hertfordshire, UK) for 10 year in South Korea (March 1, 2008-October 30, 2008). They were counted and recorded along with the weather factors. Symptom index was evaluated and recorded by calling to allergic patients daily. Airborne pollen has two peak seasons that is May and September in Korea. The peak season for mold was June. There was the tree pollen seasons from the middle of February to late July, then followed during the grasses and weed season from the middle of July to the end of October. Ragweed was one of the most common pollen of autumn in Korea. In skin prick test, Ragweed was the highest sensitization rate (5.9%), followed by Mugwort (5.8%), alder (4.9%), birch (4.8%), oak grasses among the pollen extracts in Korean school aged children. Ragweed pollen counts were gradually increased since 2000. In same period, sensitization rates for airborne pollen, especially weeds in Korean children were increased annually (1999: 4.4%, 2000: 7.1%, 2001: 7.4%, 2002: 8.5%, 2003: 7.7%). There are significantly related between symptom index from allergic patients and allergic pollen concentrations. Sensitization rates for pollens are increased in Korean children with age. There are significantly related between symptom index from allergic patients and allergic pollen concentrations. Risk Grade of pollen for allergy pollen forecast among each allergic plant was established and still remain to confirm it. [Pediatr Allergy Respir Dis(Korea) 2009;19:4-11]

      • 만성골수성백혈병에서의 동종골수이식 : 국내 경험의 후향적 분석 Retrospective Analysis of Korean Experience

        이규형,이제환,이정신,김상희,김우건,김춘추,이종욱,김병국,박선양,이홍기,윤성수,김효철,남동기,한지숙,민유홍,현명수,황태주,정익주,박영석,이정애 대한조혈모세포이식학회 1998 대한조혈모세포이식학회지 Vol.3 No.2

        연구방법: 국내에서 시행된 만성골수백혈병의 치료를 위한 가족간 동종골수이식의 임상적 특징을 후향적으로 분석하였다. 9개의 병원에서 1986년 9월부터 1997년 6월까지 시행한 137예의 가족간 동종골수이식을 보고하였다. 결과: 전체 환자 중 62%인 85예가 남자였고 연령은 15세에서 50세까지 분포하였다(중앙치 30세). 95예(71%)의 환자는 이식 당시 만성골수성백혈병 만성기의 상태였고 38예(28%)는 가속기 또는 모세포성발증기의 상태였다. 70예(51%)의 환자는 이식전처치로 busulfan+cyclophosphamide (BuCy) 치료를 받았고 42예(31%)의 환자는 cyclophosphamide+전신방사선 조사(Cy-TBI)를 받았다. 환자에게 이식된 단핵구의 수는 0.06-9.5×10^(8)/kg(중앙치 1.2×10^*/kg)였다. 1 예를 제외한 모든 환자에서 이식 후 8-100일(중앙치 17일)에 중성구 500/㎕ 이상의 착상이 관찰되었다. 급성 및 만성이식편대숙주질환은 각각 46%와 43%의 환자에서 관찰되었다. 중앙추적기간 20개월(범위 3-135개월) 경과 후 137예의 환자 중 52예의 환자가 사망하였다. 사망 원인은 감염(27%), 백혈병의 지속 또는 재발(23%), 이식편대숙주질환(21%), 치료독성(15%), 그리고 이식편거부(8%) 등이었다. 환자들의 event-free survival에 영향을 주는 인자로는 이식전 병의 상태(p<0.001)와 환자의 혈청 HBsAg 양성여부(p=0.012)가 중요하였다. Overall survival에 영향을 주는 인자도 이식전 병의 상태와 환자 혈청 HBsAg 양성여부로 나타났다. 결론: 본 연구에서 국내 만성골수성백혈병에 대한 동종골수이식술은 그 시행 예가 급격히 증가하고 있음을 보여주었다. 환자들의 임상 특성과 생존 성적은 외국의 성적과 유사하였다. B형 간염 감염환자의 경우 예후가 유의하게 불량하였고, 이는 추후의 임상연구에서 확인이 필요한 소견으로 사료된다. Background and Methods: Clinical features of allogeneic bone marrow transplantation (BMT) performed for patients with chronic myelocytic leukemia (CML) in Korea were analyzed retrospectively. Nine hospitals reported a total of 137 cases of allogeneic BMT performed between September, 1986 and June, 1997. Results: There were 85 male (62%) and 52 female patients with median age of 30 years (range 15-50). Ninety five patients (71%) were in chronic phase and 38 patients (28 %) were in accelerated/blastic phase of the disease. Seventy patients (51%) received busulfan-cyclophosphamide (BuCy) regimen for preparation and 42 patients (31%) received cyclophosphamide-total body irradiation (Cy-TBI) regimen. The median mononuclear cell dose given to patients was 1.2×10^(8)/kg (range, 0.06-9.5×10^(8)/kg). All but one patient achieved absolute neutrophil count of 500/μl after median 17 days after BMT (range, 8-100 days). Acute and chronic graft-versus-host disease (GVHD) were reported in 61/133 (46%) and in 57/134 (43%) patients, respectively. The median follow-up time of survivors was 20 months (range, 3-135 months). There were 52 deaths (38%). The causes of death were infection (14 patients, 27%), recurrent/persistent disease (12 patients, 23%), GVHD (11 patients, 21%), regimen related toxicity (8 patients, 15%), graft rejection/failure (4 patients, 8%), and unknown (3 patients, 6%). The factors influencing event free survival of the patients were disease status before BMT (p<0.001, by log-rank test) and serum hepatitis B surface antigen status (p=0.012). Longer duration of disease before BMT showed poorer outcome but the difference did not reach statistical significance. The factors affecting overall survival of the patients were disease status before BMT (p=0.009) and hepatitis B surface antigen status (p=0.036). The donor hepatitis B antigen status did not influence event free survival or overall survival of the patients. Conclusion: Clinical features and survival patterns of patients with CML treated with allogeneic BMT in Korea were similar to historical data from other countries. Further data analyses are warranted for the role of hepatitis B virus infection influencing the outcome of allogeneic BMT for CML.

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