Risk factor for contralateral occult carcinoma in patients with unilateral papillary thyroid carcinoma

안하림,강상율,윤현조,정성후 대한종양외과학회 2020 Korean Journal of Clinical Oncology Vol.16 No.1

Purpose: The extent of surgery necessary in patients with unilateral papillary thyroid carcinoma (PTC) on preoperative radiologic imaging is still in doubt. In this study, we aimed to define risk factors that could be indicators for malignant nodules in the contralateral thyroid lobe. Methods: We included 438 patients who underwent total thyroidectomy between January 2011 and December 2014 at our institution. In this study, patients were divided into two groups according to the presence of contralateral occult carcinoma identified by postoperative pathological examination. We analyzed the clinicopathologic factors including characteristics of coexistent nodules in the contralateral lobe based on preoperative radiological imaging. Results: A total of 96 patients (21.9%) had PTC in the contralateral lobe. There were no significant differences between patients with or without contralateral occult carcinoma with respect to gender, age, primary tumor size, central lymph node metastasis, extrathyroidal extension and stage. The presence of Hashimoto’s thyroiditis was an independent predictive factor for contralateral occult carcinoma (P=0.01). Conclusion: A risk factor for contralateral occult carcinoma in unilateral PTC patients is Hashimoto’s thyroiditis. Therefore, more caution is needed when determining optimal surgical methods for PTC patients with Hashimoto’s thyroiditis.

선행항암화학요법을 시행한 유방암 환자에서 영상학적 액와부 병기의 정확성

안하림,강상율,정성후,윤현조 한국유방암학회 2020 Journal of Breast Disease Vol.8 No.2

Purpose: Neoadjuvant chemotherapy (NACT) in breast cancer patients has the advantage of decreasing related morbidities by reducing the extent of axillary surgery. However, it remains a controversy with regards to the appropriate extent of axillary lymph node dissection after NACT. Therefore, this study aims to investigate the accuracy of breast ultrasonography (US) and breast magnetic resonance imaging (MRI) to assess the axillary nodal status after NACT. Methods: We reviewed pre- and post-NACT axillary imaging and clinicopathological data of patients who received NACT for primary breast cancer and underwent surgery. After NACT, accuracy of imaging modalities were evaluated through the comparison of pathologic lymph node (LN) status and imaging LN status. Results: Fifty seven patients completed NACT and underwent surgery. Breast US was found to have a sensitivity of 61.1%, specificity of 57.7%, negative predictive value (NPV) of 68.2%, and positive predictive value (PPV) of 50.0%. For breast MRI, sensitivity was 58.3%, specificity 75.8%, NPV 71.4%, and PPV 63.6%. For US combined with MRI, sensitivity was 66.7%, specificity 54.5%, NPV 69.2%, and PPV 51.6%. The accuracy of imaging modalities was 59.1% for US, 68.4% for MRI, and 59.6% for US combined with MRI. Conclusion: In breast cancer patients who received NACT, MRI showed a higher specificity, NPV, and PPV than US, although it had a lower sensitivity. However, due to the low accuracy, breast MRI alone is not sufficient to determine the extent of axillary surgery. Therefore, determining the extent of axillary surgery based on the results of intraoperative sentinel lymph node biopsy may be the right method for accurate staging.

Hyperglycemia during Adjuvant Chemotherapy as a Prognostic Factor in Breast Cancer Patients without Diabetes

안하림,강상율,윤현조,정성후 한국유방암학회 2020 Journal of breast cancer Vol.23 No.4

Purpose: Breast cancer treatments, including chemotherapy, administered in combination with glucocorticoids can induce hyperglycemia. This study aimed to investigate the effect of hyperglycemia during adjuvant chemotherapy on the prognosis of breast cancer patients without a known history of diabetes. Methods: In this study, 936 patients who underwent breast cancer surgery from 2010 to 2015 were initially selected as participants. Chemotherapy-related hyperglycemia was defined as fasting plasma glucose levels ≥ 100 mg/dL or random blood glucose levels ≥ 140 mg/dL during 2 or more cycles of adjuvant chemotherapy. After dividing the patients into the euglycemia and hyperglycemia groups, univariate and multivariate analyses were performed, and survival outcomes were analyzed by propensity score matching. Results: The mean age of the patients was 47.4 ± 7.7 years, and the median follow-up period was 70.1 months. Eighty-two patients (19.4%) were diagnosed as having hyperglycemia. There were significant differences between the euglycemia and hyperglycemia groups with respect to age, hypertension, body mass index, axillary surgery extents, nodal stage, and total steroid dosage. T stage, vascular invasion, and hyperglycemia were identified as prognostic factors of relapse-free survival (RFS). The 5-year RFS rates were 92.0% and 82.3% in the euglycemia and hyperglycemia groups, respectively, and there was a statistically significant difference between the 2 groups (p = 0.011). The 5-year overall survival rates were 94.6% and 92.0% in the euglycemia and hyperglycemia groups, respectively, showing no statistically significant difference between the 2 groups (p = 0.113). Conclusion: These data suggest that hyperglycemia during adjuvant chemotherapy is a prognostic factor for RFS in breast cancer patients without diabetes.

Atomic Layer Deposition법에 의한 Al-doped ZnO Films의 전기적 및 광학적 특성

안하림,백성호,박일규,안효진,An, Ha-Rim,Baek, Seong-Ho,Park, Il-Kyu,Ahn, Hyo-Jin 한국재료학회 2013 한국재료학회지 Vol.23 No.8

Al-doped ZnO(AZO) thin films were synthesized using atomid layer deposition(ALD), which acurately controlled the uniform film thickness of the AZO thin films. To investigate the electrical and optical properites of the AZO thin films, AZO films using ALD was controlled to be three different thicknesses (50 nm, 100 nm, and 150 nm). The structural, chemical, electrical, and optical properties of the AZO thin films were analyzed by X-ray diffraction, X-ray photoelectron spectroscopy, field-emssion scanning electron microscopy, atomic force microscopy, Hall measurement system, and UV-Vis spectrophotometry. As the thickness of the AZO thin films increased, the crystallinity of the AZO thin films gradually increased, and the surface morphology of the AZO thin films were transformed from a porous structure to a dense structure. The average surface roughnesses of the samples using atomic force microscopy were ~3.01 nm, ~2.89 nm, and ~2.44 nm, respectively. As the thickness of the AZO filmsincreased, the surface roughness decreased gradually. These results affect the electrical and optical properties of AZO thin films. Therefore, the thickest AZO thin films with 150 nm exhibited excellent resistivity (${\sim}7.00{\times}10^{-4}{\Omega}{\cdot}cm$), high transmittance (~83.2 %), and the best FOM ($5.71{\times}10^{-3}{\Omega}^{-1}$). AZO thin films fabricated using ALD may be used as a promising cadidate of TCO materials for optoelectronic applications.

염료감응형 태양전지의 저비용 상대전극을 위한 N-doped ZnO 나노입자-탄소나노섬유 복합체

안하림,안효진,An, Ha-Rim,Ahn, Hyo-Jin 한국재료학회 2014 한국재료학회지 Vol.24 No.10

Nitrogen-doped ZnO nanoparticle-carbon nanofiber composites were prepared using electrospinning. As the relative amounts of N-doped ZnO nanoparticles in the composites were controlled to levels of 3.4, 9.6, and 13.8 wt%, the morphological, structural, and chemical properties of the composites were characterized by means of field-emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). In particular, the carbon nanofiber composites containing 13.8 wt% N-doped ZnO nanoparticles exhibited superior catalytic properties, making them suitable for use as counter electrodes in dye-sensitized solar cells (DSSCs). This result can be attributed to the enhanced surface roughness of the composites, which offers sites for $I_3{^-}$ ion reductions and the formation of Zn3N2 phases that facilitate electron transfer. Therefore, DSSCs fabricated with 13.8 wt% N-doped ZnO nanoparticle-carbon nanofiber composites showed high current density ($16.3mA/cm^2$), high fill factor (57.8%), and excellent power-conversion efficiency (6.69%); at the same time, these DSSCs displayed power-conversion efficiency almost identical to that of DSSCs fabricated with a pure Pt counter electrode (6.57%).

전기방사법을 이용하여 제조된 Sb-Doped SnO₂ 투명전도막의 전기적 및 광학적 특성

안하림,구본율,안효진,이태근,An, Ha-Rim,Koo, Bon-Ryul,Ahn, Hyo-Jin,Lee, Tae-Kum 한국재료학회 2015 한국재료학회지 Vol.25 No.4

Sb-doped $SnO_2$(ATO) thin films were prepared using electrospinning. To investigate the optimum properties of the electrospun ATO thin films, the deposition numbers of the ATO nanofibers(NFs) were controlled to levels of 1, 2, 4, and 6. Together with the different levels of deposition number, the structural, chemical, morphological, electrical, and optical properties of the nanofibers were investigated. As the deposition number of the ATO NFs increased, the thickness of the ATO thin films increased and the film surfaces were gradually densified, which affected the electrical properties of the ATO thin films. 6 levels of the ATO thin film exhibited superior electrical properties due to the improved carrier concentration and Hall mobility resulting from the increased thickness and surface densification. Also, the thickness of the samples had an effect on the optical properties of the ATO thin films. The ATO thin films with 6 deposited levels displayed the lowest transmittance and highest haze. Therefore, the figure of merit(FOM) considering the electrical and optical properties showed the best value for ATO thin films with 4 deposited levels.

자동유방초음파: 현재와 미래

윤현조,안하림,강상율,정성후 대한외과초음파학회 2022 대한외과초음파학회지 Vol.9 No.2

Automated breast ultrasound (ABUS) is a novel imaging method, introduced to overcome the main limitations of traditional hand-held ultrasound, such as the lack of standardization, low reproducibility, small field of view, high operator dependency, and high commitment of physician time. ABUS is a standardized radiologic modality with many advantages in both screening and diagnostic settings. It increases the detection rate of breast cancer, improves workflow, and reduces the examination time. On the other hand, ABUS has some limitations, these include the inability to assess the axilla, vascularization, and elasticity of a lesion. With respect to the interpretation, the disadvantages of ABUS are the artifacts due to poor positioning, lack of contact, or those related to motion or some specific tumors. However, these disadvantages can be diminished by additional attention and training. ABUS can be used in clinical settings and is a promising modality in breast imaging. The purpose of this review is to present a summary of the characteristics and clinical applications of ABUS, and provide future perspectives.

Ultrasonography for Staging Axillary Lymph Node in Breast Cancer Patients

윤현조,안하림,강상율,정성후 대한외과초음파학회 2020 대한외과초음파학회지 Vol.7 No.1

The identification of axillary lymph node metastases in breast cancer patients is a critical factor in determining the stage, deciding the treatment modality, and predicting the prognosis. Over the years, axillary staging has evolved from a radical axillary lymph node dissection to a more conservative sentinel lymph node biopsy. The main goal of axillary imaging techniques is to identify metastatic lymph nodes with optimal accuracy, high enough to initially select patients for an upfront lymph node dissection. Features suggestive of an axillary lymph node metastasis may be seen with a range of imaging modalities. On the other hand, ultrasonography is the method of choice for evaluating the node morphology and allowing image-guided interventions of abnormal nodes. Gray-scale ultrasonography is not perfect on its own. Newer techniques, such as elastography or contrast-enhanced ultrasonography, have shown promise in identifying axillary lymph node metastases. This review provides a comprehensive overview of ultrasonography for an axillary lymph node assessment in breast cancer patients.

유방 관상피내암에서 초음파와 MRI의 종양 크기 예측 정확도 비교

강상율,안하림,변정희,윤현조,정성후 한국유방암학회 2021 Journal of Breast Disease Vol.9 No.2

Purpose: The purpose of this study was to compare the accuracy of preoperative breast tumor size measured by ultrasonography (US) and magnetic resonance imaging (MRI) in patients with ductal carcinoma in situ (DCIS). Methods: Medical records of 74 patients postoperatively diagnosed with DCIS were retrospectively analyzed. Tumor size measurements obtained using the two imaging modalities were compared for accuracy with those obtained during the final pathologic examination. Patients with only microcalcification on imaging were excluded. Results: For all patients, Lin’s concordance correlation coefficient (CCC) of MRI was 0.725, which was more accurate than 0.670 of US. In subgroup analysis, CCC of US was 0.757, more accurate than 0.697 of MRI in premenopausal DCIS patients. Background parenchymal enhancement (BPE) was the only risk factor deteriorating the accuracy of US and MRI examinations. Moderate and marked BPE was associated with the inaccurate tumor size estimations in both US and MRI (odds ratio [OR]:2.23, 95% confidence interval [CI]=1.12−3.52, p=0.001 in US, OR:8.16, 95% CI=1.17−15.2, p=0.031 in MRI). Conclusion: MRI was more accurate for measuring tumor size in patients with DCIS. Moderate and marked BPE was a risk factor that prevented accurate measurement of preoperative tumor size. In premenopausal patients, US would help measure tumor size accurately.

유방 초음파에서 인공 지능의 진단적 유용성

윤현조,정형은,안하림,강상율,정성후 대한외과초음파학회 2023 대한외과초음파학회지 Vol.10 No.1

Breast cancer is the most commonly diagnosed cancer in women and its incidence and the mortality associated with it have increased over the years. Early detection of breast cancer via various imaging modalities can significantly improve the prognosis of patients. Ultrasound is a useful imaging tool for breast lesion characterization due to its acceptable diagnostic performance and non-invasive and real-time capabilities. However, one of the major drawbacks of ultrasound imaging is operator dependence. Artificial intelligence (AI), particularly deep learning, is gaining extensive attention for its excellent performance in image recognition. AI can make a quantitative assessment by recognizing imaging information, thereby improving ultrasound performance in the diagnosis of breast cancer lesions. The use of AI for breast ultrasound in clinical practice is extremely important, as it saves time, reduces radiologist fatigue, and compensates for a lack of experience and skill in some cases. This review article discusses the basic technical knowledge required, the algorithms of AI for breast ultrasound, and the application of AI in image identification, segmentation, extraction, and classification. In addition, we also discuss the future perspectives for the application of AI in breast ultrasound.