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갑상선 유두암 환자에서 경부 림프절 재발에 대한 최소 갑상선외 침습의 임상적 중요성
황성배(Seong-Bae Hwang),류우상(Woo-Sang Ryu),서우형(U-Hyoung Seo),이재복(Jea-Bok Lee),배정원(Jung-Won Bae),구범환(Bum-Hwan Koo) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.5
Purpose: Extra-thyroidal extension has been recognized as a poor prognostic factor for increased regional recurrence risk in papillary thyroid carcinoma, and is known to require treatment that is more aggressive. In the recent UICC TNM 6th Classification, an extra-thyroidal extension was divided into a minimal extra-thyroidal extension (T3) and a massive extra-thyroidal extension (T4). The aim of this study was to investigate the clinical effect of a minimal extra-thyroidal extension of a papillary carcinoma for the recurrence of regional cervical lymph nodes. Methods: We retrospectively studied 154 patients with papillary thyroid carcinoma where a thyroidectomy was performed from Feb. 2003 to May. 2006 at the Department of Surgery, with the exclusion of 6 patients with a massive extra-thyroidal extension. We divided the cases into a no extra-thyroidal extension group and a minimal extra-thyroidal extension group according to the grading of the extra-thyroidal extension. The grading of the extra-thyroidal extension was based on both pathological findings and intraoperative surgical findings. Clinicopathological factors associated with each group were analyzed by univariate and multivariate analysis. We divided the cases into two groups according to age (<45 yrs, ≥45 yrs) and lymph node status (positive, negative), and compared each group with regards to disease free survival according to the grading of the extra-thyroidal extension. Results: By univariate analysis, a minimal extra-thyroidal extension was related to lymph node metastasis, tumor size, mutifocality (P<0.05), and was not related to cervical lymph node recurrence statistically (P=0.108). Cervical lymph node recurrence was related to being male, lymph node metastasis and tumor size (P<0.05). By multivariate analysis, a minimal extra-thyroidal extension was independently related to tumor size, multifocality, and lymph node metastasis (P<0.05). In both groups with regards to age and lymph node status, a minimal extra-thyroidal extension was not statistically related to disease free survival (P>0.05). Conclusion: We need to downstage to less than T3 for a minimal extra-thyroidal extension because there is no significant difference in disease free survival according to the grading of an extra-thyroidal extension in patients with papillary thyroid carcinoma.
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고해상도 연속절단면 컬러해부영상을 이용한 한국인 성인여성 복셀팬텀 VKH-Woman 개발
정종휘,염연수,한민철,김찬형,함보경,황성배,김성훈,이동명,Jeong, Jong Hwi,Yeom, Yoen Soo,Han, Min Cheol,Kim, Chan Hyeong,Ham, Bo Kyoung,Hwang, Sung Bae,Kim, Seong Hoon,Lee, Dong-Myung 한국의학물리학회 2012 의학물리 Vol.23 No.3
전신에 대해 방사선에 민감한 주요장기가 미리 정의된 인체 전산팬텀(compuational human phantom)은 의료분야에서 방사선 치료에 의한 이차암 위험도 평가 및 진단방사선에 의한 유효선량 평가 등에 유용하게 활용될 수 있다. 본 연구에서는 한국인 여성사체에 대한 고해상도 연속절단면 컬러해부영상을 이용하여 장기 및 조직을 전신에 걸쳐 약 2 mm 간격으로 정밀하게 분할하였고, 이를 이용하여 몬테칼로 전산모사에 사용될 수 있는 VHK-Woman 복셀팬텀을 개발하였다. VKH-Woman 복셀팬텀은 키 160 cm, 몸무게 52.72 kg으로 한국인 여성의 표준체형에 가까우며, 유효선량을 계산할 수 있도록 ICRP 103에 제시된 27개 장기 및 기타 관심장기 12개를 포함한다. VKH-Woman의 복셀 해상도는 $1.976{\times}1.976{\times}2.0619mm^3$이며 복셀행렬의 크기는 $261{\times}109{\times}825$이고, 몬테칼로 코드에 입력하여 사용될 수 있도록 이진파일과 ASCII 파일 형식으로 데이터화되었다. The computational human phantom including major radiation sensitive organs at risk (OARs) can be used in the field of radiotherapy, such as the variation of secondary cancer risks caused by the radiation therapy and the effective dose evaluation in diagnostic radiology. The present study developed a Korean adult female voxel phantom, VKH-Woman, based on serially sectioned color slice images of Korean female cadaver. The height and weight of the developed female voxel phantom are 160 cm and 52.72 kg, respectively that are virtually close to those of reference Korean female (161 cm and 54 kg). The female phantom consists of a total of 39 organs, including 27 organs recommended in the ICRP 103 publication for the effective dose calculations. The female phantom composes of $261{\times}109{\times}825$ voxels (=23,470,425 voxels) and the voxel resolution is $1.976{\times}1.976{\times}2.0619mm^3$ in the x, y, and z directions. The VHK-Woman is provided as both ASCII and Binary data formats to be conveniently implemented in Monte Carlo codes.
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