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Surgical Outcomes of Adrenocortical Carcinoma; 20 Years of Experience in a Single Institution
Min Jhi Kim,Eun Jeong Ban,Soo Jung Jung,Hai Young Son1,Cho Rok Lee,Sang-Wook Kang,Jong Ju Jeong,Kee-Hyun Nam,Woong Youn Chung,Cheong Soo Park 대한갑상선-내분비외과학회 2014 The Koreran journal of Endocrine Surgery Vol.14 No.4
Purpose: Adrenocortical carcinoma (ACC) is a rare malignant tumor. Early detection is difficult and prognosis is poor. We report on 20 years of ACC surgical experience at our institution. Methods: This study included 32 ACC patients who underwent surgical resection at the Department of Surgery of the Yonsei University Health System in South Korea between January 1990 and February 2012. We reviewed these 32 patients and retrospectively analyzed long-term clinical outcomes and prognosis after radical surgery for ACC. Results: The median age of the 32 patients at diagnosis was 42.25 years (range 3∼81 years). There were 16 (50%) female and 16 (50%) male patients. Mean tumor size was 12.36 cm (range 1.8∼20 cm). Twenty-five patients (78.12%) had nonfunctioning tumors while the other seven patients (21.87%) had functioning tumors. Seventeen patients (53.12%) were classified as stage II, two (6.25%) as stage III, and 13 (40.62%) as stage IV. Fourteen patients underwent radical surgical resection, while 14 patients received adjuvant chemotherapy, two received adjuvant radiotherapy, and two received adjuvant chemoradiation. Four patients were lost to follow-up. Among the remaining 28 patients, 15 patients survived. The 5- and 10-year overall survival was 60.6% and 37.8%, respectively (median survival=85±24.3 months). Seventeen patients (53%) experienced disease recurrence. Five- and 10-year recurrence-free survival was 41.5% and 29.7%, respectively (median survival=18±5.5 months). Conclusion: Early stage at diagnosis and surgical resection were the most important prognostic factors associated with prolonged survival. The role of additional therapy remains controversial and new agents should continually be evaluated for efficacy.
Kwangsoon Kim,Won Woong Kim,Jung Bum Choi,Min Jhi Kim,Cho Rok Lee,Jandee Lee,Sang-Wook Kang,Kee-Hyun Nam,Woong Youn Chung,Jong Ju Jeong 대한외과학회 2018 Annals of Surgical Treatment and Research(ASRT) Vol.95 No.4
Purpose: Recently, the American Thyroid Association (ATA) dynamic risk stratification (DRS) has been verified to be more valuable than the static anatomical staging system for predicting prognosis in patients with differentiated thyroid carcinoma (DTC). The purpose of this retrospective study was to compare the clinical usefulness of DRS, which is based on the response to initial treatment, with that of ATA initial risk stratification in pediatric patients. Methods: A total of 144 pediatric patients underwent thyroid operation from August 1982 to December 2013 at Yonsei University Hospital (Seoul, Korea). Among them, 128 patients with complete clinical data were enrolled in this study. Clinicopathologic features and surgical outcomes were retrospectively analyzed by medical chart review. The mean followup duration was 11.5 years. Results: The mean tumor size was 2.1 cm; 80.4% of patients were diagnosed with conventional papillary thyroid carcinoma, and 7.0% of patients were diagnosed with follicular thyroid carcinoma. Low-risk patients had the highest probability of an excellent response to initial treatment (66.6%). High-risk patients had the highest probability of a structural incomplete response (100%) and the lowest probability of an excellent response (11.1%). The ATA risk stratification and the DRS system were independent risk factors for disease-free survival (DFS) (P = 0.041 and P < 0.001, respectively). Conclusion: The DRS system, which is based on the response to initial treatment, can offer more useful prognostic information compared with ATA risk stratification in pediatric patients with DTC.
Lee, Paengro,Kim, Jinwoong,Kim, Jin Gul,Ryu, Min-tae,Park, Hee-min,Kim, Namdong,Kim, Yongsam,Lee, Nam-Suk,Kioussis, Nicholas,Jhi, Seung-Hoon,Chung, Jinwook IOP 2016 Journal of physics, an Institute of Physics journa Vol.28 No.8
<P>We observe the modified surface states of an epitaxial thin film of a homologous series of (Bi<SUB>2</SUB>)<SUB>m</SUB>(Bi<SUB>2</SUB>Se<SUB>3</SUB>)<SUB>n</SUB>, as a topological insulator (TI), by angle-resolved photoemission spectroscopy measurements. A thin film with <I>m</I> : <I>n</I> = 1 : 3 (Bi<SUB>8</SUB>Se<SUB>9</SUB>) has been grown with Bi<SUB>2</SUB> bilayers embedded every other three quintuple layers (QLs) of Bi<SUB>2</SUB>Se<SUB>3</SUB>. Despite the reduced dimension of continuous QLs due to the Bi<SUB>2</SUB> heterolayers, we find that the topological surface states stem from the inverted Bi and Se states and the topologically nontrivial structures are mainly based on the prototype of 3D TI Bi<SUB>2</SUB>Se<SUB>3</SUB> without affecting the overall topological order.</P>
Proximity Effect Induced Electronic Properties of Graphene on Bi<sub>2</sub>Te<sub>2</sub>Se
Lee, Paengro,Jin, Kyung-Hwan,Sung, Si Jin,Kim, Jin Gul,Ryu, Min-Tae,Park, Hee-Min,Jhi, Seung-Hoon,Kim, Namdong,Kim, Yongsam,Yu, Seong Uk,Kim, Kwang S.,Noh, Do Young,Chung, Jinwook American Chemical Society 2015 ACS NANO Vol.9 No.11
자궁경부암 환자에서 방사선 치료가 골무기물 함량에 미치는 영향
윤선민(Seon Min Youn),최태진(Tae Jin Choi),구은실(Eun Sil Koo),김옥배(Ok Bae Kim),이성문(Seung Moon Lee),서수지(Soo Jhi Suh) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.2
목 적 : 자궁경부암 환자에서 방사선치료시 방사선조사면내의 골무기물 함량변화를 정상대조군과 환자군의 골무기물 함량을 비교하여 방사선이 골무기물에 미치는 영향을 조사하였다. 재료 및 방법 : 120kVp와 80kVp X선을 이용하는 이중에너지 전산화단층 촬영을 이용하여 환자군과 정상대조군에서 제 3, 4 및 제 5 요추의 해면골무기물 함량을 정량적으로 측정하였다. 총 인원수는 정상대조군 43명과 환자군 43명으로서 86명이며 각 연령별로는 정상대조군 40대 22명, 50대 10명, 60대 11명이었고, 환자군에서는 40대 14명, 50대 14명, 60대 15명이었다. 방사선조사부위는 골반과 제 5 요추를 포함하여 치료하였으며 외부방사선량은 45-54Gy였으며, 강내치료는 고선량률로 30Gy를 조사하였다. 결 과 : 정상대조군과 환자군의 여성에서 골무기물 함량은 나이가 증가함에 따라 감소함을 보였으며, 환자군은 정상군에 비해 약 13%에서 최대 40%의 감소를 보였다. 환자군에서 방사선 조사부위에 포함되지 않은 제 3, 4 요추의 각각 골무기물 함량은 40대 119.5±30.6, 117.0±31.7, 50대 83.3±37.8, 88.3±46.8, 60대 61.5±18.3, 56.2±26.6mg/cc로 나타났으며, 반면에 정상군은 각각 40대 148±19.9, 153.2±23.2, 50대 96.1±30.2, 105.6±26.5 및 60대 73.9±27.9, 77.2±27.2mg/cc를 각각 보였다. 정상군의 요추골의 골무기물함량은 제 5요추가 각연령층에서 가장 높았으며, 제 3, 4 요추는 제 5 요추에 가까울수록 높은 값에 비해 환자군에서는 방사선조사면에 가까울수록 골무기물함량의 감소하는 경향을 보였다. 특히 방사선조사부위인 환자군의 제 5 요추는 전연령층에서 제 3 요추나 제 4 요추에 비해 낮은 골무기물함량을 보였으며, 정상군에 비해서 40대 33%, 50대 31%와 60대 40%의 골무기물함량의 감소를 보여 방사선의 영향에 의한 감소가 현저하였다. 결 론 : 환자군의 요추골의 골무기물함량은 정상군에 비해 현저한 감소를 보였으며, 정상대조군의 제 5 요추가 제 3, 4 요추에 비해 높은 골무기물 함량수치를 보인 반면, 환자군에서는 방사선조사범위에 있는 제 5 요추의 골무기물 함량이 훨씬 낮게 나타나 방사선조사가 요추의 골무기물 함량의 감소에 상당한 영향을 끼침을 알 수 있다. Purpose : To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. Method and materials : Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using photon energy of 120 and 80kVp. The numbers of patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth, and 11 in seventh decade, those of patient group were 14 in fifth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for pelvic irrdiation with 45- 54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer. Results : The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about 13% to 40% maximally. The BMC of L3 and L4 a region that is out of a radiation field for the patient group demonstrated 119.5±30.6, 117.0±31.7 for fifth, 83.3±37.8, 88.3±46.8 for sixth and 61.5±18.3, 56.2±26.6mg/cc for seventh. Contrasted by the normal control group has shown 148.0 ±19.9, 153.2±23.2 for fifth, 96.1±30.2, 105.6±26.5 for sixth and 73.9±27.9, 77.2±27.2mg/cc for seventh decade, respectively. The BMC of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In particular, the BMC of L5 within the radiation field was significantly decresed to 33%, 31%, 40% compared with the control group of the fifth, sixth and seventh decades, respectively. Conclusion : The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in patient group with pelvic irradiation in contrast to that of the normal control groups.
Kyorim Back,Min Jhi Kim,Jun-Ho Choe,Jung-Han Kim,Jee Soo Kim 대한갑상선-내분비외과학회 2018 The Koreran journal of Endocrine Surgery Vol.18 No.3
Purpose: We focused on the comparison of the diagnostic accuracy of preoperative ultrasonography (US) with that of computed tomography (CT), especially for lateral lymph node metastasis (LLNM) in N1b papillary thyroid carcinoma (PTC). Methods: We conducted a retrospective cohort study at the Thyroid Cancer Center of Samsung Medical Center, a tertiary referral center in Korea, by analyzing data collected between January 1997 and June 2015. A total of 1,323 patients who met the following inclusion criteria were enrolled. Results: Diagnostic values were calculated on a “per level” basis by comparing the results of US, CT, and histopathology. Between US and CT, there was no significant difference in the sensitivity (59.3% vs. 61.0%, P=0.073), specificity (83.0% vs. 81.1%, P=0.051), or accuracy (68.6% vs. 68.9%, P=0.660). However, US+CT showed significantly higher sensitivity (74.6% vs. 59.3%, P<0.001) and accuracy (74.0% vs. 68.6%, P<0.001) compared to US alone. Conclusion: There was no significant difference in sensitivity, specificity, and diagnostic accuracy for LLNM between US and CT; however, a combination of CT and US had significantly higher sensitivity, specificity, and diagnostic accuracy in detection of LLNM compared to US or CT alone. We conclude that the strategy for the examination of the lateral neck in PTC patients can be effectively determined by the combination of CT and US rather than US or CT only.