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A Novel Approach for Gastric Cancer Staging in Elderly Patients Based on the Lymph Node Ratio
Park, Joonseon,Jeon, Chul Hyo,Kim, So Jung,Seo, Ho Seok,Song, Kyo Young,Lee, Han Hong The Korean Gastric Cancer Association 2021 Journal of gastric cancer Vol.21 No.1
Purpose: To date, no studies have been performed on staging based on the lymph node ratio (LNR) in elderly patients with gastric cancer who may require limited lymph node (LN) dissection due to morbidity and tissue fragility. We aimed to develop a new N staging system using the LNR in elderly patients with gastric cancer. Materials and Methods: The present study included patients aged over 75 years who underwent curative gastrectomy between January 1989 and December 2018. Clinicopathological data including the number of retrieved and metastatic LNs were collected and the LNR values were obtained (LNR = the number of metastatic LNs/the number of retrieved LNs). Eleven LNR groups with intervals of 0.1 were divided into four stages based on the inflection points at which the hazard ratio (HR) increased. Survival analysis was performed to evaluate the prognostic value of the LNR. Results: The four LNR stages included LNR0 (n=364), LNR1 (n=128), LNR2 (n=103), and LNR3 (n=10). In the multivariate analysis, both N staging and LNR staging exhibited significant prognostic values for predicting survival outcomes. However, the incremental change in the hazard ratio (HR) between consecutive stages was greater for the LNR staging than for the N staging (HRs: 1.607, 2.758, and 3.675 for N staging; 1.583, 3.514, and 10.261 for LNR staging). Conclusions: LNR staging is more useful than N staging in predicting the prognosis in elderly patients with gastric cancer and may be used as a complement or alternative to N staging.
중성점 전압 변동을 고려한 멀티레벨 컨버터의 제어에 관한 연구
안준선(Joonseon Ahn),박종찬(Jong-Chan Park),유선종(Sunjong Yu),임응춘(EungChun Lim) 대한전기학회 2009 대한전기학회 학술대회 논문집 Vol.2009 No.11
본 논문에서는 3-레벨 컨버터의 일반적인 내용을 고찰하고, 3-레벨 컨버터의 주요 제어 문제 중 하나인 중성점 전압변동에 대한 이론적인 내용을 논한다. 또한 중성점 전압 변동을 해결하기 위한 제어방식중 비교적 구현이 간단하며 그 특성이 우수한 방식을 구현하여 시뮬레이션을 통한 제어 특성을 살펴보고 그 타당성을 논하였다.
Protruding Huge Thyroid Mass Concurrent Hemorrhage and Skin Necrosis: A Case Report
Solji An,Joonseon Park,Kwangsoon Kim,Ja Seong Bae,Jeong Soo Kim 대한내분비외과학회 2023 The Koreran journal of Endocrine Surgery Vol.23 No.4
Papillary thyroid carcinoma (PTC), a prevalent subtype of thyroid cancer, is typically characterized by slow growth and a favorable prognosis. However, this report presents an unusual case of PTC with tall cell features that exhibited rapid growth, extensive extrathyroidal extension and skin necrosis. The patient’s thyroid mass, considerably increased in size within a few weeks, reaching over 10 cm in diameter. The mass was associated with skin necrosis and hemorrhage and consisted of both cystic and solid components. Due to the risk of hemorrhage, preoperative fine needle aspiration biopsy was not performed. A computed tomography scan confirmed a large mixed cystic and solid mass with tracheal deviation and enlarged lymph node (LN). Total thyroidectomy with lateral neck dissection, and wound reconstruction was performed. Pathological examination revealed PTC with tall cell features and LNs were harvested in a total of 28, with only one LN showing confirmed metastasis. In clinical practice, encountering patients with rapidly growing, exceptionally large cystic masses should raise awareness about the potential presence of PTC, as demonstrated in this case.
Bong Jun Kwak,Joonseon Park,Yong Kyong Kwon,Jung Hyun Kwon,Young Chul Yoon 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.6
Purpose: Spontaneously ruptured hepatocellular carcinoma (srHCC) is known to be a life-threatening complication with poor prognosis. Although there are various treatment modalities, there is no definite treatment guideline. The purpose of this study was to review the surgical outcome and prognosis of srHCC treated with intraoperative radiofrequency ablation (RFA) and distilled water peritoneal lavage (DWPL). Methods: From March 2012 to October 2018, 9 patients with srHCC who underwent emergent surgery were reviewed. After hematoma removal, intraoperative RFA and DWPL were applied to all patients. Hepatectomy was performed if necessary. Patients with multiple tumors, distant metastasis, and vascular tumor involvement in radiologic imaging were excluded. Results: Six of 9 patients with diameters less than 7 cm were able to obtain hemostasis using RFA alone (RFA group). However, 3 patients with a tumor size of more than 10 cm underwent liver resection because they could not obtain hemostasis with RFA (hepatectomy only group). The RFA group had shorter operation time (148.3 ± 31.7 minutes vs. 251.7 ± 20.2 minutes, P < 0.05) and less red blood cell transfusion (5.8 ± 2.5 packs vs. 24.0 ± 11.5 packs, P < 0.05) than the hepatectomy only group. There was no peritoneal metastasis at long-term follow-up in the RFA group. Five-year recurrence-free survival rate was 0% in both groups. However, 5-year overall survival rate was better in the RFA group (83.3% vs. 0%, P < 0.05). Conclusion: Intraoperative RFA and DWPL are easy to perform and theoretically the best methods for managing relatively small srHCC.
Kang Il Ku,Jung Chan Kwon,Kim Kwangsoon,Park Joonseon,Kim Jeong Soo,Bae Ja Seong 대한내분비외과학회 2022 The Koreran journal of Endocrine Surgery Vol.22 No.4
There are sparse cases of carcinoma arising from the pyramidal lobe (PL). Thyroglossal duct cyst (TGDC), which is the most common anomaly concerning the thyroid gland, is typically where malignant changes arise. Here we report a case of papillary thyroid carcinoma (PTC) occurring in front of the thyroid cartilage, thus mimicking TGDC carcinoma but having a final diagnosis of PL carcinoma. A 52-year-old female presented with a palpable neck mass. Preoperative ultrasound revealed a 3-cm-sized solid and cystic nodule in the infrahyoid area of the neck. Another 6-mm-sized nodule in the left lobe of the thyroid gland was also observed. Fine needle aspiration cytology revealed that both lesions were PTC. A computed tomography scan was performed to determine the extent of surgery, which confirmed the ultrasound TGDC carcinoma diagnosis. The patient underwent a Sistrunk operation and left lobectomy of the thyroid gland. Histopathology showed PTC findings, but no TGDC tissue was present. Thus, PTC arising from the PL was confirmed in the final pathology. PL carcinoma in the neck’s thyrohyoid area should be considered.