Bilateral Papillary Thyroid Cancer Increases the Risk of Lymph Node Metastasis Compared with Unilateral Multifocal Papillary Thyroid Cancer

한자령,정진향,김완욱,이지연,박호용,김혜정,박지영 대한갑상선-내분비외과학회 2017 The Koreran journal of Endocrine Surgery Vol.17 No.2

Purpose: Papillary thyroid cancer (PTC) has a strong propensity for lymph node metastasis, which is related with local recurrence, and disease-specific survival in the elderly. We evaluated the association between lymph node metastasis and disease multifocality, bilaterality, and other clinicopathological variables to identify risk factors and aid surgical decision-making. The relationship between the number of foci and metastasis to cervical lymph node was also evaluated. Methods: Patients with PTC (n=819) undergoing thyroidectomy at our institution were included. The study population was segregated into 4 groups based on PTC multifocality and bilaterality. Results: Cervical lymph node metastasis, tumor size, and tumor extent were significantly different between the study groups. The frequency of central and lateral cervical lymph node metastasis was the highest in the bilateral multifocal disease group, followed by the bilateral solitary group, unilateral multifocal group, and the unilateral solitary group. One PTC focus per thyroid lobe was associated with increased metastasis (53.8%). Moreover, lymph node positivity doubled with 5–7 foci (71.4%), and tripled with ≥8 foci (100.0%). Bilateral solitary and bilateral multifocal PTC were identified as independent predictors of cervical lymph node metastasis. Conclusion: Bilateral PTC was associated with lymph node positivity, which increased proportionally with the number of PTC foci. Bilateral solitary or multifocal PTC were associated with more aggressive features such as larger primary tumor size, more frequent extrathyroidal extensions, and regional lymph node metastasis. The presence of multiple bilateral foci or more than 3 foci are independent risk factors of lymph node metastases.

Bilateral Papillary Thyroid Cancer Increases the Risk of Lymph Node Metastasis Compared with Unilateral Multifocal Papillary Thyroid Cancer

Ja Ryung Han 1,Jin Hyang Jung,Wan Wook Kim,Jeeyeon Lee,Ho Yong Park,Hye Jung Kim,Ji-Young Park 대한갑상선-내분비외과학회 2017 The Koreran journal of Endocrine Surgery Vol.17 No.2

Purpose: Papillary thyroid cancer (PTC) has a strong propensity for lymph node metastasis, which is related with local recurrence, and disease-specific survival in the elderly. We evaluated the association between lymph node metastasis and disease multifocality, bilaterality, and other clinicopathological variables to identify risk factors and aid surgical decision-making. The relationship between the number of foci and metastasis to cervical lymph node was also evaluated. Methods: Patients with PTC (n=819) undergoing thyroidectomy at our institution were included. The study population was segregated into 4 groups based on PTC multifocality and bilaterality. Results: Cervical lymph node metastasis, tumor size, and tumor extent were significantly different between the study groups. The frequency of central and lateral cervical lymph node metastasis was the highest in the bilateral multifocal disease group, followed by the bilateral solitary group, unilateral multifocal group, and the unilateral solitary group. One PTC focus per thyroid lobe was associated with increased metastasis (53.8%). Moreover, lymph node positivity doubled with 5–7 foci (71.4%), and tripled with ≥8 foci (100.0%). Bilateral solitary and bilateral multifocal PTC were identified as independent predictors of cervical lymph node metastasis. Conclusion: Bilateral PTC was associated with lymph node positivity, which increased proportionally with the number of PTC foci. Bilateral solitary or multifocal PTC were associated with more aggressive features such as larger primary tumor size, more frequent extrathyroidal extensions, and regional lymph node metastasis. The presence of multiple bilateral foci or more than 3 foci are independent risk factors of lymph node metastases.

양측성 구순열

김종렬,변준호 대한구순구개열학회 2007 대한구순구개열학회지 Vol.10 No.1

The bilateral cleft lip, a more severe form of cleft than unilateral cleft lip, involves separation of the lip along philtral lines, isolating the central segment (prolabium). Bilateral cleft lip may be either symmetrical or asymmetrical, in which case the cleft lip is split more on one side than on the other. The cleft affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child s ability to eat, speak, hear, and breathe. Although there would seem to be quite a variance in reported figures, ratios of cleft lip with or without cleft palate have gone as high as 1:500 and as low as 1:1000. It is known that less than 10% of cleft lips are bilateral. Although bilateral cleft lip is less common than unilateral cleft lip, the deformity is more severe, and the reconstructive technique is more complex. Surgery is the only treatment necessary for patients with bilateral cleft lip. Accompanying the evolution of surgical repair is the increasingly important role of orthodontic support with early presurgical alveolar and nasal molding. Repositioning the maxillary and alveolar segments into a more anatomic position allows the surgeon to repair the lip and associated nasal deformity under more optimal conditions. The purpose of this article is to review the related anatomy, presurgical management, and surgical management of bilateral cleft lip.

배란유도 및 인공수정 후 발생한 양측 난관임신 1 예

유재경(Jae Kyoung Yoo),이재주(Jae Ju Lee),송정호(Jung Ho Song),전성철(Sung Chul Jeon),강지훈(Ji Hoon Kang),김성(Sung Kim),박철홍(Cheol Hong Park),조대현(Dae Hyun Cho) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12

N/A Bilateral tubal pregnancy is the least common type of all extrauterine pregnancies, 1:725-1:1580 of pregnancies are bilateral. Simultaneous tubal pregnancies have been reported in natural cycles, recently, after ovulation induction, assisted reproductive techniques. The high incidence of ectopic pregnancy assisted with ovulation induction continues to be a problem. Bilateral tubal pregnancy associated with the ovulation induction has been reported few cases of 3.0% to 6.0% in frequency. This paper describes a case of simultaneous bilateral tubal pregnancy after ovulation induction and intrauterine insemination in a 27 year old patient. The diagnosis was confirmed by laparoscopy performed 30 days after intrauterine insemination, which revealed bilateral tubal pregnancy and mild hyperstimulated ovaries. Bilateral salpingectomy was performed. With a review of the literature on this topic, diagnostic aspect and incidence and treatment options are discussed.

칼라도플러음낭초음파검사상 좌측 정계정맥류로 진단된 환자에서 양측 미세수술 정계정맥류절제술의 효과

최만수,김상득,박정선,김명기,박종관 대한남성과학회 2008 The World Journal of Men's Health Vol.26 No.3

Purpose: The objective of this study was to evaluate the accuracy of color Doppler ultrasonography (CDU) and to assess the effects of microsurgical bilateral varicocelectomy on patients diagnosed with a left varicocele by CDU. Materials and Methods: 69 patients with varicocele were enrolled between March 2005 and May 2007. The patients were randomized into 2 groups: group I-preoperative bilateral varicoceles were diagnosed by color CDU, and group II-only a left varicocele was diagnosed by CDU. All patients underwent an inguinal microsurgical varicocelectomy bilaterally. Statistical analysis was performed by paired Student's t-test and one way ANOVA. Results: Mean age of the patients was 27.5±7.9 years. After surgery, semen parameters were significantly improved in sperm number in group I (p=0.002) and semen volume in group II (p<0.005). At the time of surgery, we found that 16 (88.9%) of 18 patients had bilateral varicoceles in group II. The accuracy of CDU to diagnose varicoceles was not perfect. Conclusions: The bilateral microsurgical varicocelectomy in patients with only a left varicocele diagnosed by CDU significantly increased their semen volume. Most (88.9%) patients diagnosed with a left varicocele actually had bilateral varicoceles. Therefore, microsurgical bilateral varicocelectomy may be appropriate for infertile men with a left varicocele diagnosed by CDU.

완전 골성 양측성 후비공 폐쇄 환자의 구개부를 통한 외과적 치험례

김경원,조용석,양수남,Kim, Kyoung-Won,Cho, Yong-Seok,Yang, Soo-Nam 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.2

23세의 건강한 산모에게서 정상 분만되고, 출생시 체중 3.lkg의 여자 아이가 출생 직후 청색증, 호홉 곤란 등의 소견을 보이나, 육안적으로 관찰되는 불완전 양측성 구순열 이외에는 특별한 두개안면 이형증 등의 소견은 관찰되지 않아서, 소아과 담당의사가 전비공을 통하여 비인두강 내의 분비물 등의 이물질 홉인을 시도하려다 작은 고무 도관의 삽입이 이루어지지 않아서 후비공 폐쇄를 의심하였다. 경구 호홉관을 이용하여 기도 확보 후에 후비공 폐쇄 여부의 진단을 위해서, 비강내 방사선 비투과성 물질의 접적 주입한 후에 방사선 사진, 컴퓨터 단층 촬영 등을 통하여 완전 골성 양측성 후비공 폐쇄를 확진하였다. 양측성 후비공 폐쇄는 출생시 주기적인 호홉 곤란의 증상을 보이며, 특히 포유시에 호홉 곤란의 증상이 악화되어서 신생아의 생명을 위협하는 응급 상황으로 이에 대한 외과적인 처치를 시행하기로 결정하였다. 후비공 폐쇄에 대한 외과적인 처치는 비강을 통한 접큰법, 구개부를 통한 접근법, 비중격을 통한 접근법 등의 여러 가지 접근법이 있으나, 본 환자의 경우는 완전 골성 양측성 후비공 폐쇄로 확진이 되었고, 이에 대한 저자들의 경험이 전혀 없는 상태이었기에 보다 좋은 수술 시야를 용이하게 확보할 수 있으며, 새로이 형성해준 후비공을 따라 점막 피판을 보존해 줄 수 있고, 수술 후 후비공의 개통성을 보다 확실하게 얻을 수 있을 것으로 예상되는 구개부를 통한 접근법을 이용하여 외과적인 처치를 시행하였다. 수술 후 약 1 년이 경과하였으나 임상적으로 호홉 곤란 등의 특별한 문제점이 없이 만족할 만한 경과를 보였다. 일반적인 교과서에서 설명하듯이 기성품으로 제작된 자가보전 견인자의 설압자는 이와 같은 신생아의 증례에서는 크기가 상대적으로 너무 커서 사용이 곤란하였다는 점을 염두에 두어야 할 것으로 생각되며, 추후 유사한 증례의 수술시에 도움을 주고자 매우 희귀한 증례인 완전 골성 양측성 후비공 폐쇄 환자에 대한 치험례를 문헌 고찰과 함께 보고하는 바이다. Choanal atresia may be membrane or bony, unilateral or bilateral. Approximately 90% of the choanal atresia are bony type. Unilateral choanal atresia often eludes the diagnosis because of the absence of subjective symptoms in the neonatal period. However, bilateral choanal atresia presents at birth with cyclic respiratory distress aggravated by feedings. So complete bilateral choanal atresia is considered as a neonatal emergency. Examinations for the diagnosis of chonal atresia include 1) attempt at passing a rubber catheter or probe through the patient s nose, 2) mirror examination of the nasopharynx, 3) digital examination of the nasopharynx, 4) X-ray examination after installation of radiopaque materal into the nasal cavity. But, computed tomography has become accepted method for evaluation of choanal atresia. Surgical repair of choanal atresia is accomplished via transnasal or transpalatal approach. Advantages of the transpalatal approach are improved exposure and the preservation of mucosal flap along the newly formed apertures. On the other hand, the transpalatal approach carries the risk of injury to the greater palatine neurovascular complex, and requires longer operative time. After careful physical and radiographic examinations, we accomplished the surgical repair of the complete bony bilateral choanal atresia via transpalatal approach without complications.

Incidental Bilateral Renal Oncocytoma in a Patient with Metastatic Carcinoma of Unknown Primary: a Pitfall on $^{18}F$-FDG PET/CT

Makis, William,Ciarallo, Anthony,Novales-Diaz, Javier-A.,Lisbona, Robert The Korea Society of Nuclear Medicine 2011 핵의학 분자영상 Vol.45 No.4

Bilateral renal masses are uncommon but can raise a strong suspicion of primary or secondary malignancy, especially during the initial work-up of an oncology patient. Renal oncocytomas are benign renal tumors that are commonly discovered incidentally on diagnostic imaging with a small percentage occurring bilaterally. Although $^{18}F$-FDG uptake in renal oncocytomas has been described, a case of a bilateral $^{18}F$-FDG-avid renal oncocytoma has not been previously reported in the literature. A variety of malignant causes of bilateral $^{18}F$-FDG positive renal masses are known, however it is important to include this benign etiology in the differential diagnosis. We report an unusual case of an incidental bilateral renal oncocytoma evaluated with contrast enhanced CT and $^{18}F$-FDG PET/CT.

하루 양안 동시 유리체강 내 애플리버셉트주입술에 대한 안전성 분석

안자영,변지윤,장규환,손준홍,황덕진 한국망막학회 2020 Journal of Retina Vol.5 No.2

Purpose: To evaluate the safety of bilateral same-day intravitreal aflibercept injections by analyzing ophthalmic complications. Methods: Medical records were retrospectively reviewed for patients who underwent bilateral same-day intravitreal aflibercept injections between January 2016 and December 2018. The patients visited 1 day, 1 week, 1 month, and 2 months after the injection. Results: Same-day intravitreal aflibercept injections were administered to a total of 31 patients, including 62 eyes, 208 bilateral. The causes of injection were neovascular age-related macular degeneration in 192 (92.31%) injections and diabetic macular edema in 16 (7.69%) injections. None of the patients had endophthalmitis, vitreous hemorrhage or acute increase in intraocular pressure. Three (1.44%) eyes with acute intraocular inflammation were observed. Two eyes improved without any treatment. One eye showed 3+ cells in the anterior chamber 1 day after the injection, but the inflammation improved after 1 week of treatment. Four (1.92%) eyes had subconjunctival hemorrhage. Conclusions: Bilateral same-day intravitreal aflibercept injections are safe, time-saving, and more economically favorable, which may reduce the burden on patients and physicians. 목적:하루 양안 동시 유리체강 내 애플리버셉트주입술 후 발생한 안과적 합병증을 분석하여 이에 대한 안전성을 확인하고자 하였다. 대상과 방법: 2016년 1월부터 2018년 12월까지 하루에 양안 동시 유리체강 내 애플리버셉트주입술을 시행받은 환자를 대상으로 의무기록을 후향적으로 고찰하였다. 환자들은 주사 후 1일, 1주일, 1개월 그리고 2개월에 외래를 내원하였다. 결과: 총 31명 62안에서 208회의 양안 동시 유리체강 내 애플리버셉트주입술이 하루에 시행되었다. 원인 질환으로 삼출성 나이관련황반변성으로 인한 주사 치료가 192회(92.31%)였으며, 당뇨황반부종이 16회(7.69%)였다. 주입술 후 안내염, 유리체출혈, 급성 안압상승은 모든 환자에서 관찰되지 않았다. 급성 안내 염증은 3회(1.44%)의 주사 치료에서 관찰되었다. 이 중 2안은 특별한 치료 없이 호전되었고 1안은 주사 후 1일째 전방 내 세포 3+를 보였으나 치료 1주일 후 염증은 호전되었다. 결막하출혈은 4회(1.92%)의 주사 치료에서 관찰되었다. 결론: 하루 양안 유리체강 내 애플리버셉트주입술은 안전하게 시행될 수 있는 시술로 환자와 의료진에게 시간적, 경제적으로 유리하며 치료의 부담을 덜어줄 수 있는 방법으로 사료된다.

The Necessity of Establishing a Management System for Obligated Items Subject to Bilateral Cooperation Agreement

Seongmi Han,In-Chul Kim,Mun-Young Ryu 한국방사성폐기물학회 2022 한국방사성폐기물학회 학술논문요약집 Vol.20 No.2

The main purpose of the Bilateral Nuclear Cooperation Agreement is to obtain the prior consent of suppliers in the case of peaceful use of items covered by the agreement, application of IAEA safeguards, reprocessing, enrichment or transfer to a third country. Reports on inventory changes and status for mutually transferred obligated items should be exchanged annually. According to the Agreement, items subject to bilateral agreement information must be exchanged with each other prior to direct or indirect transfer of controlled items. And the importing country proceeds with prior confirmation. After that, upon receipt of the target item, shipment notification and shipment confirmation are made, and an annual report on the target item is made. Such as the Korea Atomic Energy Research Institute (KAERI), annual reporting and management of obligated items are made centered on institutions that use a lot of nuclear materials. But there are cases of delays in the agreement work due to the implementation, and discrepancies in data are occurring in the process of checking inventory details of obligated items. In addition, it was difficult to check the inventory of items subject to the agreement and the status of Export and Import status online, making it impossible for managers to monitor all aspects of bilateral agreements. Currently, there is generated to inconsistent in information between the annual report and the international transfer report in terms of Export and Import control. To solve these problems, KAERI is aim of promoting transparency in the international nuclear power sector and enhancing national reliability. And It is planning to establish an Export and Import management system for items subject to bilateral. In order to ensure the accuracy, it is going to enhance the efficiency of management methods such as new registration for new institutions when exporting and Importing items. This has the ultimate purpose of improving the efficiency of the implementation of the agreement items through the systemization of the database of agreement items and the management of the implementation of the agreement based on the sincere and timely implementation of the agreement.

A Hierarchical Bilateral-Diffusion Architecture for Color Image Encryption

Menglong Wu,Yan Li,Wenkai Liu 한국정보처리학회 2022 Journal of information processing systems Vol.18 No.1

During the last decade, the security of digital images has received considerable attention in various multimediatransmission schemes. However, many current cryptosystems tend to adopt a single-layer permutation ordiffusion algorithm, resulting in inadequate security. A hierarchical bilateral diffusion architecture for colorimage encryption is proposed in response to this issue, based on a hyperchaotic system and DNA sequenceoperation. Primarily, two hyperchaotic systems are adopted and combined with cipher matrixes generationalgorithm to overcome exhaustive attacks. Further, the proposed architecture involves designing pixelpermutation,pixel-diffusion, and DNA (deoxyribonucleic acid) based block-diffusion algorithm, consideringsystem security and transmission efficiency. The pixel-permutation aims to reduce the correlation of adjacentpixels and provide excellent initial conditions for subsequent diffusion procedures, while the diffusionarchitecture confuses the image matrix in a bilateral direction with ultra-low power consumption. The proposedsystem achieves preferable number of pixel change rate (NPCR) and unified average changing intensity (UACI)of 99.61% and 33.46%, and a lower encryption time of 3.30 seconds, which performs better than some currentimage encryption algorithms. The simulated results and security analysis demonstrate that the proposedmechanism can resist various potential attacks with comparatively low computational time consumption.