Jeoung Won Bae

Korea University Medical Center, Sŏul, Seoul, South Korea

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Publications (63)85.18 Total impact

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    ABSTRACT: Background Papillary thyroid carcinomas (PTC) with lymph node metastases have a high recurrence rate. We analyzed the potential of lymph node ratio (LNR) and the level of pre-ablation stimulated thyroglobulin (sTg) as risk factors predicting recurrence in patients with pathological N1a PTC. Materials and methods This study involved 192 patients with pathologically confirmed PTC and central neck lymph node metastases who underwent total thyroidectomy with central lymph node dissection (CLND). The clinico-pathological characteristics, the pre-ablation sTg level and post-treatment recurrences were examined. Univariate and multivariate analyses were performed to identify factors associated with recurrence in these patients. Results During a median follow-up of 63 months, 17 patients had loco-regional recurrences. Receiver operating characteristic curve analysis showed that the appropriate cut-off values for LNR and the pre-ablation sTg level was 0.48 and 9.3 ng/mL, respectively. Patients with LNR values of ≥0.48 had a significantly worse disease-free survival (DFS) than those with LNR values of <0.48 (P = 0.015), and patients with pre-ablation sTg level values of ≥9.3 ng/mL had significantly worse DFS than those with pre-ablation sTg level values <9.3 ng/mL (P < 0.001). Relative to patients with LNR values of <0.48, those with LNR values of ≥0.48 had higher median pre-ablation sTg level values (0.55 vs. 4.20; P < 0.001). The correlation covariant between the LNR value and the pre-ablation sTg level value was r = 0.454 (P < 0.001). Multivariate analysis showed that a LNR value of ≥0.48 (P = 0.386) was not an independent risk factor for recurrence. To the contrary, a pre-ablation sTg level value of ≥9.3 ng/mL (P < 0.001) was an independent risk factor for recurrence. Conclusion A high pre-ablation sTg level is a better predictor of recurrence in pathological N1a PTC than a high LNR value. Careful follow-up of patients with this risk factor is recommended.
    Full-text · Article · Feb 2016 · International Journal of Clinical Oncology
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    ABSTRACT: Background: In preoperative assessment of breast cancer, MRI has been shown to identify more additional breast lesions than are detectable using conventional imaging techniques. The characterization of additional lesions is more important than detection for optimal surgical treatment. Additional breast lesions can be included in focus, mass, and non-mass enhancement (NME) on MRI. According to the fifth edition of the breast imaging reporting and data system (BI-RADS®), which includes several changes in the NME descriptors, few studies to date have evaluated NME in preoperative assessment of breast cancer. Objectives: We investigated the diagnostic accuracy of BI-RADS descriptors in predicting malignancy for additional NME lesions detected on preoperative 3T dynamic contrast enhanced MRI (DCE-MRI) in patients with newly diagnosed breast cancer. Patients and Methods: Between January 2008 and December 2012, 88 patients were enrolled in our study, all with NME lesions other than the index cancer on preoperative 3T DCE-MRI and all with accompanying histopathologic examination. The MRI findings were analyzed according to the BI-RADS MRI lexicon. We evaluated the size, distribution, internal enhancement pattern, and location of NME lesions relative to the index cancer (i.e., same quadrant, different quadrant, or contralateral breast). Results: On histopathologic analysis of the 88 NME lesions, 73 (83%) were malignant and 15 (17%) were benign. Lesion size did not differ significantly between malignant and benign lesions (P = 0.410). Malignancy was more frequent in linear (P = 0.005) and segmental (P = 0.011) distributions, and benignancy was more frequent in focal (P = 0.004) and regional (P < 0.001) NME lesions. The highest positive predictive value (PPV) for malignancy occurred in segmental (96.8%), linear (95.1%), clustered ring (100%), and clumped (92.0%) enhancement. Asymmetry demonstrated a high positive predictive value of 85.9%. The frequency of malignancy was higher for NME lesions located in the same quadrant with the index cancer (P = 0.006), and benignancy was higher in the contralateral breast (P = 0.015). On multivariate analysis, linear (P = 0.001) and segmental (P = 0.005) distributions were significant predictors of malignancy. Conclusion: The possibility of malignancy is strongly indicated when additional NME lesions show linear or segmental enhancement on preoperative 3T DCE-MRI in patients with recently diagnosed breast cancer. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology.
    Preview · Article · Jan 2016 · Iranian Journal of Radiology
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    ABSTRACT: Background: Breast cancer is a heterogeneous disease with diverse prognoses. The main prognostic determinants are lymph node status, tumor size, histological grade, and biological factors, such as hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki-67 protein levels, and p53 expression. Diffusion-weighted imaging (DWI) can be used to measure the apparent diffusion coefficient (ADC) that provides information related to tumor cellularity and the integrity of the cell membranes. Objectives: The goal of this study was to evaluate whether ADC measurements could provide information on the prognostic factors of breast cancer. Patients and Methods: A total of 71 women with invasive breast cancer, treated consecutively, who underwent preoperative breast MRIs with DWI at 3.0 Tesla and subsequent surgery, were prospectively included in this study. Each DWI was acquired with b values of 0 and 1000 s/mm2. The mean ADC values of the lesions were measured, including the entire lesion on the three largest sections. We performed histopathological analyses for the tumor size, lymph node status, histological grade, hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki-67, p53, and molecular subtypes. The associations with the ADC values and prognostic factors of breast cancer were evaluated using the independent-samples t test and the one-way analysis of variance (ANOVA). Results: A low ADC value was associated with lymph node metastasis (P < 0.01) and with high Ki-67 protein levels (P = 0.03). There were no significant differences in the ADC values among the histological grade (P = 0.48), molecular subtype (P = 0.51), tumor size (P = 0.46), and p53 protein level (P = 0.62). Conclusion: The pre-operative use of the 3.0 Tesla DWI could provide information about the lymph node status and tumor proliferation for breast cancer patients, and could help determine the optimal treatment plan. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology.
    Preview · Article · Jan 2016 · Iranian Journal of Radiology
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    ABSTRACT: Background: This study evaluates the efficacy of intraoperative neuromonitoring (IONM) on voice performance in robotic thyroidectomy. Materials and methods: The study was based on a prospective randomized series. Between June 2011 to September 2012, 50 patients with thyroid cancer who underwent robotic thyroidectomy were enrolled. The IONM and non-IONM groups consisted of 25 patients each. Voice Handicap Index (VHI), voice range profile (VRP), and laryngoscopy were used to assess voice function before surgery and at 2 weeks, 3 months, and 6 months after the operation. Results: No palsy was diagnosed by laryngoscopy in either group. VHI values were similar in both groups. In the IONM group, there was significantly earlier recovery in VRP minimum intensity compared with the non-IONM group. However, there were no differences of mean change of VRP maximum frequency and intensity or minimum frequency between the two groups. Conclusions: We found that IONM facilitated more rapid recovery of voice function, especially in VRP minimum intensity, during robotic thyroid surgery.
    No preview · Article · Nov 2015 · Journal of Laparoendoscopic & Advanced Surgical Techniques
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    ABSTRACT: Conventional open thyroidectomy is considered as a safe surgery nowadays. However, surgeons sometimes encounter unexpected difficulty when performing thyroidectomies. The aim of this paper was to identify the predictors of a difficult thyroidectomy for the management of patients with papillary thyroid carcinoma. A database of patients who underwent open conventional thyroidectomy with cervical lymph node dissection after diagnosed papillary thyroid carcinoma between July 2008 and June 2013 was examined. In addition, the patients were subgrouped by difficult thyroidectomy (DT) and nondifficult thyroidectomy to determine the predictors of DT according to operation time. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated. No between-group differences in clinicopathologic factors and postoperative complications, except for male sex (p < 0.001) and tumor size (p = 0.039), were noted. Male sex [odds ratio (OR) 4.158, 95% confidence interval (CI) 2.020-8.559, p = 0.043] and age < 45 years (OR 2.239, 95% CI 1.304-3.843, p = 0.003) were independent factors associated with DT in a multivariate logistic regression model. Elevated antithyroglobulin antibody (OR 1.004, 95% CI 1.000-1.008, p = 0.030) was a variable which is statistically significant, but not clinically significant. Young age and male sex might be regarded as predictors of DT. Expecting DT before surgery might help surgeons, especially beginners, prevent troublesome situations. Copyright © 2015. Published by Elsevier Taiwan.
    No preview · Article · Aug 2015
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    ABSTRACT: Recurrent laryngeal nerve (RLN) palsy is the most common and serious complication of thyroid surgery. The use of energy-based devices (EBDs) has replaced hand-tying methods in many institutions. However, EBD use proximal to the RLN presents risks related to lateral thermal spread and associated nerve damage. THUNDERBEAT (TB) is one of the most widely used EBDs. This study aimed to test the safety of TB during thyroidectomy. Four piglets weighing 30-40 kg experienced thyroidectomy while continuous electrophysiologic monitoring (continuous intraoperative neuromonitoring) occurred, using an electromyography endotracheal tube and NIM 3.0 response system. TB was applied at various distances from the RLN, and we assessed the safety of the protocols. Adverse electromyography events did not occur at distances >3 mm from the RLN. Amplitude decreased at 2 mm from the RLN after 8 s. However, immediate loss of signal occurred at 1 mm from the RLN, likely due to immediate shrinkage of surrounding tissue after TB application. TB can be used safely at 3 mm from the RLN but must be used for <8 s at more proximal locations. This is the first report assessing the safety of TB, and findings indicate that TB should be used at least 1 mm from the RLN to avoid injury. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jul 2015 · Journal of Surgical Research
  • Seung Pil Jung · Hye Yoon Lee · Jeoung Won Bae · Hoon Yub Kim
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    ABSTRACT: Breast metastases of medullary thyroid carcinoma (MTC) are extremely rare, and only a few cases have been reported in the literature so far. Here, we report a case of metastatic MTC to the breast and axillary lymph nodes (LN). The case illustrates that (1) metastatic MTC of the breast could be clinically and pathologically misdiagnosed as primary breast cancer, such as invasive lobular carcinoma with axillary LN involvement; (2) unlike other metastatic breast cancer patients, who have very poor prognoses, our patient survived for more than 5 years after the breast and axillary surgery; and (3) metastasis of MTC to the breast is accompanied by axillary LN metastasis, which requires thorough axillary LN dissection, as in most primary breast cancers.
    No preview · Article · Jun 2015 · Indian Journal of Surgery
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    ABSTRACT: Background: The purpose of this study was to identify predictors of difficult robotic thyroidectomy using the bilateral axillo-breast approach (BABA) for the management of patients with papillary thyroid carcinoma (PTC). Methods: We examined a database containing details of patients with PTC who had undergone robotic thyroidectomy with cervical lymph node dissection between July 2008 and June 2013. Patients were subgrouped into difficult thyroidectomy and non-difficult thyroidectomy to identify predictors associated with difficult thyroidectomy corresponding to the time of operation. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated. Results: Male sex was the only significantly different clinicopathologic factor between the 2 groups (p = .013). Other factors, such as age (p = .809) and body mass index (BMI; p = .202), were comparable between the 2 groups. The rates of postoperative complications, such as hypoparathyroidism, vocal cord palsy, and seroma, in the difficult thyroidectomy group were not significantly different from those in the non-difficult thyroidectomy group. There was no hematoma or wound infection. Male sex was the only independent factor associated with difficult thyroidectomy (odds ratio [OR] = 5.379; 95% confidence interval [CI] = 1.052-27.502; p = .043), according to the multivariate logistic regression model. Conclusion: Male sex was the only predictive factor for difficult robotic thyroidectomy using BABA. Further evaluations should be performed to ascertain additional factors associated with difficult robotic thyroidectomy. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
    No preview · Article · May 2015 · Head & Neck

  • No preview · Article · May 2015 · Cancer Research
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    ABSTRACT: Central lymph node dissection (CLND) in patients with papillary thyroid microcarcinoma (PTMC) is still controversial. The aim of this study was to examine the risk factors and the incidence of central lymph node metastases (CLNMs) in patients with PTMC who underwent thyroidectomy and CLND. Between 2002 and 2013, 613 patients were enrolled who underwent thyroidectomy with routine CLND for PTMC at the Korea University Medical Center, Ansan Hospital and risk factors and the incidence of CLNM were analyzed. In addition, we also evaluated the complications after thyroidectomy with CLND. Out of 613 patients, 239 (39.0%) were found to have CLNM. Male sex (p = 0.012), tumor size ≥ 0.5 cm (p = 0.001), capsular invasion or extrathyroidal extension (p = 0.029), and multifocality (p = 0.004) were independent risk factors for CLNM. Among the 69 patients who had PTMC without these risk factors, CLNM was identified in 12 (17.4%). In this study group, two (0.3%) had permanent recurrent laryngeal nerve injury, two (0.3%) had persistent hypocalcemia, and two (0.3%) developed postoperative hemorrhage. CLNM in PTMC is highly prevalent in male sex, tumor size ≥ 0.5 cm, extrathyroidal extension, and multifocality. Even in PTMC patients without these risk factors, the incidence of CLNM is rather higher than expected, and the complication rate of thyroidectomy with CLND is acceptable. Thus, CLND should be considered in all patients with PTMC. Copyright © 2015. Published by Elsevier Taiwan.
    Full-text · Article · Apr 2015
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    ABSTRACT: The cervical lymph node metastasis (CLNM) of papillary thyroid microcarcinoma (PTMC) is not uncommon. However, prophylactic cervical lymph node dissection in all PTMC is debatable. Molecular markers of predicting CLNM would help to decide to either do or not do cervical lymph node dissection which might increase morbidities. We aimed to characterize gene expression profiles and molecular markers of CLNM in PTMC. The thyroid frozen tissues were obtained with from six PTMC patients, who underwent total thyroidectomy. We performed oligonucleotide microarray analysis with three PTMCs with CLNM and three without CLNM. Real-time quantitative reverse transcription-polymerase chain reaction was used to validate the gene. We used linear models for microarray data. We identified 12 differentially expressed gene, and most one is endoplasmic reticulum aminopeptidase 2 (ERAP2). ERAP2 might be associated with CLNM in PTMC.
    No preview · Article · Apr 2015 · Journal of cancer research and therapeutics
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    ABSTRACT: Background The aim of the present study was to compare the surgical outcomes of robotic thyroidectomy using the bilateral axillo-breast approach (BABA) with open conventional thyroidectomy.Methods Database of patients who underwent thyroidectomy with cervical lymph node dissection after diagnosed as papillary thyroid carcinoma between July 2008 and February 2013 were examined. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities of robot group and open group were investigated.ResultsThe dominant tumor size (P = 0.974), body mass index (BMI) (P = 0.426), and the mean number of metastatic lymph nodes in central compartment neck dissection (P = 0.269) were comparable between the two groups. The mean number of retrieved central lymph nodes was higher in the open group than in the robot group (P = 0.001). Postoperative complications were comparable: hypoparathyroidism in 2 weeks (P = 0.296) and 3 months (P = 0.446) after the surgery; vocal cord palsy in 2 weeks (P = 0.363) and 3 months (P = 0.312); hematoma (P = 0.162); and wound infection (P = 0.421).Conclusions Robotic thyroidectomy using BABA may be a technically feasible and safe procedure comparable to conventional open surgery especially in node-negative patients. J. Surg. Oncol. 2015 111:141-145. © 2014 Wiley Periodicals, Inc.
    No preview · Article · Feb 2015 · Journal of Surgical Oncology
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    ABSTRACT: To evaluate the feasibility and safety of robotic thyroidectomy using the da Vinci surgical system. Between July 2008 and April 2011, the data revealed an initial series of 100 consecutive patients who underwent robotic thyroidectomy with the da Vinci-S surgical system using the bilateral axillo-breast approach for thyroid cancer. Prospectively collected data were analyzed retrospectively. There were 88 cases of total thyroidectomy, 11 cases of lobectomy, and 1 case of total thyroidectomy with modified radical neck dissection. There was no conversion. The mean total operation time was 287.15±45.19 minutes for total thyroidectomy and 236.27±48.98 minutes for lobectomy. Nineteen patients experienced transient hypocalcemia and 3 patients experienced transient vocal fold palsy. All of the patients recovered within 3 months. Robotic thyroid surgery for patients with thyroid malignancy is safe and results in fewer postoperative complications than open thyroid surgery.
    No preview · Article · Feb 2015 · Surgical laparoscopy, endoscopy & percutaneous techniques
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    ABSTRACT: One of the most serious complications of breast reconstruction and augmentation using silicone implants is capsular contracture. Several preventive treatments, including vitamin E, steroids, antibiotics, and cysteinyl leukotriene inhibitors, have been studied, and their clinical effects have been reported. However, the problem of capsular contracture has not yet been completely resolved. This study was performed to compare anti-adhesion barrier solution (AABS) and fibrin in their ability to prevent fibrotic capsule formation and simultaneously evaluated their effect when used in combination by capsular thickness analysis and quantitative analysis of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), and type I collagen within the fibrous capsule. This study used female six-week-old Sprague-Dawley rats. Eighty rats were equally subdivided into the four following groups: AABS-treated, fibrin-treated, AABS and fibrin combined-treated, and untreated control groups. Each rat received two silicone chips under the panniculus carnosus muscle layer. The test materials were applied around the silicon chips. Four weeks later, the implantation sites including the skin and muscle were excised to avoid the risk of losing the fibrous capsule around the implants. The capsular thickness was analyzed by Masson's trichrome stain. Quantitative analysis of type I collagen, MMPs, and TIMPs was performed by real-time PCR, Western blot, and zymography. The mean capsular thickness was 668.10 ± 275.12 μm in the control group, 356.97 ± 112.11 μm in the AABS-treated group, 525.96 ± 130.97 μm in the fibrin-treated group, and 389.24 ± 130.51 μm in the AABS and fibrin combined-treated group. Capsular thickness was significantly decreased in all experimental groups (p < 0.05). Capsular thickness was greater in the fibrin-treated group than in the AABS-treated group (p < 0.05). There was no statistically significant difference in capsular thickness between the AABS and fibrin combined-treated group and the AABS- or fibrin-treated group (p > 0.05). Compared to the control group, the experimental groups had significantly lower expressions of type I collagen and MMP-1 (p < 0.05), but there was no statistically significant difference in expressions of type I collagen and MMP-1 between the AABS-, fibrin-, and AABS and fibrin combined-treated groups (p > 0.05). The expressions of MMP-2 and TIMP-2 were not significantly different between the control and the experimental groups (p > 0.05). AABS is more effective in reducing capsular thickness compared with fibrin treatment in a white rat model. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
    No preview · Article · Dec 2014 · Aesthetic Plastic Surgery
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    ABSTRACT: Background: Although endoscopic thyroid surgery is gaining wide acceptance, existing endoscopic methods for thyroidectomy are blamed for the increased frequency of flap dissections and longer surgical times. More recently, transoral endoscopic thyroidectomy has overcome the limitations of previous approaches. Herein, we present our initial experience with transoral periosteal thyroidectomy (TOPOT) in cadaver and porcine models. Using these models, the surgical view was improved and had greater freedom of motion; the technique was then performed in human subjects using robotic TOPOT, which has not previously been reported. Method: TOPOTs were performed in seven fresh human cadavers and ten live pigs. Total thyroidectomies were performed in all cadavers and pigs. After the cadaver and animal trials, four human patients underwent robotic TOPOT performed using the da Vinci® surgical system at Korea University Anam Hospital. Recurrent laryngeal nerve function, intra- and postoperative complications, and postoperative outcomes were assessed in all patients. Result: One left lobectomy for follicular adenoma, two right lobectomies for nodular hyperplasia, and one left lobectomy with a central neck dissection for papillary thyroid microcarcinoma were performed in the human subjects using a robotic transoral periosteal approach. In three cases, paresthesia occurred in the mental nerve, but this improved within 4 weeks in all cases. No local infections occurred at the incision site or anterior neck, and no recurrent laryngeal nerve cord palsies occurred postoperatively. Conclusion: TOPOT may be an effective and safe approach for robotic thyroid surgery.
    No preview · Article · Aug 2014 · Surgical Endoscopy
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    ABSTRACT: Secretory breast carcinoma is a very rare and distinct subtype of breast cancer, characterized by the presence of intracellular and extracellular secretory material. Secretory breast carcinoma has a good clinical outcome and systemic involvement is rare. The majority of studies of this tumor have been case reports or separate analyses, and due to the rarity of these tumors, it has been difficult to fully elucidate their characteristics and define optimal treatment strategies. To add to the current knowledge of secretory breast carcinoma, the present study reports three cases of secretory breast carcinoma in patients of different ages, and with different hormone receptor statuses and treatment methods. The present study identified that each patient with secretory breast carcinoma may present with different symptoms and clinical characteristics. Therefore, therapeutic options should be selected based on the overall status of the patient and the characteristics of this rare disease.
    Full-text · Article · Aug 2014 · Oncology letters
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    ABSTRACT: Collagen is one of numerous components of the cellular microenvironment. To date, the association between the microenvironment and tumorigenesis of malignant breast cancer remains elusive. Therefore, the aim of the present study was to investigate the potential role of a secretory protein of stromal cells, type I collagen, in the development of the aggressive characteristics of breast cancer cells. MDA-MB231 and MCF7 breast cancer cell lines were maintained in cultured media of normal human dermal fibroblasts (HDFs) and type I collagen-containing media. The morphological changes, adhesion capacity and matrix metalloproteinase (MMP)-1, -2 and -9 mRNA levels were evaluated. The results revealed that cell sprouting and adhesion capacity were enhanced in the MCF7 and MDA-MB231 breast cancer cells in HDF-conditioned culture media as well as in response to type I collagen treatment. The expression of MMP-9 mRNA was high in breast cancer cells cultured with the media of normal HDFs, compared with that of the control media. These data indicate that type I collagen, which is secreted by stromal fibroblasts, may augment the aggressive characteristics of breast cancer cells through the induction of MMP-9 mRNA.
    Preview · Article · Aug 2014 · Oncology letters
  • Woo Young Kim · Hoon Yub Kim · Gil Soo Son · Jeoung Won Bae · Jae Bok Lee
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    ABSTRACT: Background and Aims: Extrathyroidal extension (ETE) is one of the most important factors correlated to poor outcome of papillary thyroid carcinoma (PTC). However, the role of ETE in the prognosis of papillary thyroid microcarcinoma (PTMC) and the factor associated with ETE of PTMC are unclear. We investigated clinicopathological, immunohistochemical factors associated with ETE of PTMC to identify whether PTMC with ETE would have more adverse prognostic factors and higher risk for recurrence. Setting and Design: We enrolled patients performed thyroidectomy due to PTC between January 2003 and June 2008 and selected patients diagnosed with PTMC among them. We investigated numerous clinicopathological, immunohistochemical factors of selected patients. Materials and Methods: Data from 325 patients diagnosed with conventional PTMC by intraoperative frozen section and final pathology were recorded retrospectively. Statistical Analysis Used: A χ2 test or an independent two-sample t-test, multiple logistic regression analysis, the Kaplan-Meier method, and log-rank test. Results: Thirty-four percent of patients (325 of 952) had PTMC on final pathology. Among them, the number of patients with and without ETE was 91 and 234, respectively. On both univariate and multivariate analysis; ETE of PTMC correlated with size (P < 0.001); tumor, node, and metastasis (TNM) staging (P = 0.001); multifocality (P = 0.001); lymph node metastasis (P < 0.001); radioactive iodine (RAI) therapy (P = 0.001); and recurrence (P = 0.037). Conclusions: ETE of conventional PTMC is associated with size, multifocality, lymph node metastasis, and recurrence. More extensive surgery should be considered for patients having ETE identified by intraoperative frozen sections, preoperative imaging, and intraoperative finding and other high risk factors.
    No preview · Article · Apr 2014 · Journal of cancer research and therapeutics
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    ABSTRACT: Background: Endoscopic thyroid surgery is gaining wide acceptance; however, existing endoscopic methods for thyroidectomy have shown several limitations. Recently, a transoral technique using video assistance and endoscopy has been reported for thyroidectomy. The aim of this study was to define a new technique of transoral thyroidectomy using a mandibular periosteal approach to complement other types of natural orifice surgery and minimally invasive surgery. Materials and methods: Transoral periosteal thyroidectomies were performed in seven living pigs to evaluate the feasibility and safety of the new approach. Total thyroidectomies were performed in all animals. Follow-up examinations were carried out for 7 days and followed by autopsy. Results: Through three trocars in the mandibular periosteal area, it was possible to create a working space under the platysma muscle and to reach the pretracheal area. Total thyroidectomies were also performed via the transoral, mandibular periosteal approach without complications in seven orally intubated living pigs. Postoperatively, the white blood cell count remained normal in all cases. On the postoperative sacrifice of the pigs, three locally encapsulated seromas were observed. Both recurrent laryngeal nerves were intact in all cases. Conclusions: Transoral periosteal thyroidectomy could be feasible and safe.
    No preview · Article · Apr 2014 · Journal of Laparoendoscopic & Advanced Surgical Techniques
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    ABSTRACT: Primary breast lymphoma (PBL) is a rare disease, particularly in males. Diffuse large B cell lymphoma is the most common PBL, while follicular lymphoma is less common. Furthermore, primary follicular lymphoma of a male breast is rarely reported. We report a male patient with primary follicular lymphoma of the breast and hepatocellular carcinoma (HCC). A 46-year-old man was diagnosed with liver cirrhosis secondary to chronic hepatitis B infection. Ten years later, he underwent segmentectomy of the liver due to HCC. Another 5 months later, he presented with a painless mass in the right chest wall. The mass was diagnosed as follicular lymphoma of the breast. The stage was IEA and he did not receive adjuvant therapy. Although only a few cases have been reported, lymphoma should be considered as a possible cause of breast mass, even in male patients.
    Preview · Article · Jan 2014 · Cancer Research and Treatment

Publication Stats

224 Citations
85.18 Total Impact Points

Institutions

  • 2015
    • Korea University Medical Center
      Sŏul, Seoul, South Korea
  • 2000-2015
    • Korea University
      • • Department of Surgery
      • • College of Medicine
      Sŏul, Seoul, South Korea
  • 2013
    • Sungkyunkwan University
      • Department of Surgery
      Sŏul, Seoul, South Korea
  • 2010
    • University of Seoul
      Sŏul, Seoul, South Korea