• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2629-2633
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• 2012

Background: Raw betel nut (RBN) chewing is an important contributing factor for esophageal squamous cell carcinoma (ESCC), although associated genomic changes remain unclear. One difficulty in assessing the effects of exclusively RBN induced genetic alterations has been that earlier studies were performed with samples of patients commonly using tobacco and alcohol, in addition to betel-quid. Both CDKN2A (at 9p21) and Rb1 gene (at 13q14.2) are regarded as tumor suppressors involved in the development of ESCC. Therefore, the present study aimed to verify the RBN's ability to induce ESCC and assess the involvement of CDKN2A and Rb1 genes. Methods: A panel of dinucelotide polymorphic markers were chosen for loss of heterozygosity studies in 93 samples of which 34 were collected from patients with only RBN-chewing habit. Promoter hypermethylation was also investigated. Results: Loss in microsatellite markers D9S1748 and D9S1749, located close to exon $1{\beta}$ of CDKN2A/ARF gene at 9p21, was noted in 40% ESCC samples with the habit of RBN-chewing alone. Involvement of a novel site in the 9p23 region was also observed. Promoter hypermethylation of CDKN2A gene in the samples with the habit of only RBN-chewing alone was significantly higher (p=0.01) than Rb1 gene, also from the samples having the habit of use both RBN and tobacco (p=0.047). Conclusions: The data indicate that the disruption of 9p21 where CDKN2A gene resides, is the most frequent critical genetic event in RBN-associated carcinogenesis. The involvement of 9p23 as well as 13q14.2 could be required in later stages in RBN-mediated carcinogenesis.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.4
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• pp.462-469
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• 2018

HSP90 regulates various proteins involved in differentiation and cell survival. Levels of HSP90 tend to increase during development of squamous cell carcinoma in the head and neck including the mouth. Thus, many studies have been conducted to treat these cancers through suppression of HSP90. This study investigated the effect of two HSP90 inhibitors, geldanamycin and 17-AAG, on the proliferation, apoptosis, and invasion of human oral squamous cell carcinoma cells. Cell survival and cell cycle analyses, as well as western blot analysis, were performed with oral cancer cell lines, YD-10B and YD-38. After treatment with HSP90 inhibitors, cell proliferation was significantly inhibited. When YD-10B and YD-38 cells were treated with various concentrations of geldanamycin and 17-AAG (0, 0.1, 0.3, 1 and $10{\mu}M$) for 24 hr, the growth of YD-10B cells was markedly reduced compared to that of YD-38 cells. Thereafter, the cells were subjected to flow cytometry, which revealed G2 arrest. These results demonstrated that geldanamycin induced G2 arrest and inhibited cell proliferation through the $p-GSK-3{\beta}$ pathway in YD-10B and YD-38 cells, thus inhibiting cell survival. HSP90 inhibitors are therefore expected to have a therapeutic effect on various cancer cell lines.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.441-448
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• 2019

Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. Methods We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. Results Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a splitthickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. Conclusions We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.8-13
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• 2011

Purpose: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. Method: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. Result: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. Conclusion: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.

• Imaging Science in Dentistry
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• v.33 no.4
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• pp.239-244
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• 2003

Malignant fibrous histiocytoma (MFH) is a pleomorphic soft tissue sarcoma. Three cases of MFH were reported in our study. The first case involved in the right infratemporal fossa of a 32-year-old female was presented. MR imaging revealed a 5.0 × 3.3 cm soft tissue mass of inhomogeneous high signal intensity. The second case was found in the right hard palate of a 66-year-old male. CT demonstrated bone destruction and MR imaging showed a 4 × 4 cm sized soft tissue mass of heterogeneous high signal intensity. The final case was found in the left masticator space of a 37-year-old male. The CT image showed a large mass with massive bone destruction of the left mandibular ramus, while the MRI displayed a soft tissue mass, 8 cm diameter. Our cases exhibited the general features of MFH. MRI is essential in the imaging of MFH, namely to depict tumor borders and demonstrate relationships with adjacent structures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.2
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• pp.155-160
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• 2002

Oral squamous cell carcinoma (OSCC), the most common head and neck cancer, shows poor prognosis as a result of frequent local invasion and lymph node metastasis that is mediated by multiple proteolytic enzymes and angiogenesis. In recent reports, angiogenesis is known to play an important role in tumor invasion and metastasis. The purpose of this study was to determine the role of angiogenesis in OSCCs, particularly with respect to the invasive and the metastatic potential. The microvessel density (CD31) in 34 human OSCC cases were investigated by immunohistochemistry, and reviewed with respect to the invasiveness and the presence of lymph node metastasis and following results were obtained. The blood vessel density $(28.8{\pm}7.9)$ in the strong invasive cases were significantly higher than those $(23.3{\pm}6.9)$ in the weak invasive cases. (p<0.05) In the 14 cases with lymph node metastasis, the average blood vessel density was $28.5{\pm}9.6$. On the other hand, in the 20 cases without lymph node metastasis, the blood vessel density was $25.2{\pm}6.4$. The blood vessel density was not statistically related to lymph node metastasis. (p>0.05) These results suggest that angiogenesis may be related to the local invasion of OSCC and further research will be needed to investigate the possibility that antiangiogenic agent can be used as an anticancer agent for OSCC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.125-127
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• 2010

The coexistence of aspergillosis and squamous cell carcinoma (SCC) in the maxillary sinus was very rare. To our knowledge, this is the second report of coexistent SCC and aspergillosis in the maxillary sinus. A 58-year-old man underwent surgery for unilateral maxillary sinus infection with oroantral fistula. In the surgical specimen, SCC and aspergillosis were co-detected with routine and immunohistochemical stainings. Moreover, human papillomavirus 18 (HPV-18) was detected by polymerase chain reaction in the sinus specimen. The patient was re-operated with subtotal maxillectomy and has been followed up for two years without any evidence of recurrence or metastasis. Although it is not understood how aspergillosis could induce carcinoma formation, the chronic inflammation caused by prolonged fungal infection might be carcinogenic. Moreover, HPV-16 and -18 were another causative pathogens of SCC in the head and neck region. We recommend careful examination, including preoperative cytology, in patients with maxillary sinus fungal infections because of the potential for cancer development.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.3
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• pp.217-220
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• 2010

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative lesion on oral mucosa featuring as a benign mass of self-limiting growth. It can be easily misdiagnosed as squamous cell carcinoma (SCC) due to its long healing period and elevated or rolled-up margin. A 57-year old male patient who visited our department was diagnosed as SCC according to the clinical features, results of positron emission tomography (PET) and magnetic resonance imaging (MRI) of the oral lesion. However, after performing incisional biopsy, histopathologically, there were no atypical cells, but eosinophil and CD 30+ T-cells were clustered in subcutaneous and muscle tissue. It is very significant to consider this reactive lesion in the field of oral and maxillofacial surgery because of its possibility of mistaken as malignant disease. Here, we will report a couple of cases of TUGSE with references and limit of radiographic tools used for diagnosis of head and neck cancer.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.769-775
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• 2015

Background The radial forearm flap is a versatile, widely used flap. However, the possibility of donor site complications has led to concern over its use. Some surgeons prefer using other flaps whose donor sites can be closed primarily with less morbidity, including avoiding unpleasant scarring. However, in our experience, donor site stability of the radial forearm flap can be reliably achieved by using well-implemented specific procedures. Here, we present a collection of donor site cases of the radial forearm flap and investigate factors that affect the aesthetic results as the basis for a reference for selecting a radial forearm flap. Methods In this retrospective study, we reviewed 171 cases in which a radial forearm flap was used for free tissue transfer after resecting head and neck cancer. We focused on donor site morbidity rates. Each operation involved a detailed procedure designed to minimize donor site morbidity. Moreover, statistical investigations were conducted for 22 cases to determine factors affecting the scar appearance. Results Only one case developed total skin graft necrosis as a major complication. Scar-related aesthetic results were acceptable, and the body-mass index, body weight, diabetes, and cardiac problems were significant factors related to the appearance of scars. Conclusions Performing the radial forearm flap using a well-implemented detailed technique helps achieve acceptable donor site morbidity results. The aesthetic results were more promising for patients without excess body weight, diabetes, or cardiac problems. Therefore, anxiety about donor site morbidity should not be a reason to avoid selecting the radial forearm flap in suitable patients.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.274-283
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• 2005

Purpose: To survey the functional status, self-esteem and depression of a community of indwelling clients with total laryngectomy, and to evaluate the correlation among these three variances. Methods: From May 2002 to October 2002, 76 clients who had undergone total laryngectomy more than three months ago were surveyed with using Baker's functional status in head & neck cancer-self report, Rosenberg's self rating self-esteem scale and Zung's self rating depression scale. Results: 1. The functionaI status score was $48.67{\pm}10.12$. The subjects aged 70 years or older had significantly higher scores than the subjects aged $50{\sim}59$ years. The group of clients who were operated on more than five years ago showed higher scores than the patients operated on within a year. 2. The self-esteem score was $30.47{\pm}6.44$. 3. The depression score was $47.26{\pm}8.01$. The subjects who bad three family members and the subjects who had five family members had significantly higher scores than the subjects who had two family members. 4. A significant correlation found between the functional status and self-esteem. Significant negative correlations were found between the functional status and depression and also between self-esteem and depression. Conclusion: Remarkable correlations were observed among functional status, self-esteem and depression. Nurses should consider the status of layngectomy patients and pay more attention to their pre- and post- operative nursing care and rehabilitation.