• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.360-364
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• 2005

The anterolateral thigh flap was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral circumflex artery. This flap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous flap, or a myocutaneous flap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a 2-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because flap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to classify the vascular anatomy and to assess the suitability of anterolateral thigh flap for head and neck reconstruction in Korean. We performed an anatomic study on cadavers and analyzed the anatomic pattern of the lateral circumflex femoral arterial system and the perforators nourishing the anterolateral thigh flap. This study suggest the characteristics of vascular anatomic patterns of anterolateral thigh flap of Korean and utility of this flap for head and neck reconstruction.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.126-131
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• 2005

Objectives: To evaluate the efficacy and safety of induction chemotherapy with docetaxel and cisplatin in locally advanced head and neck cancer. Materials and Methods: Between June 1998 and December 2004, 30 patients were enrolled and among them, 20 patients were evaluable. Patients were treated with docetaxel $75mg/m^2$ and cisplatin $60mg/m^2$ on day 1 every 21 days. Results: The median age was 71(range 54-80) years old. All 20 patients were male. Nineteen patients had pathologically squamous cell carcinoma and 1 had undifferentiated carcinoma. Fourteen of 20 patients(70%) demonstrated an objective response with two(10%) achieving a complete clinical response and eleven(60%) a partial response. The median response duration was 5.3(1.6-32.1) months and the median time to progression was 5.6(1.4-33.8) months. The median overall survival of all patients was 14(range 2.2-34) months. The median overall survival of responders was 17.5(range 5-34) months and that of non-responders was 3.2(range 2.2-23) months, but it was not statistically significant(p=0.106). During a total of 92 cycles, granulocytopenia worse than CTC(Common toxicity criteria) grade 2 occurred in 6%, thrombocytopenia in 2%, and anemia in 3%, respectively. Non-hematologic toxicities were minor and easily controlled. Conclusion: The induction chemotherapy of docetaxel and cisplatin has moderate efficacy with acceptable toxicities in patients with locally advanced head and neck cancer.

• Korean Journal of Head & Neck Oncology
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• v.9 no.2
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• pp.227-233
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• 1993

For malignant neoplasms of salivary tissues. two of the better determinants of progosis are histologic classification and size of the neoplasm. Proper management of these tumors requires an accurate diagnosis by the pathologist and correct interpretation by the surgeon. Malignant mixed tumors account for between 3 and 13 precent of all cancers of the salivary glands and 2 percent of all tumors in these locations. The typical history of these tumors is that of slowly growing mass demonstrating a sudden increase in growth. The duration of onset of the tumor mass and the diagnosis of malignancy has been demonstrated to be 10 to 18 years. The risk of malignat transformation of a benign mixed tumor increases with the duration of the tumor. We analyzed retrospectively 13 cases of malignant mixed tumor who visited from Jan. 1985 to Dec. 1992. Mean age of the patients was 56.5 years. The origin of tumors were parotid gland 7 cases, submandibular gland 2 cases, and minor salivary gland 4 cases(palate 3 cases, tonsil pillar 1 case). According to the criteria of the AJCC on staging, stage I was 1 case, stage II 1 case, stage III 2 cases, and stage IV 9 cases. Histopathologically, carcinma ex pleomorphic adenoma were 12 cases and the true malignant mixed tumor was 1 case. The major treatment modalities were curative surgery, and radiation therapy followed. In conclusion, aggressive therapy of combined surgery and postoperative radiation therapy is required for these lesions, and patients with known or suspected benign tumor should be encouraged to undergo surgery early on in their disease to avoid malignant degeneration at a later dete.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.135-141
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• 2002

Backgrounds and Objectives: Metastasis is a complex multistep process that requires sequential interactions between the invasive cell and the extra-cellular matrix. Transforming growth factor-${\beta}1$ ($TGF-{\beta}1$) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by $TGF-{\beta}1$ plays important roles in neoplastic progression. The aim of this study was to investigate the role of $TGF-{\beta}1$ in the neoplastic invasion and metastasis through matrix metalloproteinase (MMP) of laryngeal cancer cell lines. Material and Methods: Two laryngeal cancer cell lines, SNU-899 and SNU-1076 were treated with recombinant $TGF-{\beta}1$, and the expression of MMP-2 and MMP-9 was immunohistochemically evaluated and gelatinase activity was studied by gelatin zymogram. Results: The cell growth inhibition was evident on 4th days after 1ng/ml and 10ng/ml $TGF-{\beta}1$ treatment. The expressions of MMP-2 and MMP-9, and their gelatinase activities were increased in dose-dependent manner. Conclusion: $TGF-{\beta}1$ treatment in laryngeal cancer cell lines induces the expression of MMP-2 and MMP-9, thus playing a role in the digestion of extracellular matrix gelatin.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.821-825
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• 2012

Purpose: Centromere protein H (CENP-H) and Ki67 are overexpressed in some malignancies, but whether they are predictors of survival after primary resection for hypopharyngeal squamous cell carcinoma (HSCC) remains unknown. Methods: We assessed immunohistochemical expression of CENP-H and Ki67 in 112 HSCC specimens collected between March 2003 and March 2005 for analysis by clinical characteristics. The Kaplan-Meier method was used to analyze relapse-free survival and logistic multivariate regression to determine risk factors of relapse-free survival. Cholecystokinin octapeptide assays and flow cytometry were used to examine cell proliferation and apoptosis after siRNA inhibition of CENP-H in HSCC cells. Results: Overall, 50 (44.6%) HSCC specimens showed upregulated CENP-H expression and 69 (61.6%) upregulated Ki67. An increased CENP-H protein level was associated with advanced cancer stage and alcohol history (P=0.012 and P=0.048, respectively) but an increased Ki67 protein level only with advanced cancer stage (P=0.021). Increased CENP-H or Ki67 were associated with short relapse-free survival (P<0.001 or P=0.009, respectively) and were independent predictors of relapse-free survival (P=0.001 and P=0.018, respectively). siRNA knockdown of CENP-H mRNA inhibited cell proliferation and promoted cancer cell apoptosis in vitro. Conclusions: Upregulated CENP-H and Ki67 levels are significantly associated with short relapse-free survival in HSCC. These factors may be predictors of a relapsing phenotype in HSSC cases.

• Korean Journal of Head & Neck Oncology
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• v.29 no.2
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• pp.65-67
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• 2013

Osteomyelitis is an infection of bone or bone marrow, caused by pyogenic bacteria or mycobacterium. Osteomyelitis can be acute or chronic, inflammatory process of the bone and its structures. Chronic osteomyelitis will result in variable sclerosis and deformity of the affected bone. With an infection of the bone, the subsequent inflammatory response will elevate this overlying periosteum, leading to a loss of the nourishing vasculature, vascular thrombosis, and bone necrosis, resulting occasionally in formation of sequestra. These become areas that are more resistant to systemic antibiotic therapy due to lack of the normal Havesian canals that are blocked by scar tissue. At this aspect, not only systemic antibiotic therapy, but also surgical debridement maybe required to remove the affected bone and prevent disease propagation to adjacent areas. We experienced a patient who diagnosed tongue cancer and underwent wide partial glossectomy few years before, with an ulcerative lesion around right retromolar trigon. We diagnosed cancer recurrence because PET indicated hot uptake on mandible which was nearby previous tongue tumor site. The patient received hemiglossectomy via paramedian mandibulotomy, partial mandibulectomy and fibula osteocutaneous free flap reconstruction. But final diagnosis was mandible osteomyelitis on pathology report. Here, we present the case with a review of the related literatures.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2133-2137
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• 2012

Objective: To investigate the prognostic role of antigen KI-67 (Ki-67) and G1/S-specific cyclin-D1 (cyclin-D1) in patients with laryngeal squamous cell carcinoma (LSCC). Methods: Immunohistochemical staining (IHS) was used to determine the protein expression of Ki-67 and cyclin-D1 in LSCC tissues. Kaplan-Meier survival curves was calculated with reference to Ki-67 and cyclin-D1 levels. Results: Cyclin-D1 and Ki67 were expressed in the nuclei of cancer cells. Among the total of 92 cancer tissues examined by immunohistochemistry, 60 (65.22%) had cyclin-D1 overexpression and 56 (60.87%) had Ki67 overexpression. Cyclin-D1 overexpression is associated with the advanced stage of the cancer (P=0.029), but not with gender, age, stage of cancer, histological differentiation, anatomical site, smoking history and alcohol consumption history. Ki67 overexpression is not associated with the advanced stage, gender, age, histological differentiation, anatomical site, smoking history and alcohol consumption history. A statistically significant correlation was found between lymph node status and the expression of Ki67 (p = 0.025). Overexpression of cyclin-D1 was correlated to shorter relapse-free survival period (P<0.001). Conclusions: Overexpression of cyclin-D1 can be used as a marker to predict relapse in patients with LSCC after primary curative resection.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.3-14
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• 1998

Objectives: Many complicated problems exist in establishing head and neck cancer(HNCa) patient registry system. In this study, a newly devised and simplified approach named as 'Single Sheet Multiple Event System' was compared with a conventional approach named as 'Multiple Sheet System'. Material and Method: According to several kinds of registry sheets in the two systems, data were collected from 486 patients with HNCa diagnosed at Department of Otolaryngology, Seoul National University Hospital from 1979 through 1994. Results: The new system produced more simple and efficient data retrieval. Conclusion: It could make the implementation of HNCa patient registry system more simple and efficient.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.61-64
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• 2018

Malignant lesion of the trachea predominantly results from direct spread of adjacent tumors, whereas primary tracheal malignancies are rarely observed. Tracheal tumors are usually diagnosed late on account of delayed specific symptoms: dyspnea, stridor, coughing and hemoptysis. Primary tracheal tumors, although very rare, may extend into the thyroid gland and present as a thyroid mass. Surgery, followed by adjuvant radiotherapy, is the treatment of choice. A case of primary tracheal cancer with thyroid invasion is reported, and a review of the literature is presented.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3645-3651
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• 2015

Background: Previous studies evaluating the association between the xeroderma pigmentosum group G (XPG) Asp1104His polymorphism and head and neck cancer susceptibility have proven controversial. This meta-analysis of the literature was performed to obtain a more precise estimation of the relationship. Materials and Methods: We systematically searched PubMed, Embase and Web of Science with a time limit of Dec 18, 2014. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of any association. Results: We performed a meta-analysis of eight published case-control studies, including 3,621 cases and 5,475 controls. Overall, no significant association was found between the XPG Asp1104His polymorphism and head and neck cancer susceptibility under all genetic models. In the subgroup analysis by ethnicity, the XPG Asp1104His polymorphism had statistically significant association with elevated head and neck cancer risk under CC vs GG (OR=1.24, 95% CI=1.00~1.54) and the recessive model (OR=1.22, 95%CI=1.01~1.46) in Asian populations. A similar result was found under CC vs GG (OR =1.22, 95%CI=1.01~1.47) in the population based subgroup by source of control. When performed by tumor site, the XPG Asp1104His polymorphism had statistically significant association with elevated laryngeal cancer under all genetic models (CC vs GG: OR=1.59, 95% CI=1.16~2.19; GC vs GG: OR=1.38, 95%CI=1.10~1.72; dominant model: OR=1.42, 95% CI=1.15~1.74; recessive model: OR=1.36, 95% CI=1.02~1.81). Conclusions: This meta-analysis suggested that the XPG Asp1104His polymorphism is a risk factor for head and neck cancer susceptibility, especially for laryngeal cancer and in Asian populations.