• Nuclear Medicine and Molecular Imaging
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• v.40 no.6
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• pp.309-315
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• 2006

Purpose: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell canter (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings. Materials & Methods: Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test. Results: Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively. Conclusion: There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.

• Korean Journal of Head & Neck Oncology
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• v.35 no.1
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• pp.13-20
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• 2019

Background/Objectives: Despite multiple approaches of treatments for salivary duct carcinoma, there has been a need for more successful treatment methods because of its poor prognosis. Treatment options like immunotherapy using new technologies have been attempted. Based on recent study results indicating that targeting programmed death receptors are effective in treating various cancers, this study aimed to identify the frequency of PD-L1 expression and its impact on survival rate in salivary duct carcinoma. Materials & Methods: We studied 33 patients with salivary gland cancer who were available for histologic specimens. We examined the expression of PD-L1 in the tissues and analyzed the association with the survival rate and the association with various clinical parameters. Results: According to this study and review of similar studies, we discovered that the expression of PD-L1 in salivary duct carcinoma was lower than other types of cancers. The impact of PD-L1 on survival rate also showed inconsistency in salivary duct carcinoma. Conclusion: Immunotherapy by PD-1/PD-L1 checkpoint blockade in salivary duct carcinoma needs further evaluation for clinical application.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1865-1868
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• 2016

Background: The number of patients with oral cancer in India is increasing gradually (especially in younger people). Although the diagnostic modalities and therapeutic management of oral cancer are improving, the treatment outcome and prognosis of oral cancer remain poor. The absence of definite early warning symptoms for most head and neck cancers suggests that sensitive and specific biomarkers are likely to be important in screening for high-risk patients. Aims: To analyze serum adenosine deaminase (ADA) levels in oral squamous cell carcinoma (OSCC) cases who reported to our institute. Materials and Methods: A prospective study was performed on 100 histopathologically proven cases of OSCC (study group) and 100 normal healthy individuals (control group). Independent sample and one sample t-tests and one way ANOVA followed by Tuckey's POST HOC test were conducted for analysis. Results: Statistically significant increase in serum ADA levels was observed in OSCC cases compared to the control group. Also serum ADA level increased significantly with the histopathological grade. Conclusions: Serum ADA levels in OSCC may be a useful diagnostic and prognostic biomarkers in clinical practice and our findings suggest that a large-scale study is warranted to confirm clinical utility as a prognostic and diagnostic biomarker.

• Radiation Oncology Journal
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• v.9 no.2
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• pp.205-213
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• 1991

In order to determine the value of induction chemotherapy (CT) for inoperable head and neck cancer, the authors conducted a retrospective study. Fifty-five patients were treated with CT and radiotherapy (R-T)(CT+RT group). This group was compared with a group of 54 patients treated RT alone (RT alone group). The CT regimen used were CF (cis-platine+5-FU), CVB (cyclophos-phamide+vincristine+bleomycin), CAP (cyclophosphamide+adriamycin+prednisolone) or PVBM(cis-platine+vincristine+bleomycin+methotrexate). Toxicity from induction chemo-therapy was minimal, and toxicity was limited primarily to nausea and vomiting, mucositis and myelosuppression. The complete response (CR) rate to CT was $14.5\%$ and the partial response (PR) rate was $47.3\%$ for an overall major response rate of $61.8\%$. The major response rate at the completion of loco-regional therapy was $87.3\%$(48/55) with 32 CR ($58.2\%$) and 16 PR ($29.1\%$) for CT-RT group and $81.5\%$(44/55) with 27 CR ($50.0\%$) and 17 PR ($31.5\%$) for RT alone group (p=0.57). Median follow-up of CT-RT group was 17 months and 11 months for RT alone group. Median survival was 30 months for CT-RT group and 24 months for RT alone group (p=0.3). The overall survival rate at 2 years, 3 years and 5 years, respectively was $60.9\%,\;48.6\%\;and\;42.5\%$, for CT-RT group, and $54.9\%,\;49.9\%\;and\;49.9\%$ for RT alone group (p=0.33). Comparision between patients in both groups, stratified by overall stage, T and N stage, site, and pathology, all failed to show any significant difference in survival rates. We conclude that this retrospective study failed to demonstrate an advantage for induction chemotherapy in inoperable head and neck cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.1
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• pp.69-75
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• 2006

Head and neck squamous cell carcinoma(HNSCC) is the sixth most common cancer among men in the developed world affecting the tongue, pharynx, larynx and oral cavity. HNSCC is thought to represent a multistep process whereby carcinogen exposure leads to genetic instability in the tissue and accumulation of specific genetic events, which result in dysregulation of proliferation, differentiation, and cell loss and the acquisition of invasive capacity. Despite therapeutic and diagnostic progress in oncology during the past decades, the prognosis of HNSCC remains poor. Thus it seems that finding a biological tumor markers which will increase the early diagnosis and treatment monitoring rates, is of paramount importance in respect to improving prognosis. In an effort to identify gene expression signatures that may serve as biomarkers, this study several genes were selected, such as H3,3A, S100A7, UCHL1, GSTP1, PAI-2, PLK, TGF${\beta}$1 and bFGF, and used 7 HNSCC cell lines that were established various anatomical sites, and also 17 other cancer cell lines were used for control group using real-time quantitative RT-PCR and immunocytochemical analysis with a monoclonal antibody. In this study, S100A7 showed a clearly restricted occurrence in tongue originated cell line, and GSTP1 expression level in the pharynx originated cell line was very increased, relative to corresponding other cell lines. These results suggest that S100A7 and GSTP1 genes' expression can occur during tongue and pharynx originated head and neck tumorigenesis and that genetic change is an important driving force in the carcinogenesis process. This data indicate that S100A7 and GSTP1 expression pattern in HNSCC reflect both diagnostic clue and biological marker. And this is provides a foundation for the development of site-specific diagnostic strategies and treatments for HNSCC.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.105-108
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• 1998

Backgrounds: Cervical epidural nerve block is useful in the management of a variety of acute, chronic and cancer related pain syndromes involving the head, face, neck and upper extrimity. To safely perfom the cervical epidural block, an appreciation of the expected distance from skin to epidural space is important. We studied the distance from skin to cervical epidural space of adults to determine if any relationship exists between patient height, weight and neck circumference and the distance from skin to epidural space. Methods: Patients 170, suffering from neck and upper extremity pain with cervical HIVD(herniated intervertebral dics) were selected. Cervical epidural block was performed at $C_{6\sim7}$ or $C_{7-}T_1$ intervertebral space. Then measured the distance from skin to epidural space and analysed the relationship between age, height, weight and neck circumference and the distance from skin to epidural space. Results: The cervical epidural depth of male $C_{6\sim7}$, male $C_{7-}T_1$, female $C_{6\sim7}$ and female $C_{7-}T_1$ groups were $5.17{\pm}0.63$, $5.47{\pm}0.59$, $4.84{\pm}0.56$ and $5.01{\pm}0.60$ cm respectively. Cervical epidural depth significantly correlated with body weight, ponderal index and neck circumference. Conclusions: The distance from skin to cervical epidural space has significant relationships with weight, ponderal index and neck circumference. Although experience is important, patient's weight and neck circumference are indicating factor, of the cervical epidural depth.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.617-627
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• 2003

Purpose: The purpose of this study is to investigate fatigue and its related factors in cancer patients receiving radiotherapy. Method: The subjects of this study consisted of 98 patients receiving radiotherapy. Subjects were recruited from C University Hospital radiation oncology unit located in Gwangju from March to May, 2001. Questionnaire and medical records were used for data collection. The obtained data was analyzed using SAS program that included descriptive statistics, t-test, ANOVA, Post-hoc test(Fisher's LSD) and Pearson's correlation coefficients. Result: The fatigue perceived by the subjects was middle level ($5.59{\pm}1.59$) and 72.4% of them reported greater than 5 points. The subjects in no religion, low income, and spouse caregiver groups experienced the higher fatigue than another groups, respectively. The subjects in nasopharyngeal cancer, head & neck radiation site, and analgesics medication groups did, experience fatigue as well. The fatigue not only positively correlated with symptom distress, disruption of usual activity, sleep dissatisfaction, and mood state, but also negatively with less family support. Conclusion: Cancer patients receiving radiotherapy experience the middle level of fatigue and it correlates with the multi-dimensional factors. However, further research is needed to identify the changes in fatigue over the radiotherapy period through longitudinal design and to develop nursing intervention for fatigue decrease.

• Radiation Oncology Journal
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• v.22 no.3
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• pp.208-216
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• 2004

Purpose: DNA-dependent protein kinase (DNA-PK) is a serine/threonine kinase consisting of a 470 kDa catalytic subunit (DNA-PKcs) and a heterodimeric regulatory complex, called Ku, which is composed of 70 kDa(Ku 70) and 86 kDa (Ku 80) proteins. The DNA-PK has been shown to play a pivotal role in rejoining DNA double-strand-breaks (dsb) in mammalian cells. The purpose of this study is to examine the relationship between the level of Ku expression and radiation sensitivity. Methods and Materials: Nine head and neck, cancer cell lines showed various intrinsic radiation sensitivities. Among the nine, AMC-HN-3 cell was the most sensitive for X-ray irradiation and AMC-HN-9 cell was the most resistance. The most sensitive and resistant cell lines were selected and the test sensitivity of radiation and expression of Ku were measured. Radiation sensitivity was obtained by colony forming assay and Ku protein expression using Western blot analysis. Results: Ku80 increased expression by radiation, wheres Ku70 did not. Overexpression of Ku80 protein increased radiation resistance in AMC-HN9 cell line. There was a correlation between Ku8O expression and radiation resistance. Ku80 was shown to play an important role in radiation damage response. Conclusion: Induction of Ku80 expression had an important role in DNA damage repair by radiation. Ku80 expression may be an effective predictive assay of radiosensitivity on head and neck cancer.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.59-62
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• 2001

Objectives: We report an interim result of conformal radiotherapy in a patient with early stage cancer at the base of the tongue, which developed in a previously irradiated area. Materials and Methods: A 64-year-old male patient was diagnosed with T4N0M0 supraglottic cancer. He received 72Gy of radiation therapy from 21 November 1988 to 24 February 1989. He had local failure and underwent a salvage total laryngectomy on 28 August 1989. Subsequently, he did well. In early 1999, he suffered from throat pain. He had a 2.5cm ulcerative mass at the base of his tongue, in the area that had been irradiated previously. Biopsy showed squamous cell carcinoma. After workup, he was diagnosed with base of tongue cancer with T2N0M0. Surgery was not feasible because the morbidity was not acceptable. Since it was difficult to re-irradiate the area with a curable dose using conventional 2D radiation therapy with an acceptable morbidity, we decided to try conformal radiotherapy. We used 7 static beam ports with field sizes from $7x6.4\;to\;8x8cm^2$, using 6 and 10MV photons. The fractionation regimen was 1.8Gy, 5 times per week. He received 64.8Gy in 36 fractions from 9 April 1999 to 1 June 1999. Results: In the 21 months since radiotherapy, the patient has not experienced any acute or chronic complications, such as xerostomia. He experienced relief of pain shortly after the start of radiotherapy, showed a complete response, and is still doing well. Conclusion: Conformal radiotherapy can be used to treat cancer that develops within a previously irradiated field, with curative intent.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.21-24
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• 2015

Voice therapy after post-thyroidectomy dysphonia is designed to improve glottal closure without supraglottic hyperfunction by development of abdominal support for breathing and intrinsic muscle strengthening exercises. Regarding voice therapy of unilateral vocal fold paresis/paralysis, several techniques such as head positioning, digital manipulation, pushing and pulling method are used for trial or temporary therapy. And the holistic voice therapy such as LSVT, Accent method, VFE are useful for hypofunctional voice disorders. These may be effective interventions as a temporary improvement until normal voice recovers or may provide the essentials for long-term rehabilitation.