• Title/Summary/Keyword: Head neck

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Oral Squamous Cell Carcinoma and Associated Risk Factors in Jazan, Saudi Arabia: A Hospital Based Case Control Study

  • Quadri, Mir Faeq Ali;Alharbi, Fahd;Bajonaid, Amal Mansoor S;Moafa, Ibtisam Hussain Y;Sharwani, Abubakker Al;Alamir, Abdulwahab Hussain A
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4335-4338
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    • 2015
  • Background: Oral cancer is the third most common malignancy in Saudi Arabia, the highest incidence of which is reported from Jazan province. The objective of this study was to evaluate the association of various locally used substances, especially shamma, with oral cancer in the Jazan region of Saudi Arabia. Materials and Methods: A hospital-based case-control study was designed and patient records were scanned for histologically confirmed oral cancer cases. Forty eight patients who were recently diagnosed with oral cancer were selected as cases. Two healthy controls were selected for each observed case and they were matched with age (+/- 5 years) gender and location. Use of different forms of tobacco such as cigarettes, pipe-smoking and shamma (smokeless-tobacco) was assessed. Khat, a commonly used chewing substance in the community was also included. Descriptive analysis was first performed followed by multiple logistic regression (with and without interaction) to derive odds ratios (ORs) and 95% confidence interval (CIs). Results: Mean age of the study sample (56% males and 44% females) was 65.3 years. Multinomial regression analysis revealed that shamma use increased the odds of developing oral cancer by 29 times (OR=29.3; 10.3-83.1). Cigarette (OR=6.74; 2.18-20.8) was also seen to have an effect. With the interaction model the odds ratio increased significantly for shamma users (OR=37.2; 12.3-113.2) and cigarette smokers (OR=10.5; 2.88-3.11). Khat was observed to have negative effect on the disease occurrence when used along with shamma (OR=0.01; 0.00 - 0.65). Conclusions: We conclude that shamma, a moist form of smokeless tobacco is a major threat for oral cancer occurrence in the Jazan region of Saudi Arabia. This study gives a direction to conduct further longitudinal studies in the region with increased sample size representing the population in order to provide more substantial evidence.

A case of postoperative nasopharyngeal reflux associated with retropharyngeal lymphangioma in newborn infant (수술 후 비인두 역류가 동반된 신생아의 후인두림프관종 1례)

  • Koo, Kyo Yeon;Lee, Jun Seok;Lee, Soon Min;Park, Min Soo;Namgung, Ran;Park, Kook In;Lee, Chul;Yoon, Choon Sik;Jung, Woo Hee;Choi,, Hong Shik
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.258-261
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    • 2010
  • Lymphangioma is a rare benign congenital tumor of the lymphatic system, which is commonly diagnosed before 2 years of age. In the natronal report, cystic lymphangioma was usually reported as a huge translucent mass located in the head and neck area. It's occurrence in retropharyngeal space with respiratory obstruction and swallowing difficulty in neonate is extremely rare and postoperative nasopharyngeal reflux has rarely been reported. Complete resection is the standard therapy. However, involvement of the upper airway may be determining prognosis in the extensive lymphangiomas because of the difficulty of complete excision. We present a case of cystic lymphangioma in neonate which was initially asymptomatic but gradually progressed to cause respiratory obstruction due to enlargement. After resection, nasopharyngeal reflux developed with dysfunction of the soft palate and gradually improved with conservative care over 5 months.

DNA Ligase4 as a Prognostic Marker in Nasopharyngeal Cancer Patients Treated with Radiotherapy

  • Kim, Dong Hyun;Oh, Sung Yong;Kim, So Yeon;Lee, Seul;Koh, Myeong Seok;Lee, Ji Hyun;Lee, Suee;Kim, Sung-Hyun;Park, Heon Soo;Hur, Won Joo;Jeong, Jin Sook;Ju, Mi Ha;Seol, Young Mi;Choi, Young-Jin;Chung, Joo Seop;Kim, Hyo-Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10985-10989
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    • 2015
  • Background: The capability for DNA double-strand breaks (DSBs) repair is crucial for inherent radiosensitivity of tumor and normal cells. We have investigated the clinicopathologic significance of DNA repair gene expression in nasopharyngeal (NP) carcinoma. Materials and Methods: A total of 65 NP cancer patients who received radiotherapy were included. The immunopositivity to Ku 70, DNA-PKcs, MRN, RAD50, XRCC4, and LIG4 were examined in all tumor tissues. Results: The patients comprised 42 males and 23 females, with a median age of 56 years (range, 18-84). The expression levels of RAD50 (0,+1,+2,+3) were 27.7%, 32.3%, 21.5%, and 18.5%. LIG4 (${\pm}$) were 43.1% and 56.9% respectively. The 5-year OS rate of patients with LIG4 (${\pm}$) were 90% and 67.9%, respectively (p=0.035). The 5-year TTP rate of patients with LIG4 (${\pm}$) were 75.9%, 55.5%, respectively (P=0.039). Conclusions: Our results suggest the possibility of predicting the radiosensitivity of NP cancer by performing immunohistochemical analysis of LIG4.

CHEMOSENSITIVITY TEST OF HUMAN OSTEOSARCOMA AND EPIDERMOID CARCINOMAS USING MTT ASSAY (MTT법을 이용한 사람 골육종과 상피암 세포주들에 대한 항암제 감수성 검사)

  • Park, Sung-Oh;Shin, Hyo-Keun;Kim, Oh-Whan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.4
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    • pp.391-404
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    • 1991
  • Three anticncer agents which are different in time or dosage dependence as well as in phase specificity, namely mitomycin and adriamycin from natural products, and widely different cancer cell lines_Four epidermoid carcinomas originated from larynx, cervix, skin and gut were used toghether with one osteosarcoma as the target cell of single and combined administration of anticancer drugs. Semiautomated tetrazolium dye assay(MTT) appears to offer an attractive option for chemosensitivity of head and neck cancers since it is a simple, valid and inexpensive method of assessing chemosensitivity for large samples in a short time. The results obtained form this study were as follows. 1. Good correlations were obtained with the results of the MTT test and those of $^3H$ thymidine uptake assay. 2. $LD_{50}$ values of HIST and St.Ca. which showed relatively high doubling time on adriamycin were $30{\mu}g/ml$ and $15{\mu}g/ml$ while those of HeLa, Hep-2 and KHOS/NP were $2.1{\mu}g/ml$, $4.8{\mu}g/ml$, and $6.8{\mu}g/ml$ respectively. 3. The $LD_{50}$ value of 5-FU on five cancer cells were very high ranging from 15mg/ml to almost indefinite number, which means 5-FU is very resistant to epidermoid carcinomas or osteosarcoma examined in this study. 4. Mitomycin was relatively effective showing 80% cancer killing effect on HeLa, 70% on St. Ca. and 50% on Hep-2 at the high concentrations used. 5. Adriamycin was the most effective showing 90% cancer cell killing effect on KHOS/NP, 98% on HeLa, 80% both on Hep-2 and St. Ca. The least susceptible cancer cells toward adriamycin was HIST having only 55% cell killing effect at the high cincentration. 6. Combined therapy of adriamycin and 5-FU was more effective than single administration in all the cases examined. Most effective synergism was observed on St. Ca. at the low concentration, showing 21 times higher than each single administration.

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Formulation of a reference coordinate system of three-dimensional (3D) head & neck images: Part I. Reproducibility of 3D cephalometric landmarks (3차원 두부영상의 기준좌표계 설정을 위한 연구: 1부 CT영상에서 3차원 계측점의 재현성)

  • Park, Jae-Woo;Kim, Nam-Kug;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.35 no.5 s.112
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    • pp.388-397
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    • 2005
  • The purpose of this study was to redefine the cephalometric landmarks in three-dimensional (3D) images, which are used in orthodontic cephalometric radiography, and to evaluate the reproducibility of each landmark for 3D cephalometric analysis. Eighteen CT scans were taken at the Department of Diagnostic Radiology at Seoul National University Dental Hospital and manipulated with V works 4.0(Cybermed Inc., Seoul, Korea). The coordinate system was established using 7 reference points, with no more than 4 points on the same plane. These 7 points were generated as a volume model, the voxel size of which was 4 by 4 by 2 (threshold value=639). The cephalometric landmarks were selected at the multiplanar reformation (MPR) window on the volume mode of V works 4.0. The selected landmarks were exported to V surgery (Cybermed Inc., Seoul, Korea) for the calculation of coordinate values. All the data were taken twice with a lapse of 2 weeks by one investigator The reproducibility of each landmark was $0.17\~1.21mm$ in the x axis, $0.30\~1.53mm$. In the y axis, and $0.27\~1.81mm$ in the z axis. In all three axes, the range of error was similar. These error ranges were acceptable with regards to the pixel space and slice thickness. The most reproducible points were 1 points which were selected on the basis of the volume model. The least reproducible points were J points that were defined by sutures.

Effect of Pilocarpine Mouthwash on Xerostomia (구강건조증에 대한 필로카핀 구강양치액의 효과)

  • Kim, Ji-Hyun;Park, Ju-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.21-24
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    • 2011
  • Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

Chemical Neurolytic Block with Absolute Ethyl Alcohol on Cervical Sympathetic Ganglion in Rabbits (토끼에서 경부 교감신경절의 무수 에틸 알코올에 의한 화학적 차단)

  • Kang, Yoo-Jin;Suh, Jae-Hyun
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.162-169
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    • 1994
  • Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

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A STUDY ON THE PHYSICAL PROPERTIES AND COLOR STABILITY OF MAXILLOFACIAL PROSTHETIC SILICONE MATERIAL (악안면 보철용 실리콘의 물리적 특성 및 색조안정성에 관한 연구)

  • Park, Chan-Jin;Kim, Chang-Whe;Kim, Yung-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.2
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    • pp.330-343
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    • 1997
  • Extraoral maxillofacial prostheses are essential for restoring facial structures that are lost as a result of congenital missing, injuries from accidents, surgical treatments of head and neck cancer. Recently, silicone is the most useful material for this purpose and is more advantageous than other maxillofacial prosthetic materials. However, there are some problems for long-term usage of silicone prostheses due to tear and color change. These are major contributing environmental factors to those problems that are such as ultraviolet light, cleansing agents, changes in humidity and successive adhesion and removal. The aim of this study is to evaluate the physical properties and color changes of maxillofacial prosthetic silicone material by those environmental factors using A-2186 silicone material (Factor II, USA) and two pigments, cadmium yellow medium and cosmetic red. Aluminium molds were fabricated according to the ASTM No. D412 & D624 specifications and resulted specimens from molds were fabicated and treated as follows. Control group and experimental I group were fabricated with 0.1% wt. pigment mixing in silicone elastomer and II-1 group, II-2 group of experimental II group were fabricated with 0.2%, 0.3% wt. pigment mixing in silicone elastomer, respectively. Control group was kept in darkroom at room temperature, I-1 group was kept under natural sunlight during 1week, I-2 group was soaked in 20% soap water during 1wk. I-3 group was successively adhered and removed 200 times on inner region of arm using Daro adhesive-33. Experimental II groups were kept in darkroom at room temperature. Instron universal testing machine was used to measure the % elongation, tensile strength, tear strength of control, experimental I, II groups and reflectance spectrophotometer(COLOR EYE-3000, Macbeth, USA) was used to measure the color differences between control group and experimental I group. The results were as follows : 1. When compared with control group, natural weathering group and 20% soap-water soaking group had no significant differences in % elongation(p>0.05). 2. 200 times successive adhesion and removal group, 0.2% wt. pigment group and 0.3% wt. pigment group had significant decreases in % elongation(p<0.05). 3. Natural weathering group, 20% soap-water soaking group and 200 times successive adhesion and removal group had no significant differences in tensile strength (p>0.05). 4. 0.2%, 0.3% wt. pigment groups had significant decreases in tensile strength(p<0.05). 5. Values of all experimental groups were decreased in tear strength. and 200 times successive adhesion and removal group had significant decrease in tear strength(p<0.05). 6. Natural weathering group and 20% soap-water soaking group had significant color differences(${\Delta}E$) and it could be detectable to naked eye(p<0.05). 7. Color differences between control group and 200 times adhesion and removal group were not detectable to the naked eye (${\Delta}E<1.0$).

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Outcome of Extraarticular Dorsal Closing Wedge Osteotomy for Freiberg's Disease (관절외 배부 폐쇄 쐐기 절골술을 이용한 Freiberg병의 치료 결과)

  • Lee, Jun Young;Kim, Woong Hee;Jung, Sung;Yang, Sung Hun
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.126-130
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    • 2016
  • Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

A Pilot Study on Environmental Factors Contributing to Childhood Home Slip-Down Injuries (가정 내 낙상으로 인한 아동 손상의 유발 환경 인자에 관한 예비연구)

  • Ryu, Jeong-Min;Seo, Min Hoo;Kim, Won-Young;Kim, Won;Lim, Kyoung-Soo
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.51-56
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    • 2009
  • Purpose: The purpose of this study was to investigate environmental factors contributing to childhood home slip-down injuries. Methods: Among a total of 2,812 injured children in our Customer Injury Surveillance System (CISS), we performed a prospective study on 262 children with home slip-down injuries who visited the pediatric emergency department of Asan Medical Center between March 2008 and February 2009. We made a frequency analysis on parameters such as activities just before the accident, the presence of any obstacles or lubricant materials, specific home place in the home where the injuries occurred, flooring materials on which the slip-down happened, additional objects hit after slip down, the site and kind of injury, the duration of therapy, and the disposition. Results: Walking was the most common activity just before the injury. Because rooms and bathrooms were most common places in the home for slip down injuries, laminated papers/ vinyl floor coverings and tiles were the most common flooring materials used in the places where the injuries occured. Most commonly, no obstacles caused the children to slip down, but the furniture, stairs, doorsills, wetness, or soapy fluid followed after that. Over half of the children who slipped (58%) also collided with other than the floor itself after the slip-down, most common objects hit were the edges of the furniture, and doorsills, followed by stairways. The head and neck were the most commonly injured sites, and a laceration was the most common kind of injury. Most children needed less than 1 week of therapy, only 4 children (1.53%) admitted. There were no mortalities. Conclusion: The environmental factors contributing to slip-down injuries were the bathroom, laminated papers/vinyl floors, the furniture, stairs, doorsills, and wetness or soapy fluid. Especially, the furniture, stairs, and doorsills can be both primary obstacles and secondary collision objects. For the safety of our children, we must consider these factors on housing, when decorating or remodeling our house.