• Archives of Plastic Surgery
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• v.32 no.2
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• pp.175-182
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• 2005

Skull base tumors have been determined inoperable because it is difficult to accurately diagnose the extent of the involvement and to approach and excise the tumor safely. However, recently, the advent of sophisticated diagnostic tools such as computed tomography and magnetic resonance imaging as well as the craniofacial and neurosurgical advanced techniques enabled an accurate determination of operative plans and safe approach for tumor excision. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amenable to local tissue closure. The purpose of this study is to analyze experiences of skull base reconstruction and to evaluate long term survival rate and complications. All cranial base reconstructions performed from July 1993 to September 2000 at Department of Plastic and Reconstructive Surgery of the Seoul National University Hospital were observed. The medical records were reviewed and analysed to assess the location of defects, reconstruction method, existence of the dural repair, history of preoperative radiotherapy and chemotherapy, complications and causes of death of the expired patients. There were 12 cases in region II, 8 cases in region I and 1 case in region III according to the Irish classification of skull base. Cranioplasty was performed in 4 patients with a bone graft and microvascular free tissue transfer was selected in 17 patients to reconstruct the cranial base and/or mid-facial defects. Among them, 11 cases were reconstructed with a rectus abdominis musculocutaneous free flap, 2 with a latissimus dorsi muscluocutaneous free flap, 1 with a fibular osteocutaneous free flap, 2 with a scapular osteocutaneous free flap, and 1 with a forearm fasciocutaneous free flap, respectively. During over 3 years follow-up, 5 patients were expired and 8 lesions were relapsed. Infection(3 cases) and partial flap loss(2 cases) were the main complications and multiorgan failure(3 cases) by cancer metastasis and sepsis(2 cases) were causes of death. Statistically 4-years survival rate was 68%. A large complex defects were successfully reconstructed by one-stage operation and, the functional results were also satisfactory with acceptable survival rates.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.129-135
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• 2015

Purpose: This study investigated the long-term clinical outcomes of patients with $p22^{phox}$-deficient chronic granulomatous disease (CGD) on Jeju Island and retrospectively evaluated the effects of interferon-gamma (IFN-${\gamma}$) prophylaxis. Methods: The medical records of 15 patients with CGD were retrospectively reviewed. The efficacy of IFN-${\gamma}$ prophylaxis was evaluated by comparing the frequency of severe infections before and after starting continuous prophylaxis with IFN-${\gamma}$. Results: At the time of the analysis, 14 patients were alive, with a median age of 14.3 years. The diagnosis of CGD was made at a median age of 2.4 years, and the median age at onset of severe infection was 0.3 years. Thirteen of the 15 patients had their first severe infection within the first year of life. The overall incidence of severe infection was 1.36 infections per patient-year; pneumonia, suppurative lymphadenitis, and skin and subcutaneous abscesses were the most common infections. Aspergillus species were the most frequently isolated microorganisms, present in 15.8% of isolates. IFN-${\gamma}$ did not significantly change the rate of severe infection. The survival rate for patients after 2 years of age was 93%; there was a prolonged survival plateau beyond the age of 2. Conclusion: Compared with cases of X-linked CGD reported in other studies, patients with CGD on Jeju Island did not show obviously different clinical manifestations, but they had a significantly higher survival rate. Further studies with a substantially longer period of observation, and with more patients under intensive surveillance are necessary to elucidate the prophylactic efficiency of IFN-${\gamma}$.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7395-7400
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• 2013

Objective: The long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating nasopharyngeal carcinoma (NPC) with metastatic foci in cervical lymph nodes was evaluated. Methods: A total of 154 cases of N2 or N3 stage NPC were randomized into two groups: hyperthermia group (76 cases) and control group (78 cases). Both received cisplatin chemotherapy and radiotherapy. In addition, the hyperthermia group further received microwave hyperthermia to the metastatic cervical nodes with different patterns (before or after radiotherapy), heating temperatures (T90< $43^{\circ}C$ and $T90{\geq}43^{\circ}C$) and hyperthermia episodes (< 4 times, 4-10 times and > 10 times). Results: The 3-month and 5-year complete response (CR) rates of cervical lymph nodes in the hyperthermia group were significantly higher than those in the control group. The 5-year disease-free survival (DFS) rate and the 3-year / 5-year overall survival rate in the hyperthermia group were also significantly higher. There was no significant difference in 5-year metastatic rates. In the hyperthermia group, the 3-month and 5-year CR rates of T90< $43^{\circ}C$ treatment were significantly lower than with $T90{\geq}43^{\circ}C$ treatment. The CR rate was highest when the hyperthermia was performed 4-10 times. There were no significant differences in 3-month and 5-year CR rates between hyperthermia before or after radiotherapy treatment. Conclusion: Microwave hyperthermia combined with chemoradiotherapy can increase local control, DFS and 3, 5-year overall survival rates of patients with N2 ~ N3 stage NPC. The heating temperature should be over $43^{\circ}C$ with hyperthermia repeated 4-10 times.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.41-52
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• 2018

Background: Few studies have evaluated the long-term impact of postoperative infectious complications in patients with non-small cell lung cancer (NSCLC). We aimed to determine the impact of infectious complications on long-term outcomes after surgical resection for NSCLC. Methods: We performed a retrospective study of 1,380 eligible patients who underwent pulmonary resection for NSCLC from 2003 to 2012. Complications were divided into infectious complications and non-infectious complications. Kaplan-Meier survival analysis was used to compare unadjusted 5-year cancer-specific survival (CSS) rates and recurrence-free survival (RFS) rates. Cox regression was used to determine the impact of infectious complications on 5-year CSS and RFS. Results: The rate of total complications and infectious complications was 24.3% and 4.3%, respectively. In the node-negative subgroup, the 5-year CSS and RFS rates were 75.9% and 57.1% in patients who had infectious complications, compared to 87.9% and 78.4% in patients who had no complications. Infectious complications were a negative prognostic factor for 5-year RFS (hazard ratio, 1.92; 95% confidence interval, 1.00-3.69; p=0.049). In the node-positive subgroup, the 5-year CSS rate and RFS were 44.6% and 48.4% in patients who had infectious complications, compared to 70.5% and 48.4% for patients who had no complications. Conclusion: Postoperative infectious complications had a negative impact on CSS and RFS in node-negative NSCLC. Our findings may help improve risk assessment for tumor recurrence after pulmonary resection for node-negative NSCLC.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.35-39
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• 1998

Objectives: Minimal improvement in the long-term survival of head and neck cancer(HNC) patients has occurred despite a multitude of advances in the control of loco regional disease and a second primary malignancy(SPM) contribute to the continued poor prognosis for the HNC patients. This study was performed in order to identify the clinical characteristics of SPM in the HNC patients. Materials and Methods: The medical records of 354 patients of head and neck squamous cell carcinoma that were followed up after initial treatment during the period of 1987 through 1994 were reviewed. This study examines the medical records of 354 patients with squamous cell carcinoma of the head and neck, of whom 26 subsequently developed a second neoplasm. Results: The actuarial SPM rate was 7.3%, and median time to presentation for the SPM was 26.8 months. The SPM were more likely to occur in male patients who had oral cavity index tumors. Patient whose index tumor was small at diagnosis had a greater chance of developing a second tumor as did those with no cervical lymph node metastases to the neck. Initial treatment modality was not associated with an increased risk of developing a second tumor. The commonest sites for the SPM were the lung and other head and neck area. The 3-year survival for patients who developed a secondary tumor from the time of its diagnosis was 27.8%. Conclusion: The SPM in the head and neck cancer patients are not uncommon and early detection of the SPM will contribute to increase the long-term survival of HNC patients.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.245-252
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• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

• Journal of Ginseng Research
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• v.44 no.4
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• pp.593-602
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• 2020

Background: Heat stress orchestrates neurodegenerative disorders and results in the formation of reactive oxygen species that leads to cell death. Although the immunomodulatory effects of ginseng are well studied, the mechanism by which ginseng alleviates heat stress in the brain remains elusive. Methods: Rats were exposed to intermittent heat stress for 6 months, and brain samples were examined to elucidate survival and antiinflammatory effect after Korean Red Ginseng (KRG) treatment. Results: Intermittent long-term heat stress (ILTHS) upregulated the expression of cyclooxygenase 2 and inducible nitric oxide synthase, increasing infiltration of inflammatory cells (hematoxylin and eosin staining) and the level of proinflammatory cytokines [tumor necrosis factor α, interferon gamma (IFN-γ), interleukin (IL)-1β, IL-6], leading to cell death (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay) and elevated markers of oxidative stress damage (myeloperoxidase and malondialdehyde), resulting in the downregulation of antiapoptotic markers (Bcl-2 and Bcl-x_L) and expression of estrogen receptor beta and brain-derived neurotrophic factor, key factors in regulating neuronal cell survival. In contrast, KRG mitigated ILTHS-induced release of proinflammatory mediators, upregulated the mRNA level of the antiinflammatory cytokine IL-10, and increased myeloperoxidase and malondialdehyde levels. In addition, KRG significantly decreased the expression of the proapoptotic marker (Bax), did not affect caspase-3 expression, but increased the expression of antiapoptotic markers (Bcl-2 and Bcl-x_L). Furthermore, KRG significantly activated the expression of both estrogen receptor beta and brain-derived neurotrophic factor. Conclusion: ILTHS induced oxidative stress responses and inflammatory molecules, which can lead to impaired neurogenesis and ultimately neuronal death, whereas, KRG, being the antioxidant, inhibited neuronal damage and increased cell viability.

• Korean Journal of Transplantation
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• v.32 no.4
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• pp.84-91
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• 2018

Background: This study examined the outcomes of ABO incompatible living donor liver transplantation (LDLT). The changes in the immunologic factors that might help predict the long term outcomes were also studied. Methods: Twenty-three patients, who underwent ABO incompatible LDLT from 2010 to 2015, were reviewed retrospectively. The protocol was the same as for ABO compatible LDLT except for the administration of rituximab and plasma exchange. The clinical outcomes and immunologic factors, such as isoagglutinin titer and cluster of differentiation 20+ (CD20+) lymphocyte levels were reviewed. Results: The center showed a 3-year survival of 64% with no case of antibody-mediated rejection. When transplantation-unrelated mortalities (for example, traffic accidents and myocardial infarction) were removed from statistical analysis, the 3-year survival was 77.8%. Although isoagglutinin titers continued to remain at low levels, the CD20+ lymphocyte levels recovered to the pre-Rituximab levels at postoperative one year. Conclusions: As donor shortages continue, ABO incompatible liver transplantation is a feasible method to expand the donor pool. On the other hand, caution is still needed until more long-term outcomes are reported. Because CD20+ lymphocytes are recovered with time, more immunologic studies will be needed in the future.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.45 no.5
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• pp.260-266
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• 2019

Objectives: Dental implants shorter than 8 mm, called short dental implants (SDIs), have been considered to have a lower success rate than standard length implants. But recent studies have shown that SDIs have a comparable success rate, and implant diameter was more important for implant survival than implant length. Also, SDIs have many advantages, such as no need for sinus lifting or vertical bone grafting, which may limit use in medically compromised patients. Materials and Methods: In this study, 33 patients with 47 implants 7-mm long were examined over the last four years. All patients had special medical history and were categorized into 3 groups: systemic disorders, such as diabetes mellitus (controlled or uncontrolled), mental disability, and uncontrolled hypertension; oral cancer ablation with reconstruction, with or without radiotherapy; diverse osteomyelitis, such as osteoradionecrosis and bisphosphonate-related osteonecrosis of the jaw. Most of these patients have insufficient residual bone quality due to mandible atrophy or sinus pneumatization. Results: The implant diameters were 4.0 (n=38), 4.5 (n=8), and 5.0 mm (n=1). Among the 47 implants placed, 2 implants failed before the last followup. The survival rate of 7-mm SDIs was 95.74% from stage I surgery to the last follow-up. Survival rates did not differ according to implant diameter. The mean marginal bone loss (MBL) at 3 months, 1 and 2 years was significantly higher than at implant installation, and the MBL at 1 year was also significantly higher than at 3 months. MBL at 1 and 2 years did not differ significantly. Conclusion: Within the limitations of the present study, the results indicate that SDIs provide a reliable treatment, especially for medically compromised patients, to avoid sinus lifting or vertical bone grafting. Further, long-term follow-up is needed.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.175-181
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• 2003

Primary chest wall tumors originate from soft tissue, bone or cartilage of the chest wall and it comprises 1∼2% of all primary tumors. Resection of tumor is often indicated for chronic ulceration or pain, and long-term survival might be achieved after surgery depending on the histology and the surgical procedure. Material and Method: Retrospective study of 125 primary chest wall tumors (86 benign, 39 malignant) operated between Sep. 1976 to Mar 2001 were reviewed and their clinical outcomes were analyzed. Follow-up data were collected at the outpatient clinic. Result: All patients with benign tumors were treated by excision without recurrence or death, and most malignancies were treated by wide resection. Malignant fibrous histiocytoma and chondrosarcoma constituted 46.2% of the malignant neoplasm. There was no operative death. The overall 3-year survival for patients with primary malignant neoplasm was 76.0%, and the 10-year survival was 60.5%. All deaths were disease-related and the tumor recurred in 11 patients. There was no significant difference in survival between patients with resection margins less than 4 cm and those with resection margins greater than 4 cm. Conclusion: Chest wall resection offers excellent results for benign chest wall tumors and substantial long-term survival for malignant diseases. Safe resection margin of 4 cm or more did not correlate with the survival rate although the tumor recurrence correlated with poor survival.