• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.32-36
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• 2007

Background and Objective：A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods：From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$；OPMI $pico^{(R)}$；Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results：There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion：Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.3-8
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• 2000

Background and Objectives: Adenoid cystic carcinoma of salivary glands is characterized by insidious growth over many years, local recurrences, and distant metastasis and classified to three distinct histologic subtypes: tubular, cribriform, and solid. The solid type is known to have the worst prognosis. However, histopathologic heterogeneity is observed in tumors from the same patient. We have attempted to elucidate the genotypic differences, characterized by polysomies of chromosome 17, in adenoid cystic carcinoma according to the phenotypic histopathologic heterogeneity. Materials and Methods: Fluorescence in situ hybridization was performed on formalin-fixed paraffin blocks from seven patients with head and neck adenoid cystic carcinoma, using the centromeric $\alpha$-satellite probe of chromosome 17 to detect nuclei exhibiting polysomy. The difference in polysomeric chromosome expression in cribriform, tubular, solid type and type I, II, III according to the Szanto classification was analyzed. Results: Polysomy of chromosome 17 was found in 15.28% of the cribriform type, in 15.68% of the tubular type, and in 18.87% of the solid type. The proportion of polysomy was statistically higher in the solid type than in the cribriform type(p<0.05), and the proportion of polysomy increased progressively from type 1 to type 3, but this trend was statistically insignificant(p>0.05). Conclusion: We suggest that there may be genetic variations in tumor from the same patient depending on the histopathologic heterogenetiy in adenoid cystic carcinomas.

• Korean Journal of Head & Neck Oncology
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• v.31 no.1
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• pp.34-38
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• 2015

Progressive transformation of germinal centers(PTGC) is a rare benign lymph node enlargement characterized by chronic lymphadenopathy and the presence of germinal centers with fused and expanded mantles within a lymph node that are 3-5 times the size of a typical reactive follicle. Although PTGC is reported in 3.5-10% of chronic lymphadenopathy, head and neck surgeons do not often experience this condition and its clinical implications. Althoug PTGC is benign disease, it could not be excluded the association with other malignant lymphoid diseases. Therefore, periodic follow up of PTGC patient could be required. We report two cases at this study ; a 16 years old man who visited out-patient clinic due to palpable mass of right cervical area, several months ago, and a 35 years old man who visited out-patient clinic for evaluating right cervical mass. Both of two patients were diagnosed with PTGC. In this study, we focus on the clinic-pathologic features of this uncommon disease along with other literature reviews.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.37-40
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• 2010

Ectopic hamartomatous thymoma is a rare benign tumor of the lower neck occurring in the male adult predominantly. The origin of this tumor has been debated, but it is now believed to arise from remnants of the cervical sinus of His from early development. They are composed of epithelial, adipocytic, and spindle cells in variable amounts. Recognition of ectopic harmatomatous thymoma is important and needs to be differentiated from high-grade sarcomas such as synovial sarcoma or glandular malignant peripheral nerve sheath tumor. We here report on a case of ectopic hamartomatous thymoma arising in the left lateral neck of 33-year-old male patient.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.185-189
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• 2001

Background: Cervical metastasis of unknown origin is defined as histologic evidence of malignancy in the cervical lymph nodes with no apparent primary site of origin for the metastatic tumor. Patients and Methods: A retrospective review of 20 cervical metastasis of unknown origin diagnosed and managed between january 1989 and December 1999 at the Korea University was undertaken to determine outcome. Patient age ranged 46 to 78 years (mean 60). There were 17 men and 3 women. The aim of this study is to ananlyze the diagnostic approach and the result of treatment of the cervical metastasis of unknown origin. Result: Histopathologically, squamous cell carcinoma (15 case, 75%) were the most common, followed by adenocarcinoma (4 case, 20%), undifferentiated carcinoma (1 case, 5%) According to the criteria of the AJCC on staging, N1 was 2 cases, N2a 2 cases, N2b 5 cases, N2c 1 cases, N3 10 cases. Overall survival rate for all patients at 2 years was 45% and 5 years 25%, and in the combination therapy(surgery and radiotherapy group (12 cases)) it was 67% and 34% respectively, high compared with other treatment modality such as surgery or radiotherapy alone. In extracapsular spread positive group, 5 year survival rate was 12%, but was 33% in the extracapsular spread negative group. Conclusion: With no stastatical significance, extracapsular spread group was poor outcome in our study. Combination of radiotherapy and surgery was more effective treatment result than surgery alone or radiotherapy alone in our study. But, overall prognosis of cervical metastasis of unknown origin was very poor despite aggressive treatment (5 year survival rate: 25%).

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.108-113
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• 2016

Background and Objectives : After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. Materials and Methods : Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. Results : Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). Conclusion : The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

• Molecules and Cells
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• v.46 no.6
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• pp.360-373
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• 2023

Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid carcinoma. Despite a good prognosis, approximately a quarter of PTC patients are likely to relapse. Previous reports suggest an association between S-phase kinase-associated protein 2 (SKP2) and the prognosis of thyroid cancer. SKP1 is related to apoptosis of PTC cells; however, its role in PTC remains largely elusive. This study aimed to understand the expression and molecular mechanism of SKP2 in PTC. SKP2 expression was upregulated in PTC tissues and closely associated with clinical diagnosis. In vitro and in vivo knockdown of SKP2 expression in PTC cells suppressed cell growth and proliferation and induced apoptosis. SKP2 depletion promoted cell autophagy under glucose deprivation. SKP2 interacted with PH domain leucine-rich repeat protein phosphatase-1 (PHLPP1), triggering its degradation by ubiquitination. Furthermore, SKP2 activates the AKT-related pathways via PHLPP1, which leads to the cytoplasmic translocation of SKP2, indicating a reciprocal regulation between SKP2 and AKT. In conclusion, the upregulation of SKP2 leads to PTC proliferation and survival, and the regulatory network among SKP2, PHLPP1, and AKT provides novel insight into the molecular basis of SKP2 in tumor progression.

• Proceedings of the KSLP Conference
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• 2015.03a
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• pp.17-17
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• 2015

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.22-25
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• 1996

A very important and interesting problem occasionally seen in the neck of children and adults is a branchial cleft anomaly. It is a rare congenital neck disease and presents a painless palpable mass of neck in most cases. We have retrospectively reviewed the medical records of 28 patients operated upon for branchial cleft anomaly at Department of Surgery, Chonnam University Hospital between January, 1991 and December, 1995. Three of these lesions were considered to have originated from the first branchial cleft, and 25 from the second branchial cleft. Females are about twice more common than male patients. Pathological findings showed the cysts were lined squamous epithelium and subepithelial lymphoid follicles in most cases. Five out of 28 patients with branchial cleft anomalies had previous incision procedures. All patients after complete removal of branchial anomalies have no recurrences.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.280-284
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• 1996

Carotid body tumors are uncommon tumors of the head and neck Surgery is the primary treatment for the tumor. Large carotid body tumors frequently encircle the common, internal, and exernal carotid arteries, and extensive bleeding often complicates the resection, increasing the risk of carotid artery rupture and damange to major cranial nerves. Grafting should be used in high-risk patients. We have experienced a case of carotid body tumor which encircle the common, internal and external carotid arteries, treated with ligation of external carotid artery and grafting using Gortex between common carotid artery and internal carotid artery.