• Title/Summary/Keyword: Neck tumor

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FIBRIN SEALANTS IN MAXILLOFACIAL SURGERY : A INTRODUCTORY REPORT (악안면 외과 영역에서의 FIBRIN SEALANTS 의 이용)

  • Kim, Myung-Jin;Park, Hyung-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.129-136
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    • 1991
  • The fibrin sealant was first designed as an alternative to surgical suture for the purpose of surface-to-surface union especially in parenchymal organs like the liver, spleen and kidney. The clinical application of currently used fibrin sealant was first introduced in 1972. The fibrin sealant consists of principal two components; lyophilized human fibrinogen and bovine thrombin. The fibrinogen component also contains coagulation factor XIII. A solution of aprotinin, an inhibitor of fibrinolysis is used to dissolve the fibrinogen and to provide the first component, and a solution of calcium chloride is also used to provide the second component. From July to December in 1990, during 6 months, we used fibrin sealant in the 28 patients of 33 various cases, in the following ways; supportive application of fibrin sealant after free autogenouse nerve graft for the repair of inferior alveolar nerve, facial nerve or accessory nerve, treament of hemangioma or lymphangioma to thrombosize and lead to the tumor shrinking, skin grafting to stimulate the adhesion and tissue repair, bone grafting in the patients of cleft alveolus, mandibular reconstruction or orthognathic surgery to facilitate the knitting of bone chips, tissue adhesion after tumor resection, radical neck dissection or flap reconstructions, and supportive adhesion of external auditory cannal after TMJ surgery via postauricular approach. No adverse effects were observed, none of the patients developed hepatitis or other blood transmitted disease, and the wound healing were acceptable.

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Myxoid Leiomyosarcoma of the Superior Vena Cava Syndrome (상대 정맥에서 발생한 점액성 평활근육종 1예)

  • Jung, Ki-Hwan;Lee, Seung-Heon;Kim, Byung-Gyu;Kong, Hee-Sang;Kim, Je-Hyeong;Bak, Sang-Myeon;Shin, Cheol;Shim, Jae-Jeong;In, Kwang-Ho;Kim, Han-Gyum;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.2
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    • pp.173-177
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    • 2001
  • A 38-year-old woman presented with facial edema with neck vein engorgement for about 45 days. Chest roentgenography showed bulging soft tissue opacities in the right superoanterior mediastinum and a lobulated intraluminal mass was noted in the superior vena cava on the venacavogram. The superior vena cava was incised and the tumor located from the junction of the superior vena cava and internal jugular vein to the right atrial inlet was excised. Grossly, the tumor was myxoid or gelatinous in appearance. A combination of microscopic and immunohistochemical features showed myxoid leiomyosarcoma arising from the wall of the superior vena cava.

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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.

Characteristics of Classified Congenital Muscular Torticollis Applied Therapeutic Massage and Manual Stretch Therapy During 6 Months (6개월간의 치료적 마사지와 도수신장 치료에 대한 선천성 근성 사경 환아의 유형별 특성)

  • Kim, Yong-Wook;Kim, Min-Hee
    • The Journal of the Korea Contents Association
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    • v.10 no.4
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    • pp.216-224
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    • 2010
  • The main purpose of this prospective longitudinal study was to evaluate, according to a standard clinical classification and assessment method, the effect of a standardized manual stretching and therapeutic massage program on patients with clearly defined congenital muscular torticollis. A total of 52 cases of congenital muscular torticollis who were first seen when they were less than one year old and were treated with conservative physical therapy. Before treatment, the patients were divided into one of three clinical groups: (1) sternomastoid tumor group, (2) muscular torticollis group, and (3) postural torticollis group. Of the 52 patients, 32 (61.5%) made up the sternomastoid tumor group; 15 (28.9%) the muscular torticollis group; and 5 (9.6%) the postural torticollis group. Multivariate analysis of the outcomes showed that the duration of treatment was significantly differentiated according to the clinical group (p<0.01), age at presentation (p<0.01), and a passive rotation deficit of the neck (p<0.01). The current study showed that well controlled conservative physical therapy is safe and effective in the treatment of congenital torticollis in about 84.6% of patients who are first seen before the age of one year.

Neoadjuvant intra-arterial chemotherapy combined with radiotherapy and surgery in patients with advanced maxillary sinus cancer

  • Kim, Won Taek;Nam, Jiho;Ki, Yong Kan;Lee, Ju Hye;Kim, Dong Hyun;Park, Dahl;Cho, Kyu Sup;Roh, Hwan Jung;Kim, Dong Won
    • Radiation Oncology Journal
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    • v.31 no.3
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    • pp.118-124
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    • 2013
  • Purpose: The optimal treatment of advanced maxillary sinus cancer has been challenging for several decades. Intra-arterial chemotherapy (IAC) for head and neck cancer has been controversial. We have analyzed the long-term outcome of neoadjuvant IAC followed by radiation therapy (RT) and surgery. Materials and Methods: Twenty-seven patients with advanced maxillary sinus cancer were treated between 1989 and 2002. Five-fluorouracil (5-FU, $500mg/m^2$) was infused intra-arterially, and followed by RT (total 50.4 Gy/28 fractions). A planned surgery was performed 3 to 4 weeks after completion of IAC and RT. Results: At a median follow-up of 77 months (range, 12 to 169 months), the 5-year rates of overall survival in all patients were 63%. The 5-year rates of overall survival of stage T3/T4 patients were 70.0% and 58.8%, respectively. Seven of fourteen patients with disease recurrence had a local recurrence alone. The 5-year actuarial local control rates in patients with stage T3/T4, and in all patients were 20.0%, 32.3%, and 27.4%, respectively. Overall response rate after the completion of IAC and RT was 70.3%. During the follow-up, seven patients (25.9%) showed mild to moderate late complications. The tumor extent (i.e., the involvement of either orbit and/or base of skull) appeared to be related with local recurrence. Conclusion: Neoadjuvant IAC with 5-FU followed by RT and surgery may be effective to improve local tumor control in the patients with advanced maxillary sinus cancer. However, local failure was still the major cause of death. Further investigations are required to determine the optimal treatment schedule, radiotherapy techniques and chemotherapy regimens.

Analysis of the Recurrence after Surgical Treatment of the Hemangioma in the Extremities (사지에 발생한 혈관종의 수술적 치료 후 재발에 대한 분석)

  • Kim, Young-Sin;Choi, Hee-Lack;Lee, Jun-Mo;Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.74-79
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    • 2010
  • Purpose: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. Materials and Methods: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. Results: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. Conclusion: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.

Medulloblastoma: Radiotherapy Result with Emphasis on Radiation Dose and Methods of Craniospinal Treatment (후두와 선량 및 전중추신경계 치료방법을 중심으로 한 수아세포종의 방사선치료 성적)

  • Kim Il Han;Ha Sung Whan;Park Charn Il;Cho Byung-Kyu
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.183-194
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    • 1988
  • Twenty five patients with histologically proven medulloblastoma received craniospinal radiotherapy (CSRT) at the Seoul National University Hospital from 1979 to 1984. The extent of tumor removal was biopsy only in 2 patients, partial in 18, and near total in 5. With orthogonal technique of CSRT, mainly 55Gy was delivered to the posterior fossa (PF), 40Gy to whole brain (WB), and 30Gy to whole spine (WS). And with AP; PA technique, 50Gy to PF, 45-50Gy to WB, and 36 Gy to WS. Complete remission was obtained in $84\%$ of patients. Among 21 CR's 10 failures were observed, thus total failure rate was $56\%$ (14/25). Of 14 faiure 13 had the primary failure, 11 failed in primary site alone, 1 failure was combined with ventricular seeding, and another 1 was combined with neck node metastasis. There was 1 isolated spinal failure. Actuarial overall survival rates at 3 and 5 years were $75\%$ and $54\%$, and disease-free survival rates were $58\%$ and $36\%$, respectively. Better 5 year disease-free survival was noted in patients with 55 Gy to the posterior fossa than those with 50Gy $(62\%\;vs\;17\%,\;p<0.05)$, in patients treated with orthogonal technique than those treated with AP:PA technique $(87\%\;vs\;12\%,\;p<0.05)$, and in patients with near total removal than those with partial or less removal of tumor $(56\%\;vs\;30\%,\;N.S.)$ Re-irradiation was not satisfactory No severe late sequelae was noted among the survivors. For the higher control of medulloblastoma, dose to posterior fossa should be at least 55Gy with orthogonal CSRT to small tumor burden. And dose reduction in the subarachnoidal spaces might be safe, but optimal dose to the subarchnoidal spaces should be determined by the thorough tumor staging before radiotherapy.

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The Usefulness of F-18 FDG Whole Body PET in the Evaluation of Postoperative Recurrence of Cancer (수술 후 암 재발 판정에 있어서 전신 F-18 FDG-PET의 유용성)

  • Kang, Won-Jun;So, Young;Jeong, Jae-Min;Kwark, Cheol-Eun;Lee, Dong-Soo;Kang, Soon-Bem;Jung, Hee-Won;Kim, Kwang-Hyun;Park, Jae-Gahb;Lee, Myung-Chul;Koh, Chang-Soon;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.372-380
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    • 1997
  • The purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for detecting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(14 brain tumor, 15 head and neck cancer, 23 gynecologic cancer, 16 gastrointestinal cancer, 16 thyroid cancer, and 20 other cancers). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET, and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specificity of CI were 78% and 68%. CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively, We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnostic methods.

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MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE (기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료)

  • Cha, Yoon-Sun;Kim, Ji-Hun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.38-42
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    • 2014
  • A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

CONCOMITANT INHIBITION OF EPIDERMAL GROWTH FACTOR AND VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTOR TYROSINE KINASES IN ORAL SQUAMOUS CELL CARCINOMA (구강 편평상피세포암에서 상피성장인자 수용체와 혈관내피성장인자 수용체 타이로신 활성화효소의 동시 억제)

  • Park, Young-Wook;Lee, Sang-Shin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.3
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    • pp.193-201
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    • 2006
  • Squamous cell carcinoma(SCC) of head and neck(SCCHN) is the sixth most common human malignant tumor. However, despite advances in prevention and treatment of SCC, the five-year survival rates for patients remain still low. To improve the outcome for patients with SCCHN, novel treatment strategies are needed. Overexpression of the epidermal growth factor(EGF) and activation of its receptor(EGFR) are associated with progressive growth of SCCHN. Vascular endothelial growth factor(VEGF) signaling molecules are related with neoangiogenesis and vascular metastasis of SCC. In this study, we determined the therapeutic effect of AEE788(Novartis Pharma AG, Basel, Switzerland), which is a dual inhibitor of EGFR/ErbB2 and VEGFR tyrosine kinases, on human oral SCC. At first, we screened the expression of EGFR, c-ErbB2(HER-2) and VEGFR-2 in a series of human oral SCC cell lines. And then we evaluated the effects of AEE788 on the phosphorylation of EGFR and VEGFR-2 in a oral SCC cell line expressing EGFR/HER-2 and VEGFR-2. We also evaluated the effects of AEE788 alone, or with paclitaxel(Taxol) on the oral SCC cell growth and apoptosis. As a result, all oral SCC cells expressed EGFR and VEGFR-2. Treatment of oral SCC cells with AEE788 led to dose-dependent inhibition of EGFR and VEGFR-2 phosphorylation, growth inhibition, and induction of apoptosis. Moreover, AEE788 sensitizes the cells to paclitaxel-mediated toxicity and apoptosis. These data mean EGFR and VEGFR-2 can be reliable targets for molecular therapy of oral SCC, and therefore warrant clinical use of EGFR/VEGFR inhibition in the treatment of patients with recurrent or metastatic oral SCC.