• Radiation Oncology Journal
• /
• v.37 no.2
• /
• pp.134-142
• /
• 2019

Purpose: The aim is to study the dependence of deformable based auto-segmentation of head and neck organs-at-risks (OAR) on anatomy matching for a single atlas based system and generate an acceptable set of contours. Methods: A sample of ten patients in neutral neck position and three atlas sets consisting of ten patients each in different head and neck positions were utilized to generate three scenarios representing poor, average and perfect anatomy matching respectively and auto-segmentation was carried out for each scenario. Brainstem, larynx, mandible, cervical oesophagus, oral cavity, pharyngeal muscles, parotids, spinal cord, and trachea were the structures selected for the study. Automatic and oncologist reference contours were compared using the dice similarity index (DSI), Hausdroff distance and variation in the centre of mass (COM). Results: The mean DSI scores for brainstem was good irrespective of the anatomy matching scenarios. The scores for mandible, oral cavity, larynx, parotids, spinal cord, and trachea were unacceptable with poor matching but improved with enhanced bony matching whereas cervical oesophagus and pharyngeal muscles had less than acceptable scores for even perfect matching scenario. HD value and variation in COM decreased with better matching for all the structures. Conclusion: Improved anatomy matching resulted in better segmentation. At least a similar setup can help generate an acceptable set of automatic contours in systems employing single atlas method. Automatic contours from average matching scenario were acceptable for most structures. Importance should be given to head and neck position during atlas generation for a single atlas based system.

• Journal of Gastric Cancer
• /
• v.7 no.4
• /
• pp.200-205
• /
• 2007

Purpose: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer. Materials and Methods: We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy. Results: There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%). Conclusion: The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.

• Korean Journal of Bronchoesophagology
• /
• v.2 no.1
• /
• pp.63-70
• /
• 1996

Reconstruction for hypopharynx and cervical esophagus after wide resection of extensive hypopharynx and larynx cancers have been used various methods including myocutaneous flaps, gastric pull up, md jejunal or large bowel free graft. Recently, the authors had experienced hypopharynx and larynx cancers with extension to the posterior hypopharyngeal wall and thoracic esophagus. Of course, these reconstructive methods should be selected in accordance with the patient's age, physical status, extend of prim.:W lesion, and defect after on block resection, however, gastric pull up was performed in hypopharynx cancer which had skipped lesion in the thoracic esophagus and jejunal free grafts were performed in case 2, 3 which had a extended lesions to the posterior pharyngeal wall. Some complications were noted, which were successfully stabilized by conservative managements. The gastric pull up and jejunal free graft were considered suitable methods for reconstrunction of hypopharynx and cervical esophagus, however, further studies are necessary about it.

• Medical Lasers
• /
• v.8 no.2
• /
• pp.84-86
• /
• 2019

Pyriform sinus cyst is a rare disease. This disease can be found by chance or appear as lymph nodes with cancer, infections, shortness of breath, or airway compromise, and can be an unusual cause of dysphonia. This paper presents a case of a pyriform sinus cyst in the pharyngeal wall of the left pyriform sinus, which presented as neck discomfort in a 63-year-old female. The plan was to remove this cyst with a transoral CO₂ laser because a CO₂ laser is a useful tool for removing cysts without bleeding and consuming time. The excision was performed successfully. Transoral laser pyriform sinus cyst excision is a simple, safe, and effective method for the treatment of pyriform sinus cysts. This procedure is likely to be used as a selective treatment when managing this condition.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.12
• /
• pp.7555-7560
• /
• 2013

Background: Beedi rollers are exposed to unburnt tobacco dust through cutaneous and pharyngeal route and it is extremely harmful to the body since it is carcinogenic in nature and can cause cancer during long exposure. This indicates that occupational exposure to tobacco imposes considerable genotoxicity among beedi workers. Materials and Methods: In the present study, 27 beedi workers and age and sex matched controls were enrolled for clinical, cytogenetics and molecular analysis. Clinical features were recorded. The workers were in the age group of 28-67 years and were workers exposure from 8-60 years. Blood samples were collected from workers and control subjects and lymphocyte cultures were carried out by using standard technique, slides were prepared and 50 metaphases were scored for each sample to find the chromosomal abnormalities. For molecular analysis the genomic DNA was extracted from peripheral blood, to screen the variations in gene, the exon 1 of CYP1A1 gene was amplified by polymerase chain reaction (PCR) and then screened with Single Strand Conformation Polymorphism (SSCP) analysis. Results: A statistically significant increase was observed in the frequencies of chromosomal aberrations in exposed groups when compared to the respective controls and variations observed in Exon 1 of CYP1A1(Cytochrome P450, family 1, subfamily A, polypeptide 1) gene. Conclusions: This study shows that, the toxicants present in the beedi that enter into human body causes disturbance to normal state and behavior of the chromosomes which results in reshuffling of hereditary material causing chromosomal aberrations and genomic variations.

• International Journal of Oral Biology
• /
• v.45 no.3
• /
• pp.107-114
• /
• 2020

Acacetin, which is present in damiana (Turnera diffusa) and black locust (Robinia pseudoacacia), has several pharmacologic activities such as antioxidant, anti-inflammatory, and anti-proliferative effects on cancer cells. However, the effect of acacetin on head and neck cancers has not been clearly established. This study aimed to examine the effects of acacetin on cell growth and apoptosis induction in FaDu human pharyngeal carcinoma cells. These were investigated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, Live/Dead cell assay, 4',6-diamidino-2-phenylindole dihydrochloride staining, caspase-3 and caspase-7 activation assay, and immunoblotting in FaDu cells. Acacetin induced FaDu cell death in a dose-dependent manner, with an estimated IC₅₀ value of 41.9 µM, without affecting the viability of L-929 mouse fibroblasts as normal cells. Acacetin treatment resulted in nuclear condensation in the FaDu cells. It promoted the proteolytic cleavage of procaspase-3, -7, -8, and -9 with increasing amounts of the cleaved caspase isoforms in FaDu cells. Acacetin-induced apoptosis in FaDu cells was mediated by the expression of Fas and activation of caspase-8, caspase-3, and poly (ADP-ribose) polymerase. Immunoblotting showed downregulation of the anti-apoptotic mitochondrial proteins Bcl-2 and Bcl-xL, but upregulation of the mitochondria-dependent pro-apoptotic proteins Bax and Badin FaDu cells after acacetin treatment. These findings indicate that acacetin inhibits cell proliferation and induces apoptotic cell death in FaDu human pharyngeal carcinoma cells via both the death receptor-mediated extrinsic apoptotic pathway and the mitochondria-mediated intrinsic apoptotic pathway.

• Korean Journal of Head & Neck Oncology
• /
• v.7 no.2
• /
• pp.120-128
• /
• 1991

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.10
• /
• pp.4429-4434
• /
• 2015

Background: Public awareness/knowledge on oral and pharyngeal cancer (OPC), potentially malignant disorders (PMODs) and their risk factors is crucial for prevention and early detection of OPC and PMODs. Yet, there are no published data available on the awareness and knowledge of OPC and PMODs among people living in Far North Queensland, Australia. Materials and Methods: This study was conducted as a cross sectional survey. A self-administered questionnaire was designed and consisted of relevant questions to ascertain socio-demographic information, awareness and knowledge of OPC, PMODs and risk factors and questions on participant's exposure to risk factors and dietary history were also included. Survey was carried out at the Dental Clinic of the James Cook University School of Dentistry (JCU Dental), Cairns, Australia. Subjects above the age of 20 years (n=366) were randomly selected during the period from 31st July to 6th September 2013 and questionnaire was distributed to complete while they are waiting for treatment. Data analysis was carried out using SPSS version 21 and the chi -squared test was employed to compare groups. P<0.05 was considered statistically significant. Results: The study revealed that 52.3% of the respondents were aware of the existence of OPC but only 19.0% were aware of PMODs. Of those who were aware of oral cancer, 92% agreed or strongly agreed that smoking is a strong risk factor for OPC. Similarly a relatively high proportion of the respondents agreed or strongly agreed that tobacco chewing (84%), tobacco chewing with areca nut (68%), chewing areca nut alone (51%) and exposure to actinic radiation (71%) as risk factors. However, the results for alcohol intake, age, and HPV infection were found to be relatively poor with proportions 33%, 34%, and 23% respectively. Conclusions: This study revealed an alarming lack of awareness and knowledge of OPC and PMODs.

• Radiation Oncology Journal
• /
• v.34 no.1
• /
• pp.26-33
• /
• 2016

Purpose: To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Materials and Methods: Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Results: Recurrence was not observed in any patients during the follow-up period. $V_{95%}$ for PTV showed no significant difference between IMRT and LAFT plans, while $V_{100%}$ was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median $V_{5Gy}$ (90.0%), $V_{25Gy}$ (13.5%), and $V_{50Gy}$ (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Conclusion: Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.6 no.2
• /
• pp.185-197
• /
• 1999

For the past 10 years, the number of male smokers has dwindled. On the other hand, the number of female smokers has increased abruptly. Cigarette smoking is more hazardous to a woman than to a man because it can affect her health and her fetus during pregnancy. Many studies show that cigarette smoking is one of the most important risk factors determining the mortality and the morbidity of various kinds of diseases such as lung cancer and pharyngeal cancer. But, it is also known to be one of the risk factors we can handle and prevent easily. The subjects of this study consisted of 263 female nursing students in Seoul and Chonbuk Province. Using questionnaires, we were collected data from December 1 to December 10 1998. The questionnaire included 24 questions related to environmental factors and 14 questions related with self-efficacy. The statistical analysis was done with SPSS ver. 8.0(SPSS Inc. U.S.). The results of this study are as follows. 1) Cigarette smoking in women was influenced by her family or friends. That is to say, the higher number of her friends or family members who smoked cigarettes, the more likely a woman was to become a smoker. Economic status and knowledge level about the risks of cigarette smoking were also related to women smoking. So, women with lower levels of economic status and less knowledge about the risks of cigarette smoking were the more likely to become smokers. 2) Woman with higher levels of self-efficacy were less likely to become smokers. 3) The factors influencing a woman's smoking were whether her friends smoked, whether her mother smoked and her self-efficacy in that order. Environmental factors, self-efficacy were found to be important factors influencing smoking in women. It is suggested a quit-smoking program for women college students, be based on consideration of these environmental factors and self-efficacy.