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The Failure of Initial Treatment for TNM Stage I & II Squamous Cell Carcinomas of the Oral Cavity (조기(TNM Stage I & II) 구강 편평세포암종의 초치료 실패)

  • Lee Hyun-Seok;Jeong Han-Sin;Kim Tae-Wook;Son Young-Ik;Baek Chung-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.1
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    • pp.26-31
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    • 2005
  • Backgrounds and Objectives: Squamous cell carcinomas of the oral cavity(SCOC) in TNM stage I & II have relatively high chance to be cured compared to those in the advanced stage, but sometimes result in the treatment failure with poor prognosis. There have been few reports on the patterns of failure and the clinical courses for SCOC in stage I & II after the failure of initial treatment. This study is directed at identifying the clinical outcomes of stage I & II SCOC and the salvage rate after initial treatment and suggesting an optimal level of treatment by analyzing the patterns of failure. Material and Methods: The medical records of 36 patients with SCOC, initially diagnosed between 1995 and 2001 as TNM stage I & II were reviewed retrospectively. The patterns of failure, salvage treatment, clinical courses, and the survival of these subjects were analyzed. The minimum follow-up period of no-evidence of disease(NED) was 12 months with an average of 32.2 months. Results: Overall rate of the treatment failure in SCOC of stage I & II was 41. 7%(15/36 cases). Most of the treatment failure in the subjects with stage I tumors occurred in regional lymph node. Local failure was the most frequent form of failure in the subjects with stage II tumors after wide excision of primary tumor with elective neck dissection and/or radiation therapy. No significant correlation was noted between the safety margin and the local failure. Elective neck dissections in stage I & II SCOC had a tendency to reduce regional failure (p=0.055). The salvage rates at 24 months were 85.7% in stage I, and 37.5% in stage II. The 3-year survival rate after the failure of initial treatment was 55.0%. Conclusion: SCOC of stage I & II after the failure of initial treatment showed poor prognosis despite of the salvage treatments. This study implies that the elective neck dissections for regional lymph node should be required for SCOC of stage I & II to reduce the treatment failure.

Korean Red Ginseng aqueous extract improves markers of mucociliary clearance by stimulating chloride secretion

  • Cho, Do-Yeon;Skinner, Daniel;Zhang, Shaoyan;Lazrak, Ahmed;Lim, Dong Jin;Weeks, Christopher G.;Banks, Catherine G.;Han, Chang Kyun;Kim, Si-Kwan;Tearney, Guillermo J.;Matalon, Sadis;Rowe, Steven M.;Woodworth, Bradford A.
    • Journal of Ginseng Research
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    • v.45 no.1
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    • pp.66-74
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    • 2021
  • Background: Abnormal chloride (Cl-) transport has a detrimental impact on mucociliary clearance in both cystic fibrosis (CF) and non-CF chronic rhinosinusitis. Ginseng is a medicinal plant noted to have anti-inflammatory and antimicrobial properties. The present study aims to assess the capability of red ginseng aqueous extract (RGAE) to promote transepithelial Cl- secretion in nasal epithelium. Methods: Primary murine nasal septal epithelial (MNSE) [wild-type (WT) and transgenic CFTR-/-], fisher-rat-thyroid (FRT) cells expressing human WT CFTR, and TMEM16A-expressing human embryonic kidney cultures were utilized for the present experiments. Ciliary beat frequency (CBF) and airway surface liquid (ASL) depth measurements were performed using micro-optical coherence tomography (μOCT). Mechanisms underlying transepithelial Cl- transport were determined using pharmacologic manipulation in Ussing chambers and whole-cell patch clamp analysis. Results: RGAE (at 30㎍/mL of ginsenosides) significantly increased Cl- transport [measured as change in short-circuit current (ΔISC = ㎂/㎠)] when compared with control in WT and CFTR-/- MNSE (WT vs control = 49.8±2.6 vs 0.1+/-0.2, CFTR-/- = 33.5±1.5 vs 0.2±0.3, p < 0.0001). In FRT cells, the CFTR-mediated ΔISC attributed to RGAE was small (6.8 ± 2.5 vs control, 0.03 ± 0.01, p < 0.05). In patch clamp, TMEM16A-mediated currents were markedly improved with co-administration of RGAE and uridine 5-triphosphate (8406.3 +/- 807.7 pA) over uridine 5-triphosphate (3524.1 +/- 292.4 pA) or RGAE alone (465.2 +/- 90.7 pA) (p < 0.0001). ASL and CBF were significantly greater with RGAE (6.2+/-0.3 ㎛ vs control, 3.9+/-0.09 ㎛; 10.4+/-0.3 Hz vs control, 7.3 ± 0.2 Hz; p < 0.0001) in MNSE. Conclusion: RGAE augments ASL depth and CBF by stimulating Cl- secretion through CaCC, which suggests therapeutic potential in both CF and non-CF chronic rhinosinusitis.

Clinical Features of Multiple Primary Malignancies: a Retrospective Analysis of 72 Chinese Patients

  • Jiao, Feng;Yao, Li-Juan;Zhou, Jin;Hu, Hai;Wang, Li-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.331-334
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    • 2014
  • There is a scarcity of reports addressing patients with multiple primary malignancies (MPM), especially for Chinese cses. The aim of this study was to present a detailed analysis of Chinese patients presenting with at least two primary malignancies. Particularly, the clinical characteristics and survival between synchronous and metachronous MPM were compared. Out of 6,545 cases, 72 patients (1.1%) including 39 males (54.2%) and 33 females (45.8%) were diagnosed as MPM, giving a male: female sex ratio of 1.2:1. Of these, there were 16 (22.2%) cases of synchronous MPM (7 males, 9 females), 55(76.4%) metachronous (31 males, 24 females), and 1 "mixed form". For first tumor diagnosis time, synchronous MPM patients generally presented later than the metachronous cases. The top three sites for malignancies with metachronous MPM were colorectum, head and neck, and lung, while for synchronous they were lung, colorectum and breast. Among MPM patients, the median survival time was 15.7 years and the 5-year survival was 56%, and there was statistical difference in MPM categories (P < 0.05). The median survival time was 17.3 years and 3.8 years for metachronous and synchronous MPM patients, respectively. In comparison with synchronous MPM patients, those metachronous had a longer survival. This studies increase understanding of the clinical features of Chinese MPM patients and suggest that those presenting with metachronous cancers have a higher incidence and a better prognosis.

Growth and Rooting Rate of 'Maehyang' Strawberry as Affected by Irrigation Method on Cutting Propagation in Summer Season (하절기 '매향' 딸기의 삽목 번식 시 관수방법에 따른 생육 및 발근율)

  • Kim, Hyeon Min;Kim, Hye Min;Jeong, Hyeon Woo;Lee, Hye Ri;Jeong, Byoung Ryong;Kang, Nam Jun;Hwang, Seung Jae
    • Journal of Bio-Environment Control
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    • v.27 no.2
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    • pp.103-110
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    • 2018
  • This study was conducted to investigate the optimum irrigation method for propagation of cutting strawberry ($Fragaria{\times}ananassa$ Duch. cv. Maehyang) plantlet in summer season. The cutting strawberry plantlets were planted in 24-cell tray ($60{\times}34{\times}10cm$) filled with commercial mixed medium (Tosilee) and placed in semi closed-type small plastic tunnel. Each semi closed-type small plastic tunnel was treated as follows; control (non-treatment), over head irrigation (twice a day), capillary mats irrigation (twice a day), or fog irrigation (30 minutes turn on and 10 minutes off from 8:00 to 18:00). The strawberry plantlets were rooted during 8 days in the semi closed-type small plastic tunnel, and then plastic film was removed. Growth parameters, such as plant height, root length, number of primary roots, petiole length, leaf length, leaf width, crown diameter, SPAD, leaf area, fresh and dry weights of the shoot and root, were measured at 61 days after cutting. Relative humidity in tunnel was high in the order by fog irrigation, over head irrigation, capillary mats, and the control as 72.5, 56.3, 45.8, and 29% on average, respectively. However, the air temperature was similar in all treatments. On the 4 and 8 days, the rooting rate of strawberry plantlet was significantly higher in the over head irrigation and fog irrigation treatments. Plant height, petiole length, crown diameter, and leaf area were highest in the over head irrigation and fog irrigation treatments. In addition, fresh and dry weights of shoot were greater in over head irrigation and fog irrigation treatments than the others. Dry weight of root was differed significantly heaviest in the fog irrigation treatment. However, root length, no. of primary roots, SPAD value, and fresh weight of root were not significantly different in all treatments. These results indicated that growth and rooting for propagation of cutting strawberry plantlet 'Maehyang' were best achievement in the over head irrigation and fog irrigation treatments.

A Clinical Analysis of Minor Salivary Gland Tumors (소타액선 종양에 관한 임상적 고찰)

  • Lee Chong-Soo;Choi Jong-Ouck;Lee Seung-Ho;Jung Kwang-Yoo;Lee Nam-Joon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.25-30
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    • 1994
  • Minor salivary gland tumors vary in their primary sites, histopathology and bilogical behavior. Therefore various factors are considered in selecting the treatment modality and predicting the prognosis. The prognosis of milignant tumors of minor salivary glands are worse than that of such lesions of major salivary glands. Authors experienced 26 cases of minor salivary gland tumors(10 benign tumors and 16 malignant tumors) during the past 7 years and analyzed their clinical characteristics. 1) The palate was the most common site of origin of minor salivary gland tumors (38.5%). 2) The most common benign tumor was pleomorphic adenoma and majority of them occur red in the palate(60.0%) and the remaining occured in the nasal cavity or the paranasal sinuses (30.0%), and the lip ( 10.0%). 3) In the case of malignant tumors the most frequent sites were the nasal cavity or the paranasal sinuses (31.3%) with the following histopathologic frequencies: adenoid cystic carcinoma(56.3%), malignant pleomorphic adenoma(12.5%), mucoepidermoid carcinoma(12.5%), polymorphic adenocarcinoma (12.5%), epthelial-myoepithelial carcinoma (6.25%). 4) Minor salivary gland tumors have high probability of malignancy and tumor extension is important to their treatment.

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Stomal Recurrence after Total Laryngectomy - A Critical Analysis of Etiology and Therapeutic Problems­ (후두전적출술 후 기공주변의 재발)

  • Choi Jong-Duck;Jung Kwang-Yoon;Oh Jae-Hoon;Kim Young-Hwan;Kim Byong-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.152-156
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    • 1994
  • Stomal recurrence after total laryngectomy presents serious therapeutic problems despite aggressive treatment methods. The purpose of this study is to evaluate the critical analysis of etiology and treatment results and to clarify the treatment plans and prevention of stomal recurrence. Among 159 cases who had undergone total laryngectomy for cancers of larynx(135 cases) and hypopharynx(24 cases) during recent 10 years, stomal recurrence occured in 12 cases(1 case with type I, 2 cases with type II, 2 cases with type III, 3 cases of type IV and unclassified 4 cases according to Sisson's classification) and the retrospective analysis of results were as follows: 1) Average duration of stomal recurrence was $8.2{\pm}4.35$ months after cessation of primary treatment. 2) The overall incidence of stomal recurrence was 7.6%. 3) The suggested etiology in the pathogenesis of stomal recurrence could be inadequate surgical margin, delayed laryngectomy after initial tracheostomy and improper management of metastatic nodes. 4) Mean survival time was $7.3{\pm}5.61$ months and one case with type I underwent surgical salvage is still alive out of 7 cases with chemotherapy and radiotherapy and 5 cases with surgical salvage and adjacent therapy. In summary, aggressive surgical resection should be recommended in cases with high risks of stomal recurrence.

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Changes in Oral Microbiota in Patients Receiving Radical Concurrent Chemoradiotherapy for The Head and Neck Squamous Cell Carcinoma

  • Kim, Jin Ho;Choi, Yoon Hee;An, Soo-Youn;Son, Hee Young;Choi, Chulwon;Kim, Seyeon;Chung, Jin;Na, Hee Sam
    • International Journal of Oral Biology
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    • v.43 no.1
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    • pp.13-21
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    • 2018
  • Radiotherapy (RT) is a mainstay in the treatment of head and neck squamous cell carcinoma (HNSCC). For locally advanced HCSCC, concurrent chemoradiotherapy (CCRT) benefits HCSCC patients in terms of better survival and loco-regional control. In this study, we evaluated changes in oral microbiota in patients, who received CCRT for head and neck cancer. Oral rinsed samples were weekly collected before and during CCRT and at 4 weeks following treatment from HNSCC patients, who had received 70 Gy of radiation delivered to the primary sites for over 7 weeks and concurrent chemotherapy. Oral microbiota changes in three patients were analyzed by next-generation sequencing using 16S rRNA 454 pyrosequencing. On an average, 15,000 partial 16S rRNA gene sequences were obtained from each sample. All sequences fell into 11 different bacterial phyla. During early CCRT, the microbial diversity gradually decreased. In a patient, who did not receive any antibiotics during the CCRT, Firmicutes and Proteobacteria were the most abundant phylum. During the early CCRT, proteobacteria gradually decreased while Firmicutes increased. During the late CCRT, firmicutes gradually decreased while Bacteroides and Fusobacteria increased. In all the patients, yellow complex showed a gradual decrease, while orange and red complex showed a gradual increase during the CCRT. At 4 weeks after CCRT, the recovery of oral microbiota diversity was limited. During CCRT, there was a gradual increase in major periodontopathogens in association with the deterioration of the oral hygiene. Henceforth, it is proposed that understanding oral microbiota shift should provide better information for the development of effective oral care programs for patients receiving CCRT for HNSCC.

Risk Factor Analysis of Endoscopic Dilation Procedure for the Management of Subglottic Stenosis in Pediatric Patients (성문하 협착 소아 환자에 대한 내시경적 기도 확장 시술 후 치료 실패 위험 요인 분석)

  • Park, Min Hae;Choi, Nayeon;Song, Bok Hyun;Jeong, Han-Sin;Son, Young-Ik;Chung, Man Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.19-26
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    • 2020
  • Background and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS. Materials and Methods This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed. Results The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure. Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

Mediastinal Lymph Node Metastasis from Head and Neck Cancer: Predictive Factors and Imaging Features (두경부암의 종격동 림프절 전이: 예측인자 및 영상 소견)

  • Il Kwon Ko;Dae Young Yoon;Sora Baek;Ji Hyun Hong;Eun Joo Yun;In Jae Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1246-1257
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    • 2021
  • Purpose To assess the predictive factors and describe the imaging features of mediastinal lymph node (MLN) metastases in patients with head and neck cancer. Materials and Methods We compared the clinical features and disease characteristics (sex, age, site of primary tumor, histologic type, history of prior treatments, TNM stages, and metastasis in cervical LNs) of patients with head and neck cancers between the MLN metastasis and no MLN metastasis groups. We also evaluated the chest CT (distribution and maximum dimension of the largest LN) and PET/CT (maximum standardized uptake value) features of MLN metastases based on the MLN classification. Results Of the 470 patients with head and neck cancer, 55 (11.7%) had MLN metastasis, involving 150 mediastinal stations. Hypopharynx cancer, recurrent tumor, T4 stage, N2/N3 stages, and M1 stage were found to be significant predicting factors for MLN metastasis. The most common location of MLN metastasis was ipsilateral station 2 (upper paratracheal LNs, 36.4%), followed by ipsilateral station 11 (interlobar LNs, 27.3%) and ipsilateral station 10 (hilar LNs, 25.5%). Conclusion Metastasis to MLNs should be considered in patients with head and neck cancer, especially in cases that are associated with a hypopharyngeal cancer, recurrent tumor, and high TNM stages.

Congenital Fibroepithelial Polyp Presenting as a Cutaneous Horn on the Nasal Tip: A Case Report (코에서 선천성 섬유상피폴립이 피부뿔로 발현한 환자 증례보고)

  • Kwon, Yongseok;Jun, Dongkeun;Lee, Myungchul;Choi, Hyungon;Shin, Donghyeok;Kim, Jeenam
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.33-36
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    • 2020
  • Cutaneous horn is the clinical entity, which is circumscribed, conical, markedly hyperkeratotic lesion in which the height of the keratotic mass amounts to at least half of its largest diameter. It may be associated with many different pathological lesions. It is a relatively rare and a kind of epidermal tumor that generally appears as a conical projection. Here, we report rare case of congenital cutaneous horn. A 39-month-old female Korean patient presented at our clinic with a mass at the tip of her nose present since birth. Under general anesthesia, cutaneous horn of nasal tip was completely excised without any complications. The operation site was small enough to perform a primary closure, without any nasal deformity. Histopathologically, it was reported as a fibroepithelial polyps. After operation, there is no evidence of recurrence at 16 months of follow-up.