• Title/Summary/Keyword: Salivary gland

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The Role of Radiation Therapy in the Treatment of Adenoid Cystic Carcinoma of the Head and Neck (두경부에 생긴 선양 낭포암의 치료에 있어서 방사선치료의 역할)

  • Kim, Won-Dong;Park, Charn-Ii;Kim, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.35-41
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    • 1992
  • Forty eight patients with adenoid cystic carcinoma (ACC) in the head and neck treated between 1979 and 1990 were reviewed according to treatment modalities and clinical courses. The common site of origin was minor salivary gland ($69\%$), mostly hard palate and maxillary sinus. 11 patients received radiation therapy (RT) alone and 37 patients received combined surgery and radiation therapy. The follow-up period of the survivors ranged from 4 to 118 months (median 49.5 months). The 5 year local control rate was $69.3\%$, $67.3\%$ and 83.9$\%$ in RT alone, conservative operation (OP)+RT and radical OP+RT group, respectively (p>0.05). The control of local disease was best achieved with radical OP+RT. In postoperative RT, high dose ($\ge$60 Gy) and generous field size($\ge$64 cm$^2$) yielded a better local control rate. Actuarial overall survival rate was $79.0\%$, at 5 years and $19.2\%$ at 10 years. Distant metastases (DM) developed in $40\%$ of patients, mostly in the lung. Disease-free (NED) survival rate was $45.8\%$ at 5 years and significant differences did not exist according to primary sites and treatment options. Survival rate after the onset of DM was $19.5\%$ at 5 years. Occurrence of DM tends to lower survival significantly. In an effort to find the role of RT in the treatment of ACC, our data suggest that a well-planned postoperative RT employing a high dose and generous field size can produce high local control rate and remaining urgent problem of distant metastasis demands more effective chemotherapy for the purpose of improving survival of ACC patients.

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IMMUNOHISTOCHEMICAL ASSAYS FOR THE EXPRESSION OF EPIDERMAL GROWTH FACTOR-SIGNALING PROTEINS IN ADENOID CYSTIC CARCINOMAS OF HUMAN SALIVARY GLANDS (타액선 선양낭성암종에서 상피성장인자 신호전달 단백의 발현에 관한 면역조직화학적 연구)

  • Park, Young-Wook;Kim, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.499-510
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    • 2006
  • Malignant tumors of the human salivary glands may arise from major or minor salivary glands. Adenoid cystic carcinoma (ACC) is the second most common malignant neoplasm in the salivary glands. ACC is occasionally highly aggressive tumor that readily invades adjacent tissues and metastasize to distant organs at early stages of the disease. Although ACC tends to grow slowly, treatment outcome may be poor due to wide local infiltration, perineural or intraneural spread and a propensity for hematogenous metastasis. Therefore, knowledge of cellular and molecular characteristics that influence the growth, survival and metastasis of tumor cells, is important for new treatment strategies of salivary ACC. I determined expressions of epiderma growth factor (EGF)-signaling molecules using surgical specimens of human ACCs. Protein expressions of EGF, transforming growth $factor(TGF)-{\alpha}$, EGF receptor (EGFR), phosphorylated EGFR (pEGFR), and human EGF receptor (HER)-2 were assessed in 18 cases of salivary ACC by immunohistochemical staining. Adjacent normal salivary tissues and mucosal tissues, uninvolved by the malignant tumor, served as internal controls. Most of the tumors, especially ACC with a tubulocribriform pattern, were positive for EGF signaling molecules. The overall percentages of the 18 specimens expressing EGF, $TGF-{\alpha}$, EGFR, pEGFR, and HER2 were 50, 89, 61, 61 and 83% respectively. Moreover, tumor-associated endothelial cells and infiltrating immune-related cells in the stroma of ACC, also expressed these biomarkers. Taken together, EGF-signaling molecules are actively expressed in salivary ACC. Therefore, we suggest that these biomarkers can be molecular targets for new treatment strategies of salivary tumors.

Studies on the phrases of Yellow Emperor's internal classic(黃帝內經) for the physiology on the spleen and stomach (비위생리(脾胃生理)에 수용(授用)되는 황제내경(黃帝內經) 어구(語句)에 관(關)한 연구(硏究))

  • Won, Jin-Hui
    • The Journal of Korean Medicine
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    • v.16 no.2
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    • pp.453-489
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    • 1995
  • The research of the phrases related with physiology of stomach and spleen in the contents of Huang Di Nei Jing(黃帝內經) known as the Bible of oriental medicine will make a contribution to a deep understanding of disease of stomach and spleen and a proper clinical diagnosis and treatment of them. In this research of the most appropriate glosses recorded nine kinds of representative medical books including Huang Di Nei Jing Somoon(黃帝內經素問) of Wang Bing(王氷) were picked out: The summaries of the selected contents are as follows: 1. The word 'saliva(涎)' in 'the spleen controls saliva(脾爲涎)' can be viewed as a generic term referring to oral cavity secretion gland as well as the secretion fluid of salivary gland. 2. The phases 'a large reservoir(太倉)', barn organs', 'a reserboir of food stuff', 'a stomach as the market(胃爲之市)', etc mean the function of stomach to receive food(胃主受納). 3. The phase 'generation of five tastes(五味出焉)' means both 'the function of stomach to transform food into chyme(胃主腐熟)' and 'the channelling function of spleen.(脾主運化)' 4. The flowing of the food-Qi(食氣) into stomach brings about spreading Jung(精) into liver and then percolating Jung(精) flow into channel. The channel-Qi(脈氣) flows into lung through channel. As a result, all kinds of channels gather together in lung and Jung(精) is sent into skin and hair. The assembly of Jung(精) with skins and channels moves Qi(氣) into fu-organ and so jung(精) and mental activity(神明) in fu-organ(府) come to be in four organs(四臟). Then if Qi(氣) comes back to power balance unit(權衡) being in the state of equilibrium(權衡以平), the hole of Qi(氣口) comes to determine the matter of life and death through achieving Chun-quan-chi(-寸-關-尺). The above mentioned phrases means the digestion, asorption and transmission of food. When food is taken in stomach, Jung-Qi(精氣) comes to be over flowed upward into spleen, back into lung, finally downward into bladders through water-conduit(水道) controlled by lung. When water- Jung(水精) radiates into whole body with channels of five organs(五臟), both of them fit together with and yin-yang(陰-陽). Therefore, the grasping of the rise and decline of yin-yang(陰C-陽) is necessary to consult patients. The above mentioned phrases is properly viewed to designate the asorption, transmission and excretion of food. 5. Spleen controls flesh(脾之合肉也), the state of spleen is known by human lips, and what this means is that liver plays functions of spread and expansion(肝主疏泄). 6. The phrase 'Jung Jung'((中精)) in 'gallbladder dominates Jung jung(膽主中精)', which in one of the specific expression of 'liver plays functions of spread and expansion(肝主疏泄). 7. It is right that the phase 'The eleven organs in all are determined by gallbladder'(凡十,一臟取決於膽也) is correctly paraphrased as 'only one of ten organs, spleen, is determined by gallbladder'.(凡十,一臟取決於膽也), 8. The small intestine is an organ. which receives the materials digested and sends them out. This means that the function of transforming materials(化物) factually refers to that of separating clearity and blur(泌別淸濁). And it is also thought to have the function of ascending clearity and descending blur(升淸降濁), 9. A large intestine is a transmitting organ(傳導之官) from which a change comes out(變化出焉). the phrase 'change'(變化) in this sentence means both the intake of water and nutrition and the formation procedure of stool through excretion of mucocele.

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The Evaluation and Development of Head and Neck Radiation Protective Device for Chest Radiography in 10 Years Children (소아(10세) 흉부 방사선촬영에서의 두경부 방사선 방어기구 개발 및 평가)

  • Lee, Jun Ho;Lim, Hyun Soo;Lee, Seung Yeol
    • Journal of Radiation Protection and Research
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    • v.40 no.2
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    • pp.118-123
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    • 2015
  • The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

Primary Adenoid Cystic Carcinoma Arising in the Bronchus (기관지에 발생한 선양 낭포성 암종)

  • Kim, Young-Keun;Chung, Kyung-Young;Shin, Dong-Hwan;Kim, Hae-Jin;Kim, Chang-Nyun;Kang, Shin-Myung;Ko, Won-Ki;Kim, Young-Sam;Lee, Jun-Gu;Park, Jae-Min;Kim, Se-Kyu;Chang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.591-598
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    • 2001
  • Background : Primary adenoid cystic carcinoma arising in the bronchus is an uncommon disease that is histologically and ultrastructurally identical to the salivary gland tumor of the same name and regarded as a slow growing low-grade malignancy. We examined its clinical characteristics. Method : We collected 13 Korean cases of primary adenoid cystic carcinoma arising in the bronchus including 5 cases of our own and 8 cases from the literature. Result : The patients ages ranged from 20 to 74. Men numbered 9 and women 4. The presenting symptoms were cough, dyspnea, and hemoptysis. The fiberoptic bronchoscopic findings were primarily hypervascular polypoid mass with a smooth surface that obstructed airway totally or near totally. There were three inoperable cases including two cases with distant metastasis to bone or cervical lymph node and one case with mediastinal invasion. The remaining 10 patients underwent surgical resection. Among them, two patients received postoperative radiotherapy. The median survival was 21 months in the 8 surgical and evaluable cases. One patient lived 13 years without recurrence. The prognosis was relatively favorable in operable cases. Conclusion : It was not common for primary adenoid cystic carcinoma arising in the bronchus to have distant metastasis or invasion to the mediastinum on presentation. The prognosis was relatively favorable in operable cases. It would be important to perform flexible bronchoscopy for early diagnosis and to do surgical treatment if possible.

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Adenoid Cystic Carcinoma of the Head and Neck (두경부의 Adenoid Cystic Carcinoma)

  • 박준식;설대위
    • Proceedings of the KOR-BRONCHOESO Conference
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    • pp.14.2-14
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    • 1981
  • In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

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Effects of Chronic and Acute Stress on Clusterin Secretion of the Rat Submandibular Gland (급만성 스트레스가 백서 악하선의 Clusterin 분비에 미치는 영향)

  • Jin, Sang-Bae;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.31 no.1
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    • pp.79-89
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    • 2006
  • The aim of this study is to know how the rat submandibular gland changes under various emotional stress condition, using molecular biological methods. Restraint and chronic unpredictable mild stress (CUMS) experiment is conducted on fifty one 7-week old Sprague-Dawley rats (restraint stress experiment: 21, CUMS: 30). The rats were sacrificed, the submandibular glands were excised immediately at certain time, and examined by the use of immunohistochemistry and western blotting. In CUMS experiment, sucrose preference test, water intake change, weight change were implemented at 1 week interval for the experimental period The results are as follows: 1. The number of clusterin-secreting cells of restraint stress group compared to control group showed significantly decreasing tendency in all experimental groups except for the 1st hour group (p<0.001 in the 9th, 24th, 72nd, 120th, and 168th hour group). 2. The number of clusterin-secreting cells of CUMS group compared to control group showed significantly increasing tendency in the 2nd week group (p<0.01), and significantly decreasing tendency in the 4th and 5th week group (p<0.001). 3. Sucrose preference test in CUMS experiment showed significant difference between the 5th week experimental group and control group (p<0.01). 4. Weight change in CUMS experiment showed significant difference between the 5th week experimental group and control group (p<0.01), but water intake change didn't show significant difference compared to control group. 5. In western blot analysis, clusterin expression was decreased on a gradual basis in due time compared to the control group in the restraint stress group. As for CUMS group (chronic unpredictable mild stress group), it was increased till the 2nd week and decreased till the 5th week after that, which is similar to immunohistochemical analysis result and the decreasing tendency of sucrose preference and weigh changes. Through the test, it was proved that expression of clusterin in saliva glands decreases after receiving either acute or chronic stress, indicating relation with depression caused by chronic stress. Unlike other data, however, apoptotic tendency was hardly found in tissues. Diverse possibilities could be suggested on that: first, the stress was not enough to expedite apoptosis; second, apoptosis-related protein was already being secreted though not detected with microscope; third, clusterin, a major secretion molecule of saliva, decreased with saliva's malfunction due to stress. In the respect, it will be necessary to examine proteins expressed in case of cell death or other heat-shock proteins at the same time, in order to see whether any cellular change or death is caused by decreasing clusterin under high stress, and whether the original state is restored as time goes by under mild stress, through longer-term tests using even higher acute stress.

Prelectin Histochemistry for Effects of N-Nitrosodimethylamine on Glycoconjugates in the Rat Lingual Glands (N-Nitrosodimethylamine이 흰쥐 설선의 Glycoconjugates에 미치는 영향에 대한 Prelectin 조직화학)

  • 조운복;조기진
    • Journal of Life Science
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    • v.8 no.5
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    • pp.509-519
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    • 1998
  • The effect of N-Nitrosodimethylamine(NDMA) on the glycoconjugates of rat lingual salivary gland was examined by prelectin histochemical methods. Sprague-Dawley rats weighing about 250-300g were divided into control and experimental groups. Each rat of experimental groups was administrated NDMA(17mg/kg) orally and sacrificed in 3, 6, 12, 24, 48, 72, 96 and 120 hours after NDMA administration. The regional differences and change of glycoco-njugates were elucidated by prelectin histochemical methods, such as periodic acid Schiff's(PAS) reaction, alcian blue (AB) pH 2.5, AB pH 0.4, AB pH 2.5-PAS, aldehyde fuchsin(AF) pH 1.7-AB pH 2.5 and high iron diamine(HID)-AB pH 2.5 staining. The major morphological changes in the von Ebner’s gland of NDMA administrated groups were withering and des-truction of serous acini, diminution and disappearance of cytoplasmic granules and vacuolation in cytoplasm of serous cells, and mucinous changes of duct epithelial cells. These changes were noted in NDMA administrated groups for 12 to 72 hours. In the lingual mucous gland of NDMA administrated groups, the major morphological changes were enlargement, fusion and destruction of mucous acini, loss of cytoplasmic granules and vacuolated generation in cytop-lasm of mucous cells, and mucinous change of duct epithelial cells. These changes were severe in NDMA administra-ted groups for 12 to 72 hours. In NDMA administrated groups of lingual von Ebner's gland for 12 and 72 hours, the neutral glycoconjugates be-come diminished remarkably compared to the control group. The decreased amount of neutral glycoconjugates tended to be gradually recovered from 96 hours group. The acidic glycoconjugates which were not detected in control group were found in a few serous cells of these gland of NDMA administrated groups for 6 to 48 hours and 120 ho-urs. The remarkable decrease of neutral and acidic glycoconjugates was observed in the lingual mucous glands 3, 24 and 48 hours after NDMA administration, and the striking decrease of acidic glycoconjugates was found in 72 hours groups. Among acidic glycoconjugates, sulfated glycoconjugates tended to decrease in NDMA administrated groups for 72 hours, while sialic glycoconjugates were increased in NDMA administrated groups for 3, 12 and 48 hours.

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The Fabricating and Utilizing of the Transmission Scan Tool for I-131 Whole Body Scan (I-131 전신 스캔을 위한 Transmission Scan Tool 제작과 활용)

  • Shin, Chae-Ho;Pyo, Sung-Jai;Kim, Bong-Su;Cho, Yong-Gyi;Jo, Jin-Woo;Kim, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.40-46
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    • 2009
  • Purpose: A whole body scan using a radioactive iodine (I-131) for the patients with differentiated thyroid cancer is generally an useful method to detect the remnant thyroid tissue, recurred lesion or metastasis lesion after a surgery. The high dose treatment using the radioactive iodine recently tends to increase, and a hospitalization wait for the treatment has been delayed for several months. In this hospital, the treatable patients per week were increased in number through expanding a water-purifier tank and the examination time also increased as the I-131 whole body scan patients increased. Improvement for this problem, this research reduce the existing examination time and classifying the lesion's exact position intended to by fabricating and utilizing the transmission scan tool and an excellent resolution for whole body imaging. Materials and Methods: After conducting the whole body scan for patients who visited the department from February to July 2008 and received the I-131 whole body scan using the ORBITER Gamma Camera. A rail was installed in the examination table for the transmission scan for show a contour of surface area and then the transmission image was obtained and fused to the whole body scan through fabricating the tool to put a flood phantom of diluted 2 mCi $^{99m}Tc$-pertechnetate. Results: Fused image of I-131 whole body scan and the transmission scan had the excellent resolution to discriminate an oral cavity or salivary gland region, neck region's lesion, and metastasis region's position through a simple marking, and could reduce the examination time of 8~28 minutes because without the additional local image. Conclusions: In I-131 whole body scan, the transmission scan can accurately show a contour of surface area through the attenuation of radioactivity, and is useful to indicate the remnant thyroid tissue or metastasis lesion's position by improving the resolution through the fusion image with alreadyexecuted I-131 whole body scan. Also, because the additional local image is not necessary, it can reduce the time required for the examination. It will extensively apply to other clinical examinations to be helpful for identifying an anatomical position because it shows the contour of surface area.

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Hypothyroidism Following Surgery and Radiation Therapy for Head and Neck Cancer (두경부암 환자에서 수술 및 방사선치료 후 갑상선 기능 저하)

  • Park, In-Kyu;Kim, Jae-Cheol
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.225-231
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    • 1997
  • Purpose : Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. Materials and Methods : From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy The follow-up duration was 3 to 80 months. Results :The overall incidence of hypothyroidism was 56.3\%$);7 out of 71 patients $(9.9\%)$ developed clinical hypothyroidism and 33 patients $(46.4\%)$ developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000), Four of 26 patients $(15.4\%)$ with neck dissection alone developed hypothyroidism while 36 of 45 patients $(80\%)$ with laryngectomy and neck dissection developed hypothyroidism. Conclusion : The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced theincidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.

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