• Korean Journal of Head & Neck Oncology
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• v.6 no.2
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• pp.71-78
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• 1990

The reconstruction of huge surgical defect is one of the major problems in the surgical treatment of the cancer of the head and neck. The latissimus dorsi myocutaneous flap, which is one of the most versatile myocutaneous flap, is a reliable method of reconstruction for extensive wounds in the head and neck. Due to the difficult patient positioning, its uses are reserved for the extensive defects or for the cases in which other traditional flaps have failed. The authors successfully reconstructed large surgical defects in the head and neck region using LDMC flap in five patients.

• Journal of Trauma and Injury
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• v.33 no.2
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• pp.134-137
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• 2020

Here we present a 43-year-old man who was brought with a self-inflicted cut throat injury; 18 hours after the suicidal attempt. On examination a deep 12 cm cut at the level of the hyoid bone exposing the posterior pharyngeal wall was seen. Emergency surgery with primary repair, tracheostomy and feeding gastrostomy was done. Post-operative period was uneventful and patient recovered without any speech or swallowing abnormalities. Through this article we would like to stress that even in cases of frightening ghastly wounds, by maintaining simple surgical principles we can achieve good outcomes.

• Korean Journal of Head & Neck Oncology
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• v.3 no.1
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• pp.79-83
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• 1987

Carotid body tumor is rare tumor in the neck. Among the pathologic conditions affecting paraganglionic tissue. the carotid body is most frequently involved. There are controversies in terms of natural history. biological behaviors, technique of excision, risks of the operation. Carotid angiography is the most valuable diagnostic aid and important for the planning of therapy. Definite treatment of carotid body tumor is surgical excision. Considerable degree of caution and vascular surgical armamentation are required because of its anatomical location and profuse vascularity. Surgical removal of this kind of paraganglioma must be predicated upon several factors such as tumor character. location. symptom, vascularity, and surgeon's ability.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.137-144
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• 1994

To provide the wide and satisfactory surgical field is essential requirement for en-bloc resection of nasopharyngeal angiofibroma invading central skull base. The new design of the surgical approach to the skull base lesions was developed and described the details of this technique and its usefullness. We compared the usefullness of naso-maxillary approach to that of infratemporal fossa approach in cases of angiofibroma invading skull base. Our experience indicates that the naso-maxillary swing approach is better than lateral approach for the large nasopharyngeal angiofibroma. A new approach. naso-maxillary swing approach. is described.

• Radiation Oncology Journal
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• v.23 no.4
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• pp.236-242
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• 2005

Purpose: To evaluate the role of surgical clips and scars in determining electron boost field for early stage breast cancer undergoing conserving surgery and postoperative radiotherapy and to provide an optimal method in drawing the boost field. Materials and Methods: Twenty patients who had $4{\sim}7$ surgical clips in the excision cavity were selected for this study. The depth informations were obtained to determine electron energy by measuring the distance from the skin to chest wall (SCD) and to the clip implanted in the most posterior area of tumor bed. Three different electron fields were outlined on a simulation film. The radiological tumor bed was determined by connecting all the clips implanted during surgery Clinical field (CF) was drawn by adding 3 cm margin around surgical scar. Surgical field (SF) was drawn by adding 2 cm margin around surgical clips and an Ideal field (IF) was outlined by adding 2 cm margin around both scar and clips. These fields were digitized into our planning system to measure the area of each separate field. The areas of the three different electron boost fields were compared. Finally, surgical clips were contoured on axial CT images and dose volume histogram was plotted to investigate 3-dimensional coverage of the clips. Results : The average depth difference between SCD and the maximal clip location was $0.7{\pm}0.55cm$. Greater difference of 5 mm or more was seen in 12 patients. The average shift between the borders of scar and clips were 1.7 1.2, 1.2, and 0.9 cm in superior, inferior, medial, and lateral directions, respectively. The area of the CF was larger than SF and IF in 6y20 patients. In 15/20 patients, the area difference between SF and if was less than 5%. One to three clips were seen outside the CF in 15/20 patients. In addition, dosimetrically inadequate coverage of clips (less than 80% of prescribed dose) were observed in 17/20 patients when CF was used as the boost field. Conclusion: The electron field determined from clinical scar underestimates the tumor bed in superior-inferior direction significantly and thereby underdosing the tissue at risk. The electron field obtained from surgical clips alone dose not cover the entire scar properly As a consequence, our technique, which combines the surgical clips and clinical scars in determining electron boost field, was proved to be effective in minimizing the geographical miss as well as normal tissue complications.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5815-5818
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• 2014

For an exact comparison of mRNA transcription in different samples or tissues with real time quantitative reverse transcription-polymerase chain reaction (qRT-PCR), it is crucial to select a suitable internal reference gene. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and beta-actin (ACTB) have been frequently considered as house-keeping genes to normalize for changes in specific gene expression. However, it has been reported that these genes are unsuitable references in some cases, because their transcription is significantly variable under particular experimental conditions and among tissues. The present study was aimed to investigate which reference genes are most suitable for the study of gastric cancer tissues using qRT-PCR. 50 pairs of gastric cancer and corresponding peritumoral tissues were obtained from patients with gastric cancer. Absolute qRT-PCR was employed to detect the expression of GAPDH, ACTB, RPII and 18sRNA in the gastric cancer samples. Comparing gastric cancer with corresponding peritumoral tissues, GAPDH, ACTB and RPII were obviously upregulated 6.49, 5.0 and 3.68 fold, respectively. Yet 18sRNA had no obvious expression change in gastric cancer tissues and the corresponding peritumoral tissues. The expression of GAPDH, ${\beta}$-actin, RPII and 18sRNA showed no obvious changes in normal gastric epithelial cells compared with gastric cancer cell lines. The carcinoembryonic antigen (CEA), a widely used clinical tumor marker, was used as a validation gene. Only when 18sRNA was used as the normalizing gene was CEA obviously elevated in gastric cancer tissues compared with peritumoral tissues. Our data show that 18sRNA is stably expressed in gastric cancer samples and corresponding peritumoral tissues. These observations confirm that there is no universal reference gene and underline the importance of specific optimization of potential reference genes for any experimental condition.

• Radiation Oncology Journal
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• v.24 no.3
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• pp.192-200
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• 2006

[ $\underline{Purpose}$ ]: To evaluate the movement of surgical clips implanted in breast tumor bed during normal breathing. $\underline{Materials\;and\;Methods}$: Seven patients receiving breast post-operative radiotherapy were selected for this study. Each patient was simulated in a common treatment position. Fluoroscopic images were recorded every 0.033 s, 30 frames per 1 second, for 10 seconds in anterior to posterior (AP), lateral, and tangential direction except one patient's images which were recorded as a rate of 15 frames per second. The movement of surgical clips was recorded and measured, thereby calculated maximal displacement of each clip in AP, lateral, tangential, and superior to inferior (SI) direction. For the comparison, we also measured the movement of diaphragm in SI direction. $\underline{Results}$: From AP direction's images, average movement of surgical clips in lateral and SI direction was $0.8{\pm}0.5\;mm$ and $0.9{\pm}0.2\;mm$ and maximal movement was 1.9 mm and 1.2 mm. Surgical clips in lateral direction's images were averagely moved $1.3{\pm}0.7\;mm$ and $1.3{\pm}0.5\;mm$ in AP and SI direction with 2.6 mm and 2.6 mm maximal movement in each direction. In tangential direction's images, average movement of surgical clips and maximal movement was $1.2{\pm}0.5\;mm$ and 2.4 mm in tangential direction and $0.9{\pm}0.4\;mm$ and 1.7 mm in SI direction. Diaphragm was averagely moved $14.0{\pm}2.4\;mm$ and 18.8 mm maximally in SI direction. $\underline{Conclusion}$: The movement of clips caused by breathing was not as significant as the movement of diaphragm. And all surgical clip movements were within 3 mm in all directions. These results suggest that for breast radiotherapy, it may not necessary to use breath-holding technique or devices to control breath.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6087-6091
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• 2012

Context: Patients diagnosed with a cancer have a life time risk of developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Of late the detection of new primary has increased mainly due to refinement in both diagnostic and treatment modalities. Cancer victims are surviving longer and thus are more likely to develop a new metachronous malignancy. Aims: To report our observed trend of increase in prevalence of both synchronous and metachronous second malignant neoplasms among cancer victims and to review the relevant literature. Settings and Design: A hospital based retrospective collection of prospective data of patients diagnosed with second denovo malignancy. Materials and Method: The study was conducted over a 5 year period from July 2008 to June 2012. All patients diagnosed with a histologically proven second malignancy as per Warren Gate's criteria were included. Various details regarding sex, age at presentation, synchronous or metachronous, treatment and outcome were recorded. Conclusions: The occurrence of multiple primary malignancies is not rare. Awareness of the possibility alerts the clinician in evaluation of patients with a known malignancy presenting with unusual sites of metastasis. Individualizing the treatment according to the stages of the primaries will result in durable cancer control particularly in synchronous double malignancy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.480-483
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• 2012

Schwannoma is a benign, slow-growing, tumor of the peripheral nerves without specific symptoms, so that early diagnosis may be difficult. Though approximately 25~40% of all schwannomas occur extracranially in the head and neck region, only 1% of schwannomas are reported in the oral cavity. An 18-years-old female patient visited our clinic with a mass on the middle-right-dorsal surface of the tongue slowly growing for 1.5 years. The patient underwent the surgical removal of the neoplasia under general anesthesia. The mass was well capsulated and a cleavage plane was easily found. There was no recidivation during the course of a one-year follow-up. The treatment for schwannoma is surgical excision of the lesion and recurrence after excision of schwannoma is rare. The final diagnosis is made after a histological examination. Differential diagnoses must be made in relation to malignant tumors and in relation to numerous benign neoformations based on epithelial and connective tissues.

• Radiation Oncology Journal
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• v.31 no.2
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• pp.72-80
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• 2013

Purpose: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. Materials and Methods: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. Results: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). Conclusion: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.