The authors reviewed 114 cases of malignant major and minor salivary gland tumors at Presbyterian Medical Center seen from February, 1963 to December, 1983. The results were obtained as follows; 1) Overall male and female sex ratio was 2:1. The peak age of patients with major and minor salivary gland tumor were both 5 th decade. 2) The ratio of benign and malignant tumor was 83:114. The incidence of malignancy in each group was 52% in parotid (50 patients), 75% in minor salivary gland (45 patients), 49% in submaxillary gland(18 patients) and 25% in sublingual gland (1 patient). 3) The incidence according to the anatomic primary site for minor salivary cancers was 10 cases in the nasal cavity, each 8 in the palate and the maxillary antrum, 7 in the tongue, 5 in the gum, 3 in the larynx and 2 in the buccal mucosa. 4) Adenoid cystic carcinoma was the most common cancer of minor salivary gland and malignant mixed tumor was the most common in major salivary glands, each comprising 34 cases (76%) of minor and 19 cases (28%) of major salivary gland tumors. 5) The incidence of cervical lymph node metastasis was 50% in the submaxillary gland cancers, 44% in the parotid gland cancers and 21% in malignant tumors of minor salivary glands. The highest incidence of lymph node metastasis according to histopathological classification was formed in high grade of mucoepidermoid (67%). 6) Nerve invasion was common in mucoepidermoid carcinoma. According to anatomic site, nerve invasion occurred most often in adenoid cystic carcinoma of the submaxillary gland (44%). 7) The lung was the commonest site for distant metastasis comprising 12 cases among 26 cases in which distant spread occurred. 8) The recurrence rate was 50% for major salivary gland cancer and 52% in cancer of the minor salivary gland. In accordance with pathological classification, adenocarcinoma most frequently recurred after excision. This being seen in 88% of patients undergoing definitive therapy. 9) The determinate 5 year survival rate was 78% in major salivary gland tumors, but 69% in minor salivary gland tumors.
During the period from January, 1975, to June, 1989, one hundred patients with histopathologically proven polymorphic reticulosis in the upper respiratory tract were treated with radiation therapy and the analysis of treatmemt results was undertaken. One hundred patients (69 males, 31 females) with a mean age of 46 years (range 12-79 years) were presented. Nasal cavity was the most frequent site of involvement ($56{\%}$), and 44 cases had multifocal sites of involvement. The incidence of cervical lymph node metastasis at initial diagnosis was $24{\%}$. Staging was determined by Ann-Arbor classification, retrospectively. The number of patients of stage IE, IIE, IIIE and IVE were 35, 60, 1, and 4, respectively. The overall 5 year actuarial survival rates were $38.4{\%}$. The difference in 5 year survival rates between patients with stage IE and IIE, with solitary and multiple, with CR and PR after irradiation were significant statistically. For the analysis of failure patterns, failure sites include the following: local failure alone (30/55=$54.6{\%}$), systemic failure alone (9/55=$16.4{\%}$), both local and systemic failure (16/55=$29.0{\%}$). Retrograde slide review was available in 29 cases of PMR with respect to histopathologic bases, and immunohistochemical studies were performed using MT1 and DACO-UCHL-1 as T-cell markers, MB2 as a B-cell marker and alpha-1-antichymotrypsin as a histiocytic markers. All that 29 cases showed characteristic histologic features similar to those of peripheral T-cell lymphoma and showed positive reactio to the T-cell marker. These findings suggest strongly that quite a significant portion of PMR may be in fact T-cell lymphoma.
Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.
Kim, Uk-Kyu;Lee, Kwang-Ho;Song, Won-Wook;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Jong-Ryoul;Chung, In-Kyo
Maxillofacial Plastic and Reconstructive Surgery
/
v.32
no.4
/
pp.324-331
/
2010
The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.
Background: Extra nodal lymphoma (ENL) constitutes about 33 % of all non-Hodgkin's lymphoma. 18-28% develops in the head and neck region. A multimodality treatment with multi-agent chemotherapy (CT) and radiotherapy (RT) is considered optimum. Materials and Methods: We retrieved the treatment charts of patients of HNENL treated in our institute from 2001-2012. The charts were reviewed and the demographic, treatment details and outcome of HNENL patients were retrieved using predesigned pro-forma. Results: We retrieved data of 75consecutive patients HNENL. Median age was 47years (Range: 8-76 years). Of the 75 patients 51 were male and 24 were female. 55patients were evaluable. The patient and tumor characteristics are summarized in Table 1. All patients were staged comprehensively with contrast enhanced computed tomography of head, neck, thorax, abdomen, pelvis and bone marrow aspiration and biopsy 66 patients received a combination multi-agent CT with CHOP being the commonest regimen. 42 patients received 4 or lesser number of cycles of chemotherapy whereas 24received more than 4 cycles chemotherapy. Post radiotherapy, 41 out of 42 patients had a complete response at 3 months. Only 21patients had a complete response after chemotherapy. All patients received radiation (mostly involved field radiation) as a part of the treatment. The median radiation dose was 45 Gray (Range: 36 Gray-50 Gray). The radiation was planned by 2D fluoro simulation based technique in 37cases and by 3 Dimensional conformal radiation therapy (3DCRT) in 36 cases. Two patients were planned by the intensity modulated radiation therapy (IMRT) technique. IMRT was planned for one thyroid and one nasal cavity primary. 5 patients experienced relapse after a median follow up of 19 months. The median survival was not reached. The estimated two and three year survival were 92.9% (95%CI- 68.6- 95.35) and 88% (95%CI- 60.82 - 92.66) respectively. Univariate analysis revealed higher stage and poorer baseline performance status to be significantly associated with worse progression free survival. 5 patients progressed (relapse or primary disease progression) after treatment. Of the 5 patients, two patients were primary orbital NHL, two patients had NHL nasal cavity and one was NHL thyroid. Conclusions: Combined modality treatment in HNENL confers excellent disease control with acceptable side effects.
Lee, Tae Sung;Pyon, Jai Kyong;Mun, Goo Hyun;Bang, Sa lk;Oh, Kap Sung;Lim, So Young
Archives of Plastic Surgery
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v.35
no.6
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pp.698-702
/
2008
Purpose: Basal cell carcinoma is one of the most common cancers in the western population and the annual incidence rate is still on an increasing course. In Asian countries such as Korea, the incidence of basal cell carcinoma is reported to be remarkably low but is estimated to be in a steep increase nowadays. This study was to analyze the recent clinical trends of basal cell carcinoma in Korea by reviewing a single institution's experience. Methods: Throughout an 11-year period, the surgical excision of 143 cases of basal cell carcinoma was performed in our department. General data of these cases such as the primary site of cancer, age and sex of the patient, operative methods, recurrence rate were reviewed retrospectively. Results: Among the 143 patients included in this study, 82 patients were men and 61 patients were women. The ages ranged from 27 to 89 years with a mean age of 64.0 years. The head and neck region was the most frequently involved primary site for the cancer as 95.1% of the total cases occurred in this area. Especially the nose and perinasal area were the most frequent region, which was followed by the periorbital area, cheek, and perioral area. During this study period, 9 cases showed recurrence of the cancer as the overall recurrence rate was 6.3%. Conclusion: Gradual increase in the incidence of basal cell carcinoma was demonstrated in this study. Basal cell carcinoma showed high incidence in the old-age population as 68.5% of the total patients were more than 60 years of age. High recurrence rate was noted in the nasal region especially after local flap reconstruction. A more cautious approach is to be required when handing such high risk lesions. Multiple factors such as extended life span, increased outdoor leisure activity and exposure to sunlight, higher accessibility to medical services and increased understanding of the public about skin cancer are assumed to be the main reasons for this increase of basal cell carcinoma.
Background and Purpose : Allergic rhinitis is a well-known, relatively controllable chronic disease. Although a number of methods for treating allergic rhinitis have been tried, many patients have not been satisfied with their treatment. Therefore, this study tried to evaluate the effect of a cooperative system of Oriental and Western medicine and to develop a new diagnosis protocol for treatment of allergic rhinitis. Methods : We measured improvement rate and acoustic rhinometry after the allergeninduction test and performed a filter paper test as a nonspecific hypersensitivity test with 60 patients who are allergic to house dust mite. Patients were divided into two groups, one treated with Western medicine only and one treated with both Western and Oriental herbal medicine. For the group with Western medicine only, antihistamine for one week and local steroid medicine for two weeks were prescribed. For the group with combined medicine, Oriental herbal medicine was prescribed according to the patient s constitution, along with Western medicine. After all treatments, the above tests were re-performed and the improvement rate was compared. Results and Conclusion : We observed better results in the group treated with both Western and Oriental herbal medicines, comparing improvement rate and the alteration of total nasal volume through acoustic rhinometry after the allergen induction test. In the filter paper test, there was no significant difference between the two groups. In conclusion, we showed the additive effect of Oriental herbal medicine without any severe side effects compared with treatment with Western medicine only. In this study, we set only two patient groups, but further study is required to create various experimental groups and compare among them. We suggest that it might enhance understanding of the improved effect of Oriental herbal medicine in the therapy of allergic rhinitis.
Human cytochrome P4502E1 (CYP2E1) is a well-conserved xenobiotic-metabolizing enzyme expressed in liver, kidney, nasal mucosa, brain, lung, and other tissues. CYP2E1 is inducible by ethanol, acetone, and other low-molecular weight substrates and may mediate development of chemically-mediated cancers. CYP2E1 polymorphisms alter the transcriptional activity of the gene. This study was conducted in order to investigate the allele frequency variation in different populations of Andhra Pradesh. Two hundred and twelve subjects belonging to six populations were studied. Genotype and allele frequency were assessed through TaqMan allelic discrimination (rs6413419) and polymerase chain reaction-sequencing (-1295G>C and -1055C>T) after DNA isolation from peripheral leukocytes. The data were compared with other available world populations. The SNP rs6413419 is monomorphic in the present study, -1295G>C and -1055C>T are less polymorphic and followed Hardy-Weinberg equilibrium in all the populations studied. The -1295G>C and -1055C>T frequencies were similar and acted as surrogates in all the populations. Analysis of HapMap populations data revealed no significant LD between these markers in all the populations. Low frequency of $CYP2E1^*c2$ could be useful in the understanding of south Indian population gene composition, alcohol metabolism, and alcoholic liver disease development. However, screening of additional populations and further association studies are necessary. The heterogeneity of Indian population as evidenced by the different distribution of $CYP2E1^*c2$ may help in understanding the population genetic and evolutionary aspects of this gene.
Lee C.G.;Park K.R.;Kim S.K.;Suh C.O.;Kim G.E.;Loh J.K.;Koh E.H.;Kim B.S.;Hong W.P.
Korean Journal of Head & Neck Oncology
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v.3
no.1
/
pp.97-105
/
1987
Chondrosarcoma of the head and neck is very rare tumor and this incidence was reported to be about 10% of all chondrosarcomas. Maxilla is the most common site of involvement and mandible, paransal sinus, nasal cavity and base of skull in that order. In general, chondrosarcoma has been known to be radioresistant, however since the Princess Margaret Hospital reported that it was radioresponsive tumor in 1980, the role of radiotherapy has been emphasized in terms of local control, especially in head and neck regions where complete excion is often difficult to achieve. The authors experienced 4 cases of chondrosarcoma of head and neck among all 29 chondrosarcoma patients from 1971 to 1985. The clinical and pathologic feature of this disease, it's treatment and prognosis were reviewed along with the literatures.
Sohn, Ji Soo;Jung, Youngae;Han, Ji Soo;Hwang, Geum-Sook
Journal of the Korean Magnetic Resonance Society
/
v.22
no.2
/
pp.26-33
/
2018
Xanthium sibiricum is used as a traditional folk medicine for the treatment of cancer, fever, headache, nasal sinusitis, and skin pruritus. This study aimed to identify components from Xanthium sibiricum extracts using an SPE-800MHz NMR-MS hyphenated system. The simultaneous acquisition of MS and NMR spectra from the same chromatographic peaks significantly increases the depth of information acquired for the compound and allows the elucidation of structures that would not be possible using MS or NMR data alone. LC -NMR analysis was conducted using a HPLC separation system coupled to 800 MHz spectrometer equipped with a cryoprobe, and a SPE unit was used to automatically trap chromatographic peaks using a HPLC pump. LC-MS analysis was conducted with a Q-TOF MS instrument using ESI ionization in the negative ion mode. Using the hyphenated analysis, several secondary metabolites were identified, such as 3',5'-O-dicaffeoylquinic acid, 1',5'-O-dicaffeoyl- quinic acid, and ethyl caffeate. These results demonstrate that the SPE-800MHz NMR-MS hyphenated system can be used to identify metabolites within natural products that have complex mixtures.
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