• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.164-169
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• 2003

Background and Objectives: The reconstruction is very important in Head and neck cancer surgery to repair the defect created by resection of tumors, to enable successful wound healing, to restore function and to provide acceptable cosmesis. The radial forearm free flap has been the most useful reconstructive flap because it provides a moderate amount of thin, pliable, relatively hairless skin and comparatively simple to do with minimal morbidity. The aims of this study is to estimate the outcome of the reconstruction with radial forearm free flap with the several factors in 140 head and neck cancer cases in our hospital for last 10 years. Materials and Methods: Retrospective review of the records of 140 patients underwent resection of the head and neck tumors and reconstruction with a radial forearm free flap from 1993 to 2003. The age, sex of the patients, Primary site, the complication of donor and recipient site, flap survival rate, median time to start diet, patient subjective symtoms about swallowing and articulating and the fact of revision reconstructive surgery were analyzed. Results: In primary pathologic site, 56 cases were oral cavity cancers, 44 cases, oropharyngeal cancers and 22 cases, hypopharyngeal cancers. Flap survival rate was 93.6% (13 leases). On donor site, wound dehiscence, hematoma, sensory change and infection were noted and on recipient site, most common complication were fistula and wound dehiscence. The complication rate of recipient's site was 19.1 % and donor site, 3.5%. In 118 cases (84.3%), the patients could take all kinds of food. Swallowing difficulty were noted in 22 cases 05.7%). In 5 cases, there was articulation difficulty but most of patients except patients having total laryngectomy (18 cases) couldn't have any difficulty in articulation and speaking. Conclusion: We conclude that the radial forearm free flap is the most appropriate reconstructive material for treating the defect in head and neck reconstruction.

• Korean Journal of Community Nutrition
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• v.20 no.2
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• pp.129-140
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• 2015

Objectives: We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors. Methods: A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model. Results: Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05). Conclusions: Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.

• Journal of Gastric Cancer
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• v.1 no.2
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• pp.92-99
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• 2001

Purpose: E-cadherin is an adhesion molecule essential for tight connection between cells, forming the cadherin/catenin complex. Truncated $\beta$-catenin disrupts the interaction between E-cadherin and $\alpha$-catenin, leading to the loss of intercellular adhesion. Met protein, the hepatocyte growth factor receptor, plays important roles in signal transduction. We investigated the relationships between the expressions of E-cadherin, $\beta$-catenin, and c-met protein and the clinicopathological and prognostic parameters in gastric adenocarcinomas. Materials and Methods: The patterns of E-cadherin, $\beta$-catenin, and c-met protein expression were studied using immunohistochemistry in formalin-fixed, paraffin-embedded archival tissues from 76 surgically resected gastric adenocarcinomas. Results: Increased expressions of E-cadherin, $\beta$-catenin, and c-met were more significantly correlated in early gastric cancers (EGC) than in advanced gastric cancers (AGC) (P=0.002, P=0.003 and P=0.026). The positive immunoreactivities of all three markers were markedly lower in signet ring-cell type and poorly differentiated type lesions than in intestinal-type lesions. Decreased expression of the $\beta$-catenin protein correlated well with increased tumor invasion depth (P=0.039), and increased lymph node metastasis correlated well with reduced expression of c-met (P=0.046). Conclusion: In gastric cancers, reduced expressions of the E-cadherin, $\beta$-catenin, and c-met proteins may play some role in poorer tumor differentiation, deeper tumor invasion, and increased lymph node metastasis. Also, the c-met gene is thought to play a specific role in the mechanism of the yet unknown catenin action.

• Journal of Korean Neurosurgical Society
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• v.62 no.1
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• pp.106-113
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• 2019

Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.

• Journal of Gastric Cancer
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• v.20 no.3
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• pp.233-244
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• 2020

Purpose: For unresectable or initially metastatic gastric cancer, conversion surgery (CVS), after systemic chemotherapy, has received attention as a treatment strategy. This study evaluated the prognostic value of ypTNM stage and the oncologic outcomes in patients receiving CVS. Materials and Methods: A retrospective review of clinicopathologic findings and oncologic outcomes of 116 patients who underwent CVS with curative intent, after combination chemotherapy, between January 2000 and December 2015, has been reported here. Results: Twenty-six patients (22.4%) underwent combined resection of another organ and 12 patients received para-aortic lymphadenectomy (10.3%). Pathologic complete remission (CR) was confirmed in 11 cases (9.5%). The median overall survival (OS) and disease-free survival (DFS) times were 35.0 and 21.3 months, respectively. In multivariate analysis, ypTNM stage was the sole independent prognostic factor for DFS (P=0.042). Tumors invading an adjacent organ or involving distant lymph nodes showed better survival than those with peritoneal seeding or solid organ metastasis (P=0.084). Kaplan-Meier curves showed that the 3-year OS rate of patients with pathologic CR and those with CR of the primary tumor but residual node metastasis was 81.8% and 80.0%, respectively. OS was 65.8% for stage 1 patients, 49.8% for those at stage 2, and 36.3% for those at stage 3. Conclusions: The ypTNM staging is a significant prognostic factor in patients who underwent CVS for localized unresectable or stage IV gastric cancers. Patients with locally advanced but unresectable lesions or with tumors with distant nodal metastasis may be good candidates for CVS.

• Journal of Gastric Cancer
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• v.12 no.3
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• pp.179-186
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• 2012

Purpose: The use of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography-computed tomography as a routine preoperative modality is increasing for gastric cancer despite controversy with its usefulness in preoperative staging. In this study we aimed to determine the usefulness of preoperative positron emission tomography-computed tomography scans for staging of gastric cancer. Materials and Methods: We retrospectively analyzed 396 patients' positron emission tomography-computed tomography scans acquired for preoperative staging from January to December 2009. Results: The sensitivity of positron emission tomography-computed tomography for detecting early gastric cancer was 20.7% and it was 74.2% for advanced gastric cancer. The size of the primary tumor was correlated with sensitivity, and there was a positive correlation between T stage and sensitivity. For regional lymph node metastasis, the sensitivity and specificity of the positron emission tomography-computed tomography were 30.7% and 94.7%, respectively. There was no correlation between T stage and maximum standardized uptake value or between tumor markers and maximum standardized uptake value. Fluorodeoxyglucose uptake was detected by positron emission tomography-computed tomography in 24 lesions other than the primary tumors. Among them, nine cases were found to be malignant, including double primary cancers and metastatic cancers. Only two cases were detected purely by positron emission tomography-computed tomography. Conclusions: Positron emission tomography-computed tomography could be useful in detecting metastasis or another primary cancer for preoperative staging in gastric cancer patients, but not for T or N staging. More prospective studies are needed to determine whether positron emission tomography-computed tomography scans should be considered a routine preoperative imaging modality.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.541-545
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• 2006

Purpose: There are many methods for the reconstruction of the facial defect after an excision of a skin cancer; such as skin graft, local flap, free flap, etc... Skin graft has its' limitations; it could remain in different color with in regards of the recipient to donor, with an unfavorable scar. Free flap can lead to big donor site morbidity with long operation time and uncontrolled scar as a disadvantage factor. Compared to the prior, local flap offers several merits; sufficient blood supply, good tissue quality and short operation time. We revised 'V-Y-S flap' for the facial defect, which proved to have favorable outcomes. Methods: Total 7 V-Y-S flaps were performed to patients with skin cancers(six squamous cell carcinoma and one basal cell carcinoma). Two of these flaps were combined with composite grafts, one with full thickness skin graft. Six patients were female and one male. The average diameter of defects after excision was 2.3 cm. The follow-up period was 18 months maximally. Results: We treated seven facial skin cancers with 'V-Y-S flap'. There were no flap necrosis, cancer recurrence and scar contracture as a result. Furthermore, this method also offers a favorable central scar line that is parallel to the nasolabial fold and the nasojugal groove, especially in the nasolabial area and superomedial side of the cheek. With this method, we could cover a maximum diameter of 4cm facial defect. Conclusion: In conclusion, it is suggested that V-Y-S flap is a useful method to cover facial defects after the excision of a skin cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8541-8551
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• 2016

Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

• Journal of Gastric Cancer
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• v.11 no.2
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• pp.69-77
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• 2011

Purpose: In an effort to examine the clinicopathological characteristics of GC and the status of its surgical treatment, the Korean Gastric Cancer Association (KGCA) conducted a nationwide survey targeting surgically-treated gastric cancer patients in 2009. Materials and Methods: A standardized electrical case report was sent to every member institution of the KGCA via E-mail with detailed instructions regarding the survey data. Completed data forms were retrieved from each institution and analyzed by the KGCA information committee. Results: Data on 14,658 patients was collected from 59 institutions. The mean patient age was $59.2{\pm}11.9$ years with a male to female ratio of 2.05 : 1. Lower third cancer (56.0%) was the most common among all gastric cancers. The histological type revealed poorly differentiated adenocarcinoma (34.1%) to be the most common, and the Lauren classification revealed the intestinal type (50.0%) to be the most prevalent. Curative surgery was performed in 92.4% of patients with laparoscopic surgery in 25.8% of patients. A Billroth I reconstruction was performed most frequently after a distal gastrectomy (63.4% of distal gastrectomy). T1 cancers accounted for 57.6% of all cases, and 62.6% of patients showed no lymph node metastasis. Compared to previous reports, it was found that patients are becoming older, laparoscopic surgery is being performed increasingly, and the proportion of T1 cancer is increasing with time. Conclusions: This survey presented the clinicopathological characteristics and current status of the surgical treatment of gastric cancer in Korea. This survey is expected aid research studies as well as planning and evaluation programs targeting cancer control.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.490-495
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• 2011

Introduction: Development of carcinoma on oral tongue may cause bilateral cervical lymph node metastasis, rapid invasion and growth of the cancer cells due to rich blood supply in muscle tissues. It is not only difficult to develop an animal experimental model, but also to proceed follow-up research after the development of such model as the induction of cancer lead to difficulty in taking nutrition for the experimental animals that often causes early death. Materials and Methods: IIn this study, author have transplanted YD-$10B_{mod}$ cells into nude mouse oral tongues with different cells number ($5{\times}10^4$, $5{\times}10^5$, $5{\times}10^6$ cells/mouse) and observed the development aspect of oral tongue cancers. Results: The cancer developed from orthotopic transplantation of YD-$10B_{mod}$ cells into nude mouse oral tongue show invasion and central necrosis of the tumor, similar to the cancers developed human oral tongue cancer. The difference in tumor size and the time of central necrosis development depending on the number of transplanted tumor cells shows the feasibility of extending the survival period of the nude mouse by limiting the transplanted tumor cells to < $5{\times}10^4$ cells/mouse or under per nude mouse. Conclusion: This nude mouse model could be used effectively in developing effective chemotheray agent and establishing an animal experimental model that can be used to study the mechanism of cervical lymph node metastasis of the oral tongue cancer.