• Journal of Chest Surgery
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• v.37 no.4
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• pp.356-363
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• 2004

Esophageal cancer is an aggressive disease with a poor prognosis. Recently, every effort has been made to improve the long term survival, but the general prognosis for patients with this disease remains poor. In this study, we reviewed 8 years of experiences with esophageal cancer patients managed in our department at Dong-A University Hospital and evaluated the effectiveness of cervical lymph node dissection performed selectively. Material and Method: From January 1995 to August 2003, 70 patients underwent esophagectomy for esophageal cancer in our department. Among them, 51 patients who underwent curative resection, had no double primary tumors and no neoadjuvant therapy were analyzed retrospectively. In most patients, intrathoracic esophagectomy and cervical esophago-gastrostomy was performed. Since 1997, 3-field lymph node dissection was performed selectively. Result: There were 46 men and 15 women. The median age was 60 years. The tumor was located in the upper third part in 10 patients (19%), middle third in 21 (41%), and lower third in 20 (40%). Majority of the patients (90%) had squamous cell carcinoma. Cervical anastomosis was made in 41 patients, and intrathoracic anastomosis in 10. 2-field lymph node dissection was done in 40 patients, and 3-field lymph node dissection in 11. The pathologic staging were as follows: stage I in 9 patients (17.6%), IIA in 20 (39.2%), IIIB in 7 (13.7%), III in 11 (21.6%), IVA in 2 (3.9%), and IVB in 2 (3.9%). The in-hospital mortality was 3.9% (2 patients) and complications occurred in 24 patients (47%). Overall actuarial 1, 3, and 5-year survival rates were 74.4%, 48.4%, and 48.4% including operative mortality. The 4-year survival rate did not differ significantly between 3-field lymph node dissection group (50.5%) and 2-field lymph node dissection group (48.9%). In 3-field lymph node dissection group, the respiratory complications were more frequent and operative time was significantly longer. Conclusion: We think that curative resection for esophageal cancer can be performed with acceptable mortality, and aggressive surgical approach may improve the long term survival. even for advanced stages. Effectiveness of 3-field lymph node dissection needs further investigations.

• Tuberculosis and Respiratory Diseases
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• v.42 no.6
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• pp.855-861
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• 1995

Background: Parathyroid hormone-related protein(PTHrp) was first identified as the cause of hypercalcemia in malignancy. Hypercalcemia can be found in malignancy, especially in the epidermoid carcinoma of the lung, even without extensive metastases to the bones. The application of sensitive assays for PTHrp may help in the early diagnosis of lung cancer, in the monitoring of treatment and in the detection of recurrence. Method: Serum PTHrp was measured by radioimmunoassay detecting the N-terminal 1~34 peptide of human PTHrp(PTHrp 1-34) in 63 histologically confirmed lung cancer patients and 22 healthy controls. Result: Serum PTHrp(mean$\pm$S.E.) was $312{\pm}68.9pg/ml$ in 63 lung cancer patients and $158{\pm}38.2pg/ml$ in 22 controls(p>0.05). PTHrp was $356{\pm}103.9pg/ml$ in 34 epidermoid carcinoma patients, $281{\pm}148.7pg/ml$ in 15 adenocarcinoma patients and $316{\pm}140.8pg/ml$ in 9 small cell carcinoma patients. In epidermoid carcinoma patients, PTHrp was $570{\pm}472.3pg/ml$ in stage II(n=3; p<0.05 vs controls), $166{\pm}22.4pg/ml$ in stage IIIa(n=9), $282{\pm}113.3pg/ml$ in stage IIIb(n=12) and $668{\pm}367.9pg/ml$ in stage IV(n=9; p<0.05 vs controls). PTHrp was significantly increased in 8 epidermoid carcinoma patients with bone metastases($1526{\pm}811.2\;pg/ml$; p<0.0005 vs controls). Hypercalcemia was observed in an epidermoid carcinoma patient whose PTHrp value was 244 pg/ml. Conclusion: The serum PTHrp was increased in advanced epidermoid carcinoma patients even without hypercalcemia. The measurement of PTHrp may be not helpful in the early diagnosis of lung cancer. But the lung cancer should be suspected in the marked elevation of PTHrp. It may be of value in detecting patients of advanced diseases with bone metastases or patients who might develop the malignancy associated hypercalcemia.

• Journal of Life Science
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• v.19 no.8
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• pp.1047-1054
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• 2009

Oral squamous carcinoma (OSC) cells present resistance to chemotherapeutic agents-mediated apoptosis in the late stages of malignancy. Advances in the understanding of bacterial toxins have produced new strategies for the treatment of cancers. It was demonstrated here that Pseudomonas aeruginosa exotoxin A (PEA) significantly decreased the viability of chemoresistant YD-9 cells in the apoptosis mechanism. Apoptotic manifestations were evident through changes in nuclear morphology and generation of DNA fragmentation. PEA treatment induced caspase-3, -6 and -9 cleavage, and activation. These events preceded proteolysis of the caspase substrates poly (ADP-ribose) polymerase (PARP), DNA fragmentation factor 45 (DFF45), and lamin A in YD-9 cells. The reduction of mitochondrial membrane potential, release of cytochrome c and SmacjDlABLO from mitochondria to cytosol, andtranslocation of AlF into nucleus were shown. While p53, p21 and $14-3-3{\gamma}$ were upregulated, cyclin Band cdc2 were downregulated by PEA treatment. Taken together, PEA induces apoptosis in chemoresistant YD-9 cells via activation of caspases, mitochondrial events and regulation of cell cycle genes.

• Tuberculosis and Respiratory Diseases
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• v.51 no.3
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• pp.281-288
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• 2001

Background : The most common anterior mediastinal tumors originate from the thymus. Among them, thymic carcinomas occur as an early local invasion and wide spread metastases. However, when squamous cell carcinoma in the thymus or mediastinum is identified, an occult primary lung cancer must be excluded because the histologic types resemble those found more typically in the lung. CD5 and cytokeratin immunohistochemical staining is useful in evaluating biopsy samples from those tumors. Squamous cell carcinoma of an unknown primary origin in the mediastinum is a rare occurrence and there are only a handful of case reports. Here we describe a case with an anterior mediastinal mass of squamous cell carcinoma with unknown primary origin. A resection of the mediastinal mass without an association with the lung was performed. Immunohistochemical stallings were positive using cytokeratin 13, and negative using CD5 and cytokeratin 7. This was followed by chemotherapy for presumed thymic carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.33-42
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• 2008

Head and neck squamous cell carcinoma(HNSCC) is notorious for its poor outcome and increasing incidence. But, the studies of cytogenetic analysis in HNSCC are relatively rare, because of difficulties in culturing solid tumor cells and complexity in chromosomal DNA abberations associated with the lesions. The purpose of this study is to evaluate the location of chromosomal aberrations in Korean HNSCC cell lines (SNU-1041, 1066, and 1076) with comparative genomic hybridization(CGH) and array based CGH(array-CGH). Chromosomal gains of 3q23-q27, 5p13-p15.3, 7p21-pter, 8q11.2-q12, 8q21.1-qter, 9q22-q34, 16q22-q24, and 20q11.2-qter, as well as chromosomal losses on 3p10-p14 were found in all 3 SNU cell lines. Losses on 3p15- p23, 4q22-q27, 4q31.3-qter, 6q14-q15, 7q31-q34, 8p12-pter, 18q21-q23, and 21q11.2-q12 were observed in 2 of 3 cell lines. In array-CGH, many genes were altered including gains of PIK3CA, MYC, EVI1, MAD1L1 genes and losses of SERPIN genes. These aberrations of gene and chromosome coincide with other results of study, generally. These data about the patterns of chromosomal aberrations could be a basic step for understanding more detailed genetic events in the carcinogenesis and also provide information for diagosis and treatment in HNSCC.

• Journal of Oral Medicine and Pain
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• v.34 no.1
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• pp.49-54
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• 2009

Lichen planus is a relatively common chronic inflammatory disease involving the skin and mucous membranes showing small flat polygonal papules. The accurate etiology is unknown but it's suggested that cell-mediated immune response to an induced antigenic changes in skin or mucosa. Oral lichen planus was regarded as an benign lesion but oral lichen planus was classified as premalignant lesion by WHO criteria. It was not known that progress of malignat transmmission in the the patient with oral lichen planus, and chronic inflammatory disease including oral lichen planus showed malignacy in oral cancer unrelated common risk factors(Ex: tabacco, alcohol). Although malignant development in the patient with oral liche planus was various greatly in the literature, from 0.5% upward to 5%. It has been reported that a specific clinical type of oral lichen planus, hyperkeratotic or erosive had a higher chance of transformation into an squamous carcinoma. Clinician has to follow-up check of at least one or two visit per year to detect of malignancy of oral lichen planus and improved prognosis with squamous cell carcinoma. At this case with the middle aged women with squamous cell carcinoma developed from oral lichen planus of more than a decade of persisting, we try to discuss the malignacy of oral lichen planus and cosideration with follow-up.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.527-535
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• 1996

Background : Cell adhesion molecules knave been Implicated In the various stages of tumor progression and metastasis. ICAM-1 plays a important roles in cell-cell interactions in inflammatory and immune response of several diseases. Recently, elevated levels of sICAM-1 in circulation was reported as association with liver metastasis in gastric, Colonic, gall bladder and pancreatic cancer, with reduced survival in malignant melanoma. This study was performed to measure the sICAM-1 in patients with lung cancer and to evaluate the relations between staging of lung cancer and level of sICAM-1. Methods : Serum sICAM-1 was measured in 36 patients with lung cancer according to the pathologic types and clinical staging before therapy and in 8 controls with ICAM-1 ELISA kit. Results : Serum sICAM-1 levels were elevated in patients with lung cancer except small cell type. Also progression and metastasis of lung cancer associated with elevation of sICAM-1 levels. Conclusion : These results suggest that higher levels of serum ICAM-1 reflect the progression and metastasis of lung cancer and it may be used as a marker with diagnostic and prognostic significance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.8-17
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• 2009

Purpose: We determined the therapeutic effect of an epidermal growth factor receptor (EGFR)-specific monoclonal antibody (mAb), cetuximab (Erbitux) on the growth of oral squamous cell carcinoma (OSCC) xenografted in athymic nude mice. Experimental Design: We induced subcutaneous tumors by inoculating human tumor cell suspension into the right flank of nude mice. Nude mice with subcutaneous tumors were randomized to receive cetuximab alone, paclitaxel alone, cetuximab plus paclitaxel, or a placebo (control). Antitumor mechanisms of cetuximab were determined by immunohistochemical and apoptosis assays. Results: Cetuximab, paclitaxel, and cetuximab/paclitaxel combined therapy resulted in 50%, 52%, 67% in vivo inhibition of tumor proliferation, respectively. Tumors of mice treated with cetuximab plus paclitaxel demonstrated decreased PCNA-positive tumor cells and increased apoptotic tumor cells, which slowed growth of the murine tumors. Conclusion: These data show that EGFR can be a molecular target for the treatment of OSCC. And combination therapy with cetuximab and paclitaxel warrants further clinical study.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.121-126
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• 1990

Primary squamous cell carcinoma occuring in the salivary glands involves a grave prognosis since the tumor exhibit infiltrative properties, metastasizes early and recurs readily. But it is so rare that the clinician may see only a few in a lifetime of practice. The following report describes a case of primary squamous cell carcinoma arising from the submaxillary gland treated by combined therapy including surgery, radiotherapy and hyperthermia. The biologic behavior of the tumor was quite abnormal that immediate recurrence was noticed in two weeks after surgery. The progress was dismal and the disease became overwhelming before long.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.2
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• pp.147-155
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• 1993

The combined induction chemotherapy is usually used to treat the advanced head and neck cancer. In particular, it is considered that the COB(Cisplatin, Oncovin, Bleomycin)regimen is very effective against the squamous cell carcinoma in head and neck region. The purpose of this study is to evaluate the cancer tissue response to chemotherapy (COB Regimen) histopath ologically.