• Archives of Plastic Surgery
• /
• v.42 no.4
• /
• pp.461-468
• /
• 2015

Background Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection. Methods Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy. Results Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy. Conclusions The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.

• Korean Journal of Clinical Pharmacy
• /
• v.30 no.1
• /
• pp.11-18
• /
• 2020

Background: Nivolumab and pembrolizumab are antagonists of the programmed death-ligand 1 (PD-L1) receptor that function as immuno-oncological agents. This study aimed to evaluate the safety and efficacy of nivolumab and pembrolizumab in elderly patients in outpatient settings. Methods: The safety and efficacy of nivolumab and pembrolizumab were compared retrospectively among patients at the Veterans Health Service (VHS) Medical Center in Seoul, South Korea, from September 1, 2017 to August 25, 2018. Results: Eighty-seven patients were selected for the study. The median progression-free survival was 63 days for nivolumab (95% confidence interval (CI), [14 to 282]) vs. 243 days for pembrolizumab (95% CI, [22 to 348]) (p =0.04). The objective response rate (ORR) was 0% in the nivolumab group vs 5.6% in the pembrolizumab group (p =0.310). All the patients exhibited treatment-related adverse effects. More than 89% of the patients exhibited diseases of the gastrointestinal (GI) tract. Pneumonia, of grades three or higher, was the most common adverse effect, followed by weakness and anorexia. Conclusions: There was no statistically significant difference between the nivolumab group and the pembrolizumab group with respect to the ORR. The incidence and severity of the adverse effects in this study were higher than those of previous studies; however, these adverse effects are generally manageable in a real-world clinical setting. Further randomized controlled studies will be necessary to confirm these results in elderly patients.

• YAKHAK HOEJI
• /
• v.51 no.4
• /
• pp.285-290
• /
• 2007

The oxidative stress causes many diseases like cancer, aging, cardiovascular disease, degenerative neurological disorders (Parkinson’s disease, and Alzheimer's disease) by damage of cell membrane, protein deformation, and damage of DNA due to the oxidation of lipid of cell membrane, protein of tissue or enzyme, carbohydrate, and DNA. It is caused by the reactive oxygen species (ROS) that is produced in the metabolic process of oxygen in cell. The superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) in cell systemize the antioxidative enzymes to control the oxidative stress. In this research, it is measured that the survival rate of cell by the typical isoflavonoid of daidzein or genistein, activity of antioxidative enzyme, and ROS level, in order to study the effect of isoflavonoid over the ROS production in cell and antioxidative system. As the similar action of the isoflavonoid with the estrogen is examined, women are encouraged to get bean. In view of this trend, it is very important to find out a combination medicine that lowers the oxidative stress caused by the daidzein in the ovarian cell. In the combined treatment of the typical antioxidant of vitamin C to oxidative stress which induced by daidzein recover the control level particularly lowering the ROS in cell by 30%. However, it made no effect in the combined treatment with genistein. Therefore, the research took the combination effect of daidzein with vitamin C in order to check it effect over the antioxidative system. In conclusion, it was disclosed that the oxidative stress caused by daidzein is related to the lowering activity of SOD, and the specific combination effect of daidzein with vitamin C is related to the recovery of SOD activity.

• Journal of Food Hygiene and Safety
• /
• v.28 no.3
• /
• pp.202-206
• /
• 2013

High-grade mucoepidermoid carcinomas (MECs) have difficulty in cure and 5-year survival rate is quiet low. Therefore, we need new therapeutic agents and molecular targets. Betulinic acid (BA) is one of the materials which is easily found in the world and shows tumor-suppress effects in various tumor types. In addition, many kinds of normal tissues have a resistance to BA treatment. In this study, we investigated the anti-proliferative activity of BA and its molecular targets in MC-3 human MEC cells using western blot analysis and DAPI staining. BA inhibited cell viability and induced apoptosis in MC-3 cells. It affected Specificity protein 1 (Sp1) and its downstream molecule, survivin whereas it did not affect myeloid cell leukemia-1 (Mcl-1). Therefore, we suggest that BA can be a potential anti-cancer drug candidate regulating Sp 1 and survivin to exert apoptotic cell death.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.13 no.8
• /
• pp.1699-1704
• /
• 2009

If detected early enough, cervical cantor may have a good survival rate due to its preneoplastic state. However, the process is so time consuming that a medical expert can handle only a small amount of such examinations. In this paper, we propose a new nucleus extraction algorithm for uterine cervical pap smears in order to mitigate such burdens of medical experts. In the preneoplastic state cytodiagnosis images, it is important to differentiate three main areas - background, cytoplasm and nucleus. Thus, we apply lighting compensation and $3{\times}3$ mask of B channel in order to restore damaged image and remove noises respectively. The cell object is obtained from those clean binarized images with Grossfire algorithm. When there are clusters of cells, the target nucleus can be obtained with repetitive binarization of R channel brightness. In our experiment of using uterine cervical pap smears of 400 magnifications that is common in the diagnostic cytology, our method is able to extract 40 nucleus out of 45 population successfully.

• Journal of Microbiology and Biotechnology
• /
• v.25 no.12
• /
• pp.1989-1996
• /
• 2015

Ice-binding proteins (IBPs) can inhibit ice recrystallization (IR), a major cause of cell death during cryopreservation. IBPs are hypothesized to improve cell viability after cryopreservation by alleviating the cryoinjury caused by IR. In our previous studies, we showed that supplementation of the freezing medium with the recombinant IBP of the Arctic yeast Glaciozyma sp. (designated as LeIBP) could reduce post-thaw hemolysis of human red blood cells and increase the survival of cryopreserved diatoms. Here, we showed that LeIBP could improve the viability of cryopreserved mammalian cells. Human cervical cancer cells (HeLa), mouse fibroblasts (NIH/3T3), human preosteoblasts (MC3T3-E1), Chinese hamster ovary cells (CHO-K1), and human keratinocytes (HaCaT) were evaluated. These mammalian cells were frozen in dimethyl sulfoxide (DMSO)/fetal bovine serum (FBS) solution with or without 0.1 mg/ml LeIBP at a cooling rate of -1℃/min in a -80℃ freezer overnight. The minimum effective concentration (0.1 mg/ml) of LeIBP was determined, based on the viability of HeLa cells after treatment with LeIBP during cryopreservation and the IR inhibition assay results. The post-thaw viability of mammalian cells was examined. In all cases, cell viability was significantly enhanced by more than 10% by LeIBP supplementation in 5% DMSO/5% FBS: viability increased by 20% for HeLa cells, 28% for NIH/3T3 cells, 21% for MC3T3-E1, 10% for CHO-K1, and 20% for HaCaT. Furthermore, addition of LeIBP reduced the concentrations of toxic DMSO and FBS down to 5%. Therefore, we demonstrated that LeIBP can increase the viability of cryopreserved mammalian cells by inhibiting IR.

• Korean Journal of Head & Neck Oncology
• /
• v.18 no.1
• /
• pp.41-45
• /
• 2002

Background and Objectives: To evaluate the efficacy of the neoadjuvant chemotherapy and radiation therapy in treatment of patients with advanced hypopharyngeal cancer, which is notorious for its poor prognosis and severe surgical morbidity with functional deficits. Materials and Methods: Medical records and radiologic findings of 107 patients with squamous cell carcinoma of the hypopharynx, Stage III or IV (AJCC, 1997), were retrospectively reviewed. Results: Neoadjuvant chemotherapy followed by radiation therapy showed 74% complete remission (CR) rate. The patients who did not show CR after chemotherapy had a high likelihood of treatment failure, even though they achieved CR following subsequent radiotherapy. Twenty-eight of 57 patients were able to preserve their larynges for more than three years by chemotherapy and radiation. Conclusions: This approach appeared to be as effective as radical surgery with postoperative radiation therapy without comprising of survival. To improve the cure rates, we need to develop better strategies to increase CR rates with chemotherapy and determine the best treatment option for patients who are partially or nonresponsive to chemotherapy.

• Archives of Plastic Surgery
• /
• v.40 no.1
• /
• pp.44-50
• /
• 2013

Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

• Archives of Plastic Surgery
• /
• v.40 no.3
• /
• pp.238-243
• /
• 2013

Background Primary malignant tumors of the hand, although unusual, may present varied and often complex clinical problems. The main treatment modality of skin cancer of the hand has changed. Methods We retrospectively reviewed the medical records of 43 patients who underwent surgery for malignant skin tumors of the hand during an 18-year period, from September 1994 to February 2012. The characteristics of the tumor, methods of reconstruction, and long-term results were reviewed. Results We had 43 patients with 27 melanomas, 14 squamous cell carcinomas, and 2 sarcomas. Their ages ranged from 19 to 74 years (mean, $53.4{\pm}14.5$ years), from 46 to 79 years (mean, $59.7{\pm}9.6$ years), and from 15 to 43 years (mean, $29{\pm}19.8$ years), respectively. Thirty-four cases occurred on the fingertip (16 of those cases on the thumb), 5 cases occurred on the palm, and 4 cases on the dorsum of the hand. Amputation was most frequently used in early cases, but recently, tissue-sparing excision has been performed frequently. The incidence of local recurrence was 3 cases and distant metastasis was 1 case, and the 5-year survival rate was 100%, except in 4 cases due to follow-up loss. Conclusions The principles of treatment-to be curative and to preserve function and appearance-are important points. "Preservative surgery" preserves function and cosmesis of the involved finger or hand dorsum or palm. Preservative surgery not only emphasizes less resection and surgery of a smaller scale, but also optimal reconstruction of the soft tissue defect of the digit.

• Korean Journal of Head & Neck Oncology
• /
• v.3 no.1
• /
• pp.65-70
• /
• 1987

하인두암은 거의 대부분 이상동(Pyriform Sinus) 에서 발생하며 상당한 정도 진행 시까지 별다른 증상을 나타내지 않는다. 저자들은 1966년부터 1985년까지 만 20년간 하인두에서 발생된 암환자 63명을 중심으로 임상 관찰 및 문헌고찰과 함께 발표하는바이다. 원발병소로는 전체 중 58명에서 이상동, 하인두벽(hypopharyngeal wall) 3명, Postcricoid hypopharynx 와 pharyngopalatine fold 에서 각각 1명씩의 발생빈도를 보였다. 저자들은 설저(base of tongue)암, supraglottic Ca. 및 경부 식도(cervical esophagus)암 경우는 모두 제외시켰다. 임상증상으로서는 경부 종괴(lump)가 33 예로써 가장 현저했으며 또한 첫증상으로써 연하곤란(dysphagia) 또는 sore throat를 나타낸 경우는 32 예 이었다. 그 외에 hoarseness 가 20 예, bloody sputum 4 례 및 호흡곤란 2 예의 순이었다. 내원까지의 증상기간은 대부분 $4{\sim}6$ 개월 이었다. 흡연관계는 1일 1값 이상의 중등도 흡연 경우는 전체의 58% 이었으며 흡연 사실이 있었던 경우는 전체의 88% 이었다. 연령별 발생빈도는 50대$\sim$60대에서 48명으로서 현저히 높았다. 완치 목적의 수술적 치료는 24명에서 시행하였으며 치료 거절은 16명이었다. 치료 거절하였던 환자들 중 81% 가 임상적 제 4 병기였으며 보조적 치료 요법을 실시한 환자들의 78% 에서 제 4 병기였다. 또한 완치 목적의 치료 실시 경우의 67% 에서 제 4 병기였다. 수술요법은 일반적으로 "후두 인두 적출술 및 양측 경정맥 임파군 곽청술"(laryngopharyngectomy with bilateral jugular dissection) 또는 후두 인두 적출술 및 동측의 표준 광범위 경부 곽청술(standard radical neck dissection) 과 반대측의 경정맥 임파군 곽청술을 시행하였다. 3 년 이내와 3 년 이상무병 상태(free of disease) 경우가 각각 4명씩이었다. 마지막 예후 추적 조사시까지 무병 상태였던 환자를 포함하여 예후 추적 조사기간 중 추적 실패 경우는 7명이었다. 확정된 3 년 생존율(determinate 3-year survival rate) 은 31% 이었다. 수술 사망이 1명 있었으며 재발경우는 9 명이었다. 재발부위로는 원발병소 재발이 7명, 경부 재발 1명 및 원격전이가 1명 이었으며, 저자들은 이에 대한 실패 원인을 규명코져 하였다.