• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.503-508
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• 1998

Background: Tuberculous cervical lymphadenitis is one of the common causes of cervical mass in adult (especially in woman) in korea. Sometimes it appears to be difficult in defining the role of surgery and duration of antituberculous chemotherapy. Method: To clarify the proper duration and/or combination of regimens, we analyzed the clinical data of 31 patient with cervical lymphadenitis diagnosed at Chungnam National University Hospital from March 1996 to December 1996 and all patients were prospectively randomized into two groups(2HREZ/4HRE and 6HREZ) by treatment method. Result: Prevalent age, male to female ratio, association with pulmonary tuberculosis and history of previous antituberculous medication were not statistically different between two groups. The average size of the largest lymph node before teatment was $2.43{\pm}0.98cm$ and $3.15{\pm}1.74cm$, respectively and was 0.63cm and 0.6cm after treatment, respectively. In both groups, 2 patients have engrowing node or not changed node during tratment and no recurrence was found during follow up period upto 12 months. In both groups, no significant side reaction resulting in discotinuation or changing the regimens was noticed. Conclusion: Short course antituberculosis therapy(2HREZ/4HRE) could be recommanded as effective standard therapy for superficial lymph node tuberculosis. Longterm follow up at least 36 months to observe recurrence might be needed to confirm this conclusion.

• Tuberculosis and Respiratory Diseases
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• v.65 no.1
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• pp.52-56
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• 2008

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. Since Brincker first noted a statistically significant increase of malignant tumors among sarcoidosis patients, there have been several reports on simultaneously developed sarcoidosis and malignancy. A 30-year-old man was admitted to our hospital because of multiple enlarged mediastinal lymph nodes. The patient had been well until approximately 10 days before admission, when he developed a cough. Chest X-ray and computed tomography (CT) of the chest that were performed at the outpatient department revealed multiple enlarged mediastinal lymph nodes. Cervical lymph node biopsy revealed both non-caseating granuloma and metastatic papillary carcinoma, whereas the mediastinal lymph node showed only non-caseating granuloma. The thyroid gland surgical specimen showed papillary carcinoma. We report here on a case of a 30-year-old man who had sarcoidosis and thyroid cancer, and we include a review of the literature.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6227-6232
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• 2014

Background: Oral squamous cell carcinoma (OSCC) remains as one of the most difficult malignancies to control because of its high propensity for local invasion and cervical lymph node dissemination. The aim of present study was to evaluate the efficacy of novel pH and temperature sensitive doxorubicin-methotrexate-loaded nanoparticles (DOX-MTX NP) in terms of their potential to change the VEGF-C expression profile in a rat OSCC model. Materials and Methods: 120 male rats were divided into 8 groups of 15 animals administrated with 4-nitroquinoline-1-oxide to induce OSCCs. Newly formulated doxorubicin-methotrexate-loaded nanoparticles (DOX-MTX NP) and free doxorubicin were IV and orally administered. Results: Results indicated that both oral and IV forms of DOX-MTX-nanoparticle complexes caused significant decrease in the mRNA level of VEGF-C compared to untreated cancerous rats (p<0.05). Surprisingly, the VEGF-C mRNA was not affected by free DOX in both IV and oral modalities (p>0.05). Furthermore, in DOX-MTX NP treated group, less tumors characterized with advanced stage and VEGF-C mRNA level paralleled with improved clinical outcome (p<0.05). In addition, compared to untreated healthy rats, the VEGF-C expression was not affected in healthy groups that were treated with IV and oral dosages of nanodrug (p>0.05). Conclusions: VEGF-C is one of the main prognosticators for lymph node metastasis in OSCC. Down-regulation of this lymph-angiogenesis promoting factor is a new feature acquired in group treated with dual action DOX-MTX-NPs. Beside the synergic apoptotic properties of concomitant use of DOX and MTX on OSCC, DOX-MTX NPs possessed anti-angiogenesis properties which was related to the improved clinical outcome in treated rats. Taking together, we conclude that our multifunctional doxorubicin-methotrexate complex exerts specific potent apoptotic and anti-angiogenesis properties that could ameliorate the clinical outcome presumably via down-regulating dissemination factor-VEGF-C expression in a rat OSCC model.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.402-410
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• 2009

Purpose: The aim of this study was to determine the incidence and malignant rate of incidental asymmetric palatine tonsillar uptake (ATU) on $^{18}F$-FDG PET/CT in various clinical indications and to evaluate the clinical and PET/CT findings suggesting malignancy. Materials and Methods: We retrospectively reviewed a total of 2,901 patients ($58.4{\pm}12.3$ yrs, range 20~88 yrs, M:F = 1,841:1,060) who underwent $^{18}F$-FDG PET/CT during an 1-year period with various indications except primary tonsillar cancer and lymphoma evaluation. On $^{18}F$-FDG PET/CT, metabolic abnormality of the palatine tonsil and cervical lymph node were visually assessed. ATU was defined as increased palatine tonsillar uptake with diffuse, focal, or irregular pattern compared to contralateral side. The incidence and malignant ratio of ATU were evaluated according to clinical and PET/CT findings. Results: Of 2,901 cases, 290(10,0%) showed ATU. The incidence of ATU showed seasonal variation and was high in the winter (12.1%). Of 209 cases with ATU confirmed pathologically and/or clinically, five (2.4%) were malignant lesions. ATU with irregular uptake pattern (2/2) and in cases referred for cervical lymph node metastasis of unknown origin (3/5) were frequently associated with malignant lesion (p<0.05). Conclusion: ATU was not infrequently observed on $^{18}F$-FDG PET/CT, and the malignant risk of ATU was low. However, ATU with cervical lymph node metastasis or with irregular pattern on PET/CT would be further evaluated by the histopathologic examination.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.544-550
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• 2010

Purpose: The result of all malignant neoplasms including oral cancer is decided by long-term prognosis. However, until now, there are only a few reports about long-term prognosis of cancer secluded in the oral cavity. So, we investigated all patients that visited our clinic for oral squamous cell carcinoma (SCCa) for the last 10 years. From this survey, we hope to find important factors that influence prognosis of the disease. Patients and Methods: A retrospective study was performed for patients that visited the oral oncology clinic for oral cancers from Jan. 2001 to Feb. 2010. We selected the patients that were diagnosed with SCCa and received curative treatment. In these patients, we investigated basic epidemiology, smoking history, body mass index, recurrence rate, treatment methods, pathologic data and 5-yr survival rate. Results: There was a total of 185 patients (115 males, 70 females and mean age: 57.3 years) that visited the oral oncology clinic for oral SCCa. Areas of primary lesion were tongue (105 cases, 57%), lower gum (19 cases, 10%), floor of mouth (16 caess, 8%), retromolar trigone (12 cases, 6.5%), and buccal cheek (11 cases, 6%). Other involved areas were upper gum, palate, lip, and salivary glands-of 1 case each. The overall 5-year survival rate was 63.7%. The factors that influenced prognosis of the disease were stage of the disease, status of differentiation, recurrence, metastasis of cervical lymph node and age. Conclusion: The factors that influence prognosis of disease are stage of the disease, status of differentiation, recurrence, metastasis of cervical lymph node and age. To point out a current trend, the mean age of patients that developed oral cancer was lower than that of before. Secondly, the prevalence of oral cancer in non-smoker are on the rise. Thus, further studies on etiology and epidemiology should be done.

• Radiation Oncology Journal
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• v.29 no.3
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• pp.174-180
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• 2011

Purpose: To evaluate the radiotherapy treatment outcome of patients in stage IE and IIE nasal natural killer/T-cell lymphoma. Materials and Methods: From August 1999 to August 2009, 46 patients with stage IE and IIE nasal natural killer/T-cell lymphoma were treated by definitive radiotherapy and chemotherapy. 33 patients were treated with chemotherapy followed by radiotherapy (CT + RT) and they received 50.4 Gy in 28 fractions. 13 patients were treated with concurrent chemoradiotherapy (CCRT) and they received 40 Gy in 20 fractions. Results: The median follow-up period was 4.6-137.6 months (median, 50.2 months) for all patients. The 4-year overall survival was 68.6% and 4-year disease free survival (DFS) was 61.9%. The 4-year locoregional recurrence free survival was 65.0%, and 4-year distant metastasis free survival (DMFS) was 66.2%. For patients treated with CT + RT, 15 patients (45.5%) achieved complete response after chemotherapy, and 13 patients (39.4%) achieved partial response. 13 patients (81.8%) achieved complete response after radiotherapy, and 6 patients (18.2%) achieved partial response. For patients treated with CCRT, 11 patients (84.6%) achieved complete response, and one patient (7.7%) achieved partial response. In univariate analysis, presence of cervical lymph node metastasis was only significant prognostic factor for DFS and DMFS. Conclusion: This study did not show satisfactory overall survival rate and disease free survival rate of definitive radiotherapy and chemotherapy for stage IE and IIE nasal natural killer/T-cell lymphoma. For patients with cervical lymph node metastasis, further investigation of new chemotherapy regimens is necessary to reduce the distant metastasis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.4
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• pp.212-220
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• 2012

Objectives: Fluorine-18 fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET) is a non-invasive diagnostic tool for many human cancers wherein glucose uptake transporter-1 (GLUT-1) acts as a main transporter in the uptake of $^{18}F$-FDG in cancer cells. Increased expression of glucose transporter-1 has been reported in many human cancers. In this study, we investigated the correlation between $^{18}F$-FDG accumulation and expression of GLUT-1 in oral cancer. Materials and Methods: We evaluated 42 patients diagnosed with oral squamous cell carcinoma (OSCC) and malignant salivary gland tumor as confirmed by histology. 42 patients underwent pre-operative $^{18}F$-FDG PET, with the maximum standardized uptake value ($SUV_{max}$) measured in each case. Immunohistochemical staining was done for each histological specimen, and results were evaluated post-operatively according to the percentage (%) of positive area, intensity, and staining score. Results: For OSCC, $SUV_{max}$ significantly increased as T stage of tumor classification increased. For malignant salivary gland tumor, $SUV_{max}$ significantly increased as T stage of tumor classification increased. For OSCC, GLUT-1 was expressed in all 36 cases. GLUT-1 staining score (GSS) increased as T stage of tumor classification increased, with the difference statistically significant. For malignant salivary gland tumor, GLUT-1 expression was observed in all 6 cases; average GSS was significantly higher in patients with cervical lymph node metastasis than that in patients without cervical lymph node metastasis. Average GSS was higher in OSCC ($11.11{\pm}1.75$) than in malignant salivary gland tumor ($5.33{\pm}3.50$). No statistically significant correlation between GSS and $SUV_{max}$ was observed in OSCC or in malignant salivary gland tumor. Conclusion: We found no statistically significant correlation between GSS and $SUV_{max}$ in OSCC or in malignant salivary gland tumor. Studies on the various uses of GLUT during $^{18}F$-FDG uptake and SUV and GLUT as tumor prognosis factor need to be conducted through further investigation with large samples.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.164-168
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• 1998

Background: Supraglottis and glottis have a different embryologic origin. Supraglottic cancer is characterized by high incidence of cervical lymph node metastasis at initial diagnosis, and favored surgical management of the early supraglottic cancer was partial supraglottic laryngectomy, however the procedure resulted in frequent incidences of postsurgical aspiration and voice disabilities. Objectives: We retrospectively analyzed the problems and the advantages of the endoscopic laser assisted supraglottic partial laryngectomy as a part of surgical management for early supraglottic cancer. Materials and Methods: During the past nine years 25 cases of supraglottic cancer(Tl 10 cases, T2 15 cases) were treated by tracheotomy and laser assisted supraglottic partial laryngectomy(KTP532, 15 Watt, continuous type) and in 10 cases with cervical lymph node metastasis, they were additionally managed by neck dissection one week later, and all cases received postoperative irradiation therapy. Results: At present, 19 cases are alive with no evidence of disease. During the follow up period total of six cases(primary failure: three cases, nodal failure: three cases) were recurred. In relation to tumor staging, One of the 10 Tl cases and two of the 15 T2 cases recurred showing 88% locoregional recurrence rate for early supraglottic cancer. Postoperative com-plication included bleeding in three cases who were controlled by electrocautery under general anesthsia, one case of longstanding aspiration and two cases of laryngeal stenosis as a delayed complication. Conclusion: High control rate suggests that the endoscopic laser assisted supraglottic partial laryngectomy may be a good initial management method for early supraglottic cancer, however it is difficult to determine the resection margin, therefore, accurate tumor staging must be done prior to surgery. In order to prepare for postoperative bleeding, edema and aspiration, the tracheotomy must be performed prior to surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4271-4275
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• 2015

Objectives: To investigate the expression of vimentin and Ki-67 proteins in cervical squamous cell carcinoma (CSCC) and their relationships with patient clinicopathological features. Materials and Methods:Fifty-seven CSCC samples archived in Department of Pathology in the First Affiliated Hospital of Wenzhou Medical University were selected. The expression of vimentin and Ki-67 proteins in CSCC tissue were detected using immunohistochemical SP method, and correlations between them and their relationships with clinicopathological features were analyzed. Results: Among 57 CSCC tissues, there were 43 with positive expression of Vimentin, and the positive rate was 75.4%; there were 57 cases with positive expression of Ki-67, and the positive rate came up to 100.0%. The results of Pearson correlation analysis displayed that the expression of vimentin had a significantly-positive correlation with Ki-67 in CSCC tissue (r=0.984, co0.000). The expression of both Ki-67 and vimentin was intimately associated with the presence or absence of local invasion and lymph node metastasis as well as differentiated degrees of the tumor (P=0.003, 0.017, 0.000; P=0.001, 0.008, 0.003) instead of the age, tumor size and clinical staging (P>0.05). Conclusions: Epithelial-mesenchymal transition (EMT) tends to appear in poorly-differentiated CSCC tissue, and the up-regulation of vimentin expression is accompanied by high expression of Ki-67, suggesting that invasion and metastasis readily occur in these tumor cells.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.