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Optimal timing for salvage surgery after definitive radiotherapy in hypopharyngeal cancer

  • Chun, Seok-Joo;Keam, Bhumsuk;Heo, Dae Seog;Kim, Kwang Hyun;Sung, Myung-Whun;Chung, Eun-Jae;Kim, Ji-hoon;Jung, Kyeong Cheon;Kim, Jin Ho;Wu, Hong-Gyun
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.192-199
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    • 2018
  • Purpose: Use of radiotherapy combined with chemotherapy is increasing in hypopharyngeal cancer. However, many show residual tumor after radiotherapy. Timing for treatment evaluation and salvage therapy is essential. However, optimal timing for salvage surgery has not been suggested. In this study, we tried to evaluate optimal timing for salvage surgery. Methods and Materials: Patients who were diagnosed with hypopharyngeal squamous cell carcinoma between 2006 and 2015 were retrospectively analyzed. All patients received definitive radiotherapy with or without chemotherapy. Response of all treated patients were analyzed at 1, 3, and 6 months after radiotherapy. Any patients with progression before 6 months were excluded. Results: A total of 54 patients were analyzed. Complete remission (CR) rates at 1 month (CR1), 3 months (CR3) and 6 months (CR6) were 66.7%, 81.5%, and 90.7%, respectively. Non-CR at 1 month (NCR1), 3 months (NCR3), and 6 months (NCR6) showed poor locoregional recurrence-free survival rates (1-year rates of 63.7%, 66.7%, and 0.0%, respectively) compared to CR1, CR3, and CR6 (1-year rates 94.3%, 88.0%, and 91.5%, respectively). Particularly significant differences were seen between CR6 and NCR6 (p < 0.001). Of 10 patients with NCR3, 5 showed CR at 6 months (NCR3/CR6). There was no statistical difference in locoregional recurrence-free survival between CR3 and NCR3/CR6 group (p = 0.990). Conclusion: Our data suggest half of patients who did not show CR at 3 months eventually achieved CR at 6 months. Waiting until 6 months after radiotherapy may be appropriate for avoiding additional salvage therapy.

Gene signature for prediction of radiosensitivity in human papillomavirus-negative head and neck squamous cell carcinoma

  • Kim, Su Il;Kang, Jeong Wook;Noh, Joo Kyung;Jung, Hae Rim;Lee, Young Chan;Lee, Jung Woo;Kong, Moonkyoo;Eun, Young-Gyu
    • Radiation Oncology Journal
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    • v.38 no.2
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    • pp.99-108
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    • 2020
  • Purpose: The probability of recurrence of cancer after adjuvant or definitive radiotherapy in patients with human papillomavirus-negative (HPV(-)) head and neck squamous cell carcinoma (HNSCC) varies for each patient. This study aimed to identify and validate radiation sensitivity signature (RSS) of patients with HPV(-) HNSCC to predict the recurrence of cancer after radiotherapy. Materials and Methods: Clonogenic survival assays were performed to assess radiosensitivity in 14 HNSCC cell lines. We identified genes closely correlated with radiosensitivity and validated them in The Cancer Genome Atlas (TCGA) cohort. The validated RSS were analyzed by ingenuity pathway analysis (IPA) to identify canonical pathways, upstream regulators, diseases and functions, and gene networks related to radiosensitive genes in HPV(-) HNSCC. Results: The survival fraction of 14 HNSCC cell lines after exposure to 2 Gy of radiation ranged from 48% to 72%. Six genes were positively correlated and 35 genes were negatively correlated with radioresistance, respectively. RSS was validated in the HPV(-) TCGA HNSCC cohort (n = 203), and recurrence-free survival (RFS) rate was found to be significantly lower in the radioresistant group than in the radiosensitive group (p = 0.035). Cell death and survival, cell-to-cell signaling, and cellular movement were significantly enriched in RSS, and RSSs were highly correlated with each other. Conclusion: We derived a HPV(-) HNSCC-specific RSS and validated it in an independent cohort. The outcome of adjuvant or definitive radiotherapy in HPV(-) patients with HNSCC can be predicted by analyzing their RSS, which might help in establishing a personalized therapeutic plan.

Molecular genetic characterization of multiple antimicrobial resistant Salmonella spp. isolated from pigs and cattle (소와 돼지유래 다제내성 Salmonella속 균의 분자유전학적 특성)

  • Lee, Woo-Won;Jung, Byeong-Yeal;Lee, Gang-Rok;Lee, Dong-Soo;Kim, Yong-Hwan
    • Korean Journal of Veterinary Service
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    • v.32 no.1
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    • pp.61-76
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    • 2009
  • At the present study, it was aimed to explore the molecular genetic characterization of multiple antimicrobial resistant Salmonella spp. isolates from pigs and cattle. A total of 138 Salmonella Typhimurium (S. Typhimurium) isolates were typed with phage, among them, 83.3% of S. Typhimurium tested could divide into a 10 phage types. Definitive type 193 (DT193) (25.4%) and DT195 (24.6%) were exhibited as the dominant types. DT104 and U302 were found from pigs and cattle. On the other hand, S. Enteritidis had 6 phage types, of them, phage type 21 (PT21) and PT11b were the popular types. In the plasmid profiles, 135 of S. Typhimurium isolates were exhibited 1 to 6 plasmid bands which molecular weight ranged from 90 to 2kb. 35 isolates (25.4%) harbored a 90kb plasmid which is thought to be the serotype specific virulence plasmid. Two of twenty five S. Enteritidis had common plasmids at 2 and 1.5kb. With multiplex polymerase chain reaction, virulence genes (invA and spvC) were detected from all Salmonella spp. from 167 of S. Typhimurium, S. Enteritidis and chloramphenicol resistant S. Schwarzengrund, but some drug resistant genes, such as PSE-1, cml/tetR and flo were not determined but other drug resistant genes, for example TEM and int were found. The detection rates of spvC, TEM and int gene was 35.3%, 29.3% and 72.5%, respectively. The TEM gene was highly popular in S. Typhimurium, which was detected from ampicillin and amoxicillin resistant strains as 95.9%. int gene was able to detect from all the isolates identified as multidrug resistsnt (MDR), particularly DT193 was thought as the most prevalent virulence and multidrug resistance isolate. The major plasmid profile and drug resistance pattern of DT193 were 90, 40, 10.5, 6.3, 3.0kb and ACCbDNaPSSuT, respectively. MDR was commonly found in other phage types, particularly DT104, U302 and DT203.

Apodemus agrarius as a new definitive host for Neodiplostomum seoulense

  • Chai, Jong-Yil;Park, Jae-Hwan;Guk, Sang-Mee;Kim, Jae-Lip;Kim, Hyo-Jin;Kim, Won-Hee;Shin, Eun-Hee;Klein, Terry A.;Kim, Heung-Chul;Chong, Sung-Tae;Song, Jin-Won;Baek, Luck-Ju
    • Parasites, Hosts and Diseases
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    • v.45 no.2 s.142
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    • pp.157-161
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    • 2007
  • A total of 1,496 rodents and insectivores were live-trapped at Yeoncheon-gun (n = 351), Paju-shi (804), and Pocheon-gun (343), Gyeonggi-do (Province), and examined for intestinal helminths, including Neodiplostomum seoulense, seasonally from December 2004 to September 2005. Six species of rodents, including Apodemus agrarius (1,366), Mus musculus (32), Micronytus fortis (28), Eothenomys regulus (9), Micronys minutus (6), and Cricetulus triton (3), and 1 species of insectivores Crocidura lasiura (54) were collected. A total of 321 adult N. seoulense were collected from 19 (1.4%) A. agrarius. The worm burden ranged from 1 to 101 per A. agrarius (mean; 16.9). No N. seoulense was observed in other rodent or insectivore species examined. The infection rate during autumn (4.5%) was higher than those during spring (0.8%), summer (0.8%), and winter (0.5%). The average number of N. seoulense in infected A. agrarius was the highest in spring (66.0 specimens), followed by autumn (15.2), winter (4.5), and summer (3.3). This study first confirms that A. agrarius is a natural definitive host for N. seoulense, and demonstrates that the infection rates and intensities vary seasonally and geographically.

Computer-aided design and manufacturing-based full mouth rehabilitation for a patient with excessive attrition and restricted vertical dimension: A case report (심한 치아 마모와 수복 공간 부족을 보이는 환자에서 CAD/CAM 기술을 활용한 완전 구강 회복: 증례 보고)

  • Cho, Jun-Ho;Yoon, Hyung-In;Yeo, In-Sung;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.495-505
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    • 2019
  • This study reported the treatment of a patient with excessive worn dentition and limited maxillo-mandibular space for restoration, utilizing the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. After the thorough examination of the patient's occlusal vertical dimension (OVD), full mouth rehabilitation was planned with increase of the OVD. The patient was satisfied with the provisional restorations establishing the increased OVD. The horizontal and vertical data of the patient's jaw relation that the provisional restorations contained were transferred to the definitive metal ceramic fixed prostheses by double scanning and three-dimensional printing. After the fixed restorations were cemented to the abutments, electronic surveying and three-dimensional printing were used to fabricate metal frameworks for the patient's removable partial dentures. The mandibular definitive removable prostheses were delivered to the patient's mouth and the full mouth rehabilitation procedures were completed. The digital technologies used for this case produced fixed and removable restorations satisfactory in masticatory, phonetic and aesthetic functions to both the patient and the dental clinician.

Application of various digital technique on full mouth rehabilitation: A case report (디지털 기술을 활용한 전악 고정성 보철 수복 증례)

  • Bae, Min-Soo;Song, Kwang-Yeob;Ahn, Seung-Geun;Park, Ju-Mi;Lee, Jung-Jin;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.43-54
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    • 2021
  • Based on rapid improvement in digital fields, many advanced digital technologies are utilized in prosthodontic treatment. Especially, intraoral scanners and 3D printing technology are commonly used, and facial scanning technology is recently being attempted to be part of these digital routines. This case report aims to introduce a digital procedure using the intraoral scanner, facial scanner, and 3D printing technology to create definitive restorations, which are esthetic and harmonious with patient's face. From thoroughly evaluated full-mouth provisional restoration which was manufactured and fitted conventionally, definitive prostheses were fabricated using various digital technique. Stable occlusion with functionally and aesthetically satisfying results were achieved.

Fabrication of removable partial denture on scleroderma patient using 3-dimensional intraoral scanner (전신성 피부경화증 환자에서의 3차원 구강스캐너를 이용한 가철성 국소의치 제작 증례)

  • Kim, Ung-Gyu;Han, Jung-Suk;Yoon, Hyung-In;Yeo, In-Sung Luke
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.116-125
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    • 2021
  • A three-dimensional (3D) intraoral scanner, which is one of the major developments in digital dentistry, is widely used in fixed prosthodontics. The application of intraoral scanner is now increasing in removable prosthodontics. Sclerotic change induced by scleroderma causes the limitation of mouth opening and multiple loss of the teeth. Conventional prosthodontic procedures are challenging for patients with this disease. This study showed a case of digital approach to the removable prosthodontic treatment of a patient who had the scleroderma and the consequent microstomia. At the provisional stage, the optical impression of patient's oral structures was digitally obtained. Using a 3D printer, the provisional dentures were fabricated. After extraction of hopeless tooth, the definitive digital impression was taken and the metal frameworks were fabricated, based on the data acquired from the impression. The definitive removable partial dentures were completed and delivered to the patient, who was satisfied with the prostheses.

Effect of milling and sintering process on integrity of zirconia prosthesis: a literature review (밀링과 소결과정이 지르코니아 보철물의 완성도에 미치는 영향에 관한 문헌고찰)

  • Lee, Kiun;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.3
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    • pp.127-137
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    • 2022
  • Zirconia is fabricated through various processes. Each element in fabricating process can affect the physical properties of the definitive prosthesis. In particular, both the milling process and the sintering process can affect the final integrity of the zirconia prosthesis. Most of the milling machines adopt the ultra-precision 5-axis machining method, and the results vary depending on which milling method was used and how the milling equipment was managed. Milling blocks are selected according to cutting efficiency and aesthetic reproducibility. The sintering method can affect the grain growth and optical properties, and an accurate evaluation can be made only with additional research on the recent speed sintering procedure. Not only the sintering temperature but also the temperature holding time can affect the quality of definitive prosthesis.

Fabrication of complete denture using digital technology in patient with mandibular deviation: a case report (하악 편위 환자에서 디지털 방식을 이용한 총의치 제작 증례)

  • Lee, Eunsu;Park, Juyoung;Park, Chan;Yun, Kwi-Dug;Lim, Hyun-Pil;Park, Sangwon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.34-41
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    • 2022
  • Recently, digital technology and computer-aided design/computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of dentures. The denture manufacturing method with CAD/CAM technology simplifies the treatment and laboratory process to reduce the occurrence of errors and provides clinical efficiency and convenience. In this case, complete dentures were fabricated using stereolithography (SLA)-based 3D printing in patient with mandibular deviation. Recording base were produced in a digital model obtained with an intraoral scanner, and after recording a jaw relation in the occlusal rim, a definitive impression was obtained with polyvinyl siloxane impression material. In addition, facial scan data with occlusal rim was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a Food and Drug Administration (FDA)-approved liquid photocurable resin. The denture showed adequate retention, support and stability, and results were satisfied functionally and aesthetically.

Fabrication of fixed prosthesis by employing functionally generated path technique and dual scan technique in a tardive dyskinesia patient: a case report (지연성 운동이상증 환자에서 functionally generated path 술식과 이중스캔법을 이용한 고정성 보철물 제작: 증례 보고)

  • Shilpa;Du-Hyeong Lee
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.3
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    • pp.227-233
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    • 2023
  • Tardive dyskinesia is an involuntary neurological movement disorder caused by long-term use of dopamine receptor-blocking drugs leading to dental implications like uncontrolled gnashing and grinding of teeth which in turn imperil the oral rehabilitation procedures as the excessive load increases the risk of prosthesis fracture. A 40-year male with a medical history of tardive dyskinesia visited the hospital to receive oral rehabilitation for missing maxillary anterior teeth. After the oral examination, tooth preparation was done on teeth 13, 15, and 23. After that silicon impression was made and the gypsum cast was digitalized using a desktop scanner and an interim prosthesis was fabricated by milling a resin block. During the try-in, the occlusal one-third of the interim prosthesis was trimmed, and an auto-polymerizing acrylic resin was applied on the occlusal surfaces and inserted in the patient's mouth. Then, the functionally generated path (FGP) of occluding surfaces of opposing arches was traced on the resin surface. When the resin was hardened, the modified interim prosthesis was removed and digitized using an intraoral scanner. The scan image was used in designing the occlusal morphology of definitive prosthesis by modifying the design of the interim prosthesis using the dual scan method. Lastly, a monolithic zirconia prosthesis was fabricated by milling a zirconia block. The definitive prosthesis was delivered reflecting the patient's occlusal scheme. This case report shows that the FGP technique with the dual scan method can help in fabricating fixed prosthesis with harmonious occlusion in a tardive dyskinesia patient.