• 대한두개안면성형외과학회지
• /
• 제17권2호
• /
• pp.56-62
• /
• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.

• 한국자기학회지
• /
• 제26권5호
• /
• pp.173-178
• /
• 2016

두경부와 전립선 암 환자에서 CT조영제가 방사선치료계획에 미치는 영향을 확인하고 선량계산 정확성 향상을 위하여 본 연구를 실시하였다. 30명의 환자에 대하여 Pinnacle 8.0 시스템을 이용하여 조영제에 의한 조직의 전자밀도 변화를 측정하였으며 각각의 방사선치료계획을 통한 선량계산을 실시하였다. Pinnacle과 Tomotherapy planning 시스템을 이용하여 각각의 전자밀도와 3D 입체조형방사선치료(3D CRT)와 세기변조방사선치료(IMRT)계획을 수립하였다. 조영제에 의한 전자밀도의 변화는 4%이하로 두경부: 표적용적 2.1%, 이하선 1.9%, 하악선 3.6%, 혀 0.9%, 척수 0.3%, 식도 2.6%, 하악골 0.1%, 전립선: 표적용적 0.7%, 림프절 1.1%, 방광 1.2%, 직장 1.5%, 소장 1.2%, 대장 0.6%, penile bulb 0.8%, 대퇴골두 -0.2%로 나타났다. 선량계산의 차이는 2.5% 이하의 선량 증가가 발생하였다(3D CRT: 두경부 0.69~2.51%, 전립선 0.04~1.14%, IMRT: 두경부 0.58~1.31%, 전립선 0.36~1.04%). 이러한 오차는 임상에서 허용 가능한 오차 이내이지만 영상융합(조영증강 영상과 조영증강 하지않은 영상)이나 ROI import 기능을 활용하여 조영 증강하지 않은 영상에서 선량계산을 실시한다면 1~3%의 방사선치료계획 선량 오차를 줄일 수 있을 것으로 기대된다.

• Archives of Reconstructive Microsurgery
• /
• 제5권1호
• /
• pp.80-91
• /
• 1996

A free rectus abdominis flap can include a variable amount of muscle length depending on recipient site requirements. There is also great flexibility in flap design in terms of size, orientation of its axis, and the level of its location over the muscle. It is safe to design the skin island across the midline. Though skin islands designed over the most inferior portion of the abdomen have not always proved reliable when based on the superior epigastric artery, free flaps based on the inferior pedicle can be successfully designed in this area. As free flap based on the inferior epigastric vessels, this flap has been useful for large head and neck defects following ablative procedures, for facial contour restoration as a buried flap, for upper extremity defects, for lower extremity defects such as coverage of grade III tibial fractures and for breast reconstruction. A free rectus abdominis muscle or myocutaneus flap was used in 8 patients. The operations were performed between Sep. of 1994 and April of 1996. The patients were tongue cancer 1 case, chronic facial palsy 1 case, unilateral breast reconstruction 1 case, upper and lower extremity injury 5 cases. The free rectus abdominis muscle flaps were 4 cases and the free myocutaneous flaps were 4 cases. There was no failure of the flap, except one partial necrosis. One case of the skin grafts on the muscle flap was regrafted. One case of reoperation due to venous thrombosis was performed. In tongue cancer patient, a orocutaneous fistula was occurred, but conservative treatment and secondandry skin graft were done. In conclusion, a free rectus abdominis flap has many advantages such as a long and constant pedicle, easy dissection, enough soft tissue available, scar on the donor site to be hiddened, no need for changing position. So we think that this flap is the most useful one for small or moderate sized defects on the various sites.

• Natural Product Sciences
• /
• 제26권1호
• /
• pp.28-49
• /
• 2020

The efficacy and side effects associated with anticancer drugs have attracted an extensive research focus. Onconephrology is an evolving field of nephrology that deals with the study of kidney diseases in cancer patients. Most renal diseases in cancer patients are unique, and management of renal disease can be challenging especially in the presence of continuing use of the nephrotoxic drugs. Cisplatin is one of the most important chemotherapeutic agents used in the treatment of various malignancies, such as head, neck, ovarian, and cervical cancers. The major limitation in the clinical use of cisplatin is its tendency to induce adverse effects, such as nephrotoxicity. Recently, plant-derived phytochemicals have emerged as novel agents providing protection against cisplatin-induced renal cytotoxicity. Owing to the diversity of phytochemicals, they cover a wide spectrum of therapeutic indications in cancer and inflammation and have been a productive source of lead compounds for the development of novel medications. Of these agents, the effectiveness of triterpenoids, isolated from various medicinal plants, against cisplatin-induced renal cytotoxicity has been reported most frequently compared to other phytochemicals. Triterpenes are one of the most numerous and diverse groups of plant natural products. Triterpenes ameliorate cisplatin-induced renal damage through multiple pathways by inhibiting reactive oxygen species, inflammation, down-regulation of the MAPK, apoptosis, and NF-κB signaling pathways and upregulation of Nrf2-mediated antioxidant defense mechanisms. Here, we reviewed recent findings on the natural compounds with protective potential in cisplatin-induced renal cytotoxicity, provided an overview of the protective effects and mechanisms that have been identified to date, and discussed strategies to reduce renal cytotoxicity induced by anticancer drugs.

• The Journal of Advanced Prosthodontics
• /
• 제8권3호
• /
• pp.229-234
• /
• 2016

PURPOSE. The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS. This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS. Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION. The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required.

• Imaging Science in Dentistry
• /
• 제36권3호
• /
• pp.151-155
• /
• 2006

Purpose : Stroke is one of the leading causes of death in Korea. Atherosclerotic disease in the carotid artery bifurcation is the most common cause of stroke. The carotid artery calcification is easily appreciated by CT (Computed tomography). CT is often taken in a dental hospital for the diagnosis of inflammation, injury, cyst or tumor on maxillofacial region. However, there was no report of carotid artery calcification on CT in dental patients. This study was to determine the prevalence of carotid artery calcification on CT in dental patients. Materials and Methods : The presence of carotid artery calcification was evaluated by an experienced radiologist on CT scans of 287 patients (166 males, 121 females, average age 42, range 6 to 86 years) and the medical history of the patient and the interpretation of CT were reviewed. Results : Carotid artery calcification was detected on CT scans of 57 patients (19.8%; 35 males, 22 females). All the male patients with carotid artery calcification were older than 50, and all the female patients with carotid artery calcification were older than 60. Among the 57 patients, 10 had Diabetes mellitus, 20 had cardiovascular disease, 3 had history of stroke and 3 underwent radiation therapy for head and neck cancer. Carotid artery calcification was not included in the interpretation of CT of dental patients except one patient. Conclusion : The prevalence of carotid artery calcification on CT of dental patients was about 20% in this study. Carotid artery calcification should be included in the interpretation of CT of dental patients.

• 대한두경부종양학회지
• /
• 제14권1호
• /
• pp.27-34
• /
• 1998

Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases. Results: The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy. Conclusion: Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

• 대한핵의학회지
• /
• 제30권3호
• /
• pp.325-331
• /
• 1996

$^{99m}Tc$-pertechnetate를 이용하여 두경부암 환자에서 이하선과 악하선의 방사선 조사 전후 및 추적 검사에서 방사선 조사로 인한 타액선의 기능 변화, 기능저하의 회복 여부, 이하선과 악하선의 방사선에 대한 감수성 차이, 그리고 구강건조증이 있던 환자와 없던 환자 사이의 기능 저하 차이를 객관적으로 평가하고자 하였다. 방사선 치료를 받는 두경부암 환자중 방사성 동위원소를 이용하여 이하선과 악하선 기능 검사를 시행한 19명의 환자를 대상으로 하였다. $^{99m}Tc$-pertechnetate를 이용한 이하선과 악하선 기능 검사는 측정된 방사능치에 의한 섭취 곡선과 구연산으로 자극하였을 때의 평균 배출율에 의한 배출 곡선을 포함하였다. 이하선과 악하선의 섭취 곡선에서는 방사선 치료전보다 치료 1주후에서 증가하였고 치료 2주후와 3주후 그리고 치료 종료시에서는 치료 전과 비슷하거나 약간 증가하였으며 방사선 치료 후에서는 시간이 지날수록 점점 감소하였다. 이하선과 악하선의 배출 곡선에서는 방사선 치료 시작부터 종료시까지는 급격히 감소하였고 방사선 치료 후 1년까지의 검사에서는 배출율이 회복되지 않았다. 이하선과 악하선의 방사선에 대한 감수성 차이는 나타나지 않았고 구강건조증을 호소하는 환자와 호소하지 않는 환자 사이의 이하선과 악하선의 평균 배출율 차이는 발견되지 않았다. $^{99m}Tc$-pertechnetate를 이용한 이하선과 악하선기능 검사로 방사선 치료에 따른 이하선과 악하선의 기능 변화를 객관적으로 평가할 수 있고, 방사선 치료후 1년까지는 이하선과 악하선의 기능 회복이 없어 방사선 치료를 받은 두경부암 환자의 타액선 기능에 관한 예후추정에 도움이 되리라 사료된다.

• Molecules and Cells
• /
• 제41권6호
• /
• pp.515-522
• /
• 2018

Patients with head and neck cancer are treated with therapeutic irradiation, which can result in irreversible salivary gland dysfunction. Because there is no complete cure for such patients, stem cell therapy is an emerging alternative for functional restoration of salivary glands. In this study, we investigated in vitro characteristics of primarily isolated epithelial cells from human salivary gland (Epi-SGs) and in vivo formation of acini-like structures by Epi-SGs. Primarily isolated Epi-SGs showed typical epithelial cell-like morphology and expressed E-cadherin but not N-cadherin. Epi-SGs expressed epithelial stem cell (EpiSC) and embryonic stem cell (ESC) markers. During long-term culture, the expression of EpiSC and ESC markers was highly detected and maintained within the core population with small size and low cytoplasmic complexity. The core population expressed cytokeratin 7 and cytokeratin 14, known as duct markers indicating that Epi-SGs might be originated from the duct. When Epi-SGs were transplanted in vivo with Matrigel, acini-like structures were readily formed at 4 days after transplantation and they were maintained at 7 days after transplantation. Taken together, our data suggested that Epi-SGs might contain stem cells which were positive for EpiSC and ESC markers, and Epi-SGs might contribute to the regeneration of acini-like structures in vivo. We expect that Epi-SGs will be useful source for the functional restoration of damaged salivary gland.

• Archives of Plastic Surgery
• /
• 제46권5호
• /
• pp.441-448
• /
• 2019

Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. Methods We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. Results Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a splitthickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. Conclusions We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.