• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.169-173
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• 2001

Objectives: The p53 tumor suppressor gene encodes a nuclear transcription factor that is critical regulator of cell growth and proliferation through its action in cell-cycle checkpoint control. The wide variety of stressful stmuli which include DNA damage, hypoxia, heat shock, metabolic changes activate the p53 protein, which in turn drives a series of events that culminate either in cell cycle arrest or apoptosis. Mutations of the p53 gene is the most common genetic alteration in human cancer. This gene is altered in approximately 40-60% of head and neck cancers. Whereas the wild-type form of the p53 protein plays a central role in cell-cycle control in response to DNA damage, most of the mutant forms are unable to do so. The high levels of p53 protein expression in tissues are related to the increased cellular proliferative activity and may be associated with the poor clinical outcome. To determine whether the expression of the p53 protein has prognostic significance and is associated with patterns of treatment failure in head and neck squamous cell carcinoma (HNSCC), We analyzed p53 overexpression in 40 cases of HNSCC. Materials and Methods: Immunohistochemical analysis with a monoclonal antibody (DO7) specific for p53 protein was used to detect expression of the protein in formalin-fixed, paraffin-embedded tumor samples from 40 HNSCC. We evaluated p53 protein expression and analyzed the relationship between the p53 overexpression and age, sex, primary tumor site, stage, survival rate, recurrence. All reported P values resulted from two-sided statistical tests. Results: Overexpression of p53 was detected in 20 cases(50%) among 40 cases of HNSCC. The p53 overexpression was not associated with age, sex, primary tumor site, stage, recurrence and survival rate. Conclusions: In our results, p53 was not significant prognostic factor in HNSCC. Based on many previous studies, It is evident that p53 has a certain role in tumorigenesis of HNSCC. So, the further study is needed to evaluate the prognostic significance of p53 in HNSCC.

• Radiation Oncology Journal
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• v.38 no.1
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• pp.18-25
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• 2020

Purpose: This study was aim to evaluate the patterns of failure according to radiotherapy (RT) target volume for cervical lymph nodes in metastases of unknown primary origin in head and neck region (HNMUO). Materials and Methods: Sixty-two patients with HNMUO between 1998 and 2016 were retrospectively reviewed. We analyzed the clinical outcomes and primary site failure depending on the radiation target volume. The target volume was classified according to whether the potential head and neck mucosal sites were included and whether the neck node was treated involved side only or bilaterally. Results: Potential mucosal site RT (mucosal RT) was done to 23 patients and 39 patients did not receive mucosal RT. Mucosal RT showed no significant effect on overall survival (OS) and locoregional recurrence (LRR). The location of primary site failure encountered during follow-up period was found to be unpredictable and 75% of patients with recurrence received successful salvage therapies. No significant differences in OS and LRR were found between patients treated to unilateral (n = 35) and bilateral neck irradiation (n = 21). Treatment of both necks resulted in significantly higher mucositis. Conclusions: We found no advantages in OS and LRR of patients with HNMUO when mucosal sites and bilateral neck node were included in the radiation target volume.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.360-364
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• 2005

The anterolateral thigh flap was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral circumflex artery. This flap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous flap, or a myocutaneous flap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a 2-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because flap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to classify the vascular anatomy and to assess the suitability of anterolateral thigh flap for head and neck reconstruction in Korean. We performed an anatomic study on cadavers and analyzed the anatomic pattern of the lateral circumflex femoral arterial system and the perforators nourishing the anterolateral thigh flap. This study suggest the characteristics of vascular anatomic patterns of anterolateral thigh flap of Korean and utility of this flap for head and neck reconstruction.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.198-203
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• 2018

Background and Objectives : Pediatric orbital blowout fractures occur in discreet patterns, in reference to the characteristic developmental anatomy of the facial skeleton at the time of injury. The purpose of this study was to investigate the clinical characteristics, ocular symptom, fracture type and postoperative results of orbital blowout fractures in the pediatric population. Material and Methods : A retrospective study was conducted from January 2009 to June 2015 in 116 patients with orbital floor fractures ; all less than 18 years old. Patients were divided into 3 groups by age : 0 to 6, 7 to 12, and 13 to 18 years of age. The cause of fracture, fracture site and type, preoperative and postoperative ocular symptoms, timing of surgery were reviewed from their records. Results : Medial wall fractures were the most common site in the 0 to 6 years old group, and floor fractures were the most common site in other age groups. However, floor fracture was the most common site of the need for surgery in all age groups. Trapdoor type of fractures occurred more frequently than open door type of fractures in all age groups. Preoperative symptoms did not differ among the 3 age groups. In case of need surgery, frequency of preoperative ocular symptoms increased with age. However, as age group was young, rate of residual postoperative ocular symptoms were increased. Conclusions : The younger patients are more to have trapdoor type fracture and residual postoperative ocular symptom. Earlier surgical intervention more needed for children with entrapment results.

• Journal of Rhinology
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• v.25 no.2
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• pp.80-85
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• 2018

Background and Objectives: Obesity is one of the most important risk factors for obstructive sleep apnea (OSA). There is limited evidence regarding the obesity-related anthropometric characteristics of Korean patients. Materials and Method: Medical records of 984 patients referred to 3 tertiary referral hospitals for habitual snoring or sleep apnea were analyzed. We defined OSA as apnea-hypopnea index (AHI) ${\geq}5$ and analyzed data to determine the anthropometric characteristics of patients with OSA such as neck circumference (NC), waist circumference (WC), hip circumference (HC), and waist to hip ratio (WHR). Results: A total of 952 patients (719 men) were included in the analysis. The main findings were: 1) BMI, WC, NC, HC, and WHR were greater among patients with OSA than among controls (AHI <5); 2) for both sexes, the proportion of patients with an OSA diagnosis increased with age; it increased steeply for women aged >50 years; 3) WC and WHR were most strongly correlated with AHI for men and women, respectively. Conclusion: OSA is associated with anthropometric characteristics, although different patterns were observed between men and women. OSA was more strongly associated with NC or WC among men and with WHR among women.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.60 no.3
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• pp.107-111
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• 2017

Background and Objectives The bedside head impulse test (bHIT) in bare eyes often overlooks possible vestibular losses by missing the corrective saccade. This is why it is necessary to compare bHIT against video head impulse test (vHIT), which is more accurate in identifying vestibular losses than the bedside test. Subjects and Method A total of 51 vHIT positive ears underwent the study, and out of those, 47 were diagnosed with dizziness. bHIT and vHIT were performed for patients, and the occurrence rate of overt saccade (OS) was calculated. Results Among the 51 vHIT positive ears, 33 (64.7%) were bHIT positive ears and 18 ears (35.3%) were bHIT negative. Patterns of positive vHIT were classified as A: no corrective saccade, B: covert saccade (CS) only, C: OS only, and D: CS with OS (CS+OS), which were 45 out of 51 ears (88%). The occurrence rate of OS was higher in the bHIT positive group than in the bHIT negative group (p=0.05), and higher in the CS negative group (CS-) than in the CS positive group (CS+) (p<0.001). Conclusion Possible causes of false negative results of bHIT are seen as following: the absence of corrective (covert and overt) saccade, the occurrence of CS only, and missing the OS during the bHIT (probably due to low occurrence rate of OS). The occurrence of CS should be considered as an important factor in false negative bHIT when lowering the occurrence rate of OS.

• Journal of Mechanical Science and Technology
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• v.17 no.1
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• pp.32-39
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• 2003

In this study we examined connections between vertebral motion and patterns of muscle activation during voluntary head tracking movements. A Rhesus (Maraca mulatta) monkey was trained to produce sinusoidal tracking movements of the head in the sagittal plane while seated. Radio-opaque markers were placed in the cervical vertebrae, and intramuscular patch electrodes were implanted to record from eight neck muscles. Videofluoroscopic images of cervical vertebral motion, and EMG (electromyographic) responses were simultaneously re-corded. Experimental results demonstrated that head and vertebrae moved synchronously and that motion occurred primarily at skull-C$_1$, C$\_$6/-C$\_$7/ and Csub 7/-C$_1$. Our findings illustrate that although the biomechanical constraints of each species may limit the number of solutions available, it is the task requirements that appear to govern CNS (central nervous system) selection of movement behaviors.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.64-70
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• 2022

Background: Anterolateral thigh (ALT) flaps are versatile soft tissue flaps that have become the standard soft-tissue flaps used for head and neck reconstruction. They provide a long vascular pedicle, constant vessel diameter, abundant soft tissue coverage, and minimal donor site morbidity. The ALT flap was initially designed on the basis of a septocutaneous (SC) perforator. However, more recent research has shown that a substantial number of ALT flaps are now based on musculocutaneous (MC) perforators, and the ratio between MC and SC perforators varies among studies. In this study, we analyzed the perforating pattern of ALT flaps along with their clinical outcomes during head and neck reconstruction in the Korean population. Methods: From October 2016 to July 2020, 68 patients who had undergone an ALT flap procedure for head and neck reconstruction were enrolled retrospectively. The perforating pattern of the cutaneous perforator vessel (MC perforator/SC perforator/oblique branch), pedicle length, and flap size were analyzed intraoperatively. Patient demographics and flap necrosis rates were also calculated. Results: The highest number of cutaneous perforator vessels supplying the ALT flap were the MC perforators (87%). The proportion of MC perforators was significantly higher than that of the SC perforators and oblique branches. Flap necrosis occurred in seven cases (11.86%); sex, hypertension, diabetes mellitus, coronary artery disease, perforator course, and history of radiotherapy did not significantly affect flap necrosis. Conclusion: The ALT free flap procedure remains popular for reconstruction of the head and neck. In this study, we observed that the majority of cutaneous vessels supplying the flaps were MC perforators (87%). When using the MC perforator during flap elevation, careful dissection of the perforator is required to achieve successful ALT flaps because intramuscular dissection is difficult. Perforator pattern and history of radiotherapy did not affect flap necrosis.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.21-28
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• 2010

Purpose: The purpose of this study was to investigate the kinematic adaptation of head and trunk to ascend stairs and a ramp. Subjects were healthy young adults. Three-dimensional kinematic patterns of head and trunk movements were examined during stair climbing and steeper ramp climbing. Methods: Fourteen young subjects with no history of chronic or acute musculoskeletal, cardiovascular or respiratory disorders took part in this experiment. Kinematic data were collected using a 6 camera Vicon system (Oxford Metrix, Oxford, England). Repeated measures ANOVA analyses were used to investigate the effect of gait mode on kinematics of the head and trunk. Results: The angle of the trunk while ascending stairs or a ramp was modified in three human planes (p<0.05). The angle of head and neck during the ascending of stairs or a ramp was not changed in the sagittal plane but was changed in the frontal and transverse planes (p<0.05). Conclusion: This study describes and discusses some basic kinematic mechanisms underlying the pattern of head and trunk changes during stair and ramp climbing and showed that postural adaptation of the head and trunk is necessary to maintain balance.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3949-3953
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• 2012

Head and neck cancers are amongst the commonest malignancies, accounting for approximately 20% of the cancer burden in India. The major risk factors are tobacco chewing, smoking and alcohol consumption, which are all preventable. This retrospective study presents data from the histopathology register for a five year period from 2002-2006 at Patna Medical College and Hospital, a tertiary care hospital drawing patients from the entire Bihar state, the 3rd most populous state of India with the majority of the population residing in rural areas. Incidence rates based on sex, age, site of lesion, including age standardized incidence rates for males and females, with mean age of presentation, distribution of histological variants and year wise trend were calculated. Out of 455 head and neck neoplasias, 241 were benign while 214 were malignant. The most common age group for all malignant biopsies was 7th decade for males and the 5th decade for females. Malignant cases were commoner in males than females with the male:female ratio of 3.1:1, which was found to be statistically significant by the chi-square (${\chi}^2$) test. The crude rate and age standardized incidence rate was 0.05 and 0.06 per 100,000 population respectively. Squamous cell carcinoma (SCC) contributed about 96% of all cases, with grade I being the most common. Larynx was the most common site for malignancy, the supraglottic region being its most commonly affected sub-site. This observed incidence patterns in the region are a reminder of widespread unawareness, low healthcare utilization with virtually non-existent cancer programs. It also underlines the need to advocate for reliable cost-effective programs to create awareness, for early detection and plan appropriate management strategies. There is a compelling demand for a cancer registry in this region as well as proper implementation of preventive measures to combat this growing threat of cancer, many of whose risk factors are preventable.