• 대한치과기공학회지
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• 제44권1호
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• pp.24-30
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• 2022

This research introduces the manufacturing process of the metal-framework of one of the maxillary partial dentures, the "obturator", using milling wax-blocks, for patients with palate loss due to oral cancer. It explains the protocol of taking the patient's oral impression, preparation of a working cast, scanning, designing using a computer-aided design program, investing the milling wax-blocks, and completing the obturator. This method does not follow the traditional wax and agar process thereby reducing the errors arising during the manufacturing process and decreasing the time, material, and labor required. Moreover, the retention, stability, and compatibility of the metal framework were observed to be high in both the working cast and oral cavity.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권2호
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• pp.136-142
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• 2004

Malignant fibrous histiocytoma(MFH) is the malignant part of mesenchymal cell-originated tumor, which is supposed that the tumor is presented various histologic features consisted of fibrosarcomatic and histiocytic portions. When the tumor is arisen in the head and neck region, the most affected sites are the nasal cavity and paranasal sinuses, and secondly the maxillary alveolar bone is occasionally influenced. Therefore, MFH can readily involve the adjacent alveolar bone. The treatment of MFH in the head and neck is various, that is, the involved sites and the differentiation of tumor must be considered when the tumor is treated. The treatment protocols are subjected to general ones of soft tissue sarcoma, and simple or combination therapy is used in the surgery, chemotherapy and radiation therapy. So, we report a clinical case of chemotherapy involving intraarterial chemotherapy, and surgery of malignant fibrous histiocytoma(MFH) in the maxilla, with review of the literature.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.4957-4961
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• 2014

Background: Head and neck cancer without distant metastases is amenable to various modalities of treatment. However, the stage at presentation is a very important determinant for treatment success. The present study was conducted to determine the stage-wise presentation of non-metastatic head and neck cancer patients from the hilly regions in Kumaon division of Uttarakhand, India. Materials and Methods: The hospital records for non-metastatic head and neck cancer patients from the only functional cancer centre of the region for the period of two-years (January 2012-December 2013) were included. Nasopharyngeal carcinoma was excluded due to its staging system being different. Non-squamous histopathologies were also excluded. Patients hailing from nearby regions of Uttar Pradesh and Nepal were excluded, as were patients from non-hilly regions of Kumaon. Results: Of the 271 patients of head and neck cancer, 27 with distant metastases at diagnosis were excluded from the analysis. Of the 244 eligible patient records, 90.1% (n=222) were male, and 9.9% (n=22) were female. The proportions of patients with carcinoma of the larynx, oropharynx, oral cavity, hypopharynx and maxillary antrum were 31.9% (n=78), 27.9% (n=68), 20.5% (n=50), 12.7% (n=31) and 1.2% (n=3). A further 5.7% (n=14) were diagnosed as having secondary involvement of neck nodes with unknown primaries. The proportion of patients presenting in stages I, II, III, IVA and IVB were 0.8% (n=2), 2.5% (n=6), 9.4% (n=23), 51.6% (n=126) and 35.7% (n=87) respectively. Conclusions: An abysmally low proportion (3.3%) of non-metastatic head and neck cancer patients presented in the early stages (I and II). A vast majority of the patients (88.1%) presented with stages IVA and IVB. Not only does this reflect a poor therapeutic outlook, but also exposes the dire need for programmes focusing on cancer awareness and early detection in the region.

• 구강회복응용과학지
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• 제34권4호
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• pp.331-337
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• 2018

상악골 결손을 갖고 있는 무치악 환자를 폐쇄장치로 수복할 때 임상가들은 많은 어려움을 겪게 된다. 결손부를 통한 공기의 누출, 안정성과 지지의 부족, 감소된 의치 피개 면적은 의치의 흡착과 변연 폐쇄를 어렵게 한다. 본 증례는 편평상피암에 이환된 우측 상악동 부위에 상악골 절제술을 받은 무치악 환자로 술전 치과 검진, 수술용 폐쇄장치, 이행 폐쇄장치, 그리고 최종 폐쇄장치에 이르는 단계적 치료 과정을 통해 보철적 재건을 완료하였다. 본 증례의 환자는 전상악골 및 양측 상악 결절이 온전하며 한정된 크기의 결손부를 가져 적절한 유지와 지지를 갖는 폐쇄장치를 제작할 수 있었으며 심미 및 기능면에서 양호한 예후를 보였기에 이를 보고하는 바이다.

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.49-54
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• 2009

상악골 악성종양의 경우 적출 후 골편들을 이식해 상악동 전체를 재건하는 경우는 재발이 많아 잘 시행하지 않는다. 이러한 이유로 안와하연의 재건을 통해 안구 및 안면윤곽만을 재건하는데, 저자들이 시행한 혈행화된 부분 두께의 골이식(vascularized split thickeness calvarium)은 술기방법에 있어 골피판이 혈관경에서 쉽게 분리되는 성질이 있어 시행에 주의가 필요하고 혈관경을 포함한 temporalis muscle이 부피감을 주므로 미용상 불리한 점이 있는 반면에 골편의 높은 생존율이 보장된다는 장점과 공여부의 합병증이 적다는 장점을 가진다. 또한 술후 복시 현상이나 안구함몰이 관찰되지 않았다는 점이 합리적인 술기임을 지지해준다. 따라서 측두동맥 및 정맥을 혈관경으로 하는 혈행화된 두정골 부분층 이식술은 안와하벽을 재건하는데 있어 안전하게 시행가능 한 술기였음을 보고하는 바이다.

• 대한장애인치과학회지
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• 제6권2호
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• pp.112-115
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• 2010

화학치료와 방사선 치료는 보존적이고 효과적인 항암치료 방법이다. 그러나 악골 및 치아의 성장이 완료되지 않은 성장기 아동의 경우에는 발육 장애를 유발할 수 있다. 환자 의 삶의 질 개선을 위해 이러한 부작용을 예방할 수 있는 방법이 모색되어야 할 것이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권2호
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• pp.103-115
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• 2009

In vertebrates, the face is mainly formed with neural crest derived neural crest cells by the inherent programs and the interactive environmental factors. Extracellular signaling-regulated kinase (Erk) is one of such programs to regulate the various cellular functions. And retinoic acid (RA) also plays an important role as a regulator in differentiation process at various stages of vertebrate embryogenesis. We wanted to know that the segregation as well as the patterning of maxillary and mandibular structure is greatly influenced by the maxillomandibular cleft (MMC) and the failure of this development may result in the maxillomandibular fusion (syngnathia) or other patterning related disorder. It has been well documented that the epithelium at this cleft region has significant expression of Fibroblast growth factor (Fgf) 8, and it is essential for the patterning of the first arch derived structures. By the morphological, skeletal, cell proliferation and apoptotic, and hybridization analysis, we checked the effects of Erk inhibition and/or RA activation onto MMC and could observe that Erk and RA signaling is individually and synergically involved in the facial patterning in terms of FGF signaling pathway via Barx-l. So RA and Erk signaling work together for the MMC patterning and the segregation of maxilla-mandible by controlling the Fgf-related signaling pathways. And the abnormality in MMC brought by aberrant Fgf signaling may result in the disturbances of maxillary-mandibular segregation.

• Radiation Oncology Journal
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• 제16권3호
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• pp.259-264
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• 1998

목적 :상악동암에서 수술 전 방사선 치료를 시행함으로써 안면 보존의 가능성이 어느 정도 되는지를 알아보고자 하였다. 대상 및 방법 : 1986년 6월부터 1990년 9월까지 상악동암으로 방사선치료를 받은 42례의 환자를 대상으로 후향적 분석을 시행하였다. 환자의 연령은 24세에서 75세로 중간값은 56세였으며, 남자 27예, 여자 15예였다. 병기별 분포는 T2 2예, T3 19예, T4 21예로 진단 당시 대부분 진행된 상태였다. 조직학적으로는 편평 상피암 38예, 미분화 세포암 1예, 이행 상피암 1예, 선양 낭종암 2예였다. 모든 환자에 대해 동측 부비동을 포함하는 쌍쐐기빔 방법의 방사선치료를 시행하였다. 방사선 치료선량은 50.4-70.2 Gy로 중간값은 70.2 Gy였다. 11례의 환자에 대해 방사선치료와 유도 화학요법을 병행하였다. 화학요법은 5-fluorouracil과 cisplatin으로 2회 시행하였다. 대상 환자의 추적기간은 3개월에서 92개월로 중간값은 16개월이었다. 방사선치료 후 6 내지 8개월 경과 후 전산화단층촬영을 실시하여 병소의 반응을 평가하였다. 완전관해가 된 경우는 계속 추적검진만 하였으며 병변이 의심되는 경우는 콜드웰-뤼크 수술을 시행하여 확인하였다. 병변이 확인된 경우는 상악동전절제술을 시행하였다. 결과 : 방사선 및 화학요법 시행 후 9예 (21.4$\%$)에서 완전관해를 보였고 33예 (88.6$\%$)에서 잔여병변이 확인되었다. 완전관해를 보인 9예의 환자 중 7예가 국소제어되었으며 2예에서 국소재발하였다. 잔여병변이 있는 33예의 환자 중 10예에서 근치적 수술이 가능하였고 그 중 2예에서 국소제어가 되었다. 전체 환자의 5년 생존율은 23.1$\%$였고 5년 무병생존율은 16.7$\%$였다. 방사선치료에 대한 반응 (P<0.05) 만이 생존율에 영향을 미치는 유의한 인자였다. 결론 : 방사선치료에 대한 반응만이 생존율에 영향을 미치는 유의한 인자였다. 전체적으로 7예(16.7$\%$) 에서 수술 전 방사선치료로 안면보존이 가능하였다.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.111-116
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• 1997

The oral cavity is easily accessible for direct exposure of a malignant disease. 1 percent of the oral malignant tumors are of metastatic origin and approximately 10 percent to 25 percent of the 1 percent fraction originate from the lungs. A case of metastatic lung carcinoma to the gingiva in a 88-year-old male is reported. He complained of pain and swelling between right maxillary 1st premolar and 2nd molar. Although surgical excision of the lesion has been done, the gingival lesion developed as a quickly growing mass and recurred 2 weeks after surgical excision. The gingival mass was histopathologically diagnosed as an undifferentiated carcinoma. Epithelial layer was continuous without ulceration and it seems that the cancer cells are originated from primary tumor. Infiltrated cancer cells were pleomorphic and dyskeratotic. The cells had 2 or more nuclei, not showing squamous or glandular differentiation. Immunohistochemical study revealed the cells originated from the epithelial cells. The prognosis is poor, because prognosis depends on surgical elimination of the primary tumor.

• Radiation Oncology Journal
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• 제36권4호
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• pp.304-316
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• 2018

Purpose: The indication of elective neck treatment (ENT) for clinically N0 (cN0) paranasal sinus (PNS) carcinoma remains unclear. We aimed to investigate different treatment outcomes regarding ENT and propose optimal recommendations for ENT. Materials and Methods: We identified patients with cN0 PNS carcinoma who underwent curative-intent treatment between 1992 and 2015. Survival outcomes and pattern of failure were compared between patients who received ENT and those who did not. We sought to identify significant patient or pathologic factors regarding treatment outcomes. Results: Among 124 patients meeting the inclusion criteria, 40 (32%) received ENT ('ENT (+) group') and 84 (68%) did not ('ENT (-) group'). With a median follow-up of 54 months, the 5-year overall survival (OS) was 67%, and the 5-year progression-free survival (PFS) was 45%. There was no significant difference between the ENT (+) and ENT (-) groups regarding OS (p = 0.67) and PFS (p = 0.50). Neither group showed a significantly different pattern of failure, including regional failure (p = 0.91). There was no specific benefit, even in the subgroups analysis by tumor site, histologic type, and T stage. Nevertheless, patients who ever had regional and/or distant failure showed significantly worse prognosis. Conclusion: ENT did not significantly affect the survival outcome or pattern of failure in patients with cN0 PNS carcinomas, showing that ENT should not be generalized in this group. However, further discussion on the optimal strategy for ENT should continue because of the non-negligible regional failure rates and significantly worse prognosis after regional failure events.