• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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• pp.1-10
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• 2008

Oral squamous cell carcinoma (OSCC) is the most frequent form of oral cancer and holds the eighth position in the cancer incidence ranking. OSCC patients are treated by classical therapeutic modalities consisting of surgery, radiotherapy, and/or chemotherapy. But OSCC still shows significant mortality rates. Thus, new therapeutic approaches have been investigated and the most promising one is naturally acquired agents with known anti-cancer effects. Genistein is a compound extracted from soy bean. Its anti-cancer effect on breast cancer is well established now and it is investigated whether it has similar effect on OSCC. It inhibited the growth and invasive-ness of OSCC cells in vitro, but these effects did not work in living animals in vivo. Catechin is a compound from green tea and its anti-cancer effect on OSCC is known better than other agents. Catechin showed its anti-cancer effect in vitro via induction of apoptosis, cell cycle arrest, inhibition of growth, and down-regulation of invasion/metastasis. These effects were confirmed in vivo with mouse model. Cordycepin is one of major pharmacologically important components in Cordyceps Militaris and may exert its anti-cancer effect as an adenosine receptor agonist. In recent study, it inhibited the proliferation of OSCC cells via A3 adenosine receptor. But because there is very scarce evidence on this effect, more researches are needed on this theme.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.351-360
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• 2010

Purpose: As the influence of mass media increases, the general standard of attractiveness or beauty of a face also changes. The primary purpose of the study is to find out the factors of the attractive and beautiful face recognized by public. Methods: We picked out standard model photography and operated with Adobe$^{(R)}$ Photoshop$^{(R)}$ and Monariza$^{(R)}$ virtual plastic surgery program. The contour of face, eye, nose, forehead, zygoma, chin and proportion of upper, middle, lower face were changed. The interview survey was conducted through structured standard photo for 310 respondents. That was utilized in the final analysis. Multiple regression analysis was executed by SPSS 12.0. It was used to deal with statistical data and all the other necessary analysis. Results: According to general characteristics of the respondents, many differences were found in preferred face and facial aesthetic subunits. The younger generation preferred the lozenge and inverted triangle shape contour. The respondents over 40 of age preferred the egg shape contour. In chin and zygoma contour, the respondents at the age of 20 preferred distinctly small chin and relatively small lower face. On the other hand, the respondents over 40 of age preferred the wide zygoma relatively. In the proportion of upper, middle, lower face, 51.0% of respondents answered 1 : 1 : 1. If they want to have an aesthetic operation, they preferred protruding forehead. Also they preferred the small chin and V-shaped chin in frontal view. Conclusion: Many respondents preferred to have a plastic surgery for the better facial subunit. The statistical evidence from this study suggests that the harmony and balance of facial aesthetic subunits make attractive and beautiful face.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.49-62
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• 2021

Purpose: This study aimed to investigate the prognostic value of lymph node ratio (LNR) in patients with locally advanced gastric cancer who received neoadjuvant chemotherapy. Materials and Methods: We retrospectively enrolled gastric cancer patients treated with neoadjuvant chemotherapy and curative surgery at the First Affiliated Hospital of Zhejiang University from 2004 to 2015 as the study cohort. Patients with the same inclusion criteria treated in 2016-2017 were enrolled as the validation cohort. Kaplan-Meier curves were assessed using the log-rank test to analyze the differences in overall survival (OS). Multivariate survival analysis was performed using the Cox proportional hazards model. The areas under the receiver operating characteristic curve of ypN and LNR categories for predicting the actual 3-year OS were compared. Results: A total of 265 patients were included in the proposal cohort. The median number of retrieved lymph nodes (rLNs) was 32. The number of positive lymph nodes (pLNs) increased as rLN increased (P=0.037), but the LNR remained relatively constant (P=0.462). The LNR was categorized into 4 groups according to the prognosis: ypNr0, node-negative with rLN>25; ypNr1, node-negative with rLN≤25 or 00.3. In the validation cohort of 43 enrolled patients, there was a clear distinction in OS that significantly (P<0.001) varied depending on the LNR values and LNR was the only independent prognostic factor in multivariate analysis (P<0.001). Conclusions: LNR was an independent prognostic factor for survival of patients with gastric cancer after preoperative chemotherapy and might be an alternative predictor for ypN stage.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.226-237
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• 2005

Purpose : Extensive defect of oral and maxillofacial area is usually reconstructed with composite flap including skin paddle. However, if the defects are lined with only skin components, the mucosa's role in mastication and texture are not restored. Furthermore, stiffness and hair-growing prevent denture rehabilitation and good oral hygiene. This study was performed to overcome the disadvantages of composite soft tissue flaps including the skin and to make a model for myo-mucosal flaps. Materials and methods : Buccal mucosa sized $0.5\times1.0\;cm^2$ from New Zealand rabbit (around 1.5kg) was harvested and cultivated by the modification of Rheinwald and Green's keratinocyte culture method. Cultured mucosa was grafted on the fascia of latismus dorsi as form of mucosal sheet. After 7, 10, 14 days, the myomucosal flap was excised and evaluated under light microscope with H & E and immunohistochemical staining. As control group, harvested buccal mucosa from rabbit was transplanted to gracilis muscle(n=6). Results : From 7 days after prelamination, the basal layer of the grafted mucosa resembled that of normal mucosa. As control group, transplanted mucosa had original shape but there's slight inflammatory reaction. Prelaminated mucosa has 19.8$\pm$4.59 cell layers and some samples have more than 20 layers. The expression rate of PCNA was relatively strong (42.9%$\pm$14.1) at the basal layer of grafted mucosa and the laminin was found at the basal layer. On the contrary, prelaminated mucosa at 10 days showed moderate expression rate of PCNA(32.4%$\pm$4.62). We found the mucosal layer was somehow disappeared and there is strong inflammatory reaction. After 14 days prelamination, the grafted oral keratinocytes were almost disappeared and expression of PCNA was not observed. Conclusion : We can make 75 fold large mucosal($3850mm^2$) sheet from small samples of mucosa $(50mm^2)$. Epithelial sheet that grafted on the fascia of muscle underwent differentiation and proliferation. But after 10, 14 days, there was strong inflammatory reaction and the grafted mucosa was destroyed from surface layer. In rabbit model, transfer of fascio-mucosal flap should be done from 7 to 10 days after prelamination.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.191-205
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• 2000

The purpose of this study was undertaken to determine the effects of orthognathic surgery on speech. The hyposis stated herein is that functional behaviors of the dentofacial complex, such as speech production, may be adversely affected by deviations of a structural nature(especially, Class III malocclusion). Twenty adults with Class III malocclusion(13 female and 7 male) were studied preoperative, immediate postoperative and either 6 or 12 months postoperative lateral cephalograms. They had mandibular prognathism and had undergone mandible setback operation. The position of tongue, soft palate(Uvula), hyoid bone, respiratory track width, and pharyngeal depth were assessed on lateral cephalograms with 23 cephalometric variables, ANOVA, Paired t-tests and Pearson's product-moment correlation coefficient tests were used to evalute the operative changes in all cephalometric parameters. A experienced speech and language pathologists performed narrow phonetic transcriptions of tape-recorded words and sentences produced by each of the ninth patients and the recording tapes were analyzed by phonetic computer program(Computerized Speech Lab(CSL) Model 4300BI(U.S.A.)) These judges also recorded their ratings of each patient's overall consonants, hypernasality, hyponasality, and articulation proficiency. The results obtained are as follows; 1. There were significant changes in distance of posterior pharyngeal wall to tongue (TI-TW2, TS-TW3) after the surgery at 6 months postoperatively(each p<0.01 p<0.05). 2. The posterior tongue point(TI, TS, PPT) moved posteriorly after surgery and remained to its changed position at 6 months postoperatively(p<0.05). The displacement of tongue was correlated with the movement of mandibular setback amount(p<0.05). The hyoid bone moved posteriorly superiorly after immediate postoperative period. There was significant changes in hyoid bone movement after immediated postoperative period(p<0.05), but returned to its original position during the follow-up period(p>0.05) 3. The soft palate was displaced posteriorly superiorly after immediated operative period and remained to its changed position at 6 months postoperatively(p<0.05). ANS-PNS-SPT angle increasing, PPU-PPPo distance narrowing was showed after surgery, and remained its appearance 6 months postoperatively(p<0.05). 4. There were significant changes in formant value and squre diagram of vowel sound after the orthognathic surgery and the follow-up period. There were significant changes in /ㅅ/sound and posterior tongue sound. 5. The posterior movement of tongue and the posteriosuperior movement of soft palate was correlated with mandibular setback amount after orthognathic surgery. On the vowel squre diagram, the author found that the place of articulation after operation moved downward, backward, upward. 6. In assessing speech abnormalities, dental occlusion should be considered as a contributing factor. The vast majority of subjects with preoperative misarticulations eliminated or reduced their errors following orthognathic surgery. There was significant difference in speech impovement between pre- and postoperation.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.631-636
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• 2008

Purpose: Adipose tissue-derived stem cells(ADSC) has an osteoconductive potential and demineralized bone matrix(DBM) is an osteoinductive material. A combination of DBM and ADSC wound probably create osteoinductive properties. The purpose of this study is to determine the effect of the combination of DBM and ADSC mixture on healing of rat calvarial defect. Methods: Thirty adult male Sprague-Dawley rats were randomized into 3 groups(n=10) as 1) Control, 2) DBM alone, 3) DBM with ADSC mixture. DBM with ADSC mixture group has had a 3-day preculture of ADSC from groin fat pad. An 6 mm critical size circular calvarial defect was made in each rat. Defect was implanted with DBM alone or DBM with ADSC mixture. Control defect was left unfilled. 6 and 12 weeks after the implantation, the rats were sacrificed and the defects were evaluated by histomorphometric and radiographical studies. Results: Histomorphometric analysis revealed that DBM with ADSC mixture group showed significantly higher bone formation than DBM alone group(p<0.05). Although radiographs from DBM alone group and DBM with ADSC group revealed similar diffuse radiopaque spots dispersed throughout the defect. Densitometric analysis of calvarial defect revealed DBM with ADSC mixture group significantly higher bone formation than DBM alone(p<0.05). There was correlation of densitometry with new bone formation(Spearman's correlation of coefficient=0.804, 6 weeks, 0.802, 12 weeks). Conclusion: The DBM with ADSC mixture group showed the best healing response and the osteoinductive properties of DBM were accelerated with ADSC mixture. It will be clinically applicable that DBM and ADSC mixture in plastic and reconstructive surgery, such as alveolar cleft and congenital facial deformities that bone graft should be required.

• Journal of Chest Surgery
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• 제55권1호
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• pp.10-19
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• 2022

Background: According to the eighth TNM (tumor-node-metastasis) staging system, the presence of separate tumor nodules in the same lobe is designated as a T3 descriptor. However, it remains unclear whether adjuvant chemotherapy confers survival advantages in this setting. Methods: We retrospectively identified 142 pathologic T3N0M0 patients with additional pulmonary nodules in the same lobe from a single-institutional database from 2004 to 2019. The main outcomes were overall survival and recurrence-free survival. Multivariable Cox regression was used to identify the benefit of adjuvant chemotherapy while adjusting for other variables. Results: Sixty-one patients received adjuvant chemotherapy (adjuvant group) and 81 patients did not receive adjuvant therapy after surgery (surgery-only group). There were no demonstrable differences between the 2 groups regarding hospital mortality and postoperative complications, indicating that treatment selection had not significantly occurred. However, the use of adjuvant chemotherapy was associated with improved 5-year overall survival (70% vs. 59%, p=0.006) and disease-free survival (60% vs. 46%, p=0.040). A multivariable Cox model demonstrated that adjuvant chemotherapy was associated with a survival advantage (adjusted hazard ratio, 0.54; p<0.001). In exploratory analyses of subgroups, the effect of adjuvant chemotherapy seemed to be insufficient in those with small main tumors (<4 cm). Conclusion: Adjuvant chemotherapy was associated with better survival in T3 cancers with an additional tumor nodule in the same lobe. However, the role of adjuvant chemotherapy in patient subgroups with small tumors or those without risk factors should be determined via large studies.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1994년도 춘계학술대회
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• pp.127-130
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• 1994

This study is focused on investigating the mechanical properties of the human cornea and its shape through the inverse nonlinear finite element approach using the clinical and experimental data. The results of the inverse approach were used to construct the finite element model of the photorefractive excimer laser surgery for the myopia patients. The results of the finite element model were compared with those of the current clinical experiences and showed good agreements. Finally this study came to the conclusion that the finite element method has potential of the application to the medicine.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1041-1047
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• 1992

The consecutive 35 patients underwent isolated aortic valve replacement with the low-profile model of the Ionescu-Shiley pericardial xenograft valve from 1984 to 1991. Operative mortality was 2.9%, and early survivors were followed up for a total 136.1 patient-years[Mean$\pm$SD, 4.00$\pm$2.14 years]. The linearized late mortality was 2.204% /pt-yr. Three patients required rereplacement of the valve with overall valve failure rate of 2.204% /pt-yr: two for endocarditis and one for paravalvular leak. There was no case of primary tissue failure. The linearized annual rates of complication were: thromboembolism 0.735% /pt-yr, bleeding 0.735%pt-yr, and endocarditis 2.204% /pt-yr. The actuarial survival at 8 years of follow-up was 90.4$\pm$5.3%, and the probabilities of freedom from thromboembolism and from rereplacement were 95.6$\pm$4.4% and 88.2$\pm$6.7% at 8 years respectively. Although the low profile Ionescu-Shiley pericardial valve provided favorable clinical performance comparable with the standard model up to 8 years, it needs prolonged follow-up to assess the pattern of its durability.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1998년도 추계학술대회
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• pp.277-278
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• 1998

CT/MRI images were frequently taken to evaluate the anatomic structure and disease status, and to plan the treatment modality for oral and maxillofacial surgery. However, surgeons have many difficulties in reading and understanding 2D images without long time experiences. This study presents the method of 3D reconstruction with fine CT slices and its clinical application. We applied this method a clinical patient with oral and maxillofacial trauma and produced 3D reconstructed model which shows the fracture line in panfacial area and bone defect.