• Journal of Korean Dental Science
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• v.13 no.1
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• pp.21-27
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• 2020

Purpose: The aim of this study was to investigate the types and frequency of the various incidental findings (IFs) on magnetic resonance images (MRI) taken from the patients with temporomandibular disorder (TMD) symptoms. Materials and Methods: Temporomandibular joint (TMJ) MRI taken from 1,013 patients with TMD symptoms were evaluated retrospectively. IF was defined as imaging features that were accidentally or unexpectedly found, rather than degenerative bony changes of TMJ complex or disc derangement. They were classified into two groups as TMJ site-specific findings and unexpected findings at other regions. The frequency of the sub groups was analyzed. Result: A total of 26 (2.57%) cases with IFs were classified into 13 cases with TMJ site-specific findings and 13 cases with unexpected findings at other region. TMJ site-specific findings included synovial chondromatosis in 6 cases, synovial cyst in 6 cases and osteochondroma in one case. Unexpected findings included salivary gland tumor in 3 cases, developmental cyst in 3 cases, vascular malformation in 2 cases, mastoiditis in 4 cases and sialadenitis on parotid gland in one case. Conclusion: When diagnosing TMD through TMJ MRI, clinicians should carefully read the image, considering the possibility of IFs because TMJ MRI can provide pathologic information in TMJ region and other oral and maxillofacial region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.85-99
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• 2004

Purpose: This study observed the changes in the telomerase activity, it's developmental regulation, PCNA expression, and their correlation in rat's upper digestive organs during growth and aging. Materials and Methods: Upper digestive organs(buccal mucosa, gingiva, palate, submandibular and parotid glands, and tongue) were aseptically removed from Sprague-Dawley rats of fetal(gestational 20 days), growing(1, 2, 3, 5, and 7 weeks after birth) and adult(12 week old). Samples for telomerase activity were frozen on liquid nitrogen immediately after sacrifice, and stored until the use at $-75^{\circ}C$ in order to measure it. Telomerase activity was measured by a PCR-based telomeric repeat amplication protoco(TRAP) assay and quantitated with Photometric Telo TAGGG Telomerase PCR ELISA plus(Roche Diagnostics GmbH. Mannheim. Germany). PCNA expression were measured immunohistochemistry with anti PCNA Ab-1, Clone PC10(NeoMark. California. USA). Results: 1. Telomerase activities in buccal mucosa, palate and gingiva were the highest in fetus and decreased gradually or rapidly after birth and then diminished, but In salivary gland and tongue were the highest in fetus and also high at 1 week and then decreased rapidly. 2. PCNA expression in buccal mucosa, gingiva, Tongue and salivary gland was the highest in fetus and decreased gradually and then diminished. but only in palate decreased rapidly after birth and then diminished. Conclusion: The highest telomerase activity of embryonic stage decreased rapidly after birth in rat's upper digestive organs. There may be a developmental regulation of telomerase activity, but not a tissue-specific. This telomerase activity seems correlated closely with PCNA expression in rat's upper digestive system.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.2
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• pp.505-519
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• 1998

The occurrence of PVNS in the TMJ is very rare. We report a case of PVNS which was misdiagnosed as a parotid tumor at first. CT and conventional radiograph revealed a well defined mass demonstrating higher attenuation than adjacent soft tissue. Erosion and expansion of the cortical plate of the mandibular condyle and sclerotic change beneath the margin of the lesion were also shown. MRI demonstrated well defined mass of very low signal intensity on both Tl and T2-weighted images due to ferromagnetic effect of the high concentrated hemosiderin and clearly delineated the extent of the lesion. Histopathologic findings and characteristic appearance of the various imaging methods were described and the usefulness of these images for diagnosis and pretreatment evaluation of PVNS were also discussed.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.138-140
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• 2002

The spinal cord dose is the one of the limiting factor for the radiation treatment of the head & neck (H&N) or the thorax region. Due to the fact that the cord is the elongated shaped structure, it is not an easy task to maintain the cord dose within the clinically acceptable dose range. To overcome this problem, the spinal cord partial block technique (PBT) with the dynamic Multi-Leaf Collimator (dMLC) has been developed. Three dimension (3D) conformal beam directions, which minimize the coverage of the normal organs such as the lung and the parotid gland, were chosen. The PBT field shape for each field was designed to shield the spinal cord with the dMLC. The transmission factors were determined by the forward calculation method. The plan comparisons between the conventional 3D conformal therapy plan and the PTB plan were performed to evaluate the validity of this technique. The conformity index (CI) and the dose volume histogram (DVH) were used as the plan comparison indices. A series of quality assurance (QA) was performed to guarantee the reliable treatment. The QA consisted of the film dosimetry for the verification of the dose distribution and the point measurements. The PBT plan always generated better results than the conventional 3D conformal plan. The PBT was proved to be useful for the H&N and thorax region.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.985-992
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• 2016

Objective of the study is to evaluate volumetric and dosimetric alterations taking place during radiotherapy for locally advanced head and neck cancer (LAHNC) and to assess benefit of replanning in them. Materials and Methods: Thirty patients with LAHNC fulfilling the inclusion and exclusion criteria were enrolled in a prospective study. Planning scans were acquired both pre-treatment and after 20 fractions (mid-course) of radiotherapy. Single plan (OPLAN) based on initial CT scan was generated and executed for entire treatment course. Beam configuration of OPLAN was applied to anatomy of interim scan and a hybrid plan (HPLAN30) was generated. Adaptive replanning (RPLAN30) for remaining fractions was done and dose distribution with and without replanning compared for remaining fractions. Results: Substantial shrinkage of target volume (TV) and parotids after 4 weeks of radiotherapy was reported (p<0.05). No significant difference between planned and delivered doses was seen for remaining fractions. Hybrid plans showed increase in delivered dose to spinal cord and parotids for remaining fractions. Interim replanning improved homogeneity of treatment plan and significantly reduced doses to cord (Dmax, D2% and D1%) and ipsilateral parotid (D33%, D50% and D66%) (p<0.05). Conclusions: Use of one or two mid-treatment CT scans and replanning provides greater normal tissue sparing along with improved TV coverage.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1583-1588
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• 2012

Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.56-59
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• 2002

Background and Objective: Even though major salivary gland tumor is a rare disease, the diversity of histopathologic characteristics makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guideline of treatment. Materials and Method: Sixty-eight major salivary gland tumors and tumor-like glandular enlargements treated at Sanggye Paik Hospital during the past seven years between June, 1995 and January, 2002 are analyzed for histopathologic diagnosis, treatment modality, clinical manifestation, local control, and treatment-related morbidity, recurrence rate, retrospectively. Results: In twenty-eight patients the swellings were diagnosed as non-tumorous condition. The clinical features, diagnostic and surgical management of fourty salivary neoplasms involving the parotid and submandibular glands are correlated with their histological features. Conclusion: We have concluded that salivary gland neoplasms are needed multimodal treatment, because of their highly variable biologic behavior in each tumor type. Thirty-four cases were benign and six cases were malignant. Most of benign cases were pleomorphic adenoma and they showed wide age-distribution. In six malignant cases, there were acinic cell carcinoma, adenocarcinoma, carcinoma ex-plemorphic adenoma, myoepithelioma, and adenoid cystic carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.9 no.2
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• pp.227-233
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• 1993

For malignant neoplasms of salivary tissues. two of the better determinants of progosis are histologic classification and size of the neoplasm. Proper management of these tumors requires an accurate diagnosis by the pathologist and correct interpretation by the surgeon. Malignant mixed tumors account for between 3 and 13 precent of all cancers of the salivary glands and 2 percent of all tumors in these locations. The typical history of these tumors is that of slowly growing mass demonstrating a sudden increase in growth. The duration of onset of the tumor mass and the diagnosis of malignancy has been demonstrated to be 10 to 18 years. The risk of malignat transformation of a benign mixed tumor increases with the duration of the tumor. We analyzed retrospectively 13 cases of malignant mixed tumor who visited from Jan. 1985 to Dec. 1992. Mean age of the patients was 56.5 years. The origin of tumors were parotid gland 7 cases, submandibular gland 2 cases, and minor salivary gland 4 cases(palate 3 cases, tonsil pillar 1 case). According to the criteria of the AJCC on staging, stage I was 1 case, stage II 1 case, stage III 2 cases, and stage IV 9 cases. Histopathologically, carcinma ex pleomorphic adenoma were 12 cases and the true malignant mixed tumor was 1 case. The major treatment modalities were curative surgery, and radiation therapy followed. In conclusion, aggressive therapy of combined surgery and postoperative radiation therapy is required for these lesions, and patients with known or suspected benign tumor should be encouraged to undergo surgery early on in their disease to avoid malignant degeneration at a later dete.

• Korean Journal of Head & Neck Oncology
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• v.8 no.2
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• pp.63-71
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• 1992

After analysis according to age, sex, site of origin, nodal involvement, perineural invasion. histopathology and treatment modality. authors had reached the following conclusion about the 28 cases of adenoid cystic carcinoma of the salivary gland, which were, histopathologically, diagnosed at Yonsei University Severance Hospital and Yongdong, Severance Hospital during the 8-year period from Apr. 1983 to Mar. 1991. Among the 28 cases, 13 were females and 15 were males, which implies that there isn't any sigificant distinction of gender. The age range was 24 years to 69 years with a mean age of 49 years, and the most common site of origin in order was 6 cases(21.4%) of maxillary sinus, 5 cases(17.8%) of submandibular gland, each 4 cases(14.4%) of parotid gland, palate, 3 cases(10.4%) of nasal cavity and each 2 cases(7.1%) of mouth floor, nasopharynx with each one case(3.6%) of buccal mucosa and retromolar trigone. With clinical staging by UICC, the 5-year survival of adenoid cystic carcinoma was 100% in stage I and II, 87.5% in stage III. In stage IV, all of the patient were died within 3 years. We have known that the prognosis was poorer in following cases; the cases with higher clinical stage, primary site other than the major salivary gland especially maxillary sinus and positive neural or nodal invasion.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2195-2199
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• 2014

Background: Despite being rare in incidence, malignant tumors of major salivary glands show diverse histological variation. There are limited data on major salivary gland tumor management and outcome from Pakistan. The objective of this study was to share our experience with management of malignant tumors of major salivary glands. Materials and Methods: Patients who received treatment at Shaukat Khanum Cancer Hospital and Research Center from July 2002 to June 2011 with an underlying diagnosis of a major salivary gland malignancy were included. Patient characteristics and treatment modalities were assessed. Local, regional and distant failures were determined. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan Meier curves and the Log rank test was used to determine statistical significance. Univariate and multivariate analyses were performed using Cox proportional hazard regression. Results: The parotid gland was the primary site of origin in 104 (80%) patients. Mucoepidermoid carcinoma (43%) and adenoid cystic carcinoma (24%) were the most common histological types. Surgery followed by adjuvant radiation remained the mainstay treatment modality with 81 (62%) patients. Nineteen (15%) patients were treated with surgery alone and 30 (23%) patients with locally advanced surgically inoperable tumors received radiation only. Forty one (32%) patients failed the treatment (local 12, regional 11, locoregional 5, distant 13). The expected 5 year DFS and OS were 65% and 74% respectively. On multivariate analysis, grade was the only independent predictor of DFS and nodal involvement was the only independent predictor of overall survival. Conclusions: Employing existing standards of treatment, comparable survival can be achieved in Pakistani population with major salivary gland malignancies as elsehwere in the world.