• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.80-84
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• 1999

Primary hryperparathyroidism is a relatively rare disease entity in Korea. It's characterized by severe skeletal and renal changes due to hypersecretion of parathyroid hormone, and rarely shows peptic ulceration, hypertension, pancreatitis and impaired mentality. Recently the determination of the serum calcium level has become a routine laboratory test and the awareness of primary hyperparathyroidism has been incerased, the disease is being diagnosed with increasing frequency. Primary hyperparathyroidism is most commonly caused by parathyroid adenoma and rarely hyperplasia, cancer of parathyroid glands. The authors operated sucessfully a case of primary parathyroid adenoma by diagnosed by nuclear medical diagnostic work-up. The patient had anterior neck mass(soft, non tender nodule) on physical examination, multiple goiter on thyroid ultrasonogram and scan. The parathyroid lesion was difficult to find preoperatively.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.359-370
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• 1994

The reconstruction of major head and neck defects must be an integral part of the overall cancer treatment plan. The priorities of surgical treatment of head and neck tumor are 1) local tumor control, 2) relief of pain, 3) avoidance of difficult dressing, 4) provision of oral continence, and 5) ability to swallow and manage saliva. The recent advances in reconstructive surgery including the development of musculocutaneous flaps and microvascular free tissue transfer have allowed the surgical restoration of head and neck tumor defects that previously were not possible. These techniques have provided the opportunity to undertake larger, more aggressive resection while at the same time permitting functional rehabilitation. The timing of reconstruction demands on the nature of the resection, the ability of the ablative and reconstructive teams to coordinate efforts, the overall health of the patients, the patient's needs and wishes. So, we report to emphasize current methods for restoring major head and neck tumor defects after tumor ablation, reviewing for the reconstructive operations, postoperative complications, and postoperative sequelae etc, of patients from Jan, 1990 to Dec, 1993.

• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.53-58
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• 1988

We have experienced 3 cases of papillary carcinoma of the thyroid gland seen as lateral neck cyst, Usually cystic lesions of the neck have been considered as benign lesions from clinical viewpoint. The usual differential diagnosis includes branchial cleft cyst, cystic hygroma, dermoid cyst, cold abscess(tuberculous lymphadenitis) and cavitating squamous cell carcinoma. A lateral neck cyst as the sole presenting complaint of the papillary thyroid carcinoma is very rare. Preoperative diagnosis of lateral neck cyst is often diagnostic dilemma. Fine-needle aspiration cytology can be helpful in detecting the cancer cells and in demonstrating the nature of the fluid component of the lateral neck cyst. Presence of brown murky fluid from the aspirated fluid is highly suggestive of thyroid carcinoma. The thyroid scans and B-mode ultrasonography mayor may not be helpful to detect the primary focus of the thyroid gland. We suggest that a patient with a lateral neck cyst in adult age group should be considered to be a possibility of underlying thyroid carcinoma presanting as lateral neck cyst.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.53-56
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• 2011

Vocal cord paralysis (VCP) is a common complication after thyroidectomy despite the continuity of the recurrent laryngeal nerve (RLN) is preserved. Much efforts have been made into preventing VCP, but few of them focuses on the treatment strategies and prognosis after VCP take place. In this case, patient visited the clinic for papillary thyroid cancer in Rt. thyroid gland without VCP. She underwent total thyroidectomy with central neck dissection. During dissection, Rt main mass was encircling Rt. RLN. To make matters worse, Lt. RLN was severed due to tight attachment with Berry's ligament. After that, intratumoural dissection of Rt. RLN and end to end anastomosis of Lt. RLN were performed with microscopy to preserve the functions of RLNs as much as possible, otherwise permanent bilateral VCPs were inevitable. We report this case, since both vocal cords recovered from VCPs with symmetric, synchronous movements at postoperative follow up.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2955-2958
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• 2013

Background: Mast cells can influence tumor progression via different pathways and increased mast cell density has been demonstrated in oral squamous cell carcinoma (OSCC). It has been shown that the serum tryptase level is elevated with some malignant tumours and may thus be a useful parameter. However, there are no data available about OSCC. The main aim of this study was the evaluation of mast cell tryptase (MCT) level in OSCC patient serum. Materials and Methods: In this cross-sectional, analytic study, the circulating levels of MCT were assessed in sera of 55 OSCC patients and 34 healthy individuals with ELISA technique. Results: The serum MCT level in OSCC patients was 12-14 ng/ml, which was not significantly higher than the healthy control group. While the serum level of MCT was higher with larger tumours, there was no apparent correlation with clinico-pathological features such as patient age, gender, tumor location, stage, nodal status, distant metastasis, histological grade and smoking. Conclusions: Our findings showed that despite the results obtained from studies of other malignant tumors, serum level of MCT in OSCC patients could not be a credited as a reliable indicator of the presence or progression of tumours.

• The Journal of the Korea Contents Association
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• v.8 no.11
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• pp.235-241
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• 2008

If the target volume cannot be included with one field at head and neck cancer, we commonly used two or more field. It is very important to irradiate uniform dose at junction area of the fields. However, according to body shape of patient or general condition of patient, skin junction area can be matched incorrect, So overdose area or underdose area can be appeared in the junction area. This study researched therapy technique which can give uniform dose at skin junction owing to applying the edge block of lateral field at head and neck cancer. We measured the changed distance and rotational angle between central line of anterior supraclavicle lymph node and low margin of right lateral field on simulation process using the shielding block of variable rotation. As a result, the changed distance between central line of anterior supraclavicle lymph node and low margin of right lateral field was below 2mm to ${\pm}$10cm distance at central line of Y axis, changed angle was average 1.28 degree. But by using it the shielding block of variable rotation, the incorrect match at junction can be minimized. We think that this technique is very efficient one to apply this technique at head and neck cancered by the movement of organs can be not included, Therefore we have to pay attention on the process to imput MLC layer

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.177-183
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• 2018

Purpose : Volumetric Modulated Arc Therapy(VMAT) has the advantage of uniformly and precisely irradiating the tumor to the shape of the tumor while reducing the risk of radiation damage to normal tissues. such as brain cancer, head and neck cancer and prostate cancer, It is being used for treatment. The purpose of this study is to evaluate the usefulness of the Jaw-Tracking technique(JTT) in VMAT for brain and head and neck cancer. Materials and Methods : We selected eight patients with brain and head and neck cancer(4 Brain, 4 head and neck) who were treated with the VMAT treatment technique. Contouring information of the patient's tumor and normal organ was fused to the Rando phantom using the deformable registration of Velocity(Varian, USA). A treatment plan was developed using the Varian Eclipse(ver 15.5, Varian, USA) with the same patient actual beam parameters except for the use of jaw-tracking. As the evaluation index, the maximum dose and mean dose of target and OAR were compared and a portal dosimetry was performed for the treatment plan verification. Results : When using JTT, the relative dose of OAR decreased by 5.24 % and the maximum dose by 7.05 %, respectively, compared with the Static-Jaw technique(SJT). In the various OARs, the mean dose and maximum dose reduction ranges ranged from 0.01 to 3.16 Gy and from 0.12 to 6.27 Gy, respectively. In the case of the target, the maximum dose of GTV, CTV, PTV decreased by 0.17 %, 0.43 %, and 0.37 % in JTT, and the mean dose decreased by 0.24 %, 0.47 % and 0.47 %, respectively. Gamma analysis The JTT and SJT passing rates were $98{\pm}1.73%$ and $97{\pm}1.83%$ on the basis of 3 % / 3 mm, respectively. Comparing the doses of all OARs applied to the experiment, it was found that the use of JTT resulted in a significant decrease in dose due to additional jaw shielding besides MLC than SJT. Conclusion : In radiation therapy using VMAT treatment plan, we can apply JTT in the case of adjacent tumor and normal organs such as brain cancer and head and neck cancer, and in radiotherapy required large field and high energy caused increase leakage dose through MLC. It is considered that the target dose of PTV can be increased by lowering the dose of normal tissue surrounding the tumor.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.179-183
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• 2002

Objective: A comparison of American Joint Committee on Cancer (AJCC) 1988 and 1997 nasopharyngeal carcinoma (NPC) classifications was made in terms of patient distribution and efficacy in predicting prognosis. Materials and Methods: Between Jan. 1981 and Dec. 1998, 60 cases of node negative nasopharyngeal carcinoma were retrospectively reviewed. The extent of disease each patients restaged according to the 4th and 5th AJCC system and Ho system, respectively. Results: The overall and disease free 5-year survival rates were 61.1% and 62.6%, respectively. Among T classifications of 4th AJCC, 5th AJCC and Ho staging system were not observed significantly different in disease-free survival rates, respectively. Conclusion: We observed a better patient distribution with AJCC 1997 comparing to AJCC 1988. The new classification also attained better statistical significances among stages in the overall survival and disease free survival rates was needed.

• Archives of Craniofacial Surgery
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• v.16 no.3
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• pp.105-113
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• 2015

The main challenge in pharyngoesophageal reconstruction is the restoration of swallow and speech functions. The aim of this paper is to review the reconstructive options and associated complications for patients with head and neck cancer. A literature review was performed for pharynoesophagus reconstruction after ablative surgery of head and neck cancer for studies published between January 1980 to July 2015 and listed in the PubMed database. Search queries were made using a combination of 'esophagus' and 'free flap', 'microsurgical', or 'free tissue transfer'. The search query resulted in 123 studies, of which 33 studies were full text publications that met inclusion criteria. Further review into the reference of these 33 studies resulted in 15 additional studies to be included. The pharyngoesophagus reconstruction should be individualized for each patient and clinical context. Fasciocutaneous free flap and pedicled flap are effective for partial phayngoesophageal defect. Fasciocutaneous free flap and jejunal free flap are effective for circumferential defect. Pedicled flaps remain a safe option in the context of high surgical risk patients, presence of fistula. Among free flaps, anterolateral thigh free flap and jejunal free flap were associated with superior outcomes, when compared with radial forearm free flap. Speech function is reported to be better for the fasciocutaneous free flap than for the jejunal free flap.