• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권4호
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• pp.237-241
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• 2022

Sclerosing polycystic adenosis (SPA) is a rare, asymptomatic disease that occurs mainly in the salivary glands. We report the case of a 51-year-old man who presented with trismus and pain upon mouth opening. Magnetic resonance imaging revealed a 2-cm mass located in the anterior portion of the left parotid gland. SPA was diagnosed based on histopathological examination of the surgical specimen. In pathologic findings, there was a well-circumscribed multicystic nodule in the parenchyma. Dense fibrosis and chronic non-specific inflammatory cells were observed in the stroma. In 13 previous reports on SPA, the most preferred treatment was superficial or total parotidectomy. This report suggests that simple excision of SPA preserves facial nerve function and facial volume.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권4호
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• pp.316-333
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• 1998

Obstructive sialadenitis of major salivary glands is a common entity that occurs either in sialolithiasis or in foreign-body obstruction of the excretory ducts. This is characterized histologically by the presence of duct-like structural groups in a highly fibrotic stroma. Although the pathologic features are well recognized, the various cell types involved in the atrophy and subsequent regeneration of the obstructed salivary gland have been controversial. For this reason, an animal model of obstructive sialadenitis that induced atrophy in the salivary gland was used. Experimental study was performed to observe changes of submandibular gland in rabbit and apply the results to clinical activity. Forty-five rabbits each weighing about 3Kg were used and divided into control and experimental group. In the experimental group, ducts of submandibular gland was ligated and cutted divided into each twenty rabbits. Rabbits were serially sacrificed on the 3rd, 5th, 14th, 30th day of experiment. The submandibular glands were dissected out at sacrifice and stained with H&E, MT, immunohistochemical stain and the histological examinations were carried out under the light and transmission electron microscope. After examination and comparison of all specimens, the results of this study were as follows: 1. In the features of H&E stain, moderate infiltration of inflammatory cell were present at 3rd day of experiment. The features of ductal metaplasia was observed after 7th day in the ligation group and destructive changes was continued. In the cutting group, atrophic changes were less severe than ligation group but the small ductule were separated from stroma after 7th day. 2. In the feature of MT stain, apposition of connective tissue was increased in all group, more active in ligation group. 3. In the features of immunohistochemical stain, ligation group showed increased PCNA positive response at 7th day and the higher activity of duct cells was observed. Severance group showed more PCNA positive response than ligation group at 30th day. 4. In TEM features, ductal metaplasia was started at 7th day and degenerative change with margination of nucleus had been severe. Although ductal metaplasia was seen in the severance group, more numerous granule in different size was founded than ligation group. From above results, degenerative change was identified with ductal metaplasia, apically apposition of granule, r-ER destruction in ligation group. Severance of duct elicit degenerative change of grandular cells but the change was less severe than ligation group and more PCNA positive cell was founded at acinar cell.

• 대한두경부종양학회지
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• 제34권2호
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• pp.23-28
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• 2018

Background/Objectives: Adenoid cystic carcinoma is the second most common salivary carcinoma. It occurs commonly in the submandibular gland, sublingual gland and minor salivary gland. Local recurrence and distant metastasis are the leading cause of death. The aim of this study was to evaluate long-term oncologic outcomes of patients with head and neck adenoid cystic carcinoma focusing on distant metastasis. Materials & Methods: We retrospectively studied 39 patients who were diagnosed with and treated for adenoid cystic carcinoma of the head and neck from December 1996 to May 2018. The clinicopathologic characteristics of patients such as age, sex, primary site and TNM stage, and treatment methods, recurrence and distant metastasis after treatment, survival rate, and treatment method for recurrence were analyzed. Results: Of 39 patients, 18 were males and 21 were females, and the mean age was $5.9{\pm}14.4$ (28-89) years. The most common primary site was oral cavity (12 cases), and followed by sino-nasal cavity (11 cases), parotid gland (5 cases), and etc. For treatment, 17 patients underwent surgery alone, 16 received surgery with postoperative radiation therapy, and 3 patients received radiation therapy only. Three patients refused any further treatments. Recurrence occurred in 15 patients. The most common site of recurrence was the lung. The mean time to recurrence was 31.7 months. The 5 and 10 years' overall survival rate was 79.3% and 74%, respectively. The 2 and 5 years' overall survival rate was 69.6% and 62.6% in patients with distant metastasis. Conclusion: Distant metastasis is an important prognostic factor in adenoid cystic carcinoma, and eventually one third of patients have distant metastasis, especially in the lung. An appropriate treatment for lung metastasis is necessary because some patients with pulmonary metastasis survive for a quite long time.

• 대한세포병리학회지
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• 제4권2호
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• pp.111-120
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• 1993

Fine needle aspiration cytology has become a frequently used technique for the diagnosis of lesions in the head and neck. Fine needle aspiration cytology of the salivary glands were performed on 66 patients. In 59 patients with satisfactory samples, cytologic diagnoses were as follows; there were 47 benign lesions, including pleomorphic adenoma(20), Warthin's tumor(3), benign cystic lesion(4), Inflammatory lesion(4), lymphoid lesion(3), myoepithelioma(1), unspecified benign neoplasm (5), and unclassified benign lesion(7). There were 6 cases of undetermined malignancy and 6 malignant lesions including mucoepidermoid carcinoma(3), adenoid cystic carcinoma(1), carcinoma ex pleomorphic adenoma(1), and metastatic carcinoma(1) in cytologic diagnosis. In 25 patients, the cytologic diagnosis was correlated with histologic findings. The sensitivity of the benign lesion was 96% and the specificity was 82%. There was no false-positive diagnosis. The sensitivity and the specificity of pleomorphic adenoma were 75% and 95%, respectively. Some of Warthin's tumors were confused with benign cystic lesion due to frequent cystic change of the tumor. The sensitivity and specificity of the malignant lesions were 56% and 88%, respectively. There were three false negative diagnoses. Two mucoepidermoid carcinomas were correctly diagnosed by cytology. Two of three adenoid cystic carcinomas were misdiagnosed as benign tumors.

• 치과방사선
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• 제25권1호
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• pp.27-38
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• 1995

The organ or tissue doses were determined with head and neck phantom measurement for multiple axial scans (36 slices), multiple coronal scans (13 slices), 3 types of single axial scans(orbit, maxillary sinus and mandibular canal) and single coronal scan (maxillary sinus). For each scan sequence 30 TLDs were placed in selected sites(16 internal sites and 14 external sites) in a tissue-equivalent phantom. The exposure was made at 120kVp, 500mAs with 5 mm slice width. The results were as follows : 1. In multiple axial scans, the greatest effective dose recorded was that delivered to the thyroid glands(2.77 mSv) and the least was that received by the skin(0.05 mSv). From these data, stochastic effects were 202.2x10/sup -6/ and 3.7×10/sup -6/, respectively. 2. In multiple coronal scans, the greatest effective dose recorded was that delivered to the salivary glands(0.58 mSv) and the least was that received by the skin(0.01 mSv). From these data, stochastic effects were 42.2×10/sup -6/ and 0.7×10/sup -6/, repectively. 3. Among single axial scans, the greatest effective dose recorded was that delivered to the salivary gland(0.38 mSv) in maxillary sinus scan. From this data, stochastic effect was 27.7×10/sup -6/. 4. In single coronal scan, the greatest effective dose recorded was that delivered to the salivary gland(0.01 mSv). From this data, stochastic effect was 1.0×10/sup -6/. 5. The equivalent dose measured that delivered to the lens of the eyes was 69.64 mSv in multiple axial scan, 39.32 mSv in multiple coronal scan and 36.77 mSv in single axial scan(orbit).

• 핵의학기술
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• 제19권2호
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• pp.81-86
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• 2015

동적 타액선 신티그라피는 비침습적인 방법으로 타액선의 기능을 평가하는데 널리 사용되어 왔다. 본 연구에서는 타액선 신티그라피의 시간-방사능 곡선에서 다양한 기능적 매개변수지표를 측정하고 구강건조증 환자 그룹과 건강한 Control 그룹과 비교를 통해 유용성을 알아보고자 한다. 2014년 12월부터 2015년 2월까지 구강 건조증으로 내원하여 동적 타액선 신티그라피를 시행한 환자 그룹 30명과 건강한 Control 그룹 10명을 대상으로 하였다. 검사방법은 370 MBq의 $^{99m}Tc$-과산화테크네슘을 정맥으로 순간 주사 후 약 30분간 동적 타액선 신티그라피를 연속 촬영하였으며, 주사 후 20분째에 최타 자극제로 비타민C 파우더를 이용하였다. 정량분석은 이하선과 악하선의 시간-방사능 곡선을 통해 기능적 매개변수 지표를 획득하고, 통계 프로그램을 이용하여 구강 건조증 환자와 건강한 Control 그룹과 비교하였다. 동적 타액선 신티그라피에서 이하선과 악하선의 기능적 매개변수 지표인 섭취율(Uptake Ratio, UR), 최대 방사능 시간(Time at Maximum counts, Tmax), 최소 방사능 시간(Time at Minimum counts, Tmin), 최대 축적율(Maximum Accumulation, MA), 축적속도(Accumulation Velocity), 최대 배출율(Maximum Secretion, MS), 최대 자극 배출율(Maximum Stimulation Secretion, MSS), 배출속도(Secretion Velocity, SV)를 각각 측정하였다. 구강 건조증 환자와 건강한 Control 그룹간의 이하선과 악하선의 기능적 매개변수 지표 비교에서는 최소 방사능 시간을 제외한 모든 지표에서 건강한 Control 그룹이 환자 그룹에 비하여 유의성 있게 높게 측정되었으며, 시간에 따른 변화량도 Control 그룹이 환자 그룹에 비하여 유의성 있게 변화량이 크게 측정 되었다. 동적 타액선 신티그라피에서 다양한 기능적 매개변수 지표를 이용한 정량분석은 구강 건조증 환자의 타액선 기능을 평가하는데 객관적이고 표준화된 정보를 제공해 줄 것으로 사료된다.

• 대한소아치과학회지
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• 제35권1호
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• pp.47-56
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• 2008

리스페리돈(risperidone)은 세계적으로 가장 널리 처방되고 있는 정신분열증 치료제로서 소아자폐증의 선택약물로 FDA 승인을 받았으며 틱장애, 뚜렛장애의 치료제로도 쓰이고 있다. 치과와 관련된 리스페리돈의 이상반응으로 구강건조가 보고되고 있으며 그 기전은 밝혀지지 않은 상태이다. 본 연구의 목적은 리스페리돈이 타액분비 기전의 중요한 요소인 세포내 칼슘농도에 미치는 영향을 세포수준에서 밝히고자 하는 것이다. 세포내 칼슘농도를 측정하기 위해 Human salivary gland cell line(HSG)에 Fura-2/AM을 세포내로 부하한 뒤 340 및 380 nm의 파장으로 교대로 여기시킬 때 방출되는 형광강도를 500 nm 파장에서의 비율로 측정하였다. 각 실험 후 형광강도의 비율을 실제 세포내 칼슘농도로 보정하기 위한 calibration 실험을 시행하였다. 카바콜, ATP, 히스타민을 처리하여 세포내 칼슘농도의 변화를 측정하고 리스페리돈의 전처리가 이에 미치는 효과를 비교하였으며 다음과 같은 결과를 얻었다. 1. HSG에서 카바콜, ATP, 히스타민 처리로 인해 세포내 칼슘농도가 증가하였으며 리스페리돈을 전처리한 경우 카바콜과 ATP의 작용에는 영향을 주지 않았으나 히스타민의 작용을 억제하였다. 2. HSG의 세포내 칼슘 변화에 미치는 히스타민의 효과는 농도의존적인 양상을 보였으며 50% 유효농도($EC_{50}$)는 $3.3{\pm}0.5\;{\mu}M$이었다. 3. 히스타민에 의한 HSG에서 칼슘 변화에 미치는 리스페리돈의 저해 효과는 농도의존적인 양상을 보였으며 대조군의 효과를 50% 억제하는 농도($IC_{50}$)는 $104.4{\pm}14\;nM$로 리스페리돈의 적정혈중농도 이하에 해당되었다. 4. 리스페리돈은 히스타민에 의한 소포체에서의 칼슘 유리와 세포 밖 칼슘 유입을 모두 유의성 있게 억제하였다(p<0.05). 항정신병 약물은 장기간 복용하고 적정혈중농도가 계속 유지되기 때문에 이러한 약물이 타액분비감소를 일으킬 경우 다발성우식증 등 심각한 치과적 질환을 야기할 수 있으므로 이에 대한 예방 및 치료방안이 필요하리라 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권3호
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• pp.177-185
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• 2010

Introduction: Epidermal growth factor receptor (EGFR) is expressed in human epithelial tumors including salivary cancers, and known to be correlated with tumor progression and poor clinical courses in some epithelial tumors. In this study, we determined the therapeutic effect of the anti-EGFR monoclonal antibody Erbitux (C225, cetuximab) in combination with the DNA topoisomerase I inhibitor irinotecan (CPT-11) on human salivary adenoid cystic carcinoma (SACC) cells growing in nude mice. Materials and Methods: At first, immunocytochemical analysis for the expression of EGFR and phosphorylated EGFR (pEGFR) on a human salivary ACC cell line (ACC3). To determine the in vivo effects of Erbitux and CPT-11, nude mice with orthotopic parotid tumors were randomized to receive intraperitoneal Erbitux (1 mg) two times per week, intraperitoneal Irinotecan (50 mg/kg) once per week, Erbitux plus CPT-11, or placebo. (control) Tumor volume and weight were measured. And mechanisms of in vivo activity of Erbitux and/or CPT-11 were determined by immunohistochemical/ immunofluorescent analyses. Results: Immunocytochemical staining of ACC3 demonstrated that EGFR was expressed and phosphorylated. CPT-11 inhibited ACC tumor growth in nude mice. Tumors of mice treated with CPT-11 and CPT-11 plus Erbitux exhibited increased tumor cell apoptosis and decreased microvessel density, which correlated with a decrease in the tumor volume in nude mice. But, CPT-11 seems not to be synergistic with Erbitux in our ACC3 model system. Conclusion: These results suggest that anti-EGFR monoclonal antibody and the DNA topoisomerase I inhibitor will be effective in the treatment of recurred or metastatic lesions of salivary ACC.

• 한국수산과학회지
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• 제40권2호
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• pp.63-67
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• 2007

To prevent food poisoning after ingesting sea snails containing tetramine we measured the tetramine $[(CH_3){_4}N^+]$ contents of sea snails from the Korean coast using both ion chromatography (IC) and spectrometry. In total, 177 sea snails were collected from the east (Pohang, 19 species, 95 individuals), the west (Gunsan, 4 species, 46 individuals), and the south (Tongyeong, 8 species, 36 individuals) coasts. The working solution of tetramine standard for IC and the tetramine extract from the salivary gland of Neptunea arthritica cumingii were very stable for one month at $18^{\circ}C,\;4^{\circ}C$, and room temperature. The tetramine content was high in the salivary gland of Heptunea species such as N. intersculpta $(9,813{\mu}g/g)$, N. arthritica $(8,240{\mu}g/g)$, N. arthritica cumingii $(6,967{\mu}g/g)$, N. eulimata $(6,946{\mu}g/g)$, N. constricta $(5,965{\mu}g/g)$, and N, amianta $(4,502{\mu}g/g)$. The mid-gut gland and muscle contained small amounts of tetramine. The tetramine content was highest in the autumn, but no clear regional variations were observed.