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Prognosis of tongue squamous cell carcinoma associated with individual surgical margin and pathological features

  • Cho, Seongji;Sodnom-Ish, Buyanbileg;Eo, Mi Young;Lee, Ju Young;Kwon, Ik Jae;Myoung, Hoon;Yoon, Hye Jung;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.5
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    • pp.249-258
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    • 2022
  • The specific muscular structure of the tongue greatly affects margin shrinkage and tumor invasion, making the optimal surgical margin controversial. This study investigated surgical margin correlated prognosis of TSCC (tongue squamous cell carcinoma) according to margin location and its value, and the histopathologic factors which are suggestive of tumor invasion. And we would like to propose defining of the surgical margin for TSCC via prognosis according to location and margin values. We reviewed 45 patients diagnosed with TSCC who visited Seoul National University Dental Hospital (SNUDH) (Seoul, Republic of Korea) from 2010 to 2019, who were managed by a single surgical team. Patient clinical and pathological data of patients were retrospectively reviewed, and in 36 out of 45 patients, the pathologic parameters including the worst pattern of invasion (WPOI) and tumor budding were investigated via diagnostic histopathology slide reading. When standardized with as 0.25 cm anterior margins, as 0.35 cm deep margin, there was no significant difference in disease specific survival (DSS) or loco-regional recurrence-free survival (LRFS). Additionally, there was a non-significant difference in DSS and LRFS at the nearest margin of 0.35 cm (PDSS=0.276, PLRFS=0.162). Aggressive WPOI and high tumor budding showed lower survival and recurrence-free survival, and there were significant differences in close margin and involved margin frequencies. In TSCC, the value and location of the surgical margin did not have a significant relationship with prognosis, but WPOI and tumor budding suggesting the pattern of muscle invasion affected survival and recurrence-free survival. WPOI and tumor budding should be considered when setting an optimal surgical margin.

[Retracted]Analysis of Slope Safety by Tension Wire Data ([논문철회]지표변위계를 활용한 비탈면 안정성 예측)

  • Lee, Seokyoung;Jang, Seoyong;Kim, Taesoo;Han, Heuisoo
    • Journal of the Korean GEO-environmental Society
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    • v.16 no.4
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    • pp.5-12
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    • 2015
  • Civil engineers have taken the numerous slope monitoring data for an engineering project subjected to hazard potential of slide. However, the topics on how to deal with and draw out proper information from the data related to the slope behavior have not been widely discussed. Recently, several researchers had installed the real-time monitoring system to cope with slope failure; however they are mainly focused on the hardware system installation. Therefore, this study tries to show how the measured data could be grouped and connected each other. The basic idea of analyzing method studied in this paper came from the clustering, which is the part of data mining analysis. Therefore, at the base of classification of time series data, the authors suggest three mathematical data analyzing methods; Average Index of different displacement ($AD_{i,j}$), Difference of average relative displacement ($\overline{RD}_{i,j}$) and Coordinate system of average and relative displacement ($\overline{RD}$, AD). These analyzing methods are based on the statistical method and failure mechanism of slope. Therefore they showed clustering relationships of the similar parts of the slope which makes the same sliding mechanism.

Prognostic Relevance of WHO Classification and Masaoka Stage in Thymoma (흉선종양에서의 WHO 분류와 Masaoka 병기, 임상양상간의 상관관계연구)

  • Kang Seong Sik;Chun Mi Sun;Kim Yong Hee;Park Seung Il;Eeom Dae W.;Ro Jaee Y.;Kim Dong Kwan
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.44-49
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    • 2005
  • Although thymomas are relatively common mediastinal tumors, to date not only has a universal system of pathologic classification not been established but neither has a clearly defined predictable relationship between treatment and prognosis been made. Recently, a new guideline for classification was reported by WHO, and efforts, based on this work, have been made to better define the relationship between treatment and pro­gnostic outcome. In the present study a comparative analysis between the WHO classification and Masaoka stage system with the clinical disease pattern was conducted. Material and Method: A total of 98 patients undergoing complete resection for mediastinal thymoma between Juanuary 1993 and June 2003 were included in the present study. The male female ratio was 48 : 50 and the mean age at operation was $49.6{\pm}13.9\;years.$ A retrospective analytic comparison studying the relationship between the WHO classification and the Masaoka stage system with the clinical disease pattern of thymoma was conducted. Pathologic slide specimens were carefully examined, details of postoperative treatment were documented, and a relationship with the prognostic outcome and recurrence was studied. Result: There were 7 patients in type A according to the WHO system of classification, 14 in AB, 28 in B 1, 23 in B2, 18 in B3, and 9 in type C. The study of the relationship between the Masaoka stage and WHO classification system showed 4 patients to be in WHO system type A, 7 in type AB, 22 in B 1, 17 in B2, and 3 in type B3 among 53 $(54{\%})$ patients shown to be in Masaoka stage I. Among 28 $(28.5{\%})$ patients in Masaoka stage II system, there were 2 patients in type A, 7 in AB, 4 in B 1, 2 in B2, 8 in B3, and 5 in type C. Among 15 $(15.3{\%})$ in Masaoka stage III, there were 1 patient in type B1, 3 in B2, 7 in B3, and 4 in type C. Finally, among 2 $(2{\%})$ patients found to be in Masaoka stage IV there was 1 patient in type B1, and 1 in type B2. The mean follow up duration was $28{\pm}6.8$ months. There were 3 deaths in the entire series of which 2 were in type B2 (Masaoka stages III and IV), and 1 was in type C (Masaoka stage II). Of the patients that experienced relapse, 6 patients remain alive of which 2 were in type B2 (Masaoka III), 2 in type B3 (Masaoka I and III) and 2 in type C (Masaoka stage II). The 5 year survival rate by the Kaplan-Meier method was $90{\%}$ for those in type B2 WHO classification system, $87.5{\%}$ for type C. The 5 year freedom from recurrence rate was $80.7{\%}$ for those in WHO type B2, $81.6{\%}$ for those in type B3, and $50{\%}$ for those in type C. By the Log-Rank method, a statistically significant correlation between survival and recurrence was found with the WHO system of classification (p<0.05). An analysis of the relationship between the WHO classification and Masaoka stage system using the Spearman correction method, showed a slope=0.401 (p=0.023), showing a close correlation. Conclusion: As type C of the WHO classification system is associated with a high postoperative mortality and recurrence rate, aggressive treatment postoperatively and meticulous follow up are warranted. The WHO classification and Masaoka stage system were found to have a close relationship with each other and either the WHO classification method or the Masaoka stage system may be used as a predict prognostic outcome of Thymoma.

Clinical significance of loss of p16 protein by immunohistochemical staining in acute lymphoblastic leukemia (급성림프구성백혈병에서 면역조직화학염색에 의한 p16 단백질 소실의 의의)

  • Jin, Hye Young;Kang, Kyoung In;Kim, Sun Young;Youn, You Sook;Kang, Joon Won;Jo, Deog Yeon;Kwon, Kye Chul;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.73-77
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    • 2008
  • Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

Evaluation of frictional forces between orthodontic brackets and archwires (교정용 브라켓과 교정선 사이의 마찰력)

  • Jeong, Tae-Jong;Choie, Mok-Kyun
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.613-623
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    • 2000
  • The purpose of this study was to amount of the frictional forces with the brackets and wires, ligation methods, dry/wet, offsets, interbracket distances, velocity and to compare them each other by different conditions. This study tested 0.018'x0.025' slot sized 8 types of orthodontic bracket systems and 0.016', 0.016'x0.022' sized stainless steel, NiTi, Cu-NiTi orthodontic wires. One cuspid bracket were positioned on the slide glass and archwire was engaged into bracket and ligated with elastomeric modules. The values of frictional forces were measured with the instron universal testing machine. The results were as follows; 1. Polycrystalline ceramic bracket had the highest mean frictional forces and followed and by ceramic reinforced plastic bracket, metal bracket, plastic bracket with metal slot, monocrystalline ceramic bracket, single bracket, self-ligating bracket, friction free bracket in descending order. The self-ligating bracket showed low frictional forces in the round wires and high frictional forces in the rectangular wires. 2. Stainless steel wires had the least frictional forces and followed by NiTi, Cu-NiTi wires in descending order. Round wires had lower frictional forces then that of rectangular wires. 3. The stainless steel ligation method had significantly greater mean frictional forces them the elastomeric module ligation method. 4. Artificial saliva statistically increased the frictional forces in stainless steel wire, NiTi wire and Cu-NiTi wire. 5. There was a statistically significant difference with offset change 6. There was no statistically significant difference with interbracket distance in stainless steel wires but a significant difference in NiTi wires as the interbracket was decreased. 7 There was no statistically significant difference with velocity change. From the above findings, self-ligating bracket, stainless steel wires and the elastomeric module ligation method might be effective than any other materials to reduce the frictional forces in the orthodontic treatment and can be correlated to clinical situations seen in orthodontic patient care.

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THE MORPHOLOGICAL OBSERVATION OF HUMAN PERIODONTAL LIGAMENT CELLS ATTACHMENT AND SPREADING ON THE SURFACE OF SLIDE GLASS (치주인대세포의 부착과 전개에 관한 형태학적 관찰)

  • Lee, Jin-Mi;Suh, Jo-Young;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.23 no.1
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    • pp.97-108
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    • 1993
  • One of the important initial events required for periodontal regeneration is the attachment and subsequent spreading of periodontal ligament cells on the root surface. The purposes of this study is to investigate the attachment and spreading pattern of human periodontal ligament cell on the surface of glass slides. After establishment of a cell line of the primary cell culture from the periodontal ligament of 1st premolar teeth which were extracted for the purpose of orthodontic treatment, author dispersed the cells at $5{\times}10^3\;cells/ml$ into the each 35mm culture petri-dish containing 2 glass slides. To observe the morphological changes of the cells which attached to the surfaces of glasses at every designed time schedule, author used the inverted phase contrast microscope and scanning electron microscope. During the whole experiment culture condition was at $37^{\circ}C$, 100% Humidity, 5% $CO_2$ gas incubator. The following results were obtained. Periodontal ligament cells showed spherical outline and started to attach to glass surface by basal sytoplasmic extension after 10min in culture. After 30min in culture, periodontal ligament cells were attached to glass surface by well - developed filopodia which protruded from the lamellipodia. The cell surface is covered with bubble-like structures and occasional microvillus can be seen with diffculty among these structures. After 1.5hr in culture, peridontal ligament cells shhowed radially well-spread cytoplasm and the nucleus was centered on its cytoplasm. Unspread central region of the cell was covered with numerous microvilli. The change of cell attachment and spreading pattern was manifest at 6hr in culture. At this time, periodontal ligament cell showed elongated outline and an oval-shaped nucleus. After 12hr in culture, periodontal ligament cells showed more stretched fibroblast-like appearance with polarity. Two long lamellipodia can be seen around the both terminal ends of cells. After 24hr in culture, periodontal ligament cells showed spindle shapes and an oval-shaped nucleus was slanted toward one side of the cell.

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Acoustic Characteristics of Gas-related Structures in the Upper Sedimentary Layer of the Ulleung Basin, East Sea (동해 울릉분지 퇴적층 상부에 존재하는 가스관련 퇴적구조의 음향 특성연구)

  • Park, Hyun-Tak;Yoo, Dong-Geun;Han, Hyuk-Soo;Lee, Jeong-Min;Park, Soo-Chul
    • Economic and Environmental Geology
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    • v.45 no.5
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    • pp.513-523
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    • 2012
  • The upper sedimentary layer of the Ulleung Basin in the East Sea shows stacked mass-flow deposits such as slide/slump deposits in the upper slope, debris-flow deposits in the middle and lower slope, and turbidites in the basin plain. Shallow gases or gas hydrates are also reported in many area of the Ulleung Basin, which are very important in terms of marine resources, environmental changes, and geohazard. This paper aims at studying acoustic characteristics and distribution pattern of gas-related structures such as acoustic column, enhanced reflector, dome structure, pockmark, and gas seepage in the upper sedimentary layer, by analysing high-resolution chirp profiles. Acoustic column shows a transparent pillar shape in the sedimentary layer and mainly occurs in the basin plain. Enhanced reflector is characterized by an increased amplitude and laterally extended to several tens up kilometers. Dome structure is characterized by an upward convex feature at the seabed, and mainly occurs in the lower slope. The pockmark shows a small crater-like feature and usually occurs in the middle and lower slope. Gas seepage is commonly found in the middle slope of the southern Ulleung Basin. These gas-related structures seem to be mainly caused by gas migration and escape in the sedimentary layer. The distribution pattern of the gas-related structures indicates that formation of these structures in the Ulleung Basin is controlled not only by sedimentary facies in upper sedimentary layer but also by gas-solubility changes depending on water depth. Especially, it is interpreted that the chaotic and discontinuous sedimentary structures of debris-flow deposits cause the facilitation of gas migration, whereas the continuous sedimentary layers of turbidites restrict the vertical migration of gases.

Epidemiological Studios on Clonorchis sinensis Infection along the Nam-river in Gyeongnam Province, Korea (남강유역 간흡충감염의 역학적 조사연구)

  • 배경훈;안영겸
    • Parasites, Hosts and Diseases
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    • v.21 no.2
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    • pp.116-186
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    • 1983
  • An epidemiological study on Clonorchis sinensis infection along the Nam-river (total length ; 186km) flowing in Gyeongsang-nam-do, southern part of Korea, was carried out. Formalin-ether concentration technique and Stoll's egg counting method were employed to figure out the prevalence of C. sinensis infection. For the detection of cercariae from Parafossarulus sp., the snail host of C. sinensis, each snail was placed in aerated tap water, and examined for expelled cercariae. For observing the metacercariae the fresh water fish favorably eaten in raw conditions wore prepared by means of pressing the muscles between two slide glasses and/or by digesting them with artificial gastric juice. The fresh water fish were fed to the rabbits to get the worms and to identify the morphology of adult C. sinensis. The results are summarized as follows: 1. Overall Prevalence of C. sinensis infection was 38.75 from 5,291 examinees; 44.15 (1,408 out of 3,196) in male and 30.4% (637 out of 2,095) in female. 2. The prevalence rates were 42.0% at the upper stream, 41.2% around the vicinity of Jinyanglake, 34.2% at Jinju city, 34.2% at middle stream and 40.3% at down stream regions, respectively. 3. By age, the highest positive rate (53.4∼54.3%) was observed in 30 to 59 years of age. In this age group, the rate in males was 59.7∼62.2%, and in females 42.2∼44.4%, In the age group of less than 19 years it was 7.5∼20.9%. 4. By social strata, the positive rate was 16.5% in the primary school children, 22.6% in school students, 46.2% in teachers and local officers and 49.6% in the general inhabitants. 5. The quantitative examinations with the stool collected from clonorchiasis cases revealed that the light infection (less than 4,000/EPG) was 53.6%, moderate infection (4,001∼10,000 /EPG) 30.3% and heavy infection (more than 10,001/EPG) 16.1%, respectively. More than half of total cases examined were light infection, and 73.2% of female examinees were lightly infected with this cuke. 6. The average value of EPG was 4,963 (male, 6,057; female, 2,557 and the highest value was obtained from the age group of 30 to 59 years (5,240∼6,454). 7. The prevalence of Metagonimus yokogawai infection in humans was 5.5%, and 89.8% of metagonimiasis cases wore double-infected arith C. sinensis. The highest prevalence rate was observed in Jinju city (11.2%). 8. Total of 5,005 Parafossarulus sp., the snail intermediate host of C. sinensis, were examined for the detection of cercariae. The cercarial expulsion rate was 0.34%, and the snails collected in Jin-yang-lake side and in the down stream expelled mainly the cercariae of C, sinensis. 9. About 788 cercariaejday (range: 127∼1,503) were expelled daily from a snail naturally infected with C. sinensis. The snails which released more than 1,000 cercariae/day were 30.8% out of total collected. A snail uniquely released 5,840 cercariae/day in this study. 10. The other trematode cercariae besides C. sinensis were also detected, and the rates out of total snails were the cercariae of Losogenes liberum 6.71%, Cyathocotyle orientalis 0.26%, Notocotylus attenuatus 2.52% and Mucobucaris 0.54%, 11. Ten out of 18 species of fresh water fish caught along the river harbored the metacercariae of C, sinensis. The highest rate of metacercarial infection in fish was detected in Pseudorasbora larva (85.9%). The fish mainly eaten by the inhabitants along the Nam-river, and the metacercarial infection rates were: Zacco platypus 8.0%, Hemibarbus sp. 18.2∼26.7%, Gnathepcgcn sp. 37.5%, Ischikauia steenackeri 42.9% and Pseudogobio esocinus 16.7%. 12. Out of 36 P. larva, the number of metacercariae were about 109 (ranEe; 18∼446) per fish and 27 per gram of flesh. The fish caught in spring harbored the highest number of metacercariae. As indicated above, the prevalence of C. sinensis infection in the inhabitants residing around the Nam-river was relatively high. The farther toward the upper stream areas, the higher was the positive rate of C. sinensis infection, and most of clonorchiasis cases were lightly infected. The snail hosts of C. sinensis distributed all around the Nam-river. Several species of freshwater fish were infected with the metacercariae of C. sinensis and the infection rates were relatively high. To prevent C. sinensis infection in the endemic areas, the effective health education system is suggested as a control measure, although mass treatment is also expected to be useful, using chemotherapeutic agents such as "praziquantel", a recently developed anthelminthic for C. sinensis inftraction.

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An Analysis of the Practices of Dental Hygienists in Offering Oral Health Education -In Case of Adult Patients Visiting Dental Clinics- (치과위생사의 구강보건지도 실천분석 -진료실내의 성인환자를 중심으로-)

  • Lee, Sung-Sook;Cho, Myung-Sook;Kim, Seol-Ag
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.131-141
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    • 1999
  • The purpose of this study was to serve as a basis for the planning of oral health education and the development of an oral health-promotion program for patients who visited dental clinics by examining how much dental hygienists offered oral health education to adult patients at dental clinics. A parent group was selected, being made up of 1,600 dental hygienists who registered with the Dental Hygienist Association and worked in Seoul. The questionnaire survey was carried out and an ${\chi}^2-test$ was made using the data collected from 218 subjects to determine how their practice of oral health education was different according to certain general characteristics(the sort of organization for which they worked, age, the term of their service, and the mean number of patients per day). As a result, the following findings were obtained: 1. Thees general characteristics made the following differences to the content of oral health, education: The sort of organization for which the subjects worked made a significant difference in the following tooth brushing instruction (p<0.05), the effect of oral prophylaxis or education about aftereffects (p<0.05), the regular examination of prosthesis (p<0.05), smoking-prohibition education (p<0.05), and the prevention poor-quality fillings (p<0.01). The mean number of patients per day made significant differences to the regular examination of prosthesis (p<0.05) and the prevention poor-quality fillings (p<0.01). But no significant disparity was generated by age or the term of service. 2. The general characteristics made the following differences to education about nutrition and diet counseling: The sort of organization for which the subjects worked had a significant effect just on the importance of a balanced menu (p<0.05). Age made significant differences in advice for vitamin, mineral, protein or other nutrients (p<0.01), and the importance of balanced menu (p<0.001). The term of service made significant differences in the importance of balanced menu (p<0.01), and advice for nutrients including vitamin, mineral or protein (p<0.01). 3. The general characteristics made the following differences to the recommendation and use of oral hygiene aids: The sort of oragnization for which they worked made significant differences only to a gingival massager and water pick (p<0.05). No significant difference was produced by age, the term of service or the mean number of patients per day. 4. The use of educational media for oral health was different according to the general characteristics: The use of pamphlets or booklets significantly varied depending on the organization for which they worked and with the mean number of patients per day (p<0.05). The use of slides or slide projectors was significantly affected by age (p<0.05). But no significant disparity was yielded by the term of service. 5. The general characteristics made the following difference as to whether a continued oral management system was carried out or not: The sort of organization for which they worked had very a significant effect on this result (p<0.001), and no significant disparity was made by age, the term of service or the mean number of patients per day. 6. The place where oral health education was giver differed according to the following general characteristics: The sort of organization for which they worked made very a significant difference as to the use of an examination room's dental unit chair or waiting room (p<0.01), and to the use of an oral health education room or reception counter (p<0.001). The term of service had a significant effect on the use of a counseling room (p<0.01). And the mean number of patients per day made significant differences in the use of a dental unit chair or reception counter (p<0.05), and to the use of an oral health education room or waiting room (p<0.01).

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A Study on the Black Box Design using Collective Intelligence Analysis (집단지성 분석법을 활용한 블랙박스 디자인 개발 연구)

  • Lee, Hee young;Hong, Jeong Pyo;Cho, Kwang Soo
    • Science of Emotion and Sensibility
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    • v.21 no.2
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    • pp.101-112
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    • 2018
  • This study was carried out to enhance the competitiveness of blackbox design for domestic and international companies, based on the explosive growth of the blackbox market due to development of blackbox design for vehicle accident prevention and post-treatment. In the past, the blackbox market has produced products indiscriminately to meet the ever-increasing demand of consumers. Therefore, we thought a new design method was necessary to effectively investigate the needs of rapidly changing consumers. In this study, we aimed to identify the best-selling blackbox to understand the design flow, and the optimum area for a blackbox, considering the uniqueness of associated vehicle. Based on discussion with blackbox design experts, we studied the direction of design and the problems with blackbox use, which were reflected in blackbox development. Through this research, two types of design - leading blackbox (A type) and mass production blackbox (B type) - were proposed for compatibility of the blackbox with the car. The leading type of blackbox was positioned so that it was wrapped with the room mirror hinge before the screw was fastened, in order to achieve an integrated design. Therefore, we designed an integrated form and resolved the placement problem of an adhesive blackbox. To blend, the mass production blackbox implemented material and surface processing in the same way with the car, and adopted the slide structure to automatically turn off the main body power when removing the SDcard, reflecting consumer needs. This study considers evolving consumer needs through a case study and collective intelligence and deals with implementation of the whole design process during mass production. In this study, we aimed to strengthen the competitiveness of the blackbox design based on design method and its realization.