• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.157-160
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• 2006

Nasotracheal intubation is performed routinely in maxillofacial surgery to optimize visualization of the surgical field. The CaldwellLuc operation is an approach to the maxillary sinus through the labiogingival sulcus and canine fossa. The operation is used to treat chronic maxillary sinusitis, and involves curettage of the mucosa of the maxillary sinus and the creation of an inferior meatal antrostomy. After the operation, a nasal Foley catheter is inserted into the inferior nasal meatus for the discharge of blood and tissue fluid. Then, the nostril is packed with vaseline gauze. Before the patients awaken, they experience impaired switching from nasal to oral breathing. Pulmonary edema can result from excessive negative intrathoracic pressure caused by acute airway obstruction in patients breathing spontaneously. During anesthesia and sedation, airway obstruction can occur at the levels of the pharynx and larynx. Even in patients who are awake, alteration in the ability to change the breathing route from nasal to oral may affect breathing in the presence of an airway obstruction, causing this catastrophic event. We experienced a case in which acute pulmonary edema resulted from acute airway obstruction triggered by the patient's inability to switch the breathing route from nasal to oral during emergence from anesthesia.

• The Korean Journal of Legal Medicine
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• v.42 no.4
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• pp.168-171
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• 2018

In Korea, small octopus (Octopus minor) and webfoot octopus (Octopus ocellatus) are food items and fatal laryngeal choking due to ingestion of live octopus is not uncommon. We recently encountered two autopsy cases of accidental choking on small octopus and webfoot octopus. Case 1 involved a 58-year-old fisherman who ingested two live webfoot octopuses in his fishing boat and collapsed. He was immediately taken to the hospital but died. During autopsy, one of the webfoot octopuses was found between his pharynx and esophagus; it was obstructing the epiglottis and upper esophagus. His blood alcohol concentration was 0.140%. Case 2 involved a 55-year-old man who ingested an intact body part of a small octopus and was found dead in his house. He had a history of cerebral infarction and angina pectoris. During autopsy, an intact body part of the small octopus was found to be lodged in the laryngeal inlet.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.14.3-15
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• 1981

Midline Granulcma(Malignant midline reticulosis) of upper respiratory tract was known as one of the fatal diseases that involve the nasal cavity, paranasal sinuses, pharynx and larynx, with progressive localized necrotizing inflammation and granuloma formation. The disease was first described in 1897 by McBride and after Stewart many clinical and histological studies have been done in 1933. But its etiology is still unclear and therapeutic methods are still under development. The authors carried out a clinical study of 15 cases which were diagnosed and treated as midline granuloma, including 7 cases which received combination radiation and steroid therapy from January 1964 to December 1980. The results are as follows: 1) Age and Sex distribution: 6 cases fell into the ages from 30 to 39 years: 13 cases (87%) were male and 2 cases (13%) were female. 2) Primary lesion sites were nasal cavity and paranasal sinuses area (8 cases: 53%), palatine tonsil (3 cases: 20%) and pharynx (2 cases: 13%) in order. 3) Common symptoms were nasal stuffiness and sore throat (6 cases: 40%), headache (5 cases: 33%), nasal discharge and facial edema (3 cases: 20%) in order. 4) Microorganisms were identified in 4 cases: staphylococcus in 2 cases, pseudomonas in 1 case and streptococcus in 1 case. 5) All 7 cases who received combination radiation and steroid therapy revealed complete regression and no recurrence. 6) Among the 5 cases, who received steroid and antibiotic therapy, 2 cases died and other 3 cases improved temporarily and then developed aggrevation of symptoms.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.139-145
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• 2005

Background and Objectives: Because of squamous cell carcinoma of the head and neck undergoes a generally poor hospital course, the prognostic significance of the squamous cell carcinomas in head and neck have been evaluated to identify those features associated with aggressive biologic behavior according to the immunologic and histopathologic characteristics. Materials and Method: To assess the significance of EGFR, c-erbB-2, p21 and p53 protein in head and neck tumors and their correlation with prognostic factors, samples from 74 patients with squamous cell carcinomas of larynx, pharynx, and oral cavity were studied immunohistochemically. Results: EGFR, c-erbB-2, p21, and p53 protein were expressed 94.6%, 24.3%, 85.1%, and 55.4% in 74 cases of head and neck squamous cell carcinoma, respectively. The positive expression of EGFR was associated significantly with clinical stage and the negative expressions of p21 was associated significantly with histopathologic differentiation. There were no significant relationships between the reactivity of EGFR, c-erbB-2, p21, and p53 protein. Conclusion: The expression of EGFR, c-erbB-2, p21 and p53 protein could be related to oncogenesis, and the expression of p21 and EGFR protein can be used as a prognosticator in head and neck squamous cell carcinoma under certain limitations, but c-erbB-2 and p53 protein expression alone is not enough for evaluating prognosis of the carcinoma.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.49-54
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• 2021

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer. Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients' age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated. Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups. Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.96-101
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• 2007

Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

• Genomics & Informatics
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• v.19 no.1
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• pp.5.1-5.11
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• 2021

Head and neck squamous cell carcinoma (HNSCC) is the most frequent type of head and neck cancer that usually arises from the mucosal surfaces of several organs including nasal cavity, paranasal sinuses, oral cavity, tongue, pharynx, and larynx. The Wnt signaling pathway is a crucial mechanism for cellular maintenance and development. It regulates cell cycle progression, apoptosis, proliferation, migration, and differentiation. Dysregulation of this pathway correlates with oncogenesis in various tissues including breast, colon, pancreatic as well as head and neck cancers. The present study aims to assess the gene alterations in the Wnt family of genes so as to derive an association with HNSCC. Computational approaches have been utilized for the identification of gene alterations in the Wnt family of genes. Several databases such as cBioportal, STRING, and UALCAN were used for the purpose. The frequency of alteration was high in case of Wnt family member 11 (5%). Gene amplification, deep deletions, missense and truncating mutations were observed in HNSCC patients. There was a marked difference in the gene expression profile of WNT11 between grades as well as normal samples. The survival probability measured using the Kaplan-Meier curve also presented with a significant difference among male and female subjects experiencing a low/medium level expression. The female patients showed less survival probability when compared to the male subjects. This provides the prognostic significance of the WNT11 gene in HNSCC. Taken together, the present study provides clues on the possible association of WNT11 gene alterations with HNSCC, which has to be further validated using experimental approaches.

• Journal of Preventive Medicine and Public Health
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• v.49 no.3
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• pp.143-152
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• 2016

Objectives: Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. Methods: We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. Results: A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. Conclusions: The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.

• Archives of Craniofacial Surgery
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• v.18 no.4
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• pp.223-229
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• 2017

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.

• Journal of Ginseng Research
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• v.34 no.2
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• pp.77-88
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• 2010

Ginseng has been reported to reduce the risk of cancer in diverse organs, including the lip, oral cavity, pharynx, larynx, esophagus, lung, liver, pancreas, ovary, colon, rectum, and stomach, as demonstrated in clinical and epidemiological studies. studies, base on which findings, Panax ginseng has been classified as a "non-organ-specific cancer preventive." However, the recent keen interest in traditional medicinal herbs has been frequently questioned, about exact mode of action and the use of panaceic compounds has been a prime issue discussed in terms of complementary and alternative medicine. Several in vitro and in vivo studies have shown the mitigating effects of Korean red ginseng on Helicobacter pylori (H. pylori)-associated atrophic changes and carcinogenesis; However, evidence-based medicine, consisting of large-scale or well designed clinical studies, is still warranted whether Korean red ginseng is to be recognized as an essential therapeutic strategy regarding a "H. pylori-associated gastric cancer preventive." Specifically, comprehensive clinical trials of Korean red ginseng are needed to demonstrate that mucosal regeneration in patients with atrophic gastritis is feasible using Korean red ginseng supplements after the eradication of H. pylori infection. Ginseng is a good example of a natural herb and its ubiquitous properties may include the reduction or delay of inflammation carcinogenesis. Korean red ginseng contains ample amounts of active ginsenosides and we have demonstrated their effects in in vitro and in vivo studies with positive outcomes. In this review, the quantitative and qualitative benefits of Korean red ginseng in the treatment of H. pylori infection are described.