• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.381-387
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• 2005

Malignant hyperthermia is a catastrophic, hypermetabolic syndrome that arises in susceptible individuals when they are exposed to certain inhalational anesthetics or muscle relaxants. It is characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. We experienced a 24 year old male Malignant hyperthermia presented for orthognathic surgery under $O_2-N_2O$-sevoflurane anesthesia without succinylcholine. Two half hours after induction, tachycardia developed and was followed by unstable blood pressure and hyperpyrexia. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated by the intravenous administration of dantrolene sodium. The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. So the malignant hyperthermia clinical grading scale is recommended for use as an aid to the objective definition of this disease. This clinical grading system provides a new and comprehensive clinical case definition for the malignant hyperthermia syndrome. We recently encountered a case of delayed malignant hyperthermia during sevoflurane anesthesia that was successfully treated by the intravenous administration of dantrolene sodium. In conclusion, exposure to sevoflurane should be avoided in patients thought to be susceprible to malignant hyperthermia.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.387-391
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• 2013

Background The most common cutaneous malignant masses are basal cell carcinoma (BCC) and squamous cell carcinoma. The predominant site of a malignant mass is the face, which has many opportunities to be exposed to ultraviolet radiation. However the predilection sites of malignant masses have been equivocal due to the use of general regions, rather than anatomical landmarks, in surveys. A facial esthetic unit is an anatomical site classified as an area of similar facial contour characteristics that can be distinguished from other areas. The purpose of this study is to determine widely accepted anatomical landmarks using the esthetic unit. Methods We retrospectively analyzed 118 cases of malignant masses in our clinic from January 2005 to October 2012. We evaluated the patients' age, gender, and predilection site of the malignant mass by esthetic unit through pathology, medical records and patient photographs. We mapped the occurrence site of the malignant mass on schematic drawings of the esthetic units. Results Most of the malignant masses were BCC. The ratio of males to females was 1:1.41. The frequent predilection site of a malignant mass was on the nasal unit (33.1%), followed by the buccal unit (11.0%). Primary closure was the most common method of repairing a surgical defect (38.9%), followed by a local flap (35.5%). Conclusions This review described the relationship between clinical characteristics and esthetic units by proposing objective predilection sites for malignant masses, which can be used commonly as a framework in the study of malignant masses by unifying equivocal occurrence sites.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.217-221
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• 2011

Purpose: FGF4 (fibroblast growth factor 4) is a newly characterized gene which was found to be a transforming gene in several cancerous cells. FGF4 expression and amplification has been subsequently observed in several human cancers including stomach cancer, breast cancer, head and neck squamous cell carcinoma, lung cancer and bladder cancer. This study was designed to measure the protein expression of FGF4 in malignant skin cancers. Methods: We examined 8 normal skin tissues and 24 malignant skin tumor tissues which were 8 malignant melanomas, 8 squamous cell carcinomas and 8 basal cell carcinomas. The specimens were analyzed for the protein expression of FGF4 using immunohistochemical staining. To evaluate the amount of expression of FGF4, the histochemical score (HSCORE) was used. Results: FGF4 was expressed more intensely in malignant melanoma, followed by SCC and BCC in immunohistochemistry. The average HSCORE was 0.01 for normal skin, 2.02 for malignant melanoma, 1.28 for squamous cell carcinoma, and 0.27 for basal cell carcinoma, respectively. The expression of FGF4 in malignant melanoma and squamous cell carcinoma was increased in comparison with normal tissues and basal cell cancer, and the difference was statistically significant (p<0.05). The difference between malignant melanoma and squamous cell carcinoma was not statistically significant. Conclusion: These findings provide evidences that the expression of FGF4 plays an important role in malignant melanoma and squamous cell carcinoma progressions. This article demonstrates expression of FGF4 in human skin malignant tumors, and suggests that FGF4 is more expressed in highly aggressive skin tumors.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.91-101
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• 1994

Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.723-729
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• 1987

A retrospective study of 21 cases of chest wall tumors, 12 benign and 9 malignant, was carried out to review their clinical radiological and pathological features. On age distribution, most cases [80.9%] were found in 4th to 6th decades. The sex ration [M:F] was represented as 2.5:1. Of the 21 lesions, there were 8 cases of soft tissue tumors, 4 cases of bone and cartilage origined tumors and 9 malignant tumors which included 3 metastatic tumors. The overall mortality was 22.2% and all of the deaths were found in the malignant tumors. All of the patients with benign tumors were treated by excision without recurrence. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissue were visualized. On the basis of our analysis, we believe that all tumors of chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain as adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions.

• The Korean Journal of Cytopathology
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• v.6 no.1
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• pp.80-83
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• 1995

Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in plural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.87-90
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• 2002

Malignant melanoma of the nasal cavity occurs rarely. Malignant melanoma, originated from the upper respiratory tract including nasal cavity, has clinical feature of local recurrence and easily metastasizes to regional or distant lymph nodes, lung, and liver. Malignant melanoma originated from nasal cavity frequently shows tumor cell invasion, ulceration, or infection. Owing to these characteristics, complete surgical excision of the malignant melanoma in nasal cavity is not easy. And also the prognosis of this tumor is not so good because of a high recurrence rate. Recently the authors have recently experienced a case of malignant melanoma originated from the inferior turbinate, which was treated with lateral rhinectomy, total maxillectomy. The defect developed after surgical extirpation was reconstructed with rotational forehead flap.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.265-268
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• 1997

Malignant lymphoma is the tumor of immune system which is known as the most common nonepitheloid tumor of head and neck region. It is mainly found in the cervical, axillary and inguinal lymph node, but gastrointestinal tract, palatine tonsil, nasopharynx, oropharynx, nasal cavity and salivary glands may be involved. Primary lymphoma of the thyroid gland is an uncommon condition, comprising approximately 2% of all malignant lymphoma and 5% of all thyroid malignant neoplasms. Recently, we experienced a case of malignant lymphoma of the thyroid gland, which was histopathologically proven. So we report our findings in this patient with review of literatures.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.356-360
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• 2001

Malignant peripheral nerve sheath tumor(MPNST, primary malignant schwannoma) within the spinal canal is very rare. The prognosis of MPNST in the spinal canal is very poor due to the tendency of perineural spread, dissemination throughout subarachnoid space and local recurrance. This report details the authors' experience on the case of primary malignant spinal schwannoma with review of the literatures and other studies.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.389-395
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• 2000

Arare case of primary malignant melanoma of central nervous system in 12-month-old infant with neuro-cutaneous melanosis is presented. Primary malignant melanomas in central nervous system are very rare in children, however, it is known that leptomeningeal melanosis is malignant in 40-50% with neurocutaneous melanosis. Spinal MRI, brain CT and MRI showed diffuse intradural extramedullary mass of entire spinal cord and enhancing mass in brain stem. CSF cytology revealed abnormal cells. Biopsy from leptomeninges of posterior fossa was compatible with malignant melanoma.