• Journal of The Korean Dental Society of Anesthesiology
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• v.11 no.1
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• pp.9-15
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• 2011

배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.4
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• pp.182-190
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• 2018

Objectives: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Inconsistency in various histopathologic features for predicting nodal metastasis and overall prognosis and a better understanding of molecular mechanisms of tumourigenesis have shifted the focus to a search for more definitive predictive markers. To identify the role of two immunohistochemical (IHC) markers, E-cadherin and cyclin D1, as predictive markers of aggressiveness in HNSCC and to assess clonal expansion of tumour cells. Materials and Methods: A total of 66 cases of HNSCC with neck node dissection were studied. IHC was performed on primary tumour sections and lymph nodes showing metastatic deposits. Histopathological parameters such as tumour grade and TNM stage together with nodal status were compared according to expression of the two markers. Fischer's chi-square test was used to assess the correlation between the two markers and histopathological parameters. Results: Out of 66 cases studied, 37 showed LN metastasis. Most of the patients were male, and the most common tumour site was buccal mucosa. We found a significant association between loss of E-cadherin and node metastasis (P<0.001) and higher TNM stage (P<0.001). Cyclin D1 overexpression was significantly associated with only nodal metastasis (P=0.007). No significant association with tumour grade was found for either marker. The subgroup of E-cadherin loss with cyclin D1 overexpression was associated with the maximum incidence of nodal metastasis and higher TNM stage, highlighting the importance of using a combination of these two markers. A significant association was noted between the expression of markers at the primary site and at nodal deposits, indicating clonal expansion. Conclusion: A combination of the two markers E-cadherin and cyclin D1 can predict prognosis in HNSCC, although tumour heterogeneity may affect this association in some cases.

• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.1 s.4
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• pp.34-37
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• 2003

Postoperative stroke is uncommon even in elderly patients, who have a higher incidence of all types of postoperative complications. The mechanism of postoperative stroke is not certain, but can be explained by intravascular clottings originated from thrombus or embolus or by intracranial hemorrhage. In a 66-year-old male patient with current hypertension medication, who underwent both neck dissection for malignancy metastasis under general anesthesia, the left hemiparesis and delayed emergency were found postoperatively. After transferred to intensive care unit, he got the thrombolytic therapy and then the therapies to decrease the swelling of the brain on the diagnosis of cerebral infarction in the vascular distribution of the middle cerebral artery. A brain MRI definitely showed the midline deviation to the left of the right brain hemisphere due to the progressing edematous changes. As he got worse, the emergency neurosurgical operation was proposed but rejected by his family. He died at postoperative 3 days. In this hypertensive patient. perioperative stroke could be originated from the surgical stimuli on major vessels, which were inevitable in neck dissection during the operation. We report this case of the postoperative stroke, which could be highly possible to be associated with extensive head and neck surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.451-455
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• 2015

More than one million new patients suffer from breast cancer annually in the world. In developed countries, breast cancer is the most common malignancy diagnosed among women, and in developing regions, it often ranks second to cervical cancer. This study aimed to investigate the relationship between incidence of breast cancer and reproductive factors in North-West of Iran. This retrospective analytical control-case study was conducted with 235 breast cancer patients and 235 women in the control group. Data collection tools included a set of questions with interviews and patient medical records. Data were analyzed using statistical tests: t-test, Chi-square, Fisher, and Pearson correlation coefficient. Significantly increased risks were associated between breast cancer and older age at first pregnancy, age at menopause and history of contraceptive use. A trend for decreasing risk were observed with increasing parity. Findings of this study showed no association between breast cancer and age at menarche. The study results suggested that physiological and reproductive factors may play important roles in the development breast cancer among Iranian women.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.381-384
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• 2005

Rhabdomyosarcoma is a rare malignancy of head and neck region. When rhabdomyosarcoma occurs in maxillary area, total maxillectomy is necessary. Total maxillectomy causes defects of orbital floor, palate, gingiva, and alveolar bone, causing severe facial deformity and functional impairment. Immediate maxillary reconstruction has to cover both bone and soft tissue to minimize cosmetic and functional problems. The fibular osteocutaneous free flap can provide paranasal, gingiva, oral mucosal lining and foundation for dental prosthesis, thus ensuring good cosmetic results and mastication, phonation function. We have experienced a reconstruction case of a 19-year-old man with rhabdomyosarcoma of the left maxillary sinus. The patient underwent total maxillectomy and neck dissection. We designed a fibular free flap that had a vascularized bone segment and a double skin paddle. Surgical outcomes were excellent in cosmetic and functional aspects.

• Korean Journal of Head & Neck Oncology
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• v.25 no.1
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• pp.33-35
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• 2009

Purpose : Granular cell tumour(GCT) is a rare benign tumour that can arise in anywhere throughout the body. Histopathological diagnosis of malignancy is difficult. We report a case of a granular cell tumor which developed on lower lip. Methods : A 58-year-old male had a palpable mass and whitish plaque in the oral mucosa for three months. Results : Under local anasthesia, the tumor was removed through wide excision including normal skin margin. Immediate reconstruction using local flap was done. Pathologic observation showed nests of polygonal cells with abundant granular, eosinophilic cytoplasm and round nuclei. Immunohistopathologic staining showed positive reaction on S-100 protein Conclusion : The results support the hypothesis that granular cell tumor is derived from Schwann cells. We report here on a case of granular cell tumor of lower lip that was successfully treated with radical resection.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.301-306
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• 2018

Immunoglobulin G4-related disease (IgG4RD) is a chronic inflammatory condition characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, as well as varying degrees of fibrosis. We report a case of a 70-year-old man with a rapid-growing cervical mass for several months. Computed tomography and positron emission tomography showed a huge, ill-defined mass involving left thyroid lobe and encasing the common carotid artery, which was clinically and radiologically suspicious for anaplastic thyroid carcinoma. Ultrasonography-guided core needle biopsy was performed and histopathology examination revealed to be consistent with IgG4RD, and the IgG4/IgG ratio was 0.6. After oral corticosteroid was administered, the mass was dramatically resolved. Because IgG4RD often presents as a single localized and infiltrated mass lesion, it can be confused and misdiagnosed as a malignancy. Thus, clinicians should consider IgG4RD as a differential diagnosis in a rapid-growing neck mass to prevent unnecessary and excessive treatments.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.607-612
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• 2009

The malignant tumor in childhood is one of the main causes of children s death due to disease. The traditional treatment for the malignancy is known for the radiation therapy and the chemical therapy or both. However, the treatments tend to induce intraoral complications. Different from adults, almost all children on cancer therapy are expected to have dental complications, because their permanent teeth are on the developmental stage. The degree of dental complication depends on the patient's age, type of chemical and other factors-radiation dose and frequency. In this report, 3 children who had experienced the anti-cancer therapy on their age between 1 and 4 years were selected and dental complications were examined. The children have chance for the various oral complications including the developmental problems such as agenesis, microdontia and hypoplasia of the teeth. Therefore, it's important to understand the side-effects of anticancer therapy during the permanent teeth had been developmental stage in young patients. Also, oral health care specialists, including pediatric and hospital dentist can support the oncology team by providing basic oral care, implementing oral care protocols, delivering emergency dental treatment undergoing anticancer treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.204-210
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• 1999

Purpose: We assessed the nutritional status and the alterations of oral diets during anti-cancer chemotherapy in pediatric oncology patients. Methods: Twenty children with malignancy were evaluated from day 0 until day 21 of post-chemotherapy. Nutritional status was assessed by body weight and biochemical parameters. The amount and calories of oral diets were assessed and food preference before and during chemotherapy were analysed by questionnelle. Results: 1) The underlying diseases of 20 patients were 11 acute lymphoblastic lekemia, 2 non-Hodgkin's lymphoma, 2 Langerhans cell histiocytosis, 2 Wilm's tumor, 2 brain tumor, 1 rhabdomyosarcoma. 2) There were weight loss during chemotherapy in 8 patients (40.0%), weigt gain in 5 patients (25.0%), and no significant changes in 7 patients (35.0%). 3) Biochemical parameters showed no significant interval changes during chemotherapy except elevation of serum ALT level. 4) The daily caloric intakes of oral diets during chemotherapy were 310~600 Kcal which was much lower than average of daily recommended calory for Korean children. 5) The most favorate food was altered by chemotherapy, from meats to carbonated beverages and unfavorate food was not altered as vegetables. Conclusion: The periodic assessment of nutritional status and dietary supplements according to preferred foods of patients will be required for the optimal nutrition care in cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7077-7084
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• 2015

Background: Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy among males in India. While tobacco and alcohol are main aetiological factors, human papilloma virus (HPV) presence has surprisingly increased in head and neck Squamous Cell Carcinoma (HNSCC) in the past two decade but its frequency in OSCCS is still uncertain. We aim to explore the frequency of HPV and its major genotypes in North Indian patients and their association with clinicopathological and histopathological features and p16 expression pattern. Materials and Methods: The study group comprised 250 histologically proven cases of OSCC. HPV was detected by real time PCR in tumor biopsy specimens and confirmed by conventional PCR with PGMY09/PGMY11 primers. Genotyping for high-risk types 16/18 was conducted by type specific PCR. p16 expression was assessed by immunohistochemsitry. Results: HPV presence was confirmed in 23/250 (9.2%) OSCC cases, of which 30.4% had HPV 16 infection, 17.4%were positive for HPV 18 and 26.1% had co-infections. HPV presence was significantly associated with male gender (p=0.02) and habit of pan masala chewing (p=0.01). HPV positive cases also had a history of tobacco consumption in 91.3% cases. p16 over expression was observed in 39.1% of HPV positive cases but this was not significantly different from negative cases (p=0.54). Conclusions: The frequency of HPV in OSCC is low in North-India and majority of cases are associated with a tobacco habit. It appears that tobacco shows a confounding effect in HPV positive cases and use of p16 protein as a reliable marker to assess the potential etiological role of HPV in OSCC in our population is not suggested.