• Journal of Chest Surgery
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• 제12권2호
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• pp.82-88
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• 1979

During the past 3 years, 15 patients who could not be anesthetized generally because of poor general condition or cachecic state, of 111 patients with empyema, have been treated with modified Eloesser`s operation under the local anesthesia with 2% procaine. There were 13 males and 2 females ranging from 21 years to 61 years of age. The etiology was tuberculosis [6 cases], pyogenic pneumonia [5 cases], lung abscess [1 case], post-trauma [2 cases] and malignancy[1 case]. " The over-all mortality rate was 6.7%[1 case] and cause of its death was poor oral feeding because of post-traumatic psychosis. Modified Eloesser`s operation was performed after closed tube thoracostomy and irrigation with 1% zephanon solution for over 2 weeks. And then the other operation was not performed and all patients except 1 case appeared good progression (Complete healing; 4 cases, Progressive healing 10 cases, death: 1 case).

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.247-252
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• 2005

Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out. Sometimes, tongue lesions are present with dyspnea, dysphagia, dysarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of the tongue in 4 month old female patient. Swallowing difficulty and respiratory distress symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination. After excision of tongue mass, she had no problem with swallowing and breathing.

• Journal of Chest Surgery
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• 제54권6호
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• pp.524-527
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• 2021

Herein, we describe the case of a 20-year-old woman who presented with dysphagia of 2 months' duration associated with vomiting, moderate abdominal pain, decreased oral intake, and significant weight loss. During the past 3 years, the patient experienced intermittent mild abdominal pain with infrequent vomiting. Endoscopy at Jordan University Hospital showed a mass in the esophagus, and endoscopic biopsies were performed. The preliminary histopathological report excluded malignancy. Two days after endoscopy, the patient presented to the emergency department complaining of severely worsening pain and total dysphagia. The pain persisted despite intravenous paracetamol administration, which was concerning for esophageal perforation; therefore, an urgent surgical intervention was performed. The mass was removed surgically, along with a para-esophageal lymph node. The final histopathological results of the endoscopic and resected specimens supported the diagnosis of pseudomyogenic hemangioendothelioma (PMHE). This is the first case reporting esophageal involvement of PMHE.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6347-6352
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• 2015

Background: Breast malignancies are one of the leading causes of deaths in females worldwide. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there are insufficient data available. Materials and Methods: A case control study was conducted on females in age group between 30-80 years. This study was accomplished by retrospective data collection in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included along with 108 matched controls. Relationship of various factors with disease was studied using logistic regression to calculate odds ratios with 95 % confidence intervals. Results: A total of 14 variables were analyzed and based on and 7 were found to be risk factors: old age, family history of breast cancer, family history of other carcinomas, personal history of breast carcinoma, early age of menarche, older age of mother at first delivery and lower number of children. Five factors, parity, breast feeding, history of oral contraceptive pills intake, past history of oophorectomy and hysterectomy showed protective associations. One variable, use of hormonal replacement therapy, showed a controversial link and one other, marital status, was not significant in this study. Conclusions: It is concluded that most of the well-known risk factors for breast cancer are also associated with the disease in the female population of Karachi, Pakistan. High risk patients should be the focus with the help of this study so that screening can be more effective for early diagnosis before clinically evident breast malignancy.

• 대한기관식도과학회지
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• 제2권2호
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• pp.200-212
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• 1996

The clinical staging systems for oral squamous cell carcinoma is limited as a prognostic indicatior because of different biological characteristics of cancer in this region and variable microenvironment depending on subsites, there have been study to determine prognosis by evaluating malignancy, that is the nature of tumor cells. Many studies have been tried to determine prognostic indicator in various malignancies for the evaluation of differentiation capacity and the expression of oncogene product. EGF make a role in cellular growth and differentiation and to be essential in cellular survival. EGFR is an intergral membrane protein, stimulate cellular differentiation and hormonal secretion, and has structural homology with V-erb-B transforming protein. Recent reports have demonstrated that EGFR is overexpressed in stomach, breast, vagina, dermis, head and neck, genitourinary and lung tumors, and possibly used as a tumor marker. In head and neck region, most of studies were mainly carried out on laryngeal squamous cell carcinoma. In the present study, immunohistochemical study for EGFR and C-erb-B2 gene in paraffin sections of 45 squamous cell carcinoma in oral cavity was performed to evaluate the presense of EGFR and C- erb-B2 gene in this lesion, to evaluate them as a prognostic indicator by analysing the correlation between these expression and subsites, primary stages, clinical stages, pathologic grades, neck node metastasis, recurrences and treatment results, and to determine relation between EGFR and C-erb-B2 gene.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.3.1-3.9
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• 2019

Background: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. Methods: A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors' diverse clinical experiences. Results: We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail. Conclusions: An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.473-476
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• 2010

Purpose: Torus palatinus is a bony prominence at the middle of the hard palate. The size varies from barely discernible to very large, from flat to lobular. This oral exostosis is not a disease or a sign of disease, but if large, may be a problem. So, we present the clinical and histopathologic features and applied therapy and provide a comprehensive review of the rare case of the symptomatic exostoses. Methods: A 37-year-old woman had slowly growing exophytic nodular mass of the bone that arises the midline suture of the hard palate. The patient was concerned about discomfort associated with movement of her tongue and about frequent irritation of the palatal mucosa during mastification of the hard food. The patient had a large, unilobulated torus palatinus. It extended from the area adjacent to the canine to a point beyond the junction with the soft palate. The mass was oblong in shape, measuring about 3 cm long, 2 cm wide, and 0.8 cm in height. Results: Before surgical intervention a CT was obtained for the sake of estimating the thickness of the bone between the exostoses and the maxillary antrum and floor of the nose. The surgical procedure was performed with the patient under general anesthesia. Removal of the exostosis was performed after midline mucoperiosteal incision with osteotome and diamond burr. Histologic finding revealed decalcified dense bony tissue, the presence of lacunae, and normal osteocytes. Conclusion: Surgical removal is recommended when one or more of the following condition exist: interference with the construction of prosthesis, interference with oral function, irritation or pathology of the overlying tissue, inability of the patient to maintain proper oral hygiene, and fear of malignancy or other psychologic trauma. We report a rare case of the torus arising in hard palate with symptoms.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2743-2746
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• 2013

Background: Dilantin sodium (phenytoin) is an antiepileptic drug, which is routinely used to control generalized tonic clonic seizure and partial seizure episodes. A few case reports of oral squamous cell carcinomas arising from regions of phenytoin induced gingival overgrowth (GO), and overexpression of mitogenic factors and p53 have presented this condition as a pathology with potential to transform into malignancy. We recently investigated the genetic status of p53 and H-ras, which are known to be frequently mutated in Indian oral carcinomas in GO tissues and found them to only contain wild type sequences, which suggested a non-neoplastic nature of phenytoin induced GO. However, besides p53 and H-ras, other oncogenes and tumor suppressors such as PIK3CA, p14ARF, p16INK4a and $p21^{Waf1/Cip1}$, are frequently altered in oral squamous cell carcinoma, and hence are required to be analyzed in phenytoin induced GO tissues to be affirmative of its non-neoplastic nature. Methods: 100ng of chromosomal DNA isolated from twenty gingival overgrowth tissues were amplified with primers for exons 9 and 20 of PIK3CA, exons $1{\alpha}$, $1{\beta}$ and 2 of p16INK4a and p14ARF, and exon 2 of $p21^{Waf1/Cip1}$, in independent reactions. PCR amplicons were subsequently gel purified and eluted products were sequenced. Results: Sequencing analysis of the twenty samples of phenytoin induced gingival growth showed no mutations in the analyzed exons of PIK3CA, p14ARF, p16INK4a and $p21^{Waf1/Cip1}$. Conclusion: The present data indicate that the mutational alterations of genes, PIK3CA, p14ARF, p16INK4a and $p21^{Waf1/Cip1}$ that are frequently mutated in oral squamous cell carcinomas are rare in phenytoin induced gingival growth. Thus the findings provide further evidence that phenytoin induced gingival overgrowth as a non-neoplastic lesion, which may be considered as clinically significant given the fact that the epileptic patients are routinely administered with phenytoin for the rest of their lives to control seizure episodes.

• Journal of Oral Medicine and Pain
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• 제35권2호
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• pp.155-163
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• 2010

피부근염은 특발성의 염증성 결합조직 질환으로서 점진적인 근육의 쇠약과 특징적인 피부 발진의 증상을 보이는 전신적 자가 면역 질환의 일종이며 근력 약화와 함께 나타나거나 흔히 선행하는 특징적 발진에 의해 진단된다. 가장 특징적인 피부증상은 상안검의 부종과 함께 나타나는 푸르면서 보라색 발진인 heliotrophic rash, 안면부와 상부 흉부의 넓적하고 붉은 발진 (flat red rash), 피부의 인설(scaling)현상을 나타내는 손가락 관절(knuckle)부위의 두드러진 Gottron's papules (violaceous scaly eruption)등 이다. 근육 증상으로 주로 근위부 사지 근육의 약화를 동반한 근육의 염증성 및 퇴행성 변화를 보인다. 피부 근염은 종종 소화기계 (gastrointestinal tract)와 호흡기계 (respiratory system)를 침범하며 15%~25%에서 악성변화를 보인다. 치료는 피부증상뿐 아니라 근육 증상도 악화시킬 수 있는 자외선에 대한 노출을 피하고 일차적으로 전신적 corticosteroid를 사용하며 증상이 심하거나 steroid에 반응이 없을 때 다른 면역억제제를 사용할 수 있다. 피부근염에서 안면근은 침범되지 않으며 저작근의 이환 역시 거의 없다. 본 증례를 통해 피부근염을 앓고 있는 환자에서 개구장애가 발생할 수 있으며, 이는 근경축과 유사한 양상을 보임을 알 수 있었다. 따라서 피부근염 환자에서 발생할 수 있는 개구장애는 회복이 어려울 수 있으므로, 점진적으로 개구량이 줄어드는 것을 막고 정상적인 개구량을 확보 할 수 있도록 지속적인 개구운동 등의 치료가 필요하다고 사료된다.

• 생명과학회지
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• 제19권8호
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• pp.1047-1054
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• 2009

구강편평상피암종은 말기에서 종종 화학치료요법제들이 유도하는 세포자멸사에 저항성을 보인다. 박테리아의 독에 대한 진전된 이해는 암치료에 대한 새로운 치료전략으로 제기되어지고 있다. 본 연구는 Pseudomonas aeruginosa exotoxin A (PEA)가 세포자멸사 기작을 통해 항암제에 저항성을 보이는 YD-9 구강편평상피암종의 생존율을 현격하게 떨어뜨림을 설명하고 있다. 세포자멸사현상은 핵의 형태학적 변화와 DNA 분절 생성을 통해 입증되었다. PEA는 caspase-3, -6, -9 의 분절과 활성화를 일으켰다. 그리고 이러한 반응들은 caspase 의 기질에 해당하는 poly (ADP-ribose) polymerase (PARP), DFF45, 그리고 lamin A 의 단백질 분해를 야기했다. 사립체 막전위 감소, cytochrome c와 Smac/DlABLO의 사립체로부터 세포질로의 유리, 그리고 AIF의 사립체에서 핵으로 이동 등이 관찰되었다. p53, p21 그리고 $14-3-3{\gamma}$는 증가되는 반면 cyclin B와 cdc2는 감소되었다. 이상의 결과들을 종합해 보면 PEA는 caspase를 활성화시키고, 사립체에 변화를 야기시키고 더 나아가서 세포주기 유전자를 조절함으로써 항암제에 대한 강한 저항성을 보이는 YD-9 세포에서 세포자멸사를 유도한다.