Occult Neck Metastasis in Larynx and Hypopharynx Squamous Cell Carcinomas Confirmed with Simultaneous Bilateral Elective Neck Dissection

BACKGROUND AND OBJECTIVES: Neck metastasis is one of the most important prognostic factor in treating head and neck squamous cell carcinomas. Recently, elective neck dissection has been widely accepted for accurate pathologic staging and elective treatment of neck. Occult metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. However, occult metastasis rate confirmed with simultaneous bilateral elective dissection is rare. MATERIALS AND METHODS: Fifty patients (100 necks) who underwent surgery for laryngeal and hypopharyngeal squamous cell carcinomas as an initial treatment from 1992 to 1997 were evaluated. All had bilateral elective neck dissection at the time of surgery for the primary treatment. Charts and pathologic reports were reviewed. RESULT: Occult neck metastasis rate by primary site were as follows. Supraglottis ipsilateral 40% (8/20) contralateral 15% (3/20), glottis ipsilateral 18% (4/22), contralateral 0% (0/22), hypopharynx ipsilateral 88% (7/8), contralateral 25% (2/8). CONCLUSION: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Contralateral neck occult metastasis from glottic cancer was minimal.ope

Effects of Arytenoid Adduction and Type I Thyroplasty Combined Surgery for Unilateral Vocal Cord Paralysis

Type I thyroplasty, we know, could not overcome the large posterior glottal chink and arytenoid adduction have been proved to be uneffective in the cases of unilateral vocal cord paralysis with vocal cord atrophy or bowing deformity. So we performed type I thyroplasty in conjunction with arytenoid adduction and tried to compare the postoperative results with that of arytenoid adduction. We experienced 8 cases of arytenoid adductions and 6 cases of combined operations in the cases of unilateral vocal cord paralysis. All 14 patients had large posterior glottal chink. In order to compare the postoperative voice results of two groups as objective as possible, we performed preoperative and postoperative videoimage analysis(chink size, interarytenoid distance) and computer-assisted voice analysis(MPT, Jitter, Shimmer, S/N ratio). As a results, the postoperative voice outcome is superior with the combined operation than with the arytenoid adduction only in the cases of unilateral vocal cord paralysis with large glottal chink.ope

Clinical Analysis of Head and Neck Sarcoma

Introduction : Sarcoma of the head and neck region is a very rare disease entity. This retrospective study investigated the clinical characteristics of head and neck sarcomas and analyzed its treatment methods and outcomes. Subjects and Methods : Eighty-five patients who were diagnosed as sarcomas of the head and neck region in Shinchon Severance Hospital between 1985 and 2005 were included in the study. Data concerning age, sex, symptoms, location and size of tumor, histopathologic characteristics, treatment methods, recurrence, and distant metastasis were reviewed. Result : Overall 5 year survival rate was 38% and the 5 year survival rate in the pediatric population was 60%. The 5 year survival rates for each osteosarcoma and soft tissue sarcoma cases were 42% and 37% respectively. The 5 year survival rate was significantly higher in the cases where complete surgical resection was achieved. Conclusion : In managing head and neck sarcomas, it is important to perform wide resection and to achieve complete resection.ope

Combination gene therapy using multiple immunomodulatory genes transferred by a defective infectious single-cycle herpes virus in squamous cell cancer

Herpes simplex type 2-defective infectious single-cycle (DISC) viruses are attenuated viruses that were originally produced as viral vaccines; however, these viruses are also efficient gene transfer vehicles. The main goals of this study were to examine determinants of the gene transfer by using DISC virus for squamous cancer and to evaluate the antitumoral efficacy of vaccination with tumor cells modified by DISC viruses carrying a combination of immunomodulatory genes (interleukin-2 (IL-2), granulocyte-macrophage colony-stimulating factor (GM-CSF), B7-1) in a model of squamous cell cancer (SCCVII) in C3H/HeJ mice. SCCVII cells transduced by DISC viruses (multiplicity of infection of 10) carrying the IL-2 or GM-CSF gene produced nanogram quantities of IL-2 or GM-CSF per 10(6) cells. Irradiated (5,000 cGy, 10,000 cGy) cells secreted levels of GM-CSF or IL-2 that were comparable with nonirradiated cells. In vivo vaccination using tumor cells transduced ex vivo with DISC-IL2 or DISC-GMCSF resulted in protection against subsequent tumor challenge (P < .01), with DISC-GMCSF-transduced, irradiated tumor cells showing the greatest effects (P < .001). Marked growth arrest also was noted in established tumors after direct injection of DISC-GMCSF (P < .001). These data demonstrate that (a) DISC virus is capable of efficient gene transfer, (b) GM-CSF-secreting genetically modified tumor vaccine protects against tumor cell challenge and suppresses tumor growth, and (c) intratumoral injection of DISC-GMCSF significantly suppresses the growth of established tumors. These results not only confirm clinically relevant gene transfer but also demonstrate that the gene transfer is an effective anti-cancer therapy.ope

Diagnostic Significance of the Endoscopy-guided Biopsy with Tonsillectomy in Suspected Occult Primary Tumor

BACKGROUND AND OBJECTIVES: An occult primary tumor is defined as histologic evidence of malignancy in the cervical lymph nodes with no apparent primary site of origin for the metastatic tumor. MATERIALS AND METHODS: Twenty-three patients who have failed to detect primary tumor on their initial physical examinations, endoscopy and other imaging studies, underwent endoscopy-guided biopsy under the general anesthesia. The histologic examination of frozen sections was done in the operation room. For those failing to give results by the histologic study, we performed the ipsilateral tonsillectomy biopsy. RESULTS: Nine primary lesions were identified: four cases of tonsillar fossa, one case each of nasopharynx, base of tongue, hypopharynx, supraglottis, and esophagus. In the three of the four tonsillar cancer cases, the primary foci were also identified by tonsillectomy biopsy. All the patients whose primary foci were tonsillar fossa showed metastasis of the jugulodigastric lymph node. CONCLUSION: Our results indicate that patients who are considered to have occult primary tumor should be evaluated by endoscopy-guided biopsy under the general anesthesia. Also, this study finds that if the histologic result of the frozen section were negative, ipsilateral tonsillectomy can be justified, especially for patients who show metastasis of jugulodigastric cervical lymph node.ope

Feasibility of Robotic Surgical System in the Field of Head and Neck Surgery

The current trend in managing head and neck cancer is to perform organ preservation therapy which improves quality of life and decreases treatment related morbidity. Transoral robotic surgery (TORS) can overcome the limit of “line of sight” often met in classic transoral procedure. We utilized robotic surgical system for the treatment of oropharyngeal, hypopharyngeal and laryngeal cancer. TORS was performed using the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA). It is consisted of a surgeon’s console and a manipulator cart equipped with 3 robotic arms. The surgeon is provided with 3-dimensional magnified images from the endoscopic arm and can control 2 instrument arms for delicate operations from the console. TORS can provide magnified three dimensional views and overcome the limitation resulting from the “line of sight” which hinders classic transoral procedure. Safe resection of the head and neck cancer lesion was possible with the 3-dimensional magnified images and two robotic arms which have 360 degree joint motion. The application of TORS for lateral oropharyngectomy, partial hypopharyngectomy and partial laryngectomy is technically feasible and safe.ope

나노 입자 적층 장비를 이용하여 제작한 이산화세륨 박막의 특성 및 전기변색 응용

학위논문 (석사)-- 서울대학교 대학원 : 기계항공공학부, 2017. 2. 안성훈.We attempted to fabricate CeO2 counter electrode by using a low vacuum and room temperature dry powder deposition method for electrochromic window (ECW) application. We deposited a CeO2 film on fluorine-doped tin oxide (FTO) coated glass and investigated its use as the counter electrode. The structure of the as-deposited CeO2 film was characterized by X-ray diffraction, and the films surface morphology and thickness was investigated by Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). ECW which the CeO2 film was applied to as a counter electrode showed enhanced reversibility of 85% at a wavelength of 800 nm although transmittance modulation was decreased.Chapter 1. Introduction 1 1.1 Electrochromism 1 1.2 Electrochromic applications 3 1.3 Nano particle deposition system (NPDS) 6 1.4 Goal of research 8 Chapter 2. As-deposited CeO2 film 9 2.1 Film deposition 9 2.2 Deposition characteristic 11 2.3 Electrochemical characteristic 14 Chapter 3. CeO2 counter electrode 16 3.1 Fabrication of electrochromic windows (ECWs) 16 3.2 Electrochemical characteristic of ECWs 18 3.3 Electrochromic characteristic of ECWs 20 Chapter 4. Conclusion 23 Bibliography 24 Abstract in Korean 27Maste

The Etiologic Roles and Carcinogenic Mechanisms of Human Papilloma Virus in Head and Neck Squamous Cell Carcinoma

Background : The most frequently reported risk factors for head and neck suamous cell carcinoma are smoking and alcohol. But in a recent overview, human papilloma virus(HPV) infection was revealed the important carcinogenic factor in oropharyngeal cancer. We aimed to clarify whether HPV directly effects on the oncogenesis and biologic behavior of hean and neck squamous cell carcinoma by comparison with infection prevalence, and physical status of virus. Material and Method : We used HPV genotyping DNA chip(Biocore, Korea, Seoul) arrayed by multiple oligonucleotide probes of L1 sequence of 26 types of HPV and HPV genotypes are identified by fluorescence scanner. The copy numbers of HPV E2 and E6 open reading frames(ORF) were assessed using a TaqMan-based 5'-exonuclease quantitative real-time PCR assay. The ratio of E2 to E6 copy numbers was calculated to determine the physical status of HPV-16 viral gene. Results : We observed a significant difference in HPV prevalence between tonsillar cancer group and control group(73.1% vs. 11.6%), and most of the HPVs were type 16(87.2%) and integrated(94.1%) state. In terms of oral tongue cancer, we demonstrate that 30.5% has integrated HPV-16 in cancer tissue. But Glottic cancer only 1% is related to HPV-16 integration. Conclusion : This study revealed significant relationship of HPV prevalence with oropharyngeal and oral tongue squamous cell carcinoma. Most of HPV were 16 type and integrated or mixed, HPV-16 integration could be directly related to the carcinogenesis.ope

A Case of Transoral Robotic Radical Lateral Oropharyngectomy in Tonsilar Cancer

Transoral robotic system (TORS) is performed by positioning at least 3 robotic arms through the oral cavity that are operated by the surgeon bimanually. The elaborate movements of the operating tools and high resolution endoscopic images provided by the robot can overcome the shortcomings of transoral radical lateral oropharyngectomy, thus enabling wide and effective surgery. Also, it preserves postoperative functions and improves the quality of life, thereby decreasing postoperative morbidity. In this study, the possibility of TORS as a novel surgical method in managing tonsillar carcinoma has been identified. However, a long term observation regardingpostoperative swallowing, phonation, quality of life and oncologic safety in using TORS is further requiredope

Herpes Viral Gene Therapy for the Treatment of Head and Neck Squamous Cell Carcinoma

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