Objectives: This study aimed to explore whether common genetic variants that confer the risk of schizophrenia have similar effects between Korean and European ancestries using the polygenic risk score (PRS) analysis. Methods: Study subjects included 713 Korean patients with schizophrenia and 497 healthy controls. The Korea Biobank array was used for genotyping. Summary statistics of the most recent genome-wide association study (GWAS) of the European population were used as baseline data to calculate PRS. Logistic regression was conducted to determine the association between calculated PRS of European patients with schizophrenia and clinical diagnosis of schizophrenia in the Korean population. Results: Schizophrenia PRS was significantly higher in patients with schizophrenia than in healthy controls. The PRS at the pvalue threshold of 0.5 best explained the variance of schizophrenia (R2=0.028, p=4.4×10-6). The association was significant after adjusting for age and sex (odds ratio=1.34, 95% confidence interval=1.19-1.51, p=1.1×10−6). The pattern of the association remained similar across different p-value thresholds (0.01-1). Conclusion Schizophrenia PRS calculated using the European GWAS data showed a significant association with the clinical diagnosis of schizophrenia in the Korean population. Results suggest overlapping genetic risk variants between the two populations.

BACKGROUND AND OBJECTIVES: The purpose of the present study was to compare the results of V-shaped and modified facelift incisions for parotidectomy. SUBJECTS AND METHOD: Ninety parotidectomy patients who underwent V-shaped and modified facelift incisions from 2014 to 2018 were enrolled in this study. Patient characteristics, tumor profiles, surgical outcomes, postoperative complications, and cosmetic results were assessed for the V-shaped (n=20) and modified facelift (n=70) incision groups. RESULTS: The tumor size was significantly larger in the modified facelift incision group than in the V-shaped incision group (2.6 cm vs. 1.9 cm, p < 0.001). There were no significant differences between the two groups regarding other baseline tumor characteristics, operating time, and postoperative complications. Although the results of Vancouver Scar Scale was similar in both groups, the V-shaped incision group showed higher subjective scar satisfaction scores than the modified facelift incision group (9.3 vs. 8.6, p=0.001). CONCLUSION: The results suggest that the V-shaped incision is feasible and can provide better subjective scar satisfaction in selected parotidectomy patients without increased complications.
Cicatrix ; Humans ; Methods ; Parotid Neoplasms ; Postoperative Complications ; Rhytidoplasty*

PURPOSE: To evaluate the results of hypofractionated radiotherapy (HFX) for early glottic cancer. MATERIALS AND METHODS: Eighty-five patients with cT1-2N0M0 squamous cell carcinoma of the glottis who had undergone HFX, performed using intensity-modulated radiotherapy (IMRT, n = 66) and three-dimensional conformal radiotherapy (3D CRT, n = 19) were analyzed. For all patients, radiotherapy was administered at 60.75 Gy in 27 fractions. Forty-three patients received a simultaneous integrated boost (SIB) of 2.3–2.5 Gy per tumor fraction. RESULTS: The median follow-up duration was 29.9 months (range, 5.5 to 76.5 months). All patients achieved complete remission at a median of 50 days after the end of radiotherapy (range, 14 to 206 days). The 5-year rates for locoregional recurrence-free survival was 88.1%, and the 5-year overall survival rate was 86.2%. T2 stage was a prognostic factor for locoregional recurrence-free survival after radiotherapy (p = 0.002). SIB for the tumor did not affect disease control and survival (p = 0.191 and p = 0.387, respectively). No patients experienced acute or chronic toxicities of ≥grade 3. IMRT significantly decreased the dose administered to the carotid artery as opposed to 3D CRT (V₃₅, p < 0.001; V₅₀, p < 0.001). CONCLUSIONS: Patients treated with HFX achieved acceptable locoregional disease control rates and overall survival rates compared with previous HFX studies. A fraction size of 2.25 Gy provided good disease control regardless of SIB administration.
Carcinoma, Squamous Cell ; Carotid Arteries ; Follow-Up Studies ; Glottis ; Humans ; Radiotherapy ; Radiotherapy, Conformal ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Survival Rate

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

Background and Objectives: The incidence of papillary thyroid microcarcinoma (PTMC) continues to increase worldwide. However, there is a lack of a comprehensive understanding of recurrence after hemithyroidectomy in patients with PTMC. We aimed to evaluate the characteristics and risk factors of recurrence after hemithyroidectomy in patients with PTMC.Subjects and Method We included 527 patients with PTMC who underwent hemithyroidectomy between 2009 and 2017. Results: At a mean follow-up of 76.4 months after hemithyroidectomy, recurrence occurred in 4.2% (22/527) of the patients. The times of recurrence were <12, 12-24, 24-36, 36-48, 48-60, and >60 months after initial surgery in 1 (4.5%), 6 (27.3%), 5 (22.7%), 4 (18.2%), 4 (18.2%), and 2 (9.1%) patient(s), respectively. The most common recurrence site was the contralateral remaining thyroid lobe. In univariate analyses, only multifocality was demonstrated to be associated with an increased risk of recurrence [hazard ratio (HR), 2.834; confidence interval (CI), 1.044-7.693; p=0.041). In multivariate analyses, multifocality (HR, 2.982; CI, 1.091-8.155; p=0.033) and central lymph node metastasis (HR, 9.649; CI, 1.238-75.217; p=0.030) were demonstrated to be associated with an increased risk of recurrence. Conclusion The follow-up after hemithyroidectomy for PTMC should focus on the postoperative 1–5-year period with meticulous inspection of the remaining thyroid lobe, particularly in patients with multifocality or central lymph node metastasis.

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

BACKGROUND AND OBJECTIVES: Therapeutic comprehensive neck dissection has been recommended for the patients with recurrent papillary thyroid carcinoma (PTC) confined to the neck after initial total thyroidectomy. However, the benefit of comprehensive neck dissection to remove asymptomatic metastatic lymph node towards improving clinical recurrences or survival is largely unproven. We analyzed the pattern of recurrence in the lateral compartment of neck and evaluated the possible application of limited lymph node dissection against comprehensive neck dissection. SUBJECTS AND METHOD: A retrospective review was carried out for 43 patients who underwent surgical treatment for recurrent PTC in the lateral neck from 2000 to 2005, and their clinicopathological results were stratified according to the extent of surgery into two groups, the limited surgery group and the comprehensive surgery group. RESULTS: Recurrence rate in lateral neck after initial total thyroidectomy was 14.5% (43/296), and the most common level of recurrence was level IV (50.9%). Although limited surgery group showed a tendency toward more frequent recurrence after treatment of the first recurrence than did the comprehensive surgery group, this tendency had no statistical significance. Moreover, no patients in either group have died of PTC during over a mean follow-up period of 80 months. In the aspect of factors associated with surgical morbidity, such as operating time, duration of admission, and complication, the limited surgery group had superior results when compared to the comprehensive group. CONCLUSION: The benefit of comprehensive neck dissection concerning recurrence and survival was not verified in the present study hence a more preservative approach could be applied to selective patients with recurrent PTC in the lateral compartment of neck.
Carcinoma ; Carcinoma, Papillary ; Factor IX ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Neck ; Neck Dissection ; Recurrence ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND AND OBJECTIVES: The purpose of the present study was to evaluate the usefulness of a posterior-based buccinator myomucosal flap (the Bozola flap) for the reconstruction of oral cavity defects after tongue cancer resection. SUBJECTS AND METHOD: Fifteen patients who underwent from 2014 to 2016 reconstruction of the oral cavity with a Bozola flap after surgical management of tongue cancer were enrolled in the study. Patient characteristics, surgical outcomes, and complications associated with the Bozola flap were evaluated. RESULTS: The flap was successfully harvested and transferred in all patients. The mean flap harvesting time was 25.3 min. The donor site was closed primarily in 14 patients, and a buccal fat pad flap was used in one patient. Although partial necrosis of the flap occurred in two patients, no other major complications were noted. CONCLUSION: The results of this study demonstrate that the Bozola flap is a good option for reconstruction of moderate sized oral cavity defects in tongue cancer patients.
Adipose Tissue ; Humans ; Methods ; Mouth Mucosa ; Mouth* ; Necrosis ; Reconstructive Surgical Procedures ; Tissue Donors ; Tongue Neoplasms* ; Tongue*

Although neurilemmomas can arise from all types of cranial nerves except the optic and olfactory nerves, a hypoglossal neurilemmoma is extremely rare. Furthermore, since this neurilemmoma usually develops in the intracranial portion of the hypoglossal nerve, a hypoglossal neurilemmoma in the submandibular region is unfamiliar even to head and neck surgeons. However, the preoperative diagnosis of hypoglossal neurilemmoma in the submandibular region is very important because of the possibility of sacrificing the hypoglossal nerve during surgery under the incorrect impression of a salivary gland tumor. Therefore, we report a case of hypoglossal nerve neurilemmoma occurring in the submandibular area with a review of the literature focusing on preoperative differential diagnosis.
Cranial Nerves ; Diagnosis, Differential ; Head ; Hypoglossal Nerve ; Neck ; Neurilemmoma* ; Olfactory Nerve ; Salivary Glands ; Submandibular Gland

The use of somastostatin in chyle fistula that occurs after neck dissection is a new approach that has been reported in few cases. We report two cases of chyle fistula that occurred after neck dissection, which were successfully managed with somatostatin subcutaneous injection. Somatostatin treatment resulted in an immediate reduction of chyle leakage in both patients, and might have contributed to the reduction of patients' morbidity and duration of hospital stay. However, optimal treatment regimen with somatostatin is unclear because of its limited case and various administration methods. Further studies are required to clarify the usefulness and optimal regimen of somatostatin injection in the treatment of chyle fistula following neck dissection.
Chyle ; Fistula ; Humans ; Injections, Subcutaneous ; Length of Stay ; Neck ; Neck Dissection ; Octreotide ; Somatostatin