PURPOSE: Compared to conventional radiotherapy (RT), intensity-modulated radiotherapy (IMRT) significantly reduces the rate of treatment-induced late toxicities in head and neck cancer. However, a clear survival benefit of IMRT over conventional RT has not yet been shown. This study is among the first comparative study to compare the survival rates between conventional RT and helical tomotherapy in head and neck cancer. MATERIALS AND METHODS: From January 2008 to November 2011, 37 patients received conventional RT and 30 patients received helical tomotherapy for management of head and neck cancer. We retrospectively compared the survival rates between patients treated with conventional RT and helical tomotherapy, and analyzed the prognostic factors for survival. RESULTS: The 1- and 2-year locoregional recurrence-free survival rates were 61.2% and 58.1% for the conventional RT group, 89.3% and 80.3% for the helical tomotherapy group, respectively. The locoregional recurrence-free survival rates of the helical tomotherapy group were significantly higher than conventional RT group (p = 0.029). There were no significant differences in the overall and distant metastasis-free survival between the two groups. RT technique, tumor stage, and RT duration were significant prognostic factors for locoregional recurrence-free survival. CONCLUSION: This study showed the locoregional recurrence-free survival benefits of helical tomotherapy in the treatment of head and neck cancers.
Head ; Head and Neck Neoplasms ; Humans ; Neck ; Radiotherapy, Intensity-Modulated ; Retrospective Studies ; Survival Rate

Thirty-eight patients with a musculoskeletal chest wall syndrome were evaluated for the musculoskeletal findings of chest wall. All patients had the chest wall tenderness and the typical chest pain could be reproduced by the palpation. There was no significant difference in the diagnostic features of the pain for the onset, location, characteristics, duration, radiation, and area of references for chest pain among the different groups of the patients. However, a reproduction of pain by palpation and the pressure threshold difference between the lesion and control points by using pressure algometry was a reliable and specific diagnostic tool. Pressure threshold difference was correlated with numerical rating scale by the correlation coefficient 0.96. The common causes of the chest wall syndrome were the myofascial pain syndrome, chostochondritis, sternalis syndrome, rib-tip syndrome, xiphodynia in order. Six patients had chest wall disorders in conjunction with other associated intrathoracic condition. Thirty-two patients had an isolated chest wall syndrome. Chest wall syndrome should be considered in all patients with the chest pain, as its recognition could help the patient management.
Chest Pain ; Humans ; Myofascial Pain Syndromes ; Palpation ; Reproduction ; Thoracic Wall* ; Thorax*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

BACKGROUND: Radiation has been used in t,he medical field of dragnosis and treatment. There is widely used ionizing radiat:ion such as naturally occuring r-rays or machine-made X-ray. This radiation is able to induce the structural and functional alterations of the mammalian cells. But we have few detailed reports on the effects of radiation on epidermal cells and their immune functions. OBJECTIVE: This study was performed to investigate the effect of radiation on cultured human keratinocytes and melanocytes. MATERIALS AND METHODS: Cultured human keratinocytes and melanocytes were irradiated with 2,6, l0Gy from a Co saurce and stimulated by 100 U/ml of ekratinocyte immediately after irradiation. We investigated cell numbers and morphological changes, DNA synthesis and HLA-DR antigen expression. RESULTS: After exposure to r-ray, the proliferation of keratinocytes and melanocytes decreased in a time and dose dependent fashion to each control group. Tliey showed decreased density, a larger size and a round appearance after radiation exposure and an especially shortened and decreased number of dendrites in the melanocytes. In DNA synthesis counted using [H]-thymidine incorporation, the keratinocvtes decreased values in a dose depen(lent manner at 24 and 72 hours after irradiation but no differense was observed at 168 hours. In melanocytes, there was a greater decrease than that of keratinocytes. The melanin content/cell in all radiation exposed groups increased in a time and dose dependent fashion t,o each contr ol group. HLA-DR antigen expression on keratinocytes after radiat,ion exposure decreased to the control group, but there were no significant differences acccirding to the dose of radiation, And there were no significant diifferences of HLA-DR antigen expression on the melanocytes betweer. controls and the radiation exposed groups. CONCLUSION: Antiproliferative activity was dependent on the exposure time and dose of r-ray exposure. According to the time after radiation exposure, melanogenic activity was stimulated. The expression of HLA-DR, antigen decreased in keratinocyte after radiation exposure but there was no decrease in melanocytes.
Cell Count ; Dendrites ; DNA ; HLA-DR Antigens ; Humans* ; Keratinocytes* ; Melanins ; Melanocytes*

Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages : (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operative field. But, we also have some disadvantages of difficult handling of the pliable veins and the tmcertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.
Arteries ; Edema ; Forearm ; Hand* ; Veins ; Wounds and Injuries*

No abstract available.
Osteoblastoma* ; Spine*

No abstract available.
Head* ; Neck*

Frey syndrome is characterized by sweating and flushing on the auriculotemporal region in respense to gustatory stimuli following surgery, trauma or irfection of the parotid areas. A 22-year-old man had received a surgery for sclerosis and hypertrophy of the left mandible. Two months after operation gustatory sweating occurred, whenever he eats, on the malar area without any detectable flushing or sensory impairment. Sweating starts in 30 seconds during food intake and is clearly visible with naked eyes within 2 minutes. This syndrome is encountered uncommonly to the dermatologic practitioners but more cases might be discovered if more attention could be given to this condition.
Acitretin* ; Administration, Oral ; Eating ; Etretinate* ; Flushing ; Humans ; Hyperkeratosis, Epidermolytic ; Hypertrophy ; Ichthyosiform Erythroderma, Congenital ; Ichthyosis* ; Mandible ; Nevus ; Porcupines* ; Sclerosis ; Sweat ; Sweating ; Sweating, Gustatory* ; Young Adult

Perforator free flap (PFF) is currently a major reconstructive option for soft tissue reconstruction in adults. Although PFFs have been used commonly, most reconstructive surgeons still hesitate to perform PFFs in children. The main cause of concern is the perceived high failure rate related to the small diameter of children's perforator vessels. We present 8 consecutive cases of successful transfer of thoracodorsal artery (TDA) & anterolateral thigh (ALT) perforator flap in children. Between 2003 and 2005, 8 children(4 to 13 years old) with soft tissue defects of the extremities were reconstructed with TDA & ALT PFFs. All flaps completely survived. There were no problems relating to vascular spasm or occlusion. Range of motion of reconstructed extremities were fully recovered. Among 8 patients, only 1 patient was performed an additional flap thinning procedure. 8 cases of TDA & ALT perforator flaps were successfully transferred in children. PFF is an excellent option in reconstruction of children as well as in adults because of its thinness, long pedicle length, least donor site morbidity and acceptable donor site scar.
Adult ; Arteries ; Child ; Cicatrix ; Extremities* ; Free Tissue Flaps* ; Humans ; Perforator Flap ; Range of Motion, Articular ; Spasm ; Thigh ; Thinness ; Tissue Donors

PURPOSE: Unresectabel rectal cancer has a grave prognosis, regardless of the therapy used and median survival is less than 1 year. Also, it is reported by many authors that 50-80% of unresectable lesions were rendered respectable by radiation therapy and the median survival time for the completely resected patients were better than that of the unresected patients. So we analyzed retrospectively our data for the better treatment outcome in these patients. MATERIALS AND METHODS: From 1980 to 1992, 45 patients with initially unresectable tumors in the rectum were treated with radiation therapy with/without surgery in Department of Radiation Oncology, Yonsei Cancer Center. 10 MV radiation and multiple field technique( box or AP/PA) were used. The total dose was 8-70 Gy and median dose was 48 Gy. We evaluated the lesion status at 45-50 Gy for operability. If the lesions appeared to be respectable, the patients were operated on 4-6 weeks after radiation therapy. But if the lesions were still fixed, the radiation dose was increased to 60-65 Gy. RESULTS: For all patients, the 2-year actuarial survival was 13.3% and median survival was 9.5 months. Of 6 patients who had received less than 45 Gy, only 17% of patients responded, but in the patients who had received more than 45 Gy, 60% of response rate was achieved. Six of the 24 patinets(25%) underwent surgical resections following RT. For patients undergoing curative resection, the two-year survival was 50%, but that of the patients without resection was 9.5% (p<0.01). Survival of patients with complete response following RT was 50% at 2 years. Survival of patients with partial response, stable disease and progressive disease after RT was 13.4%, 15.4%, 0% respectively (p<0.05). Conclusion: Our data suggests that the efforts which can increase the response rate and aggressive surgical approach are needed to achieve the better local control and survival in unresectable rectal cancers.
Humans ; Prognosis ; Radiation Oncology ; Rectal Neoplasms* ; Rectum ; Retrospective Studies ; Treatment Outcome