A poor prognosis of oral squamous cell carcinoma (SCC) is partly due to the invasiveness and metastasis of the tumor. A key element in tumor invasion and metastasis in the degradation of extracellular matrix is matrix metalloproteinases (MMPs). This study was performed to determine the expression of MMP-2 and MMP-9 of oral SCCs with regard to the histologic invasiveness and differentiation in 5 normal oral mucosa and 36 oral SCCs. The histologic invasiveness of oral SCCs were classified into 4 grades. The differentiation of oral SCCs was divided into 3 grades. The streptavidin-biotin immunohistochemical staining, using MMP-2 and MMP-9 monoclonal antibodies, was performed to determine the expression of MMP-2 and MMP-9. The expression of MMP-2 was positive in 6 of 17 oral SCCs with weak invasiveness and was positive in 7 of 19 oral SCCs with strong invasiveness. The MMP-2 expression did not increase significantly with respect to the invasiveness of oral SCCs (P>0.05). The expression of MMP-9 was strongly positive in 6 out of 17 SCCs with weak invasiveness and was strongly positive in 14 of 19 SCCs with strong invasiveness. The MMP-9 expression increased significantly with respect to the invasiveness of oral SCCs; the stronger the expression, the stronger the invasiveness (P<0.05). The expression of MMP-9 was in 57.9% of well differentiated SCCs, 57.1% of moderately differentiated ones, and 33.3% of poorly differentiated SCCs. The expression of MMP-2 and MMP-9 did not increase significantly with respect to the histologic differentiation. We conclude that with respect to the invasiveness, the MMP-9 expression increases significantly in oral SCCs but the MMP-2 expression does not; and that with respect to the histologic differentiation, their expressions do not increase significantly. These results suggeste that MMP-9 can be used as a tool to evaluate the invasiveness of oral SCCs.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Extracellular Matrix ; Matrix Metalloproteinase 2* ; Matrix Metalloproteinases ; Mouth Mucosa ; Neoplasm Metastasis ; Prognosis

Angiogenesis is an essential process in tumor growth and metastasis. VEGF has been considered a leading candidate inducing tumor angiogenesis. VEGF expression was significantly correlated with clinical stage, lymph node matastasis, and prognosis of cancers of various parts of body. However, little has been known about the correlation between VEGF expression and clinicopathologic parameters in oral squamous cell carcinoma. The aim of this study was to correlate VEGF expression with the clinicopathological parameters and microvessel density. Forty six oral squamous cell carcinomas were analyzed using immunohistochemical method with primary antibodies to VEGF and CD31. VEGF expression was detected in 33 (71.7%) of the 46 cases. The microvessel density was significantly correlated with VEGF expression (P=0.002). There was no correlation between microvessel density and tumour size, clinical stage, and lymph node metastasis, respectively. VEGF expression did not correlate with the histological grade of tumour differentiation, tumour size, and clinical stages. The VEGF-positive rate seemed to be higher in patients with cervical lymph nodal metastasis than in those without it, but it was not statistically significant. In conclusion, the overexpression of VEGF in the oral squamous cell carcinoma seemed to be associated with a more aggressive course of the disease. Further study is necessary to define the role of VEGF in oral squamous cell carcinoma.
Antibodies ; Carcinoma, Squamous Cell* ; Humans ; Lymph Nodes ; Microvessels* ; Neoplasm Metastasis ; Prognosis ; Vascular Endothelial Growth Factor A*

The purpose of this study is to evaluate the prognostic significance of argyrophilic nucleoalr organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) by using DMBA hamster buccal pouch carcinogenesis which provides a good experimental model in reproducing steps from precancerous lesions to invasive squamous cell carcinomas. The buccal pouches of 50 Syrian hamsters were applied with 0.5% DMBA in mineral oil three times a week to reproduce various lesions from precancerous ones such as hyperkeratosis or epithelial dysplasia to invasive squamous cell carcinomas. Their sections were stained with H & E, and silver colloid, and processed immunohistochemically by being applied with monoclonal antibody to PCNA. The histopathologic examainations were done and the counts of AgNORs were evaluated. The PCNA labelling indices on each lesions were evaluated. The correlation between histopathological grades and counts of AgNORs or PCNA labelling indices were evaluated. The number of AgNORs was 2.22+/-0.22 in control group, 3.46+/-0.72 in carcinoma in situ (CIS), 3.78+/-0.63 in squamous cell carcinoma (SCC), respectively. AgNORs significantly increased in severe epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The PCNA Labeling Index (LI) was 39.47+/-6.68% in control group, 79.61+/-4.14% in CIS, and 85.43+/-6.25% in SCC, respectively. PCNA LI also significantly increased in epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The number of AgNORs, AgNOR area, and PCNA LI slightly increased in the advancing front than in the center of SCC, but, it was not statistically significant. It appeared that there were a good correlation between the number of AgNORs and PCNA LI (Pierson correlation coefficient : 0.649, P<0.001). These results suggested that the number of AgNORs and the PCNA LI could be useful markers for evaluating the risk of malignant transformation and prognosis of SCC. It was thought that the clinical usefulness of these markers should be verified by using human tissue specimens.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Carcinogenesis* ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Colloids ; Cricetinae* ; Humans ; Mesocricetus ; Mineral Oil ; Models, Theoretical ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver

This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients, 24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 patients). The actuarial overall and relapse free 5 year survival rate were 71.0%, 68.3% respectively. The survival rates by stage were 79.1% in stage I, and 61.2% in stage II. Treatment failure was noted in 18 of 64 patients (28.1%), locoregional failure in 8(12.5%), distant metastasis in 8(12.5%), paraaortic node metastasis in 1 and one patient had concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thickness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level, resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24(33.3%), 5000-5500 cGy+ICR 3/7(42.9%), 5000-5500 cGy external RT only group 3/33(9.1%). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose not improve results but only increases complication.
Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Pelvis ; Radiation Oncology ; Radiotherapy ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms*

Together, the cheek and neck can be considered as a single anatomic location because skin vascularity, texture and thickness are similar. The cervicofacial flap has been described as the treatment of choice for the cheek defect because of its good mobility and excellent cosmetic result. However, if the defects on the cheek are wider than the length of palpebral fissure of extended to the lower two thirds of the cheek, the conventional cervicofacial flaps would be inadequate in size without the benefit of expansion. Tissue expansion of the cheek and neck is distinguished by a particuarly high rate of complication. Prevention of various complications require careful planning and certain modifications in technique. We have used the following modifications and measures to prevent the complications and to maximize the expansion. 1) Whenever possible, expanders were placed over the rigid foundation such as mandible or posterior neck area after wide undermining. 2) Expanders were placed deep to platysma in the neck area. 3) Following optimal expansion, the further dissection extending to the clavicle and the posterior neck area was performed for optimal mobilization and draping of the expanded skin. 4) The expanded skin was advanced upward on the cervical portion and rotated forward on the cheek portion. 5) The flap should not be draped above the inferior orbital rim and postoperatively the pressure garments were applied to prevent drooping of the expanded skin. We experienced 21 cases of the expanded cervicofacial flaps with above surgical modifications and the expanded cervicofacial flaps can resurface the 95% of cheek defects with minimal complications and excellent cosmetic results.
Cheek* ; Clavicle ; Mandible ; Neck ; Orbit ; Skin ; Tissue Expansion

No abstract available.
Child* ; Glomerulonephritis, IGA ; Hematuria* ; Humans ; Nephritis* ; Purpura, Schoenlein-Henoch*

BACKGROUND: Recently, various effective and rapid acting treatment modality for depression have been massively developed. Thus, early detection and treatment of depression is vitally important to improve community mental health. Using BDI, primary practitioner can easily find depressive symptoms that can complicate other physical diseases. Finding and treating depression early can improve general prognosis of physical diseases. The purpose of this study was to find out the prevalence of depression and depressive symptoms and their correlates among residents in Jeju and to provide baseline data. METHODS: The study subjects were 1,086 residents consisting of 531 males and 555 females of 10-Li in rural Jeju island and the data was gathered from trained interviewer using BDI and questionnaire about sociodemographic factors and health behavior. Depression was defined as BDI total score over 23 in males and over 24 in females. Depressive symptom was defined as BDI STEN score over 7. RESULTS: The prevalence of depression in rural Jeju island was 5.8% in total, 4.9% among males, 6.5% among females. The prevalence of depressive symptoms was 16.7% in total, 14.9% among males, 18.4% among females. The risk factors of depressive symptoms were self-assessed living standard, education years, perceived health status, self-assessed level of stress, perceived social support, body image, breakfast intake, and sleep. Sex, marital status and drinking habit were not statistically significant risk factors. CONCLUSION: The prevalence of depression and depressive symptoms in rural Jeju island was very low, especially among females. With intensive mental health service for those who are in low socioeconomic class and low education level and those who have poor health behavior, early detection of depressive symptoms from community will be important to improve general health status.
Body Image ; Breakfast ; Depression* ; Drinking ; Education ; Female ; Health Behavior ; Humans ; Male ; Marital Status ; Mental Health ; Mental Health Services ; Prevalence* ; Prognosis ; Risk Factors ; Socioeconomic Factors ; Surveys and Questionnaires

A retrospective analysis was performed on 53 patients with brain malignant astrocytoma and glioblastoma multiforme treated with surgical resection and postoperative radiotherapy in the period between January 1980 and June 1991. There were 13 patients with malignant astrocytoma, 40 patients with glioblastoma multiforme. Survival rates were analyzed according to histologic grade, age, performance states, extent of surgical resection, tumor location, symptom duration, total radiation dose and addition of chemotherapy after radiation therapy. 5 year actuarial survival rate for malignant astrocytoma was 29.4%, for glioblastoma multiforme was 2.8%. Histologic grade, age, performance status, total radiation dose were statistitically significant prognostic factors.
Astrocytoma* ; Brain ; Drug Therapy ; Glioblastoma* ; Humans ; Radiotherapy* ; Retrospective Studies ; Survival Rate

No abstract available.
Emergencies* ; Emergency Service, Hospital*

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