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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 106 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.

Introduction Radiation therapy is an integral part of the treatment of head and neck cancer. Factors predicting radiation response are ill defined. The aim of this study was to identify genetic aberrations associated with radiation response in cell lines derived from head and neck squamous cell carcinomas (HNSCC) using comparative genomic hybridization (CGH) for genome-wide screening. Methods Five cell lines derived from HNSCC were subjected to a single course of radiation (400 cGy) in parallel with a similarly handled, untreated control. Cellular response to radiation was determined on posttreatment days 1, 2, 3, 4, and 5 using a cell viability assay (MTT assay). Radiation response was defined as 35% or greater decrease in cell survival relative to control. Tumor doubling time was determined by cell counts performed at day 0 and 1 for each cell line. All experiments were done in quadruplicate. CGH analysis was performed by differentially labeling DNA from tumor and normal tissue with fluorescent agents. The labeled DNAs were simultaneously hybridized to normal metaphase chromosomes. Image analysis for fluorescence intensity along the entire length of each metaphase chromosome allowed generation of a color ratio, which was used to detect copy number changes. Results Radioresistance was identified in two of five cell lines. The tumor doubling time was not a predictor of radiation response. CGH identified a complex pattern of aberrations, with gain of 3q common to all cell lines. The number of genetic aberration was higher in radiation-sensitive cell lines than in radiation-resistant ones. No recurrent aberrations were unique to the radiation-resistant cell lines. Recurrent gains at 7p and 17q and losses at 5q, 7q, and 18q were unique to the radiation-sensitive cell lines. Conclusions The number of aberrations identified by CGH analysis may be a predictor of radiation response. A large study of primary tumors is warranted to confirm this association and identify specific genetic aberrations associated with radiation response.

We propose a method of forming quantum-size emitters within a pre-defined photonic crystal in a self-aligned fashion through controlled removal of quantum well layers via selective wet-chemical etching. To demonstrate the effectiveness of our method, we take the example of a two-dimensional photonic crystal slab containing multiple quantum wells at its center. We successfully fabricate vertically stacked quantum nanostructures (or quantum dots) well aligned with respect to the photonic crystal backbone. Micro-photoluminescence measurements performed at 78 K reveal that the radiative transition energy blue-shifts when the lateral dimension reaches less than 100 nm, which is compared with a simple model based on the 'particle-in-a-box' picture. The proposed method may find a broad range of applications in photonics and quantum optics, where the coupling between an emitter and an optical mode needs to be maximized.

The purpose of this study was to analyze the feasibility and safety of robotic resection of benign upper neck masses through a modified facelift approach.Between November 2010 and February 2012, 9 patients were enrolled in this prospective study. Six patients received a robotic submandibular gland resection via a retroauricular approach. Two patients received robotic resection of the second branchial cleft cyst. One patient received robotic operation for the removal of lymphadenopathy, which occurred in the submental area.Robotic resection of a benign upper neck mass was successfully performed through a retroauricular approach in all patients. The average robotic system docking times and robotic operation times were 8.5 minutes and 62.4 minutes, respectively. All patients were extremely satisfied with their cosmetic results after the operation. There were no cases of nerve palsy in the marginal mandibular branch of the facial nerve, the lingual nerve, the hypoglossal nerve, or the spinal accessory nerve. No patient required blood transfusion in response to significant bleeding or was converted to open surgery. Mean blood loss was minimal (6.6 mL). The average period of follow-up for the patients was 12.7 months. All patients have maintained disease-free status.Robotic resection of a benign upper neck mass via a retroauricular approach is technically feasible and results in better cosmetic outcomes than the conventional transcervical approach. This new surgical method is safe and effective for benign upper neck masses that require surgical removal.

Treatment of the symptomatic lingual thyroid is typically accomplished through surgical resection using a transcervical approach, which carries a high risk of treatment-related morbidity and leaves a visible scar on the neck. In order to reduce morbidity and eliminate visible scarring, this study utilized transoral robotic surgery (TORS) in performing lingual thyroidectomy.Between October 2009 and October 2010, three patients with symptomatic lingual thyroid were enrolled in this prospective study. Primary symptoms included dysphagia (two patients) and hemorrhage (one patient). A da Vinci robotic system (Intuitive Surgical, Inc., Sunnyvale, CA) was used to perform TORS in all patients. A face-up 30° endoscope was inserted through the oral cavity, and two instruments were positioned on either side of the endoscope. We evaluated the robotic set-up time, operating time, volume of blood loss, surgery-related complications, postoperative symptomatic improvement, and cosmetic results.The transoral robotic lingual thyroidectomy was successfully performed in all patients. The mean operating time was 43 minutes (range 35-50 minutes), and an average of 11 minutes (range 10-15 minutes) was required to set up the robotic system. All patients were satisfied with their cosmetic results and the improvement of their symptoms after the operation. There were no perioperative complications or significant bleeding. The average volume of blood loss during the operation was 25 mL.The use of TORS for lingual thyroidectomy was both technically feasible and safe, suggesting that it may be considered a viable alternative to other invasive surgical approaches in patients with symptomatic lingual thyroid.

We demonstrate the existence of surface waves in two-dimensional photonic crystal slab edges. In finite-sized air-terminated photonic crystal boundaries, the slab-edge mode turns into a lasing mode under pulsed optical pumping conditions. Analyses of the modal behaviors of the slab-edge modes by means of calculations based on the plane wave expansion method and the finite-difference time-domain method show that resonant frequencies and quality factors are strongly dependent on the termination parameter and the shape of the slab corner.

Few-micron-sized elliptically deformed InGaAsP–InP microdisk lasers are fabricated and highly directional emissions are observed along the direction perpendicular to the surface of highest curvature. As the size of the elliptical microdisk is reduced, both the azimuthal angular spreading and the number of lobes become smaller. The improved directionality of the smaller structure is attributed to the enhanced tunneling loss at the high curvature surfaces. The far-field radiation is linearly polarized. Charge-coupled-device images confirmed the existence of strong near-field emission in the vicinity of high curvature surfaces.

The use of an optically thick slab may provide versatile solutions for the realization of a current injection type laser using photonic crystals. Here, we show that a transversely higher-order defect mode can be designed to be confined by a photonic band gap in such a thick slab. Using simulations, we show that a high-Q of 10^5 is possible from a finely tuned second-order hexapole mode. Experimentally, we achieve optically pumped pulsed lasing at 1347 nm from the second-order hexapole mode with a peak threshold pump power of 88 uW., Comment: 4 pages, 3 figures

Two-dimensional (2D) slab photonic crystals based on Er-doped hydrogenated amorphous silicon alloyed with carbon (a-Si:H:C) are proposed and realized. Freestanding and oxide-cladding slab structures are fabricated and compared. 2D slab active photonic crystal structures show enhanced extraction of the trivalent erbium ion (Er3+) luminescence independent of the pump intensity. Temperature-insensitive light extraction efficiency with negligible surface-related nonradiative recombination was experimentally observed. The maximum enhancement became eightfold in freestanding slab structures.

Two-dimensional slab photonic crystal lasers with central posts are realized. In this structure, those modes with antinode at the center are suppressed by the presence of the central post. From a five-lattice-long photonic crystal cavity, single-mode operation is experimentally observed. Thermal characteristics are drastically improved in comparison to those of the free-standing slab structure.

To improve light extraction from organic light-emitting diodes (OLEDs), we introduced a photonic crystal pattern into the glass substrate of an OLED. The periodic modulation converts the guided waves in the high-refractive-index indium-tin-oxide/organic layers into external leaky waves. We used the finite-difference time-domain method to optimize the structural parameters of the photonic crystal pattern and to analyze the microcavity effect by the metallic cathode of the OLED. With the use of an optimized photonic crystal pattern, an increase of over 80% in the extraction efficiency of the OLED is expected theoretically. An increase in the extraction efficiency of over 50% was achieved experimentally, without detriment to the crucial electrical properties of the OLED.

The findings of intraparotid facial nerve schwannoma (FNS) using preoperative diagnostic tools, including ultrasonography (US)-guided fine needle aspiration biopsy, computed tomography (CT) scan, and magnetic resonance imaging (MRI), were analyzed to determine if there are any useful findings that might suggest the presence of a lesion. Treatment guidelines are suggested. The medical records of 15 patients who were diagnosed with an intraparotid FNS were retrospectively analyzed. US and CT scans provide clinicians with only limited information; gadolinium enhanced T1-weighted images from MRI provide more specific findings. Tumors could be removed successfully with surgical exploration, preserving facial nerve function at the same time. Gadolinium-enhanced T1-weighted MRI showed more characteristic findings for the diagnosis of intraparotid FNS. Intraparotid FNS without facial palsy can be diagnosed with MRI preoperatively, and surgical exploration is a suitable treatment modality which can remove the tumor and preserve facial nerve function.

We show that, taking a two-dimensional photonic-crystal slab system as an example, surprisingly high quality factors (Q) over 10^5 are achievable, even in the absence of a rigorous photonic-band-gap. We find that the density of in-plane Bloch modes can be controlled by creating additional photon feedback from a finite-size photonic-crystal boundary that serves as a low-Q resonator. This mechanism enables significant reduction in the coupling strength between the bound state and the extended Bloch modes by more than a factor of 40., 5 pages, 4 figures

Recently, the Harmonic scalpel (HS) has been used in head and neck surgery as an alternative to conventional hand-tied ligation for hemostasis. Limited data have been published on the evidence of its safety in neck dissection (ND), especially in radical ND. We intended to investigate the safety and efficacy of the HS in ND, while using conventional hand-tied ligation to a minimum.Fifty-nine patients who underwent ND with primary head and neck cancer resection were enrolled in this study. The group using HS consisted of 29 patients, and the conventional hand-tied ligation technique (CT) group comprised of 30 patients. The following variables were examined: operating time, intraoperative bleeding, incidence of perioperative complications, the number of lymph nodes, total amount of drainage, duration of drain placement, and days of hospital stay.The use of the HS reduced the operating time of comprehensive ND by an average of 46.5 minutes (P0.001), and blood loss was significantly decreased in the HS group than the CT group (163.8 ± 33.8 cc vs. 203.8 ± 36.5 cc, P = 0.002). The number of lymph nodes was not significantly different between the two groups. No significant difference was observed in the total amount of drainage, duration of drain placement, days of hospital stay, and perioperative complications.The HS is a relatively safe and effective alternative method for hand-tie ligation in ND. Moreover, the HS significantly reduced the operating time and amount of blood loss.

Objective: Recently, various robotic surgical procedures have been performed, and most reports have proved that the application of robotic technology for surgery is technically feasible and safe. The feasibility and safety of robotic thyroid surgery was examined via transaxillary single port approach without gas insufflation.Method: The study included 109 consecutive patients with papillary thyroid cancer who underwent robot-assisted endoscopic thyroid surgery using a gasless transaxillary single port approach by a single surgeon (Y.W.K.) between May 2010 and August 2011 at the department of otorhinolaryngology, Yonsei University College of Medicine.Results: The console time for 50 hemithyroidectomy (HT) with ipsilateral central compartment neck dissection (CCND) was 45.67 min, and that of 59 total thyroidectomy (TT) with ipsilateral or bilateral CCND was 93.77 min. The amount of drainage was 194.07 mL, and the duration of drainage was 3.5 days. The hospital stay was 6.09 days. Mean primary tumor size was...

Objective: Compare the efficacy and feasibility of alternative approaches: endoscopic resection via retro-auricular (RA) approach and transoral (TO) approach for submandibular gland (SMG) resection.Method: Retrospective analysis of surgical outcomes. We performed 21 endoscopic resections of benign lesions of SMG via RA approach and 11 resections via TO approach since 2010. The following variables were assessed: age, gender, tumor size, histopathologic type, operation time, length of hospital stay, scar satisfaction, and complications.Results: There were no statistically significant differences in patient profiles, tumor size, and histopathologic type between 2 groups. The cosmetic result was generally excellent and all patients were satisfied with the outcomes. However, in the first endoscopic surgery which was done for a large tumor in SMG, temporary weakness in the marginal branch of facial nerve was observed. There was no permanent palsy. Five patients in TO approach group had complaints of limitations...

Objective: The aim of the study was to investigate the treatment outcomes of malignant parotid tumors. This investigation is to report our experience with the management of patients with malignant parotid tumors that were treated with combinations of surgery, radiation, and chemotherapy.Method: From January 1999 to December 2008, 126 patients with primary parotid cancer were treated. Data including age, sex, histologic findings, tumor stage, surgery type, complications, and prognosis were collected retrospectively from medical charts.Results: Their mean age was 55.4 years (range, 15-96 years). Mean follow-up was 29.7 months. Thirty three patients were stage I, 40 stage II, 30 stage III, 23 stage IVA. Fifteen patients had recurrences: 6 patients had local, 2 had locoregional, and 1 had regional failure, 6 had distant metastasis. The most common malignant tumor was mucoepidermoid carcinoma (38, 29.5%). Sixty-one patients underwent superficial, 43 had total, and 22 had radical parotidecomy. Postoperative rad...

Aim To evaluate the usefulness of contrast-enhanced three-dimensional (3D) T1-weighted high-resolution isotropic volume examination (THRIVE) for the preoperative assessment of head and neck cancer, by comparison with spin-echo (SE) T1-weighted sequences and the pathology specimen. Materials and methods Thirty-seven consecutive patients who were diagnosed with oral cavity, oropharyngeal, and hypopharyngeal cancer and received surgical excision with preoperative magnetic resonance imaging (MRI) using both SE and 3D THRIVE sequences after gadolinium injection were studied. Tumour conspicuity, motion- and flow-related artefacts were evaluated, and the tumour size was measured based on both sequences, which were correlated with the surgical specimen. The population correlation coefficient ( r g 2 ) and Bland–Altman plots were used to assess measurement agreement. Results There was no statistical difference between SE and THRIVE in terms of tumour conspicuity and motion-related artefacts, however, flow-related artefacts significantly decreased with THRIVE. The measurement agreement of tumour size estimated on both SE and THRIVE was good ( r g 2 = 0.87 for SE and 0.93 for THRIVE), and the difference was statistically significant. Conclusion The 3D THRIVE sequence provided satisfactory image quality for the accurate measurement of tumour size with fewer artefacts and could be an acceptable alternative for SE T1-weighted images for preoperative staging in patients with head and neck cancer.

We show that the properties of silicon can be changed profoundly when nanofabricated to below 5nm, resulting in larger bandgap emission and more efficient light generation. Moreover, three-dimensional nanostructures can be fabricated at these nanoscale dimensions by dynamic control over the dry etching process.

We performed transoral robotic surgery (TORS) or conventional surgery via a transoral or mandibulotomy approach in patients with tonsillar cancer and prospectively analyzed the oncologic outcomes and functional recovery of the 3 groups.Between May 2008 and October 2011, 57 patients were enrolled in this prospective study.Although there was no significant difference in the survival rate of the TORS group (100%) and the conventional surgery group (96.7%), a higher rate of margin negativity was observed in the TORS group, especially in cases in which the tumor extends inferiorly. Patients who received TORS or conventional transoral procedures showed more rapid recovery of swallowing, shorter hospitalization, and shorter operation time than the mandibulotomy group.Despite the weakness of this nonrandomized trial and the differences in T classification, TORS seemed to have distinct advantages over conventional transoral surgery and other conventional open surgery, but further studies are needed.

Objectives/Hypothesis: The aim of the study was to evaluate the oncologic outcome of our series of advanced laryngeal squamous cell carcinomas, primarily treated by supracricoid laryngectomy with cricohyoidopexy or total laryngectomy, to compare the two therapeutic modalities. Study Design: Retrospective controlled study. Methods: We retrospectively reviewed the medical files, operative charts, and pathology reports of 83 patients who underwent total laryngectomy or supracricoid laryngectomy with cricohyoidopexy between February 1999 and March 2009. We only included cases in which both surgical treatments were feasible. Endpoints included local control, locoregional control, overall survival, and disease-specific survival. Results: When we stratified the patients according to T stage, no statistically significant differences emerged in terms of overall and disease-specific survival. When we compared total laryngectomy to cricohyoidopexy in N1 patients, 3-year overall survival and disease-specific survival differences were statistically relevant (P = .022 and P = .030, respectively). Conclusions: Total laryngectomy warranted better results in term of overall and disease-specific survival, although the differences were not statistically significant. Local and locoregional control in the two treatment groups were overlapping, showing that cricohyoidopexy (when technically feasible) could be a valid surgical option in selected advanced laryngeal squamous cell carcinoma. Laryngoscope, 2012

The recent trend in treatment of hypopharyngeal cancer is organ preservation in order to maintain swallowing and speech function as well as improve quality of life. Transoral robotic surgery (TORS) can remove hypopharyngeal lesions successfully without an external incision, preserving physiologic functions of affected organs. However, studies have yet to assess the oncologic and functional results of TORS for the treatment of hypopharyngeal cancer. This prospective study evaluated the oncologic and functional results of TORS for the treatment of hypopharyngeal cancer obtained at our institution over a period of 3 years and confirmed the validity of TORS as a surgical organ-preserving strategy. Between April 2008 and September 2011, 23 patients who were diagnosed with hypopharyngeal cancer underwent TORS for removal of a primary lesion. The da Vinci Robotic system (Intuitive Surgical Inc., Sunnyvale, California) was used to remove the lesion. The Kaplan-Meier method was used to analyze overall survival and disease-free survival. Videopharyngogram study (VEF) was performed and functional outcome swallowing scale (FOSS) was utilized to measure and evaluate swallowing function. Acoustic wave form analysis was conducted to evaluate voice status. Overall survival at 3 years was 89% and disease-free survival was 84%. On the VEF study, serious aspiration or delay of swallowing was not observed during the pharyngeal stage of the swallowing process. Overall, 96% of the patients showed favorable swallowing abilities with an FOSS score ranging from 0 to 2. The fundamental frequency variation (vF0) and jitter were increased upon acoustic waveform analysis (vF0=2.71 ± 0.063, Jitter=2.01 ± 0.034), but the harmonic-to-noise ratio (HNR) and shimmer were maintained close to the normal range (HNR=1.28 ± 0.001, Shim=1.74 ± 0.036). The oncologic and functional results of TORS were quite acceptable for the treatment of hypopharyngeal cancer. TORS is a valid treatment option as a surgical, organ-preserving strategy for select patients with hypopharyngeal cancer.

Hexagonal ring-type resonators defined by two-dimensional photonic crystal waveguides are proposed and demonstrated. Lasing actions are observed from the photonic crystal ring resonator patterned on a free-standing slab with InGaAsP active layers emitting near 1.55 μm. For a ring resonator with 8-μm diameter, the threshold peak pump power is ∼3 mW. The quality factor of the ring resonator mode estimated from below-threshold linewidth shows that the sum of the propagation loss and the bending loss of the photonic crystal ring resonator is less than ∼260 cm−1. The photonic crystal ring resonators can be used for the characterization of the optical losses in photonic crystal waveguides.

A photonic-crystal vertical-cavity surface-emitting laser (PC-VCSEL) is proposed and demonstrated. The 850-nm-PC-VCSEL shows single-mode continuous-wave operation in the entire current range. The side-mode suppression ratio is 35–40 dB for the sample with the hole pitch (Λ) 5 μm and the hole diameter (a) 3.5 μm. The guiding effect of the single-defect triangular-lattice two-dimensional photonic crystal structure is experimentally observed and is explained by the effective index model.

Square-lattice photonic band-gap lasers are realized at room temperature from single-cell photonic crystal slab microcavities fabricated in InGaAsP quantum-well materials emitting at 1.5 μm. This single-cell photonic band-gap laser operates in a class of two-dimensional mode to be classified as the smallest possible whispering gallery mode with genuine energy null at the center. The low-loss nondegenerate mode with modal volume of 0.1 (λ/2)3 demonstrates a spectrometer-limited below-threshold quality factor >2000 and a theoretical quality factor >10 000. The other class of photonic crystal lasers is also observed outside the photonic band gap of the square lattice, operating in the dipole mode.

The purpose of this study was to describe and analyse the advantages and disadvantages of submandibular gland (SMG) resection using a robotic surgical system through a modified face-lift approach. The authors performed robotic sialoadenectomy of the SMG on 5 patients using the daVinci robot system through a modified face-lift approach. Three robotic arms were inserted through a modified face-lift incision; a face-down 30-degree endoscopic arm and two operative arms. The right arm was equipped with a harmonic scalpel and the left arm with a Maryland forceps. In all patients, robotic sialoadenectomy of the SMG was completed successfully. Diagnoses were sialolithiasis in two patients, pleomophic adenoma in two patients, and ranula in one patient. The mean robotic operative time was 90.2 min (range 62-185 min) and that for setting the robotic system was 8.2 min (range 5-15 min). No significant intra-operative or postoperative complications were observed. All patients were satisfied with the outcome and especially the cosmetic results at their last follow-up visit. In the authors opinion robotic sialoadenectomy of the SMG is technically feasible and secures a better cosmetic outcome than endoscopic submandibular resection.

The directed growth of III–V nanopillars is used to demonstrate bottom-up photonic crystal lasers. Simultaneous formation of both the photonic band gap and active gain region is achieved via catalyst-free selective-area metal–organic chemical vapor deposition on masked GaAs substrates. The nanopillars implement a GaAs/InGaAs/GaAs axial double heterostructure for accurate, arbitrary placement of gain within the cavity and lateral InGaP shells to reduce surface recombination. The lasers operate single-mode at room temperature with low threshold peak power density of ~625 W/cm^2. Cavity resonance and lasing wavelength is lithographically defined by controlling pillar pitch and diameter to vary from 960 to 989 nm. We envision this bottom-up approach to pillar-based devices as a new platform for photonic systems integration.

We demonstrate room temperature, continuous-wave lasing with enhanced far field emission directionality in coupled-cavity photonic crystal lasers, made with InAsP/InP quantum well material. These surface-emitting lasers can have a very low effective threshold power of 14.6 μW, with a linewidth of 60 pm, and 40 of the surface emitted power concentrated within a small divergence angle of ±30°. © 2011 American Institute of Physics., The authors would like to acknowledge support from the Defense Advanced Research Projects Agency under the Nanoscale Architecture for Coherent Hyperoptical Sources programme under Grant No. #W911NF-07-1-0277 and from the National Science Foundation through NSF CIAN ERC under Grant No. #EEC-0812072. J. G. would like to acknowledge support from NSF Research Experience for Teachers (RET) program through NSF CIAN ERC. P. A. P. would like to acknowledge financial support from Spanish MICINN and CAM through grants NANINPHO-QD (TEC2008- 06756-C03-01/03), CAM2010 Q&C Light (S2009ESP-1503) and Consolider-Ingenio 2010 QOIT (CSD2006-0019).

Objective: Quality of life could be deteriorated by surgical treatment of tongue cancer. Adjuvant therapy may also affect the functional outcome. Therefore, we intend to evaluate the influence of radiotherapy on the postoperative functional outcome after partial glossectomy with free flap reconstruction in early tongue cancer patients.Method: We measured the functional outcome and reviewed the charts of 31 oral tongue cancer patients. We evaluated speech integrity with Diadochokinetic test (DDK). Mobility of tongue was checked with measurement of upward, protrusion, and lateral deviation distance. We also evaluated swallowing capacity with the M.D. Anderson Dysphagia Inventory.Results: DDK rates of the surgery-only group and the postoperative radiotherapy group were 27.8 and 23.9, respectively, which was statistically different. Swallowing capacity was significantly superior in the surgery only group. Tongue mobility was not statistically different between the groups.Conclusion: The functional outcome reg...

Objective: Conventional surgical approaches for hypopharyngeal carcinomas have a great risk for developing treatment-related morbidity. To minimize this morbidity, hypopharyngectomy by transoral robotic surgery (TORS) was performed, and the efficacy and feasibility of this procedure were evaluated.Method: TORS was performed using Surgical Robot in 18 patients with T1 or T2 pyriform sinus cancer. Pyriform sinus was totally resected. Laterally, the inner perichondrium of the thyroid cartilage was peeled off to make sure of the safe margin. We evaluated the surgical margins, swallowing, decannulation, and surgery related complications.Results: Transoral robotic hypopharyngectomy was performed successfully in all eighteen patients. The mean robotic operation time was 62.4 minutes, and an average of 17.5 minutes was required for the setting of the robotic system. There was no significant perioperative complication in the cases. Swallowing function returned to all patients within 8.3 days average. Decannulation...

We report the demonstration of photonic crystal lasers formed bottom-up by patterned III-V nanopillar (NP) arrays. In this work, we present a method whereby the photonic band gap region and active gain regions are formed simultaneously by selective-area metal-organic chemical vapor deposition. This approach allows us the ability to design device parameters lithographically. By accurate control of position and diameter of the NPs, high-Q cavities can be formed entirely with NPs. This particular model cavity supports a non-degenerate hexapole mode1 with a high overlap between the E-field and the center pillars. Design optimization by finite-difference time-domain simulations yields a cavity Q of ~5000.

Purpose Most patients with tongue cancer require surgical resection of the tongue to varying degrees. As a result, quality of life, which is strongly related to speech, chewing, and swallowing, can deteriorate severely from extensive surgical treatment of tongue cancer. In addition to surgery, adjuvant therapy may affect the severity of functional impairment. Therefore, the influence of postoperative radiotherapy on functional outcome after partial glossectomy with free flap reconstruction was evaluated in patients with early oral tongue cancer. Patients and Methods Functional outcome was measured and charts of 31 patients with oral tongue cancer who were surgically treated at Yonsei Head and Neck Cancer Clinic from 2003 through 2008 were reviewed. Only patients who underwent partial glossectomy and reconstruction with radial forearm free flap and did not develop recurrence were included. Speech integrity was evaluated with diadochokinetic testing by a professional speech therapist. Tongue mobility was checked by measurements of upward distance, protrusion distance, and lateral deviation distance. Swallowing capacity was evaluated with the M.D. Anderson Dysphagia Inventory. Results Diadochokinetic rates of the surgery-only and postoperative radiotherapy groups were 27.8 and 23.9, respectively, which was statistically different. Swallowing capacity was significantly superior in the surgery-only group. Tongue mobility was not statistically different between the 2 groups. Conclusions Functional outcome of speech and swallowing is negatively influenced by postoperative radiotherapy.

We propose a novel design of an all-dielectric optical antenna based on photonic-band-gap confinement. Specifically, we have engineered the photonic-crystal dipole mode to have broad spectral response (Q ~70) and well-directed vertical-radiation by introducing a plane mirror below the cavity. Considerably large local electric-field intensity enhancement ~4,500 is expected from the proposed design for a normally incident planewave. Furthermore, an analytic model developed based on coupled-mode theory predicts that the electric-field intensity enhancement can easily be over 100,000 by employing reasonably high-Q (~10,000) resonators.

Summary Conventional surgical approaches for hypopharyngeal carcinomas have a great risk for developing treatment-related morbidity. To minimize this morbidity, hypopharyngectomy by transoral robotic surgery (TORS) was performed, and the efficacy and feasibility of this procedure were evaluated. TORS was performed using da Vinci Surgical Robot (Intuitive Surgical Inc., Sunnyvale, CA) in 10 patients with T1 or T2 pyriform sinus cancer and posterior pharyngeal wall cancer. FK retractor (Gyrus Medical Inc., Maple Grove, MN) was used for transoral exposure of the lesion. A face-up 30-degree endoscope was inserted through the oral cavity and two instrument arms were located in both sides of the endoscope. Pyriform sinus was totally resected as a cone-shape from the vallecular to apex region, and ipsilateral arytenoid cartilage was saved for function preservation. The aryepiglottic fold was resected medially. Laterally, the inner perichondrium of the thyroid cartilage was peeled off after perichondrium was incised horizontally to make sure of the safe margin of antero-lateral portion. The posterior margin is an inferior constrictor muscle of the posterior pharyngeal wall. We evaluated the robotic set up time, robotic operation time, blood loss, surgical margins, swallowing time, decannulation time, and surgery related complications. Transoral robotic hypopharyngectomy was performed successfully in all 10 patients. The mean robotic operation time was 62.4 min, and an average of 17.5 min was required for the setting of the robotic system. There was no significant perioperative complication in the cases. Swallowing function returned to all patients within 8.3 days average. Decannulation was carried out within an average of 6.3 days after surgery. Transoral robotic hypopharyngectomy was feasible and ontologically safe technique for the treatment of early hypopharyngeal cancer.

Background: Extranodal nasal-type natural killer (NK)/T-cell lymphoma (NKTL) is a rare, but distinct clinical entity in Asian populations. However, it is not uncommon for NKTL to be belatedly or postoperatively diagnosed because radiologists are not familiar with its radiological features. Purpose: To investigate the computed tomography (CT) findings in patients with extranodal nasal-type NKTL involving the head and neck. Material and Methods: Twenty-nine patients (18 male, 11 female; mean age 51.5 years) with pathologically proven extranodal nasal-type NKTL were enrolled in this study. Two head-and-neck radiologists retrospectively evaluated the CT scans with special attention to the primary site, the extent of involvement, and patterns of the lesions (i.e., morphologic features, ulceration or necrosis, and bone destruction). Results: The cases of nasal-type NKTL consisted of primary tumors arising from the sinonasal cavity in 13 patients (45%), the naso/oropharynx in three patients (10%), and simultaneous involvement in the nasal cavity and naso/oropharynx in 13 patients (45%). Fourteen patients (48%) showed tumor extension into adjacent structures. Of the 26 patients with involvement of the nasal cavity, 18 (69%) presented with an infiltrative pattern, seven (27%) with a polypoid pattern, and one (4%) with a combined pattern. Areas of necrosis within the tumor were observed in six patients (21%), bone destruction in five (17%), and regional lymphadenopathies in two (7%). Conclusion: Extranodal NKTL may be initially suggested by CT findings in the head and neck. Clinicians should consider these findings indicative of the possibility of NKTL, and should perform a histopathologic confirmation to establish a diagnosis.

Summary Incidence of isolated distant metastasis (IDM) was relatively low in patients who achieved locoregional control after primary definitive surgery. However, the prognosis of patients with IDM was dismal. The aim of this study was to evaluate the clinical outcome of patients with IDM and identify independent predictive factors of IDM after primary definitive surgery for head and neck squamous cell carcinoma (HNSCC). A retrospective data review was conducted for 795 patients who underwent primary definitive surgery without any systemic treatment for squamous cell carcinoma (SCC) of the oral cavity, oropharynx, larynx, and hypopharynx. Distant metastasis-free survival was calculated and independent predictive factors for IDM were determined by Cox proportional-hazards model. For the entire study cohort, IDM developed in 75 patients (9.4%). Among 631 patients who achieved locoregional control, IDM occurred in 44 patients (7%). The median time to IDM after primary surgery was 13 months, ranging from 2 to 70 months. The overall salvage rate was 9% (4 of 44) after salvage treatment for IDM. In the Cox proportional-hazards model, clinical N status, and histological grade were independent predictive factors of IDM. Patients who had clinically palpable neck disease and a histologically poor grade were more likely to develop IDM after primary definitive surgery. Patients with these factors should be considered candidates for proper adjuvant systemic treatment and evaluated more thoroughly for early detection of IDM during follow-up.

Lithography and dry etching has evolved to replace accurate crystal growth that enabled the definition of high-Q optical cavities in the past with dry etching approaches to define ultra-small mode volumes. These "printed" optical cavities can now be used to define micro- and nano-lasers in which the three-dimensional geometry is used to control the laser performance, and that can be lithographically coupled together in-plane. Advanced microcavity lasers now include photonic crystal mirrors and surface plasmon contact geometries. By combining new methods of design, fabrication and testing, it has become possible to develop higher-level abstract device design approaches that enable SPICE-like modeling of optical circuits. However, the complexity of back-reflections and the wave-like behavior of light in microfabricated geometries limits the applicability of these approaches. Here, the evolution of integrated opto-electronics into photonic crystals and plasmonics is reviewed, with an emphasis on the specific cases of miniaturized lasers, plasmonic light emitters and silicon photonics. Article not available.

The aim of this study was to evaluate the outcome and predictive factors for salvage treatment of isolated neck recurrence after primary curative surgery for head and neck squamous cell carcinoma (HNSCC).Case series with chart review.Head and neck cancer clinic in a tertiary care university hospital.A retrospective study was conducted with 236 patients who developed a recurrence after primary curative surgery with or without radiotherapy for HNSCC.Isolated neck recurrence developed in 61 (26%) patients. Salvage treatment was offered to 49 patients, and the overall salvage rate was 33 percent (20 of 61). The salvage rate for the surgical salvage group was 46 percent (16 of 35) and 28 percent (4 of 14) for the nonsurgical salvage group (chemoradiation) (P = 0.14). The three-year overall survival rate was 36 percent for patients with surgical salvage and 12 percent for patients with nonsurgical salvage (P = 0.101). There were no survivors of the supportive care group (0 of 12). Univariate analysis of individuals with isolated neck recurrence showed that patients who had previous treatment with surgery alone, a disease-free time longer than one year, previous pathologic N- status, recurrence in the undissected neck, or recurrent N1 had significantly improved salvage time (P0.05). However, in multivariate analysis, the factors previous treatment with surgery alone and recurrent N1 submitted to the salvage treatment were independent predictors of a successful salvage of isolated neck recurrence.Our results suggest that the ideal candidates for salvage neck treatment include those patients with recurrent N1 disease and those whose previous treatment was surgery only.

Here, we emphasize the importance of a bottom reflector for achieving unidirectional far-field emission. As a result, over 80% of photons generated inside the cavity can be collected within a divergence angle of ±30° from the top. We also discuss interesting analogy in which the nanocavity-bottom reflector coupled system is treated as a point-like emitter in front of a mirror. Based on such a view point, the observed directivity is explained by using a comprehensive interference model. Finally, we propose a very practical form of an efficient photonic crystal nanolaser bonded on a flat metal surface, which may enable current injection and room-temperature continuous-wave operation.

Human papilloma virus (HPV) infection is controversial as a causative factor in oral tongue cancer. This study aimed to clarify whether HPV directly affects the carcinogenesis and biological behaviour of oral tongue cancer by analyzing HPV prevalence, the physical status of the virus and clinicopathological parameters. Archival tissue was obtained from 36 patients diagnosed with T1 and T2 oral tongue cancer and 25 normal controls. HPV genotyping chip and real-time polymerase chain reaction were used to determine the prevalence, phenotype and physical status of HPV to clarify whether HPV directly affects oncogenesis. The results were also compared with clinicopathological parameters. HPV was detected in 36% (13/36) of oral tongue cancer patients, compared with 4% (1/25) of the control. In the HPV-positive group of oral tongue cancers, HPV-16 was the most common type and its prevalence rate was 85% (11/13). Of the HPV-16 infected oral tongue cancers, the integration rate of HPV-16 was 55% (6/11). The HPV-16 positive group showed shallower stromal invasion than the HPV-16 negative group (p = 0.045). HPV-16 may be one of the causative factors in early squamous cell oral tongue carcinoma and be associated with its depth of invasion.