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Oral mucosal melanoma is a very rare type of malignant melanoma, the characteristics of which differ from those of cutaneous melanoma. Primary amelanotic melanoma of the mandibular gingiva, which can invade the mandibular bone, is very rare worldwide. Here, we report a case in which we performed a reconstruction of the mandible and gingiva using the fibula osteocutaneous free flap procedure to treat a patient diagnosed with a primary amelanotic melanoma of the mandibular gingiva. The procedure was successful, and no recurrence was observed 10 months after surgery. Oral mucosal melanoma has a much poorer prognosis and a lower 5-year survival rate than cutaneous melanoma. However, recently, immunomodulatory therapies for mutations in melanocytic lesions have been used effectively to treat the increasing number of patients developing this type of melanoma, thus improving the prognosis of patients with oral mucosal melanoma.

The purpose of this study was to analyze the oncological outcomes and predictive factors for successful curative salvage surgery after recurrent oral cavity squamous cell carcinoma. A retrospective study was conducted involving 73 patients who received surgery-based salvage treatment. The pattern of failure for primary treatment was local failure in 29 patients, regional failure in 29 patients, and loco-regional failure in 15 patients. The 5-year overall, loco-regional failure-free, and disease-free survival rates were 54.8%, 58.9% and 49.3%, respectively. Patients with an advanced initial N stage, previous treatment with combined modality therapy, loco-regional recurrence, advanced recurrent T stage, a disease-free survival of less than 8 months prior to salvage, and recurrence in a previously treated field had a significantly worse prognosis. Given the potential surgical morbidity, salvage surgery should be undertaken after careful consultation with patients who have factors for a poor prognosis.

Benign pigmented skin lesions, particularly solar lentigines and seborrheic keratoses, commonly spur visits to a dermatologist...

Background Although uncommon, intra-parotid lymph node (IPLN) metastasis should be considered in the differential diagnosis of parotid masses in patients with head and neck cancers. Purpose To compare the clinical and imaging features of IPLN metastases from head and neck cancers and simultaneous parotid primary tumors. Material and Methods A retrospective review of 2199 patients with non-parotid head and neck cancers revealed 63 patients who also underwent parotidectomy during curative resection of head and neck cancer. After exclusion of direct extension to the parotid gland from adjacent primary tumors (n = 12) and IPLN metastases from skin cancer (n = 5), the final study group was composed of 46 patients, including 26 (1.2%) with 33 IPLN metastases and 20 (0.9%) with 24 simultaneous parotid primary tumors. We compared clinical features of patients (sex, age, site of primary tumor, histologic type, history of prior treatment for malignancy, TNM stages, side of parotid lesion, multiplicity, and metastasis in ipsilateral cervical LNs) and the CT (location in parotid gland, maximum dimension, margins, and central necrosis or cystic change) and 18F-FDG PET/CT (maximum standardized uptake value) findings. Results Ipsilateral level II LN metastasis was more frequent in the IPLN metastasis group than in the simultaneous parotid primary tumor group (73.1% vs. 35.0%, P Conclusion CT and PET/CT findings of IPLN metastasis are indistinguishable from simultaneous parotid primary tumor in patients with head and neck cancers.

// Young-Gyu Eun 1, 2 , Dongjin Lee 1, 3 , Young Chan Lee 2 , Bo Hwa Sohn 1 , Eui Hyun Kim 1, 4 , Sun Young Yim 1, 5 , Kee Hwan Kwon 3 and Ju-Seog Lee 1 1 Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA 2 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea 3 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Hallym University, Seoul, Republic of Korea 4 Department of Neurosurgery, Severance Hospital, Brain Tumor Center, Yonsei University College of Medicine, Seoul, Republic of Korea 5 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea Correspondence to: Ju-Seog Lee, email: jlee@mdanderson.org Keywords: YAP1; gene signature; head and neck cancer; prognosis Received: February 27, 2017 Accepted: July 18, 2017 Published: November 27, 2017 ABSTRACT By analyzing the genomic data of head and neck squamous cell cancer (HNSCC), we investigated clinical significance of YAP1 activation. Copy number and mRNA expression of YAP1 were analyzed together to assess clinical relevance of YAP1 activation in HNSCC. The clinical significance of YAP1 activation was further validated in four independent test cohorts. We also assessed the correlation of YAP1 activation with genomic alterations such as copy number alteration, somatic mutation, and miRNA expression. The YAP1-activated (YA) subgroup showed worse prognosis for HNSCC as tested and validated in five cohorts. In a multivariate risk analysis, the YAP1 signature was the most significant predictor of overall survival. The YAP1-inactivated (YI) subgroup was associated with HPV-positive status. In multiplatform analysis, YA tumors had gain of EGFR and SNAI2; loss of tumor-suppressor genes such as CSMD1, CDKN2A, NOTCH1, and SMAD4; and high mutation rates of TP53 and CDKN2A. YI tumors were characterized by gain of PIK3CA, SOX2, and TP63; deletion of 11q23.1; and high mutation rates of NFE2L2, PTEN, SYNE1, and NSD1. YA tumors also showed weaker immune activity as reflected in low IFNG composite scores and YAP1 activity is negatively associated with potential response to treatment of pembrolizumab. In conclusion, activation of YAP1 is associated with worse prognosis of patients with HNSCC and potential resistance to immunotherapy.

Objectives: This retrospective study was carried out to investigate the effectiveness and safety of office-based electromyography-guided injection of botulinum toxin in the cricopharyngeus muscle of patients who did not show upper esophageal sphincter passage in a swallowing study in spite of maximal swallowing rehabilitation. Methods: Thirty-six patients who showed no or limited ability to oral feed after maximum swallowing rehabilitation were enrolled. Video fluoroscopic swallowing study, flexible endoscopic evaluation of swallowing, disability rating scale, penetration aspiration score, and National Institutes of Health swallowing safety scale were used in the evaluation of dysphagia. Results: Success was defined as nondependence on gastrostomy for patients who previously were dependent on gastrostomy and improvement in disability rating scale score after botulinum toxin injections. The total success rate was 63.9%. The complication rate was very low, with only 1 patient showing temporary unilateral vocal fold paralysis. Botulinum toxin injection was more effective in patients with cranial nerve IX or X palsy than in those without it ( P = .006). Conclusions: This procedure can be a simple, safe, and effective tool in patients with cricopharyngeal dysfunction after swallowing rehabilitation, especially for cranial nerve IX or X palsy.

Although the genetic alteration of CUB and Sushi multiple domains 1 (CSMD1) is known to be associated with poor prognosis in several cancers, there is a lack of clinical relevance in head and neck cancer. The aim of this study was to offer insight into the clinical significance of CSMD1, utilizing a multimodal approach that leverages publicly available independent genome-wide expression datasets. CSMD1-related genes were found and analyzed to examine the clinical significance of CSMD1 inactivation in the HNSCC cohort of publicly available databases. We analyzed the frequency of somatic mutations, clinicopathologic characteristics, association with immunotherapy-related gene signatures, and the pathways of gene signatures. We found 363 CSMD1-related genes. The prognosis of the CSMD1-inactivated subgroup was poor. FBXW7, HLA-A, MED1, NOTCH2, NOTCH3, and TP53 had higher mutation rates in the CSMD1-inactivated subgroups. The Interferon-gamma score and immune signature score were elevated in CSMD1-inactivated subgroups. We identified several CSMD1-related pathways, such as the phosphatidylinositol signaling system and inositol phosphate metabolism. Our study using three large and independent datasets suggests that CSMD1-related gene signatures are associated with the prognosis of HNSCC patients.

Objectives Fas is the prototypic representative of the death receptor subgroup of the tumor necrosis factor (TNF) receptor family. Recently, single nucleotide polymorphisms (SNPs) of the Fas or Fas ligand (FasL) genes have been shown to be associated with an increased risk of several cancers and with the prognosis of several cancers. The objective of this study was to evaluate the association between the SNPs of the Fas and FasL genes and papillary thyroid cancer (PTC) and to assess the relationship between these SNPs and the clinicopathological characteristics of PTC. Methods Five SNPs located within the two genes of Fas and FasL were genotyped using direct sequencing in 94 patients with PTC and 364 healthy controls. Genetic data were analyzed using commercially available software. And, the statistical analyses were performed according to clinicopathologic characteristics of PTC. Results Genotyping analysis demonstrated that the intron SNP (rs1571013), promoter SNP (rs1800682) and 3′-UTR SNP (rs1468063) of Fas were significantly associated with the development of PTC. We also detected a significant difference between patients with PTC and healthy controls with respect to Fas gene allele frequencies. Furthermore, we found that the 3′-UTR SNP (rs1468063) of Fas was associated with the multifocality of cancer [dominant model, OR 0.28, p = 0.028; log-additive model, OR 0.43, p = 0.033]. Conclusion We observed a significant association between SNPs of the Fas gene and the development of PTC. In addition, there was a significant association between a Fas SNP and the multifocality of PTC.

Background The purpose of this study was to retrospectively analyze the feasibility of the surgical management of the carotid artery in advanced head and neck cancer with preoperative suspicion of carotid artery invasion. Methods A total of 47 patients were retrospectively analyzed. Twenty-one patients (44.7%) received surgery as initial treatment, and 26 patients (55.3%) had salvage surgical treatment for recurrences. Intraoperative dissection and preservation of the carotid artery was achieved in 39 patients (83%). Eight patients underwent carotid resection with/without reconstruction (17%). Results The cumulative 2-year and 5-year overall survival rates were 40.4% and 34%, and the disease-specific survival rates were 59.5% and 55.3%, respectively. The overall perioperative mortality rate was 6.4%. Carotid blowout developed in 6 patients. Conclusion Surgical treatment of the carotid artery in selected patients can provide locoregional control and the possibility of prolonged disease-free survival with acceptable morbidity. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

Preoperative nodal assessment of papillary thyroid cancer (PTC) is very important because 60 to 70 % of all disease recurrence in the neck can occur in the lymph nodes. This study explored the association between ultrasonographic intrathyroidal location and the nodal metastasis pattern in solitary PTC. Data from 218 patients who underwent total thyroidectomy with or without neck dissection for previously untreated PTC between 2006 and 2010 were retrospectively analyzed. Only patient data for which both preoperative ultrasound findings and postoperative pathologic reports were available were included. Multifocal cases, cases with extrathyroidal extension, and distant metastasis were excluded. The association between nodal metastasis pattern and clinical or pathologic features of solitary PTCs was analyzed, as was the association between ultrasonographic intrathyroidal location and central or lateral nodal metastasis in solitary PTC. Mass size larger than 2 cm (p

Objectives To evaluate the prevalence and clinical significance of focal parotid lesions identified by (18)F- FDG PET/CT in patients with nonparotid head and neck malignancies. Methods From 3,638 PET/CT examinations using (18)F-FDG conducted on 1,342 patients with nonparotid head and neck malignancies, we retrospectively identified patients showing incidental focal FDG uptake in the parotid glands. The diagnosis of parotid lesions was confirmed histopathologically or on imaging follow-up. Patient demographics, clinical features, maximum standardized uptake value (SUV(max)) on PET images, size and attenuation on corresponding contrast-enhanced CT images were assessed and correlated with the final diagnosis. Results The prevalence of incidental focal parotid FDG uptake on PET/CT was 2.1% (95% CI 1.4 - 3.0%). Among 21 patients with focal parotid lesions confirmed histologically or on imaging follow-up, 7 (33.3%) had malignant lesions (all metastases) and 14 (66.7%) had benign lesions (four pleomorphic adenomas, two Warthin's tumours, one benign lymph node, one granulomatous lesion, six lesions without histopathological confirmation). There were no significant differences in age, sex, SUV(max) or CT findings between patients with benign and those with malignant lesions. Conclusion Focal parotid FDG uptake on PET/CT in patients with head and neck malignancy warrants further investigations to ensure adequate therapy for incidental parotid lesions. Key points • The prevalence of parotid incidentaloma on PET in head and neck malignancy was 2.1% • The malignancy rate of incidental focal parotid FDG uptake was 33.3% • SUV max could not reliably differentiate malignant from benign incidental parotid lesions.

Summary Objective/Hypothesis To assess changes in the symptoms and quality of life (QOL) of patients diagnosed with laryngopharyngeal reflux (LPR) after proton pump inhibitor (PPI) treatment. Study Design Prospective study. Methods One hundred eighty patients diagnosed with LPR were evaluated. All patients were prescribed Lansoprazole (15 mg) twice daily for 12 weeks. The Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Short-Form 36-Item Health Survey version 2.0 (SF-36), and LPR–health-related quality of life (HRQOL) were collected from each patient at the initial visit and at 4- and 12-week follow-up visits. Results Significant improvement was observed in RSI and RFS scores after treatment. The LPR-HRQOL score also showed gradual improvement after PPI treatment in the voice, cough, throat clearing, swallowing, and overall impact of acid reflux. Although each domain of the SF-36 had a low score at the baseline visit, seven domains of the SF-36 had improved, except for the physical functioning domain. Conclusions We found that RSI, RFS, and most categories in the LPR-HRQOL and SF-36 improved 12 weeks after initiating PPI treatments. These findings indicate that PPI treatment for 3 months could improve the QOL of patients diagnosed with LPR.

Thyroid cancer is one of the common head and neck malignancies and may be found incidentally with other head and neck cancers.To evaluate the prevalence and risk of malignancy in incidental thyroid lesions identified by ultrasound (US) in patients with head and neck cancer.We retrospectively reviewed medical records of all patients with head and neck cancer other than of thyroid origin between January 2004 and December 2011. A total of 690 patients (537 men and 153 women; mean age, 58.9 ± 12.9 years) underwent US of the neck for the evaluation of cervical lymph node status (including thyroid gland). We evaluated the prevalence of patients with incidental thyroid lesions identified by US and the risk of malignancy in these patients.Of the 690 patients with head and neck cancer, 234 (33.9%) had incidental thyroid lesions on US. Based on US findings, 61 patients underwent fine-needle aspiration, with 39 eventually undergoing thyroidectomy. Among these thyroid lesions, 24 incidental thyroid lesions of 22 patients were histologically proven to be malignant (23 papillary and 1 follicular carcinomas). The risk of malignancy was 9.4% on a patient-by-patient basis.Screening of the thyroid gland should be included in the preoperative US examination for cervical lymph node metastases in patients with non-thyroidal head and neck cancer.

The association between polymorphism of CC chemokine ligand 5 (CCL5) and cancer has been reported in several studies, however, there is no data in papillary thyroid cancer (PTC).The aim of this study was to investigate whether a promoter single nucleotide polymorphisms (SNP) in CCL5 contributes to the development of PTC and assess the relationships between the CCL5 SNP and the cliniopathologic characteristics of PTC.One promoter SNP (rs2107538, -281C/T) in CCL5 was genotyped using direct sequencing in 93 PTC patients and 212 healthy controls. Genetic data were analyzed using SNPStats, Helixtree, and SNPAnalyzer. PTC patients were dichotomized and compared with respect to cliniopathologic characteristics of PTC.An association was evident between PTC and SNP (rs2107538) in CCL5 [codominant model 2 (T/T vs. C/C), OR = 2.74, 95% CI = 1.18-6.37, p = .019; dominant model, OR = 2.25, 95% CI = 1.01-5.03, p = .049; recessive model, OR = 1.73, 95% CI = 1.06-2.82, p = .030]. When the genetic relationships between SNP and subgroups of PTC patients were assessed, SNP rs2107538 in CCL5 was not associated with any clinicopathologic characteristics of PTC.SNP in the CCL5 -281 promoter gene could increase the risk of developing PTC in Koreans.

Background We investigated whether single nucleotide polymorphisms (SNPs) of integrin beta 1 (ITGB1) and integrin beta 2 (ITGB2) contribute to the development of papillary thyroid cancer (PTC). Methods Two synonymous SNPs (rs2230396 and rs2298141) of ITGB1 and 1 synonymous SNP (rs2352326), 1 5′ URT-region SNP (rs2070947), and 1 promoter SNP (rs2070946) of ITGB2 SNPs were genotyped using direct sequencing in 94 patients with PTC and 213 healthy controls. Genetic data were analyzed using SNPStats (http://bioinfo.iconcologia.net/SNPstats), Helix Tree (Golden Helix Inc, Bozeman, MT), and SNPAnalyzer (ISTECH Corp, Goyang City, Republic of Korea). Results The promoter SNP (rs2070946) of ITGB2 was significantly associated with the development of PTC (dominant model, log-additive model). The G allele frequencies of the promoter SNP (rs2070946) of ITBG2 in patients with PTC (19.9%) were increased by about 2-fold compared with controls (10.2%). Conclusions Our results suggest that a promoter SNP (rs2070946) of ITGB2 might be associated with a risk of PTC.

The FOSB gene is involved in cell proliferation, differentiation and transformation in several tumor types. We investigated whether coding single-nucleotide polymorphisms (cSNPs) and promoter SNPs of FOSB contribute to the development of papillary thyroid cancer (PTC). We also assessed the associations between FOSB SNPs and the clinicopathological characteristics of PTC. One coding SNP (rs2282695, Ala39Ala) and one promoter SNP (rs12373539, -158) in the FOSB gene were genotyped using direct sequencing in 94 PTC patients and 213 healthy controls. Genetic data were analyzed using SNPStats, HelixTree and SNPAnalyzer. PTC patients were dichotomized and compared with respect to clinicopathological characteristics of PTC. We detected an association between PTC and cSNP (rs2282695) in FOSB [codominant model 1 (C/C vs. G/C); OR=1.75; 95% CI, 1.04-2.94; P=0.024; codominant model 2 (C/C vs. G/G): OR=2.55; 95% CI, 1.15-5.64; P=0.045; dominant model: OR=1.89; 95% CI, 1.16-3.08; P=0.010; Log-additive model: OR=1.64; 95% CI, 1.15-2.35; P=0.007]. The G allele was a risk allele in the geno-type and allele analyses of cSNP (rs2282695) in the FOSB gene (OR=1.57; 95% CI, 1.10-2.24; P=0.012). A promoter SNP (rs12373539) in FOSB was associated with cervical lymph node metastasis of PTC [codominant model 1 (G/G vs. A/G): OR=0.23; 95% CI, 0.07-0.72; P=0.016; codominant model 2 (G/G vs. A/A): OR=0.21; 95% CI, 0.02-1.96; P=0.0.05; dominant model: OR=0.22; 95% CI, 0.08-0.66; P=0.004; overdominant model: OR=0.27; 95% CI, 0.09-0.84; P=0.02; log-additive model: OR=0.31; 95% CI, 0.12-0.78; P=0.006]. The A allele was a protective allele in the genotype and allele analyses of SNP (rs12373539) in the FOSB gene promoter (OR=0.34; 95% CI, 0.14-0.83; P=0.017). Variation in a FOSB cSNP (rs2282695) may be associated with risk of PTC. The FOSB promoter SNP (rs12373539) may be associated with lymph node metastasis of PTC.

Transforming growth factor, beta receptor II (70/80 kDa) (TGFBR2) is a tumor suppressor. Mutations in the TGFBR2 gene appear to have an increased risk of developing several cancers. To investigate whether TGFBR2 polymorphisms are associated with the development of papillary thyroid carcinoma (PTC), three single nucleotide polymorphisms (SNPs) of TGFBR2 (rs764522, -1444C/G; rs3087465, -834G/A; rs2228048, Asn389Asn) were selected and genotyped by direct sequencing in 92 PTC patients and 330 control subjects. We also assessed the relationships between three SNPs of TGFBR2 and clinicopathologic characteristics of PTC such as size ( 1 cm), number (unifocality and multifocality), location (one lobe and both lobe), extrathyroidal invasion, and lymph node metastasis. SNPStats and Haploview version 4.2 were used to analyze genetic data. Multiple logistic regression models (codominant1, codominant2, dominant, recessive, overdominant, and log-additive) were performed to calculate odds ratios (ORs), 95% confidence intervals (CIs), and P values. The three examined SNPs were not associated with PTC. In clinicopathologic characteristics, two promoter SNPs (rs3087465 and rs764522) were associated with lymph node metastasis (rs3087465, P=0.009 in the codominant1 model, P=0.043 in the dominant model, P= 0.003 in the overdominant model; rs764522, P=0.021 in the codominant1 model, P=0.044 in the dominant model, P=0.016 in the overdominant model). The synonymous SNP rs2228048 was associated with extrathyroidal invasion (P=0.024 in the dominant model, P=0.015 in the log-additive model). The allele frequency of rs2228048 was significantly different between PTC with extrathyroidal invasion and PTC without extrathyroidal invasion (P=0.018, OR=0.46, 95% CI=0.24–0.88). These results suggest that TGFBR2 may be associated with the progression of PTC in Korean population.

Background The interleukin11 (IL11) and IL11 receptor alpha (IL11RA) are involved in cellular growth, differentiation, invasiveness, and tumor progression in several tumors. We investigated whether coding single nucleotide polymorphisms (cSNPs) of IL11 and promoter SNP IL11RA would contribute to the development of papillary thyroid cancer (PTC). We also assessed the relationships between IL11 and IL11RA SNPs and the clinicopathologic characteristics of PTC. Methods One coding SNP, designated as rs1126757, Ala82Ala, in IL11 and one promoter SNP, designated as rs1061758, −106A/G, in IL11RA were genotyped using direct sequencing in 94 patents with PTC and 213 patients without PTC (controls). Genetic data were analyzed using commercially available software. The patients with PTC were dichotomized and compared with respect to clinicopathologic characteristics of PTC. Results We found an association between PTC and the coding SNP(rs1061758) in IL11RA (codominant model 1 [G/G vs A/G], odds ratio [OR] = 2.91, 95% confidence interval [CI], 1.44–5.89; P = .003; codominant model 2 [G/G vs A/A], OR = 2.95, 95% CI, 1.30–6.72; P = .01; and dominant model, OR = 2.92, 95% CI, 1.47–5.80; P = .002). Moreover, SNP rs1061758 in IL11RA was associated with the multifocality of PTC (codominant model 2 [A/A vs G/G], OR = 9.56, 95% CI, 1.77–51.69; P = .009; and recessive model, OR = 7.22, 95% CI, 1.72–30.3; P = .007). Genotype and allele analyses of SNP variant rs1126757 in IL11 revealed no statistically significant differences between patients with PTC and controls. Conclusion Our results suggest that an IL11RA promoter polymorphism — rs1061758 — may be associated with the risk of PTC in the Korean population. In addition, rs1061758 might be related to the multifocality of PTC.

The incidence of thyroid cancer has been on the increase in a number of countries, and certain genetic factors associated with the increased incidence of the papillary thyroid cancer (PTC) have been identified. However, little is known about the effect of mutations of the cystic fibrosis trans - membrane conductance regulator (CFTR) gene, expressed in the thyroid. We hypothesized and investigated that CFTR single nucleotide polymorphisms (SNPs) may be associated with the risk and/or progression of PTC. A total of 105 PTC patients, confirmed by pathological tests, and 323 controls, without any thyroidal disease, were recruited. One promoter SNP (rs4148682) and one coding SNP (rs213950, Val470Met) in the CFTR gene were analyzed, using direct sequencing. The PTC patients were sub-grouped and compared by their clinical and pathological characteristics of PTC. The results showed that the association between SNPs in the CFTR gene and the development of PTC was statistically insignificant. However, in the clinical and pathological features, rs4148682 was found to be correlated with multifocal tumors, location and cervical node metastasis of PTC. rs231950 was also correlated with multifocal tumors, location and nodal metastasis of PTC. The G allele of rs213950 was correlated with increased risk of multifocal tumors and bilateral lobe location. However, in cervical lymph node metastasis, the A allele of rs213950 was found to reflect high risk. Our study suggests that the CFTR gene polymorphisms studied may not be associated with the development of PTC, but that rs4148682 and rs213950 may be associated with clinical features and prognosis, such as multi- focality, location of cancer and cervical lymph node metastasis of PTC.

Purpose: Integrins play crucial roles in the pathogenesis of papillary thyroid carcinoma (PTC). The aim of this study was to investigate whether two single nucleotide polymorphisms (SNPs) (rs2141698, -1687A/G; rs11895564, Ala380Thr) of the integrin alpha 6 (ITGA6) gene are associated with the development and clinicopathologic characteristics of PTC such as the size (＜1 cm and ≥1 cm), number (unifocality and multifocality), location (one lobe and both lobes), extrathyroid invasion, and cervical lymph node metastasis. Methods: We enrolled 104 PTC patients and 318 control subjects. Genotypes of each SNP were determined by direct sequencing. SNPStats, SNPAnalyzer, and Helixtree programs were used to evaluate odds ratios (ORs), 95% confidence intervals (CIs), and P-values. Multiple logistic regression models were performed to analyze genetic data. Results: A missense SNP rs11895564 was associated with the development of PTC. The A allele frequency of rs11895564 was higher in PTC patients than in controls (13.5% vs. 7.1%; P = 0.005; OR, 2.04; 95% CI, 1.24 to 3.37). In the clinicopathologic characteristics, the A allele frequency of rs11895564 showed difference in the size (19.6% in ＜1 cm vs. 6.9% in ≥1 cm; P = 0.010; OR, 0.30; 95% CI, 0.12 to 0.75) and number (8.5% in unifocality vs. 20.8% in multifocality; P = 0.015; OR, 2.85; 95% CI, 1.23 to 6.59) of PTC. Conclusion: These results suggest that the A allele of rs11895564 (Ala380Thr) in ITGA6 may be a risk factor of PTC, and also contribute to the progression of PTC in the Korean population.

Objectives Among the apoptosis signals, B-cell CLL/lymphoma 2 (BCL2) is a well-known regulator of apoptosis with anti-apoptotic properties. We investigated here whether single nucleotide polymorphisms (SNPs) of the BCL2 were associated with host susceptibility of papillary thyroid cancer (PTC) occurrence and clinicopathologic parameters. Methods Ninety-two PTC patients and 222 control subjects were recruited. One promoter SNP (rs2279115, -938A/C) and one synonymous SNP (rs1801018, Thr7Thr) in the BCL2 gene were selected and genotyped using direct sequencing. Multiple logistic regression models were performed to evaluate odds ratios, 95% confidence intervals, and P-values. Results rs1801018 of the BCL2 gene was not associated with the development of PTC. In the clinicopathologic features, rs1801018 SNP was associated with the number and location. The G allele frequency of rs1801018 in PTC patients with multifocality (13.3%) was about four-fold higher than that in PTC patients with unifocality (3.4%). The G allele frequency of rs1801018 in PTC patients with both lobes (15.4%) was increased by about five-fold, compared to PTC patients with one lobe (3.2%). Conclusion The results suggest that synonymous SNP rs1801018 and the G allele of the BCL2 gene may be associated with the multifocality and bilaterality of PTC in Korean population.

In the case of tracheal rupture or stenosis, most effective way is to insert a commercially available metal stent. However, the implantation often causes a fever or a pain on the contact surface between trachea and the stent. And also the metal stent should be removed after a certain time implantation. Thus, we developed a functional tracheal drug eluting stent consisting of indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), loaded nanofibers on a bare metal stent. To control the drug release kinetics and enhancement of mucosal regeneration, gelatin and PLCL were coated layer by layer on a metal stent by an electrospinning method. Indomethacin was loaded in the gelatin layer by soaking and drying method (0.1, 0.5, and 1 wt% in ethanol for 10 min). The morphology of functional drug eluting tracheal stent was characterized by scanning electron microscope (SEM). And mechanical properties of the constructs such as air leak pressure, ultimate tensile stress, and modulus were calculated and evaluated. Drug release was performed by a high performance liquid chromatography (HPLC). Stably coated gelatin and poly(L-lactide- co-epsilon-caprolactone) (PLCL) nanofibers were observed by SEM. Bi-layered nanofibers-coated stent showed enough mechanical properties as a tracheal stent, which confirmed by a custom-designed air leak mechanical test. For indomethacin loading on a stent, stent was immersed in a series of drug solutions (different concentrations) for 10 min. At the result of HPLC, total amounts of indomethacin on a stent were approximately 77, 323, and 670 ug/stent, respectively. Time dependent drug release kinetics of the tracheal stent showed a sustained release profile regardless of indomethacin content. Thus, functionally designed nanofiber coated tracheal stent with anti-inflammatory drug may be useful for tracheal regeneration.

Collagen type XI α1 (COL11A1) gene overexpression has been implicated as a candidate marker of various types of cancers. In this study, we investigated whether coding region single nucleotide polymorphisms (cSNPs) of the COL11A1 gene are associated with papillary thyroid cancer (PTC) in a Korean population. Four cSNPs [rs12731843 (Lys276Asn), rs3753841 (Pro1335Leu), rs1763347 (Gly1516Gly) and rs2229783 (Ile1602Ile)] were genotyped using direct sequencing in 98 PTC patients and 366 control subjects. Logistic regression analysis for each cSNP revealed an association between rs1763347 and PTC in a dominant model [CT/TT vs. CC, p=0.0042, odds ratio (OR)=0.50, 95% confidential interval (CI) 0.31–0.81]. Analysis of allelic frequency showed that the T alleles of rs1763347 and rs2229783 were significantly associated with reduced risk of PTC (p=0.010, OR=0.61, 95% CI 0.42–0.89 in rs1763347; p=0.007, OR=0.62, 95% CI 0.44–0.88 in rs2229783). Additionally, in the analysis of haplotype, the CC haplotype consisting of rs1763347 and rs2229783 was associated with PTC in codominant (p=0.011, OR=1.56, 95% CI 1.11–2.21) and recessive models (p=0.020, OR=1.70, 95% CI 1.09–2.66). The TT haplotype was also associated with PTC in a codominant model (p=0.006, OR=0.58, 95% CI 0.39–0.88). The frequency of the CC haplotype was higher in the PTC patients (0.71) compared to the control subjects (0.61), whereas the frequency of the TT haplotype was lower in the PTC patients (0.20 and 0.30 in PTC patients and control subjects, respectively). The results suggest that the COL11A1 gene may be associated with PTC and, in particular, that the T allele of rs1763347 and rs2229783 may contribute to a reduced risk of PTC.

Objective Raf-1 kinase inhibitor protein has potential as a molecular determinant of tumor metastasis and may serve as a prognostic marker. The aim of this study is to analyze the correlation between Raf-1 kinase inhibitor protein expression and the clinicopathologic characteristics of papillary thyroid cancer. Study Design Immunohistochemical analysis. Setting Tertiary care teaching hospital. Subjects and Methods Fifty-nine patients with papillary thyroid cancer underwent total thyroidectomy and central neck dissection. Using specimens from total thyroidectomy and central neck dissection, we performed immunohistochemistry for Raf-1 kinase inhibitor protein and evaluated associations between Raf-1 kinase inhibitor protein expression and lymph node metastasis, tumor size, number of tumors, extrathyroidal invasion, angiolymphatic invasion, and status of the tumor border. Results We found significantly low Raf-1 kinase inhibitor protein expression in papillary thyroid cancer with lymph node metastasis. However, Raf-1 kinase inhibitor protein expression was not associated with tumor size, multifocality, extrathyroidal invasion, or status of the tumor border. Conclusion The loss of Raf-1 kinase inhibitor protein expression is associated with lymph node metastasis of papillary thyroid cancer but not with the progression of primary tumors.

This study aimed to evaluate the efficacy and safety of single-session radiofrequency tongue base reduction (RTBR) combined with uvulopalatopharyngoplasty (UPPP) for the treatment of obstructive sleep apnea syndrome (OSAS). Sixty-six patients with multilevel obstruction underwent single-session RTBR combined with UPPP. Snoring, Epworth sleepiness scale (ESS) and polysomnography were used to assess outcome before and 6 months after treatment. Sixty-six patients completed this study. Snoring level significantly decreased from 8.0 to 4.3. The mean ESS score significantly decreased from 11.4 to 7.5. The mean apnea-hypopnea index decreased significantly from 22.9 to 13.9. The overall success rate of the single-session RTBR combined with UPPP was 53.6%. Postoperative AHI in 50% of patients was normalized (AHI < 5). The success rates for patients with mild, moderate and severe OSAS were 62.5, 46.2 and 57.1%, respectively. There were two adverse effects, one ulceration of the tongue base and one transient taste change. Single-session RTBR combined with UPPP is an effective and safe treatment for OSAS patients with multilevel obstruction. It could be considered as first treatment for OSAS patients with multilevel obstruction, independent of the severity of OSAS.

Objective To identify post-operative computed tomography (CT) findings associated with delayed flap failures following head and neck cancer surgery. Materials and Methods We retrospectively reviewed 60 patients who underwent flap reconstruction after head and neck cancer surgery and post-operative (3–14 days) contrast-enhanced CT scans for suspected complications. Patients were divided into two groups: delayed flap failure patients (patients required flap revision) (n = 18) and flap success patients (n = 42). Clinical data (age, sex, T-stage, type of flap, and time interval between reconstruction surgery and CT) and post-operative CT findings of flap status (maximum dimension of the flap, intra- or peri-flap fluid collection and intra- or peri-flap air collection, fat infiltration within the flap, fistula to adjacent aerodigestive tract or skin, and enhanced vascular pedicle) were assessed and compared between the two groups. Results CT findings showed that the following flap anomalies were observed more frequently in the delayed flap failure group than in the flap success group: intra- or peri-flap fluid collection > 4 cm (61.1% vs. 23.8%, p < 0.05), intra- or peri-flap air collection > 2 cm (61.1% vs. 2.4%, p < 0.001), and fistula to adjacent aerodigestive tract or skin (44.4% vs. 0%, p < 0.001). The maximum dimension of the flap, fat infiltration within the flap, and enhanced vascular pedicle were not associated with delayed flap failures. Conclusion A large amount of fluid or air collection and fistula are the CT findings that were associated with delayed flap failures in patients with suspected post-operative complications after head and neck cancer surgery.

The purpose of this study was to retrospectively analyze the feasibility of the surgical management of the carotid artery in advanced head and neck cancer with preoperative suspicion of carotid artery invasion.A total of 47 patients were retrospectively analyzed. Twenty-one patients (44.7%) received surgery as initial treatment, and 26 patients (55.3%) had salvage surgical treatment for recurrences. Intraoperative dissection and preservation of the carotid artery was achieved in 39 patients (83%). Eight patients underwent carotid resection with/without reconstruction (17%).The cumulative 2-year and 5-year overall survival rates were 40.4% and 34%, and the disease-specific survival rates were 59.5% and 55.3%, respectively. The overall perioperative mortality rate was 6.4%. Carotid blowout developed in 6 patients.Surgical treatment of the carotid artery in selected patients can provide locoregional control and the possibility of prolonged disease-free survival with acceptable morbidity. © 2015 Wiley Periodicals, Inc. Head Neck 38: E287-E292, 2016.

The objective of this study was to analyze the oncological and functional outcomes after the surgical treatment of parotid cancer. We reviewed 80 primary parotid carcinomas retrospectively. A superficial parotidectomy was performed in 10 patients; 27 patients underwent total parotidectomy and 43 patients underwent radical parotidectomy. A facial-facial nerve anastomosis was chosen for the facial nerve reconstruction in eight patients, while an interpositional graft was selected in 24 patients. The overall N-positive rate of pathology was 21.3%. The rate of occult metastasis was 8.1%. High-grade carcinoma and lymphovascular emboli were independent factors for nodal metastasis. The 5-year disease-free survival and overall survival rates were 79.7% and 78.8%, respectively. Preoperative facial nerve palsy and extraparenchymal invasion were the independent factors associated with poor disease-free survival. Of the 41 patients in the facial nerve preservation group, 13 (31.7%) had transient facial nerve paresis. In the facial nerve sacrifice group of 39 cases, (sub)total recovery (House-Brackmann grade I/II) occurred in 14 (35.9%), partial recovery (House-Brackmann grade III/IV) in 13 (33.3%), and no recovery (House-Brackmann grade V) in 12 (30.8%). Facial nerve palsy upon presentation and extraparenchymal invasion indicate a grave prognosis. Facial nerve function after proper reconstruction is tolerable.

To analyze patterns of central lymph node (LN) metastasis to specific compartments in the neck and predictive factors of contralateral paratracheal LN metastasis in patients who underwent prophylactic bilateral central LN dissection for papillary thyroid cancer (PTC).Prospective study.Multitertiary centers.One hundred forty consecutive patients underwent total thyroidectomy and prophylactic bilateral central LN dissection for unilateral PTC without evidence of central LN metastatic disease based on preoperative ultrasound imaging. The central LN compartment was divided into prelaryngeal, ipsilateral/contralateral paratracheal, and pretracheal regions. The patterns of central LN metastasis and clinicopathologic variables for predicting contralateral metastasis were analyzed.Fifty-one (36.4%) of 140 patients had nodal involvement in the central compartment. Twelve (23.5%) patients had ipsilateral paratracheal LN metastasis, 17 (33.3%) had ipsilateral paratracheal and pretracheal LN metastasis, 14 (27.5%) had bilateral paratracheal LN metastasis, 9 (17.6%) had pretracheal-only LN metastasis, and 8 (15.7%) had prelaryngeal LN metastasis. Ipsilateral paratracheal LN metastasis was found to independently predict contralateral paratracheal LN metastasis in patients without central LN metastatic disease.Contralateral paratracheal LN metastasis is associated with ipsilateral paratracheal LN metastasis. This information may help to determine the optimal extent of prophylactic central LN dissection in patients with PTC.

Objectives:The influence of age in severity and response to proton pump inhibitor (PPI) in patients with laryngopharyngeal reflux (LPR) is unclear. Thus, we conducted a prospective cohort study to assess the difference in severity and response to PPI according to age in patients with LPR.Methods:Two hundred twenty-nine patients with LPR who were referred to the otolaryngology clinic from November 2010 to February 2012 were enrolled in the study. All of the enrolled patients were prescribed 15mg of Lansoprazole (PPI) twice daily for three months. Data, including the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and LPR-Health related quality of life (LPR-HRQOL), were collected from patients at the baseline visit and at 1 and 3 months post-baseline.Results:The older patients group (60-79 years) showed a higher score in RSI (P < 0.001) and LPR-HRQOL (p

X-Linked inhibitor of apoptosis (XIAP)-associated factor-1 (XAF1) antagonizes XIAP-mediated caspase inhibition. XAF1 also serves as a tumor-suppressor gene, and loss of XAF1 expression correlates with tumor progression. This study investigated whether XAF1 missense single-nucleotide polymorphisms (SNPs) are associated with the development of papillary thyroid cancer (PTC) and their clinicopathological features in a Korean population. Eighty-nine cases of PTC and 276 controls were enrolled. Two missense SNPs [rs34195599 (Glu85Gly) and rs2271232 (Arg132His)] in XAF1 were genotyped using direct sequencing. The SNPStats, SNPAnalyzer, Helixtree, and Haploview version 4.2 programs were used to evaluate genetic data. Multiple logistic regression models were used to determine odds ratios (ORs), 95% confidence intervals (CIs), and p-values. Missense SNP rs34195599 was weakly-associated with the development of PTC (p=0.046 in genotypic distributions; p=0.048 in allelic distributions). For the clinicopathological features, rs34195599 was strongly related to multifocality [unifocality (A/G, 1.7%) vs. multifocality (A/G, 16.7%), OR=11.44, 95% CI=1.27-103.26, p=0.015 in genotypic distributions] [unifocality (G, 0.8%) vs. multifocality (G, 8.3%), OR=10.64, 95% CI=1.21-93.23, p=0.017 in allelic distributions] and location [one lobe (A/G, 1.6%) vs. both lobes (A/G, 19.2%), OR=15.63, 95% CI=1.62-150.46, p=0.008 in genotypic distributions] [one lobe (G, 0.8%) vs. both lobes (G, 9.6%), OR=13.30, 95% CI=1.51-116.82, p=0.009 in allelic distributions]. Our data suggest that the G allele of rs34195599 of XAF1 may be a risk factor for the clinicopathological features of PTC, especially for multifocality and location (both lobes).

As the occult nodal metastasis ratio is low and there is no statistical benefit of elective neck dissection, elective neck dissection is not always necessary during salvage surgery. However, in patients with N positive at initial treatment and cases developing a recurrence within 1 year, elective neck dissection should be considered during salvage surgery.The aim of this study was to evaluate the role of ipsilateral or contralateral elective neck dissection during salvage surgery in head and neck squamous cell carcinoma.A total of 154 node negative and previously undissected heminecks were electively dissected or observed. We estimated the occult metastasis rate in the electively dissected group and compared the regional control rate and disease-specific survival rate between the elective neck dissection group and the observation group.Six of 80 electively dissected heminecks (7.5%) had occult nodal metastasis. When comparing the regional control rate and disease-specific survival rate between the elective neck dissection group and the observation group, there was no statistically significant difference between groups. However, N-positive cases at initial treatment and recurrent cases that developed within 1 year had a significant advantage for elective neck dissection during salvage surgery.

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the pattern of SNPs in ECRG1 and FGFR4 gene of oral squamous cell carcinoma, and to evaluate the association between SNPs and prognostic parameters. MATERIALS AND METHODS: Total 24 cases of oral squamous cell carcinoma patients were enrolled in this study. We analyzed the pattern of SNPs in ECRG1 and FGFR4 gene using PCR and direct sequence. Also we evaluated the association between SNPs pattern and clinicopathologic parameters of oral squamous cell carcinoma. RESULTS: The allele type Arg/Arg in ECRG1 gene was found in 13 (54.2%) patients, Arg/Gln in 11 (45.8%) patients and Gln/Gln in no patient. No clinical or pathological factor was associated with the SNP pattern in ECRG1. The allele types of FGFR4 amino acid 388 in 24 OSCC patients were Arg/Arg (8.3%), Arg/Gly (54.2%) and Gly/Gly (37.5%). No clinical or pathological factor was significantly associated with the SNP pattern except the nodal stage. The patients carrying FGFR4 allele Arg/Arg or Arg/Gly at amino acid 388 were associated with advanced N stage (pathologic N2 + N3), compared to Gly/Gly allele carrying group (p = 0.009). CONCLUSION: This study is the first to describe a SNP pattern of both FGFR4 and ECRG1 gene with OSCC in Asian patients. In this study, FGFR4 Arg allele carrier was associated with higher N stage compared with Gly allele. If the important biological role of FGFR4 and ECRG1 in OSCC can be confirmed in further studies, this might be a rational to consider the evaluation of these genes as a therapeutic target in OSCC.

Preoperative radiological evaluation of the extent of local invasion in maxillary squamous cell carcinoma (SCC) is very important in planning curative surgery. The aim of this study was to examine the accuracy of preoperative radiological evaluation with magnetic resonance imaging (MRI) for the extent of local invasion in maxillary SCC. A retrospective study was conducted of 33 patients who underwent a maxillectomy for maxillary SCC. We compared the MRI findings for 18 structures around the maxillary sinus with intraoperative or postoperative pathological findings. Discrepancies were found between preoperative MRI findings and intraoperative or postoperative pathological findings for 22 patients (66.7%). Overall, the specificity, sensitivity, positive predictive value, and negative predictive value of MRI were 83.4%, 83.0%, 64.5%, and 90.4%, respectively. The receiver operating characteristic curve showed that MRI evaluation of the posterolateral structures including the pterygoid plate, pterygoid muscle, and infratemporal fossa had a lower area under the curve (0.614) and a significantly lower accuracy when compared with the other structures ( P =0.294, 95% confidence interval 0.405–0.822). In conclusion, as the accuracy of preoperative MRI evaluation of the posterolateral structures is low, careful evaluation of local extension to the posterolateral structures is needed when planning curative surgery for maxillary SCC.

Purpose: To determine whether a Fas-associated via death domain (FADD) promoter single-nucleotide polymorphism (SNP) is associated with susceptibility to papillary thyroid cancer (PTC) and clinicopathological features of PTC. Methods: To identify a possible association with PTC, 94 patients with PTC and 346 healthy controls were recruited. One promoter SNP (rs10898853, -16C/T) was analyzed by direct sequencing. Multiple logistic regression models (co-dominant, dominant, recessive, and log-additive models) were applied, and odds ratios (ORs), 95% confidence intervals (CIs), and p values were calculated. Results: The genotype of the promoter SNP (rs10898853) of FADD was found to be significantly associated with PTC in the co-dominant model 2 (T/T vs. C/C; p = 0.002, OR = 2.80, 95% CI = 1.39-5.65), the recessive model (p = 0.003, OR = 2.21, 95% CI = 1.31-3.71), and the log-additive model (p = 0.002, OR = 1.71, 95% CI = 1.20-2.44). Allele frequency analysis showed that the C allele of rs10898853 was significantly associated with an increased risk of PTC (p = 0.002, OR = 1.67, 95% CI = 1.21-2.32). Conclusions: Our results suggest that the FADD promoter polymorphism is associated with susceptibility to PTC.

There is little data that determine the clinical characteristics of prelaryngeal lymph nodes (PLN) metastasis in patients with papillary thyroid cancer (PTC). The aims of this prospective study were to evaluate the incidence and the clinical characteristics of metastasis to the PLN for PTC patients who underwent total thyroidectomy and prophylactic central neck dissection. Sixty-seven patients who underwent total thyroidectomy and prophylactic bilateral central lymph node neck dissection for PTC were enrolled. Central neck compartment was further divided into prelaryngeal, ipsilateral/contralateral paratracheal, and pretracheal regions. Clinicopathologic factors including age, sex, tumor size and location, extrathyroidal extension, and central and lateral nodal metastasis were evaluated. Of the 67 patients who underwent PLN dissection, 13 (19.4 %) had evidence of PLN metastasis. Tumor size was significantly larger in patients with PLN involvement (2.28 versus 1.12 cm; p = 0.020). Additionally, primary tumors larger than 1 cm, extrathyroidal extension, and isthmus involvement were more prevalent in PLN-positive patients. Patients with positive PLNs were also more frequently found to have lateral lymph node metastasis (23.1 vs. 1.9 %; p = 0.021), pretracheal lymph node metastasis (76.9 vs. 27.8 %; p = 0.003), and bilateral central lymph node metastasis (38.5 vs. 11.1 %; p = 0.031) than PTC patients without PLN involvement. The incidence of PLN metastasis in PTC patients who underwent prophylactic central lymph node neck dissection was 19.4 %. PLN metastasis was associated with tumor size, extrathyroidal extension, isthmus involvement, and other compartment lymph node metastasis.

In this study, we investigated whether single nucleotide polymorphisms (SNPs) of the interleukin-1 beta (IL-1B) were associated with papillary thyroid carcinoma (PTC). We also assessed the relationships between IL-1B SNPs and the clinicopathologic characteristics of PTC patients. Ninety-three PTC patients and 324 controls were recruited. The patients with PTC were dichotomized and compared with respect to the clinicopathologic characteristics of PTC. Seven SNPs in the IL-1B gene were selected and genotyped using direct sequencing. Four SNPs (rs1143627, rs3136558, rs1143633, and rs1143643) in the IL-1B gene were significantly associated with PTC (p < 0.05). In clinicopathologic features, 3 SNPs (rs1143630, rs1143633, and rs1143643) showed a strong relationship with lymph node metastasis of PTC. The genotype and allele frequencies of rs1143630 and rs1143643 remained significantly associated with lymph node metastasis after Bonferroni correction for multiple testing. In haplotype analysis, two linkage disequilibrium blocks (block 1 consisted of rs1143627, rs3917356, and rs1143630; block 2 consisted of rs1143633 and rs1143643) also revealed significant associations with lymph node metastasis. Our results suggest that IL-1B polymorphisms may be associated with the risk of PTC in the Korean population. Especially, IL-1B polymorphisms might be a predictive factor for lymph node metastasis of PTC patients.

This study investigated whether insulin-like growth factor 1 receptor (IGF1R) single-nucleotide polymorphisms (SNPs) are associated with the development of papillary thyroid cancer (PTC) and their clinicopathologic features in the Korean population. One hundred and five PTC patients and 312 control subjects were enrolled. Two exonic SNPs (rs3743262, Thr766Thr; rs2229765, Glu1043Glu) in IGF1R were genotyped using direct sequencing. SNPStats, SPSS 18.0, and Haploview version 4.2 programs were used to evaluate genetic data. Multiple logistic regression models were used to determine odds ratios (ORs), 95% confidence intervals (CIs), and P values. A SNP (rs2229765) was associated with the development of PTC (OR = 0.56, 95% CI = 0.35-0.89, P = 0.016 in a codominant model 1; OR = 0.29, 95% CI = 0.11-0.78, P = 0.012 in a codominant model 2; OR = 0.51, 95% CI = 0.32-0.79, P = 0.0028 in a dominant model; OR = 0.38, 95% CI = 0.15-1.01, P = 0.031 in a recessive model; OR = 0.55, 95% CI = 0.38-0.80, P = 0.0001 in a log-additive model; OR = 1.78, 95% CI = 1.25-2.54, P = 0.002 in allele distribution). Our data suggest that the IGF1R may be a risk factor of susceptibility in PTC.

Platelet-derived growth factor (PDGF) acts as a regulator in cancer development and progression. We investigated whether single nucleotide polymorphisms (SNPs) of platelet-derived growth factor receptor α polypeptide (PDGFRA) and platelet-derived growth factor receptor β polypeptide (PDGFRB) genes are associated with papillary thyroid cancer (PTC) in a Korean population. Two promoter SNPs (rs6554162, -1309A/G and rs1800812, -635G/T) of PDGFRA and one promoter SNP (rs3828610, -202A/C) of PDGFRB were genotyped using direct sequencing in 93 PTCs and 212 controls. Genetic data were analyzed using the SNPAnalyzer Pro, SNPStats and Haploview programs. Two promoter SNPs (rs6554162 and rs1800812) in PDGFRA revealed significant differences between PTC and controls (for rs6554162, p=0.0018 in the codominant model and p=0.0005 in the dominant model; for rs1800812, p=0.016 in the codominant model and p=0.007 in the dominant model). In the analysis of allele frequency, we also found that the A allele of rs6554162 (p=0.004) and the T allele of rs1800812 (p=0.029) were associated with PTC. Additionally, by haplotype analysis, the GG and AT haplotypes consisting of rs6554162 and rs1800812 were associated with PTC (GG, p=0.0033; AT, p=0.0270). However, rs3828610 in PDGFRB showed no significant difference between PTC and controls. The results suggest that PDGFRA promoter SNPs (rs6554162 and rs1800812) may be associated with the risk of PTC.

Objectives/Hypothesis: To compare surgical outcomes after intraoral removal of proximal submandibular stones versus traditional submandibular gland (SMG) resection. Study Design: A prospective randomized study. Methods: Forty-four consecutive patients were diagnosed with proximal submandibular stones in the hilum of the submandibular gland by ultrasonography or computed tomography. All of the patients were randomized to undergo removal of the stones either by an intraoral approach (IORS group, 22 patients) or through SMG resection (SMGR group, 22 patients). We then compared the surgical outcomes between these two groups. Results: Stones in the IORS group were significantly smaller than those in the SMGR group. There was no significant difference in the distance of the stones from the hilum between groups. The mean operation time in the IORS group was significantly shorter than that of the SMGR group. The mean hospital stay of the IORS group was also significantly shorter than that of the SMGR group, and IORS patients felt significantly less pain than did SMGR patients. No patient experienced any complication after surgery with the exception of a single patient who experienced transient and mild neck swelling. Conclusions: Intraoral removal of proximal submandibular stones has several advantages over SMG resection. Based on our results, we suggest that our intraoral removal method be selected as the primary procedure for the removal of proximal submandibular stones rather than SMG resection. Laryngoscope, 2010

This study shows the possibility that multilevel surgery for obstructive sleep apnea (OSA) is helpful to improve the levels of pro-inflammatory cytokines and adipokines, which are related to complications of OSA.The effects of multilevel surgery on adipokines and pro-inflammatory cytokines in patients with OSA were assessed.Fifty-one patients with OSA underwent uvulopalatopharyngoplasty and radiofrequency tongue base reduction. Body mass index (BMI), Epworth sleepiness scale (ESS) and subjective symptoms using visual analog scales were assessed at baseline and 4 weeks after treatment. Adiponectin, leptin, interleukin (IL)-6, and tumor necrosis factor (TNF)-α were measured with a LINCOplex Human Immunoassay at baseline and 4 weeks after surgical treatment.Significant improvements in subjective symptoms and ESS were found at 4 weeks after multilevel surgery. No significant change in BMI was observed. Adiponectin level was significantly increased after surgical treatment. Postoperative leptin, IL-6, and TNF-α levels were significantly decreased. The percent changes of adiponectin, leptin, IL-6, and TNF-α after multilevel surgery were not significantly different among patients with mild, moderate, and severe OSA.

To compare the anatomic features and the results of a multilevel surgery in patients with rapid eye movement-related obstructive sleep apnea (REM OSA) and non-REM OSA.Cohort study of 90 consecutive mild or moderate OSA patients.The apnea-hypopnea index (AHI) was also calculated during REM sleep (AHI(REM)) and during non-REM sleep (AHI(NREM)), and patients were classified as having REM OSA if their AHI(REM)/AHI(NREM) ratio was2, otherwise they were classified as non-REM OSA patients. All patients underwent concurrent uvulopalatopharyngoplasty and a radiofrequency tongue base reduction procedure.A total of 31.1 percent patients were classified as REM OSA and 68.9 percent patients as non-REM OSA. There were no differences in the anatomical features between two groups. However, the AHI, HI, and arousal index were significantly higher in the non-REM OSA group than in the REM OSA group. When a successful outcome was defined as a postoperative AHI20 with at least a 50 percent reduction from the preoperative level, 50 percent of the patients with REM OSA and 35.5 percent of the patients with non-REM OSA met the criteria for a successful outcome.REM OSA patients had milder obstructive sleep apnea, and multilevel surgery might be more effective in REM OSA patients.

Conclusion. Microarray analysis may be a useful tool to identify some candidate genes related to the pathogenesis of cholesteatoma. Objective. The aim of this study was to investigate gene expression profiles in human cholesteatoma using an oligonucleotide chip including 10 115 genes. Materials and methods. Gene expression from five cholesteatoma matrices and five normal retroauricular skins was analyzed by Macrogen human oligo-chip and the expression levels of some selected genes were also confirmed by RT-PCR. Results. In all, 1327 up-regulated or 767 down-regulated genes that were over 3 times more prominent in cholesteatoma than in skin were identified by 5 samples of microarray data. Among these up-regulated or down-regulated genes in cholesteatoma, 291 genes were identified in 3 samples or more out of 5 samples as up-regulated expression more than threefold in density and 191 genes were down-regulated more than threefold in density. RT-PCR of 21 selected genes revealed that those expression levels were higher in choleasteatoma than retroauricular skin.