A Case of Primary Squamous Cell Carcinoma of The Thyroid Gland / 대한두경부종양학회지

Primary squamous cell carcinoma of thyroid is a very rare malignant tumor with poor prognosis. It is usually diagnosed as an advanced disease infiltrating adjacent organs, and characterized by aggressive clinical course with an average postoperative survival time of less than 1 year. Recently, we had a 79- year-old woman with a painful neck mass who was diagnosed as primary squamous cell carcinoma of thyroid gland. She underwent total thyroidectomy and selective neck dissection(level Ⅲ, Ⅵ) with no further postoperative managements such as radiation therapy or chemotherapy; she died of poor general condition and pneumonia resulting from rapid progression of the lesion on the 38th day after surgery. We report this case with a review of relevant literatures.

A Case of Paradoxical Vocal Fold Movement Due to Psychological Causes

Paradoxical vocal fold movement (PVFM) is a dystonic laryngeal disorder characterized by involuntary vocal fold adduction during inspiration and/or expiration. PVFM is uncommon and may aggravate airway obstruction. And patients with PVFM have a specific etiology; therefore, treatment must be individualized and given immediately. We present a case of 63-year-old male presenting with intermittent dyspnea. After multidisciplinary workup, we presumed psychogenic PVFM and evaluated with speech-language pathologist and psychologist. In this report, we describe a rare case of psychogenic PVFM patient.

Epithelial-Mesenchymal Transition in Head and Neck Cancer / 대한이비인후과학회지

Metastasis is one of the most important factors in the prognosis and choice of treatment strategy of patients with head and neck squamous cell carcinoma (HNSCC). In order for dissemination to take effect, tumor cells must segregate themselves from their primary tumor site and migrate into the blood or lymphatic vessels. To detach from the primary tumor, cells have to disrupt cell-cell adhesion, remodel of the cytoskeleton, change in cell-matrix adhesion and finally return to their original condition. This temporary and reversible process is known as the epithelial-mesenchymal transition (EMT). EMT is a dynamic cellular process in which epithelial cells acquire mesenchymal features and suggested to play an important role during cancer invasion and metastasis. With the recent explosion of knowledge on EMT in carcinogenesis, EMT has become an interesting target for anticancer therapy. This review article first highlights at the biochemical changes that take place around the cell membrane called cadherin switching during EMT and looks at the current literature on EMT in HNSCC. Understanding the mechanism of EMT will provide insight to the metastasis of HNSCC and may lead to the development of novel anti-cancer therapeutics.

Classification and Management in Patients with Laryngomalacia

Laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms begin to appear after weeks of age, become worse at 4-8 months, improve between 8-12 months, and usually heal naturally at 12-18 months. Despite these common natural processes, the symptoms of the disease can be very diverse and, in severe cases, require surgical treatment. The diagnosis can be made by suspicion of clinical symptoms and direct observation of the larynx with the spontaneous breathing of the child. Typical laryngeal features include omega-shaped epiglottis, retroflexed epiglottis, short aryepiglottic fold, poor visualization of the vocal folds, and edema of the posterior glottis, including inspiratory supra-arytenoid tissue prolapse. In this review, we discuss the classification and treatment based on symptoms and laryngoscopic findings in patients with laryngomalacia.

A Case of Foreign Body in Larynx Involving Thyroid

Pharyngeal and laryngeal foreign bodies are common problem at ENT clinic. Removal of a foreign body is mostly simple with the manipulation of endoscope and various instruments. Rarely, migration of swallowed sharp foreign body makes complication. We describe a 74-year-old patient diagnosed with foreign body in larynx involving thyroid. In this case, we present this disease and the treatment course which has been successfully treated by surgical removal and conservative treatment. Furthermore, we discuss its symptoms, physical examinations through literature review.

Partial Superficial Parotidectomy via Retroauricular Hairline Incision

OBJECTIVES: The purpose of this study was to evaluate the usefulness of retroauricular hair line incision (RAHI) in partial superficial parotidectomy by comparison with modified Blair incision or facelift incision. METHODS: Medical records of 73 patients with benign parotid tumor who underwent partial superficial parotidectomy were retrospectively reviewed. Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey's syndrome, and cosmetic outcomes were compared among RAHI, facelift incision (FLI), modified Blair incision (MBI) groups. RESULTS: RAHI group showed better cosmetic results than FLI group or MBI group compared with other type of incisions (P0.999), occurrence of temporary or permanent facial nerve paralysis (P=0.745) and Frey's syndrome (P=0.940). CONCLUSION: Partial superficial parotidectomy can be done safely by RAHI in most cases of benign parotid tumor. Compared with MBI or FLI, RAHI has better cosmetic outcome with no increase of operative time or postoperative complications.

Factors Influencing on Perinatal Outcomes of Asian Marriage Immigrant Women: Ten-year Experience in a Single Center / 대한주산의학회잡지

PURPOSE: We aimed to analyze the maternal and perinatal factors associated with perinatal outcomes by examining families comprised of Korean fathers, Asian immigrant mothers, and their newborns. METHODS: Medical records of newborn infants admitted to Jeonju Jesus Hospital nursery or ne-onatal intensive care unit (NICU) from January 2004 to June 2013 and their Asian immigrant mothers were reviewed retrospectively. The newborns were divided into two groups depending on whether they were admitted NICU or not, and factors influencing on perinatal outcomes were compared between the two groups. The newborn were divided into the two groups, including those who did not receive inpatient care and those treated in the NICU. The differences between the two groups were analyzed. RESULTS: The study included 180 newborns and 172 mothers, and 94 (52.3%) and 86 (47.7%) newborns were classified as the nursery group and the NICU group, respectively. There were no statistically significant differences between the two groups in terms of the mothers' nationality, maternal age, maternal education level, maternal occupation, residential area, maternal height and weight, maternal weight gain during pregnancy, maternal hepatitis B antigen positivity, maternal parity, paternal age, and age gap between spouses. However, underweight maternal prepregnancy body mass index (BMI) and hemoglobin level over 11.0 g/dL were significantly more frequent in the NICU group in the comparative analysis. The NICU group showed significantly more frequent no iron supplements during pregnancy (OR=4.06) and gestational disease (OR=3.81). CONCLUSION: In cases where married immigrant mothers had underweight prepregnancy BMI, gestational disease, or no iron supplements during pregnancy, their newborns were more likely to have NICU care. Therefore, married immigrant women should have appropriate perinatal care including education about a balanced diet to maintain an appropriate body weight with ensuring an adequate iron supplements intake.

A Case of Squamous Cell Carcinoma Arising in a Second Branchial Cleft Cyst / 대한이비인후과학회지

The existence of primary brancial cleft cyst carcinoma is controversial since first described by Volkmann in 1882. Martin and Khafif proposed criteria for diagnosis of primary branchiogenic carcinoma, which are now widely accepted in the literature. The most important criterion is the presence of squamous cell carcinoma arising from the benign squamous epithelium of branchial cleft cyst. We report a case of a 69-year-old man with branchial cleft cyst carcinoma, which was suspected to be cervical lymph node metastases from an unknown primary tumor. The subject underwent a surgical operation, and postoperative pathologic findings revealed a squamous cell carcinoma developing in the stratified squamous epithelial lining of the branchial cleft cyst. This case meets the criteria established by Martin and Khafif, thus we present it with a review of literature.

Diagnosis and Therapy for Dysphonia in the Professional Voice User / 대한이비인후과학회지

Characteristics of voice problems occurring with professional voice users are not too different from those with general public. However, they react sensitively to relatively subtle changes of voice and have strong demands for their treatments as well. Consequently, treatments for the professional voice users should be implemented in the form of team approach consisting of not only otolaryngologists with plenty of treatment experience and sufficient knowledge but also speech-language pathologist, vocal coach. While treating professional voice users is burdensome and a challenging problem even to otolaryngologists rich in experience, knowledge and experience obtained through treating them will be much help for voice treatments of other general public. In this article, the authors have reviewed approaches and treatment directions for voice problems occurring with professional voice users.