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Purpose: Head and neck squamous cell carcinoma (HNSCC) is comprised of heterogeneous populations of cells, and CD271 (NGFR; p75NTR) has been associated with a tumor-initiating cell subpopulation. This study assessed the role of CD271 in modulating metastatic behavior in HNSCC.Experimental Design: CD271 was overexpressed in murine and human oral squamous cell carcinoma cells to assess the impact of CD271 activation on the invasive and metastatic phenotype of these cells, using in vitro and orthotopic in vivo modeling. Treatment with human nerve growth factor (NGF) to activate CD271, as well as shRNA knockdown of the CD271-upregulated Snai2 expression, was used to assess the mechanism of the CD271-induced invasive phenotype. Relevance of CD271 expression in human HNSCC was evaluated in patient-derived xenografts (PDX) and primary human oral cancers, annotated with clinical behavior characteristics and survival data.Results: Forced expression of CD271 resulted in a more invasive and metastatic phenotype. Slug, an epithelial-to-mesenchymal transition (EMT)-related transcription factor, encoded by Snai2, was highly expressed in MOC2-CD271 and HSC3-CD271, compared with respective parental cells. CD271 activation by NGF conferred enhanced invasiveness in CD271-overexpressing cells, which was abrogated by Snai2 knockdown. In PDXs and primary human HNSCC, CD271 expression correlated with higher Snai2 expression, greater nodal metastasis, and shorter disease-free survival.Conclusions: Activation of CD271 results in upregulation of Snai2/Slug, which, in turn, results in a more invasive phenotype and an enhanced capacity for metastasis to regional lymph nodes. These findings point to CD271 as a promising, therapeutic target for oral cancer metastasis. Clin Cancer Res; 24(3); 674–83. ©2017 AACR.

Supplementary Figure S1. Comparisons of mRNA expressions of EMTrelated genes (Vimentin, CDH1, CDH2, Twist1, TGFß1) between MOC2 vs MOC2-CD271 cells, and between HSC3 vs HSC3-CD271 cells by qRT-PCR; Supplementary Figure S2. Comparisons of mRNA expression of ligands (NGF, BDNF, NT-4) for the CD271 receptor between CD45+ cells, stromal cells and tumors by qRTPCR; Supplementary Figure S3. Representative photomicrographs of morphologic changes of murine or human cancer cells (MOC2-CD271, HSC3-CD271, respectively) in response to rhNGF-β treatment for 48 hrs; Supplementary Figure S4. CD271 activation induces Snai2 expression through the ERK1/2 pathway; Supplementary figure S5. Quantification methods for CD271 expression in primary oral tumor by immunohistochemistry using Photoshop and Image J; Supplementary Table 1. Profiles of patients with oral squamous cell carcinoma analyzed by immunohistochemistry CD271 expression; Supplemental Table 2. Cox proportional hazard model to identify predictors of disease-free survival in pN+ patients.

Introduction: Pulmonary metastatic head and neck cancer has a poor prognosis. Pulmonary metastasectomy has been performed but only in carefully selected patients. The aim of this study was to examine the clinical characteristics and oncological follow-up of patients who underwent pulmonary metastasectomy. Methods: Data of 54 patients with squamous-cell carcinoma (SCC) or adenoid cystic carcinoma (ACC) who underwent metastasectomy between 2003 and 2019 at two tertiary referral centers were retrospectively reviewed. Results: The 3-year and 5-year disease-free survival rates after metastasectomy were 49.9% and 39.9% for SCC and 38.9% and 32.4% for ACC, respectively. Univariate analysis revealed that a disease-free interval (DFI) less than 14 months and R1 resection (hazard ratio [HR] [95% confidence interval]: 2.95 [0.77–5.62], 4.64 [0.99–21.65], respectively) were risk factors for recurrence in SCC and that a high T stage (HR: 5.24 [1.22–22.58]) was a risk factor in ACC. In SCC, a DFI less than 14 months and R1 resection (hazard ratio: 6.35 [1.36–29.54], 12.79 [1.53–106.95], respectively) were risk factors in a multivariate analysis. Conclusion: Pulmonary metastasectomy had a fair effect on head and neck SCC and ACC, and the prognosis was better in SCC patients with a DFI greater than 14 months.

Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII.Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30.Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII.Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

This study was conducted to elucidate the germination characteristics and dormancy types in Maianthemum dilatatum (A. W. Wood) A. Nelson and J. F. Macbr. M. dilatatum seeds were collected from the Nari Basin on Ulleungdo Island, South Korea and used in a water imbibition test; the seed weight increased by approximately 20% within 48 h. The embryo-to-seed ratio at the time of seed dispersal was 0.57 ± 0.03. When the seeds were incubated under light and dark conditions, they germinated under dark conditions, and the germination rate was higher at 25 °C than at 20 °C. However, the final germination rates under dark conditions were 27.4 ± 3.6 and 47.1 ± 7.6%, respectively. Under 4, 8, 12, and 16 weeks of cold stratification treatment, the highest germination rate of 83.6 ± 3.6% was observed at 25 °C at 12 weeks of cold stratification treatment, the germination start date was decreased by more than 10 d, and the mean germination time (MGT) was shortened from 50 d to 39 d. However, the germination rate, germination start date, and MGT did not differ significantly among the gibberellic acid hormone treatments. Therefore, it was evident that M. dilatatum demonstrated physiological dormancy (PD) that can broken by cold stratification treatment and dark conditions.

Background and Objectives Scalp angiosarcoma is a rare but aggressive vascular malignancy. It is often found in the advanced state and tends to cause distant metastasis at an early stage. There is no consensus on a treatment modality, although wide excision followed by adjuvant therapy is currently used. The purpose of this study was to analyze the treatment results and disease progress pattern of scalp angiosarcoma in a single institution.Subjects and Method We enrolled patients who diagnosed with scalp angiosarcoma at Asan Medical Center from March 2011 to September 2019. Disease course and prognostic factors were analyzed by estimating overall survival rate and disease free survival.Results A total 12 patients were enrolled in this study. The median overall survival was 16.0 months. The 3-year-survival rate was 10.6%, and the median disease free survival was 5.0 months. On the average, it took 11.4 months till death after recurrence.Conclusion Although wide surgical excision and multiple adjuvant therapies are employed, scalp angiosarcoma showed frequent recurrences and metastasis which led to poor outcomes. Further investigations for scalp angiosarcoma are necessary to improve treatment outcomes.

Background Assessment of the optical outcome and adverse events in post-epikeratopathic eyes after removal of the epikeratoplasty lenticule (EKPL). Methods This was a retrospective case-series study of patients who underwent EKPL removal between 2002 and 2020. Ten eyes were included in the analysis. We compared the clinical characteristics of the patients before surgery, 6 months after surgery, before lenticular removal, and after removal, and reported optical or ocular surface complications. Results We removed EKPL due to the lenticular opacity in five eyes (50%), intraocular lens (IOL) insertion (n = 4, 40%) after cataract surgery (n = 3) or in aphakic eyes (n = 1), and lenticule-induced irregular astigmatism in one eye (10%). After EKPL removal, the mean refractive power of the cornea (Km) revealed a tendency to increase. Out of nine cases, six cases showed corneal steepening and three cases revealed corneal flattening. When the keratometric readings of pre-epikeratoplasty and post-lenticular removal were compared within the same case, the average difference was 5.1 D ± 4.0 (n = 8). Complications were observed in 3 of 10 cases (excessive corneal flatness, ectatic change, and abnormal epithelial cell ingrowth) after removal. Conclusions The surgeon should expect the corneal refractive power to steepen or flatten in some cases with abnormal astigmatism and irregularity. Epikeratophakic eyes may exhibit serious ectatic changes, and abnormal epithelial cell ingrowth after removal of epikeratophakic lenticules.

Purpose To investigate the causes of bullous keratopathy (BK) in the Korean population and analyze the results of penetrating keratoplasty (PK) in BK eyes associated with the top two causes: pseudophakic bullous keratopathy (PBK) and glaucoma surgery-associated BK (GBK). Methods Medical records were reviewed of patients diagnosed with BK at a tertiary referral center between 2010 and 2020. The predisposing conditions, clinical characteristics and therapeutic outcomes after PK were analyzed and compared. Results Of total 340 BK eyes, 70% (238 eyes) were associated with ocular surgery; most commonly, cataract surgery (48%, 162 eyes) and glaucoma surgery/laser (21%, 70 eyes). The BK onset was faster following glaucoma surgery/laser (91.7 ± 94.4 months) than following cataract surgery (160.7 ± 138.0 months, p < 0.001). The median survival time of allografts was shorter in GBK than in PBK (24.0 vs 51.0 months, p = 0.020). Best-corrected logMAR visual acuities were lower in GBK than in PBK after PK (1.4 ± 0.7 vs 0.9 ± 0.6, p = 0.017 at one year; 1.8 ± 0.7 vs 1.1 ± 0.8, p = 0.043 at three years). Conclusions Intraocular surgery is the major predisposing condition of BK in Korea. GBK developed earlier and its therapeutic outcome was poorer, compared to PBK.

Penthorum chinense Pursh is a plant belonging to the Crassulaceae family and is a representative perennial herb that grows nationwide in watersides and wetlands. This study was conducted to enhance the competitiveness of wild plant seeds and contribute to the conservation of species diversity through the evaluation of antioxidant and antidiabetic activities of P. chinense seed extracts based on extraction solvents. The total phenolics content was 19.83 mg GAE/g seeds in the 75% ethanol extract, whereas the flavonoid content was the highest (10.89 mg QE/g seeds) in the 75% methanol extract. Total phenolicss content was higher in the organic solvent extract than in the water extract. The DPPH radical scavenging activity was the highest (IC50 27.60 μg/mL) in the 75% methanol extract, and the ABTS radical scavenging activity was the highest (IC50 53.54 μg/mL) in the 75% methanol extract. Total antioxidant capacity was the highest (30.87 μmol AAE/g) in the 75% ethanol extract. The α-glucosidase-inhibitory activity was the highest (IC50 46.47 μg/mL) in the 75% ethanol extract. From the results of this study, it was confirmed that P. chinense seed extracts, which possess high phenolics content, exhibit antioxidant and antidiabetic effects, and could be used as an effective health functional food material and natural medicine.

Background and Objectives The ideal flap for head and neck reconstruction should be pliable, have sufficiently long pedicle and minimize donor defects. Anterolateral thigh free flap (ALTFF) and radial forearm free flap (RFFF) have been the workhorse flaps for head and neck reconstruction. However, ALTFF is too bulky and RFFF leaves a conspicuous scar on the donner site. Medial sural artery perforator free flap (MSAPFF) is a possible alternative, which has the benefit of thin RFFF and low donor site morbidity of ALTFF. Here, we evaluated for the first time the usefulness of MSAPF for head and neck reconstruction in Korean patients. Subjects and Method We carried out a retrospective study of patients who underwent MSAPFF for head and neck reconstruction from October 2018 to July 2019 by retrieving their data from electronic medical records. Patient characteristics, flap characteristics, surgical outcomes, and complications of donor sites were analyzed. Results Eight patients underwent MSAPFF reconstruction after head and neck surgery. The recipient sites were the following: the floor of the mouth, palate, tongue, the base of the tongue and nasolabial fold. The average median flap size was 34.1 cm2 (range 17.5-50 cm2), length 7.1 cm (5.0-10.0 cm), width 4.7 cm (range 3.5-5.0 cm), and pedicle length 9.2 cm (range 8-10 cm). There was one flap failure because of pedicle arterial insufficiency. All donor sites were closed primarily without any complication. Conclusion Based on the findings of this study, MSAPFF may be a new workhorse flap because it has thin, pliable tissue with low donor-site morbidity for head and neck reconstruction.

Objectives: To analyze the effects of an intervention protocol for perioperative smoking cessation on short- and long-term smoking abstinence of patients.Methods: A total of 115 patients who were s...