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Chih-Ying Su

Publications and source records attributed to Chih-Ying Su.

At least 19 recordsLinked to original sources
PubMed2006

High expressions of CD105 and VEGF in early oral cancer predict potential cervical metastasis.

BACKGROUND AND OBJECTIVES: Although elective neck dissection has become a popular treatment modality for early oral cancer among most head and neck surgeons, a large portion of patients revealed pathological N0 postoperatively. Our study is aimed to evaluate the expressions of the angiogenic factors, vascular endothelial growth factor (VEGF), and CD105 (endoglin) on the prediction of neck metastasis for clinical N0 patients in early oral cancer. PATIENTS AND METHODS: Between July 1996 and July 2005, the preoperative biopsy specimens among 176 patients who underwent surgical treatment for early oral cancer were retrieved for the immunohistochemical study for VEGF and CD105. RESULTS: High expressions of CD105 and VEGF significantly correlated with positive nodal metastasis, respectively (P<0.001). The expression of CD105 also significantly correlated with that of VEGF (P<0.001). Furthermore, the sensitivity and specificity for prediction of cervical metastasis by high expressions of CD105 versus VEGF were 81.8% and 97.7% versus 93.2% and 72%, respectively. Low expression of CD105 and VEGF also significantly correlated with higher survival rate, respectively (P<0.001). CONCLUSIONS: Besides the image studies, the expressions of both CD105 and VEGF could be useful to guide the elective treatment for clinical N0 neck in early oral cancer.

Analysis of Variance↗
PubMed2006

Parietal-eye phototransduction components and their potential evolutionary implications.

The parietal-eye photoreceptor is unique because it has two antagonistic light signaling pathways in the same cell-a hyperpolarizing pathway maximally sensitive to blue light and a depolarizing pathway maximally sensitive to green light. Here, we report the molecular components of these two pathways. We found two opsins in the same cell: the blue-sensitive pinopsin and a previously unidentified green-sensitive opsin, which we name parietopsin. Signaling components included gustducin-alpha and Galphao, but not rod or cone transducin-alpha. Single-cell recordings demonstrated that Go mediates the depolarizing response. Gustducin-alpha resembles transducin-alpha functionally and likely mediates the hyperpolarizing response. The parietopsin-Go signaling pair provides clues about how rod and cone phototransduction might have evolved.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed2006

Schwannoma of the tympanic membrane.

Schwannoma arising from the tympanic membrane is a rare neoplasm. This report describes an external ear canal mass obscuring the tympanic membrane. A transcanal approach identified a tumour adhered to the tympanic membrane. The tumour was excised without myringoplasty. Pathology confirmed the diagnosis of schwannoma. Clinical examination revealed no evidence of recurrence during a follow-up period of one year. The possible origins of schwannoma of the tympanic membrane and lesion management are also discussed.

Aged↗
PubMed2006

Clinicopathologic significance of CD105 expression in squamous cell carcinoma of the hypopharynx.

BACKGROUND: Induction of angiogenesis is a key process in tumor growth and metastasis. We studied the CD105 (endoglin) and vascular endothelial growth factor (VEGF) in hypopharyngeal cancer to evaluate their clinicopathologic significance. METHODS: Seventy-three patients who underwent complete excision of hypopharyngeal cancer were included in this study. Clinicopathologic data were collected retrospectively. Immunohistochemical analysis was performed with antibodies of CD105 and VEGF. Positive-stained microvessels for CD105 were counted on hot spots of tumors. The staining intensity for VEGF was also evaluated. RESULTS: High expression of CD105 correlated significantly with positive nodal metastasis (p < .001) and TNM stage (p < .01). High expression of VEGF correlated significantly with advanced tumor (T) classification (p < .01). The overall 5-year survival rate was worse in patients with higher CD105 expression (p < .001), advanced TNM stage (p < .01), advanced T classification (p < .01), and positive nodal metastasis (p < .001). Furthermore, Cox regression analysis revealed that CD105 expression in microvessels of tumor tissue, advanced T classification, and nodal status were independent factors for survival. CONCLUSION: Our results suggest that expression of CD105 is a useful predictive prognostic factor in hypopharyngeal cancer.

Adult↗
PubMed2006

Malignant lymphoepithelial lesions of the salivary gland.

OBJECTIVES: To describe a relatively large series of patients with uncommon malignant lymphoepithelial lesions (MLEL) in the salivary glands, to present treatment-outcome data to support therapeutic decision-making, and to evaluate the incidence of co-occurrence of MLEL and Epstein-Barr virus (EBV). STUDY DESIGN AND SETTING: Ten patients with MLEL were treated between 1987 and 2002. All lesions were surgically removed, with or without neck dissection, and the patients treated with radiotherapy or radiotherapy and chemotherapy. Histopathology and in situ hybridization studies for EBV-encoded RNA (EBER1) were performed. RESULTS: With aggressive treatment, outcomes were good, regardless of the presenting stage, except when distal metastases were present. All 10 patients tested positive for EBV. CONCLUSION AND SIGNIFICANCE: This and previous investigations support the use of aggressive surgical excision of the tumor and local metastases and radiotherapy or radiotherapy and chemotherapy, as optimal treatment for MLEL. The EBV finding may indicate a role for EBV in the pathogenesis of MLEL. EBM RATING: C-4.

Adult↗
PubMed2006

Scanning electron microscopic study of the nasolabial cyst: its clinical and embryological implications.

OBJECTIVE: Nasolabial cyst is an uncommon midfacial cyst. It is considered to be a developmental anomaly arising from the rest of nasal respiratory epithelium. Although the cyst is a well-recognized entity, there remains some confusion of its origin, cell types, and ultrastructures. Based on the routine light microscopic study, some authors reported the epithelial cells of the inner lining of the nasolabial cyst were ciliated; some others reported they were nonciliated. To clarify this, a scanning electron microscopic study is needed. STUDY DESIGN: This was a prospective clinical series. METHODS: A transnasal marsupialization method was used to treat 10 patients with nasolabial cyst. With patients under local anesthesia, the roof of the cyst wall and a disk of nearby nasal mucosa were excised together with a sickle knife and scissors. Surgical specimens were dissected and processed for scanning electron microscopy and histochemistry. Patients were followed up for 8 to 65 months. RESULTS: Marsupialization of cysts was successfully performed on all patients. Electron microscopically, the inner surface of the nasolabial cysts in all the cases was lined with nonciliated columnar epithelium consisting chiefly of goblet cells and basal cells. It is suggested that goblet cells contributed to clear, thin, and yellow mucus present in the cyst lumen. Instead of cilia, these epithelial cell surfaces were equipped with numerous short, globular, or irregular microvilli. Apical cytoplasm of adjacent cells did not tightly adhere to each other. Instead, microsulci of 1 to 3 microm in width formed between cells. Cytoplasmic processes from the lateral border spanned the microsulcus and contacted with those from neighboring cells. CONCLUSION: The novel study has proved that the lining epithelium on the inner surface of the nasolabial cyst is columnar epithelium that chiefly consisted of two types of cells: goblet cells and basal cells. Not present were ciliated cells that were essential in the other portion of the respiratory tract. Numerous microvilli, instead of cilia, covered the inner lining of the nasolabial cyst, probably as a result of lacking the stimulation of air in ventilation as that on the other portion of the respiratory tract. The cilia of the epithelium were ill developed.

Adult↗
PubMed2006

High expression of CD105 as a prognostic predictor of early tongue cancer.

OBJECTIVES: The purpose of this article is to investigate the expressions of vascular endothelial growth factor (VEGF) and endoglin (CD105) in the biopsy tissues of squamous cell carcinoma of the tongue in early tumor stages and their relationship with the clinicopathologic features. STUDY DESIGN AND METHODS: The authors conducted retrospective clinical and biologic studies. Immunohistochemistry was used to study the expressions of VEGF and CD105 in the biopsy tissues taken from 94 patients with T1 and T2 tongue cancers. The expressions of VEGF and CD105 were analyzed and correlated to the clinicopathologic features of these patients. RESULTS: High expressions of VEGF and CD105 significantly correlated with a relatively advanced tumor stage (P=.001 and P<.001), positive nodal status (P<.001 and P<.001), presence of tumor necrosis (P=.022 and P=.01), and greater tumor thickness (P<.001 and P<.001), respectively. In addition, high expression of CD105 correlated with the presence of perineural invasion (P=.003). However, the expression of VEGF and CD105 did not significantly correlate with age, gender, vascular invasion, or histologic grading. The cumulative 5-year disease-free survival rate significantly correlated with low expression of VEGF (P=.003), CD105 (P<.001), positive nodal status (P<.001), a relatively advanced tumor stage (P=.024), greater tumor thickness (P=.023), and presence of tumor necrosis (P=.003). Nonetheless, Cox's regression analysis revealed that only the expression of CD105 was an independent prognostic predictor for survival (P<.001). CONCLUSIONS: Higher expression of either CD105 or VEGF in the tumor bed implicates a more aggressive potential for T1 and T2 tongue cancers, and the expression of CD105 is a useful predictive prognostic factor in early tongue cancer.

Adult↗
PubMed2006

Tympanoplasty for chronic otitis media in post-irradiated nasopharyngeal carcinoma patients.

OBJECTIVES: We evaluated the surgical outcome of tympanoplasty for chronic otitis media in post-irradiated patients with nasopharyngeal carcinoma. METHODS: Nineteen ears were treated in 15 patients with nasopharyngeal carcinoma who had undergone radiotherapy in this retrospective clinical series. Only patients with simple perforations of the tympanic membrane and normal or near-normal eustachian tube function were enrolled in this study. All patients underwent type I tympanoplasty. RESULTS: All patients had been treated with radiotherapy of 64.8 to 81.0 Gy. The intervals between radiotherapy and surgery ranged from 17 months to 20 years. The tympanic membranes in 10 of 19 ears were intact after surgery. Otorrhea had subsided in 11 ears (58%), and the incidence of otorrhea was decreased in 6 ears (32%). Thirteen of the 15 patients (86.7%) reported that their quality of life had improved. CONCLUSIONS: Surgical intervention benefits some patients with nasopharyngeal carcinoma with chronic otitis media resulting from radiotherapy.

Adult↗
PubMed2005

Comparison of radial forearm free flap, pedicled buccal fat pad flap and split-thickness skin graft in reconstruction of buccal mucosal defect.

There are a variety of methods to reconstruct the mucosal defect after the ablation of buccal cancer. We used the radial forearm free flap (RFFF), pedicled buccal fat pad flap (PBFPF) or split-thickness skin graft (STSG) to reconstruct the buccal mucosal defect in our series respectively and compared the mouth-open width among these methods. We found there was no significant difference in the change of mouth-open width between the Group STSG and Group PBFPF. However, the negative effect on the mouth opening was significantly less (p<0.05) in Group RFFF when compared with the Group STSG or Group PBFPF. In conclusion, reconstruction with radial forearm free flap for buccal mucosal defect carries more chances to preserve the original mouth-open width than with pedicled buccal fat pad flap or split-thickness skin graft among the selected patients who undergo tumor resection for T2 or T3 buccal cancer.

Adult↗
PubMed2005

Laser myringotomy for otitis media with effusion in nasopharyngeal carcinoma patients.

OBJECTIVE: To evaluate the effectiveness of laser myringotomy in otitis media with effusion (OME) in patients with nasopharyngeal carcinoma (NPC). STUDY DESIGN AND SETTING: Laser myringotomy was performed with a CO 2 laser otoscope in 53 NPC patients (68 ears) and 32 non-NPC patients (37 ears). All patients had a history of OME. RESULTS: In the NPC group, 40% of ears developed persistent perforation, 37% had recurrent OME, and 23% were free of disease. In the non-NPC group, only 3% of ears developed persistent perforation, and 43% were free of disease. Significant differences in perforation and disease-free state were evident between the 2 groups. Tumor stage was found to be a significant determining factor for clinical outcome in NPC group. CONCLUSION: Laser myringotomy for NPC group carries a significantly higher risk of persistent perforation and lower rate of cure. This procedure may be considered for early staging NPC patients with serious OME symptoms.

Adult↗
PubMed2005

Bipedicled strap muscle transposition for vocal fold deficit after laser cordectomy in early glottic cancer patients.

OBJECTIVE: In treating early glottic carcinomas, the outcomes of endoscopic laser cordectomy have been proven to be valuable in local control, survival, and vocal function preservation. In some extended cases, however, laser cordectomy may leave patients with poor vocal function because of vocal fold deficit. This work assesses the vocal outcome of medialization laryngoplasty with bipedicled strap muscle transposition for vocal fold deficit resulting from laser cordectomy in early glottic cancer patients. STUDY DESIGN: A prospective clinical series. METHODS: Thirteen early glottic cancer patients who had vocal fold deficit caused by previous laser cordectomy underwent medialization laryngoplasty with bipedicled strap muscle transposition. The thyroid lamina on the cordectomy side was paramedially separated. The inner perichondrium was circumspectly raised from the overlying thyroid cartilage. After separating the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally. A bipedicled strap muscle flap was then transposed into the area between the lamina and the paraglottic soft tissue. The thyroid cartilages were carefully sutured back in position. All patients received pre- and postoperative voice assessments comprising laryngostroboscopy and vocal function studies. RESULTS: Vocal enhancement was present in 92% (12/13) of patients after medialization laryngoplasty with strap muscle transposition. The glottal closure and maximal phonation time were noticeably improved by surgery. No dyspnea or other significant complications were observed in any patients. CONCLUSION: The outcomes show that bipedicled strap muscle transposition is a prosthesis-free, safe, and valuable laryngoplastic technique for correcting glottal incompetence caused by endoscopic laser cordectomy in early glottic cancer patients.

Glottis↗
PubMed2005

Functional significance of arytenoid adduction with the suture attaching to cricoid cartilage versus to thyroid cartilage for unilateral paralytic dysphonia.

OBJECTIVE: In the treatment of unilateral paralytic dysphonia, traditional arytenoid adduction is designed to place suture through the muscular process of the arytenoid attaching anteriorly to the thyroid ala. In contrast with the suture direction of this technique, a new paramedian approach to arytenoid adduction anchors anteroinferiorly to the cricoid cartilage, mimicking the force action of the lateral cricoarytenoid muscle (the major adductor of the larynx). This study investigated the influence of these changes in suture direction on the vocal fold level as well as the vocal outcomes in these two techniques of arytenoid adduction. STUDY DESIGN: A prospective clinical series. METHODS: Thirty patients with unilateral paralytic dysphonia underwent medialization laryngoplasty with arytenoid adduction and strap muscle transposition. Under local anesthesia, the thyroid lamina on the involved side was paramedially separated. The inner perichondrium was carefully elevated away from the overlying thyroid cartilage, carrying the dissection posteriorly to the level of the superior and inferior cornua. The lamina was retracted laterally, the inner perichondrium was opened near the midpoint, and the lateral cricoarytenoid muscle identified. Tracing the muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 Prolene suture was placed through the muscular process and temporarily tied to the anterolateral aspect of the thyroid ala (AA-thyroid suture). Intraoperative acoustic and perceptual assessments were performed. After releasing the tie, the suture was anchored to the cricoid cartilage at the origin of the lateral cricoarytenoid muscle (AA-cricoid suture). Voice assessments were repeated, and the outcomes of the two tests were compared. The choice of the type of arytenoid adduction suture was made intraoperatively according to which condition provided better vocal performance. After securing the suture, a bipedicled strap muscle flap was transposed into the space between the lamina and inner perichondrium and the thyroid cartilages sutured back into place. RESULTS: The intraoperative acoustic and perceptual assessments revealed the vocal performance was significantly better with AA-cricoid suture than the AA-thyroid suture in this series. No major complications occurred in the study. CONCLUSION: This study suggests that arytenoid adduction with suture attachment along the longitudinal axis of the lateral cricoarytenoid muscle to the cricoid cartilage is more physiologic and effective than that attaching the suture to the thyroid ala. A paramedian approach to arytenoid adduction with or without strap muscle transposition is a safe and effective method for treatment of unilateral paralytic dysphonia.

Adult↗
PubMed2005

Reconstruction of extensive composite mandibular defects with large lip involvement by using double free flaps and fascia lata grafts for oral sphincters.

BACKGROUND: Extensive composite mandibular defects involving large lip defects are the most difficult to repair among head and neck reconstructions. This study presents the authors' approach using double free flaps and fascia lata grafts for oral sphincters. METHODS: Ten patients were studied after ablative oral cancer surgery. Segmental defects of the mandible ranged from 6 to 14 cm. Cheek defects ranged from 9 x 6 cm to 15 x 12 cm, and intraoral defects ranged from 9 x 7 cm to 16 x 16 cm. Upper lip defects ranged from 10 percent to 50 percent, and lower lip defects ranged from 50 percent to 90 percent. A fibula osteocutaneous flap was used for reconstruction of mandibular defects and intraoral lining, and an anterolateral thigh flap was used for cheek and lip defects. Then, a sheet of fascia lata graft was used to reconstruct the oral sphincter. The tendon graft was passed into the subcutaneous layers of the reconstructed lip, woven into the remaining orbicularis oris muscle of the lip, and anchored to the upper lip near the philtral columns to complete the oral ring with adequate tension. RESULTS: Free flap survival was 100 percent. Complications included one patient with neck hematoma and distal anterolateral thigh flap necrosis, three patients with neck wound infection, and one patient with osteomyelitis of the mandible. All but one patient had adequate oral competence. All the patients were able to resume a soft diet. The speech ability was nearly normal for all the patients, and all the patients had gained an acceptable appearance. CONCLUSIONS: For extensive composite mandibular defects combined with large lip defects, immediate reconstruction with double free flaps and a fascia lata graft for oral sphincter has proved to be a useful option for better functional and cosmetic results.

Adult↗
PubMed2005

Kikuchi's disease in Asian children.

OBJECTIVE: Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a unique form of self-limiting lymphadenitis and typically affects the head and neck regions. It usually occurs in young adults and has a female predilection. The aim of this study was to review the authors' institutional experience with KD in children over a 16-year period. METHODS: Between January 1986 and May 2002, a total of 23 patients who were younger than 16 years underwent cervical lymph node biopsies and received a diagnosis of KD. Clinical features, laboratory values, pathologic parameters, specific characteristics of our pediatric patients, and long-term follow-up results are discussed. The follow-up period averaged 8 years. RESULTS: There were 8 girls and 15 boys with a mean age of 12.8. All 23 patients had affected cervical lymph nodes located in the posterior cervical triangle, and 2 cases additionally had affected nodes in the anterior triangle. Cervical lymph nodes were affected unilaterally in 82.6% (19) and bilaterally in 17.4% (4) of these patients. The dimensions of the affected lymph nodes were commonly in the range of 0.5 to 3 cm (52.2%; 12 of 23) and 3 to 6 cm (39.1%; 9 of 23). In 2 (8.7%) patients, the size of the enlarged lymph nodes reached >6 cm. Leukopenia was observed in 5 (21.7%) patients, and fever was observed in 7 (30.4%) patients. One child with KD developed systemic lupus erythematosus 5 years later. The cervical lymphadenopathy usually resolved itself without any medical treatment within 6 months after definite diagnosis was made. Neither recurrence nor persisting KD has since been noted. CONCLUSION: KD, although rare, should be part of the differential diagnosis for posterior cervical lymphadenopathy in children, especially in patients of Asian descent. In our pediatric series, KD demonstrated a male predominance, which is in contrast to previously reported adult series demonstrating a female predominance. The children with KD require a systemic survey and regular follow-up for several years to rule out the development of systemic lupus erythematosus.

Adolescent↗
PubMed2004

The clinical significance of adenoid-choanae area ratio in children with adenoid hypertrophy.

OBJECTIVE: We designed a method to compare the adenoid-choanae area ratio (A/C ratio) measured in children with symptoms of adenoid hypertrophy with those from children without any symptoms related to adenoid hypertrophy. METHODS: A prospective analysis of A/C ratio of 42 patients undergoing adenoidectomy and tonsillectomy from January 2000 to September 2003 in a medical center was compared with 28 patients receiving treatment other than the above-mentioned procedures in the same period. We used 0 degrees telescope to take pictures of the nasopharynx under general anesthesia preoperatively. The pictures were transformed digitally. The A/C ratio was calculated by the program we developed after these pictures were processed by the Photoshop 6.0 (Adobe, USA) software. RESULTS: The A/C ratio in adenoid hypertrophy group (0.863+/-0.0983) is significantly higher (p<0.001) than that of control group (0.445+/-0.1431). Mouth breathing, nasal obstruction and snoring were found to be more severe in children with high A/C ratio (p<0.001). CONCLUSIONS: The A/C ratio provided the two-dimensional information of the nasopharyngeal airway. The A/C area ratio is significantly higher in the group of symptomatic adenoid hypertrophy when compared with symptomatic-free group. For practical purposes, the adenoid with an A/C ratio more than 2/3 is considered a pathological enlargement.

Adenoids↗
PubMed2004

Kimura's disease presenting as bilateral parotid masses.

Kimura's disease, a unique angiolymphoid proliferative disorder with unknown cause, is apparently more prevalent in a young Oriental males, but also occurs rarely in Western people. It has occasionally been misdiagnosed as malignant tumor or other serious diseases, leading to unnecessary radical surgery. Hence, clinicians should be made aware of this disease. The most common presentation is a unilateral soft-tissue mass in the head and neck region. Kimura's disease of bilateral parotid involvement has been reported rarely. We encountered a rare case of Kimura's disease presenting as bilateral parotid region masses and treated it successfully with surgery.

Adult↗