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Chung-Feng Hwang

Publications and source records attributed to Chung-Feng Hwang.

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

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

Schwannoma (neurilemmoma) of the tongue.

CONCLUSION: Schwannoma of the tongue always presents as a painless mass on the lingual surface and exhibits no gender preference. A schwannoma on the base of tongue is usually larger at presentation than one on the tongue itself, since it is asymptomatic initially. Complete resection is achievable and recurrence is uncommon. OBJECTIVES: To describe the patient demographics, presenting signs and symptoms, tumor location, imaging studies, management, and therapeutic outcomes of schwannoma of the tongue, an uncommon tumor of neuroectodermal origin that may arise from any myelinated nerve fiber. PATIENTS AND METHODS: In this retrospective study, records of 10 patients who underwent surgical removal of schwannomas of the tongue or base of the tongue between January 1988 and June 2005 were reviewed and summarized. RESULTS: The records of five men and five women with ages ranging from 9 to 45 years (mean 27.4 years) were reviewed. The locations of the schwannomas were as follows: four on the lateral border of the tongue, two on the tongue tip, one on the ventral side of the tongue, and three on the base of the tongue. The major clinical sign was a painless mass on the lingual surface. For all patients, no tumor recurrence or complication was noted after tumor extirpation.

Adolescent↗
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

Overexpression of cyclooxygenase-2 in nasopharyngeal carcinoma and association with lymph node metastasis.

Cyclooxygenase-2 (COX-2) has been shown to be involved in multiple steps of carcinogenesis. In this study, we examined COX-2 expression in nasopharyngeal carcinoma (NPC). COX-2 mRNA analyzed by reverse-transcription polymerase chain reaction (RT-PCR) was detected in 66% (16 of 24) of tumor tissues. Western blot analysis demonstrated that COX-2 protein level was increased in tumor tissues and was correlated with the expression level of mRNA. Immunohistochemical study showed that COX-2 was predominantly detected in cancer cells, and the staining pattern was cytoplasmic. Ten histologically normal nasopharyngeal tissues obtained from nasopharyngeal hyperplasia were also investigated. We found that COX-2 mRNA was detectable in three tissues and the COX-2 protein level was very low. The frequency of COX-2 overexpression was significantly higher in patients of the N1-N3 group than in patients of the N0 group (P=0.006). Taken together, these data suggest that COX-2 is overexpressed and is associated with increased lymphatic invasion in NPC.

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

Tracheostomal fire during an elective tracheostomy.

Some surgeries, a tracheostomy and oral surgeries in particular, have a higher risk of fire. Often it can occur when leaking flammable gas contacts an ignition heat source. Fire during a tracheostomy can sometimes be seen to produce different degrees of insult to the patient. The essential components of a fire, i.e., the fuel source, ignition, and an oxidizer, can be avoided or blocked in order to prevent fires from occurring. Herein, we discuss a fire during a tracheotomy, and ways to avoid its occurrence, and how to stop once it gets started. This case demonstrates 2 important points regarding tracheostomies. First, extreme caution should be exercised when cautery is used in an approximately 100% oxygen gaseous condition, and second, immediate extubation is not absolutely necessary if a fire breaks out during a tracheostomy. The procedures which can be taken when facing this type of emergency are also considered and discussed.

Female↗
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

Intranasal tooth: report of three cases.

Intranasal teeth are uncommon, with only a few reported cases in the past few decades. The clinical manifestations of an intranasal tooth are quite variable. Unilateral nasal obstruction is a common complaint, but even though nasal symptoms are present, an intranasal tooth can be an incidental finding during routine examination in patients without nasal discomfort. Although the diagnosis is not difficult to make, a complete workup that included radiological investigations is important before any surgery is attempted. Transnasal endoscopic surgical approaches have been described with no evidence of recurrence or complications in similar cases. Herein, three patients with an intranasal tooth are described, along with possible etiologies, potential complications, differential diagnoses and their treatments.

Adolescent↗
PubMed2003

The clinicopathological significance of p53 and p21 expression in squamous cell carcinoma of hypopharyngeal cancer.

To evaluate the roles of p53 and p21 expression in the squamous cell carcinoma of hypopharyngeal cancer, we performed the immunohistochemical studies in 58 patients with hypopharyngeal cancer. We found significant correlation between a high expression of p53 and a histological grade of well differentiation, advanced tumor (T) and TNM stage. Furthermore, low expression of p21 correlated significantly with advanced TNM stage and positive nodal status. Cox's regression analysis revealed tumor stage and nodal status were the only prognostic factors for survival. Therefore, we concluded that p53 and p21 are useful markers in predicting some clinicopathological features in hypopharyngeal cancer.

Adult↗
PubMed2003

Low expression levels of p27 correlate with loco-regional recurrence in nasopharyngeal carcinoma.

To clarify the roles of p27 and c-myc in nasopharyngeal carcinoma (NPC), we used immunohistochemical studies to examine the expression of p27 and c-myc proteins in 69 patients with NPC. The results show that a low level of expression was observed in 47 and 41 cases, respectively. A low level of p27 expression was significantly correlated with loco-regional recurrence, and reduction in the c-myc protein was also correlated with neck metastasis in NPC. Our study indicates that a reduction in p27 expression is frequently seen in NPC. Furthermore, low expression levels of p27 and c-myc may contribute to the aggressive behavior of NPC.

Adolescent↗
PubMed2003

Kikuchi's disease: a review and analysis of 61 cases.

OBJECTIVE: Kikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare self-limiting disorder that typically affects the cervical lymph nodes. It has occasionally been misdiagnosed as malignant lymphoma or another serious diseases; hence, clinicians should be made more aware of this disease. METHODS: From January 1986 to January 2001, a series of 61 patients who underwent a biopsy of a cervical lymph node and proved histologically to have KD were enrolled in this study. We retrospectively reviewed the clinical records and pathologic parameters of each patient. The patients were followed up from 6 months to 14.3 years (mean, 6.9 years). RESULTS: There were 34 women and 27 men (1.26:1 ratio; age range, 6 to 46 years; mean age, 21 years). The affected cervical lymph nodes were commonly located in the posterior cervical triangle (54 of 61, or 88.5%). Unilateral and bilateral cervical lymph nodes were affected in 54 and 7 patients, respectively. The dimensions of affected lymph nodes were commonly in the range of 0.5 to 4 cm (57 of 61, or 93.4%). In 2 patients, the size of the enlarged lymph nodes was greater than 6 cm. Leukopenia was observed in 14 patients (23%); fever, in 18 patients (29.5%). Five patients had a past history of tuberculosis. Two patients developed systemic lupus erythematosus, 1 month and 5 years later, respectively. The cervical lymphadenopathy usually resolved without any medical treatment within 6 months after definite diagnosis was made. In 3 patients, the enlarged lymph nodes eventually disappeared after more than 1 year. No recurrence has since been noted. CONCLUSION: The results of this study support the theory that KD is a self-limiting disorder that does not require any specific management. The female predominance was not as striking as in the studies performed in Western countries. We suggest that the patients with KD require a systemic survey and regular follow-up for several years; 2 of our patients developed systemic lupus erythematosus. An effective communication between the otolaryngologist and pathologist is needed because the clinical and pathologic characteristics of KD are essential in making an accurate diagnosis.

Adolescent↗
PubMed2003

Salivary duct carcinoma of submandibular gland with trigeminal nerve invasion to intracranium.

Salivary duct carcinoma is a rare and invasive malignant tumour with rapid distant metastasis and dismal prognosis. Clinically, perineural invasion of the salivary duct carcinoma is commonly noted. Here, we present a case of salivary duct carcinoma of submandibular gland origin with perineural invasion of the trigeminal nerve proximal to the intracranium, that was well demonstrated by a magnetic resonance image (MRI) and was consistent with the clinical presentation. This case received radical resection and radiotherapy with inclusion of the skull base within the field. There was no tumour recurrence and distant metastasis 24 months post-operatively.

Carcinoma, Ductal↗
PubMedDate not supplied

Paraganglioma presenting as chronic otitis media with cholesteatoma: pitfalls and strategies.

The coexistence of paraganglioma with cholesteatoma is a very rare clinical disorder. The clinical presentations are nonspecific. There may be radiological characteristics of either cholesteatoma or paraganglioma in the middle ear area, but the diagnosis of the coexistence of the 2 is usually made only postoperatively. Here is such a case that is made more interesting not only because it initially presented with conductive hearing loss but also because the clinical picture mimicked chronic otitis media. The patient underwent postauricular tympanomastoidectomy with extended facial recess approach to remove the tumor. No evidence of recurrence and complications were noted.

Cholesteatoma, Middle Ear↗
PubMedDate not supplied

Cholesterol granuloma of the maxillary sinus presenting as sinonasal polyp.

Cholesterol granuloma is usually found in chronic middle ear diseases. However, it rarely occurs in the sinonasal regions and only a few case reports can be found in the literature. The etiology of sinonasal cholesterol granuloma is not yet known, and the clinical manifestations are nonspecific. Most patients presented with nasal discharge. Our patient is the only reported case presenting with nasal obstruction and facial pain. Here we present a patient with cholesterol granuloma of the maxillary sinus with a nasal polyp, whose clinical, imaging, and histological characteristics were unique. The tumor was excised via the transnasal endoscopic sinus approach without recurrence after 3 years of follow-up.

Adult↗