Selection of irrigation fluid to eradicate free cancer cells during head and neck cancer surgery

Hah, J. Hun,Roh, Dong Hwan,Jung, Young Ho,Kim, Kwang Hyun,Sung, Myung‐,Whun Wiley Subscription Services, Inc., A Wiley Company 2012 Head & Neck Vol.34 No.4

<P><B>Abstract</B></P><P><B>Background</B></P><P>Free cancer cells can be spilled out from exposed tumors or ruptured tumors. We examined the cytocidal effect of various irrigation fluids on free cancer cells in an animal wound model mimicking head and neck surgery.</P><P><B>Methods</B></P><P>Cancer cell–contaminated wounds were made with C3H/HeJ mice and syngeneic squamous cell carcinoma (SCC VII) cells. Distilled water, 5% povidone–iodine, 1.5% H<SUB>2</SUB>O<SUB>2</SUB>, normal saline, and cisplatin were used to irrigate for 5 minutes. In vitro tumor growth assays were done with different concentrations and exposure times of povidone–iodine and distilled water.</P><P><B>Results</B></P><P>In the animal study, povidone–iodine significantly inhibited tumor growth. Povidone–iodine caused substantial inhibition of in vitro tumor growth, even at the concentration of 0.05%. After 30 seconds of exposure to 1% povidone–iodine, cancer cells were completely inhibited.</P><P><B>Conclusions</B></P><P>Povidone–iodine could be selected preferentially for the irrigation fluid during head and neck surgery, especially when the wound is suspected of cancer cell contamination. © 2011 Wiley Periodicals, Inc. Head Neck, 2012</P>

갑상선전절제술과 중심경부절제술을 시행한 환자에서 부갑상선 자가이식의 결과

하정훈 ( J. Hun Hah ),최효근 ( Hyo Geun Choi ),성명훈 ( Myung-whun Sung ),김광현 ( Kwang Hyun Kim ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.1

Background and Objectives: Hypoparathyroidism is an important complication after total thyroidectomy, especially with central neck dissection. Although parathyroid gland autotransplantation (PTGAT) during thyroidectomy has been shown to reduce the incidence of permanent hypoparathyroidism, the value of the procedure during central neck dissection combined with thyroidectomy has not been reported well. Materials and Methods: Operative principles include preservation of parathyroid glands in situ and autotransplantation of parathyroid glands inadvertently resected or devascularized during operation. Seventy-nine patients were included in this study. Among 44 patients underwent total thyroidectomy only, 25 patients underwent PTGAT. Among 35 patients received total thyroidectomy with central neck dissection, 26 patients underwent PTGAT. Immediate hypocalcemia was defined as the case with symptomatic hypocalcemia, requiring calcium supplementations. Permanent hypoparathyroidism was defined as the case with iPTH level below 10 pg/ml at postoperative 3^rd month. Results: Thirty four patients (43.0%) showed immediate hypocalcemia and 7 patients (8.9%) showed permanent hypoparathyroidism. Central neck dissection is the most important risk factor of immediate hypocalcemia (p=0.011). Though PTGAT didn't affect outcomes in the patients underwent thyroidectomy only, it could partly reduce permanent hypoparathyroidism in the patients underwent central neck dissection combining total thyroidectomy (p=0.095). Conclusion: PTGAT might be helpful during total thyroidectomy with central neck dissection. To get better outcomes, technical improvement in surgical dissection and PTGAT may be needed.

기관삽관과 관련된 경부 기관의 기관식도루

하정훈,Hah, J. Hun 대한기관식도과학회 2012 大韓氣管食道科學會誌 Vol.18 No.2

Acquired tracheoesophageal fistula (TEF) can occur rarely from various causes. Recently, cuff-related tracheal injury after endotracheal intubation with the orotracheal tube and tracheostomy cannula is the most common etiology of nonmalignant TEF. Since cuff-related TEF is usually preventable with proper selection of the cuffed tube and close monitoring of cuff pressure. Although most patients present increased secretions, recurrent pneumonia, or coughing after swallowing, a high index of suspicion is required in patients at risk for developing a TEF. Surgical correction for the defectis required. In most cases, primary closure of the esophageal defect and tracheal resection and end-to-end anastomosis give the best results.

되돌이후두신경과 상후두신경의 수술중 신경감시

하정훈,진영주,Hah, J. Hun,Jin, Young Ju 대한후두음성언어의학회 2015 대한후두음성언어의학회지 Vol.26 No.1

Intraoperative neuromonitoring of thyroid surgery has gained universal validity to help in nerve identification, safe nerve dissection, and prediction of postoperative vocal cord function. In this article, standard intraoperative neuromonitoring procedure, interpretation about loss of signal, and the indications covered by health insurance will be described.

경성 기관지내시경의 시술 방법과 마취

하정훈,최익준,Hah, J.-Hun,Choi, Ik-Joon 대한기관식도과학회 2009 大韓氣管食道科學會誌 Vol.15 No.2

Gastric Choristoma of the Oropharynx

장현,안영진,임윤성,J. Hun Hah 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.2

Heterotopic gastric mucosa tissue is also called gastric choristoma, and this type of lesion can be found anywhere in the alimentary tract. However, gastric choristoma in the pharynx is very rare; only 10 cases of pharyngeal gastric choristoma have been reported in the English medical literature. A 32-yr-old woman was referred to our institution for the evaluation of a large mass that originated from the posterior wall of the oropharynx. The mass did not cause any symptoms except for the occasional sensation of a foreign body. Gadolinium-enhanced T1 weighted imaging showed a 5 cm-sized mass with central enhancement and hypointense portions, yet the radiological diagnosis was not clear. Transoral mass excision was performed with using electrocautery for making the diagnosis and for treating the mass. The microscopic analysis revealed gastric choristoma. Heterotopic gastric mucosa tissue is also called gastric choristoma, and this type of lesion can be found anywhere in the alimentary tract. However, gastric choristoma in the pharynx is very rare; only 10 cases of pharyngeal gastric choristoma have been reported in the English medical literature. A 32-yr-old woman was referred to our institution for the evaluation of a large mass that originated from the posterior wall of the oropharynx. The mass did not cause any symptoms except for the occasional sensation of a foreign body. Gadolinium-enhanced T1 weighted imaging showed a 5 cm-sized mass with central enhancement and hypointense portions, yet the radiological diagnosis was not clear. Transoral mass excision was performed with using electrocautery for making the diagnosis and for treating the mass. The microscopic analysis revealed gastric choristoma.

A Korean Girl with Campomelic Dysplasia caused by a Novel Nonsense Mutation within the SOX9 Gene

Ko, Jung Min,Hah, J.-Hun,Kim, Suk-Wha,Cho, Tae-Joon,Kim, Gu-Hwan,Yoo, Han-Wook Korean Society of Medical Genetics and Genomics 2012 대한의학유전학회지 Vol.9 No.2

Campomelic dysplasia (CMD) is a rare, often lethal, genetic disorder characterized by multiple congenital anomalies and abnormal development of the reproductive organs in males. Mutations in the SOX9 gene are known to cause CMD. We present a Korean CMD girl with a normal 46,XX karyotype and a female reproductive organ phenotype. She was born at 2.35 kg at 38 weeks of gestation and showed characteristic phenotypes, including cleft palate, micrognathia, hypertelorism, flat nasal bridge, congenital bowing of limbs, hypoplastic scapulae, deformed pelvis, and 11 pairs of ribs. She also had an atrioseptal defect of the heart and marked laryngotracheomalacia requiring tracheostomy and tracheopexy. SOX9 mutation analysis revealed the presence of a novel nonsense mutation, $p.Gln369^*$, and the patient was genetically confirmed to have CMD. Although she showed marked failure to thrive and neurodevelopmental delay, she is now 40 months of age and is the only surviving patient with CMD in Korea.

Dexamethasone treatment inhibits VEGF production via suppression of STAT3 in a head and neck cancer cell line

Shim, Seon-Hui,Hah, J Hun,Hwang, So-Yeon,Heo, Dae Seog,Sung, Myung-Whun Spandidos Publications 2010 ONCOLOGY REPORTS Vol.23 No.4

<P>Glucocorticoids (GCs) modulate the synthesis of many pro-inflammatory cytokines and influence multiple transduction pathways. GCs negatively or positively influence the transcription factors of their target genes. All of these transcription signals are closely connected to cancer survival or death. We investigated the action of dexamethasone (DEX) on head and neck cancer cell lines. When SNU-1041 and SNU-1076 were treated with DEX, the cell lines showed different patterns of responses. DEX inhibition of cell growth depended on concentration in SNU-1041, but not in SNU-1076. Furthermore, DEX suppressed vascular endothelial growth factor (VEGF) secretion from SNU-1041, but not from SNU-1076. We explored the mechanism that explains these distinct differences. After DEX treatment, the differences of NF-kappaB (p65), glucocorticoid receptor and p-AKT were not observed between the cell lines. However, phospho-signal transducer and activator of transcription 3 (STAT3) decreased in SNU-1041 only. Moreover, STAT3 inhibition using si-RNA suppressed VEGF secretion. When STAT3 was overexpressed after DEX treatment, the level of VEGF in the culture media was restored. Taken together, we suggest that p-STAT3 can be a mediating factor which regulates VEGF secretion in the DEX treatment. Because the relationship between the three molecules DEX, STAT3 and VEGF is scarcely known, our findings clarified one of the signaling pathways of DEX, which is often used in clinical conditions.</P>

The Effect of Cancer Associated Fibroblasts(CAFs) and CD44 of CAFs on the Motility of Cancer Cells in Head and Neck Squamous Cell Carcinoma

Seon-Hui Shim(심선희),J. Hun Hah(하정훈),Soo Youn Cho(조수연),Tae-min Kim(김태민),Young-il Koh(고영일),Dong-Wan Kim(김동완),Choon-Taek Lee(이춘택),Dae Seog Heo(허대석),Myung-Whun Sung(성명훈) 대한두경부종양학회 2014 대한두경부 종양학회지 Vol.30 No.2

배경 및 목적 암-연관 섬유아세포(Cancer-associated fibroblasts, CAF)는 종양미세환경의 가장 중요한 요소의 하나다. 그래서 두경부편평세포암에 대해 CAF가 암세포의 운동성에 미치는 영향을 평가하고, CAF에 과발현되는 CD44의 역할에 대해 평가하고자 하였다. 재료 및 방법 두경부암환자의 종양조직에서 CAF를 분리하고, 비종양성 조직으로부터 정상 섬유아세포(NHF)를 분리하였다. 창상치유분석과 상하 챔버를 이용한 3차원 세포 이동 분석을 이용하여, CAF가 암세포의 이동에 미치는 영향을 분석하고, CAF에서 과발현되는 CD44를 중화항체로 CAF를 차단했을 때 암세포 이동의 변화를 관찰하였다. 결 과 NHF에 비해 CAF에서 CD44가 과발현되는 것을 관찰하였다. 창상치유분석에서 CAF와 같이 배양된 암세포는 NHF 와 같이 배양된 암세포에 비해 더 빠른 이동을 보였다. CD44 중화 항체를 처리했을 때는 암세포의 이동성이 저해되었다. 결 론 CAF는 종양미세환경에서 암세포의 운동성을 조절하는 중요한 인자의 하나일 것으로 사료된다. CD44는 CAF의 기능을 매개하는 중요한 표지자 중 하나로 생각된다.

A Korean Girl with Campomelic Dysplasia caused by a Novel Nonsense Mutation within the SOX9 Gene

Jung Min Ko,J-Hun Hah,Suk-Wha Kim,Tae-Joon Cho,Gu-Hwan Kim,Han-Wook Yoo 대한의학유전학회 2012 대한의학유전학회지 Vol.9 No.2

Campomelic dysplasia (CMD) is a rare, often lethal, genetic disorder characterized by multiple congenital anomalies and abnormal development of the reproductive organs in males. Mutations in the SOX9 gene are known to cause CMD. We present a Korean CMD girl with a normal 46,XX karyotype and a female reproductive organ phenotype. She was born at 2.35 kg at 38 weeks of gestation and showed characteristic phenotypes, including cleft palate, micrognathia, hypertelorism, flat nasal bridge, congenital bowing of limbs, hypoplastic scapulae, deformed pelvis, and 11 pairs of ribs. She also had an atrioseptal defect of the heart and marked laryngotracheomalacia requiring tracheostomy and tracheopexy. SOX9 mutation analysis revealed the presence of a novel nonsense mutation, p.Gln369*, and the patient was genetically confirmed to have CMD. Although she showed marked failure to thrive and neurodevelopmental delay, she is now 40 months of age and is the only surviving patient with CMD in Korea.