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류준선,박원서,정유석 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.1
Low grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is an extremely rare variant of nasopharyngeal cancer, which exhibits distinct clinicopathological characteristics. Surgical resection has been regarded as the principal treatment. For this, transpalatal or transfacial approach has been classically used for exposure of the field. Up for now, there has been no report on applying endoscopic approach for this disease, which could be an effective alternative to minimize possible morbidities of palatotomy or maxillotomy. Endoscopic approach can be justified considering narrow extent and indolent behavior of LGNPPA. We report a patient with LGNPPA, which was successfully resected exclusively by endoscopic visualization. Our case exhibited narrow-based exophytic features with compatible immunopathologic profiles of LGNPPA. Exclusive endoscopic resection can be effective and less-morbid modality for this rare disease as in this case
두경부 편평세포암에서 경부림프절 전이와 미세혈관밀도, Ki67, p53 변이 및 DNA 유세포계측과의 관계에 대한 연구
류준선,백정환,고예정,노영수 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.10
Background and Objectives:Lymph node metastasis is believed to be the single most important prognostic factor in the head evaluated the relationship between cervical nodal status and several parameters, such as microvesel density, p53, Ki67, and DNA ploidy, and compared it with the conventional clinical parameters including histologic grade of the tumors. Materials and Method:This study group included 26 specimens from the primary sites of patients who were diagnosed with squamous cell cancers of the head and neck. Immunohistochemstry and DNA flowcytometry were performed at almost the same sections of the thelial cells positively stained with CD-31 under the magnification filed power of 200 by two investigators; the cell number was determined by taking the average of the highest values of thre counts made by each investigator. Immunohistochemical staining with Ki67 and p53 were also done to evaluate the cellular proliferation of tumors and the overexpresion of mutated tumor sup-presor gene. DNA flowcytometry was performed to evaluate the ploidy and proliferation index. These results were compared and analyzed with clinical parameters. Results:this study. However, the microvessel density of the laryngeal cancers showed a statisticaly significant relationship with the cervical nodal metastasis (p=0.045). Conclusion:The microvessel density may have a corelation to the lymph nodal metastasis in the head and neck squamous cell cancer and may be regarded as an additional prognostic factor for planing treatment. (Korean J Otolaryngol 2002;45:990-7)
뇌인성 양측성대마비 환자의 뇌영상 소견과 자연경과에 관한 고찰
류준선,최진수,박윤근,김욱년 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.6
Background and Objectives:Bilateral vocal cord paralysis is a potentially life-threating problem, but it acompanies a relatively rare complication of acute cerebral lesions. We attempted to estimate the usefulness of radiologic studies as predi-ctive factors of recovery from this condition. Materials and Method:Five patients who developed acute respiratory failure after acute ischemic stroke were included in the study and followed up. Radiologic studies (CT or MRI)localize the brain lesions. Bilateral vocal cord paralyses were confirmed by rigid or fiberoptic laryngoscopy. Results:Re-covery of vocal cord mobility was observed in three patients. Vocal cord paralysis was not resolved in two patients with lateral medullary infarction and large subcortical infarction. Conclusion:Bilateral vocal cord paralyses resulting from acute cerebral lesions have diferent prognoses according to their location and extent. Therefore, radiological studies may be useful (Korean J Otolaryngol 2002;45:608-12)
방사성 옥소치료에 내성을 가진 분화 갑상선암의 진단 및 치료적 접근
류준선 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.7
Unlike most thyroid cancers which have an excellent prognosis with standard treatments such as surgery and additional radioactive iodine therapy followed by long term TSH suppression, 15-20% of differentiated thyroid cancers are unresponsive, showing locally aggressive behavior or distant metastasis. It has been reported that the ability of iodine uptake among residual follicular cells is usually impaired in such unresponsive cases. As the general incidence of thyroid cancer increases, the number of this radioactive iodine refractory disease is also increasing. This becomes clinically challenging because iodine-based diagnostic and therapeutic approaches are not applicable anymore. Moreover, other conventional modalities including radiotherapy or cytotoxic chemotherapy is neither effective in this subset of thyroid cancer. So many researches are currently under way to find effective molecular targeted therapies, which will play a role in the treatment of these unresectable and advanced cases. This review discusses the recent research progress regarding the iodine avidity of follicular cells in thyroid cancer, and outcomes of clinical studies using targeted agents.
두경부 편평세포암에서 미세혈관밀도와 경부림프절전이에 대한 연구
류준선 동국대학교 경주대학 2000 東國論集 Vol.19 No.-
Lymph node metastasis is believed to be the single most important prognostic factor in the head and neck squamous cell cancer. To identify potential biological parameters for predicting cervical lymph node metastasis, we evaluated the relationship between cervical nodal status and several parameters, such as microvessel density, p53, Ki67, and DNA ploidy, and compared with conventional clinical parameters including histologic grade and TNM staging of the tumors. This study group included 26 specimens of the primary site in patients who were diagnosed as squamous cell cancers of the head and neck. Recurred cases after chemotherapy or radiotherapy were excluded from this investigation. Analysis was performed by immunohistochemstry and DNA flowcytometry at the almost same section of the primary sites. To quantify the angiogenesis of the primary site, the immunohistochemical staining with CD-31 monoclonal antibody was performed. Microvessel density was determined by counting of CD-31 positively stained vascular endothelial cells under the magnification of x 200 field by two investigators, at an average of the largest numbers after 3 times of digitizing. Immunohistochemical staining with Ki67 and p53 were also done to evaluate the cellular proriferation of tumors and the overexpression of mutated tumor suppresor gene. DNA flowcytometry was performed to evaluate the ploidy and proliferation index. These results were compared and analyzed with clinical parameters. Any parameters failed to show significant relation to nodal status in the head and neck cancers. However, the microvessel density of the laryngeal cancers showed statistical significancy with cervical nodal metastasis. (p=0.045) Therefore, the microvessel density may have a relationship to lymph nodal metastasis in head and neck squamous cell cancer and might be used as an additional prognostic factor for planning treatment.
류준선(Junsun Ryu) 대한신경모니터링학회 2023 Journal of Neuromonitoring & Neurophysiology Vol.3 No.1
Since most thyroid cancers are slowly growing and are not fatal, prevention of surgical complications is as important as removing the lesion. Although permanent vocal cord paralysis, a significant complication of thyroid surgery, is reported to occur in about 1-2% of cases, the actual incidence is expected to be higher for various reasons. When nerve damage occurs despite the surgeon's utmost care, appropriate measures should be taken immediately. However, even with the most aggressive approach, nerve repair (neurorraphy) rarely restores normal vocal cord movement; it is known only to maintain tension in the vocal cords to prevent atrophy. Therefore, preventing nerve damage is considered much more important. To achieve this goal, a thorough preoperative examination and understanding of the anatomical variations of the nerves around the thyroid, as well as precise and careful capsular dissection, are necessary. In this paper, the authors discuss methods for preventing and treating nerve damage during thyroid surgery.