N0 설암에서 술 중 파수꾼 림프절 조직검사의 임상적 유용성에 관한 예비고찰

조광재,김민식,김주환,선동일,조승호 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.6

Background and Objectives: (SLNB) sems to have the potential to change our attitude toward the surgical treatment of cN0-staged necks in the near future. If SLN localization can predict which patient requires a neck dissection, then such neck dissections may be avoided in patients with negative sentinel nodes, thus reducing the asociated cosmetic deformities and shoulder dysfunction. The purpose of this study is to evaluate the feasibility and predictive ability of the SLN localization technique for patients with squamous cel carcinoma of the tongue. Materials and Method:We tried to localize the SLN with the lymphoscintigraphy preoperatively and the gamma probe intraoperatively, excised it, and performed frozen sections in 6 patients with lateral T1-T2, N0, and M0 squamous cell carcinoma of the tongue. In 3 of them, we performed supraomohyoid neck dissection. Results:We localized the SLN in 6/6 with lymphoscintigraphy and 5/6 with gama probe. The pathologic results of the frozen sections of SLN and neck disection specimen were al negative, with the negative predictive value of SLNB being 100%. Conclusion:the head and neck surgery and is predictive of cervical metastasis. (Korean J Otolaryngol 2003 ;46 :502-7)

상윤상후두부분적출술 후 Modified Barium Swallow를 이용한 연하 재활

조광재,김민식,선동일,조승호 대한기관식도과학회 2002 大韓氣管食道科學會誌 Vol.8 No.1

Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.

만성 흡인의 병태생리 및 평가

조광재,Cho, Kwang-Jae 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.1

나노 입자를 이용한 약물전달체계의 개선 및 암치료

조광재 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.7

두경부 편평세포암종에서 단측성 염색체 소실 범위와 메틸화 양상

조광재,김민식,유문간,조승혼 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.9

Background and Objectives:Carcinogenesis is known to arise as a result of the accumulation of genetic alterations including unilateral chromosomal losses and epigenetic modification. In this study, we investigated the extent of chromosomal losses and the status of CpG methylation in squamous cell carcinoma of the head and neck in relation to the clinicopathologic factors. Subjects and Method:A total of 20 tumor foci from 12 cases were examined wtih PCR-based loss of heterozygosity (LOH) analysis using a panel of 41 microsatellite markers on 8 chromosomes and a total of 10 tumor foci from 5 cases were examined with methylation-specific PCR on 2 extragenic regions of the 3 cancer-linked genes. Results:In 20 tumor foci, LOH was found most frequently on the chromosome 8p. Multiple tumor foci of a given case had the same or a similar extent of chromosomal losses and yielded an overall mean value of 5.5 per tumor focus. Even though the tumor foci showed histological homogeneity, they revealed genetical heterogeneity. The relation between methylation changes between the paired normal mucosa and tumor site was variable and 10 tumor sites examined for the methylation status of 6 extragenic regions showed 21 (35%) hypomethylation changes, 6 (10%) hypermethylation changes, and 33 (55%) no methylation changes. The degree of methylation changes indicated the tendency to cluster in the range of U1 and M1 low-grade changes. With respect to relationship between bet methylation changes and clinicopathologic factors, hypomethylation changes were dominant in those cases with increased depth of invasion. Conclusion:These results showed that multiple intratumoral foci of the head and neck cancer patients were generallyunder the influence of a similar level of chromosomal losses and hypomethylation changes.

크로랄 하이드레이트와 하이드록시진 병용투여 연구

조광재 고려대학교 대학원 통계학과 1994 통계상담 Vol.9 No.1

치과 치료시 아동이 나타낼 수 있는 반응은 불안, 공포 및 두려움 등이 있다. 이러한 반응을 줄이기 위한 통상적인 방법으로 행동 조절이 어렵거나 나이가 어린 아동과 장애인에게 약물을 투여한 진정요법과 전신 마취하에서의 치과 치료를 시행하고 있다. 최근에는 진정요법에 관한 많은 연구가 진행되고 있다. 본 보고서에서는 크로랄 하이드레이트의 단독 투여와 하이드록시진을 병용할 때의 진정도 평가와 하이드록시진이 크로랄 하이드레이트의 효과에 미치는 영향 및 이들 약제가 심박동과 동맥혈 산소 포화도에 미치는 영향을 알아보고자 통계 분석을 실시하였다.

일반총설 : 나노입자를 이용한 표적전달 및 암치료

조광재 ( Kwang Jae Cho ) 한국조직공학과 재생의학회 2008 조직공학과 재생의학 Vol.5 No.2

갑상선으로 전이된 비인강암 1예

조광재(Kwang Jae Cho),조승호(Seung Ho Cho),유영화(Young Hwa Yoo),김민식(Min Sik Kim) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.2

Metastatic carcinomas to the thyroid gland are rare, and thyroid involvement by secondary carcinomas commonly results from direct the extension of malignant cells from adjacent organs such as the larynx or the trachea. The common primary sites of thyroid metastasis are kidney, breast, lung, and lymphoid tissue. Among head and neck cancers, nasopharyngeal carcinoma has a relatively high incidence of distant metastases to other sites and commonly involving sites are bone, lung, and liver. Recently, we experienced a case of a 43-year-old male who had been presented with neck mass for 3 months. He was diagnosed non-keratinizing nasopharyngeal carcinoma in 1993. And, thyroid metastasis of nasopharyngeal carcinoma was confirmed by total thyroidectomy. So we report this rare case with the review of literatures.

구강암과 구인두암의 절제술 후 전완유리피판술을 이용한 재건술

조광재(Kwang Jae Cho),천병준(Byung Jun Chun),선동일(Dong Il Sun),조승호(Seung Ho Cho),김민식(Mn Sik Kim) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.1

Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

새열낭종에서 기원한 암종으로 오인된 전이성 편평세포암종 1예

조광재(Kwang Jae Cho),박현진(Hyun Jin Park),신옥란(Ok Ran Shin),이동희(Dong Hee Lee) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.1

The existence of primary branchiogenic carcinoma is controversial. In 1950, Martin et al. established four criteria for the diagnosis of primary branchiogenic carcinoma. In 1989, Khafif et al. proposed new modified criteria, which are currently most recognized in the literature. A 54-year-old woman presented the well-defined, fluctuant, painless mass on her left neck and underwent a complete excision under the clinical diagnosis of the branchial cleft cyst. The initial pathological impression was a branchiogenic squamous cell carcinoma. However, it did not coincide with a true primary branchiogenic carcinoma clinically. After the guided biopsy of suspicious areas found a squamous cell carcinoma of the tongue base, the patient was treated by combination chemotherapy with radiotherapy. Thus, we report this case with a review of the literature.