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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.
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.
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.
급성 림프구성 백혈병 환자에서 이하선 비대로 나타난 골수외 재발 1례
이동희,조광재,Lee, Dong-Hee,Cho, Kwang-Jae 대한기관식도과학회 2005 大韓氣管食道科學會誌 Vol.11 No.1
Acute lymphocytic leukemia(ALL) is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Currently, only $20-30\%$ of adults with ALL are cured with standard chemotherapy regimens. It is very important risk factor whether to failure to achieve complete remission within 4 weeks or not. The relapse of leukemia is usually classified as hematologic and extramedullary relapse, and extramedullary leukemic infiltration is rarely observed in patients with ALL. In October 2004, a 23-year-old man presented with painless enlargement of both parotid glands. He was diagnosed as ALL(L2 subtype) one month ago, and he gained complete remission with induction chemotherapy. Fine needle aspiration cytology and bone marrow biopsy revealed extramedullary and hemtologic remission. To our knowledge this is the first report of extramedullary relapse in the parotid in ALL.
주영훈,정찬권,조광재,선동일,박준욱,김민식,Joo, Young-Hoon,Jung, Chan-Kwon,Cho, Kwang-Jae,Sun, Dong-Il,Park, Jun-Ook,Kim, Min-Sik The Korean Society for Head and Neck Oncology 2011 대한두경부 종양학회지 Vol.27 No.1
연구 및 목적 : 이번 연구의 목적은 한국인에서 편도 편평세포암종의 발생에 고위험 인간유두종 바이러스(high risk human pap-illomavirus)의 역할 및 관여 인자에 대해 밝히고자 한다. 재료 및 방법 : 연구는 편도 편평상피세포암종으로 진단받은 54명을 대상으로 하였다. 고위험 인간유두종 바이러스의 감염을 알기위해 in situ hybridization 방법을 이용하였다. 고위험 인간유두종 바이러스의 감염과 나이, 성별, 흡연, 음주, 병기, 병리학적 특징 등과의 관계를 분석하였다. 결 과 : 고위험 인간유두종 바이러스의 양성율은 31.5%(17/54)였다. 고위험 인간유두종 바이러스 감염은 젊은 연령(50세 미만), 비흡연자, 림프절 전이와 유의한 상관관계가 있었다(각각 p=0.008, p=0.042, p=0.027). 하지만 성별, 음주, 원발부위 병기, 종양분화도, 피막외침범, 혈관 및 신경 침범과 고위험 인간유두종 바이러스와의 관계는 통계적으로 유의하지 않았다. 6개월 이상 추적 관찰이 가능한 환자를 대상으로 조사한 5년 전체 생존율 및 질병 특이 생존율은 각각 60%와 62%였다. 고위험 인간유두종 바이러스의 양성율은 질병 특이 생존율과 유의한 상관관계가 있었다(p=0.019). 결 론 : 한국인의 고위험 인간유두종 바이러스 감염은 젊은 연령 및 비흡연자의 편도 편평세포암종의 발생에 관련이 있고 예후 인자로 중요한 역할을 한다.
두경부암 수술 후 발생한 합병증에서 대흉근피판의 임상적 유용성
주영훈(Young-Hoon Joo),조광재(Kwang-Jae Cho),박준욱(Jun-Ook Park),남인철(In-Chul Nam),선동일(Dong-Il Sun),김민식(Min-Sik Kim) 대한두경부종양학회 2011 대한두경부 종양학회지 Vol.27 No.1
Background and Objectives:The pectoralis major myocutaneous flap(PMMCF) has been considered to be the “workhorse” of pedicled flaps in head and neck reconstruction. Even with the worldwide use of free flaps, the PMMCF is still considered the mainstay in head and neck reconstruction. The aim of the study is to evaluate the application and reliability of the PMMCF in selected cases of head and neck complication. Materials and Methods:We conducted a retrospective review of 14 patients who underwent the surgical reconstruction us-ing the PMMCF due to the complications after head and neck ablative surgery between 1997 and 2007. Out-come measures included the indications of PMMCF, complications and post-operative functional result. Re-sults:PMMCFs were used to reconstruct defects in the following series; wound dehiscence(7 patients), flap failure(4 patients), pharyngocutaneous fistula(3 patients). Flap survival was 100 percent and mean flap size was 67.2cm 2 . Five patients had complications such as pharyngocutaneous fistula, marginal necrosis, carotid blowout. Conclusions:The PMMCF is a safe and convenient method for reconstruction of the surgical com-plications after resection of advanced tumors and can be still used as a salvage procedure after free flaps failure.
Young-Hoon Joo(주영훈),Chan-Kwon Jung(정찬권),Kwang-Jae Cho(조광재),Dong-Il Sun(선동일),Jun-Ook Park(박준욱),Min-Sik Kim(김민식) 대한두경부종양학회 2011 대한두경부 종양학회지 Vol.27 No.1
연구 및 목적 이번 연구의 목적은 한국인에서 편도 편평세포암종의 발생에 고위험 인간유두종 바이러스(high risk human pap-illomavirus)의 역할 및 관여 인자에 대해 밝히고자 한다. 재료 및 방법 연구는 편도 편평상피세포암종으로 진단받은 54명을 대상으로 하였다. 고위험 인간유두종 바이러스의 감염을 알기위해 in situ hybridization 방법을 이용하였다. 고위험 인간유두종 바이러스의 감염과 나이, 성별, 흡연, 음주, 병기, 병리학적 특징 등과의 관계를 분석하였다. 결 과 고위험 인간유두종 바이러스의 양성율은 31.5%(17/54)였다. 고위험 인간유두종 바이러스 감염은 젊은 연령(50세 미만), 비흡연자, 림프절 전이와 유의한 상관관계가 있었다(각각 p=0.008, p=0.042, p=0.027). 하지만 성별, 음주, 원발부위 병기, 종양분화도, 피막외침범, 혈관 및 신경 침범과 고위험 인간유두종 바이러스와의 관계는 통계적으 로 유의하지 않았다. 6개월 이상 추적 관찰이 가능한 환자를 대상으로 조사한 5년 전체 생존율 및 질병 특이 생존율 은 각각 60%와 62%였다. 고위험 인간유두종 바이러스의 양성율은 질병 특이 생존율과 유의한 상관관계가 있었다 (p=0.019). 결 론 한국인의 고위험 인간유두종 바이러스 감염은 젊은 연령 및 비흡연자의 편도 편평세포암종의 발생에 관련이 있고 예후 인자로 중요한 역할을 한다.
후두 편평상피암종의 림프절 피막외 침범에 대한 FDG PET/CT 영상의 유용성
주영훈(Young-Hoon Joo)유이령(Ie-Ryung Yoo),조광재(Kwang-Jae Cho),송지남(Jee-Nam Song),유동준(Dong-Joon Yoo),이호석(Ho-Suk Lee),김민식(Min-Sik Kim) 대한두경부종양학회 2012 대한두경부 종양학회지 Vol.28 No.2
Backgrounds:To evaluated the use of FDG PET/CT for the identification of extracapsular spread(ECS) with histologic correlation in laryngeal cancer. Methods:We reviewed 79 medical records of patients who under-went of FDG PET/CT for laryngeal cancer before surgery. Results:ECS was present in 41.9%(18/43) dis-sected necks and in 34.5%(20/58) dissected cervical levels. There was a significant difference in the SUVmax between cervical lymph nodes with ECS and without ECS(6.39±4.53 vs. 1.19±1.64, p<0.001). The cut-off value for the SUVmax for differentiating with ECS from without ECS was 2.8 with the sensitivity of 85.7% and the specificity of 85.6%. Conclusion:The median SUVmax cut-off values of FDG PET/CT higher than 2.8 was associated with greater risk cervical lymph node metastasis with ECS in patients with laryngeal cancer.