갑상선 결절에서 세침흡인검사와 동결조직검사의 의의

송달원(Dal Won Song),손수길(Su Gil Sohn),최종원(Jong Won Choi),신승진(Seung Jin Shin),김태종(Tae Jong Kim),남성일(Sung Il Nam),안병훈(Byung Hoon Ahn) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.1

Background and Objectives: Fine needle aspiration (FNA) cytology is a simple, safe and relatively accurate procedure of diagnosing thyroid nodules. Although the frozen section biopsy is well known as more reliable method than FNA and has high specificity, whether it is necessary it leaves room for adverse criticism. Authors have compared preoperative FNA cytology and frozen section biopsy with permanent histologic findings and evaluated the significance of FNA cytology and frozen section biopsy. Materials and Methods: The medical records of 110 patiens who underwent FNA cytology and frozen section during thyroidectomy from September. 1997 to December. 2001 at the Department of Otolaryngology, School of Medicine, Keimyung University were analyzed retrospectively. Results: Sensitivity, specificity, accuracy of FNA was 75%, 91.4%, and 85.5% respcetively. Sensitivity, specificity and accuracy rate of frozen section biopsy were 92.5%, 100% and 97.3% respectively. Conclusion: FNA is simple, with rare complication and its diagnostic accuracy is comparatively so high that it is being used as primary test to diagnosis thyroid nodules. But frozen section is more accurate and may be helpful to suspicious FNA findings or if it beyond capacity of FNA. Therefore despite of the fact that the intra-operative frozen is more expensive and time consuming, it is very helpful to the treatment of thyroid nodules by using jointly with FNA.

타액선 악성 종양 환자에 대한 치료성적

송달원(Dal Won Song),안재현(Jae Hyun Ahn),손진식(Jin Sik Sohn),김태종(Tae Jong Kim),안병훈(Byung Hoon Ahn) 대한두경부종양학회 2000 대한두경부 종양학회지 Vol.16 No.1

Objectives: Primary malignant tumors in the salivary glands are relatively rare. Because of the rarity and the different histopathologic patterns, it is difficult to establish a uniform treatment strategy. The prime treatment of salivary gland malignancy is the surgery, but the role of radiotherapy has been under debate. Radiation therapy combined with conservative surgical procedures may be as successful and perhaps more rational treatment than radical surgery alone. The aim of this study is to evaluate clinical pattern, incidence, treatment modality and outcome of the salivary gland maligancy. Materials and Methods: The medical records of 32 patients with malignant neoplasm of salivary gland who treated at the Keimyung university Dongsan hospital were analyzed retrospectively. Results: The overall 5 year survival rate was 77.9% stage I : 100%, stage II : 75%, stage III : 66.7%, stage IV : 55.6%). The 5 year survival rate according to tumor grade was 100% in low grade malignancy, 71.8% in high grade malignancy. The 5 year survival rate according to treatment modalities was as follows: Surgery only group was 83.3%, combined treatment group with surgery and posoperative radiation was 74.6%. Conclusion: The factors affecting prognosis is variable, but the stage at the time of diagnosis, site of lesion, tumor grade, histologic subtype were important factors. Surgery was the prime treatment tool and postoperative radiotherapy was also imperative in higher stage patient, high grade tumor, or patients with positive surgical margin.

후두암 환자에 대한 치료성적과 예후인자

송달원(Dal Won Song),여창기(Chang Ki Yeo),송인혁(In Hyuk Song),남영진(Young Jin Nam),이준엽(Jun Yeop Lee),구민본(Min Bon Koo),남성일(Sung Il Nam),안병훈(Byung Hoon Ahn) 대한두경부종양학회 2007 대한두경부 종양학회지 Vol.23 No.1

Background and Objectives :The prevalence rate of laryngeal cancer, the cancer known as good prognosis in comparison to other malignancy, accounts for 1% of all malignancy in Korea(Korea Central Cancer Registry, 2002). The purpose of this study is to review the treatment experiences of our hospital and find prognostic fac-tors in laryngeal cancer patients. Materials and Method :A retrospective study was conducted on 244 laryngeal cancer patients between January 1987 through December 2003. Age, sex, TNM stage, 5 year survival rate, prognostic factors were analyzed. Results :The overall 5 year survival rate was 57.8%. The 5 year survival rate according to primary site and treatment method showed supraglottis 49.5%, glottis 79.2%, transglottis 28.2% and surgery only 71.4%, radio-therapy only 58.1%, post operative radiotherapy 47.2%, salvage operation 52.0%. There was no statistically significant difference among the results obtained by 4 different methods of treatment. but in supraglottis, surgery only has good 5 year survival rate(75.8%) compare to radiotherapy only(38.3%), postoperative radiotherapy (20.0%), salvage operation(43.7%) and there was statistically significant difference. The 5 year survival rate according to clinical stage and T status showed 84.1%, 37.2%, in stage I & II, III & IV respectively, 72.9%, 37.5% in stage T1 & T2, T3 & T4 respectively. The 5 year survival rate according to nodal status showed N(-)77.1%, N(+)35.6%. Conclusion :Those patient with early T stage, early clinical stage, glottic cancer, negative neck node and surgery only patient in supraglottis showed good treatment results in univariate analysis. The clinical stage and primary site of laryngeal cancer were found to be significant prognostic factors in laryngeal cancer patients in multivariate analysis.

두개내에서 발생하여 두개외로 연장된 설하신경초종 1례

송달원(Dal Won Song),김희준(Hee Jun Kim),이복수(Bok Su Lee),임만빈(Man Bin Yim) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.1

Neurinoma originates from any nerve covered with a Schwann cell sheath and can occur in any cranial, sympathetic, or peripheral nerve. Hypoglossal neurinomas are rare and most of them are intracranial, but they may extend extracranially. Most intracranial neurinoma arise from the sensory division of cranial nerve but a motor nerve such as hypoglossal nerve is rarely involved. Although the typical sign of hypoglossal neurinoma is ipsilateral hemiatrophy of the tongue, it is easily overlooked. For the diagnosis of hypoglossal nerve tumor, CT scanning with contrast enhancement and MRI should be included, and they are greatly aids in planning the radical removal of the tumor. We experienced a case of intracranial hypoglossal neurinoma with extracranial extension in a 43-year-old woman. The patient showed otherwise unremarkable except 4 months history of right infraauricular mass and right tongue hemiatrophy. Computed tomography and magnetic resonance imaging for local diagnosis was valuable and we could remove the mass by one stage operation via suboccipital transcervical approach.

두경부암 전이와 nm23-H1/NDP Kinase A와 CD44v8-10 유전자 발현과의 관계

정현수(Hyun Soo Jeong),송달원(Dal Won Song),김영한(Young Han Kim),안재현(Jae Hyun Ahn),이인환(In Hwan Leel) 대한체질인류학회 2000 대한체질인류학회지 Vol.13 No.1

두경부암 10례에서 증식과 전이에 관련된 유전자인 nm23-Hl/NDP kinase와 CD44 두 유전자의 발현 양상을 nm23-HIINDP kinas ε단크론 항체 HI-203 파 CD44variant 단크론 항체인 CD44v8-10을 이용하여 면역 조직화학기법요효 성험하고 종양의 전이여부와 유전자 발현과의 관계를 조사하였다. 두경부암의 10례중 8례가 편평상피세포압 이었으며 이를 피부의 정상 상피 빚 편평상피세포암과 비교하였다. nm23-HIINDP kinase의 발현은 정상 상피에 비해 전반적으로 강소하였으며 원격전이가 있는 경우 더욱 낮은 발현을 보였다. CD44v8-10의 발현은 전이 유우에 따라 현격한 차이를 보여, 원격 전이가 있는 경우에서는 거의 발현이 없었고 원격전이 및 림프절 전이가 없는 경우에서는 강한 발현 보였다. 전이가 전혀 없는 경우는 피부의 편평상피세포암의 성적과 일치하였으며 종양 자체내의 발현은 분화가 진행될수록 낮은 발현을 보였다. 결론적으로 두경부 종양에서 두 유전자는 항전이 유전자로서의 역항이 뚜렷하였다

변형 Mallampati 지수 및 편도 지수와 무호흡-저호흡지수의 지수의 상관관계

안병훈,최종원,박연호,송인혁,남영진,송달원,Ahn, Byung-Hoon,Choi, Jong-Won,Park, Youn-Ho,Song, In-Hyuk,Nam, Young-Jin,Song, Dal-Won 대한수면의학회 2004 수면·정신생리 Vol.11 No.2

Objectives: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. Methods: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI):control (n=24), and patients with sleep apnea (n=70). Results: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p<0.05) Conclusion: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method. 목 적:폐쇄성 수면 무호흡증은 병력청취, 이학적 검사, 방사선학적 검사, 수면다원검사로 진단할 수 있는데 이를 임상적으로 검사할 때에는 편도의 비대와 좁아진 구인두의 관찰에 초점을 두어야 한다. 이 연구에서는 폐쇄성 수면무호흡증의 심한 정도를 예측하는데 있어 변형 Mallampati 지수(MMG)와 편도지수(TG)의 유용성을 알아보고자 하였다. 방 법:MMG와 TG는 심한정도에 따라 각각 4군 및 5군으로 나뉜다. 2002년 3월부터 2004년 4월까지 계명대학교 동산의료원에서 코골이와 수면무호흡증으로 수면다원검사와 이비인후과적 검진을 받은 94례를 대상으로 이들의 의무기록을 후향적으로 분석하였다. 환자들은 무호흡-저호흡지수(AHI)에 따라 비교군(n=24)과 수면무호흡군(n=70)으로 나누었다. 결 과:변형 Mallampati 지수(MMG)와 편도지수(TG)가 높을수록 높은 AHI 값을 가지며 TG와 MMG 모두 AHI와 통계적으로 유의한 연관성을 보였다. 결 론:MMG와 TG는 수면무호흡증을 진단하는데 신뢰할만한 예측인자이며 치료방법을 결정하는데 유용한 척도가 될 수 있다.

하악골에 발생한 방사선속발 골육종 1례

안병훈(Byung Hoon Ahn),박선호(Sun Ho Park),김덕준(Deok Jun Kim),송달원(Dal Won Song) 대한두경부종양학회 1997 대한두경부 종양학회지 Vol.13 No.2

저자들은 30여년전 비인강 혈관 섬유종으로 방사선 치료를 받은 남자환자의 하악골에 발생한 방사선 속발골육종 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Although primary surgical excision is the treatment of choice for the vast majority of patients with nasopharyngeal angiofibroma, radiation therapy is also employed as a primary tool or in the cases of tumor recurrence or massive intracranial extension. But, especially in young patients, postradiation sequelae such as osteomyelitis, atrophic rhinitis, thyroid or bone malignancy are of concern. Postirradiation osteosarcoma is a rare, but well-recognized complication of radiotherapy, which comprise roughly 2 to 5 percent of all osteogenic sarcoma. Recently we experienced a case of postirradiation osteosarcoma of the mandible who had treated by radiation therapy for the nasopharyngeal angiofibroma 30 years ago, presently he is ongoing chemotherapy and relatively being well.

하인두에 발생한 활막육종(Synovial Sarcoma) 1예

신호철(Ho Chul Shin),손수길(Su Gil Sohn),김태종(Tae Jong Kim),송달원(Dal Won Song) 대한두경부종양학회 2001 대한두경부 종양학회지 Vol.17 No.2

Synovial sarcoma is commonly found in the extremities of mesenchymal origin, but rare in the head and neck area. Histopathology is diagnostic and it shows a biphasic pattern with two neoplastic elements; spindle cell, sarcoma like stroma and gland like clefts lined by epitheloid cells. Synovial sarcoma is high-grade neoplasm that expresses epithelial as well as supporting features. This paper presents a case of synovial sarcoma of hypopharynx on 25 years old male. He was treated by surgical excision and postoperative chemoradiotherapy. There were no evidences of local recurrence & distant metastasis for 19 months postoperatively.

임상적 N0 경부에서 예방적 경부청소술의 경험

송달원,안재현,김영한,이복수,손진식,안병훈 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.12

경부 결핵성 임파선염의 임상적 분석

송달원 啓明大學校 醫科大學 1999 계명의대학술지 Vol.9 No.4

Tuberculous cervical lymphadenitis remains a diagnostic and therapeutic challenge because it mimics other pathalogic processes, and because of inconsistent reliability of physical and labaratory findings. 17 cases of tuberculous cervical lymphadenitis were treated and analyzed at the Department of Otolaryngology, Keimyung University Hospital from Jan. 1986 through Dec. 1989. The results were as follows, 1) Most common age and sex were 20∼40 years, female. 2) Associated pulmonary tuberculosis was exhibited by 6 cases(35%). 3) 7 patients(41%) had abscess formation in the infected nodes and surrounding deep neck space. 4) Associated head and neck lesions were tonsil, middle ear and external ear canal, parotid gland, larynx and pharynx. 5) Histologic examination of the excisional biopsy was most reliable test for confirm the diagnosis. 6) 14 out 17 cases had surgical intervention for I & D and excision of nodes. 7) All patients were subsequently treated with 8∼18 months of antituberculous chemotherapy and had a good results without complication except 1 case recurrence.