설결손의 재건 후 기능적 예측 인자의 분석

홍현준,이원재,유대현,나동균,탁관철 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.3

Purpose: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function.Methods: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months.Results: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance.Conclusion: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.

소아의 경부종물

홍현준 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.2

Neck mass can be frequently encountered in pediatric patients. Most neck mass in pediatric patients are either inflammatory lesions or benign tumors but their differential diagnoses are not always easy. We must not forget the study results that a considerable portion of pediatric neck mass constitutes malignant tumors. Generally neck mass can be divided into inflammatory, developmental (congenital), and tumorous lesions. Developmental neck mass are generally thyroglossal duct cyst, branchial cleft cyst, dermoid cyst, vascular malformation, or hemangioma. Manifestations of inflammatory neck mass are reactive cervical lymphadenopathy, infectious lymphadenitis (viral or bacterial), mycobacterial cervical lymphadenopathy, or Kawasaki disease. The more uncommonly found pediatric malignant neck mass are lymphoma, rhabdomyosarcoma, or thyroid carcinoma. For the diagnosis of pediatric neck mass complete blood count, purified protein derivative test for tuberculosis, and measurement of titers for Epstein-Barr virus are required and in special cases, infectious diagnostic panels for cat-scratch disease, cytomegalovirus, human immunodeficiency virus, or toxoplasmosis may be needed. Ultrasonography is the most convenient and feasible diagnostic method in differentiating various neck mass. Computed tomography is performed when identifying the anatomical aspects of the neck mass or where deep neck infection or retropharyngeal abscess is suspected. Surgical management for congenital neck mass is recommended to prevent secondary infection or various complications following size increase. Most pediatric neck mass originate from bacterial lymphadenitis and antibacterial therapy is considered first line of conservative treatment. However if the neck mass is either over 2 cm in size without any evidence of inflammation, firm or fixed to surrounding tissue, accompanied by B symptoms, unresponsive to initial antibacterial therapy or over 4 weeks of conservative management, or considered keep growing for over 2 weeks, one must suspect the possibility of malignancy and must consult a head and neck specialist for further detailed evaluation. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(2):88-95

구강과 인후두의 악성종양 치료 시 발생한 누공의 진단과 치료

홍현준,이원재,유대현,나동균,송승용 대한성형외과학회 2009 Archives of Plastic Surgery Vol.36 No.5

Purpose: The rate of fistulas occuring followed by resection of oral cavity, oropharyngeal, hypopharyngeal, and laryngeal cancer are reported to be 9-23% according to various documents. Neglected treatment of the fistula can result in a setback in proper treatment with restrictions in oral intake leading to delayed return to daily life. Furthurmore, in severe cases, it may injure important vessels and adjacent structures of the neck area. The author reviewed previously reported cases of treatment methods for fistulas recurring after diverse head and neck operations and with sharing the treatment experiments of our patients, we tried to present a treatment algorism for different fistula types. Methods: Our study was based on retrograde analysis of 64 patients who were clinically diagnosed with fistula after operation for cancer of the head and neck from 1997 to 2008 at Severance Hospital. Their primary sites of cancer were 8 oral cavity, 22 oropharynx, 25 hypopharynx, and 9 larynx. The patients were aged 45 to 75 years and the male to female ratio was 11 to 1. The patient’s operation records and progress notes were evaluated for determination of degree of fistula and treatment methods. Results: Most fistulas were clinically suspected after 5 days postoperatively and symptoms noted for detection of the fistula were erythema, purulent discharge, edema, tenderness, and fluctuation. The fistula was definitely diagnosed in 2 weeks postoperatively with barium test and treatment method ranging from conservative management to operative procedure were applied to each patients. Total 21 patients were managed with conservative protocol. In 15 cases, direct repair of the fistula was done and more stable repair of the fistula was possible with using of TachoComb®. Pharyngostoma was performed in 14 patients. Among them, 4 patients healed spontaneously, 5 patients were taken direct closure, 4 patients were taken pectoralis major musculocutaneous flap, and one patient was taken esophageal transfer. The other 14 patients were taken 11 pectoralis major musculocutaneous flaps and 3 free flaps without pharyngostoma formation. Conclusion: Fistula is a troublesome complication resulting after resection of head and neck cancer. Early detection and adequate treatment according to the period and condition of the fistula may prevent further complications and reduce the pain of the patient.

탄성 모세관력을 이용한 신개념 세포배양시스템의 개발

홍현준,박성제,나문희,김동성 대한기계학회 2014 대한기계학회 춘추학술대회 Vol.2014 No.4-4

Endoscopic Thyroidectomy via an Axillo-Breast Approach without Gas Insufflation for Benign Thyroid Nodules and Micropapillary Carcinomas: Preliminary Results

홍현준,고윤우,김원식,이소윤,신유섭,구용철,박윤아,최은창 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.4

Purpose: To examine the feasibility of endoscopic thyroidectomy (ET) via an axillo-breast approach without gas insufflation for large thyroid tumors and micropapillary carcinomas. Materials and Methods: The patients in the benign group were separated into groups 1 (n=95, <4 cm in tumor diameter) and 2 (n=37, ≥4 cm in tumor diameter). Also, 57 patients in the micropapillary carcinoma group underwent an endoscopic hemithyroidectomy (HT) (group 3) and were compared with 60 patients who received conventional open HT (group 4). Postoperative functional outcome, local complications, surgical outcomes, and pathological outcomes were compared between the groups. Results: In the benign group, there was no significant difference in mean operating time, hospital stay, or overall perioperative complications between the two groups. In the micropapillary carcinoma group, mean operating time and hospital stay in group 3 were significantly longer than in group 4 (p=0.015 and p≤0.001). The overall perioperative complications did not differ significantly between the groups. The postoperative cosmetic result was better in groups 1-3 (endo group) than in group 4 (open group). Conclusion: ET via a gasless axillo-breast approach seems to be a safe procedure even for benign thyroid lesions ≥4 cm and micropapillary carcinomas. Although it has the advantage of better cosmetic results over open thyroidectomy, there is room for improvement in terms of lessening its invasiveness and shortening the operative time.

탄성모세관현상 기반의 자연 모사 세포 배양 시스템의 개발

홍현준(H. Hong),김동성(D. S. Kim),박성제(S. J. Park),나문희(M. H. Na) 한국정밀공학회 2014 한국정밀공학회 학술발표대회 논문집 Vol.2014 No.5월

콜라겐 겔 압축 공정을 응용한 복합체 형태의 각막 상피 재건 용 콜라겐 시트의 제작

홍현준(H. Hong),허만일(M.-I. Huh),김홍균(H.-K. Kim),박상민(S. M. Park),서경덕(K. D. Seo),김동성(D. S. Kim) 한국정밀공학회 2015 한국정밀공학회 학술발표대회 논문집 Vol.2015 No.12월

Semantic 통신의 물리적 한계를 보완한 저 PAPR 통신 시스템 설계

홍현준(Hong Hyun Jun),이영학(Lee Young Hak),최선웅(Choi Seon Ung),이용규(Lee Yong Kyu),유한주(Yoo Han Ju),채찬병(Chae Chan Byoung) 한국통신학회 2024 한국통신학회 학술대회논문집 Vol.2024 No.1

각막 상피 재건을 위한 콜라겐 겔 압축 공정 기반의 하이브리드 콜라겐 시트 제작

홍현준(Hyeonjun Hong),허만일(Man-Il Huh),김홍균(Hong-Kyun Kim),김동성(Dong Sung Kim) 대한기계학회 2015 대한기계학회 춘추학술대회 Vol.2015 No.11

Limbal stem cell deficiency is one of a critical corneal disease which is accompanied by recurrent epithelial defects, corneal vascularization and conjunctivalisation, resulting in a blindness. Many research groups tried to develop a tissueengineered substrate for carrying limbal epithelial cells to regenerate the corneal epithelium. However, in vitro construction of tissue-engineered cell carrier is limited in materials to satisfy both mechanically stable and biologically compatible properties. In this regard, this study firstly suggest hybrid collagen sheet and its fabrication process to overcome the drawback. The hybrid collagen sheet can be successfully developed through integrating reconstituted type I collagen and decellularized corneal lenticule based on adequate collagen compression system and process.

두경부암 병기 설정의 최신 변화: AJCC 암 병기설정 매뉴얼8판

홍현준(Hyun Jun Hong) 대한두경부종양학회 2017 대한두경부 종양학회지 Vol.33 No.2

The recently released the 8th edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior 7th edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December 31st 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.