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하정훈,Hah, J. Hun 대한기관식도과학회 2012 大韓氣管食道科學會誌 Vol.18 No.2
Acquired tracheoesophageal fistula (TEF) can occur rarely from various causes. Recently, cuff-related tracheal injury after endotracheal intubation with the orotracheal tube and tracheostomy cannula is the most common etiology of nonmalignant TEF. Since cuff-related TEF is usually preventable with proper selection of the cuffed tube and close monitoring of cuff pressure. Although most patients present increased secretions, recurrent pneumonia, or coughing after swallowing, a high index of suspicion is required in patients at risk for developing a TEF. Surgical correction for the defectis required. In most cases, primary closure of the esophageal defect and tracheal resection and end-to-end anastomosis give the best results.
하정훈,진영주,Hah, J. Hun,Jin, Young Ju 대한후두음성언어의학회 2015 대한후두음성언어의학회지 Vol.26 No.1
Intraoperative neuromonitoring of thyroid surgery has gained universal validity to help in nerve identification, safe nerve dissection, and prediction of postoperative vocal cord function. In this article, standard intraoperative neuromonitoring procedure, interpretation about loss of signal, and the indications covered by health insurance will be described.
갑상선전절제술과 중심경부절제술을 시행한 환자에서 부갑상선 자가이식의 결과
하정훈 ( J. Hun Hah ),최효근 ( Hyo Geun Choi ),성명훈 ( Myung-whun Sung ),김광현 ( Kwang Hyun Kim ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.1
Background and Objectives: Hypoparathyroidism is an important complication after total thyroidectomy, especially with central neck dissection. Although parathyroid gland autotransplantation (PTGAT) during thyroidectomy has been shown to reduce the incidence of permanent hypoparathyroidism, the value of the procedure during central neck dissection combined with thyroidectomy has not been reported well. Materials and Methods: Operative principles include preservation of parathyroid glands in situ and autotransplantation of parathyroid glands inadvertently resected or devascularized during operation. Seventy-nine patients were included in this study. Among 44 patients underwent total thyroidectomy only, 25 patients underwent PTGAT. Among 35 patients received total thyroidectomy with central neck dissection, 26 patients underwent PTGAT. Immediate hypocalcemia was defined as the case with symptomatic hypocalcemia, requiring calcium supplementations. Permanent hypoparathyroidism was defined as the case with iPTH level below 10 pg/ml at postoperative 3<sup>rd</sup> month. Results: Thirty four patients (43.0%) showed immediate hypocalcemia and 7 patients (8.9%) showed permanent hypoparathyroidism. Central neck dissection is the most important risk factor of immediate hypocalcemia (p=0.011). Though PTGAT didn't affect outcomes in the patients underwent thyroidectomy only, it could partly reduce permanent hypoparathyroidism in the patients underwent central neck dissection combining total thyroidectomy (p=0.095). Conclusion: PTGAT might be helpful during total thyroidectomy with central neck dissection. To get better outcomes, technical improvement in surgical dissection and PTGAT may be needed.
심선희,하정훈,조수연,김태민,고영일,김동완,이춘택,허대석,성명훈,Shim, Seon-Hui,Hah, J. Hun,Cho, Soo Youn,Kim, Tae-Min,Koh, Young-Il,Kim, Dong-Wan,Lee, Choon-Taek,Heo, Dae Seog,Sung, Myung-Whun The Korean Society for Head and Neck Oncology 2014 대한두경부 종양학회지 Vol.30 No.2
배경 및 목적 암-연관 섬유아세포(Cancer-associated fibroblasts, CAF)는 종양미세환경의 가장 중요한 요소의 하나다. 그래서 두경부편평세포암에 대해 CAF가 암세포의 운동성에 미치는 영향을 평가하고, CAF에 과발현되는 CD44의 역할에 대해 평가하고자 하였다. 재료 및 방법 두경부암환자의 종양조직에서 CAF를 분리하고, 비종양성 조직으로부터 정상 섬유아세포(NHF)를 분리하였다. 창상치유분석과 상하 챔버를 이용한 3차원 세포 이동 분석을 이용하여, CAF가 암세포의 이동에 미치는 영향을 분석하고, CAF에서 과발현되는 CD44를 중화항체로 CAF를 차단했을 때 암세포 이동의 변화를 관찰하였다. 결과 NHF에 비해 CAF에서 CD44가 과발현되는 것을 관찰하였다. 창상치유분석에서 CAF와 같이 배양된 암세포는 NHF와 같이 배양된 암세포에 비해 더 빠른 이동을 보였다. CD44 중화 항체를 처리했을 때는 암세포의 이동성이 저해되었다. 결론 CAF는 종양미세환경에서 암세포의 운동성을 조절하는 중요한 인자의 하나일 것으로 사료된다. CD44는 CAF의 기능을 매개하는 중요한 표지자 중 하나로 생각된다.
Seon-Hui Shim(심선희),J. Hun Hah(하정훈),Soo Youn Cho(조수연),Tae-min Kim(김태민),Young-il Koh(고영일),Dong-Wan Kim(김동완),Choon-Taek Lee(이춘택),Dae Seog Heo(허대석),Myung-Whun Sung(성명훈) 대한두경부종양학회 2014 대한두경부 종양학회지 Vol.30 No.2
배경 및 목적 암-연관 섬유아세포(Cancer-associated fibroblasts, CAF)는 종양미세환경의 가장 중요한 요소의 하나다. 그래서 두경부편평세포암에 대해 CAF가 암세포의 운동성에 미치는 영향을 평가하고, CAF에 과발현되는 CD44의 역할에 대해 평가하고자 하였다. 재료 및 방법 두경부암환자의 종양조직에서 CAF를 분리하고, 비종양성 조직으로부터 정상 섬유아세포(NHF)를 분리하였다. 창상치유분석과 상하 챔버를 이용한 3차원 세포 이동 분석을 이용하여, CAF가 암세포의 이동에 미치는 영향을 분석하고, CAF에서 과발현되는 CD44를 중화항체로 CAF를 차단했을 때 암세포 이동의 변화를 관찰하였다. 결 과 NHF에 비해 CAF에서 CD44가 과발현되는 것을 관찰하였다. 창상치유분석에서 CAF와 같이 배양된 암세포는 NHF 와 같이 배양된 암세포에 비해 더 빠른 이동을 보였다. CD44 중화 항체를 처리했을 때는 암세포의 이동성이 저해되었다. 결 론 CAF는 종양미세환경에서 암세포의 운동성을 조절하는 중요한 인자의 하나일 것으로 사료된다. CD44는 CAF의 기능을 매개하는 중요한 표지자 중 하나로 생각된다.
C-arm 방사선 투영법을 이용한 식도 점막 하 이물 제거
김희진,김효상,차원재,성명훈,하정훈,Kim, Heejin,Kim, Hyo-Sang,Cha, Wonjae,Sung, Myung-Whun,Hah, J. Hun 대한기관식도과학회 2013 大韓氣管食道科學會誌 Vol.19 No.1
Esophageal foreign body is common condition for visit emergency room, and most of them were successfully removed with endoscopy. However, in case of esophageal foreign body impaction, it can be difficult to localize the foreign body. We report a 29-year old man with esophageal foreign body impaction. We successfully localized and removed the esophageal submucosal foreign body using rigid endoscopy under C-arm guidance, avoiding more invasive procedure. The patient was followed up without any complication.
Radiotherapy as a First-Line Modality for Tongue Base Adenoid Cystic Carcinoma : Report of 3 Cases
김경수,우홍균,성명훈,하정훈,김태민,Kim, Kyung Su,Wu, Hong-Gyun,Sung, Myung-Whun,Hah, J. Hun,Kim, Tae Min The Korean Society for Head and Neck Oncology 2014 대한두경부 종양학회지 Vol.30 No.2
주로 작은 침샘에서 발생하는 샘낭암종의 치료 방침은 수술과 수술 후 보조적 방사선치료가 주로 행해져 왔다. 그러나 설근부에 발생한 샘낭암종에 대해서는 수술적 치료가 가져오는 삶의 질의 저하가 크기 때문에 수술적 치료를 적용하기 쉽지 않다. 또한 샘낭암종의 치료에 있어서 항암제의 역할이 거의 없는 상황에서 방사선치료가 중요한 역할을 할 수 있겠다. 이에 본 저자들은 설근부에 발생한 샘낭암종 세 증례의 방사선치료 결과를 보고 하며 샘낭암종의 치료에 대해서 문헌고찰을 통해 논의하고자 한다.
유소아 기도 이물의 임상 양상과 환기형 기관지 내시경술의 결과 : 서울대 병원의 경험 120례
차원재,최효근,문성중,하정훈,성명훈,김광현,Cha, Won-Jae,Choi, Hyo-Geun,Moon, Sung-Joong,Hah, J.-Hun,Sung, Myung-Whun,Kim, Kwang-Hyun 대한기관식도과학회 2006 大韓氣管食道科學會誌 Vol.12 No.2
Backgroud and Objectives: Inhalation of foreign bodies in respiratory tract can be fatal to infants and child. After ventilating bronchoscopy technique was widelyused, most of the pediatric airway foreign bodies could be managed effectively. In this study, we aimed to analyze clinicalfeatures and outcomes of ventilating bronchoscopic removal of pediatric airway foreign bodies. Materials and Methods: One hundred twenty cases of ventilating bronchoscopy for pediatric airway foreign bodies at Seoul National University Hospital for the past 15 years were analyzed retrospectively. Results: In 120 cases, sex ratio (male: female) was 2.2:1 and mean age was 27.0 months. Most frequent type of airway foreign was peanut (60.2%). One hundred thirteen patients, in whom a foreign body was confirmed in the airway, were successfully managed by ventilating bronchoscopy. Delayed diagnosis and management made a significantly long postoperative hospital stay. Conclusion: Great care must be given when feeding young children, especially younger than 36 months, with nuts. Early intervention with ventilating bronchoscopy following a clinical suspicion is critical to successful treatment.
원발성 다형선종과 재발성 다형선종의 면역조직화학적 특성
서명환(Myung Whan Suh),하정훈(J Hun Hah),이경분(Kyung Bun Lee),정영호(Young Ho Jung),권성근(Seong Keun Kwon),김광현(Kwang Hyun Kim),성명훈(Myung Whun Sung) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2
Background and Objectives: When the pleomorphic adenoma(PA) recures, the tumor tends to become a multinodular mass that infiltrates into the normal tissue which is not a common condition for a benign tumor. This manifestation is probably due to the difference in cell biology of the recurrent tumor compared to that of the primary PA. The aim of this study is to assay the immunhistochemical characteristics of the recurrent PA compared to the primary PA and to evaluate whether this property can be used for developing a method that can select the patients who have higher risk to recur. Materials and Methods: Thirteen patients were enrolled in the primary PA group and 15 patients who had a recurrent PA were enrolled in the recurrent PA group. To evaluate the cell biology of the tumor, immunohistochemical stainings of Ki-67, bcl-2 and p53 were performed. Results: There was no difference in the expression of Ki-67 (p=0.117, p=.208) and p53 (p=.430, p=.328). The extent stained by bcl-2 was significantly larger in the recurrent PA group (p=.033, p=.014). The expression of bcl-2 did not increase while time passed. Conclusion: The high expression of bcl-2 seems to be a property of the recurrent PA group which can be found even during first operation before recurrence. By this immunhistochemical characteristic, we would be able to sort out the patients who have higher risk to recur.