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두경부암 환자에서 루골용액을 이용한 식도 내시경 선별검사
하남욱,이강대,이형신,홍종철,이환호,박선자 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.10
Background and Objectives:Second primary esophageal cancer has been reported to comprise 6-9% of head and neckcancer cases, which are frequently detected in the advanced stage. Thus, detecting esophageal cancer in the early stage is importantin the prognosis of head and neck cancer. However, it is difficult to detect early lesions using the conventional endoscopy.In the current study, the feasibility of endoscopic screening using Lugols solution was assessing for detecting early esophagealcancer in patients of head and neck cancer. Subjects and Method:Sixty-two patients (Group I-synchronous cancer studygroup) diagnosed with head and neck cancer between November, 2003 and November, 2004 were prospectively studied. Fortysixpatients (Group II-metachronous cancer study group) under the follow-up care with head and neck cancer during the sameperiod were also evaluated. The esophagus was initially observed under direct endoscopic view and then Lugol dye was sprayedat the esophagus. Any unstained area was biopsied. Results:Of 34 patients (54.8%) with unstained lesions in Group I, 10(16.1%) showed dysplasia and 4 (6.4%) had cancer. Of 21 patients (45.6%) with unstained lesions in Group II, 2 (4.3%)showed dysplasia and 5 (10.8%) had cancer. Among 9 (8.3%) second primary esophageal cancer, 6 were detected with superficialesophageal cancer while the other 3 were found to be in the advanced stage of cancer. This superficial cancer revealed nonspecificmucosal findings in the direct endoscopic view and was difficult to be visualized as a pathologic lesion; however, itrevealed unstained areas when Lugol’s solution was sprayed, thus could be diagnosed as cancer through biopsy of the area.Conclusion:Endoscopy of esophagus with Lugol’s solution could be highly effective as a screening method to detect secondprimary esophageal cancer in patients with head and neck cancer. (Korean J Otolaryngol 2006;49:1008-13)
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손성환,이강대,하남욱,김성원,이형신,유태현,이환호 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.4
Background and Objectives:Early stages of laryngeal carcinoma are usually treated with three different therapeutic options:partial or total laryngectomy, radiotherapy and transoral endoscopic CO2 laser partial laryngectomy. Combined use of CO2 laserand operating microscope, initially described by Strong and Jako in 1972, has been developed to a variety of procedures by manysurgeons. The aim of this study was to define when laser resection of early stage laryngeal carcinoma is indicated and to comparethe results obtained by laser surgery with other therapeutic options. Materials and Method:A retrospective study of 50patients (glottic carcinoma 41 cases, supraglottic carcinoma 9 cases) treated between May, 1997 and March, 2003 at Departmentof Otolaryngology, Head and Neck Surgery of Kosin Medical College Hospital, was performed. Glottic cancers were treatedwith cordectomy type I to V, according to the classification proposed by the European Laryngological Society in 2000. Supraglotticcancer was treated with partial epiglottectomy, epiglottectomy, supraglottic partial laryngectomy, supraglottic laryngectomy,and extended supraglottic laryngectomy. Results:The overall survival rate at 3 years was 100% for the glottic cancer (Tis, 3;T1a, 27;T1b, 5;T2, 2;rT1a, 3;rT2, 1) and local recurrence was identified in 1 patient, thus local control rate was 97.6%.Overall survival rate at 3 years was 100 % for the supraglottic cancer (T1, 3;T2, 2;T3, 1;rT2, 2;rT3, 1) and local controlrate was 100%. Conclusion:Our results suggest that transoral endoscopic laser resection is a cost-effective procedure with goodoncologic results and has acceptable functional results in early laryngeal carcinoma.
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가족성 갑상선 수질암에 대한 RET 유전자의 점돌연변이 분석
이강대,문효성,김주연,정헌,최소희,하남욱,Shinya Uchino 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.9
Background and Objectives:Hereditary medullary thyroid carcinoma is presented as a part of MEN2A (65- 75% ) or MEN2B, but can also be inherited alone, which is called familial medullary thyroid carcinoma. The author sought to detect point mutations of the RET proto-oncogene using the molecular genetic method on the family line of the familial medulary thyroid carcinoma, which is identified by the family history of an index patient, and to investigate the presence of point mutation cariers among the Subjects and Method:DNA was extracted from the peripheral blod leukocyte of 5 patients who were asumed to have sporadic medulary thyroid carcinoma and 1 patient who was an index of a family line asumed to contain hereditary medullary thyroid carcinoma according to the family history. The PCR amplification of exons, 10, 11, 13, 14, 15, 16 was then caried out, and we investigated point mutations of the RET proto-oncogene using a DNA sequence analyzer. After family. Results:We identified point mutation of TGC (Cys)→CGC (Arg) at codon 618 of the RET proto-oncogene exon 10, using the automatic DNA sequence analyzing method on the index patient and detected the same point mutation with 4 of the 9 family members. Among them, the index patient and her mother who had biochemical and clinical symptoms underwent a total thyroidectomy and neck disection and are now being folowed up;operations are scheduled for two other members later on. Conclusion:test and that more complete aproach through early diagnosis would be posible by carrying out the screning test for point mutation in patients with the hereditary medulary thyroid carcinoma .
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