화학 소작술로 치료한 새성 기형 5례

연제엽,정지성,이동욱 대한기관식도과학회 2003 大韓氣管食道科學會誌 Vol.9 No.2

Branchial cleft fistula is one of the most common congenital neck masses. Most of the branchial cleft fistula patients complain of reucrrent neck infection or abscesses even with appropriate previous treatment. The traditional treatment of these patients was agreed to be a complete surgical removal of whole fistula tract with infection control. However this surgical treatment has risks of injuring important major vessels o. nerves adjacent to the track and difficulties in dealing with previous recurrent infections and scars of previous procedures such as drainage or incomplete surgical excision. Today, obliteration of internal opening with chemical or electrical cauterization has been introduced as a new way of treating branchial anomaly with a less invasive procedure. In this article, we reports 5 cases of branchial anomalies treated with TCA(trichloroacetic acid) chemical cauterization.

비강내 종괴로 진단된 형질세포 골수종

연제엽, 최다빈, 송형근 충북대학교 의과대학 충북대학교 의학연구소 2015 忠北醫大學術誌 Vol.25 No.2

71세 남자 환자가 2주전부터 시작된 우측 비출혈을 주소로 내원하였다. 영상의학검사에서 우측 비강에 서 시작된 종괴가 우측 부비강을 침범하고 전비강의 벽을 따라 연부조직까지 침범한 소견을 보였다. 비 강에서 실시된 조직검사에서 악성종양인 형질세포 골수종으로 진단되었다. 면역조직화학 염색으로 람 다 경쇄의 단클론성 증식을 확인하였다. 비강과 부비동을 침범한 형질세포종은 발생빈도가 낮으나 악성 도가 높은 악성종양으로 비강과 부비동을 흔히 침범하는 악성 소세포 암들과의 감별 진단을 중심으로 증례 보고하는 바이다.

비전두관 손상을 동반한 전두동 골절의 치료

심우섭, 연제엽, 유승두, 최지철 충북대학교 의과대학 충북대학교 의학연구소 2009 忠北醫大學術誌 Vol.18 No.2

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돌발성 난청환자에서 고실내 스테로이드 주사의 치료효과

최영석, 신시옥, 연제엽 충북대학교 의과대학 충북대학교 의학연구소 2009 忠北醫大學術誌 Vol.18 No.2

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Alveoloar Rhabdomyosarcoma of Tongue Base in an Infant : A Case Report

김지성,연제엽,박재홍,이용문,이동욱,Kim, Jisung,Yeon, Je Yeob,Park, Jae-Hong,Lee, Yong-Moon,Lee, Dong Wook The Korean Society for Head and Neck Oncology 2013 대한두경부 종양학회지 Vol.29 No.2

영아의 설근부에 발생하는 악성 종양은 매우 드물다. 저자들은 연하곤란과 폐쇄성 수면 무호흡증으로 의뢰된 17개월 남아의 설근부에 발생한 횡문근육종을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 외래에서 실시한 이학적 검사 상 설근부 전체가 돌출되어 있었으며 단단한 종괴가 촉지 되었다. 조직검사와 기관절개술을 시행하였으며 컴퓨터단층촬영, 양전자 방출 단층 촬영 그리고 뼈 스캔과 함께 염색체 분석을 실시하였다. 조직검사 결과 폐포성 횡문근육종이 확인되었으며 전이의 증거는 없었다. 염색체 분석상 폐포성 횡문근육종에 상응하는 PAX7-FKHR 유전자 전좌가 발견되었다. 8 회의 항암화학요법과 방사선 치료 후 촉지되는 설근부의 종괴는 없었으며 환자가 호소하는 증상도 개선되었다. 추적 관찰 시 시행된 자기공명영상 결과 확연한 종괴 크기의 감소를 확인할 수 있었다. 횡문근육종은 매우 드문 악성 종양으로 수술과 함께 항암화학요법, 방사선치료 등 여러 치료 방법이 동원되지만 전이나 재발이 있을 시 예후는 매우 불량하다. 그러므로 영아에서 연하곤란, 호흡 곤란 등의 증상이 있을 시에는 설근부를 포함한 상부호흡소화관을 적극적으로 검사하여야 하며 악성 종양의 가능성을 염두에 두어야 하겠다.

Langerhans Cell Histiocytosis of Thyroid Gland : A Case Report

장철순,연제엽,박수경,이동욱,Jang, Chul Soon,Yeon, Je Yeob,Park, Soo Kyoung,Lee, Dong Wook The Korean Society for Head and Neck Oncology 2013 대한두경부 종양학회지 Vol.29 No.1

랑게르한스 세포 조직구증은 골수에서 유래하는 랑게르한스 세포 조직구의 이상 증식에 의해 발병하는 희귀한 질병으로 알려져 있다. 비록 모든 장기에서 발생 할 수 있으나 갑상선을 침범하는 경우는 매우 드물다. 18세 남자가 5달전부터 점점 커지는 갑상선 종괴를 주소로 내원하여 세침흡인 세포검사, 총샘검, 경부 전산화단층촬영을 시행하였다. 세침흡인 세포검사에서 악성신생물이 의심되었고, 총생검에서 랑게르한스 세포 조직구증으로 나타났다. 경부 전산화단층촬영에서는 우측 갑상선에서 윤곽이 잘 구분되는 저음영의 종괴와 우측 기관 주위 림프절의 종대가 관찰되었다. 갑상선 전절제술과 우측 중앙 선택적 경부 림프절 청소술이 시행되었다. 랑게르한스 세포 조직구증이 갑상선을 침범하는 경우는 드물지만 갑상선 비대가 있는 환자가 뇌하수체 기능부전의 증상이나 뼈와 폐의 침범과 관련된 증상을 호소한다면 갑상선의 랑게르한스 세포 조직구증 침범을 고려해야 한다. 또한, 다른 장기의 랑게르한스 세포 조직구증을 치료한 과거력이 있는 경우는 갑상선 종괴를 감별 진단하는데 있어 랑게르한스 세포 조직구증을 고려해야 한다.

후인두 농양의 치료에 대한 고찰

정지성,이동욱,연제엽 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.9

Background and Objectives:The incidence of retropharyngeal absces has ben decreased with use of antibiotics, but it still causes critical complications such as airway obstruction, aspiration pneumonia, mediastinitis, or sepsis. For this reason, early diag-maintaining airway, performing surgical drainage, and administering antibiotics; but there are no definite guidelines for treating patients with retropharyngeal abscess, nor a golden rule for the corect surgical approach. Subjects and Method:A retrospec-tive analysis of patients with retropharyngeal abscess who were treated at the Chungbuk University Hospital from 1993 to 2003 was performed. We analized general symptoms, signs, causing factors, and causing bacteria. We also analized the treatment outcome and selected approaches from the surgically treated patients. Results:The general symptoms of retropharyngeal abscess were sore throat, fever, dyspnea, with the most common cause being the uper airway infection. Bacteriologically, hemolytic streptococ-cus was the most common bacteria among aerobes and bacteroides was the most common bacteria among anaerobes. However, in most cases, both aerobe and anaerobes were cultured at the same time. Among 18 cases, 6 cases were treated conservatively s-cervical approach. Conclusion:Retropharyngeal abscess can be treated with either conservative or surgical treatment according to initial absces size.The absces size which is greater than 3 cm is prefered to be treated surgicaly,and transoral aproach is a useful way of dealing with les invasive procedure.

구개편도로 전이된 자궁 평활근육종 1예

이현석,이동욱,연제엽,정우진 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.11

Metastatic malignancy of the palatine tonsil is extremely rare. Several primary malignancies with tonsillar spread that have been But metastatic leiomyosarcoma of the palatine tonsil has not ben previously reported. In this report, we present a 53-year-old female patient who had metastatic uterine leiomyosarcoma spread to the palatine tonsil. In adition, she was confirmed to have distant metastasis in the lung. Uterine leiomyosarcoma with palatine tonsil metastasis is reported here for the first time.

두경부 편평상피세포암 세포주 PCI-1, PCI-13과 PCI-50의 염색체이상 분석

문영은,최영석,연제엽,지아람,이동욱 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.9

Background and Objectives The knowledge about chromosomal aberrations manifestated in cancer has been spotlighted recently. The genetic analyses based on the knowledge about chromosomal aberrations are important for the development of diagnotic methods and evaluation of prognostic factors in cancers. Comparative genomic hybridization (CGH) is a powerful tool for evaluating chromosomal aberrations and array CGH significantly enhances these diagnostic effectiveness. The incidence of head and neck squamous cell carcinoma (HNSCC) has been increasing worldwide but the treatment outcomes still have been limited. The aim of this study is to evaluate the location of chromosomal aberrations in HNSCC cell lines with the combination of CGH and array CGH. Materials and Method The locations of chromosomal aberrations were evaluated in 3 HNSCC cell lines (PCI-1, PCI-13, PCI-50) using the combination of CGH and array CGH. Results The sites of chromosomal gain shown by CGH in all 3 cell lines were 8q22-qter, 9q32- qter, 10q22, 10q26-qter, 16q12.1-qter, 17p10-p13, 17q21-qter, 19p13.2-pter and 20q. The chromsomal loss found in 2 cell lines were 3p, 4q21-qter, and 18q21-qter. In array-CGH, gained loci were AHRR, MYT1 and PTGIS, etc. Loci of genetic losses were ELAVL4 and GRM7. Conclusion In this study, we identified various genetic gains and losses using CGH and high resolution array-CGH. These data about the patterns of chromosomal aberrations in HNSCC cell lines would be a basic step for understanding more detailed genetic events in the carcinogenesis. CGH combined with array CGH can be a powerful option for transitional oncologic research.

Clinical Characteristics of Labyrinthine Concussion

최미숙,신시옥,연제엽,최영석,김지성,박수경 대한청각학회 2013 Journal of Audiology & Otology Vol.17 No.1

Background and Objectives: Inner ear symptoms like hearing loss, dizziness or tinnitus are often developed after head trauma, even in cases without inner ear destruction. This is also known as labyrinthine concussion. The purpose of this study is to determine the clinical manifestations, characteristics of audiometry and prognostic factors of these patients. Materials and Methods: We reviewed the medical records of the 40 patients that had been diagnosed as labyrinthine concussion from 1996 to 2007. We studied the hearing levels in each frequency and classified them according to type and degree of hearing loss. Rates of hearing improvement were evaluated according to age, sex, hearing loss type, degree and presence of dizziness or tinnitus. To find out any correlation between hearing improvement and these factors, we used χ2 test or Fisher’s exact test. Results: Bilateral hearing loss was observed in 22 patients, and unilateral hearing loss in 18 patients. There were 4 (6.5%) ascending, 34 (54.8%) descending, 24 (38.7%) flat type hearing loss, which indicated hearing loss was greater in high frequencies than low frequencies. Among 62 affected ears, 20 (32.3%) gained improvement, and it was achieved mainly in low frequencies. There were only 2 ears with dizziness in 20 improved ears and among 20 dizziness accompanied ears, also only 2 ears were improved. Conclusions: High frequencies are more vulnerable to trauma than low frequencies. The hearing gain is obtained mainly in low frequencies, and association with dizziness serves poor prognosis.