부인두강 종물로 발현된 갑상선 유두상암종

우정수(Jeong Su Woo),김용환(Yong Whoan Kim),정광윤(Kwang Yoon Jung),최건(Geon Choi),최종욱(Jong Ouck Choi) 대한두경부종양학회 1996 대한두경부 종양학회지 Vol.12 No.1

An unusual case of nodal metastases from thyroid neoplasm known as parapharyngeal space mass is likely to be overlooked. And identification of the primary lesion by excisional biopsy calls for a secondary operation. Therefore, it is important to be aware of the possible lymphatic spread of the thyroid neoplasm to the parapharyngeal space. In this case, completion thyroidectomy should be considered. Here, we present a case of thyroid papillary carcinoma masquerading as a parapharyngeal space tumor. The mass was removed by transcervical approach and pathologically diagnosed as a metastatic thyroid papillary carcinoma. Successful results were obtained after additional completion thyroidectomy.

OK-432를 이용한 재발성 하마종 치험 1례

우정수(Jeong Su Woo),이흥만(Heung Man Lee),권순영(Soon Young Kwon),정광윤(Kwang Yoon Jung) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.1

Plunging ranula is occured in about 10% of all ranula cases although surgery is the first choice therapy. However, frequent recurrences of the disease due to insufficient surgery have been reported, and various therapies have been designed in addition to surgery. We here report a case on whom we conducted intralesional injection of OK-432 for recurrent plunging ranula. A 36-year-old man was admitted who had a 2-months history of swelling of right submandibular area. He had been operated for right plunging ranula twice, 7 years ago. Under fluoroscopic guidance, contents of the ranula were aspirated and OK-432 solution was injected twice with 3-week interval. Examination after 6 weeks showed that the cystic ranula seen before therapy had disappeared completely and no recurrence was encountered after 18months. Therefore the intralesional injection of OK-432 is effective method for treatment of the plunging ranula.

허리엉치신경얼기의 말단가지를 이루는 척수신경구성

우정수(Jung-Su Woo),허미선(Mi-Sun Hur),김호정(Ho-Jeong Kim),이규석(Kyu-Seok Lee) 대한체질인류학회 2011 해부·생물인류학 (Anat Biol Anthropol) Vol.24 No.2

이 연구는 허리엉치신경얼기에서 분지하는 각 말단신경의 척수신경 구성과 참여량을 밝히는 데 목적이있다. 한국성인 시신의 25쪽(남: 17, 여자: 8, 왼쪽: 13, 오른쪽: 12, 평균나이: 73.6세)에서 허리엉치신경얼기와 그 말단신경을 떼어내 Guanidine-HCl (0.2 M)에 약 2주 동안 담가 신경주위결합조직을 부드럽게 한 후 수술현미경(OPMI-Pico, Carl Zeiss) 아래에서 신경다발을 분리하였다. 허리엉치신경얼기에서 분지되는 말단신경의 주요 구성성분으로 엉덩아랫배신경은 88.2%에서 L1로만 구성되었고 엉덩샅굴신경은 100% 모두 L1로, 음부넙다리신경은 62.5%에서 L1과 L2로, 가쪽넙다리피부신경 56.0%에서 L2와 L3으로, 넙다리신경은 88.0%에서 L2, L3 그리고 L4로 구성되었다. 또 폐쇄신경은 100%에서 L2, L3 그리고 L4로 구성되었고, 궁둥신경의 온종아리부분은 84.0%에서 L4, L5, S1 그리고 S2로, 정강부분은 96.0%에서 L4, L5, S1 그리고 S2로, 위볼기신경은 56.0%에서 L4, L5 그리고 S1로 구성되었다. 아래볼기신경은 54.2%에서 L5와 S1 그리고 S2로, 뒤넙다리피부신경은 40.0%에서 S1과 S2로, 관통피부신경은 56.0%에서 S2와 S3으로, 음부신경은 52.9%에서 S3으로만 구성되었다. 한편, 참여하는 척수신경의 굵기를 살핀 결과, 엉덩아랫배신경의 경우 L1 (0.72 ㎜)이 가장 많이 참여하였고 엉덩샅굴신경도 L1 (0.63 ㎜)에서, 음부넙다리신경은 L2 (0.72 ㎜)에서, 가쪽넙다리피부신경도 L2 (0.80 ㎜)에서, 넙다리신경은 L3 (2.68 ㎜)에서, 폐쇄신경도 L3 (1.27 ㎜)에서, 궁둥신경의 온종아리부분은 S1 (2.12 ㎜)에서, 궁둥신경의 정강부분도 S1 (2.22 ㎜)에서, 위볼기신경은 L5 (1.09 ㎜)에서, 아래볼기신경은 S1 (1.27 ㎜)에서, 뒤넙다리피부신경은 S2 (1.04 ㎜)에서, 관통피부신경은 S3 (1.09 ㎜)에서, 음부신경은 S4 (1.46 ㎜)에서 가장 많은 신경섬유가 참여하였다. 이 연구의 결과는 척수신경뿌리 병변시 임상적 증상을 예측하는 데 도움이 될 것으로 생각된다. The purpose of this study was to classify the spinal nerve compositions of the terminal branches of the lumbosacral plexus, providing data of their participating quantities. Twenty-five sides of the lumbosacral plexus extracted from Korean adult cadavers were used in this study. The iliohypogastric nerve was mostly arisen from L1 (88.2%, thickness L1 0.7 ㎜). The ilioinguinal nerve was arisen from only L1 (100%, thickness L1 0.6 ㎜). The genitofemoral nerve was commonly arisen from L1 and L2 (62.5%, thickness L1 0.6 ㎜, L2 0.7 ㎜). The lateral femoral cutaneous nerve was classified into 4 types, and the most common type was that L2 and L3 composed this nerve (56.0%, thickness L2 0.8 ㎜, L3 0.4 ㎜). The femoral nerve was classified into 2 types, and it was usually composed of L2, L3 and L4 (88.0%, thickness L2 1.4 ㎜, L3 2.7 ㎜, L4 2.3 ㎜). The obturator nerve was arisen from L2, L3 and L4 in all cases (100%, thickness L2 0.5 ㎜, L3 1.3 ㎜, L4 1.1 ㎜). The common fibular component of sciatic nerve was mostly arisen from L4, L5, S1 and S2 (84.0%, thickness L4 0.9 ㎜, L5 2.0 ㎜, S1 2.1 ㎜, S2 1.2 ㎜). The tibial component of sciatic nerve was mainly arisen from L4, L5, S1 and S2 (96.0%, thickness L4 0.9 ㎜, L5 1.9 mm, S1 2.2 ㎜, S2 1.9 ㎜). The superior gluteal nerve was commonly derived from L4, L5 and S1 (56.0%, thickness L4 0.7 ㎜, L5 1.1 ㎜, S1 0.9 ㎜). The inferior gluteal nerve was comprised of L5, S1 and S2 in several cases (54.2%, thickness L5 0.9 ㎜, S1 1.3 ㎜, S2 0.8 ㎜). The posterior femoral cutaneous nerve was composed of S1 and S2 in higher freqeuncy (40.0%, thickness S1 0.9 ㎜, S2 1.0 ㎜, S3 0.8 ㎜). The perforating cutaneous nerve was arisen from S2 and S3 in higher frequency (56.0%, thickness S1 0.7 ㎜, S2 0.9 ㎜, S3 1.1 ㎜). The pudendal nerve was derived from S3 in many cases (52.9%, thickness S3 1.5 ㎜). These anatomical results may be helpful to predict the spinal nerve root lesions of the lumbosacral plexus.

비전형적인 형태의 제 1 새성기형 환자 2예

김수종(Su Jong Kim),김태훈(Tae Hun Kim),방승환(Seung Hwan Bang),우정수(Jeong Soo Woo) 대한두경부종양학회 2017 대한두경부 종양학회지 Vol.33 No.1

First branchial cleft anomaly is a very rare disease and exhibits various clinical presentations. Therefore, the diagnosis of first branchial cleft anomaly may be difficult; the condition is often misdiagnosed and mismanaged. Accurate diagnosis is very important, because if not diagnosed correctly, patients with first branchial cleft anomaly would be treated with local incision and drainage repeatedly. We report two cases of first branchial cleft anomaly. The first patient visited for recurrent swell and discharge in the infra-auricular area with a history of previous incision and drainage. The other patient showed a cystic mass in the infra-auricular area and all of them were misdiagnosed initially by their treating specialists elsewhere. The objective of this study is to share our experiences of first branchial cleft anomaly, and emphasize its various clinical patterns and the significance of accurate diagnosis.

팔동맥변이 1례

김호정(Ho-Jeong Kim),김덕임(Deog-Im Kim),박재영(Jae-Young Park),우정수(Jung-Su Woo),이규석(Kyu-Seok Lee) 대한체질인류학회 2008 대한체질인류학회지 Vol.21 No.2

팔에서의 동맥변이는 자주 출현하지만 한쪽 팔에서 여러 변이가 동시에 같이 나타나는 경우는 드물다. 학생 실습에 사용된 86세 여자 시신 오른팔 팔동맥에 여러 변이가 동시에 나타나 이를 보고하고자 한다. 출현한 변이는 다음과 같다 1. 두 개의 갑상목동맥을 형성하며 가쪽가지에서 속가슴동맥이 분지되었다. 2 가슴봉우리동맥이 크게 두 개의 가지로 갈라지며 그 중 작은 가지에서 가쪽가슴동맥이 분지되었다. 3. 위팔동액이 큰 원근의 아래모서리에서 먼쪽으로 14.9㎜ 떨어진 곳에서 두 가지로 갈라졌다. 두 가지중 안쪽가지(바깥지름: 2.4㎜)는 정중신경을 따라 내려가다 팔오금부위에서 정중신경을 가로질러 노동맥이 되었다. 가쪽가지(바깥지름: 3.5㎜) 역시 정중신경을 따라 내려가다 아래팔 가쪽에서 자동맥이 되었다. 4. 노동맥이 얕은손바닥가지와 깊은손바닥가지로 갈라지는 위치가 노뼈의 붓돌기에서 몸쪽으로 46.9㎜ 떨어진 곳에 위치하였고 깊은손바닥동맥활을 형성하는 가지는 손등에서 두 개의 가지로 갈라져 둘째손가락의 안쪽면부터 다섯째손가락까지 혈액을 공급하였고 얕은손바닥동맥활에서 첫째손가락과 둘째손가락의 가쪽면에 혈액을 공급하는 가지가 분지되었다. 팔동맥의 변이는 정맥내주사나 피판술과 같은 시술 시 심한 출혈이나 조직의 괴사 등을 유발하거나 진단을 잘못 할 수도 있다. 팔동맥 변이에 대한 해부학적 지식을 잘 아논 것은 이러한 임상적 문제가 발생되는 것을 줄일 수 있을 것이다. The arterial variations of the upper limb are frequently encountered in the human body. However, the appearance of multiple variations in one limb is uncommon. The present arterial variations were found in the right upper limb of 86 years-old female cadaver during a routine dissection. The variations of the arterial patterns are as follows: 1. Two thyrocervical trunks from subclavian artery and the internal thoracic artery is rising from lateral branch of thyrocervical trunks. 2. Thoracoacromial artery was divided two branches and the lateral thoracic artery arises from the small of two branches. 3. The distance of bifurcation of the brachial artery is 14.9 ㎜ from the inferior border of teres major muscle. Medial branch of the brachial artery passes along the median nerve and becomes radial artery. Lateral branch of the brachial artery passes along the median nerve and becomes ulnar artery. 4. Bifurcation of radial artery is occurred at the distance of 46.9 ㎜ from styloid process of radius. Deep palmar branch of radial artery is bifurcated on dorsum of hand. Branches for supplying first and second fingers arise from superficial palmar arch. The arterial variations of the upper limb could be caused a several bleeding in intravenous injection or surgeries and a wrong diagnosis. The knowledge of the arterial variation of the upper limb should be decreased to raise clinical problems.

후두암 세포주에서 $TGF-{\beta}1$에 의한 MMP2와 MMP9의 발현 양상

권남영,김형진,우정수,권순영,정광윤,Kwon Nam-Young,Kim Hyung-Jin,Woo Jeong-Su,Kwon Soon-Young,Jung Kwang-Yoon 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.2

Backgrounds and Objectives: Metastasis is a complex multistep process that requires sequential interactions between the invasive cell and the extra-cellular matrix. Transforming growth factor-${\beta}1$ ($TGF-{\beta}1$) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by $TGF-{\beta}1$ plays important roles in neoplastic progression. The aim of this study was to investigate the role of $TGF-{\beta}1$ in the neoplastic invasion and metastasis through matrix metalloproteinase (MMP) of laryngeal cancer cell lines. Material and Methods: Two laryngeal cancer cell lines, SNU-899 and SNU-1076 were treated with recombinant $TGF-{\beta}1$, and the expression of MMP-2 and MMP-9 was immunohistochemically evaluated and gelatinase activity was studied by gelatin zymogram. Results: The cell growth inhibition was evident on 4th days after 1ng/ml and 10ng/ml $TGF-{\beta}1$ treatment. The expressions of MMP-2 and MMP-9, and their gelatinase activities were increased in dose-dependent manner. Conclusion: $TGF-{\beta}1$ treatment in laryngeal cancer cell lines induces the expression of MMP-2 and MMP-9, thus playing a role in the digestion of extracellular matrix gelatin.

기관절제술후 기관 단단문합술 치험 결과

신동진,조우진,백승국,우정수,권순영,정광윤,Shin Dong-Jin,Cho Woo-Jin,Baek Sungkuk,Woo Jeong Su,Kwon Soon-Young,Jung Kwang-Yoon 대한기관식도과학회 2004 大韓氣管食道科學會誌 Vol.10 No.1

Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

Frequency and Quantity of the C7 Contribution to the Ulnar Nerve

Mi-Sun Hur(허미선),Jung-Su Woo(우정수),Ho-Jeong Kim(김호정),Kyu-Seok Lee(이규석) 대한체질인류학회 2013 해부·생물인류학 (Anat Biol Anthropol) Vol.26 No.3

말초신경을 연구하는 많은 해부학자와 임상가들은 팔신경얼기 끝신경의 척수신경 뿌리구성에 대해 관심을 가지고 있다. 이러한 관점에서, 자신경의 척수신경 뿌리구성은 명확하지 않다. 여러 해부학 교과서에는 자신경이 C8, T1의 앞가지로 구성되어 있고, 종종 C7도 포함되는 것으로 기술되어 있다. 그러나 자신경에 참여하는 C7의 빈도와 참여량에 대한 문헌은 있지 않다. 이 연구의 목적은 자신경에 참여하는 C7의 빈도와 참여량을 관찰하는 데 있다. 한국성인시신의 팔신경얼기 100쪽을 사용하였다. 자신경을 포함하는 팔신경얼기를 겨드랑에서 떼어낸 후, Guanidine-HCl (0.2 M)에 2주 동안 담구어 신경다발을 둘러싸는 결합조직을 부드럽게 하였다. C7은 모든 경우에서 자신경에 분포하였다(100%). 자신경에 분포하는 C7의 말이집축삭의 수는 1,452±429 (mean±S.D.)였다. C7의 말이집축삭의 수가 C8의 말이집축삭의 수보다 적었고, T1의 말이집축삭의 수와 비슷하였지만, C7은 자신경에 자주 참여하는 것이 참여하는 것이 아니라, 항상 참여하는 성분으로 여겨질 수 있다. 이 연구의 결과는 다양한 사고로 인한 자신경 손상시 정확한 진단과 치료에 대한 자료를 제공할 것이다. Many anatomists and clinicians who investigate the peripheral nerve concern about the composition of the spinal roots of each terminal nerve of the brachial plexus. From this viewpoint, the spinal root composition of the ulnar nerve is still unclear. Several anatomy textbooks describe that the ulnar nerve is composed of the ventral rami of the C8, T1 and often C7. There is no literature regarding the frequency and contribution quantity of C7 to the ulnar nerve. The purpose of present study was to determine frequency and contribution quantity of the C7 to the ulnar nerve. Fifty cadavers of brachial plexus were obtained from cadavers of Korean adults. The brachial plexus containing the ulnar nerve were extracted from the axilla and the extracted samples were immersed in Guanidine-HCl (0.2 M) for 2 weeks to soften the connective tissue around the nerve bundles. C7 was contributed to the ulnar nerve in all sides (100%). The numbers of the myelinated axons of C7 participating to the ulnar nerve was 1,452±429 (mean±S.D.). Thus the C7 can be considered as always participating component of the ulnar nerve, not often participation, although numbers of the myelinated axons of C7 was lesser than those of the C8, but similar to those of the T1. The results of the study provide a reference for accurate diagnosis and treatment regarding ulnar nerve injury due to various accidents.

Median Nerve Branch Innervating the Brachialis Muscle

Mi-Sun Hur(허미선),Ho-Jeong Kim(김호정),Jung-Su Woo(우정수),Kyu-Seok Lee(이규석) 대한체질인류학회 2010 대한체질인류학회지 Vol.23 No.1

정상적으로 근육피부신경이 분포하는 위팔근에 정중신경의 가는 가지가 분포하는 예를 한국성인 남성의 왼쪽 팔에서 관찰하였다(나이: 74세). 이 정중신경의 가지는 정중신경과 근육피부신경의 연결과 함께 출현하였으며 위팔근의 안쪽아래의 일부분에 분포하고 있었다. 이 신경가지는 다섯째와 여섯째 목신경에서 기원하였으며 328개의 유수신경섬유로 구성되어 있었다. 이러한 변이는 과거에 보고된 정중-근육피부신경 연결형의 일부 형태에서 정중신경의 일부 성분이 두 신경의 신경연결을 경유하여 위팔근에 분포하는 형태와 달리 이 예에서는 정중신경에서 분지되어 나온 가지가 두 신경의 신경연결을 경유하지 않고 직접분포하는 유형으로 현재까지 기술된 적이 없는 형태이다. We observed a slender nerve branch of the lateral root of the median nerve innervating the brachialis muscle, which is normally innervated by the musculocutaneous nerve, at the left arm of a Korean male (age, 74 years). The present nerve branch was accompanied with the communicating branch between the median and musculocutaneous nerves and supplied to the medial inferior portion of the brachialis muscle. The spinal root origins of this branch were C5 and C6. The nerve fiber number of the nerve branch innervating the brachialis muscle was 328. This variation may be very rare case and was different from previous observation.

이하선에 발생한 림프상피낭종 1예

추호석(Ho Suk Chu),권윤환(Yoon Hwan Kwon),우정수(Jeong Su Woo),정광윤(Kwang Yoon Jung) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2

Benign lymphoepithelial cysts of parotid gland were first described by Miculicz in 1888, have been presented for a long time, uncommonly. But, recently it has been reported with increasing frequency since the onset of human immunodeficiency virus (HIV) infection. Benign lymphoepithelial cysts can be diagnosed by the fine needle aspiration in conjunction with the history and physical examination. The therapeutic options of benign lymphoepithelial cysts have been limited to aspiration, surgical resection, medical therapy, radiotherapy and sclerotherapy. Recently, we experienced a case of benign lymphoepithelial cyst of right parotid gland, so we report this case with review of the literatures.