설기저부에 발생한 소타액선 기원의 점액선암종 1예

정승원(Seung Won Chung),전현수(Hyun Su Jun),백승국(Seung Kuk Baek),정광윤(Kwang Yoon Jung) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.1

Mucinous adenocarcinoma is rarely reported in head and neck region. In other organ, it usually occur in breast, gastrointenstinal tract and so on. The specific histologic findings of mucinous adenocarcinoma are the large amount of extracellular mucin and tumor cell nests such as floating in mucin pool. It may develop rarely in major or minor salivary gland, but only one case of mucinous adenocarcinoma originating from parotid gland was presented in south korea. We report a case of mucinous adenocarcinoma in the tongue base considered to develop from minor salivary gland with a review of literatures.

The Utility of $^{18}F$-FDG PET/CT for Following Up Head and Neck Cancer

정은재,백승국,우정수,권순영,정광윤,Chung, Eun-Jae,Baek, Seung-Kuk,Woo, Jeong-Soo,Kwon, Soon-Young,Jung, Kwang-Yoon The Korean Society for Head and Neck Oncology 2010 대한두경부 종양학회지 Vol.26 No.2

서 론 : 두경부암의 예후에 가장 중요한 인자는 진단시 병기와 치료 후 재발의 유무이다. 따라서, 재발 병변을 조기에 발견하는 것이 매우 중요하다. 본 연구에서는 두경부암 환자의 추적 관찰에서 $^{18}F$-FDG PET/CT의 유용성에 대해 알아보고자 하였다. 대상 및 방법 : 2004년 4월부터 2008년 8월까지 고려대 안암병원에서 두경부암으로 치료를 완료한 후 추적관찰이 가능하였던 88 예의 환자를 대상으로 하였다. 환자는 본원의 두경부암 추적관찰 양식에 따라 술 후 6, 12개월째 $^{18}F$-FDG PET/CT를 시행하였으며, 원발부위 및 경부 재발, 원격전이와 중복암의 진단에 있어 $^{18}F$-FDG PET/CT의 민감도, 특이도, 양성예측율, 음성예측율을 평가하였고, 기존의 추적관찰 방법과 이를 비교하였다. 결 과 : 원발부위 재발의 진단에 있어 민감도, 특이도, 양성예측율, 음성예측율은 각각 95%, 97%, 90%, 98% 였다. 경부전이 재발의 진단에 있어서는 각각 94%, 98%, 83%, 99%였으며, 원격전이 및 이차암 진단에 있어서는 94%, 100%, 100%, 99%였다. 원발부위 재발은 고식적인 진단 방법, 원격전이와 이차암은 $^{18}F$-FDG PET/CT가 진단에 의미있게 유리하였다. 결 론 : $^{18}F$-FDG PET/CT는 두경부암의 추적관찰 과정에서 재발 여부를 판정하는데 있어 매우 유용하며, 특히 원격전이 및 이차암의 발견에 있어 유용하다. 그러나, 위양성 및 위음성의 가능성으로 고식적인 진단 방법과 병행해야 진단의 효과를 높힐 것으로 생각된다.

설근부에서 시작된 인후두협착과 식도협착 1례

최환,백승국,권순영,정광윤,김광택,Choe, Hwan,Baek, Seung-Kuk,Kwon, Sonn-Young,Jung, Kwang-Yoon,Kim, Kwang-Taik 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.1

Caustic bums of the upper aerodigestive tract continue to be a significant clinical problem. Wide -field pharyngoesophagectomy is commonly performed as treatment for malignancies of the hypopharynx. A total laryngectomy is often necessary at the time of this procedure because of the anatomical proximity of the cancer or because of the likely compromise of swallowing postoperatively. When preservation of the larynx is attempted, aspirations after surgery frequently require a second-stage laryngectomy. And various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the patient's status. A 54-year-old women whose symptom was severe dysphagia and X-ray revealed laryngopharyngeal stricuture. She had attempted suicide by swallowing lye liquids 32 years ago. She has entire laryngopharyngeal and esophageal stricutures. Total laryngectomy was performed and reconstruction of theesophagus was carried out with unusual reversed-gastric tube formation. Hence, we report this case with the review of literaturefor proper management in the future.

제4새 성기형으로 추정되는 낭종 1례

이정규,정승원,백승국,정광윤,Lee Jung Kyu,Jung Seung Won,Baek Seung Kuk,Jung Kwang Yoon 대한기관식도과학회 2004 大韓氣管食道科學會誌 Vol.10 No.1

The fourth branchial clef cyst is very rare entity ana only 35 cases have been reported worldwide. There have been some controversial attempts to prove its anatomical route through embryological background. However some reports even suggested that it might be impossible to prove its entity anatomically Recently, reports are coming out on the diagnostic approaches using anatomical pathway. We experienced in 45 years old woman, one case of lateral cystic neck mass which were anatomically presumed to be fourth brachial cleft cyst.

관통성 경부 손상에 관한 임상적 고찰

최환,홍석진,김연수,조재구,백승국,우정수,정광윤,권순영,Choe, Hwan,Hong, Seok-Jin,Kim, Yeon-Soo,Cho, Jae-Gu,Baek, Seung-Kuk,Woo, Jeong-Soo,Jung, Kwang-Yoon,Kwon, Soon-Young 대한기관식도과학회 2010 大韓氣管食道科學會誌 Vol.16 No.2

Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

경부에 발생한 지방모세포종 1예

김재형,최인학,김영찬,백승국,Kim, Jae Hyung,Choi, ln Hak,Kim, Young-Chan,Baek, Seung-Kuk 대한두경부종양학회 2019 대한두경부 종양학회지 Vol.35 No.1

Lipoblastoma is a rare benign tumor with 80-90% occurring in children less than 3 years of age and 40% occurring in children less than 1 year of age. The most common site of incidence is limb, and then trunk. Neck is the rare site of incidence. The main symptom that the patient complains about is a rapidly growing neck mass without pain. When the size of mass increases, it can cause dyspnea, Horner's syndrome. Lipoblastoma is usually diagnosed as a lipoma in the fine needle aspiration. Since it is not differentiated from lipoma, liposarcoma, and hibernating adenoma in CT and MRI, the definitive diagnosis is histologic diagnosis through surgical resection. The treatment is complete surgical resection. And recurrence rate is 9-25% due to incomplete resection. Authors report this case with a review of literatures since we experienced a case of lipoblastoma diagnosed histopathologically after surgical treatment of neck mass.

KTP-532 레이저에 의한 성문상부 협착증 치험

최종욱,전병선,강희준,백승국,최건,정광윤,주형로,Choi, Jong-Ouck,Jun, Byung-Sun,Kang, Hee-Joon,Baek, Seung-Kuk,Choi, Geun,Jung, Kwang-Yoon,Chu, Hyung-Ro 대한기관식도과학회 1999 大韓氣管食道科學會誌 Vol.5 No.2

Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.

갑상연골과 설골 골절을 동반한 후두외상 1례

강선묵,최환,정광윤,백승국,Kang, Sun-Mook,Choe, Hwan,Jung, Kwang-Yoon,Baek, Seung-Kuk 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.1

Laryngeal trauma is an uncommon injury but can be life-threatening event. So, early diagnosis is important for appropriate surgical management and better outcome. Because there have been some controversies about Initial airway management, appropriate diagnostic evaluation, operative indication and timing, operative technique, it is difficult to make a common management pathway in laryngeal trauma. A case of laryngeal trauma with thyroid cartilage and hyoid bone fracture is presented with a brief review of literature.

원격전이를 동반한 선양낭포암에 대한 고찰

권순영,김형진,조성동,백승국,정광윤,최건,최종욱,Kwon, Soon-Young,Kim, Hyung-Jin,Jo, Sung-Dong,Baek, Seung-Kuk,Jung, Kwang-Yoon,Choi, Geon,Choi, Jong-Ouck 대한기관식도과학회 2001 大韓氣管食道科學會誌 Vol.7 No.1

Background and Objectives: Adenoid cystic carcinoma (ACC) is an aggressive, often indolent tumor, with a high incidence of distant metastasis (DM). Relatively little has been written about the factor that influence distant spread and subsequent survival because it is uncommon and has protracted clinical course. We attempted to reemphasize the biologic behavior of ACC by investigating the relationship between the clinical features and prognosis. Materials and Methods : We have retrospectively studied 24 determinate patiens who received definitive treatment in our hospital between 1984 and 1995 for ACC in all salivary sites. Inclusion criteria were no prior treatment elsewhere other than excisional biopsy and eligibility for follow-up of at least 5 years. Variables assessed for their impact on distant metastasis included age, gender, size, node status, stage, histologic pattern, locoregional treatment failure. Results : Treatment failure occurred in a total of 16 of 24 determinate Patients (64%), 12 of whom had DM (50%). This was usually associated with locoregional recurrence (8 patients), but DM was the only indication of failure in 4 whose primary tumor was controlled. Of the 12 patients with known DM, the lung was recored as the only involved site in 7 Patients, lung was involved in addition to other sites in 1, bone and liver metastasis occurred in 2 respectively. Disease-free intervals varied from 3 month to 14 years (median 3 years). The only significant factors influencing survival were the size of the primary tumor, locoregional recurrence. Conclusion : The high incidence of DM with locoregional failure confirms the importance of aggressive initial surgery. combined with irradiation, for high-stage tumors or involved surgical margins. Large tumor size and locoregional recurrence, rather than microscopic appearance, were predictive of DM.

Prognostic Factor of Laryngeal Papillomatosis: 20 Years Experience

정은재,홍석진,조재구,백승국,우정수,권순영,정광윤,Chung, Eun-Jae,Hong, Seok-Jin,Cho, Jae-Gu,Baek, Seung-Kuk,Woo, Jeong-Soo,Kwon, Soon-Young,Jung, Kwang-Yoon The Korean Bronchoesophagological Society 2010 大韓氣管食道科學會誌 Vol.16 No.2

Background: Laryngeal papillomatosis, which is cased by human papillomavirus, is the most common benign neoplasm of the larynx. However, the prognosis of this disease remains really unpredictable. The aim of this paper is to determine whether any clinical features at the time of diagnosis could predict its course. Material and Method: Eighty-six patients treated at our institution during the last 20 years were analyzed retrospectively. All patients had microsurgery under general anesthesia. All patients' follow-up period was more than 1 year. We divided the patients into 1) Juvenile versus adult group based on their age 20, 2) single surgical method with laser versus dual surgical method with laser and microdebrider group, and 3) single subsite versus multiple subsites group. And we compared the therapeutic outcome. Results: The recurrence rate was 100% (15 patients) in the JP group and 56% (40 patients) in the AP group. Juvenile versus adult group was the only independent prognostic factor by univariate, and multivariate analysis. Microdebrider resection technique and multiple subsites were not associated with treatment result. Time period from the first surgery to recurrence detection was different statistically only for the age group. The number of surgery in the JP group ranged from 1 to 31 (mean 8.8). In the AP group the number of surgery ranged from 1 to 25 (mean 3.7). It was statistically different. Conclusion: Prognosis for the laryngeal papillomatosis remains unpredictable. Only patients' age was the only independent prognostic factor.