두경부 선양낭성암종에서 원격전이와 관련된 임상적, 병리학적 예측 인자

성명훈(Myung Whun Sung),권택균(Taek Kyun Kwon),이상준(Sang Joon Lee),김광현(Kwang Hyun Kim),김정훈(Jeong Whun Kim) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.2

Background and Objectives : Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods : Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results : DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM (p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions : Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

안면신경마비 동물모델에서 전기활성고분자를 이용한 눈 깜박임 기능의 회복

권성근,성명훈,김광현,김희찬,Kwon, Seong-Keun,Sung, Myung-Whun,Kim, Kwang-Hyun,Kim, Hee-Chan 대한기관식도과학회 2006 大韓氣管食道科學會誌 Vol.12 No.2

There have been numerous modalities to recover blink function of orbicularis oculi muscle in patients with facial paralysis. However, there is still no optimal method for reanimation of eyelid. In this study, we tried to recover blink function of paralyzed rabbit's eyelid with the ion polymer metal composite (IPMC) which is one of the electroactive polymers that is spotlighted as artificial muscle. We manufactured IPMC by plating the platinum over perfluorosulphonic acid polymer ($Nafion^{(R)}$). IPMC was coated by Norland optical adhesive for the purpose of insulation and keeping it from dry. IPMC modifications by roughening the surface of Nafion, repetitive plating (maximum 4 times) with platinum, and lengthening the width of IPMC were done. The facial paralysis was induced in the rabbit by sectioning of facial nerve at the main trunk. After minimum period of 4 weeks, IPMC was inserted in the paralyzed rabbit's eyelid. By modification, the force generated by IPMC was enhanced. Restoration of blink function in paralyzed rabbit was achieved on electrical stimulation of the IPMC by 5 voltage direct current. IPMC can be promising option for facial reanimation, but further studies are needed to enhance the efficiency of IPMC.

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.

경부에 발생하는 신경초종에서 수술적 치료와 정기적 경과관찰의 임상적 비교

홍성룡(Sung-Lyong Hong),정영호(Young Ho Jung),안수연(Soo-Youn An),하정훈(J. Hun Hah),성명훈(Myung-Whun Sung),김광현(Kwang Hyun Kim) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.1

Backgrounds and Objectives :Most patients with neck schwannomas are asymptomatic. Surgical manage-ment of neck schwannomas could cause various complications. The aim of this study is to evaluate the necessity of surgical management in all of the neck schwannoma patients. Material and Methods :Thirty-four patients diagnosed and undergone surgical management as neck schwan-nomas and 30 patients diagnosed and observed closely by OPD base from 1996 to 2005 were included. The me-dical records were reviewed retrospectively. Results :In surgical management group, mean age was 39.3 years and mean size of tumors was 4.4cm. Twen-ty-five patients had their tumors at parapharyngeal space, 2 at anterior neck and 7 at lateral neck. Nerves of origin were vagus nerve in 12 patients, cervical sympathetic chain in 11. Presenting symptoms were neck mass in 22 pa-tients and no symptom in 9. On the other hand, in close observation group, mean age was 47.1 years and mean size of tumor was 3.7cm. Seventeen patients had their tumors at parapharyngeal space, 5 at anterior neck and 8 at lateral neck. Presenting symptoms were neck mass in 13 patients and no symptom in 13. There were no patients with neurologic complications. Mean follow-up duration was 38.2 months and there were only 2 patients whose size of tumors was increased and no patients who had newly emerged symptoms. Conclusion :Neck schwannomas grows slowly, has little chance of malignant transformation, but can com-plicate serious problems after surgical management. Therefore close observation could be considered in many asymptomatic patients.

구개열 환자 발음 판별을 위한 특징 추출 방법 분석

김성민(Sung Min Kim),김우일(Wooil Kim),권택균(Tack-Kyun Kwon),성명훈(Myung-Whun Sung),성미영(Mee Young Sung) 한국정보과학회 2015 정보과학회논문지 Vol.42 No.11

본 논문에서는 구개열 환자의 장애 발음과 정상인의 발음을 자동으로 구분하여 판별하는데 사용될 수 있는 특징 추출 방법들의 성능을 분석하는 실험에 대하여 소개한다. 이 연구는 발성 장애인의 복지 향상을 추구하며 수행하고 있는 장애 음성 자동 인식 및 복원 소프트웨어 시스템 개발의 기초과정이다. 실험에 사용된 음성 데이터는 정상인의 발음, 구개열 환자의 발음, 그리고 모의 환자의 발음의 세 그룹으로부터 수집된 한국어 단음절로서 14개의 기본 자음과 5개의 복합 자음, 7개 모음이다. 발음의 특징 추출은 LPCC, MFCC, PLP의 세 가지 방법으로 각각 수행하였고, GMM 음향 모델로 인식 훈련을 한 후, 수집된 단음절 데이터를 대상으로 하여 인식 실험을 실시하였다. 실험 결과, 정상인과 구개열 환자의 장애발음을 구별하기 위하여 특징을 추출함에 있어서 MFCC 방법이 전반적으로 가장 우수하였다. 본 연구의 결과는 구개열 환자의 부정확한 발음을 자동으로 인식하고 복원하는 연구와 구개열 장애 발음의 정도를 측정할 수 있는 도구에 대한 연구에 도움이 될 것으로 기대된다. This paper presents an analysis of feature extraction methods used for distinguishing the speech of patients with cleft palates and people with normal palates. This research is a basic study on the development of a software system for automatic recognition and restoration of speech disorders, in pursuit of improving the welfare of speech disabled persons. Monosyllable voice data for experiments were collected for three groups: normal speech, cleft palate speech, and simulated clef palate speech. The data consists of 14 basic Korean consonants, 5 complex consonants, and 7 vowels. Feature extractions are performed using three well-known methods: LPC, MFCC, and PLP. The pattern recognition process is executed using the acoustic model GMM. From our experiments, we concluded that the MFCC method is generally the most effective way to identify speech distortions. These results may contribute to the automatic detection and correction of the distorted speech of cleft palate patients, along with the development of an identification tool for levels of speech distortion.

두경부암 환자의 등록 체제

변성완(Sung Wan Byun),김춘동(Chun Dong Kim),홍순관(Soon Kwan Hong),성명훈(Myung Whun Sung),김광현(Kwang Hyun Kim) 대한두경부종양학회 1998 대한두경부 종양학회지 Vol.14 No.1

재발, 추시 중 소실, 다른 원발성 암의 병발 등으로 복잡해질 수 있는 두경부암 환자 등록에 있어서, '단일등록양식다중항목체제'라는 새로운 체제로, 서울대학교 병원에서 진단한 486명의 두경부암 환자를 대상으로 하여, 데이터베이스를 구성하고, 이의 운용을 '다중등록양식체제'라는 기존의 체제와 비교하였다. 새로운 방법의 구조와 흐름이 보다 간단하고 자료의 검색이 더 효율적이었다. 두경부암 환자 등록의 전용 프로그램 개발에도 이 체제의 도입이 필요할 것으로 사료된다. Objectives: Many complicated problems exist in establishing head and neck cancer(HNCa) patient registry system. In this study, a newly devised and simplified approach named as 'Single Sheet Multiple Event System' was compared with a conventional approach named as 'Multiple Sheet System'. Material and Method: According to several kinds of registry sheets in the two systems, data were collected from 486 patients with HNCa diagnosed at Department of Otolaryngology, Seoul National University Hospital from 1979 through 1994. Results: The new system produced more simple and efficient data retrieval. Conclusion: It could make the implementation of HNCa patient registry system more simple and efficient.

일측 성대에 동시 발생한 다른 두 종류의 성대 낭종 1례

안수연,안영진,성명훈,김광현,권택균,An, Soo-Youn,Ahn, Young-Jin,Sung, Myung-Whun,Kim, Kwang-Hyun,Kwon, Tack-Kyun 대한후두음성언어의학회 2008 대한후두음성언어의학회지 Vol.19 No.1

A 66-year-old woman described a 6-month history of hoarseness after upper respiratory infection. She was a house wife and referred from an outside clinic under a diagnosis of vocal fold nodules. Strobovideolaryngoscopy revealed bilateral vocal fold lesions, and decreased mucosal wave of both vocal folds. She was brought to the operating room for microsuspension laryngoscopy. Under general anesthesia, dual intracordal cysts on left vocal fold were completely resected with microflap technique. The lesion on the right vocal fold turned out to be a reactive fibrous mass, which was also resected. Dual intracordal cysts were confirmed histopathologically. The one was an epidermoid cyst lined with squamous epithelium, and the other was a mucus retention cyst lined with cuboidal epithelium. Postoperative voice was acceptable by the patient and the mucosal vibration has much improved after the surgery.

모의 음성 모델을 이용한 효과적인 구개인두부전증 환자 음성 인식

성미영,권택균,성명훈,김우일,Sung, Mee Young,Kwon, Tack-Kyun,Sung, Myung-Whun,Kim, Wooil 한국정보통신학회 2015 한국정보통신학회논문지 Vol.19 No.5

본 논문에서는 VPI 환자 음성을 정상인 음성으로 복원하기 위한 기술의 단계로서 효과적인 VPI 음성 인식 기술을 소개한다. 소량의 VPI 환자 음성을 모델 적응에 효과적으로 사용하기 위해 정상인의 모의 음성을 이용하여 화자 적응을 위한 사전 모델로 이용하는 기법을 제안한다. MLLR 기법을 이용한 화자 적응을 통해 평균 83.60%의 인식률을 보이고, 모의 음성 모델을 화자 적응의 사전 모델로 이용함으로써 평균 6.38%의 인식률 향상을 가져온다. 음소 인식 평가 결과는 제안한 화자 적응 방식이 대폭적인 음성 인식 성능 향상을 가져오는 것을 증명한다. 이러한 결과는 본 논문에서 제안하는 모의 음성 모델을 이용한 화자 적응 기법이 대량의 VPI 환자 음성을 취득하기 어려운 조건에서 보다 향상된 성능의 VPI 환자 음성 인식기를 구축하는데 효과적임을 입증한다. This paper presents an effective recognition method of VPI patient's speech for a VPI speech reconstruction system. Speaker adaptation technique is employed to improve VPI speech recognition. This paper proposes to use simulated speech for generating an initial model for speaker adaptation, in order to effectively utilize the small size of VPI speech for model adaptation. We obtain 83.60% in average word accuracy by applying MLLR for speaker adaptation. The proposed speaker adaptation method using simulated speech model brings 6.38% improvement in average accuracy. The experimental results demonstrate that the proposed speaker adaptation method is highly effective for developing recognition system of VPI speech which is not suitable for constructing large-size speech database.

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.

후두 악성종양에 대한 내시경적 레이저 수술의 적용

김광현(Kwang Hyun Kim),성명훈()Myung Whun Sung,이효정(Hyo Jeong Lee),이동욱(Dong Wook Lee),박범정(Bum Jung Park),성원진(Weon Jin Seong),민양기(Yang Gi Min),이철희(Chul Hee Lee),이재서(Chae Seo Rhee),이상준(Sang Jun Lee),노종열(Jong L 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.1

Background and Objectives: To determine if laser endoscopic microsurgery is a reliable and appropriate approach in the treatment of laryngeal carcinomas. Materials and Methods: Retrospective study of 62 patients treated with CO2 laser from June 1988 to November 2000 at Seoul National University Hospital for laryngeal squamous cell carcinoma. All patients were treated with curative intention. Fifty three untreated patients with laryngeal carcinoma (39 glottic and 14 supraglottic carcinoma patients) had primary carbon dioxide laser microsurgery. Nine radiation failure patients were treated. Postoperative radiotheray was done for 17 patients. Neck dissection was performed simultaneously for 4 supraglottic cases with cervical nodal metastasis. Mean follow-up duration was 40 months. Results: In primary laser surgery group, distribution of tumors (American Joint Committee on Cancer, 1997) were 38 cases with Tl, 13 cases with T2, 2 cases with T3. Cure rate was 88.7%(47/53) and local control rate was 92.5%(49/53). Larynx was preserved in 94%(50/53) of patients. The overall 5-year survival rate(Kaplan-Meier) was 81.5%. In radiation failure group, 56% of patients were recurred after laser surgery. Conclusion: Laser surgery could be a better treatment modality for early laryngeal cancers and selected advanced cases. Additional radiation therapy should be considered if resection margin is not satisfactory.