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.

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.

두경부 수술후 발생한 인두피부누공의 치료

정은재,정광윤,Chung, Eun-Jae,Jung, Kwang-Yoon 대한기관식도과학회 2008 大韓氣管食道科學會誌 Vol.14 No.1

Subcutaneous cervicofacial, mediastinal emphysemas are complications associated with head and neck surgery, trauma, infectious processes, tooth extraction. Drill cooling stream and dental syringe air ject are the sources of high pressure air that may enter exposed soft tissue. Since the introduction of the high-speed air turbine drill in the 1960s, The incidence of iatrogenic subcutaneous emphysema has increased. Most cases begin to resolve after 2 to 3 days and residual swelling is usually minimal at the end of 7 to 10 days. Surgical approach is not advised because it is likely to be ineffective. The differential diagnosis of neck swelling after dental procedure includes hematoma, cellulitis, angioedema, allergic reaction, subcutaneous emphysema. We report a rare case of patient with subcutaneous cervicofacial emphysema and mediastinal emphysema secondary to third molar extraction.

갑상선 수술 후 발생하는 음성장애의 치료

정은재,Chung, Eun-Jae 대한후두음성언어의학회 2016 대한후두음성언어의학회지 Vol.27 No.1

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

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

Eun-Jae Chung(정은재),Seung-Kuk Baek(백승국),Jeong-Soo Woo(우정수),Soon-Young Kwon(권순영),Kwang-Yoon Jung(정광윤) 대한두경부종양학회 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 관찰에서18F-FDG PET/CT의 유용성에 대해 알아 보고자 하였다. 대상 및 방법 2004년 4월부터 2008년 8월까지 고려대 안암병원에서 두경부암으로 치료를 완료한 후 추적관찰이 가능하였던 88예의 환자를 대상으로 하였다. 환자는 본원의 두경부암 추적관찰 양식에 따라 술 후 6, 12개월째 18F-FDG PET/ CT를 시행하였으며, 원발부위 및 경부 재발, 원격전이와 중복암의 진단에 있어 18F-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 18F-FDG PET/CT가 진단에 의미있게 유리하였다. 결 론 18F-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.

당귀 추출물의 피부 흡수 증가를 위한 마이크로에멀젼 조성

정은재(Eun-Jae Jung),최준호(Joonho Choi),박충범(Chun-Geon Park),최애진(Ae-Jin Choi),정세호,정석재(Suk-Jae Chung),심창구(Chang-Koo Shim),김대덕(Dae-DuK Kim) 대한약학회 2012 약학회지 Vol.56 No.3

Angelica gigas is one of the most widely used herbal medicines in Asia. Root extract of Angelica gigas is known to have anti-oxidant activity and skin whitening effect. The aim of this study was to prepare microemulsion system of root extracts of Angelica gigas for topical delivery. Microemulsion was successfully prepared by using MCT (medium chain triglyceride) as an oil phase, Labrasol as a surfactant, and the mixture of propyleneglycol and phosphatidylcholine (4 : 1) as a cosurfactant. In vitro and in vivo skin permeation and deposition of decursin, as a marker, was determined using hairless mouse. Microemulsion significantly increased the in vitro skin permeation of decursin for up to 12 hours and was significantly higher than the control (water). Moreover, microemulsion formulation showed significantly higher skin deposition of decursin compared to the control in both in vitro and in vivo studies. Thus, microemulsion could be a useful vehicle for topical application of root extracts of Angelica gigas.

편평세포암 동물 모델에서 고려인삼잎-다당체(MB40)의 항암치료효과

주은정(Eun Jung Joo),최 준(Jun Choi),정은재(Eun Jae Chung),홍석진(Seok Jin Hong),조재구(Jae Gu Cho),백승국(Seung Kuk Baek),우정수(Jeong Soo Woo),정광윤(Kwang Yoon Jung),권순영(Soon Young Kwon) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.1

Background and Objectives:Panax ginseng C.A. Meyer is a medical plant that has been widely utilized as a tonic and nutritional agent since ancient times in Korea. Ginseng has anti-metastatic property of cancer and immunomodulating activity. The novel acidic polysaccharide compound(MB40) was isolated from the leaves of Panax ginseng C.A. Meyer. To determine immunomodulating activities of MB40, we evaluate anti-cancer and anti-metastatic effects of MB40 in tumor bearing immune competent mice. Material and Methods:C3H mice were divided into three equal groups(Cisplatin treatment group, MB40treat- ment group, Cisplatin and MB40 treatment group) and were transplanted SCC(Squamous Cell Carcinoma) cells(2×106) to the lateral side of abdomen. From day 4 after transplantation, MB40 was administrated at dose of 10mg/kg, respectively, every other day by intratumoral injection. Cisplatin was systemically administrated at doses of 1mg/kg, respectively, every week by intraperitoneal injection. Results:5 days after administration, tumors can be palpated in every mice group. After 13 days of administra-tion, the mice group to which MB40 were administrated exhibited reduction in tumor size respectively, com-pared to cisplatin group. Overall status of mice such as body weight and activity were superior in MB40 group than cisplatin group. Conclusion:The result of this study indicates MB40 may have significant therapeutic effect and decreases com-plications induced by systemic chemotheraphy. MB40 may be developed as a novel and potent immunotropics to improve the cell immune system and anti-cancer drug for the treatment of cancer patients in head and neck squamous cell carcinoma.

근전도유도하 윤상인두근 보톡스 주입 술의 유용성

김현성,정은재,노영수,박동식,Kim, Hyun-Sung,Chung, Eun-Jae,Rho, Young-Soo,Park, Dong-Sik 대한기관식도과학회 2013 大韓氣管食道科學會誌 Vol.19 No.1

Objective The objective was to evaluate changes in swallow safety and dietary status after the transcutaneous injection of botulinum toxin into the upper esophageal sphincter in a series of outpatients with dysphagia. Methods Patients who were at risk for aspiration and who had an unsuccessful trial of swallowing therapy were admitted to the study. All patients showed significant pooling of fluids in the pyriform sinus. All patients were treated in the office; none had previous esophageal dilatation. The upper border of the cricoid cartilage was identified using standard electromyogram procedures and botulinum toxin was injected. Outcomes were assessed using the penetration-aspiration scale, NIH swallowiwng safety score, patients' short-term and long-term subjective impressions of their ability to swallow, and change in dietary status. Results Ten patients underwent an instrumental evaluation of swallowing function. Of the 10 patients, 9 showed an overall improvement in their ability to take an oral diet safely. The penetration-aspiration scale, NIH swallowiwng safety score, patients' short-term and long-term subjective impressions of their ability to swallow, and change in dietary status were significantly improved after office-based botox injection. Conclusion Office-based EMG guided botox injection to the cricopharyngeus muscle is a simple, safe, and effective tool for dysphagia patients. Injection of Botox in the office should be considered when the dysphagia pattern is aspiration after swallow.

보톡스 주입술로 치료된 윤상인두 연하장애 1예

최규영,노영수,이동진,정은재,Choi, Kyu-Young,Rho, Young-Soo,Lee, Dong-Jin,Chung, Eun-Jae 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.1

Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.

분화성 갑상선암에 의한 후두기관침습의 치료

정광윤 ( Kwang-yoon Jung ),정은재 ( Eun-jae Chung ),백승국 ( Seung-kuk Baek ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.2

Locally invasive thyroid cancer is an uncommon disease process, which carries significant morbidity and mortality. Differentiated thyroid cancer (DTC) invasion of the recurrent laryngeal nerve, strap muscles and trachea are the most common followed by invasion of the esophagus, internal jugular vein and carotid artery. Surgical resection is the primary treatment for locally advanced DTC. Although the optimal surgical approach (ranging from conservative shave excision to aggressive en bloc resection of tumor and vital structures) in patients with locally advanced DTC is controversial, a curative resection should be the goal unless complete tumor resection results in unwanted perioperative morbidity and mortality or widely metastatic disease is present. Postoperative radioiodine ablation with TSH suppression is imperative after surgical resection of locally advanced DTC. Patients with microscopic or small gross residual disease, after surgical resection, may benefit from postoperative external radiotherapy for local control of disease.