성인에서 우연히 발견된 경부 기관지원성 낭종 2예

홍수원,심윤상,이국행,모정아,이수정,고재수,Hong, Soo-Won,Shim, Youn-Sang,Lee, Guk-Haeng,Mo, Jeong-A,Lee, Soo-Jung,Koh, Jae-Soo 대한기관식도과학회 2008 大韓氣管食道科學會誌 Vol.14 No.1

Bronchogenic cysts are rare congenital anomalies of the tracheobronchial tree. Most cases present within the mediastinum or pulmonary parenchyma without a patent connection to the tracheobronchial tree or digestive tract in the pediatric age group. Cervical bronchogenic cysts in adults are rare. In this report, we describe two cases of incidentally found paratracheal bronchogenic cysts that presented as asymptomatic neck masses in a 66-year-old female with papillary thyroid carcinoma and in a 59-year-old male of Catleman's disease.

유리공장을 이용한 인두 및 경부식도 재건술

오경균(Kyung Kyoon Oh),심윤상(Youn Sang Shim),이용식(Yong Sik Lee),박혁동(Hyuk Dong Park),김기환(Gi Hwan Kim),심영목(Young Mog Shim),조재일(Jae Ill Zo) 대한두경부종양학회 1991 대한두경부 종양학회지 Vol.7 No.2

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.

비인강암의 방사선 치료

고경환,박우윤,조철구,류성렬,심윤상,오경균,Koh Kyoung Hwan,Park Woo Yoon,Cho Chul Koo,Yoo Seong Yul,Shim Youn Sang,Oh Kyung Kyoon The Korean Society for Radiation Oncology 1990 Radiation Oncology Journal Vol.8 No.1

Total of 154 patients of pathologically proven and previously untreated nasopharyngeal carcinoma who were treated in the Department of Therapeutic Radiology, Korea Cancer Center Hospital during the period from 1964 to 1984 were analyzed. Minimal follow-up period of survivors was 3 years. Thirteen percent of the patients had $T_4$ primary lesions and $65\%$ had stage IV disease. Total radiation dose to the primary site was $1550\~1750$ ret in 82 and above 1750 ret in 72 patients. Local control was obtained in $79\%$ of patients. Significant prognostic factors for the survival were tumor dose (above vs. below 1750 ret), age (below vs. above 30 years), stage (AJCC I-III vs. IV), T stage ($T_1\;vs.\;T_2-4$), and N stage (NO vs. $N^+$). 1964년부터 1984년까지 원자력병원 치료방사선과에서 비인강암으로 근치적 목적의 방사선치료를 받은 154명의 환자에 대한 임상적 특성과 치료결과를 분석하였다. 생존자의 최소추적기간은 3년이었다. 환자의 $13\%$가 $T_4$의 원발병소를 가졌고, $65\%$가 AJCC병기 제 4 기였다. 병소부위의 총방사선량은 82명에서 $1550\~1750$ret였고, 72명에서 1750ret이상이었다. 국소적 완전관해율은 $79\%$이었다. 유의한 예후인자로는 방사선량(1750ret이상 또는 이하), 나이 (30세이하 또는 이상), 병기 (AJCC 제 $1\~3$기 또는 제 4기), 원발병 소정도 ($T_1$ 또는 $T_2\~T_4$병기), 경부임파절유무 (NO 또는 $N^+$)이었다.

Correlation Between Response to Induction Chemotherapy and Subsequent Radiotherapy in Previously Untreated Patients with Squamous Cell Carcinomas of the Head and Neck

박우윤,류성렬,고경환,조철구,박영환,심윤상,오경균,이용식,Park Woo Yoon,Yoo Seong Yul,Koh Kyoung Hwan,Cho Chul Koo,Park Young Hwan,Shim Youn Sang,Oh Kyung Kyoon,Lee Yong Sik The Korean Society for Radiation Oncology 1990 Radiation Oncology Journal Vol.8 No.2

유도화학요법과 방사선치료후 종양 관해의 상호 관련성을 파악하고자 1986년부터 1989년까지 원자력병원에서 소정의 충분한 유도화학요법과 근치적 방사선치료를 받은 국소적으로 진행된 두경부 악성종양 환자 60예에 대한 후향적 분석을 시도하였다. 유도화학요법은 CDDP를 기본으로한 복합요법을 2 내지 3회 시행한바, 20예에서 Bleomycin+CDDP(BP), 37예에서 5-FU+CDDP(FP), 그리고 3예에서 BP/FP의 교대요법을 시행하였으며, 방사선은 병소에 따라서 65 Gy 내지 75 Gy 또는 그이상을 조사하였다. 유도화학요법에 의한 종양의 관해율은원발병소에서는 $80\%$(48/60), 경부임파절에서는 $79\%$(31/39)였으며, 약제, T-병기, 그리고 N-병기에 의한 통계적 유의성은 관찰되지 않았다. 방사선조사 6개월후 원발부위에서는 $67\%$(40/60)의 완전관해를, 경부임파절에서는 $77\%$(30/39)의 완전관해를 보인바, 이를 유도화학요법에 의한 관해 유무에 따른 차이를 분석한 결과 원발부위에서는 유도화학요법에 의한 관해(완전관해 또는 부분 관해)를 얻었던 48예중 39예에서 완전관해를 얻었으나($81\%$), 관해를 얻지못한 12예에서는 1예에서만이 방사선 치료에 의해 완전관해를 얻을 수 있었으며 ($8\%$) (p<0.0005), 경부임파절에서는 유도화학요법에 의해 관해를 얻었던 32예중 28예에서 완전관해를 얻은 반면 ($90\%$), 관해를 얻지 못한 8예에서는 2예에서만이 방사선 치료에 의해 완전관해를 얻을 수 있었던바($25\%$) (p<0.001), 모두 통계적으로 유의한 차이를 보였다. 한편 이를 원발부위, T-병기 그리고 N-병기에 따라 분석해본 결과, 특히 T-병기중 T3, 4에서는 유의한 차이가 관찰되었으나(p<0.0005), T1, 2에서는 유의한 차이가 관찰 되지 않았다(0.3<p), 따라서 유도화학요법과 방사선치료에 의한 종양의 관해 정도는 대체적으로 상호연관성이 관찰되고 있으나, 초기 병변에서는 이러한 현상이 관찰되지 않는바 유도화학요법에 의해 관해가 없더라도 방사선 치료에 의해 완전관해를 얻을 수 있을 것이다. To determine the correlation between the response to induction chemotherapy and subsequent radiotherapy we analyzed the clinical records of 60 patients with locally advanced carcinoma of the head and neck retrospectively who had completed a full course ($2\~3$ cycle) of induction chemotherapy and curative radiotherapy in Korea Cancer Center Hospital between 1986 and 1989. Chemotherapy was administeredd with CDDP+Bleomycin (BP) in 20, CDDP+5-FU (FP) in 37, and hybrid of BP and FP in three patients. Radiotherapy was giver conventionally with a dose of 65 to 75 Gy or more over seven to eight weeks according to the size of lesion. Response rates following induction chemotherapy were $80\%$ for the tumors and $879\%$ for the nodes whereas complete reponse rates were $12\%\;and\;13\%$, respectively. Six months after radiotherapy $67\%$ of the tumors and $77\%$ of the nodes achieved a complete response. Among the 48 tumor responders and the 31 nodal responders to chemotherapy,39 ($81\%$) and 28 ($90\%$), respectively, achieved complete response after radiotherapy. Thus, whether or not the tumor and node respond to induction chemotherapy was predictive of the response to subsequent radiotherapy (p<0.0005 in tumor, p<0.0001 in node). By reanalyzing according to disease subsets (i.e. primary site, T-stage, N-stage) this relationship was not observed at T1-T2 disease (p>0.3). Therefore the tumor or node's response to induction chemotherapy is a predictor for subsequent radiotherapy except in T1-T2 tumors, and complete response to radiotherapy can be expected despite the failure of induction chemotherapy in $T_1-T_2$ tumors.

성문암 방사선치료 15년 성적

류성렬(Seong Yul Yoo),고경환(Kyoung Hwan Koh),서성희(Sung Hee Suh),김진용(Chin Yong Kim),심윤상(Youn Sang Shim) 대한방사선종양학회 1985 Radiation Oncology Journal Vol.3 No.1

To assess the result of radiation therapy for fifteen years experience, a total of 81 cases of pathologically proven vocal cord cancer had been analysed according to patient survival retrospectively. All the patients had been treated with radiation therapy using Co-60 teletherapy unit in curative aim. The results are as follows ; 1. According to AJCC staging, (ive year survival rate was 75.0% in stage I, 73.1% in stage II, 36.0% in stage III, and 20.0% in stage IV. 2. According to T-staging, five year survival rate was 75.0% in T1, 73.1% in T2, 24.3% in T3, and 25.0% in T4. 3. According to nodal status, five year survival rate was 59.4% in negative node group and 14.2% in positive group. 4. According to the histologic grade, the better in differentiation, the more in number of cases and the better in prognosis. 5. In summary, five year actuarial survival rate was 55.5% and ten year survival rate was 49.8% and ten year survivors totalled 12 cases.

聲門上部癌 放射線治療 15年 成績

유성열(Seong Yul Yoo),고경환(Kyoung Hwan Koh),서성희(Sung Hee Suh),김진용(Jin Yong Kim),심윤상(Youn Sang Shim) 대한방사선종양학회 1984 Radiation Oncology Journal Vol.2 No.2

To assess the result of radiation therapy for fifteen years experience, a total of 125 cases of pathologically proven supraglottic laryngeal cancer had been analyzed according to patient survival retorospectively. All the patients had been treated with radiation therapy in curative aim using Co-60 teletherapy machine. The results are as follows; 1. According to AJCC staging, five year survival rate was 58.3% in stage Ⅰ, 44.4% in Ⅱ,31.8% in Ⅲ, and 28.6% in Ⅳ. 2. According to T-staging, five year survival rate was 57.1% in T1, 40.5% in T2, 34.0% in T3, and 19.0% in T4. 3. According to N staging, five year survival rate was 43.5% in negative node group and 26.8% in positive node group. 4. According to the histologic grade, the better in differentiation, the more in number of cases and the better in prognosis. 5. In summary, five year actuarial survival rate was 37.3% and ten year surrival rate was 34.2%, and ten year survivors totalled 16 cases.

Correlation Between Response to Induction chemotherapy and Subsequent Radiotherapy in Previously Untreated Patients with Squamous Cell Carcinomas of the Head and Neck

Woo Yoon Park(박우윤),Seong Yul Yoo(류성렬),Kyong Hwan Koh(고경환),Chul Koo Cho(조철구),Young Hwan Park(박영환),Youn Sang shim(심윤상),Kyung Kyoon Oh(오경균),Yong Sik Lee(이용식) 대한방사선종양학회 1990 Radiation Oncology Journal Vol.8 No.2

유도화학요법과 방사선치료후 종양 관해의 상호 관련성을 파악하고자 1986년부터 1989년까지 원자력병원에서 소정의 충분한 유도화학요법과 근치적 방사선치료를 받은 국소적으로 진행된 두경부 악성종양 환자 60예에 대한 후향적 분석을 시도하였다. 유도화학요법은 CDDP를 기본으로한 복합요법을 2내지 3회 시행한바, 20에에서 Bleomycin + CDDP(BP), 37예에서 5-FU+CDDP(FP), 그리고 3예에서 BP/FP의 교대요법을 시행하였으며, 방사선은 병소에 따라서 65Gy 내지 75GY 또는 그 이상을 조사하였다. 유도화학요법에 의한 종양의 관해율은 원발병소에서는 80%(48/60), 경부임파절에서는 79%(31/39)였으며, 약제, T-병기, 그리고 N-병기에 의한 통계적 유의성은 관찰되지 않았다. 방사선조사 6개월후 원발부위에서는 67%(40/60)의 완전관해를, 경부임파절에서는 77%(30/39)의 완전관해를 보인바, 이를 유도화학요법에 의한 관해 유무에 따른 차이를 분석한 결과 원발부위에서는 유도화학요법에 의한 관해(완전관해 또는 부분관해)를 얻었던 48예중 39예에서 완전관해를 얻었으나(81%), 관해를 얻지 못한 12예에서는 1예에서만이 방사선 치료에 의해 완전관해를 얻을 수 잇었으며(8%)(p<0.0005), 경부임파절에서는 유도화학요법에 의해 관해를 얻었던 32예중 28예에서 완전관해를 얻은 반면(90%), 관해를 얻지 못한 8예에서는 2예에서만이 방사선 치료에 의해 완전관해를 얻을 수 있었던바 (25%)(p<0.001), 모두 통계적으로 유의한 차이를 보였다. 한편 이를 원발부위, T-병기 그리고 N-병기에 따라 분석해본 결과, 특히 T-병기중 T3,4에서는 유의한 차이가 관찰되었으나 (p<0.0005), T1,2에서는 유의한 차이가 관찰되지 않았다(0.3<p). 따라서 유도화학요법과 방사선치료에 의한 종양의 관해정도는 대체적으로 상호연관성이 관찰되고 있으나, 초기 병변에서는 이러한 현상이 관찰되지 않는바 유도화학요법에 의해 관해가 없더라도 방사선 치료에 의해 완전관해를 얻을 수 있을 것이다. To determine the correlation between the response to induction chemotherapy and subsequent radiotherapy we analyzed the clinical records of 60 patients with locally advanced carcinoma of the head and neck retrospectively who had completed a full course(2~3 cycle) of induction chemotherapy and curative radiotherapy in Korea Cancer Center Hospital between 1986 and 1989. Chemotherapy was administered with CDDP+Bleomycin (BP)in 20, CDDP+5-FU(FP) in 37, and hybrid of BP and FP in three patients. Radiotherapy was given conventionally with a dose of 65 to 75 Gy or more over seven to eight weeks according to the size of lesion. Response rates following induction chemotherapy were 80% for the tumors and 79% for the nodes whereas complete response rates were 12% and 13%, respectively. Six months after radiotherapy 67% of the the tumors and 77% of the nodes achieved a complete response. Among the 48 tumor responders and the 31 nodal responders to chemotherapy. 39(81%) and 28(90%), respectively, achieves complete response ofter radiotherapy. Thus, whether or not the tumor and node respond to induction chemotherapy was predictive of the response to subsequent radiotherapy (p<0.0005 in tumor, p<0.0001 in node). By reanalyzing according to disease (p>0.3). Therefore the tumor of node's response to induction chemotherapy is a predictor for subsequent radiotherapy except in T1-t2 tumors, and complete response to radiotherapy can be expected despite the failure of induction chemotherapy in T1-T2 tumors.

급성 이산화질소가스 흡입이 흰쥐 기도의 조직 호흡에 미치는 영향에 관한 실험적 연구

沈潤相 대한이비인후과학회 1977 대한이비인후과학회지 두경부외과학 Vol.20 No.3