비디오 종격동경을 이용한 수술은 좁은 시야와 제한된 수술 기구의 여용으로 수술 적응증의 폭넓은 확대가 어렵지만, 종격동, 폐, 흉막 질환에서 진단 흑은 치료 방법의 하나로서 중요한 영역을 확보하고 있다.

Minimally invasive surgery (MIS) has several advantages over conventional open surgery. Less pain, less morbidity, early recovery and better cosmetic outcomes are well-known benefits of MIS. However, indications of MIS are highly dependent on the experience of surgeon and the disease status, In the benign diseases with less surgical complexity, MIS can be performed relatively and safely. However. in advanced malignant diseases which require more complex surgical manipulation, the of patients and the principles of oncologic surgery should be considered before the selection of surgical methods, MIS would be performed more and more with aid or technologic advancement. However, long-term result with equivalent oncologic outcomes to open surgery is necessary to be one of standard surgical treatments in thoracic surgery.

NOTES (Natural orifice transluminal endoscopic surgery) is a new technique in minimally invasive procedure, surgeon use normal orifice and hollow viscus for procedurs as approaching route, Currently the NOTES are performed for diagnostic and therapeutic purpose by some investigators in research setting. NOTES has potential benefit in terms of sear, pain, post op recovery. Rut Bacterial contamination, deal with major complication are needed more stud) and development.

Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

Titania nanomaterials are widely used as cosmetics and dyes, however the impacts on human health are uncertain, We investigated the biodistribution of inhaled titania nanoparticles in rats, Methods Eight weeks-old SD rats were intubated and inhaled with 3 mg titania nanoparticles, twice a week, for 2 weeks, After inhalation, the rats were sacrificed and tissues or heart, lung. intestine, brain, and liver were obtained, We investigated the tissues with optical microscope (OM), transmission electron microscope (EM), scanning EM, And to analyze titania concentration of each tissue, we lysed the tissues with radioimmunoprecipitation assay (RlPA) lysis buffer or acid. Results Granulation tissues in lung were confirmed on the optical microscope, however the other organs had no abnormalities in OM images, In EM images, the rats which inhaled titania nanoparticles showed calcium deposition at heart, brain, and intestine, Titania concentration in lung was increased on the inhaled rat sacrificed I month after last exposure. Conclusion Inhaled titania nanoparticles is thought to be deposited and make inflammatory reaction in lung, and the deposition was not efficiently cleared over a month. However inhaled titania nanoparticles may rarely pass through the alveolus-blood barrier and distribute to other organs of the bod.

Background and Objectives Various tumor markers have been studied in an attempt to evaluate and decide the optimal treatment of the patients with head and neek squamous cell carcinoma (HNSCC). A nuclear antigen Ki-67 is a proliferative marker of tumor cells in all phases of cell cycle except G0. c-met gene, the tyrosine kinase receptor for hepatocyte growth tactor, may play various roles in malignant transformation. The authors evaluated the prognostic significance of Ki-67 and c-Met in surgical specimens of HNSCC to determine the relationship with the various clinicopathological characteristics. Materials and Methods Formatin-fixed paraffin-embedded surgical specimens were obtained from 54 patients with HNSCC. Ki-67 and c-Met expressions were analyzed by immunohistochemical staning and were compared with the clinicopathological characteristics such as, pathologic differentiation, tumor stage, clinical stage and lymph node metastasis. Results Ki-67 and c-Met over-expression was detected in 66.7% and 90.7% in HNSCC. There was positive correlation of increased expression of Ki-67 with tumor stage. and clinical stage, increased expression of e-Met with tumor stage, clinical stage, and nodal status. The expression of c-Met had a significant positive relationship with Ki-67 index (p<0.05). Conclusion Therefore, Ki-67 and c-Met are useful markers of tumor progression, aggressiveness and prognosis in HNSCC.

Fracture of tracheostomy tube with subsequent migration into the tracheobronchial tree is rare, but tracheobronchial foreign body in child carries the potentially fatal risk of respiratory obstruction, We report a case of a 5-year-old girl who had aspirated a fractured tracheostomy tube which was removed under rigid bronchoscope.

Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. Occult bronchial foreign bodies arc rare in adults, whereas tracheobronchial aspiration of foreign bodies occurs commonly in children. A 65-year-old man with chronic cough, sputum production, and fever was transferred for treatment of right middle and lower lobc collapse and obstructive pneumonitis as evidenced by imaging studies. The patient was treated with right middle-lower bilobectomy because fiberoptic bronchoscopic removal of the foreign body failed. We report this case with review of literatures.

Epidermal cyst in the floor of mouth is relatively rare disease. Patients usually present soft and non-tender mass at the midline of mouth floor. Careful history taking and imaging study are needed for the diagnosis and surgical excision is the choice of treatment. We report a case of huge epidermal cyst located in the floor of mouth mimicking plunging ranula, which was successfully removed by transoral surgical excision without any complication. It was diagnosed as an epidermal cyst by pathologic examination.

Cystic hygroma is a rarc congenital malformation of the lymphatic system and seen rarely in adults. It represents an error in communication between the large draining lymphatic channels and the venous system, Conventional surgical excision remains the most popular method of treatment in many developing countries despite the dangers associated with treatment modality. We present a case of huge cervical cystic hygroma in a 26-year old female who was treated with OK-432 sclerotherapy.

Congenital esophageal stenosis due to tracheobronchial remnants is a rare anomaly, resulting in dysphagia and recurrent pneumonia, We have experienced three cases of csophageal stenosis due to ectopic tracheobronchial remnants and performed operative correction. Two patients were 20 months and five year old male with a chief complaints of swallowing difficulty from birth and the other was a twenty three year old female with a slowly increasing symptom of dysphagia for twenty years. Esophagogram of the patient with tracheobronchial remnants shows abrupt narrow segment at distal esophagus with marked proximal dilatation, and linear barium collections perpendicularly projecting from the stenotic esophagus. All of them were performed surgical correction by esophagectomy of the stenotic portion and esopahgo-gastrostomy with anti-reflux procedures, The resected specimens of these patients showed ectopic tracheobronchial chondroepithelial tissue within the esophageal wall histopathologically. Postoperative course was uneventful and have been in good condition without any problems.

Adenoid cystic carcinoma (ACC) of larynx is a rare disease, accounting for less than 1% of laryngeal malignancies, These tumors arise almost exclusively in the subglottic and supraglottic regions, while the proportion of glottic ACCs is small. We describe a case of a young man with a subglottis adenoid cystic carcinoma, The patient underwent laryngeal microscopic surgery and radiotherapy, Five years after radiotherapy, local recurrence and distant metastasis Clung and kidney) was detected and he underwent palliative chemotherapy and local treatment. He is still alive for seven years after the initial diagnosis. The treatment strategies for laryngeal ACC are still controversial due to the rarity of the condition. We suggest that multimodality approach may be helpful in deciding a treatment option, and thorough and consistent follow-up for recurrence is mandatory for these patients.