• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.37-40
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• 2023

Schwannoma is a slow growing benign tumor that can occur anywhere in our body. About 25~45% cases of schwannomas occur in the head and neck, but intra-thyroidal schwannomas are very rare, and mostly are diagnosed by post-thyroidectomy pathologic study. In this article, we present a case of intra-thyroidal schwannoma diagnosed preoperatively with core needle biopsy. The patient underwent enucleation of the thyroid tumor, and the pathology of the tumor was confirmed as schwannoma. Few cases of intra-thyroidal schwannomas have been reported in the literature, but none of them have been diagnosed through core needle biopsy preoperatively. Preoperative diagnosis of intra-thyroidal schwannoma can be helpful when determining appropriate surgical extent and avoid unnecessary thyroidectomy.

• Korean Journal of Head & Neck Oncology
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• v.28 no.1
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• pp.8-11
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• 2012

배경 및 목적 : 섬유소 응고제(fibrin sealants)는 다양한 두경부수술에서 지혈목적으로 사용되고 있다. 본 연구의 목적은 배액관을 삽입하지 않는 갑상선 수술에서 섬유소 응고제의 효용성과 안정성을 알아보고자 하였다. 재료 및 방법 : 최근 1년간 108명의 갑상선 수술환자 중에서 수술 후 배액관의 삽입없이 수술을 받은 103명의 환자를 대상으로 하여 임상적인 특징을 분석하였다. 결과 : 103명의 대상환자 중에서 남성은 16예, 여성은 87예였다. 대상환자의 평균연령은 $46.7{\pm}13.0$세였고, 연령분포는 17세에서 72세였다. 갑상선 종물의 평균크기는 $2.08{\pm}1.61cm$였고, 종물의 크기는 최소 0.2cm에서 최대 10.0cm까지의 분포를 보였다. 수술에는 갑상선 엽절제술이 5예, 갑상선반절제술이 41예, 아갑상선 절제술이 8예, 갑상선 전절제술이 6예, 갑상선 전절제술과 중심경부림프절 절제술이 37예, 갑상선 전절제술과 선택적경부림프절 절제술이 6예가 있었다. 수술 후 합병증은 11예(10.6%)에서 발생하였고, 발생한 합병증으로는 장액성종창이 3예, 혈종이 1예, 일측성 성대마비가 3예, 저칼슘혈증이 4예 있었다. 성대마비는 수술 후 3개월 이내에 모두 호전되었고, 장액성 종창은 반복적인 세침흡인으로 호전되었다. 1예의 혈종은 지연성으로 발생하였고, 수술 후 5일째에 수술을 통해 제거하였다. 결론 : 이러한 결과에 근거하여 갑상선 수술에서 섬유소 응고제의 사용은 다양한 갑상선 수술에서 효과적인 지혈과 함께 안전하게 사용될 수 있으며, 배액관의 삽입을 감소시켜 줄 수 있을 것으로 생각된다.

• Journal of Oral Medicine and Pain
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• v.19 no.2
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• pp.81-97
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• 1994

두개하악장애는 환자의 신체적 소인, 관련조직의 구조적 변화, 정신적 스트레스 등의 복합적 요인에 의 발생하는 다인성 질환으로 최근 대두되는 원인중의 하나가 신체, 특히 두경부의 자세이상이다. 비정상적인 두경부자세는 하악의 위치변화를 수반하여 종종 두개하악장애를 야기시키게 되나 이를 설명할 수 있는 과학적 증거는 아직 부족한 실정이다. 저자는 두경부 자세가 교합장치물에 의해 변화되는지를 저작근의 근전도학적 측면에서 규명하고자 21세에서 26세의 치과대학생으로 치아상실 및 교합간섭이 없고 두 개하악장애의 증후 및 경부운동제한을 가지지 않은 정상인 20명을 대상으로 각도계를 사용하여 시상면상에서 인위적으로 유도한 세 가지의 두경부자세변화 (0$^{\circ}$, 30$^{\circ}$ 굴절, 45$^{\circ}$ 신전)에 따른 교합안정장치의 장착(1시 간) 전후 및 안정위와 근접촉위(초기치아접촉위)에서의 두경부 근육(측두근, 교근, 악이복근)의 근전도를 Bioelectric Microprocessor EM2ⓡ를 사용하여 측정한 후 통계학적으로 비교, 분석, 평가하여 다음과 같은 결과를 얻었다. 1. 교합안정장치 장착전 하악 안정위 및 근접촉위에서 두부의 30$^{\circ}$굴절은 악이복근의 근활성도를, 45$^{\circ}$신전은 교근 및 악이복근의 근활성도를 증가시켰다.(p<0.05) 2. 교합안정장치 장착후 하악 안정위에서 두부의 30$^{\circ}$굴절은 악이복근의 근활성도를, 45$^{\circ}$신전은 교근 및 악이복근의 근활성도를 증가시켰으며, 하악 근접촉위에서 두부의 45$^{\circ}$신전은 악이복근의 근활성도를 증가시켰다(p<0.05). 3. 교합안정장치 장착 전후 및 두부의 30$^{\circ}$굴절, 45$^{\circ}$신전에 따른 측두군 및 교근의 하악 근접촉위에서의 근활성도가 안정위에서의 근활성도에 비해 유의한 증가를 나타냈다(p<0.05).

• Radiation Oncology Journal
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• v.18 no.2
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• pp.127-132
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• 2000

Purpose : To determine if the tumor intersitial fluid pressure (TIFP) and/or its change in patients with metastatic Iymph node in head and neck area can predict radiotherapy outcome. Materials and Methods : In 26 biopsy Proven metastatic Iymph node Patients in head and neck area with accessible by direct inspection and palpation, and of sufficient thickness (>1 cm) to permit accurate needle placement, we measured TIFP at cervical Iymph node before and during radiotherapy. Tumor size was measured clinically and radiologically. Results : The mean preradiotherapy TIFP was 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). Preradiotherapy TIFP significantly decreased when tumor size decreased (p=0.009). Preradiotherapy TIFP was not different between complete response group and group with partial or less response (p=0.75). Radiotherapy outcome was not different between group with above and group with below than average TIFP (p=0.229). TIFP decreased 36mmHg in complete response group and 29.7 mmHg in group with partial or less response. Conclusion :The mean TIFP was elevated with 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). TIFP decreased 36 mmHg in complete response group and 29.7 mmHg in group with partial or less respone but there was no statistically significant relationship in two groups.

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.569-584
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• 1997

The present study assessed the effects of Rapid Maxillary Expansion on head posture and hyoid bone position. For this study, 32 Angle's class III patients - hellman 3c $\~$ adult stage, mean age 12y9m - were selected and divided into two groups, A,B according to craniocervical angulation. Craniocervical angulation Increased in Group A and decreased in Group B after the therapy. And 23 Angle's class I persons $\~$ same hellman stage, mean age 12y7m $\~$ were selected (or the control group. Cephalometric analysis of skeletal pattern, pharyngeal space, head posture, hyoid bone position was performed. The results were as follows, 1. Comparison of skeletal pattern and pharyngeal space 1) All two groups(A,B) had Mandibular plane inclined inferiorly and no pharyngeal space change was obseved after RME therapy 2) Skeletal pattern and pharyngeal space of Group A, B were normal before and after treatment. 2. Comparison of head posture 1) Craniocervical angulation of Group A was increased after treatment. That of Group B was decreased and mandibular plane was inclined inferiorly after treatment. 2) Before treatment, craniocervical inclination was normal in Group A but larger than normal in Group B. After treatment, all two groups(A, B) had normal craniocervical angulation. 3. Comparison of hyoid bone position 1) After treatment, long axis of hyoid in Group A, B was not changed. Antero- posteriorly, hyoid position was changed posteriorly in Group A but no change was founded in Group B after treatment. Vertically, hyoid bone position were not changed in two groups except increase in APHFH in Group A after treatment 2) Long axis of hyoid bone was normal in Group A, B before and after treatment. Anteroposteriorly, hyoid bone position was more anterior than Group B, C before treatment but all the position of two groups had normal position after treatment. Vertical position of hyoid bone was normal in all two groups before and after treatment.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.23-28
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• 2018

Background/Objectives: Adenoid cystic carcinoma is the second most common salivary carcinoma. It occurs commonly in the submandibular gland, sublingual gland and minor salivary gland. Local recurrence and distant metastasis are the leading cause of death. The aim of this study was to evaluate long-term oncologic outcomes of patients with head and neck adenoid cystic carcinoma focusing on distant metastasis. Materials & Methods: We retrospectively studied 39 patients who were diagnosed with and treated for adenoid cystic carcinoma of the head and neck from December 1996 to May 2018. The clinicopathologic characteristics of patients such as age, sex, primary site and TNM stage, and treatment methods, recurrence and distant metastasis after treatment, survival rate, and treatment method for recurrence were analyzed. Results: Of 39 patients, 18 were males and 21 were females, and the mean age was $5.9{\pm}14.4$ (28-89) years. The most common primary site was oral cavity (12 cases), and followed by sino-nasal cavity (11 cases), parotid gland (5 cases), and etc. For treatment, 17 patients underwent surgery alone, 16 received surgery with postoperative radiation therapy, and 3 patients received radiation therapy only. Three patients refused any further treatments. Recurrence occurred in 15 patients. The most common site of recurrence was the lung. The mean time to recurrence was 31.7 months. The 5 and 10 years' overall survival rate was 79.3% and 74%, respectively. The 2 and 5 years' overall survival rate was 69.6% and 62.6% in patients with distant metastasis. Conclusion: Distant metastasis is an important prognostic factor in adenoid cystic carcinoma, and eventually one third of patients have distant metastasis, especially in the lung. An appropriate treatment for lung metastasis is necessary because some patients with pulmonary metastasis survive for a quite long time.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.20-20
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• 1991

악성종양의 발생과 진행에 면역 방어기능이 중요한 역할을 하리라는 가설은 모두가 공감하는 사실이다. 이중 T-lymphocyte와 Natural killer cell (이하 NK cell이라함)은 종양 면역학에 특히 중요한 임파구로 이런 임파구의 혈액분포양상은 면역방어기능을 짐작할 수 있는 간접적인 자료가 될 수 있다. 저자들은 치료전 두경부 악성종양환자에서 혈액을 채취하여 T-lymphocyte와NK cell의 분포양상을 검사하고, 방사선치료 환자에서는 NK cell activity를 측정하였기에 다음과 같은 결과를 보고하는 바이다. 1) 두경부 악성 종양 환자군에서 CD3+ cell은 감소하고 NK cell은 증가하며 CD4/CD8 비율은 변화가 없었다. 2) 병변이 진행되면서 CD3+ cell과 CD4+ cell은 감소하고 NK cell은 증가하였으며 CD4/CD8 비율의 변화는 없었다. 3) 방사선치료에 의해 CD3+ cell과 CD4+ cell, CD4/CD8 비율은 감소하였고, NK cell과CD8+cell은 증가하였다. 4) 방사선치료에 의한 CD4/CD8 비율의 감소와, CD8+ cell의 증가는 NK cell의 증가에 의한 것이라 추정되고, NK cell을 제외하면 CB4/CD8 비율의 변화는 없었다. 5) 방사선치료 환자에서 NK cell activity는 증가하였고, 이런 증가가 T-lymphocyte기능의 감소를 보상해 주고 있었다.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.281-285
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• 2018

Columnar cell variant of papillary thyroid carcinoma (CCV-PTC) is a rare variant representing 0.15-0.2% of all PTCs. The CCV is aggressive, due to its rapid growth, high local recurrence rate, and frequent lung, brain and bone metastasis. Aggressive surgical and medical management are recommended for these neoplasias. The authors experienced a case of CCV-PTC in a 45-year-old man. We performed total thyroidectomy with neck dissection. The patient received radiation and radioactive iodine therapy. There were no recurrences or complications in the following 24 months after the operation. The patient will closely undergo continuous follow up. We present the clinical characteristics, pathology, treatment, and prognosis of the tumor with a review of the literature.

• Korean Journal of Head & Neck Oncology
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• v.23 no.1
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• pp.41-45
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• 2007

A 60 years old female patient presented with $8{\times}6\;cm$ sized painless oval mass in the left parietal region. She had left lobectomy of thyroid gland 10 years ago. Cranial CT, MRI, FGD PET-CT showed a solid mass which invaded left parietal bone. After embolization, craniectomy with tumor excision was performed. Histological examination revealed metastatic follicular cancer originated thyroid gland, with vascular and dura invasion. Postoperatively, neck CT showed right thyroid multiple nodules and right level III multiple lymph node enlargement. Thyroid function test was normal, but level of thyroglobulin was high (72ng/ml). So she had right lobectomy of thyroid gland with lymph node dissection under a diagnosis of follicular carcinoma. But histological examination revealed adenomatous hyperplasia and not lymph node metastasis. After operation, she received radioiodine therapy of 150mCi and then the level of thyroglobulin normalized (8.4ng/ml). The patient is under follow-up since she had operation 4 months ago.

• Korean Journal of Head & Neck Oncology
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• v.29 no.1
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• pp.18-21
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• 2013

랑게르한스 세포 조직구증은 골수에서 유래하는 랑게르한스 세포 조직구의 이상 증식에 의해 발병하는 희귀한 질병으로 알려져 있다. 비록 모든 장기에서 발생 할 수 있으나 갑상선을 침범하는 경우는 매우 드물다. 18세 남자가 5달전부터 점점 커지는 갑상선 종괴를 주소로 내원하여 세침흡인 세포검사, 총샘검, 경부 전산화단층촬영을 시행하였다. 세침흡인 세포검사에서 악성신생물이 의심되었고, 총생검에서 랑게르한스 세포 조직구증으로 나타났다. 경부 전산화단층촬영에서는 우측 갑상선에서 윤곽이 잘 구분되는 저음영의 종괴와 우측 기관 주위 림프절의 종대가 관찰되었다. 갑상선 전절제술과 우측 중앙 선택적 경부 림프절 청소술이 시행되었다. 랑게르한스 세포 조직구증이 갑상선을 침범하는 경우는 드물지만 갑상선 비대가 있는 환자가 뇌하수체 기능부전의 증상이나 뼈와 폐의 침범과 관련된 증상을 호소한다면 갑상선의 랑게르한스 세포 조직구증 침범을 고려해야 한다. 또한, 다른 장기의 랑게르한스 세포 조직구증을 치료한 과거력이 있는 경우는 갑상선 종괴를 감별 진단하는데 있어 랑게르한스 세포 조직구증을 고려해야 한다.