• 대한기관식도과학회지
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• 제8권1호
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• pp.42-49
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• 2002

Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.263-268
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• 1998

이상에서 저자 등은 $T_{1-3}$의 편평상피 세포암의 3증례에서 적출 후 연조직 결손부의 재건을 위해 Tashiro 등에 의해 변형된 Farr등의 경부 도상 피판을 이용하여 술후 특이한 합병증 없이 성공적인 결과를 얻을 수 있었다. 피판 작도시 부피의 한계와 경부 임파절의 전이나 혹은 예방적으로 경부에 3 Gy 이상의 방사선을 투여 받은 환자에서의 사용의 제한점에도 불구하고, 경부도상 피판은 결손 부위에 따른 피판의 다양한 변형이 가능하며, 적출과 동시에 빠르고 간단하게 효과적으로 결손부를 재건할 수 있으며, 공여부에 대한 피부이식이 필요하지 않고, 부가적으로 수술 시간과 입원 기간의 단축을 초래해 환자들의 삶의 질을 높일 수 있다고 사료된다.

• 한국임상수의학회지
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• 제30권3호
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• pp.214-217
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• 2013

3세령의 암컷 고슴도치(Atelerix albiventris)가 심하게 종대된 하악 병변의 평가를 위해 내원하였다. 세포학적 검사를 위해 세침흡인을 실시하였으며, 도말표본을 제작 후 로마노프스키식 염색으로 염색하였다. 세포학적 검사에서 원형을 포함한 다양한 모양의 편평상피세포가 주로 관찰되었으며, 일부 세포는 유사 방추 모양 또는 매우 길쭉한 모양을 띄고 있었다. 세포학적 소견은 편평상피암종이었으며, 조직검사를 위해 수술적으로 제거하였다. 조직병리상 악성 편평상피암종세포들이 중등도의 콜라겐과 방추형 섬유모세포로 이루어진 간질에 둘러싸여 있었으며, 인접한 골격근과 골조직으로의 침습이 관찰되었다. 종양세포는 중등도의 세포 대소부동과 핵 대소부동을 보였으며, 중등도 이상의 각화상태를 보였다. 종양의 중심부에서는 극세포해리가 있었으며 림프형질세포 및 호중구성 염증소견이 동반되었다. 유사 분열상은 고배율에서 2-3개가 관찰되었다. 이와 같은 소견에 기초해서 편평상피암종으로 진단하였으며, 보호자는 종괴의 수술적 제거 후 더이상의 치료를 원치 않아 바로 퇴원하였다. 환자는 추가 처치 없이 3개월 생존 후 폐사하였다.

• 대한두경부종양학회지
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• 제17권2호
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• pp.179-184
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• 2001

Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.528-534
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• 2005

Angiogenesis is important for the growth and metastasis of solid tumors. Some growth factors, inflammatory cytokines, and angiogenin are known to promote tumor angiogenesis. Among them, Vascular endothelial growth factor (VEGF) is the most intriguing factor in regard to tumor angiogenesis. Inhibition of VEGF activity by neutralizing antibodies or by the introduction of dominant negative VEGF receptors into endothelial cells of tumor-associated blood vessels resulted in the inhibition of tumor growth and in tumor regression, indicating that VEGF is a major initiator of tumor angiogenesis. VEGF promotes angiogenesis through their receptors, Flt-1 and Flk-1/KDR. on vascular endothelial cells. These two receptors were usually believed to be expressed specifically on vascular endothelial cell. Several reports have now shown that VEGF is not only significantly associated with microvessel density but also has prognostic value in both node-negative and node-positive oral squamous cell carcinoma. For many years several histologic features of the neoplasms are being considered when assessing the influence of malignancy grading on recurrence and prognosis. Among the characteristics investigated, degree of keratinization, nuclear pleomorphism, mode of invasion, microscopic depth of invasion, intravascular invasion, lymphocyte infiltration, and number of mitoses have been considered as important prognostic factors. So, this study was conducted to evaluate the correlation of vascular endothelial growth factor expression with malignancy in paraffin-embedded biopsy specimens from 11 patients with tongue cancers. Our results showed that high immunoreactivity specimens of VEGF expression were significantly lower keratinization degree and more pronounced nuclear pleomorphism than in low immunoreactivity specimens. Thus, VEGF expression could be used as a prognostic marker in tongue cancer.

• 한국미생물·생명공학회지
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• 제22권4호
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• pp.368-372
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• 1994

Three more unusual macrolides in addition to concnamycin B were isolated from the mycelium of Streptomyces sp. strain Bal6. These four compounds showed a potent cytotoxity to hunian cancer cell lines, SNU-1 (stomach cancer cell line), SNU-354 (liver cancer cell line), MCF- 7 (breast cancer cell line) and KB-3-1 (oral epidermoid carcinoma cell line). Interestingly, these compounds confered slight differential cytotoxity on RHEK-1, a human epidermal keratinocyte cell line immotalized by AD12-SV40 hybrid virus and RHEK-1/pSV$_{2}$ ras which was resulted from H-ras transfomation of RHEK-1. These compounds were determined to be concanamycin A, conca- namycin E and 0-methyl concanamycin B by NMR and other spectral analysis.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1087-1092
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• 1992

We underwent two surgical resection of synchronous primary esophageal squamous cell carcinoma and gastric adenocarcinoma after obtaining histologic comfirmation 74-years old male pateint was recieved esophagectomy & total gastrectomy with esophagojejunostomy and 59-years old man was recieved near total esophagectomy and total gastrectomy with esophagocolo-gejunostomy. Their was no postoperative complications. The hospital day was 15 and 21 days postoperatively. All of them started oral intake at 7 days postoperatively and possible soft diet soon. We conclude that total resection of esophagus and stomach is the recommendable methods for prolong the life of double primary cancer patients of esophagus and stomach. Also, the reconstruction of the esophagus with colon or jejunal transposition is one of the recommenable procedure for curative surgical resection of double primary cancer in esophagus and stomach. And we also wish to emphasize the importance of detailed preopertive gastric examination for detect of gastric lesion and of careful intraoperative inspection of the gastric mucosa in patients with esophageal cancer whose preoperative gastric examination provide inconclusive evidence due to the severe esophageal stenosis.

• Journal of Chest Surgery
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• 제20권2호
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• pp.374-378
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• 1987

Plummer-Vinson syndrome is also termed Paterson-Brown-Kelly syndrome and sideropenic dysphagia, because it was described originally by Paterson and Kelly in 19`19 and it was often combined with iron-deficiency anemia. The syndrome is encountered most often in middle-aged anemic female. It is characterized by dysphagia referred to the upper esophagus, atrophy of the oral or pharyngeal mucous membranes, koilonychia, and stenosis or webs of the upper esophageal mucosa. And it is also related to the late occurrence of the carcinoma of the upper esophagus. Here is presented a case of upper esophageal web with dysphagia and iron-deficiency anemia with review of literature, which was treated by the surgical esophagoplasty to relieve the symptom of dysphagia and to widen the upper esophageal narrowing.

• 음성과학
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• 제9권4호
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• pp.3-14
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• 2002

VPI occurs when the velum and lateral and posterior pharyngeal wall fail to separate the nasal cavity from the oral cavity during deglutition and speech. There are a number of congenital and acquired conditions which result in VPI. Congenital conditions include cleft palate, submucous cleft palate and congenital palatal insufficiency (CPI). Acquired conditions include carcinoma of the palate or pharynx and neurologic disorders. The speech characteristics of VPI is characterized by hypernasality, nasal air emission, decreased intraoral air pressure, increased nasal air flow, decreased intelligibility. VPI can be treated with various methods that include speech therapy, surgical procedures to reduce the velopharyngeal gap, speech aid prosthesis, and combination of surgery and prosthesis. This article describes four cases of VPI treated by speech aid prosthesis and speech therapy with satisfactory result.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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• pp.6.2-6
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• 1978

Granular Cell Myoblastoma는 근육에 발생하는 극히 드문 종양으로 1931년 Ahrikossott 씨가 성대에서 발생한 것을 처음으로 보고 하였다. 호발부위는 설이며 그외 구강의 다른 부위나 후두, 기관에 생길 수 있다. 이 질환은 그 상부점막의 가성상피증식이 동반되는 수가 많으므로 악성종양으로 혼동되기 쉬운 점 때문에 임상적으로 중요하다. 저자들은 17세된 여자로서 3년간 계속된 사성을 주소로 내원하여 수술받은 성문하부의 granular cell myoblastoma 1례를 경험하였기에 문헌고찰과 더불어 보고하는 바이다.