• Radiation Oncology Journal
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• 제30권1호
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• pp.36-42
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• 2012

Purpose: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Materials and Methods: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. Results: The mean radial displacements were 2.26 (${\pm}1.03$) mm in the control group and 3.05 (${\pm}1.97$) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. Conclusion: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

• 대한수의학회지
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• 제40권1호
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• pp.27-34
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• 2000

A 20-day-old female Diprosopia in Holstein calf was observsd macroscopically and radiographically. Anterior head duplication(Diprosopia) was observed and all structures caudal to it were normal. She had two muzzles, three eyes, two ears and two tongues. The tongues were joined at their base just posterior and had one hyoid bone. Schistognathia and cleft lips were also observed in the lower jaws. She had an oral cavity, single epiglottis and a laryngeal cavity communicated with one trachea. The cerebral hemispheres were duplicated and fused together in the caudal region. The olfactory and optic nerves were duplicated. The incisive, nasal, pterygoid, parietal, ethmoid bones and vomer were duplicated, respectively. The skull of Diprosopia was shared by an occipital bone. The mandibules, palatines and sphenoid bones were duplicated incompletely. Three orbits and two fontanelles were observed. The medial lacrimal bones and maxillae were duplicated incompletely and fused with each other, respectively. Cleft palates were observed. Medial mandibular mass which was fused together and was duplicated incompletely at the part of its cranial, was shown synchondrosis with the left mandible, but not with the right.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.95-95
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• 1993

상악암은 비교적 진행되어서야 발견되는 수가 많지만 경부 임파절 전이나 원격 전이는 다른 두경부 암에 비해 흔하지 않기 때문에 종양의 국소 억제가 치료의 성패를 좌우하게 된다. 그러나, 상악동은 안와나 두개저에 접하고 있어서 다른 악성 종양처럼 충분하게 안전한 절제연을 두고 제거하는 것이 불가능한 수가 많다. 한편 대부분의 시설에서 수술과 방사선요법을 단독 또는 병행요법으로 시행하고 있는데 그 치료성적이 보고자에 따라 다양하며 비교적 좋지 못한 형편이다. 저자들은 88년 t월부터 91년 12월까지 상악암으로 진단받고 동맥내 항암제 주입요법, 방사선 치료및 수술을 포함한 집합적 치료를 시행하였던 16례(전례 편평상피암, T2 1례, T3 6례, T4 9례, 평균 연령 57.2세)에 대하여 그 결과를 후향적으로 검토하였다. Kaplan-Meier법에 의한 5년 생존률은 51.95%였으며 안구나 구개, 안면 피부등을 일부 보존할 수 있었고 기능적으로도 만족할 만하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.604-607
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• 2008

턱밑 기관내 삽관술은 기본적인 수술적 술기가 필요하지만, 간단하고 안전하며 술식이 빠른 장점을 가지고 있다. 또한 술 중 악간 고정이 가능하며, 수술 시야를 확보할 수 있으며, 술 후 합병증이 적고 기관절개술로 인한 부작용을 줄일 수 있다는 장점을 가지고 있다. 따라서 기본적인 술기의 습득과 마취과와의 협조가 동반된다면 많은 분야에서 사용 될 수 있는 방법이라고 생각된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권5호
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• pp.383-389
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• 2002

This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

• Advances in pediatric surgery
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• 제2권1호
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• pp.64-67
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• 1996

1세된 남아에서 세열낭종을 의심한 좌측 경부 종양이 수술을 시행한 결과 고형종양이였고, 조직검사상 이소성 흉선으로 판명되었다. 술후 초음파상 흉선은 정상적으로 있었고, 현재 환자의 면역기능은 아무 이상없이 정상으로 자라고 있다.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.477-480
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• 2010

Purpose: Ganglioneuromas are well-differentiated tumors derived from neuroectodermal neural crest cells. Although these tumors can occur anywhere along the sympathetic chain from the base of the skull to the pelvic cavity, they usually develop in the posterior mediastinum and retroperitoneum these tumors are rarely found in the cervical region. Method: We report the case of a 16-year-old male patient with neurofibromatosis type 1 who was admitted because of a palpable mass centrally located on the left side of the neck. A preoperative contrast-enhanced neck computed tomography image showed a low-density homogeneous mass on the parapharyngeal space along with marked displacement of the trachea and carotid vessels. Round and soft masses were also detected on both axillae. Results: The patient subsequently underwent complete excision of the neck mass via the transcervical approach. The mass was smooth and well encapsulated between the sternocleidomastoid muscle and the trachea. Further, the mass appeared to arise from the cervical sympathetic chain, which was preserved during surgery. Both the axillary masses were also excised. The histopathological findings were ganglioneuroma for the neck mass and neurofibroma for both the axillary masses. Conclusion: Cervical ganglioneuromas are rare tumors that present as enlarging parapharyngeal cervical masses in the oropharynx or neck. To our knowledge, a case of cervical ganglioneuroma associated with neurofibromatosis type 1 has never been reported. In patients with neurofibromatosis, multiple tumors may develop, and therefore periodic clinical and radiological follow-up is recommended. Further, repeated imaging analysis should be performed if the presence of another tumor is suspected.

• 대한두경부종양학회지
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• 제32권2호
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• pp.91-94
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• 2016

A 37 year-old male presented with sudden right proptosis and bilateral nasal obstruction. A huge tumor was noted in bilateral nasal cavities, ethmoid sinuses and central frontal sinus on magnetic resonance imaging. Right posterior frontal sinus wall and bilateral medial orbital wall was destructed by the tumor. Complete resection of the tumor was performed via minimal invasive craniofacial resection. Histopaghologic examination revealed sinonasal undifferentiated carcinoma (SNUC). Cerebrospinal fluid leakage was developed after 2 days of the surgery. On the 5th day, anterior skull base was reconstructed with forearm free flap (FFF). The patient got 6000cGy of radiotherapy and survived in 27 months of follow up.

• Journal of Korean Neurosurgical Society
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• 제39권3호
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• pp.198-203
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• 2006

Objective : To evaluate the natural histories and growth rates of meningiomas, the authors perform this retrospective observational study and attempt to identify those factors predicting tumor growth. Methods : Between 1993 and 2004, a total of 83 patients were diagnosed by computed tomography[CT] scans or magnetic resonance[MR] imaging as having an intracranial meningioma, and were treated by observation only using regular clinical and radiological examinations. Twenty-six of these 83 patients, with available data were included in this study. Follow up periods ranged from 9 to 137 months [mean, 55.6 mo.; median, 60 mo.]. The tumor volumes, absolute growth rates, and tumor doubling times were calculated. Results : Patient age and sex distributions were comparable to those of other studies, but exceptionally 16 meningiomas [62%] were located at the skull base in the present study. During follow-up monitoring, the majority of meningiomas grew, though 77% showed low absolute annual growth rates [$<1cm^3/yr$]. The tumor doubling times ranged from 2.87 to 201.72 years [mean, 42.91 yr]. Based on Imaging analysis, peritumoral edema and the absence of calcification were probable factors predicting tumor growth. Tumor-related symptoms seemed to be slightly related to tumor growth. Other factors, e.g., gender, age, tumor location, and T2-weighted signal Intensities on MR imaging, were not significantly related to tumor growth. Conclusion : This study shows that the majority of meningiomas are slow growing. However, variations in tumor growth are unexplained, thus individualized optimal treatment strategies should be provided in each meningioma.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.128-132
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• 2001

뇌기저동맥 체간부에 존재하는 동맥류는 매우 희귀하며 그 수술적 치료는 복잡한 해부학적 구조와 근접해있는 중요한 신경혈관 구조때문에 수술적 접근이 매우 어려운 부위이다. 산화 단층촬영과 자기공명영상의 발달은 두개저 병변을 정확히 진단할 수 있게 하였고 두개저 부위의 수술적 접근에 많은 발전을 가져오게 하였다. 뇌기저동맥 체간부에 존재하는 동맥류의 수술 방법중의 하나로 저자들은 소뇌와 측두엽의 견인이 적어 소뇌 부종을 극소화 할 수 있고 와우, 미로, 안면신경등의 구조물을 보존하여 청력손실, 안면신경마비등의 합병증이 없고 횡정맥동, S상정맥동의 보존뿐만 아니라 Labbe's 정맥을 보존할 수 있으며 수술시야가 비교적 좋은 장점들이 있는 후미로 전S상정맥동 경천막을 통한 추체로접근법을 이용하여 뇌기저동맥 체간부에 발생한 동맥류의 직접 결찰수술을 시행하여 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.