신생아에서 발생한 선천성 후두개 낭종 1례

서덕중,이준규,Seo, Deok-Jung,Lee, Joon-Kyoo 대한기관식도과학회 2007 大韓氣管食道科學會誌 Vol.13 No.2

Congenital epiglottic cyst is rare cause of stridor in neonate and if managed inadequately, disaster such as death can occur. Diagnosis of congenital epiglottic cyst includes imaging studies and endoscopy. Fiberoptic or rigid endoscopic examination excludes other causes of stridor in neonate. Complete excision of cyst is treatment of choice under suspension laryngoscopic guidance. Here, we report a case of congenital epiglottic cyst and concomitant laryngomalacia presenting with seizure and respiratory difficulty in neonate with a review of literature.

돌발성 난청 환자에서 청력 변화에 대한 연구

이준규,서덕중,조형호,조연,김행재,조용범 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.7

Background and Objectives:Sudden sensorineural hearing los is a disease that is developed within several hours to several days, but its etiology is not verified yet. Therefore, no specific regimen is available for the treatment of this disease. patients through many variables known as prognostic factors. The author also tried to find a relationship betwen the hearing recovery patterns and the prognostic factors that were not established yet. Materials and Method:Clinical analysis was performed in 173 patients with sudden hearing los admitted in Chonnam National University Hospital from January 1996 to July 2001. Results:Recovery was sen in 104 cases out of 173 cases, with the total recovery rate of 60.1% . Patients who (p≤0.05). The recovery rate was better for the moderate-severe, and severe hearing loss (p≤0.05). Patients of all audiograms except the profound one had a better recovery rate (p≤0.05). Among the patients who had been treated within a week, the dizzy pat-ients had the lower recovery rate than the non-dizzy patients (p≤0.05). Other factors such as age and sex, tinitus and ear fulness as accompanying symptoms, the site of disease, and the presence of underlying disease were not related with progn-osis. Conclusion:The recovery rate was beter in patients who had been treated within a week, and for those whose hearing was moderate-severe and severe, and their audiogram upsloping, V-shape, flat, and downsloping, and who were not dizzy. (Korean J Otolaryngol 2002;45:656-61)

두경부 편평세포암종에서 Matrix Metalloproteinase-2,-9의 발현과 경부 림프절 전이의 피막외 파급의 관련성

조재식,김정현,임상철,조연,서덕중,박창수 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.7

Background and Objectives:Cervical lymph node metastasis is the most important prognostic factor in head and neck squamous cell carcinoma (HNSC ). Further, it is important to predict extracapsular spread (ECS) before treatment, because ECS makes prognosis worse. It has been well established that matrix metalloproteinases (MMPs) expression correlates with cervical lymph node metastasis, but studies on its involvement in extracapsular spread are not enough. The aim of this study was to investigate the correlationship between extracapsular spread of cervical lymph node metastasis and expression of ma-trix metaloproteinases in the primary sites of head and neck cancer and metastatic cervical lymph nodes. Subjects and Method:An imunohistochemical study was caried out using monoclonal antibodies to MMP-2, MMP-9 on tissue obtai-ned from 46 patients with head and neck cancer who underwent a surgery of primary tumor removal and neck dissection. We evaluated corelations betwen the expresions of MMP-2, MMP-9 in the primary tumor and ECS of metastatic lymph nodes, Results:The result showed that while there is no significant correlation between expressions of MMP-2, MMP-9 in primary tumor and ECS of cervical lymph nodes, expresions of the MMPs in the positive lymph nodes and ECS of the lymph nodes have significant relationships. Conclusion:Expression of MMP-2,-9 may play a pivotal role in extracapsular spread beyond lymphatic metastasis and in the progresion of HNSC. (Korean J Otolaryngol 2002;45:687-92)

조기 성문암에서 방사선치료 반응 예측 인자로서 bcl-2, c-myc, EGFR의 면역조직화학적 연구

조재식,임상철,나애선,서덕중,김창국 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.2

Background and Objectives:of radiotherapy is the preservation of good voice quality after treatment but the main problem is increased complications in the salvage surgery when local control fails. So, it is important to predict the success of radiotherapy. The purpose of this study is to find predictable factors of the radiosensitivity in the early glotic cancer. Materials and Method:Imunohistochemical staining was performed on the parafin sections of the biopsy specimens of 57 patients with early glottic cancer who had undertaken the anti-bcl-2 monoclonal antibody, the anti-c-myc monoclonal antibody, and the anti-EGFR monoclonal antibodies. The relation betwen the local control outcome after radiotherapy and the result of imunostaining was analyzed by the chi-square and the Fishers exact test. Results:Positive expresion of bcl-2 was 21.1% in the local controlled group and 12.3% in the uncontrolled group. There was no statistical significance between two groups. The expresion rate of c-myc was statisticaly higher in the controlled group (36.8%) than in the uncontrolled group (7.0%) (p=0.025). Expresion of EGFR was 57.9% in the controlled group and 22.5% in the uncontolled group. However, there was no statistical significance betwen two groups. Conclusion:The relation betwen the positive c-myc expression and the radiosensitivity sugests that c-myc might be a predictable factor of the radiosensitivity in early glottic cancer. (Korean J Otolaryngol 2003 ;46 :134-8)

두경부 혈관부종에 대한 임상적 고찰

이준규,최현석,윤태미,김각,서덕중,임상철 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.8

Angioedema is a localized, nonpitting edema resulting from extravasation of fluid into the interstitial space. It usually develops suddenly and fades during the course of 24 to 48 hours. However, angioedema of the upper respiratory tract can result in serious acute respiratory distress, airway obstruction, and death. The purpose of this study was to analyze clinical characteristics of angioedema in the head and neck. Subjects and Method:A review of 144 patients with angioedema of the head and neck over 3-year period was conducted. Results:The presumptive causes were 115 allergic reactions to food, drug, or environmental exposure, 3 losses of C1 esterase inhibitor, 1 angiotensin-converting enzyme inhibitor use, and 25 idiopathic conditions. The main locations of the edema were 100 face/lips, 4 oral cavity/oropharynx, 5 larynx/hypopharynx, and 35 multiple sites of the head and neck. Most of patients were treated with steroids and H1 and H2 blockers. All of 7 patients with low oxygen saturation and 14 out of 18 patients with hypotension on arrival were improved within 24 hours. There were 4 patients with airway distress treated with urgent airway intervention, three of them were completely recovered within 110-240 hours but one of them died of the disease. Patients with the cause of idiopathic and loss of C1 esterase inhibitor were found to stay longer in the hospital over 48 hours (p<0.05). Conclusion:Angioedema of the head and neck usually responds well to the treatment. However, there might be cases with life-threatening airway obstruction. (Korean J Otorhinolaryngol-Head Neck Surg 2008;51:726-30)

비인강암에서 방사선치료와 항암화학요법의 병행요법의 예후인자로서의 의의 및 치료성적

임상철,조재식,조연,김판수,이준규,서덕중 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.9

Background and Objectives:The diagnosis of a nasopharyngeal carcinoma is frequently made at an advanced stage. The anatomic complexicity of the nasopharynx makes a surgical approach difficult, so the radiation therapy is traditionally used as a primary option. Because of the high incidence of a locoregional failure folowing the radiotherapy and the distant metastasis, the combined treatment modality with the chemotherapy has been applied. The author attempted to investigate the clinical characteristics and the treatment outcomes of nasopharyngeal cancer patients treated with the combination of the radiotherapy and the chemotherapy. Subjects and Method:We retrospectively analyzed 82 patients who were diagnosed with the naso-pharyngeal carcinoma in Chonnam National University Hospital. Results:The cumulative survival rates for a 5-year period were 42%. The pathologic type, the clinical stage, the cranial nerve invasion, and the response to the radiotherapy were related to the survival rate of the Kaplan-Meier test (p<0.05). In the Cox proportional hazard model, only the response to radiotherapy was related to the survival rate (p=0.05), as the clinical stage wasnt (p=0.06). In the multivariate analysis betwen the responses to radiation and the clinical factor, the histological type (p=0.018) and the response to the chemotherapy (p=0.021) was statisticaly significant. Conclusion:The response to radiation is the most important in the patients survival. The cli-nical stage is a probable prognostic factor. Factors affecting the response to radiation are the histological type and the response to chemotherapy. (Korean J Otolaryngol 2002;45:897-901))

비강 및 부비동의 반전성 유두종에서 인유두종바이러스검출과 p53및 c-erbB-2의 발현

조재식(Jae Shik Cho),백준(Joon Baik),임상철(Sang Chul Lim),조연(Yeon Cho),윤제환(Je Hwan Yoon),서덕중(Duk Jung Seo),박창수(Chang Soo Park) 대한두경부종양학회 2001 대한두경부 종양학회지 Vol.17 No.2

Background: Inverted papilloma(IP) of the nasal cavity and paranasal sinuses is a benign neoplastic condition that can be associated with squamous cell carcinoma (SCC). Several studies have indicated an etiologic role for viruses in the development of inverted papilloma. And it is necessary to find out the significance of a biologic markers such as p53, c-erbB-2 to predict the malignant potential. The purposes of this study are to detect HPV in inverted papilloma of the nasal cavity and paranasal sinus, to examine role of HPV as an etiological agent, to examine the relationship between HPV subtype and malignant transformation of inverted papilloma, and to investigate the relation between expression rate of p53, c-erbB-2 and HPV in recurrent or malignant transformation cases. Material and Methods: Thirty two cases of inverted papilloma(IP) in the nasal cavity and paranasal sinuses were reviewed and classified into 3 groups; simple IP, IP with dysplasia group, IP with squamous cell carcinoma group. Paraffin embedded achival tissue was used in this study. The HPV was detected by in situ hybridzation (ISH) using HPV type 6/11, 16/18, 31/33/35 DNA probes. Expression of p53 and c-erbB-2 was examined by immunohistochemical staining. Results: 1) The HPV was detected in 6(19%) out of 32 cases. 2) The HPV 6/11 was dectected in 4 out of 21 cases of simple IP, HPV 16/18 in 1, HPV 31/33/35 in lout of 8 cases of IP with dysplasia respectively. 3) The positive expression of p53 was 13 cases out of 32 cases; 2 out of 21 cases of simple IP, all of 8 cases of IP with dysplasia and 3 cases of IP with squamous cell carcinoma 4) The positive expression of c-erbB-2 was in 24 out of 32 cases; 16 out of 21 cases of simple IP, 6 out of 8 cases of IP with dysplasia, 2 out of 3 cases of IP with squamous cell ca. 5) The recurrence of IP occurred in lout of 6 cases of positive for HPV, in 4 out of 26 cases negative for HPV. 6) The recurrence of IP occurred only in positive cases for p53. 7) The recurrence of IP occurred in 4(17%) out of 24 cases positive for c-erbB-2, in 1(13%) out of 8 cases negative for c-erbB-2. Conclusion: The p53 expression was associated with Inverted papillomas exhibiting evidence of malignant transformation. Also, there was a correlation between the p53 expression and recurrence.