비인두에 발생한 골수외 형질세포종 1예

최혁기,조광재,박현진,최지영 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.1

Multiple myeloma, solitary bone plasmacytoma, extramedullary plasmacytoma, plasmablastic sarcoma, and multifocal form of tumors and is found predominantly in the head and neck region. This tumor is a solitary tumor consisting of monoclonal plasma cell proliferation that occurs in soft tisues other than bone. The frequent sites in the upper aerodigestive tract are the paranasal sinus and the nasal cavity. Because the diagnosis is based on imunophenotypical finding of monoclonal plasma cels and there the nasopharynx has rarely been reported. We experienced a case of nasopharyngeal extramedullary plasmacytoma which was treated with combined therapy. So we report this case with a review of literatures.

면역부전환자에서 호흡부전을 유발한 침습성 기관-기관지 아스페르길루스증 1예

최혁기,조광재,김형태,조승호 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.9

Aspergillus infection localized to the tracheobronchial tree is an unusual form of invasive aspergillosis in which patients are usually immunocompromised. The infected airway may produce mucosal exudates and become obstructed partially or completely with fungal plugs and pseudomembranes. Microscopically, the superficial portion of the airway wall is acutely inflammed and invaded by fungal hyphae. We recently experienced a case of invasive aspergillus tracheobronchitis that occurred in a 43 yearold woman with acute lymphoblastic leukemia, for which she had received a 2nd consolidation chemotherapy. We report this case with a review of literatures. (Korean J Otolaryngol 2003;46:783-6)

기니픽 와우신경절에서 성체신경줄기세포의 분리 배양

최혁기 ( Hyeog Gi Choi ),김창현 ( Chang Hyun Kim ),박시내 ( Shi Nae Park ),최미영 ( Mi Yung Choi ),남승규 ( Seung Gyu Nam ),박성천 ( Sung Chun Park ),이성재 ( Sung Jae Lee ),이종민 ( Chong Min Lee ),이세윤 ( Sei Yun Lee ),여상원 ( 한국조직공학·재생의학회 2009 조직공학과 재생의학 Vol.6 No.4

The somatic stem cells in the auditory organs can be utilized for the treatment of sensory neuronal hearing loss. The aim of this study was to isolate and culture of adult stem cells from guinea pig spiral ganglion in order to investigate the presence of soamtic stem cells in auditory organs of adult mammals. Spiral ganglions were obtained from the cochlea of guinea pigs, which weigh about 300 g. The tissues were dissociated and cultured in a medium added with epidermal growth factor and fibroblast growth factor. Then they were labeled with many markers for the stem cells and their differentiated cells, and identified under immunofluorecence microscope to find out the presence of somatic stem cells. The cultured cells can differentiate into neuronal cells positive for β III tubulin and glial cells positive for S-100. They were confirmed to be differentiated cells from neurosphere as the positive results for known stem cell marker such as bromodeoxyuridine(BrdU) and nestin. It was confirmed that the neural stem cells were existed in the spiral ganglion of guinea pig, which have the capability of self renewal and differentiation into specific neural cells. This fact presents a possibility of stem cell treatment for the patients of hearing impairment.

편도암의 수술적 치료

방충일,최혁기,김민식,선동일,박동선,조광재,조승호 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.2

Background and Objectives:Surgery and postoperative radiation therapy have been the main stream management of tonsil cancer. There is a variety of surgical approach methods are used for the resection of tonsil cancer, however, there have only been of our surgical treatments of tonsil cancer. Subjects and Method:32 medical records, from 1994 April to 2003 June, of patients surgicaly treated for tonsil cancer were reviewed. Evaluated were disease status, surgical approach methods, types of the neck dissection, surgical margin, reconstruction methods, postoperative complications, time of oral diet and decannulation, recurence, and survival rate. Results:Mean follow up periods were 2.3 years. There was 1 patient in Stage I, 5 in Stage II, 2 in Stage III, pharyngotomy approach. Surgical defects were primary closed in 5 patients and reconstructed with pectoralis major myocutaneous flap in 7 patients and radial forearm fasciocutaneous free flap in 20 patients. There were 2 local recurences, 5 regional recurrences, and one distant metastasis. The mean time of the beginning of oral diet/decannulation after operation were 19.8/11.3 days in lateral pharyngotomy and 25.3/12.9 days in mandibulotomy. The mean survival period was 41.4 months. Conclusion:Because pharyngotomy approach had priority to other surgical approaches in selected cases except T4. It has advantages of full range of vision for resection, better functional status and less postoperative morbidity. (Korean J Otolaryngol 2004 ;47 :168-73)

Ru Nanoparticle이 첨가된 Sn-58Bi 솔더의 기계적 신뢰성 및 계면반응에 관한 연구

김병우,최혁기,전혜원,이도영,손윤철,Kim, Byungwoo,Choi, Hyeokgi,Jeon, Hyewon,Lee, Doyeong,Sohn, Yoonchul 한국마이크로전자및패키징학회 2021 마이크로전자 및 패키징학회지 Vol.28 No.2

대표적인 저온솔더인 Sn-58Bi에 Ru nanoparticles을 첨가하여 Sn-58Bi-xRu 복합솔더를 제작하고 Cu/OSP 및 ENIG 표면처리된 PCB 기판과 반응시켜 계면반응 및 솔더조인트 신뢰성을 분석하였다. Cu/OSP와의 반응에서 형성된 Cu₆Sn₅ IMC는 Ru 함량에 따른 두께 변화가 거의 없고 100hr aging 후에도 큰 변화없이 고속 전단시험시 솔더 내부로 연성파괴가 발생하였다. ENIG 와의 반응시에는 Ru 함량이 증가함에 따라서 Ni₃Sn₄ IMC 두께가 감소하는 경향을 보였으며 일부 시편에서 ENIG 특유의 취성파괴 현상이 발견되었다. Ru 원소는 계면 부근에서 발견되지 않아서 계면반응에 크게 관여하지 않는 것으로 판단되며 주로 Bi phase와 함께 존재하는 것으로 분석되고 있는데 어떠한 형태로 두 원소가 공존하고 있는지에 대해서는 추가적인 연구가 필요하다. Sn-58Bi-xRu composite solders were prepared by adding Ru nanoparticles to Sn-58Bi, a typical low-temperature solder, and the interfacial reaction and solder joint reliability were analyzed by reacting with Cu/OSP and ENIG surface treated PCB boards. The Cu₆Sn₅ IMC formed by the reaction with Cu/OSP had little change in thickness depending on the Ru content, and ductile fracture occurred inside the solder during the high-speed shear test without any significant change even after 100 hr aging. In reaction with ENIG, the Ni₃Sn₄ IMC thickness tended to decrease as the Ru content increased, and ENIG-specific brittle fracture was found in some specimens. Since Ru element is not found near the interface, it is judged not to be significantly involved in the interfacial reaction, and it is analyzed that it mainly exists together with the Bi phase.

양성성대질환의 기저막영역과 고유층 최상층의 조직병리학적 변화에 따른 병인학적 가설

김형태,주영훈,최혁기,김현수,조승호 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.1

Background and Objectives:The epithelium, basement membrane zone (BMZ) and superficial layer of lamina propria (SLLP)in the vocal fold possess similar mechanical properties and behave as one single tissue, which is commonly referred to as the “cover”. The purpose of this study is to elucidate the ultra structural and histopathological changes and differences in the cover of benign laryngeal lesions, and also to investigate the pathogenetic response. Materials and Method:The cover of the vocal fold in vocal nodule, polyp and Reinke’s edema was investigated on 87 patients. Immunohistochemical analysis was performed with monoclonal antibodies directed against collagen type III and VII for identification of SLLP and anchoring fiber. Control specimens were obtained from 10 uninvolved side vocal fold in the laryngeal specimen after total laryngectomy. Results:One type of injury in the cover was due to a little or no change of SLLP, which was seen more often in vocal nodules. The second type of pathologic finding shows disorganized anchoring fiber and extensive interstitial injury, which was seen more often in vocal polyp. The third type shows injury in the anchoring fiber and sparse distribution of collagen type III in SLLP, which was the main finding in Reinka’s edema. These findings lead us to understand the pathogenesis of the disease that developed as different entities. Conclusion:We conclude that collagens in BMZ and SLLP are the structures that seem to provide the pathogenetic portion of benign laryngeal diseases which develop from the same phonotrauma into clinically different disease entities. (Korean J Otolaryngol 2005;48:65-9)

기능적 3차원 후두단층촬영의 임상적 유용성:일측성 성대마비를 중심으로

전범조,김형태,최혁기,김현수,조광재,박영학,김민식,조승호 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.2

Background and Objectives:There are many clinical procedures that are related to the evaluation of kinematic events con-cerning vocal fold vibration. However, many of these procedures are hardly applicable for precise analyses of physiological and morphological changes in vocal folds with respect to the pitch control, and vocal fold volume changes from the phonatory aspect of larynx. The purpose of this study was to examine the clinical feasibility of a new 3 dimensional image method, the functional laryngeal CT, which can provide a clear sagittal image of the vocal fold in each of the anteroposterior directions during phonation and resting state. Subjects and Method:Functional laryngeal CT was performed in 4 normal control and 2 cases of unilateral vocal fold paralysis. The subjects were instructed at resting position to produce sustained vowel phonation of thre diferent on personal computer, using the DICOM (Digital Image and Communication in Medicine) file of axial images. Results:The dynamic vocal fold 3D image that was reconstructed by serial section image during phonation showed that the vocal fold became thin and volume was decreased in relation to the increase in pitch. Typical subglotic shoulder formation and ventricular widening was noted in the high pitched tone. Conclusion:Functional 3D laryngeal CT (F3DLxCT) is an informative tol for visualizing the active changes in length, tension and mas of the vocal folds for pitch control. Furthermore, the volume defect and the level diference in the paralysed vocal fold are easily detectable with this new techinque.

Expression of HSP70 and Its Relation with Other Cytokines in Human Middle Ear Effusion

박시내,박경호,최혁기,신지현,이동희,장기홍,여상원 대한이비인후과학회 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.1

Objectives. While other cytokines are known to be associated with otitis media with effusion (OME), the involvement of heat shock protein 70 (HSP70) in middle ear effusion (MEE) is unknown. This study was undertaken to investigate the possibility of there being a HSP70 expression in human MEE and to determine its potential role as a cytokine in OME. Methods. The levels of HSP70, tumor necrosis factor-alpha and interleukin-1beta were measured by enzyme-linked immunosorbent assay in the effusion of different groups of OME patient following collection of the MEE using our new collection system. The clinical characteristics of the OME patients and the MEE status were analyzed. Results. HSP70 was expressed in all the types of MEE. The mucous and seromucous effusions showed higher HSP70 levels than that of the serous effusion. The HSP70 level was correlated with the levels of tumor necrosis factor (TNF)-a and interleukin (IL)-1b in the effusions. The positive correlations between HSP70, TNF-a and IL-1b were statistically significant (P<0.05). Conclusion. The highly elevated level of HSP70 in the seromucous and mucous effusions implicates this protein in the chronicity of OME.

이명 환자에서 약물요법과 병행한 변형된 이명재훈련치료의 단기치료 효과

오현진,박경호,여상원,장기홍,최혁기,최봉진,한민아,박시내 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.8

Background and Objectives According to the neurophysiologic model of tinnitus, emotion and autonomic nervous systems are closely related to generation of tinnitus. We performed this study to evaluate the treatment response of modified tinnitus retraining therapy (TRT) with medication in the patients with sensorineural tinnitus. Subjects and Method Forty-three tinnitus patients who were diagnosed as sensorineural tinnitus through audiologic evaluation and have normal hearing in speech frequency were included in this study. Tinnitus and psychological status were measured by tinnitus questionnaire, Korean version of Brief Encounter Psychosocial Instrument (BEPSI) scale, Beck Depression Inventory (BDI), Spielberger State Trait Anxiety Inventory (STAI). Patients treated with anxiolytics and microcirculation enhancer were Group 1 and those treated with modified TRT and medications were Group 2. Short-term therapeutic response was analyzed and compared between two groups. Results Loudness, awareness, annoyance and effect on life of tinnitus and tinnitus handicap score were significantly decreased in Group 2. Relief of tinnitus in more than 2 of 4 subjective parameters was achieved in 4 patients (30.7%) in Group 1 and 15 patients (75%) in Group 2. Stress score was also decreased significantly after treatment in Group 2. Conclusion Tinnitus patients in Group 2 treated with medication and modified TRT showed the higher compliance and the response rate of treatment than the patients in Group 1 treated with medication alone. Modified TRT, in addition to medical therapy, should be considered to increase the therapeutic response in patients with sensorineural tinnitus.

기도폐쇄를 유발한 인두후 혈종 1예

박영학,전범조,조주은,최혁기 대한기관식도과학회 2003 大韓氣管食道科學會誌 Vol.9 No.1

Retrophayngeal hematomas frequently develop in patients who had cervical vertebra fracture. The hematoma develops in the space between buccopharyngeal fascia and prevertebral fascia. But it rarely causes severe airway obstruction. We recently treated a patient who had dyspnea and dysphagia due to a retropharyngeal hematoma without any significant trauma history. First, tracheostomy was performed to maintain the airway. Then, incision and drainage was done under suspension laryngoscope. This case shows the fact that a retropharyngeal hematoma can result in severe airway obstruction even after a minor trauma.