편측성 비부비동염에서 최근 유병률 변화 경향 및 감별진단에 유용한 인자

모지훈,정동식,정영준 대한비과학회 2018 Journal of rhinology Vol.25 No.1

Background and Objectives: Unilateral sinus lesions can be caused by many diseases and exact preoperative diagnosis is often difficult to make. The aims of this study were to evaluate the recent trends for prevalence of unilateral sinus lesions and find useful factors in differential diagnosis. Materials and Method: Preoperative clinical diagnosis including computed tomography (CT) images, endoscopic findings and postoperative diagnosis based on pathology were assessed retrospectively in 384 consecutive patients who underwent unilateral sinus surgery from 2004 to 2013. Results: Chronic bacterial rhinosinusitis (40%) was the most common cause of unilateral sinus lesions, followed by fungal sinusitis (21%), benign and malignant tumors (14%), and odontogenic sinusitis (11%). The incidence of odontogenic sinusitis has recently increased and mismatches of pre- and post-operative diagnosis were commonly found among patients with chronic bacterial rhinosinusitis, fungal sinusitis, or odontogenic sinusitis. Microcalcification in fungal sinusitis and dental lesions in odontogenic sinusitis were confirmed as critical factors by logistic regression analysis. Conclusion: The incidence of odontogenic sinusitis has been increasing steadily over the last 10 years. The findings of microcalcification and dental lesions on CT could provide crucial information to make a precise preoperative diagnosis among chronic bacterial rhinosinusitis, fungal sinusitis and odontogenic sinusitis.

만성비부비동염의 병인에서 선천성면역의 역할

모지훈 대한비과학회 2014 Journal of rhinology Vol.21 No.1

Chronic rhinosinusitis (CRS) is a multifactorial and heterogeneous disease, and variousfactors, such as inflammation,infection, fungus, and superantigens, have been proposed to play crucial roles in its pathogenesis. Recently,the dominant mechanismof CRS pathogenesis has shiftedfrom microbial infection and environmental factors to host susceptibility. Host susceptibility relies not only on adaptive immunity, but also on innate immunity, and there has recently been much research into innate immunity. Innate immunity is an evolutionally conserved immunesystem that recognizes microbial signature molecules via pattern recognition receptors and is a primary defensesystem that elicits inflammatory and bactericidal responses. Dysfunction of the host response to pathogens is suggested to be involved in pathogenesis of CRS and an irrelevant response of the host’s innate immunity could cause a failure toeradicate the pathogens, thereby contributing to CRS pathogeneses. Among these innate immune systems, toll-like receptors and epithelial barrier functions have been studied extensively, and new players, such as innate lymphoid cells,have beensurfacing. Betterunderstanding of innate immunity couldhelp to investigateand treat this complex disease. In this review, toll-like receptors, epithelial barrier functions, and innate lymphoid cells,among many subjects related to innate immunity,will be discussed in terms of pathogenesis.

Association of Particulate Matter With ENT Diseases

모지훈 대한이비인후과학회 2019 Clinical and Experimental Otorhinolaryngology Vol.12 No.3

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알레르기비염 마우스 모델의 이론과 실제

모지훈 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.3

Allergic rhinitis is a one of the most prevalent disease and its prevalence has been increasing these days. Many researchers have used the mouse models to study the mechanism of allergic rhinitis and development of anti-allergic medications. In the fields of allergic disease, several models such as allergic asthma, allergic contact dermatitis, and allergic rhinitis etc are introduced and several modifications are used. In case of mouse models of allergic rhinitis, it has been developed and modified from allergic asthma model. Most commonly used allergic rhinitis models are acute models and chronic models are used less. Ovalbumin, house dust mite and fungus are most commonly used allergens. Usually, mouse are sensitized with allergen and adjuvant such as aluminum hydroxide gel or Freund adjuvant for 2-3 weeks (once/week) then are challenged with allergen intranasally every day for 1 week. Mouse are sacrificed within 24 hours after final challenge and several parameters of allergic rhinitis are evaluated. They include nasal rubbing and sneezing count, eosinophil count in the nasal mucosa, total and allergen specific immunoglobulin E, nasal cytokine level and splenic cytokine level by splenocyte culture. By revealing those parameters, researchers could identify the allergic status of the mouse. However, there are many variables in mouse model of allergic rhinitis such as mouse strain, type of allergen, sensitization time, adjuvant, acute or chronic type, and allergen administration route etc. In this review, several variables and protocols of mouse model of AR will be discussed in detail.

T세포의 분화와 Th17

모지훈 대한이비인후과학회 2008 대한이비인후과학회지 두경부외과학 Vol.51 No.8

The Role of Plasmacytoid and Myeloid Dendritic Cells in Induction of Asthma in a Mouse Model and the Effect of a TLR9 Agonist on Dendritic Cells

모지훈,정영준,Tomoko Hayashi,이종대,Eyal Raz 대한천식알레르기학회 2011 Allergy, Asthma & Immunology Research Vol.3 No.3

Purpose: To determine the role of plasmacytoid dendritic cells (pDC) and myeloid dendritic cells (mDC) in priming effector T cells to induce allergy, and to evaluate the effect of immunostimulatory sequences (ISS, TLR9 agonist) on dendritic cells. Methods: Cultured mDC and pDC with/without ISS were injected intratracheally into sensitized Balb/C mice. Mice were sacrificed, and then pulmonary function tests, bronchoalveolar lavage (BAL), cell counts, and cytokine levels were evaluated. Migration of dendritic cells was also evaluated after ISS administration. Results: In mice injected with mDC, airway hyperresponsiveness, eosinophil counts, and Th2 cytokine levels in BAL increased with increasing numbers of mDC injected. However,in mice injected with pDC, none of these changed, suggesting poor priming of T cells by pDC. In addition, mDC pulsed with ISS inhibited asthmatic reactions, and ISS administration inhibited migration of DC to the lung. Conclusions: We suggest that pDC played a limited role in priming T cells in this asthma model and that mDC played a major role in inducing asthma. In addition, ISS inhibited migration of DC to the lung.

수면무호흡과 전신질환

모지훈 대한비과학회 2013 Journal of rhinology Vol.20 No.1

As society industrializes and develops, people become increasingly concerned about quality of life and sleep-related disorders. Sleep disordered breathing (SDB) includes obstructive sleep apnea (OSA) and upper airway resistance syndrome. Most of the patients that snore have OSA, and OSA can result in not only cardiovascular and neuro-cognitive diseases but also in severe morbidities and mortalities; therefore, its importance cannot be emphasized too strongly. The mechanism by which OSA induces such morbidities is related to sleep fragmentation and intermittent hypoxia, which result in sympathetic activation, endothelial dysfunction, and metabolic dysregulation. All of these conditions produce a humoral imbalance, a hypercoagulable state, and atherosclerosis, which finally result in multi-morbidities. These comorbidities include cardiovascular, respiratory, neurologic, metabolic, and genitourinary disorders. The clinical relevance of OSA is mainly due to its strong association with morbidities such as hypertension, metabolic syndrome, diabetes, heart failure, coronary artery disease, arrhythmias, stroke, pulmonary hypertension, and neurocognitive and mood disorders. A high mortality rate has also been associated with OSA. It is important to acknowledge the comorbidities of OSA to achieve a better understanding of the disease and for better treatment of patients with OSA. In this review, the comorbidities of OSA will be discussed in detail.

Viability and Regeneration of Chondrocytes after Laser Cartilage Reshaping Using 1,460 nm Diode Laser

모지훈,김지선,이재욱,정필상,정영준 대한이비인후과학회 2013 Clinical and Experimental Otorhinolaryngology Vol.6 No.2

Objectives. Cartilage reshaping by laser irradiation is used to correct septal and auricular cartilage deformities. Chondrocyteviability following laser irradiation and reshaping has been well established. However, the regeneration process ofchondrocyte after laser irradiation has not been revealed yet. The aims of this study were to determine the mechanismof cartilaginous thermal injury and the regenerative process of damaged cartilage following laser irradiation. Methods. Laser irradiation was performed on human septal cartilage and rabbit auricular cartilage using a 1,460-nm diodelaser. We observed change in the shape of cartilage and evaluated the extent of cartilage injury using live/dead cell assayvia confocal microscopy. Hoechst and propidium iodide (PI) staining was used to evaluate the mechanism of chondrocyteinjury after laser irradiation. To evaluate the regeneration of cartilage, laser irradiated cartilages were reimplantedinto a subperichondrial pocket and were harvested at 1, 2, and 4 weeks after reimplantation for viability assessmentand histologic examination. Results. Laser irradiation using a 1,460-nm diode laser produced a marked shape change in both human septal and rabbitauricular cartilages. Thermal damage on cartilage was correlated with the exposure time and the laser power. Hoechstand PI staining showed that chondrocyte death by laser irradiation was due to mainly necrosis, rather than apoptosis. In lower power treatment group (0.3 W and 0.5 W), all the chondrocytes regenerated within 4 weeks, however, in 1W treatment group, chondrocytes could not regenerate until 4 weeks. Conclusion. Reshaping of cartilage using 1,460 nm diode laser was attained concurrently with the thermal injury to thechondrocytes. The extent of thermal damage on chondrocytes was dependent on the exposure time and the laser powerand the damaged chondrocytes irradiated with lower level of laser power could be regenerated after reimplantationinto subperichondrial pocket.

인체 상부식도괄약근의 조직화학적 특징에 관한 연구

모지훈,박민현,정영호,성원진,이동욱,김광현,성명훈 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.6

소아 비부비동염 환자에서 비내시경 수술의 장기 추적 결과

모지훈,김상협,정영준 대한비과학회 2019 Journal of rhinology Vol.26 No.1

Background and Objectives: Chronic pediatric sinusitis continues to be a challenging problem to otolaryngologists and hasbeen reported to show worse prognosis than that of adults. However, most studies were performed with short-term follow-up. Inthis study, we aimed to assess the clinical outcome of pediatric endoscopic sinus surgery (ESS) with a longer follow-up and todetermine the effect of age on postoperative outcome. Subjects and Method: A retrospective analysis was performed on pediatric patients than 15 years with ESS younger from2005 to 2014 in a tertiary referral hospital. All patients completed a questionnaire regarding symptoms before to from 1 to 9 yearsafter surgery. Telephone survey was performed to evaluate symptoms including nasal obstruction, nasal discharge, PND, andheadache at 1 to 9 years after surgery. Results: Seventy-one pediatric patients with bilateral chronic sinusitis were treated with ESS. They showed gradual symptomimprovement from 5 year after surgery for the following: nasal obstruction (p=0.032), PND (p=0.005), and headache (p=0.048). However, there was improvement in rhinorrhea after 9 years (p=0.042). In addition, when analyzed in terms of age, the outcomewas poor in children younger than 13 years (p=0.003) compared with the older age group. Multivariate analysis showed that preoperativenasal obstruction was dependent on AR, and postoperative symptoms were dependent on presence of AR and involuntarysmoking. Nasal discharge was dependent on presence of AR and involuntary smoking preoperatively and postoperatively. These suggest the importance of AR and involuntary smoking as risk factors for prognosis. Conclusion: Chronic pediatric sinusitis showed gradual improvement after ESS and should be more carefully monitored on along-term basis. We should keep in mind that long-term follow-up is needed for pediatric ESS cases.