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CT-Guided Core Needle Biopsy of Deep Suprahyoid Head and Neck Lesions
En-Haw Wu,Yao-Liang Chen,Yi-Ming Wu,Yu-Ting Huang,Ho-Fai Wong,Shu-Hang Ng 대한영상의학회 2013 Korean Journal of Radiology Vol.14 No.2
Objective: To evaluate the efficacy of computer tomography (CT)-guided core needle biopsy (CNB) in the diagnosis of deep suprahyoid lesions in patients with treated head and neck cancers. Materials and Methods: Between December, 2003 and May, 2011, 28 CT-guided CNBs were performed in 28 patients with deep suprahyoid head and neck lesions. All patients had undergone treatment for head and neck cancers. Subzygomatic, paramaxillary, and retromandibular approaches were used. The surgical results, response to treatment, and clinical follow-up were used as the diagnostic reference standards. Results: All biopsies yielded adequate specimens for definitive histological diagnoses. A specimen from a right parapharyngeal lesion showed atypia, which was deemed a false negative diagnosis. Diagnostic accuracy was 27/28 (96.4%). Two minor complications were encountered: a local hematoma and transient facial palsy. Between the 18 or 20 gauge biopsy needles, there was no statistical difference in the diagnostic results. Conclusion: CT-guided core needle biopsy, with infrequent and minor complications, is an accurate and efficient method for the histological diagnosis of deep suprahyoid lesions in post-treated head and neck cancer patients. This procedure can preclude an unnecessary surgical intervention, especially in patients with head and neck cancers.
전유미(Yu-Mi Jeon),김상범(Sang-Bum Kim),정화해(Haw-Hae Jeong),서윤경(Youn-Kyoung Seo),이준희(Jun-Hee Lee),송용태(Yong-Tai Song),백두진(Doo-Jin Paik) 대한체질인류학회 2007 해부·생물인류학 (Anat Biol Anthropol) Vol.20 No.4
코안 및 코곁굴 내시경 수술 시 위코선반, 중간코선반, 아래코선반은 코안 구조물을 찾는 표지점이 되기 때문에 위치나 크기에 대한 명확한 해부학적 이해가 요구된다. 고정된 한국 성인 시신 43구(남자 23구, 여자 20구, 평균 나이 66.81세)의 머리뼈 86쪽을 대상으로 코안가쪽벽에서 맨위코선반의 존재 여부를 관찰하고 코안 가쪽벽에서 코점막을 제거하기 전과 후로 나누어 앞코가시점과 코선반 사이의 거리와 코선반뒤끝점사이의 거리, 코선반의 길이를 계측하였다. 나비벌집오목이 뚜렷하여 위쪽에 맨위코선반이 나타나는 경우는 66.7%이었다. 코점막 박리 후 앞코가시점을 기준으로 위코선반의 앞끝점과의 거리는 46.75 ㎜, 중간코선반의 앞끝점과의 거리는 38.23 ㎜, 아래코선반의 앞끝점과의 거리는 18.51 ㎜이었고 위코선반의 뒤끝점과의 거리는 55.11 ㎜, 중간코선반의 뒤끝점과의 거리는 54.72 ㎜, 아래코선반의 뒤끝점과의 거리는 50.26㎜이었다. 코점막 박리 후 위코선반의 길이는 22.20 ㎜, 중간 코선반의 길이는 40.14 ㎜, 아래코선반의 길이는 40.97㎜이었다. 이상의 결과는 코곁굴 내시경 시술 시 안전하고 정확한 시술을 위한 해부학적 지표가 될 것이다. Recently, with the increasing interests in the endoscopic nasal surgery, it is essential for practitioners to have detailed knowledges of the anatomical structures for the successful surgery. This study was undertaken to provide morphological information of the nasal turbinates as anatomical reference during endoscopic nasal surgery. A total of 43 adult cadaver heads were bisected midsagitally and evaluated morphometrically. The results were as follows: The highest nasal turbinatee were observed in 66.7% of the case. After removal of the mucosa, the distances from the akanthion to the anterior end of superior, middle, inferior nasal turbinate were 46.75 ㎜ , 38.23 ㎜ , 18.51 ㎜ respectively. The distances from the akanthion to the posterior end of superior, middle, inferior nasal turbinate were 55.11 mm, 54.72 ㎜ , 50.26 ㎜ respectively. The lengths of the superior, middle, inferior nasal turbinate were 22.20 ㎜ , 40.14 ㎜ , 40.97 ㎜ respectively. The detailed measurements of the nasal turbinates performed in this study may provide useful anatomical landmarks for the endonasal endoscopic surgery.
전유미(Yu-Mi Jeon),김상범(Sang-Bum Kim),정화해(Haw-Hae Jeong),서윤경(Youn-Kyoung Seo),백두진(Doo-Jin Paik) 대한체질인류학회 2007 대한체질인류학회지 Vol.20 No.4
코 내시경 수술시 출혈을 조절하기 위해 혈관을 결찰하거나 마취할 때 해부구조의 이해를 돕고자 나비입천장동맥과 날개입천장신경절의 가지가 지나는 나비입천장구멍의 형태와 위치를 관찰하기 위하여 본 연구를 시도하였다. 고정된 한국 성인 시신 21구(남자 12구, 여자 9구, 평균 나이 62.9세)의 머리뼈 42쪽을 대상으로 나비입천장구멍의 형태를 분류하였고 크기, 앞코가시점과의 거리와 각도, 각 코선반 앞뒤끝점과의 거리, 나비굴과의 거리, 큰입천장구멍과의 거리를 계측하였다. 나비입천장구멍은 난원형이 35.7%로 가장 많았으며, 오른쪽과 왼쪽이 대칭인 경우는 28.6%이고 세로너비는 5.5 ㎜, 가로너비는 5.3㎜이었다. 나비입천장구멍의 가장 앞지점은 앞코가시점에서 54.4 ㎜, 중간코선반 앞지점에서 36.2 ㎜, 중간코선반 뒤지점에서 6.2 ㎜, 큰입천장구멍에서 27.2㎜인 지점에 위치하였고, 나비입천장구멍의 가장 위부분은 나비굴의 가장 위앞점에서 22.3 ㎜, 나비굴의 가장 아래점에서 18.6㎜인 지점에 위치하였다. 본 연구의 결과는 내시경으로 코안 시술시 관찰 가능한 앞코가시점, 중간코선반이나 나비굴을 기준으로 나비입천장구멍의 위치를 확인할 수 있는 유용한 자료가 될 것이다. This study aims to investigate the anatomical information of the sphenopalatine foramen with special reference to the bleeding control of the sphenopalatine artery and to the blockage of the pterygopalatine ganglion during functional endoscopic sinus surgery. Forty-three midsagittal sectioned Korean heads were used in the study. The mucosa on the lateral nasal wall was removed for showing the sphenopalatine foramen. The shapes of the sphenopalatine foramen were classified by 4 types. Angle from the akanthion and distances from akanthion, conchae, sphenoidal sinus and greater palatine foramen were measured. The sphenopalatine foramen was frequently found as oval shape and bilateral symmetry of 28.6%. The vertical length was 5.5 ㎜ , the horizontal length was 5.3 ㎜ . The most anterior point of the sphenopalatine foramen was located on 54.4 ㎜ few and angles were between 15.9˚and 22.1˚from akanthion. The distances were 36.2 ㎜ from anterior end of middle nasal concha, 6.2 ㎜ from posterior end of middle nasal concha, 27.2 ㎜ from greater palatine foramen. The uppermost point of the sphenopalatine foramen was located on 22.3 ㎜ from the most superoanterior end of the sphenoidal sinus, 18.6 ㎜ from the lowermost end of the sphenoidal sinus. This study could be useful to provide the confidence about the location of the sphenopalatine foramen during functional endoscopic sinus surgery.
유한동(Han Dong Yu),김낙인(Nack In Kim),심우영(Woo Young Sim),허충림(Choong Rim Haw) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.5
Bowenoid papulosis is manifested by clinically the benign-appearing papules of anogenital region and histopathologically similar features of squamous cellurar inoma in situ in human. A cause is thought to be Human Papillomavirus infection, type 16. The treatment is mainly through conservative management but others are topical application of podophyllin, shave excision, local excision, cryotherapy, electrodessication, topical applcation of 5-FU ointment and subcutaneous injection of recombinant interferon gamma. We present a case of Howenoid papulosis treated with DNCB imriunotherapy. The patient, had multiple papules on the penis with mild pruitus. Histopatnologic findings showed crowding and irregular arrangement of the nucleic many of which are large, hyperchromatic, and pleomorphic. Dyskeratotic and multinucleated keratinocytes wire also present, as were atypical mitoses, scattered in epidermal layer. We treated him with DNCB immunotherapy. Initially he was sensitized with 2,000 ug/0.1ml and two weeks later he received 50 ug/0.1ml per every week. After 3 weeks, he had showed no improvement and we elevated the dose to 100 ug/0.1ml. He was improved after 6th trial and his skir. lesions were almostly disappeared at present. (Kor J Dermatol 1992;30(5):869-673)
유한동(Han Dong Yu),김낙인(Nack In Kim),심우영(Woo Young Sim),김영설(Young Sul Kim),허충림(Choong Rim Haw) 대한피부과학회 1992 대한피부과학회지 Vol.30 No.3
Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control. (Kor J Dermatol 1992; 30(3): 411-417)