아급성 괴사성 림프절염의 임상적 고찰

이흥만(Heung Man Lee),황순재(Soon Jae Hwang),우정수(Jeong Su Woo),정은재(Eun Jae Jung),추호석(Ho Suk Chu) 대한두경부종양학회 2003 대한두경부 종양학회지 Vol.19 No.2

Background and Objectives: Kikuchi's disease or subacute necrotizing lymphadenitis is a cause of persistently enlarged lymph nodes unresponsive to antibiotic therapy. It affects predominantly young women under the age of 30, and it is seen primarily in the Asian population. Although this disease usually follows a benign course, all describing a clinical entity that has been mistaken for malignant lymphoma, lupus, and an assortment of infectious diseases. The purpose of this study is to report clinical characteristics and treatment outcome in order to contribute to the precise diagnosis and treatment. Materials and Methods: We reviewed 27 cases, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy during the past 5 years from January 1998 to December 2002. Results: It occurred more often in females (20 cases ; 74%) than males (7cases ; 26%), and it was seen more frequently in the second and third decades (21 cases ; 78%). Cervical lymphadenopathy were usually multiple (24 cases, 89%) and measured less than 2cm (20 cases, 74%). The posterior cervical and deep jugular chains are the most common location(34 cases ; 81%). Leukopenia(18 cases, 67%) and elevated ESR(20 cases, 75%) were commonly noted in laboratory data. Conclusions: It is easy that Kikuchi's disease is mistaken for malignant lymphoma. So we should consider fine needle aspiration or open biosy of lymph node for histologic diagnosis in patients who have localized cervical lymphadenopathy unresponsive to antibiotic therapy.

만성 비부비동염에서 균막의 역할

이흥만 ( Heung Man Lee ) 대한천식알레르기학회 2011 천식 및 알레르기 Vol.31 No.1

Chronic rhinosinusitis (CRS) is a disease commonly encountered in the rhinology clinic. Patients with CRS lead lower quality of life and pay for significant costs for treatment. However, some patients with CRS have persistent and recurrent nfections despite aggressive medical and surgical managements. It is believed that 99% of all bacteria are present in biofilms, and only 1% of all bacteria live in a free-floating or planktonic state at any given time. A bacterial biofilm differs from its planktonic counterpart with respect to the genes that are transcribed. It is defined as an assemblage of microbial cells enclosed in a self-produced polymeric matrix that is irreversibly associated with an inert or living surface. The requirements for oxygen and nutrients are reduced in this state, and waste products are handled by water channels. The life cycle of biofilms can be divided into 5 steps: attachment, adhesion, aggregation, growth and detachment. Biofilms provide bacteria with distinct advantages including antimicrobial resistance and protection by host defense. Biofilms have been shown to be involved in many chronic infectious diseases. In CRS, there has been growing evidence to support the crucial role of biofilms in recalcitrance and disease progression. (Korean J Asthma Allergy Clin Immunol 2011;31:9-16)

비용종에서 Vascular Endothelial Growth Factor와 Fibronectin의 발현 비내 스테로이드제제의 효과

이흥만 ( Heung Man Lee ) 대한천식알레르기학회 2005 천식 및 알레르기 Vol.25 No.2

인두 이물감 환자의 식도 운동성 장애

이흥만,오승철,이우섭,김경현,최건,박영태,Lee, Heung-Man,Oh, Seung-Cheol,Lee, U-Seob,Kim, Kyung-Hyun,Choi, Geon,Bak, Young-Tae 대한기관식도과학회 1996 大韓氣管食道科學會誌 Vol.2 No.2

Burning and lump sensation in the throat is a common disorder in middle aged woman. It is generally considered to be a neurotic origin but its pathophysiology is still remained unknown. The purpose of this study was to evaluate the prevalence of the Pharyngoesophageal structural lesions and the esophageal motility disorders among the patients with globus pharyngeus and to elucidate whether any specific manometric abnormality might have any causative role in the pathogenesis of the globus sensation, and we also wanted to know whether such tests were necessary in evaluating those patients. Structural lesions were demonstrated in 21 cases(17.5 %) among 120 patients. But among 44 controls, there were also Two cases(4.5 %) of structural lesions, and there was less significantly difference in the prevalence of the structural lesions between the patients and controls(p=0.0625) Manometric abnormalities over the lower esophageal sphincter and the lower esophageal body were demonstrated in 28 cases (23.3 %) of the patients, while only one case (2.3 %) of the controls revealed such abnormality ( p=0.0037). Various manometric parameters of the upper esophageal sphincter and pharynx showed no difference between the patients and controls except the upper esophageal sphincter pressure at lateral sides which was lower in patients than in controls (p=0.0034). Globus sensation is a kind of symptom of esophageal dysmotility, and esophageal manometry is necessary to detect such abnormality in patients with globus sensation, Careful physical examination is also necessary to detect structural lesions in the pharynx and esophagus.

비강수술로 호전된 폐쇄성 수면무호흡증후군 1 례

최지호,이흥만,권순영,이상학,신철,이승훈,Choi, Ji-Ho,Lee, Heung-Man,Kwon, Soon-Young,Lee, Sang-Hag,Shin, Chol,Lee, Seung-Hoon 대한수면의학회 2005 수면·정신생리 Vol.12 No.1

폐쇄성 수면무호흡증은 이비인후과영역에서 흔하게 관찰되는 질환 중 하나로 수면 중에 상기도의 폐쇄로 인한 호흡정지가 주요한 병인이며 상기도를 구성하는 비강, 구강, 인두, 후두 중 어느 한 부분에서 폐쇄가 일어나도 질환의 원인이 될 수 있다. 비폐색의 가능한 원인들로는 주로 비중격 만곡, 비용, 기포성 갑개, 후비공 폐쇄, 종양, 이물, 술 후 또는 외상 후 발생한 유착, 여러 가지 비염, 기타 질환 등이 있다. 폐쇄성 수면무호흡증의 수술적 치료에는 비강수술, 구개인 두수술, 편도 및 아데노이드 절제술, 설부 축소수술, 기관절개술 등 여러 가지가 있는데 문헌들을 고찰한 결과 지금까지 성인에서 수면무호흡증 치료로 시행한 비강수술의 효과에 대해서는 아직 논란의 여지가 있는 상태이다. 최근 저자들은 비폐색과 동반된 코골이 및 수면무호흡증 환자에서 비폐색과 수면무호흡증의 원인으로 생각되는 비중격 만곡증 및 비후성비염을 교정하기 위해 비중격 교정술 및 하비갑개 절제술을 시행한 결과 수술 전, 후의 증상 및 수면 다원검사 비교에서 뚜렷한 호전을 경험하였기에 보고하는 바이다. Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.

OK-432를 이용한 재발성 하마종 치험 1례

우정수(Jeong Su Woo),이흥만(Heung Man Lee),권순영(Soon Young Kwon),정광윤(Kwang Yoon Jung) 대한두경부종양학회 2002 대한두경부 종양학회지 Vol.18 No.1

Plunging ranula is occured in about 10% of all ranula cases although surgery is the first choice therapy. However, frequent recurrences of the disease due to insufficient surgery have been reported, and various therapies have been designed in addition to surgery. We here report a case on whom we conducted intralesional injection of OK-432 for recurrent plunging ranula. A 36-year-old man was admitted who had a 2-months history of swelling of right submandibular area. He had been operated for right plunging ranula twice, 7 years ago. Under fluoroscopic guidance, contents of the ranula were aspirated and OK-432 solution was injected twice with 3-week interval. Examination after 6 weeks showed that the cystic ranula seen before therapy had disappeared completely and no recurrence was encountered after 18months. Therefore the intralesional injection of OK-432 is effective method for treatment of the plunging ranula.

인두 이물감과 식도 운동성 장애

박영태(Young Tae Bak),연종은(Jong Eun Youn),권소영(So Yung Kwon),김재선(Jae Seon Kim),이흥만(Heung Man Lee),변관수(Kwan Soo Byun),김진호(Jin Ho Kim),김종극(Jong Guk Kim),이창홍(Chang Hong Lee) 대한내과학회 1996 대한내과학회지 Vol.50 No.2

N/A Objectives: Lump sensation in the throat is a common disorder. ft is generally considered to be a neurotic origin and ignored by many physicians. This study was done to evaluate the prevalence of the pharyngoesophageal structural lesions and the esophageal motility disorders among the patients with globus pharyngeus and to elucidate whether any specific manometric abnormality might have and causative role in the pathogensis of the globus sensation, and we also wanted to know whether such tests are necessary in evaluating those patients. Methods: 77 patients complaining globus sensation in the throat were enrolled, but 12 of them were excluded from this study due to other coexisting esophageal symptom(s) such as chest pain, dyspagia, hearburn, and/or regurgitation. Mean(±SD) age of the included 65 cases (M/F: 17/48) was 39.8(±10.3) years. Duration (median& interquartile range) of the symptom of globus sensation was 10(3-36) months. Mean(±SD) age of the 37 control subjects (M/F: 13/24) was 40.8(±13.0) years. Thorough throat and esophageal examinations including indirect laryngoscopy, esophagoscopy &/or barium pharyngoesophagography, and esophageal manometry were performed. Results: Structural lesions were demonstrated in 10 cases(15.4%) among 65 patients. But among 44 controls, there were also 4 cases(9.1%) of structural lesions, and there was no significant difference in the prevalence of the structural lesions between the patients and controls (p=0.5017). Manometric abnormalities over the lower esophageal sphincter and the lower esophageal body were demonstrated in 18 cases(27.7%) of the patients, while only 1 case(2.3%) of the controls revealed such abnormality(p=0.0015). Nonspecific esophageal motility disorder(14 cases) represented the most common abnormal finding among them. Other abnormalities were hypertonic lower esophageal sphincter (2 cases), diffuse esophageal spasm(1 case), and nut- cracker esophagus(1 case). Various manometric parameters of the upper esophageal sphincter and pharynx showed no difference between the patients and controls except the upper esophageal sphincter pressure at lateral sides which was lower in patients than in controls(p=0,0367). The meaning of this finding is unclear. Conclusion: Globus sensation is a predictor of esophageal dysmotility, and esophageal manometry is necessary to detect such abnormality in patients with glnbus sensation. The value of diagnostic tests to detect structural lesions in the pharynx and esphagus could not be affirmed

Alloderm을 이용한 비중격 천공의 치료

이흥만,김선태,조재훈,최충식,이제혁,황순재,이상학 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.12

알레르기성 비염환자의 비점막에서 HSP72의 발현

이흥만,이우섭,최충식,이상학 대한이비인후과학회 1999 대한이비인후과학회지 두경부외과학 Vol.42 No.11

흰쥐 비점막에서 혈장의 혈관외유출에 대한 산화질소의 역할

이흥만,최충식,송재준,황순재,이상학 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.2