2019년 발행된 ‘안면신경마비 한의표준임상진료지침’에 대한 학술적 검토 및 문제점 분석 연구

전범조 대한의사협회 의료정책연구원 2023 의료정책포럼 Vol.21 No.1

와우핵에서 Patch-Clamp Technique를 이용한 전기생리학적 연구

전범조 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.6

나선형 고해상도 전산화 단층촬영 영상을 이용한 측두골의 3차원 컴퓨터 영상재건:측두골의 해부 및 임상적 응용

전범조,송선화,이동희,조주은,천병준,조광재,여상원 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.5

Background and Objectives:The intricate anatomy of the temporal bone has always been dificult to visualize. In this regard, the advantages of computer-asisted reconstruction of temporal bone based on image data from computed tomography (CT) are (3D) reconstruction of computed tomography in determining the anatomy and topographic relationship of various important structures. Subjects and Method:For 40 ears of 20 patients with various otological diseases, 3D reconstruction based on image data from spiral high-resolution CT was performed by segmentation, volume-rendering and surface-rendering algorithm on a personal computer. The scanning was caried out in axial plane with technical factors of 140 kV, 100 mAs, 1 m thickness, and 1 second scanning time. A software (VworksTM ) was used for image processing. Results:We were able to demonstrate the 3D display of the midle and iner ear structures. The computer-assisted measurement of reconstructed structures demonstrated the anatomic details comprehensively, which improved the surgeons understanding of their spatial relationship, and provided many details that could not be easily measured in vivo. Conclusion:The 3D reconstruction of temporal bone CT can be useful in demonstrating ecessary to confirm the correlation betwen 3D reconstructed images and histologic sections through the validation study.

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.

LPS에 의해 유도된 중이염에서 구심성 청신경을 통한중추청각계 전염증성 사이토카인의 신경면역학적 발현

전범조,김형태,송창은,이동희,여상원 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.10

Background and Objectives:The goal of this study was to identify the central modulation of the auditory pathway by peripheral inflammation and loud sound exposure, which is associated with proinflammatory cytokines. Materials and Method:Eight male adult Sprague-Dawley rats were exposed to 125-8,000 Hz, 90 dB white noise for three hours. Immediately, 6 hours, 24 hours, and 3 days after the sound stimuli, 2 rats were sacrificed respectively. For the inflammatory stimuli, 10 rats were inoculated with LPS (100 μg/50 μl) through ipsilateral tympanic membrane. In 3 hours, 6 hours, 24 hours, 3 days and 7 days, 2 rats were sacrificed respectively. The brains of rats were prepared including the cochlear nucleus and inferior colliculus. The brains were stained for c-fos (proto-oncogene proteins) and IL-1β. Two normal control rats were sacrificed without treatment. Results:In the noise exposure group, c-fos and IL-1β were expressed along the previously known auditory neural pathway and some non-hearing-related nuclei. In the LPS injection group, the c-fos and inflammatory cytokine IL-1β were mainly expressed along the ascending afferent auditory pathway such as cochlear nucleus, trapezoid body, lateral lemniscus, inferior colliculus. IL-1β expression was also found in the nuclei of non auditory pathway such as locus coeruleus, lateral parabrachial nucleus, and vestibular nucleus. Conclusion:These results show that inflammatory reactions of peripheral middle ear cavity and loud sound exposure may induce expression of proinflammatory cytokines along the afferent auditory circuit and the functional auditory pathway. It might be suggested that peripheral changes by inflammation or loud sound could induce functional and physiologic alterations in the auditory system via neuroimmunomodulation. (Korean J Otolaryngol 2006;49:978-85)

비부비동 전산화 단층촬영을 이용한 3차원 영상 재건의 임상적 적용:일측성 만성 상악동염 환자에서의 통기도 평가

전범조,송선화,이동희,조주은,천병준,조광재,여상원 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.12

Background and Objectives:The purposes of this study were to evaluate the aeration of maxillary sinus, using 3-dimensional reconstruction of computed tomography (3DR-CT), to compare the estimated air volume of the normal maxillary sinus with area of natural ostium. Subjects and Method:In 10 patients having unilateral maxillary sinusitis refractory to proper medical therapy, 3-dimensional reconstruction images were obtained based on high-resolution CT by surface-rendering technique on a personal computer. A software (VworksTM 4.0, CyberMed Inc, Korea) was used for 3-dimensional reconstruction. Maxillary ostium on CT was defined to measure the maxillary natural ostium on 3-dimensional reconstruction images. Results:In unila-teral maxillary sinusitis, an air volume of the affected sinus was 4.71± 13.29± 9.76 mL. The area of the afected maxilary ostium on CT was 11.10± 14.40 mm2, and that of the contralateral normal sinus was 24.20± 18.64 mm2. The air volume and area of maxillary ostium on CT of the afected maxillary sinus were reduced significantly, compared with those of the contralateral normal one (p<0.05). But, there was no significant correlation betwen the aeration of maxilary sinus and the degree of decreased area of maxilary ostium on CT (p= 0.285). Conclusion:3DR-CT is the new technique, which enables us to measure the volume of maxillary sinus as well as the area of maxillary ostium. Also, it is helpful in assessing the aeration of maxillary sinus. (Korean J Otolaryngol 2003 ;46 :1035-9)

한국인에서 연령에 따른 상악동 체적의 변화:전산화 단층촬영의 3차원 재건 영상을 통한 분석

전범조,송선화,박찬순,이동희,김동기,조광재,조진희 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.2

Background and Objectives:The purpose of this study was to evaluate the maxillary sinus volume in human depending on age and sex by using 3-dimensional reconstruction of computed tomography (3DR-CT). Subjects and Method:One hundred seventy three people (238 maxillary sinuses), who had taken paranasal sinus high resolution CT between December 2000 and November 2003, and had no evidence of inflammation or hypoplasia in CT finding, and had no specific history of surgery of paranasal sinus or maxillofacial trauma, were retrospectively analyzed. 3-dimensional reconstruction images were obtained using the surfacerendering technique with images by high-resolution CT on a personal computer. A software used for 3-dimensional reconstruction was Vwork 4.0 (CyberMedTM, Korea) used. The mean volume of maxillary sinus were evaluated in both sex. The ratio of maximal horizontal and half horizontal extension and the degree of descent of sinus below the nasal floor were evaluated. Results:The development of maxillary sinus were found in males in their twenties and in teen females. The mean volume of maxillary sinus in an early adult were 24043 mm3 (Male) and 15859.5 mm3 (Female). There was a significant difference observed in the sinus volume (p<0.05) according to sex and the significant difference in the volume of maxillary sinus according to age groups between sex before reaching maximal volume. But there were no significant correlation among aging process, aeration of maxillay sinus after its maximal growth and the descent below the nasal floor. Conclusion:The growth of maxillary sinus is continued until the age of twenties in male and teens in female. Therefore, maxillay sinus operation affecting bony structures before those age may affect the sinus development; inferior meatal antrostomy also should be done after confirming the level of inferior extension of maxillary sinus below the nasal floor.

의료영상저장 전송시스템과 측두골 3차원 영상합성을 이용한 중이 수술에서의 임상적 유용성

전범조,여상원 최신의학사 2004 最新醫學 Vol.47 No.1

이비인후과 영역에서의 3차원 입체 영상 연구의 유용성

전범조(Beom Cho Jun) 대한두개저학회 2015 대한두개저학회지 Vol.10 No.1

전정신경초종 환자의 자기공명영상을 이용한 내이도 수직 재구성 영상의 임상적 유용성

전범조(Beomcho Jun),장기홍(Kihong Chang),김동훈(Dong-Hoon Kim) 대한두개저학회 2012 대한두개저학회지 Vol.7 No.1

Introduction : In vestibular schwannoma, conventional temporal bone MRI is a useful tool of measuring the dimension and location of tumor. However, it is hard to get surgical information about relationship between the tumor mass and anatomical structures such as VII, VIII nerves and vessel. So we tried to confirm the clinical feasibility of perpendicular images to IAC in temporal bone MRI in a case of vestibular schwannoma. Material and methods : Temporal bone MR Imaging was obtained with T2 weighted three dimensional turbospin echo after contrast injection. The thickness of axial slices was 0.6mm and FOV(field of view) was 150x200. Reformatted images were achieved using threedimensional reconstruction software(Vworks 4.0tm) with 0.2mm thickness perpendicular to the axis of IAC from brainstem to the end of cochlear. Results : The reformatted image of IAC gave us information not only about the relationship between the tumor and vascular structure but also about the degree of tumor extent to the facial and cochlear nerve which expected to be preserved during the surgery. Additionally, in case of vascular loop, perpendicular image of IAC told us surgical information helpful to the prevention of unexpected severe bleeding during microsurgery. Conclusions : Reformatted perpendicular image to IAC gives us detail information about nerves and vascular structure in IAC, especially in case of moderate to small sized masses of vestibular schwannoma. However, in case of huge mass of vestibular schwannoma filling entire IAC, it is hard to discern the tumor from the nerves in the canal.