Expression of EGFR and Microvessel Density in Middle Ear Cholesteatoma

진봉준,민현정,정진혁,박철원,이승환 대한이비인후과학회 2011 Clinical and Experimental Otorhinolaryngology Vol.4 No.2

Objectives. Cholesteatoma destructs bony tissue by the interactions between hyperproliferative epithelial cells and subepithelial inflammatory cells. The aim of this study was to evaluate the expression of epidermal growth factor receptor (EGFR) and microvessel density (MVD) in middle ear cholesteatoma tissue in an effort to determine the relationship between expression of EGFR and neovascularization. Methods. We evaluated the expression of EGFR and MVD by immunohistochemical staining for CD31 and Factor VIII in 32 cholesteatoma tissue samples and 7 normal postauricular skin samples. We also analyzed the correlation between EGFR expression and MVD. Results. The expression of EGFR was higher in cholesteatoma than in postauricular skin, but the difference was not statistically significant. EGFR was more highly expressed in the suprabasal layer than in the basal layer. Using CD31 and Factor VIII, we analyzed the MVD and found that it was significantly higher in cholesteatoma than in postauricular skin, and significantly correlated with the expression of EGFR. Conclusion. Our results suggest that overexpression of EGFR and neovascularization are correlated with the growth of cholesteatoma.

신티카메라를 이용한 99mTcO4 뇌혈관 영상검사

진봉준,이성용,박용휘 대한핵의학회 1982 핵의학 분자영상 Vol.16 No.1

후두개의 연령증가에 따른 형태변화 -방사선학적 관찰-

진봉준 대한영상의학회 1983 대한영상의학회지 Vol.19 No.1

In man the epiglottis is a thin lamella of a yellow elastic cartilage. The upper part is free and is known as leaf and lower part participates in the formation of the anterior wall of the vestibule of the larynx. The ipithelial covering extends forwards onto the base of the tongue over the medial glossoepiglottic folds. The sides of epiglottis are connected with the cartilages of Wrisberg and arytenoid cartilage by the aryepiglottic fold. In view of these anatomical complexities, the function and physiology of the epiglottis have been debated since Magen야 (1815), who proposed the theory that the epiglottis acts as a flap valve to prevent food entering the windpipe, and who found that he could remove the free part of the epiglottis in dog without spoiling the dog. Following the introduction of laryngoscopy (Garcia, 1815 ; Liston, 1840 ; Czermark, 1861) and modern cineradiographic equipments in 1950's, the anatomy and physiology ofepiglottis has become much clearrer. age as it is seen on the lateral x-ray of the neck. In the present study we have made an attempt to systematically analyze aging changes of the epiglottis I the lateral x-ray of the neck in 245 healthy adults. The age ranged from 16 to 65 years old. Based on our observation the epiglottis was classified into type A, B and C according to their curvatures. Thus, type A represented those with posterior curvature, type B those with straight epiglottis and type C anterior curvature. Type C was subdivided into I, II and III according to the degree of curvature. Thus, type C-I, C-II and C-III represented mild, moderate and marked anterior curvature, respectively. Type A epiglottis was found in the second, third and fourth decades and type C-III in the older age group. Type A was least common and type C most prevalent. It seems that the epiglottis inclines anteriorly with backward curvature with age (p < 0.0001).

CSF Otorrhea Resulting from Osteoradionecrosis of the Temporal Bone in a Patient with Recurrent Meningioma

박철원,진봉준,이승환,정승원,민현정,신지훈 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.2

Osteoradionecrosis of the temporal bone is a very rare but potentially lethal complication of radiotherapy for head and neck or skull base tumors. Only two cases of osteoradionecrosis of the temporal bone complicating cerebrospinal fluid (CSF) otorrhea have been reported in the literature. This report describes a case of CSF otorrhea and osteoradionecrosis of the temporal bone in a patient with meningioma who was treated with tympanomastoid surgery and autologous fat obliteration in the mastoid. Osteoradionecrosis of the temporal bone is a very rare but potentially lethal complication of radiotherapy for head and neck or skull base tumors. Only two cases of osteoradionecrosis of the temporal bone complicating cerebrospinal fluid (CSF) otorrhea have been reported in the literature. This report describes a case of CSF otorrhea and osteoradionecrosis of the temporal bone in a patient with meningioma who was treated with tympanomastoid surgery and autologous fat obliteration in the mastoid.

급성 골수성 백혈병 환자에서 경구개를 침범한 비내모균증 1예

정진혁,진봉준,태경,김경래 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.10

Mucormycosis is a rare, opportunistic fungal infection. But if it occurs it can be acute, fatal, and cause death in diabetic orimmunocompromise patients. The rhinocerebral mucormycosis usually occurs in the nose, and it can spread to the paranasalsinuses, orbit, and the brain, and in some cases, to the oral cavity and hard palate which warrants thorough examination andcomputed tomograph of the head and neck including the oral cavity. In case of hard palate involvement by mucormycosis,resection of hard palate should be considered. Recently, we had experienced a case of nasal mucormycosis that has invaded thehard palate in an acute myelogeneous leukemia patient. Through endoscopic debridement of nasal cavity and consecutive hardpalate resection, she could survive the disease. In this report, the clinical courses and treatment of the patient will be describedwith a brief literature review. (Korean J Otolaryngol 2006;49:1027-30)

The Role of Laryngopharyngeal Reflux as a Risk Factor in Laryngeal Cancer: A Preliminary Report

태경,진봉준,지용배,정진혁,조석현,이승환 대한이비인후과학회 2011 Clinical and Experimental Otorhinolaryngology Vol.4 No.2

Objectives. To evaluate the significance of laryngopharyngeal reflux (LPR) as a risk factor in laryngeal cancer. Methods. We performed a case-control study with 29 consecutive laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring from 2003 to 2006. The control group included 300 patients who had undergone 24-hour ambulatory double pH monitoring due to LPR-related symptoms. We analyzed the prevalence of LPR and numerous parameters from the 24-hour ambulatory double pH monitoring in the laryngeal cancer patient and control groups. Pathologic LPR is defined when more than three episodes of LPR occur in 24 hours. Results. The prevalence of pathologic LPR was significantly higher in the laryngeal cancer group than the control group (P=0.049). The reflux number of the upper probe was significantly higher in the laryngeal cancer group (P<0.001). However the effects of pathologic LPR on laryngeal cancer risk were diluted after adjusting for smoking and alcohol consumption in the multivariable logistic regression. Conclusion. The pathologic LPR might be a possible risk factor in the development of laryngeal cancer. A further study should be necessary to verify the exact role of LPR in laryngeal cancer.

전두동 개구부 봉소가 전두동염의 발생에 미치는 영향

정주환,진봉준,정진혁,조석현,이승환,김경래 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.11

Background and Objectives Frontal recess anatomy can be very complex, with accessory cells extending to the frontal sinus and possibly contributing to the obstruction of the frontal sinus. However, there is still controversy on the effect of the frontal recess cells. We designed this study to assess the effect of frontal recess cells on frontal sinusitis. Subjects and Method We retrospectively reviewed chart and collected data of those who visited the outpatient clinic between January and June, 2011. Parnasal sinus CT was taken with Brillance 64-slice computed tomography scanners. The image was reviewed by two or more otolaryngologists to identify the frontal recess cells. The nasofrontal isthmus diameter and the area of nasofrontal isthmus was reconstructed and measured with workstation. Then, we compared the radiological results of frontal recess cells with the frequency of frontal sinusitis. Results The presence of anterior group of frontal recess cells showed no influence on the frontal recess anatomy. The presence of frontal bullar cell was significantly associated with the development of frontal sinusitis by simple (p=0.001) and multiple (p=0.038) logistic regression models. It was shown that the narrower the area of frontal isthmus the more developed were the frontal sinusitis, showing statistically significance in the simple (p=0.013) and multiple (p= 0.017) logistic regression models. Conclusion Our results also showed that similar results compared to previous Asianreport. The narrowness of nasofrontal isthmus could be the cause of frontal sinusitis. The frontal bullar cell could be the cause of frontal sinusitis encroaching on the frontal recess and affect the nasofrontal pathway.

Orbital Apex Syndrome in a Patient with Sphenoid Fungal Balls

조석현,진봉준,이용섭,백승삼,고명규,이형중 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.1

Orbital apex syndrome (OAS) is a rare disease that presents with a complex of symptoms, including ophthalmoplegia, ptosis and visual loss. Due to the poor prognosis, making a prompt diagnosis and administering the appropriate treatment must be initiated without delay if OAS is suspected. We report here on a case of a patient with sphenoid fungal balls, and he presented with acute visual loss and ophthalmoplegia. Orbital apex syndrome (OAS) is a rare disease that presents with a complex of symptoms, including ophthalmoplegia, ptosis and visual loss. Due to the poor prognosis, making a prompt diagnosis and administering the appropriate treatment must be initiated without delay if OAS is suspected. We report here on a case of a patient with sphenoid fungal balls, and he presented with acute visual loss and ophthalmoplegia.

조기 성무암종에서 경구강 CO₂레이저 성대절제술의 의의

태경,지용배,진봉준,박철원,이형석 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.5

Background and Objectives:For the treatment of early glottic cancer, not only complete excision of tumor, but also preservationof laryngeal function is important. Several methods such as open partial laryngectomy, transoral endoscopic CO2 laserpartial laryngectomy, radiation therapy are possible. This study was performed to investigate the utility of laser cordectomy andits oncologic and functional outcomes. Subjects and Method:A retrospective analysis was performed for patients of 31 casesof early glottic cancer who were treated with transoral CO2 laser cordectomy at the Hanyang University Hospital from November1997 to Decemcer 2004. We analyzed oncologic and functional outcomes with the review of medical records. Results:Among31 cases of early glottic cancer, 30 cases were male and 1 case was female. The mean age was 61.4 years (45-77 years), andthe mean follow up period was 34 months (13-97 months). Histopathologically, one case was verrucous carcinoma and theothers were squamous cell carcinoma. According to T stage, 31 cases were classified into 3 Tis, 22 T1a, 4 T1b, and 2 T2. Localrecurrence occurred in 2 cases. One patient was in disease free state after salvage total laryngectomy and 1 patient was alive withdisease state because he denied further treatment. The major complications such as aspiration, respiratory distress were notfound in any of 31 cases. Minor complications such as anterior web, polyp, granulation tissue were found in 8 cases (25.8%).Conclusion:Transoral CO2 laser cordectomy might be the effective treatment modalitiy in early glottic carcinoma becauseof high local control rate, excellent functional outcomes and low complication rate. (Korean J Otolaryngol 2006;49:538-42)

비주에 발생한 연골양 한관종 1예

조석현,금효섭,진봉준,박문향 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.10

Chondroid syringoma, or mixed tumor of skin is a benign cutaneous neoplasm of sweat gland origin. It is rare in incidence, andmost frequently found at the head and neck area. It is usually present as a slowly growing, painless intradermal or subcutaneousnodule in patients between the ages of 20 and 60 years. Histologically, there are two types, which are tubular, branching luminatype and small, tubular lumina type, and it contains both epithelial and stromal component. The treatment of choice is completelocal excision. We report a case of chondroid syringoma presenting as a nasal columellar mass in a 50 year old woman with abrief review of literature. (Korean J Otolaryngol 2006;49:1024-6)