A Case of Large Laryngomucocele

Sue Jean Mun(문수진),Ji-eun Lee(이지은),Seung No Hong(홍승노),Hyo Geun Choi(최효근),Kwang Hyun Kim(김광현),Young Ho Jung(정영호) 대한두경부종양학회 2012 대한두경부 종양학회지 Vol.28 No.2

후두낭종은 후두소낭의 비정상적인 팽창으로 발생하는 드문 질환이다. 후두낭종의 크기와 증상에 따라 치료 방법은 단순 경과관찰에서부터 흡인, 경화제 주입, 수술적 치료까지 다양하다. 수술적 치료는 외적 접근법, 내시경적 접근법 또는 두 접근법을 혼용한 접근법을 통해 이루어진다. 최근 저자들은 경부 외적 접근법 및 연골막하 절제를 통한 혼합 후두점액낭종 1예의 치료를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

A case of nasal septal gossypiboma removal and mucosal defect reconstruction

Seok Hyun Kim(Seok Hyun Kim),Hyo Beom Jang(Hyo Beom Jang),Da Hee Park(Da Hee Park),Sue Jean Mun(Sue Jean Mun) 대한미용의학회 2022 대한미용의학회지 Vol.6 No.2

The term “gossypiboma” refers to a mass of the cotton matrix that is left in the body following an operation. It can remain silent postoperatively and appear several years later with a variety of symptoms or non-specific radiological findings. In addition, gossypiboma that persists in the human body for a long time can cause many complications when surgically removed. We report the case of a 33-year-old man who underwent rhinoseptoplasty and presented with nasal obstruction by a foreign body sensation. On endoscopic examination, protruding fabric material and granulation tissue were detected in the medial portion of the left nasal septum. Severe adhesion between the gossypiboma and septal mucosa resulted in a significant defect in the septal mucosa after endoscopic removal. The septum was approximated and reconstructed using a posterior-based inferior turbinate flap. The nasal obstruction completely resolved after surgery, and the septum healed at the six-month follow-up. This case emphasizes the possibility of gossypiboma when missing gauze remains in the patient after rhinoseptoplasty and a large septal perforation occurs as a consequence of gossypiboma removal. Rhinoplasty surgeons should be cautious to prevent materials being left inside the patient and efficiently follow-up on patients with nonspecific postoperative complaints.

Surgical repair of nasal septal perforation using temporalis fascia and homologous rib cartilage grafts: a case report

Jun Kim,Sue Jean Mun,Tae Ui Hong 대한미용의학회 2023 대한미용의학회지 Vol.7 No.2

Nasal septal perforation, often encountered as a complication of rhinoplasty, presents a significant clinical challenge, particularly following procedures focused on nose lengthening or augmenting, such as septal extension surgeries. Herein, we present a case of septal perforation, which was successfully treated through a temporalis fascia graft combined with costal cartilage graft from a donor. We explored the etiology of nasal septal perforation and delved into various treatment options through this investigation involving a female patient who experienced persistent crusting and nasal obstruction following rhinoplasty. The surgical approach adopted for the case and the outcomes, and the nuances in managing septal perforation complexity are presented.

Audiologic Results of Ossiculoplasty Using Malleus Footplate Assembly: The Comparison between Autologous Incus and Hydroxyapatite

Sun O Chang,Sue Jean Mun,Joo Hyun Park,Chang Myeon Song,Kyu-Hee Han,이준호,Seung Ha Oh 대한청각학회 2011 Journal of Audiology & Otology Vol.15 No.3

Introduction A disruption of the ossicular chain of the middle ear causes conductive hearing loss. Ossicular reconstruction is performed to restore hearings in those patients with congenital ossicular chain anomaly or ossicular chain disruption caused by chronic otitis media or cholesteatoma. A study from Japan with 52 auditory ossicular malformation revealed that 44% of the patients had a fixation of the stapes, 40% had incudostapedial joint defects followed by fixation of the malleus and/or incus and defects in the incudostapedial joint with a fixation of the stapes.1) One of the most common ossicular chain anomalies in Korea was a stapes footplate fixation (54.5%) followed by a mobile stapes footplate with other anomalies (19.7%) including a stapes without suprastructure and an incus long process, stapes without anterior crus and an incus long process.2) One of the most common ossicular chain anomalies is the absence of an incus with or without an intact stapes suprastructure. In incudostapedial deformed ears, ossiculoplasty is mandatory to restore the hearing process. Ossiculoplasty is also needed in cases with incus long process erosion with inflammation. As the most vulnerable ossicles, one report said that incus erosion is found in 80% of the chronic otitis media.3) Austin-Kartush classified ossicular chain disruptions into four categories after 1,151 operation on chronic otitis media. Group A ears with an intact malleus handle and a stapes suprastructure was found in 59.2% followed by group B ears with an intact malleus handle but an eroded stapes suprastructure group.4) In the group of a tympanic membrane and malleus preserved but a stapes suprastructure eroded, ossicular continuity can be restored between the stapes footplate and manubrium of the malleus with the method of malleus footplate assembly (MFA) using either the incus body or if the incus is unavailable, a biocompatible material such as hydroxyapatite (HA).5,6,7) Until now, MFA has proven to be the safe and effective way to restore hearings in such patients.8,9,10,11,12)Though successful results using MFA with either incus body or biocompatible material are reported world widely, there were a few reports on audiologic results after MFA ossiculoplasty in Korea. Authors reviewed our procedure and report hearing results of ossiculoplasty with MFA using either incus or HA. In this paper, a single-surgeon series of 32 MFA operations was analyzed. The cases were limited to autologous interposition grafts performed on Austin-Kartush group B ears in order to provide consistency within the analysis. Subjects and Methods Data collection A retrospective evaluation has been carried out on patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in Seoul National University Hospital. A total of 55 patients with Austin-Kartush type B defect repaired with incus body or HA were identified. Of those, 20 were excluded due to a failure to recover operation records or a lack of no more than 1 year postoperative audiograms. Three patients who had undergone MFA with a homologous incus were excluded in order to provide consistency within the analysis. Finally, 32 cases were enrolled into the study. All procedures were conducted by a single surgeon. All data including previous operations, follow-up duration, age, sex, etiology, materials which were used in the operation, combined mastoidectomy, complications, and revision operations were analyzed. Eustachian tube function was analyzed according to the results of the Eustachian tube test. The status of the middle ear mucosa was described as either 'healthy' or 'inflamed' according to the operation records. Demographic data are presented in Table 1. Analysis of audiologic data Preoperative and postoperative hearing results were evaluated according to the guidelines of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head Neck Surgery Foundation13) an... Background and Objectives: Absence of incus is one of the most common ossicular anomalies and also frequently found in chronic otitis media or chornic otitis media with cholesteatoma. Ossiculoplasty with malleus footplate assembly (MFA) can be an excellent option in the above situations. We reviewed our procedures and evaluated the hearing results of ossiculoplasty using the MFA. Subjects and Methods: This study retrospectively reviews a series of 32 patients who underwent MFA ossiculoplasty between September 2001 and March 2010 in an academic tertiary referral center. The autologous incus or hydroxyapatite (HA) was used as materials for reconstruction. Results: Thirteen of 32 patients (40.6%) had ossicular chain anomaly, 9 patients (28.1%) had congenital cholesteatoma and 8 patients (25.0%) had chronic otitis media with cholesteatoma and 2 patients (6.3%) had chronic otitis media. The patients with ossicular chain anomaly showed the greatest air-bone gap (ABG) closure. Overall, postoperative ABG was 17.7±11.7 dB at postoperative 6 months and 19.7±14.3 dB at postoperative 1 year, compared with preoperative ABG of 37.9±9.3 dB. There was no statistical difference of ABG at postoperative 12 months, 24 months between MFA using incus (n=17) and HA (n=15)(p=0.300, and p=0.563). There was no meaningful difference of postoperative ABG between the patients with combined mastoidectomy (n=10) and those without mastoidecmoy (n=22)(p=0.555). No extrusions occurred.

Novel Risk Factors for Allergic Rhinitis in Korean Elementary School Children: ARCO-kids Phase II in a Community

Han, Doo Hee,Ahn, Jae-Cheul,Mun, Sue Jean,Park, Sue K.,Oh, Se-Young,Rhee, Chae-Seo The Korean Academy of Asthma, Allergy and Clinical 2015 Allergy, Asthma & Immunology Research Vol.7 No.3

<P><B>Purpose</B></P><P>Allergic rhinitis (AR) is a multifactorial disease whose genetic and environmental risk factors have been studied for decades. Many pediatric studies have pointed out the familial history of allergy, hygiene hypothesis, breast-feeding, pet ownership, and diets as risk factors of AR. However, most of factors are still up for debate. This preliminary report aimed to confirm the known risk factors and find the novel risk factors for AR in the Korean pediatric population.</P><P><B>Methods</B></P><P>A bi-seasonal, winter and summer, study in 2 elementary schools included all students whose parents completed the questionnaire of medical and social histories, quality of life, infant and early-childhood history, and the living styles. Skin prick tests and endoscopic examinations were conducted on all participants.</P><P><B>Results</B></P><P>Among total 1,020 children, 338 participants had AR. The multivariate logistic regression analysis highlighted 6 factors: male gender (OR, 2.10; 95% CI, 1.32-3.33), older age (1.65; 1.03-2.65), previous history of allergic conjunctivitis (14.25; 4.99-40.74), asthma (2.73; 0.96-7.76) and pneumonia (0.39; 0.19-0.82), and an hour increase in daily playing time (0.90; 0.80-1.00).</P><P><B>Conclusions</B></P><P>Lack of pneumonia in early childhood and short playing time are newly found risk factors for Korean pediatric AR in this study confirming male gender, older age and previous history of allergic conjunctivitis and asthma as the risk factors.</P>

A Case of Large Laryngomucocele

문수진,이지은,홍승노,최효근,김광현,정영호,Mun, Sue Jean,Lee, Ji-Eun,Hong, Seung No,Choi, Hyo Geun,Kim, Kwang Hyun,Jung, Young Ho The Korean Society for Head and Neck Oncology 2012 대한두경부 종양학회지 Vol.28 No.2

후두낭종은 후두소낭의 비정상적인 팽창으로 발생하는 드문 질환이다. 후두낭종의 크기와 증상에 따라 치료 방법은 단순 경과관찰에서부터 흡인, 경화제 주입, 수술적 치료까지 다양하다. 수술적 치료는 외적 접근법, 내시경적 접근법 또는 두 접근법을 혼용한 접근법을 통해 이루어진다. 최근 저자들은 경부 외적 접근법 및 연골막하 절제를 통한 혼합 후두점액낭종 1예의 치료를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Dendritic cells and M2 macrophage play an important role in suppression of Th2-mediated inflammation by adipose stem cells-derived extracellular vesicles

Cho, Kyu-Sup,Kang, Shin Ae,Kim, Sung-Dong,Mun, Sue-Jean,Yu, Hak Sun,Roh, Hwan-Jung Elsevier 2019 Stem cell research Vol.39 No.-

<P><B>Abstract</B></P> <P>Although stem cell-derived extracellular vesicles (EVs) have been shown to facilitate regeneration of injured tissue, there is no report that evaluates the immune-modulating effect of stem cell-derived EVs on Th2-mediated inflammation. In this study, we evaluated the immunomodulatory effects of adipose stem cells (ASCs)-derived EVs on Th2-mediated inflammation induced by <I>Aspergillus</I> protease antigen in lung epithelial cells. The EVs were isolated from supernatant of ASCs and the diameters of EVs were measured by using dynamic light scattering. The mice primary lung epithelial cells and mouse lung epithelial cell line (MLE12) were pre-treated with 200 ng/ml of <I>Aspergillus</I> protease and then treated with 1 μg/ml of ASC-derived EVs. Real time PCR was performed to determine the expression levels of eotaxin, IL-25, TGF-β, and IL-10 mRNAs after EV treatment. To evaluate the role of EVs in macrophage polarization and dendritic cells (DCs) differentiation, <I>in vitro</I> bone marrow-derived macrophage and DCs stimulation assay was performed. EV treatment significantly decreased the expression of eotaxin and IL-25 and increased TGF-β and IL-10 in both lung epithelial cells. EV treatment significantly increased the expression of co-stimulatory molecules such as CD40, CD80, and CD 86 in immature DCs. Furthermore, EV treatment significantly enhanced the gene expression of M2 macrophage marker such as Arg1, CCL22, IL-10, and TGF-β. In conclusion, EVs of ASCs ameliorated Th2-mediated inflammation induced by <I>Aspergillus</I> protease antigen through the activation of dendritic cells and M2 macrophage, accompanied by down-regulation of eotaxin and IL-25, and up-regulation of TGF-β and IL-10 in mouse lung epithelial cells.</P> <P><B>Highlights</B></P> <P> <UL> <LI> EVs of ASCs ameliorated Th2-mediated inflammation induced by <I>Aspergillus</I> protease antigen. </LI> <LI> ASCs secrete EVs with a size range of approximately 100–200 nm. </LI> <LI> EVs of ASCs induced M2 macrophage polarization. </LI> <LI> EVs of ASCs induced DCs maturation. </LI> <LI> EVs of ASCs might be an alternative candidate to treat allergic airway diseases. </LI> </UL> </P>

How to release shallow nostril stenosis after pediatric trauma?

Gab-Kyun Lee,Seok Hyun Kim,Hyo Beom Jang,Da-Hee Park,Sue Jean Mun 대한미용의학회 2023 대한미용의학회지 Vol.7 No.2

Nostril or vestibular stenosis is a rare disease that usually occurs after trauma, infection, or burns in acquired cases. Nostril stenosis in pediatric cases is even rarer; however, it must be considered after trauma. Nostril stenosis involves the proliferation of secondary fibrous tissue in damaged subcutaneous tissues, resulting in a circumferential scar that leads to nasal obstruction on the involved side. Because each case of vestibular stenosis is diverse, no standard treatment has been established. Here, we present cases of successfully treated posttraumatic shallow nostril stenosis in pediatric patients and highlight the importance of early surgery.

외측 연수 경색에 의해 발생한 중추성 수면 무호흡 환자의 자동-적응형 양압기를 사용하여 치료한 경험

김대진,조재욱,김현우,최정수,문수진,Kim, Dae Jin,Cho, Jae Wook,Kim, Hyun Woo,Choi, Jeong Su,Mun, Sue Jean 대한임상검사과학회 2020 대한임상검사과학회지(KJCLS) Vol.52 No.3

중추성 수면 무호흡은 수면 중 상기도 저항이 없을 때 흉부와 복부의 호흡 노력 없이 10초 이상의 호흡부전을 보이는 것이 특징이다. 본 증례에서 뇌자기공명영상 확산 강조 영상검사를 통해 외측 연수 경색의 진단을 받은 환자가 수면다원검사를 통해 중추성 수면 무호흡 진단 기준에 미치지 못하는 호흡부전과 중추성 수면 무호흡이 관찰되었다. 호흡부전과 중추성 수면 무호흡에 대한 일차 치료는 CPAP을 사용하였다. CPAP을 사용한 후 수면다원검사와 이전의 수면다원검사를 비교한 결과 무호흡-저호흡 지수(42.5/hr→82.8/hr)와 각성 지수(21.7/hr→40.8/hr)는 악화되었다. 이에 이차 치료로 ASV를 사용하여 적정압력검사를 시행하였다. 이전의 수면다원검사와 비교한 결과 무호흡-저호흡 지수(42.5/hr→8.6/hr)가 상당히 호전되었다. 이러한 결과로 ASV는 중추성 수면 무호흡과 호흡부전에 대한 좋은 치료방법이 될 수 있다. Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.

한국인 폐쇄성 수면 무호흡 환자의 적정 양압을 위한 수동화 양압 측정법과 자동화 양압 측정법의 비교

김대진,최병걸,조재욱,문수진,이민우,김현우,Kim, Dae Jin,Choi, Byoung Geol,Cho, Jae Wook,Mun, Sue Jean,Lee, Min Woo,Kim, Hyun-Woo 대한임상검사과학회 2019 대한임상검사과학회지(KJCLS) Vol.51 No.2

폐쇄성 수면 무호흡 환자들의 양압기 사용을 위한 적정 양압측정은 편리함과 경제성뿐만 아니라 다양한 원인으로 CPAP 측정법보다는 APAP 측정법을 더 선호한다. 그러나 PSG 감시하에 진행하는 CPAP 측정법보다 정확성에 대한 의문이 아직까지 남아있다. 이에 본 연구에서는 동일한 대상자에 대한 CPAP과 APAP 측정법의 적정 압력과 무호흡-저호흡 지수를 변수로서 두 방법간의 효율성과 정확성을 비교하였다. 대상자는 분할 수면다원검사 중 CPAP 양압 측정과 7일 이상 APAP 양압 측정에 성공한 79명이 모집되었다. CPAP과 APAP 측정법의 적정 양압은 $7.0{\pm}1.8cmH_2O$, $7.6{\pm}1.6cmH_2O$ 무호흡-저호흡 지수는 $1.3{\pm}1.5/h$, $3.0{\pm}1.7/h$로 CPAP 측정법이 두 변수 모두 통계적으로 유의하게 낮게 나타났다(P<0.001). 그러나 미국수면학회 가이드라인 무호흡-저호흡 지수 5/h이하의 적정 양압 도달 비율은 CPAP 측정법이 96.2% (76명), APAP 측정법이 94.9% (75명)으로 유의미한 차이를 보이지 않았다(r=-0.045, P=0.688). 본 연구를 요약하면, CPAP은 APAP 측정법보다 좀 더 효율적인 측정법으로 나타났다. 그렇지만 적정 양압에 도달하는 비율은 두 방법 모두 통계적 차이를 나타내지 않아 정확성을 가진다. 따라서 CPAP과 APAP 측정법 중 요구되는 상황에 따라 적절한 방법을 선택하여 적정 양압을 측정할 수 있겠다. Although auto-adjusting positive airway pressure (APAP) titration at home has several advantages over a CPAP titration in terms of convenience and time saving, there are still concerns as to whether it will show corresponding accuracy when compared to laboratory-based polysomnography (PSG) and CPAP titration. To obtain more evidence supporting home-based auto-titration, APAP titration was performed at home for patients who were presented with OSA on laboratory-based diagnostic PSG followed by CPAP titration. A total of 79 patients were included in the study. They all underwent split-night PSG with CPAP titration, and APAP titration for more than 7 days. The patients with successful titration at both situations were selected. The optimal pressure and apnea-hypopnea index (AHI) of CPAP and APAP titration were compared. The optimal pressure for CPAP and APAP titration were $7.0{\pm}1.8cmH_2O$ and $7.6{\pm}1.6cmH_2O$ (P<0.001), whereas the corresponding AHI were $1.3{\pm}1.5/h$ and $3.0{\pm}1.7/h$ (P<0.001). As a result, the achievement rates of optimal pressure for CPAP and APAP titration were 96.2% and 94.9% (r=-0.045, P=0.688), respectively. The results of this study did not differ with regard to the optimal pressure between CPAP and APAP titration. Overall, CPAP and APAP titrations should be chosen depending on a required situation.