| Sung Min Chung | 8 Articles |
|
[English]
In the past decade, vocal fold injection (VFI) has re-emerged as a valuable treatment modality for a variety of laryngeal disorders. It offers many advantages for the treatment of glottal insufficiency. It can avoid surgical scar and is easily performed with local anesthesia. In this article, we describe the indication of injection laryngoplasty, variable injection materials and discuss about vocal fold injection approaches. Citations Citations to this article as recorded by
[English]
[English]
The aim of this study is to obtain the basic knowledge for safer clinical use of oxymetazoline, one of nasal decongestants, by observing changes of ciliary activity and histopa-thologic findings after topical application of oxymetazoline to the cultured human basak mucosa. The nasal mucosa, obtained from the inferior tubinates in healthy non-smokers without any nasal symptoms or signs, was cultured and then, exposed to oxymetazoline solu-tion at different concentrations from 0.0123% to 0.25%, containing no preservatives. Ciliary activity was observed under an inverted microscope and the histopathology of the mucosa was examined by light microscopy 1,3,6,12,24 and 48 hours after exposure, respectively. Oxymetazoline impaired ciliary activity and induced mucosal injury at dose- and time-dependent patterns. Once the ciliary activity disappeared, it was not restored at least for the next 48 hours. Furthermore, these functional and morphologic changes resulted from applying oxymetazoline at the concentration of clinical use. Oxymetazoline as a topical vasoconstrictor should be administered for the minimal period even at clinical dose.
[English]
The surgical modalities for treatment of chronic maxillary sinusitis have changed in recent years. The radical Caldwell-Luc operation has been replaced by the more conservative endoscopic sinus surgery(ESS). Good clinical results for the ESS technique have been reported(Wigand, 1978 ; Stammberger, 1991 ; Kennedy, 1992), but only a few papers give detailed data on the symptoms(Kamel, 1989 ; Levin, 1990 ; Lund, 1991). From April 1992 to January 1996, a total of 118 patients(primary ESS 62 patients and ESS after previous nasal surgery 56 patients) who underwent ESS at the department of otolaryngology, Ewha womans university Hospital, were evaluated. Preoperative nasal symptoms, except for nasal discharge were higher in revision cases. The previous most common nasal surgery was polypectomy accounting for 25(44.6%) of the 56 revision cases. All had preoperative CT scans of the ostiomeatal unit area(OMU CT) and severity of inflammatory disease had been graded by CT. In revision cases, 30(53.6%)cases had complete opacification of one or more major sinuses. But in primary ESS cases, 19(30.6%) had findings limited to the osteomeatal complex. Overall, 43(76.8%) patients benefited from ESS in revieion cases, and 58(93.5%) in primary ESS cases. Synechia was the most common complication in revision and primary FESS cases. The difference of outcomes between primary ESS and ESS after previous nasal surgery is explained by the difference of preoperative state of the sinus mucosa. The author's review of 118 patients showed that there was significant difference in the postoperartive success rate between the primary ESS and ESS after previous nasal surgery.
[English]
The host immune system normally functions to destroy neoplastic cells that continually develop as a result of somatic mutations. However, patients with head and neck squamous cell carcinoma have depressed cell-mediated immune function, which has recently been shown to be most pronounced in the local and regional environment of the primary tumor. Recent studies suggest a local modulation of the host immune response to tumor by secreted immunoregulatory factors such as cytokines, especially pro-inflammatory cytokines(interleukin-1, interleukin-6, interleukin-8, interferons, and tumor necrosis factor). To assessthe ability of head and neck squamous cell carcinoma to produce these cytokines, initially, we have performed immunohistochemical staing for interleukin-6 and tumor necrosis factor in 20 cases of laryngeal squamous cell carcinoma and 10 cases of laryngeal nodule as a control group. We detected interleukin-6 in 11 cases of laryngeal squamous cell carcinoma(55%) and tumor necrosis factor in 11 cases of laryngeal squamous cell carcinoma(55%). All of 10 papillomas showed no expression of interleukin-6 and tumor necrosis factor. There is no statistical correlation between interleukin-6 and tumor necrosis factor expression and clinical stage or pathologic grade. These results suggest that laryngeal squamous cell carcinoma may secrete cytokines influencing the response of local immune cells. But future studies of the role of tumorderived cytokines in the local immune response to tumor could be investigated,since cytokines may directly or indirectly regulate tumor growth and metastasis.
[English]
Various mechanisms are involved in drug resistance of tumor cells. Among them one such mechanism is the overexpression of the multidrug resistance(mdr1) gene product P-glycoprotein(Pgp) that functions as an energy - dependent drug efflux pump. The expression of P-glycoprotein by immunohistochemistry was examined in 20 cases of laryngeal squamous cell carcinoma and vocal nodules as a control pump using a newly developed monoclonal antibody(MDR/JSB-1) which is specipic to human mdr1 gene product and recognizes an external epitope of the protein. Mdr1 gene product expression was compared with clinical response to chemotherapy in six patients who received mdr1 dependent drugs. The results are summerized as follows. 1) Among 20 laryngeal cancer tissues, P-glycoprotein was detected in 8 patients and none of 20 vocal nodules showed expression of P-glycoprotein. 2) There is a correlation in between positive P-glycoprotein staining and tumor differentiation. 3) No correlation in between positive P-glycoprotein standing and tumor stage of tumor site is observed. 4) 2 patients with negative clinical response to chemotherapy among 6 patients who received inductive chemotherapy with cisplatin, vincristine and p pepleomycin revealed positive P-glycoprotein staining. Therefore, analyzing the expression of P-glycoprotein may play a role when planning chemotherapeutic regimens for patients with head and neck cancer and may be an additional prognostic and diagnostic tools in these patients.
[English]
Chronic maxillary sinusitis is one of the most common disorder in pediatric otolaryngology and it is remained also the major problem restrict to management. Management of the children with chronic maxillary sinusitis is a through search for underlying etiologic anatomical, systemical and local factor. As one of etiologic factors, hypertrophied tonsils and adenoid cause obstruction of narrow ansopharynx and stagenation and infection of paranasal sinus. But chronic maxillary sinusitis is remained uncontrolled disease in spite of tonsillectomy and adenoidectomy, maxillary antrum prncture and irrigation, and antibiotic therapy. This follow up research was performed in 104 cases that received tonsillectomy and adenoedectomy at department of otolaryngology, Ewha University Hospital during last 5 years(from 1986 January to 1990 December), they showed chronic maxillary sinusitis by preoperative PNS X-ray. The result was that improvement of chronic maxillary sinusitis was noted in 57% at survey study and in 63% at PNS x-ray study after tonsillectomy and adenoidectomy. was effective in treating chronic maxillary sinusitis in children.
[English]
The neck mass is easily found by physical examination but diagnosis is so difficult that conclusive diagnosis can be reached only histopathologically. Among the 65 cases of neck mass during last 2 years. 22 cases of neck tumor confirmed by histopathological examination was clinically analysed retrospetively. The results were followings : 1) Of 65 cases, 11 cases( 16.9%) were benign tumor and 11 cases(16.9%) were malignancy. 2) The most frequent benign tumor was salivary gland tumor(45.5%) and malignant was metastatic(54.6%). 3) Male to female ratio was 1: 1.2 in benign tumor and 4.5:1 in malignant masses. 4) Benign tumor was frequent before fifth decades(72.7%), whereas malignancy was detected mostly after the patient of fifth decades(90.1%). 5) 90.1% of benign tumor was located at anterior triangle and 63.6% of malignancy was located at middle jugular lymph node group. 6) Primary sites of metastatic neck masses were larynx, nasopharynx. tongue, thyroid and salivary gland.
|
|
, Han Su Kim
