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Biomedical subjects

M W Sung

Publications and source records attributed to M W Sung.

At least 19 recordsLinked to original sources
PubMed2003

Dynamic and quantitative evaluation of eyelid motion using image analysis.

Evaluation of facial movement, especially eyelid movement, has depended on the subjective judgment of trained clinicians. Recently, a few objective methods have been reported, but they required uncomfortable markers to be attached to the eyelids and a special-purpose, high-speed video camera. This study had two aims: one was to develop a new device for measuring eyelid motion dynamically and quantitatively, without eyelid markers or a high-speed camera; the other was to devise feasible parameters for eyelid motion. The system consisted of a personal computer with a general-purpose multimedia board and a software program that the authors named blepharokymography. A sequence of blinking eyes was recorded with a video camera. After the capturing process of the video, kymograms were produced from the movie file. Kymograms were converted to binary images by threshold filtering. The lower margin of the upper eyelid was traced, and displacement and velocity curves were obtained. Some parameters were devised and verified in preliminary clinical data. The analysis revealed that the displacement (8 mm in normal compared with 5.2 mm in paralysis), average closing velocity (74 mm s(-1) in normal compared with 30.6 mm s(-1) in paralysis) and peak closing velocity (154 mm s(-1) in normal against 63.4 mm s(-1) in paralysis) were useful parameters for differentiating the normal and facial-paralysis states.

Adolescent↗
PubMed2002

Volume of cervical lymph nodes using 3D ultrasonography. Differentiation of metastatic from reactive lymphadenopathy in primary head and neck malignancy.

PURPOSE: To assess the usefulness of volume measurement using 3D US for depicting metastatic cervical lymph nodes. MATERIAL AND METHODS: Thirty-five cervical lymph nodes in 13 patients with primary head and neck malignancy were included in this study. US with volume acquisition was prospectively performed with a 5-10 MHz linear mechanical volume probe. Volume measurement of the node was calculated using a 3D automatic volume calculation program. The excised nodes matched on US were examined histopathologically. RESULTS: The volume of malignant nodes ranged from 0.444 to 4.442 cm3, the volume of the benign nodes from 0.143 to 1.176 cm3. Combinations of high positive (>80%) and negative (>90%) predictive values were obtained at a cut-off value of 0.7 cm3. CONCLUSION: Volume measurement of cervical nodes using 3D US can be a useful tool for differentiating metastatic from benign nodes in patients with primary head and neck malignancy.

Adult↗
PubMed2001

Association of p53 and BCL-2 expression with Epstein-Barr virus infection in the cancers of head and neck.

BACKGROUND: Reports that have both evaluated the site-specific Epstein-Barr virus (EBV) infection and compared it with the expression of the EBV-related proto-oncogenes and tumor suppressor genes in the various cancers of head and neck are scarce. METHODS: Thirty-eight nasopharyngeal carcinoma (NPC) cases, 32 oropharyngeal or hypopharyngeal carcinoma (OPC/HPC) cases, and 93 laryngeal carcinoma (LC) cases were evaluated with in situ hybridization on EBV-encoded small RNA (EBER) and immunohistochemical assessments of the p53, bcl-2, and epidermal growth factor receptor (EGFR) by use of formalin-fixed paraffin-embedded tissue array slides. RESULTS: The expression of viral EBERs was observed in more than two thirds (71.1%) of the NPC cases. In contrast, only 1 case of OPC and none of the HPC or LC cases exhibited EBV positivity. In the nonkeratinizing NPC, the EBV positivity was significantly associated with both frequent p53 overexpression (p =.033) and bcl-2 expression (p =.001). In the EBV-positive nonkeratinizing NPC, a correlation between p53 overexpression and the tumor infiltration lymphocyte (TIL) density was noted (p =.012). CONCLUSIONS: A site-specific expression of viral EBER was demonstrated in the head and neck cancers, which suggests an important role for both p53 and bcl-2 in the carcinogenesis of an EBV-infected NPC. The correlation between p53 overexpression and the TIL density in the EBV-infected NPC suggests that the product of a lymphoepithelial interaction, such as A20, can induce a dysfunctional p53 protein.

Adolescent↗
PubMed2001

Advanced hypopharyngeal carcinoma treatment results according to treatment modalities.

BACKGROUND: The purpose of this retrospective study is to compare the treatment results of locally advanced hypopharyngeal carcinoma according to treatment modalities. METHODS: Seventy-three patients with locally advanced hypopharyngeal carcinoma treated at the Department of Therapeutic Radiology, Seoul National University Hospital, between August 1979 and July 1997 were retrospectively analyzed. Twenty-three patients were treated with radiotherapy (RT) alone, 18 patients were treated with surgery and postoperative RT, and 32 patients were treated with neoadjuvant chemotherapy (CTx) and RT. Median follow-up period was 28 months. RESULTS: The overall 5-year survival rates were 15.7% for the RT alone group, 46.8% for surgery and postoperative RT group, and 43.0% for neoadjuvant CTx and RT group. The 5-year disease-free survival rates were 13.9%, 47.4%, and 30.7%, respectively. Surgery and postoperative RT or neoadjuvant CTx and RT showed superiority over RT alone in terms of both overall survival and disease-free survival rates. No significant differences were found in overall and disease-free survival rates between the surgery and postoperative RT group and neoadjuvant CTx and RT group (p =.15, p =.13). In the neoadjuvant CTx and RT group, 12 patients (38%) retained their larynx more than 5 years. CONCLUSION: Neoadjuvant CTx and RT is an effective strategy to achieve organ preservation without compromising the survival of patients with locally advanced hypopharyngeal carcinoma.

Adult↗
PubMed2001

Intratumoral adenovirus-mediated suicide gene transfer for hepatic metastases from colorectal adenocarcinoma: results of a phase I clinical trial.

Animal studies have shown that direct injection of an adenoviral vector (Adv.RSV-tk) expressing the herpes thymidine kinase gene into established tumors in the liver, followed by systemic ganciclovir administration, was effective in inducing tumor necrosis. Toxicities were minimal at therapeutically effective vector doses, although severe hepatic necroinflammation was seen at much higher supratherapeutic doses. We conducted a clinical phase I trial in patients with metastatic colorectal adenocarcinoma in the liver to assess the safety of intratumoral Adv.RSV-tk injection (escalating doses) followed by intravenous ganciclovir (fixed dose). The vector was injected into a metastatic tumor in the liver under local anesthesia by percutaneous needle placement with concurrent ultrasonographic monitoring to prevent injection or leakage into adjacent normal liver structures. We treated 16 patients in five dose level cohorts of Adv.RSV-tk, from 1.0x10(10) to 1.0x10(13) virus particles per patient. Hepatic toxicities were low, with transient grade 1 elevations in serum aminotransferase levels in 3 of 16 patients. Other toxicities were also transient: grade 2-3 fevers in 5 of 16 patients, grade 3 thrombocytopenia in 1 of 16 patients, and grade 2 leucopenia in 3 of 16 patients. These results indicate that Adv.RSV-tk can be safely administered by percutaneous intratumoral injection in patients with hepatic metastases at doses up to 1.0x10(13) virus particles per patient, and can provide the basis for future clinical trials involving intratumoral adenoviral vector injection.

Adenocarcinoma↗
PubMed2001

A method for assessing the regional vibratory pattern of vocal folds by analysing the video recording of stroboscopy.

Stroboscopy and kymography have been used to examine the motional abnormality of vocal folds and to visualise their regional vibratory pattern. In a previous study (Laryngoscope, 1999), we introduced the conceptual idea of videostrobokymography, in which we applied the concept of kymography on the pre-recorded video images using stroboscopy, and showed its possible clinical application to various disorders in vocal folds. However, a more detailed description about the software and the mathematical formulation used in this system is needed for the reproduction of similar systems. The composition of hardwares, user-interface and detail procedures including mathematical equations in videostrobokymography software is presented in this study. As an initial clinical trial, videostrobokymography was applied to the preoperative and postoperative videostroboscopic images of 15 patients with Reinke's edema. On preoperative examination, videostrobokymograms showed irregular pattern of mucosal wave and, in some patients, a relatively constant glottic gap during phonation. After the operation, the voice quality of all patients was improved in acoustic and aerodynamic assessments, and videostrobokymography showed clearly improved mucosal waves (change in open quotient: mean +/- SD= 0.11 +/- 0.05).

Female↗
PubMed2001

Sclerotherapy with picibanil (OK-432) for congenital lymphatic malformation in the head and neck.

HYPOTHESIS/OBJECTIVES: Congenital lymphatic malformations of the head and neck (LMHN) present special challenges to the otolaryngologist-head and neck surgeon. Recently, a number of sclerotherapy trials have shown promising results. In this study, we present our experiences with picibanil (OK-432) sclerotherapy for this lesion. STUDY DESIGN: Retrospectively review. METHODS: We retrospectively reviewed 21 patients who have undergone sclerotherapy with picibanil for LMHN. RESULTS: Satisfactory response with complete or nearly complete shrinkage of the lesions was observed in 15 cases after repeated sclerotherapy (average, two times). We did not observe any significant morbidity or complications in the patients treated with picibanil. Reduction in size of the mass was achieved in weeks to months. Some of the patients who had not had any other previous treatment showed remarkable reductions in size even after the first therapy. When we used picibanil sclerotherapy as a primary treatment for the LMHN, most of our patients showed satisfactory results regardless of the size or location of the lesions. CONCLUSION: Given with our experience and the reports that failure of picibanil sclerotherapy does not hinder subsequent surgical salvage procedures, we recommend trying picibanil sclerotherapy as a primary treatment for the LMHN and performing surgical excision as a secondary modality if the response to the sclerotherapy is not satisfactory.

Child↗
PubMed2001

Bifid epiglottis associated with Joubert's syndrome.

This report presents the case of a 2-year-old boy who had a bifid epiglottis associated with Joubert's syndrome. He had episodic tachypnea and apnea, inspiratory stridor, aspiration, and growth and mental retardation. Direct laryngoscopy demonstrated agenesis of the right half of the epiglottis and hypertrophied mucosa over the arytenoid cartilage. After the hypertrophied mucosa was partially vaporized with a CO2 laser, the inspiratory stridor soon improved and the aspiration was alleviated. Brain magnetic resonance imaging showed cerebellar vermian agenesis and enlargement of the fourth ventricle.

Abnormalities, Multiple↗
PubMed2000

Therapeutic dilemmas in the management of thyroid cancer with laryngotracheal involvement.

Invasion of the larynx and trachea by thyroid cancer is an uncommon but difficult problem. There is no consensus on indication for or extent of surgery, particularly when there is a requirement for airway reconstruction. From 1989 through 1996, we treated 22 patients with thyroid carcinoma with invasion of the larynx and trachea. Seventeen of these patients had recurrent disease. We applied radioactive iodine therapy after regional ablative surgery to resectable tumors with or without lung metastasis, larynx-preserving surgery to extraluminal or small intraluminal tumors restricted to the short segment of trachea, or total laryngectomy to recurrent tumors deeply invading the cartilage framework of the larynx. We performed arytenoid adduction or thyroplasty in one stage if the recurrent laryngeal nerve was paralyzed or resected intraoperatively. We could get relatively good survival and functional results by aggressive surgical treatment in 20 patients, but the disease was inoperable in 2 patients. It is stressed that head and neck surgeons who have to deal with cancer of the thyroid should not only be familiar with various techniques of airway reconstruction and voice rehabilitation but also must be aware of the biologic behavior of the thyroid carcinoma.

Adult↗
PubMed2000

Reconstruction of human hard-palate mucosal epithelium on de-epidermized dermis.

Artificial hard-palate mucosa equivalents were reconstructed using keratinocytes derived from normal human hard-palate and de-epidermized dermis. Reconstructed hard-palate mucosal epithelium formed in three-dimensional culture was compared to native hard-palate mucosal epithelium and reconstructed oral buccal mucosal epithelium with regard to keratin expression. Artificial hard-palate mucosal epithelium reconstructed in medium with delipidized serum showed a differentiation pattern similar to that of hard-palate epithelium in vivo. The present study also confirmed that keratinocytes derived from hard-palate mucosa are intrinsically different from those of nonkeratinizing oral surfaces.

Cell Communication↗
PubMed2000

CoMed: a real-time collaborative medicine system.

CoMed is a prototype of a real-time collaborative medicine system that allows medical specialists to share patient records and to communicate with each other on the Internet. CoMed consists of a multimedia medical database containing relevant information about laryngeal diseases and a real-time collaboration system including a teleconferencing system, a whiteboard and a chatting system. CoMed is web-based. We adopted the object database O2 and CORBA technologies for the multimedia medical database. Therefore, our system can provide the flexibility, extensibility and location transparency of patient databases. We developed a SeeYou Active X control for the teleconferencing system and a Java applet for the whiteboard and chatting system. CoMed improves the efficiency of the overall system by separating the servers on a UNIX machine and a Windows NT machine. CoMed can be utilized for stand-alone research, for collaborative consultations among medical specialists and for a telemedicine in participation with the patients and medical specialists. Our system can be extended easily into other types of the collaborative systems, such as collaborative distance learning, collaborative science system, etc.

Humans↗
PubMed2000

Enhancement of adenoviral transduction with polycationic liposomes in vivo.

Although the high transfection efficiency with adenovirus in vitro is well documented, it is still not clear whether adenoviral vectors are effective in vivo in solid tumor models. In our preliminary experiment, transduction of tumor tissue was limited to just around the injection site after intratumoral injection of the adenoviral vector. To improve the transduction efficiency in vivo, we tried a combination of adenoviral vector and liposome in our animal model. Adenovirus carrying human placental alkaline phosphatase (AdALP) and Lipofectamine or 1,3-di-oleoyloxy-2-(6-carboxyspermyl)-propylamide were used as a marker gene and the cationic liposome, respectively. A >15-fold increase in the transfection efficiency was observed in CT26 tumor cell lines with the combination of AdALP adenovirus carrying murine granulocyte-macrophage colony-stimulating factor (AdmGM-CSF), and liposome compared with adenovirus alone, showing the feasibility of the combination treatment. In the animal model, with the combination of liposome and AdALP, deeper and wider distribution of the marker gene in the tumor mass was shown. We conclude that the limitations of direct application of adenoviral vectors in a solid tumor model could be overcome by the use of cationic liposomes. This approach will facilitate the more effective delivery of adenoviral vectors in a clinical trial setting.

Adenocarcinoma↗
PubMed2000

Pyriform sinus fistula: management with chemocauterization of the internal opening.

A branchial remnant originating in the pyriform sinus causes a recurrent fistula or abscess in the neck. In spite of excision, recurrence may result from inadequate removal of the fistula tract. We attempted chemocauterization of the internal opening of the fistula tract with trichloroacetic acid (TCA) on direct endoscopy. This is a 6-year review of 18 patients with pyriform sinus fistula. Medical history, barium esophagography, computed tomography scans, operative findings, and treatment results were analyzed. By direct endoscopy, all patients were found to have a fistula opening in the pyriform sinus, exclusively on the left side. In only 9 patients, the fistula tract was identified by barium esophagography before operation. Computed tomography revealed a suspicious fistula tract originating from the pyriform sinus in 8 of 10 patients. Sixteen patients were initially managed by TCA chemocauterization. There were no serious intraoperative or postoperative complications. Four patients had recurrent masses, which were managed by simple excision in 2 patients and repeated TCA cauterization in the other 2 patients with unobliterated internal openings. We recommend barium swallow study and direct endoscopy for all patients presenting with a recurrent lateral neck abscess, especially on the left side. Our results suggest that initial chemocauterization of the internal opening can be a reasonable alternative procedure for the management of pyriform sinus fistula.

Abscess↗
PubMed1999

Neoadjuvant chemotherapy and radiation therapy compared with radiation therapy alone in advanced nasopharyngeal carcinoma.

PURPOSE: To analyze the impact of neoadjuvant chemotherapy on the treatment of locoregionally advanced nasopharyngeal carcinoma and to assess the outcomes of patients receiving such treatment. METHODS AND MATERIALS: We analyzed 137 previously untreated and histologically confirmed advanced stage nasopharyngeal carcinoma patients treated with either radiation therapy only or combined radiation therapy and chemotherapy at the Seoul National University Hospital between 1984 and 1996. The stage distribution was as follows: AJCC Stage III-21, Stage IV-61 in the radiation therapy group (RT group); AJCC Stage III-1, Stage IV-54 in neoadjuvant chemotherapy and radiation therapy group (CT/RT group). The median follow-up for surviving patients was 48 months. RESULTS: The 5-year overall survival (OS) rates were 71% for the CT/RT group and 59% for the RT group (p = 0.04). The 5-year actuarial disease-free survival (DFS) rates were 63% for the CT/RT group and 52% for the RT group (p = 0.04). Distant metastasis (DM) incidence was significantly lower in the CT/RT group. The 5-year freedom from distant metastasis rates were 84% for the CT/RT group and 66% for the RT group (p = 0.01). The incidence of locoregional failures was also lower in the CT/RT group, although this difference did not reach statistical significance (69% vs. 56%, p = 0.09) CONCLUSION: While not providing conclusive evidence, historical evidence from this institution suggests that neoadjuvant chemotherapy significantly improves both overall and the disease-free survival of patients with advanced stage nasopharyngeal carcinoma.

Adolescent↗
PubMed1999

Effects of free radicals on ciliary movement in the human nasal epithelial cells.

OBJECTIVE: There have been few reports on the effects of free oxygen radicals on ciliary mobility of nasal respiratory epithelial cells. The aim of this study was to determine the effects of free radicals and antioxidants on human nasal epithelial cells (HNECs) using video-computerized analysis. METHODS: Human nasal epithelial cells were obtained from the nasal cavity of normal volunteers. Ciliary beat frequency (CBF) was calculated as the mean value of ten randomly selected cells. The proportion of the area with normal CBF (above 8 Hz) was calculated from 10 randomly selected sites per specimen. Free radicals were produced by xanthine-xanthine oxidase enzymatic system. The generation of free radicals was confirmed by chemoilluminometer. CBF and the proportion of the area with normal CBF were measured at every 5 min for 30 min after the addition of enzyme. For the evaluation of the antioxidant effects on free radical-mediated ciliary slowing in HNECs, cells were incubated in superoxide dismutase solution (300 unit/ml) for 30 min and 3-aminobenzamide (5 mM). RESULTS: Superoxide produced by 0.4 mM xanthine and 400 miliunit/ml xanthine oxidase decreased CBF (7.71 +/- 1.91 Hz). A total of 2 min later, ciliary slowing was evident (3.87 +/- 1.10 Hz). Regarding the changes in proportion of epithelial area that showed normal CBF experimental group showed a significant decrease in percentage of epithelial area with normal CBF over time. Superoxide dismutase prevented ciliary slowing (8.76 +/- 0.99 Hz). Moreover, 3-aminobenzamide, an inhibitor of the DNA repair enzyme poly-ADP ribose polymerase, prevented inhibition of CBF (8.32 +/- 0.61 Hz). CONCLUSIONS: These results suggest that oxygen-mediated damage to DNA may be the mechanism of the deterioration effects of oxygen radicals on the ciliated respiratory nasal epithelium.

Antioxidants↗