• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.14.2-14
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• 1983

후두외상의 손상은 그 정도나 범위에 따라 차이는 인지만 주요 후유증으로는 기도폐쇄, 부종, 주위조직의 봉와직염 및 농양, 누공, 후두연골 및 연골지막염, 만성 후두협착, 성대마비, 기관발거곤란증, 성음장애 등을 들 수 있고, 일반적인 후두외상의 치료방법은 일차적으로 신속한 기도유지를 위한 처치를 한 다음 상기각 후유증에 따르는 이차 시술을 시행하는 것이 보통이다. 최근 저자들은 교통사고로 인한 후두부 및 경부의 폐쇄적 외상으로 갑상연골 골절과 좌측 성대마비, 연하장애 및 우측 쇄골 골절을 보인 환자에게서 갑상연골 정복술을 시행 후 술후 2개월에 상기 증세의 호전을 보인 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한기관식도과학회지
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• 제10권2호
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• pp.52-54
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• 2004

Esophageal foreign bodies are common problems in the part of otolaryngology department, and may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheoesophageal fisula, pneumothorax and pyothorax. Therefore, early diagnosis and intervention is needed to reduce morbidity and motality. But, calcification of the laryngeal cartilages may masquerade as foreign body in some patients with a history of foreign body ingestion. Recently, We experienced a case of calcification of thyroid cartilage which was misunderstood as an esophageal foreign body and report this case with a review of literatures.

• 한국산학기술학회논문지
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• 제11권12호
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• pp.4935-4944
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• 2010

본 연구의 목적은 방사성요오드 치료를 받는 갑상선암환자가 전처치기 및 입원치료기간 중 경험한 방사성 요오드 치료와 관련한 지각된 어려움, 의료진으로부터 제공받은 방사성요오드 치료정보 수준 및 치료과정에 대한 만족도를 파악하는 것이다. 조사대상은 갑상선전절제술과 방사성요오드 치료를 받은 총 165명의 갑상선암환자이었다. 구조화된 설문지와 개방형 질문을 이용해 수집된 자료는 기술통계와 내용분석법으로 분석하였다. 연구결과 방사성요오드 치료 전처치기 및 입원치료기에 환자들이 가장 빈번히 지각한 어려움은 갑상선 특이적 증상이었으며(38.2% vs 43.0%) 방사성요오드 치료와 관련한 의료진의 정보제공 수준은 보통 이상으로 평가하였다(평균$3.63{\pm}0.80$점). 방사성 요오드 치료과정에 대한 만족도는 중등도 수준(평균$6.43{\pm}2.21$점)으로 의학적 관심과 환자요구에 대한 의료진 대처절차에서 만족도($7.64{\pm}2.37$점)가 가장 높았다. 그러나 정보 적절성($5.67{\pm}2.78$점)에서 가장 낮았다. 따라서 방사성요오드 치료를 받는 갑상선암환자를 위한 간호중재 프로그램은 갑상선 특이적 증상과 관련한 환자의 요구를 지지할 수 있고 방사성요오드 치료절차에 대한 환자의 이해를 증진시킬 수 있도록 개발되어져야 하며 이를 통해 환자들은 치료 행위에 효과적으로 참여할 수 있는 역량을 가질 수 있을 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5107-5110
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• 2014

Background: The incidence rate of thyroid cancer has been increasing worldwide in recent years, and it is also the most prevalent cancer when it comes to the number of patients among Korean women. With it, ultrasonographic screening test has also become very common. However, there is still controversy over the performance of this screening test. Therefore, the National Evidence-based Healthcare Collaborating Agency (NECA) organized a Round-table Conference on the issues regarding ultrasonographic screening for thyroid cancer in Korea. The objective of the conference was mainly about delivering worthwhile information reflecting social value for the current situation, which was based on evidence surrounding thyroid cancer screening that relevant experts investigated and agreed on. The significance of this Round-table Conference lies in the fact that we reviewed the current evidence, and we were able to discuss the social value and future direction for ultrasonographic screening in Korea.

• Journal of Radiation Protection and Research
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• 제19권3호
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• pp.199-208
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• 1994

한국 환경을 고려하여 개발된 동적 섭식경로 모델을 이용하여 한국인이 섭취하는 음식물에 대한 유도개입준위를 산정하였다. 섭식경로에 있어 중요한 피폭효과를 가지는 I-131은 유아의 갑상선에 대한 예탁선량당량에 대해, Cs-137과 Sr-90은 전신에 대한 예탁선량당량에 근거한 선량개입준위로부터 연령군별로 13개 음식물에 대해 유도개입준위를 산정하였다. 성인은 Cs-137과 Sr-90의 음식물에 대한 유도개입준위 산정에 있어 가장 중요한 연령 군으로 평가되었다. 성인의 경우 쌀에서 Cs-137과 Sr-90의 유도개입준위는 여름철 침적의 경우 각각 2390, 47 Bq/kg, 겨울철 침적의 경우 각각 198, 79 Bq/kg으로 침적시점과 핵종에 따라 매우 다른 값의 변화를 보여주었다.

• 대한방사선기술학회지:방사선기술과학
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• 제43권3호
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• pp.169-176
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• 2020

Interventional radiology is performed under real-time fluoroscopy, and patients are exposed to a wide range of exposures for a long period of time depending on the examination and procedure. However, studies on radiation protection for patients during an intervention are insufficient. This study aims to evaluate the doses exposed during the intervention and the applicability of 3D printing materials. The organ dose for each intervention site was evaluated using a monte carlo simulatio. Also, the dose reduction effect of the critical organs was calculated when using a shielding device using 3D printing materials. As a result, the organ dose distribution for each intervention site showed a lower dose distribution for organs located far from the x-ray tube. It was analyzed that the influence of scattered rays was higher in the superficial organs of the back of the human body where x-rays were incident. The dose reduction effect on the critical organ using the 3D printing shield showed the highest testis among the gonads, and in the case of other organs, the dose reduction effect gradually decreased in the order of the eye, thyroid, breast, and ovary. Accordingly, it is judged that the 3D printed shield will be sufficiently usable as a shielding device for the radiation protection of critical organs.

• Clinical and Experimental Pediatrics
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• 제61권7호
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• pp.221-225
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• 2018

Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.

• Korean Journal of Radiology
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• 제23권2호
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• pp.280-288
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• 2022

Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.370-379
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• 2018

본 연구는 갑상선암 수술환자의 치료기간에 따른 삶의 질 변화에 대해 알아보고, 삶의 질 변화에 영향을 미치는 요인을 파악하여 갑상선암 환자의 삶의 질을 향상시키기 위한 개입 필요성과 증상관리 프로그램 개발을 위한 기초자료를 제공하고자 하였다. 대전광역시 소재 일개 상급종합병원 이비인후과에서 2013년 7월부터 2014년 12월까지 갑상선암 진단을 받고 갑상선절제수술을 받은 환자 76명을 대상으로 하였고, 삶의 질에 영향을 미치는 요인을 알아보기 위해 t-test와 ANOVA에서 통계적으로 유의하게 나온 변수를 산출하여 다중회귀분석(multiple regression)을 실시하였다. 연구결과에서 수술 전과 후 1개월까지의 삶의 질 변화에서는 성별, 암 병력, 피로가 통계적으로 유의하였고, 수술 후 3개월까지의 삶의 질 변화에서는 병기, 암 병력, 불안, 통증이 통계적으로 유의한 변화가 있었다(P<.05). 회귀분석 결과 조사시기별 삶의 질 변화에 영향을 미치는 요인은 수술 전과 후 1개월에서는 우울과 피로였으며, 수술 후 3개월에서는 불안이었고, 수술 후 6개월에서는 모두 유의하지 않은 것으로 조사되었다. 따라서 수술 전과 후 1개월 시기에 우울과 피로 증상을 관리하여 환자의 신체적, 정신적 고통을 줄일 수 있도록 노력해야 하며, 수술 후 3개월에서는 불안 증상을 관리하여 환자의 삶의 질을 향상시킬 수 있도록 해야 할 것이다. 이는 결과적으로 건강관리 시스템에 대한 부담을 줄이고, 공중보건에 긍정적인 영향을 미치는 사회적 비용을 감소시킬 수 있을 것으로 생각된다.

• Korean Journal of Radiology
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• 제25권1호
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• pp.55-61
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• 2024

Objective: This study aimed to evaluate the safety and efficacy of intranodal lymphangiography and thoracic duct embolization (TDE) for chyle leakage (CL) after thyroid surgery. Materials and Methods: Fourteen patients who underwent intranodal lymphangiography and TDE for CL after thyroid surgery were included in this retrospective study. Among the 14 patients, 13 underwent bilateral total thyroidectomy with neck dissection (central compartment neck dissection [CCND], n = 13; left modified radical neck dissection (MRND), n = 11; bilateral MRND, n = 2), and one patient underwent left hemithyroidectomy with CCND. Ten patients (76.9%) had high-output CL (> 500 mL/d). Before the procedure, surgical intervention was attempted in three patients (thoracic duct ligation, n = 1; lymphatic leakage site ligation, n = 2). Lymphangiographic findings, technical and clinical successes, and complications were analyzed. Technical success was defined as the successful embolization of the thoracic duct after access to the lymphatic duct via the transabdominal route. Clinical success was defined as the resolution of CL or surgical drain removal. Results: On lymphangiography, ethiodized oil leakage near the surgical bed was identified in 12 of 14 patients (85.7%). The technical success rate of TDE was 78.6% (11/14). Transabdominal antegrade access was not feasible due to the inability to visualize the identifiable cisterna chyli or a prominent lumbar lymphatic duct. Among patients who underwent a technically successful TDE, the clinical success rate was 90.1% (10/11). The median time from the procedure to drain removal was 3 days (with a range of 1-13 days) for the 13 patients who underwent surgical drainage. No CL recurrence was observed during the follow-up period (ranging from 2-44 months; median, 8 months). There were no complications, except for one case of chylothorax that developed after TDE. Conclusion: TDE appears to be a safe and effective minimally invasive treatment option for CL after thyroid surgery, with acceptable technical and clinical success rates.