• 대한두경부종양학회지
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• 제22권2호
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• pp.137-141
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• 2006

Purpose : It has been generally accepted that lobectomy is a standard surgical procedure in treatment of benign thyroid nodules. However lobectomy may cause postoperative hypothyroidism. Most of surgeons believe that nodulectomy has its limitation in treatment of thyroid nodules due to recurrence of nodules and presence of cancer. The current study attempts to determine whether nodulectomy is justified in aspects of preservation of thyroid function, risk of recurrence and complications. Methods: Data was collected retrospectively on 74 patients undergoing thyroidectomy(single nodulectomy, n=43;bilateral nodulectomies, n=9;lobectomy with nodulectomy, n=22) for benign thyroid nodules from 1999 to 2004. All patients were evaluated for complication, postoperative thyroid function, and recurrence of benign nodule and cancer were followed by regular ultrasonographic examination for 2-6 years. Results : The pathologic results of 74 patients were nodular hyperplasia(55 patients), Hashimoto's thyroiditis(8 patients), follicular adenoma(7 patients) and papillary carcinoma(4 patients). Average operation time was 30 minutes from skin incision to specimen out. In postoperative follow-up of 70 patients, six cases(8.5%) became mild hypothyroid, and ultrasonographically detected micronodule was also six cases(8.5%). There were no other complications. Conclusion : Thyroid nodulectomy appears to have advantages of relatively few complication and simple procedure with no access to laryngeal nerves. Therefore, it may be one of treatment options in selected cases of benign thyroid nodules.

• 대한두경부종양학회지
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• 제33권2호
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• pp.23-27
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• 2017

Background and Objectives: Gastric acid reflux is known to be the most important cause of contact granuloma. Therefore, anti-gastric acid reflux medication has been used as the first line treatment although there are other treatment methods such as surgery or steroid injections. Actually, the role of surgery in the treatment of contact granuloma has not been established clearly. The purpose of this study was to evaluate the effectiveness of surgical treatment for contact granuloma. Materials and Methods: We retrospectively reviewed the medical records of 14 patients who were diagnosed with contact granuloma and treated with surgery from 2011 to July 2016 at Hanyang University hospital. Results: Of 14 patients, 9 (64.3%) were male and 5 (27.4%) were female. The mean age was 53.8 (${\pm}6.1$) years. The main symptoms were voice change followed by globus, dyspnea, and asymptomatic. Mean Reflux Finding Score (RFS) before surgery was 13.5 and mead Reflux Symptom Index (RSI) was 10.4. The causes of surgery were inadequate response to proton pump inhibitor (PPI) in 4 cases, airway obstruction with large granuloma in 8 cases, and differential diagnosis in 2 cases. Of 14 patients, recurrence occurred in 8 (53.3%) patients after surgery. In 8 recurrent cases, 5 patients showed complete remission and 3 patients showed partial remission with PPI medication. Conclusion: The role of surgery in the treatment of contact granuloma might be limited due to high recurrence rate.

• 대한두경부종양학회지
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• 제33권2호
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• pp.17-22
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• 2017

Background and Objectives: Voice change after thyroidectomy may develop without injury of recurrent laryngeal nerve. Psychogenic or emotional factors related to voice change after thyroidectomy has been rarely studied. In this study, we sought to analyze the impact of anxiety on early state of post-thyroidectomy voice change. Materials and Methods: We made a retrospective chart review of 36 patients who underwent thyroidectomy for papillary thyroid carcinoma and voice exam before surgery, 2 weeks after and 1 month after surgery. All patients included in the study answered a questionnaire for State-Trait Anxiety Inventory ; STAI-KYZ (form Korean YZ). Clinico-pathologic factors and parameters of voice analysis were reviewed to analyze correlation to the anxiety index. Results: No differences were identified between clinicopathologic factors and preoperative parameters of voice analysis between patients with higher and lower level of anxiety. Noise to harmonic ratio (NHR) was higher in those patients with higher level of anxiety, 2 weeks after surgery (p=0.043). However, none of the parameters showed any difference 1 month later. Conclusion: With limited number of patients and short period of follow up, significant impact of preoperative anxiety on postoperative voice change after thyroidectomy could not be identified in this preliminary study.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.107-111
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• 2019

Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.

• 한국화재소방학회논문지
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• 제26권5호
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• pp.54-60
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• 2012

이 연구는 소방 119구급대에서 근무하는 1급 응급구조사의 병원임상수련 실태를 조사한 연구이다. 조사대상은 소방에 근무하는 1급 응급구조사 42명으로 하였으며, 2012년 5월 11일부터 2012년 5월 12일까지 구조화된 무기명 자기기입식 설문지를 이용한 설문조사에 의하였다. 연구결과 1급 응급구조사의 업무범위를 한 번 이상 직접 경험한 경우는 56.5 %였고, 이들 중 기관내삽관 66.9 %, 후두마스크 8.4 %, 정맥로확보 76.6 %, 니트로글리세린 설하투여 61.2 %, 기관지확장제 흡입 50.0 %, 수액투여 73.8 %, 인공호흡기 사용 57.6 %, 포도당 주입 57.6 %를 경험하였으며, 1급 응급구조사 업무범위를 16개 의료기관별로 살펴본 결과 58.0 %가 한 번 이상 직접 경험하였다. 향후 1급 응급구조사의 교육 요구도에 대한 지속적 연구가 필요하며, 병원임상수련의 문제점 분석, 임상실습지침서의 보완과 실무중심의 교육프로그램 운영 및 관리에 대한 규정과 지속적인 평가가 필요하다.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.81-86
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• 2004

Background and Objectives : In general, ambulatory 24-hour pH monitoring is considered the current gold standard for larynogopharyngeal reflux(LPR). There is no validated instrument whose purpose is to document the physical finding and severity of laryngopharyngeal reflux. The purposes of this study are to revaluate the validity and reliability of the reflux finding score(RFS) and to quantify laryngoscopic findings using reflux finding score. Material and Methods : Thirty-three LPR patients confirmed by dual-probe pH monitoring and thirty patients of control were selected. The RFS was documented for each patient with telescopic laryngoscopy before treatment. For test-retest intraobserver reliability assessment, a blinded laryngologists determined the RFS on two separate occasions. To evaluate interobserver reliability assessment, the RFS was determined by t재 different blinded laryngologists. Results : The mean age of the cohort with pH-documented LPR was 45.8 years and the mean RFS was 11.4. The mean age of cotrol subjects was 52 years and the mean RFS was 5.4. The mean RFS for laryngologist no. 1 was 10.8 at the initial screening and 10.9 at the repeat evaluation. The mean FRS for laryngologist no.2 was 11.1 at the intial test and 10.9 at the repeat evaluation. The correlation coefficient for interobserver variability was 0.93 and intraobserver variability was 0.94. Conclusion : The RFS demonstrates excellent inter-and introaobserver reproducibility and is helpful for quantifying laryngeal finding in LPR. We can be 95% certain that an individual with a RFS greater than 7 has LPR.

• 대한두경부종양학회지
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• 제12권1호
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• pp.8-15
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• 1996

When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

• Journal of Chest Surgery
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• 제27권11호
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• pp.922-929
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• 1994

This research represents an attempt to study the postoperative results among 32 patients who underwent complete resections of primary lung and involved mediastinal lymph nodes between January 1988 and June 1993. Ages ranged from 34 to 73 years with a mean age of 51.31 $\pm$ 8.17 years. There were 29 male patients[90.6%]. Left lung cancers were more frequent than right lung cancers. There were 19 cases of left lung cancers accounting for 59.4% of the total lung cancers. The difference, however, was insignificant. There was no T1 lesion. T2 and T3 lesions were 21[65.6%] and 11 cases[34.4%], respectively. As for cell type, squamous cell carcinomas were reported in 25 cases making up 78.1% of the cell types. Pneumonectomy was conducted on 20[62.5%] cases. Lobectomy and sleeve lobectomy were conducted on 12[37.5%] cases respectively. Mediastinal lymph node involvemednts were most frequent in subcarinal lymph node[9/13] among right lung cancers, while subaortic lymph noce[12/19] was most frequent among left lung cancers. Postoperative complications were reported in 18.9% of the total cases, including 2 cases each of paralysis of the recurrent laryngeal nerve and 1 case each of chylothorax and pyothorax. They were more frequent among patients who underwent pneumonectomy. The operative mortality stood at 3.1% with 1 patient who underwent pneumonectomy dying of pulmonary edema. The 1-year and 5-year survival rates were 50.8% and 30.1%, respectively. Patients treated with squamous cell carcinoma, involvement of single level mediastinal lymph node and lobectomy showed a higher level of survival. These fidings suggest that a long-term survival can be expected of a considerable number of N2 non-small cell lung cancer patients with a selective complete surgical resection of primary lung cancers involved mediastinal lymph nodes.

• 대한한방내과학회지
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• 제13권2호
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• pp.35-47
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• 1992

This study has been carried out to compare the exogenous cough(外感咳嗽) to western medicine. The results were as follows: 1. The exogenous cough(外感咳嗽) on the oriental medicine was similar to U.R.I., Infectious pneumonia, acute bronchitis on the western medicine and acute bronchitis was most similar to the exogenous cough(外感咳嗽). 2. The exogenous cough(外感咳嗽) was caused by the six devils of the environment(六淫) involving the lung and clinically divided into poonghan cough(風寒咳嗽), poongyul cough(風熱咳嗽) and poongjo cough(風燥咳嗽). 3. The symptom of the exogenous cough(外感咳嗽). a. poonghan cough(風寒咳嗽): sputum-rare and white color, laryngeal voice and tickel, stuffed-up and running nose, chilling and fever, headache and generalache, seoltae(舌苔) - thin and white color, pulse - boogin(浮緊). b. poongyul cough(風熱咳嗽): sputum-thick and yellow color, difficult expectoration sore thraot and thirsty, fever and chilling, sweating or headache, seoltae(舌苔) - thin and white color, pulse - boosak(浮數). c. poongjo cough (風燥咳嗽): dry cough with no or a little sputum and difficult expectoration, chest pain, dryness on the pharynx and lips, chilling and fever, seoltae(舌苔) - thin and dry, yellow color, pulse - sesak(細數) 4. The treatment of the exogenous cough(外感咳嗽). a. poonghan cough(風寒咳嗽) : sopoongsanhan sunpyuegihae (疎風散寒 宣肺止咳) b. poongyul cough(風熱咳嗽) : sopoongcheongyul sunpyuegihae (疎風淸熱 宣肺止咳) c. poongjo cough(風操咳嗽) : chungpyueyunjo saenggingihae (淸肺潤燥 生津止咳)

• Clinical and Experimental Pediatrics
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• 제61권4호
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• pp.108-113
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• 2018

Purpose: This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children. Methods: We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest. Results: Fourteen patients were identified. Of these, 13 were young children (<2 years old), and 1 was 14 years old. All patients had been previously healthy and had no specific risk factors for sudden cardiorespiratory arrest. Most cases (n=11, 79%) were defined as cardiac or cardiorespiratory arrest, while the remaining cases (n=3, 21%) were defined as respiratory arrest. Aspiration (n=3), acute myocarditis (n=2), and laryngeal chemoreflex (n=1) were presumed as the causes; however, the exact causes were unclear. The overall prognosis was poor (death, n=7; morbidity, n=5; full recovery, n=2). The medical institutions faced severe backlash because of these incidents (out-of-court settlement, n=5; medical lawsuit, n=5; continuous harassment, n=3). Conclusion: Cardiorespiratory arrest after venipuncture is unpredictable and the probable cause of most cases is a vasovagal reaction. Medical personnel must be aware of the risk of unexpected cardiorespiratory arrest during routine intravenous procedures.