인후두역류증의 진단에 있어서 후두내시경검사 소견 점수화의 유용성에 대한 재검증

권기환,반재호,이경철,Kwon, Kee-Hwan,Ban, Jae-Ho,Lee, Kyung-Chul 대한후두음성언어의학회 2004 대한후두음성언어의학회지 Vol.15 No.2

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.

구강내 발생한 지방종 2례

권기환(Kee Hwan Kwon),이상혁(Sang Hyuk Lee),진성민(Sung Min Jin),이용배(Yong Bae Lee) 대한두경부종양학회 2000 대한두경부 종양학회지 Vol.16 No.1

Lipoma is a benign neoplasm composed of mature fat cells and usually circumscribed by a fibrous capsule. The fat cells are arranged in irregular lobules, partitioned by fibrous septa with supportive vascular channels. Lipoma of the oral cavity is uncommon, and has been reported to be infrequent in the literature in the world so far. An oral lipoma mainly occurs in the cheek and tongue. Surgical excision is the only treatment recommended, and prognosis is uniformly excellent. Recently we experienced two cases of lipoma of the oral cavity and removed the tumor completely by surgical excision.

악하선에 발생한 종양 혈전을 동반한 다형선종유래 선암종

권 철(Chul Kwon),박철언(Choel Eon Park),신일호(Il Ho Shin),은영규(Young Gyu Eun),권기환(Kee Hwan Kwon) 대한두경부종양학회 2010 대한두경부 종양학회지 Vol.26 No.2

Carcinoma ex pleomorphic adenoma is rare, aggressive, poorly understood malignancy that occurs in the salivary glands. The patient was 70-year-old male presenting ovoid elevated submandibular mass that has been present for 30 years and rapid growing for 6 months. The initial cytologic finding by fine needle aspiration biopsy showed highly malignant cells and the radiologic finding revealed a 3.6×3.7×4.8cm sized mass with cervical lymphadenopathy. After wide excision of submandibular gland and modified radical neck dissection, the histologic examination revealed that tumor was composed partly of a benign pleomorphic adenoma and partly of an adenocarcinoma component with areas of calcification and frequent angiolymphatic invasion. We present a rare case of adenocarcinoma ex pleomorphic adenoma with tumor thrombus in the submandibular gland.

초기 상후두암종에서 레이저를 이용한 내시경하 상후두부분절제술의 적용

최종욱(Jong Ouck Choi),권기환(Kee Hwan Kwon),오준환(Joon Hwan Oh),한승훈(Seung Hoon Han),이승훈(Seung Hoon Lee),최건(Geon Choi) 대한두경부종양학회 1998 대한두경부 종양학회지 Vol.14 No.2

레이저를 이용한 내시경하 상후두부분절제술은 술전에 정확한 병기판정으로 초기 국소병변의 선택을 신중하게 하고 경부 림프절전이의 치료를 효율적으로 시행하는 경우 기존의 수술법과 유사한 생존율을 얻을 수 있었다. 환자의 상태에 따라서 충분한 수술시야를 확보하는데 어려움이 있으며, 병변의 위치에 따라서 술중 절제연의 확인이 힘들다는 제한점을 고려해야 하며, 술 후 발생할 수 있는 출혈, 부종, 오연 등의 합병증에 대비하기 위하여 술 전 기관절개술이 유용할 것으로 생각된다. Background: Supraglottis and glottis have a different embryologic origin. Supraglottic cancer is characterized by high incidence of cervical lymph node metastasis at initial diagnosis, and favored surgical management of the early supraglottic cancer was partial supraglottic laryngectomy, however the procedure resulted in frequent incidences of postsurgical aspiration and voice disabilities. Objectives: We retrospectively analyzed the problems and the advantages of the endoscopic laser assisted supraglottic partial laryngectomy as a part of surgical management for early supraglottic cancer. Materials and Methods: During the past nine years 25 cases of supraglottic cancer(Tl 10 cases, T2 15 cases) were treated by tracheotomy and laser assisted supraglottic partial laryngectomy(KTP532, 15 Watt, continuous type) and in 10 cases with cervical lymph node metastasis, they were additionally managed by neck dissection one week later, and all cases received postoperative irradiation therapy. Results: At present, 19 cases are alive with no evidence of disease. During the follow up period total of six cases(primary failure: three cases, nodal failure: three cases) were recurred. In relation to tumor staging, One of the 10 Tl cases and two of the 15 T2 cases recurred showing 88% locoregional recurrence rate for early supraglottic cancer. Postoperative com-plication included bleeding in three cases who were controlled by electrocautery under general anesthsia, one case of longstanding aspiration and two cases of laryngeal stenosis as a delayed complication. Conclusion: High control rate suggests that the endoscopic laser assisted supraglottic partial laryngectomy may be a good initial management method for early supraglottic cancer, however it is difficult to determine the resection margin, therefore, accurate tumor staging must be done prior to surgery. In order to prepare for postoperative bleeding, edema and aspiration, the tracheotomy must be performed prior to surgery.

실시간 위험물 수송차량 추적관리용 모바일 단말

김상태(Sang Tae Kim),권기환(kee Hwan Kwon),김원기(Won Ki Kim),김영호(Young Ho Kim),김현덕(Hyun Deok Kim) 한국통신학회 2008 한국통신학회 학술대회 및 강연회 Vol.2008 No.4

교사 직업군에서의 음성장애와 악화요인에 관한 연구

김태형,진성민,송윤경,이승석,이경철,권기환,Kim, Tae-Hyung,Jin, Sung-Min,Song, Yun-Kyung,Lee, Seung-Suk,Lee, Kyung-Chul,Kwon, Kee-Hwan 대한후두음성언어의학회 2004 대한후두음성언어의학회지 Vol.15 No.1

Background and Objective : Voice disorders are one of the major occupational hazards of school teaching. Prolonged voice use through verbal instruction has been implicated as a cause of vocal impairment among members of this profession. They all depend on their voice for their livelihood and are greatly alarmed by slightest alteration in voice quality. Despite considerable research in the area of voice problems in teachers, the prevalence of voice disorders in this group is unknown. Severe voice problems can affect teacher's ability to teach in the classroom. Materials and Method : This study investigated the prevalence of self-reported voice problems in teachers using a survey of a simple random sample of middle school teachers (n=1000). As part of the survey, teachers were asked to report voice problems for the day of the survey, duration, main symptom, smoking, caffeine, alcohol history etc. Results : The reponse rate was 91%(n=94) with 89.7%(n=812) teachers reporting voice problems on the day of the survey, and 40%(n=330) of these group reporting the history of medical consult. Conclusion : These finding indicate a need for vocal hygiene education in teachers and for the development of educational programs aimed at preventing voice problems in this group of professional voice users.

편도암의 수술적용 형태에 따른 치료효과

주형로(Hyung Ro Chu),한승훈(Seung Hoon Han),권기환(Kee Hwan Kwon),정광윤(Kwang Yoon Jung),최건(Geon Choi),최종욱(Jong Ouck Choi) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.1

Objectives: The treatment for squamous cell carcinoma of the tonsil remains controversial. Surgery or radiation therapy alone is effective in treating early tonsil cancer, but results with single treatment modality in advanced disease have been disappointing. We retrospectively analyzed 37 patients with advanced squamous cell carcinoma of the tonsil for two treatment modalities in an effort to identify more efficacious therapeutic options. Materials and Methods: From 1990 through 1997, 37 patients who were treated primarily with surgery, were retrospectively sudied. The patients were grouped into two groups according to the method of treatment, extended tonsillectomy followed by irradiation and/or postradiation neck dissection(Group I) and a combination of composite resection and postoperative radiation(Group II). Results: The three year disease-tree survival in patients with stage IV lesions was 59.09% for the Group I patients, and 56.25% for the Group II patients. This difference was not statistically significant(p=0.775). The primary tumor recurrence rate in Group I was 16.7% in contrast to 23.1% for Group II. The local recurrence rate in the neck was 16.7% for the Group I patients and 23.1% for the Group II patients. There was no significant difference in the frequency of recurrences in the primary or neck in the patients treated with extended tonsillectomy or composite resection(p=0.639). Fistula formation and aspiration occurred in four patients after composite resection. Additionally, there were three trismus, one soft tissue necrosis, and one velopharyngeal insufficiency. Major complications were not observed in the patients treated with extended tonsillectomy and irradiation: velopharyngeal insufficiency was observed in eight patients and soft tissue necrosis in two patients. Conclusion: Extended tonsillectomy followed by irradiation may be an effective therapy with low morbidity in selected patients with tonsil cancer.

소아에서 발생한 연구개 점액표피양 종양 1례

정 훈(Hoon Jung),은영규(Young Gyu Eun),권기환(Kee Hwan Kwon) 대한두경부종양학회 2008 대한두경부 종양학회지 Vol.24 No.2

The purpose of this paper is to review our experience with mucoepidermoid carcinoma(MEC), a rare tumour in minor salivary glands, in a paediatric patients. 15-year-old boy was noted to have a irregular round mass appearing atthe soft palate just to the right of the mid-line. A computed tomographic(CT) scan showed a palatal mass limited to soft palate with no bony erosion . The lesion was curetted and debulked. Pathology was reported as an intermediate-grade mucoepidermoid carcinoma, and the patient was consider-ed to radiation therapy institution for further treatment. To date, patients remain free of disease. Wide local excision is the treatment of choice for low to intermediate grade MEC of the minor salivary glands in pae-diatric patients.

임신 중 발생한 벨마비의 임상적 연구

기경도 ( Kyung Do Ki ),변재용 ( Jae Yong Byun ),김상훈 ( Sang Hoon Kim ),송동화 ( Dong Wha Song ),권기환 ( Kee Hwan Kwon ),박문서 ( Moon Suh Park ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.4

목적: 임신 시 벨마비의 발생 빈도는 비임신 시에 비해 높게 보고되고 있다. 비임신 시와 비교하여 임신 시 발생한 벨마비의 발병 시기, 임상 양상, 회복률에 대해 알아보고자 하였다. 연구 방법: 1996년부터 2006년까지 임신 중 벨마비가 발생한 43명의 환자를 대상으로 하였으며 비임신 시 벨마비가 발생한 가임기 여성 61명을 대조군으로 의무기록을 토대로 후향적 연구를 시행하였다. 결과: 임신 중 벨마비는 평균 재태연령 32주에 발생하였으며, 81.4% Objective: Although Bell`s palsy is not common in pregnancy, it is more prevalent among pregnant women than among non-pregnant women. Since the exact clinical characteristics of this condition are not fully understood, we evaluated the epidemiology, pathop

비내시경적 누낭비강 문합술에서의 후누강 접근술

이경철,권기환 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.2